bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ischemia From Nonculprit Stenoses Is Not Associated With Reduced Culprit Infarct Size in Patients with ST-Segment–Elevation Myocardial Infarction
Authors: Ekström Kathrine , Nielsen Julie V.W. , Nepper-Christensen Lars , Ahtarovski Kiril A. , Kyhl Kasper , Göransson Christoffer , Bertelsen Litten , Ghotbi Adam A. , Kelbæk Henning , Høfsten Dan E. , Køber Lars , Schoos Mikkel M. , Vejlstrup Niels , Lønborg Jacob , Engstrøm Thomas 
Published: May 2021

Background:
In patients with ST-segment–elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention, reperfusion injury accounts for a significant fraction of the final infarct size, which is directly related to patient prognosis. In animal studies, brief periods of ischemia in noninfarct-related (nonculprit) coronary arteries protect the culprit myocardium via remote ischemic preconditioning. Positive fractional flow reserve (FFR) documents functional significant coronary nonculprit stenosis, which may offer remote ischemic preconditioning of the culprit myocardium. The aim of the study was to investigate the association between functional significant, multivessel disease (MVD) and reduced culprit final infarct size or increased myocardial salvage (myocardial salvage index [MSI]) in a large contemporary cohort of STEMI patients.

Methods:
Cardiac magnetic resonance was performed in 610 patients with STEMI at day 1 and 3 months after primary percutaneous coronary intervention. Patients were stratified into 3 groups according to FFR measurements in nonculprit stenosis (if any): angiographic single vessel disease (SVD), FFR nonsignificant MVD (functional SVD), or FFR-significant, functional MVD.

Results:

A total of 431 (71%) patients had SVD, 35 (6%) had functional SVD, and 144 (23%) had functional MVD. There was no difference in final infarct size (mean infarct size [%left ventricular mass] SVD, 9±3%; functional SVD, 9±3%; and functional MVD, 9±3% [
P
=0.82]) or in MSI between groups (mean MSI [%left] SVD, 66±23%; functional SVD, 68±19%; and functional MVD, 69±19% [
P
=0.62]). In multivariable analyses, functional MVD was not associated with larger MSI (
P
=0.56) or smaller infarct size (
P
=0.55).

Conclusions:
Functional MVD in nonculprit myocardium was not associated with reduced culprit final infarct size or increased MSI following STEMI. This is important knowledge for future studies examining a cardioprotective treatment in patients with STEMI, as a possible confounding effect of FFR-significant, functional MVD can be discarded.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01435408 (DANAMI 3-iPOST and DANAMI 3-DEFER) and NCT01960933 (DANAMI 3-PRIMULTI).
Preparing for Military Action: Judith’s Purificatory Washing in Judith 12:7
Authors: Scales Joseph 
Published: May 2021

Abstract
In the twelfth chapter of the Book of Judith, the eponymous heroine departs from the Assyrian camp in order to bathe and pray over three successive nights. Judith’s bath has been interpreted as a ritual bath which achieves purification. Scholars have offered various reasons for Judith’s purificatory wash, but none fully account for all the details of this episode. This paper discusses the proposed solutions and offers a new suggestion to account for Judith’s bath; Judith bathes to prepare herself for the assassination of Holofernes.
A Restorative Response to Victims in Proceedings before the International Criminal Court: Reality or Chimaera?
Authors: Cuppini Alessandra 
Published: May 2021

Abstract
The integration of the framework of victims’ participation into the legal proceeding of the International Criminal Court (icc) has been seen as a transformation of the icc process beyond narrow retribution to better accommodate restorative justice (rj) values and practices. However, there is little research into whether, or how the icc metes out rj. This article argues that rj principles brought within icc emphasise the growing importance that victims’ participation in proceedings plays in achieving justice for victims. It then examines how the icc process aligns to the key elements of rj practice, namely victim-offender meeting; offender’s acknowledgement of responsibility and apology; collaborative conflict-resolution approach; victims’ healing and reconciliation; symbolic reparation and material restitution. This article demonstrates that these elements, developed to address ordinary juvenile criminality, are not structured to operate in the particular context of the icc, characterised by grave harm caused to victims and communities by mass atrocity.
Introduction
Authors: Capone Francesca , Longobardo Marco 
Published: May 2021

