bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emphasizing Sexual Orientation and Gender Identity Data Capture for Improved Cardiovascular Care of the LGBTQ+ Population
Authors: Deb Brototo , Porter Kadijah , van Cleeff Ashlan , Reardon Leigh C. , Cook Stephen 
Published: January 2024

ImportanceThe rising self-identifying lesbian, gay, bisexual, transgender, and queer (LGBTQ+) population makes understanding the unique health care needs of sexual and gender minoritized patients an urgent one. The interaction between minority stress and cardiovascular disease has been well described among underrepresented minoritized populations. The underrepresentation of minoritized populations in clinical research is partly responsible for worse cardiovascular outcomes in these populations. The absence of sexual orientation and gender identity and expression (SOGIE) data makes it difficult to understand the cardiovascular health of LGBTQ+ adults, thereby widening health care disparities in this population. Advancing cardiovascular health equity for LGBTQ+ patients must begin with careful and accurate SOGIE data collection.ObservationsCurrent SOGIE data capture remains inadequate despite federal mandates. Challenges in data collection include political and regulatory discrimination, patient/practitioner hesitancy, lack of supportive guidance on SOGIE data collection, improper terminology, regulatory inertia, and inadequate and often incorrect integration of SOGIE data into electronic health records (EHRs). Additional challenges include grouping participants as “others” for statistical significance. The inclusion of SOGIE data has demonstrated an impact in other fields like cancer survivorship and surgery. The same needs to be done for cardiology.Conclusions and RelevancePotential solutions for improving much-needed SOGIE data collection include (1) implementing LGBTQ+ inclusive policies, (2) integrating SOGIE data into the EHR, (3) educating health care professionals on the relevance of SOGIE to patient-centered care, and (4) creating a diverse cardiovascular workforce. These steps can substantially enhance the ability to collect SOGIE data to address LGBTQ+ cardiovascular health care disparities.
Dapagliflozin and Mode of Death in Heart Failure With Improved Ejection Fraction
Authors: Vardeny Orly , Desai Akshay S. , Jhund Pardeep S. , Fang James C. , Claggett Brian , de Boer Rudolf A. , Hernandez Adrian F. , Inzucchi Silvio E. , Kosiborod Mikhail N. , Lam Carolyn S. P. , Martinez Felipe A. , Shah Sanjiv J. , Mc Causland Finnian R. , Petrie Mark C. , Vaduganathan Muthiah , McMurray John J. V. , Solomon Scott D. 
Published: January 2024

ImportanceHeart failure with improved ejection fraction (HFimpEF), defined as prior left ventricular ejection fraction (LVEF) 40% or lower that has increased to greater than 40%, is understudied.ObjectiveTo examine mode of death and the association of dapagliflozin with reductions in cause-specific death in patients with HFimpEF.Design, Setting, and ParticipantsThis was a post hoc analysis from the Dapagliflozin Evaluation to Improve the Lives of Patients With Preserved Ejection Fraction Heart Failure (DELIVER) randomized clinical trial, conducted from August 2018 to December 2020. The trial randomly assigned patients with HF with LVEF greater than 40%, New York Heart Association class II to IV symptoms, and elevated natriuretic peptides to treatment with dapagliflozin (10 mg, once daily) or placebo. The presence of HFimpEF was captured through study case report forms. The primary outcome was a composite of worsening HF events (hospitalization or urgent HF visits) or cardiovascular death. Clinical outcomes were adjudicated by a blinded clinical end points committee. Data were analyzed from May 2022 to August 2023.InterventionDapagliflozin vs placebo.Main Outcomes and MeasuresThe mode of death in relation to HFimpEF status was examined, as well as the association of randomized treatment with cause-specific death in Cox regression models.ResultsOf 1151 patients with HFimpEF in DELIVER, 190 (16.5%) died, compared with 833 patients (16.3%) of 5112 with LVEF consistently greater than 40%. The overall distribution of mode of death was similar in those with HFimpEF compared with those with LVEF consistently greater than 40% (noncardiovascular death: 103 of 190 [54%] vs 428 of 833 [51%]; cardiovascular death: 87 of 190 [46%] vs 405 of 833 [49%], respectively). Most deaths in individuals with HFimpEF were noncardiovascular (103 of 180 [54%]). For cardiovascular deaths, sudden deaths were most common (36 of 190 events [19%]), followed by HF-related (29 of 190 events [15%]). Among patients with HFimpEF, treatment with dapagliflozin was associated with lower rates of cardiovascular death relative to placebo, a difference primarily due to lower rates of sudden death (hazard ratio, 0.38; 95% CI, 0.18-0.79; P for interaction = .01).Conclusions and RelevanceThe findings in this study support current guideline recommendations for use of sodium-glucose transport protein 2 inhibitor therapy, and further suggest that the addition of a sodium-glucose transport protein 2 inhibitor therapy to other guideline-directed medical therapies may help reduce cardiovascular mortality in patients with HFimpEF.Trial RegistrationClinicalTrials.gov Identifier: NCT03619213
Recruiting a Diverse Cardiology Physician Workforce
Authors: Snow Sarah C. , Alhanti Brooke , Douglas Pamela S. 
Published: January 2024

