bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence-Based Process Performance Measures and Clinical Outcomes in Patients With Incident Heart Failure With Reduced Ejection Fraction: A Danish Nationwide Cohort Study
Authors: Schjødt Inge , Johnsen Søren P. , Strömberg Anna , DeVore Adam D. , Valentin Jan B. , Løgstrup Brian B. 
Published: March 2022

Background:
Data on the association between quality of heart failure (HF) care and outcomes among patients with incident HF are sparse. We examined the association between process performance measures and clinical outcomes in patients with incident HF with reduced ejection fraction.

Methods:
Patients with incident HF with reduced ejection fraction (n=10 966) between January 2008 and October 2015 were identified from the Danish HF Registry. Data from public registries were linked. Multivariable regression analyses were used to assess the association between 6 guideline-recommended HF care processes (New York Heart Association assessment, use of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, beta-blockers, and mineralocorticoid receptor antagonists, exercise training, and patient education) and all-cause and HF readmission, all-cause and HF hospital days, and mortality within 3 to 12 months after HF diagnosis. The associations were analyzed according to the percentages of all relevant performance measures fulfilled for the individual patient (0%–50% [reference group], >50%–75%, and >75%–100%) and for the individual performance measures.

Results:
Fulfilling >75% to 100% of the performance measures (n=5341 [48.7%]) was associated with lower risk of all-cause readmission (adjusted hazard ratio, 0.78 [95% CI, 0.68–0.89]) and HF readmission (adjusted hazard ratio, 0.71 [95% CI, 0.54–0.92]), lower use of all-cause hospital days (adjusted mean ratio, 0.73 [95% CI, 0.70–0.76]) and HF hospital days (adjusted mean ratio, 0.79 [95% CI, 0.70–0.89]), and lower mortality (adjusted hazard ratio, 0.42 [95% CI, 0.32–0.53]). A dose-response relationship was observed between fulfilling more performance measures and mortality (adjusted hazard ratio, 0.62 [95% CI, 0.49–0.77] fulfilling >50%–75% of the measures). Fulfilling individual performance measures, except mineralocorticoid receptor antagonist therapy, was associated with lower adjusted all-cause readmission, lower adjusted use of all-cause and HF hospital days, and lower adjusted mortality.

Conclusions:
Fulfilling more process performance measures was associated with better clinical outcomes in patients with incident HF with reduced ejection fraction.
NF-κB Signaling-Mediated Activation of WNK-SPAK-NKCC1 Cascade in Worsened Stroke Outcomes of Ang II–Hypertensive Mice
Authors: Bhuiyan Mohammad Iqbal H. , Young Cullen B. , Jahan Israt , Hasan Md Nabiul , Fischer Sydney , Meor Azlan Nur Farah , Liu Mingjun , Chattopadhyay Ansuman , Huang Huachen , Kahle Kristopher T. , Zhang Jinwei , Poloyac Samuel M. , Molyneaux Bradley J. , Straub Adam C. , Deng Xianming , Gomez Delphine , Sun Dandan 
Published: March 2022

Background:
Worsened stroke outcomes with hypertension comorbidity are insensitive to blood pressure-lowering therapies. In an experimental stroke model with comorbid hypertension, we investigated causal roles of ang II (angiotensin II)–mediated stimulation of the brain WNK (with no lysine [K] kinases)-SPAK (STE20/SPS1-related proline/alanine-rich kinase)-NKCC1 (Na-K-Cl cotransporter) complex in worsened outcomes.

Methods:
Saline- or ang II–infused C57BL/6J male mice underwent stroke induced by permanent occlusion of the distal branches of the middle cerebral artery. Mice were randomly assigned to receive either vehicle dimethyl sulfoxide/PBS (2 mL/kg body weight/day, IP), a novel SPAK inhibitor, 5-chloro-N-(5-chloro-4-((4-chlorophenyl)(cyano)methyl)-2-methylphenyl)-2-hydroxybenzamide (ZT-1a‚ 5 mg/kg per day, IP) or a NF-κB (nuclear factor-κB) inhibitor TAT-NBD (transactivator of transcription-NEMO-binding domain‚ 20 mg/kg per day, IP). Activation of brain NF-κB and WNK-SPAK-NKCC1 cascade as well as ischemic stroke outcomes were examined.