Abstract
The predicted expansion of international law ultimately resulted in the imposition on States of several and far reaching obligations to criminalise certain offences, in order to, inter alia, uniform States’ criminal law framework to the maximum extent possible. The aim of the special issue is to provide a forum to discuss the many and multifaceted aspects connected to obligations of domestic criminalisation, using Italy as a case study. The special issue is divided in three sections, addressing, respectively, broad issues of general application, Italy’s implementation of obligations to criminalise conducts amounting to international crimes, and further ambits of analysis (i.e. gender based violence, cyber crimes against minors and corruption).
Three Women in Time: Beatrice Edgell, Josephine Nash Curtis, and Mary Sturt
Authors: Wearden John H. 
Published: May 2021

Abstract
This article discusses research on time perception published by three women (Beatrice Edgell, Josephine Nash Curtis, and Mary Sturt) active in the early years of the 20th. Century. Edgell (On time judgment, Am. J. Psychol., 1903) was involved in psychophysical studies on the perception of brief durations, in the tradition of Vierordt and other mostly German authors. Curtis (Duration and the temporal judgment, Am. J. Psychol., 1916) provided detailed reports of introspections from participants performing timing tasks, in the manner of her supervisor, Titchener. Sturt (via the article by Oakden & Sturt, The development of the knowledge of time in children, Br. J. Psychol., 1922, an article by Sturt herself, Experiments on the estimate of duration, Br. J. Psychol. 1923, and her book The Psychology of Time, 1925) was involved in extensive developmental studies on the understanding of everyday time concepts, such as years, months, and dates, as well as other work involving variations in time judgements as a function of different conditions, such as when receiving painful stimulation.
A Modeling Investigation of the Potential Impacts of Pollution Aerosols on Hurricane Harvey
Authors: Cotton William R , Walko Robert 
Published: May 2021

AbstractWe examine the potential role of aerosol pollution on the rainfall and intensity of hurricane Harvey. For this study, we use the global model, OLAM, with aerosol estimates from the global atmospheric chemistry model GEOS-Chem. Two sets of simulations of hurricane Harvey were performed. Simulations in the first set cover the intensification phase of Harvey until initial landfall in Texas and focus on the sensitivity of storm track and intensity, while simulations in the second set examine the sensitivity of storm track and precipitation during the period after initial landfall when record flooding occurred near Houston. During each period, simulations were performed with no anthropogenic sources of aerosol, with both natural and anthropogenic aerosol sources, and with both sources enhanced ten times.During the rapid intensification phase, the results indicate that aerosol amounts had very little impact on storm motion. Moreover, very little difference was found on the intensity of the simulated storm to aerosol amounts for the no-anthropogenic vs the GEOS-Chem estimated amounts with anthropogenic sources. However, when both natural and anthropogenic aerosol amounts were enhanced ten times, the simulated storm intensity was enhanced appreciably in terms of minimum sea-level pressure.During the second period of the simulation, through which Harvey remained a tropical storm, the main result was that very little sensitivity was found in precipitation or any other TC characteristic to aerosol concentrations. We cannot definitively state why the individual convective cells did not respond to high aerosol concentrations during this phase of the storm. However, the abundant precipitation in all three simulations scavenged the vast majority of aerosol as it flowed radially inward, and we speculate that this modulated the potential impact of aerosols on the inner TC and eyewallOverall, the simulated response of hurricane Harvey to aerosols was far less spectacular than what has been simulated in the past. We conclude that this is because hurricane Harvey was a strongly dynamically-driven storm system that as a result was relatively impervious to the effects of aerosols.
CEBPA-bZip mutations are associated with favorable prognosis in de novo AML: a report from the Children’s Oncology Group
Authors: Tarlock Katherine , Lamble Adam J. , Wang Yi-Cheng , Gerbing Robert B. , Ries Rhonda E. , Loken Michael R. , Brodersen Lisa Eidenschink , Pardo Laura , Leonti Amanda , Smith Jenny L. , Hylkema Tiffany A. , Woods William G. , Cooper Todd M. , Kolb E. Anders , Gamis Alan S. , Aplenc Richard , Alonzo Todd A. , Meshinchi Soheil 
Published: May 2021

