bluuebunny/crossref_metadata_2025_split huggingface dataset:
Statistical analysis plan for evaluating different intensities of blood pressure control in the ENhanced Control of Hypertension And Thrombolysis strokE stuDy
Authors: Anderson Craig S , Woodward Mark , Arima Hisatomi , Chen Xiaoying , Lindley Richard I , Wang Xia , Chalmers John , Robinson Thompson G 
Published: October 2018

Background The ENhanced Control of Hypertension And Thrombolysis strokE study (ENCHANTED) trial was initiated as a 2 × 2 partial-factorial active-comparison, prospective, randomized, open, blinded endpoint clinical trial to evaluate in thrombolysis-eligible acute ischemic stroke (AIS) patients whether: (1) Arm A – low-dose (0.6 mg/kg body weight) intravenous (iv) alteplase has noninferior efficacy and lower risk of symptomatic intracerebral hemorrhage (sICH) compared with standard-dose (0.9 mg/kg body weight) iv alteplase; and (2) Arm B – early intensive blood pressure (BP) lowering (systolic target 130–140 mmHg) has superior efficacy and lower risk of ICH compared with guideline-recommended BP control (systolic target <180 mmHg). Arm A was completed in 2016; Arm B is now concluding. Objective To outline in detail and make public the predetermined statistical analysis plan (SAP) for the ‘BP control’ arm of this study. Methods All data collected by participating researchers will be reviewed and formally assessed. Information pertaining to the baseline characteristics of patients, their process of care, and the delivery of treatments will be outlined, and for each item, statistically relevant descriptive elements will be described. For the trial outcomes, the most appropriate statistical comparisons to be made between groups are planned and described. Results A SAP was developed for the results of the BP control arm of this study that is transparent, available to the public, verifiable, and predetermined before completion of data collection. Conclusions We have developed a predetermined SAP for the ENCHANTED BP control arm to be followed to avoid analysis bias arising from prior knowledge of the study findings. Clinical trial registration ClinicalTrials.gov (NCT01422616); ISRCTN Register (ISRCTN82387104); Australian New Zealand Clinical Trial Registry (ACTRN12611000236998); EU Clinical Trials Register (2011-005545-12); and Clinical Trials Registry – India (REF/2017/05/014334).
High five-year mortality rates of ischemic stroke subtypes: A prospective cohort study in Brazil
Authors: Cabral Norberto Luiz , Nagel Vivian , Conforto Adriana B , Magalhaes Pedro SC , Venancio Vanessa G , Safanelli Juliana , Ibiapina Felipe , Mazin Suleimy , França Paulo , Liberato Rafaela M , Longo Alexandre , Zetola Viviane F 
Published: October 2018

Background Studies regarding long-term outcomes of ischemic stroke subtypes are scarce in low- and middle-income countries. We aimed to measure the five-year prognosis of ischemic stroke subtypes in Joinville, Brazil. Methods All first-ever ischemic strokes that occurred in Joinville in 2010 were followed-up for five years. Results We included 334 ischemic stroke patients. Over five years, 156 died, 51 had a recurrent stroke, and 128 were free of recurrent stroke. The overall cumulative risk of death was 17% (95% CI, 13% to 22%) at 30 days and 47% (95% CI, 41% to 52%) after five years. Undetermined with incomplete investigation ischemic stroke had a significantly worse survival probability (β −4.91; 95% CI, −6.31 to −3.50; p < 0.001), followed by cardioembolic ischemic stroke (β −3.07; 95% CI, −4.32 to −1.83; p < 0.001) and large artery disease ischemic stroke (β −1.95; 95% CI, −3.30 to −0.60; p = 0.005). The survival probability of undetermined with negative investigation or cryptogenic ischemic stroke did not differ significantly from small artery disease ischemic stroke (β −1.022; 95% CI, −3.37 to −1.43; p = 0.414). The five-year mortality for small artery disease ischemic stroke was 30% (95% CI, 22% to 39%) and 47% (95% CI, 35% to 60%) for large artery ischemic stroke. The risk of stroke recurrence was 2% in the first year and 5% in the second year. The proportion of disability among survivors in the first month ranged from 8% (95% CI, 3–15) for small artery disease ischemic stroke to 40% (95% CI, 30–52) for cardioembolic ischemic stroke patients. Conclusions Cardioembolic and undetermined with incomplete investigation ischemic stroke sub-types have a poor long-term prognosis. An alarming finding was that our patients with both small and large artery ischemic stroke had higher five-year mortality rates compared with subjects from high-income countries.
Axial-Oblique Versus Standard Axial 3-T Magnetic Resonance Imaging for the Detection of Trochlear Cartilage Lesions: A Prospective Study
Authors: LaPrade Robert F. , Cram Tyler R. , Mitchell Justin J. , Geeslin Andrew G. , Lockard Carly A. , Fitzcharles Eric K. , Dornan Grant J. 
Published: October 2018

