bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deviation From Personalized Blood Pressure Targets Is Associated With Worse Outcome After Subarachnoid Hemorrhage
Authors: Silverman Andrew , Kodali Sreeja , Strander Sumita , Gilmore Emily J. , Kimmel Alexandra , Wang Anson , Cord Branden , Falcone Guido , Hebert Ryan , Matouk Charles , Sheth Kevin N. , Petersen Nils H. 
Published: September 2019

Background and Purpose—
Optimal blood pressure (BP) management during the early stages of aneurysmal subarachnoid hemorrhage remains uncertain. Observational studies have found worse outcomes in patients with increased hemodynamic variability, suggesting BP optimization as a potential neuroprotective strategy. In this study, we calculated personalized BP targets at which cerebral autoregulation was best preserved. We analyzed how deviation from these limits correlates with functional outcome.

Methods—
We prospectively enrolled 31 patients with aneurysmal subarachnoid hemorrhage. Autoregulatory function was continuously measured by interrogating changes in near-infrared spectroscopy (NIRS)-derived tissue oxygenation—a surrogate for cerebral blood flow—as well as intracranial pressure (ICP) in response to changes in mean arterial pressure using time-correlation analysis. The resulting autoregulatory indices were used to identify the upper and lower limit of autoregulation. Percent time that mean arterial pressure exceeded limits of autoregulation was calculated for each patient. Functional outcome was assessed using the modified Rankin Scale at discharge and 90 days. Associations with outcome were analyzed using ordinal multivariate logistic regression.

Results—

Personalized limits of autoregulation were computed in all patients (age 57.5±13.4, 23F, mean World Federation of Neurological Surgeons 2±1, monitoring time 67.8±50.8 hours). Optimal BP and limits of autoregulation were calculated on average for 89.5±6.7% of the total monitoring period. ICP- and NIRS-derived optimal pressures strongly correlated with one another (
P
<0.0001). Percent time that mean arterial pressure deviated from limits of autoregulation significantly associated with worse functional outcome at discharge (NIRS,
P
=0.001; ICP,
P
=0.004) and 90 days (NIRS,
P
=0.002; ICP,
P
=0.003), adjusting separately for age, World Federation of Neurological Surgeons, vasospasm, and delayed cerebral ischemia.

Conclusions—
Both invasive (ICP) and noninvasive (NIRS) determination of personalized BP targets after aneurysmal subarachnoid hemorrhage is feasible, and these 2 approaches revealed significant collinearity. Furthermore, exceeding individualized limits of autoregulation was associated with poor functional outcomes.
<p><strong><em>Murispora aquatica sp. nov.</em> and <em>Murispora fagicola</em>,<em> </em>a new record from freshwater habitat in China</strong></p>
Authors: BAO DAN-FENG , WANASINGHE DHANUSHKA N. , LUO ZONG-LONG , MORTIMER PETER E. , KUMAR VINIT , SU HONG-YAN , HYDE KEVIN D. 
Published: September 2019

We are currently studying lignicolous freshwater fungi in China. In this paper, we introduce two taxonomic accounts to the family Amniculicolaceae in Pleosporales viz. Murispora aquatica sp. nov (from Yunnan) and a new record of Murispora fagicola (from Tibet). The conclusions were derived from both morphological comparisons and the results of phylogenetic analyses (concatenated ITS, LSU, SSU and TEF1-α sequence data). The new species is compared with other existing species of Murispora and comprehensive descriptions and micro-photographs are provided.
Length Scales of Hydrological Variability as Inferred from SMAP Soil Moisture Retrievals
Authors: Koster Randal D. , Reichle Rolf H. , Schubert Siegfried D. , Mahanama Sarith P. 
Published: September 2019

Abstract
Hydrological variability at a given location is characterized in part by a horizontal length scale—a measure of how far one can travel from that location and still see similar time variations of a hydrological variable of interest. Here, using Level-2 soil moisture retrievals produced by the NASA Soil Moisture Active Passive (SMAP) mission, we compute global distributions of these length scales for the Northern Hemisphere warm and cold seasons (May–September and November–March, respectively). The length scales show significant spatial and seasonal variability, with, as expected, much larger values (e-folding scales of greater than 500 km) often seen in the cold season, when convective rainfall is less prominent. The SMAP-derived length scales are found to be largely consistent with those derived directly, where possible, from precipitation measurements. This suggests a unique value of the retrievals: outside of well-instrumented areas, satellite-based soil moisture datasets have the potential to provide otherwise unattainable estimates of the horizontal length scales of hydrological variability.
ADF Offensive Cyberspace Operations and Australian Domestic Law: Proprietary and Constitutional Implications
Authors: Evans Hywel , Williams Andrew 
Published: September 2019

