bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arrhythmias and Adaptations of the Cardiac Conduction System in Former National Football League Players
Authors: Aagaard Philip , Sharma Shishir , McNamara David A. , Joshi Parag , Ayers Colby R. , de Lemos James A. , Lincoln Andrew E. , Baranowski Bryan , Mandsager Kyle , Hill Elizabeth , Castle Lon , Gentry James , Lang Richard , Dunn Reginald E. , Alexander Kezia , Tucker Andrew M. , Phelan Dermot 
Published: July 2019

Background

Habitual high‐intensity endurance exercise is associated with increased atrial fibrillation (
AF
) risk and impaired cardiac conduction. It is unknown whether these observations extend to prior strength‐type sports exposure. The primary aim of this study was to compare
AF
prevalence in former National Football League (
NFL
) athletes to population‐based controls. The secondary aim was to characterize other conduction system parameters.

Methods and Results

This cross‐sectional study compared former
NFL
athletes (n=460, age 56±12 years, black 47%) with population‐based controls of similar age and racial composition from the cardiovascular cohort Dallas Heart Study‐2 (n=925, age 54±9 years, black 53%).
AF
was present in 28 individuals (n=23 [5%] in the
NFL
group; n=5 [0.5%] in the control group). After controlling for other cardiovascular risk factors in multivariable regression analysis, former
NFL
participation remained associated with a 5.7 (95%
CI
: 2.1–15.9,
P
<0.001) higher odds ratio of
AF
. Older age, higher body mass index, and nonblack race were also independently associated with higher odds ratio of
AF
, while hypertension and diabetes mellitus were not.
AF
was previously undiagnosed in 15/23 of the former
NFL
players. Previously undiagnosed
NFL
players were rate controlled and asymptomatic, but 80% had a
CHA
2
DS
2
‐
VAS
c score ≥1. Former
NFL
players also had an 8‐fold higher prevalence of paced cardiac rhythms (2.0% versus 0.25%,
P
<0.01), compared with controls. Furthermore, former athletes had lower resting heart rates (62±11 versus 66±11 beats per minute,
P
<0.001), and a higher prevalence of first‐degree atrioventricular block (18% versus 9%,
P
<0.001).

Conclusions

Former
NFL
participation was associated with an increased
AF
prevalence and slowed cardiac conduction when compared with a population‐based control group. Former
NFL
athletes who screened positive for
AF
were generally rate controlled and asymptomatic, but 80% should have been considered for anticoagulation based on their stroke risk.
Diet evolution in litter frogs: reassessing the Toft’s hypotheses
Authors: Nadaline Junior , Confetti André E. , Pie Marcio R. 
Published: July 2019

Abstract
In a series of papers starting in the early 1980s, Toft proposed a general scenario to explain dietary evolution in leaf litter anurans in which species would “form a continuum from those that specialize on ants and mites, through generalists, to species that avoid ants and mites”, and these differences would in turn correlate with foraging strategies, morphology, and defense mechanisms. In this study, we reassess this hypothesis using a global dataset on the dietary composition of 120 anuran species. Surprisingly, we found that the relative contribution of ants and mites in anuran diets were largely orthogonal to one another. Moreover, we did not find evidence for the continuum of dietary composition envisioned by Toft. These results suggest that, although ants and mites have played a major role in the evolution of aposematic species, the trends found in those species might not be directly extrapolated to all leaf litter anurans.
Global and Regional Projected Changes in 100-yr Subdaily, Daily, and Multiday Precipitation Extremes Estimated from Three Large Ensembles of Climate Simulations
Authors: Martel Jean-Luc , Mailhot Alain , Brissette François 
Published: July 2019

