bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rising and Falling High‐Sensitivity Cardiac Troponin in Diagnostic Algorithms for Patients With Suspected Myocardial Infarction
Authors: Haller Paul M. , Sörensen Nils A. , Hartikainen Tau S. , Goßling Alina , Lehmacher Jonas , Toprak Betül , Twerenbold Raphael , Richter Janine , Banko Thorben , Korschid Solaf , Schmidt Jakob , Keller Till , Zeller Tanja , Blankenberg Stefan , Westermann Dirk , Neumann Johannes T. 
Published: May 2023

Background
High‐sensitivity cardiac troponin (hs‐cTn)‐based diagnostic algorithms are recommended for the management of patients with suspected myocardial infarction (MI) without ST elevation. Although mirroring different phases of myocardial injury, falling and rising troponin patterns (FPs and RPs, respectively) are equally considered by most algorithms. We aimed to compare the performance of diagnostic protocols for RPs and FPs, separately.

Methods and Results
We pooled 2 prospective cohorts of patients with suspected MI and stratified patients to stable, FP, and RP during serial sampling separately for hs‐cTnI and hs‐cTnT and applied the European Society of Cardiology 0/1‐ and 0/3‐hour algorithms comparing the positive predictive values to rule in MI. Overall, 3523 patients were included in the hs‐cTnI study population. The positive predictive value for patients with an FP was significantly reduced compared with patients with an RP (0/1‐hour: FP, 53.3% [95% CI, 45.0–61.4] versus RP, 76.9 [95% CI, 71.6–81.7]; 0/3‐hour: FP, 56.9% [95% CI, 42.2–70.7] versus RP, 78.1% [95% CI, 74.0–81.8]). The proportion of patients in the observe zone was larger in the FP using 0/1‐hour (31.3% versus 55.8%) and 0/3‐hour (14.6% versus 38.6%) algorithms. Alternative cutoffs did not improve algorithm performances. Compared with stable hs‐cTn, the risk for death or MI was highest in those with an FP (adjusted hazard ratio [HR], hs‐cTnI 2.3 [95% CI, 1.7–3.2]; RP adjusted HR, hs‐cTnI 1.8 [95% CI, 1.4–2.4]). Findings were similar for hs‐cTnT tested in 3647 patients overall.

Conclusions
The positive predictive value to rule in MI by the European Society of Cardiology 0/1‐ and 0/3‐hour algorithms is significantly lower in patients with FP than RP. These are at highest risk for incident death or MI.

REGISTRATION:
URL:
https://www.clinicaltrials.gov
; Unique identifiers: NCT02355457, NCT03227159.
Geographic Disparities in Case Fatality and Discharge Disposition Among Patients With Primary Intracerebral Hemorrhage
Authors: Bako Abdulaziz T. , Potter Thomas , Pan Alan , Tannous Jonika , Rahman Omar , Langefeld Carl , Woo Daniel , Britz Gavin , Vahidy Farhaan S. 
Published: May 2023

Background
We evaluate nationwide trends and urban–rural disparities in case fatality (in‐hospital mortality) and discharge dispositions among patients with primary intracerebral hemorrhage (ICH).

Methods and Results
In this repeated cross‐sectional study, we identified adult patients (≥18 years of age) with primary ICH from the National Inpatient Sample (2004–2018). Using a series of survey design Poisson regression models, with hospital location–time interaction, we report the adjusted risk ratio (aRR), 95% CI, and average marginal effect (AME) for factors associated with ICH case fatality and discharge dispositions. We performed a stratified analysis of each model among patients with extreme loss of function and minor to major loss of function. We identified 908 557 primary ICH hospitalizations (overall mean age [SD], 69.0 [15.0] years; 445 301 [49.0%] women; 49 884 [5.5%] rural ICH hospitalizations). The crude ICH case fatality rate was 25.3% (urban hospitals: 24.9%, rural hospitals:32.5%). Urban (versus rural) hospital patients had a lower likelihood of ICH case fatality (aRR, 0.86 [95% CI, 0.83–0.89]). ICH case fatality is declining over time; however, it is declining faster in urban hospitals (AME, −0.049 [95% CI, −0.051 to −0.047]) compared with rural hospitals (AME, −0.034 [95% CI, −0.040 to −0.027]). Conversely, home discharge is increasing significantly among urban hospitals (AME, 0.011 [95% CI, 0.008–0.014]) but not significantly changing in rural hospitals (AME, −0.001 [95% CI, −0.010 to 0.007]). Among patients with extreme loss of function, hospital location was not significantly associated with ICH case fatality or home discharge.