AbstractBiallelic CEBPA mutations are associated with favorable outcomes in acute myeloid leukemia (AML). We evaluated the clinical and biologic implications of CEBPA-basic leucine zipper (CEBPA-bZip) mutations in children and young adults with newly diagnosed AML. CEBPA-bZip mutation status was determined in 2958 patients with AML enrolled on Children’s Oncology Group trials (NCT00003790, NCT0007174, NCT00372593, NCT01379181). Next-generation sequencing (NGS) was performed in 1863 patients (107 with CEBPA mutations) to characterize the co-occurring mutations. CEBPA mutational status was correlated with disease characteristics and clinical outcomes. CEBPA-bZip mutations were identified in 160 (5.4%) of 2958 patients, with 132 (82.5%) harboring a second CEBPA mutation (CEBPA-double-mutated [CEBPA-dm]) and 28 (17.5%) had a single CEBPA-bZip only mutation. The clinical and laboratory features of the 2 CEBPA cohorts were very similar. Patients with CEBPA-dm and CEBPA-bZip experienced identical event-free survival (EFS) of 64% and similar overall survival (OS) of 81% and 89%, respectively (P = .259); this compared favorably to EFS of 46% and OS of 61% in patients with CEBPA-wild-type (CEBPA-WT) (both P &lt; .001). Transcriptome analysis demonstrated similar expression profiles for patients with CEBPA-bZip and CEBPA-dm. Comprehensive NGS of patients with CEBPA mutations identified co-occurring CSF3R mutations in 13.1% of patients and GATA2 mutations in 21.5% of patients. Patients with dual CEBPA and CSF3R mutations had an EFS of 17% vs 63% for patients with CEBPA-mutant or CSF3R-WT (P &lt; .001) with a corresponding relapse rate (RR) of 83% vs 22%, respectively (P &lt; .001); GATA2 co-occurrence did not have an impact on outcome. CEBPA-bZip domain mutations are associated with favorable clinical outcomes, regardless of monoallelic or biallelic status. Co-occurring CSF3R and CEBPA mutations are associated with a high RR that nullifies the favorable prognostic impact of CEBPA mutations.
Transbronchial mediastinal cryobiopsy in the diagnosis of mediastinal lesions: a randomised trial
Authors: Zhang Jing , Guo Jie-Ru , Huang Zan-Sheng , Fu Wan-Lei , Wu Xian-Li , Wu Na , Kuebler Wolfgang M. , Herth Felix J.F. , Fan Ye 
Published: May 2021

BackgroundGuidelines recommend endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) as an initial investigatory technique for mediastinal nodal staging in lung cancer. However, EBUS-TBNA can be limited by the inadequacy of intact tissues, which might restrict its diagnostic yield in mediastinal lesions of certain aetiologies. We have previously shown that EBUS-guided transbronchial mediastinal cryobiopsy can provide intact samples with greater volume.MethodsThis randomised study determined the diagnostic yield and safety of transbronchial mediastinal cryobiopsy monitored by endosonography for the diagnosis of mediastinal lesions. Patients with a mediastinal lesion of ≥1 cm in the short axis were recruited. Following identification of the mediastinal lesion by linear EBUS, fine-needle aspiration and cryobiopsy were sequentially performed in a randomised order. Primary end-points were diagnostic yield, defined as the percentage of patients for whom mediastinal biopsy provided a definite diagnosis, and procedure-related adverse events.ResultsIn total, 197 patients were enrolled and randomly allocated. The overall diagnostic yield was 79.9% and 91.8% for TBNA and transbronchial mediastinal cryobiopsy, respectively (p=0.001). Diagnostic yields were similar for metastatic lymphadenopathy (94.1%versus95.6%, p=0.58), while cryobiopsy was more sensitive than TBNA in uncommon tumours (91.7%versus25.0%, p=0.001) and benign disorders (80.9%versus53.2%, p=0.004). No significant differences in diagnostic yield were detected between “TBNA first” and “Cryobiopsy first” groups. We observed two cases of pneumothorax and one case of pneumomediastinum.ConclusionsTransbronchial cryobiopsy performed under EBUS guidance is a safe and useful approach that offers diagnostic histological samples of mediastinal lesions.
Association of performance in a stair-climbing test with complications and survival after lung cancer resection in the video-assisted thoracoscopic surgery era: population-based outcomes
Authors: Helminen Olli , Valo Johanna , Andersen Heidi , Söderström Johan , Sihvo Eero 
Published: May 2021

