bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐Term Clinical Implications of High‐Risk Cardiac Computed Tomography Findings in Patients With Acute Ischemic Stroke
Authors: Rinkel Leon A. , Cramer Olivia N. , Özata Z. Beyda , Beemsterboer Chiel F. P. , Guglielmi Valeria , Nio Shan Sui , Bouma Berto J. , Boekholdt S. Matthijs , Lobé Nick H. J. , Beenen Ludo F. M. , Marquering Henk A. , Majoie Charles B. L. M. , Roos Yvo B. W. E. M. , van Randen Adrienne , Planken R. Nils , Coutinho Jonathan M. 
Published: April 2024

Background
Cardiac computed tomography (CT) acquired during the initial acute stroke imaging protocol (acute cardiac CT) is increasingly used to screen for cardioembolism, but information on the long‐term clinical implications of its findings is lacking.

Methods and Results
We performed a prospective, single‐center cohort study in which consecutive patients with ischemic stroke underwent ECG‐gated acute cardiac CT and were followed up for 2 years. The primary outcome was functional outcome assessed using the modified Rankin Scale. Secondary outcomes were death and occurrence of major adverse cardiovascular events (composite of recurrent ischemic stroke, myocardial infarction, and cardiovascular death). We compared patients with and without a high‐risk structural source of embolism on acute cardiac CT. Of 452 included patients, 55 (12.2%) had a high‐risk source of embolism, predominantly cardiac thrombi (38 patients) and signs of endocarditis (8 patients). Follow‐up at 2 years was complete for 430 (95.1%) patients. Patients with a high‐risk source of embolism had a worse functional outcome (median modified Rankin Scale, 6 [IQR, 2–6] versus 2 [IQR, 1–5]; adjusted common odds ratio, 2.92 [95% CI, 1.62–5.25]), increased mortality rate (52.7% versus 23.7%; adjusted hazard ratio [HR], 3.28 [95% CI, 1.94–5.52]), and major adverse cardiovascular events (38.9% versus 17.5%; adjusted HR, 3.20 [95% CI, 1.80–5.69]). A high‐risk source of embolism was not associated with recurrent ischemic stroke (11.1% versus 9.6%; adjusted HR, 1.30 [95% CI, 0.49–3.44]).

Conclusions
Structural high‐risk sources of embolism on acute cardiac CT in patients with ischemic stroke were associated with poor long‐term functional outcome and occurrence of major adverse cardiovascular events but not with recurrent stroke.
Predicting Outcomes Following Lower Extremity Endovascular Revascularization Using Machine Learning
Authors: Li Ben , Aljabri Badr , Verma Raj , Beaton Derek , Hussain Mohamad A. , Lee Douglas S. , Wijeysundera Duminda N. , de Mestral Charles , Mamdani Muhammad , Al‐Omran Mohammed 
Published: April 2024

Background
Lower extremity endovascular revascularization for peripheral artery disease carries nonnegligible perioperative risks; however, outcome prediction tools remain limited. Using machine learning, we developed automated algorithms that predict 30‐day outcomes following lower extremity endovascular revascularization.

Methods and Results
The National Surgical Quality Improvement Program targeted vascular database was used to identify patients who underwent lower extremity endovascular revascularization (angioplasty, stent, or atherectomy) for peripheral artery disease between 2011 and 2021. Input features included 38 preoperative demographic/clinical variables. The primary outcome was 30‐day postprocedural major adverse limb event (composite of major reintervention, untreated loss of patency, or major amputation) or death. Data were split into training (70%) and test (30%) sets. Using 10‐fold cross‐validation, 6 machine learning models were trained using preoperative features. The primary model evaluation metric was area under the receiver operating characteristic curve. Overall, 21 886 patients were included, and 30‐day major adverse limb event/death occurred in 1964 (9.0%) individuals. The best performing model for predicting 30‐day major adverse limb event/death was extreme gradient boosting, achieving an area under the receiver operating characteristic curve of 0.93 (95% CI, 0.92–0.94). In comparison, logistic regression had an area under the receiver operating characteristic curve of 0.72 (95% CI, 0.70–0.74). The calibration plot showed good agreement between predicted and observed event probabilities with a Brier score of 0.09. The top 3 predictive features in our algorithm were (1) chronic limb‐threatening ischemia, (2) tibial intervention, and (3) congestive heart failure.