AbstractMany studies have reported projected increases in the frequency and intensity of extreme precipitation events in a warmer future climate. These results challenge the assumption of climate stationarity, a standard hypothesis in the estimation of extreme precipitation quantiles (e.g., 100-yr return period) often used as key design criteria for many infrastructures. In this work, changes in hourly to 5-day precipitation extremes occurring between the 1980–99 and 2080–99 periods are investigated using three large ensembles (LE) of climate simulations. The first two are the global CanESM2 50-member ensemble at a 2.8° resolution and the global CESM1 40-member ensemble at a 1° resolution. The third is the regional CRCM5 50-member ensemble at a 0.11° resolution, driven at its boundaries by the 50-member CanESM2 ensemble over the northeastern North America (NNA) and Europe (EU) domains. Results indicate increases in the frequency of future extreme events, and, accordingly, a reduction of the return period of current extreme events for all tested spatial resolutions and temporal scales. Agreement between the three ensembles suggests that extreme precipitations, corresponding to the 100-yr return period over the reference period, become 4–5 (2–4) times more frequent on average for the NNA (EU) domain for daily and 5-day annual maximum precipitation. Projections by CRCM5-LE show even larger increases for subdaily precipitation extremes. Considering the life-span of many public infrastructures, these changes may have important implications on service levels and the design of many water infrastructures and for public safety, and should therefore be taken into consideration in establishing design criteria.
Single-subject structural cortical networks in clinically isolated syndrome
Authors: Collorone Sara , Prados Ferran , Hagens Marloes HJ , Tur Carmen , Kanber Baris , Sudre Carole H , Lukas Carsten , Gasperini Claudio , Oreja-Guevara Celia , Andelova Micaela , Ciccarelli Olga , Wattjes Mike P , Ourselin Sebastian , Altmann Daniel R , Tijms Betty M , Barkhof Frederik , Toosy Ahmed T ,   for the MAGNIMS Study Group
Published: July 2019

Background: Structural cortical networks (SCNs) represent patterns of coordinated morphological modifications in cortical areas, and they present the advantage of being extracted from previously acquired clinical magnetic resonance imaging (MRI) scans. SCNs have shown pathophysiological changes in many brain disorders, including multiple sclerosis. Objective: To investigate alterations of SCNs at the individual level in patients with clinically isolated syndrome (CIS), thereby assessing their clinical relevance. Methods: We analyzed baseline data collected in a prospective multicenter (MAGNIMS) study. CIS patients ( n = 60) and healthy controls ( n = 38) underwent high-resolution 3T MRI. Measures of disability and cognitive processing were obtained for patients. Single-subject SCNs were extracted from brain 3D-T1 weighted sequences; global and local network parameters were computed. Results: Compared to healthy controls, CIS patients showed altered small-world topology, an efficient network organization combining dense local clustering with relatively few long-distance connections. These disruptions were worse for patients with higher lesion load and worse cognitive processing speed. Alterations of centrality measures and clustering of connections were observed in specific cortical areas in CIS patients when compared with healthy controls. Conclusion: Our study indicates that SCNs can be used to demonstrate clinically relevant alterations of connectivity in CIS.
Does statin increase the risk of intracerebral hemorrhage in stroke survivors? A meta-analysis and trial sequential analysis
Authors: Teoh Ru Jian Jonathan , Huang Chi-Jung , Chan Chi Peng , Chien Li-Yin , Chung Chih-Ping , Sung Shih-Hsien , Chen Chen-Huan , Chiang Chern-En , Cheng Hao-Min 
Published: July 2019

Background: It remains debatable whether statin increases the risk of intracerebral hemorrhage (ICH) in poststroke patients. Methods: We systematically searched PubMed, EMBASE, and CENTRAL for randomized controlled trials. Trial sequential analysis (TSA) was conducted to assess the reliability and conclusiveness of the available evidence in the meta-analysis. To evaluate the overall effectiveness, the net composite endpoints were derived by totaling ischemic stroke, hemorrhagic stroke, transient ischemic attack (TIA), myocardial infarction, and cardiovascular mortality. Results: A total of 17 trials with 11,576 subjects with previous ischemic stroke, TIA, or ICH were included, in which statin therapy increased the risk of hemorrhagic stroke (risk ratio [RR], 1.42; 95% confidence interval [CI], 1.07–1.87), but reduced the risk of ischemic stroke (RR, 0.85; 95% CI, 0.75–0.95). For the net composite endpoints, statin therapy was associated with a 17% risk reduction (95% CI, 12–21%; number needed to treat = 6). With a control event rate 2% and RR increase 40%, the TSA suggested a conclusive signal of an increased risk of hemorrhagic stroke in stroke survivors taking statin. However, with the sensitivity analysis by changing assumptions, the conclusions about hemorrhagic stroke risk were less robust. Conclusions: Statin therapy in poststroke patients increased the risk of hemorrhagic stroke but effectively reduced ischemic stroke risk. Weighing the benefits and potential harms, statin has an overall beneficial effect in patients with previous stroke or TIA. However, more studies are required to investigate the conclusiveness of the increased hemorrhagic stroke risk revealed in our study.
Artificial Pancreas: Evaluating the ARG Algorithm Without Meal Announcement
Authors: Fushimi Emilia , Colmegna Patricio , De Battista Hernán , Garelli Fabricio , Sánchez-Peña Ricardo 
Published: July 2019

