bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac index predicts long-term outcomes in patients with heart failure
Authors: Ibe Tatsuro , Wada Hiroshi , Sakakura Kenichi , Ugata Yusuke , Maki Hisataka , Yamamoto Kei , Seguchi Masaru , Taniguchi Yousuke , Jinnouchi Hiroyuki , Fujita Hideo 
Published: June 2021

BackgroundThe role of cardiac index (CI) and right atrial pressure (RAP) for predicting long-term outcomes of heart failure has not been well established. The aim of this study was to investigate long-term cardiac outcomes in patients with heart failure having various combinations of CI and RAP.MethodsA total of 787 heart failure patients who underwent right-heart catheterization were retrospectively categorized into the following four groups: Preserved CI (≥2.5 L/min/m2) and Low RAP (<8 mmHg) (PRE-CI/L-RAP; n = 285); Preserved CI (≥2.5 L/min/m2) and High RAP (≥8 mmHg) (PRE-CI/H-RAP; n = 242); Reduced CI (<2.5 L/min/m2) and Low RAP (<8 mmHg) (RED-CI/L-RAP; n = 123); and Reduced CI (<2.5 L/min/m2) and High RAP (≥8 mmHg) (RED-CI/H-RAP; n = 137). Survival analysis was applied to investigate which groups were associated with major adverse cardiovascular events (MACE).ResultsThe RED-CI/L-RAP and RED-CI/H-RAP groups were significantly associated with MACE as compared with the PRE-CI/L-RAP and PRE-CI/H-RAP groups after adjustment for confounding factors (RED-CI/L-RAP vs. PRE-CI/L-RAP: HR 2.11 [95% CI 1.33–3.37],p= 0.002; RED-CI/H-RAP vs. PRE-CI/L-RAP: HR 2.18 [95% CI 1.37–3.49],p= 0.001; RED-CI/L-RAP vs. PRE-CI/H-RAP: HR 1.86 [95% CI 1.16–3.00],p= 0.01; RED-CI/H-RAP vs. PRE-CI/H-RAP: HR 1.92 [95% CI 1.26–2.92],p= 0.002), whereas the difference between the RED-CI/H-RAP and RED-CI/L-RAP groups was not significant (HR 1.03 [95% CI 0.64–1.66],p= 0.89).ConclusionsThe hemodynamic severity categorized by CI and RAP levels provided clear risk stratification in patients with symptomatic heart failure. Low CI was an independent predictor of long-term cardiac outcomes.
External validation of a claims-based model to predict left ventricular ejection fraction class in patients with heart failure
Authors: Mahesri Mufaddal , Chin Kristyn , Kumar Abheenava , Barve Aditya , Studer Rachel , Lahoz Raquel , Desai Rishi J. 
Published: June 2021

Background
Ejection fraction (EF) is an important prognostic factor in heart failure (HF), but administrative claims databases lack information on EF. We previously developed a model to predict EF class from Medicare claims. Here, we evaluated the performance of this model in an external validation sample of commercial insurance enrollees.

Methods
Truven MarketScan claims linked to electronic medical records (EMR) data (IBM Explorys) containing EF measurements were used to identify a cohort of US patients with HF between 01-01-2012 and 10-31-2019. By applying the previously developed model, patients were classified into HF with reduced EF (HFrEF) or preserved EF (HFpEF). EF values recorded in EMR data were used to define gold-standard HFpEF (LVEF ≥45%) and HFrEF (LVEF<45%). Model performance was reported in terms of overall accuracy, positive predicted values (PPV), and sensitivity for HFrEF and HFpEF.

Results
A total of 7,001 HF patients with an average age of 71 years were identified, 1,700 (24.3%) of whom had HFrEF. An overall accuracy of 0.81 (95% CI: 0.80–0.82) was seen in this external validation sample. For HFpEF, the model had sensitivity of 0.96 (95%CI, 0.95–0.97) and PPV of 0.81 (95% CI, 0.81–0.82); while for HFrEF, the sensitivity was 0.32 (95%CI, 0.30–0.34) and PPV was 0.73 (95%CI, 0.69–0.76). These results were consistent with what was previously published in US Medicare claims data.

