bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Cardiac Care Regionalization With Access, Treatment, and Mortality Among Patients With ST-Segment Elevation Myocardial Infarction
Authors: Shen Yu-Chu , Krumholz Harlan , Hsia Renee Y. 
Published: March 2021

Background:
Regionalization of ST-segment elevation myocardial infarction (STEMI) systems of care has been championed over the past decade. Although timely access to percutaneous coronary intervention (PCI) has been shown to improve outcomes, no studies have determined how regionalization has affected the care and outcomes of patients. We sought to determine if STEMI regionalization is associated with changes in access, treatment, and outcomes.

Methods:
Using a difference-in-differences approach, we analyzed a statewide, administrative database of 139 494 patients with STEMI in California from 2006 to 2015 using regionalization data based on a survey of all local Emergency Medical Services agencies in the state.

Results:
For patients with STEMI, the base rate of admission to a hospital with PCI capability was 72.7%, and regionalization was associated with an increase of 5.34 percentage points (95% CI, 1.58–9.10), representing a 7.1% increase. Regionalization was also associated with a statistically significant increase of 3.54 (95% CI, 0.61–6.48) percentage points in the probability of same-day PCI, representing an increase of 7.1% from the 49.7% base rate and a 4.6% relative increase (2.97 percentage points [95% CI, 0.1–5.85]) in the probability of receiving PCI at any time during the hospitalization. There was a 1.84 percentage point decrease (95% CI, −3.31 to −0.37) in the probability of receiving fibrinolytics. For 7-day mortality, regionalization was associated with a 0.53 (95% CI, −1 to −0.06) percentage point greater reduction (representing 5.8% off the base rate of 9.1%) and a 1.75 percentage point decrease in the likelihood of all-cause 30-day readmission (95% CI, −3.39 to −0.11; representing 6.4% off the base rate of 27.4%). No differences were found in longer-term mortality.

Conclusions:
Among patients with STEMI in California from 2006 to 2015, STEMI regionalization was associated with increased access to a PCI-capable hospital, greater use of PCI, lower 7-day mortality, and lower 30-day readmissions.
Biological Pathways in Adolescent Aortic Stiffness
Authors: Zachariah Justin P. , Wang Yunfei , Newburger Jane W. , deFerranti Sarah D. , Mitchell Gary F , Vasan Ramachandran S. 
Published: March 2021

Background
Aortic stiffening begins in youth and antedates future hypertension. In adults, excess weight, systemic inflammation, dyslipidemia, insulin resistance, neurohormonal activation, and altered adipokines are implicated in the pathogenesis of increased aortic stiffness. In adolescents, we assessed the relations of comprehensive measures of aortic stiffness with body mass index (BMI) and related but distinct circulating biomarkers.

Methods and Results

A convenience sample of 246 adolescents (mean age, 16±2 years; 45% female, 24% Black, and 43% Hispanic) attending primary care or preventive cardiology clinics at 2 tertiary hospitals was grouped as normal weight (N=98) or excess weight (N=148, defined as BMI ≥age‐ and sex‐referenced 85th percentile). After an overnight fast, participants underwent anthropometry, noninvasive arterial tonometry, and assays for serum lipids, CRP (C‐reactive protein), glucose, insulin, renin, aldosterone, and leptin. We used multivariable linear regression to relate arterial stiffness markers (including carotid‐femoral pulse wave velocity) to BMI
z
score and a biomarker panel. Carotid‐femoral pulse wave velocity was higher in excess weight compared with normal weight group (5.0±0.7 versus 4.6±0.6 m/s;
P
<0.01). After multivariable adjustment, carotid‐femoral pulse wave velocity was associated with BMI
z
score (0.09 [95% CI, 0.01–0.18];
P
=0.04) and with low‐density lipoprotein cholesterol (0.26 [95% CI, 0.03–0.50];
P
=0.03).

Conclusions
Higher BMI and low‐density lipoprotein cholesterol were associated with greater aortic stiffness in adolescents. Maintaining optimal BMI and lipid levels may mitigate aortic stiffness.
Outcomes of Large Vessel Occlusion Stroke in Patients Aged ≥90 Years
Authors: Fujita Kyohei , Tanaka Kanta , Yamagami Hiroshi , Yoshimoto Takeshi , Uchida Kazutaka , Morimoto Takeshi , Imamura Hirotoshi , Sakai Nobuyuki , Ohara Nobuyuki , Matsumoto Yasushi , Takeuchi Masataka , Shigeta Keigo , Toyoda Kazunori , Yoshimura Shinichi 
Published: March 2021

Background and Purpose:
Outcomes in patients ≥90 years of age with stroke due to large vessel occlusion were compared between endovascular therapy (EVT) and medical management.

