bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence and predictors of futile recanalisation after endovascular therapy in acute vertebrobasilar artery occlusion patients: insight from the ANGEL-ACT registry
Authors: Sun Dapeng , Yang Xinguang , Huo Xiaochuan , ‑ Raynald , Jia Baixue , Tong Xu , Wang Anxin , Ma Ning , Gao Feng , Mo Dapeng , Miao Zhongrong 
Published: October 2023

ObjectivesTo identify the occurrence rate and predictors of futile recanalisation after endovascular therapy (EVT) for acute vertebrobasilar artery occlusion (VBAO).MethodsParticipants of the Endovascular Treatment Key Technique and Emergency Workflow Improvement of Acute Ischaemic Stroke (ANGEL-ACT) registry were selected for the analysis. Futile recanalisation was defined as patients did not achieve a 90-day good outcome (modified Rankin Scale ≤3) despite successful recanalisation (modified Treatment in Cerebral Ischaemia Scale ≥2b) after the procedure. Multivariable logistic regression analysis was conducted to find independent predictors of futile recanalisation in VBAO patients undergoing EVT.ResultsThree hundred and fifteen patients with VBAO who achieved successful recanalisation after EVT were included in current analysis, of whom, 155 (49.2%) suffered futile recanalisation, and 160 achieved effective recanalisation. After the multivariable analysis, we found admission National Institutes of Health Stroke Scale (NIHSS) ≥19 (OR 4.81, 95% CI 2.76 to 8.39, p<0.001), platelet-lymphocyte ratio (PLR) ≥162.2 (OR 1.93, 95% CI 1.14 to 3.27, p=0.001), onset-to-puncture time (OTP) ≥334 min (OR 2.15, 95% CI 1.25 to 3.68, p=0.005) and use of general anesthesia (GA) (OR 1.87, 95% CI 1.09 to 3.22, p=0.024) were associated with futile recanalisation.ConclusionsFutile recanalisation after EVT occurred 49.2% of VBAO patients in the ANGEL-ACT registry. NIHSS≥19, PLR≥162.2, OTP≥334 min and use of GA were independent predictors of futile recanalisation.
Supplementary Table S1 from Memory-like Differentiation, Tumor-Targeting mAbs, and Chimeric Antigen Receptors Enhance Natural Killer Cell Responses to Head and Neck Cancer
Authors: Jacobs Miriam T. , Wong Pamela , Zhou Alice Y. , Becker-Hapak Michelle , Marin Nancy D. , Marsala Lynne , Foster Mark , Foltz Jennifer A. , Cubitt Celia C. , Tran Jennifer , Russler-Germain David A. , Neal Carly , Kersting-Schadek Samantha , Chang Lily , Schappe Timothy , Pence Patrick , McClain Ethan , Zevallos Jose P. , Rich Jason T. , Paniello Randal C. , Jackson Ryan S. , Pipkorn Patrik , Adkins Douglas R. , DeSelm Carl J. , Berrien-Elliott Melissa M. , Puram Sidharth V. , Fehniger Todd A. 
Published: October 2023

<p>Supplementary Table S1. Demographic and clinical data of advanced head and neck squamous cell carcinoma patients. </p>
Cardiac Autonomic Dysfunction and Risk of Silent Myocardial Infarction Among Adults With Type 2 Diabetes
Authors: Kaze Arnaud D. , Fonarow Gregg C. , Echouffo‐Tcheugui Justin B. 
Published: October 2023

Background
There is a paucity of large‐scale epidemiological studies on the link between cardiac autonomic neuropathy (CAN) and the risk of silent myocardial infarction (SMI) in type 2 diabetes. We evaluated the association between CAN and the risk of SMI in a large sample of adults with type 2 diabetes.

