bluuebunny/crossref_metadata_2025_split huggingface dataset:
Time to cardiovascular benefits of empagliflozin: a post hoc observation from the EMPA‐REG OUTCOME trial
Authors: Verma Subodh , Leiter Lawrence A. , Zinman Bernard , Sharma Abhinav , Mattheus Michaela , Fitchett David , George Jyothis , Ofstad Anne Pernille , Kosiborod Mikhail N. , Wanner Christoph , Inzucchi Silvio E. 
Published: June 2021

AbstractAimsIn the EMPA‐REG OUTCOME trial, in patients with type 2 diabetes and established atherosclerotic cardiovascular (CV) disease, empagliflozin vs. placebo reduced the risk of hospitalization for heart failure (HHF) by 35%, CV death/HHF by 34%, and CV death by 38%, with an early separation of the cumulative incidence curves. We explored at what time point after randomization these benefits became apparent.Methods and resultsWe expressed time trajectories for the effect of pooled empagliflozin doses vs. placebo on HHF, CV death/HHF, and CV death based on hazard ratios (95% confidence interval) and calculated the hazard ratio on the day the effect reached significance using Cox proportional hazards models. Overall, 7020 patients aged ≥18 years were treated with empagliflozin 10 mg (N = 2345), empagliflozin 25 mg (N = 2342), or placebo (N = 2333) once daily in addition to standard of care. Mean age (years ± SD) was 63.1 ± 8.6, and 72% were male. The benefit of empagliflozin on CV death first reached statistical significance on Day 59 (HR [95% confidence interval]) (0.28 [0.08, 0.96], P = 0.0424) and was generally sustained throughout the trial (overall 0.62 [0.49, 0.77], P < 0.0001). Risk reduction with empagliflozin on HHF reached statistical significance on Day 17 (0.10 [0.01, 0.87], P = 0.0372) and was sustained throughout the study (overall 0.65 [0.50, 0.85], P = 0.0017). For the composite outcome of CV death or HHF, risk reduction with empagliflozin reached statistical significance on Day 27 (0.28 [0.08, 0.97], P = 0.0445) and was sustained throughout follow‐up (overall 0.66 [0.55, 0.79], P < 0.0001).ConclusionsIn EMPA‐REG OUTCOME, the benefit of empagliflozin in reducing the risk of HHF, CV death/HHF, and CV death emerged within weeks after treatment initiation. The earliest benefit appears to be on HHF.
Study of mechanical properties and enhancing auxetic mechanism of composite auxetic structures
Authors: Shi Zengqin , Wang Qing , Li Yunfeng , Wang Ning , Lei Lulu , Li Xiaodong 
Published: June 2021

AbstractThe auxetic structures attract much attention because of their good properties, such as enhanced energy absorption capacity and buckling resistance. It is an important topic to combine the auxetic structures with other materials or structures to improve their mechanical properties. In this paper, a composite auxetic structure was proposed, in which the embedded structure and re‐entrant structure can deform independently to adjust the mechanical properties. Under uniaxial compression, the effects of changes in the embedded structure and re‐entrant structure on Poisson's ratio, relative Young's modulus, and energy absorption of the composite auxetic structure were studied. By introducing the rate of change of mechanical properties, the effects of the embedded structure and re‐entrant structure on the composite auxetic structure were studied. The results show that changing the embedded structure for Poisson's ratio and relative Young's modulus and changing the re‐entrant structure for energy absorption can maximize the material utilization. And changing the re‐entrant structure can make the mechanical properties of the composite auxetic structure reach a larger adjustable range. This study can provide a new way for the combination of future auxetic structures to meet the needs of different applications in civil engineering.
Evaluation of seismic performance of as‐built and retrofitted reinforced concrete frame structures with LAP splice deficiencies
Authors: Opabola Eyitayo A. , Elwood Kenneth J. , Liel Abbie B. 
Published: June 2021

