bluuebunny/crossref_metadata_2025_split huggingface dataset:
Magnitude of Systolic Blood Pressure Reduction and Early Achieved Blood Pressure and Clinical Outcomes After Acute Ischemic Stroke
Authors: Zhai Yujia , Shi Mengyao , Liu Yang , Peng Yanbo , Zhu Zhengbao , Wang Aili , Peng Hao , Xu Tian , Chen Jing , Xu Tan , Zhang Yonghong , He Jiang , Zhong Chongke 
Published: October 2023

Background
We aimed to evaluate the relationships between the magnitude of systolic blood pressure (SBP) reduction and achieved SBP in the acute phase of ischemic stroke onset and subsequent clinical outcomes.

Methods and Results
This study was a secondary analysis of CATIS (China Antihypertensive Trial in Acute Ischemic Stroke), a multicenter randomized controlled trial of 4071 patients with acute ischemic stroke. SBP reduction was defined as the proportional SBP changes from baseline to 24 hours after randomization, and achieved SBP was the mean of SBP measurements at day 7. The study outcomes included functional outcome of death or major disability (modified Rankin Scale score ≥3), death, and cardiovascular events at 3 months after recruitment. Compared with the reference group of increase or no change in SBP within the first 24 hours, the odds ratios (95% CIs) of functional outcome of death or major disability were 0.62 (0.47–0.83) and 0.61 (0.42–0.87) for the reduction of 11% to 20% and >20%, respectively. Compared with participants in highest achieved SBP group (≥160 mm Hg) at day 7, odds ratios or hazard ratios of lower achieved SBP (<130 mm Hg) were 0.54 (95% CI, 0.37–0.80) for functional outcome, and 0.36 (95% CI, 0.17–0.80) for death or cardiovascular events.

Conclusions
A moderate magnitude of SBP reduction and a lower early achieved SBP were associated with a decreased risk of poor functional outcome, death, and cardiovascular events after acute ischemic stroke. Further studies are warranted to confirm these findings.

REGISTRATION: URL:
ClinicalTrials.gov
; Unique identifier: NCT01840072.
Prognostic Impact of Renal Function on 5‐Year Outcomes After Fractional Flow Reserve‐Guided Deferral of Revascularization
Authors: Itakura Ryosuke , Kuramitsu Shoichi , Kikuchi Jun , Kawase Yoshiaki , Mizukami Takuya , Shinozaki Tomohiro , Horie Kazunori , Takashima Hiroaki , Terai Hidenobu , Kikuta Yuetsu , Ishihara Takayuki , Saigusa Tatsuya , Sakamoto Tomohiro , Suematsu Nobuhiro , Shiono Yasutsugu , Asano Taku , Tsujita Kenichi , Masamura Katsuhiko , Doijiri Tatsuki , Toyota Fumitoshi , Ogita Manabu , Kurita Tairo , Matsuo Akiko , Harada Ken , Yaginuma Kenji , Sonoda Shinjo , Yokoi Hiroyoshi , Tanaka Nobuhiro , Matsuo Hitoshi ,   the J‐CONFIRM investigators
Published: October 2023

Background
Chronic kidney disease (CKD) might influence fractional flow reserve (FFR) value, potentially attenuating its prognostic utility. However, few large‐scale data are available regarding clinical outcomes after FFR‐guided deferral of revascularization in patients with CKD.

Methods and Results

From the J‐CONFIRM registry (Long‐Term Outcomes of Japanese Patients With Deferral of Coronary Intervention Based on Fractional Flow Reserve in Multicenter Registry), 1218 patients were divided into 3 groups according to renal function: (1) non‐CKD (estimated glomerular filtration rate ≥60 mL/min per 1.73 m
2
), n=385; (2) CKD (estimated glomerular filtration rate 15–59 mL/min per 1.73 m
2
, n=763); and (3) end‐stage renal disease (ESRD) (eGFR <15 mL/min per 1.73 m
2
, n=70). The primary study end point was the cumulative 5‐year incidence of target vessel failure (TVF), defined as a composite of cardiac death, target vessel myocardial infarction, and clinical driven target vessel revascularization. Cumulative 5‐year incidence of TVF was significantly higher in the ESRD group than in the CKD and non‐CKD group, whereas it did not differ between the CKD and non‐CKD groups (26.3% versus 11.9% versus 9.5%,
P
<0.001). Although the 5‐year TVF risk increased as the FFR value decreased regardless of renal function, patients with ESRD had a remarkably higher risk of TVF at every FFR value than those with CKD and non‐CKD.

