bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex Disparities in Resuscitation Quality Following Out of Hospital Cardiac Arrest
Authors: Delardes Belinda , Schwarz Jenna , Ralph Tara , Anderson David , Nehme Emily , Nehme Ziad 
Published: June 2024

Background
Women are known to be disadvantaged compared with men in the early links of the Chain of Survival, receiving fewer bystander interventions. We aimed to describe sex‐based disparities in emergency medical service resuscitation quality and processes of care for out‐of‐hospital cardiac arrest.

Methods and Results
We conducted a retrospective analysis of patients who were nontraumatic with out‐of‐hospital cardiac arrest aged ≥16 years where resuscitation was attempted between March 2019 and June 2023. We investigated 18 routinely captured performance metrics and performed adjusted logistic and quantile regression analyses to assess sex‐based differences in these metrics. During the study period, 10 161 patients with out‐of‐hospital cardiac arrest met the eligibility criteria, of whom 3216 (32%) were women. There were no clinically relevant sex‐based differences observed in regard to external cardiac compressions; however, women were 34% less likely to achieve a systolic blood pressure >100 mm Hg on arrival at the hospital (adjusted odds ratio [AOR], 0.66 [95% CI, 0.47–0.92]). Furthermore, women had a longer time to 12‐lead ECG acquisition after return of spontaneous circulation (median adjusted difference, 1.00 minute [95% CI, 0.38–1.62]) and 33% reduced odds of being transported to a 24‐hour percutaneous coronary intervention‐capable facility (AOR, 0.67 [95% CI, 0.49–0.91]). Resuscitation was also terminated sooner for women compared with men (median adjusted difference, −4.82 minutes [95% CI, −6.77 to −2.87]).

Conclusions
Although external cardiac compression quality did not vary by sex, significant sex‐based disparities were seen in emergency medical services processes of care following out‐of‐hospital cardiac arrest. Further investigation is required to elucidate the underlying causes of these differences and examine their influence on patient outcomes.
Implementation of a Cell‐Enabled Remote Blood Pressure Monitoring Program During the Postpartum Period at a Safety‐Net Hospital
Authors: Mujic Ema , Parker Samantha E. , Nelson Kerrie P. , O'Brien Megan , Chestnut Idalis A. , Abrams Jasmine , Yarrington Christina D. 
Published: June 2024

Background
Postpartum hypertension is a risk factor for severe maternal morbidity; however, barriers exist for diagnosis and treatment. Remote blood pressure (BP) monitoring programs are an effective tool for monitoring BP and may mitigate maternal health disparities. We aimed to describe and evaluate engagement in a remote BP monitoring program on BP ascertainment during the first 6‐weeks postpartum among a diverse patient population.

Methods and Results
A postpartum remote BP monitoring program, using cell‐enabled technology and delivered in multiple languages, was implemented at a large safety‐net hospital. Eligible patients are those with hypertensive disorders before or during pregnancy. We describe characteristics of patients enrolled from January 2021 to May 2022 and examine program engagement by patient characteristics. Linear regression models were used to calculate mean differences and 95% CIs between characteristics and engagement metrics. We describe the prevalence of patients with BP ≥140/or >90 mm Hg. Among 1033 patients, BP measures were taken an average of 15.2 days during the 6‐weeks, with the last measurement around 1 month (mean: 30.9 days), and little variability across race or ethnicity. Younger maternal age (≤25 years) was associated with less frequent measures (mean difference, −4.3 days [95% CI: −6.1 to −2.4]), and grandmultiparity (≥4 births) was associated with shorter engagement (mean difference, −3.5 days [95% CI, −6.1 to −1.0]). Prevalence of patients with BP ≥140/or >90 mm Hg was 62.3%, with differences by race or ethnicity (Black: 72.9%; Hispanic: 52.4%; White: 56.0%).

Conclusions
A cell‐enabled postpartum remote BP monitoring program was successful in uniformly monitoring BP and capturing hypertension among a diverse, safety‐net hospital population.
Impact of Defibrillator Electrode Placement on Outcome of Electrical Cardioversion of Atrial Fibrillation: A Pilot Observational Study
Authors: Madanat Luai , France Josh , Shoukri Nolan , Bilolikar Abhay N. , Walsh Daniel , Kutinsky Ilana , Gundlapalli Sujana , Zhao Lili , Goel Anil , Williamson Brian , Cami Elvis , Gallagher Michael , Bloomingdale Richard , Dixon Simon , Haines David , Mehta Nishaki 
Published: June 2024

Background
Anterior–posterior electrode placement is preferred in electrical cardioversion of atrial fibrillation. However, the optimal anterior–posterior electrode position in relation to the heart is not studied.

