bluuebunny/crossref_metadata_2025_split huggingface dataset:
Temporal Trend in Revascularization for Patients With Ischemic Cardiomyopathy and Multivessel Coronary Artery Disease
Authors: Alzahrani Anas H. , Alabbadi Sundos , Itagaki Shinobu , Egorova Natalia 
Published: January 2024

Background
Current guidelines recommend revascularization in patients with ischemic cardiomyopathy (ICM). However, there is limited information about the trends and outcomes of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in ischemic cardiomyopathy patients with multivessel coronary artery disease.

Methods and Results

Using New Jersey state mandatory registries, 8083 patients with ischemic cardiomyopathy with CABG or PCI revascularization for multivessel coronary artery disease from 2007 to 2018 were included in the analysis. Joinpoint regression and multivariable logistic regression analyses were performed to assess the annual percentage change in trends and predictors of the 30‐day mortality rate, respectively. A decline in CABG procedures was observed from 2007 to 2011 (annual percentage change, −11.5%;
P
=0.003), followed by stabilization. The PCI trend remained unchanged from 2007 to 2010 and then increased significantly (annual percentage change, 3.2%;
P
=0.02). In the subsample of patients with proximal left anterior descending artery plus circumflex and right coronary artery, CABG was a predominant procedure until 2011, and the proportion of both procedures did not differ thereafter. In the subsample of patients with left anterior descending artery and any other artery stenosis, PCI remained dominant from 2007 to 2018, while in patients with left main and any other artery stenosis, CABG remained dominant from 2007 to 2018 (
P
<0.001). The 30‐day risk‐adjusted mortality rate was higher after PCI versus CABG for each year, but after adjustment for completeness of revascularization, there was no difference between groups.

Conclusions
The patterns of revascularization procedures for patients with ischemic cardiomyopathy with multivessel coronary artery disease have changed over the years, as evidenced by the changes in CABG and PCI trends. CABG and PCI had comparable 30‐day risk‐adjusted mortality risks.
Von Willebrand Factor Antigen Levels Predict Poor Outcomes in Patients With Stroke and Cancer: Findings From the Multicenter, Prospective, Observational SCAN Study
Authors: Kawano Tomohiro , Gon Yasufumi , Sakaguchi Manabu , Yamagami Hiroshi , Abe Soichiro , Hashimoto Hiroyuki , Ohara Nobuyuki , Takahashi Daisuke , Abe Yuko , Takahashi Tsutomu , Okazaki Shuhei , Todo Kenichi , Mochizuki Hideki , Sasaki Tsutomu ,   the SCAN Study Investigators
Published: January 2024

Background
Patients with acute ischemic stroke and active cancer have more severe neurological symptoms, elevated risks of stroke recurrence, and death compared with the general population. We examined whether von Willebrand factor (vWF) antigen levels at stroke onset were associated with the poor outcomes of patients with stroke and cancer.

Methods and Results

Using data from 90 patients with acute ischemic stroke and active cancer who were registered in the SCAN (Ischemic Stroke in Patients With Cancer and Neoplasia) study, a prospective multicenter, observational study in Japan, we divided patients into 2 groups according to their median vWF antigen levels (high, n=46; or low, n=44). The high‐vWF group had a significantly higher initial National Institutes of Health Stroke Scale score (median, 7 [interquartile range, 3–11.25] versus 3 [interquartile range, 1–8.5];
P
<0.05) and a significantly higher incidence of cryptogenic stroke (32 [70%] versus 16 [36%];
P
<0.01) and venous thromboembolism (7 [15%] versus 0 [0%];
P
<0.01), as well as multiple lesions (28 [62%] versus 12 [27%];
P
<0.001), than the low‐vWF group. We observed no significant difference in the rate of stroke recurrence within 1 year between the groups. However, increased vWF levels were an independent predictor of death within 1 year of stroke onset, after adjusting for potential confounders (odds ratio, 6.77 [95% CI, 1.49–30.78];
P
<0.05).

