bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of coronary artery calcium score in the primary prevention of cardiovascular disease
Authors: Nasir Khurram , Cainzos-Achirica Miguel 
Published: May 2021

Abstract

First developed in 1990, the Agatston coronary artery calcium (CAC) score is an international guideline-endorsed decision aid for further risk assessment and personalized management in the primary prevention of atherosclerotic cardiovascular disease. This review discusses key international studies that have informed this 30 year journey, from an initial coronary plaque screening paradigm to its current role informing personalized shared decision making. Special attention is paid to the prognostic value of a CAC score of zero (the so called “power of zero”), which, in a context of low estimated risk thresholds for the consideration of preventive therapy with statins in current guidelines, may be used to
de-risk
individuals and thereby inform the safe delay or avoidance of certain preventive therapies. We also evaluate current recommendations for CAC scoring in clinical practice guidelines around the world, and past and prevailing barriers for its use in routine patient care. Finally, we discuss emerging approaches in this field, with a focus on the potential role of CAC informing not only the personalized allocation of statins and aspirin in the general population, but also of other risk-reduction therapies in special populations, such as individuals with diabetes and people with severe hypercholesterolemia.
New Linked-Wire-Type External Fixator (the Ichi-Fixator System) for Metacarpal Fractures: Case Series and Literature Review
Authors: Igeta Yuka , Ichihara Satoshi , Hara Akira , Suzuki Masao , Otani Satoshi , Maruyama Yuichiro , Nozawa Masahiko 
Published: May 2021

Background: External fixator is an effective treatment option in the comminuted or unstable metacarpal fractures. The new linked-wire type of external fixator (the Ichi-Fixator System) developed for hand and wrist fractures enables fine adjustment of the fixation under fluoroscopic inspection through small screws inside the fixator fitted externally. This technique is designed to reinforce the stability and rigidity of conventional percutaneous Kirchner wire fixation. The aim of this study is to assess the effectiveness of the fixator for comminuted or unstable metacarpal fractures through the evaluation of short-term results in ten cases. Methods: Patients were fixated with fixator pins and metal clamps using the Ichi-Fixator System. All patients were then examined for post-operative complications, functional recovery, visual analogue scale (VAS) score, and the Quick Disabilities of the Arm, Shoulder, and Hand (Q-DASH) score at the end of the final follow-up consultation. Results: Operative treatment using the Ichi-Fixator System facilitates anatomical reduction and allows immediate full mobilization, producing good outcomes. No infections were observed in all cases, including those at pin insertion sites. There were no implant failure and nonunion. Patients could perform all routine activities with normal grip strength and retained a full range of hand motion without pain. This treatment method with improved postoperative comfort would allow immediate return to work, which would clearly boost patient satisfaction. Conclusions: Ichi-Fixator System is considered to be useful for the treatment of metacarpal fractures, and this will provide a new surgical option for all hand fractures.
The Landscape of Cell-Free HBV Integrations and Mutations in Cirrhosis and Hepatocellular Carcinoma Patients
Authors: Zheng Bo , Liu Xiao-Long , Fan Rong , Bai Jian , Wen Hao , Du Lu-Tao , Jiang Guo-Qing , Wang Chun-Ying , Fan Xiao-Tang , Ye Yi-Nong , Qian Yun-Song , Wang Ying-Chao , Liu Gao-Jing , Deng Guo-Hong , Shen Feng , Hu He-Ping , Wang Hui , Zhang Qing-Zheng , Ru Lan-Lan , Zhang Jing , Gao Yan-Hang , Xia Jie , Yan Hua-Dong , Liang Min-Feng , Yu Yan-Long , Sun Fu-Ming , Gao Yu-Jing , Sun Jian , Zhong Chun-Xiu , Wang Yin , Kong Fei , Chen Jin-Ming , Zheng Dan , Yang Yuan , Wang Chuan-Xin , Wu Lin , Hou Jin-Lin , Liu Jing-Feng , Wang Hong-Yang , Chen Lei 
Published: May 2021

Abstract

Purpose:
Intratumoral hepatitis B virus (HBV) integrations and mutations are related to hepatocellular carcinoma (HCC) progression. Circulating cell-free DNA (cfDNA) has shown itself as a powerful noninvasive biomarker for cancer. However, the HBV integration and mutation landscape on cfDNA remains unclear.