ImportanceUnderstanding trends in the representation of women and individuals from underrepresented racial and ethnic populations in cardiovascular disease and cardiovascular subspecialty fellowships is essential to improving the diversity of the cardiology workforce.ObjectiveTo examine changes in the representation of women and underrepresented individuals in cardiovascular disease and cardiovascular subspecialty fellowships over time.Design, Setting, and ParticipantsThis cross-sectional study of trainee sex and race and ethnicity in various training programs from 2008 to 2022 used data from the Accreditation Council for Graduate Medical Education’s publicly available online source. Participants included all residents, internal medicine residents, general surgery residents, and fellows in cardiovascular disease and cardiovascular subspecialty fellowships.Main Outcomes and MeasuresPercentages of women and Black and Hispanic trainees in these programs were calculated for each year. Mann-Kendall tests were used to determine if changes over the years represented a significant trend.ResultsAmong the 3320 cardiovascular disease trainees in 2022, 848 (25.5%) were women, and 459 (13.8%) were Black or Hispanic, less than the representation among internal medicine trainees at 43.8% and 15.6%, respectively. However, the percentage of women trainees in cardiovascular disease significantly increased from 17.6% in 2008 (P = .001 for time trend) and also increased for interventional cardiology fellowships (from 6.3% in 2008 to 20.1% in 2022; P = .002). Over the same period, the proportion of women in general surgery increased from 27.4% to 45.2% (P &amp;lt; .001). The percentage of Black and Hispanic trainees in internal medicine significantly increased from 8.6% in 2012 (P &amp;lt; .001) while increases in general surgery were not statistically significant (9.7% to 16.1%; P = .35). There were also important increases in the percentages of Black and Hispanic trainees in cardiovascular disease (from 8.3% in 2012; P = .09) and interventional cardiology (3.8% to 13.4%; P = .12).Conclusions and RelevanceIn this study, the representation of women in cardiovascular fellowships, including interventional cardiology, increased over recent years. While representation of Black and Hispanic individuals is low in all residencies, including cardiovascular fellowships, recent positive trends are important to recognize and provide hope to drive future efforts.
Prevalence, Incidence, and Reversal Pattern of Childhood Stunting From Birth to Age 2 Years in Ethiopia
Authors: Goddard Frederick G. B. , Hunegnaw Bezawit Mesfin , Luu Jonathan , Haneuse Sebastien J. P. A. , Zeleke Mesfin , Mohammed Yahya , Bekele Chalachew , Tadesse Daniel , Solomon Meles , Bekele Delayehu , Chan Grace J. 
Published: January 2024