Background: Imaging of the femoral trochlea has been inherently difficult because of its convex anatomy. Purpose/Hypothesis: The purpose of this study was to compare the diagnostic utility of a standard axial magnetic resonance imaging (MRI) sequence with an axial-oblique MRI sequence of the knee for the detection of trochlear articular cartilage lesions on a high-field 3-T MRI scanner. We hypothesized that axial-oblique MRI scans of the knee obtained along the true axis of the trochlea would significantly improve the detection of high-grade cartilage lesions. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Patients who underwent MRI and subsequent surgery for any indication were prospectively enrolled into this study between June 2014 and February 2015. The articular cartilage of the trochlea was evaluated independently by 3 raters on axial and axial-oblique MRI and compared with arthroscopic findings (gold standard). The interrater and intrarater reliability of mild (International Cartilage Repair Society [ICRS] grades 1 or 2) and severe (ICRS grades 3 or 4) lesions on MRI were assessed as well as the sensitivity, specificity, positive predictive value, and negative predictive value. Results: A total of 99 knees in 96 patients were included in the study. Interrater and intrarater agreement for the identification of severe lesions were moderate to good on the proximal trochlea and fair to moderate on the distal trochlea. No significant differences in sensitivity were found between axial and axial-oblique scans for any grade of lesion (55% vs 51%, respectively; P = .700) or for severe lesions (61% vs 52%, respectively; P = .289). Similarly, specificity for detecting severe lesions was not significantly different between axial and axial-oblique scans (95% vs 87%, respectively; P = .219). Last, no significant differences in sensitivity or specificity were found between MRI sequences when separately evaluating proximal and distal trochlear lesions (all P > .05). Conclusion: The axial-oblique sequence was unable to improve the sensitivity of MRI in detecting articular cartilage lesions on the trochlea. Both conventional axial and axial-oblique sequences, reviewed independently of the complete MRI series, had low sensitivity in detecting trochlear articular cartilage lesions. For this reason, clinicians should utilize all MRI planes to evaluate the articular cartilage of the trochlea. Future studies should focus on improving MRI techniques for detecting and characterizing cartilage lesions of the trochlea.
Near-surface characterization using traveltime and full-waveform inversion with vertical and horizontal component seismic data
Authors: Alam Md. Iftekhar 
Published: October 2018

Seismic imaging of the shallow subsurface (approximately 5 m) can be very challenging when reflections are absent and the data are dominated by ground roll. I analyzed the transmission coda to produce fine-scale, interpretable vertical and horizontal component seismic velocity ([Formula: see text] and [Formula: see text]) models using full-waveform inversion (FWI). Application of FWI is tested through imaging two buried targets. The first target is a pair of well-documented utility pipes with known diameters (0.8 m) and burial depths (approximately 1.5 m). The second target is a poorly documented former location of the pipe(s), which is now a backfilled void. Data are acquired along a 23 m 2D profile using a static array with single-component vertical and horizontal geophones. Our results indicate considerable velocity updates in the [Formula: see text] and [Formula: see text] models across the pipes and backfill. The pipes appear as negative velocity updates in the final inverted [Formula: see text] and [Formula: see text] models, whereas the backfilled area represents negative and positive velocity updates in the [Formula: see text] and [Formula: see text] models, respectively. Variations of the polarities in the inverted models ([Formula: see text] and [Formula: see text]) across the backfill can be indicative of the medium, which respond differently to the vertical and horizontal component seismic waves. The attenuation models show a general decreasing trend with increasing depth. Therefore, simultaneous applications of vertical ([Formula: see text]) and horizontal ([Formula: see text]) component seismic velocity modeling can be an effective tool to understand the subsurface medium in near-surface characterization.
Effect of Apneic Oxygenation on Tracheal Oxygen Levels, Tracheal Pressure, and Carbon Dioxide Accumulation: A Randomized, Controlled Trial of Buccal Oxygen Administration
Authors: Toner Andrew J. , Douglas Scott G. , Bailey Martin A. , Avis Hans J. , Pillai Arani V. , Phillips Michael , Heard Andrew 
Published: October 2018

BACKGROUND:
Apneic oxygenation via the oral route using a buccal device extends the safe apnea time in most but not all obese patients. Apneic oxygenation techniques are most effective when tracheal oxygen concentrations are maintained >90%. It remains unclear whether buccal oxygen administration consistently achieves this goal and whether significant risks of hypercarbia or barotrauma exist.

