bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of prior use of antiplatelet agents and non-vitamin K antagonist oral anticoagulants on stroke outcomes among endovascular-treated patients with high pre-stroke CHA2DS2-VASc score
Authors: Kim Chulho , Sohn Jong-Hee , Lee Minwoo , Kim Yerim , Mo Hee Jung , Oh Mi Sun , Yu Kyung-Ho , Lee Sang-Hwa 
Published: August 2023

BackgroundWe assessed the influence of prior non-vitamin K antagonist (NOAC) use on stroke outcomes after endovascular treatment (EVT) in patients at a high risk of stroke based on their pre-stroke CHA2DS2-VASc score, and compared them with those who did not use any antithrombotic (NAU) or antiplatelet (APT) agents.MethodsData were collected from a multicenter database comprising consecutive acute ischemic stroke patients who underwent EVT during a span of 103 months. We evaluated pre-stroke CHA2DS2-VASc scores in enrolled patients and measured instances of successful reperfusion and symptomatic hemorrhagic transformation (SHT) following EVT as the main outcome measures.ResultsAmong 12 807 patients with acute ischemic stroke, 3765 (29.4%) had a history of atrial fibrillation. Of these, 418 patients with CHA2DS2-VASc scores ≥2 received EVT alone. The prior NOAC group showed higher successful reperfusion rates compared with the prior NAU and APT groups (p=0.04). Multivariate analysis revealed that prior NOAC use increased the likelihood of successful reperfusion after EVT (OR [95% CI] 2.54 [1.34 to 4.83], p=0.004) and improved stroke outcomes, while the prior APT group did not. Furthermore, the prior NOAC use group was not associated with SHT after EVT. Propensity score matching confirmed these findings.ConclusionPrior use of NOAC is associated with improved outcomes in high-risk stroke patients (pre-stroke CHA2DS2-VASc score ≥2) undergoing EVT.
Predictors of tissue infarction from distal emboli after mechanical thrombectomy
Authors: Fuller Emily , Vivanco-Suarez Juan , Fain Nicholas H , Zevallos Cynthia B , Lu Yujing , Ortega-Gutierrez Santiago , Derdeyn Colin 
Published: August 2023

BackgroundDistal embolization after endovascular thrombectomy (EVT) is common. We aimed to determine factors associated with tissue infarction in the territories of distal emboli.MethodsThis is a retrospective cohort study of consecutive patients with anterior circulation large vessel occlusions who underwent EVT from 2015 to 2021. Patients with Thrombolysis In Cerebral Infarction (TICI) 2b reperfusion and follow-up imaging were identified. Baseline characteristics, procedural details, and imaging findings were reviewed. Primary outcome was categorized according to the occurrence of infarction at the territory of distal embolus on follow-up diffusion-weighted imaging MRI.ResultsOf 156 subjects, 97 (62%) had at least one infarction in the territories at risk. Hypertension was significantly more prevalent in the infarct group (83% vs 53%, P=0.001). General anesthesia was more commonly used in the infarct group (60% vs 43%, P=0.037). The median number of distal emboli and diameter of the occluded vessel were similar. After adjusting for confounders, hypertension (aOR 4.73, 95% CI 1.81 to 13.25, P=0.002), higher blood glucose (aOR 1.01, 95% CI 1.00 to 1.03, P=0.023), and general anesthesia (aOR 2.75, 95% CI 1.15 to 6.84, P=0.025) were independently associated with infarction. The presence of angiographic leptomeningeal collaterals predicted tissue survival (aOR 0.13, 95% CI 0.05 to 0.33, P<0.001). 90-day modified Rankin scale (mRS) scores were worse for the infarction patients (mRS 0–2: infarct, 39% vs 55%, P=0.046).ConclusionsNearly 40% of patients with TICI 2b had no tissue infarction in the territory of a distal embolus. The association of infarction with hypertension and general anesthesia suggests late or post-procedural blood pressure management could be a modifiable factor. Patients with poor leptomeningeal collaterals or hyperglycemia may benefit from further attempts at revascularization.
Early and effective intracerebral hemorrhage evacuation is associated with a lower 1-year residual cavity volume and better functional outcomes
Authors: Ali Muhammad , Ascanio Luis C , Smith Colton , Odland Ian , Murtaza-Ali Muhammad , Vasan Vikram , Downes Margaret , Schuldt Braxton Riley , Lin Anthony , Dullea Jonathan , Schupper Alexander J , Hardigan Trevor , Asghar Nek , Mocco J , Kellner Christopher Paul 
Published: August 2023