ImportanceAlthough there has been a reduction in stunting (low-height-for-age and low-length-for-age), a proxy of malnutrition, the prevalence of malnutrition in Ethiopia is still high. Child growth patterns and estimates of stunting are needed to increase awareness and resources to improve the potential for recovery.ObjectiveTo estimate the prevalence, incidence, and reversal of stunting among children aged 0 to 24 months.Design, Setting, and ParticipantsThis population-based cohort study of the Birhan Maternal and Child Health cohort in North Shewa Zone, Amhara, Ethiopia, was conducted between December 2018 and November 2020. Eligible participants included children aged 0 to 24 months who were enrolled during the study period and had their length measured at least once. Data analysis occurred from Month Year to Month Year.Main Outcomes and MeasuresThe primary outcome of this study was stunting, defined as length-for-age z score (LAZ) at least 2 SDs below the mean. Z scores were also used to determine the prevalence, incidence, and reversal of stunting at each key time point. Growth velocity was determined in centimeters per month between key time points and compared with global World Health Organization (WHO) standards for the same time periods. Heterogeneity was addressed by excluding outliers in sensitivity analyses using modeled growth trajectories for each child.ResultsA total of 4354 children were enrolled, out of which 3674 (84.4%; 1786 [48.7%] female) had their length measured at least once and were included in this study. The median population-level length was consistently below WHO growth standards from birth to 2 years of age. The observed prevalence of stunting was highest by 2 years of age at 57.4% (95% CI, 54.8%-9 60.0%). Incidence of stunting increased over time and reached 51.0% (95% CI, 45.3%-56.6%) between ages 12 and 24 months. Reversal was 63.5% (95% CI, 54.8%-71.4%) by age 6 months and 45.2% (95% CI, 36.0%-54.8%) by age 2 years. Growth velocity point estimate differences were slowest compared with WHO standards during the neonatal period (−1.4 cm/month for girls and −1.6 cm/month for boys). There was substantial heterogeneity in anthropometric measurements.Conclusions and RelevanceThe evidence from this cohort study highlights a chronically malnourished population with much of the burden associated with growth faltering during the neonatal periods as well as after 6 months of age. To end all forms of malnutrition, growth faltering in populations such as that in young children in Amhara, Ethiopia, needs to be addressed.
EMS Treatment Guidelines in Major Traumatic Brain Injury With Positive Pressure Ventilation
Authors: Gaither Joshua B. , Spaite Daniel W. , Bobrow Bentley J. , Barnhart Bruce , Chikani Vatsal , Denninghoff Kurt R. , Bradley Gail H. , Rice Amber D. , Howard Jeffrey T. , Keim Samuel M. , Hu Chengcheng 
Published: January 2024

ImportanceThe Excellence in Prehospital Injury Care (EPIC) study demonstrated improved survival in patients with severe traumatic brain injury (TBI) following implementation of the prehospital treatment guidelines. The impact of implementing these guidelines in the subgroup of patients who received positive pressure ventilation (PPV) is unknown.ObjectiveTo evaluate the association of implementation of prehospital TBI evidence-based guidelines with survival among patients with prehospital PPV.Design, Setting, and ParticipantsThe EPIC study was a multisystem, intention-to-treat study using a before/after controlled design. Evidence-based guidelines were implemented by emergency medical service agencies across Arizona. This subanalysis was planned a priori and included participants who received prehospital PPV. Outcomes were compared between the preimplementation and postimplementation cohorts using logistic regression, stratified by predetermined TBI severity categories (moderate, severe, or critical). Data were collected from January 2007 to June 2017, and data were analyzed from January to February 2023.ExposureImplementation of the evidence-based guidelines for the prehospital care of patient with TBI.Main Outcomes and MeasuresThe primary outcome was survival to hospital discharge, and the secondary outcome was survival to admission.ResultsAmong the 21 852 participants in the main study, 5022 received prehospital PPV (preimplementation, 3531 participants; postimplementation, 1491 participants). Of 5022 included participants, 3720 (74.1%) were male, and the median (IQR) age was 36 (22-54) years. Across all severities combined, survival to admission improved (adjusted odds ratio [aOR], 1.59; 95% CI, 1.28-1.97), while survival to discharge did not (aOR, 0.94; 95% CI, 0.78-1.13). Within the cohort with severe TBI but not in the moderate or critical subgroups, survival to hospital admission increased (aOR, 6.44; 95% CI, 2.39-22.00), as did survival to discharge (aOR, 3.52; 95% CI, 1.96-6.34).Conclusions and RelevanceAmong patients with severe TBI who received active airway interventions in the field, guideline implementation was independently associated with improved survival to hospital admission and discharge. This was true whether they received basic airway interventions or advanced airways. These findings support the current guideline recommendations for aggressive prevention/correction of hypoxia and hyperventilation in patients with severe TBI, regardless of which airway type is used.
Towards Automation in 3D Cell Culture: Selective and Gentle High‐Throughput Handling of Spheroids and Organoids via Novel Pick‐Flow‐Drop Principle
Authors: Zieger Viktoria , Frejek Daniel , Zimmermann Stefan , Miotto Guilherme A. A. , Koltay Peter , Zengerle Roland , Kartmann Sabrina 
Published: January 2024

