bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of type II diabetes on LV remodeling and function in patient with severe aortic stenosis
Authors: Seillier G , Pozzi M , Paillard M , Pierrard R , Chalabreysse L , Nouviant C , De-Bourguignon C , Givre L , Farha F , Vola M , Uhlrich W , Bessyre-Des-Horts T , Obadia JF , Bergerot C , Thibault H 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): PHRC inter régional

Background
Type II diabetes (T2DM) can specifically cause left ventricular (LV) remodeling and systolic and/or diastolic abnormalities. This diabetic cardiomyopathy is associated with an increased risk of heart failure. T2DM is frequently associated with LV pressure overload as encountered in aortic stenosis (AS). The effect of T2DM on LV remodeling induced by AS remained unclear.

Purpose
We aimed to evaluate the impact of T2DM on left ventricular (LV) remodeling and function in patients with severe AS referred for aortic valve replacement.

Methods
We included patients with severe AS and no overt heart disease referred for aortic valve replacement. Patients with atrial fibrillation, left ventricular ejection fraction (LVEF) &lt;50%, significant coronary stenosis or a more than mild associated valvular heart disease were excluded. Baseline ultrasound parameters were measured including 2D and 3D left ventricle mass (LVM), LVEF, posterior wall thickness (PWT) and global longitudinal strain (GLS). We also studied LV diastolic function and left ventricular filling pressure according to current guidelines.

Results
82 patients were included; 32 were diabetics. Hypertension and dyslipidemia were more frequent in T2DM patients. Aortic mean gradient, aortic valve area and cardiac index were similar between the two groups. There was no difference in valvuloarterial impedance indexed to height^2.04.
PWT, 3D LVM and 3D LVM index to height^2.7 were higher in T2DM patients (p = 0.03, p = 0.01 and p = 0.04, respectively). In multivariable analysis, after controlling for age, gender, BMI and hypertension, T2DM remained associated with a greater 3D LVM index (p= 0.04).
Diabetic patients also presented a worse LV systolic function with a lower absolute value of GLS compared to non-diabetics (15.1 ± 2.7 vs. 17.8 ± 2.0; p &lt; 0.01). The association of T2DM with a decreased GLS remained significant in multivariate analysis (p &lt; 0.01; Table 1). Estimated left ventricular filling pressure was not significantly affected by T2DM. However, there was a trend towards more patients with elevated LV filling pressure in T2DM group (40% vs 22% in non T2DM patients; p = 0.08).

Conclusion
T2DM increases LV hypertrophy and LV dysfunction in patients with severe AS. Prognostic issues should be further assessed as it may encourage an earlier management of T2DM patients with severe AS. Abstract Figure. Parameters Associated with GLS
Evaluating the performance of unenhanced computed tomography in the diagnosis of pulmonary embolism
Authors: Hatami F , Ehsanbakhsh A , Valizadeh N , Khorashadizadeh N , Norouzirad F 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Pulmonary embolism (PE) is the third most common cardiovascular pathology after coronary artery disease and stroke with an incidence rate of 1 per 1000 individuals. Computed tomography pulmonary angiography (CTPA) as the gold standard examination in the detection of PE is contraindicated or unavailable in certain cases.

Purpose
The current study aimed to assess the accuracy of unenhanced CT in the diagnosis of PE.

Methods
A total of 195 consecutive participants with clinical suspicion for PE were enrolled in this prospective cohort study between October 2020 and March 2021. All patients were examined with a 16 slice multidetector (MD) CT scanner before performing the CTPA. Scans were independently reviewed by two expert radiologists who were blinded to patients’ clinical and laboratory history for imaging variables including presence and location of PE, hyper/hypodense intraluminal signs, pulmonary trunk enlargement, peripheral wedge-shaped opacity, and pleural effusion. First unenhanced CT scan and then CTPA were independently reviewed on a picture archiving and communications system workstation.