IntroductionWith a population-based cohort in the video-assisted thoracoscopic surgery (VATS) era, we aimed to evaluate the value of the stair-climbing test (SCT) on short- and long-term outcomes of lung cancer surgery.MethodsAll patients operated due to primary lung cancer in Central Finland and Ostrobothnia from 2013 to June 2020 were included. For the analysis, clinical variables including the outcome of SCT and cause-specific mortality were available. Short- and long-term outcomes were compared between <11 m (n=66) and >12 m SCT (n=217) groups.ResultsPatients with poor performance (<11 m) had more comorbidities and worse lung function but did not differ in tumour stage or treatment. No differences between groups were observed in major morbidity rate (10.6%versus11.1%, p=0.918) or median hospital stay (5 (IQR 4–7)versus4 (IQR 3–7), p=0.179). At 1-year, fewer patients were alive and living at home in the climbing <11 m group (81.3%) compared to the >12 m group (94.2%), p=0.002. No difference was observed in cancer-specific 5-year survival. Non-cancer-specific survival (62.9%versus83.1%, p<0.001) and overall survival (49.9%versus70.0%, p<0.001) were worse in the <11 m group. After adjustment for confounding factors, SCT remained as a significant predictor for non-cancer-specific (HR 4.28; 95% CI 2.10–8.73) and overall mortality (HR 2.38; 95% CI 1.43–3.98).ConclusionsWith SCT-based exercise testing, VATS can be performed safely, with a similar major morbidity rate in the poor performance group (<11 m) compared to >12 m group. Poor exercise performance increases non-cancer-specific mortality. Being a major predictor of survival, exercise capacity should be included in prognostic models.
Can perioperative hemodilution be monitored with non-invasive measurement of blood hemoglobin?
Authors: Hahn Robert G. , Wuethrich Patrick Y. , Zdolsek Joachim H. 
Published: May 2021

Abstract
Background
Trends in non-invasive measurements of blood hemoglobin (Hb) may be useful for identifying the need for transfusion in the perioperative period.

Methods
Crystalloid fluid (5–20 mL/kg) was administered intravenously or by mouth to 30 volunteers and 33 surgical patients in five non-randomized clinical studies where Hb was measured on 915 occasions by non-invasive (Radical-7™) and invasive methodology. The hemodilution curves were compared by volume kinetic analysis and linear regression, with the slope and scattering of the data as key outcome measures.

Results
The slope was 1.0, indicating unity between the two modes of measuring Hb when crystalloid fluid was infused in volunteers; however, only 40–45% of the variability in the non-invasive Hb could be explained by the invasive Hb. Patients undergoing major surgery, who showed the most pronounced hemodilution (median 24 g/L); non-invasive Hb explained 72% of the variability but indicated only half the magnitude of the invasive Hb changes (slope 0.48, P < 0.001 versus the volunteers). Simulations based on volume kinetic parameters from the volunteers showed 25% less plasma volume expansion after infusion when based on non-invasive as compared to invasive Hb, while no difference was found during infusion.

Conclusions
In volunteers the non-invasive Hb had good accuracy (low bias) but poor precision. In surgical patients the non-invasive Hb had good precision but systematically underestimated the hemodilution. Despite severe limitations, the non-invasive technology can be used to follow Hb trends during surgery if supported by occasional invasive measurements to assure acceptable quality of the hemodilution curve.

Trial registrations
ControlledTrials.gov NCT01195025, NCT01062776, NCT01458678, NCT03848507, and NCT01360333 on September 3, 2010, February 4, 2010, October 25, 2011, February 20, 2019, and May 25, 2011, respectively.
A strategy for optimal fitting of multiplicative and additive hazards regression models
Authors: Lefebvre François , Giorgi Roch 
Published: May 2021

AbstractBackgroundIn survival analysis, data can be modeled using either a multiplicative hazards regression model (such as the Cox model) or an additive hazards regression model (such as Lin’s or Aalen’s model). While several diagnostic tools are available to check the assumptions underpinning each type of model, there is no defined procedure to fit these models optimally. Moreover, the two types of models are rarely combined in survival analysis. Here, we propose a strategy for optimal fitting of multiplicative and additive hazards regression models in survival analysis.MethodsThis section details our proposed strategy for optimal fitting of multiplicative and additive hazards regression models, with a focus on the assumptions underpinning each type of model, the diagnostic tools used to check these assumptions, and the steps followed to fit the data. The proposed strategy draws on classical diagnostic tools (Schoenfeld and martingale residuals) and less common tools (pseudo-observations, martingale residual processes, and Arjas plots).ResultsThe proposed strategy is applied to a dataset of patients with myocardial infarction (TRACE data frame). The effects of 5 covariates (age, sex, diabetes, ventricular fibrillation, and clinical heart failure) on the hazard of death are analyzed using multiplicative and additive hazards regression models. The proposed strategy is shown to fit the data optimally.ConclusionsSurvival analysis is improved by using multiplicative and additive hazards regression models together, but specific steps must be followed to fit the data optimally. By providing different measures of the same effect, our proposed strategy allows for better interpretation of the data.
Evaluating the measures taken to contain a Candida auris outbreak in a tertiary care hospital in South India: an outbreak investigational study
Authors: Sathyapalan Dipu Thareparambil , Antony Remya , Nampoothiri Vrinda , Kumar Anil , Shashindran Nandita , James Jini , Thomas Jisha , Prasanna Preetha , Sudhir Akkulath Sangita , Philip Jeslyn Mary , Edathadathil Fabia , Prabhu Binny , Singh Sanjeev , Moni Merlin 
Published: May 2021