METHODS:
We conducted a randomized trial of buccal or sham oxygenation in healthy, nonobese patients (n = 20), using prolonged laryngoscopy to maintain apnea with a patent airway until arterial oxygen saturation (Spo
2) dropped <95% or 750 seconds elapsed. Tracheal oxygen concentration, tracheal pressure, and transcutaneous carbon dioxide (CO2) were measured throughout. The primary outcome was maintenance of a tracheal oxygen concentration >90% during apnea.

RESULTS:
Buccal patients were more likely to achieve the primary outcome (P < .0001), had higher tracheal oxygen concentrations throughout apnea (mean difference, 65.9%; 95% confidence interval [CI], 62.6%–69.3%; P < .0001), and had a prolonged median (interquartile range) apnea time with Spo
2 >94%; 750 seconds (750–750 seconds) vs 447 seconds (405–525 seconds); P < .001. One patient desaturated to Spo
2 <95% despite 100% tracheal oxygen. Mean tracheal pressures were low in the buccal (0.21 cm·H2O; SD = 0.39) and sham (0.56 cm·H2O; SD = 1.25) arms; mean difference, −0.35 cm·H2O; 95% CI, 1.22–0.53; P = .41. CO2 accumulation during early apnea before any study end points were reached was linear and marginally faster in the buccal arm (3.16 vs 2.82 mm Hg/min; mean difference, 0.34; 95% CI, 0.30–0.38; P < .001). Prolonged apnea in the buccal arm revealed nonlinear CO2 accumulation that declined over time and averaged 2.22 mm Hg/min (95% CI, 2.21–2.23).

CONCLUSIONS:
Buccal oxygen administration reliably maintains high tracheal oxygen concentrations, but early arterial desaturation can still occur through mechanisms other than device failure. Whereas the risk of hypercarbia is similar to that observed with other approaches, the risk of barotrauma is negligible. Continuous measurement of advanced physiological parameters is feasible in an apneic oxygenation trial and can assist with device evaluation.
Emergency Department Airway Management Responsibilities in the United States
Authors: Chiaghana Chukwudi , Giordano Christopher , Cobb Danielle , Vasilopoulos Terrie , Tighe Patrick J. , Sappenfield Joshua W. 
Published: October 2018

BACKGROUND:
In the 1990s, emergency medicine (EM) physicians were responsible for intubating about half of the patients requiring airway management in emergency rooms. Since then, no studies have characterized the airway management responsibilities in the emergency room.

METHODS:
A survey was sent via the Eastern Association for Surgery and Trauma and the Trauma Anesthesiology Society listservs, as well as by direct solicitation. Information was collected on trauma center level, geographical location, department responsible for intubation in the emergency room, department responsible for intubation in the trauma bay, whether these roles differed for pediatrics, whether an anesthesiologist was available “in-house” 24 hours a day, and whether there was a protocol for anesthesiologists to assist as backup during intubations. Responses were collected, reviewed, linked by city, and mapped using Python.

RESULTS:
The majority of the responses came from the Eastern Association for Surgery of Trauma (84.6%). Of the respondents, 72.6% were from level-1 trauma centers, and most were located in the eastern half of the United States. In the emergency room, EM physicians were primarily responsible for intubations at 81% of the surveyed institutions. In trauma bays, EM physicians were primarily responsible for 61.4% of intubations. There did not appear to be a geographical pattern for personnel responsible for managing the airway at the institutions surveyed.

