bluuebunny/crossref_metadata_2025_split huggingface dataset:
Right Ventricular‐Vascular Uncoupling Predicts Pulmonary Hypertension in Clinically Diagnosed Heart Failure With Preserved Ejection Fraction
Authors: Chen Zheng‐Wei , Chung Yi‐Wei , Cheng Jen‐Fang , Huang Chen‐Yu , Chen Ssu‐Yuan , Lin Lian‐Yu , Lai Hung‐Chun , Wu Cho‐Kai 
Published: December 2023

Background
Pulmonary hypertension (PH) is highly prevalent in patients with heart failure with preserved ejection fraction (HFpEF), and it is a strong predictor of adverse outcomes. We aimed to determine possible echocardiographic parameters to predict the presence of PH in patients with HFpEF

Methods and Results
A total of 113 patients with HFpEF were prospectively enrolled from November 2017 to July 2022. The patients underwent invasive cardiac catheterization and simultaneous echocardiography at rest and during exercise. The parameters indicating right ventricle‐pulmonary artery uncoupling, including tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) and tricuspid annular systolic velocity (TAS’)/PASP were calculated. Receiver operating characteristic curve analysis was used to determine the optimal cut‐off points of TAPSE/PASP and TAS’/PASP to differentiate patients with HFpEF with PH from those without PH. Sixty‐eight patients with HFpEF with PH and 45 without PH were included. Those with PH had lower TAPSE/PASP and TAS’/PASP at rest and during exercise compared with those without PH. Both resting/stress TAPSE/PASP and TAS’/PASP were correlated with rest/exercise pulmonary capillary wedge pressure and mean pulmonary artery pressure. In multivariable regression analysis, TAPSE/PASP remained a significant predictor of exercise pulmonary capillary wedge pressure and mean pulmonary artery pressure. In receiver operating characteristic curve analysis, the optimal cut‐off points of TAPSE/PASP and TAS’/PASP to differentiate patients with HFpEF with PH from those without PH were ≤0.62 and ≤0.47, respectively.

Conclusions
Right ventricle‐pulmonary artery uncoupling is closely correlated with abnormal rest/exercise hemodynamics (pulmonary capillary wedge pressure and mean pulmonary artery pressure) in patients with HFpEF. TAPSE/PASP and TAS’/PASP can be useful parameters to detect PH in patients with HFpEF.
Impact of Bariatric Surgery on Left Ventricular Structure and Function
Authors: Hughes Diarmaid , Aminian Ali , Tu Chao , Okushi Yuichiro , Saijo Yoshihito , Wilson Rickesha , Chan Nicholas , Kumar Ashwin , Grimm Richard A. , Griffin Brian P. , Tang W. H. Wilson , Nissen Steven E. , Xu Bo 
Published: December 2023

Background
Obesity leads to an increased risk of cardiovascular disease morbidity and death, including heart failure. Bariatric surgery has been proven to be the most effective long‐term weight management treatment. This study investigated the changes in cardiac structure and function after bariatric surgery, including left ventricular global longitudinal strain.

Methods and Results

There were 398 consecutive patients who underwent bariatric surgery with pre‐ and postoperative transthoracic echocardiographic imaging at a US health system between 2004 and 2019. We compared cardiovascular risk factors and echocardiographic parameters between baseline and follow‐up at least 6 months postoperatively. Along with decreases in weight postoperatively, there were significant improvements in cardiovascular risk factors, including reduction in systolic blood pressure levels from 132 mm Hg (25th–75th percentile: 120–148 mm Hg) to 127 mm Hg (115–140 mm Hg;
P
=0.003), glycated hemoglobin levels from 6.5% (5.9%–7.6%) to 5.7% (5.4%–6.3%;
P
<0.001), and low‐density lipoprotein levels from 97 mg/dL (74–121 mg/dL) to 86 mg/dL (63–106 mg/dL;
P
<0.001). Left ventricular mass decreased from 205 g (165–261 g) to 190 g (151–236 g;
P
<0.001), left ventricular ejection fraction increased from 58% (55%–61%) to 60% (55%–64%;
P
<0.001), and left ventricular global longitudinal strain improved from −15.7% (−14.3% to −17.5%) to −18.6% (−16.0% to −20.3%;
P
<0.001) postoperatively.

