bluuebunny/crossref_metadata_2025_split huggingface dataset:
Blood Pressure Variability and Cardiovascular Outcomes in Patients With Prior Stroke
Authors: de Havenon Adam , Fino Nora F. , Johnson Brian , Wong Ka-Ho , Majersik Jennifer J. , Tirschwell David , Rost Natalia 
Published: September 2019

Background and Purpose—
Every year in the United States, almost 185 000 ischemic strokes occur in patients with a prior stroke. Recurrent stroke has significantly higher morbidity and mortality. Among modifiable risk factors for recurrent stroke, hypertension is the most prevalent. Reducing systolic blood pressure is standard of care for secondary stroke prevention. Recent literature suggests that increased blood pressure variability (BPV) is associated with primary stroke, although studies have not convincingly shown that it is associated with recurrent stroke, which was the goal of this analysis.

Methods—
We conducted a secondary analysis of 17 916 patients in the PRoFESS (Prevention Regimen for Effectively Avoiding Second Strokes) trial, which is the largest trial of patients with potential recurrent stroke. We calculated BPV and evaluated its effect on recurrent stroke (composite and stratified by ischemic or hemorrhagic stroke), major cardiovascular events (death from cardiovascular causes, recurrent stroke, myocardial infarction, or new or worsening heart failure), and all-cause death.

Results—

Both systolic and diastolic BPV were associated with recurrent stroke, major cardiovascular events, and all-cause death. The association with stroke was significant for ischemic, but not hemorrhagic, stroke. For every 10-point increase in BPV (systolic SD, range =0–54.2), the hazard ratio for a recurrent ischemic stroke was 1.15 (95% CI, 1.02–1.32;
P
=0.02), for major cardiovascular events was 1.19 (95% CI, 1.09–1.31;
P
<0.001), and for all-cause death was 1.24 (95% CI, 1.10–1.39;
P
<0.001).

Conclusions—
Our study adds to the growing body of literature suggesting that BPV is an important and potentially modifiable risk factor for ischemic stroke, cardiovascular events, and all-cause death. Specifically, it is the first study to demonstrate that increased BPV is associated with recurrent ischemic stroke and that diastolic BPV can be as important as systolic BPV. Future work should focus on evaluating whether actively reducing BPV, using widely available and inexpensive antihypertensive medications, reduces the risk of cardiovascular disease.
B. Yoma 35b: Some Observations Concerning Divine Mediators and Rabbis
Authors: Basser Herbert W. 
Published: September 2019

Abstract
The familiar “Hillel-meets-his-teachers” tradition (B. Yoma 35b) reveals a deeper story that features mystical, apocalyptic images representing none other than the beloved masters of early rabbinic culture. Here we find the image of a heavenly being enthroned on high that was identified in non-rabbinic circles with God’s demiurge (Enoch, Yehoel, Metatron). This provides evidence that rabbis defused the mystical stories that were leading to two-power challenges to rabbinic authority and to the increasingly antinomian positions of Jews inside and outside of Christian churches. We can therefore appreciate the Rabbis’ portrayal of Torah scholars as embodying true Enochian power.
Cisterns, Waterways, and Rabbis: a Rabbinic Lens into Conflict Avoidance in the Riparian World
Authors: Wachs Meir 
Published: September 2019

Abstract
In the liminal spaces between concretized biblical law and a world in which “every man did what was right in his own eyes” (Judg. 17:6), the Rabbinic tradition developed enactments toward the pursuit of harmony and to minimize conflict. This paper delves into the role of one such mechanism, found throughout the primary sources, in an area of irrigation policy. The article seeks to understand the topic’s contours in the arena of rhetoric vs. reality. I argue that, contrary to initial appearances, the enactment of peace under discussion has every indication of being rooted in its social, legal and natural milieus.
Revolutionary Law Abidance: Kachin Rebel Governance and the Adoption of ihl in Resistance to Myanmar State Violence
Authors: de la Cour Venning Alicia 
Published: September 2019