Methods and Results

We performed a prospective observational study on patients presenting for cardioversion of atrial fibrillation. Electrodes were placed in the anterior–posterior position and shock was delivered in a step‐up approach (100 J→200 J→360 J). Fluoroscopic images were obtained, and distances were measured from points A, midanterior electrode; and B, midposterior electrode, to midpoint of the cardiac silhouette. Patients requiring one 100 J shock for cardioversion success (group I) were compared with those requiring >1 shock/100 J (group II). Logistic regression was used to determine the impact of electrode distance on low energy (100 J) cardioversion success. Computed tomography scans from this cohort were analyzed for anatomic landmark correlation to the cardiac silhouette. Of the 87 patients included, 54 (62%) comprised group I and 33 (38%) group II. Group I had significantly lower distances from the mid–cardiac silhouette to points A (5.0±2.4 versus 7.4±3.3 cm;
P
<0.001) and B (7.3±3.0 versus 10.0±3.8 cm;
P
=0.002) compared with group II. On multivariate analysis, higher distances from the mid–cardiac silhouette to point A (odds ratio, 1.33 [95% CI, 1.07–1.70];
P
=0.01) and B (odds rsatio, 1.24 [95% CI, 1.05–1.50];
P
=0.01) were independent predictors of low energy (100 J) cardioversion failure. Based on review of computed tomography scans, we suggest that the xiphoid process may be an easy landmark to guide proximity to the myocardium.

Conclusions
In anterior–posterior electrode placement, closer proximity to the cardiac silhouette predicts successful 100 J cardioversion irrespective of clinical factors.
Abbreviated Versus Standard Dual Antiplatelet Therapy Times After Percutaneous Coronary Intervention in Patients With High Bleeding Risk With Acute Coronary Syndrome: Insights From the SWEDEHEART Registry
Authors: Håkansson Anton , Koul Sasha , Omerovic Elmir , Andersson Jonas , James Stefan , Agewall Stefan , Mokhtari Arash , van Der Pals Jesper , Wester Axel , Szummer Karolina , Jernberg Tomas , Erlinge David , Mohammad Moman A. 
Published: June 2024

Background
Dual antiplatelet therapy (DAPT) reduces ischemic events but increases bleeding risk, especially in patients with high bleeding risk (HBR). This study aimed to compare outcomes of abbreviated versus standard DAPT strategies in patients with HBR with acute coronary syndrome undergoing percutaneous coronary intervention.

Methods and Results

Patients from the SWEDEHEART (Swedish Web‐system for Enhancement and Development of Evidence‐Based Bare in Heart Disease Evaluated According to Recommended Therapies) registry with at least 1 HBR criterion who underwent percutaneous coronary intervention for acute coronary syndrome were identified and included. Patients were divided into 2 groups based on their planned DAPT time at discharge: 12‐month DAPT or an abbreviated DAPT strategy and matched according to their prescribed P2Y12 inhibitor at discharge. The primary outcome assessed was time to net adverse clinical events at 1 year, which encompassed cardiac death, myocardial infarction, ischemic stroke, or clinically significant bleeding. Time to major adverse cardiovascular events and the individual components of net adverse clinical events were considered secondary end points. A total of 4583 patients were included in each group. The most frequently met HBR criteria was age older than 75 years (65.6%) and Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy score ≥25 (44.6%) in the standard DAPT group and oral anticoagulant therapy (79.6%) and age 75 years and older (55.2%) in the abbreviated DAPT group. There was no statistically significant difference in net adverse clinical events (12.9% versus 13.1%; hazard ratio [HR], 0.99 [95% CI, 0.88–1.11],
P
=0.83), major adverse cardiovascular events (8.6% versus 7.9%; HR, 1.08 [95% CI, 0.94–1.25]), or their components between groups. The results were consistent among all of the investigated subgroups.