Experimental Design:
A cSMART (Circulating Single-Molecule Amplification and Resequencing Technology)-based method (SIM) was developed to simultaneously investigate HBV integration and mutation landscapes on cfDNA with HBV-specific primers covering the whole HBV genome. Patients with HCC (n = 481) and liver cirrhosis (LC; n = 517) were recruited in the study.

Results:
A total of 6,861 integration breakpoints including TERT and KMT2B were discovered in HCC cfDNA, more than in LC. The concentration of circulating tumor DNA (ctDNA) was positively correlated with the detection rate of these integration hotspots and total HBV integration events in cfDNA. To track the origin of HBV integrations in cfDNA, whole-genome sequencing (WGS) was performed on their paired tumor tissues. The paired comparison of WGS data from tumor tissues and SIM data from cfDNA confirmed most recurrent integration events in cfDNA originated from tumor tissue. The mutational landscape across the whole HBV genome was first generated for both HBV genotype C and B. A region from nt1100 to nt1500 containing multiple HCC risk mutation sites (OR &gt; 1) was identified as a potential HCC-related mutational hot zone.

Conclusions:
Our study provides an in-depth delineation of HBV integration/mutation landscapes at cfDNA level and did a comparative analysis with their paired tissues. These findings shed light on the possibilities of noninvasive detection of virus insertion/mutation.
Mediator of DNA Damage Checkpoint 1 (MDC1) Is a Novel Estrogen Receptor Coregulator in Invasive Lobular Carcinoma of the Breast
Authors: Sottnik Joseph L. , Bordeaux Evelyn K. , Mehrotra Sanjana , Ferrara Sarah E. , Goodspeed Andrew E. , Costello James C. , Sikora Matthew J. 
Published: May 2021

AbstractInvasive lobular carcinoma (ILC) is the most common special histologic subtype of breast cancer, and nearly all ILC tumors express estrogen receptor alpha (ER). However, clinical and laboratory data suggest ILC are strongly estrogen-driven but not equally antiestrogen-sensitive. We hypothesized ILC-specific ER coregulators mediate ER functions and antiestrogen resistance in ILC, and profiled ER-associated proteins by mass spectrometry. Three ER+ ILC cell lines (MDA MB 134VI, SUM44PE, and BCK4) were compared with ER+ invasive ductal carcinoma (IDC) line data, and we examined whether siRNA of identified proteins suppressed ER-driven proliferation in ILC cells. This identified mediator of DNA damage checkpoint 1 (MDC1), a tumor suppressor in DNA damage response (DDR), as a novel ER coregulator in ILC. We confirmed ER:MDC1 interaction was specific to ILC versus IDC cells, and found MDC1 knockdown suppressed ILC cell proliferation and tamoxifen resistance. Using RNA-sequencing, we found in ILC cells MDC1 knockdown broadly dysregulates the ER transcriptome, with ER:MDC1 target genes enriched for promoter hormone response elements. Importantly, our data are inconsistent with MDC1 tumor suppressor functions in DDR, but suggest a novel oncogenic role for MDC1 as an ER coregulator. Supporting this, in breast tumor tissue microarrays, MDC1 protein was frequently low or absent in IDC, but MDC1 loss was rare in ER+ ILC. ER:MDC1 interaction and MDC1 coregulator functions may underlie ER function in ILC and serve as targets to overcome antiestrogen resistance in ILC.Implications:MDC1 has novel ER coregulator activity in ILC, which may underlie ILC-specific ER functions, estrogen response, and antiestrogen resistance.
Bispecific Antibodies to PD-1 and CTLA4: Doubling Down on T Cells to Decouple Efficacy from Toxicity
Authors: Burton Elizabeth M. , Tawbi Hussein A. 
Published: May 2021

Abstract

Summary:
Although combination anti–PD-1 and anti-CTLA4 mAbs have revolutionized outcomes for many cancers, their utility has been limited due to significant immune-related toxicities and the emergence of resistance. In this issue of Cancer Discovery, Dovedi and colleagues describe the development and preclinical testing of MEDI5752, a bispecific anti–PD-1/CTLA4 antibody designed to optimize therapeutic response by maximizing CTLA4 blockade on antigen-experienced T cells, thereby increasing efficacy and potentially minimizing toxicity.
See related article by Dovedi et al., p. 1100.
Effects of Ambient Air Pollution on Blood Pressure Among Children and Adolescents: A Systematic Review and Meta‐Analysis
Authors: Huang Miao , Chen Jingyuan , Yang Yiping , Yuan Hong , Huang Zhijun , Lu Yao 
Published: May 2021

Background
Previous studies have investigated the association of ambient air pollution with blood pressure (BP) in children and adolescents, however, the results are not consistent. We conducted a systematic review and meta‐analysis to assess the relationship between short‐term and long‐term ambient air pollutant exposure with BP values among children and adolescents.