Conclusions
At 5 years, patients with ESRD showed a higher incidence of TVF than patients with CKD and non‐CKD, although with similar outcomes between patients with CKD and non‐CKD. Patients with ESRD had an excess risk of 5‐year TVF at every FFR value compared with those with CKD and non‐CKD.

Registration

URL:
https://www.umin.ac.jp
; Unique identifier: UMIN000014473.
Residual Responsibility to Implement: the AU, the Constitutive Act, and the Responsibility to Protect
Authors: Afewerky Rahel Kessete 
Published: October 2023

Abstract
Decades after the African Union adopted the Constitutive Act and the Responsibility to Protect (R2P), mass atrocities continue to go unchecked in Africa. The continent hosts a rising number of unresolved conflicts and humanitarian crises, rendering the promise of ‘African solutions to African problems’ mere rhetoric. This article analyses both the complementary features of the Constitutive Act and R2P, which provide the AU with the power to prevent and stop mass atrocity crimes, and the challenges which continue to impede it from successfully upholding its responsibilities.
Prevalence, Timing, Locational Distribution, and Risk Factors for Heterotopic Ossification After Elbow Arthroscopy
Authors: Ben Hui , Kholinne Erica , Zeng Chu Hui , Alsaqri Hood , Lee Jun-Bum , So Sang-Pil , Koh Kyoung-Hwan , Jeon In-Ho 
Published: October 2023

Background: Arthroscopic techniques aim to reduce complications and accelerate recovery of the elbow after treatments for posttraumatic stiffness, arthritis diseases, lateral epicondylitis, ligament reconstruction, and elbow trauma. However, data on the true prevalence and characteristics of heterotopic ossification (HO) formation after elbow arthroscopy are limited. Purpose: To investigate the prevalence, timing, locational distribution, and risk factors of HO after elbow arthroscopy. Study Design: Cohort study; Level of evidence, 4. Methods: Data on 205 patients undergoing elbow arthroscopy by a single senior elbow surgeon at a single institution between May 2011 and January 2022 were retrospectively reviewed. The patients were evaluated at 2 weeks, 8 weeks, 6 months, and then annually after surgery or more frequently if HO developed, with a minimum of 1 year of postoperative follow-up. Postoperative anteroposterior and lateral elbow radiographs were taken at 2 weeks to rule out fracture and at 8 weeks to identify HO. The clinical outcomes were evaluated based on the pain visual analog scale; the shortened version of the Disabilities of the Arm, Shoulder and Hand score; Mayo Elbow Performance Score; and the Single Assessment Numeric Evaluation scores before and after surgery. Bivariate logistic regression analyses were used to determine factors affecting HO prevalence. Results: Thirteen (12 male, 1 female) of 205 (6.3%) patients developed HO, with 10 (76.9%) with HO that formed on the medial compartment of the elbow. Ten (76.9%) patients were diagnosed at 8 weeks after arthroscopic surgery, 1 (7.7%) at 6 months after surgery, and 2 (15.4%) at 12 months after surgery. HO was not found at 2 weeks after surgery in any patient. The mean follow-up time was 3.5 years (range, 1.0-11.8 years). Eleven asymptomatic patients were treated nonoperatively, and 2 symptomatic patients underwent HO excision arthroscopically or had a combination of open surgery and arthroscopy. Age was a protective factor for HO formation (odds ratio [OR], 0.953; 95% CI, 0.910-0.999; P = .047). The risk factors for HO formation were tourniquet time (OR, 1.042; 95% CI, 1.019-1.065; P < .001) and surgical time (OR, 1.026; 95% CI, 1.011-1.041; P < .001). Conclusion: Among 205 patients who underwent elbow arthroscopy, HO was a minor complication of elbow arthroscopy, with a prevalence rate of 6.3%, and was usually located on the medial compartment of the elbow. Although the presence of HO may not affect the clinical outcomes in most patients, it should be carefully monitored for a minimum of 8 weeks postoperatively. Younger age, longer tourniquet time, and longer surgical time contributed to HO formation after elbow arthroscopy.
A Safe and Simple Method of Augmentation Mastopexy
Authors: Le Tong , Higgs Michael John 
Published: October 2023