Results
There were 82 (42.1%) men and 113 (57.9%) women with the mean age ± standard deviation of 56 ±0.24 years. Based on CTPA results, 47 (24.1%) of 195 patients had PE of which 28 (59.5%) patients had central PE and 19 (40.5%) patients had peripheral PE. However, only 20 cases (42.5%) were detected with PE on MDCT scans consisting of 17 cases with (85%) central emboli and 3 cases with (15%) peripheral emboli. Given intraluminal clot density, 12 (60%) patients had hyperdense signs, 3 (15%) patients had hypodense signs, and 5 (25%) patients had mixed hyper-hypodense signs. There was a significant difference between central and peripheral embolies detected by MDCT. Intraluminal sign had the highest specificity and sensitivity (98.6%, 42.5%, AUC:0.734) followed by pulmonary trunk enlargement (84.4%, 36.1%, AUC: 0.603), peripheral wedge-shaped opacity (72.9%, 34%, AUC: 0.535), and pleural effusion (58.7%, 40.4%, AUC: 0.496). Our results did not show a remarkable difference in secondary findings from the MDCT scan including pulmonary trunk enlargement, peripheral wedge-shaped opacity, and pleural effusion concerning the presence of PE. Pleural effusion as the most common secondary finding in patients with PE was found in 31 (68.8%) of them.

Conclusion
Unenhanced MDCT has an acceptable performance to detect PE particularly central clots and should be considered as an alternative modality when CTPA is not available or indicated. Furthermore, the intraluminal sign is the main indicator of PE in MDCT images with the highest specificity and sensitivity. We recommend radiologists and other clinicians to be aware of intraluminal signs in case of unexpected PE.
Description of cardiovascular imaging abnormalities among hospitalized COVID-19 patients with elevated cardiac biomarkers
Authors: Manla Y , Khalouf A , Bonilla MF , Eltahlawy W , Bafadel A , Al Badarin F 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background and aims
Myocardial injury is commonly encountered among severely-ill COVID-19 patients. Underlying mechanisms, however, remain incompletely understood. Describing cardiovascular imaging (CVI) abnormalities in this population will provide additional insight into mechanisms of myocardial injury with COVID-19 and may potentially guide management for these patients. Therefore, we aimed to describe CVI abnormalities in COVID-19 patients with elevated high-sensitivity cardiac troponin (hs-cTn).

Methods
Consecutive hospitalized COVID-19 patients (n = 694) between February and July 2020 were retrospectively identified, including 409 patients with available hs-cTn (≥14 ng/dL was considered abnormal) Abnormality with any CVI—including transthoracic echocardiography (TTE), cardiac CT angiography, cardiac MR or invasive coronary angiography (ICA)—were identified through review of electronic records.

Results
Hospitalized COVID-19 patients with abnormal hs-cTn (107/409; 26.2%) had more frequent utilization of CVI compared with those with normal hs-cTn (61.7% vs. 30.5%, OR:3.7, 95%CI [2.3,5.8]) or those without available hs-cTn data (61.7% vs. 29.9%, OR:3.8, 95%CI [2.4,6]). Most utilized CVI modalities were TTE (63/107; 58.9%) followed by ICA (6/107; 5.6%). Echocardiographic abnormalities detected include right or left ventricular systolic dysfunction (22%), pericardial effusion (11%), while coronary artery disease was identified in 83.3% of patients who underwent ICA.

Conclusion
In this single center experience, cardiac biomarker elevation in hospitalized COVID-19 patients was associated with a 3-fold increase in the likelihood of CVI utilization, most commonly TTE. Ventricular systolic dysfunction and severe coronary artery disease were commonly encountered in patients with abnormal hs-cTn. However, these results need to be interpreted in the context of inconsistent use of CVI in patients with elevated cardiac biomarkers, which may preclude arrival at definitive conclusions. Prospective studies with standardized use of CVI in high-risk COVID-19 patients are warranted to advance our understanding of cardiac toxicity with COVID-19.
Microbial ecology of the atmosphere
Authors: Šantl-Temkiv Tina , Amato Pierre , Casamayor Emilio O , Lee Patrick K H , Pointing Stephen B 
Published: February 2022

