bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Preprocedural Diastolic Blood Pressure on Outcomes in Patients Undergoing Percutaneous Coronary Intervention
Authors: Warren Josephine , Dinh Diem , Brennan Angela , Tan Christianne , Dagan Misha , Stehli Julia , Clark David J. , Ajani Andrew E. , Reid Christopher M. , Sebastian Martin , Oqueli Ernesto , Freeman Melanie , Stub Dion , Duffy Stephen J. ,   On behalf of the Melbourne Interventional Group Investigators
Published: September 2023

BACKGROUND:
Recent US guidelines recommend lower blood pressure (BP) targets in hypertension, but aggressive lowering of diastolic BP (DBP) can occur at the expense of myocardial perfusion, particularly in the presence of coronary artery disease. We sought to establish the long-term impact of low DBP on mortality among patients undergoing percutaneous coronary intervention with well-controlled systolic BP.

METHODS:
We analyzed data from 12 965 patients undergoing percutaneous coronary intervention between 2009 and 2018 from the Melbourne Interventional Group registry who had a preprocedural systolic BP of ≤140 mm Hg. Patients with ST-elevation myocardial infarction, cardiogenic shock, and out-of-hospital arrest were excluded. Patients were stratified into 5 groups according to preprocedural DBP: <50, 50 to 59, 60 to 69, 70 to 79, and ≥80 mm Hg. The primary outcome was long-term, all-cause mortality. Mortality data were derived from the Australian National Death Index.

RESULTS:

Patients with DBP<50 mm Hg were older with higher rates of diabetes, renal impairment, prior myocardial infarction, left ventricular dysfunction, peripheral and cerebrovascular disease (all
P
<0.001). Patients with DBP<50 mm Hg had higher 30-day (2.5% versus 0.7% for the other 4 quintiles;
P
<0.0001) and long-term mortality (median, 3.6 years; follow-up, 29% versus 11%;
P
<0.0001). Cox-regression analysis revealed that DBP<50 mm Hg was an independent predictor of long-term mortality (hazard ratio [HR], 1.55 [95% CI, 1.20–2.00];
P
=0.001).

CONCLUSIONS:
In patients with well-controlled systolic BP undergoing percutaneous coronary intervention, low DBP (<50 mm Hg) is an independent predictor of long-term mortality.
Contribution of Deep Vertical Velocity to Deficiency of Sverdrup Transport in the Low-Latitude North Pacific
Authors: Zhang Kun , Wang Qiang , Yin Baoshu , Yang Dezhou , Yang Lina 
Published: September 2023

Abstract
Deep vertical velocity is a critical factor causing deficiencies in Sverdrup theory. However, few studies have focused on its influence in the low-latitude western Pacific. Through multiple analyses of observational, reanalysis, and simulation data, this study explored the contribution of deep nonzero vertical velocity to the Sverdrup transport inaccuracy in the low-latitude North Pacific. The vertical velocities inducing relatively small non-Sverdrup transport exist within 1500–2500 m, which exhibit similar patterns with opposite values to the south and north of 13°N. The zonally integrated meridional volume transport associated with these vertical velocities displays nonnegligible dipolar zonal bands west of approximately 150°W. The positive and negative transport bands, centered at 11° and 17°N, can reach an amplitude of approximately 8.0 Sv (1 Sv ≡ 106 m3 s−1) when integrated from the eastern boundary to 140°E. On average, such integrated meridional transport makes up roughly half of the prominent Sverdrup transport discrepancies in the central-western Pacific. Further investigation indicated that the spatial pattern of these vertical velocities is modulated by ocean topography and deep meridional currents. Moreover, a near-global test suggested that the meridional non-Sverdrup transport related to deep vertical velocity is widespread and undergoes remarkable multidecadal variation. This study reveals the disruptive role of deep vertical velocity in disturbing the Sverdrup balance and emphasizes the consideration of its long-term variation when diagnosing wind-driven circulation changes using Sverdrup theory.
Estimating the Volume Transport of Kuroshio Extension Based on Satellite Altimetry and Hydrographic Data
Authors: Guo Haihong , Chen Zhaohui , Yang Haiyuan , Long Yu , Zhu Ruichen , Zhang Yueqi , Jing Zhao , Yang Chen 
Published: September 2023

