bluuebunny/crossref_metadata_2025_split huggingface dataset:
Remnant Cholesterol and the Risk of Coronary Artery Calcium Progression: Insights From the CARDIA and MESA Study
Authors: Hao Qing-Yun , Gao Jing-Wei , Yuan Zhi-Min , Gao Ming , Wang Jing-Feng , Schiele François , Zhang Shao-Ling , Liu Pin-Ming 
Published: July 2022

Background:
Remnant cholesterol (RC) contributes to residual risk of atherosclerotic cardiovascular disease, but population-based evidence on the prospective relationship between RC and coronary artery calcium (CAC) progression is rare.

Methods:
We pooled data obtained from 6544 atherosclerotic cardiovascular disease–free individuals from the CARDIA study (Coronary Artery Risk Development in Young Adults; n=2635) and MESA (Multi-Ethnic Study of Atherosclerosis; n=3909), with a mean±SD age of 47.2±19.8 years; 3019 (46.1%) were men who completed computed tomography of CAC at baseline. RC was measured as total cholesterol minus HDL (high-density lipoprotein) cholesterol minus calculated LDL (low-density lipoprotein) cholesterol (LDL-C) estimated by using the Martin/Hopkins equation. Adjusted Cox models were used to assess the relationships between RC levels and CAC progression. We also performed discordance analyses examining the risk of CAC progression in RC versus LDL-C discordant/concordant groups using median cut points and clinically relevant LDL-C targets.

Results:
During a median follow-up of 8.6 years, 2778 (42.5%) participants had CAC progression. After multivariable adjustment for demographics and cardiovascular risk factors, a 1-mg/dL increase in RC levels was associated with a 1.3% higher risk of CAC progression (hazard ratio, 1.013 [95% CI, 1.008–1.017]). Results were similar when we categorized individuals by RC quartiles. Furthermore, the discordant high RC/low LDL-C group had a significantly higher risk of CAC progression than the concordant low RC/LDL-C group regarding their medians (hazard ratio, 1.195 [95% CI, 1.063–1.343]) or when setting the clinical LDL-C cut points at 100 and 130 but not 70 mg/dL. The association remained robust across a series of sensitivity analyses.

Conclusions:
Elevated RC levels were associated with an increased risk of CAC progression independent of traditional cardiovascular risk factors, even in individuals with optimal LDL-C levels.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifiers: NCT00005130 (CARDIA) and NCT00005487 (MESA).
Primary Aldosteronism Screening Rates Differ with Sex, Race, and Comorbidities
Authors: Turcu Adina F. , Nhan Winnie , Grigoryan Seda , Zhang Lei , Urban Caitlin , Liu Haiping , Holevinski Lynn , Zhao Lili 
Published: July 2022

Background
Primary aldosteronism (PA) is a common but under‐recognized cause of secondary hypertension. Data directly comparing screening rates across single and overlapping indications are lacking.

Methods and Results
We conducted a retrospective review of adults with hypertension seen in outpatient clinics at a tertiary referral academic center between January 1, 2017, and June 30, 2020. We included patients with hypertension plus at least one of the following: resistant hypertension; age<35 years; obstructive sleep apnea; hypokalemia; or an adrenal mass. We excluded patients with adrenal insufficiency, severe renal disease, or heart failure, and renovascular hypertension. Of 203 535 patients with hypertension, 86044 (42.3%) met at least 1 PA screening criterion, and of these, 2898 (3.4%) were screened for PA. Screening occurred in 2.7% of patients with resistant hypertension; 4.2% of those with obstructive sleep apnea; 5.1% of those <35 years; 10.0% of those with hypokalemia; and 47.3% of patients with an adrenal mass. Screening rates were higher in patients with multiple risk factors: 16.8% for ≥3, 5.7% for 2, and 2.5% for 1 criterion. Multiple logistic regression showed that the odds of PA screening were higher in patients with hypokalemia: odds ratio (95% CI): 3.0 (2.7–3.3); women: 1.3 (1.2–1.4); Black versus White: 1.5 (1.4–1.7); those with obstructive sleep apnea, chronic renal disease, stroke, and dyslipidemia.