AbstractThe atmosphere connects habitats across multiple spatial scales via airborne dispersal of microbial cells, propagules and biomolecules. Atmospheric microorganisms have been implicated in a variety of biochemical and biophysical transformations. Here, we review ecological aspects of airborne microorganisms with respect to their dispersal, activity and contribution to climatic processes. Latest studies utilizing metagenomic approaches demonstrate that airborne microbial communities exhibit pronounced biogeography, driven by a combination of biotic and abiotic factors. We quantify distributions and fluxes of microbial cells between surface habitats and the atmosphere and place special emphasis on long-range pathogen dispersal. Recent advances have established that these processes may be relevant for macroecological outcomes in terrestrial and marine habitats. We evaluate the potential biological transformation of atmospheric volatile organic compounds and other substrates by airborne microorganisms and discuss clouds as hotspots of microbial metabolic activity in the atmosphere. Furthermore, we emphasize the role of microorganisms as ice nucleating particles and their relevance for the water cycle via formation of clouds and precipitation. Finally, potential impacts of anthropogenic forcing on the natural atmospheric microbiota via emission of particulate matter, greenhouse gases and microorganisms are discussed.
A new anisotropic poroelasticity model to describe damage accumulation during cyclic triaxial loading of rock
Authors: Lyakhovsky Vladimir , Panteleev Ivan , Shalev Eyal , Browning John , Mitchell Thomas M , Healy David , Meredith Philip G 
Published: February 2022

SUMMARY
Crustal rocks undergo repeated cycles of stress over time. In complex tectonic environments where stresses may evolve both spatially and temporally, such as volcanoes or active fault zones, these rocks may experience not only cyclic loading and unloading, but also rotation and/or reorientation of stresses. In such situations, any resulting crack distributions form sequentially and may therefore be highly anisotropic. Thus, the tectonic history of the crust as recorded in deformed rocks may include evidence for complex stress paths, encompassing different magnitudes and orientations. Despite this, the ways in which variations in principal stresses influence the evolution of anisotropic crack distributions remain poorly constrained. In this work, we build on the previous non-linear anisotropic damage rheology model by presenting a newly developed poroelastic rheological model which accounts for both coupled anisotropic damage and porosity evolution. The new model shares the main features of previously developed anisotropic damage and scalar poroelastic damage models, including the ability to simulate the entire yield curve through a single formulation. In the new model, the yield condition is defined in terms of invariants of the strain tensor, and so the new formulation operates with directional yield conditions (different values for each principal direction) depending on the damage tensor and triaxial loading conditions. This allows us to discern evolving yield conditions for each principal stress direction and fit the measured amounts of accumulated damage from previous loading cycles. Coupling between anisotropic damage and anisotropic compaction along with the damage-dependent yield condition produces a reasonable fit to the experimentally obtained stress–strain curves. Furthermore, the simulated time-dependent cumulative damage is well correlated with experimentally observed acoustic emissions during cyclic loading in different directions. As such, we are able to recreate many of the features of the experimentally observed directional 3-D Kaiser ‘damage memory’ effect.
On the use of the microtremor HVSR for tracking velocity changes: a case study in Campo de Dalías basin (SE Spain)
Authors: Seivane Helena , García-Jerez Antonio , Navarro Manuel , Molina Luis , Navarro-Martínez Francisco 
Published: February 2022

SUMMARY
The stability of the low-frequency peaks (&lt;1 Hz) obtained in the passive seismic survey of Campo de Dalías basin (CDB) by applying the horizontal-to-vertical spectral ratio (HVSR) method was investigated. Three temporary seismic stations were installed in remote sites that enabled studying the stationarity of their characteristic microtremor HVSR (MHVSR) shapes. All stations began to operate in mid-2016 and recorded at least 1 yr of continuous seismic ambient noise data, having up to 2 yr in some. Each seismic station was counted with a monitored borehole in their vicinity, registering the groundwater level every 30 min. The MHVSR curves were calculated for time windows of 150 s and averaged hourly. Four parameters have been defined to characterize the shape of the MHVSR around the main peak and to compare them with several environmental variables. Correlations between MHVSR characteristics and the groundwater level are shown to be the most persistent. The robustness of MHVSR method for applications to seismic engineering was not found to be compromised since the observed variations were within the margins of acceptable deviations. The results of this study have widen the possibilities of the MHVSR method from being a reliable predictor for seismic resonance to also being an autonomous monitoring tool, especially sensitive to the S-wave modifications.
Saffronizing diplomacy: the Indian Foreign Service under Hindu nationalist rule
Authors: Huju Kira 
Published: February 2022