BackgroundWe explored the clinical significance of the residual hematoma cavity 1 year after minimally invasive intracerebral hemorrhage (ICH) evacuation.MethodsPatients presenting with spontaneous supratentorial ICH were evaluated for minimally invasive surgical evacuation. Inclusion criteria included age ≥18 years, preoperative hematoma volume (Hv) ≥15 mL, presenting National Institutes of Health Stroke Scale score ≥6, and premorbid modified Rankin Scale (mRS) score ≤3. Patients with longitudinal CT scans at least 3 months after evacuation were included in the study. Remnant cavity volumes (Cv) after evacuation were computed using semi-automatic volumetric segmentation software. Relative cavity volume (rCv) was defined as the ratio of the preoperative Hv to the remnant Cv.Results108 patients with a total of 484 head CT scans were included in the study. The median postoperative Cv was 2.4 (IQR 0.0–11) mL, or just 6% (0–33%) of the preoperative Hv. The median residual Cv on the final head CT scan a median of 13 months (range 11–27 months) after surgery had increased to 9.4 (IQR 3.1–18) mL, or 25% (10–60%) of the preoperative Hv. rCv on the final head CT scan was negatively associated with measures of operative success including evacuation percentage, postoperative Hv ≤15 mL, and decreased time from ictus to evacuation. rCv on the final head CT scan was also associated with a worse 6-month functional outcome (β per mRS point 17.6%, P<0.0001; area under the receiver operating characteristic curve 0.91).ConclusionAfter minimally invasive ICH evacuation the hematoma lesion decompresses significantly, with a residual Cv just 6% of the original lesion, but then gradually increases in size over time. Early and high percentage ICH evacuation may reduce the remnant Cv over time which, in turn, is associated with improved functional outcomes.
NANOGrav signal from double-inflection-point inflation and dark matter
Authors: Gao Tie-Jun 
Published: August 2023

AbstractThe NANOGrav collaboration has published a suspected stochastic gravitational wave (GW) background signal in its analysis of 12.5 years PTA data, so in this work, we investigate the possibility to explain the signal by the inflationary models with double-inflection-point. We calculate the energy spectrum of GWs induced by scalar perturbations, and show that the curve lies in the $$2\sigma $$

2
σ

region of the NANOGrav constraints. In addition, we analyze the reheating process and dark matter production by assuming that the inflaton is coupled with the standard model (SM) Higgs boson and singlet fermionic dark matter field. We discuss the radiative stability of the inflationary potential under one-loop corrections, calculate the reheating temperature, the dark matter production, and constraints on the coupling parameters using the bounds of BBN, Lyman-$$\alpha $$
α
, etc.
Efficiency and Safety of Temperatures Management in Aortic Arch Surgery: A System Review and Meta-Analysis
Authors: Yu Yang , Ding Zheng , Shi Enyi , Gu Tianxiang 
Published: August 2023

Objective. The study evaluates the safety and efficacy of hypothermic cardiac arrest (HCA) at various temperatures in aortic arch surgeries. Methods. We conducted a literature search in PubMed, Google Scholar, and Embase databases. For single proportion assessments, we employed fixed-effect and random-effect models in the general linear mixture model and the inverse variance model for other computations. We analyzed factors such as age, sex, operation time, and postoperative complications, with subgroup and metaregression analyses. We used funnel plots to depict potential publication bias. Results. Our research incorporated 43 papers with 34,797 cases. HCA temperatures were divided into five groups (A: 30–32°C, B: 28–30°C, C: 26–28°C, D: 24–26°C, and E: <24°C). There is no statistically significant difference in myocardial ischemia time (