Results:

Stroke triggered a 2- to 5-fold increase of WNK (isoforms 1, 2, 4), SPAK/OSR1 (oxidative stress-responsive kinase 1), and NKCC1 protein in the ang II–infused hypertensive mouse brains at 24 hours after stroke, which was associated with increased nuclear translocation of phospho-NF-κB protein in the cortical neurons (a Pearson correlation r of 0.77,
P
<0.005). The upregulation of WNK-SPAK-NKCC1 cascade proteins resulted from increased NF-κB recruitment on
Wnk1, Wnk2, Wnk4, Spak
, and
Nkcc1
gene promoters and was attenuated by NF-κB inhibitor TAT-NBD. Poststroke administration of SPAK inhibitor ZT-1a significantly reduced WNK-SPAK-NKCC1 complex activation, brain lesion size, and neurological function deficits in the ang II–hypertensive mice without affecting blood pressure and cerebral blood flow.

Conclusions:
The ang II–induced stimulation of NF-κB transcriptional activity upregulates brain WNK-SPAK-NKCC1 cascade and contributes to worsened ischemic stroke outcomes, illustrating the brain WNK-SPAK-NKCC1 complex as a therapeutic target for stroke with comorbid hypertension.
Exploring Citizen Diplomacy’s Local Impact: The Case of Global Ties Kalamazoo
Authors: Popkova Anna 
Published: March 2022

Summary
This article examines the local impact of citizen diplomacy through the case study of a volunteer-driven citizen diplomacy organisation Global Ties Kalamazoo (GTKzoo) based in Kalamazoo, Michigan (United States). Drawing on the data from 25 in-depth interviews with GTKzoo volunteers, this study demonstrates that citizen diplomats view citizen diplomacy as more authentic compared to traditional diplomacy. Representation as a key component of citizen diplomacy is also discussed, with GTKzoo volunteers struggling to reconcile their desire to ‘show the good parts of America’ with their understanding that ‘the good parts’ alone are not giving visitors a complete picture. This study also introduces two approaches to assessing the local impact of citizen diplomacy — instrumental and reflexive. The study concludes that the reflexive approach dominates citizen diplomats’ discussions as they focus on learning from the visitors, feeling inspired to be better community members, and seeing their local community through a more nuanced perspective.
Allegories of Light and Fire: Ignatian Effigies Painted on Copper
Authors: Zierholz Steffen 
Published: March 2022

Abstract
This article examines two small portraits of Ignatius of Loyola painted on copper between 1598 and 1622. Rather than focusing on the true likeness of the founder of the Jesuits, it sheds light on the neglected early history of the Ignatius-ignis pun, according to which his name is juxtaposed with the Latin word for fire. For this purpose, the article connects to the growing interest in the materiality of art. In contrast to traditional supports, the use of copper generates extraordinarily brilliant pictorial effects. This “magical” production of light plays, I argue, a crucial role in representing both Pedro Ribadeneyra’s account of Ignatius’s fiery physiology and Filippo Neri’s report concerning Ignatius’s supernatural splendor. However, the presence of light is no metaphor of the divine but is closely related to the contemporary physics and metaphysics of light. With Francesco Patrizi da Cherso in mind, the portraits can be construed as allegories of light and fire.
Immunogenicity of erenumab: A pooled analysis of six placebo-controlled trials with long-term extensions
Authors: Zhou Yanchen , Zhang Feng , Starcevic Manning Marta , Hu Zheng , Hsu Cheng-Pang , Chen Po-Wei , Peng Cheng , Loop Brett , Mytych Daniel T , Paiva da Silva Lima Gabriel 
Published: March 2022

