bluuebunny/crossref_metadata_2025_split huggingface dataset:
Polineuropatia Desmielinizante Inflamatória Crônica: relato de caso
Authors: Hamamoto Amanda Kaori , Cunha Beatriz Ferreira , Koba Luana Nozella Monteiro , Martins Tayla Ranieri , Bagio Tony Maronesi , Lima Eloíza Zacharini de 
Published: July 2023

A Polineuropatia Desmielinizante Inflamatória Crônica é uma doença de caráter progressivo, incapacitante e rara, sendo necessário maior entendimento para melhor abordagem propedêutica e terapêutica, agregando maior qualidade de vida ao paciente. O objetivo deste estudo é relatar o caso de um paciente do sexo masculino, 48 anos com queixa de perda de movimentos de 4º e 5º quirodáctilo bilateral, associado a perda de força de membros superiores há dois meses atendido em Unidade Básica de Saúde. Realizado diagnóstico de Polineuropatia Desmielinizante Inflamatória Crônica em serviço especializado e iniciado tratamento com imunoglobulina. Atualmente encontra-se estável clinicamente com metilprednisolona. O tratamento atual baseia-se na diminuição do processo inflamatório e consequente melhora dos sintomas, entretanto não possui um esquema terapêutico com fortes evidências de superioridade entre as opções disponíveis.
Vitamina D - Aspectos Fisiológicos, Nutricionais, Imunológicos, Genéticos. Ações em doenças autoimunes, tumorais, infecciosas. Funções musculoesqueléticas e cognitivas
Authors: Ruscalleda Regina Maria Innocencio 
Published: July 2023

Vitamina D representa de fato, um hormônio esteroide lipossolúvel com funções endócrinas, parácrinas e autócrinas. Este artigo buscou realizar revisão de aspectos fisiológicos, ambientais, nutricionais e genéticos relacionados a esta vitamina, classificação dos níveis séricos da forma circulante representativa do status, bem locais de armazenamento em tecidos. Sugestões são apresentadas, de acordo com literatura consultada, quanto a hábitos alimentares, exposição solar adequada, suplementação oral e/ou necessidade de doses de manutenção, riscos de toxicidade. Funções imunológicas, imunomoduladoras, participação a nível celular e tecidual em doenças autoimunes, tumorais, infecto-contagiosas, com ênfase ao SARS-CoV-2 também foram abordadas. Entre as inúmeras ações da vitamina D, houve destaque à participação no metabolismo musculoesquelético, ocorrência de quedas, particularmente entre os idosos, sistema nervoso central, com ênfase à cognição, demência, doença de Alzheimer. Aspectos consensuais ou controversos também foram abordados, bem como sugestões de novos estudos a nível mundial para esclarecimento de resultados questionáveis.
First record of Horned Grebe Podiceps auritus (Linnaeus, 1758) (Aves: Passeriformes: Podicipedidae) from Jammu & Kashmir, India
Authors: Zargar Bilal Nasir , Umer Nazir  , Najar Zakir Hussain 
Published: July 2023

The recent literature documented many sightings of Horned Grebe Podiceps auritus in some states of India excluding Jammu & Kashmir. Here we report the first record of the species in the Wular Lake, located in the Union Territory of Jammu & Kashmir, India. During the routine birding, the Horned Grebes were sighted and documented. The head, beak, plumage colour pattern, and longish neck were used to identify the bird. This finding will be a new member to the bird checklist of Jammu & Kashmir.
DASH-HF Study: A Pragmatic Quality Improvement Randomized Implementation Trial for Patients With Heart Failure With Reduced Ejection Fraction
Authors: Verma Aradhana , Fonarow Gregg C. , Hsu Jeffrey J. , Jackevicius Cynthia A. , Vaghaiwalla Mody Freny , Nguyen Amanda , Amidi Omid , Goldberg Sarah , Vetrivel Reeta , Upparapalli Deepti , Theodoropoulos Kleanthis , Gregorio Stephanie , Chang Donald S. , Bostrom Kristina , Althouse Andrew D. , Ziaeian Boback 
Published: July 2023

BACKGROUND:
Heart failure is a prevailing diagnosis of hospitalization and readmission within 6 months, and nearly a quarter of these patients die within a year. Guideline-directed medication therapies reduce risk of mortality by 73% over 2 years; however, the implementation of these therapies to their target dose in clinical practice continues to be challenging. In 2020, the Veterans Affairs (VA) Health Care System developed a HF dashboard to monitor and improve outpatient HF management. The DASH-HF (Dashboard Activated Services and Telehealth for Heart Failure) study is a randomized, pragmatic clinical trial to evaluate proactive dashboard-directed telehealth clinics to improve the use and dosing of guideline-directed medication therapy for patients with heart failure with reduced ejection fraction not on optimal guideline-directed medication therapy within the VA.

