bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reproducibility of Glucose Fluctuations Induced by Moderate Intensity Cycling Exercise in Persons with Type 1 Diabetes
Authors: Notkin Gabriel Tafdrup , Kristensen Peter Lommer , Pedersen-Bjergaard Ulrik , Jensen Andreas Kryger , Molsted Stig 
Published: March 2021

Aims. The purpose was to assess the reproducibility of glucose changes during three sessions of standardized moderate intensity continuous training of cycling on an individual level in people with type 1 diabetes. Methods. Twelve adults (six females) with type 1 diabetes performed three test sessions on an ergometer bicycle (30 min, 67% of predicted heart rate) on three different days. The participants were 36.5 (26.6-45.5) (median, IQR) years old, and their HbA1c was

65
±
15

mmol/mol (

mean
±
SD

). Two hours before the tests, the participants had a standard meal. Interstitial glucose (IG) and capillary glucose (CG) were measured using an iPro2 Medtronic continuous glucose monitor and the Bayer Contour XT-device, respectively. Prior to the test sessions, resting heart rate was measured using a digital blood pressure monitor to estimate the desired intensity of the exercise. Results. The average within-participant relationship between the average slope in glucose during sessions 2 and 1 was in IG -0.29 (95% CI -1.11; 0.58) and in CG -0.04 (-0.68; 0.77). Between sessions 3 and 2, IG is 0.18 (-0.27; 0.64) and in CG 0.13 (-0.25; 0.55). Between sessions 3 and 1, IG was 0.06 (-0.57; 0.71) and in CG 0.06 (-0.39; 0.52). The results indicate low reproducibility at participant levels and remained unchanged after adjustment for baseline glucose values. Conclusion. On an individual level, the glucose declines during three standardized sessions of PA were not associated with identical responses of the measured IG and CG levels. An overall anticipated decline of glucose concentrations was found in the moderate intensity cycling sessions. This highlights the importance of regular CG measurements during and after physical activity and awareness towards potential exercise-induced hypoglycemia in persons with type 1 diabetes.
amenaza del dengue, un riesgo real para Chile. Propuesta de nueva estrategia para su control
Authors: Díaz Sepúlveda Aldo 
Published: March 2021

Señor editor:
Sin duda la pandemia por COVID-19 ha mantenido la atención de todo el mundo dado la magnitud de la situación y las consecuencias de la misma, no obstante, resulta necesario mantenernos alerta en todos los flancos interviniendo oportunamente. Así como hace mención el Dr. Mauricio Canals (2020) en la editorial titulada “Modelos epidemiológicos y la pandemia COVID-19 en Chile”: la globalización, los cambios demográficos, ambientales y climáticos mantienen latente la aparición de enfermedades emergentes y re-emergentes, así como una progresiva expansión de las mismas en las zonas ya afectadas. Es así como previo al inicio de la pandemia por COVID-19, la afección por dengue representaba una de las enfermedades infecciosas más importantes en América Latina y el Caribe, alcanzando inclusive el máximo registro histórico en la notificacion de casos en la región y a nivel mundial durante el año 2019 (Organización Mundial de la Salud, 2020). Preocupa además en dengue la falta de medidas que impacten de forma significativa y sostenida en el tiempo, junto a la ausencia de tratamientos específicos y de vacunas efectivas, seguras, y de uso amplio, puesto que, la actual vacuna disponible solo está considerada en un subgrupo de la población ya expuesta al virus para la prevención de dengue grave.
Fontan‐Associated Dyslipidemia
Authors: Lubert Adam M. , Alsaied Tarek , Palermo Joseph J. , Anwar Nadeem , Urbina Elaine M. , Brown Nicole M. , Alexander Craig , Almeneisi Hassan , Wu Fred , Leventhal Andrew R. , Aldweib Nael , Mendelson Michael , Opotowsky Alexander R. 
Published: March 2021

Background
Hypocholesterolemia is a marker of liver disease, and patients with a Fontan circulation may have hypocholesterolemia secondary to Fontan‐associated liver disease or inflammation. We investigated circulating lipids in adults with a Fontan circulation and assessed the associations with clinical characteristics and adverse events.