Conclusions
Elevated vWF antigen levels were associated with adverse outcomes in patients with cancer‐associated stroke and may represent a useful biomarker to guide future therapeutic interventions.
Impella Versus Intra‐Aortic Balloon Pump in Patients With Cardiogenic Shock Treated With Venoarterial Extracorporeal Membrane Oxygenation: An Observational Study
Authors: Yeo Ilhwan , Axman Rachel , Lu Daniel Y. , Feldman Dmitriy N. , Cheung Jim W. , Minutello Robert M. , Karas Maria G. , Iannacone Erin M. , Srivastava Ankur , Girardi Natalia I. , Naka Yoshifumi , Wong Shing‐Chiu , Kim Luke K. 
Published: January 2024

Background
Venoarterial extracorporeal membrane oxygenation (VA‐ECMO) is increasingly used for patients with cardiogenic shock. Although Impella or intra‐aortic balloon pump (IABP) is frequently used for left ventricular unloading (LVU) during VA‐ECMO treatment, there are limited data on comparative outcomes. We compared outcomes of Impella and IABP for LVU during VA‐ECMO.

Methods and Results

Using the Nationwide Readmissions Database between 2016 and 2020, we analyzed outcomes in 3 groups of patients with cardiogenic shock requiring VA‐ECMO based on LVU strategies: extracorporeal membrane oxygenation (ECMO) only, ECMO with IABP, and ECMO with Impella. Of 15 980 patients on VA‐ECMO, IABP and Impella were used in 19.4% and 16.4%, respectively. The proportion of patients receiving Impella significantly increased from 2016 to 2020 (6.5% versus 25.8%;
P
‐trend<0.001). In‐hospital mortality was higher with ECMO with Impella (54.8%) compared with ECMO only (50.4%) and ECMO with IABP (48.4%). After adjustment, ECMO with IABP versus ECMO only was associated with lower in‐hospital mortality (adjusted odds ratio [aOR], 0.83;
P
=0.02). ECMO with Impella versus ECMO only had similar in‐hospital mortality (aOR, 1.09;
P
=0.695) but was associated with more bleeding (aOR, 1.21;
P
=0.007) and more acute kidney injury requiring hemodialysis (aOR, 1.42;
P
<0.001). ECMO with Impella versus ECMO with IABP was associated with greater risk of acute kidney injury requiring hemodialysis (aOR, 1.49;
P
=0.002), higher in‐hospital mortality (aOR, 1.32;
P
=0.001), and higher 40‐day mortality (hazard ratio, 1.25;
P
<0.001).

Conclusions
In patients with cardiogenic shock on VA‐ECMO, LVU with Impella, particularly with 2.5/CP, was not associated with improved survival at 40 days but was associated with increased adverse events compared with IABP. More data are needed to assess Impella platform‐specific comparative outcomes of LVU.
High‐Sensitivity C‐Reactive Protein Is Associated With Heart Failure Hospitalization in Patients With Metabolic Dysfunction‐Associated Fatty Liver Disease and Normal Left Ventricular Ejection Fraction Undergoing Coronary Angiography
Authors: Zhou Xiao‐Dong , Chen Qin‐Fen , Targher Giovanni , Byrne Christopher D. , Shapiro Michael D. , Tian Na , Xiao Tie , Sung Ki‐Chul , Lip Gregory Y. H. , Zheng Ming‐Hua 
Published: January 2024

Background
Systemic chronic inflammation plays a role in the pathophysiology of both heart failure with preserved ejection fraction (HFpEF) and metabolic dysfunction‐associated fatty liver disease. This study aimed to investigate whether serum hs‐CRP (high‐sensitivity C‐reactive protein) levels were associated with the future risk of heart failure (HF) hospitalization in patients with metabolic dysfunction‐associated fatty liver disease and a normal left ventricular ejection fraction.

Methods and Results
The study enrolled consecutive individuals with metabolic dysfunction‐associated fatty liver disease and normal left ventricular ejection fraction who underwent coronary angiography for suspected coronary heart disease. The study population was subdivided into non‐HF, pre‐HFpEF, and HFpEF groups at baseline. The study outcome was time to the first hospitalization for HF. In 10 019 middle‐aged individuals (mean age, 63.3±10.6 years; 38.5% women), the prevalence rates of HFpEF and pre‐HFpEF were 34.2% and 34.5%, with a median serum hs‐CRP level of 4.5 mg/L (interquartile range, 1.9–10 mg/L) and 5.0 mg/L (interquartile range, 2.1–10.1 mg/L), respectively. Serum hs‐CRP levels were significantly higher in the pre‐HFpEF and HFpEF groups than in the non‐HF group. HF hospitalizations occurred in 1942 (19.4%) patients over a median of 3.2 years, with rates of 3.7% in non‐HF, 20.8% in pre‐HFpEF, and 32.1% in HFpEF, respectively. Cox regression analyses showed that patients in the highest hs‐CRP quartile had a ≈4.5‐fold increased risk of being hospitalized for HF compared with those in the lowest hs‐CRP quartile (adjusted‐hazard ratio, 4.42 [95% CI, 3.72–5.25]).

