bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Antihypertensives by Class on Cerebral Small Vessel Disease: A Post Hoc Analysis of SPRINT-MIND
Authors: Goldstein Eric D. , Wolcott Zoe , Garg Gauri , Navarro Kayla , Delic Alen , Yaghi Shadi , Sederholm Benson , Prabhakaran Shyam , Wong Ka-Ho , McLean Kaitlin , de Havenon Adam H. 
Published: May 2022

Background:
Treatment of uncontrolled arterial hypertension reduces the risk of cerebral small vessel disease (CSVD) progression, although it is unclear whether this reduction occurs due to blood pressure control or class-specific pleiotropic effects, such as improved beat-to-beat arterial pressure variability with calcium channel blockers. The goal of this study was to investigate the influence of antihypertensive medication class, particularly with calcium channel blocker, on accumulation of white matter hyperintensities (WMH), a radiographic marker of CSVD, within a cohort with well-controlled hypertension.

Methods:
We completed an observational cohort analysis of the SPRINT-MIND trial (Systolic Blood Pressure Trial Memory and Cognition in Decreased Hypertension), a large randomized controlled trial of participants who completed a baseline and 4-year follow-up brain magnetic resonance image with volumetric WMH data. Antihypertensive medication data were recorded at follow-up visits between the magnetic resonance images. A percentage of follow-up time participants were prescribed each of the 11 classes of antihypertensive was then derived. Progression of CSVD was calculated as the difference in WMH volume between 2 scans and, to address skew, dichotomized into a top tertile of the distribution compared with the remaining.

Results:

Among 448 individuals, vascular risk profiles were similar across WMH progression subgroups except age (70.1±7.9 versus 65.7±7.3 years;
P
<0.001) and systolic blood pressure (128.3±11.0 versus 126.2±9.4 mm Hg;
P
=0.039). Seventy-two (48.3%) of the top tertile cohort and 177 (59.2%) of the remaining cohort were in the intensive blood pressure arm. Those within the top tertile of progression had a mean WMH progression of 4.7±4.3 mL compared with 0.13±1.0 mL (
P
<0.001). Use of angiotensin-converting enzyme inhibitors (odds ratio, 0.36 [95% CI, 0.16–0.79];
P
=0.011) and dihydropyridine calcium channel blockers (odds ratio, 0.39 [95% CI, 0.19–0.80];
P
=0.011) was associated with less WMH progression, although dihydropyridine calcium channel blockers lost significance when WMH was treated as a continuous variable.

Conclusions:
Among participants of SPRINT-MIND trial, angiotensin-converting enzyme inhibitor was most consistently associated with less WMH progression independent of blood pressure control and age.
The Last Natural Philosophers in Plato’s Phaedo 99b2-c6
Authors: Vázquez Daniel 
Published: May 2022

Abstract
This paper examines the possible sources of the theories introduced in Phaedo 99b2-c6. It argues that Plato is primarily alluding to Aristophanes’ Clouds and views held by Diogenes of Apollonia and Archelaus of Athens. But the passage, I also suggest, could serve another rhetorical function. By inviting us to reflect on whether and to what extent other natural philosophers fit the description of these theories, the text emphasises the gulf between Socrates and his predecessors. The paper concludes by discussing the implications of identifying these references for our understanding of the autobiographical passage in the Phaedo.
Walking a Thin Line of Representation: Analyzing the Behavior of Egyptian MPs
Authors: Hassan Mazen , Abdrabou Ahmed , Abdelgawad Hala 
Published: May 2022

Abstract
This article is part of the Special Issue “Parliaments in the Middle East and North Africa: A Struggle for Relevance.” While legislators in democratic settings have the electorate as their main principal, mps in semi- and nondemocratic settings need to serve two principals to remain in office: the regime and the active segment of the electorate. This dichotymy sometimes requires particular skills in parliamentary behavior. For the case of Egypt, we investigate how mps strike a balance between regime support and representing their constituents up to an extent that does not endanger their chances for re-election. A content analysis of session scripts of the Egyptian parliament in 2016 was conducted to examine how mps walk this – traditionally understudied – thin line. Our findings indicate that representation gets reduced to “descriptive representation,” i.e. a representation that puts more emphasis on representing local constituents and demographic segments, like Copts and women, that mps are presumably elected to represent. We therefore show that mps fulfill the important tasks of citizens representation even in semi- and nondemocratic settings.
Triple, Quadruple, and Higher-Order Helices: Historical Phenomena and (Neo-)Evolutionary Models
Authors: Leydesdorff Loet , Lawton Smith Helen 
Published: May 2022