Methods and Results

We enrolled 164 outpatients with a Fontan circulation, aged ≥18 years, in the Boston Adult Congenital Heart Disease Biobank and compared them with 81 healthy controls. The outcome was a combined outcome of nonelective cardiovascular hospitalization or death. Participants with a Fontan (median age, 30.3 [interquartile range, 22.8–34.3 years], 42% women) had lower total cholesterol (149.0±30.1 mg/dL versus 190.8±41.4 mg/dL,
P
<0.0001), low‐density lipoprotein cholesterol (82.5±25.4 mg/dL versus 102.0±34.7 mg/dL,
P
<0.0001), and high‐density lipoprotein cholesterol (42.8±12.2 mg/dL versus 64.1±16.9 mg/dL,
P
<0.0001) than controls. In those with a Fontan, high‐density lipoprotein cholesterol was inversely correlated with body mass index (
r
=−0.30,
P
<0.0001), high‐sensitivity C‐reactive protein (
r
=−0.27,
P
=0.0006), and alanine aminotransferase (
r
=−0.18,
P
=0.02) but not with other liver disease markers. Lower high‐density lipoprotein cholesterol was independently associated with greater hazard for the combined outcome adjusting for age, sex, body mass index, and functional class (hazard ratio [HR] per decrease of 10 mg/dL, 1.37; 95% CI, 1.04–1.81 [
P
=0.03]). This relationship was attenuated when log high‐sensitivity C‐reactive protein was added to the model (HR, 1.26; 95% CI, 0.95–1.67 [
P
=0.10]). Total cholesterol, low‐density lipoprotein cholesterol, and triglycerides were not associated with the combined outcome.

Conclusions
The Fontan circulation is associated with decreased cholesterol levels, and lower high‐density lipoprotein cholesterol is associated with adverse outcomes. This association may be driven by inflammation. Further studies are needed to understand the relationship between the severity of Fontan‐associated liver disease and lipid metabolism.
Prospective Validation and Comparative Analysis of Coronary Risk Stratification Strategies Among Emergency Department Patients With Chest Pain
Authors: Mark Dustin G. , Huang Jie , Kene Mamata V. , Sax Dana R. , Cotton Dale M. , Lin James S. , Bouvet Sean C. , Chettipally Uli K. , Anderson Megan L. , McLachlan Ian D. , Simon Laura E. , Shan Judy , Rauchwerger Adina S. , Vinson David R. , Ballard Dustin W. , Reed Mary E. ,   for the Kaiser Permanente CREST Network Investigators
Published: March 2021

Background
Coronary risk stratification is recommended for emergency department patients with chest pain. Many protocols are designed as “rule‐out” binary classification strategies, while others use graded‐risk stratification. The comparative performance of competing approaches at varying levels of risk tolerance has not been widely reported.

Methods and Results

This is a prospective cohort study of adult patients with chest pain presenting between January 2018 and December 2019 to 13 medical center emergency departments within an integrated healthcare delivery system. Using an electronic clinical decision support interface, we externally validated and assessed the net benefit (at varying risk thresholds) of several coronary risk scores (History, ECG, Age, Risk Factors, and Troponin [HEART] score, HEART pathway, Emergency Department Assessment of Chest Pain Score Accelerated Diagnostic Protocol), troponin‐only strategies (fourth‐generation assay), unstructured physician gestalt, and a novel risk algorithm (RISTRA‐ACS). The primary outcome was 60‐day major adverse cardiac event defined as myocardial infarction, cardiac arrest, cardiogenic shock, coronary revascularization, or all‐cause mortality. There were 13 192 patient encounters included with a 60‐day major adverse cardiac event incidence of 3.7%. RISTRA‐ACS and HEART pathway had the lowest negative likelihood ratios (0.06, 95% CI, 0.03–0.10 and 0.07, 95% CI, 0.04–0.11, respectively) and the greatest net benefit across a range of low‐risk thresholds. RISTRA‐ACS demonstrated the highest discrimination for 60‐day major adverse cardiac event (area under the receiver operating characteristic curve 0.92, 95% CI, 0.91–0.94,
P
<0.0001).