AbstractAn Australian Offensive Cyberspace Operations (OCO) capability has emerged as an important sub-component of national power. While significant academic literature exists concerning OCO’s place within the international law of armed conflict, and international law in general, literature regarding domestic law is scarce. Nevertheless, an understanding of the domestic law governing the Australian Defence Force’s (ADF’s) authority to conduct OCO is necessary as the gap in the research potentially exposes the Government and individuals to legal risks that are not well understood. The aim of this article is to analyse the proprietary and constitutional implications of ADF OCO to inspire further research at a time when the Comprehensive review of the legal framework governing the National Intelligence Community is underway. The qualitative research analyses statutory and case law authorities to argue that Australian proprietary and constitutional law creates important implications for ADF OCO. The analysis suggests that these implications oblige the Commonwealth to be careful in balancing its legislative and executive power to provide the ADF with the legal authority to conduct OCO. The research finds that OCO impinges upon the proprietary rights of others, requiring legal authority which, if created under statute, generates an obligation to compensate proprietors under just terms. However, if the authority arises under the executive power, then the obligation to compensate may not apply. Further, such executive powers may exist under a royal war prerogative. As a corollary, we suggest that in an escalated conflict environment, the ADF may be able to conduct OCO without any legislative amendments to the criminal law although express immunities would be preferred.
Association Between Running Shoe Characteristics and Lower Extremity Injuries in United States Military Academy Cadets
Authors: Helton Gary L. , Cameron Kenneth L. , Zifchock Rebecca A. , Miller Erin , Goss Donald L. , Song Jinsup , Neary Michael T. 
Published: September 2019

Background: Running-related overuse injuries are very common among recreational runners, with the reported annual injury rates ranging from 39% to 85%. Relatively few large prospective cohort studies have been conducted to investigate injury risk associated with different running shoe characteristics, and the results of the existing studies are often contradictory. Purpose/Hypothesis: The purpose was to investigate the relationship between running shoe characteristics and lower extremity musculoskeletal injury. It was hypothesized that the risk of injury would be increased in individuals wearing shoes with minimal torsional stiffness and heel height compared with those wearing shoes with greater levels of torsional stiffness and heel height. Study Design: Cohort study; Level of evidence, 2. Methods: The study included 1025 incoming cadets. Shoe torsional stiffness and heel height were calculated and recorded. Demographic data were recorded and analyzed as potential covariates. Lower extremity injuries sustained over 9 weeks during cadet basic training were documented by use of the Armed Forces Health Longitudinal Technology Application and the Cadet Illness and Injury Tracking System. Kaplan-Meier survival curves were estimated, with time to incident lower extremity injury as the primary outcome by level of the independent predictor variables. Risk factors or potential covariates were carried forward into multivariable Cox proportional hazards regression models. Absolute and relative risk reduction and numbers needed to treat were calculated. Results: Approximately 18.1% of participants incurred a lower extremity injury. Cadets wearing shoes with moderate lateral torsional stiffness were 49% less likely to incur any type of lower extremity injury and 52% less likely to incur an overuse lower extremity injury than cadets wearing shoes with minimal lateral torsional stiffness, both of which were statistically significant observations. Injury risk was similar among cadets wearing shoes with minimal and extreme lateral torsional stiffness. Conclusion: Shoes with mild to moderate lateral torsional stiffness may be appropriate in reducing risk of lower extremity injury in cadets. Shoes with minimal lateral torsional stiffness should be discouraged in this population.
Quantitative analysis of extraocular muscle volume and exophthalmos reduction after radiation therapy to treat Graves’ ophthalmopathy: A pilot study
Authors: Kim Myungsoo , Chang Ji Hyun , Lee Nam Kwon 
Published: September 2019

