bluuebunny/crossref_metadata_2025_split huggingface dataset:
Left Atrial Strain in the Assessment of Diastolic Function in Heart Failure: A Machine Learning Approach
Authors: Carluccio Erberto , Cameli Matteo , Rossi Andrea , Dini Frank Lloyd , Biagioli Paolo , Mengoni Anna , Jacoangeli Francesca , Mandoli Giulia Elena , Pastore Maria Concetta , Maffeis Caterina , Ambrosio Giuseppe 
Published: February 2023

Background:
Diastolic dysfunction (DD) assessment in heart failure is still challenging. Peak atrial longitudinal strain (PALS) is strongly related to end-diastolic pressure and prognosis, but it is still not part of standard DD assessment. We tested the hypothesis that a machine learning approach would be useful to include PALS in DD classification and refine prognostic stratification.

Methods:
In a derivation cohort of 864 heart failure patients in sinus rhythm (age, 66.6±12 years; heart failure with reduced ejection fraction, n=541; heart failure with mildly reduced ejection fraction, n=129; heart failure with preserved ejection fraction, n=194), machine learning techniques were retrospectively applied to PALS and guideline-recommended diastolic variables. Outcome (death/heart failure rehospitalization) of the identified DD-clusters was compared with that by guidelines-based classification. To identify the best combination of variables able to classify patients in one of the identified DD-clusters, classification and regression tree analysis was applied (with DD-clusters as dependent variable and PALS plus guidelines-recommended diastolic variables as explanatory variables). The algorithm was subsequently validated in a prospective cohort of 189 heart failure outpatients (age, 65±13 years).

Results:

Three distinct echocardiographic DD-clusters were identified (cluster-1, n=212; cluster-2, n=376; cluster-3 DD, n=276), with modest agreement with guidelines-recommended classification (kappa=0.40;
P
<0.001). DD-clusters were predicted by a simple algorithm including E/A ratio, left atrial volume index, E/e′ ratio, and PALS. After 36.5±29.4 months follow-up, 318 events occurred. Compared to guideline-based classification, DD-clusters showed a better association with events in multivariable models (C-index 0.720 versus 0.733,
P
=0.033; net reclassification improvement 0.166 [95% CI, 0.035–0.276],
P
=0.013), without interaction with ejection fraction category. In the validation cohort (median follow-up: 18.5 months), cluster-based classification better predicted outcome than guideline-based classification (C-index 0.80 versus 0.78,
P
=0.093).

Conclusions:
Integrating PALS by machine learning algorithm in DD classification improves risk stratification over recommended current criteria, regardless of ejection fraction status. This proof of concept study needs further validation of the proposed algorithm to assess generalizability to other populations.
Burden of Hypertensive Crisis in Patients With End-Stage Kidney Disease on Maintenance Dialysis: Insights From United States Renal Data System Database
Authors: Pothuru Suveenkrishna , Chan Wan-Chi , Mehta Harsh , Vindhyal Mohinder R. , Ranka Sagar , Hu Jinxiang , Yarlagadda Sri G , Wiley Mark A. , Hockstad Eric , Tadros Peter N , Gupta Kamal 
Published: February 2023

Background:
There is paucity of information on the incidence, clinical characteristics, admission trends, and outcomes of hypertensive crisis (HTN-C) in patients with end-stage kidney disease (ESKD) who are on maintenance dialysis.

Methods:
We conducted a retrospective observational study of HTN-C admissions in patients with end-stage kidney disease using the United States Renal Data System. We identified patients with end-stage kidney disease aged ≥18 years on dialysis and were hospitalized for HTN-C from January 2006 to August 2015.

Results:

A total of 54 483 patients with end-stage kidney disease were hospitalized for HTN-C during the study period. After study exclusions, 37 214 patients were included in the analysis. A majority of patients were Black, there were more women than men and the South region of the country accounted for a great majority of patients. During the study period, hospitalization rates increased from 1060 per 100 000 beneficiary years to 1821 (
P
trend
<0.0001). Overall, in-hospital mortality, 30-day, and 1-year mortality were 0.6%, 2.3%, and 21.8%, respectively, and 30-day readmission rate was 31.1%. During the study period, most study outcomes showed a significant decreasing trend (in-hospital mortality 0.6%–0.5%, 30-day mortality 2.4%–1.9%, 1-year mortality 23.9%–19.7%,
P
trend
<0.0001 for all).