Conclusions
The successful validation of the Medicare claims-based model provides evidence that this model may be used to identify patient subgroups with specific EF class in commercial claims databases as well.
The Interplay Between Tax Havens, Geographic Disclosures and Corporate Tax Avoidance: Evidence from European Union
Authors: Kobbi-Fakhfakh Sameh 
Published: June 2021

Abstract
This study examines the interplay between tax haven use, geographic disclosures and corporate tax avoidance. Based on a panel of 497 non-financial EU listed firms during the period 2006–2012, we provide evidence that corporate groups with affiliates in tax havens tend to have lower effective tax rates and lower geographic disclosures fineness scores. We, also, find a positive association between geographic disclosures fineness scores and the firms’ effective tax rates. We, further, find that the negative association between tax haven use and the effective tax rate is more pronounced for firms disclosing geographic information at a more aggregated level, showing a moderating effect of geographic disclosures fineness on such association. Our findings are based upon hand-collected data on corporate geographical dispersion, and corroborated by several additional and robustness tests. The research results should be of concern to policymakers and others interested in multinational companies’ segment reporting practices and tax planning activities.
Efficacy of individualized homeopathic medicines in primary dysmenorrhea: a double-blind, randomized, placebo-controlled, clinical trial
Authors: Ghosh Shubhamoy , Ravindra Rai Khushboo , Modak Amila , Maiti Shukdeb , Nath Arunava , Koley Munmun , Saha Subhranil 
Published: June 2021

Abstract

Objectives
Homeopathic treatment is claimed to be beneficial for primary dysmenorrhoea (PD); still, systematic research evidences remain compromised. This study was undertaken to examine the efficacy of individualized homeopathic medicines (IH) against placebo in the treatment of PD.

Methods
A double-blind, randomized, placebo-controlled trial was conducted at the gynecology outpatient department of Mahesh Bhattacharyya Homoeopathic Medical College and Hospital, West Bengal, India. Patients were randomized to receive either IH (n=64) or identical-looking placebo (n=64). Primary and secondary outcome measures were 0–10 numeric rating scales (NRS) measuring intensity of pain of dysmenorrhea and verbal multidimensional scoring system (VMSS) respectively; all measured at baseline, and every month, up to 3 months. Group differences and effect sizes (Cohen’s d) were calculated on intention-to-treat (ITT) sample.

Results
Groups were comparable at baseline (all p>0.05). Attrition rate was 10.9% (IH: 7, placebo: 7). Differences between groups in both pain NRS and VMSS favoured IH over placebo at all time points (all p<0.001, unpaired t-tests and two-ways repeated measures analysis of variance) with medium to large effect sizes. Natrum muriaticum and Pulsatilla nigricans (n=20 each; 15.6%) were the most frequently prescribed medicines. No harms, serious adverse events and intercurrent illnesses were recorded in either of the groups.

Conclusions
Homeopathic medicines acted significantly better than placebo in the treatment of PD. Independent replication is warranted. Trial registration: CTRI/2018/10/016013.
Review on nonlinearity effect in radio over fiber system and its mitigation
Authors: Jain Vishal , Bhatia Richa 
Published: June 2021

Abstract
Modern communication generation for high data rate requirement is fifth generation. The fifth generation has many advantages like low delay, high spectrum availability, high reliability, low jitter, and more capacity. To combat with the high capacity and high data rate requirement, optical fiber helps in the backhaul of 5G network. When fiber is used as a mode of propagation, many nonlinearities arises. This nonlinearity effect in the optical fiber communication is one of the most undesirable phenomena for the modern communication system which results in harmonic distortion, intermodulation distortion, phase distortion, and adjacent channel interference, etc. In most fiber optic communication systems, the major fiber nonlinear effect is the Kerr nonlinearity and Scattering effect that produced due to the variation of refractive index due to signal intensity. To minimize the effect of nonlinear distortion, some techniques are used which considerably improve the transmission capacity by reducing or compensating the effect of nonlinear distortion along with minimal infrastructure modifications and minimum cost for implementation. To overcome the effect of nonlinearity, fiber nonlinearity mitigation techniques are preferred to achieve the significant performance gains. Mitigation techniques can be implemented to improve and optimize the performance of optical communication network. In this paper, a brief description of the fiber nonlinearity effect and a review of various fiber nonlinearity compensation techniques are described.
Evaluation of the Durability of Hydrophobic Treatments on Concrete Architectural Heritage
Authors: Lucquiaud V. , Courard L. , Gérard O. , Michel F. , Handy M. , Aggoun S. , Cousture A. 
Published: June 2021