Conclusions
RISTRA‐ACS and HEART pathway were the optimal rule‐out approaches, while RISTRA‐ACS was the best‐performing graded‐risk approach. RISTRA‐ACS offers promise as a versatile single approach to emergency department coronary risk stratification.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03286179.
Acids and Rust: A New Perspective on the Chemical Revolution
Authors: Jacoby Franklin 
Published: March 2021

AbstractThis paper uses scientific perspectivism as a lens for understanding acid experiments from the Chemical Revolution. I argue that this account has several advantages over several recent interpretations of this period, interpretations that do not neatly capture some of the historical experiments on acids. The perspectival view is distinctive in that it avoids discontinuity, allows for the rational resolution of disagreement, and is sensitive to the historical epistemic context.
Lockdown Politics: A Response to Panagiotis Sotiris
Authors: Dale Gareth 
Published: March 2021

Abstract
In ‘Thinking Beyond the Lockdown’, Panagiotis Sotiris argues that lockdowns are repressive and should be opposed. In this response I take issue with his analysis. He posits the existence of a ‘lockdown strategy’ which has little relation to reality. He identifies lockdowns with neoliberalism, flirts with the Great Barrington project, and calls for anti-lockdown resistance – without so much as a glance at the right-wing libertarian camps that are also staked out on this terrain. On these points, and in respect of his interpretation of Foucault, I offer a rebuttal.
Internationalization of Higher Education under the Belt and Road Initiatives
Authors: Jiang Xiaoying 
Published: March 2021

Abstract
This is a systematic literature review of the internationalization of higher education in the context of the Belt and Road Initiative (bri). Following the systematic literature review methods, the author selected eight English and 29 Chinese studies in the academic databases. Through an inductive thematic analysis, the author synthesized five primary themes: (a) philosophical and theoretical foundations of bri education; (b) introduction of higher education development in bri countries; (c) higher education cooperation between China and bri countries; (d) international higher education and economic development; and (e) international student education management. The goal of this review is to underline new opportunities and challenges of bri education discussed within the literature and to present how the research can inform scholars, practitioners, and policymakers in the field of international higher education. It called for more joint research among Chinese scholars and overseas scholars in bri countries. In terms of the future research direction, the author suggested more research on the theoretical exploration and empirical investigation in international higher education within the context of bri.
The original description and date of publication of Cylindrophis lineatus and remarks on its type locality (Reptilia: Squamata: Cylindrophiidae)
Authors: FIGUEROA ALEX , LOW MARTYN E.Y. 
Published: March 2021

The snake genus Cylindrophis Wagler, 1828 belongs to the monogeneric family Cylindrophiidae comprising 15 species distributed predominately throughout SE Asia, with one extralimital species occurring in Sri Lanka (Bernstein et al. 2020: 535). Cylindrophis lineatus is a rare species known from only eight museum specimens (discussed herein), and a photograph of one live individual from Kuching, Sarawak, East Malaysia (Stuebing et al. 2014: 63). Despite being originally described with Singapore as the type-locality (Blanford 1881: 217, 218), it is currently understood that C. lineatus is endemic to western Sarawak, East Malaysia (Stuebing et al. 2014: 63). Wallach et al. (2014: 204) stated that C. lineatus is also found in Kalimantan, but did not provide any references. This appears to have been followed by Bernstein et al. (2020: 537), who provide a map indicating C. lineatus occurrences in Kalimantan. The original description of Cylindrophis lineatus is conventionally cited as Blanford (1881: 217, 218, pl. 20). Herein, we demonstrate that the authorship and date of publication of this taxon should correctly be Cylindrophis lineatus Dennys, 1880b, and discuss that the type locality should be changed to “Borneo”.
Middlemarch
Authors: Roberts Adam 
Published: March 2021

In Middlemarch, George Eliot draws a character passionately absorbed by abstruse allusion and obscure epigraphs. Casaubon’s obsession is a cautionary tale, but Adam Roberts nonetheless sees in him an invitation to take Eliot’s use of epigraphy and allusion seriously, and this book is an attempt to do just that.
Roberts considers the epigraph as a mirror that refracts the meaning of a text, and that thus carries important resonances for the way Eliot’s novels generate their meanings. In this lively and provoking study, he tracks down those allusions and quotations that have hitherto gone unidentified by scholars, examining their relationship to the text in which they sit to unfurl a broader argument about the novel – both this novel, and the novel form itself.
Middlemarch: Epigraphs and Mirrors is both a study of George Eliot and a meditation on the textuality of fiction. It is essential reading for specialists and students of George Eliot, the nineteenth century novel, and intertextuality. It will also richly reward anyone who has ever taken pleasure in Middlemarch.
Impact of gender in patients with continuous-flow left ventricular assist device therapy in end-stage heart failure
Authors: Zubarevich Alina , Szczechowicz Marcin , Osswald Anja , Arjomandi Rad Arian , Vardanyan Robert , Pompeu BO Sá Michel , Van den Eynde Jef , Schmack Bastian , Wendt Daniel , Koch Achim , Pizanis Nikolaus , Kamler Markus , Ruhparwar Arjang , Weymann Alexander , Zhigalov Konstantin 
Published: March 2021