Introduction:Combining breast augmentation with mastopexy has historically been considered challenging, with concerns about complications and suboptimal aesthetic outcomes. However, recent data suggest that the combined procedure can be performed safely and effectively.Materials and Method:This article presents a technique for augmentation mastopexy that aims to minimize complications and is safe to perform. The technique focuses on preserving a robust blood supply, minimizing lower breast contour bottoming out, maintaining upper pole fullness, reducing the risk of recurrent ptosis, minimizing scar burden, and avoiding periareolar scar widening. Precise preoperative and intraoperative markings are crucial for achieving long-lasting results. The use of tailor tacking and marking the vertical excess with the patient in an upright position provides a reliable method for determining the amount of soft tissue resection required.Results:The results are shown in the postoperative photographs at 10 days, 1 month, and 3 months, respectively. These are compared with the preoperative photographs of the patient’s features.Discussion:The technique incorporates the use of an implant placed in the dual-plane subpectoral pocket to address upper pole flatness and provide structural support in the lower pole. The article emphasizes the importance of preserving Cooper’s ligaments during skin resection to maintain the supportive role of the skin. Vertical wedge resection of the lower pole is employed to reconstruct the breast cone and create a strong vertical fibrous band, which contributes to the long-term shape and support of the breast. The article also discusses techniques to mitigate nipple-areolar complex widening and emphasizes the importance of patient selection based on specific criteria.Conclusion:Overall, the authors present a safe and simple technique for augmentation mastopexy that aims to achieve long-lasting results with minimal complications. The authors advocate for careful patient selection and adherence to their methodology, which incorporates principles of preserving blood supply, maintaining breast contours, and minimizing scar burden.
Evaluation of the effectiveness of behavioral interventions for autism spectrum disorders: A systematic review of randomized controlled trials and quasi-experimental studies
Authors: Pruneti Carlo , Coscioni Gabriella , Guidotti Sara 
Published: October 2023

The objective of this research was to assess the efficacy of behavioral therapy interventions in the treatment of autism spectrum disorders (ASD). The study utilized the PubMed and Embase databases to locate randomized controlled trials, quasi-experimental treatment studies, and randomized clinical trial comparisons. The experimental group received treatment based on an applied behavioral approach, such as PECS, DTT, PRT, TEACCH, ESDM, and EIBI. After examining seventeen studies, the researchers found that each type of behavioral intervention had a positive impact. Naturalistic protocols that employed PRT and PECS improved ASD symptoms in general, despite their targeting of particular cognitive domains such as language. ESDM enhanced receptive language, particularly in preschool-aged children. Structured and integrated interventions, like EIBI and TEACCH, improved overall adaptive functioning. Combining DTT with a TEACCH program produced greater benefits in linguistic, affective-social, and personal autonomy domains. However, there is a scarcity of high-quality research available on behavioral interventions for ASD. Further comparative studies are necessary to identify cost-efficient interventions. For example, PRT and PECS significantly improved social communication skills in only 15–40 hours over six months. The authors emphasized the need for continued research and the application of evidence-based interventions in specialized settings.
Utilization of Norwegian crisis shelters before and during the COVID-19 pandemic
Authors: Baste Valborg , Haukenes Inger , Morken Tone , Moen Bente E. , Alsaker Kjersti 
Published: October 2023