AbstractSeveral studies have looked at the development of hinge models to simulate the hysteretic response of flexure‐ and shear‐critical reinforced concrete (RC) beam‐column components from damage initiation to onset of gravity collapse. However, few studies have been conducted to develop similar models for older type bond‐critical beam‐column components. First, using existing experimental data, this paper describes the calibration of simple and efficient hinge models to simulate the inelastic hysteretic response of as‐built and retrofitted splice‐deficient columns. Subsequently, to demonstrate the applicability of the hinge models, the seismic performance of as‐built and fibre‐reinforced polymer (FRP) ‐retrofitted two‐ and four‐story nonductile RC frame buildings with splice‐deficient columns are assessed using nonlinear dynamic analysis procedures. The results show that buildings with bond‐critical columns may have a lower collapse potential than buildings with shear‐critical columns, implying that in certain cases a longer splice length may actually worsen performance. According to the analyses, local retrofitting of the columns can significantly improve the seismic performance of the buildings. Contrary to results presented in this study, a significant U.S. evaluation methodology for RC frame buildings, FEMA P‐2018, indicates that buildings with bond‐critical columns have similar collapse potential as buildings with shear‐critical columns. Modifications are proposed to improve the FEMA P‐2018 provisions. The modelling approach presented in this paper are recommended for incorporation into ASCE/SEI 41, engineering practice and future research.
Supraspinal nociceptive networks in neuropathic pain after spinal cord injury
Authors: Huynh Vincent , Lütolf Robin , Rosner Jan , Luechinger Roger , Curt Armin , Kollias Spyridon , Hubli Michèle , Michels Lars 
Published: June 2021

AbstractNeuropathic pain following spinal cord injury involves plastic changes along the whole neuroaxis. Current neuroimaging studies have identified grey matter volume (GMV) and resting‐state functional connectivity changes of pain processing regions related to neuropathic pain intensity in spinal cord injury subjects. However, the relationship between the underlying neural processes and pain extent, a complementary characteristic of neuropathic pain, is unknown. We therefore aimed to reveal the neural markers of widespread neuropathic pain in spinal cord injury subjects and hypothesized that those with greater pain extent will show higher GMV and stronger connectivity within pain related regions. Thus, 29 chronic paraplegic subjects and 25 healthy controls underwent clinical and electrophysiological examinations combined with neuroimaging. Paraplegics were demarcated based on neuropathic pain and were thoroughly matched demographically. Our findings indicate that (a) spinal cord injury subjects with neuropathic pain display stronger connectivity between prefrontal cortices and regions involved with sensory integration and multimodal processing, (b) greater neuropathic pain extent, is associated with stronger connectivity between the posterior insular cortex and thalamic sub‐regions which partake in the lateral pain system and (c) greater intensity of neuropathic pain is related to stronger connectivity of regions involved with multimodal integration and the affective‐motivational component of pain. Overall, this study provides neuroimaging evidence that the pain phenotype of spinal cord injury subjects is related to the underlying function of their resting brain.
Conjugate heat transfer analysis of a rotor blade with coolant channels
Authors: Singh Alankrita , Pujari Arun Kumar , Prasad B. V. S. S. S. 
Published: June 2021

AbstractThe present study deals with the conjugate heat transfer analysis of a cooled high‐pressure turbine rotor blade consisting of eight cooling channels. Computational investigations are performed in a five‐bladed cascade to determine characteristics of flow and heat transfer at different values of mainstream and coolant flow rate. Surface temperature measurements using infrared thermography are performed for validating the computational fluid dynamics results. The results show nonuniform variation of surface effectiveness: (a) higher average surface temperature on the pressure side than on the suction side, (b) peak surface temperature at the pressure side trailing edge region, (c) lowest temperature at midspan region of both pressure and suction sides, (d) intermediate values of temperature on the leading edge, and (e) these temperature patterns vary with the changes in mainstream Reynolds number and coolant flow rates, signifying the importance of carrying out conjugate heat transfer analysis. This study also emphasizes the importance of considering realistic coolant channel geometry over the idealized, an illustration showed that the maximum Nusselt number may vary up to 200% due to idealization.
Individualized Bone-Protective Management in Long-Term Cancer Survivors With Bone Metastases
Authors: Rachner Tilman D , Coleman Robert , Hadji Peyman , Hofbauer Lorenz C 
Published: June 2021

ABSTRACT
Antiresorptive therapy is an important component of a multimodal approach to treating patients with advanced malignancies and metastatic bone disease. Over the past decade, overall survival of affected patients has improved in most cancer entities, and long-term disease control is a realistic goal in many cases. There are emerging clinical studies showing the benefits of an initial antiresorptive therapy using bisphosphonates or denosumab. However, some adverse events of these therapies, such as osteonecrosis of the jaw, correlate with the cumulative doses given, and there is an increasing clinical need for new antiresorptive concepts to treat long-term survivors. This review summarizes the clinical evidence of antiresorptive therapies across different cancers with bone involvement and presents concepts of dose-reduction protocols for long-term survivors with established metastatic bone disease. © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
ivTerm—An R package for interactive visualization of functional analysis results of meta‐omics data
Authors: Dong Xiaorui , Xue Hongzhang , Wei Chaochun 
Published: June 2021