Abstract
In this study, an effective method of estimating the volume transport of the Kuroshio Extension (KE) is proposed using surface geostrophic flow inferred from satellite altimetry and vertical stratification derived from climatological temperature/salinity (T/S) profiles. Based on velocity measurements by a subsurface mooring array across the KE, we found that the vertical structure of horizontal flow in this region is dominated by the barotropic and first baroclinic normal modes, which is commendably described by the leading mode of empirical orthogonal functions (EOFs) of the observed velocity profiles as well. Further analysis demonstrates that the projection coefficient of moored velocity onto the superimposed vertical normal mode can be represented by the surface geostrophic velocity as derived from satellite altimetry. Given this relationship, we proposed a dynamical method to estimate the volume transport across the KE jet, which is well verified with both ocean reanalysis and repeated hydrographic data. This finding implicates that, in the regions where the currents render quasi-barotropic structure, it takes only satellite altimetry observation and climatological T/S to estimate the volume transport across any section.

Significance Statement
The Kuroshio Extension (KE) plays an important role in the midlatitude North Pacific climate system. To better understand the KE dynamic and its influences, it is very important to estimate the KE transport. However, direct observation is very difficult in this area. Combining a subsurface mooring array and climatological temperature/salinity data, the vertical structure of the KE is explored in this study using mode decomposition methods. The relationship between the vertical structure of the zonal velocity and surface geostrophic flow observed by satellite altimetry in the KE region is further investigated. Based on this relationship, the KE transport can be well estimated by using satellite altimetry observation and historical hydrographic observation.
Safety of an express freight train running over a bridge in crosswind
Authors: Wen Jingcheng , Li Qi , Lu Zhenggang 
Published: September 2023

Owing to the blunt car body and high design speed of express freight trains, the running safety is significantly affected by crosswinds when the train runs over a bridge; moreover, severe accidents, such as derailment or overturning may occur. Therefore, adequate measures should be adopted to avoid the occurrence of such accidents. In this study, a finite element model of the train, ballastless track, and parameterized 5-span simply supported girder bridge along with modal superposition method are adopted to establish the train-track-bridge coupling dynamic system. Numerical simulation of stochastic wind speed, wind tunnel tests, and computational fluid dynamics (CFD) simulation of vehicle-bridge scale model were conducted to calculate the wind load acting on the train and bridge. The dynamic responses of the bridge and train were evaluated to present the diagrams of wind and train speed limits for safe operation. The results indicated that the running safety of the vehicle declined with the wind and train speeds, and the wheel unloading rate was the most sensitive to wind speed. For safe operation, the train speed must be restricted if the mean wind speed is greater than 22.7 m/s, and an extreme scenario of derailment may occur for a mean wind speed of 34.0 m/s. In addition, the wind speed limit should be appropriately adjusted and improved according to the pier height of the bridge and terrain category. This research provides a theoretical basis and data support for the assessment of safety of express freight trains in actual operation.
Morin hydrate suppresses lipoteichoic acid-induced oxidative stress-mediated inflammatory events in macrophages via augmenting Nrf2/HO-1 and antioxidant defense molecules
Authors: Hsieh Cheng-Ying , Jayakumar Thanasekaran , Lin Kao-Chang , Yen Ting-Lin , Hsia Chih-Wei , Huang Wei-Chieh , Sheu Joen-Rong , Hsia Chih-Hsuan 
Published: September 2023