Conclusions
Consideration for PA is given in a small subset of at‐risk patients, and typically after comorbidities have developed.
Gains and Losses Affect Learning Differentially at Low and High Attentional Load
Authors: Boroujeni Kianoush Banaie , Watson Marcus , Womelsdorf Thilo 
Published: July 2022

Abstract
Prospective gains and losses influence cognitive processing, but it is unresolved how they modulate flexible learning in changing environments. The prospect of gains might enhance flexible learning through prioritized processing of reward-predicting stimuli, but it is unclear how far this learning benefit extends when task demands increase. Similarly, experiencing losses might facilitate learning when they trigger attentional reorienting away from loss-inducing stimuli, but losses may also impair learning by increasing motivational costs or when negative outcomes are overgeneralized. To clarify these divergent views, we tested how varying magnitudes of gains and losses affect the flexible learning of feature values in environments that varied attentional load by increasing the number of interfering object features. With this task design, we found that larger prospective gains improved learning efficacy and learning speed, but only when attentional load was low. In contrast, expecting losses impaired learning efficacy, and this impairment was larger at higher attentional load. These findings functionally dissociate the contributions of gains and losses on flexible learning, suggesting they operate via separate control mechanisms. One mechanism is triggered by experiencing loss and reduces the ability to reduce distractor interference, impairs assigning credit to specific loss-inducing features, and decreases efficient exploration during learning. The second mechanism is triggered by experiencing gains, which enhances prioritizing reward-predicting stimulus features as long as the interference of distracting features is limited. Taken together, these results support a rational theory of cognitive control during learning, suggesting that experiencing losses and experiencing distractor interference impose costs for learning.
Controls on Subtropical Cloud Reflectivity during a Waterbelt Scenario for the Cryogenian Glaciations
Authors: Braun Christoph , Voigt Aiko , Hoose Corinna , Ekman Annica M. L. , Pinto Joaquim G. 
Published: July 2022

Abstract
Waterbelt climate states with an ice-free tropical ocean provide a straightforward explanation for the survival of advanced marine species during the Cryogenian glaciations (720–635 million years ago). Previous work revealed that stable waterbelt states require the presence of highly reflective low-level mixed-phase clouds with a high abundance of supercooled liquid in the subtropics. However, the high uncertainty associated with representing mixed-phase clouds in coarse-scale general circulation models (GCMs) that parameterize atmospheric convection has prohibited assessment of whether waterbelt states are a robust feature of Earth’s climate. Here we investigate whether resolving convective-scale motion at length scales of hectometers helps us to assess the plausibility of a waterbelt scenario. First, we show that substantial differences in cloud reflectivity among GCMs do not arise from the resolved atmospheric circulation. Second, we conduct a hierarchy of simulations using the Icosahedral Nonhydrostatic (ICON) modeling framework, ranging from coarse-scale GCM simulations with parameterized convection to large-eddy simulations that explicitly resolve atmospheric convective-scale motions. Our hierarchy of simulations supports the existence of highly reflective subtropical clouds if we apply moderate ice nucleating particle (INP) concentrations. Third, we test the sensitivity of cloud reflectivity to the INP concentration. In the presence of high but justifiable INP concentrations, cloud reflectivity is strongly reduced. Hence, the existence of stable waterbelt states is controlled by the abundance of INPs. We conclude that explicitly resolving convection can help to constrain Cryogenian cloud reflectivity, but limited knowledge concerning Cryogenian aerosol conditions hampers strong constraints. Thus, waterbelt states remain an uncertain feature of Earth’s climate.

Significance Statement
The purpose of this study is to assess the impact of atmospheric convection and small airborne ice nucleating particles on the reflectivity of mixed-phase clouds over a subtropical ice margin. This is important as these clouds can determine whether the Cryogenian Earth (720–635 million years ago) was in a hard “snowball” state with a fully ice-covered ocean or a habitable waterbelt state with an ice-free tropical ocean. Our results indicate a clear impact of convection but neither confirm nor deny the existence of a waterbelt state since cloud reflectivity depends critically on the abundance of ice nucleating particles. Therefore, a Cryogenian waterbelt scenario remains uncertain, which calls for more comprehensive Earth system modeling approaches in future studies.
Experimental study on vertical vehicle-rail-bridge coupling of medium and low speed maglev train based on track beam with different stiffness
Authors: Chen Chen , Xu Junqi , Lu Yang , Lin Guobin , Ji Wen 
Published: July 2022

