bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Serum High‐Density Lipoprotein Cholesterol Levels and Progression of Chronic Kidney Disease: Results From the KNOW‐CKD
Authors: Nam Ki Heon , Chang Tae Ik , Joo Young Su , Kim Joohwan , Lee Sangmi , Lee Changhyun , Yun Hae‐Ryong , Park Jung Tak , Yoo Tae‐Hyun , Sung Su Ah , Lee Kyu‐Beck , Oh Kook‐Hwan , Kim Soo Wan , Lee Joongyub , Kang Shin‐Wook , Choi Kyu Hun , Ahn Curie , Han Seung Hyeok ,   the KNOW‐CKD (KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease) Investigators
Published: March 2019

Background

High‐density lipoprotein cholesterol (
HDL
‐C) levels are generally decreased in patients with chronic kidney disease (
CKD
). However, studies on the relationship between
HDL
‐C and
CKD
progression are scarce.

Methods and Results

We studied the association between serum
HDL
‐C levels and the risk of
CKD
progression in 2168 participants of the
KNOW
‐
CKD
(Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease). The primary outcome was the composite of a 50% decline in estimated glomerular filtration rate from baseline or end‐stage renal disease. The secondary outcome was the onset of end‐stage renal disease. During a median follow‐up of 3.1 (interquartile range, 1.6–4.5) years, the primary outcome occurred in 335 patients (15.5%). In a fully adjusted Cox model, the lowest category with
HDL
‐C of <30 mg/dL (hazard ratio, 2.21; 95% CI, 1.30–3.77) and the highest category with
HDL
‐C of ≥60 mg/dL (hazard ratio, 2.05; 95%
CI
, 1.35–3.10) were associated with a significantly higher risk of the composite renal outcome, compared with the reference category with
HDL
‐C of 50 to 59 mg/dL. This association remained unaltered in a time‐varying Cox analysis. In addition, a fully adjusted cubic spline model with
HDL
‐C being treated as a continuous variable yielded similar results. Furthermore, consistent findings were obtained in a secondary outcome analysis for the development of end‐stage renal disease.

Conclusions

A U‐shaped association was observed between serum
HDL
‐C levels and adverse renal outcomes in this large cohort of patients with
CKD
. Our findings suggest that both low and high serum
HDL
‐C levels may be detrimental to patients with nondialysis
CKD
.
Recent Strengthening of Greenland Blocking Drives Summertime Surface Warming over Northern Canada and Eastern Siberia
Authors: Wang Sai , Nath Debashis , Chen Wen , Wang Lin 
Published: March 2019

AbstractIn the last three decades, rapid surface warming is observed in the land areas of northern high latitudes during boreal summer months. Although the warming trend is thought to be driven by early snowmelt, the exact causes, especially its relationship with atmospheric circulation changes, remain a subject of debate. By analyzing ERA-Interim data, this study examines the possible factors for rapid subarctic warming. It is found that more than half of the warming trend over the entire subarctic and 80% over northern Canada and eastern Siberia (regions with maximum amplification) can be explained by enhanced downward infrared radiation (IR). Downward IR is largely driven by horizontal atmospheric moisture flux convergence and warm-air advection. The positive trend in geopotential height over the Greenland region is key for moisture flux convergence over northern Canada and eastern Siberia through changes in the storm tracks. An enhanced summertime blocking activity in the Greenland region seems responsible for the positive trend in geopotential heights.
Mechanisms of Seasonal Soil Moisture Drought Onset and Termination in the Southern Great Plains
Authors: Seager Richard , Nakamura Jennifer , Ting Mingfang 
Published: March 2019

