bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of low exercise cardiac output in patients with severe pulmonic regurgitation
Authors: Karsenty Clément , Khraiche Diala , Jais Jean Philippe , Raimondi Francesca , Ladouceur Magalie , Waldmann Victor , Soulat Gilles , Pontnau Florence , Bonnet Damien , Iserin Laurence , Legendre Antoine 
Published: November 2020

Background and objectivesChronic pulmonic regurgitation (PR) following repair of congenital heart disease (CHD) impairs right ventricular function that impacts peak exercise cardiac index (pCI). We aimed to estimate in a non-invasive way pCI and peak oxygen consumption (pVO2) and to evaluate predictors of low pCI in patients with significant residual pulmonic regurgitation after CHD repair.MethodWe included 82 patients (median age 19 years (range 10–54 years)) with residual pulmonic regurgitation fraction >40%. All underwent cardiac MRI and cardiopulmonary testing with measurement of pCI by thoracic impedancemetry. Low pCI was defined <7 L/min/m2.ResultsLow pCI was found in 18/82 patients. Peak indexed stroke volume (pSVi) tended to compensate chronotropic insufficiency only in patients with normal pCI (r=−0.31, p=0.01). Below 20 years of age, only 5/45 patients had low pCI but near-normal (≥6.5 L/min/m2). pVO2(mL/kg/min) was correlated with pCI (r=0.58, p=0.0002) only in patients aged >20 years. Left ventricular stroke volume in MRI correlated with pSVi only in the group of patients with low pCI (r=0.54, p=0.02). No MRI measurements predicted low pCI. In multivariable analysis, only age predicted a low pCI (OR=1.082, 95% CI 1.035 to 1.131, p=0.001) with continuous increase of risk with age.ConclusionsIn patients with severe PR, pVO2is a partial reflection of pCI. Risk of low pCI increases with age. No resting MRI measurement predicts low haemodynamic response to exercise. Probably more suitable to detect ventricular dysfunction, pCI measurement could be an additional parameter to take into account when considering pulmonic valve replacement.
Oncolytic vaccinia virus reinvigorates peritoneal immunity and cooperates with immune checkpoint inhibitor to suppress peritoneal carcinomatosis in colon cancer
Authors: Lee Yu Seong , Lee Won Suk , Kim Chang Woo , Lee Seung Joon , Yang Hannah , Kong So Jung , Ning John , Yang Kyung-Mee , Kang Beodeul , Kim Woo Ram , Chon Hong Jae , Kim Chan 
Published: November 2020

BackgroundPeritoneal carcinomatosis (PC) is a common and devastating manifestation of colon cancer and refractory to conventional anticancer therapeutics. During the peritoneal dissemination of colon cancer, peritoneal immunity is nullified by various mechanisms of immune evasion. Here, we employed the armed oncolytic vaccinia virus mJX-594 (JX) to rejuvenate the peritoneal antitumor immune responses in the treatment of PC.MethodsPC model of MC38 colon cancer was generated and intraperitoneally treated with JX and/or anti-programmed cell death protein 1 (PD-1) antibody. The peritoneal tumor burden, vascular leakage, and malignant ascites formation were then assessed. Tumors and peritoneal lavage cells were analyzed by flow cytometry, multiplex tissue imaging, and a NanoString assay.ResultsJX treatment effectively suppressed peritoneal cancer progression and malignant ascites formation. It also restored the peritoneal anticancer immunity by activating peritoneal dendritic cells (DCs) and CD8+ T cells. Moreover, JX selectively infected and killed peritoneal colon cancer cells and promoted the intratumoral infiltration of DCs and CD8+ T cells into peritoneal tumor nodules. JX reinvigorates anticancer immunity by reprogramming immune-related transcriptional signatures within the tumor microenvironment. Notably, JX cooperates with immune checkpoint inhibitors (ICIs), anti-programmed death-1, anti-programmed death-ligand 1, and anti-lymphocyte-activation gene-3 to elicit a stronger anticancer immunity that eliminates peritoneal metastases and malignant ascites of colon cancer compared with JX or ICI alone.ConclusionsIntraperitoneal immunotherapy with JX restores peritoneal anticancer immunity and potentiates immune checkpoint blockade to suppress PC and malignant ascites in colon cancer.
Developing a ‘Doctors’ Assistant’ role to ease pressure on doctors and improve patient flow in acute NHS hospitals
Authors: McNally Scarlett , Huber Jörg 
Published: November 2020

IntroductionThe UK is short of doctors, whose workloads have increased. The new role of Doctors’ Assistant has been evaluated with the aim of addressing workload and patient-flow issues.MethodsFive Doctors’ Assistants were introduced at two busy acute hospitals, recruited from the healthcare assistant workforce. We devised a 2-week induction, ongoing supervision and communication exercise. The evaluation used a mixed-method design. Doctors and Doctors’ Assistants completed self-reported diary entries and timings of tasks and ward rounds. Qualitative feedback was sought from other hospital staff and analysed by theme.ResultsDiary cards showed 44% of doctors’ time spent on administrative tasks. Doctors’ Assistants’ shifts documented tasks undertaken (including venepuncture, updating patient lists and drafting discharge summaries) with 84% resulting in earlier decision/diagnosis or care. Feedback reported key messages: Doctors’ Assistants provide considerable practical help, their attitude enhances the team and they improve patient flow.DiscussionThe project proved safe, successful and well liked. Unexpectedly, the project had to collect financial data to justify its continuation. Acute hospitals have few clinical roles at this level. Role transition requires training, supervision and line management.ConclusionThe role of Doctors’ Assistant should be developed more widely, with attention to detail and economic benefits.
Prophylactic administration of tirofiban for preventing thromboembolic events in flow diversion treatment of intracranial aneurysms
Authors: Wu Qiaowei , Shao Qiuji , Li Li , Liang Xiaodong , Chang Kaitao , Li Tianxiao , He Yingkun 
Published: November 2020