Objectives Oxidative stress induces chronic inflammatory diseases in aerobic organisms, and antioxidants from plants represent an efficient strategy to prevent this condition. Morin hydrate (MH), a bioactive flavonoid, has a wide range of pharmacological properties, including anti-inflammatory and anti-oxidant. This study evaluated the protective effects of MH on lipoteichoic acid (LTA)-induced inflammation in RAW 264.7 macrophages by testing the main oxidative and inflammatory biomarkers and also investigating the molecular pathways involved. Methods The antioxidant and anti-inflammatory effects of MH were evaluated in a cell-free system and RAW264.7 cells. Quantitative real-time PCR (RT-qPCR) and assay kits were used to measure the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase 1 (HO-1) mRNA, as well as the activity of antioxidant enzymes. The effects of MH on LTA-induced inducible nitric oxide synthase (iNOS), IL-1β, and TNF-α mRNA and protein expression were also evaluated by RT-qPCR and Western blotting. Results MH reduced DPPH and ABTS radicals in a cell-free system and LTA-induced ROS and NO production in RAW264.7 cells. MH upregulated Nrf2 and HO-1 mRNA expression and reversed LTA-mediated reduction of antioxidant enzymes, at a high concentration of 20 µM pretreated cells. MH also effectively attenuated LTA-induced iNOS, IL-1β, and TNF-α mRNA and protein expression, and these effects were reversed by ML385. Conclusions The study found that the Nrf2/HO-1 played role in the inhibition of LTA-induced oxidative stress in macrophages by MH. This study may consider to be a promising induced macrophage-targeted strategy via regulating anti-oxidative defense to control inflammatory-related disease.
Carotid total plaque area as an independent predictor of short-term subclinical polyvascular atherosclerosis progression and major adverse cardiac and cerebrovascular events
Authors: Genkel Vadim , Kuznetsova Alla , Lebedev Evgeniy , Salashenko Alexey , Savochkina Albina , Nikushkina Karina , Pykhova Lubov , Sumerkina Veronika , Shaposhnik Igor 
Published: September 2023

Background: The use of ultrasound-based methods for imaging of subclinical atherosclerosis, including measurement of carotid plaque burden (cPB), is a promising direction for further improvement of major adverse cardiac and cerebrovascular events (MACCE) prediction. Objectives: The aim of the study was to research the prognostic values’ significance of cPB indicators with regard to the short-term progression of polyvascular subclinical atherosclerosis and the long-term onset of MACCE. Design: Single-center prospective cohort study. Methods: The study included patients 40–64 years of age. All patients underwent duplex scanning (DS) of the carotid and lower limb arteries. The following cPB indicators were determined: carotid plaque score (cPS), maximum carotid plaque thickness (cPTmax), and carotid total plaque area (cTPA). The combined endpoint included the following components: cardiovascular death; nonfatal myocardial infarction; nonfatal stroke or transient ischemic attack (TIA); revascularization of the coronary and/or peripheral arteries. Results: The study included 387 patients, among whom 142 (36.7%) patients underwent repeated DS after 12–24 months. The median follow-up time was 20.0 (13.0; 36.5) months. MACCE were recorded in 33 (8.52%) of patients. cTPA and cPTmax, but not cPS, were independently associated with the progression of subclinical polyvascular atherosclerosis over a period of 13.9 months of follow-up. cTPA, but not cPTmax and cPS, was independently associated with the development of MACCE over a period of 20.0 months of follow-up. Only a cTPA > 42.0 mm2 proved to be an independent predictor of both the progression of subclinical polyvascular atherosclerosis and MACCE. Conclusion: In patients from 40 to 64 years of age with various cardiovascular risks, among the indicators of the cPB, only an increase in cTPA > 42.0 mm2 was shown to be independently associated with an increase in the relative risk (RR) of progression of subclinical polyvascular atherosclerosis by 2.38 (1.08–5.25) times, as well as with the development of MACCE by 3.10 (1.54–6.26) times.
Stroke Thrombectomy and Right Atrial Clot Aspiration in 29 Year Old Woman
Authors: Rao Rahul , Aladamat Nameer , Robbins Sarah , Jumaa Mouhammad , Zaidi Syed 
Published: September 2023

We present a case report of a previously healthy 29 year old woman who developed thromboembolic events in rapid fashion after a recent orthopedic surgery. This case highlights the importance of understanding risk factors for clot formation even in those who had no prior events, the efficacy of novel aspiration techniques to remove emboli, and how rapid triaging of acute symptoms can lead to the best outcomes. She presented to the emergency department with shortness of breath and was found to have a large bilateral pulmonary embolus. She was given intravenous thrombolysis. Shortly after, she developed aphasia and right-sided weakness and was taken emergently for mechanical thrombectomy of a left middle cerebral artery occlusion. She was later found to have a patent foramen ovale and a highly mobile right atrial thrombus which was aspirated. Further evaluation revealed right lower extremity peroneal and popliteal deep venous thrombi. She was placed on anticoagulation, made a full clinical recovery, and was discharged home. Prompt recognition of symptoms, efficient in-hospital work flow, and a multidisciplinary approach led to an outstanding outcome in this young patient.
Perceived barriers to access to hepatitis C for people who inject drugs in Morocco: A qualitative explorative study
Authors: Belrhiti Zakaria , Serghini Fatima Zohra 
Published: September 2023