Conclusions
Our machine learning models accurately predict 30‐day outcomes following lower extremity endovascular revascularization using preoperative data with good discrimination and calibration. Prospective validation is warranted to assess for generalizability and external validity.
ELUCIDATE Trial: A Single‐Center Randomized Controlled Study
Authors: Lin Jiun‐Lu , Liu Sung‐Chen , Liu Tze‐Fan , Chuang Shih‐Ming , Huang Chun‐Ta , Chen Ying‐Ju , Lee Chun‐Chuan , Chien Ming‐Nan , Hou Charles Jia‐Yin , Yeh Hung‐I. , Chiang Chern‐En , Hung Chung‐Lieh 
Published: April 2024

Background
Dapagliflozin, a sodium–glucose cotransporter 2 inhibitor, is an epochal oral antidiabetic drug that improves cardiorenal outcomes. However, the effect of early dapagliflozin intervention on left ventricular (LV) remodeling in patients with type 2 diabetes free from cardiovascular disease remains unclear.

Methods and Results

The ELUCIDATE trial was a prospective, open‐label, randomized, active‐controlled study that enrolled 76 patients with asymptomatic type 2 diabetes with LV ejection fraction ≥50%, randomized to the dapagliflozin 10 mg/day add‐on or standard‐of‐care group. Speckle‐tracking echocardiography–based measurements of the cardiac global longitudinal strain were performed at baseline and 24 weeks after treatment initiation. Patients who received dapagliflozin had a greater reduction in LV dimension (1.68 mm [95% CI, 0.53–2.84];
P
=0.005), LV end‐systolic volume (5.51 mL [95% CI, 0.86–10.17];
P
=0.021), and LV mass index (4.25 g/m
2.7
[95% CI, 2.42–6.09];
P
<0.0001) compared with standard of care in absolute mean differences. Dapagliflozin add‐on therapy led to a significant LV global longitudinal strain increment (0.74% [95% CI, 1.00–0.49];
P
<0.0001) and improved LV systolic and early diastolic strain rates (0.27/s [95% CI, 0.17–0.60]; and 0.11/s [95% CI, 0.06–0.16], respectively; both
P
<0.0001) but not in global circumferential strain. No significant changes were found in insulin resistance, NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) levels, or other biomarkers at 6 months after the dapagliflozin administration.

Conclusions
Dapagliflozin add‐on therapy could lead to more favorable cardiac remodeling accompanied by enhanced cardiac mechanical function among patients with asymptomatic type 2 diabetes. Our findings provide evidence of the efficacy of dapagliflozin use for the primary prevention of diabetic cardiomyopathy.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03871621.
Stroke Recovery–Related Changes in Cortical Reactivity Based on Modulation of Intracortical Inhibition
Authors: Harquel Sylvain , Cadic-Melchior Andéol , Morishita Takuya , Fleury Lisa , Witon Adrien , Ceroni Martino , Brügger Julia , Meyer Nathalie H. , Evangelista Giorgia G. , Egger Philip , Beanato Elena , Menoud Pauline , Van de Ville Dimitri , Micera Silvestro , Blanke Olaf , Léger Bertrand , Adolphsen Jan , Jagella Caroline , Constantin Christophe , Alvarez Vincent , Vuadens Philippes , Turlan Jean-Luc , Mühl Andreas , Bonvin Christophe , Koch Philipp J. , Wessel Maximilian J. , Hummel Friedhelm C. 
Published: April 2024

BACKGROUND:
Cortical excitation/inhibition dynamics have been suggested as a key mechanism occurring after stroke. Their supportive or maladaptive role in the course of recovery is still not completely understood. Here, we used transcranial magnetic stimulation (TMS)-electroencephalography coupling to study cortical reactivity and intracortical GABAergic inhibition, as well as their relationship to residual motor function and recovery longitudinally in patients with stroke.

METHODS:
Electroencephalography responses evoked by TMS applied to the ipsilesional motor cortex were acquired in patients with stroke with upper limb motor deficit in the acute (1 week), early (3 weeks), and late subacute (3 months) stages. Readouts of cortical reactivity, intracortical inhibition, and complexity of the evoked dynamics were drawn from TMS-evoked potentials induced by single-pulse and paired-pulse TMS (short-interval intracortical inhibition). Residual motor function was quantified through a detailed motor evaluation.