Abstract
The protection of historical concrete structures is a challenge for the coming years. Hydrophobic treatment may reduce the deterioration process while providing protection against water penetration. Existing commercial products - mainly silane or siloxane in either water or solvent based formulations - were submitted to different ageing processes including UV radiation, dry-wet cycles, thermal shocks, freeze-thaw cycles, carbonation and their effectiveness has been evaluated on the basis of contact angle, vapour and chloride permeability and, capillarity water absorption. The results obtained clearly show that hydrophobic treatments display a good behaviour under the main ageing conditions.
Adapting Hydrophobizing Impregnation Agents to the Object
Authors: Engel J. , Heinze P. , Plagge R. 
Published: June 2021

Abstract
In general, old buildings consume substantially more energy than new ones. Many historical buildings have brick-, natural stone and lavishly decorated facades that limit installation of outer insulation hence this is done on the inner side during energetic refurbishment. As a result, heat hardly gets into these walls during winter. Therefore, when driving rain penetrates into the facade in winter months, moisture cannot properly dry out and consequently, such facades remain wet for a very long time cooling down extremely, which increases the potential for frost damages. A solution is to match the degree of water repellency of the existing building materials in the specific construction with its driving rain load as well as to the properties of the chosen interior insulation. This should be done under the premise of a minimum intervention, i.e., do as much as necessary but as little as possible. One example is thoroughly discussed to illustrate this approach.
Life Cycle Cost Analysis on Impregnated Bridge Edge Beams
Authors: During O. , Malaga K. 
Published: June 2021

Abstract
The aim of this study is to perform a life cycle cost analysis (LCC), where the economic cost of extending service life by the impregnation of bridge edge beams is compared to the reparation of an edge beam. Previous economic analyses on bridge edge beams had shown that there was no clear economic benefit in impregnating the edge beams. However, results from this study pointed out that in most cases there is a clear economic benefit to impregnate the bridge edge beams even if it has to be repeated every 15 years.
The impact of COVID-19 on diagnostic biomarkers in neuropsychiatric and neuroimmunological diseases: a review
Authors: Dadkhah Masoomeh , Talei Sahand , Doostkamel Donya , Molaei Soheila , Rezaei Nima 
Published: June 2021

Abstract
Coronavirus disease 2019 (COVID-19) is an infectious respiratory disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Evidence-based emerging reports of neurological manifestations show that SARS-CoV-2 can attack the nervous system. However, little is known about the biomarkers in disease in neuropsychiatric and neuroimmunological disorders. One of the important keys in the management of COVID-19 is an accurate diagnosis. Biomarkers could provide valuable information in the early detection of disease etiology, diagnosis, further treatment, and prognosis. Moreover, ongoing investigations on hematologic, biochemical, and immunologic biomarkers in nonsevere, severe, or fatal forms of COVID-19 patients provide an urgent need for the identification of clinical and laboratory predictors. In addition, several cytokines acting through mechanisms to emerge immune response against SARS-CoV-2 infection are known to play a major role in neuroinflammation. Considering the neuroinvasive potential of SARS-CoV-2, which can be capable of triggering a cytokine storm, the current evidence on inflammation in psychiatry and neurodegenerative by emerging neuroinflammation is discussed in this review. We also highlighted the hematologic, biochemical, and immunologic biomarkers in COVID-19 diagnosis. COVID-19 prognostic biomarkers in patients with neuropsychiatric and neuroimmunological diseases are also explained.
Die Kraft der Bilder
Authors: Haußmann Annette 
Published: June 2021

ZusammenfassungBilder sind allgegenwärtig in digitaler Kommunikation, insbesondere in sozialen Medien. Sie fungieren als Gefühls- und Bedeutungsträger, illustrieren und transzendieren die alltägliche Lebenswelt und eröffnen spirituelle Dimensionen. Als Form der Selbstmitteilung und Selbstdarstellung sind sie auch auf persönliche Begegnung angelegt, fördern Emotionsreaktionen und regen interaktive Prozesse an. Insofern generieren sich über statische und bewegte Bilder und die Praxis des Bildteilens neue digitale Gemeinschaften, die das Potenzial zur gegenseitigen Sorge und zum Austausch über Spiritualität und spirituelle Praxis bergen. Diese Prozesse gilt es wahrzunehmen und die Chancen visueller Kommunikation für Spiritual Care und Seelsorge auszuloten.
Pretreatment of diabetic aged rats with combination of ginsenoside-Mc1 and silibinin protects liver from ischemia-reperfusion injury through an AMPK-dependent mechanism
Authors: Wang Hao , Zhu Jiali , Jia Zhe , Lu Sucai 
Published: June 2021

Abstract

Objectives
This study evaluated the protective efficacy of combination treatment with ginsenoside-Mc1 and silibinin against hepatic ischemia-reperfusion (IR) injury in diabetic-aged rats, and further explored AMPK’s role in this protection.