Conclusions
This study has shown the long‐term impact of bariatric surgery on cardiac structure and function, with reductions in left ventricular mass and improvement in left ventricular global longitudinal strain. These findings support the cardiovascular benefits of bariatric surgery.
Investigation of Mesosphere and Lower Thermosphere Dynamics over Central and Northern Peru Using SIMONe Systems
Authors: Conte J. Federico , Chau Jorge L. , Yiğit Erdal , Suclupe José , Rodríguez Rodolfo 
Published: December 2023

Abstract
One year of Spread spectrum Interferometric Multistatic meteor radar Observing Network (SIMONe) measurements are analyzed and compared for the first time between two low-latitude locations in Peru: Jicamarca (12°S, 77°W) and Piura (5°S, 80°W). Investigation of the mean horizontal winds and tides reveals that mesosphere and lower thermosphere (MLT) planetary-scale dynamics are similar between these two locations, although differences can be seen in some tidal components, e.g., the diurnal tide. On the other hand, 28-day median values of the momentum fluxes obtained with 4-h, 4-km time–altitude bins indicate that the mesoscale dynamics differ significantly between Jicamarca and Piura, places separated by approximately 850 km. From the middle of July until October 2021, a strong acceleration of the background zonal wind by westward-propagating gravity waves (GWs) is observed above ∼90 km at both locations, although with larger amplitudes over Jicamarca. From the middle of January until April 2022, a second strong acceleration of the background zonal wind, again by westward-propagating GWs, is observed, but this time with larger amplitudes over Piura. The latter is further supported by the dominance of negative vertical gradients of the zonal momentum flux above 89 km of altitude. Thus, these results observationally confirm the previous studies based on general circulation model simulations indicating that the directions of the zonal GW drag and the zonal background wind coincide in the low-latitude MLT. The weak correlations between the horizontal wind gradients over Jicamarca and Piura reinforce the fact that the mesoscale dynamics are different at these two locations.
Impact of social support and religiosity/spirituality on recovery from acute cardiac events and heart surgery in Switzerland
Authors: Eglin Micha , Schmid Jean-Paul , Ronel Joram , Khatami Ramin , Leiggener Christoph , Koenig Harold G. , Hefti René 
Published: December 2023

Objective The aim of this study was to evaluate the impact of social support and religiosity/spirituality (R/S) on the recovery from an acute cardiac event or cardiac surgery during cardiac rehabilitation (CR). Methods In this prospective study, a convenience sample of 159 patients participating in a CR program were enrolled. Religiosity/spirituality, social support, anxiety, depression, health related quality of life (QoL), and exercise capacity (6-min walk test, cycle ergometer test) were assessed. Results Social support was significantly associated with less anxiety ( p < .01), less depression ( p < .01), and better QoL ( p < .05) on admission. After adjustment for age, gender, education level, and morbidity, social support remained significantly associated with less depression ( p < .001). Religiosity/spirituality was significantly associated with less depression ( p < .05), better QoL ( p < .05), and better exercise capacity ( p < .05) at admission. After adjustment for covariates, however, significance was lost. There were no significant impact of either social support or R/S on the course of CR measured by change in QoL or exercise capacity. Conclusion Social support may be a protective factor against depression in the recovery from cardiac events or surgery. Neither social support nor R/S had a significant impact on the course of the 3-week CR program.
The Role of Age in Adult ADHD Quality Care: A Longitudinal Analysis of Electronic Health Record Data
Authors: Callen Elisabeth F. , Clay Tarin , Alai Jillian , Goodman David W. , Adler Lenard A. , Faraone Stephen V. 
Published: December 2023

Objective: Several studies have shown that Adult ADHD presents differently in younger and older adults. We sought to assess the difference in care between these two groups using previously identified quality measures (QMs). Methods: Using electronic health record data, we matched a younger group of ADHD patients to an older group. We then assessed the achievement of the QMs using probit models with and without interaction terms. Results: The majority of QMs shown an increase in achievement for both groups over time. However, significant differences in quality of care between younger and older adult ADHD patients persisted. By the end of the study period, with the exception of three QMs, younger patients achieved the QMs more. Conclusion: While, in general, the quality of care for adult ADHD increased from 2010 to 2020, there were still differences in care between younger and older adult ADHD patients.
Blunt solid organ injury: Resident operative experience on the decline
Authors: de Angelis Paolo , Chandramouli Mathangi , An Anjile , Gupta Aakanksha , Barie Philip S. , Winchell Robert J. , Narayan Mayur 
Published: December 2023