P

= 0.90) and isolated cerebral perfusion (ICP) time (

P

= 0.95). Groups A and C have the best performance in avoiding postoperative complications including transient nerve injury (TNI), permanent nerve injury (PNI), renal failure (RF), and mortality occurrence rate. Group A has the lowest occurrence rate in PNI (3%) and mortality (3%). Group C has the lowest RF incidence (5%). Conclusion. Maintaining temperatures of 30–32°C in en bloc anastomosis or 26–28°C during arch replacement with separate grafts can significantly reduce complications including PNI, RF, and in-hospital mortality.
Placenta-Derived Extracellular Vesicles From Preeclamptic Pregnancies Impair Vascular Endothelial Function via Lectin-Like Oxidized LDL Receptor-1
Authors: Villalobos-Labra Roberto , Liu Ricky , Spaans Floor , Sáez Tamara , Semeria Maitret Tamara , Quon Anita , Sawamura Tatsuya , Cooke Christy-Lynn M. , Davidge Sandra T. 
Published: August 2023

BACKGROUND:
Preeclampsia is a complex syndrome that includes maternal vascular dysfunction. Syncytiotrophoblast-derived extracellular vesicles from preeclampsia placentas (preeclampsia-STBEVs) were shown to induce endothelial dysfunction, but an endothelial transmembrane mediator is still unexplored. The LOX-1 (lectin-like oxidized low-density lipoprotein receptor-1) is a transmembrane scavenger receptor that can cause endothelial dysfunction, and its expression is increased in the endothelium of preeclampsia women. In this study, we hypothesized that LOX-1 mediates the effects of preeclampsia-STBEVs on endothelial function.

METHODS:
Preeclampsia-STBEVs were collected by perfusion of placentas from women with preeclampsia and in vitro and ex vivo endothelial cell function were assessed.

RESULTS:
In human umbilical vein endothelial cells, inhibition of LOX-1 with LOX-1 blocking antibody (TS20) reduced the uptake of preeclampsia-STBEVs (61.3±8.8%). TS20 prevented the activation of ERK (extracellular signal-regulated kinase, a kinase downstream of LOX-1) and reduced the activation of NF-κB (nuclear factor kappa-light-chain-enhancer of activated B cells; 21.1±8.0%) and nitrative stress (23.2±10.3%) that was induced by preeclampsia-STBEVs. Vascular function was assessed by wire myography in isolated mesenteric arteries from pregnant rats that were incubated overnight with preeclampsia-STBEVs±TS20. TS20 prevented endothelium-dependent vasodilation impairment induced by preeclampsia-STBEVs. Nitric oxide contribution to the relaxation was reduced by preeclampsia-STBEVs, which was prevented by TS20. Superoxide dismutase or apocynin, an inhibitor of NOX (nicotinamide adenine dinucleotide phosphate oxidase), restored the impaired endothelium-dependent vasodilation in arteries exposed to preeclampsia-STBEVs.

CONCLUSIONS:
Taken together, our findings demonstrate that LOX-1 mediates the endothelial dysfunction induced by preeclampsia-STBEVs. Our study further expands on the mechanisms that may lead to adverse outcomes in preeclampsia and proposes LOX-1 as a potential target for future interventions.
Characterisation of the neonatal brain using myelin-sensitive magnetisation transfer imaging
Authors: Cábez Manuel Blesa , Vaher Kadi , York Elizabeth N. , Galdi Paola , Sullivan Gemma , Stoye David Q. , Hall Jill , Corrigan Amy E. , Quigley Alan J. , Waldman Adam D. , Bastin Mark E. , Thrippleton Michael J. , Boardman James P. 
Published: August 2023