AbstractInterpreting functional analysis results derived from environmental samples using direct sequencing meta‐omics data, including metagenomics and meta‐transcriptomics data, is challenging due to their complexity. Visualization of functional analysis results can help researchers discover relevant biological insights. Despite the availability of many R packages, there lacks interactive and comprehensive graphic systems for displaying functional terms and corresponding genes in meta‐omics analysis results. Here, we present ivTerm, an R‐shiny package with a user‐friendly graphical interface that enables users to inspect functional annotations, compare results across multiple experiments, create customized charts, and download these charts. It provides various basic and innovative chart types to visualize functional terms and involved genes. Users can also browse the description of terms obtained from the database web servers automatically. Two examples, including a metagenome analysis data for human gut and a meta‐transcriptome data for coral symbiomes, are given to show the usage of ivTerm. In the end, we compared ivTerm with existing tools with similar functions, such as GOplot, ViSEAGO, and Chordomics. The tool ivTerm is convenient and efficient for biologists to gain an integrated view and develop deep insights by interactive analysis of meta‐omics data. It can accelerate the procedure to develop insights from complex meta‐omics data. The code for ivTerm is freely available at https://github.com/SJTU-CGM/ivTerm.
Evaluation of automated molecular tests for the detection of SARS‐CoV‐2 in pooled nasopharyngeal and saliva specimens
Authors: Al‐Hail Hamad , Mirza Faheem , Al Hashemi Alaa , Ahmad Muneera Naseer , Iqbal Muhammad , Tang Patrick , Hasan Mohammad Rubayet 
Published: June 2021

AbstractBackgroundPooling of samples for SARS‐CoV‐2 testing in low‐prevalence settings has been used as an effective strategy to expand testing capacity and mitigate challenges with the shortage of supplies. We evaluated two automated molecular test systems for the detection of SARS‐CoV‐2 RNA in pooled specimens.MethodsPooled nasopharyngeal and saliva specimens were tested by Qiagen QIAstat‐Dx Respiratory SARS‐CoV‐2 Panel (QIAstat) or Cepheid Xpert Xpress SARS‐CoV‐2 (Xpert), and the results were compared to that of standard RT‐qPCR tests without pooling.ResultsIn nasopharyngeal specimens, the sensitivity/specificity of the pool testing approach, with 5 and 10 specimens per pool, were 77%/100% (n = 105) and 74.1%/100% (n = 260) by QIAstat, and 97.1%/100% (n = 250) and 100%/99.5% (n = 200) by Xpert, respectively. Pool testing of saliva (10 specimens per pool; n = 150) by Xpert resulted in 87.5% sensitivity and 99.3% specificity compared to individual tests. Pool size of 5 or 10 specimens did not significantly affect the difference of RT‐qPCR cycle threshold (CT) from standard testing. RT‐qPCR CT values obtained with pool testing by both QIAstat and Xpert were positively correlated with that of individual testing (Pearson's correlation coefficient r = 0.85 to 0.99, p < 0.05). However, the CT values from Xpert were significantly stronger (p < 0.01, paired t test) than that of QIAstat in a subset of SARS‐CoV‐2 positive specimens, with mean differences of −4.3 ± 2.43 and −4.6 ± 2 for individual and pooled tests, respectively.ConclusionOur results suggest that Xpert SARS‐CoV‐2 can be utilized for pooled sample testing for COVID‐19 screening in low‐prevalence settings providing significant cost savings and improving throughput without affecting test quality.
Is there an increased cardiovascular risk in patients with prolactinoma? A challenging question
Authors: Yazici Dilek , Sunbul Murat , Yasar Mehmet , Deyneli Oguzhan , Yavuz Dilek 
Published: June 2021