AbstractMechanisms of drought onset and termination are examined across North America with a focus on the southern Plains using data from land surface models and regional and global reanalyses for 1979–2017. Continental-scale analysis of covarying patterns reveals a tight coupling between soil moisture change over time and intervening precipitation anomalies. The southern Great Plains are a geographic center of patterns of hydrologic change. Drying is induced by atmospheric wave trains that span the Pacific and North America and place northerly flow anomalies above the southern Plains. In the southern Plains winter is least likely, and fall most likely, for drought onset and spring is least likely, and fall or summer most likely, for drought termination. Southern Plains soil moisture itself, which integrates precipitation over time, has a clear relationship to tropical Pacific sea surface temperature (SST) anomalies with cold conditions favoring dry soils. Soil moisture change, however, though clearly driven by precipitation, has a weaker relation to SSTs and a strong relation to internal atmospheric variability. Little evidence is found of connection of drought onset and termination to driving by temperature anomalies. An analysis of particular drought onsets and terminations on the seasonal time scale reveals commonalities in terms of circulation and moisture transport anomalies over the southern Plains but a variety of ways in which these are connected into the large-scale atmosphere and ocean state. Some onsets are likely to be quite predictable due to forcing by cold tropical Pacific SSTs (e.g., fall 2010). Other onsets and all terminations are likely not predictable in terms of ocean conditions.
Simultaneous Parameter Optimization of an Arctic Sea Ice–Ocean Model by a Genetic Algorithm
Authors: Sumata Hiroshi , Kauker Frank , Karcher Michael , Gerdes Rüdiger 
Published: March 2019

AbstractImprovement and optimization of numerical sea ice models are of great relevance for understanding the role of sea ice in the climate system. They are also a prerequisite for meaningful prediction. To improve the simulated sea ice properties, we develop an objective parameter optimization system for a coupled sea ice–ocean model based on a genetic algorithm. To take the interrelation of dynamic and thermodynamic model parameters into account, the system is set up to optimize 15 model parameters simultaneously. The optimization is minimizing a cost function composed of the model–observation misfit of three sea ice quantities (concentration, drift, and thickness). The system is applied for a domain covering the entire Arctic and northern North Atlantic Ocean with an optimization window of about two decades (1990–2012). It successfully improves the simulated sea ice properties not only during the period of optimization but also in a validation period (2013–16). The similarity of the final values of the cost function and the resulting sea ice fields from a set of 11 independent optimizations suggest that the obtained sea ice fields are close to the best possible achievable by the current model setup, which allows us to identify limitations of the model formulation. The optimized parameters are applied for a simulation with a higher-resolution model to examine a portability of the parameters. The result shows good portability, while at the same time, it shows the importance of the oceanic conditions for the portability.
Discharge Delay in Head and Neck Free Flap Surgery: Risk Factors and Strategies to Minimize Hospital Days
Authors: Lang Dustin M. , Danan Deepa , Sawhney Raja , Silver Natalie L. , Varadarajan Varun V. , Balamohan Sanjeev , Bernard Stewart H. , Boyce Brian J. , Dziegielewski Peter T. 
Published: March 2019

ObjectiveLength of stay (LOS) includes time medically necessary in the hospital and time waiting for discharge (DC) afterward. This DC delay is determined in head and neck free flap patients. Reasons for and factors leading to DC delay, as well as associated adverse outcomes, are elucidated.MethodsRetrospective chart review was performed for all head and neck free flap surgeries from 2012 to 2017. Data including demographics, comorbidities, and perioperative factors were collected. Regression analyses were performed to identify factors associated with DC delay.ResultsIn total, 264 patients were included. Mean total LOS was 13.1 days. DC delay occurred in 65% of patients with a mean of 4.8 days. Factors associated with DC delay on univariate analysis included Medicaid/self‐pay insurance, DC to a facility, and not having children (P <. 05). Multivariate analysis showed prolonged medically necessary LOS and surgery on a Monday/Friday (P <. 05) were associated with DC delay. Top reasons for DC delay included case management shortages, rejection by facility, and awaiting supplies. Eleven percent experienced complications during the DC delay.DiscussionDC delay can add days and complications to the LOS. Prevention begins preoperatively with DC planning involving the patient's closest family. Understanding limitations of the patient's insurance may help plan DC destination. Optimizing hospital resources when available should be a focus.Implications for PracticeHead and neck free flap patients require a team of teams unified in optimizing quality of care. DC delay is a novel quality metric reflecting the team's overall performance. Through strategic DC planning and capitalizing on available resources, DC delay can be minimized.
Continuous Vagal Neuromonitoring Using the Laryngeal Adductor Reflex: Can Preincision Dyssynchrony Predict Intraoperative Nerve Behavior?
Authors: Roldan Maria De Los Angeles Sanchez , Téllez Maria J. , Ulkatan Sedat , Sinclair Catherine F. 
Published: March 2019