CONCLUSIONS:
The majority of institutions have EM physicians managing their airways in both emergency rooms and trauma bays. This may support the observations of an increased percentage of airway management in the emergency room and trauma bay setting by EM physicians compared to 20 years ago.
Archival Excess in Latinx Print Culture
Authors: Varon Alberto 
Published: October 2018

Abstract
This essay considers the Latinx archive and argues for the continued importance of the nation in understanding Latinx culture. For decades, scholars have recovered a variety of divergent forms of writing that challenge the possibility of a Latinx literary canon. These writings operate in disparate modes and genres, do not always fit neatly within traditional understandings of “literature,” and are frequently fragmentary or incomplete—what the essay terms “archival excess,” which runs counter to the perceived lack of US Latinx literary and cultural production and is inherently unstable and evolving. The essay asserts that an unstable Latinx archive is not only symptomatic of but also essential to the project of contemporary latinidad. The US nation and its attendant discourses of nationalism help contain archival excess, even as the Latinx archive challenges national borders and narratives. For this reason and for its political urgency, Latinx studies needs to maintain recourse to the US nation, despite the field necessarily operating as methodologically transnational.
Telephonic Modernismo
Authors: Kreitz Kelley 
Published: October 2018

Abstract
This essay analyzes the Havana-based literary weekly La Habana Elegante to consider the hemispheric dimensions of late nineteenth-century media change and the role that writers of Latin American descent played in it. As new electric media and improved print technology powered an expanding and interconnected world of print, La Habana Elegante mediated a hemispheric, Spanish-speaking print culture, especially through its foreign correspondence from New York City. The periodical defined that print culture through a notion of latinidad that bridged Latin America and the United States—and by envisioning a two-way flow of ideas between writers and readers. As US-based English-language newspapers developed emerging mass cultural forms that starkly divided producers and consumers, La Habana Elegante tapped into notions of simultaneity inspired by the telegraph and, especially, the telephone to promote a more interactive modern media system meant to circulate Latin American culture throughout the hemisphere.
Super-resolution imaging of live sperm reveals dynamic changes of the actin cytoskeleton during acrosomal exocytosis
Authors: Romarowski Ana , Velasco Félix Ángel G. , Torres Rodríguez Paulina , Gervasi María G. , Xu Xinran , Luque Guillermina M. , Contreras-Jiménez Gastón , Sánchez-Cárdenas Claudia , Ramírez-Gómez Héctor V. , Krapf Diego , Visconti Pablo E. , Krapf Dario , Guerrero Adán , Darszon Alberto , Buffone Mariano G. 
Published: October 2018

ABSTRACT
Filamentous actin (F-actin) is a key factor in exocytosis in many cell types. In mammalian sperm, acrosomal exocytosis (denoted the acrosome reaction or AR), a special type of controlled secretion, is regulated by multiple signaling pathways and the actin cytoskeleton. However, the dynamic changes of the actin cytoskeleton in live sperm are largely not understood. Here, we used the powerful properties of SiR-actin to examine actin dynamics in live mouse sperm at the onset of the AR. By using a combination of super-resolution microscopy techniques to image sperm loaded with SiR-actin or sperm from transgenic mice containing Lifeact-EGFP, six regions containing F-actin within the sperm head were revealed. The proportion of sperm possessing these structures changed upon capacitation. By performing live-cell imaging experiments, we report that dynamic changes of F-actin during the AR occur in specific regions of the sperm head. While certain F-actin regions undergo depolymerization prior to the initiation of the AR, others remain unaltered or are lost after exocytosis occurs. Our work emphasizes the utility of live-cell nanoscopy, which will undoubtedly impact the search for mechanisms that underlie basic sperm functions.
This article has an associated First Person interview with the first author of the paper.
Mechanisms of integrin αVβ5 clustering in flat clathrin lattices
Authors: Zuidema Alba , Wang Wei , Kreft Maaike , te Molder Lisa , Hoekman Liesbeth , Bleijerveld Onno B. , Nahidiazar Leila , Janssen Hans , Sonnenberg Arnoud 
Published: October 2018

ABSTRACT
The family of integrin transmembrane receptors is essential for the normal function of multicellular organisms by facilitating cell-extracellular matrix adhesion. The vitronectin-binding integrin αVβ5 localizes to focal adhesions (FAs) as well as poorly characterized flat clathrin lattices (FCLs). Here, we show that, in human keratinocytes, αVβ5 is predominantly found in FCLs, and formation of the αVβ5-containing FCLs requires the presence of vitronectin as ligand, Ca2+, and the clathrin adaptor proteins ARH (also known as LDLRAP1), Numb and EPS15/EPS15L1. Integrin chimeras, containing the extracellular and transmembrane domains of β5 and the cytoplasmic domains of β1 or β3, almost exclusively localize in FAs. Interestingly, lowering actomyosin-mediated contractility promotes integrin redistribution to FLCs in an integrin tail-dependent manner, while increasing cellular tension favors αVβ5 clustering in FAs. Our findings strongly indicate that clustering of integrin αVβ5 in FCLs is dictated by the β5 subunit cytoplasmic domain, cellular tension and recruitment of specific adaptor proteins to the β5 subunit cytoplasmic domains.
The RHEB–mTOR axis regulates expression of Tf2 transposons in fission yeast
Authors: Nakase Yukiko , Matsumoto Tomohiro 
Published: October 2018