AbstractA cardinal feature of the encephalopathy of prematurity is dysmaturation of developing white matter and subsequent hypomyelination. Magnetisation transfer imaging (MTI) offers surrogate markers for myelination, including magnetisation transfer ratio (MTR) and magnetisation transfer saturation (MTsat). Using data from 105 neonates, we characterise MTR and MTsat in the developing brain and investigate how these markers are affected by gestational age at scan and preterm birth. We explore correlations of the two measures with fractional anisotropy (FA), radial diffusivity (RD) and T1w/T2w ratio which are commonly used markers of white matter integrity in early life. We used two complementary analysis methods: voxel-wise analysis across the white matter skeleton, and tract-of-interest analysis across 16 major white matter tracts. We found that MTR and MTsat positively correlate with gestational age at scan. Preterm infants at term-equivalent age had lower values of MTsat in the genu and splenium of the corpus callosum, while MTR was higher in central white matter regions, the corticospinal tract and the uncinate fasciculus. Correlations of MTI metrics with other MRI parameters revealed that there were moderate positive correlations between T1w/T2w and MTsat and MTR at voxel level, but at tract level FA had stronger positive correlations with these metrics. RD had the strongest correlations with MTI metrics, particularly with MTsat in major white matter tracts. The observed changes in MTI metrics are consistent with an increase in myelin density during early postnatal life, and lower myelination and cellular/axonal density in preterm infants at term-equivalent age compared to term controls. Furthermore, correlations between MTI-derived features and conventional measures from diffusion MRI provide new understanding about the contribution of myelination to non-specific imaging metrics that are often used to characterise early brain development.
Year in review: Highlights in ECLS Innovation and Technology, Anno 2022-2023
Authors: Vercaemst Leen 
Published: August 2023

Background In the field of extracorporeal life support (ECLS), the rapid influx of novel technologies and innovative techniques presents an ongoing challenge for professionals to stay informed about these advancements. To address this issue and ensure the ECLS community remains up-to-date, we have compiled a concise overview of recent technological innovations in ECLS. Purpose This overview focuses primarily on academically investigated and reported advancements in the ECLS domain. It underscores the importance of transparent communication regarding technological limitations in healthcare and advocates for collaboration between medical professionals and engineers to elevate patient care. Research Design This manuscript presents a compilation of recent technological advancements in ECLS, with an emphasis on innovations that have been academically explored and documented. The research approach involves gathering information from scholarly sources, reports, and studies to provide a comprehensive overview. Study Sample The study sample comprises a diverse range of recent technological innovations in the field of extracorporeal life support (ECLS). These innovations span various aspects of ECLS technology and have been investigated and reported on within the academic literature. Analysis Data collection involved systematically reviewing academic literature, reports, and studies related to recent technological advancements in ECLS. The collected information was then analyzed to identify common trends, notable developments, and the impact of these innovations on patient care. Results The compilation highlights several significant technological innovations within the ECLS domain. Notable advancements include the development of new dual lumen cannulae, innovative devices for left ventricular (LV) unloading, lightweight ECMO transport systems, streamlined driving consoles to facilitate patient mobility, intricate systems for extracorporeal cardiopulmonary resuscitation (ECPR), standardized driving consoles for networking, and non-invasive circuit pressure monitoring. Some of these innovations have obtained regulatory approvals for distribution in the United States and/or authorization for the European market. Conclusions The manuscript underscores the critical role of collaboration between clinicians, researchers, and industry in driving recent technological innovations within the ECLS field. It emphasizes the necessity of open communication about technological limitations and the potential for repurposing established technologies in novel ways. However, the resourcefulness of physicians in repurposing devices requires validation through comprehensive scientific and technical investigation. Thus, fostering broader collaboration among stakeholders is recommended to ensure the rigorous evaluation and validation of new applications for established ECLS devices.
On a Personal Note: A Music Therapist's Reflections on Working with those who are Living with a Terminal Illness
Authors: Hartley Nigel Alan 
Published: August 2023

Music therapists are constantly called upon to justify their work through research projects and evaluation processes. Rarely do we get the opportunity to talk personally about our work, the effects it has on us as music therapists, indeed, as human beings. This paper traces my own journey as a music therapist working with the terminally ill. Using audio extracts of music improvised with patients at the end of their lives, the concept of “attention” in music is addressed and explored. The paper will investigate: a) What is the difference between the quality of attention that is available to ourselves and our patients “in” music, as opposed to other ways of being together?; b) What does musical experience, particularly when achieved through improvisation, enable us and our patients to be that we cannot achieve in other ways?; c) Can “being in music” with another person fulfil a sense of longing that is evident in people at the end of their lives? In her book Waiting For God, Simone Weil suggests, ‘Those who are unhappy have no need for anything else in this world other than people capable of giving them their attention…” (1). Can the improvisation of music offer a unique and uncomplicated medium for being close?
Challenges in the Management of Children and Adolescents With Epilepsy in China During the COVID-19 Pandemic: An Online Survey-Based Study
Authors: Lu Qian , Dun Shuo , Wang Qiu-Hong , Wang Yang-Yang , Chen Hui-Min , Zhang Qi , Zou Li-Ping 
Published: August 2023