Abstract
Carayannis and Campbell (2009; 2010) have argued for using quadruple and quintuple helices as models encompassing and generalizing triple-helix dynamics. In the meantime, quadruple and quintuple helices have been adopted by the European Committee for the Regions and the European Commission as metaphors for further strategy development such as in EU-programs in Smart Specialization, Plan S, Open Innovation 2.0, etc. Here we argue that the transition from a double helix to a triple helix can change the dynamic from a trajectory to a regime. However, next-order transitions (e.g., to quadruple, quintuple, or n-tuple helices) can be decomposed and recombined into interacting Triple Helices. For example, in the case of four helices A, B, C, and D, one can distinguish ABC, ABD, ACD, and BCD; each triplet can generate synergy. The triple-helix synergy indicator can thus be elaborated for more than three dimensions. However, whether innovation systems are national, regional, sectorial, triple-helix, quadruple-helix, etc., can inform policies with evidence if one proceeds to measurement. A variety of perspectives can be used to interpret the data. Software for testing perspectives will be introduced.
Animal Telos and Preference Adaptation
Authors: Milligan Tony 
Published: May 2022

Abstract
This article considers Bernard Rollin’s justification of the genetic modification of the telos of livestock animals for welfare purposes. While agreeing that a pragmatic approach to animal welfare might well reach this far, the claim is that Rollin’s approach leaves some important harms out of the picture. Section (1) will outline the rationale for a pragmatic approach towards animal rights. Section (2) will outline Rollin’s telos-based argument for allowing modification. Sections (3) and (4) will draw upon analogies that (respectively) lend support to and problematize Rollin’s telos-based argument: the production of anencephalic ‘Chicken Little’ lumps of animal tissue as a way to avoid suffering; and the manipulation of preferences by ‘hypnopaedia’ in Huxley’s Brave New World. Section (5) will suggest that this does not rule out modification, but it does require us to recognize that modification involves harms, even if they are sometimes outweighed by benefits.
Universal elevator round trip time calculation for general traffic conditions with extension to batch arrivals
Authors: So Albert , Al-Sharif Lutfi , Chan Ricky 
Published: May 2022

Recent studies have revealed that the dominant traffic pattern of a modern high-rise building is much more complicated than the conventional up-peak model, i.e. incoming traffic only, upon which the popular formula of round trip time (RTT) calculation is based. RTT calculation is still recommended by ISO 8100:32:2020 and CIBSE Guide D: 2020 to precede any computer simulation. Nowadays, the concern is more on the lunch peak with a mixture of incoming, outgoing and interfloor traffic patterns. Moreover, the independent one-passenger arrival model should be replaced by the more practical batch arrival model, in particular during lunch-time peak. This article first summarizes what were previously published on the universal RTT evaluation for mixed traffic conditions, highlights the main arguments, updates and supplements some previously introduced formulae such as that related to coincidental stops, uses more symmetrical and easily manipulated graphics, and, second in particular, brings in the concept of batch arrivals of any desirable probability distribution, where the conventional independent one-passenger arrival up-peak model now becomes a special case. A step-by-step presentation is adopted for convenient application of this universal calculation approach by designers and the detailed verification of the whole process by Monte Carlo simulation is also included. Practical applications: Round trip time calculation is still recommended the first step of traffic design by the industry but it should reasonably include the consideration of mixed traffic patterns, versus a pure incoming (i.e. up-peak) approach in the past. Such universal RTT calculation was described in several articles previously, but with some missing details. Here, the whole process is summarized, updated and presented in a more graphical way for convenient use by designers. Furthermore, the more contemporarily practical batch passenger arrival mode is included in this universal RTT model as an extension to the methodology so that what are discussed in this article include incoming, outgoing, interfloor traffic patterns with batch arrival consideration. It is hoped that this article could provide a comprehensive universal RTT methodology that can eventually be popularly applied globally by designers and consultants.
The Legality and Ethical Issues of Certifying Laypersons as Mental Health Counselors in India
Authors: Philip Sharad , Chander K. Rakesh , Varshney Prateek , Patley Rahul , Pandey Praveen , Suhas Satish , Nirisha P. Lakshmi , Suchandra  , Vinay B. , Manjunatha Narayana , Kumar C. Naveen , Math Suresh Bada 
Published: May 2022