Background Immunogenicity of erenumab, a human anti-calcitonin gene-related peptide receptor monoclonal antibody developed for migraine prevention, has been evaluated throughout clinical development. Methods Integrated post hoc analysis assessing immunogenicity of erenumab across six clinical trials in patients with episodic and chronic migraine (N = 2985). Anti-erenumab antibody incidence and potential impact on pharmacokinetics, efficacy, and safety were evaluated in short-term (double-blind treatment phase 12–24 weeks) and long-term (double-blind treatment phase plus extensions of up to 5 years) analyses. Results Anti-erenumab binding antibody incidence was low with few patients developing neutralizing antibodies. Antibody responses were mostly transient with low magnitude. Binding antibodies developed as early as 2–4 weeks after the first dose; the majority developed within the first 6 months and very few after the first year. Serum concentrations of erenumab in antibody-positive patients were generally lower than, but within the range of, antibody-negative patients. There was no impact of anti-erenumab antibodies on erenumab efficacy or safety with no differences between antibody-positive and antibody-negative patients in change in monthly migraine days or adverse event rates. Conclusions This pooled analysis showed that immunogenicity had no meaningful clinical impact on efficacy or safety of erenumab in patients with migraine. Clinical Trial Registration: ClinicalTrials.gov, NCT01952574; ClinicalTrials.gov, NCT02456740; Clinicaltrials.gov NCT02483585; Clinicaltrials.gov, NCT02174861; Clinicaltrials.gov, NCT02630459; Clinicaltrials.gov, NCT03812224
Rooming-In Practice During the Pandemic: Results From a Retrospective Cohort Study
Authors: Costa Simonetta , Priolo Francesca , Fattore Simona , Tedesco Marta , Rubortone Serena Antonia , Giordano Lucia , Chioma Roberto , Neri MD Caterina , Lanzone Antonio , Buonsenso Danilo , Valentini Piero , Vento Giovanni 
Published: March 2022

Background: The Coronavirus disease 2019 (COVID-19) pandemic emerged in December 2019 and spread rapidly worldwide. So far, evidence regarding the breastfeeding and rooming-in management of mothers with COVID-19 and their newborn infants is scarce. Research Aims: 1) To assess the rate of exclusive breastfeeding at discharge among mothers with COVID-19 and their newborn infants managed either using a rooming-in or a separation regimen; and 2) to evaluate different neonatal outcomes, including the need for re-hospitalization related to COVID-19 among newborn infants in the two groups. Method: We conducted a retrospective two-group comparative observational study. The sample was participants with COVID-19 and their newborn infants ( N = 155 dyads) between March 1, 2020, and April 30, 2021. Two time periods were outlined resulting from the two different clinical practices of mother–infant separation and rooming-in. Results: Within the sample, 145 (93.5%) were asymptomatic. All neonates had documented Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) test results, and six tested positive by reverse transcriptase polymerase chain reaction within 48 hr of life. The rate of exclusive breastfeeding was significantly higher ( p < .0001) within the rooming-in group. Length of hospital stay was significantly lower ( p = .001) within the rooming-in group. Conclusions: Protected rooming-in practice has proven to be safe and effective in supporting breastfeeding: None of the infants enrolled were hospitalized due to COVID-19 infection and the rate of exclusive breastfeeding at discharge was increased compared to those infants separated from their mothers.
Health-Related Quality of Life of Omani Colorectal Cancer Survivors
Authors: Al-Shandudi Maryam , Al-Mandhari Mansour , Chan Moon Fai , Al-Hajri Thuraiya , Al-Balushi Muna , Al-Azri Mohammed 
Published: March 2022

Background Colorectal cancer (CRC) patients often experience physical and psychological symptoms which affect quality of life (QOL). Purpose This study aimed to identify factors affecting QOL among adult Omani CRC survivors. Methods A prospective cross-sectional study of 124 adult CRC survivors was conducted at the two main oncology referral hospitals in Oman. A validated Arabic version of the European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaire for Colorectal Cancer-29 (EORTC QLQ-CR29) was used to collect data. Results Of the 118 participants (response rate: 95.2%), 59 (50.0%) were male. The mean age was 52.7 years. Overall, 102 (86.4%) had been diagnosed with CRC at stages II or III. High mean scores on the QLQ-CR29 functional scale were reported for body image (88.9), weight (79.3), and anxiety (75.4). Mean scores for sexual interest were lower in men (31.4) compared to women (62.2). Severe anxiety was reported in 12 survivors (10.2%). Age, gender, the presence of comorbidities, and tumor location were significant predictors of QOL ( P ≤.05). Conclusion Omani CRC survivors demonstrated satisfactory QOL, although men reported more anxiety and sexual problems. Healthcare providers in Oman should conduct regular assessments of CRC survivors and offer counseling services if necessary.
“Outcomes of optical penetrating keratoplasty with the large sized donor for failed therapeutic grafts for infectious keratitis from the tertiary eye care center, South India”
Authors: Anitha Venugopal , Ravindran Meenakshi , Jacob Ann Divya , Ghorpade Aditya , Uduman Mohammed Sithiq 
Published: March 2022