METHODS:
Three hundred veterans with heart failure with reduced ejection fraction met inclusion criteria with an optimization potential score (OPS) of 5 or less out of 10, representing nonoptimal guideline-directed medication therapy. The primary outcome was a composite score of guideline-directed medical therapy, the OPS, 6 months after the end of the intervention. Secondary outcomes included active prescriptions for each individual guideline-directed medical therapy class, HF-related hospitalizations, deaths, and clinician time per patient during the intervention clinics.

RESULTS:
There was no significant difference between the intervention arm and usual care group in the primary outcome (OPS, 2.9; SD=2.1 versus OPS, 2.6, SD=2.1); adjusted mean difference 0.3 (95% CI, −0.1 to 0.7) or in the prespecified secondary outcomes for hospitalization and all-cause mortality for the intervention of proactive dashboard-based clinics.

CONCLUSIONS:
A dashboard-based clinic intervention did not improve the OPS or secondary outcomes of hospitalization and all-cause mortality. There remains a larger opportunity to better target patients and provide more intensive follow-up to further evaluate the utility of proactive dashboard-based clinics for HF management and quality improvement.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT05001165.
Patients’ Perspectives Regarding Generator Exchanges of Implantable Cardioverter Defibrillators
Authors: Montembeau Sarah C. , Merchant Faisal M. , Speight Candace , Kramer Daniel B. , Matlock Daniel D. , Horný Michal , Dickert Neal W. , Rao Birju R. 
Published: July 2023

BACKGROUND:
Shared decision-making is mandated for patients receiving primary prevention implantable cardioverter defibrillators (ICDs). Less attention has been paid to generator exchange decisions, although at the time of generator exchange, patients’ risk of sudden cardiac death, risk of procedural complications, quality of life, or prognosis may have changed. This study was designed to explore how patients make ICD generator exchange decisions.

METHODS:
Emory Healthcare patients with primary prevention ICDs implanted from 2013 to 2021 were recruited to complete in-depth interviews exploring perspectives regarding generator exchanges. Interviews were conducted in 2021. Transcribed interviews were qualitatively coded using multilevel template analytic methods. To investigate benefit thresholds for pursuing generator exchanges, patients were presented standard-gamble type hypothetical scenarios where their ICD battery was depleted but their 5-year risk of sudden cardiac death at that time varied (10%, 5%, and 1%).

RESULTS:
Fifty patients were interviewed; 18 had a prior generator exchange, 16 had received ICD therapy, and 17 had improved left ventricular ejection fraction. As sudden cardiac death risk decreased from 10% to 5% to 1%, the number of participants willing to undergo a generator exchange decreased from 48 to 42 to 33, respectively. Responses suggest that doctor’s recommendations are likely to substantially impact patients’ decision-making. Other drivers of decision-making included past experiences with ICD therapy and device implantation, as well as risk aversion. Therapeutic inertia and misconceptions about ICD therapy were common and represent substantive barriers to effective shared decision-making in this context.

CONCLUSIONS:
Strong defaults may exist to continue therapy and exchange ICD generators. Updated risk stratification may facilitate shared decision-making and reduce generator exchanges in very low-risk patients, especially if these interventions are directed toward clinicians. Interventions targeting phenomena such as therapeutic inertia may be more impactful and warrant exploration in randomized trials.
Predicting Region-Dependent Biases in a GOES-16 Machine Learning Precipitation Retrieval
Authors: Goldenstern Eric , Kummerow Christian 
Published: July 2023