Conclusions
Improving access to neurocritical care resources, particularly in resource‐limited communities, may reduce the ICH outcomes disparity gap.
Factors Impacting Treatment of Out‐of‐Hospital Cardiac Arrest: A Qualitative Study of Emergency Responders
Authors: Missel Amanda L. , Dowker Stephen R. , Dzierwa Drake , Krein Sarah L. , Coulter‐Thompson Emilee I. , Williams Michelle , Trumpower Brad , Swor Robert , Hunt Nathaniel , Friedman Charles P. 
Published: May 2023

Background
Of the more than 250 000 emergency medical services‐treated out‐of‐hospital cardiac arrests that occur each year in the United States, only about 8% survive to hospital discharge with good neurologic function. Treatment for out‐of‐hospital cardiac arrest involves a system of care that includes complex interactions among multiple stakeholders. Understanding the factors inhibiting optimal care is fundamental to improving outcomes.

Methods and Results
We conducted group interviews with emergency responders including 911 telecommunicators, law enforcement officers, firefighters, and transporting emergency medical services personnel (ie, emergency medical technicians and paramedics) who responded to the same out‐of‐hospital cardiac arrest incident. We used the American Heart Association System of Care as the framework for our analysis to identify themes and their contributory factors from these interviews. We identified 5 themes under the structure domain, which included workload, equipment, prehospital communication structure, education and competency, and patient attitudes. In the process domain, 5 themes were identified focusing on preparedness, field response and access to patient, on‐scene logistics, background information acquisition, and clinical interventions. We identified 3 system themes including emergency responder culture; community support, education, and engagement; and stakeholder relationships. Three continuous quality improvement themes were identified, which included feedback provision, change management, and documentation.

Conclusions
We identified structure, process, system, and continuous quality improvement themes that may be leveraged to improve outcomes for out‐of‐hospital cardiac arrest. Interventions or programs amenable to rapid implementation include improving prearrival communication between agencies, appointing patient care and logistical leadership on‐scene, interstakeholder team training, and providing more standardized feedback to all responder groups.
Racial and Ethnic Differences in Cardiac Surveillance Evaluation of Patients Treated With Anthracycline‐Based Chemotherapy
Authors: DeRemer David L. , Nguyen Nam K. , Guha Avirup , Ahmad Faraz S. , Cooper‐DeHoff Rhonda M. , Pepine Carl J. , Fradley Michael G. , Gong Yan 
Published: May 2023

Background
Anthracyclines remain a key treatment for many malignancies but can increase the risk of heart failure or cardiomyopathy. Specific guidelines recommend echocardiography and serum cardiac biomarkers such as BNP (B‐type natriuretic peptide) or NT‐proBNP (N‐terminal proBNP) evaluation before and 6 to 12 months after treatment. Our objective was to evaluate associations between racial and ethnic groups in cardiac surveillance of survivors of cancer after exposure to anthracyclines.

Methods and Results

Adult patients in the OneFlorida Consortium without prior cardiovascular disease who received at least 2 cycles of anthracyclines were included in the analysis. Multivariable logistic regression was performed to estimate the odds ratios (ORs) and 95% CIs for receiving cardiac surveillance at baseline before anthracycline therapy, 6 months after, and 12 months after anthracycline exposure among different racial and ethnic groups. Among the entire cohort of 5430 patients, 63.4% had a baseline echocardiogram, with 22.3% receiving an echocardiogram at 6 months and 25% at 12 months. Non‐Hispanic Black (NHB) patients had a lower likelihood of receiving a baseline echocardiogram than Non‐Hispanic White (NHW) patients (OR, 0.75 [95% CI, 0.63–0.88];
P
=0.0006) or any baseline cardiac surveillance (OR, 0.76 [95% CI, 0.64–0.89];
P
=0.001). Compared with NHW patients, Hispanic patients received significantly less cardiac surveillance at the 6‐month (OR, 0.84 [95% CI, 0.72–0.98];
P
=0.03) and 12‐month (OR, 0.85 [95% CI, 0.74–0.98];
P
=0.03) time points, respectively.

