bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Abnormal Lung Function and Its Subtypes With Arterial Stiffness: A Longitudinal Cohort Study
Authors: Wu Zhiyuan , Zhang Haiping , Jiang Yue , Li Zhiwei , Wang Yutao , Tian Yixing , Guo Zheng , Zheng Yulu , Li Xia , Tao Lixin , Guo Xiuhua 
Published: December 2023

Background
Prior studies have reported the cross‐sectional relationship between lung function and arterial stiffness, while the longitudinal association remains unclear to date. This study aimed to investigate whether abnormal lung function and its subtypes at baseline are associated with increased arterial stiffness using a cohort.

Methods and Results
This was a secondary analysis extracting 2461 participants from Beijing Health Management Cohort as baseline and annually followed for development of arterial stiffness. Abnormal lung function was defined by forced expiratory volume in 1s <80% of the predicted value, forced vital capacity of the predicted value, or forced expiratory volume in 1s/forced vital capacity ratio <70%. Increased arterial stiffness was determined by brachial‐ankle pulse wave velocity ≥1400 cm/s. Cox proportional hazards model was used to calculate the hazard ratio and population attributable fraction. The mean age was 42.8±8.1 years, and 444 (18.0%) cases developed increased arterial stiffness during a median follow‐up of 3.0 years. The adjusted hazard ratio (95% CI) of arterial stiffness was 1.47 (95% CI, 1.10–1.96) for abnormal lung function, with a population attributable fraction of 3.9% (95% CI, 0.8–7.1). Of subtypes, only obstructive ventilatory dysfunction was significantly associated with arterial stiffness (adjusted hazard ratio, 2.06 [95% CI, 1.27–3.36]), not restricted ventilatory dysfunction (adjusted hazard ratio, 0.95 [95% CI, 0.54–1.65]). Consistent results were observed on multiple sensitivity analyses.

Conclusions
Our study indicated a longitudinal association of abnormal lung function with increased arterial stiffness using a large cohort, especially for the obstructive ventilatory dysfunction.
Pattern of Endothelialization in Left Atrial Appendage Occluder by Optic Coherence Tomography: A Pilot Study
Authors: Chen Jien‐Jiun , Chiu Fu‐Chun , Chang Sheng‐Nan , Cheng Hsiao‐Liang , Huang Pang‐Shuo , Wu Cho‐Kai , Wang Yi‐Chih , Hwang Juey‐Jen , Tsai Chia‐Ti 
Published: December 2023

Background
Implantation of the left atrial appendage occluder (LAAO) has been proven to prevent stroke effectively in patients with atrial fibrillation who cannot tolerate anticoagulants. Incomplete endothelization of LAAO may cause device‐related thrombus, and currently no good image modality exists to clearly see LAAO endothelialization. We aimed to use coronary optic coherence tomography (OCT) to visualize LAAO endothelialization.

Methods and Results
We enrolled 14 patients (72.8±9.4 years old) undergoing pulmonary vein isolation with a preexisting LAAO implanted more than 1 year ago (5 Watchman and 9 Amulet). After pulmonary vein isolation, we did OCT via steerable sheath and coronary guiding catheter to adjust OCT probe location and injected contrast medium to visualize the LAAO surface. In vitro testing was also performed to see the bare occluder. In vitro OCT showed the surface of the bare device as an interrupted granule pattern, which included the Watchman surface polytetrafluoroethylene membrane string, Amulet disc metal strut, and inner polytetrafluoroethylene membrane string. In the implanted Watchman, OCT showed endothelialization as a smooth surface layer with noninterrupted coarser granules. In the implanted Amulet, OCT showed endothelialization as thin (early) or thick (late) endothelialization layer covering struts with OCT shadows. Among patients with Watchman, 2 showed no, 2 early, and 1 complete endothelialization. Among patients with Amulet, 2 showed no, 3 early, and 4 late endothelialization.