Abstract
Despite its long history, improving upon current precipitation estimation techniques remains an active area of research. While many methods exist to assess precipitation, the use of satellites has allowed for near-global observation. However, satellites do not directly sense precipitation, resulting in retrieval uncertainties. Analysis of these uncertainties is typically conducted through validation studies, which, while necessary, are sensitive to local conditions. As such, predicting retrieval uncertainties where there is no validation data remains a challenge. In this study, we propose a method by which validation statistics can be extended to other regions. Using a neural network–style retrieval, the Geostationary Operational Environmental Satellite–16 (GOES-16) Precipitation Estimator using Convolutional Neural Networks (GPE-CNN), we show that, by exploiting the information content of both the satellite and ancillary meteorological data, one can predict large-scale retrieval behaviors over other regions without the need for that region’s validation data. By developing classes using satellite information content, we demonstrate bias prediction improvement of up to 83% relative to a simple extension of mean bias. Including relative humidity information improves the overall prediction by up to 98% relative to the original mean bias. Although limited in scope, this method presents a pathway toward characterizing uncertainties on a broader scale.
Seasonality in the Amplitude of Decadal Variability
Authors: Zheng Fei , Li Jianping , Wang Hao , Li Yuxun , Liu Xiaoning , Wang Rui 
Published: July 2023

Abstract
As the understanding of decadal variability in climate systems deepens, there is a growing interest in investigating the decadal variability of seasonal-mean or monthly mean variables. This study aims to understand the seasonality observed in the amplitude of decadal variability. To accomplish this, we analyze the decadal variability of the monthly mean North Atlantic Oscillation (NAO) index and North Pacific index (NPI) over the past decades using two different calculating processes: the full smoothing (F) process and the seasonal-specific (SS) process. Our findings suggest that the F process only captures the decadal variability of annual-mean variables, whereas the SS process is suited for capturing the seasonality of decadal variability. We find that the seasonality in decadal variability aligns with the seasonality in interannual variability. Additionally, we explore the seasonality in decadal variability in atmospheric and oceanic variables. The seasonality in oceanic decadal variability, including sea surface temperature and salinity, is found to be weak and small. The amplitude of decadal variability in the Pacific decadal oscillation (PDO) is similar across different months, indicating weak seasonality in the PDO. On the other hand, decadal variability of lower-tropospheric atmospheric circulation, including horizontal wind, geopotential height, and surface air temperature, exhibits significant seasonality in the extratropics, with the strongest decadal variability occurring in winter. Moreover, the significant seasonality in decadal variability of precipitation is observed in the tropics, with the strongest decadal variability occurring in summer. Our study provides insights into understanding the seasonality of decadal variability, which can aid in the improvement of decadal prediction of climate variability.

Significance Statement
The amplitude of decadal variability of seasonal-mean or monthly mean variables exhibits seasonality. Our results show that the seasonality in decadal variability is consistent with the seasonality in interannual variability. We also identified that the seasonality in oceanic decadal variability is weak and smaller than that in atmospheric decadal variability. Decadal variability of lower-tropospheric atmospheric circulation exhibits significant seasonality in the extratropics, with the strongest decadal variability occurring in winter. However, the significant seasonality in decadal variability of precipitation occurs in the tropics, with the strongest decadal variability occurring in summer. Our study provides insights into the seasonality of decadal variability in climate systems.
Frost suppression performance of an air source heat pump using sensible heat from indoor air to preheat outdoor air
Authors: Wei Peng , Wang Zhiwei , Feng Hengli , Wang Sheng , Fan Jufang 
Published: July 2023