Abstract
Very little is known about how Indian diplomats have made sense of the change in political power in New Delhi since 2014, when the election of Hindu nationalist Prime Minister Narendra Modi signalled a radical break from the internationalist credo of the Nehruvian Congress establishment. Attending to this gap in knowledge, this article engages with the ongoing debate about the influence of Hindu nationalism on Indian diplomacy, but departs from the conventional emphasis on foreign-policy analysis or Modi's persona. Instead, it centres on the lived experience of career diplomats in the Indian Foreign Service to whom it falls to conduct everyday diplomacy under Hindu nationalist rule. This focus invites a broader question in the global age of populism: how do contemporary diplomatic services adjust to the arrival of nationalist governments? I suggest that the delays in internalization of nationalist norms and diplomatic practices are only partly a function of ideological misalignment between an internationalist bureaucracy and a nationalist government. What matters is also the extent to which the status of the social class represented by the bureaucrats is invalidated by the government's political project. Building its arguments on the back of 85 elite interviews and archival research in India, the article considers changes to diplomatic discourse, protocol, priorities and training, and details how Indian diplomats have adjusted to and resisted Hindu nationalism. It suggests that we study nationalist critiques of ‘cosmopolitan elites’ both as an ideological denunciation of internationalist commitments and as a social rejection of the elites who hold them.
Inadequate Response, Treatment Patterns, Health Care Utilization, and Associated Costs in Patients With Ulcerative Colitis: Retrospective Cohort Study Based on German Claims Data
Authors: Bokemeyer Bernd , Picker Nils , Wilke Thomas , Rosin Ludger , Patel Haridarshan 
Published: February 2022

Abstract

Background
Real-world data regarding response rates in ulcerative colitis treatment are rare, particularly for later lines of therapy. This study aimed to assess continuity of and changes to advanced therapies, as well as costs and specific indicators defining suboptimal therapy.

Methods
German claims data were retrospectively analyzed (January 2014 to June 2019). Patients with ulcerative colitis initiating an advanced therapy (adalimumab, golimumab, infliximab, tofacitinib, vedolizumab) were included. Inadequate response was indicated by therapy discontinuation, switch, escalation, augmentation, corticosteroid dependency, disease-related hospitalization, or surgery. Health care resource utilization (inpatient, outpatient, sick leaves, medication, aids, and remedies) and related costs were assessed from therapy initiation until discontinuation or loss to follow-up.

Results
Among 574 patients (median age, 39 years; female sex, 53.5%) who initiated advanced therapies, 458 (79.8%) received an antitumor necrosis factor therapy, 113 (19.7%) vedolizumab, and 3 (0.5%) tofacitinib. After 12 months, 75% had ≥1 indicator for suboptimal therapy. The median time to first indicated inadequate response was 4.8 months. Therapy discontinuation (38%), switching (26%), and prolonged use of steroids (36%) were common within the first year of treatment. In an unadjusted comparison, all-cause total costs per person-year were significantly higher in those who switched vs patients remaining on their therapy (€44,570 vs €36,807; P &lt; .001).

Conclusions
Our study indicates a high prevalence of inadequate response to advanced therapies. Only 25% of patients showed adequate response within 12 months after therapy initiation. Frequent dose and treatment changes were observed. The economic impact of suboptimal therapy in ulcerative colitis is substantial, highlighting the ongoing need for improved treatment strategies.
Detection and Kinetics of Subgenomic Severe Acute Respiratory Syndrome Coronavirus 2 RNA Viral Load in Longitudinal Diagnostic RNA–Positive Samples
Authors: Deming Meagan E , Dong Tracy Q , Agrawal Vaidehi , Mills Margaret G , Huang Meei Li W , Greninger Alexander L , Jerome Keith R , Wener Mark H , Paasche-Orlow Michael K , Kissinger Patricia , Luk Alfred , Hoffman Risa M , Stewart Jenell , Kottkamp Angelica C , Bershteyn Anna , Chu Helen Y , Stankiewicz Karita Helen C , Johnston Christine M , Wald Anna , Barnabas Ruanne , Brown Elizabeth R , Neuzil Kathleen M 
Published: February 2022