Methods and Results
Participants with type 2 diabetes from the ACCORD (Action to Control Cardiovascular Risk in Diabetes) study without atherosclerotic cardiovascular disease at baseline were included. CAN was ascertained using heart rate variability indices calculated from 10‐s resting electrocardiograms. The heart rate variability indices included standard deviation of all normal‐to‐normal R‐R intervals and root mean square of successive differences between normal‐to‐normal R‐R intervals. CAN was defined as both the standard deviation of all normal‐to‐normal R‐R intervals and root mean square of successive differences between normal‐to‐normal R‐R intervals less than the fifth percentile of the general population. We used Cox proportional hazards regression to generate hazard ratios (HRs) for incident SMI in relation to CAN measures. Among 4842 participants (mean age, 62.5 years; 46.6% women; 60.2% White), there were 73 incident SMI cases over a median follow‐up of 4.9 years (incidence rate 3.1 out of 1000 person‐years [95% CI, 2.5–3.9]). After adjusting for confounders, low heart rate variability was associated with a higher risk of SMI (HR, 1.67 [95% CI, 1.02–2.72] and HR, 1.56 [95% CI, 0.94–2.58] for low standard deviation of all normal‐to‐normal R‐R intervals and root mean square of successive differences between normal‐to‐normal R‐R intervals, respectively). Participants with CAN had a 1.9‐fold greater risk of SMI (HR, 1.91 [95% CI, 1.14–3.20]).

Conclusions
In a large cohort of adults with type 2 diabetes, CAN was significantly associated with an increased risk of incident SMI.
Tenecteplase, 0.4 mg/kg, in Moderate and Severe Acute Ischemic Stroke: A Pooled Analysis of NOR‐TEST and NOR‐TEST 2A
Authors: Novotny Vojtech , Kvistad Christopher Elnan , Naess Halvor , Logallo Nicola , Fromm Annette , Khanevski Andrej Netland , Thomassen Lars 
Published: October 2023

Background
The optimal dose of tenecteplase in acute ischemic stroke remains to be defined. We present a pooled analysis of the 2 NOR‐TESTs (Norwegian Tenecteplase Stroke Trials) exploring the efficacy and safety of tenecteplase, 0.4 mg/kg.

Methods and Results

We retrospectively reviewed 2 PROBE (Prospective Randomized Open, Blinded End‐point) trials, NOR‐TEST and NOR‐TEST 2A. Patients were randomized to either tenecteplase, 0.4 mg/kg, or alteplase, 0.9 mg/kg. The primary end point was favorable functional outcome at 3 months (modified Rankin Scale score, 0–1) or return to baseline if prestroke modified Rankin Scale score was 2. Secondary end points included favorable functional and clinical outcome and safety data. The pooled analysis includes patients with National Institutes of Health Stroke Scale score ≥6 from both trials and an additional post hoc analysis of patients with National Institutes of Health Stroke Scale score ≤5 from NOR‐TEST. The per‐protocol analysis contains 483 patients, of whom 235 were assigned to tenecteplase and 248 were assigned to alteplase. In per‐protocol analysis, functional outcome was better in the alteplase arm with cutoff modified Rankin Scale score of 2 (odds ratio [OR], 0.52 [95% CI, 0.33–0.80];
P
=0.003) and expressed by ordinal shift analysis (OR, 1.64 [95% CI, 1.17–2.28];
P
=0.004). Mortality at 3 months was higher in the tenecteplase arm (OR, 2.48 [95% CI, 1.20–5.10];
P
=0.01). Mortality and intracranial hemorrhage rates were higher in the severe stroke group randomized to tenecteplase, whereas these rates were similar for alteplase and tenecteplase in moderate and mild stroke.

Conclusions
Tenecteplase, 0.4 mg/kg, is unsafe in moderate and severe stroke, and the risk of death and intracranial hemorrhage probably increases with stroke severity. A lower tenecteplase dose should be tested in future trials.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifiers: NCT01949948, NCT03854500.
Deep Learning Algorithms to Detect Murmurs Associated With Structural Heart Disease
Authors: Prince John , Maidens John , Kieu Spencer , Currie Caroline , Barbosa Daniel , Hitchcock Cody , Saltman Adam , Norozi Kambiz , Wiesner Philipp , Slamon Nicholas , Del Grippo Erica , Padmanabhan Deepak , Subramanian Anand , Manjunath Cholenahalli , Chorba John , Venkatraman Subramaniam 
Published: October 2023

Background
The success of cardiac auscultation varies widely among medical professionals, which can lead to missed treatments for structural heart disease. Applying machine learning to cardiac auscultation could address this problem, but despite recent interest, few algorithms have been brought to clinical practice. We evaluated a novel suite of Food and Drug Administration‐cleared algorithms trained via deep learning on >15 000 heart sound recordings.