Although armed opposition actors are increasingly prevalent within contemporary conflicts, ethnographies seeking to understand and explain their relationship with international law are scarce. While scholars highlight the state-centric nature of international law, discussing at length how it privileges state over non-state actors, few examine the way rebels perceive and relate to the international legal system. Drawing on seven months of field research among Kachin civil society and the Kachin Independence Organisation / Army (kio/A), this article demonstrates how the kio/A’s nascent engagement with international law is being strategically pursued as part of a broader rebel governance project. Ethnographic research exposes the oft neglected rebel perspective. It reveals how rebels interact with international humanitarian norms as a means to facilitate and mediate relations with both local and international actors, in an attempt to promote nation building aspirations and thereby strengthen resistance to state violence.
Wood anatomical and topochemical analyses to characterize juvenile and adult wood of lesser-known species from Central America (Mexico)
Authors: Haag Volker , Koch Gerald , Richter Hans-Georg , Evans Robert , Guzmán José Antonio Silva , Schmitt Uwe 
Published: September 2019

ABSTRACT
Anatomical and subcellular characteristics of juvenile and adult wood of seven species (Manilkara zapota (L.) P. Royen, Platymiscium yucatanum Standl., Lonchocarpus castilloi Standl., Roseodendron donnell-smithii (Rose) Miranda, Terminalia buceras (L.) Wright, Tabebuia rosea (Bertol.) DC., Lysiloma latisiliquum (L.) Benth. from Mexico, including a histometric evaluation, were investigated by light microscopy with a digitized image analysis system and by X-ray diffractometry using the SilviScan® system. The topochemical distribution of lignin and phenolic deposits in the tissue was studied by means of cellular UV-microspectrophotometry (UMSP). Extractive contents (acetone/water and water) were determined gravimetrically. The results of the structural and topochemical analyses were compared with the interrelations of certain anatomical and subcellular structures as well as the topochemical composition with regard to the physical and mechanical properties of the timbers investigated. The objective was to provide a detailed cellular and subcellular description of the heartwood of seven lesser-known timbers from Central America. All examined tree species show significant differences between juvenile and adult heartwood. For individual species, however, the differences vary greatly and have to be individually assessed in addition to general trends observed for all studied species. It has been shown that vessel size, fibre length, size of fibre lumina, and height and width of rays, as well as the content of extractives and topochemical composition of the cell walls, are suitable indicators for the differentiation of the two heartwood types. The results also contribute to a better understanding of the wood properties of the investigated timbers in relation to their utilization and added value increase.
Decolonial Theology in the North Atlantic World
Authors: Drexler-Dreis Joseph 
Published: September 2019

Abstract
This essay develops a response to the historical situation of the North Atlantic world in general and the United States in particular through theological reflection. It offers an overview of some decolonial perspectives with which theologians can engage, and argues for a general perspective for a decolonial theology as a possible response to modern/colonial structures and relations of power, particularly in the United States. Decolonial theory holds together a set of critical perspectives that seek the end of the modern/colonial world-system and not merely a democratization of its benefits. A decolonial theology, it is argued, critiques how the confinement of knowledge to European traditions has closed possibilities for understanding historical encounters with divinity, and thus possibilities of critical reflection. A decolonial theology reflects critically on a historical situation in light of faith in a divine reality, the understanding of which is liberated from the monopoly of modern/colonial ways of knowing, in order to catalyze social transformation.
The Surfacer® Inside-Out® Access System for right-sided catheter placement in dialysis patients with thoracic venous obstruction
Authors: Hentschel Dirk M , Minarsch Laura , Vega Félix , Ebner Adrian 
Published: September 2019

Purpose: Thoracic central venous obstruction is a common clinical complication in dialysis patients utilizing hemodialysis catheters. Thoracic central venous obstruction can lead to inability to utilize affected veins for catheter placement and sequential use of less preferred alternative venous access sites. The latter can affect the ability to create and/or mature permanent arteriovenous access and contribute to the future loss of thoracic veins for venous access. While alternative procedures exist for gaining venous access in patients who have exhausted routine venous access options, these procedures are complex, time-consuming, and associated with high patient risk. The Surfacer System provides a new approach in patients with right-sided thoracic central venous obstruction, enabling the ability to establish repeated access from the right side of the neck to the right atrium. Methods: We describe the use of the Surfacer System to facilitate placement of hemodialysis catheters in a series of nine patients with thoracic central venous obstruction involving one or more central veins. Patient characteristics and procedure-related outcomes were recorded for all patients. Results: Central venous access was successfully achieved in eight of nine patients using the Surfacer System. Significant venous tortuosity resulted in the inability to achieve venous access in one patient and prolonged procedural time to achieve access in another patient. The mean time required for Surfacer-related procedural steps and associated fluoroscopy time in the remaining seven patients was 13.3 and 3.7 min, respectively. Conclusion: The Surfacer System provides an efficient low-complexity alternative for gaining repeated right-sided central venous access in hemodialysis patients with obstructed thoracic veins.
Different models for prediction of radical cystectomy postoperative complications and care pathways
Authors: Taylor Jacob , Meng Xiaosong , Renson Audrey , Smith Angela B. , Wysock James S. , Taneja Samir S. , Huang William C. , Bjurlin Marc A. 
Published: September 2019