Methods:
Of 2420 acute ischemic stroke patients with large vessel occlusion in a prospective, multicenter, nationwide registry in Japan, patients aged ≥90 years with occlusion of the internal carotid artery or M1 segment of the middle cerebral artery were included. The primary effectiveness outcome was a favorable outcome at 3 months, defined as achieving a modified Rankin Scale score of 0 to 2 or return to at least the prestroke modified Rankin Scale score at 3 months. Safety outcomes included symptomatic intracranial hemorrhage within 72 hours after onset. Intergroup biases were adjusted by multivariable adjustment with inverse probability of treatment weighting.

Results:

A total of 150 patients (median age, 92 [interquartile range, 90–94] years; median prestroke modified Rankin Scale score, 2 [interquartile range, 0–4]) were analyzed. EVT was performed in 49 patients (32.7%; mechanical thrombectomy, n=43). The EVT group showed shorter time from onset to hospital arrival (
P
=0.03), higher Alberta Stroke Program Early CT Score (
P
<0.01), and a higher rate of treatment with intravenous thrombolysis (
P
<0.01) than the medical management group. The favorable outcome was seen in 28.6% of the EVT group and 6.9% of the medical management group (
P
<0.01). EVT was associated with the favorable outcome (adjusted odds ratio, 8.44 [95% CI, 1.88–37.97]). Rates of symptomatic intracranial hemorrhage were similar between the EVT group (0.0%) and the medical management group (3.9%;
P
=0.30).

Conclusions:
Patients who underwent EVT showed better functional outcomes than those with medical management without increased symptomatic intracranial hemorrhages. Given proper patient selection, withholding EVT solely on the basis of the age of patients may not offer the best chance of good outcome.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02419794.
Re-Negotiating Interconfessional Boundaries through Intertextuality: The Unborn in the Kṯāḇā ḏ-Huddāyē of Barhebraeus (d. 1286)
Authors: Jäckel Florian 
Published: March 2021

Abstract
The article analyzes the Kṯāḇā ḏ-Huddāyē, a legal work of the Syriac polymath and ecclesiastic leader Barhebraeus. The intertextual strategies are assessed, such as compilation, redaction and adaption of the Huddāyē’s source material, i.e. legal compendia by al-Ghazālī, by the Ḥanafī al-Qudūrī and texts from Christian tradition. It is argued that the different normative boundaries established by these source texts and then intertextually reworked by Barhebraeus in the Huddāyē can be read as (re-)negotiation of communal identity for a Christian community in an Islamic environment. Two treatments of unborn life and pregnancy are taken as an example: the funeral prayer for the miscarried child and financial compensation in case of induced miscarriage.
Islamicate Goods in Gothic Halls: The Afterlives of Palma De Mallorca’s Islamic Past
Authors: Bauer Doron 
Published: March 2021

Abstract
Following the conquest of Islamic Majorca in 1229, the Christian settler-colonizers embraced a purist identity that rejected altogether the island’s Islamic past and its artistic heritage. Visually, this new identity found its expression in the form of a clean, restrained, and mathematical gothic style. Palma’s towering gothic monuments embodied an ideological attempt at cultural erasure that has shaped Mallorquin identity to the present day. However, through the interstices of collective memory and material evidence it becomes clear that Islam and the Islamicate lingered beyond the singular point of the conquest through the continuity of local artistic production, the arrival of new Muslim artisans, imports of Islamicate objects, and the survival of monuments. The result was a hierarchical aesthetic system with two axes: the first consisted of the superimposed monumental, public, and official Gothic, while the second consisted of portable and less durable Islamicate objects that circulated in the gothic halls.
Marsilius of Padua and Isaac Abravanel on Kingship: The Medieval Precedents of Republicanism Revisited
Authors: Syros Vasileios 
Published: March 2021