Conclusions
There were significant racial and ethnic differences in cardiac surveillance among survivors of cancer at baseline and following anthracycline‐based treatment in NHB and Hispanic cohorts. Health care providers need to be cognizant of these social inequities and initiate efforts to ensure recommended cardiac surveillance occurs following anthracyclines.
Significant Delayed Activation on the Right Ventricular Outflow Tract Represents Complete Right Bundle‐Branch Block Pattern in Brugada Syndrome
Authors: Morimoto Yoshimasa , Morita Hiroshi , Ejiri Kentaro , Mizuno Tomofumi , Masuda Takuro , Ueoka Akira , Asada Saori , Miyamoto Masakazu , Kawada Satoshi , Nakagawa Koji , Nishii Nobuhiro , Nakamura Kazufumi , Ito Hiroshi 
Published: May 2023

Background
The appearance of complete right bundle‐branch block (CRBBB) in Brugada syndrome (BrS) is associated with an increased risk of ventricular fibrillation. The pathophysiological mechanism of CRBBB in patients with BrS has not been well established. We aimed to clarify the significance of a conduction delay zone associated with arrhythmias on CRBBB using body surface mapping in patients with BrS.

Methods and Results
Body surface mapping was recorded in 11 patients with BrS and 8 control patients both with CRBBB. CRBBB in control patients was transiently exhibited by unintentional catheter manipulation (proximal RBBB). Ventricular activation time maps were constructed for both of the groups. We divided the anterior chest into 4 areas (inferolateral right ventricle [RV], RV outflow tract [RVOT], intraventricular septum, and left ventricle) and compared activation patterns between the 2 groups. Excitation propagated to the RV from the left ventricle through the intraventricular septum with activation delay in the entire RV in the control group (proximal RBBB pattern). In 7 patients with BrS, excitation propagated from the inferolateral RV to the RVOT with significant regional activation delay. The remaining 4 patients with BrS showed a proximal RBBB pattern with the RVOT activation delay. The ventricular activation time in the inferolateral RV was significantly shorter in patients with BrS without a proximal RBBB pattern than in control patients.

Conclusions
The CRBBB morphology in patients with BrS consisted of 2 mechanisms: (1) significantly delayed conduction in the RVOT and (2) proximal RBBB with RVOT conduction delay. Significant RVOT conduction delay without proximal RBBB resulted in CRBBB morphology in patients with BrS.
Peptidase Inhibitor 16 Attenuates Left Ventricular Injury and Remodeling After Myocardial Infarction by Inhibiting the HDAC1‐Wnt3a‐β‐Catenin Signaling Axis
Authors: Wang Luyang , Du Anning , Lu Yan , Zhao Yunxi , Qiu Ming , Su Zhenyang , Shu Huanyu , Shen Hui , Sun Wei , Kong Xiangqing 
Published: May 2023

Background
Myocardial infarction (MI) is a cardiovascular disease with high morbidity and mortality. PI16 (peptidase inhibitor 16), as a secreted protein, is highly expressed in heart diseases such as heart failure. However, the functional role of PI16 in MI is unknown. This study aimed to investigate the role of PI16 after MI and its underlying mechanisms.

Methods and Results
PI16 levels after MI were measured by enzyme‐linked immunosorbent assay and immunofluorescence staining, which showed that PI16 was upregulated in the plasma of patients with acute MI and in the infarct zone of murine hearts. PI16 gain‐ and loss‐of‐function experiments were used to investigate the potential role of PI16 after MI. In vitro, PI16 overexpression inhibited oxygen–glucose deprivation–induced apoptosis in neonatal rat cardiomyocytes, whereas knockdown of PI16 exacerbated neonatal rat cardiomyocyte apoptosis. In vivo, left anterior descending coronary artery ligation was performed on PI16 transgenic mice, PI16 knockout mice, and their littermates. PI16 transgenic mice showed decreased cardiomyocyte apoptosis at 24 hours after MI and improved left ventricular remodeling at 28 days after MI. Conversely, PI16 knockout mice showed aggravated infract size and remodeling. Mechanistically, PI16 downregulated Wnt3a (wingless‐type MMTV integration site family, member 3a)/β‐catenin pathways, and the antiapoptotic role of PI16 was reversed by recombinant Wnt3a in oxygen–glucose deprivation–induced neonatal rat cardiomyocytes. PI16 also inhibited HDAC1 (class I histone deacetylase) expression, and overexpression HDAC1 abolished the inhibition of apoptosis and Wnt signaling of PI16.