Introduction Duty-hour restrictions, improved non-operative management of injured patients, new or expanded fellowship programs, and the coronavirus disease 2019 (COVID-19) pandemic have hindered resident exposure to operative trauma in the United States. In this study, we investigated trends in resident operative experience in blunt trauma over a 22-year period. Methods Accreditation Council for Graduate Medical Education (ACGME) logs from 1999 to 2021 were reviewed. The yearly number of major trauma cases, trauma splenectomies (TS), and liver drainage/repairs (LDR) were extracted. We used the non-parametric Mann–Kendall test to analyze trends. Data are reported as mean ± standard deviation or median (estimated interquartile range, eIQR); alpha = 0.05. Results Records from 24,062 respondents were examined. The average number of trauma cases performed by all residents decreased from 42 ± 22 in 1999–2000 to 31 ± 18 in 2020–2021 ( p < .01); median number of cases decreased from 36 (30, 47) to 27 (22, 36). The proportion of TS performed by chief and junior residents among all trauma cases decreased from 9.5% to 7.1% (trend test, p < .01), and from 6.6% to 6.1% (trend test, p = .03) respectively. The proportion of LDR performed by chief and junior residents decreased from 6.9% to 4.7% (trend test, p < .01), and from 4.3% to 3.9% (trend test, p = .03) respectively. Conclusions Number of major trauma cases and two common procedures for blunt solid organ injury decreased significantly over the past two decades. These findings should serve as an indicator that structural changes in surgery residency training programs in the United States may be necessary to safeguard resident exposure to operative trauma cases.
Paired DBS and TMS Reveals Dentato-Cortical Facilitation Underlying Upper Extremity Movement in Chronic Stroke Survivors
Authors: Li Xin , Baker Kenneth B. , O’Laughlin Kyle , Chen Jacqueline , Hogue Olivia , Machado Andre G. , Plow Ela B. 
Published: December 2023

Background Cerebellum shares robust di-synaptic dentato-thalamo-cortical (DTC) connections with the contralateral motor cortex. Preclinical studies have shown that DTC are excitatory in nature. Structural integrity of DTC is associated with better upper extremity (UE) motor function in people with stroke, indicating DTC are important for cerebellar influences on movement. However, there is a lack of understanding of physiologic influence of DTC in humans, largely due to difficulty in accessing the dentate nucleus. Objective Characterize DTC physiology using dentate nucleus deep brain stimulation (DBS) combined with transcranial magnetic stimulation (TMS) in stroke. Methods Nine chronic stroke survivors with moderate-to-severe UE impairment (Fugl-Meyer 13-38) underwent a paired DBS–TMS experiment before receiving experimental dentate nucleus DBS in our first-in-human phase I trial (Baker et al., 2023, Nature Medicine). Conditioning DBS pulses were given to dentate nucleus 1 to 10 ms prior to supra-threshold TMS pulses given to ipsilesional motor cortex. Effects were assessed on motor evoked potentials (MEPs). Size of DBS-conditioned MEPs was expressed relative to TMS MEPs, where values >1 indicate facilitation. Results Dentate nucleus DBS led to facilitation of MEPs at short-latency intervals (3.5 and 5 ms, P = .049 and .021, respectively), a phenomenon we have termed dentato-cortical facilitation (DCF). Higher DCF was observed among patients with more severe UE impairment. Diffusion tensor imaging revealed microstructure of thalamo-cortical portion of DTC was related to higher corticomotor excitability. Conclusions Our in vivo investigation reveals for the first time in humans the intrinsic excitatory properties of DTC, which can serve as a novel therapeutic target for post-stroke motor recovery.
Treatment, Management, and Otolaryngology Consultation for Epistaxis in the Emergency Room: An Institutional Experience
Authors: Jacobs Daniel , Wang Vickie J. , Chao Janet R. , Manes R. Peter , Lee Yan H. 
Published: December 2023