Background: The burden of mental health conditions and consequent disability impacts are felt most in low- and middle-income settings. These settings are constrained by the limited availability of resources to provide even essential aspects of mental health care (MHC). Task shifting and sharing interventions have shown promise in delivering community-based MHC across such low-resource settings. Some counseling tasks such as friendship bench interventions have been successfully shifted to laypersons. However, ethical and legal concerns regarding laypersons’ incorporation in MHC delivery systems have not been examined. Purpose: To examine the ethical and legal concerns surrounding the certification of laypersons as community-based mental health counselors. Method: We undertook an academic review of various legislations pertinent to MHC service delivery and the certification of allied health care professionals to inform on acceptable and tenable strategies toward incorporating such a task-shifted intervention. Conclusion: Scaling up the training of human resources to address access problems can be the first step in addressing the MHC access and treatment gaps. The certification of laypersons as community-based mental health counselors, although legally tenuous, can be pioneered by tertiary-level MHC institutions. This certification has sound ethical justification and is a progressive step toward realizing universal mental health coverage.
Insulin reduces pyroptosis-induced inflammation by PDHA1 dephosphorylation-mediated NLRP3 activation during myocardial ischemia-reperfusion injury
Authors: Pan Si-si , Wang Feng , Hui Yong-peng , Chen Kai-yuan , Zhou Liu , Gao Wei-long , Wu Hong-kun , Zhang Deng-sheng , Yang Si-yuang , Hu Xuan-yi , Liang Gui-you 
Published: May 2022

Background Previous studies proved that pyrin domain-containing protein 3 (NLRP3)-induced pyroptosis plays an important role in Myocardial ischemia-reperfusion injury (MIRI). Insulin can inhibit the activation of NLRP3 inflammasome, although the exact mechanism remains unclear. The aim of this study was to determine whether insulin reduces NLRP3-induced pyroptosis by regulating pyruvate dehydrogenase E1alpha subunit (PDHA1) dephosphorylation during MIRI. Methods Rat hearts were subject to 30 min global ischemia followed by 60 min reperfusion, with or without 0.5 IU/L insulin. Myocardial ischemia-reperfusion injury was evaluated by measuring myocardial enzymes release, Cardiac hemodynamics, pathological changes, infarct size, and apoptosis rate. Cardiac aerobic glycolysis was evaluated by measuring ATP, lactic acid content, and pyruvate dehydrogenase complex (PDHc) activity in myocardial tissue. Recombinant adenoviral vectors for PDHA1 knockdown were constructed. Pyroptosis-related proteins were measured by Western blotting analysis, immunohistochemistry staining, and ELISA assay, respectively. Results It was found that insulin significantly reduced the area of myocardial infarction, apoptosis rate, and improved cardiac hemodynamics, pathological changes, energy metabolism. Insulin inhibits pyroptosis-induced inflammation during MIRI. Subsequently, Adeno-associated virus was used to knock down cardiac PDHA1 expression. Knockdown PDHA1 not only promoted the expression of NLRP3 but also blocked the inhibitory effect of insulin on NLRP3-mediated pyroptosis in MIRI. Conclusions Results suggest that insulin protects against MIRI by regulating PDHA1 dephosphorylation, its mechanism is not only to improve myocardial energy metabolism but also to reduce the NLRP3-induced pyroptosis.
Early multidisciplinary prevention program of post-stroke shoulder pain: A randomized clinical trial
Authors: Glize Bertrand , Cook Amandine , Benard Antoine , Sagnier Sharmila , Olindo Stéphane , Poli Mathilde , Debruxelles Sabrina , Renou Pauline , Rouanet François , Bader Clément , Dehail Patrick , Sibon Igor 
Published: May 2022