Background: Either under standard basal-bolus treatment or hybrid closed-loop control, subjects with type 1 diabetes are required to count carbohydrates (CHOs). However, CHO counting is not only burdensome but also prone to errors. Recently, an artificial pancreas algorithm that does not require premeal insulin boluses—the so-called automatic regulation of glucose (ARG)—was introduced. In its first pilot clinical study, although the exact CHO counting was not required, subjects still needed to announce the meal time and classify the meal size. Method: An automatic switching signal generator (SSG) is proposed in this work to remove the manual mealtime announcement from the control strategy. The SSG is based on a Kalman filter and works with continuous glucose monitoring readings only. Results: The ARG algorithm with unannounced meals (ARGum) was tested in silico under the effect of different types of mixed meals and intrapatient variability, and contrasted with the ARG algorithm with announced meals (ARGam). Simulations reveal that, for slow-absorbing meals, the time in the euglycemic range, [70-180] mg/dL, increases using the unannounced strategy (ARGam: 78.1 [68.6-80.2]% (median [IQR]) and ARGum: 87.8 [84.5-90.6]%), while similar results were found with fast-absorbing meals (ARGam: 87.4 [86.0-88.9]% and ARGum: 87.6 [86.1-88.8]%). On the other hand, when intrapatient variability is considered, time in euglycemia is also comparable (ARGam: 81.4 [75.4-83.5]% and ARGum: 80.9 [77.0-85.1]%). Conclusion: In silico results indicate that it is feasible to perform an in vivo evaluation of the ARG algorithm with unannounced meals.
Promoting Health in Rural India: Enhancing Job Performance of Lay Health Care Activists
Authors: Pandey Jatin , Singh Manjari , Varkkey Biju , Mavalankar Dileep 
Published: July 2019

The health of people in a nation is a potential indicator of its development. Over and above that, the job performance of people involved in the delivery and facilitation of health care services within a nation reflects the actual health conditions in it. In developing countries, where a large chunk of the population lives in rural areas, the job performance of grass-roots health care workers gains significant importance in order to ensure effective and efficient delivery of health care services to the masses and marginalized communities. The present study takes the case of Accredited Social Health Activists (ASHAs) in difficult rural areas of India to identify factors that affect their job performance and suggests interventions through which it could be enhanced. Fifty-five ASHAs were interviewed and five focused group discussions (FGDs) were conducted. Additionally, triangulation was done by interviewing other stakeholders, while studying relevant documents. Through content analysis of these interviews and documents, this study identifies the demands, resources and stressors that affect the job performance of these important intermediaries in the health care supply chain (in the Indian context). The study also suggests policy-level decisions that could help in enhancing job performance of ASHAs by managing demands, increasing resources and reducing stressors. Key Messages We have developed a model that delineates the demands, resources and stressors that affect job performance of women workers in rural India. We have studied Accredited Social Health Activists (ASHAs) who are part of community health care sector. However, our findings are applicable to a wider set of similar job roles. We have studied the nuances of factors affecting job performance for a category of community health care workers who are not full-time employees, have received minimal training and work in close proximity of their residence in a closely knit society. We have looked at job performance of ASHAs who are women community health workers, with low educational qualifications, based in rural setting of a developing country. We have recommended policy implications that would aid in enhancing the performance of ASHAs and thus improve the health care situation in rural India.
Phase 1 study of the selective BTK inhibitor zanubrutinib in B-cell malignancies and safety and efficacy evaluation in CLL
Authors: Tam Constantine S. , Trotman Judith , Opat Stephen , Burger Jan A. , Cull Gavin , Gottlieb David , Harrup Rosemary , Johnston Patrick B. , Marlton Paula , Munoz Javier , Seymour John F. , Simpson David , Tedeschi Alessandra , Elstrom Rebecca , Yu Yiling , Tang Zhiyu , Han Lynn , Huang Jane , Novotny William , Wang Lai , Roberts Andrew W. 
Published: July 2019