RESULTS:

From 76 patients enrolled, 66 were included (68.2±13.2 years old, 18 females), with a Fugl-Meyer score of the upper extremity of 46.8±19. The comparison with TMS-evoked potentials of healthy older revealed that most affected patients exhibited larger and simpler brain reactivity patterns (
P
cluster
<0.05). Bayesian ANCOVA statistical evidence for a link between abnormally high motor cortical excitability and impairment level. A decrease in excitability in the following months was significantly correlated with better motor recovery in the whole cohort and the subgroup of recovering patients. Investigation of the intracortical GABAergic inhibitory system revealed the presence of beneficial disinhibition in the acute stage, followed by a normalization of inhibitory activity. This was supported by significant correlations between motor scores and the contrast of local mean field power and readouts of signal dynamics.

CONCLUSIONS:
The present results revealed an abnormal motor cortical reactivity in patients with stroke, which was driven by perturbations and longitudinal changes within the intracortical inhibition system. They support the view that disinhibition in the ipsilesional motor cortex during the first-week poststroke is beneficial and promotes neuronal plasticity and recovery.
Flow Diversion for Small Branches and Distal Aneurysms of the Posterior Circulation: A Subanalysis of the Post‐FD Registry
Authors: Dibas Mahmoud , Vivanco‐Suarez Juan , Rodriguez‐Calienes Aaron , Cortez Gustavo M. , Mendes Pereira Vitor , Nishi Hidehisa , Toth Gabor , Patterson Thomas , Altschul David , Feigen Chaim , Essibayi Muhammed Amir , Galecio‐Castillo Milagros , Fifi Johanna , Matsoukas Stavros , Kan Peter T. , Hafeez Muhammad Ubaid , Puri Ajit S. , Kuhn Anna Luisa , Wakhloo Ajay K. , Rabinovich Margarita , Khandelwal Priyank , Sauvageau Eric , Aghaebrahim Amin , Costa Matias , Monteith Stephen , Farooqui Mudassir , Hanel Ricardo , Ortega Gutierrez Santiago 
Published: April 2024

Background
Flow diversion (FD) has emerged as an effective treatment option for intracranial aneurysms. However, there is limited evidence regarding its safety and efficacy specifically for distal and small‐artery aneurysms of the posterior circulation. This study aimed to investigate the outcomes of FD for aneurysms arising from the posterior inferior cerebellar artery, anterior inferior cerebellar artery, superior cerebellar artery, and the P2 and P3 segments of the posterior cerebral artery.

Methods
This is a subanalysis of the Post‐FD (Posterior Circulation Aneurysms Treated With Flow Diversion) registry, highlighting distal aneurysms in the posterior inferior cerebellar artery, anterior inferior cerebellar artery, superior cerebellar artery, and the P2 and P3 segments of the posterior cerebral artery treated with FD. Aneurysm characteristics and patient outcomes were described for the total series, and a more focused analysis comparing fusiform/dissecting versus saccular aneurysms was performed. The primary treatment outcome was complete aneurysm occlusion (Raymond–Roy class 1). Primary safety outcome was major ischemic/hemorrhagic stroke following FD. Secondary outcomes included functional outcome, aneurysm retreatment, and in‐stent stenosis.

Results

Overall, 36 patients with 36 aneurysms were treated with FD, with a median age of 60.0 years (interquartile range [IQR], 52.8—65.3 years). Of those, 13 were fusiform/dissecting, while 23 were saccular aneurysms. Complete occlusion was achieved in 78.1% for all aneurysms at a median follow‐up of 14.0 months (IQR, 9.3–48.6 months). There was a nonsignificant trend in rates of complete occlusion between fusiform/dissecting (91.7%) and saccular aneurysms (70%;
P
= 0.151). Major stroke was reported in 2 cases (5.6%) and in‐stent stenosis in 4 (11.1%), and retreatment was required for 4 aneurysms (11.4%) There was no difference in rates of major stroke, in‐stent stenosis, or retreatment between fusiform/dissecting and saccular aneurysms.