Introduction To investigate the challenges in the management of children and adolescents with epilepsy in China during the coronavirus disease (COVID-19) pandemic. Methods We conducted a cross-sectional survey among 845 patients with epilepsy using an online-based questionnaire. The questionnaire focused on sociodemographic characteristics, epilepsy-related conditions, health care access, COVID-19 vaccination, and the mental health of caregivers. Depression was assessed using Patient Health Questionnaire-9. Results During the pandemic, 24.73% of the patients had increased seizures. The majority of patients (68.89%) experienced difficulty obtaining antiseizure medications. In addition, 94.79% of the patients had difficulty consulting a doctor. A total of 52.78% of the patients selected telemedicine services, and most found these services to be helpful. Moreover, 76.11% of the patients failed to complete the COVID-19 vaccination. More than half of the caregivers had anxiety and depressive symptoms. The risk factors for depression comprised irregularity in taking antiseizure medications, difficulty in obtaining antiseizure medications, and failure to consult a doctor on time. Conclusions The COVID-19 pandemic presented a great challenge in the management of children and adolescents with epilepsy in China. The findings highlight the importance of improving health care systems and medication management and the mental health of their caregivers.
Perspectives From Public Health Practitioners and Advocates on Community Development for Active Living: What are the Lasting Impacts?
Authors: Serrano Natalicio , Schmidt Laurel , Eyler Amy A. , Brownson Ross C. 
Published: August 2023

Purpose Evidence suggests differential impacts of community development, including gentrification and displacement. Public health practitioners and advocates are key stakeholders involved in the community development process related to active living, yet little is known about their perceptions of its impacts. We explored the perspectives of relevant leaders of public health departments and key community and advocacy organizations on community development, gentrification, and displacement. Approach Purposive key informant interviews. Setting CDC State Physical Activity and Nutrition (SPAN) funding recipients. Participants CDC SPAN recipient leadership (n = 10 of 16) and advocacy organizations they partnered with (n = 7 of 16). Method Interviews were recorded, transcribed, coded, and thematically analyzed with direct quotes representing key themes. Results Both groups felt community development held important benefits, specifically by creating healthy living opportunities, but also potentially leading to the displacement of long-time residents. Practitioners reported the benefits were for all community members, whereas advocates noted the benefits were seen in those with privilege, and the consequences were disproportionately seen in disadvantaged communities. Both mentioned the importance and difficulty of getting diverse representation for community engagement. Conclusions Learning how key stakeholders perceive and navigate the community development process can help inform recommendations for better equity in active living community improvements. More work is needed to further elucidate best practices for health and social equity in the community development process.
Taming the Tides of Internal Conflicts in Sub-Saharan Africa: The Role of Political Institutions and Natural Resources
Authors: Slesman Ly , Kole Ali , Abdlaziz Rizgar Abdlkarim , Raheem Ibrahim D. 
Published: August 2023

This article examines the interaction effects of resource rents and political institutions on internal conflicts in a panel of 29 Sub-Sahara African countries from 1983 to 2018. Relying on the system generalized method of moments (SGMM) estimator that controls for instrument proliferation, we find robust evidence of the adverse interaction effects between resource rents and political institutions on internal conflicts. Comprehensive marginal effect analysis on both variables reveals the following significant findings. First, there is a (broad) U-shaped marginal effect of resource rents and political institutions. Second, when each component of resource rents was analyzed, only oil and mineral rents had a negative and statistically significant interaction effect with political institutions on internal conflicts. The U-shaped marginal effects hold only for oil rents (but become narrower), while mineral rents exhibit only an L-shaped marginal effect at low levels of political institutions. Our findings are robust to a broad set of alternative measures of political institutions and alternative specifications of the interaction term. JEL Classification Q34, E02, N57