Abstract
Zanubrutinib is a potent and highly selective inhibitor of Bruton tyrosine kinase (BTK). In this first-in-human, open-label, multicenter, phase 1 study, patients in part 1 (3 + 3 dose escalation) had relapsed/refractory B-cell malignancies and received zanubrutinib 40, 80, 160, or 320 mg once daily or 160 mg twice daily. Part 2 (expansion) consisted of disease-specific cohorts, including treatment-naive or relapsed/refractory chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). The primary end points were safety and tolerability, and definition of the maximum tolerated dose (part 1). Additional end points included pharmacokinetics/pharmacodynamics and preliminary efficacy. Reported herein are results from 144 patients enrolled in the dose-finding and CLL/SLL cohorts. No dose-limiting toxicities occurred in dose escalation. Median BTK occupancy in peripheral blood mononuclear cells was &gt;95% at all doses. Sustained complete (&gt;95%) BTK occupancy in lymph node biopsy specimens was more frequent with 160 mg twice daily than 320 mg once daily (89% vs 50%; P = .0342). Consequently, 160 mg twice daily was selected for further investigation. With median follow-up of 13.7 months (range, 0.4-30.5 months), 89 CLL/SLL patients (94.7%) remain on study. Most toxicities were grade 1/2; neutropenia was the only grade 3/4 toxicity observed in &gt;2 patients. One patient experienced a grade 3 subcutaneous hemorrhage. Among 78 efficacy-evaluable CLL/SLL patients, the overall response rate was 96.2% (95% confidence interval, 89.2-99.2). Estimated progression-free survival at 12 months was 100%. Zanubrutinib demonstrated encouraging activity in CLL/SLL patients, with a low incidence of major toxicities. This trial was registered at www.clinicaltrials.gov as #NCT02343120.
Sustained Progression-Free Survival Benefit of Rituximab Maintenance in Patients With Follicular Lymphoma: Long-Term Results of the PRIMA Study
Authors: Bachy Emmanuel , Seymour John F. , Feugier Pierre , Offner Fritz , López-Guillermo Armando , Belada David , Xerri Luc , Catalano John V. , Brice Pauline , Lemonnier François , Martin Alejandro , Casasnovas Olivier , Pedersen Lars M. , Dorvaux Véronique , Simpson David , Leppa Sirpa , Gabarre Jean , da Silva Maria G. , Glaisner Sylvie , Ysebaert Loic , Vekhoff Anne , Intragumtornchai Tanin , Le Gouill Steven , Lister Andrew , Estell Jane A. , Milone Gustavo , Sonet Anne , Farhi Jonathan , Zeuner Harald , Tilly Hervé , Salles Gilles 
Published: July 2019

PURPOSE The PRIMA study (ClinicalTrials.gov identifier: NCT00140582 ) established that 2 years of rituximab maintenance after first-line immunochemotherapy significantly improved progression-free survival (PFS) in patients with follicular lymphoma compared with observation. Here, we report the final PFS and overall survival (OS) results from the PRIMA study after 9 years of follow-up and provide a final overview of safety. METHODS Patients (> 18 years of age) with previously untreated high–tumor-burden follicular lymphoma were nonrandomly assigned to receive one of three immunochemotherapy induction regimens. Responding patients were randomly assigned (stratified by induction regimen, response to induction treatment, treatment center, and geographic region) 1:1 to receive 2 years of rituximab maintenance (375 mg/m2, once every 8 weeks), starting 8 weeks after the last induction treatment, or observation (no additional treatment). All patients in the extended follow-up provided their written informed consent (data cutoff: December 31, 2016). RESULTS In total, 1,018 patients completed induction treatment and were randomly assigned to rituximab maintenance (n = 505) or observation (n = 513). Consent for the extended follow-up was provided by 607 patients (59.6%) of 1,018 (rituximab maintenance, n = 309; observation, n = 298). After data cutoff, median PFS was 10.5 years in the rituximab maintenance arm compared with 4.1 years in the observation arm (hazard ratio, 0.61; 95% CI, 0.52 to 0.73; P < .001). No OS difference was seen in patients randomly assigned to rituximab maintenance or observation (hazard ratio, 1.04; 95% CI, 0.77 to 1.40; P = .7948); 10-year OS estimates were approximately 80% in both study arms. No new safety signals were observed. CONCLUSION Rituximab maintenance after induction immunochemotherapy provides a significant long-term PFS, but not OS, benefit over observation.
How to Undo the History of Sexuality: Editing Edward Taylor’sMeditations
Authors: Stein Jordan Alexander 
Published: July 2019