Conclusion
This study suggests the safety and feasibility of FD for distal aneurysms of the posterior circulation, particularly fusiform/dissecting aneurysms. Further larger‐scale studies are warranted to confirm these findings.
Reorganization of structural connectivity in the brain supports preservation of cognitive ability in healthy aging
Authors: Neudorf Josh , Shen Kelly , McIntosh Anthony R. 
Published: April 2024

Abstract
The global population is aging rapidly, and a research question of critical importance is why some older adults suffer tremendous cognitive decline while others are mostly spared. Past aging research has shown that older adults with spared cognitive ability have better local short-range information processing while global long-range processing is less efficient. We took this research a step further to investigate whether the underlying structural connections, measured in vivo using diffusion magnetic resonance imaging (dMRI), show a similar shift to support cognitive ability. We analyzed the structural connectivity streamline probability (representing the probability of connection between regions) and nodal efficiency and local efficiency regional graph theory metrics to determine whether age and cognitive ability are related to structural network differences. We found that the relationship between structural connectivity and cognitive ability with age was nuanced, with some differences with age that were associated with poorer cognitive outcomes, but other reorganizations that were associated with spared cognitive ability. These positive changes included strengthened local intrahemispheric connectivity and increased nodal efficiency of the ventral occipital-temporal stream, nucleus accumbens, and hippocampus for older adults, and widespread local efficiency primarily for middle-aged individuals.
Developmental differences in canonical cortical networks: Insights from microstructure-informed tractography
Authors: Genc Sila , Schiavi Simona , Chamberland Maxime , Tax Chantal M. W. , Raven Erika P. , Daducci Alessandro , Jones Derek K. 
Published: April 2024

Abstract
In response to a growing interest in refining brain connectivity assessments, this study focuses on integrating white matter fiber-specific microstructural properties into structural connectomes. Spanning ages 8–19 years in a developmental sample, it explores age-related patterns of microstructure-informed network properties at both local and global scales. First, the diffusion-weighted signal fraction associated with each tractography-reconstructed streamline was constructed. Subsequently, the convex optimization modeling for microstructure-informed tractography (COMMIT) approach was employed to generate microstructure-informed connectomes from diffusion MRI data. To complete the investigation, network characteristics within eight functionally defined networks (visual, somatomotor, dorsal attention, ventral attention, limbic, fronto-parietal, default mode, and subcortical networks) were evaluated. The findings underscore a consistent increase in global efficiency across child and adolescent development within the visual, somatomotor, and default mode networks (p &lt; 0.005). Additionally, mean strength exhibits an upward trend in the somatomotor and visual networks (p &lt; 0.001). Notably, nodes within the dorsal and ventral visual pathways manifest substantial age-dependent changes in local efficiency, aligning with existing evidence of extended maturation in these pathways. The outcomes strongly support the notion of a prolonged developmental trajectory for visual association cortices. This study contributes valuable insights into the nuanced dynamics of microstructure-informed brain connectivity throughout different developmental stages.
The Czech Republic Diaspora Care Institutions and Policies
Authors: Kristek Tomáš 
Published: April 2024

Abstract
The period following 1989 witnessed a resurgence of the Czech diaspora’s involvement in the country’s political life. Rekindling ties with compatriots affirmed their integral role in the Czech Republic, and establishing institutions and policies aimed at diaspora engagement became a key priority. This study seeks to identify the primary areas of concern for the Czech Republic regarding the diaspora and examines how these policies are interrelated. The analysis of engagement policies is based on political-administrative, economic and cultural criteria and is further categorised by the specific areas to which they are directed. The study outlines the principal institutional engagement policies in three key areas: education and culture policy, citizenship, and social support and healthcare policy. It highlights the need for a central institution to manage and facilitate relations between the Czech Republic and its diaspora. The concluding section refers to the requirements of Czechs abroad.
The Moroccan Diaspora in Spain
Authors: Olivar de Julián José Manuel 
Published: April 2024

Abstract
The paper identifies the Moroccan diaspora in Spain, the largest foreign diaspora in that country, and explains the causes for its rapid establishment. After six regularisation processes, which took place between 1985 and 2023, and the ongoing regularisation process in conjunction with family reunification channels, more than 1.3 million Moroccans now live in Spain. This example shows the significant demographic transformations that can result from mass regularisation, the social and political transformations that follow in the host states that enact such measures, and the transformation in external relations with the diaspora’s state of origin.
The Politics of Protestant Missions in the English Overseas Territories, 1660–1700
Authors: Glickman Gabriel 
Published: April 2024