ABSTRACT
The human TSC2 gene, mutations in which predispose individuals to the disease tuberous sclerosis complex (TSC), encodes a GTPase-activating protein for the GTPase RHEB. Loss of TSC2 results in constitutive activation of RHEB and its target mammalian target of rapamycin (mTOR). We have previously reported that fission yeast (Schizosaccharomyces pombe) Tf2 retrotransposons (hereafter Tf2s) are abnormally induced upon nitrogen starvation in cells lacking the tsc2+ gene (Δtsc2), a homolog of the human TSC2 gene, and in cells with a dominant-active mutation in the fission yeast RHEB GTPase (rhb1-DA4). We report here that induction of Tf2s in these mutants is suppressed upon overexpression of the cgs2+ gene, which encodes a cAMP-specific phosphodiesterase, or upon deletion of components in the glucose/cAMP signaling pathway, namely Cyr1, Pka1, Tor1 and the stress-activated transcription factor Atf1. The results suggest that the glucose/cAMP signaling pathway is downregulated when cells are starved for nitrogen. We also show that Tf2 proteins are degraded via autophagy, which is under control of Tor2, a homolog of human mTOR. It appears that failure in the two processes, downregulation of the glucose/cAMP signaling pathway and induction of autophagy, allows abnormal induction of Tf2s upon nitrogen starvation in Δtsc2 and rhb1-DA4 cells.
The inhibition of checkpoint activation by telomeres does not involve exclusion of dimethylation of histone H4 lysine 20 (H4K20me2)
Authors: Audry Julien , Wang Jinyu , Eisenstatt Jessica R. , Berkner Kathleen L. , Runge Kurt W. 
Published: October 2018

DNA double-strand breaks (DSBs) activate the DNA damage checkpoint machinery to pause or halt the cell cycle. Telomeres, the specific DNA-protein complexes at linear eukaryotic chromosome ends, are capped DSBs that do not activate DNA damage checkpoints. This “checkpoint privileged” status of telomeres was previously investigated in the yeast Schizosaccharomyces pombelacking the major double-stranded telomere DNA binding protein Taz1. Telomeric DNA repeats in cells lacking Taz1 are 10 times longer than normal and contain single-stranded DNA regions. DNA damage checkpoint proteins associate with these damaged telomeres, but the DNA damage checkpoint is not activated. This severing of the DNA damage checkpoint signaling pathway was reported to stem from exclusion of histone H4 lysine 20 dimethylation (H4K20me2) from telomeric nucleosomes in both wild type cells and cells lacking Taz1. However, experiments to identify the mechanism of this exclusion failed, prompting our re-evaluation of H4K20me2 levels at telomeric chromatin. In this short report, we used an extensive series of controls to identify an antibody specific for the H4K20me2 modification and show that the level of this modification is the same at telomeres and internal loci in both wild type cells and those lacking Taz1. Consequently, telomeres must block activation of the DNA Damage Response by another mechanism that remains to be determined.
Inklusion als moralische Herausforderung – das Potential der Konstanzer Methode der Dilemmadiskussion®
Authors: Reinicke Martina 
Published: October 2018

In diesem Beitrag soll die Konstanzer Methode der Dilemma-Diskussion (KMDD?) vorgestellt und deren Einbindung in den Ethikunterricht erläutert werden. Das Anliegen dieses Artikels ist es, information pills besonders die Lerneffekte dieser inklusiven Unterrichtsmethode aufzuzeigen. Es wird der Frage nachgegangen, information pills wie durch Dialog Erkenntnis und durch einen besonderen Umgang mit Differenzierung im Ethikunterricht moralische Entwicklung realisiert werden kann. Moralische Bildung aller am Lehr- und Lernprozess Beteiligten wird in diesem Zusammenhang als eine der wichtigsten, site wenn nicht sogar als die wichtigste Voraussetzung für jede Art von echter Inklusion gesehen. Echte Inklusion meint dabei, optimale Lernbedingungen, die von den Beteiligten freiwillig getragen werden, für alle Schüler*innen zu schaffen. Die Bewältigung dieser Herausforderung wird umso dringlicher, da sich unsere Gesellschaft insgesamt im Wandel befindet- demografisch und global.