Background: The measures introduced to control the COVID-19 pandemic, including lockdowns and physical distancing, exerted considerable influence on society. Objectives: The aims of this study were to examine (1) the prevalence of people seeking Norwegian crisis shelters for domestic violence during the first period of the COVID-19 pandemic (2020) compared to the year before, (2) the demography and type of violence among first-time visitors and (3) to compare the utilization of the crisis shelters and characteristics of the users between shelters in the capital and the other shelters throughout Norway. Design: Observational study. Method: The study was based on data from each crisis shelter in 2019 and 2020. Comparison between the 2 years were based on corresponding periods (12 March until 31 December) and analysed with t-test and chi-square tests. Results: Total use of crises centres, residential stays and daytime visits were lower during the pandemic (n = 7102) compared to the pre-pandemic period (n = 11 814). There was a shift from daytime visits to phone contacts when the restrictions were established. There was a higher proportion of residential stays versus daytime visits during the pandemic (21.5%) compared to the pre-pandemic period (15.4%) (p ⩽ 0.001). The proportion of first-time users was higher during the pandemic compared to pre-pandemic period both for residents (52.4% vs 47.1%) and daytime visitors (10.9% vs 9.0%). Among first-time crisis shelter residents during the pandemic period, fewer reported having children at home compared to the pre-pandemic period. The background of the crisis-shelter users did not differ between the capital and rest of Norway, but the capital had relatively more residents with psychological violence and threats during the pandemic. Conclusion: The utilization of Norwegian crisis shelters, especially daytime visits was lower during the pandemic. There was a shift in daytime contacts from visits to phone contact at the pandemic outbreak. To ensure that information about available crisis shelters reaches the total population, these shelters should be prepared for a higher volume of phone contacts in a future pandemic situation.
Surgical management of a laryngeal rhabdomyosarcoma in a cat
Authors: Alexander Akash , Hughes Katherine , Constantino-Casas Fernando , Owen Laura Jane 
Published: October 2023

Case summary An 11-year-old male castrated British Shorthair was referred for investigations into an upper respiratory tract mass. A partial laryngectomy was performed to excise the mass. Marginal resection of the mass involved excision of parts of the thyroid cartilage and left arytenoid cartilage. A tracheostomy tube was maintained for 48 h postoperatively. The cat recovered without complication and was discharged at 72 h postoperatively. Histopathology of the mass was deemed most consistent with a rhabdomyosarcoma (RMS). Relevance and novel information Telephone follow-up 12 months postoperatively confirmed resolution of the clinical signs. To our knowledge, this is the first report of a laryngeal RMS in a cat. RMS should be considered a differential diagnosis for a laryngeal mass in a cat. This case demonstrates that resection via a partial laryngectomy may be a viable therapeutic option.
Impact of cerebral small vessel disease burden and drug level at admission on direct oral anticoagulant associated intracerebral hemorrhage
Authors: Lin Shin-Yi , Chen Ya-Fang , Chen Chih-Hao , Kuo Ching-Hua , Liu Yen-Bin , Chao Yuan-Chang , Peng Yu-Fong , Huang Chih-Fen , Tang Sung-Chun , Jeng Jiann-Shing 
Published: October 2023

Introduction: Direct oral anticoagulant (DOAC)-associated intracerebral hemorrhage (ICH) is a catastrophic complication. The aim of this study was to investigate the association between computed tomography (CT)-based cerebrovascular small vessel disease (SVD) burden and DOAC-ICH as well as the DOAC concentration upon hospital admission and ICH outcome. Patients and methods: The study included two cohorts: (1) DOAC-ICH: patients who suffered from DOAC-ICH and underwent drug level measurements upon admission; (2) DOAC-non-ICH: stable DOAC users who underwent head CT without ICH during treatment. We categorized the DOAC levels of the DOAC-ICH patients as low (<50 ng/mL), medium (50–300 ng/mL), and high (>300 ng/mL). The CT-based SVD burden (including white matter lesions [WML], lacunes, and cerebral atrophy) was evaluated, and SVD scores (range, 0–3) were used to evaluate SVD severity. Results: A total of 43 DOAC-ICH patients and 177 DOAC-non-ICH patients were enrolled. DOAC-ICH patients were more likely to have WML, lacunes, or cerebral atrophy compared to DOAC-non-ICH patients. After adjustment, the SVD burden was associated with DOAC-ICH, with a higher risk of more severe SVD (SVD score of 2; odds ratio [OR], 10.3 [3.17, 33.3]; score of 3; OR, 16.8 [4.50, 62.6]). The proportions of patients with high, medium, and low drug levels in the DOAC-ICH group were 16.3%, 55.8%, and 27.9%, respectively. Additionally, the high-level group displayed a larger hematoma size and had worse functional outcomes at 3 months than the other two groups. Discussion and conclusion: The severity of SVD burden was associated with DOAC-ICH. Furthermore, high DOAC levels in ICH were associated with unfavorable clinical outcomes. To address the potential selection bias from these two cohorts, a prospective study to investigate the co-contribution of drug levels and SVD to DOAC-ICH is essential.
Glucan Synthase-like 2 is Required for Seed Initiation and Filling as Well as Pollen Fertility in Rice
Authors: Qiu Ronghua , Liu Yang , Cai Zhengzheng , Li Jieqiong , Wu Chunyan , Wang Gang , Lin Chenchen , Peng Yulin , Deng Zhanlin , Tang Weiqi , Wu Weiren , Duan Yuanlin 
Published: October 2023

Abstract
Background
The Glucan synthase-like (GSL) genes are indispensable for some important highly-specialized developmental and cellular processes involving callose synthesis and deposition in plants. At present, the best-characterized reproductive functions of GSL genes are those for pollen formation and ovary expansion, but their role in seed initiation remains unknown.