Abstract3D cell culture is becoming increasingly important for mimicking physiological tissue structures in areas such as drug discovery and personalized medicine. To enable reproducibility on a large scale, automation technologies for standardized handling are still a challenge. Here, a novel method for fully automated size classification and handling of cell aggregates like spheroids and organoids is presented. Using microfluidic flow generated by a piezoelectric droplet generator, aggregates are aspirated from a reservoir on one side of a thin capillary and deposited on the other side, encapsulated in free‐flying nanoliter droplets to a target. The platform has aggregate aspiration and plating efficiencies of 98.1% and 98.4%, respectively, at a processing throughput of up to 21 aggregates per minute. Cytocompatibility of the method is thoroughly assessed with MCF7, LNCaP, A549 spheroids and colon organoids, revealing no adverse effects on cell aggregates as shear stress is reduced compared to manual pipetting. Further, generic size‐selective handling of heterogeneous organoid samples, single‐aggregate‐dispensing efficiencies of up to 100% and the successful embedding of spheroids or organoids in a hydrogel with subsequent proliferation is demonstrated. This platform is a powerful tool for standardized 3D in vitro research.
Gold Recovery from E‐Waste by Food‐Waste Amyloid Aerogels
Authors: Peydayesh Mohammad , Boschi Enrico , Donat Felix , Mezzenga Raffaele 
Published: January 2024

AbstractDemand for gold recovery from e‐waste grows steadily due to its pervasive use in the most diverse technical applications. Current methods of gold recovery are resource‐intensive, necessitating the development of more efficient extraction materials. This study explores protein amyloid nanofibrils (AF) derived from whey, a dairy industry side‐stream, as a novel adsorbent for gold recovery from e‐waste. To do so, AF aerogels are prepared and assessed against gold adsorption capacity and selectivity over other metals present in waste electrical and electronic equipment (e‐waste). The results demonstrate that AF aerogel has a remarkable gold adsorption capacity (166.7 mg g−1) and selectivity, making it efficient and an adsorbent for gold recovery. Moreover, AF aerogels are efficient templates to convert gold ions into single crystalline flakes due to Au growth along the (111) plane. When used as templates to recover gold from e‐waste solutions obtained by dissolving computer motherboards in suitable solvents, the process yields high‐purity gold nuggets, constituted by ≈90.8 wt% gold (21–22 carats), with trace amounts of other metals. Life cycle assessment and techno–economic analysis of the process finally consolidate the potential of protein nanofibril aerogels from food side‐streams as an environmentally friendly and economically viable approach for gold recovery from e‐waste.
Triboelectric Nanogenerators for Battery‐Free Wireless Sensor System Using Multi‐Degree of Freedom Vibration
Authors: Kim Jihye , Lee Dong‐Min , Ryu Hanjun , Kim Young‐Jun , Kim Han , Yoon Hong‐Joon , Kang Minki , Kwak Sung Soo , Kim Sang‐Woo 
Published: January 2024

AbstractIn a daily environment, several vibration energies have low amplitude and broad range of frequencies, and it is crucial to harvest them efficiently in a single triboelectric nanogenerator (TENG). Here, a multi‐degree of freedom (DOF) vibration system is coupled with TENG to make several resonant frequencies in a single device. When the number of DOF increases in the system, the number of resonant frequencies also increases. These resonant frequencies are calculated by MATLAB software using the masses and spring constant of DOF vibration system. With the masses of 20 g and the spring constant of 82.712 N m−1, it is found that 1‐DOF has one resonant frequency (20.47 Hz), 2‐DOF has two resonant frequencies (12.63 and 33.17 Hz), and 3‐DOF has three resonant frequencies (9.12, 25.55, and 36.87 Hz). At each resonant frequency, the displacement of all weight layers increases due to the constructive interference of resonance, resulting in higher output than other frequencies at the frequency sweep experiment. In addition, the magnitude and phase of output signals obtained in friction regions are evaluated through COMSOL simulation. A self‐powered wireless sensor module with 3‐DOF TENGs to detect the humidity/temperature and transmit the data every 30 min by harvesting vibration energy is demonstrated.
Dopant‐free Starlike Molecular Hole Conductor with Ordered Packing for Durable all‐Inorganic Perovskite Solar Cells
Authors: Duan Chenghao , Zou Feilin , Li Shiang , Zhu Qiliang , Li Jiong , Chen Honggang , Zhang Zheng , Chen Chang , Guo Huan , Qiu Jianhang , Wang Ke , Dong Yuyan , Qiu Yongcai , Ding Liming , Lu Xinhui , Luo Hongze , Yan Keyou 
Published: January 2024

