bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-Effectiveness of a Household Salt Substitution Intervention: Findings From 20 995 Participants of the Salt Substitute and Stroke Study
Authors: Li Ka-Chun , Huang Liping , Tian Maoyi , Di Tanna Gian Luca , Yu Jie , Zhang Xinyi , Yin Xuejun , Liu Yishu , Hao Zhixin , Zhou Bo , Feng Xiangxian , Li Zhifang , Zhang Jianxin , Sun Jixin , Zhang Yuhong , Zhao Yi , Zhang Ruijuan , Yu Yan , Li Nicole , Yan Lijing L. , Labarthe Darwin R. , Elliott Paul , Wu Yangfeng , Neal Bruce , Lung Thomas , Si Lei 
Published: March 2022

Background:
SSaSS (Salt Substitute and Stroke Study), a 5-year cluster randomized controlled trial, demonstrated that replacing regular salt with a reduced-sodium, added-potassium salt substitute reduced the risks of stroke, major adverse cardiovascular events, and premature death among individuals with previous stroke or uncontrolled high blood pressure living in rural China. This study assessed the cost-effectiveness profile of the intervention.

Methods:
A within-trial economic evaluation of SSaSS was conducted from the perspective of the health care system and consumers. The primary health outcome assessed was stroke. We also quantified the effect on quality-adjusted life-years (QALYs). Health care costs were identified from participant health insurance records and the literature. All costs (in Chinese yuan [¥]) and QALYs were discounted at 5% per annum. Incremental costs, stroke events averted, and QALYs gained were estimated using bivariate multilevel models.

Results:

Mean follow-up of the 20 995 participants was 4.7 years. Over this period, replacing regular salt with salt substitute reduced the risk of stroke by 14% (rate ratio, 0.86 [95% CI, 0.77–0.96];
P
=0.006), and the salt substitute group had on average 0.054 more QALYs per person. The average costs (¥1538 for the intervention group and ¥1649 for the control group) were lower in the salt substitute group (¥110 less). The intervention was dominant (better outcomes at lower cost) for prevention of stroke as well as for QALYs gained. Sensitivity analyses showed that these conclusions were robust, except when the price of salt substitute was increased to the median and highest market prices identified in China. The salt substitute intervention had a 95.0% probability of being cost-saving and a >99.9% probability of being cost-effective.

Conclusions:
Replacing regular salt with salt substitute was a cost-saving intervention for the prevention of stroke and improvement of quality of life among SSaSS participants.
Novel Oxygen Carrier Slows Infarct Growth in Large Vessel Occlusion Dog Model Based on Magnetic Resonance Imaging Analysis
Authors: Shazeeb Mohammed Salman , King Robert M. , Anagnostakou Vania , Vardar Zeynep , Kraitem Afif , Kolstad Josephine , Raskett Christopher , Le Moan Natacha , Winger Jonathan A. , Kelly Lauren , Krtolica Ana , Henninger Nils , Gounis Matthew J. 
Published: March 2022

Background:
Tissue hypoxia plays a critical role in the events leading to cell death in ischemic stroke. Despite promising results in preclinical and small clinical pilot studies, inhaled oxygen supplementation has not translated to improved outcomes in large clinical trials. Moreover, clinical observations suggest that indiscriminate oxygen supplementation can adversely affect outcome, highlighting the need to develop novel approaches to selectively deliver oxygen to affected regions. This study tested the hypothesis that intravenous delivery of a novel oxygen carrier (Omniox-Ischemic Stroke [OMX-IS]), which selectively releases oxygen into severely ischemic tissue, could delay infarct progression in an established canine thromboembolic large vessel occlusion stroke model that replicates key dynamics of human infarct evolution.

Methods:
After endovascular placement of an autologous clot into the middle cerebral artery, animals received OMX-IS treatment or placebo 45 to 60 minutes after stroke onset. Perfusion-weighted magnetic resonance imaging was performed to define infarct progression dynamics to stratify animals into fast versus slow stroke evolvers. Serial diffusion-weighted magnetic resonance imaging was performed for up to 5 hours to quantify infarct evolution. Histology was performed postmortem to confirm final infarct size.