Conclusions
In summary, PI16 protects against cardiomyocyte apoptosis and left ventricular remodeling after MI through the HDAC1‐Wnt3a‐β‐catenin axis.
The Belligerent Bear: Russia, Status Orders, and War
Authors: Røren Pål 
Published: May 2023

Abstract
Do states get higher social status from fighting? The prestige of war depends on the type of “status order” that it is interpreted in. Status orders condition and enable the pursuit and recognition of status within social clubs of world politics. Depending on the status order, social clubs may either value or stigmatize belligerence. An analysis comparing the status recognition that Russia received in three social clubs (the great power club, the G-8, and the UN Security Council) after it annexed Crimea and invaded eastern Ukraine in 2014 explores this assumption. The analysis shows that war generated different status effects on Russia's status within each of these clubs. Contrary to popular belief, and amid widespread condemnation, Russia was increasingly recognized as a great power within U.S. public discourse. In contrast, Russia's belligerence diminished its status within the G-8 and had little effect on its status in the UN Security Council. The findings underline the importance of context in estimating status effects of participating in wars and any other behavior that might impact a state's standing in world politics.
The Path to Atonement: West Germany and Israel after the Holocaust
Authors: Bachleitner Kathrin 
Published: May 2023

Abstract
Atonement is a state practice that comprises an official political apology and the offer of reparation payments to former victims of mass atrocities, war crimes, and human rights abuses. Despite being considered the moral and right thing to do, atonement has occurred only once at the state level: between West Germany and Israel in 1952. Whereas existing explanations view the West German pathway after the Holocaust as either an ethical choice or a domestic policy induced by U.S. pressure, atonement can also be a political decision. Politicians may give official apologies and pay reparations because such practices promise tangible political benefits. An investigation of the West German–Israeli case and a comparison with two non-atoning perpetrators of World War II, Austria and Japan, illustrate the plausibility of these claims. Atonement emerged as a bilateral strategy between West Germany and Israel because it represented a politically expedient option for both countries. This finding offers insights into when politicians may pursue atonement in other cases and points to a potential avenue toward long-term international stability and durable peace.
Estradiol and the Catechol-o-methyltransferase Gene Interact to Predict Working Memory Performance: A Replication and Extension
Authors: Louis Courtney C. , Jacobs Emily , D'Esposito Mark , Moser Jason 
Published: May 2023

Abstract
Decades of evidence across taxa have established the importance of dopamine (DA) signaling in the pFC for successful working memory performance. Genetic and hormonal factors can shape individual differences in prefrontal DA tone. The catechol-o-methyltransferase (COMT) gene regulates basal prefrontal DA, and the sex hormone 17β-estradiol potentiates DA release. E. Jacobs and M. D’Esposito [Estrogen shapes dopamine-dependent cognitive processes: Implications for women’s health. Journal of Neuroscience, 31, 5286–5293, 2011] investigated the moderating role of estradiol on cognition using the COMT gene and COMT enzymatic activity as a proxy for pFC DA tone. They found that increases in 17β-estradiol within women at two time points during the menstrual cycle influenced working memory performance in a COMT-dependent manner. Here, we aimed to replicate and extend the behavioral findings of Jacobs and D'Esposito by employing an intensive repeated-measures design across a full menstrual cycle. Our results replicated the original investigation. Within-person increases in estradiol were associated with improved performance on 2-back lure trials for participants with low basal levels of DA (Val/Val carriers). The association was in the opposite direction for participants with higher basal levels of DA (Met/Met carriers). Our findings support the role of estrogen in DA-related cognitive functions and further highlight the need to consider gonadal hormones in cognitive science research.
Altered State of Consciousness and Mental Imagery as a Function of N, N-dimethyltryptamine Concentration in Ritualistic Ayahuasca Users
Authors: Ramaekers Johannes G. , Mallaroni Pablo , Kloft Lilian , Reckweg Johannes T. , Toennes Stefan W. , van Oorsouw Kim , Mason Natasha L. 
Published: May 2023