Background: There is an ongoing debate about the influence of the female gender on postoperative outcomes after durable left ventricular assist device (LVAD) implantation. Despite the differences in pathophysiology of heart failure in females, therapy concepts are the same as in the male population. The aim of this study was to investigate the role of the female gender in surgical heart failure therapy. Materials and methods: Between August 2010 and January 2020, 207 patients were treated with durable LVAD at out institution. We matched 111 patients in two groups to compare the outcomes in male and female patients and to stratify the risk factors of mortality. Results: The groups were matched 2:1 and were comparable after matching. We found no difference in in-hospital and follow-up mortality between male and female patients. Postoperative adverse events and complications were found to be unvaried across male and female patients. Female patients had higher rates of postoperative LVAD-thrombosis compared to their male counterparts (13.5% vs 0, p = 0.001) and the rates of renal replacement therapy lasting over 90 days were also higher in the female group (33.8% vs 56.8%, p = 0.021). Furthermore, the female gender was not an independent predictor neither of in-hospital nor follow-up mortality. Conclusions: Durable continuous flow left ventricular assist devices as a bridge to transplantation or recovery in female patients are associated with a higher risk of acute kidney injury requiring RRT and are at a higher risk of LVAD-thrombosis. Nevertheless, survival rates between genders are similar.
Evaluation of Velopharyngeal Closure Function With 4-Dimensional Computed Tomography and Assessment of Radiation Exposure in Pediatric Patients: A Cross-Sectional Study
Authors: Kobayashi Yoshikazu , Kobayashi Masanao , Kanamori Daisuke , Fujii Naoko , Kataoka Yumi , Satoh Koji , Sano Yoshimi , Yoshioka Satoshi , Tateya Ichiro , Toyama Hiroshi , Matsuo Koichiro 
Published: March 2021

Objective: Some patients with cleft palate (CP) need secondary surgery to improve functionality. Although 4-dimensional assessment of velopharyngeal closure function (VPF) in patients with CP using computed tomography (CT) has been existed, the knowledge about quantitative evaluation and radiation exposure dose is limited. We performed a qualitative and quantitative assessment of VPF using CT and estimated the exposure doses. Design: Cross-sectional. Setting: Computed tomography images from 5 preoperative patients with submucous CP (SMCP) and 10 postoperative patients with a history of CP (8 boys and 7 girls, aged 4-7 years) were evaluated. Patients: Five patients had undergone primary surgery for SMCP; 10 received secondary surgery for hypernasality. Main Outcome Measures: The presence of velopharyngeal insufficiency (VPI), patterns of velopharyngeal closure (VPC), and cross-sectional area (CSA) of VPI was evaluated via CT findings. Organ-absorbed radiation doses were estimated in 5 of 15 patients. The differences between cleft type and VPI, VPC patterns, and CSA of VPI were evaluated. Results: All patients had VPI. The VPC patterns (SMCP/CP) were evaluated as coronal (1/4), sagittal (0/1), circular (1/2), and circular with Passavant’s ridge (2/2); 2 patients (1/1) were unevaluable because of poor VPF. The CSA of VPI was statistically larger in the SMCP group ( P = .0027). The organ-absorbed radiation doses were relatively lower than those previously reported. Conclusions: Four-dimensional CT can provide the detailed findings of VPF that are not possible with conventional CT, and the exposure dose was considered medically acceptable.
Treacher Collins Syndrome in the United States: Examining Incidence and Inpatient Interventions
Authors: Reid Lauren , Carroll William 
Published: March 2021