Results
We identified a rice seed mutant, watery seed 1-1 (ws1-1), which contained a mutation in the OsGSL2 gene. The mutant produced seeds lacking embryo and endosperm but filled with transparent and sucrose-rich liquid. In a ws1-1 spikelet, the ovule development was normal, but the microsporogenesis and male gametophyte development were compromised, resulting in the reduction of fertile pollen. After fertilization, while the seed coat normally developed, the embryo failed to differentiate normally. In addition, the divided endosperm-free nuclei did not migrate to the periphery of the embryo sac but aggregated so that their proliferation and cellularization were arrested. Moreover, the degeneration of nucellus cells was delayed in ws1-1. OsGSL2 is highly expressed in reproductive organs and developing seeds. Disrupting OsGSL2 reduced callose deposition on the outer walls of the microspores and impaired the formation of the annular callose sheath in developing caryopsis, leading to pollen defect and seed abortion.

Conclusions
Our findings revealed that OsGSL2 is essential for rice fertility and is required for embryo differentiation and endosperm-free nucleus positioning, indicating a distinct role of OsGSL2, a callose synthase gene, in seed initiation, which provides new insight into the regulation of seed development in cereals.
Mapping the epigenomic landscape of human monocytes following innate immune activation reveals context-specific mechanisms driving endotoxin tolerance
Authors: Amarasinghe Harindra E. , Zhang Ping , Whalley Justin P. , Allcock Alice , Migliorini Gabriele , Brown Andrew C. , Scozzafava Giuseppe , Knight Julian C. 
Published: October 2023

AbstractBackgroundMonocytes are key mediators of innate immunity to infection, undergoing profound and dynamic changes in epigenetic state and immune function which are broadly protective but may be dysregulated in disease. Here, we aimed to advance understanding of epigenetic regulation following innate immune activation, acutely and in endotoxin tolerant states.MethodsWe exposed human primary monocytes from healthy donors (n = 6) to interferon-γ or differing combinations of endotoxin (lipopolysaccharide), including acute response (2 h) and two models of endotoxin tolerance: repeated stimulations (6 + 6 h) and prolonged exposure to endotoxin (24 h). Another subset of monocytes was left untreated (naïve). We identified context-specific regulatory elements based on epigenetic signatures for chromatin accessibility (ATAC-seq) and regulatory non-coding RNAs from total RNA sequencing.ResultsWe present an atlas of differential gene expression for endotoxin and interferon response, identifying widespread context specific changes. Across assayed states, only 24–29% of genes showing differential exon usage are also differential at the gene level. Overall, 19.9% (6,884 of 34,616) of repeatedly observed ATAC peaks were differential in at least one condition, the majority upregulated on stimulation and located in distal regions (64.1% vs 45.9% of non-differential peaks) within which sequences were less conserved than non-differential peaks. We identified enhancer-derived RNA signatures specific to different monocyte states that correlated with chromatin accessibility changes. The endotoxin tolerance models showed distinct chromatin accessibility and transcriptomic signatures, with integrated analysis identifying genes and pathways involved in the inflammatory response, detoxification, metabolism and wound healing. We leveraged eQTL mapping for the same monocyte activation states to link potential enhancers with specific genes, identifying 1,946 unique differential ATAC peaks with 1,340 expression associated genes. We further use this to inform understanding of reported GWAS, for example involvingFCHO1and coronary artery disease.ConclusionThis study reports context-specific regulatory elements based on transcriptomic profiling and epigenetic signatures for enhancer-derived RNAs and chromatin accessibility in immune tolerant monocyte states, and demonstrates the informativeness of linking such elements and eQTL to inform future mechanistic studies aimed at defining therapeutic targets of immunosuppression and diseases.