Background Worldwide, approximately there are 15.6 million people who inject drugs. Recently, a rising prevalence of hepatitis C virus among the people who inject drugs community (8.2 million, 40 to 80% of people who inject drugs) urged governments to implement targeted preventive and structural interventions. Yet, social stigma, poor interaction with health workers, and limited health literacy are critical challenges to equitable access to care. This study explores the perceived barriers and facilitators of people who inject drugs access to hepatitis C virus care in Morocco. Methods We adopted an explorative qualitative single-embedded case study design. We conducted 19 semi-structured interviews and a focus group discussion with people who inject drugs, health workers, and social community health workers. We performed an inductive qualitative data analysis using thematic analysis. We coded data using NVivo software. We summarized our findings using a causal loop diagram of critical barriers and facilitators. Results Multi-layered and interdependent factors constrain access to care for people who inject drugs. People who inject drugs are considered a vulnerable population experiencing irregular housing, lack of family support, gender-based stigmatization, and incarcerations. Individual factors include limited hepatitis C virus health literacy, mistrust in health workers, and poor interaction with health workers within healthcare facilities. Both individual and structural elements decrease their perceived self-worth and self-esteem and reinforce their perceived social stigmatization. This leads to a lack of motivation to engage in hepatitis C virus care delivery. We found that peer educators are perceived as trustworthy and credible sources of hepatitis C virus health-related knowledge. Discussion Poor access to hepatitis C virus treatment for people who inject drugs involved an intertwined set of individual factors (level of knowledge, perceived social stigma, reduced self-esteem, and self-worth) and structural factors such as poor interaction with health workers and mistrust in healthcare institutions. More attention needs to be paid to alleviate structural barriers by integrating peer education, multiagency collaboration, community engagement, and capacity building of health workers for equitable access of people who inject drugs to hepatitis C virus care.
Design and Research of Form Controlled Planar Folding Mechanism based on 4D Printing Technology
Authors: Zhang Wencai , Ge Zhenghao , Li Duanling 
Published: September 2023

AbstractThe use of non-smart materials in structural components and kinematic pairs allows for flexible assembly in practical applications and is promising for aerospace applications. However, this approach can result in a complex structure and excessive kinematic pairs, which limits its potential applications due to the difficulty in controlling and actuating the mechanism. While smart materials have been integrated into certain mechanisms, such integration is generally considered a unique design for specific cases and lacks universality. Therefore, organically combining universal mechanism design with smart materials and 4D printing technology, innovating mechanism types, and systematically exploring the interplay between structural design and morphing control remains an open research area. In this work, a novel form-controlled planar folding mechanism is proposed, which seamlessly integrates the control and actuation system with the structural components and kinematic pairs based on the combination of universal mechanism design with smart materials and 4D printing technology, while achieving self-controlled dimensional ratio adjustment under a predetermined thermal excitation. The design characteristics of the mechanism are analyzed, and the required structural design parameters for the preprogrammed design are derived using a kinematic model. Using smart materials and 4D printing technology, folding programs based on material properties and control programs based on manufacturing parameters are encoded into the form-controlled rod to achieve the preprogrammed design of the mechanism. Finally, two sets of prototype mechanisms are printed to validate the feasibility of the design, the effectiveness of the morphing control programs, and the accuracy of the theoretical analysis. This mechanism not only promotes innovation in mechanism design methods but also shows exceptional promise in satellite calibration devices and spacecraft walking systems.
The effect of cognitive behavioral counseling on anxiety and worry level of women with intermediate risk during first trimester screening for down syndrome: a randomized controlled trial: a randomized controlled trial
Authors: Kharaghani Roghieh , Vaezi Farhaneh , Dadashi Mohsen , Rastegari Leila , Maleki Azam 
Published: September 2023

Abstract
Background
Anxiety related to prenatal screening programs negatively affects maternal and child health.