Conclusions:
Hospitalizations for HTN-C have increased consistently during the decade studied. Although temporal trends showed improving mortality and readmission rates, the absolute rates were still high with 1 in 3 patients readmitted within 30 days and 1 in 5 patients dying within 1 year of index hospitalization.
The Role of Coupled North Pacific Atmosphere–Ocean Interactions in Impacts of Tibetan Plateau Snow Anomalies on the Northern Hemisphere Winter Atmospheric Circulation
Authors: Liu Shizuo , Wu Qigang , Yao Yonghong , Schroeder Steven R. 
Published: February 2023

Abstract
Previous studies indicate observed influences of autumn and winter Tibetan Plateau (TP) snow-cover anomalies on the winter Pacific–North American (PNA) teleconnection. This study simulates atmospheric and oceanic responses to persistent autumn–winter TP snow forcing using an atmospheric general circulation model (AGCM) and a coupled atmospheric-oceanic general circulation model (AOGCM), and quantifies the role of atmosphere–ocean interactions over North Pacific in TP snow effects. The AOGCM experiment induces a stronger and more realistic remote PNA response to heavy TP snow anomalies, and also a significant winter horseshoe-like North Pacific sea surface temperature (SST) pattern resulting from an anomalous equivalent barotropic cyclone, or a strengthened Aleutian low, with associated cyclonic wind stress anomalies. The horseshoe-like SST anomaly pattern is used as boundary forcing (without prescribed heavy TP snow) in another AOGCM experiment, which simulates an enhanced winter Aleutian low and a PNA-like response similar to the original AOGCM responses, indicating that that the direct Pacific–North American atmospheric response to persistent TP snow forcing in the AGCM is amplified in the AOGCM by the North Pacific midlatitude atmosphere–ocean interactions. This suggests that the mechanisms of the winter PNA responses to TP snow forcing involve dynamical atmospheric processes such as horizontal propagation of Rossby wave energy and transient eddy feedbacks, and also North Pacific atmosphere–ocean interactions, which provide a positive feedback on the development of the remote PNA teleconnection.

Significance Statement
The Tibetan Plateau has a 2.5 million km2 area and a 4000 m average elevation, and is often called “the third pole” because of its polar-like climate in midlatitude Eurasia. A heavy Tibetan Plateau snow cover increases the albedo effect and causes tropospheric cold temperature and low height changes that can be carried or advected to the North Pacific by the prevailing westerlies. The purpose of this study is to better understand how Tibetan Plateau snow anomalies influence the North Pacific and the remote atmospheric circulation through numerical simulations. Our results find that those North Pacific responses amply the direct atmospheric response to Tibetan Plateau snow-cover anomalies. This greatly improves our understanding of physical mechanisms of Tibetan Plateau snow impacts.
Terdiurnal Radiational Tides
Authors: Ray R. D. , Boy J.-P. , Erofeeva S. Y. , Egbert G. D. 
Published: February 2023

Abstract
Terdiurnal atmospheric tides induce an S3 radiational ocean tide, similar to radiational tides S1 and S2 in the diurnal and semidiurnal bands. Although of small amplitude, the terdiurnal tide has some intriguing properties. The tide has an unusually pronounced seasonal variation, manifested by annual sidelines here denoted R3 and T3, which causes the tide to nearly vanish during times near an equinox. Forcing is generally largest in the winter hemisphere. Complicating matters, the two sideline frequencies coincide with those of nonlinear compound tides SK3 and SP3. Whether radiational tides or nonlinear tides (or both) are appearing at any given tide gauge can usually be determined by the relative amplitudes and phase differences of the two sidelines. The amplitudes of R3 and T3 are generally comparable; the amplitudes of SK3 and SP3 are not. Proper identification can lead to a small improvement in tidal prediction, but more importantly can lead to improved physical interpretation. An example from recent measurements under the Ross Ice Shelf bears on the role of nonlinearity in interactions between the ocean tide and the floating ice shelf.
Comparison between the Operational and Statistical Daily Maximum and Minimum Temperature Forecasts on the Central Coast of Peru
Authors: Aliaga-Nestares Vannia , De La Cruz Gustavo , Takahashi Ken 
Published: February 2023