Objective To evaluate if positioning the upper-limb promoting abduction, external rotation and flexion of the shoulder reduces the intensity of post-stroke shoulder pain at day-7 compared to usual clinical practice. Design & setting Prospective single-center randomized clinical trial using a superiority design comparing two preventive strategies of post-stroke shoulder pain in a stroke unit. Subjects Patients were included within 2 days from a first symptomatic ischemic stroke affecting shoulder motor function. Interventions Intervention group included specific positioning of the shoulder in abduction, external rotation and flexion in bed, chair and during mobilization. Control group referred to usual practice i.e. positioning using a standard support scarf. Main measures Primary outcome was the intensity of shoulder pain assessed by the visual analog scale (VAS) (0–100) at day-7 post-stroke. Other outcomes measured at day-7 and 2 months post-stroke were the VAS, motor function, spasticity, depression, functional independence and rates of complex regional Pain syndrome (CRPS). Results 76 patients (49 males; mean age = 68.3) were randomized. The shoulder pain at day-7 was not different between the control group (16.1, SD = 27.4) and the intervention group (10.3, SD = 21.5, p = 0.18) as well as at 2 months ( p = 0.12). A lower rate of depression was observed in the intervention group at 2 months 36.7% (CI95% 19.9;56.1) vs 52.9% (CI95% 35.1;70.2). No between-group difference in other outcomes was observed at 2 months. Conclusions This study failed to demonstrate the benefit of a specific positioning tool in reducing the intensity of post-stroke shoulder pain which was lower than previously reported in the literature.
Kaqchikel Maya and Spanish: Attitudes, domains, and acquisition
Authors: Holmquist Jonathan , Muzika Kahn Hana 
Published: May 2022

Aims and objectives: The goals of this study are to examine attitudes toward Kaqchikel Maya and Spanish in domains of life in a village and a town in central Guatemala and to examine the influence of indigenous participants’ attitudes toward Kaqchikel on Kaqchikel acquisition. Method: The study draws on fieldwork employing interviews and a sociolinguistic questionnaire. To investigate attitudes, we employed questions focusing on the importance of Kaqchikel and Spanish for domains of community life. The questionnaire also tested conversational ability in Kaqchikel. Data and analysis: Responses to the survey questions are examined in quantitative analyses of valuations of the importance of Kaqchikel and Spanish in domains for participants from the village and the town and of the importance of Kaqchikel for indigenous adults and students. Also gauged through quantitative analysis are correlations between attitudes toward the importance of Kaqchikel in the domains and acquired conversational ability in Kaqchikel of indigenous adults and students. Findings: The findings underscore differences and similarities in attitudes toward the two languages in the town and the village as well as differences in the attitudes of indigenous adults and students. The effects of instrumental and integrative attitudes toward Kaqchikel on Kaqchikel acquisition are highlighted for the students. Originality: Points of originality include the size of the participant sample (252), the breakdown of the sample by village and town, and by non-indigenous and indigenous participants and age groups. They include the focus on attitudes toward Kaqchikel as related to the acquisition of conversational ability in Kaqchikel for indigenous adults and students. Implications: The study confirms a shift in attitudes toward the importance of Kaqchikel for indigenous students compared to indigenous adults. For Kaqchikel-language programs for youth, the study underscores the need for fomenting awareness of the importance of Kaqchikel in domains of community life.
Avoiding the re-do sternotomy: treatment of an ascending aortic pseudoaneurysm using a percutaneous Amplatzer PFO closure device
Authors: Pajtak Renata , Lovelock Thomas , Nanayakkara Shane , Walton Antony , Vasudevan Thodur 
Published: May 2022