Conclusions
We demonstrated the feasibility of OCT to visualize LAAO endothelization with high resolution. Further studies are needed to determine antithrombotic regimens if incomplete endothelization is detected. A new OCT catheter may be designed specifically for LAAO.
Hemodynamic Effect of Repeated Epinephrine Doses Decreases With Cardiopulmonary Resuscitation Cycle Progression
Authors: Roh Young‐Il , Ahn Gyo Jin , Lee Jung Hun , Jung Woo Jin , Kim Soyeong , Im Hyeon Young , Lee Yujin , Im Dahye , Lim Jihye , Hwang Sung Oh , Cha Kyoung‐Chul 
Published: December 2023

Background
Epinephrine is administered to increase coronary perfusion pressure during advanced life support and promote short‐term survival. Recent cardiopulmonary resuscitation (CPR) guidelines recommend an epinephrine dosing interval of 3 to 5 minutes during resuscitation; however, scientific evidence supporting this recommendation is lacking. Therefore, we aimed to investigate the hemodynamic effects of repeated epinephrine doses during CPR by monitoring augmented blood pressure after its administration in a swine model of cardiac arrest.

Methods and Results
A secondary analysis of data from a published study was performed using a swine cardiac arrest model. The epinephrine dose was fixed at 1 mg, and the first dose of epinephrine was administered after no‐flow and low‐flow times of 2 minutes and 8 minutes, respectively, and subsequently administered every 4 minutes. Four cycles of dosing intervals were defined because a previous study was terminated 26 minutes after the induction of ventricular fibrillation. Augmented blood pressures and corresponding timelines were determined. Augmented blood pressure trends following cycles and the epinephrine effect duration were also monitored. Among the 140 CPR cycles, the augmented blood pressure after epinephrine administration was the highest during the first cycle of CPR and decreased gradually with further cycle repetitions. The epinephrine effect duration did not differ between repeated cycles. The maximum blood pressure was achieved 78 to 97 seconds after epinephrine administration.

Conclusions
Hemodynamic augmentation with repeated epinephrine administration during CPR decreased with cycle progression. Further studies are required to develop an epinephrine administration strategy to maintain its hemodynamic effects during prolonged resuscitation.
Impact of Acute Kidney Injury After Transcatheter Aortic Valve Replacement: A Nationwide Study
Authors: Petersen Jeppe Kofoed , Østergaard Lauge , Carlson Nicholas , Bager Lucas Grove Vejlstrup , Strange Jarl E. , Schou Morten , Køber Lars , Fosbøl Emil Loldrup 
Published: December 2023

Background
In patients undergoing transcatheter aortic valve replacement (TAVR), the impact of acute kidney injury (AKI) on the prognosis and especially on future kidney function has been sparsely examined, and data from large cohorts are warranted.

Methods and Results
With Danish nationwide registries, we identified all patients undergoing TAVR from 2014 to 2021 with no previous dialysis treatment. According to 2 plasma creatinine samples, we identified those suffering a postprocedural AKI within 21 days after TAVR. With 1 year of follow‐up, we compared the associated rates of dialysis treatment and death between patients with and without an AKI using multivariable Cox analysis. Finally, according to the lowest recorded creatinine sample, we assessed the kidney function among AKI survivors between 90 and 180 days after the index date.
We identified 4091 TAVRs: 193 (4.7%) with AKI (55.4% men; median age, 82 years) and 3898 (95.3%) without AKI (57.0% men; median age, 81 years). Compared with those without AKI, patients with AKI showed increased associated 1‐year rates of dialysis treatment (hazard ratio [HR], 7.20 [95% CI, 4.10–12.66]) and death (HR, 2.39 [95% CI, 1.59–3.58]). After 6 months, 74% of AKI survivors had complete kidney recovery, 14.7% had incomplete kidney recovery, 6.3% failed to recover, and 5.1% were on dialysis treatment.

Conclusions
We identified that AKI after TAVR was associated with an increased rate of future dialysis treatment and all‐cause death. Among survivors, 74% had complete kidney recovery within 6 months.
Prosthetic Valve Endocarditis After Aortic Valve Replacement With Bovine Versus Porcine Bioprostheses
Authors: Glaser Natalie , Sartipy Ulrik , Dismorr Michael 
Published: December 2023

Background
Whether a bovine or porcine aortic valve bioprosthesis carries a higher risk of endocarditis after aortic valve replacement is unknown. The aim of this study was to compare the risk of prosthetic endocarditis in patients undergoing aortic valve replacement with a bovine versus porcine bioprosthesis.