Abstract
Background
Candida auris infections are an emerging global threat with poor clinical outcome, high mortality rate, high transmission rate and outbreak potential. The objective of this work is to describe a multidisciplinary approach towards the investigation and containment of a Candida auris outbreak and the preventive measures adopted in a resource limited setting.

Methods
This outbreak investigational study was conducted at a 1300-bedded tertiary care academic hospital in South India. The study included 15 adult inpatients with laboratory confirmed Candida auris isolates. The outbreak cluster was identified in adult patients admitted from September 2017 to 2019. The system response consisted of a critical alert system for laboratory confirmed Candida auris infection and multidisciplinary ‘Candida auris care team’ for patient management. The team implemented stringent Infection Prevention and Control (IPC) measures including patient cohorting, standardized therapy and decolonization, staff training, prospective surveillance and introduction of Candida auris specific care bundle.

Results
Two outbreak clusters were identified; first cluster occurring between October and November 2017 and the second cluster in May 2018. The cohorts consisted of 7 and 8 Candida auris positive patients in the first and second waves of the outbreak respectively with a total survival rate of 93% (14/15). Deployment of containment measures led to gradual decline in the incidence of adult Candida auris positive cases and prevented further cluster formation.

Conclusions
The sustained implementation of guideline and evidence-based IPC measures and training of healthcare workers for improving awareness on systematically following standardized protocols of Candida auris related IPC practices successfully contained Candida auris outbreaks at our hospital. This demonstrates the feasibility of establishing a multidisciplinary model and bundling of practices for preventing Candida auris outbreaks in a Low- and Middle-income country.
Left atrial minimal volume: association with diastolic dysfunction and heart failure in patients in sinus rhythm or atrial fibrillation with preserved ejection fraction
Authors: Ben-Arzi Assaf , Hazanov Evgeni , Ghanim Diab , Rozen Guy , Marai Ibrahim , Grosman-Rimon Liza , Kachel Erez , Amir Offer , Carasso Shemy 
Published: May 2021

Abstract
Background
Evidence of diastolic dysfunction (DD) required for the diagnosis of heart failure with preserved ejection fraction (HFpEF) is elusive in atrial fibrillation (AF). Left ventricular (LV) and left atrial (LA) speckle-tracking echocardiography (STE) may provide rhythm independent indications of DD. We aimed to find common LV/LA myocardial mechanics parameters to demonstrate DD, using STE in patients with AF.

Methods
176 echocardiographic assessments of patients were studied retrospectively by STE. 109 patients with history of AF were divided in three groups: sinus with normal diastolic function (n = 32, ND), sinus with DD (n = 35, DD) and patients with AF during echocardiography (n = 42). These assessments were compared to 67 normal controls. Demographic, clinical, echocardiographic and myocardial mechanic characteristics were obtained.

Results
The patients with DD in sinus rhythm and patients with AF were similar in age, mostly women, and had cardiovascular risk factors as well as higher dyspnea prevalence compared to either controls or patients with ND. In the AF group, LV ejection fraction (LVEF) (p = 0.008), global longitudinal strain and LA emptying were lower (p < 0.001), whereas LA volumes were larger (p < 0.001) compared to the other groups. In a multivariable analysis of patients in sinus rhythm, LA minimal volume indexed to body surface area (Vmin-I) was found to be the single significant factor associated with DD (AUC 83%). In all study patients, Vmin-I correlated with dyspnea (AUC 80%) and pulmonary hypertension (AUC 90%).

Conclusions
Vmin-I may be used to identify DD and assist in the diagnosis of HFpEF in patients with AF.