AbstractPurposeEpicardial adipose tissue thickness (EATT) is considered to be a surrogate for visceral fat and a novel cardiovascular risk indicator. Hyperprolactinemia has been shown to be associated with increased cardiovascular risk. The aim was to evaluate the association between EATT, carotid intima media thickness (CIMT), and cardiac functions in patients with prolactinoma.MethodsPatients with the diagnosis of prolactinoma were included. The control group consisted of healthy age matched individuals with normal prolactin levels. Prolactin, fasting blood glucose (FBG), insulin, hemoglobin A1c (HbA1c), alanine aminotransferase (ALT), total cholesterol, triglycerides, and high (HDL) and low density lipoprotein (LDL) cholesterol were measured. EATT, CIMT, cardiac systolic, and diastolic functions were determined using echocardiography.ResultsWe evaluated 67 patients with prolactinoma (aged 40.7 ± 11.9 years, F/M: 51/16) and 57 controls (aged 42.5 ± 7.4 years, F/M: 36/21). Of the 67 patients, 24 had normal prolactin levels. FBG level was higher in prolactinoma patients than in controls. Patients and controls had similar HbA1c, HOMA‐IR, ALT, total, HDL, LDL cholesterol, and triglycerides levels, and similar cardiac systolic and diastolic functions. Prolactinoma patients had greater EATT (3.0 ± 0.5 mm vs. 2.6 ± 0.4 mm, p < 0.001) and CIMT (0.57 ± 0.08 mm vs. 0.52 ± 0.04 mm, p = 0.03) than controls. EATT was correlated with body mass index, FBG, HbA1c, and triglyceride levels.ConclusionsEATT and CIMT were greater in patients with prolactinoma, although they had normal cardiac systolic and diastolic functions.
Access opening guide produced using a 3D printer (AOG‐3DP) as an effective tool in difficult cases for dental students
Authors: Choi Yiseul , Jeon Woo Seok , Cho Jung Min , Jeong Ho‐Gul , Shin Yooseok , Park Wonse 
Published: June 2021

AbstractObjectivesThe aim of this study was to determine the effectiveness of using an access opening guide in teaching ideal access opening shape and preventing excessive tooth loss, with a focus on predoctoral dental students.MethodsNinety teeth that were mounted in a box just below the level of the cementoenamel junction using tray resin were randomly divided into two study groups. An access opening guide produced using a 3D printer (AOG‐3DP) was designed using cone‐beam computed tomography (CBCT). The AOG‐3DP was applied in the test groups, while no aid was used in the control group. Access preparations in both groups performed by predoctoral dental students were scanned using CBCT to detect overpreparation. The preparation time and access cavity volume were evaluated.ResultsThe mean times required for achieving access opening were 327.2 and 97.4 s in the control and AOG‐3DP groups, respectively, for premolars, and 547.4 and 104.5 s for molars. The mean volumes for premolars and molars differed from the ideal cavities by 38.1 and 72.2 mm3, respectively, in the control group, and by −2.0 and −8.7 mm3 the AOG‐3DP group.ConclusionsUsing the AOG‐3DP significantly reduced the access opening time for premolars and molars. However, there is a limitation in that CBCT DICOM images must be converted to stereolithographic .stl files in order to be printed via 3D technology. This requires additional preclinical treatment time for imaging and subsequent printing. It could be considered that this can be a useful method in difficult cases.
Participation pathways for women into university makerspaces
Authors: Tomko Megan , Alemán Melissa W. , Newstetter Wendy , Nagel Robert L. , Linsey Julie 
Published: June 2021

AbstractBackgroundEngineering education has observed considerable growth in academic makerspaces with initial data indicating significant potential for makerspaces to support learning.Purpose/HypothesisGiven gender disparities in engineering as a professional community of practice (CoP) and indications for makerspaces as sites for learning, educational researchers need to forge a better understanding of women's pathways into makerspaces, including the barriers that inhibit and the catalysts that broaden participation.Design/MethodThis study employed qualitative interviews with 20 women students who were identified as makers in order to gain insights into the characteristics of their pathways into university makerspaces.ResultsUsing grounded theory development, four major aspects of students' pathways emerged: (1) early forms of apprenticeship through mentors; (2) overcoming and resisting limiting gendered expectations imposed by others in early experiences in unfamiliar makerspace CoPs, resulting in failed articulations of related communities; (3) successful articulations of community grounded in making‐centered coursework and personal passions; and (4) relationships in college that expanded access, leadership, and visibility toward fuller participation in makerspace CoPs.ConclusionEducational interventions to broaden women's participation in makerspaces must be multipronged and attend to early childhood experiences, include supportive opportunities for women to participate in making in K‐12 and university curricula, expand definitions of making to legitimize the arts and crafts as part of design, and create apprenticeship opportunities for women to mentor women in makerspaces. We must change the narrative of who makers are, what making is, and who belongs in makerspaces to reduce barriers and create inclusive making communities.
Radiation therapist‐led telephone follow‐up: identifying patients who require post‐treatment care
Authors: Najem Fadila , Prosser Susan , Harris Jill , Beldham‐Collins Rachael , Cross Shamira , West Katrina 
Published: June 2021