Methods and Results
This nationwide, population‐based cohort study included all patients who underwent surgical aortic valve replacement with a bovine or porcine bioprosthesis in Sweden from 1997 to 2018. Regression standardization was used to account for intergroup differences. The primary outcome was prosthetic valve endocarditis, and the secondary outcomes were all‐cause mortality and early prosthetic valve endocarditis. During a maximum follow‐up time of 22 years, we included 21 022 patients, 16 603 with a bovine valve prosthesis and 4419 with a porcine valve prosthesis. The mean age was 73 years, and 61% of the patients were men. In total, 910 patients were hospitalized for infective endocarditis: 690 (4.2%) in the bovine group and 220 (5.0%) in the porcine group. The adjusted cumulative incidence of prosthetic valve endocarditis at 15 years was 9.5% (95% CI, 6.2%–14.4%) in the bovine group and 2.8% (95% CI, 1.4%–5.6%) in the porcine group. The absolute risk difference between the groups at 15 years was 6.7% (95% CI, 0.8%–12.5%).

Conclusions
The risk of endocarditis was higher in patients who received a bovine compared with a porcine valve prosthesis after surgical aortic valve replacement. This association should be considered in patients undergoing both surgical and transcatheter aortic valve replacement.
Association of a Heart Failure Management Incentive in Primary Care With Clinical Outcomes: A Retrospective Cohort Study
Authors: Benipal Harsukh , Demers Catherine , Cerasuolo Joshua O. , Perez Richard , You John J. , Amin Faizan , Keshavjee Karim , Lee Douglas S. 
Published: December 2023

Background
We aim to examine the association between primary care physicians' billing of Q050A, a pay‐for‐performance heart failure (HF) management incentive fee code, and the composite outcome of mortality, hospitalization, and emergency department visits.

Methods and Results
This population‐based cohort study linked administrative health databases in Ontario, Canada, for patients with HF aged >66 years between January 1, 2008, and March 31, 2020. Cases were patients with HF who had a Q050A fee code billed. Cases and controls were matched 1:1 on age, sex, patient status on being rostered to a primary care physician, cardiologist, or internist visit in the 6 months before study enrollment, Johns Hopkins Adjusted Clinical Group resource use bands, days between HF diagnosis and study enrollment (±2 years), and the logit of the propensity score. A Cox proportional hazards model assessed the association of Q050A with the outcome. A total of 59 664 cases had a Q050A billed, whereas 244 883 patients did not. Before matching, patients who had a Q050A billed were more likely to be men (52% versus 49%), were rostered to a primary care physician (100% versus 96%), had a higher Charlson Comorbidity Index, and had higher health care costs. The mean follow‐up was 481 days for cases and 530 days for controls. The composite outcome (hazard ratio, 1.11 [95% CI, 1.09–1.12]) was significantly higher for cases than controls.

Conclusions
The Q050A incentive improved financial compensation for primary care physicians managing patients with HF but was not associated with improvements in the outcome. Research on promoting evidence‐based HF management is warranted.
A Retrospective Cohort Study of the 2018 Angiotensin Receptor Blocker Recalls and Subsequent Drug Shortages in Patients With Hypertension
Authors: Devine Joshua W. , Tadrous Mina , Hernandez Inmaculada , Callaway Kim Katherine , Rothenberger Scott D. , Mukhopadhyay Nandita , Gellad Walid F. , Suda Katie J. 
Published: December 2023

Background
Valsartan was recalled by the US Food and Drug Administration in July 2018 for carcinogenic impurities, resulting in a drug shortage and management challenges for valsartan users. The influence of the valsartan recall on clinical outcomes is unknown. We compared the risk of adverse events between hypertensive patients using valsartan and a propensity score–matched group using nonrecalled angiotensin receptor blockers and angiotensin‐converting enzyme inhibitors.