Objective: Advancements have been made in the care of patients with Treacher Collins syndrome (TCS), but epidemiological data are lacking given its rarity. A national database provides a valuable opportunity for studying the incidence of rare craniofacial conditions. We sought to evaluate disease incidence of phenotypically severe cases and the frequency of the most common associated diagnoses and interventions. Design: The 2016 Kids’ Inpatient Database (KID), Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality was the first version to include updated International Classification of Diseases-Tenth Edition (ICD-10) coding encompassing a unique code for TCS. The 2016 KID was queried for the unique code. Incidence was calculated using national estimates. Diagnosis and procedure codes were pooled and analyzed. Patients: A total of 266 discharge cases with a diagnosis code for TCS (Q75.4). Main Outcomes: Disease incidence and the most frequent diagnosis and procedure codes. Results: The estimated incidence of children born with a diagnosis of TCS was approximately 1 in 80,000. Two of the three most common ICD-10 diagnosis codes were tracheostomy status and obstructive sleep apnea. The most common procedures performed were airway examination procedures. Conclusions: Treacher Collins syndrome is a rare craniofacial disorder requiring complex multidisciplinary management. Phenotypically severe cases requiring inpatient management may be rarer than previous estimates suggest. Inpatient airway interventions are very common, and multidisciplinary team members should anticipate the degree of potential airway risk these patients pose.
Experiences With COVID-19 Stressors and Parents’ Use of Neglectful, Harsh, and Positive Parenting Practices in the Northeastern United States
Authors: Connell Christian M. , Strambler Michael J. 
Published: March 2021

Objectives: To estimate household exposure to COVID-19 related stress and the association with parent report of neglectful, harsh, and positive discipline practices. Methods: Cross sectional survey data was collected from 2,068 parents in the Northeastern US. Parents reported personal and household experiences of COVID-19 stressors, their level of distress, and use of neglectful parenting and discipline practices for a randomly selected child in their home. Analyses estimated rates of COVID-19 related stress and parenting practices. Logistic regression was used to assess the relation of COVID-19 stress to parenting behaviors. Results: Individual and household stressor level, as well as distress were each positively associated with likelihood of neglect. Personal exposure to stressors was minimally related to discipline, but household stressor level and parents’ distress were positively associated with harsh and positive discipline. Discussion: Indicators of COVID-19 stress (e.g., exposure to stressors and distress) each uniquely predicted parents’ use of neglect, particularly physical and family-based sub-types, and use of harsh and positive discipline practices. Results suggest that parents may require additional support to provide appropriate care for their children while coping with the increased rates of stress associated with the pandemic and the resulting public health response.
A Novel 85-Gene Expression Signature Predicts Unfavorable Prognosis in Acute Myeloid Leukemia
Authors: Lai Yanli , Sheng Lixia , Wang Jiaping , Zhou Miao , OuYang Guifang 
Published: March 2021

Aim: Acute myeloid leukemia (AML) is a heterogeneous disorder with complex genetic basis and adverse prognosis. Cytogenetics risk, somatic mutations and gene expression profiles are important prognostic factors for AML patients. However, accurate stratification of patient prognosis remains an unsolved problem in AML. This study was to to develop a novel gene profile to accurately classify AML patients into subgroups with different survival probabilities. Methods: Survival-related genes were determined by Kaplan–Meier survival analysis and multivariate analysis using the expression and clinical data of 405 AML patients from Oregon Health & Science University (OHSU) dataset and validated in The Cancer Genome Atlas (TCGA) database. Feature selection was performed by using the Least Absolute Shrinkage and Selection Operator (LASSO) method. With the LASSO model, a prognostic 85-gene score was established and compared with 2 known gene-expression risk scores. The stratification of AML patients was performed by unsupervised hierarchical clustering of 85 gene expression levels to identify clusters of AML patients with different survival probabilities. Results: The LASSO model comprising 85 genes was considered as the optimal model based on relatively high area under curve value (0.83) and the minimum mean squared error. The 85-gene score was associated with increased mortality in AML patients. Hierarchical clustering analysis of the 85 genes revealed 3 subgroups of AML patients in the OHSU dataset. The cluster1 AML patients were associated with more female cases, higher percent of bone marrow blast cells, 85-gene score, cytogenetics risk, more frequent FLT3-ITD, DNMT3A, NP1 mutations, less frequent TP53, RUNX1 mutations, poorer overall survival than cluster2 tumors. The 85-gene score had higher AUC (0.75) than the 5-gene risk score and LSC17 score (0.74 and 0.65). Conclusions: The 85-gene score is superior to the 2 established prognostic gene signatures in the prediction of prognosis of AML patients.