ObjectiveThe laryngeal adductor reflex (LAR) is an airway‐protective response triggered by sensory laryngeal receptors and resulting in bilateral vocal fold adduction. The normal morphology of the early R1 response resembles that of the compound muscle action potential (CMAP). However, in a small subset of patients, the morphology is dyssynchronous with multiple peaks. This study investigates whether preoperative LAR dyssynchrony predicts intraoperative nerve behavior during thyroid surgeries.Study DesignRetrospective case‐control study.SettingUS academic health center.Subjects and MethodsOpening and closing LAR waveforms from 200 patients with normal preoperative laryngeal examinations monitored continuously during thyroid surgeries using the LAR were analyzed. Area under the curve (AUC) and number of “events” during surgery (defined as any transient decline in AUC >50% baseline) were determined for patients who demonstrated opening dyssynchronous LAR traces compared to demographically matched controls.ResultsSix patients had opening dyssynchronous LAR traces. These patients had significantly greater declines in R1 AUC than demographically matched patients with opening synchronized R1 traces (P =. 007). Upon thyroid removal, 1 patient converted from a dyssynchronous to synchronous trace.ConclusionsPreincision dyssynchronous LAR waveforms may indicate subclinical, potentially reversible, neuropathy of the recurrent laryngeal nerve (RLN) and predict intraoperative RLN behavior. Preincision knowledge of R1 dyssynchrony can facilitate surgical planning as such patients may glean particular benefit from continuous intraoperative nerve monitoring, frequent tissue relaxation, and saline irrigation as means to minimize nerve stress intraoperatively.
Low thalamostriate venous quantitative susceptibility measurements correlate with higher presenting NIH stroke scale score in emergent large vessel occlusion stroke
Authors: Kim Paggie , Langheinrich Kristofer , Cristiano Brian , Grigsby Phillip , Oyoyo Udo , Kido Daniel , Paul Jacobson J. 
Published: March 2019

Objective Hyperacute stroke affects various patient subgroups who may benefit from different management strategies. Magnetic resonance imaging (MRI) quantitative susceptibility mapping (QSM) is a recent MRI technique for measuring deoxyhemoglobin levels. The results of QSM thus have the potential to act as a quantitative biomarker for predicting the success of endovascular interventions. Methods Twenty-five patients with M1 occlusions were evaluated retrospectively. QSM measurements were obtained based on susceptibility-weighted imaging sequences from the most prominent veins in each of the four standard regions of interest: the cortical and thalamostriate veins ipsilateral and contralateral to the side of the stroke. The results were analyzed using Wilcoxon’s signed rank test and compared with presenting National Institutes of Health stroke scale (NIHSS) score. Results Cortical veins ipsilateral to the stroke showed the greatest elevation in susceptibility compared with all other vein groups. Both ipsilateral and contralateral thalamostriate vein susceptibilities showed strong inverse correlation with presenting NIHSS score. Conclusion Thalamostriate vein susceptibility shows a strong inverse correlation with presenting NIHSS in adult patients with hyperacute stroke who are selected for endovascular intervention by advanced imaging.
Sex differences in the contributions of spinal atypical PKCs and downstream targets to the maintenance of nociceptive sensitization
Authors: George Nicole C , Laferrière André , Coderre Terence J 
Published: March 2019

Background Chronic pain has been shown to depend on nociceptive sensitization in the spinal cord, and while multiple mechanisms involved in the initiation of plastic changes have been established, the molecular targets which maintain spinal nociceptive sensitization are still largely unknown. Building upon the established neurobiology underlying the maintenance of long-term potentiation in the hippocampus, this present study investigated the contributions of spinal atypical protein kinase C (PKC) isoforms PKCι/λ and PKMζ and their downstream targets (p62/GluA1 and NSF/GluA2 interactions, respectively) to the maintenance of spinal nociceptive sensitization in male and female rats. Results Pharmacological inhibition of atypical PKCs by ZIP reversed established allodynia produced by repeated intramuscular acidic saline injections in male animals only, replicating previously demonstrated sex differences. Inhibition of both PKCι/λ and downstream substrates p62/GluA1 resulted in male-specific reversals of intramuscular acidic saline-induced allodynia, while female animals continued to display allodynia. Inhibition of NSF/GluA2, the downstream target to PKMζ, reversed allodynia induced by intramuscular acidic saline in both sexes. Neither PKCι/λ, p62/GluA1 or NSF/GluA2 inhibition had any effect on formalin response for either sex. Conclusion This study provides novel behavioural evidence for the male-specific role of PKCι/λ and downstream target p62/GluA1, highlighting the potential influence of ongoing afferent input. The sexually divergent pathways underlying persistent pain are shown here to converge at the interaction between NSF and the GluA2 subunit of the AMPA receptor. Although this interaction is thought to be downstream of PKMζ in males, these findings and previous work suggest that females may rely on a factor independent of atypical PKCs for the maintenance of spinal nociceptive sensitization.
Relationship with children and the psychological well-being of the elderly in Indonesia
Authors: Almira Litha , Hanum Lathifah , Menaldi Adhityawarman 
Published: March 2019