Methods and Results
We validated the algorithms on a data set of 2375 recordings from 615 unique subjects. This data set was collected in real clinical environments using commercially available digital stethoscopes, annotated by board‐certified cardiologists, and paired with echocardiograms as the gold standard. To model the algorithm in clinical practice, we compared its performance against 10 clinicians on a subset of the validation database. Our algorithm reliably detected structural murmurs with a sensitivity of 85.6% and specificity of 84.4%. When limiting the analysis to clearly audible murmurs in adults, performance improved to a sensitivity of 97.9% and specificity of 90.6%. The algorithm also reported timing within the cardiac cycle, differentiating between systolic and diastolic murmurs. Despite optimizing acoustics for the clinicians, the algorithm substantially outperformed the clinicians (average clinician accuracy, 77.9%; algorithm accuracy, 84.7%.)

Conclusions
The algorithms accurately identified murmurs associated with structural heart disease. Our results illustrate a marked contrast between the consistency of the algorithm and the substantial interobserver variability of clinicians. Our results suggest that adopting machine learning algorithms into clinical practice could improve the detection of structural heart disease to facilitate patient care.
Abstract P2131: Sialidase Neu3: A Novel Cardioprotective Target Against Ischemia And Reperfusion Injury
Authors: Piccoli Marco , Coviello Simona , Lavota Ivana , Ghiroldi Andrea , Cirillo Federica , Pappone Carlo , Anastasia Luigi 
Published: October 2023

Coronary reperfusion techniques are life-saving approaches to restore blood flow to cardiac tissue after acute myocardial infarction. However, they also lead to what is known as ischemia and reperfusion injury (IRI), which causes additional damage and heart failure. Despite the urgent need for cardioprotective strategies against IRI, none has yet been introduced into clinical practice, suggesting that a more detailed characterization of the molecular mechanisms underlying the pathogenesis of IRI is essential. In this regard, our research group has shown that sialidase Neu3, an enzyme responsible for removing sialic acid from glycosphingolipids, is modulated during IRI in vivo and that its constitutive overexpression in rat cardiomyoblasts is sufficient to counteract the deleterious effects of IRI through activation of reperfusion injury salvage kinase (RISK) and the HIF-1α pathway.
Thus, in this study, we developed an inducible model of Neu3 overexpression in human cardiac cells (AC16) and in mice to further elucidate the role of this protein in promoting cardioprotection.
Inducible upregulation of Neu3 significantly increased cell resistance and reduced oxidative stress in AC16 exposed to IRI in vitro. These beneficial effects were related to Neu3-mediated maintenance of mitochondrial membrane potential, which was altered in control cells. Moreover, RNAseq data showed that Neu3 activation was associated with upregulation of the cellular responses to stress, whereas, in contrast, the pro-inflammatory signaling pathways of TNF-α and IL-22 were downregulated.
We also generated αMHC-Cre/LSL-Neu3 mice for the first time by crossing the tamoxifen-inducible αMHC-Cre mouse with a mouse carrying a floxed-transcriptional STOP sequence upstream of Neu3. These mice were characterized for cardiac morphology and functionality and showed no significant differences compared with wild-type mice. They will undergo surgical induction of IRI to test the beneficial effects of Neu3. Based on our findings, it can be hypothesized that Neu3 plays a significant role in the cardiac response to IRI. Consequently, targeting Neu3 may hold therapeutic promise in increasing cardioprotection and mitigating the incidence and severity of myocardial infarction.
Visual, Spatial and Temporal Aporias in the Post-Palestinian Films of Basma Alsharif
Authors: Hole Kristin Lené 
Published: October 2023

Abstract
This article focuses on the films of diasporic Palestinian artist Basma Alsharif, analyzing the visual strategies she mobilizes to negotiate three aporias in Palestinian experience around visuality, space and mobility and temporality. Focusing on Ouroboros (2017) and Home Movies Gaza (2013), I explore the ethical ways she represents a situation of suspended violence without spectacularizing suffering or relying on overdetermined visual conventions. The films evoke both feelings of spatial constraint, and conversely, a diasporic expansiveness that characterizes a Palestinian structure of feeling. Finally, I look at Alsharif’s engagement with the concept of the eternal return, paying particular attention to the ways that it suggests a notion of time not predicated on the unitary, revolutionary (i.e., heteromasculine) subject and proposes a way forward not based on the exclusionary rhetoric of the nation-state. Throughout the article, I put her work in conversation with other female Palestinian filmmakers handling similar themes to identify emerging patterns in how Palestine is portrayed and conceived.
Meteorological Research Enabled by Rapid-Scan Radar Technology
Authors: Bodine David J. , Griffin Casey B. 
Published: October 2023