Purpose: The aim of this study was to provide radiological information on the inherent response of Graves’ ophthalmopathy after radiation therapy. Methods: Quantitative analysis of extraocular muscle volume was performed on 96 involved extraocular muscles in a total of 16 patients. A total of 48 computed tomography images were analyzed. Exophthalmos was also measured. The percentage reductions in extraocular muscle volume and exophthalmos length were determined and compared to the pre–radiation therapy values at 6-, 12-, and 24-month follow-up. Results: The median follow-up time was 21.5 months (range: 7.2–29.4 months). The mean reduction in relative tumor volume compared to the pre–radiation therapy extraocular muscle volume was 46.1% (range: 33.3%–58.8%). The mean relative extraocular muscle volumes were 71.5% at 6 months, 59.2% at 12 months, and 54.3% at 24 months after radiation therapy. The volume of the involved extraocular muscles decreased rapidly within the first 12 months of follow-up. The mean pre–radiation therapy length of exophthalmos was 21.7 mm (range: 17.6–26.1 mm). The mean percentages of exophthalmos length by comparison with the pre–radiation therapy length were 96.7% at 6 months, 92.3% at 12 months, and 88.5% at 24 months after radiation therapy. Exophthalmos decreased slowly and steadily during the follow-up period. Conclusion: Quantitative volumetric analysis of the pattern of extraocular muscle volume reduction and exophthalmos length reduction in response to radiation therapy will allow clinicians to better understand the effect of radiotherapy on Graves’ ophthalmopathy.
Prognostic Values of Platelet-Associated Indicators in Resectable Cervical Cancer
Authors: Wang Jing-mei , Wang Ying , Huang Yue-qing , Wang Han , Zhu Jie , Shi Jian-ping , Li Yi-fan , Wang Jing-jing , Wang Wen-Jie 
Published: September 2019

Background:Cervical cancer is one of the leading causes of cancer mortality in women, which seriously threatens the health of women worldwide. Platelet (PLT)-related parameters, including PLT count, mean platelet volume (MPV), plateletcrit (PCT), and platelet distribution width (PDW), are correlated with tumor prognosis.Methods:In total, 110 patients with cervical carcinoma were recruited in this study. The patients were divided into 2 groups according to the receiver operating characteristic analysis cutoff values of PLT, MPV, PCT, or PDW. The post-/preradiotherapy ratios were defined as the rate of preradiotherapy PLT-related parameters counts and the corresponding ones obtained after radiotherapy.Results:Higher pretreatment PLT level was correlated with Higher Federation of Gynecology and Obstetrics (FIGO) stage (II). Higher pretreatment PLT level was correlated with worse progression-free survival (PFS) and overall survival (OS). Increased post-/preradiotherapy ratio of PLT was correlated with worse PFS and OS. Changes in PCT, MPV, or PDW levels had no effects on PFS or OS. Cox regression analysis model indicated that larger tumor size, higher pretreatment PLT level, and increased post-/preradiotherapy PLT ratio were independently associated with worse PFS; higher FIGO stage (II) and increased post-/preradiotherapy PLT ratio were independently associated with worse OS.Conclusion:Pretreatment PLT level and increased post-/preradiotherapy PLT ratio are correlated with outcomes of cervical cancer.
Do physical activity levels differ by number of children at home in women aged 25–44 in the general population?
Authors: Abell Laura P , Tanase Kelly A , Gilmore Madison L , Winnicki Anna E , Holmes Victor L , Hartos Jessica L 
Published: September 2019