Conclusions
In patients with HBR undergoing percutaneous coronary intervention due to acute coronary syndrome, abbreviated DAPT was associated with comparable rates of net adverse clinical events and major adverse cardiovascular events to a DAPT duration of 12 months.
Long‐Term Visit‐to‐Visit Blood Pressure Variability and Cognitive Decline Among Patients With Hypertension: A Pooled Analysis of 3 National Prospective Cohorts
Authors: Zheng Guangjun , Zhou Biying , Fang Zhenger , Chen Xia , Liu Mingliang , He Fudong , Zhang Haofeng , Zhu Haidong , Dong Yanbin , Hao Guang 
Published: June 2024

Background
A limited number of studies investigated the association between blood pressure variability (BPV) and cognitive impairment in patients with hypertension. This study aimed to identify the longitudinal association between BPV and cognitive decline and the role of blood pressure (BP) control in this association.

Methods and Results

Participants with hypertension from the HRS (Health and Retirement Study), the ELSA (English Longitudinal Study of Ageing), and the CHARLS (China Health and Retirement Longitudinal Study) were included. Variation independent of the mean (VIM) was adopted to measure BPV. Cognitive function was measured by standard questionnaires, and a standardized
Z
score was calculated. Linear mixed‐model and restricted cubic splines were adopted to explore the association between BPV and cognitive decline. The study included 4853, 1616, and 1432 eligible patients with hypertension from the HRS, ELSA, and CHARLS, respectively. After adjusting for covariates, per‐SD increment of VIM of BP was significantly associated with global cognitive function decline in
Z
scores in both systolic BP (pooled β, −0.045 [95% CI, −0.065 to −0.029]) and diastolic BP (pooled β, −0.022 [95% CI, −0.040 to −0.004]) among hypertensive patients. Similar inverse associations were observed in patients with hypertension taking antihypertensive drugs and in patients with hypertension with well‐controlled BP.

Conclusions
High BPV was independently associated with a faster cognitive decline among patients with hypertension, even those with antihypertensive medications or well‐controlled BP. Further studies are needed to confirm our results and determine whether reducing BPV can prevent or delay cognitive decline.
Ten‐Year Trend of Oral Anticoagulation Use in Postoperative and Nonpostoperative Atrial Fibrillation in Routine Clinical Practice
Authors: Yao Xiaoxi , Van Houten Holly K. , Siontis Konstantinos C. , Friedman Paul A. , McBane Robert D. , Gersh Bernard J. , Noseworthy Peter A. 
Published: June 2024

Background
The study aimed to describe the patterns and trends of initiation, discontinuation, and adherence of oral anticoagulation (OAC) in patients with new‐onset postoperative atrial fibrillation (POAF), and compare with patients newly diagnosed with non‐POAF.

Methods and Results

This retrospective cohort study identified patients newly diagnosed with atrial fibrillation or flutter between 2012 and 2021 using administrative claims data from OptumLabs Data Warehouse. The POAF cohort included 118 366 patients newly diagnosed with atrial fibrillation or flutter within 30 days after surgery. The non‐POAF cohort included the remaining 315 832 patients who were newly diagnosed with atrial fibrillation or flutter but not within 30 days after a surgery. OAC initiation increased from 28.9% to 44.0% from 2012 to 2021 in POAF, and 37.8% to 59.9% in non‐POAF; 12‐month medication adherence increased from 47.0% to 61.8% in POAF, and 59.7% to 70.4% in non‐POAF. The median time to OAC discontinuation was 177 days for POAF, and 242 days for non‐POAF. Patients who saw a cardiologist within 90 days of the first atrial fibrillation or flutter diagnosis, regardless of POAF or non‐POAF, were more likely to initiate OAC (odds ratio, 2.92 [95% CI, 2.87–2.98];
P
<0.0001), adhere to OAC (odds ratio, 1.08 [95% CI, 1.04–1.13];
P
<0.0001), and less likely to discontinue (odds ratio, 0.83 [95% CI, 0.82–0.85];
P
<0.0001) than patients who saw a surgeon or other specialties.