Abstract
The scientific community has long acknowledged the importance of high-temporal-resolution radar observations to advance science research and improve high-impact weather prediction. Development of innovative rapid-scan radar technologies over the past two decades has enabled radar volume scans of 10–60 s compared to 3–5 min with traditional parabolic dish research radars and the WSR-88D radar network. This review examines the impact of rapid-scan radar technology, defined as radars collecting volume scans in 1 min or less, on atmospheric science research spanning different subdisciplines and evaluates the strengths and weaknesses of the use of rapid-scan radars. In particular, a significant body of literature has accumulated for tornado and severe thunderstorm research and forecasting applications, in addition to a growing number of studies of convection. Convection research has benefited substantially from more synchronous vertical views, but could benefit more substantially by leveraging multi-Doppler wind retrievals and complementary in situ and remote sensors. In addition, several years of forecast evaluation studies are synthesized from radar testbed experiments, and the benefits of assimilating rapid-scan radar observations are analyzed. Although the current body of literature reflects the considerable utility of rapid-scan radars to science research, a weakness is that limited advancements in understanding of the physical mechanisms behind observed features have been enabled. There is considerable opportunity to bridge the gap in physical understanding with the current technology using coordinated efforts to include rapid-scan radars in field campaigns and expanding the breadth of meteorological phenomena studied.

Significance Statement
Recently developed rapid-scan radar technologies, capable of collecting volumetric (i.e., three-dimensional) measurements in 10–60 s, have improved temporal sampling of weather phenomena. This review examines the impact of these radar observations from the past two decades on science research and emerging operational capabilities. Substantial breadth and impact of research is evident for tornado research and forecasting applications, in addition to documentation of other rapidly evolving phenomena associated with deep convection, such as tornadoes, hail, lightning, and tropical cyclones. This review identifies the strengths and weaknesses of how these radars have been used in scientific research to inform future studies, emerging from the increasing availability and capability of rapid-scan radars. In addition, this review synthesizes research that can benefit future operational radar decisions.
Direct Care Nurses’ Needlestick Injury Experiences: A Qualitative Descriptive Study
Authors: Min Deulle , Kim Dahee , Lee Yewon 
Published: October 2023

Background: Even when education and the use of safety equipment are emphasized, nurses frequently experience needlestick injuries. Understanding the risk situations and coping mechanisms for needlestick injuries experienced by nurses facilitates their prevention. Objectives: We aimed to explore and describe the phenomenon of needlestick injuries through the research questions: (1) What causes nurses to suffer from needlestick injuries? (2) How to cope after a needlestick injury? and (3) What are the recommendations for needlestick injury prevention? Methods: This qualitative descriptive study involved focus group interviews with 31 direct care nurses in 6 groups who had experienced needlestick injuries while working in different acute care hospitals across 3 regions in South Korea. Data were collected from January 29 to March 29, 2022, and analyzed using thematic analysis. Results: The average age of the participating nurses was 29.7 years. The following 3 themes were identified: various needlestick injury experiences, post-needlestick injury coping, and expectations regarding needlestick injuries. Conclusions: Risk situations and coping mechanisms of nurses who experienced needlestick injuries were diverse. Emergency situations and novice nurses were the causes of most of the needlestick injuries. Often, personal protective equipment was found cumbersome. Reporting needlestick injuries depended on the work environment.
Three-dimensional vessel wall imaging with 1.5-T MRI to visualize invisible occluded cerebral artery
Authors: Kumagai Kosuke , Hayashi Miyuka , Takahashi Takahiro , Honma Hiroyuki , Nishida Shou , Hayashi Shinji , Ishihara Hideaki 
Published: October 2023