Objectives: While physical activity is important for health, many women do not meet recommended levels, particularly mothers. The purpose of this study was to assess whether physical activity levels differ by number of children at home in women aged 25–44 in the general US population. Methods: This cross-sectional analysis used 2017 Behavioral Risk Factor Surveillance System data for females aged 25–44 (N = 6266) from California, Colorado, New York, Texas, and Utah. Ordered logistic regression analysis assessed the relationship between physical activity levels and number of children at home while controlling for state and demographic, socioeconomic, and health-related factors. Results: About half of participants reported “inactive” or “insufficiently active” physical activity levels and about two-thirds reported having one or more children at home. The results of adjusted analysis indicated that physical activity level was significantly related to having one child (adjusted odds ratio = 0.75, 95% confidence interval = 0.63, 0.89), two children (adjusted odds ratio = 0.79; 95% confidence interval = 0.67, 0.93), and three or more children (adjusted odds ratio = 0.80, 95% confidence interval = 0.67, 0.94) at home. Conclusion: Overall, physical activity levels were significantly related to presence of children at home for women aged 25–44, but increasing number of children at home did not impact effect size. For women aged 25–44 in a primary care setting, a moderate prevalence of inactive or insufficiently active physical activity may be expected. Providers should address physical activity with all patients in this target population during well-visits, but particularly for women with children at home; educate patients about the health benefits of regular physical activity; and provide resources that will help them integrate physical activity into their daily lifestyles.
Susceptibility-guided therapy for Helicobacter pylori infection treatment failures
Authors: Yu Lou , Luo Laisheng , Long Xiaohua , Liang Xiao , Ji Yingjie , Chen Qi , Song Yanyan , Li Xiaobo , Graham David Y. , Lu Hong 
Published: September 2019

Background: Empirical therapy of Helicobacter pylori frequently results in treatment failure due to unrecognized antimicrobial resistance. The aim of this study was to investigate the effectiveness of susceptibility-guided therapy for rescue treatment of H. pylori infection in China. Methods: This was a prospective study of consecutive 200 patients infected with H. pylori with one or more treatment failures. The therapy chosen was susceptibility based using the most effective, best-tolerated regimens first and a locally proven, reliably effective regimen for multidrug-resistant infections. All patients received 14-day triple therapy, i.e. esomeprazole 20 mg and amoxicillin 1 g twice a day plus clarithromycin 500 mg twice a day, metronidazole 400 mg twice a day, or levofloxacin 500 mg daily, or, for multidrug-resistant infections, amoxicillin-containing bismuth quadruple therapy with esomeprazole 20 mg twice a day, bismuth 220 mg twice a day, amoxicillin 1 g three times a day, and metronidazole 400 mg four times a day. Antibiotic resistance was determined by agar dilution. Results: The eradication rate of susceptibility-guided therapy overall was 94.5% (189/200, 95% confidence interval: 90.4–97.2%). Around 28% (56/200) of patients carried strains susceptible to one of the tested antibiotics and were prescribed the triple therapy. A total of 144 multidrug-resistant patients received bismuth quadruple therapy. The eradication rates were all greater than 90%, i.e. 91.7% (11/12), 92.3% (12/13), and 93.5% (29/31) in those who received clarithromycin, metronidazole, and levofloxacin-containing triple therapy and 95.1% (137/144) for the bismuth quadruple therapy. There were no differences in eradication rates between the subgroups. Conclusions: Although susceptibility-guided therapy proved high efficacious despite the high proportion of multidrug-resistant strains, the strategy suggested the best approach for this population would be empirical amoxicillin-containing bismuth quadruple therapy. ClinicalTrials.gov identifier: NCT03413020.
Diminished right ventricular function at diagnosis of pulmonary hypertension is associated with mortality in bronchopulmonary dysplasia
Authors: Altit Gabriel , Bhombal Shazia , Feinstein Jeffrey , Hopper Rachel K. , Tacy Theresa A. 
Published: September 2019

Pulmonary vascular disease and resultant pulmonary hypertension (PH) have been increasingly recognized in the preterm population, particularly among patients with bronchopulmonary dysplasia (BPD). Limited data exist on the impact of PH severity and right ventricular (RV) dysfunction at PH diagnosis on outcome. The purpose of this study was to evaluate if echocardiography measures of cardiac dysfunction and PH severity in BPD‐PH were associated with mortality. The study is a retrospective analysis of the echocardiography at three months or less from time of PH diagnosis. Survival analysis using a univariate Cox proportional hazard model is presented and expressed using hazard ratios (HR). We included 52 patients with BPD and PH of which 16 (31%) died at follow‐up. Average gestational age at birth was 26.3 ± 2.3 weeks. Echocardiography was performed at a median of 43.3 weeks (IQR: 39.0–54.7). The median time between PH diagnosis and death was 117 days (range: 49–262 days). Multiple measures of PH severity and RV performance were associated with mortality (sPAP/sBP: HR 1.02, eccentricity index: HR 2.02, tricuspid annular plane systolic excursion Z‐score: HR 0.65, fractional area change: HR 0.88, peak longitudinal strain: HR 1.22). Hence, PH severity and underlying RV dysfunction at PH diagnosis were associated with mortality in BPD‐PH patients. While absolute estimation of pulmonary pressures is not feasible in every screening echocardiography, thorough evaluation of RV function and other markers of PH may allow to discriminate the most at‐risk population and should be considered as standard add‐ons to the current screening at 36 weeks.
Baicalin prevents pulmonary arterial remodeling in vivo via the AKT/ERK/NF‐κB signaling pathways
Authors: Yan Guosen , Wang Jinxia , Yi Tao , Cheng Junfen , Guo Haixu , He Yuan , Shui Xiaorong , Wu Zeyong , Huang Shian , Lei Wei 
Published: September 2019