Objective: Many older adults in Indonesia live with their children. This study examined the relationship between the quality of the relationship that elderly parents may have with their children living with them and any effects on psychological well-being. Methods: Relationship quality encompasses positive and negative aspects. This study employed convenience sampling and to reach 102 elderly participants. A measure of positive and negative social exchanges was used to measure the relationship between elderly parents and their children. Ryff’s Scale of Psychological Well-Being was utilized to measure the psychological well-being of the subjects. We used descriptive statistics, Pearson correlation coefficient, an independent t-test, and one-way analysis of variance (ANOVA) to assess the statistics produced. Results: The primary results showed no correlation between the positive qualities of the relationship and psychological well-being ( r = 0.092, p > 0.01). However, the negative qualities of the relationship were negatively correlated with psychological well-being ( r = −0.335, p < 0.01). Conclusion: Thus, negative qualities of relationships with their children were found to be more impactful on psychological well-being than positive qualities in elderly parents who maintain coresidence with their children. This means that the greater the lack of sympathy, intrusion, failure to provide needed help, and rejection/neglect from the child, the worse the psychological well-being of the elderly parent.
Association Between Bone Marrow Lesions, Chondral Lesions, and Pain in Patients Without Radiographic Evidence of Degenerative Joint Disease Who Underwent Arthroscopic Partial Meniscectomy
Authors: Bisson Leslie J. , Phillips Paul , Matthews John , Zhou Zehua , Zhao Jiwei , Wind William M. , Fineberg Marc S. , Bernas Geoffrey A. , Rauh Michael A. , Marzo John M. , Kluczynski Melissa A. 
Published: March 2019

Background: Bone marrow lesions (BMLs) have been found on magnetic resonance imaging in patients with meniscal tears. Purpose: We sought to determine the prevalence and location of BMLs, the association between BMLs and chondral lesions, and the association between BMLs and pain in patients without radiographic evidence of degenerative joint disease who underwent arthroscopic partial meniscectomy (APM). Study Design: Cohort study; Level of evidence, 2. Methods: We performed a secondary analysis of the Chondral Lesions And Meniscus Procedures (ChAMP) randomized controlled trial. BMLs were assessed on preoperative magnetic resonance imaging, and chondral lesions were documented at the time of surgery. Pain was assessed preoperatively and at 1 year after APM using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Knee injury and Osteoarthritis Outcome Score (KOOS). The chi-square test was used to examine the association between BMLs and chondral lesions, and the F test was used to examine the association between BMLs and pain. Results: Of 241 patients, 58.9% had ≥1 BMLs, and most were located on the medial tibial plateau (MTP; 74.6%) and/or medial femoral condyle (MFC; 28.9%). Most MTP BMLs were submeniscal (56%), and most MFC BMLs extended beyond the meniscus (73%). There were more MFC chondral lesions for patients with any MFC BMLs ( P = .01) and submeniscal MFC BMLs ( P = .02) versus those without BMLs, and there was no association between BMLs and chondral lesions on the MTP. There was also no association between BMLs and preoperative or postoperative pain scores. Conclusion: In patients without radiographic evidence of degenerative joint disease who underwent APM, BMLs were found in 58.9% of knees and were primarily located in the medial compartment. There was a borderline statistically significant association between BMLs and chondral lesions for the MFC; however, BMLs were not associated with pain scores preoperatively or at 1 year after surgery.
Hydroxyurea reduces cerebral metabolic stress in patients with sickle cell anemia
Authors: Fields Melanie E. , Guilliams Kristin P. , Ragan Dustin , Binkley Michael M. , Mirro Amy , Fellah Slim , Hulbert Monica L. , Blinder Morey , Eldeniz Cihat , Vo Katie , Shimony Joshua S. , Chen Yasheng , McKinstry Robert C. , An Hongyu , Lee Jin-Moo , Ford Andria L. 
Published: March 2019