Results:

In fast evolvers, OMX-IS therapy substantially slowed infarct progression (by ≈1 hour,
P
<0.0001) and reduced the final normalized infarct volume as compared to controls (0.99 versus 0.88, control versus OMX-IS drug,
P
<0.0001). Among slow evolvers, OMX-IS treatment delayed infarct progression by approximately 45 minutes; however, this did not reach statistical significance (
P
=0.09). The final normalized infarct volume also did not show a significant difference (0.93 versus 0.95, OMX-IS drug versus control,
P
=0.34). Postmortem histologically determined infarct volumes showed excellent concordance with the magnetic resonance imaging defined ischemic lesion volume (bias: 1.33% [95% CI, −15% to 18%).

Conclusions:
Intravenous delivery of a novel oxygen carrier is a promising approach to delay infarct progression after ischemic stroke, especially in treating patients with large vessel occlusion stroke who cannot undergo definitive reperfusion therapy within a timely fashion.
Effect of Deferoxamine on Trajectory of Recovery After Intracerebral Hemorrhage: A Post Hoc Analysis of the i-DEF Trial
Authors: Foster Lydia , Robinson Laura , Yeatts Sharon D. , Conwit Robin A. , Shehadah Amjad , Lioutas Vasileios , Selim Magdy ,   on behalf of the i-DEF Investigators
Published: March 2022

Background:
There are limited data on the trajectory of recovery and long-term functional outcomes after intracerebral hemorrhage (ICH). Most ICH trials have conventionally assessed outcomes at 3 months following the footsteps of ischemic stroke. The i-DEF trial (Intracerebral Hemorrhage Deferoxamine Trial) assessed modified Rankin Scale (mRS) longitudinally at prespecified time points from day 7 through the end of the 6-month follow-up period. We evaluated the trajectory of mRS among trial participants and examined the effect of deferoxamine on this trajectory.

Methods:
We performed a post hoc analysis of the i-DEF trial, a multicenter, randomized, placebo-controlled, double-blind, futility-design, phase 2 clinical trial, based on the actual treatment received. Favorable outcome was defined as mRS score of 0–2. A generalized linear mixed model was used to evaluate the outcome trajectory over time, as well as whether the trajectory was altered by deferoxamine, after adjustments for randomization variables, presence of intraventricular hemorrhage, and ICH location.

Results:

A total of 291 subjects were included in analysis (145 placebo and 146 deferoxamine). The proportion of patients with mRS score of 0–2 continually increased from day 7 to 180 in both groups (interaction
P
<0.0001 for time in main effects model), but treatment with deferoxamine favorably altered the trajectory (interaction
P
=0.0010). Between day 90 and 180, the deferoxamine group improved (
P
=0.0001), whereas there was not significant improvement in the placebo arm (
P
=0.3005).

Conclusions:
A large proportion of patients continue to improve up to 6 months after ICH. Future ICH trials should assess outcomes past 90 days for a minimum of 6 months. In i-DEF, treatment with deferoxamine seemed to accelerate and alter the trajectory of recovery as assessed by mRS.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02175225.
The Internal and ENSO-Forced Modes of the Indian Ocean Sea Surface Temperature
Authors: Ding Ruibin , Kang In-Sik , Farneti Riccardo , Kucharski Fred , Sante Fabio Di , Xuan Jiliang , Zhou Feng , Zhang Tao 
Published: March 2022