Abstract
This article offers a comparative investigation of Marsilius of Padua’s and Isaac Abravanel’s ideas on kingship. It looks at how these thinkers transform the “canonical” sources of their respective traditions of political theorizing, i.e., Aristotle’s Politics and the Bible, to articulate the notion that ultimate authority rests with the citizens/people. It also examines how these two writers’ positions on kingship relate to the political realities that prevailed in late medieval Italy. Finally, it illuminates the medieval precedents of modern republicanism in the Christian and Jewish political traditions.
Chinese Students in Indonesia and the Belt and Road Initiative
Authors: Luli Qianqian 
Published: March 2021

Abstract
This article reports on the author’s initial research on the motivations of Chinese students to study in Indonesia since 2013 when President Xi Jinping proposed that Indonesia become involved in China’s “Belt and Road” Initiative. As part of the ongoing research by the Indonesian Studies Center of Fujian Normal University, this paper explores current trends and conditions of student exchanges between Indonesia and China. The primary motivation for Chinese students to study abroad has usually been to obtain a better quality of education and an international degree, something that is more encouraged under the Belt and Road Initiative. It was found, however, that the number of Chinese students studying in Indonesia has not increased significantly during the past five years. There are several structural factors hindering the successful implementation of student exchange programs. These may be directly related to students’ place of origin, the majors they choose, or the level of the degrees which they obtained.
Equatorial Waves Triggering Extreme Rainfall and Floods in Southwest Sulawesi, Indonesia
Authors: Latos Beata , Lefort Thierry , Flatau Maria K. , Flatau Piotr J. , Permana Donaldi S. , Baranowski Dariusz B. , Paski Jaka A. I. , Makmur Erwin , Sulystyo Eko , Peyrillé Philippe , Feng Zhe , Matthews Adrian J. , Schmidt Jerome M. 
Published: March 2021

AbstractOn the basis of detailed analysis of a case study and long-term climatology, it is shown that equatorial waves and their interactions serve as precursors for extreme rain and flood events in the central Maritime Continent region of southwest Sulawesi, Indonesia. Meteorological conditions on 22 January 2019 leading to heavy rainfall and devastating flooding in this area are studied. It is shown that a convectively coupled Kelvin wave (CCKW) and a convectively coupled equatorial Rossby wave (CCERW) embedded within the larger-scale envelope of the Madden–Julian oscillation (MJO) enhanced convective phase, contributed to the onset of a mesoscale convective system that developed over the Java Sea. Low-level convergence from the CCKW forced mesoscale convective organization and orographic ascent of moist air over the slopes of southwest Sulawesi. Climatological analysis shows that 92% of December–February floods and 76% of extreme rain events in this region were immediately preceded by positive low-level westerly wind anomalies. It is estimated that both CCKWs and CCERWs propagating over Sulawesi double the chance of floods and extreme rain event development, while the probability of such hazardous events occurring during their combined activity is 8 times greater than on a random day. While the MJO is a key component shaping tropical atmospheric variability, it is shown that its usefulness as a single factor for extreme weather-driven hazard prediction is limited.
Cultural Adaptation of Health Literacy Measures: Translation Validation of the Newest Vital Sign in Arabic-Speaking Parents of Children With Type 1 Diabetes in Kuwait
Authors: Al-Abdulrazzaq Dalia , Al-Taiar Abdullah , Al-Haddad Muneera , Al-Tararwa Abeer , Al-Zanati Nabeela , Al-Yousef Amna , Davidsson Lena , Al-Kandari Hessa 
Published: March 2021

Purpose The purpose of the study was to assess the feasibility of use and reliability of the Arabic version of the Newest Vital Sign (NVS-Ar) in parents of children with type 1 diabetes (T1D). Methods The final translated version of NVS-Ar was administered to 175 adult caregivers of children with T1D who are native Arabic speakers. The association between NVS-Ar scores for the parents/legal guardians and A1C for their children was assessed. The internal consistency was evaluated by Cronbach’s α, and reliability was assessed by test-retest method. Results The median (interquartile range) score was 4.0 (3-5). The internal consistency of the NVS-Ar was moderate (α = .58). The intraclass correlation coefficient was .61. There was no correlation between NVS-Ar score and A1C (Spearman’s ρ = .055; P = .62). Furthermore, there was significant inverse association between adequate health literacy and optimal glycemic control among the children, which remained evident even after adjusting for the duration of T1D, age, or education of the parents/guardians. However, it lost statistical significance after adjustment for treatment regimen. Conclusion Study findings indicate that the NVS is unlikely to be a predictive tool for functional health literacy in Arabic settings and that there is a need to properly translate and validate other tools such as the Test of Functional Health Literacy in Adults or, alternatively, to develop a reliable tool.
Stimulating meditation: a pre-registered randomised controlled experiment combining a single dose of the cognitive enhancer, modafinil, with brief mindfulness training
Authors: Thomas Emily M , Freeman Tom P , Poplutz Patrick , Howden Kane , Hindocha Chandni , Bloomfield Michael , Kamboj Sunjeev K 
Published: March 2021