Conclusions
There was a high prevalence of baseline pre‐HFpEF and HFpEF in patients with metabolic dysfunction‐associated fatty liver disease and suspected coronary heart disease. There was an increased risk of HF hospitalization in those with elevated hs‐CRP levels.
The Language Network Reliably “Tracks” Naturalistic Meaningful Nonverbal Stimuli
Authors: Sueoka Yotaro , Paunov Alexander , Tanner Alyx , Blank Idan A. , Ivanova Anna , Fedorenko Evelina 
Published: January 2024

Abstract
The language network, comprised of brain regions in the left frontal and temporal cortex, responds robustly and reliably during language comprehension but shows little or no response during many nonlinguistic cognitive tasks (e.g., Fedorenko & Blank, 2020). However, one domain whose relationship with language remains debated is semantics—our conceptual knowledge of the world. Given that the language network responds strongly to meaningful linguistic stimuli, could some of this response be driven by the presence of rich conceptual representations encoded in linguistic inputs? In this study, we used a naturalistic cognition paradigm to test whether the cognitive and neural resources that are responsible for language processing are also recruited for processing semantically rich nonverbal stimuli. To do so, we measured BOLD responses to a set of ∼5-minute-long video and audio clips that consisted of meaningful event sequences but did not contain any linguistic content. We then used the intersubject correlation (ISC) approach (Hasson et al., 2004) to examine the extent to which the language network “tracks” these stimuli, that is, exhibits stimulus-related variation. Across all the regions of the language network, meaningful nonverbal stimuli elicited reliable ISCs. These ISCs were higher than the ISCs elicited by semantically impoverished nonverbal stimuli (e.g., a music clip), but substantially lower than the ISCs elicited by linguistic stimuli. Our results complement earlier findings from controlled experiments (e.g., Ivanova et al., 2021) in providing further evidence that the language network shows some sensitivity to semantic content in nonverbal stimuli.
Animals and Amour-Propre in Rousseau’s Second Discourse
Authors: Grimwade Robert 
Published: January 2024

Abstract
This article explores the role of human-animal relations in the emergence of amour-propre, as presented in Rousseau’s Discourse on the Origin and Foundation of Inequality Among Men (also known as the Second Discourse). Rousseau’s natural vegetarianism thesis is used to elucidate and interrogate fundamental pivots in his conjectural history of human development. The implications of the connection between amour-propre and human-animal relations are explored in relation to anthropocentrism, human exceptionalism, and the disavowal of nonhuman suffering in Western culture.
Irreversible Mixing Induced by Geostrophic Turbulence over the Global Ocean
Authors: Liu Tongya , Qian Yu-Kun , Liu Xiaohui , Peng Shiqiu , Chen Dake 
Published: January 2024

Abstract
Two recently proposed mixing diagnostics are employed to estimate the global surface irreversible mixing based on particle and tracer simulation driven by satellite-derived geostrophic velocities. These two novel diagnostics, similar to the traditional dispersion diffusivity and Nakamura’s effective diffusivity but defined in a localized and instantaneous sense, have the following advantages: 1) they reconcile the theoretical discrepancies between Eulerian-, particle-, and contour-based diffusivities and 2) they do not rely on the stationary and homogeneous assumptions of the turbulent ocean and are free from traditional average operators (e.g., Eulerian time–space or along-contour mean). Our results show that evident discrepancies among these three types of diffusivities do emerge when employing traditional estimates. However, these discrepancies could be significantly mitigated with the adoption of new diagnostic methods, implying that the three types of diffusivities can be effectively reconciled within a global framework. Moreover, finescale mixing structures and transient elevated mixing events due to geostrophic stirring can be clearly identified by the two new diagnostics, in contrast to previous estimates that are spatially and/or temporally smoothed. In particular, it is interesting to note that large values of the new diagnostics usually occur along narrow filaments/fronts associated with mesoscale eddies, and elevated mixing is observed to be located at the periphery of eddies. Our study presents a novel revisit of the global surface mixing induced by geostrophic eddies with an emphasis on irreversibility and provides new insights into previous questions regarding different mixing diagnostics in the community.