Frost forms on the surfaces of air source heat pump (ASHP) outdoor heat exchangers under heating mode in winter, when the surface temperature of the heat exchanger is lower than both 0°C and the ambient dew point temperature. This can reduce the coefficient of performance (COP) and heating capacity of the ASHP unit. A novel ASHP was examined using two rooms with the same size, orientation, and structure. To test the frost suppression performance of the novel system, two ASHPs of the same size and specifications, but one including a sensible-heat preheating device, were placed in the test platform rooms. By comparing and analyzing field-measured parameters such as COP, heat loss, and frost weight of the two ASHP units, the frost suppression performance of the novel ASHP was evaluated in severe, moderate, and mild frost areas. The results show that when the air conditions were −3.9°C and 98.7% in the moderate frost area and 3.2°C and 96.7% in the severe frost area, the novel ASHP showed significantly improved performance. The frost formation time increased from 25 min to 38.5 min, frost-defrost heat loss decreased by 31.6%–43.7%, frost weight decreased 11.8%–17.4%, and COP increased 7.4%–13.1% compared with those of the conventional ASHP. In the low temperature and mild frost area, when the air temperature was −11.8°C and the relative humidity was 88.8%, the frost suppression effect of the novel ASHP was unapparent. Affected by the climate, the operation performance of ASHP will be different. Different ASHP can be used to adapt to the weather in different regions. The novel ASHP can significantly suppress frost and improve the heating performance of the unit in the mild climate and frost serious areas.
Accurate protamine:heparin matching (not just smaller protamine doses) decreases postoperative bleeding in cardiac surgery; results from a high-volume academic medical center
Authors: Vespe Michael W , Stone Marc E , Lin Hung-Mo , Ouyang Yuxia 
Published: July 2023

Background A multidisciplinary Quality Assurance/Performance Improvement study to identify the incidence of “heparin rebound” in our adult cardiac surgical population instead detected a thromboelastometry pattern suggestive of initial protamine overdose in 34% despite Hepcon-guided anticoagulation management. Analysis of our practice led to an intervention that made an additional lower-range Hepcon cartridge available to the perfusionists. Methods One year later, an IRB-approved retrospective study was conducted in >500 patients to analyze the effects of the intervention, specifically focusing on the impact of the initial protamine dose accuracy and 18-h mediastinal chest tube drainage (MCTd). Results No differences were observed between group demographics, surgical procedures, duration of CPB or perioperative blood product transfusion. Both groups were managed using the same perfusion and anesthesia equipment, strategies, and protocols. The median initial protamine dose decreased by 19% ( p < .001) in the intervention group (170 [IQR 140–220] mg; n = 295) versus the control group (210 [180–250] mg; n = 257). Mean 18-h MCTd decreased by 13% ( p < .001) in the intervention group (405.15 ± 231.54 mL; n = 295) versus the control group (466.13 ± 286.73 mL; n = 257). Covariate-adjusted mixed effects model showed a significant reduction of MCTd in the intervention group, starting from hour 11 after surgery (group by time interaction p = .002). Conclusion Though previous investigators have associated lower protamine doses with less MCTd, this study demonstrates that more accurately matching the initial protamine dose to the remaining circulating heparin concentration reduces postoperative bleeding.
Silicone oil tamponade induced vasculitis- a rare manifestation of toxic posterior segment syndrome
Authors: Simakurthy Sriram , Kumar Madhu , Jain Hiteshi , Kanakamedala Ashok , Gudimetla Jayamadhury 
Published: July 2023

Aim To report silicone oil tamponade induced vasculitis in the early post operative period - a rare manifestation of ‘Toxic Posterior Segment Syndrome’ after pars plana vitrectomy for rhegmatogenous retinal detachment. Case description A 50-year-old gentleman presented with vasculitis after a pars plana vitrectomy with silicone oil tamponade on the first post-operative day. He was started on oral steroids (1 mg/ kg) tapered sequentially every week. All signs of vasculitis resolved over a period of one month after which the silicone oil was removed. The patient maintained a visual acuity of 20/90 even after 3 months. There was no recurrence of vasculitis observed thereafter. Conclusion Silicone oil induced vasculitis is a rarely described entity, especially as a manifestation of toxic posterior segment syndrome. This differential must be kept in mind even on the first post-operative day in cases where silicone oil has been used for tamponade.
Chinese and Western Integrative Medicine for Stage IIIb-IVb Non-Small Cell Lung Cancer: Design and Rationale of a Multi-center, Prospective Registry (NSCLC-Chinese and Western Integrative Medicine cohort)
Authors: Lin Jietao , Sun Lingling , Chen Hanrui , Chen Wenmin , Zhang Zexin , Cao Yang , Lin Lizhu 
Published: July 2023