In order to analyze and verify the adaptability of train to track beams with different stiffness, the dynamic response of vertical vehicle-track-bridge with different stiffness track beam is studied. Firstly, according to the actual vehicle-track-bridge coupling system, the corresponding mechanical and kinematic equations are established. The natural vibration characteristics of track beams (bridges) with different stiffness are studied, and the dynamic response caused by current control algorithm is analyzed. Secondly, combined with the 3-D model of vehicle-track-bridge and the actual system, the dynamic simulation and experiment of the coupling system of track beam with different stiffness in the speed range of 60 km/h are carried out. The results show that the vertical first-order natural frequency of track beam decreases with the decrease of track beam stiffness. When the deflection span ratio increases, the suspension gap fluctuation increases, but the increase of deflection span ratio within a certain range will not affect the tracking performance of control current, and the train is still in a relatively stable suspension state. For the track beam, with the decrease of stiffness, the vertical deflection of the track beam increases and the high-frequency vibration energy increases, which has a great impact on the vibration response of the coupling system. The research results of this paper can provide a useful reference for the optimization of suspension system of medium and low speed maglev train, line design, and the formulation of construction standard of maglev vehicle-track-bridge system. In addition, the research results of this paper can provide a theoretical basis for reducing the construction cost of track beam.
Nonpharmacologic Interventions and Seizure Frequency in Patients With Psychogenic Nonepileptic Seizures: An Integrative Review
Authors: Cobb Sandra J. , Vaughn Bradley V. , Sagherian Knar 
Published: July 2022

Background: Psychogenic nonepileptic seizures (PNES) pose a heavy burden on patients’ lives and the health care system. The symptoms of PNES are often debilitating and cause high rates of disability and poor quality of life. Many treatment options are available, but there is no clear consensus on best practices. Aim: To critique and synthesize the current literature on nonpharmacologic interventions and effects on seizure frequency in patients with PNES. Methods: An integrative review guided by the Whittemore and Knafl approach. Results: The review included 24 studies published from 2010 to 2020. Interventions for PNES included individualized psychotherapies, group therapies, multimodal psychotherapies, self-help therapies, and complementary and alternative medicine therapies. Individual psychotherapies such as cognitive behavioral therapy and psychoeducation were the most used treatment modalities. The most effective treatments for seizure frequency reduction were those that included multiple psychotherapy sessions with a health care provider and covered multiple domains (e.g., understanding of diagnosis, identifying triggers, and developing effective coping strategies). Conclusions: Seizure frequency can be reduced in patients with PNES with multiple nonpharmacologic interventions. However, seizure frequency is not considered a comprehensive outcome measure and provides little insight into other important life domains. Further research is needed on nonpharmacologic interventions for PNES and effects on other areas of life such as sleep, employment status, global functioning, and self-efficacy.
Macular ganglion cell-inner plexiform layer defect patterns in multiple sclerosis patients without optic neuritis: A Spectral-Domain-Optical Coherence Tomography Cross-Sectional, Case-Control, Pilot Study
Authors: Albano Valeria , Dammacco Rosanna , Manni Alessia , Sisto Dario , Iaffaldano Antonio , Mavilio Alberto , Alessio Giovanni , Trojano Maria , Paolicelli Damiano 
Published: July 2022