Background Endovascular thrombectomy (EVT) is performed for acute ischemic stroke (AIS) caused by large vessel occlusion; therefore, preoperative visualization of the occluded invisible vessel course reduces complications and ensures success. Three-dimensional (3D) proton density-weighted (PDW) vessel wall imaging (VWI) using variable refocusing flip angle pulse-turbo spin-echo sequences (VRFA-TSE) with 3.0-T magnetic resonance imaging (MRI) can provide this information. Purpose To assess the effectiveness of 3D PDW-VWI using 1.5-T MRI without VRFA function. Material and Methods Five consecutive patients with AIS caused by large vessel occlusion underwent EVT in our institute. VWI with 1.5-T MRI using 3D PDW-fast spin echo (FSE) technique was added to conventional brain imaging. Results PDW-FSE was successfully performed in all cases. 3D PDW-FSE was useful to visualize both the anterior and posterior circulations by clearly revealing invisible vessels but could not demonstrate the length and size of the clot in all five cases. Conclusion 3D PDW-FSE with 1.5-T MRI without VRFA could clearly depict the course of the invisible occluded artery and might support favorable outcomes after EVT in patients with AIS.
Impact of Mandated Case Review Policy on Opioid Discontinuation and Mortality Among High-Risk Long-Term Opioid Therapy Patients: The STORM Stepped-Wedge Cluster Randomized Controlled Trial
Authors: Li Yufei , Barr Kyle D. , Trafton Jodie A. , Oliva Elizabeth M. , Garrido Melissa M. , Frakt Austin B. , Strombotne Kiersten L. 
Published: October 2023

Background: Although long-term opioid therapy (LTOT) has its own risks, opioid discontinuation could pose harm for high-risk Veterans Health Administration (VHA) patients receiving LTOT. There is limited information on the impact of a mandate requiring providers to perform case reviews on high-risk patients with an active opioid prescription (ie, mandated case review policy) on opioid discontinuation and mortality. Methods: Our study is a secondary data analysis of a 23-month stepped-wedge cluster randomized controlled trial between April 2018 and March 2020. The study included 10 685 LTOT patients with a predicted risk of a serious adverse event between the top 1% to 5% nationally who entered the risk range between 4/18/2018 and 11/9/2019. We examined whether the mandated case review policy had an impact on opioid discontinuation and mortality for the patients. Results: Among 10 685 LTOT patients (88.2% male; mean [SD] age, 61.1 [11.7] years), 29.1% experienced discontinuation and the mortality rate was 9.5%. Patients under mandated case review had a decreased risk of opioid discontinuation (average marginal effect [AME], −11.16 [95% CI, −15.30 to −7.01] percentage points) and all-cause mortality (AME, −3.31 [95% CI, −5.63 to −1.00] percentage points), relative to patients who were not under the mandate. Conclusions: The VHA mandated case review policy was associated with lower probability of discontinuation and all-cause mortality for high-risk patients receiving LTOT. Interventions that maintain care engagement while optimizing pain management for high-risk patients may be beneficial for minimizing mortality and other risks associated with discontinuation.
Variation in telehealth use for endocrine care: Patterns and predictors under the “new normal”
Authors: Vimalananda Varsha G , Arao Kevin , Qian Shirley , Leibowitz Alison , Zupa Margaret F , Benzer Justin , Fincke B Graeme , Zocchi Mark , Meterko Mark , Berlowitz Dan , Sitter Kailyn E , Wormwood Jolie B 
Published: October 2023

Introduction Use of telehealth for outpatient endocrine care remains common since onset of the COVID-19 pandemic, though the context for its use has matured. We aimed to describe the variation in telehealth use for outpatient endocrine visits under these “new normal” conditions and examine the patient, clinician-, and organization-level factors predicting use. Methods Retrospective cross-sectional study using data from the U.S. Department of Veterans Affairs (VA) Corporate Data Warehouse on 167,017 endocrine visits conducted between 3/9/21 and 3/8/22. We used mixed effects logistic regression models to examine 1) use of telehealth vs. in-person care among all visits and 2) use of telephone vs. video among the subsample of telehealth visits. Results Visits were in person (58%), by telephone (29%), or by video (13%). Unique variability in telehealth use at each level of the analysis was 56% patient visit, 24% clinician, 18% facility. The strongest predictors were visit type (first vs. follow up) and clinician and facility characteristics. Among telehealth visits, unique variability in telephone (vs. video) use at each level was 44% patient visit, 24% clinician, 26% facility. The strongest predictors of telephone vs. video were visit type, patient age, and percent of the facility's population that was rural. Conclusions We found wide variation in use of telehealth for endocrinology under the “new normal”. Future research should examine clinician and facility factors driving variation, as many may be amenable to influence by clinical leaders and leveraged to enhance the availability of telehealth for all clinically appropriate patients.