AbstractWhile detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by diagnostic reverse-transcription polymerase chain reaction (RT-PCR) is highly sensitive for viral RNA, the nucleic acid amplification of subgenomic RNAs (sgRNAs) that are the product of viral replication may more accurately identify replication. We characterized the diagnostic RNA and sgRNA detection by RT-PCR from nasal swab samples collected daily by participants in postexposure prophylaxis or treatment studies for SARS-CoV-2. Among 1932 RT-PCR–positive swab samples with sgRNA tests, 40% (767) had detectable sgRNA. Above a diagnostic RNA viral load (VL) threshold of 5.1 log10 copies/mL, 96% of samples had detectable sgRNA with VLs that followed a linear trend. The trajectories of diagnostic RNA and sgRNA VLs differed, with 80% peaking on the same day but duration of sgRNA detection being shorter (8 vs 14 days). With a large sample of daily swab samples we provide comparative sgRNA kinetics and a diagnostic RNA threshold that correlates with replicating virus independent of symptoms or duration of illness.
South–South Knowledge Production and Hegemony: Searching for Africa in Chinese Theories of IR
Authors: Carrozza Ilaria , Benabdallah Lina 
Published: February 2022

Abstract
There is a growing community of international relations (IR) scholars who argue for the importance of investigating Global South approaches to IR scholarship, making room for theories and concepts that challenge the discipline's Eurocentricity, and debating the merits and pitfalls of globalizing IR by including perspectives from various Global South locations. In addition to acknowledging this existing critical scholarship that aims at resisting mainstream epistemologies and methodologies of knowing and doing IR, this article's central contribution is to probe the epistemic hegemony and knowledge-production hierarchies that are emerging from within the Global South. The article does not seek to uncover the truth about the representation of Global South actors by Global South IR communities. Instead, it is interested in demonstrating how epistemic hegemony and knowledge-production hierarchies do not exist only in relationships of exclusion and Othering but also in relations of inclusion and Selving. We illustrate our argument with an analysis of the representations of “Africa” in China-based IR intellectual communities. We find that Chinese discourses on solidarity, friendship, community, and shared history lead to a narrative of sameness and Selving whereby Chinese postcolonial experiences are taken to be expandable and applicable to other developing states, making Chinese perspectives seem representative of others, thereby silencing and representing African voices at once.
Extracting seizure frequency from epilepsy clinic notes: a machine reading approach to natural language processing
Authors: Xie Kevin , Gallagher Ryan S , Conrad Erin C , Garrick Chadric O , Baldassano Steven N , Bernabei John M , Galer Peter D , Ghosn Nina J , Greenblatt Adam S , Jennings Tara , Kornspun Alana , Kulick-Soper Catherine V , Panchal Jal M , Pattnaik Akash R , Scheid Brittany H , Wei Danmeng , Weitzman Micah , Muthukrishnan Ramya , Kim Joongwon , Litt Brian , Ellis Colin A , Roth Dan 
Published: February 2022

Abstract

Objective
Seizure frequency and seizure freedom are among the most important outcome measures for patients with epilepsy. In this study, we aimed to automatically extract this clinical information from unstructured text in clinical notes. If successful, this could improve clinical decision-making in epilepsy patients and allow for rapid, large-scale retrospective research.

Materials and Methods
We developed a finetuning pipeline for pretrained neural models to classify patients as being seizure-free and to extract text containing their seizure frequency and date of last seizure from clinical notes. We annotated 1000 notes for use as training and testing data and determined how well 3 pretrained neural models, BERT, RoBERTa, and Bio_ClinicalBERT, could identify and extract the desired information after finetuning.

Results
The finetuned models (BERTFT, Bio_ClinicalBERTFT, and RoBERTaFT) achieved near-human performance when classifying patients as seizure free, with BERTFT and Bio_ClinicalBERTFT achieving accuracy scores over 80%. All 3 models also achieved human performance when extracting seizure frequency and date of last seizure, with overall F1 scores over 0.80. The best combination of models was Bio_ClinicalBERTFT for classification, and RoBERTaFT for text extraction. Most of the gains in performance due to finetuning required roughly 70 annotated notes.

Discussion and Conclusion
Our novel machine reading approach to extracting important clinical outcomes performed at or near human performance on several tasks. This approach opens new possibilities to support clinical practice and conduct large-scale retrospective clinical research. Future studies can use our finetuning pipeline with minimal training annotations to answer new clinical questions.