Abstract
Multiple linear regression models were developed for 1–3-day lead forecasts of maximum and minimum temperature for two locations in the city of Lima, on the central coast of Peru (12°S), and contrasted with the operational forecasts issued by the National Meteorological and Hydrological Service—SENAMHI and the output of a regional numerical atmospheric model. We developed empirical models, fitted to data from the 2000–13 period, and verified their skill for the 2014–19 period. Since El Niño produces a strong low-frequency signal, the models focus on the high-frequency weather and subseasonal variability (60-day cutoff). The empirical models outperformed the operational forecasts and the numerical model. For instance, the high-frequency annual correlation coefficient and root-mean-square error (RMSE) for the 1-day lead forecasts were 0.37°–0.53° and 0.74°–1.76°C for the empirical model, respectively, but from around −0.05° to 0.24° and 0.88°–4.21°C in the operational case. Only three predictors were considered for the models, including persistence and large-scale atmospheric indices. Contrary to our belief, the model skill was lowest for the austral winter (June–August), when the extratropical influence is largest, suggesting an enhanced role of local effects. Including local specific humidity as a predictor for minimum temperature at the inland location substantially increased the skill and reduced its seasonality. There were cases in which both the operational and empirical forecast had similar strong errors and we suggest mesoscale circulations, such as the low-level cyclonic vortex over the ocean, as the culprit. Incorporating such information could be valuable for improving the forecasts.

Significance Statement
We wanted to compare the temperature of the operational forecast of the Meteorological and Hydrological Service, an atmospheric model, and persistence with the observed temperatures on the Peruvian central coast. In addition, we generated an empirical forecast model considering both atmospheric and local predictors. We got better results with this empirical model, considering the highest Pearson correlations and the lowest RMSE values. These results will allow us to use this empirical model as the main tool to automate the forecast on the central coast of Peru. Future work should be aimed at testing the skill of this model for forecasting in other cities of Peru.
Comparison of faecal calprotectin using two collection and extraction strategies for the BÜHLMANN CALEX® Cap – possible implications for clinical cut-offs?
Authors: Bruce Helen , Osypiw Jacqueline , Prajapati-Jha Geeta , O’Driscoll Shane , Brealey Martin , Benton Sally C 
Published: February 2023

Background Faecal calprotectin has been identified as a useful biochemical marker in the differentiation of inflammatory bowel disease and irritable bowel syndrome. Typically, patients send faecal specimens in a pot for manual extraction by the laboratory. During the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV-2) pandemic, the routine laboratory service was temporarily suspended due to the potential increased risk to staff. In this study we investigated the possibility of patients collecting samples directly into the faecal extraction tubes. Method Patients submitted paired faecal samples for calprotectin analysis using a standard faecal container (current practice) and followed instructions for faecal collection using the BÜHLMANN CALEX® Cap device. Samples were returned to the laboratory immediately after collection. Laboratory staff manually extracted the calprotectin from the faecal samples using the CALEX® Cap prior to analysis of both extracts on the Cobas c702. Results 91 paired faecal samples were included in the study. Clinical correlation was found to be 70% with numerical correlation showing a positive bias for the patient-collected CALEX® Cap sample when compared to the laboratory-extracted faecal sample around the clinical decision points 100–250 μg calprotectin/g faeces. Conclusion The study shows that collection of a faecal sample using the CALEX® Cap works well and is a good alternative to using standard containers. The correlation gives rise to the possibility that faecal calprotectin is not stable when collected into standard collection containers. Prior to further roll-out of this process, questions surrounding the current cut-offs would need to be addressed.
The prevalence of substance use disorders and associated characteristics among patients admitted to a psychiatric hospital in Botswana
Authors: Otlhapile Othalefile E. , Gitau Catherine W. , Kuria Mary W. 
Published: February 2023