Pulmonary arterial hypertension is a rapidly progressive and often fatal disease. As the pathogenesis of pulmonary arterial hypertension remains unclear, there is currently no good drug for pulmonary arterial hypertension and new therapy is desperately needed. This study investigated the effects and mechanism of baicalin on vascular remodeling in rats with pulmonary arterial hypertension. A rat pulmonary arterial hypertension model was constructed using intraperitoneal injection of monocrotaline, and different doses of baicalin were used to treat these rats. The mean pulmonary arterial pressure (mPAP) and right ventricular systolic pressure (RVSP) were measured with a right heart catheter. Moreover, the hearts were dissected to determine the right ventricular hypertrophy index (RVHI). The lung tissues were stained with H&E and Masson's staining to estimate the pulmonary vascular remodeling and collagen fibrosis, and the expression of proteins in the AKT, ERK, and NF‐κB p65 phosphorylation (p‐AKT, p‐ERK, p‐p65) was examined by Western blot analysis. We found that compared with untreated pulmonary arterial hypertension rats, baicalin ameliorated pulmonary vascular remodeling and cardiorespiratory injury, inhibited p‐p65 and p‐ERK expression, and promoted p‐AKT and p‐eNOS expression. In conclusion, baicalin interfered with pulmonary vascular remodeling and pulmonary arterial hypertension development in rats through the AKT/eNOS, ERK and NF‐κB signaling pathways.
Outcomes of the Non-fenestrated Fontan Procedure at High Altitude
Authors: Palacios-Macedo Alexis , Díliz-Nava Héctor , Tamariz-Cruz Orlando , García-Benítez Luis , Pérez-Juárez Fabiola , Araujo-Martínez Aric , Mier-Martínez Moisés , Corona-Villalobos Carlos , Castañuela Violeta , March Almudena , López-Terrazas Javier , Cabrera Antonio G. 
Published: September 2019

Background: Although high altitude has been considered a risk factor for the Fontan operation, and an indication for fenestration, there is a paucity of data to support its routine use. Fenestration, with its necessary right to left induced shunt, together with the lower partial pressure of oxygen found with progressive altitude, can significantly decrease hemoglobin oxygen saturation, and therefore, it would be desirable to avoid it. Objective: To analyze immediate and medium-term results of the non-fenestrated, extracardiac, Fontan procedure at high altitude. Methods: Retrospective analysis of data from consecutive patients who underwent non-fenestrated, extracardiac, Fontan procedure at two institutions located in Mexico City at 2,312 m (7,585 ft) and 2,691 m (8,828 ft) above sea level. High altitude was not considered a risk factor. Results: Thirty-nine patients were included, with a mean age of 6.7 years. Mean preoperative indexed pulmonary vascular resistance was 1.7 Wood units. Seventy-nine percent of the patients extubated in the operating room. There was one in-hospital death (2.56%) and one at follow-up. Median chest tube drainage time was 6.5 and 6 days for the right and left pleural spaces. Median oxygen saturation at discharge was 90%. At a median follow-up of six months, all survivors, except one, had good tolerance to daily life activities. Conclusions: The present study shows good short- and medium-term results for the non-fenestrated, extracardiac, Fontan operation at altitudes between 2,300 and 2,700 m and might favor this strategy over fenestration to improve postoperative oxygen saturation. Further studies to examine the long-term outcomes of this approach need to be considered.