Abstract
The internal and ENSO-forced modes of the Indian Ocean sea surface temperature (SST) are investigated using a high-resolution regional coupled model. Five different model simulations were performed by controlling atmospheric and oceanic boundary conditions (BCs), which are lateral walls of the model domain. In the internal run performed by prescribing the climatological mean oceanic and atmospheric BCs, the first and second empirical orthogonal functions (EOF1 and EOF2) of internal mode are similar to the observed Indian Ocean basin (IOB) and dipole (IOD) modes with relatively weak amplitudes, respectively. In the control run with observed BCs, those EOFs are much amplified with their power spectrums significantly changed, and their spatial patterns are modified, particularly for the EOF2. Three ENSO runs with combinations of ENSO-related and climatological mean BCs show that the modification of spatial pattern of EOFs is mainly due to ENSO forcing. Furthermore, ENSO forcing determines the major 4-yr period of IOB mainly through the atmosphere, whereas the major 3-yr period of IOD is determined by both ENSO atmosphere and ocean forcings. It is also found that IOB and IOD exhibit a significant seasonally dependent relationship in both internal and ENSO-forced simulations. Most importantly, by applying the empirical singular vector method to both observed and modeled data, it is found that the IOD–IOB relationship is associated with an unstable mode of Indian Ocean SST anomalies, evolving from boreal fall to the next spring. This unstable mode is intrinsic within the Indian Ocean but is substantially amplified by the ENSO.
Near Invariance of Poleward Atmospheric Heat Transport in Response to Midlatitude Orography
Authors: Cox Tyler , Donohoe Aaron , Roe Gerard H. , Armour Kyle C. , Frierson Dargan M. W. 
Published: March 2022

Abstract
Total poleward atmospheric heat transport (AHT) is similar in both magnitude and latitudinal structure between the Northern and Southern Hemispheres. These similarities occur despite more major mountain ranges in the Northern Hemisphere, which help create substantial stationary eddy AHT that is largely absent in the Southern Hemisphere. However, this hemispheric difference in stationary eddy AHT is compensated by hemispheric differences in other dynamic components of AHT so that total AHT is similar between hemispheres. To understand how AHT compensation occurs, we add midlatitude mountain ranges in two different general circulation models that are otherwise configured as aquaplanets. Even when midlatitude mountains are introduced, total AHT is nearly invariant. We explore the near invariance of total AHT in response to orography through dynamic, energetic, and diffusive perspectives. Dynamically, orographically induced changes to stationary eddy AHT are compensated by changes in both transient eddy and mean meridional circulation AHT. This creates an AHT system with three interconnected components that resist large changes to total AHT. Energetically, the total AHT can only change if the top-of-the-atmosphere net radiation changes at the equator-to-pole scale. Midlatitude orography does not create large-enough changes in the equator-to-pole temperature gradient to alter outgoing longwave radiation enough to substantially change total AHT. In the zonal mean, changes to absorbed shortwave radiation also often compensate for changes in outgoing longwave radiation. Diffusively, the atmosphere smooths anomalies in temperature and humidity created by the addition of midlatitude orography, such that total AHT is relatively invariant.

Significance Statement
The purpose of this study is to better understand how orography influences heat transport in the atmosphere. Enhancing our understanding of how atmospheric heat transport works is important, as heat transport helps moderate Earth’s surface temperatures and influences precipitation patterns. We find that the total amount of atmospheric heat transport does not change in the presence of mountains in the midlatitudes. Different pieces of the heat transport change, but they change in compensatory ways, such that the total heat transport remains roughly constant.
Jejuno-jejunal intussusception secondary to recurrent/metastatic melanoma
Authors: Cibulas Megan A. , Carrillo Eddy H. , Lee Seong K. , Rosenthal Andrew A. 
Published: March 2022

Intussusception is uncommon in adults, and usually secondary to a neoplasm. Small bowel obstruction (SBO) is prevalent in adults but rarely due to intussusception. A 55-year-old woman with history of melanoma (four years in remission) presented with abdominal pain and melena. Upper and lower endoscopy was normal. She developed bilious emesis and worsening pain, so she presented to the emergency department. CT abdomen/pelvis identified a SBO with transition point at a small bowel intussusception; she was taken to the operating room. A mid-jejunal intussusception was reduced revealing a mass; resection and primary anastomosis was performed. Final pathology demonstrated a 5.5 cm melanoma, likely metastatic. She required no additional therapy and remains in remission eighteen months later. Intussusception due to metastatic melanoma is rare but should be on the differential for patients with SBO and history of melanoma. Knowledge of this history should prompt consideration for oncologic resection to optimize outcome
Economic Growth and the Rate of Profit in Colombia 1967–2019: A VAR Time-Series Analysis
Authors: Duque Garcia Carlos Alberto 
Published: March 2022