Background Epistaxis is a common reason for emergency department (ED) visits, accounting for approximately 1 of every 200 ED visits in the United States annually and up to one-third of all otolaryngology (ENT)-related ED encounters. Objectives To detail reasons for ENT consultation for epistaxis in the ED, understand how consultation impacts patient care, assess follow-up patterns after emergency care, and study patient care after transfer or referral into the ED. Methods Retrospective chart review of 592 adult patients with epistaxis managed in a tertiary care ED setting between 2017 and 2018. Patients with known follow-up, ENT consult in the ED, or admission were included, while patients with trauma, recent head and neck surgery, or abnormal anatomy were excluded. Results The most common reasons for ENT consultation for epistaxis were for advanced management, referral to the ED from an outside facility or provider, and recent head and neck surgery. In total, 48.2% of patients treated for epistaxis in the ED received an ENT consultation. ENT consultation was associated with a higher likelihood of receiving absorbable or nonabsorbable packing (92.4% vs 36.1%). In total, 40.4% of patients referred into the ED from an outside facility or provider had no change in their management after receiving an ENT consult. Patients referred to the ED and White patients were significantly more likely to receive an ENT consult. Secondary analyses revealed that more White patients had an established outpatient ENT provider than patients of other races. On multivariate analysis, patients who received an ENT consult spent 75.2 min longer in the ED. Conclusion The high percentage of patients referred or transferred to the ED for epistaxis management with no change in interventions after ENT consultation indicates a continued need to develop more precise clinical care pathways. Additionally, there may be gaps between White and non-White patients in access to ENT care.
Service Needs, Context of Reception, and Perceived Discrimination of Venezuelan Immigrants in the United States and Colombia
Authors: Scaramutti Carolina , Schmidt Renae Danielle , Ochoa Lucas Gregorio , Brown Eric Christopher , Vos Saskia Renee , Mejia Trujillo Juliana , Perez Gomez Nicolas Augusto , Salas-Wright Christopher , Duque Maria , Schwartz Seth 
Published: December 2023

Executive Summary Millions of Venezuelans have fled their country in hopes for a better future outside the political and financial turmoil in their home country. This paper examines the self-reported needs of Venezuelans in the United States and Colombia. Specifically, it looks at perceived discrimination in each country and its effect on the service needs of Venezuelan immigrants. The authors used data from a larger project conducted in October to November 2017 to perform a qualitative content analysis on the specific services that participants and others like them would need following immigration. The sample consisted of 647 Venezuelan immigrant adults who had migrated to the United States ( n = 342) or Colombia ( n = 305). Its findings indicate statistically significant differences between the two countries. Venezuelan immigrants in the United States were more likely to identity mental health and educational service needs, while those in Colombia were more likely to list access to healthcare, help finding jobs, and food assistance. When looking at perceived discrimination, means scores for discrimination were significantly greater for participants who indicated needing housing services, who indicated needing assistance enrolling children in school and who indicated needing food assistance, compared to participants who did not list those needs. Venezuelans who had experienced greater negative context of reception were less likely to indicate needing mental health services, where 11.9 percent of those who did not perceive a negative context of reception responded that they needed mental health services. Evaluating existing service networks will be essential in working to bridge the gap between the services provided to and requested by Venezuelans. Collaboration between diverse government actors, community-based organizations (CBOs) and other stakeholders can help identify gaps in existing service networks. CBOs can also facilitate communication between Venezuelan immigrants and their new communities, on the need to invest in necessary services.
Latent Class Groups of Concurrent Substance Use Among Adolescents in an Urban Community: Correlates With Mental Health, Access to Drugs and Alcohol, and Risk Perception
Authors: Lardier David T. , Davis Alexandra N. , Verdezoto Carolina S. , Cruz Lynda , Magliulo Sabrina , Herrera Andriana , Garcia-Reid Pauline , Reid Robert J. 
Published: December 2023

Background: Concurrent substance use among adolescents has been associated with an increase in physical and mental health problems. These outcomes tend to be exacerbated among adolescents of color in underserved urban settings. The purpose of this study was to understand alcohol and concurrent drug use patterns among adolescents in an underserved urban community to provide targeted prevention and treatment recommendations. Method: This study examined data among adolescents in an underserved urban community (N = 1789; 56.90% female; 70.86% Hispanic/Latino/a; meanage = 15.96 ± 1.56). Using latent class analysis (LCA) and multinomial logistic regression modeling, analyses identified independent correlates of latent class membership. Results: Five latent classes (LC) were identified including LC group 1: Predominant alcohol use and limited to no concurrent-drug use (n = 213; 11.9%); LC group 2: Concurrent drug and alcohol use including methamphetamine, marijuana and synthetic marijuana use, and alcohol use (n = 74; 4.2%); LC group 3: Concurrent drug and alcohol use, with no marijuana use (n = 204; 11.39%); LC group 4: High Concurrent drug use and alcohol use (n = 204; 11.40%); and LC group 5: Concurrent drug use without alcohol use (n = 1101; 61.52%). Significant between group differences were noted between latent class groups and sociodemographic characteristics. Multinomial logistic regression models identified the associations between sociodemographic characteristics and corollary clinical features of substance use on latent class groupings of alcohol and concurrent drug use. Conclusion: Understanding concurrent substance use LC groups among adolescents is essential to providing targeted interventions and treatment programs, as well as early intervention programs that may help reduce substance use during adolescence.
High Seroprevalence of Hepatitis C Virus Among Cisgender Women Who Exchange Sex in the Seattle, Washington Area
Authors: Barry Michael P. , Corcorran Maria A. , Tsui Judith I. , Moreno Courtney , Buskin Susan E. , Guthrie Brandon L. , Glick Sara N. 
Published: December 2023