Background: Radical cystectomy for bladder cancer has one of the highest rates of morbidity among urologic surgery, but the ability to predict postoperative complications remains poor. Our study objective was to create machine learning models to predict complications and factors leading to extended length of hospital stay and discharge to a higher level of care after radical cystectomy. Methods: Using the American College of Surgeons National Surgical Quality Improvement Program, peri-operative adverse outcome variables for patients undergoing elective radical cystectomy for bladder cancer from 2005 to 2016 were extracted. Variables assessed include occurrence of minor, infectious, serious, or any adverse events, extended length of hospital stay, and discharge to higher-level care. To develop predictive models of radical cystectomy complications, we fit generalized additive model (GAM), least absolute shrinkage and selection operator (LASSO) logistic, neural network, and random forest models to training data using various candidate predictor variables. Each model was evaluated on the test data using receiver operating characteristic curves. Results: A total of 7557 patients were identified who met the inclusion criteria, and 2221 complications occurred. LASSO logistic models demonstrated the highest area under curve for predicting any complications (0.63), discharge to a higher level of care (0.75), extended length of stay (0.68), and infectious (0.62) adverse events. This was comparable with random forest in predicting minor (0.60) and serious (0.63) adverse events. Conclusions: Our models perform modestly in predicting radical cystectomy complications, highlighting both the complex cystectomy process and the limitations of large healthcare datasets. Identifying the most important variable leading to each type of adverse event may allow for further strategies to model cystectomy complications and target optimization of modifiable variables pre-operative to reduce postoperative adverse events.
Combined Bone Marrow Aspirate and Platelet-Rich Plasma for Cartilage Repair: Two-Year Clinical Results
Authors: Hede Kris , Christensen Bjørn B. , Jensen Jonas , Foldager Casper B. , Lind Martin 
Published: September 2019

Purpose To evaluate the clinical and biological outcome of combined bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP) on a collagen scaffold for treating cartilage lesions in the knee. Methods and Materials Ten patients (mean age 29.4 years, range 18-36) suffering from large full-thickness cartilage in the knee were treated with BMAC and PRP from January 2015 to December 2016. In a 1-step procedure autologous BMAC and PRP was seeded onto a collagen scaffold and sutured into the debrided defect. Patients were evaluated by clinical outcome scores (IKDC [International Knee Documentation Committee Subjective Knee Form], KOOS [Knee Injury and Osteoarthritis Outcome Score], and pain score using the Numeric Rating Scale [NRS]) preoperatively, after 3 months, and after 1 and 2 years. Second-look arthroscopies were performed ( n = 7) with biopsies of the repair tissue for histology. All patients had magnetic resonance imaging (MRI) preoperatively, after 1 year, and after 2 to 3.5 years with MOCART (magnetic resonance observation of cartilage repair tissue) scores evaluating cartilage repair. Results After 1 year significant improvements were found in IKDC, KOOS symptoms, KOOS ADL (Activities of Daily Living), KOOS QOL (Quality of Life), and pain at activity. At the latest follow-up significant improvements were seen in IKDC, KOOS symptoms, KOOS QOL, pain at rest, and pain at activity. MRI MOCART score for cartilage repair improved significantly from baseline to 1-year follow-up. Histomorphometry of repair tissue demonstrated a mixture of fibrous tissue (58%) and fibrocartilage (40%). Conclusion Treatment of cartilage injuries using combined BMAC and PRP improved subjective clinical outcome scores and pain scores at 1 and 2 years postoperatively. MRI and histology indicated repair tissue inferior to the native hyaline cartilage.
Pyeloplasty for pelviureteric obstruction junction obstruction
Authors: Starmer Benjamin , Weston Robin , Bromage Stephen 
Published: September 2019