Methods and Results

We searched PubMed, Web of Science, and Embase before September 6, 2020. Two reviewers independently searched and selected studies, extracted data, and assessed study quality. The studies were divided into groups by composition of air pollutants (NO
2
, particulate matter (PM) with diameter ≤10 μm or ≤2.5 μm) and length of exposure. The beta regression coefficients (β) and their 95% CIs were calculated to evaluate the strength of the effect with each 10 μg/m
3
increase in air pollutants. Out of 36 650 articles, 14 articles were included in this meta‐analysis. The meta‐analysis showed short‐term exposure to PM with diameter ≤10 μm (β=0.267; 95% CI, 0.033‒0.501) was significantly associated with elevated systolic BP values. In addition, long‐term exposure to PM with diameter ≤2.5 μm (β=1.809; 95% CI, 0.962‒2.655), PM with diameter ≤10 μm (β=0.526; 95% CI, 0.095‒0.958), and NO
2
(β=0.754; 95% CI, 0.541‒0.968) were associated with systolic BP values and long‐term exposure to PM with diameter ≤2.5 μm (β=0.931; 95% CI, 0.157‒1.705), and PM with diameter ≤10 μm (β=0.378; 95% CI, 0.022‒0.735) was associated with diastolic BP.

Conclusions
Our study indicates that both short‐term and long‐term exposure to some ambient air pollutants may increase BP values among children and adolescents.
Carotid Stenosis and Recurrent Ischemic Stroke
Authors: Yaghi Shadi , de Havenon Adam , Rostanski Sara , Kvernland Alexandra , Mac Grory Brian , Furie Karen L. , Kim Anthony S. , Easton J. Donald , Johnston S. Claiborne , Henninger Nils 
Published: May 2021

Background and Purpose:
Randomized trials demonstrated the benefit of dual antiplatelet therapy in patients with minor ischemic stroke or high-risk transient ischemic attack. We sought to determine whether the presence of carotid stenosis was associated with increased risk of ischemic stroke and whether the addition of clopidogrel to aspirin was associated with more benefit in patients with versus without carotid stenosis.

Methods:
This is a post-hoc analysis of the POINT trial (Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke) that randomized patients with minor ischemic stroke or high-risk transient ischemic attack within 12 hours from last known normal to receive either clopidogrel plus aspirin or aspirin alone. The primary predictor was the presence of ≥50% stenosis in either cervical internal carotid artery. The primary outcome was ischemic stroke. We built Cox regression models to determine the association between carotid stenosis and ischemic stroke and whether the effect of clopidogrel was modified by ≥50% carotid stenosis.

Results:

Among 4881 patients enrolled POINT, 3941 patients met the inclusion criteria. In adjusted models, ≥50% carotid stenosis was associated with ischemic stroke risk (hazard ratio, 2.45 [95% CI, 1.68–3.57],
P
<0.001). The effect of clopidogrel (versus placebo) on ischemic stroke risk was not significantly different in patients with <50% carotid stenosis (adjusted hazard ratio, 0.68 [95% CI, 0.50–0.93],
P
=0.014) versus those with ≥50% carotid stenosis (adjusted hazard ratio, 0.88 [95% CI, 0.45–1.72],
P
=0.703),
P
value for interaction=0.573.