Significance Statement
Previous estimates of eddy mixing over the global ocean, using particle-based, tracer-based, and Eulerian-based diffusivities, have shown evident discrepancies. By using recently proposed novel mixing diagnostics, this study demonstrates that the three types of diffusivity estimates agree well with each other, indicating a practical unification of the three types of diffusivities. Also, since the new mixing diagnostics do not involve any traditional average operator, the local and instantaneous mixing maps over the global ocean are presented here, in contrast to previous spatial- or temporal-averaged ones. These new insights can address several unresolved issues in the mixing community.
Lessons Learned From Adolescent COVID-19 Vaccine Administration in Medically Underserved Communities
Authors: Lin Sue C. , Donney Julie Fife , Lebrun-Harris Lydie A. 
Published: January 2024

Objectives: In May 2021, the Health Resources and Services Administration Health Center COVID-19 Vaccine Program (HCCVP) began supporting the national adolescent vaccination rollout for a safe return to in-person learning for children and adolescents from medically underserved communities. To understand the initial implementation of adolescent vaccinations, we estimated the number of vaccines administered through the HCCVP at the national and state level to adolescents aged 12-17 years, and we examined challenges and solutions in vaccine deployment. Methods: We analyzed data on vaccine administration, challenges, and solutions from the Health Center COVID-19 Survey during May 14–August 27, 2021, and we analyzed data on patients served from the 2019 Uniform Data System. National adolescent COVID-19 vaccination and population data came from CDC’s COVID Data Tracker and the US Census Bureau’s 2019 Current Population Survey. Results: HCCVP health centers administered >485 000 COVID-19 vaccine doses to adolescents during the study period, with variations across states. Health centers in 13 states and territories (Arizona, California, Colorado, Connecticut, Delaware, Maine, Massachusetts, Missouri, Nebraska, Nevada, Oregon, Virginia, and Puerto Rico) vaccinated more adolescents than their share of prepandemic adolescent patients. The most frequently reported challenges in vaccine administration were vaccine confidence and staffing availability. Conclusions: This assessment of the initial months of COVID-19 vaccine administration among adolescent health center patients suggests rapid response by health centers in several states, reaching beyond their adolescent patient population to support state-level pandemic response. Future research could examine processes to optimize strategic activation of health centers in public health emergency responses.
Optimization of impact strength and elastic modulus of polyamide-based nanocomposites: Using particle swarm optimization method
Authors: Panahizadeh Valiollah , Hamidi Ehsan , Daneshpayeh Sajjad , Saeifar Hosna 
Published: January 2024

In the current paper, the mechanical properties of polymeric nanocomposites based on a two-phase PA6/EPDM matrix reinforced with carbon nanotubes have been optimized. The compounds consist of 0, 1, 2, and 3 wt% carbon nanotubes, 5 and 10 wt% EPDM-g-MA as a compatibilizer, and 10 and 20 wt% EPDM were made by an internal mixer. The mechanical tests were done to measure mechanical properties of the samples. In addition, SEM images were used to investigate the dispersion quality of nanotubes in the polymer matrix. From SEM findings, adding up to 2 wt% nanotubes in the matrix accompanied with a proper distribution and dispersion, whereas adding 3 wt% nanotubes into matrix results in inappropriate dispersion and agglomeration. Furthermore, samples including high level of EPDM-g-MA displayed better dispersion of nanotubes in the matrix. Moreover, the findings of mechanical tests depicted that the presence of EPDM and compatibilizing agent causes 12.5% and 22% increase in impact strength, respectively. Furthermore, the addition of nanotubes up to 2 wt% has enhanced the elastic modulus of the compounds. Finally, the optimization results of the PSO method indicate that adding 13.31 wt% EPDM, 9.91 wt% EPDM-g-MA and 2.61 wt% nanotubes progress the elastic modulus (by 36%) and impact strength (by 33%) of the matrix.
The Role of Smoking Status in Making Risk-Informed Diagnostic Decisions in the Lung Cancer Pathway: A Qualitative Study of Health Care Professionals and Patients
Authors: Black Georgia B. , Janes Sam M. , Callister Matthew E. J. , van Os Sandra , Whitaker Katriina L. , Quaife Samantha L. 
Published: January 2024