Objective Substance use disorders (SUDs) have increased substantially across the globe, and has become one of the world’s most significant public health and socioeconomic challenge. This study examined the prevalence and patterns of substance use disorders among patients admitted to the main psychiatric hospital in Botswana, the Sbrana Psychiatric Hospital. Method This was a cross-sectional study of patients admitted to a major psychiatric hospital in Botswana. SUDs were assessed using the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) v13.0. Bivariate analysis was conducted to determine the association between socio-demographic characteristics and SUDs. Multivariate logistic regression was used to control for confounders. Results The final analysis involved 101 patients. Participants ranged in age from 18-60 years, and over half (59.4%) were male. The majority of participants (85.1%) had used potentially addicting substances at least once during their lifetime, with 63.4% having current substance use disorders. The most frequently used substances were tobacco, cannabis, alcohol, and cocaine at 58.4%, 42.6%, 34.7% and 12.8% respectively. SUDs were more common among participants who were male, ages 18–35 years, single, had a tertiary education, or were unemployed. Conclusions There is a high prevalence of substance use and SUDs among psychiatric patients in Botswana. Screening for and interventions to manage SUDs should be part of routine care at psychiatric health care facilities in this country. Consideration should be given to the screening of all patients admitted to psychiatric hospitals in Botswana for SUDs using the ASSIST.
Radical Reorganization of Environmental Policy: Contemporaneous Evidence from Brazil
Authors: Capelari Mauro Guilherme Maidana , Pereira Ana Karine , Rivera Nathaly M. , de Araújo Suely Mara Vaz Guimaráes 
Published: February 2023

An overview of environmental policy in Brazil since President Jair Bolsonaro took office in January 2019 suggests that the rise to power of a new political elite has led to a radical change in Brazil’s trajectory of climate change initiatives and environmental protection. The new elite is associated with the disruption of two factors historically relevant for the design of environmental policy: the participation of civil society in the governance of public policy and multilateralism in matters of environment policy. Uma análise das políticas ambientais brasileiras desde a tomada de posse de Jair Bolsonaro da presidência da República em Janeiro 2019 constata que o aparecimento de uma nova elite política acarretou em uma alteração radical na trajetória do Brasil com respeito às suas iniciativas sobre a mudança climática e a preservação ambiental. Houve uma perturbação de dois fatores por causa desta elite política que eram historicamente importantes pela elaboração de políticas ambientais: a participação de organizações de sociedade civil na governança de políticas públicas e o multilateralismo.
Between Markets and Barracks: The Economic Policy Narrative of Brazilian Authoritarianism
Authors: Søndergaard Niels 
Published: February 2023

In recent years, a series of right-wing populists has ascended to power in both the Global North and the Global South. While these leaders frequently have provided challenges to liberal democracy, neoliberal modes of economic governance have often been part of their agendas. Analysis of the economic policy narrative of the Brazilian President Jair Bolsonaro’s electoral campaign in 2018 through the theoretical lens of authoritarian neoliberalism reveals that it has worked by the relegation of economic matters to technocratic management outside the sphere of democratic debate and the instrumentalized estrangement of groups and institutions opposed to his political views. Recentemente, uma série de populistas direitistas têm chegado ao poder tanto nos países do norte como naqueles do sul. Enquanto estes lideres frequentemente apresentam desafios às democrâcias liberais, modos neoliberais de governança econômica muitas vezes desempenham um papel nas suas agendas. Uma análise da narrativa da política econômica na campanha presidencial do Presidente Jair Bolsonaro no Brasil em 2018 mediante uma visão teorética de neoliberalismo autoritário indica que ela funcionou pela relegação de assuntos econômicos a gestores tecnocrâticos que ficam fora da esféra de debate democrâtico e pelo afastamento instrumentalizado de grupos e instituições que se opõem às idéias políticas de Bolsonaro.
Morbid obesity’s impact on COVID-19 patients requiring venovenous extracorporeal membrane oxygenation: The covid-19 critical care consortium database review
Authors: Javidfar Jeffrey , Zaaqoq Akram M , Labib Ahmed , Barnett Adrian G , Hayanga JW Awori , Eschun Greg , Yamashita Michael H , Jacobs Jeffrey P , Heinsar Silver , Suen Jacky Y , Fraser John F , Bassi Gianluigi Li , Arora Rakesh C , Peek Giles J ,   on behalf of the Covid-19 Critical Care Consortium (COVID Critical)
Published: February 2023