Conclusions:
The presence of carotid stenosis was associated with increased risk of ischemic stroke during follow-up. The effect of added clopidogrel was not significantly different in patients with versus without carotid stenosis.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03354429.
The effect of organic compost of Caryocar brasiliense waste against Meloidogyne javanica in two vegetable crops
Authors: Silva Fabíola de J. , Ribeiro Regina C.F. , Xavier Adelica A. , Gomes Vanessa A. , Pacheco Paulo V.M. , Neto José A. dos S. 
Published: May 2021

Summary
Root-knot nematodes (Meloidogyne spp.) are responsible for various significant crop losses, which require taking integrated control measures. The present study aimed to identify a possible sustainable approach to the management of Meloidogyne javanica in vegetable crops using an organic compound based on pequi (Caryocar brasiliense) fruit residues. A pot experiment was conducted using cultivars of tomato and lettuce susceptible to M. javanica, with three amendments including inorganic fertiliser, cattle manure and five doses of organic compost with pequi residues. All treatments were inoculated with second-stage juveniles of M. javanica to simulate the root-knot nematode disease in field conditions. Increasing doses of organic compost with pequi residues from 5 kg m−3 to 30 kg m−3 promoted a significant decrease in the nematode population in both cultures evaluated. Organic compost (30 kg m−3) reduced the numbers of galls and eggs of M. javanica by 41.6 and 46.5% in tomato roots, and by 80.3 and 59.2% in lettuce roots, respectively, compared with non-treated control. Organic compost also increased crop development considerably. In general, there was a 43.0% increase in plant development compared to non-treated control. Hence, organic compost of pequi residues could be an alternative to toxic chemical nematicides and recommended as eco-friendly management of M. javanica in vegetable crops.
A Missing Link in a Thousand and One Nights Scholarship: A Narrative Grammar for the Frame Tale?
Authors: al-Musawi Muhsin 
Published: May 2021

Abstract
This article argues that scholarship has been missing the pre-Scheherazade dynamic scenes that set the stage for further action and narrative. These preludinal sites function as the stepping stone for action, a series of encounters that initiate and perpetuate instability and disequilibrium. It draws attention to the unnamed queens as prototypes for Scheherazade, the abducted bride, the three ladies of Baghdad, and many other women in unfolding varieties of rebellion or compromise. As there is little talk and more voyeurism in this prelude with its focus on the bedroom and garden scenes, readers and kings are spectators, and the spectacle unfolds as in cinematic close-ups. Hence, this significant turn to the spectacle contravenes common approaches to the frame tale as only an enveloping framework that accommodates an ongoing marvelous story-machine. Although cursorily passed on in scholarship, the bedroom and garden scenes offer us not only a powerful incitement for action, but also a sweeping challenge to authority which the named kings could hardly overcome. The discussion re-situates sites of trial and defiance in context of a flowing narrative. The article proposes therefore to come up with a narrative grammar that engages with current narratology.
Country of Words: Palestinian Literature in the Digital Age of the Refugee
Authors: Abu-Remaileh Refqa 
Published: May 2021

Abstract
The article reflects on how to embrace the unconventional, fragmented, scattered, transnational, exilic, and refugee elements of Palestinian Literature. Placing the refugees at the heart of the story of Palestinian literature raises serious questions about the compatibility of the national framework as the primary mode of analysis. The article explores the anatomy of Palestinian literature, including the wide array of sources, literary detective work, and expanded methodological toolbox needed to gather its fragments, and illustrates the potential of the digital sphere—drawing on the world of Digital Humanities—to house, express and visualize the data-fragments of Palestinian literature.
A Synoptic Evolution Comparison of the Smallest and Largest MCSs in Subtropical South America between Spring and Summer
Authors: Piersante Jeremiah O. , Rasmussen Kristen L. , Schumacher Russ S. , Rowe Angela K. , McMurdie Lynn A. 
Published: May 2021