Objective
The study aimed to determine the effect of Cognitive Behavioral Counseling on the anxiety and worry levels of women with intermediate risk during first-trimester screening for Down Syndrome.

Methods
The study was a randomized controlled trial conducted on 52 pregnant women with intermediate risk (1: 51 − 1:1500) during first-trimester screening for Down Syndrome and without additional structural anomalies that referred to three cities of Zanjan province in 2021. The eligible women were randomly assigned to intervention and control groups, with a block size of four. The intervention group received CBC in four sessions of 120 min two times a week by phone. Data were collected using Vandenberg Anxiety Questionnaire, and Cambridge Worry Questionnaire in three phases baseline, after the intervention, and 6 weeks follow-ups. Data were analyzed using independent t-test, chi-square, and repeated measures ANOVA at a 95% confidence level. (P < 0.05).

Results
In the counselling group, the mean (SD) of a total score of anxiety before the intervention was 67.11 (20.68) which decreased to 32.50 (13.58) in six weeks after the intervention. Furthermore, the mean (SD) of a total score of worry before the intervention was 56.19 (16.76) which decreased to 32.96 (8.89) six weeks after the intervention. Based on the repeated measures ANOVA test, the mean total score of anxiety and worry were statistically significant 6 weeks after the intervention compared with the control group(p < 0.001).

Conclusion
Based on the study results, CBC can reduce the anxiety and worry levels of women with intermediate risk during first trimester screening for Down Syndrome.

Trial registration
The study was registered at the Iranian Registry of Clinical Trials website under the code IRCT20160608028352N8, (https://en.irct.ir/trial/49998). The first trial registration date was (29/08/2020).
Preeclampsia complicated with hypofibrinogenemia: 2 case reports and review of the literature
Authors: Li Shiguang , Jin Yanhui , Gong Yanmin , Luo Xia 
Published: September 2023

Abstract
Background
Preeclampsia complicated with hypofibrinogenemia is a rare disorder. We report two cases of severe preeclampsia complicated with hypofibrinogenemia followed by postpartum haemorrhage (PPH).

Case
Two women diagnosed as preeclampsia and hypofibrinogenemia developed severe PPH after undergoing Cesarean sections. Besides supplement with fibrinogen concentrate and supportive treatment, the second patient got administration of heparin after delivery and bleeding was stopped. The haemorrhage in case 1 didn’t disappear until an hysterectomy. The two patients both recovered and were discharged soon.

Conclusions
Severe preeclampsia patients with hypofibrinogenemia could suffer PPH. It’s necessary to detect and master coagulation function. Heparin could be considered to balance hypercoagulation and hypocoagulation to avoid catastrophic haemorrhage and hysterectomy.
Association between the weight-adjusted waist index and stroke: a cross-sectional study
Authors: Ye Jiayi , Hu Yanjie , Chen Xinrong , Yin Zhe , Yuan Xingzhu , Huang Liping , Li Ka 
Published: September 2023

Abstract
Background
The weight-adjusted waist index (WWI) is a new measure of obesity, and this study aimed to determine the association between the WWI and stroke.

Methods
Using the National Health and Nutrition Examination Survey (NHANES) 2011–2020 dataset, cross-sectional data from 23,389 participants were analysed. The correlation between the WWI and stroke was investigated through multivariate logistic regression and smoothing curve fitting. Subgroup analysis and interaction tests were also carried out.

Results
The research involved 23,389 participants, of whom 893 (3.82%) had a stroke. The fully adjusted model revealed a positive correlation between the WWI and stroke [1.25 (1.05, 1.48)]. Individuals who were in the highest quartile of WWI exhibited a 62% higher likelihood of experiencing a stroke than those in the lowest quartile [1.62 (1.06, 2.48)]. Subgroup analysis and interaction tests revealed that this positive correlation was similar in different population settings (all P for interaction  > 0.05).

Conclusion
A higher WWI was associated with a higher prevalence of stroke. The results of this study underscore the value of the WWI in stroke prevention and management.