Introduction: Obesity is associated with a worse prognosis in COVID-19 patients with acute respiratory distress syndrome (ARDS). Veno-venous (V-V) Extracorporeal Membrane Oxygenation (ECMO) can be a rescue option, however, the direct impact of morbid obesity in this select group of patients remains unclear. Methods: This is an observational study of critically ill adults with COVID-19 and ARDS supported by V-V ECMO. Data are from 82 institutions participating in the COVID-19 Critical Care Consortium international registry. Patients were admitted between 12 January 2020 to 27 April 2021. They were stratified based on Body Mass Index (BMI) at 40 kg/m2. The endpoint was survival to hospital discharge. Results: Complete data available on 354 of 401 patients supported on V-V ECMO. The characteristics of the high BMI (>40 kg/m2) and lower BMI (≤40 kg/m2) groups were statistically similar. However, the ‘high BMI’ group were comparatively younger and had a lower APACHE II score. Using survival analysis, older age (Hazard Ratio, HR 1.49 per-10-years, CI 1.25–1.79) and higher BMI (HR 1.15 per-5 kg/m2 increase, CI 1.03–1.28) were associated with a decreased patient survival. A safe BMI threshold above which V-V ECMO would be prohibitive was not apparent and instead, the risk of an adverse outcome increased linearly with BMI. Conclusion: In COVID-19 patients with severe ARDS who require V-V ECMO, there is an increased risk of death associated with age and BMI. The risk is linear and there is no BMI threshold beyond which the risk for death greatly increases.
Radiological and Histological Analyses of Nonrigid Versus Rigid Fixation for Free Bone Block Procedures in a Rabbit Model of Glenoid Defects
Authors: Xu Junjie , Wu Chenliang , Han Kang , Zhang Xueying , Ye Zipeng , Jiang Jia , Yan Xiaoyu , Su Wei , Zhao Jinzhong 
Published: February 2023

Background: Nonrigid fixation techniques have been recently introduced in free bone block (FBB) procedures to treat substantial glenoid bone loss in patients with anterior shoulder instability. However, the radiological and histological effectiveness of nonrigid fixation versus conventional rigid fixation have not been comprehensively understood in vivo. Purpose: To (1) explore the radiological and histological characteristics of nonrigid fixation for FBB procedures in a rabbit model of glenoid defects and (2) further compare them with those of conventional rigid fixation. Study Design: Controlled laboratory study. Methods: Unilateral shoulder glenoid defects were created in 36 mature New Zealand White rabbits, of which 24 underwent FBB procedures using allogenic iliac crest bone and were randomly divided into rigid fixation (RF) and nonrigid fixation (N-RF) groups, with the remaining divided into 2 control groups: 6 with sham surgery for glenoid defects (GD group) and 6 native glenoids (normal group). In the RF and N-RF groups, 6 rabbits were sacrificed at 6 or 12 weeks postoperatively for radiological and histological analyses of the reconstructed glenoid, and all rabbits in the GD and normal groups were sacrificed at 12 weeks. The radiological glenoid morphology was evaluated via micro–computed tomography. Moreover, the graft-glenoid healing and graft remodeling processes were determined using histological staining. Results: At 6 weeks, both the N-RF and RF groups had similarly improved radiological axial radian and en face area of the glenoid compared with the GD group, but the N-RF group showed superiority in restoration of the glenoid radian and area compared with the RF group at 12 weeks, with the native glenoid as the baseline. Histologically, the bone graft in both groups was substantively integrated into the deficient glenoid neck at 6 and 12 weeks, showing similar osseous healing processes at the graft-glenoid junction. Moreover, the bone graft histologically presented similar regenerated vascular density, total graft bone, and integrated graft bone in both groups. In contrast, the N-RF group had a different remodeling profile on radiological and histological analyses regarding regional bone resorption, mineralization, and fibrous tissue replacement during osseointegration. Conclusion: Compared with rigid fixation, nonrigid fixation resulted in superior reconstructed glenoid morphology radiologically and similar graft-glenoid osseous healing histologically, showing different graft remodeling profiles of regional bone resorption, mineralization, and fibrous tissue replacement. Clinical Relevance: The nonrigid fixation technique can be feasible for FBB procedures to treat glenoid bone loss in anterior shoulder instability. More clinical evidence is required to determine its pros and cons compared with conventional rigid fixation.