Methods
A high-fat diet/streptozotocin was used to induce type-2 diabetes in aged rats (20–24 months). Diabetic-aged rats were pretreated with ginsenoside-Mc1 (10 mg/kg, IP) and silibinin (50 mg/kg, IP), alone or in combination, for 4 weeks before induction of hepatic IR injury.

Results
Induction of IR injury in diabetic-aged rats significantly elevated plasma levels of hepatic alanine and aspartate aminotransferases and negatively affected liver histology. Levels of 8-isoprostane, ROS production, Bax, and cleaved-caspase-3 expression were higher and manganese-superoxide dismutase (MnSOD), glutathione, and Bcl2 and p-AMPK were lower in IR-receiving group. In comparison to individual treatments, the combination of ginsenoside-Mc1 and silibinin powerfully restored IR-induced changes in liver enzymes and histopathological indices, oxidative markers, AMPK, and apoptotic protein expressions. Inhibition of AMPK using compound-C in H2O2-stimulated HepG2 cells significantly abolished the protective effects of combination treatment.

Conclusions
Combination of ginsenoside-Mc1 and silibinin was superior to their alone usage in protecting hepatocytes of diabetic-aged rats from oxidative/apoptotic damages following IR injury, through an AMPK-mediated mechanism.
Acute hypoglycemia and risk of cardiac arrhythmias in insulin-treated type 2 diabetes and controls
Authors: Andersen Andreas , Bagger Jonatan I , Baldassarre Maria P A , Christensen Mikkel B , Abelin Kirsten U , Faber Jens , Pedersen-Bjergaard Ulrik , Holst Jens J , Lindhardt Tommi B , Gislason Gunnar , Knop Filip K , Vilsbøll Tina 
Published: June 2021

Objective
Hypoglycemia is associated with an increased risk of cardiovascular disease including cardiac arrhythmias. We investigated the effect of hypoglycemia in the setting of acute glycemic fluctuations on cardiac rhythm and cardiac repolarization in insulin-treated patients with type 2 diabetes compared with matched controls without diabetes.

Design
A non-randomized, mechanistic intervention study.

Methods
Insulin-treated patients with type 2 diabetes (n = 21, age (mean ± s.d.): 62.8 ± 6.5 years, BMI: 29.0 ± 4.2 kg/m2, HbA1c: 6.8 ± 0.5% (51.0 ± 5.4 mmol/mol)) and matched controls (n = 21, age: 62.2 ± 8.3 years, BMI 29.2 ± 3.5 kg/m2, HbA1c: 5.3 ± 0.3% (34.3 ± 3.3 mmol/mol)) underwent a sequential hyperglycemic and hypoglycemic clamp with three steady-states of plasma glucose: (i) fasting plasma glucose, (ii) hyperglycemia (fasting plasma glucose +10 mmol/L) and (iii) hyperinsulinemic hypoglycemia (plasma glucose < 3.0 mmol/L). Participants underwent continuous ECG monitoring and blood samples for counterregulatory hormones and plasma potassium were obtained.

Results
Both groups experienced progressively increasing heart rate corrected QT (Fridericia’s formula) interval prolongations during hypoglycemia ((∆mean (95% CI): 31 ms (16, 45) and 39 ms (24, 53) in the group of patients with type 2 diabetes and controls, respectively) with similar increases from baseline at the end of the hypoglycemic phase (P = 0.43). The incidence of ventricular premature beats increased significantly in both groups during hypoglycemia (P = 0.033 and P < 0.0001, respectively). One patient with type 2 diabetes developed atrial fibrillation during recovery from hypoglycemia.