Conclusions
The use of and adherence to OAC were higher in non‐POAF patients than in POAF patients, but they increased over time in both groups. Patients managed by cardiologists were more likely to use and adhere to OAC, regardless of POAF or non‐POAF.
Stroke in Pregnancy and Preeclampsia: Effect of Low‐Dose Aspirin Treatment on Collateral Flow Velocity and Cerebral Blood Flow Autoregulation During Ischemia in Rats
Authors: Cipolla Marilyn J. , Tremble Sarah M. 
Published: June 2024

Background

Experimental preeclampsia (ePE) has been shown to have worsened outcome from stroke. We investigated the effect of low‐dose aspirin, known to prevent preeclampsia, on stroke hemodynamics and outcome, and the association between the vasoconstrictor and vasodilator cyclooxygenase products thromboxane A
2
and prostacyclin.

Methods and Results

Middle cerebral artery occlusion was performed for 3 hours with 1 hour of reperfusion in normal pregnant rats on day 20 of gestation and compared with ePE treated with vehicle or low‐dose aspirin (1.5 mg/kg per day). Multisite laser Doppler was used to measure changes in cerebral blood flow to the core middle cerebral artery and collateral vascular territories. After 30 minutes occlusion, phenylephrine was infused to increase blood pressure and assess cerebral blood flow autoregulation. Infarct and edema were measured using 2,3,5‐triphenyltetrazolium chloride staining. Plasma levels of thromboxane A
2
, prostacyclin, and inflammatory markers in plasma and cyclooxygenase levels in cerebral arteries were measured. ePE had increased infarction compared with normal pregnant rats (
P
<0.05) that was reduced by aspirin (
P
<0.001). ePE also had intact cerebral blood flow autoregulation and reduced collateral perfusion during induced hypertension that was also prevented by aspirin. Aspirin increased prostacyclin in ePE (
P
<0.05) without reducing thromboxane B
2
, metabolite of thromboxane A
2
, or 8‐isoprostane‐prostaglandin‐2α, a marker of lipid peroxidation. There were no differences in cyclooxygenase levels in cerebral arteries between groups.

Conclusions
Low‐dose aspirin in ePE reduced infarction that was associated with increased vasodilator prostacyclin and improved collateral perfusion during induced hypertension. The beneficial effect of aspirin on the brain and cerebral circulation is likely multifactorial and worth further study.
An exploration of clinically meaningful definitions of cough bouts
Authors: Holt Kimberley J. , Dockry Rachel J. , McGuinness Kevin , Barrett Emma , Smith Jaclyn A. 
Published: June 2024

RationaleThe measurement of cough frequency is widely used in clinical trials, typically expressed as the number of explosive cough sounds per hour. However, this measure does not capture the clustering of coughs into bouts. Coughing bouts contribute to perceived cough severity and the physical complications of coughing, but an agreed standard definition of cough bouts is lacking. The objectives of the present study were to explore the impact of different definitions of cough bouts on the parameters generated, their relationships with reported cough severity and influence of age and gender in refractory chronic cough (RCC).MethodsWe analysed 24-h acoustic recordings and concurrent cough severity visual analogue scales from 91 RCC patients (62% female, median (interquartile range) age 60.0 (54–67.0) years). A custom-built algorithm calculated cough bouts, defined by the intervals between explosive cough sounds. Bouts defined by inter-cough intervals from ≤0.5 to ≤10 s (0.5 s increments) were explored, and parameters including number of bouts, median/maximum bout length and total bout duration calculated.Measurements and main resultsUsing inter-cough intervals of >3 s to define cough bouts made little difference to cough bout parameters. Correlations between cough severity and bout parameters were weak but most likely to be significant when single coughs were removed. Cough-free time/total time spent coughing tended to have more influence on cough severity than the average cough bout length, irrespective of the interval used.ConclusionThese analyses favour definitions of cough bouts utilising inter-cough intervals of ≤3 s and the exclusion of single coughs from cough bout analysis.
Safety evaluation via conflict classification during automated shuttle bus service operations
Authors: Ziakopoulos Apostolos , Oikonomou Maria G. , Sekadakis Marios , Yannis George 
Published: June 2024