Abstract
Chronic transfusion therapy (CTT) prevents stroke in selected patients with sickle cell anemia (SCA). We have shown that CTT mitigates signatures of cerebral metabolic stress, reflected by elevated oxygen extraction fraction (OEF), which likely drives stroke risk reduction. The region of highest OEF falls within the border zone, where cerebral blood flow (CBF) nadirs; OEF in this region was reduced after CTT. The neuroprotective efficacy of hydroxyurea (HU) remains unclear. To test our hypothesis that patients receiving HU therapy have lower cerebral metabolic stress compared with patients not receiving disease-modifying therapy, we prospectively obtained brain magnetic resonance imaging scans with voxel-wise measurements of CBF and OEF in 84 participants with SCA who were grouped by therapy: no disease-modifying therapy, HU, or CTT. There was no difference in whole-brain CBF among the 3 cohorts (P = .148). However, whole-brain OEF was significantly different (P &lt; .001): participants without disease-modifying therapy had the highest OEF (median 42.9% [interquartile range (IQR) 39.1%-49.1%]), followed by HU treatment (median 40.7% [IQR 34.9%-43.6%]), whereas CTT treatment had the lowest values (median 35.3% [IQR 32.2%-38.9%]). Moreover, the percentage of white matter at highest risk for ischemia, defined by OEF greater than 40% and 42.5%, was lower in the HU cohort compared with the untreated cohort (P = .025 and P = .034 respectively), but higher compared with the CTT cohort (P = .018 and P = .029 respectively). We conclude that HU may offer neuroprotection by mitigating cerebral metabolic stress in patients with SCA, but not to the same degree as CTT.
A phase 1b study of isatuximab plus pomalidomide/dexamethasone in relapsed/refractory multiple myeloma
Authors: Mikhael Joseph , Richardson Paul , Usmani Saad Z. , Raje Noopur , Bensinger William , Karanes Chatchada , Campana Frank , Kanagavel Dheepak , Dubin Franck , Liu Qianying , Semiond Dorothée , Anderson Kenneth 
Published: March 2019

Abstract
This phase 1b dose-escalation study evaluated isatuximab plus pomalidomide/dexamethasone in patients with relapsed/refractory multiple myeloma (RRMM). Patients who had received ≥2 prior MM therapies, including lenalidomide and a proteasome inhibitor (PI), were enrolled and received isatuximab at 5, 10, or 20 mg/kg (weekly for 4 weeks, followed by every 2 weeks), pomalidomide 4 mg (days 1-21), and dexamethasone 40 mg (weekly) in 28-day cycles until progression/intolerable toxicity. The primary objective was to determine the safety and recommended dose of isatuximab with this combination. Secondary objectives included evaluation of pharmacokinetics, immunogenicity, and efficacy. Forty-five patients received isatuximab (5 [n = 8], 10 [n = 31], or 20 [n = 6] mg/kg). Patients received a median of 3 (range, 1-10) prior lines; most were refractory to their last regimen (91%), with 82% lenalidomide-refractory and 84% PI-refractory. Median treatment duration was 9.6 months; 19 patients (42%) remain on treatment. Most common adverse events included fatigue (62%), and upper respiratory tract infection (42%), infusion reactions (42%), and dyspnea (40%). The most common grade ≥3 treatment-emergent adverse event was pneumonia, which occurred in 8 patients (17.8%). Hematologic laboratory abnormalities were common (lymphopenia, leukopenia, anemia, 98% each; neutropenia, 93%; and thrombocytopenia, 84%). Overall response rate was 62%; median duration of response was 18.7 months; median progression-free survival was 17.6 months. These results demonstrate potential meaningful clinical activity and a manageable safety profile of isatuximab plus pomalidomide/dexamethasone in heavily pretreated patients with RRMM. The 10 mg/kg weekly/every 2 weeks isatuximab dose was selected for future studies. This trial was registered at www.clinicaltrials.gov as #NCT02283775.