Methods and Results
We used Optum's deidentified Clinformatics Datamart (July 2017–January 2019). Hypertensive patients who received valsartan or nonrecalled angiotensin receptor blockers/angiotensin‐converting enzyme inhibitors for 1 year before and on the recall date were compared. Primary outcomes were measured in the 6 months following the recall and included: (1) a composite measure of all‐cause hospitalization, all‐cause emergency department visit, and all‐cause urgent care visit, and (2) a composite cardiac event measure of hospitalizations for acute myocardial infarction and hospitalizations/emergency department visits/urgent care visits for stroke/transient ischemic attack, heart failure, or hypertension. We compared the risk of outcomes between treatment groups using Cox proportional hazard models. Of the hypertensive patients, 76 934 received valsartan, and 509 472 received a nonrecalled angiotensin receptor blocker/angiotensin‐converting enzyme inhibitor. Valsartan use at the time of recall was associated with a higher risk of all‐cause hospitalization, emergency department use, or urgent care use (hazard ratio [HR], 1.02 [95% CI, 1.00–1.04]) and the composite of cardiac events (HR, 1.22 [95% CI, 1.15–1.29]) within 6 months after the recall.

Conclusions
The valsartan recall and shortage affected hypertensive patients. Local‐ and national‐level systems need to be enhanced to protect patients from drug shortages by providing safe and reliable medication alternatives.
Why Monsters Are Dangerous
Authors: Morin Olivier , Sobchuk Oleg 
Published: December 2023

Abstract
Monsters and other imaginary animals have been conjured up by a wide range of cultures. Can their popularity be explained, and can their properties be predicted? These were long-standing questions for structuralist or cognitive anthropology, as well as literary studies and cultural evolution. The task is to solve the puzzle raised by the popularity of extraordinary imaginary animals, and to explain some cross-cultural regularities that such animals present—traits like hybridity or dangerousness. The standard approach to this question was to first investigate how human imagination deals with actually existing animals. Structuralist theory held that some animals are particularly “good to think with.” According to Mary Douglas's influential hypothesis, this was chiefly true of animals that disrupt intuitive classifications of species—the “monsters-as-anomalies” account. But this hypothesis is problematic, as ethnobiology shows that folk classifications of biological species are so plastic that classificatory anomalies can be disregarded. This led cognitive anthropologists to propose alternative versions of the “monsters as anomalies” account. Parallel to this, a second account of monsters—“monsters-as-predators”—starts from the importance of predator detection to our past survival and reproduction, and argues that dangerous features make animals “good to think with,” and should be overrepresented in imaginary animals. This article argues that both accounts understand something about monsters that the other account cannot explain. We propose a synthesis of these two accounts that attempts to explain why the two most characteristic aspects of monsters, anomalousness and predatoriness, tend to go together.
The Lateral Supraorbital Approach: 2-Dimensional Operative Video
Authors: Andrade-Barazarte Hugo , Hernesniemi Juha 
Published: December 2023

INDICATIONS:
The lateral supraorbital approach (LSO), a minimally invasive alternative to the pterional approach, can be used for anterior circulation aneurysms (except distal anterior cerebral artery), some posterior circulation aneurysms, and tumors located around the sellar and suprasellar regions.

ANATOMIC ESSENTIALS:
Performing one-layer myocutaneous flap that is retracted anteriorly, exposure of the superior temporal line, and zygomatic process of the frontal bone and the inferior limit of the craniotomy represent the upper edge of the Sylvian fissure, exposing the anterolateral skull base.

ESSENTIALS STEPS:
Skin incision behind the hairline, one-layer myocutaneous flap retracted anteriorly, minimal detachment of the temporalis muscle, burr hole over the superior temporal line, and craniotomy of 4 cm in diameter (inferior limit of the craniotomy represents the Sylvian fissure).

PITFALLS/AVOIDANCE OF COMPLICATIONS:
Potential risks include opening of the frontal sinus, entering the orbit and exposure of the orbital fat, wrong craniotomy location, and limited exposure. Inadequate craniotomy size limits instruments maneuverability. To avoid complication, identification of anatomic landmarks, sinus closure, preoperative evaluation of computed tomography scans, and use of neuronavigation are necessary. This requires surgical expertise and familiarity of minimal invasive craniotomies.