Purpose Spectral-domain optical coherence tomography (SD-OCT) was used to evaluate, in patients with multiple sclerosis without a history of optic neuritis (MSNON), the proportion of the different macular ganglion cell-inner plexiform layer complex (mGCIP) defect patterns. The results were compared with those of healthy controls (HCs). Methods In this cross-sectional case-control study, 34 eyes of 34 individuals, 17 with MSNON and 17 HCs, were evaluated. All participants underwent mGCIP thickness measurement using SD-OCT (Zeiss Cirrus HD-OCT 4000, macular cube protocol). The mGCIP defect patterns were classified in nine types (minimal, inner, outer, diffuse mild, diffuse severe inferior confined, inferior dominant, superior confined, and superior dominant), according to the shape derived by the deviation map of the instrument, and the proportion of each type was assessed. Results A mGCIP defect pattern was detected in 70.5% of MSNON eyes, with an inner type as the most frequent pattern (47%), followed by the outer type (11.7%) and the inferior confined type (11.7%). No defect was found in Hcs. Conclusions A significant thinning of the mGCIP with the frequent presence of an inner defect was seen in MSNON patients. The presence of this defect may serve as a biomarker of subclinical optic nerve involvement in MS patients.
Implementation of Teledermatology in Alberta, Canada: A Report of One Thousand Cases
Authors: Olteanu Cristina , Motamedi Melika , Hersthammer Jessica , Azer Brandon , Rao Jaggi 
Published: July 2022

Background Teledermatology utilizes photoimaging and background information to allow dermatologists to remotely provide a diagnosis to practitioners. ConsultDerm is an asynchronous, web-based teledermatology software that allows practitioners to submit their electronic referrals for assessment by board-certified dermatologists. Objective Our study aimed to retrospectively analyze teledermatology’s utilization in Canada by using the teledermatology platform ConsultDerm. Methods After implementing inclusion criteria, 1000 patients were selected, and relevant demographic and clinical information were extracted for data analysis. In addition, an online survey with pre-formulated questions was distributed to 7 dermatologists currently using the ConsultDerm platform to determine their experience in utilizing teledermatology. Results Of the 1000 patients, 66.5% had not received treatment prior to their teledermatology referral, and on average, patients experienced symptoms for 489.5 days prior to their referral. Diagnoses made were categorized by conditions, most common being dermatitis (37.1%), followed by acneiform conditions (10.6%), benign lesions/neoplasms (12.1%), infections (9.4%), and dyspigmentation (3.1%). Most consults originated from small population centers, and the referring practitioners were predominantly family physicians. Dermatologists utilizing the platform expressed ease of use, however, areas of improvement were identified such as increasing the quality of imaging and more detailed patient history. Conclusion Through our analysis of 1000 cases, we identified how a teledermatology consultation could be used to assess a wide variety of cutaneous conditions, improving access for patients who may face barriers to seeing a dermatologist.
Young children’s voices in an unlocked Sweden during the COVID-19 pandemic
Authors: Jenholt Nolbris M. , Ragnarsson S. , Brorsson A.-L. , Garcia de Avila M. , Forsner M. , Kull I. , Olinder A. L. , Mattson J. , Nilsson S. , Rullander A.-C. , Rydström L.-L. , Olaya-Contreras P. , Berghammer M. 
Published: July 2022

Aims: During the COVID-19 pandemic, Sweden was one of the few countries that rejected lockdowns in favour of recommendations for restrictions, including careful hand hygiene and social distancing. Preschools and primary schools remained open. Several studies have shown negative impacts of the pandemic on children, particularly high levels of anxiety. The study aim was to explore how Swedish school-aged children aged 6–14 years, experienced the COVID-19 pandemic and their perceived anxiety. Methods: In total, 774 children aged 6–14 years and their guardians answered an online questionnaire containing 24 questions, along with two instruments measuring anxiety: the Children’s Anxiety Questionnaire and the Numerical Rating Scale. A convergent parallel mixed-methods design was used for analysing the quantitative and qualitative data. Each data source was first analysed separately, followed by a merged interpretative analysis. Results: The results showed generally low levels of anxiety, with no significant sex differences. Children who refrained from normal social activities or group activities ( n=377) had significantly higher levels of anxiety. Most of the children were able to appreciate the bright side of life, despite the social distancing and refraining from activities, which prevented them from meeting and hugging their loved ones. Conclusions: These Swedish children generally experienced low levels of anxiety, except those who refrained from social activities. Life was nonetheless mostly experienced as normal, largely because schools remained open. Keeping life as normal as possible could be one important factor in preventing higher anxiety and depression levels in children during a pandemic.
Developing Leaders for Disruptive Change: An Inclusive Leadership Approach
Authors: Simmons Sara V. , Yawson Robert M. 
Published: July 2022