Pelviureteric junction obstruction (PUJO) is a common clinical presentation. Patients require investigation with biochemistry and imaging in the form of computed tomography and diuretic renography. The gold-standard pyeloplasty treatment is minimally invasive pyeloplasty. Here we discuss a typical presentation of PUJO and discuss key questions in the investigation, management and follow-up of this condition, including a review of the treatment options. Level of evidence: 3a
MMP9 inhibition increases erythropoiesis in RPS14-deficient del(5q) MDS models through suppression of TGF-β pathways
Authors: Youn Minyoung , Huang Haigen , Chen Cheng , Kam Sharon , Wilkes Mark C. , Chae Hee-Don , Sridhar Kunju J. , Greenberg Peter L. , Glader Bertil , Narla Anupama , Lin Shuo , Sakamoto Kathleen M. 
Published: September 2019

Key PointsMMP9 inhibition improves erythropoiesis in RPS14-deficient del(5q) MDS models. Increased MMP9 expression in RPS14-deficient cells activates TGF-β signaling, resulting in defective erythroid developments.
Efficacy of emicizumab in a pediatric patient with type 3 von Willebrand disease and alloantibodies
Authors: Weyand Angela C. , Flood Veronica H. , Shavit Jordan A. , Pipe Steven W. 
Published: September 2019

Key Points
Type 3 von Willebrand disease with alloantibodies is a rare clinical entity with few treatment options. Emicizumab prophylaxis in such patients may result in improved hemarthrosis control, lower cost, and enhanced quality of life.
Development of a predictive model for on-time arrival flight of airliner by discovering correlation between flight and weather data
Authors: Etani Noriko 
Published: September 2019

Abstract
An important business of airlines is to get customer satisfaction. Due to bad weather, a mechanical reason, and the late arrival of the aircraft to the point of departure, flights delay and lead to customer dissatisfaction. A predictive model of on-time arrival flight is proposed with using flight data and weather data. The key research in this paper is to discover the correlation between flight data and weather data. The relation between pressure pattern and flight data of Peach Aviation, which is LCC (low-cost carrier) in Japan, are clarified, and it is found that the sea-level pressures of 3 weather observation spots, which are Wakkanai as the most northern spot, Minami-Torishima as the most eastern spot, and Yonagunijima as the most western spot, can classify the pressure patterns. As a result, on-time arrival fight is predicted at 77% of the accuracy with using Random Forest Classifier of machine learning. Furthermore, feasibility of the predictive model is evaluated by developing a tool of on-time arrival flight prediction.
Positive End-Expiratory Pressure During Anesthesia for Prevention of Postoperative Pulmonary Complications: A Meta-analysis With Trial Sequential Analysis of Randomized Controlled Trials
Authors: Zhang Pengcheng , Wu Lingmin , Shi Xuan , Zhou Huanping , Liu Meiyun , Chen Yuanli , Lv Xin 
Published: September 2019

BACKGROUND:
Whether intraoperative positive end-expiratory pressure (PEEP) can reduce the risk of postoperative pulmonary complications remains controversial. We performed a systematic review of currently available literature to investigate whether intraoperative PEEP decreases pulmonary complications in anesthetized patients undergoing surgery.

METHODS:
We searched PubMed, Embase, and the Cochrane Library to identify randomized controlled trials (RCTs) that compared intraoperative PEEP versus zero PEEP (ZEEP) for postoperative pulmonary complications in adults. The prespecified primary outcome was postoperative pulmonary atelectasis.

RESULTS:
Fourteen RCTs enrolling 1238 patients met the inclusion criteria. Meta-analysis using a random-effects model showed a decrease in postoperative atelectasis (relative risk [RR], 0.51; 95% confidence interval [CI], 0.35–0.76; trial sequential analyses [TSA]-adjusted CI, 0.10–2.55) and postoperative pneumonia (RR, 0.48; 95% CI, 0.27–0.84; TSA-adjusted CI, 0.05–4.86) in patients receiving PEEP ventilation. However, TSA showed that the cumulative Z-curve of 2 outcomes crossed the conventional boundary but did not cross the trial sequential monitoring boundary, indicating a possible false-positive result. We observed no effect of PEEP versus ZEEP ventilation on postoperative mortality (RR, 1.78; 95% CI, 0.55–5.70).