AbstractIntroductionRadiation therapists implemented telephone follow‐up (TFU) in 2015 as an additional point of care post‐treatment. The purpose of this study was to determine whether TFU identified patients who required additional post‐treatment care before the next scheduled review.MethodsBetween January 2015 and July 2016, all patients who were prescribed curative intent treatment aged 18 years or over were called 10 days post‐radiation therapy (RT). Eight questions were developed and included asking patients how they were coping, if their side effects were improving, if they needed to contact the hospital and if more dressings were required. Patients who could not be contacted after two attempts were excluded from the study. Microsoft Excel and Statistical Package for Social Sciences (SPSS) were used to analyse the responses.ResultsData were collected from 850 patients. A total of 28/846 (3%) of patients reported they were not coping after RT, with 26/830 (3%) reporting their side effects were getting worse. A total of 97/826 (12%) of patients felt they needed to contact the hospital because they were unwell. This study identified 104/677 (15%) of patients who responded required more dressings, with 67/104 (65.7%) and 10/104 (9.8%) of this cohort identified in the breast, and head and neck groups, respectively.ConclusionRadiation therapist‐led TFU has shown to be beneficial in identifying a small cohort of breast and head and neck cancer patients who required additional care post‐radiation treatment.
How do residents respond to negative environmental impacts from tourism? The role of community participation in empowering residents' environmentally responsible behavior
Authors: Xu Songjun , Hu Yaou 
Published: June 2021

AbstractThis study examined a model linking perceived negative environmental impacts, support for tourism development, environmentally responsible behavior (ERB), and community participation in the ecotourism setting. The findings reveal that perceived negative environmental impacts restrained residents' ERB. This relationship was mitigated by the moderation of community participation such that the suppression effect of perceived negative environmental impacts on ERB became less strong as community participation increased. Moreover, support for tourism development mediated the moderating effect. This study provides novel insights on understanding residents' attitudes and behaviors towards environmental impacts and identifying the role of community participation in empowering residents' ERB. Managerial implications and future research directions are discussed.
Deep Learning Pitfall: Impact of Novel Ultrasound Equipment Introduction on Algorithm Performance and the Realities of Domain Adaptation
Authors: Blaivas Michael , Blaivas Laura N , Tsung James W 
Published: June 2021

ObjectivesTo test deep learning (DL) algorithm performance repercussions by introducing novel ultrasound equipment into a clinical setting.MethodsResearchers introduced prospectively obtained inferior vena cava (IVC) videos from a similar patient population using novel ultrasound equipment to challenge a previously validated DL algorithm (trained on a common point of care ultrasound [POCUS] machine) to assess IVC collapse. Twenty‐one new videos were obtained for each novel ultrasound machine. The videos were analyzed for complete collapse by the algorithm and by 2 blinded POCUS experts. Cohen's kappa was calculated for agreement between the 2 POCUS experts and DL algorithm. Previous testing showed substantial agreement between algorithm and experts with Cohen's kappa of 0.78 (95% CI 0.49–1.0) and 0.66 (95% CI 0.31–1.0) on new patient data using, the same ultrasound equipment.ResultsChallenged with higher image quality (IQ) POCUS cart ultrasound videos, algorithm performance declined with kappa values of 0.31 (95% CI 0.19–0.81) and 0.39 (95% CI 0.11–0.89), showing fair agreement. Algorithm performance plummeted on a lower IQ, smartphone device with a kappa value of −0.09 (95% CI −0.95 to 0.76) and 0.09 (95% CI −0.65 to 0.82), respectively, showing less agreement than would be expected by chance. Two POCUS experts had near perfect agreement with a kappa value of 0.88 (95% CI 0.64–1.0) regarding IVC collapse.ConclusionsPerformance of this previously validated DL algorithm worsened when faced with ultrasound studies from 2 novel ultrasound machines. Performance was much worse on images from a lower IQ hand‐held device than from a superior cart‐based device.