AbstractThis essay establishes how the scholarly labors that brought Edward Taylor’s works to light in the 1930s foreclosed any understanding of them as queer. The absence of a queer critical reception history is this essay’s subject, and to trace that absence, it focuses on the material and intellectual terms of Taylor’s initial critical reception and on the political forces and critical assumptions that bear on those terms. Taylor’s devotional Meditations offer an exemplary case for understanding how many of the ordinary labors associated with recovery and publication—the scholarly acts that stand, ultimately, behind nearly any interpretation of any literary text, including genre classification, editorial presentation, and genealogical authentication—have often been versions of what Eve Kosofsky Sedgwick described in the late 1980s as “the extremely elusive and maddeningly plural ways in which cultures and their various institutions efface and alter sexual meaning.”
Passions for Justice: Kleist’s Michael Kohlhaas and Coetzee’s Michael K
Authors: Robinson Benjamin Lewis 
Published: July 2019

AbstractJ. M. Coetzee conceived of Life & Times of Michael K (1983) as an “interpretive translation” of Heinrich von Kleist’s Michael Kohlhaas (1808/10). Drawing on Coetzee’s notes and drafts, this essay explores his attempt to generate the literary and political “passion + urgency” of Kleist’s text, which Coetzee felt the times called for but his own writing lacked. While Michael Kohlhaas became a guerrilla out of his “passion for justice,” Michael K, despite the incessant provocations of the state, does not join the guerrillas but emerges instead as a very different kind of figure: a gardener who “just lives.” Between the guerrilla and the gardener, Coetzee elaborates an antinomy of justice not only in apartheid South Africa but inherent to the institutionalization of modern political life.
Colonial Economic Improvement: How Spain Created NewConsuladosto Preserve and Develop Its American Empire, 1778–1795
Authors: Tavárez Fidel J. 
Published: July 2019

AbstractAfter implementing comercio libre (free internal trade) in 1778, the Spanish crown endeavored to create multiple new consulados (chambers of commerce) to facilitate commercial exchange within Spain's Atlantic territories. However, while the crown established new metropolitan consulados in the mid-1780s, it approved colonial consulados only in the 1790s, after the death of the minister of the Indies, José de Gálvez, in 1787. Why did the crown initially hesitate to establish colonial consulados? I argue that unlike Gálvez, who was committed to an extractive system of imperialism, the post-1787 ministers were inspired by a distinct kind of soft imperialism, which held that the empire's survival depended on stimulating colonial economic growth while promoting reciprocal bonds among all Spanish subjects. In reconstructing this history, I show how the post-1787 ministers established a new regime of colonial economic improvement to bind the empire during a moment of impending crisis.
An Indian It-Narrative and the Problem of Circulation: Reconsidering a Useful Concept for Literary Study
Authors: Mulholland James 
Published: July 2019

AbstractFor decades scholars have relied on the concept of circulation to explain the operation of texts and to animate the significance of literary studies. Its overuse has elided differences in the virtual relationships created by reading and has blurred empirical details about the production and consumption of texts. Circulation has been turned into a “widespread cultural ideal” and remains one of the least examined stipulations of literary study. For these reasons, reconsidering its role in literary study is essential. The eighteenth century was a vital period for the creation of a modern definition of circulation, so this essay returns to one especially pertinent case from that period, Helenus Scott’s it-narrative The Adventures of a Rupee (1782), which describes the movements of a rupee coin in the world economy. Attending to the linguistic form and publication history of Scott’s novel offers a model of circulation that emphasizes coagulation and stasis rather than liquidity, mobility, and flows. This model explains how texts repeat while altering preexisting forms of circulation, which has consequences for understanding how reading publics arise and reproduce themselves.