Abstract
Consumption of the psychedelic brew ayahuasca is a central ritualistic aspect of the Santo Daime religion. The current observational, baseline controlled study was designed to assess whether members (n = 24) of the Santo Daime church would show enhanced capacity for mental imagery during an ayahuasca experience. In addition, this study assessed whether the effects of ayahuasca on consciousness and mental imagery were related to peak serum concentration of N, N-dimethyltryptamine (DMT), the main psychoactive component. Measures of altered states of consciousness (5-Dimensional Altered States of Consciousness Questionnaire) and ego dissolution (Ego Dissolution Inventory [EDI]) as well as measures of mental imagery (visual perspective shifting, vividness of visual imagery, cognitive flexibility, associative thinking) were taken on two subsequent days on which members of Santo Daime were sober or drank a self-selected volume of ayahuasca. Measures of altered states of consciousness revealed that feelings of oceanic boundlessness, visual restructuralization, and EDI increased most prominently after drinking and shared a positive correlation with peak DMT concentration. Measures of mental imagery did not noticeably differ between the baseline and ayahuasca condition, although subjective ratings of cognitive flexibility were lower under ayahuasca. Two measures related to mental imagery, that is, perspective shifts and cognitive flexibility, were significantly correlated to peak DMT concentrations. Peak concentrations of DMT and other alkaloids did not correlate with ayahuasca dose. These findings confirm previous notions that the primary phenomenological characteristics of ayahuasca are driven by DMT. Compensatory or neuroadaptive effects associated with long-term ayahuasca intake may have mitigated the acute impact of ayahuasca in Santo Daime members on mental imagery.
Things That Sing: The Liveliness of Vessels in Early Greek Art and Poetry
Authors: Steiner Deborah T. 
Published: May 2023

Abstract
At the outset of Olympian 7, Pindar figures the ode currently being performed to the phorminx and pipes as an all-gold phiale ‘plashing within with the dew of the vine’ (1–12); elsewhere, the poetic voice addresses his chorodidaskalos as a ‘sweet kratēr of loudly-sounding songs’ (Ol. 6.91). This paper proposes that we take these equations between songs and cups, bowls, and containers more generally at the most literal level: as my discussion of protome cauldrons, kraters, and kylikes demonstrates, early Greek artists and craftsmen created a series of manufactured goods that through their materiality, their functions, modes of deployment, and their iconography invited viewers and users to perceive them as artefacts endowed with music- and song-making powers largely independent of human agency. Using the insights of New Materialism and Posthumanism, my close scrutiny of the three types of vessels, together with texts describing these, permits us to discern their musical emissions, vocal and instrumental both, and alerts us to the ways in which music was conceived while even prompting us to recreate something of its lost sonorities.
War-Canoes and Poisoned Arrows
Authors: Winter Cameron 
Published: May 2023

Abstract
The paper examines the repulse of fifteenth century Portuguese slave raids in the Senegambia by the armed forces of the empires of Great Jolof and Imperial Mali, within the context of the ongoing Military Revolution debate and with an emphasis on the military organization and weaponry deployed by both sides. Despite the claims of some historians about early European advantages in naval warfare, any such superiority on the part of the European vessels was not demonstrated in these encounters, with the war-canoes and poisoned arrows of the Jolof and Malian marines proving highly effective against the caravels, cannons, and crossbows of the Portuguese sailors. The African militaries of the Senegambia region were well-organized, well-disciplined, and more than capable of defeating European marauders. If Europeans did develop notable military advantages over West Africans in the sixteenth century, they had not yet begun to do so in the fifteenth.
Effect of Early Versus Delayed Laparoscopic Cholecystectomy on Postoperative Morbidity and Difficult Cholecystectomy in Patients With Grade II Cholecystitis According to Tokyo 2018 Guidelines: A Prospective Study
Authors: Kilinc Tuncer Gizem , Tuncer Korhan , Sert Ismail , Emiroglu Mustafa 
Published: May 2023

Background The timing of the cholecystectomy in patients with acute cholecystitis is still controversial. In our study, we aimed to investigate the effect of early and delayed cholecystectomy on difficult cholecystectomy, morbidity and mortality in patients diagnosed with Grade II acute cholecystitis according to Tokyo 2018 guidelines. Methods Patients who presented to the emergency department and diagnosed with Grade II acute cholecystitis between December 2019 and June 2021 were included in this study. Cholecystectomy was performed within 7 days and 6 weeks after symptom onset. The effect of early and delayed cholecystectomy was observed. Results A total of 92 patients were included in the study. The timing of cholecystectomy was not a risk factor for mortality, morbidity and difficult cholecystectomy. The conversion rate was higher in delayed group ( P = .007). The bleeding was significantly higher in early group ( P = .033). Total hospital stay was higher in delayed group ( P < .001). CRP was a predictive parameter for increased Parkland score in early group ( P < .001). Conclusions Delayed cholecystectomy does not facilitate cholecystectomy in patients with Grade II acute cholecystitis. Early cholecystectomy can be performed safely and high CRP levels can be used to determine difficult cholecystectomy in early period.