Background: Injection drug use (IDU) is a risk factor for hepatitis C virus (HCV) acquisition and occurs disproportionately among women who exchange sex (WES). However, little is known about HCV epidemiology in this population. We estimated HCV seroprevalence, identified correlates of HCV seropositivity, and characterized social networks by HCV serostatus and IDU history among WES in the Seattle, Washington, area. Methods: This was a secondary analysis of data from the 2016 National HIV Behavioral Surveillance survey in the Seattle, Washington area, a cross-sectional survey that used respondent-driven sampling (RDS) to enroll WES for money or drugs (N = 291). All participants were offered rapid HCV-antibody testing. We estimated HCV seropositivity and used log regression methods to estimate crude and adjusted prevalence ratios (PRs) for correlates of HCV seropositivity among WES. Using RDS recruitment chain data, we computed homophily indices to estimate the extent to which participants were likely to recruit another participant with the same HCV serostatus and IDU history. Results: In the study sample of WES in the Seattle, Washington area, 79% reported lifetime IDU and 60% were HCV seropositive. HCV seropositivity was strongly associated with ever injecting drugs (PRadj: 7.7 [3.3, 18.0]). The RDS homophily scores for HCV seropositivity (0.07) and ever injecting drugs (0.02) suggested that participants did not tend to recruit others with the same characteristics beyond what would be expected by chance. Conclusion: Among this sample of WES in Seattle, Washington area, HCV seroprevalence was high and strongly associated with a history of IDU. The high burden of HCV among WES suggests this marginalized group would benefit from additional harm reduction services and targeted HCV treatment campaigns to reduce forward transmission. We saw little evidence of preferential recruitment among WES who were HCV seropositive or reported a history of IDU, suggesting the potential futility of peer-based referrals for HCV treatment.
Kidney Function in Patients With Adrenal Adenomas: A Single-Center Retrospective Cohort Study
Authors: Rahimi Leili , Kittithaworn Annop , Gregg Garcia Raul , Saini Jasmine , Dogra Prerna , Atkinson Elizabeth J , Achenbach Sara J , Kattah Andrea , Bancos Irina 
Published: December 2023

Abstract

Context
Patients with nonfunctioning adrenal adenomas (NFA) and mild autonomous cortisol secretion (MACS) demonstrate an increased risk of chronic kidney disease (CKD); however, factors associated with CKD are unknown.

Objective
We aimed to identify the factors associated with CKD and assess the effect of adrenalectomy on kidney function in patients with NFA or MACS.

Methods
A single-center cohort study of patients with NFA and MACS, 1999 to 2020, was conducted. MACS was diagnosed based on post dexamethasone suppression test (DST) cortisol greater than or equal to 1.8 mcg/dL. Age, sex, dysglycemia, hypertension, therapy with statin, angiotensin-converting enzyme inhibitor, or angiotensin II receptor blocker were included in the multivariable analysis. Outcomes included estimated glomerular filtration rate (eGFR) at the time of diagnosis with MACS or NFA and postadrenalectomy delta eGFR.

Results
Of 972 patients, 429 (44%) had MACS and 543 (56%) had NFA. At the time of diagnosis, patients with MACS had lower eGFR (median 79.6 vs 83.8 mL/min/1.73 m2; P &lt; .001) than patients with NFA. In a multivariable analysis, factors associated with lower eGFR were older age, hypertension, and higher DST. In 204 patients (MACS: 155, 76% and NFA: 49, 24%) treated with adrenalectomy, postadrenalectomy eGFR improved in both groups starting at 18 months up to 3.5 years of follow-up. Factors associated with increased eGFR were younger age, lower preadrenalectomy eGFR, and longer follow-up period.

Conclusion
DST cortisol is an independent risk factor for lower eGFR in patients with adrenal adenomas. Patients with both MACS and NFA demonstrate an increase in eGFR post adrenalectomy, especially younger patients with lower eGFR pre adrenalectomy.