Conclusions
In insulin-treated patients with type 2 diabetes and controls without diabetes, hypoglycemia causes clinically significant and similar increases in cardiac repolarization that might increase vulnerability for serious cardiac arrhythmias and sudden cardiac death.
Intralipid therapy and adverse reproductive outcome: is there any evidence?
Authors: Kumar Parijot , Marron Kevin , Harrity Conor 
Published: June 2021

Controversy exists regarding the benefits of intravenous intralipid therapy in patients with a poor reproductive history. It is frequently reported that there is no evidence to support the effectiveness, utility or safety for this treatment. While individual studies may be perceived as weak, a systematic review and meta-analysis were performed to determine if there is any advantage to patients. PubMed, Embase and Scopus searches were performed with the target populations being either recurrent pregnancy loss (RPL), or recurrent implantation failure (RIF) undergoing assisted reproductive technology (ART) and receiving intralipid infusions. These cohorts were compared with either placebo, no intervention or alternative treatments. The most relevant outcome measures were considered to be clinical pregnancy rate (CPR), live birth rate (LBR), implantation rate (IR) and miscarriage rate (MR). Twelve studies encompassing 2676 participants met the criteria for selection and were included and reviewed. Treatment of the target population with intralipid led to an improvement in IR (Odds Ratio (OR): 2.97, 2.05–4.29), pregnancy rate (OR: 1.64, 1.31–2.04), and LBR (OR: 2.36, 1.75–3.17), with a reduction in MR (OR: 0.2, 0.14–0.30). Although intravenous intralipid is not recommended as a routine treatment for recurrent miscarriage or implantation failure, there is enough data to suggest consideration in selected patients where routine testing is unremarkable, standard treatments have failed and immunological risk factors are present. The presence of abnormal uterine natural killer (uNK) cells needs more study as a target marker to determine those who could benefit.

Lay summary
There is controversy regarding the benefits and efficacy of intravenous intralipid therapy in patients with a poor reproductive history. It is frequently reported that there is no credible evidence to support their use. A situation we frequently face as medical professionals is patients asking us to consider immune therapy (such as intralipid) for reproductive failure where good quality embryos have been used. Intralipid infusions have been reported to improve pregnancy rates with IVF, and reduce the miscarriage risk in selected patient groups, but study results are not universally accepted. We have performed a detailed review and analysis of the literature to determine if there is any benefit to this immune treatment in specific patient groups. Our paper identified and analyzed 12 studies, finding that treatment with intravenous intralipid leads to an improvement in implantation, pregnancy and live birth rates, with a decrease in miscarriage rate. This study shows that there is evidence to suggest consideration of intralipid in certain patients where standard treatments have failed.
An Initiative to Decrease Laboratory Testing in a NICU
Authors: Klunk Christopher J. , Barrett Renee E. , Peterec Steven M. , Blythe Eleanor , Brockett Renee , Kenney Marta , Natusch Amber , Thursland Caitlin , Gallagher Patrick G. , Pando Richard , Bizzarro Matthew J. 
Published: June 2021

BACKGROUND AND OBJECTIVES
Laboratory testing is performed frequently in the NICU. Unnecessary tests can result in increased costs, blood loss, and pain, which can increase the risk of long-term growth and neurodevelopmental impairment. Our aim was to decrease routine screening laboratory testing in all infants admitted to our NICU by 20% over a 24-month period.

METHODS
We designed and implemented a multifaceted quality improvement project using the Institute for Healthcare Improvement’s Model for Improvement. Baseline data were reviewed and analyzed to prioritize order of interventions. The primary outcome measure was number of laboratory tests performed per 1000 patient days. Secondary outcome measures included number of blood glucose and serum bilirubin tests per 1000 patient days, blood volume removed per 1000 patient days, and cost. Extreme laboratory values were tracked and reviewed as balancing measures. Statistical process control charts were used to track measures over time.

RESULTS
Over a 24-month period, we achieved a 26.8% decrease in laboratory tests performed per 1000 patient days (∽51 000 fewer tests). We observed significant decreases in all secondary measures, including a decrease of almost 8 L of blood drawn and a savings of $258 000. No extreme laboratory values were deemed attributable to the interventions. Improvement was sustained for an additional 7 months.

CONCLUSIONS
Targeted interventions, including guideline development, dashboard creation and distribution, electronic medical record optimization, and expansion of noninvasive and point-of-care testing resulted in a significant and sustained reduction in laboratory testing without notable adverse effects.