Introduction: This planned multicenter observational study will evaluate the overall survival of those undergoing integrated Chinese and Western medicine for stage IIIb-IVb non-small cell lung cancer and analyze the factors related to the prognosis. Method and Analysis: The prospective cohort will enroll patients with stage IIIb-IVb NSCLC from March 1, 2019, to December 31, 2025, and follow them for 5 years. We plan to collect data on the patients’ demographics, treatment, overall survival, and factors related to the prognosis. Ethics and Dissemination: The institutional review board and ethics committee reviewed the study protocol. All patients will provide informed consent before enrollment. Trial registration number: ChiCTR1900021430
Cognitive Adaptation to Stress and Trauma: The Role of Self-Appraised Problem-Solving in Posttraumatic Stress Disorder
Authors: Padmanabhanunni Anita , Pretorius Tyrone B. 
Published: July 2023

Background Cognitive appraisals play a fundamental role in mental health outcomes following exposure to trauma. Appraisals influence emotional reactions, coping responses, and adaptation to stress and represent a modifiable factor that can serve as a central focus for intervention. Most studies have primarily focused on the role of dysfunctional cognitions in the persistence of posttraumatic stress disorder (PTSD). In this study, we extend research in this area by investigating the role of problem-solving appraisal, an adaptive cognitive strategy, in the association between stress and PTSD. Methods A total of 322 participants completed the Perceived Stress Scale, the problem-solving inventory (PSI), and the PTSD Checklist for DSM-5. Descriptive statistics were generated, and intercorrelations and mediation analysis were performed. Results Problem-solving confidence and personal control partially mediated the relationship between stress and PTSD. However, contrary to existing research, the approach-avoidance style, which is a subscale of the PSI, did not mediate the relationship between these variables. Conclusion Interventions for PTSD should incorporate a complementary focus on developing and increasing adaptive cognitions pertaining to personal control and confidence in problem-solving abilities. This could potentially form part of a broader process of rebuilding the individual's cognitive worldview following exposure to trauma.
Optogenetic cortical spreading depolarization induces headache-related behaviour and neuroinflammatory responses some prolonged in familial hemiplegic migraine type 1 mice
Authors: Dehghani Anisa , Schenke Maarten , van Heiningen Sandra H. , Karatas Hulya , Tolner Else A. , van den Maagdenberg Arn M. J. M. 
Published: July 2023

Abstract
Background
Cortical spreading depolarization (CSD), the neurophysiological correlate of the migraine aura, can activate trigeminal pain pathways, but the neurobiological mechanisms and behavioural consequences remain unclear. Here we investigated effects of optogenetically-induced CSDs on headache-related behaviour and neuroinflammatory responses in transgenic mice carrying a familial hemiplegic migraine type 1 (FHM1) mutation.

Methods
CSD events (3 in total) were evoked in a minimally invasive manner by optogenetic stimulation through the intact skull in freely behaving wildtype (WT) and FHM1 mutant mice. Related behaviours were analysed using mouse grimace scale (MGS) scoring, head grooming, and nest building behaviour. Neuroinflammatory changes were investigated by assessing HMGB1 release with immunohistochemistry and by pre-treating mice with a selective Pannexin-1 channel inhibitor.

Results
In both WT and FHM1 mutant mice, CSDs induced headache-related behaviour, as evidenced by increased MGS scores and the occurrence of oculotemporal strokes, at 30 min. Mice of both genotypes also showed decreased nest building behaviour after CSD. Whereas in WT mice MGS scores had normalized at 24 h after CSD, in FHM1 mutant mice scores were normalized only at 48 h. Of note, oculotemporal stroke behaviour already normalized 5 h after CSD, whereas nest building behaviour remained impaired at 72 h; no genotype differences were observed for either readout. Nuclear HMGB1 release in the cortex of FHM1 mutant mice, at 30 min after CSD, was increased bilaterally in both WT and FHM1 mutant mice, albeit that contralateral release was more pronounced in the mutant mice. Only in FHM1 mutant mice, contralateral release remained higher at 24 h after CSD, but at 48 h had returned to abnormal, elevated, baseline values, when compared to WT mice. Blocking Panx1 channels by TAT-Panx308 inhibited CSD-induced headache related behaviour and HMGB1 release.

Conclusions
CSDs, induced in a minimally invasive manner by optogenetics, investigated in freely behaving mice, cause various migraine relevant behavioural and neuroinflammatory phenotypes that are more pronounced and longer-lasting in FHM1 mutant compared to WT mice. Prevention of CSD-related neuroinflammatory changes may have therapeutic potential in the treatment of migraine.