Purpose To evaluate the preoperative risk factors, complications, and postoperative outcomes following regraft with the large-sized donor for failed therapeutic grafts. Methods In this retrospective interventional case series, patients who underwent optical penetrating keratoplasty for failed therapeutic keratoplasty (TPK) from 2010 till 2019 were studied at the Cornea clinic, Tertiary eye care center, with a maximum follow-up period of 3 years within the study period. Demographic patterns, preoperative risk factors, graft survival, visual outcomes, and complications were reviewed from the electronic medical records. Results A total of 77 eyes of 77 patients underwent optical penetrating keratoplasty, with the mean age of 46.18 ± 12.56 years. The median interval between the two procedures was 10.29 months (IQR: 9.0-15.5) and a mean follow-up of 31.27 months. Non-healing fungal keratitis (n = 48) was the most common indication for TPK. The mean size of the donor used was 10 mm (IOR: 9.5-11 mm). The presence of Peripheral anterior synechiae (p < 0.001) and deep limbal vessels (p = 0.011) showed a significant association with the graft outcomes. Four eyes (5%) developed graft reinfection, one patient (1.2%) underwent evisceration, 28 eyes (39%) had graft rejection; among them, 11 eyes (14.28%) resolved with treatment, and in 17 eyes (22.07%), graft failed. Forty-seven eyes (61%) had secondary glaucoma, of which in 32 eyes (68.08%), intraocular pressure was controlled with anti-glaucoma medications; fifteen eyes (31.19%) needed surgery. The graft's cumulative success rate was 83.1% at six months, 58.4% at one year, and 35.1% at three years. Conclusion We conclude that despite the high complication rate following optical penetrating keratoplasty for failed therapeutic grafts, the visual and clinical outcomes are satisfactory for such high-risk grafts. Hence, it is imperative to venture surgical intervention to salvage these eyes.
Gender Diversity in Hand Surgery Leadership
Authors: Brisbin Alyssa K. , Chen Wendy , Goldschmidt Ezequiel , Smith Brandon T. , Bourne Debra A. 
Published: March 2022

Background: Diversity in leadership drives innovation; however, women are underrepresented in leadership positions across academic medicine. The aim of this study was to assess the current gender representation in hand surgery leadership positions. Methods: This was a cross-sectional analysis of leaders in hand surgery. Leaders were defined as President, Board and Committee members of the American Society for Surgery of the Hand and the American Association for Hand Surgery, as well as hand surgery fellowship program directors and physician lead editors of peer-reviewed hand journals. The representation of women in leadership was compared to the percentage of female hand fellows over the same period. Years in practice, academic rank, additional degrees, h-index, m-index, National Institutes of Health (NIH) funding, publications, and citations were compared between male and female leaders. Results: Twenty-nine of 213 leadership positions (13.6%) are held by women which is fewer than would be expected based on hand surgery fellowship composition. Female leaders were earlier in practice than their male counterparts (13.5 ± 5.7 versus 20.8 ± 11.1 years, P < .01). Women were more likely to hold position of assistant professor and less likely to be full professors ( P < .05). There was no gender difference in NIH funding, h-index, m-index, publications, or citations. The greatest gender disparity was at the level of National Society President, which is a title held by only 2 women and 119 men. Conclusions: Gender disparities in hand surgery exist and are accentuated at the leadership level. Further work is needed to decrease leadership promotion disparities between men and women.
Factors associated with self-reported pain and hand function following surgical A1 pulley release
Authors: Koopman Jaimy E. , Hundepool Caroline A. , Wouters Robbert M. , Duraku Liron S. , Smit Jeroen M. , Selles Ruud W. ,   the Hand-Wrist study group, Zuidam J. Michiel 
Published: March 2022