AbstractThe widespread adoption of Connected and Automated Vehicles (CAVs) is being propelled, not only in the realm of private vehicles but also within transit systems. This development serves to enhance urban transport activities, rendering transportation more appealing to passengers. The present study aims to identify and examine the safety effects of testing different operational speed shuttle bus services in various future mobility conditions. To investigate impacts of autonomous shuttle bus services and to further examine their operational speed, the microscopic simulation method was performed. Specifically, four sets of simulation scenarios were comprised: a baseline scenario representing the current conditions and three operational speed scenarios (15 km/h, 30 km/h and 45 km/h) for an autonomous shuttle service. Each one of these sets included eleven CAV market penetration rates (MPRs) of CAVs of the general traffic (ranging from 0 to 100% in 10% increments). By analyzing the trajectory data extracted from microsimulation, traffic conflicts were identified and further analyzed by developing Mixed-Effects Multinomial Logit Regression models (ME-MLMs) in order to associate conflict type taking into account network characteristics as well as traffic conditions. Several aspects were determined as statistical significant parameters influencing type of conflict. The analysis yielded several significant findings that provide quantitative measurements and assessments of the effects observed, enabling a better understanding of the safety implications associated with the widespread adoption of automated services.
Genomic determinants, architecture, and constraints in drought-related traits in Corymbia calophylla
Authors: Ahrens Collin W. , Murray Kevin , Mazanec Richard A. , Ferguson Scott , Jones Ashley , Tissue David T. , Byrne Margaret , Borevitz Justin O. , Rymer Paul D. 
Published: June 2024

Abstract
Background
Drought adaptation is critical to many tree species persisting under climate change, however our knowledge of the genetic basis for trees to adapt to drought is limited. This knowledge gap impedes our fundamental understanding of drought response and application to forest production and conservation. To improve our understanding of the genomic determinants, architecture, and trait constraints, we assembled a reference genome and detected ~ 6.5 M variants in 432 phenotyped individuals for the foundational tree Corymbia calophylla.

Results
We found 273 genomic variants determining traits with moderate heritability (h2SNP = 0.26–0.64). Significant variants were predominantly in gene regulatory elements distributed among several haplotype blocks across all chromosomes. Furthermore, traits were constrained by frequent epistatic and pleiotropic interactions.

Conclusions
Our results on the genetic basis for drought traits in Corymbia calophylla have several implications for the ability to adapt to climate change: (1) drought related traits are controlled by complex genomic architectures with large haplotypes, epistatic, and pleiotropic interactions; (2) the most significant variants determining drought related traits occurred in regulatory regions; and (3) models incorporating epistatic interactions increase trait predictions. Our findings indicate that despite moderate heritability drought traits are likely constrained by complex genomic architecture potentially limiting trees response to climate change.
Whole-genome landscape of histone H3K4me3 modification during sperm cell lineage development in tomato
Authors: Song Yunyun , Chang Zhikai , Feng Yixuan , Wang Tai , Liu Lingtong 
Published: June 2024

Abstract
Background
During male gametogenesis of flowering plants, sperm cell lineage (microspores, generative cells, and sperm cells) differentiated from somatic cells and acquired different cell fates. Trimethylation of histone H3 on lysine 4 (H3K4me3) epigenetically contributes to this process, however, it remained unclear how H3K4me3 influences the gene expression in each cell type. Here, we conducted chromatin immunoprecipitation sequencing (ChIP-seq) to obtain a genome-wide landscape of H3K4me3 during sperm cell lineage development in tomato (Solanum lycopersicum).

Results
We show that H3K4me3 peaks were mainly enriched in the promoter regions, and intergenic H3K4me3 peaks expanded as sperm cell lineage differentiated from somatic cells. H3K4me3 was generally positively associated with transcript abundance and served as a better indicator of gene expression in somatic and vegetative cells, compared to sperm cell lineage. H3K4me3 was mutually exclusive with DNA methylation at 3’ proximal of the transcription start sites. The microspore maintained the H3K4me3 features of somatic cells, while generative cells and sperm cells shared an almost identical H3K4me3 pattern which differed from that of the vegetative cell. After microspore division, significant loss of H3K4me3 in genes related to brassinosteroid and cytokinin signaling was observed in generative cells and vegetative cells, respectively.

Conclusions
Our results suggest the asymmetric division of the microspore significantly reshapes the genome-wide distribution of H3K4me3. Selective loss of H3K4me3 in genes related to hormone signaling may contribute to functional differentiation of sperm cell lineage. This work provides new resource data for the epigenetic studies of gametogenesis in plants.