AbstractAll‐inorganic n‐i‐p perovskite solar cells (PSCs) using doped Spiro‐OMeTAD as hole transport material (HTM) suffer from photothermal stability due to ionic diffusion and radical‐induced degradation by the dopants. In this article, dopant‐free starlike molecule (N2, N2‐bis(4‐(bis(4‐methoxyphenyl)amino)phenyl)‐N5,N5‐bis(4‐methoxyphenyl)pyridine‐2,5‐diamine (BD)) is synthesized to engineer the stacking properties and delivered higher hole mobility than doped Spiro‐OMeTAD (3.2 × 10−4 versus 1.76 × 10−4 cm2 V−1 s−1) as dopant‐free HTM. Starlike BD HTM has a twisted acceptor unit and strong dipole, forming crystalline and ordered packing film to ensure intramolecular charge transfer and improve mobility. The BD CsPbI3 PSCs deliver the maximum efficiency of 19.19%, which is the highest performance for all‐inorganic PSCs based on dopant‐free HTMs. Meanwhile, the ordered molecules‐packing blocks the migration channel of I− ions to metal electrodes and improves the device stability. BD‐based devices maintain more than 93% and 80% of the initial efficiency after 85 °C storage for 35 days and maximum power point (MPP) tracking at 85 °C for 1000 h, respectively.
Supramolecular Complexation of Metal Oxide Cluster and Non‐Fluorinated Polymer for Large‐Scale Fabrication of Proton Exchange Membranes for High‐Power‐Density Fuel Cells
Authors: Liu Lu , Huang Aowen , Yang Junsheng , Chen Jiadong , Fu Kewen , Sun Weigang , Deng Jie , Yin Jia‐Fu , Yin Panchao 
Published: January 2024

AbstractCost‐effective, non‐fluorinated polymer proton exchange membranes (PEMs) are highly desirable in emerging hydrogen fuel cells (FCs) technology; however, their low proton conductivities and poor chemical and dimension stabilities hinder their further development as alternatives to commercial Nafion®. Here, we report the inorganic‐organic hybridization strategy by facilely complexing commercial polymers, polyvinyl butyral (PVB), with inorganic molecular nanoparticles, H3PW12O40 (PW) via supramolecular interaction. The strong affinity among them endows the obtained nanocomposites amphiphilicity and further lead to phase separation for bi‐continuous structures with both inter‐connected proton transportation channels and robust polymer scaffold, enabling high proton conductivities, mechanical/dimension stability and barrier performance, and the H2/O2 FCs equipped with the composite PEM show promising power densities and long‐term stability. Interestingly, the hybrid PEM can be fabricated continuously in large scale at challenging ~10 μm thickness via typical tape casting technique originated from their facile complexing strategy and the hybrids’ excellent mechanical properties. This work not only provides potential material systems for commercial PEMs, but also raises interest for the research on hybrid composites for PEMs.
Dynamically Modulating the Dissymmetry Factor of Circularly Polarized Organic Ultralong Room‐Temperature Phosphorescence from Soft Helical Superstructures
Authors: Liu Jiao , Wu Jun‐Jie , Wei Juan , Huang Zhi‐Jun , Zhou Xin‐Yu , Bao Jin‐Ying , Lan Ruo‐Chen , Ma Yun , Li Bing‐Xiang , Yang Huai , Lu Yan‐Qing , Zhao Qiang 
Published: January 2024

AbstractAchieving circularly polarized organic ultralong room‐temperature phosphorescence (CP‐OURTP) with a high luminescent dissymmetry factor (glum) is crucial for diverse optoelectronic applications. In particular, dynamically controlling the dissymmetry factor of CP‐OURTP can profoundly advance these applications, but it is still unprecedented. This study introduces an effective strategy to achieve photoirradiation‐driven chirality regulation in a bilayered structure film, which consists of a layer of soft helical superstructure incorporated with a light‐driven molecular motor and a layer of room‐temperature phosphorescent (RTP) polymer. The prepared bilayered film exhibits CP‐OURTP with an emission lifetime of 805 ms and a glum value up to 1.38. Remarkably, the glum value of the resulting CP‐OURTP film can be reversibly controlled between 0.6 and 1.38 over 20 cycles by light irradiation, representing the first example of dynamically controlling the glum in CP‐OURTP.