Background: Mindfulness-meditation has a variety of benefits on well-being. However, individuals with primary attentional impairments (e.g. attention deficit disorder) or attentional symptoms secondary to anxiety, depression or addiction, may be less likely to benefit, and require additional mindfulness-augmenting strategies. Aims: To determine whether a single dose of the cognitive enhancer, modafinil, acutely increases subjective and behavioural indices of mindfulness, and augments brief mindfulness training. Methods: A randomised, double-blind, placebo-controlled, 2 (drug: placebo, modafinil) × 2 (strategy: mindfulness, relaxation control) experiment was conducted. Seventy-nine meditation-naïve participants were assigned to: placebo–relaxation, placebo–mindfulness, modafinil–relaxation or modafinil–mindfulness. Pre-drug, post-drug and post-strategy state mindfulness, affect and autonomic activity, along with post-strategy sustained attention and mind-wandering were assessed within a single lab session. After the session, participants were instructed to practice their assigned behavioural strategy daily for one week, with no further drug administration, after which, follow-up measures were taken. Results: As predicted, modafinil acutely increased state mindfulness and improved sustained attention. Differential acute strategy effects were found following mindfulness on autonomic activity but not state mindfulness. There were no strategy or drug effects on mind-wandering. However, exploratory analyses indicated that participants receiving modafinil engaged in more strategy practice across strategy conditions during follow-up. Conclusions: Modafinil acutely mimicked the effects of brief mindfulness training on state mindfulness but did not enhance the effects of this training. Limitations of the current study, and recommendations for future research examining modafinil as an adjunct to mindfulness- (or relaxation-) based treatments are discussed.
Genome-wide interference of ZNF423 with B-lineage transcriptional circuitries in acute lymphoblastic leukemia
Authors: Iglesias Pablo , Puller Ann-Christin , Seoane Marcos , Spohn Michael , Raasch Sabine , Klokow Marianne , Müller Jürgen , Burkhardt Lia , Indenbirken Daniela , Horstmann Martin A. 
Published: March 2021

Abstract
Aberrant expression of the transcriptional modulator and early B-cell factor 1 (EBF1) antagonist ZNF423 has been implicated in B-cell leukemogenesis, but its impact on transcriptional circuitries in lymphopoiesis has not been elucidated in a comprehensive manner. Herein, in silico analyses of multiple expression data sets on 1354 acute leukemia samples revealed a widespread presence of ZNF423 in various subtypes of acute lymphoblastic leukemia (ALL). Average expression of ZNF423 was highest in ETV6-RUNX1, B-other, and TCF3-PBX1 ALL followed by BCR-ABL, hyperdiploid ALL, and KMT2A-rearranged ALL. In a KMT2A-AFF1 pro-B ALL model, a CRISPR-Cas9–mediated genetic ablation of ZNF423 decreased cell viability and significantly prolonged survival of mice upon xenotransplantation. For the first time, we characterized the genome-wide binding pattern of ZNF423, its impact on the chromatin landscape, and differential gene activities in a B-lineage context. In general, chromatin-bound ZNF423 was associated with a depletion of activating histone marks. At the transcriptional level, EBF1-dependent transactivation was disrupted by ZNF423, whereas repressive and pioneering activities of EBF1 were not discernibly impeded. Unexpectedly, we identified an enrichment of ZNF423 at canonical EBF1-binding sites also in the absence of EBF1, which was indicative of intrinsic EBF1-independent ZNF423 activities. A genome-wide motif search at EBF1 target gene loci revealed that EBF1 and ZNF423 co-regulated genes often contain SMAD1/SMAD4-binding motifs as exemplified by the TGFB1 promoter, which was repressed by ZNF423 outcompeting EBF1 by depending on its ability to bind EBF1 consensus sites and to interact with EBF1 or SMADs. Overall, these findings underscore the wide scope of ZNF423 activities that interfere with B-cell lymphopoiesis and contribute to leukemogenesis.
Gene co-expression analysis of tomato seed maturation reveals tissue-specific regulatory networks and hubs associated with the acquisition of desiccation tolerance and seed vigour
Authors: Bizouerne Elise , Buitink Julia , Vu Benoît Ly , Vu Joseph Ly , Esteban Eddi , Pasha Asher , Provart Nicholas , Verdier Jérôme , Leprince Olivier 
Published: March 2021