CONCLUSIONS:
The evidence that intraoperative PEEP reduces postoperative pulmonary complications is suggestive but too unreliable to allow definitive conclusions to be drawn.
Development and Pilot Study of an iOS Smartphone Application for Perioperative Functional Capacity Assessment
Authors: Rubin Daniel S. , Dalton Allison , Tank Allyson , Berkowitz Mark , Arnolds David E. , Liao Chuanhong , Gerlach Rebecca M. 
Published: September 2019

BACKGROUND:
Functional capacity assessment plays a core role in the preoperative evaluation. The Duke Activity Status Index (DASI) and the 6-minute walk test (6MWT) are 2 methods that have demonstrated the ability to evaluate functional capacity and predict perioperative outcomes. Smartphones offer a novel method to facilitate functional capacity assessment as they can easily administer a survey and accelerometers can track patient activity during a 6MWT. We developed a smartphone application to administer a 6MWT and DASI survey and performed a pilot study to evaluate the accuracy of a smartphone-based functional capacity tool in our Anesthesia and Perioperative Medicine Clinic.

METHODS:
Using the Apple ResearchKit software platform, we developed an application that administers a DASI survey and 6MWT on an iOS smartphone. The DASI was presented to the patient 1 question on the screen at a time and the application calculated the DASI score and estimated peak oxygen uptake (Vo
2). The 6MWT used the CMPedometer class from Apple’s core motion facility to retrieve accelerometer data collected from the device’s motion coprocessor to estimate steps walked. Smartphone estimated steps were compared to a research-grade pedometer using the intraclass correlation coefficient (ICC). Distance walked was directly measured during the 6MWT and we performed a multivariable linear regression with biometric variables to create a distance estimation algorithm to estimate distance walked from the number of steps recorded by the application.

RESULTS:
Seventy-eight patients were enrolled in the study and completed the protocol. Steps measured by the smartphone application as compared to the pedometer demonstrated moderate agreement with an ICC (95% CI) of 0.87 (0.79–0.92; P = .0001). The variables in the distance estimation algorithm included (β coefficient [slope], 95% CI) steps walked (0.43, 0.29–0.57; P < .001), stride length (0.38, 0.22–0.53; P < .001), age in years (−1.90, −3.06 to −0.75; P = .002), and body mass index (−2.59, −5.13 to −0.06; P = .045). The overall model fit was R
2 = 0.72, which indicates a moderate level of goodness of fit and explains 72% of the variation of distance walked during a 6MWT.

CONCLUSIONS:
Our pilot study demonstrated that a smartphone-based functional capacity assessment is feasible using the DASI and 6MWT. The DASI was easily completed by patients and the application clearly presented the results of the DASI to providers. Our application measured steps walked during a 6MWT moderately well in a preoperative patient population; however, future studies are needed to improve the smartphone application’s step-counting accuracy and distance estimation algorithm.
The Parkinson's disease gene PINK1 activates Akt via PINK1 kinase-dependent regulation of the phospholipid PI(3,4,5)P3
Authors: Furlong Rachel M. , Lindsay Andrew , Anderson Karen E. , Hawkins Phillip T. , Sullivan Aideen M. , O'Neill Cora 
Published: September 2019

ABSTRACT
Akt signalling is central to cell survival, metabolism, protein and lipid homeostasis, and is impaired in Parkinson's disease (PD). Akt activation is reduced in the brain in PD, and by many PD-causing genes, including PINK1. This study investigated the mechanisms by which PINK1 regulates Akt signalling. Our results reveal for the first time that PINK1 constitutively activates Akt in a PINK1-kinase dependent manner in the absence of growth factors, and enhances Akt activation in normal growth medium. In PINK1-modified MEFs, agonist-induced Akt signalling failed in the absence of PINK1, due to PINK1 kinase-dependent increases in PI(3,4,5)P3 at both plasma membrane and Golgi being significantly impaired. In the absence of PINK1, PI(3,4,5)P3 levels did not increase in the Golgi, and there was significant Golgi fragmentation, a recognised characteristic of PD neuropathology. PINK1 kinase activity protected the Golgi from fragmentation in an Akt-dependent fashion. This study demonstrates a new role for PINK1 as a primary upstream activator of Akt via PINK1 kinase-dependent regulation of its primary activator PI(3,4,5)P3, providing novel mechanistic information on how loss of PINK1 impairs Akt signalling in PD.
This article has an associated First Person interview with the first author of the paper.