Purpose Ascending aortic pseudoaneurysms are a common phenomenon requiring surgical intervention but can pose high surgical risks in medically complex patients. We report a novel approach to percutaneous closure of ascending aortic pseudoaneurysms using an Amplatzer PFO closure device. Case Report We present the case of a 65-year-old male with haemoptysis on a background of multiple cardiac surgeries and chronic kidney disease. Serial computerised tomography scans of the thoracic aorta demonstrated an enlarging ascending aortic pseudoaneurysm. Percutaneous closure was considered the safest treatment option. With angiography, the pseudoaneurysm was defined and a 25 mm Amplatzer PFO closure device was deployed. Repeat Computed Tomography aortography performed 43 days later confirmed stable device position and resolution of the pseudoaneurysm. The patient was clinically stable at this follow-up point. Conclusion The off-label use of the Amplatzer PFO device may provide a viable alternative treatment for ascending aortic pseudoaneurysms in medically complex patients to reduce morbidity and mortality.
Endoscopic Endonasal Approach to the Pterygopalatine Fossa and Infratemporal Fossa: Comparison of the Prelacrimal and Denker’s Corridors
Authors: Li Lifeng , London, Nyall R. , Prevedello Daniel M. , Carrau Ricardo L. 
Published: May 2022

Background Both the endoscopic transnasal Denker’s and prelacrimal approaches provide surgical access to the pterygopalatine fossa (PPF) and infratemporal fossa (ITF). Objectives This study compares the potential maximum exposure of the PPF and ITF and quantifies the difference in surgical freedom via endoscopic Denker’s and prelacrimal approaches. Methods Six cadaveric specimens (12 sides) were dissected using a prelacrimal approach on one side and an endoscopic Denker’s approach on the contralateral side. The contents of the PPF and ITF were sequentially exposed. Surgical freedom for each corridor was subsequently calculated. Results This study confirms that both the prelacrimal and Denker’s approaches provide adequate exposure of the PPF and ITF. The maximum exposure boundaries were similar for both approaches, including the middle cranial fossa superiorly, floor of the maxillary sinus inferiorly, zygomatic arch and temporomandibular joint laterally, and post-styloid space posteriorly. However, the data revealed a statistically significant difference ( p < 0.05) regarding the surgical freedom of the prelacrimal (388.17 ± 32.86 mm2) and the endoscopic Denker’s approaches (906.35 ± 38.38 mm2). Conclusion When compared with an endoscopic Denker’s approach, a prelacrimal approach seems to achieve a similar extent of exposure (ie, visualization) of the PPF and ITF. Nonetheless, the endoscopic Denker’s approach offers superior surgical freedom; thus, it is preferred for the management of complex lesions which requires increased instrument maneuverability with a 3- or 4-handed technique.
Knowledge and Attitude towards COVID-19 Vaccination and Associated Factors among College Students in Northwest Ethiopia, 2021
Authors: Aklil Mastewal Belayneh , Temesgan Wubedle Zelalem 
Published: May 2022

Background It is imperative to ensure optimal vaccine uptake at the population level to combat the deadly COVID-19 pandemic disease. However, refusal of the COVID-19 vaccine, poor knowledge, and a negative attitude towards vaccination are the challenges of the world. College students are among the high-risk subgroups of the population to COVID-19 infection and the main source of information and trust in vaccines to the society. Also, their judgement on vaccine affect the public attitude towards vaccination. Therefore, this study aimed to assess knowledge and attitude towards COVID-19 vaccination and associated factors among college students in Gondar city, northwest Ethiopia. Methods An institution-based cross-sectional study was conducted among 626 study participants in Gondar city. A multistage sampling technique was used to recruit the study participants. A pretested self-administered questionnaire was used to collect the data. Bivariable and multivariable logistic regression analyses were performed to assess factors associated with knowledge and attitude towards COVID-19 vaccination. The level of significance was claimed based on a p-value < 0.05. Results In this study, 46.8% (95% CI: 43.3, 50.6) of study participants had good knowledge and 50% (95% CI: 45.9, 53.7) had a positive attitude towards COVID-19 vaccination. Having comorbidity disease and being male were significantly associated with good knowledge. In addition, being married, being a health science student, being exposed to mass media, having a good knowledge of COVID-19 vaccination, and having paternal primary education were significantly associated with a positive attitude towards COVID-19 vaccination. Conclusion In general, knowledge and attitude towards COVID-19 vaccination among college students are low. Comorbidity disease and sex were predictors of COVID-19 vaccination knowledge, whereas, marital status, category of college students, mass media, paternal education and knowledge about COVID-19 vaccination were predictors of COVID-19 vaccination attitude. Alleviating participants’ concerns and improving their confidence through health education is crucial.