VARIANTS/REASONS:
Anatomic limitations of the LSO include temporomesial region, distal Sylvian +/−, posterior communicating artery aneurysms medial projection, retro carotid space, and carotid cave. For pathologies requiring an additional lateral trajectory, we use an extended LSO, drilling the sphenoid wing through the fronto-pterio-orbital window without drilling of the temporal bone. Additional variations include performing an intradural or extradural clinoidectomy. The patient consented to the procedure and to the publication of their image.
The ongoing evolution of mentorship: Advancing the formal mentorship program at AKU-SONAM
Authors: Rehman Rehana , Ali Tazeen Saeed , Khalid Saira , Ali Rahila 
Published: December 2023

Objective: To investigate the perceptions of mentors, mentees, administrators (including chairs, co-chairs, and coordinators of the mentoring program), and leadership regarding the Faculty Mentorship Program at AKU School of Nursing and Midwifery (AKU-SONAM). Additionally, the study aimed to explore the strengths and challenges faced by the program.
Methods: A qualitative exploratory study on mentorship was carried out in AKU-SONAM from February till December 2021. In this study we conducted purposive criterion sampling. The study participants included mentors, mentees, administrators, and the dean of AKU-SONAM. An interview guide was developed, validated, and reviewed by experts. After piloting, two focused group discussions and three in-depth interviews were conducted.
Results: Thematic analysis of the data revealed the following themes: “Nurturing growth and development in mentoring relationships,” “Establishing a strong foundation for effective mentoring,” and “Opportunities for growth and development through overcoming challenges.”
Conclusion: The participants expressed confidence in the existing support system, leadership, and mentorship program at the institution. They highlighted the significance of regular monitoring to recognize areas of improvement uphold high standards and ensure excellence.
doi: https://doi.org/10.12669/pjms.40.3.8212
How to cite this: Rehman R, Ali TS, Khalid S, Ali R. The ongoing evolution of mentorship: Advancing the formal mentorship program at AKU-SONAM. Pak J Med Sci. 2024;40(3):514-519. doi: https://doi.org/10.12669/pjms.40.3.8212
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
EXPLICIT AND IMPLICIT MARKERS OF CONFLICT SPEECH BEHAVIOR IN INTERNET-MEDIATED COMMUNICATION DURING THE COVID-19 PANDEMIC
Authors: Gukos'yanc O. , Alimuradov O. 
Published: December 2023

Introduction. The Internet leaves a significant imprint on the features of the construction and means of implementing conflict communication. The calculation of these tools allows us to differentiate communicative conflicts on the Internet with a sufficient degree of clarity and suppress them.
Aim. Identification and comprehensive study of the conflict speech behavior in the process of exchanging comments on posts in the LiveJournal for the period from January 2020 to December 2022.
Methodology and research methods. A continuous sampling method is used to select study material, a method of complex communicative-pragmatic analysis provides the assessment of comments as conflicting, linguostylistic analysis and contextual analysis contribute to detect the explicit and implicit markers of conflict interaction.
Results. Detected explicit markers: profanity, zoometaphores, negative facial nomination from the point of view of origin, mental development, health status, level of education, from the point of view of the interests of society, occasionalism of the pandemic period, naming of the interlocutor as representatives of hostile ideology, emotive verbs with negative meaning, neutral device nominations when referring to the interlocutor, lexical means with threat, isolation, vaccinating semantics. Detected implicit markers: means that contribute to the construction of a dichotomy "own - alien", phraseologisms with negative connotations, an abundance of punctuation marks, Internet memes for the transmission of emotions, typeface, parcellated constructions, English-language interspersions, erratives, multiple questions, incomplete sentences, parallel constructions, repetitions, imperatives, subjunctive mood in an incentive meaning, modal words with the semantics of dignity. Means-enhancers of conflict interaction: adversative conjunctions, hyperbolization, phonetic pun, indefinite pronouns, double negation, adverbs-intensifiers, amplifying-excretory particles.
Scientific novelty. A wide range of verbal and non-verbal means that show conflict explicitly and implicitly has been identified.
Practical significance. We believe that the achieved results will ensure the regulation of the increase in conflict situations on the Internet.