In recent decades, there has been a growing literature dealing with the empirical estimation of the rate of profit and other Marxian variables in several countries. Nonetheless, there has been a paucity of econometric research about the impact of those Marxian variables on the growth rate in developing countries. This article seeks to evaluate the rate of profit and the rate of accumulation as determinants of the growth rate in Colombia during 1967–2019, using a generalized vector autoregressive model. We find that both variables are statistically significant and, in concordance with Marxian theory predictions, affect positively the growth rate. We also identify direct impacts of the growth rate over the profit rate and the accumulation rate as well as an economic relevant relationship between these latter variables. JEL Classification: B51, C22, O54
Irremediable Psychiatric Suffering in The Context of Medical Assistance in Dying: A Delphi-Study
Authors: van Veen Sisco M.P. , Evans Natalie , Ruissen Andrea M. , Vandenberghe Joris , Beekman Aartjan T.F. , Widdershoven Guy A.M. 
Published: March 2022

Objective Patients with a psychiatric disorder are eligible to request medical assistance in dying (MAID) in a small but growing number of jurisdictions, including the Netherlands and Belgium. In Canada, MAID for mental illness will become possible in 2023. For this request to be granted, most of these jurisdictions demand that the patient is competent in her request, and that the suffering experienced is unbearable and irremediable. Especially the criterion of irremediability is challenging to establish in patients with psychiatric disorders. The aim of this research is to establish what criteria Dutch and Belgian experts agree to be necessary in characterising irremediable psychiatric suffering (IPS) in the context of MAID. Methods A two-round Delphi procedure among psychiatrists with relevant experience. Results Thirteen consensus criteria were established: five diagnostic and eight treatment-related criteria. Diagnostically, the participants deem a narrative description and attention to contextual and systemic factors necessary. Also, a mandatory second opinion is required. The criteria concerning treatment show that extensive biopsychosocial treatment is needed, and the suffering must be present for several years. Finally, in the case of refusal, the participants agree that there are limits to the number of diagnostic procedures or treatments a patient must undergo. Conclusions Consensus was found among a Dutch and Belgian expert group on potential criteria for establishing IPS in the context of MAID. These criteria can be used in clinical decision-making and can inform future procedural demands and research.
Report of Low Incidence of Thrombosis with Early Prophylaxis in Hospitalized Patients with COVID-19 from Two Saudi Tertiary Centers
Authors: Owaidah Tarek , Maghrabi Khalid , Alfraih Feras , Haroon Alfadil , Siddiqui Khawar , Alnounou Randa , AlOtair Hadeel , Alqahtany Fatmah S , Maghrabi Mohannad , Owaidah Mustafa , AlSaleh Khalid 
Published: March 2022

Background Thrombotic events can increase the COVID-19 associated disease mortality. The administration of prophylactic anticoagulants had been shown to decrease the incidence of thrombosis, mortality, and ICU admission rates in COVID-19 patients. Aims The present study investigates the rate of thrombosis with early anticoagulation prophylaxis, the various risk factors for thrombotic events, and the overall survival rate in hospitalized COVID-19 cases. Methods In this prospective observational study, 425 patients aged ≥14 years were included in the study who were hospitalized with COVID-19 related symptoms from March to October 2020 at two tertiary care hospitals in the Kingdom of Saudi Arabia. Venous thromboembolism (VTE) score was evaluated, and VTE prophylaxis was administered according to the hospital guidelines. Patients’ demographics, comorbidities, disease presentation, and sequential hematological profiles were also recorded. Samples were collected at different time points to determine the hematological profiles. Results Out of 425 with positive COVID-19 subjects, eight (1.9%) patients developed thrombosis during admission, with pulmonary embolism being the most common type. VTE prophylaxis was administered to 394 (92.7%) patients. These anticoagulants included enoxaparin (86.3%), heparin (12.7%), warfarin (0.8%) and apixaban (0.3%). Comorbid conditions were recorded in 253 (59.5%) patients. ICU admission rate was 28% (n = 119), with a median time to transfer to ICU of 1 day (r: 0-33 days). A trend of high VTE score (5.0) with ICU admission and mortality ( P = <.001) was observed. The observed mortality rate for our cohort was 5.9% (25 events out of 425); however, for patients admitted in ICU, it was 16% (19 events out of 119 admissions). Conclusion We are reporting a low incidence of thrombosis in COVID-19 patients. We have demonstrated that the early administration of prophylactic anticoagulants might reduce the risk of thrombotic events and the associated mortality. We observed a higher VTE score and thrombosis in patients admitted to the ICU.
A fatal disseminated cryptococcal infection in a patient treated with zanubrutinib for Waldenström’s macroglobulinemia
Authors: Patel Dave , Sidana Megan , Mdluli Xolani , Patel Vallari , Stapleton Ann , Dasanu Constantin A 
Published: March 2022