ProblemAcross all sectors, leadership decision-makers question how to professionally develop leaders who foster cohesive, collaborative, and high performing workforce environments in diverse organizations. They doubt the efficacy of traditional leadership development modalities when confronted by unpredictable emerging workforce and workplace challenges.SolutionThe article’s conceptual framework is centered on the premise that the best interaction between leader and led in diverse organizations is inclusive leadership. Leaders who deliberately role model inclusive leadership behaviors create a culture where everyone works to their full potential, stimulate learning organizations, and catalyze workforce relationships towards achieving strategic goals.StakeholdersThis article is ideal for Human Resources, Human Resource Development, Organizational Development, and Diversity, Equity, Inclusion, and Accessibility professionals, trainers, facilitators, consultants, practitioners, change agents and leaders. It may be helpful in generating ideas and practices for developing interventions catalyzing inclusive practices among leaders and workforce members.
Effect of microbubbles on transcranial doppler ultrasound-assisted intracranial recombinant tissue-type plasminogen activator thrombolysis
Authors: Liu Wei-Song , Zhu Shao-Fen , Guo Yuan-Ling , Huang Rong , Yang Xue 
Published: July 2022

Objectives The aim of this study was to evaluate the effect of microbubbles on the efficacy of transcranial doppler (TCD) ultrasound-assisted thrombolytic therapy of recombinant tissue-type plasminogen activator (rt-PA). Methods Male New Zealand white rabbits ( n = 36) were randomly divided into an rt-PA group ( n = 18) and an rt-PA plus microbubble group ( n = 18). After the cerebral infarction model was constructed with autologous blood clots, rt-PA and rt-PA plus microbubble intervention were performed, respectively. The hemodynamic changes and infarct size of the two groups were recorded. In addition, the ELISA method was used to detect the level of nitric oxide (NO), superoxide dismutase (SOD), and malondialdehyde (MDA) in the brain tissue of the two-group graph model and high-sensitivity C-reactive protein (hs-CRP) in the serum. Results In the rt-PA group, the recanalization rate was 38.9% and the average infarct size was 11.8%. In the rt-PA plus microbubble group, the recanalization rate was 66.7% and the average infarct size was 8.2%. In addition, the average values for NO, SOD, MDA, and hs-CRP were 16.48 ± 5.39 μmol/L, 730.2 ± 9.86 U/mg, 0.92 ± 0.43 nmol/mg, and 8.56 ± 1.64 mg/L in the rt-PA group, respectively, and the average values were 9.18 ± 3.37 μmol/L, 426.2 ± 6.39 U/mg, 0.73 ± 0.44 nmol/mg, and 5.23 ± 0.94 mg/L in the rt-PA plus microbubble group, respectively. Conclusions The addition of microbubbles enhanced the effects of TCD-assisted rrt-PA thrombolysis.
Women with larger breasts are less satisfied with their breasts: Implications for quality of life and physical activity participation
Authors: Oon Isobel H , Mara Jocelyn K , Steele Julie R , McGhee Deirdre E , Lewis Vivienne , Coltman Celeste E 
Published: July 2022

Introduction: Although low breast satisfaction has been associated with a range of potential negative health implications, little is known about key factors that influence breast satisfaction across the lifespan. This study aimed to determine the impacts of age, body mass and breast size on breast satisfaction and how breast satisfaction impacts psychosocial and sexual well-being-related quality of life outcomes and physical activity behaviours. Methods: Three hundred and forty-five women (age range: 18.1–83.7 years) had their body mass (kg), standing height (cm) and breast volume (ml) measured. A 13-item questionnaire comprising the Breast-Q and Active Australia Survey was used to assess breast satisfaction, quality of life outcomes and participation in physical activity. Results: Breast satisfaction was influenced by breast size, such that women with larger breasts were less satisfied with their breasts compared to their counterparts with smaller breasts. Greater breast satisfaction was associated with improved psychosocial and sexual well-being-related measures of quality of life, and time spent participating in physical activity. Conclusion: Interventions to improve breast satisfaction among women across the breast size spectrum should be encouraged in public health initiatives to better engage and encourage positive health behaviours and reduce potential adverse health implications.