AbstractSubtropical South America (SSA) east of the Andes Mountains is a global hotspot for mesoscale convective systems (MCSs). Wide convective cores (WCCs) are typically embedded within mature MCSs, contribute over 40% of SSA’s warm-season rainfall, and are often associated with severe weather. Prior analysis of Tropical Rainfall Measuring Mission (TRMM) Precipitation Radar (PR) data identified WCCs in SSA and associated synoptic conditions during austral summer. As WCCs also occur during the austral spring, this study uses the 16-year TRMM PR dataset and ERA5 reanalysis to compare anomalies in environmental conditions between austral spring (SON) and summer (DJF) for the largest and smallest WCCs in SSA. During both seasons, large WCCs are associated with an anomalous mid-level trough that slowly crosses the Andes Mountains and a northerly South American low-level jet (SALLJ) over SSA, though the SON trough and SALLJ anomalies are stronger and located farther northeastward than in DJF. A synoptic pattern evolution resembling large WCC environments is illustrated through a multi-day case during the RELAMPAGO field campaign (10-13 November 2018). Unique high-temporal resolution soundings showed strong mid-level vertical wind shear associated with this event, induced by the juxtaposition of the northerly SALLJ and southerly near-surface flow. It is hypothesized that the Andes help create a quasi-stationary trough/ridge pattern such that favorable synoptic conditions for deep convection persist for multiple days. For the smallest WCCs, anomalously weaker synoptic-scale forcing was present compared to the largest events, especially for DJF, pointing to future work exploring MCS formation under weaker synoptic conditions.
Urgency of Esophageal Foreign Body Removal: Differentiation Between Coins and Button Cell Batteries
Authors: Safavi Arash R. , Brook Christopher D. , Sakai Osamu , Setty Bindu N. , Zumwalt Ann , Gonzalez Mauricio , Platt Michael P. 
Published: May 2021

ObjectiveCoin‐shaped button battery foreign bodies have a similar initial presentation to coin ingestion, but delayed retrieval of a battery from the esophagus can have devastating consequences. Variations in timing of retrieval for children with ingestion of coin foreign bodies have been reported. The study assesses the sensitivity and specificity of conventional and digital radiographs to differentiate button batteries from coin foreign bodies.Study Design3B case control study.Study SettingTertiary academic medical center.MethodsA radiographic study of the 12 most common commercially available button batteries and 66 coins of varying international origins was performed. Foreign bodies were placed at the cervical esophagus of a cadaver, and anteroposterior (AP) and lateral conventional radiographs of the neck were obtained. Digital AP and lateral radiographs of standalone coins and batteries were also obtained. Images were blindly read by 2 otolaryngologists and 2 radiologists. Statistical analysis was performed to determine accuracy in identifying coins vs batteries.ResultsUsing conventional radiographs to identify button batteries yielded a sensitivity of 0.88 and a specificity of 0.92 (positive predictive value [PPV] = 0.75, negative predictive value [NPV] = 0.97). Digital radiography yielded an overall sensitivity of 0.98 and specificity of 0.97 (PPV = 0.87, NPV = 0.99). Features of button batteries were only seen on AP conventional radiographs using reverse contrast.ConclusionsNeither conventional nor digital radiographic imaging had perfect accuracy in identifying coins vs batteries. Features of common disc batteries were identified, which may aid in diagnosis. With potential devastating consequences from retained battery in the esophagus, emergent removal of any possible disc battery foreign body should be considered.
The Effect of the COVID‐19 Pandemic on Pediatric Tympanostomy Tube Placement
Authors: Diercks Gillian R. , Cohen Michael S. 
Published: May 2021

ObjectiveTo evaluate how the coronavirus disease 2019 (COVID‐19) pandemic has affected tympanostomy tube placement and practice patterns.Study DesignA retrospective review of billing data.SettingA large‐volume practice with both community and tertiary care providers.MethodsAs part of a quality initiative, billing data were queried to identify children <18 years of age who underwent tympanostomy tube placement between January 2019 and December 2020. Patient age, practice location, and case numbers were gathered.ResultsThe study included data from 2652 patients. Prior to state‐mandated clinic and operating room restrictions, there were no significant differences in the number of tympanostomy tubes placed (P =. 64), including month‐to‐month comparisons, the distribution of patients being cared for at community vs tertiary care sites (P =. 63), or patient age at the time of surgery (P =. 97) between 2019 and 2020. After resumption of outpatient clinical and elective surgical activities, the number of tympanostomy tubes placed decreased significantly between 2019 and 2020 (831 vs 303 cases, P =. 003), with a persistent month‐to‐month difference. In addition, patients undergoing tube placement were older (4.5 vs 3.2 years, P <. 001). The distribution of cases performed in the community setting decreased during this time period as well (P <. 001).ConclusionDuring the COVID‐19 pandemic, the rate of pediatric tympanostomy tube placement has significantly decreased. The age of patients undergoing surgery has increased, and more children are being cared for in a tertiary setting. These findings may reflect changes in the prevalence of acute and chronic otitis media as the result of the pandemic.