Abstract
Background
During maturation seeds acquire several physiological traits to enable them to survive drying and disseminate the species. Few studies have addressed the regulatory networks controlling acquisition of these traits at the tissue level particularly in endospermic seeds such as tomato, which matures in a fully hydrated environment and does not undergo maturation drying. Using temporal RNA-seq analyses of the different seed tissues during maturation, gene network and trait-based correlations were used to explore the transcriptome signatures associated with desiccation tolerance, longevity, germination under water stress and dormancy.

Results
During maturation, 15,173 differentially expressed genes were detected, forming a gene network representing 21 expression modules, with 3 being specific to seed coat and embryo and 5 to the endosperm. A gene-trait significance measure identified a common gene module between endosperm and embryo associated with desiccation tolerance and conserved with non-endospermic seeds. In addition to genes involved in protection such LEA and HSP and ABA response, the module included antioxidant and repair genes. Dormancy was released concomitantly with the increase in longevity throughout fruit ripening until 14 days after the red fruit stage. This was paralleled by an increase in SlDOG1–2 and PROCERA transcripts. The progressive increase in seed vigour was captured by three gene modules, one in common between embryo and endosperm and two tissue-specific. The common module was enriched with genes associated with mRNA processing in chloroplast and mitochondria (including penta- and tetratricopeptide repeat-containing proteins) and post-transcriptional regulation, as well several flowering genes. The embryo-specific module contained homologues of ABI4 and CHOTTO1 as hub genes associated with seed vigour, whereas the endosperm-specific module revealed a diverse set of processes that were related to genome stability, defence against pathogens and ABA/GA response genes.

Conclusion
The spatio-temporal co-expression atlas of tomato seed maturation will serve as a valuable resource for the in-depth understanding of the dynamics of gene expression associated with the acquisition of seed vigour at the tissue level.
The relationship between the expression of Ki-67 and the prognosis of osteosarcoma
Authors: Zeng Ming , Zhou Jian , Wen Lifang , Zhu Yanshan , Luo Yingquan , Wang Wanchun 
Published: March 2021

Abstract
Background
A number of studies have linked positive Ki-67 expression with the prognosis of osteosarcoma (OS) patients. However, the results have been conflicting. To address this controversy, we conducted an analysis using a meta-analysis and a TCGA dataset to estimate the value of Ki-67 expression in the prognosis of OS.

Methods
A comprehensive search for relevant papers was conducted using NCBI PubMed, Embase, Springer, ISI Web of Knowledge, the Cochrane Library, and CNKI regardless of the publication year. The associations between Ki-67 expression and the clinical features and main prognostic outcomes of OS were measured. The TCGA dataset was also analyzed. The pooled odds ratio (OR) and its 95% confidential intervals (CIs) were utilized for statistical analysis.

Results
Overall, a total of 12 studies with 500 cases were included, and the results indicated that the expression of Ki-67 was significantly associated with Enneking stage (OR = 6.88, 95% CI: 2.92–16.22, p < 0.05), distant metastasis (OR = 3.04, 95% CI: 1.51–6.12, p < 0.05) and overall survival (OR = 8.82, 95% CI: 4.68–16.65, p < 0.05) in OS patients. Additionally, we observed no significant heterogeneity among all retrieved studies. Associations between Ki-67 expression and overall survival and disease-free survival of sarcoma were confirmed using the TCGA and Kaplan-Meier plotter datasets.

Conclusion
The present study strongly suggests that positive Ki-67 expression was associated with Enneking stage, distant metastasis, and overall survival of OS, and it may be used as a potential biomarker to predict prognosis and guide clinical therapy for OS.