Introduction Zanubrutinib is a second generation, irreversible small-molecule Bruton tyrosine kinase inhibitor (BTK) approved for the treatment of Waldenström's macroglobulinemia, mantle cell lymphoma, and marginal zone lymphoma. As a class, BTKs have been linked with an increased risk of respiratory infections in clinical trials. Case Report We describe a 75-year-old patient who presented with generalized weakness, fevers, dyspnea, and dry cough four months after starting zanubrutinib therapy for Waldenström's macroglobulinemia. He was subsequently diagnosed with pneumonia. Septic work-up led to diagnosis of disseminated cryptococcal infection, complicated by fungal pneumonia and meningitis. Management and outcome Zanubrutinib was held on admission, and the patient was started on combination oral and intravenous antifungal therapy. Despite clearance of fungemia, aggressive resuscitation, and appropriate antimicrobial therapy, respiratory status deteriorated requiring intubation. His condition progressed to septic shock, multiorgan failure, and demise. Discussion/Conclusion We report herein a case of fatal disseminated cryptococcosis in the setting of zanubrutinib use for Waldenström's macroglobulinemia. At the time of diagnosis, his Waldenström's macroglobulinemia was in a partial response. The mechanism by which Bruton tyrosine kinase inhibitors (BTKs) lead to invasive fungal infections in these patients remains to be explored. T- and B-cell immune defects accompanying low-grade B-cell lymphomas may contribute to the severity of these infections.
Livedoid Vasculitis in a Patient With Sjogren Syndrome Successfully Treated With Methotrexate
Authors: Aldehaim Abdulkarim Yousef , Alarfaj Abdurhman Saud 
Published: March 2022

Introduction: Cutaneous vasculitis occurs in a sizable minority of patients with Sjogren syndrome. In addition, their response to different modalities of therapy is variable. Case Description: We present a case of a 66-year-old female with Sjogren syndrome cutaneous vasculitis in whom combination treatment with Rituximab and Azathioprine failed to show a favorable response. However, methotrexate proved to be an excellent alternative. Discussion: In cutaneous vasculitis, in addition to the necessary local therapy applied to the affected limbs, methotrexate produced a complete response when other treatment modalities failed. Therefore, it may be advisable to use methotrexate to treat cutaneous vasculitis before trying Rituximab. Conclusion: In cutaneous vasculitis associated with Sjogren syndrome, methotrexate can be an early effective therapeutic strategy.
Secondary debris resulting from concrete slabs subjected to contact detonations
Authors: Hupfauf Moritz , Gebbeken Norbert 
Published: March 2022

As a consequence of terrorist attacks with explosives and malfunction of machinery detonations can lead to secondary debris on the protective side of a concrete wall. The term secondary debris in this context describes the debris resulting from a breakup of the loaded concrete structure in contrast to primary debris which results from the explosive or its casing. A test series has been conducted in order to investigate the physical phenomenology of the damaging process. A total of 15 reinforced concrete slabs with scaled thicknesses between 1.6 and 2.8 cm g−1/3 were loaded by contact detonations. The protective side of the concrete slabs was recorded with high-speed cameras during testing, and the damaged concrete slabs were measured with 3D-scans afterward. The acquired data will be evaluated for the velocity and mass of the secondary debris, to build the basis for an empirical model, which can make predictions about the occurring secondary debris. The objective of this paper is, to present the conducted experiments and propose the first part of an empirical model. This model predicts the geometry of the spalling crater on the protective side of the concrete slab, as well as the maximum velocity of the secondary debris. In following papers, the correlation between the mass and the velocity of the secondary debris will be derived from numerical simulations. With this, predictions can be made about the effects of the secondary debris on humans and installations on the protective side of the concrete slabs.