Background Lung cancer clinical guidelines and risk tools often rely on smoking history as a significant risk factor. However, never-smokers make up 14% of the lung cancer population, and this proportion is rising. Consequently, they are often perceived as low-risk and may experience diagnostic delays. This study aimed to explore how clinicians make risk-informed diagnostic decisions for never-smokers. Methods Qualitative interviews were conducted with 10 lung cancer diagnosticians, supported by data from interviews with 20 never-smoker lung cancer patients. The data were analyzed using a framework analysis based on the Model of Pathways to Treatment framework and data-driven interpretations. Results Participants described 3 main strategies for making risk-informed decisions incorporating smoking status: guidelines, heuristics, and potential harms. Clinicians supplemented guidelines with their own heuristics for never-smokers, such as using higher thresholds for chest X-ray. Decisions were easier for patients with high-risk symptoms such as hemoptysis. Clinicians worried about overinvestigating never-smoker patients, particularly in terms of physical and psychological harms from invasive procedures or radiation. To minimize unnecessary anxiety about lung cancer risk, clinicians made efforts to downplay this. Conversely, some patients found that this caused process harms such as delays and miscommunications. Conclusion Improved guidance and methods of risk differentiation for never-smokers are needed to avoid diagnostic delays, overreassurance, and clinical pessimism. This requires an improved evidence base and initiatives to increase awareness among clinicians of the incidence of lung cancer in never-smokers. As the proportion of never-smoker patients increases, this issue will become more urgent. Highlights Smoking status is the most common risk factor used by clinicians to guide decision making, and guidelines often focus on this factor. Some clinicians also use their own heuristics for never-smokers, and this becomes particularly relevant for patients with lower risk symptoms. Clinicians are also concerned about the potential harms and risks associated with deploying resources on diagnostics for never-smokers. Some patients find it difficult to decide whether or not to go ahead with certain procedures due to efforts made by clinicians to downplay the risk of lung cancer. Overall, the study highlights the complex interplay between smoking history, clinical decision making, and patient anxiety in the context of lung cancer diagnosis and treatment.
Chest CT at X-Ray Dose Using a Noise-Mitigating Weighted Projection: The Thoracic Tomogram. Diagnostic Performance for Pneumonia Detection in Hemato-Oncology Patients
Authors: Sanchez Tijmes Felipe , Kandel Sonja , Kavanagh John , Carey Sean , May Mary , Chen Shiyi , Mattsson Jonas , Rogalla Patrik 
Published: January 2024

Purpose: To compare the diagnostic performance of a thick-slab reconstruction obtained from an ultra-low-dose CT (termed thoracic tomogram) with standard-of-care low-dose CT (SOC-CT) for rapid interpretation and detection of pneumonia in hemato-oncology patients. Methods: Hemato-oncology patients with a working diagnosis of pneumonia underwent an SOC-CT followed by an ultra-low-dose CT, from which the thoracic tomogram (TT) was reconstructed. Three radiologists evaluated the TT and SOC-CT in the following categories: (I) infectious/inflammatory opacities, (II) small airways infectious/inflammatory changes, (III) atelectasis, (IV) pleural effusions, and (V) interstitial abnormalities. The TT interpretation time and radiation dose were recorded. Sensitivity, specificity, diagnostic accuracy, ROC, and AUC were calculated with the corresponding power analyses. The agreement between TT and SOC-CT was calculated by Correlation Coefficient for Repeated Measures (CCRM), and the Shrout-Fleiss intra-class correlations test was used to calculate interrater agreement. Results: Forty-seven patients (mean age 58.7 ± 14.9 years; 29 male) were prospectively enrolled. Sensitivity, specificity, accuracy, AUC, and Power for categories I/II/III/IV/V were: 94.9/99/97.9/0.971/100, 78/91.2/86.5/0.906/100, 88.6/100/97.2/0.941/100, 100/99.2/99.3/0.995/100, and 47.6/100/92.2/0.746/87.3. CCRM between TT and SOC-CT for the same categories were .97/.81/.92/.96/.62 with an interobserver agreement of .93/.88/.82/.96/.61. Mean interpretation time was 18.6 ± 5.4 seconds. The average effective radiation dose of TT was similar to a frontal and lateral chest X-ray (0.27 ± 0.08 vs 1.46 ± 0.64 mSv for SOC-CT; P < .01). Conclusion: Thoracic tomograms provide comparable diagnostic information to SOC-CT for the detection of pneumonia in immunocompromised patients at one-fifth of the radiation dose with high interobserver agreement.