Abstract
Through the later seventeenth century, Protestant missions in English America were surrounded by controversy. Missionaries working with Amerindians and enslaved Africans were accused of threatening the stability of overseas dominions. Crown officials were alleged to have impeded evangelism, and colluded in a culture of colonial godlessness. In modern scholarship, these conflicts have been located within a context of long-term tension between “religion” and “empire.” This article suggests that they were rooted in the transatlantic divisions within English Protestantism, and in political conditions peculiar to the 1660 Restoration. Colonial missions developed competitively and acrimoniously, when the Church of England vied against Protestant rivals in America, and when ecclesiastical policy in England remained unsettled. Battles for converts between Anglicans, Quakers, and Congregationalists stirred disputes over the management of England’s multi-confessional dominions. Simultaneously, they raised questions over how a colonizing kingdom could export the reformed religion, when its own confessional environment was severely divided.
The Forest Withdrawn
Authors: Tan Zi Hao 
Published: April 2024

Abstract
Historical chronicles in Southeast Asia often designate the forest as an area where animals and spirits prowl, where heroes meditate or journey across. But the forest is neither a mere setting nor a passive witness to the unfolding of events. Using nineteenth- and twentieth-century historical chronicles from Cirebon, West Java, this article examines how the forest is storied to mediate the past. Discussion is centred around three narrative topoi: the first concerns the establishment of new settlements, as prefigured through forest-clearing; the second accentuates the forest’s rhetorical function as a site of disappearance during Islamization; and the third analyses the creaturely figure Menjangan Wulung, who sabotages the Cirebonese sultanate and lurks in the wilderness. An inquisitive reading of these episodes reveals the forest to be a historiographical trope. Conceived as a topography of concealment, the forest exemplifies a withdrawn reality where contentious pasts are subdued yet sustained, preserving continuity amidst change.
The Revealed and the Hidden: a Reading of The Cambridge History of Chinese Literature
Authors: Zuo Dongling 
Published: April 2024

Abstract
In many respects, The Cambridge History of Chinese Literature consciously avoids traditional approaches to the compilation of literary history in order to emphasize its unique understanding of Chinese literature. The innovative approaches described by the editors have yielded practical results, particularly in the attempt to “avoid the division of the field into genres and to move toward a more integrated historical approach.” They chose a new approach to historical periodization, and the book “pays greater attention to the ways in which all received Chinese literary texts are filtered and reconstructed by later generations.” However, there are still some shortcomings, such as the neglect of certain literary genres, the perfunctory choice of the dividing moment between the two volumes, and the subjective nature of the historical reconstruction. Furthermore, two fundamental problems characterize the book’s discussion of literary history: the limitations of the editors’ and authors’ specialized research experience, and the work’s use of recent academic research. The editors also fail to adequately respect academic norms. Therefore, The Cambridge History of Chinese Literature is an innovative and unique work of literary history that nonetheless contains major shortcomings, leaving much room for improvement.
On a Far-Off Journey – a Commentary on the “History of Literary Culture” Approach in The Cambridge History of Chinese Literature
Authors: Xu Yan 
Published: April 2024

Abstract
The Cambridge History of Chinese Literature is based on a “history of literary culture” approach that differs clearly from the standard literary-historical narrative favored by most Chinese scholars. The conventional approach to literary history tends to focus on the most engaging elements of a literary canon, while the history of literary culture model attempts to study literary texts in conjunction with their historical contexts. Based on historical documentation, this approach seeks to rehabilitate literary works that have been misinterpreted over time. With this approach, both texts and contexts are at the heart of literary history. If literary texts are restored to the context of their literary production, we are asked to reconsider the following three important research questions. Where did the texts originate? Why were they selected as part of the literary canon? What are their special characteristics and how are they related to other texts? Answers to these questions make literary research more varied and three-dimensional. In terms of theory, the contributors to The Cambridge History of Chinese Literature clearly aspire towards historicism. In their own writing, however, they seem willing to compromise and follow “a middle way” between conventional and alternative narratives of Chinese literary history.