Surgical A1 pulley release can considerably reduce pain and improve hand function, but individual outcomes are highly variable. This study aimed to identify factors contributing to self-reported pain and hand function 3 months postoperatively. We included 2681 patients who had received surgical treatment for a trigger finger or thumb and who completed the Michigan Hand outcomes Questionnaire (MHQ). Hierarchical linear regression models were used to investigate patient and clinical characteristics associated with postoperative pain and hand function. For both pain and hand function, the most influential factors associated with worse outcomes were worse MHQ scores at baseline (β 0.38 and 0.33, respectively) and ≥3 preoperative steroid injections (β –0.36 and –0.35). These factors indicated that patients with severe preoperative symptoms represent a group with a more advanced disease that is more difficult to treat. These findings can assist clinicians in patient counselling, expectation management and decision-making about the timing of the intervention. Level of evidence: II
Are culturally vibrant communities healthier? Relationships between performing arts activity and health outcomes in the 500 largest US cities
Authors: McCrary J M , Großbach M , Altenmüller E 
Published: March 2022

Aims: Recent reviews have demonstrated broad links between performing arts participation (e.g. music-making; dancing; acting) and receptive engagement (e.g. listening to music; attending a dance/theatre performance) and improved health, including reduced disease and mortality risk. However, no investigations to date have interrogated the links between community-level performing arts activity (i.e. participation  +  receptive engagement) and health outcomes – that is, do the performing arts help create healthy communities? This study aims to address this question by examining links between performing arts activity and health outcomes across 500 cities in the US. Methods: Secondary analysis of demographic, health outcome, performing arts activity (estimated by annual performing arts revenue), and preventive/unhealthy behaviour data for 500 large cities in the US – data extracted from the US Centers for Disease Control 500 Cities Project, Dun & Bradstreet Hoovers Database, and US Census. Links between performing arts activity and 12 health/disease outcomes were evaluated using a series of hierarchical beta regression models which progressively controlled for demographic variables and preventive/unhealthy behaviour prevalence. Results: The 500 analysed US cities comprise 33.4% of the total US population and 84,010 performing arts businesses (total annual revenue $27.84 billion). No significant associations were found between performing arts activity and 9 of 12 health outcomes in fully adjusted models ( p ⩾ .17). Statistically significant relationships ( p < .01) between increased performing arts activity and increased prevalence of chronic kidney disease, coronary heart disease, and stroke were determined to be clinically equivocal. Conclusions: This study contributes to a growing body of conflicting epidemiologic evidence regarding the impact of the performing arts on health/disease and mortality outcomes, evaluated using a range of disparate methodologies. A consensus, psychometrically rigorous approach is required to address this prevailing uncertainty in future epidemiologic studies examining the effects of performing arts activities both within and across countries and communities.
Do Home and Community Environments Explain Self-Rated Health Among Older Canadians? Evidence From the 2018 Canadian Housing Survey
Authors: Cheung Ethan Siu Leung , Mui Ada C. 
Published: March 2022

Objectives: This study examined the associations between home and community environmental factors and self-rated health (SRH) among older Canadians and how these associations vary by gender and living arrangements. Background: In social gerontology research, the psychosocial determinants of SRH have been widely investigated. Based on the environmental gerontology framework, this study examined the home and community environmental correlates of SRH. Method: The sample (aged 60 or older) was drawn from the 2018 Canadian Housing Survey (4,086 men living alone; 6,471 men living with others; 9,170 women living alone; 4,876 women living with others). Multiple regression analyses were used to examine the relationships between SRH and potential environmental correlates in a hierarchical model. Results: Findings show that older men and women living alone reported lower levels of SRH than those living with others. Regression findings show common and unique home and community environmental predictors of SRH by group. Common predictors of higher SRH were private housing residence, larger living space, satisfaction with dwelling, volunteering, no perceived need for community services, and community safety. Home maintenance needs predicted lower SRH among older men and women living with others; uninhabitable conditions predicted poor SRH among older men living with others and older women living alone. Conclusion: Results support the important effects of place in terms of home and community environments for older adults’ SRH, and associations differed by gender and living arrangements.