BackgroundFlow diverter (FD) is widely used in the treatment of intracranial aneurysms. However, thromboembolic events (TEs) continue to be the major complications during the periprocedural phase. To evaluate the safety and efficacy of the prophylactic use of tirofiban, combined with the conventional dual antiplatelet therapy (DAT), as a new antiplatelet protocol in patients with intracranial aneurysms treated with FDs.MethodsAt least 3–5 days before the procedure, daily DAT were administrated to the patients. Tirofiban was administered as an intravenous bolus (5 µg/kg) over a 3 min period during or immediately after FD deployment, followed by a 0.05 µg/kg/min maintenance infusion for 24–48 hours. Periprocedural TEs and hemorrhagic events (HEs) were recorded.ResultsA total of 331 patients were included, including 229 (69.2%) who received tirofiban administration (tirofiban group) and 102 (30.8%) who received only DAT (non-tirofiban group). Periprocedural TEs occurred in 12 (3.6%) patients, including eight (7.8%) in the non-tirofiban group and four (1.7%) in the tirofiban group. In multivariate analysis, patients receiving tirofiban administration had significantly lower TEs as compared with those who received only DAT (P=0.004). Balloon angioplasty and longer procedure time (>137 min) were also risk factors for TEs. Also, no increase was observed in the rate of HEs related to tirofiban administration.ConclusionsThe current study suggested that prophylactic administration of tirofiban combined with conventional oral DAT seems safe and efficient for preventing TEs during FD treatment of unruptured intracranial aneurysms. Balloon angioplasty and prolonged procedure are associated with a high risk of TEs.
Addition of dexamethasone to local infiltration analgesia in elective total knee arthroplasty: double-blind, randomized control trial
Authors: El-Boghdadly Kariem , Short Anthony James , Gandhi Rajiv , Chan Vincent 
Published: November 2020

Background and objectivesTotal knee arthroplasty is associated with significant pain, and effective analgesia is beneficial to patient satisfaction and functional outcomes. Studies have demonstrated that dexamethasone may have a facilitatory role on the action of local anesthesia, but this effect, when added to a local infiltration analgesia (LIA) mixture for patients having knee arthroplasty, is underexplored. Our hypothesis was that the addition of dexamethasone to local anesthetic infiltration would improve analgesic outcomes following total knee arthroplasty.MethodsWe performed a double-blind, randomized controlled trial of 140 patients undergoing elective, unilateral, total knee arthroplasty. Patients were randomly allocated to receive either 2 mL of saline 0.9% or 2 mL of dexamethasone 4 mg/mL added to a LIA mixture. Our primary outcome was 24 hours of oral morphine equivalent consumption. Our secondary outcomes included short-term and long-term analgesic and functional outcomes and adverse events.ResultsA total of 72 patients were included in the saline group and 68 were included in the dexamethasone group. We found comparable 24 hours of morphine consumption between saline and dexamethasone groups, with a median of 60 (IQR 40–105 (range 16–230)) mg and 56 (IQR 41–75 (range 0–300)) mg, respectively (p=0.096). Dexamethasone was associated with a statistically significant reduction in total inpatient opioid consumption, incidence of requiring rescue patient-controlled analgesia, length of hospital stay, and postoperative nausea, compared with saline. Patients in the dexamethasone group had a greater range of joint movement and distance walked on postoperative day 1 than the saline group. There were no differences in rest or active pain scores, timed up and go or 3-month outcomes.ConclusionsDexamethasone 8 mg was associated with no improvements in 24 hours of morphine consumption but was associated with modest improvements in short-term analgesia, short-term function, length of stay and postoperative nausea. There were no long-term benefits in the use of dexamethasone in LIA for patients undergoing total knee arthroplasty.Trial registration numberNCT02760043
The treatment of SARS-CoV2 with antivirals and mitigation of the cytokine storm syndrome: the role of gene expression
Authors: Luo Wenxia , Ige Olufola O. , Beacon Tasnim H. , Su Ruey-Chyi , Huang Shujun , Davie James R. , Lakowski Ted M. 
Published: November 2020

In the absence of a vaccine, the treatment of SARS-CoV2 has focused on eliminating the virus with antivirals or mitigating the cytokine storm syndrome (CSS) that leads to the most common cause of death: respiratory failure. Herein we discuss the mechanisms of antiviral treatments for SARS-CoV2 and treatment strategies for the CSS. Antivirals that have shown in vitro activity against SARS-CoV2, or the closely related SARS-CoV1 and MERS-CoV, are compared on the enzymatic level and by potency in cells. For treatment of the CSS, we discuss medications that reduce the effects or expression of cytokines involved in the CSS with an emphasis on those that reduce IL-6 because of its central role in the development of the CSS. We show that some of the medications covered influence the activity or expression of enzymes involved in epigenetic processes and specifically those that add or remove modifications to histones or DNA. Where available, the latest clinical data showing the efficacy of the medications is presented. With respect to their mechanisms, we explain why some medications are successful, why others have failed, and why some untested medications may yet prove useful.
Invisible Higgs search through vector boson fusion: a deep learning approach
Authors: Ngairangbam Vishal S. , Bhardwaj Akanksha , Konar Partha , Nayak Aruna Kumar 
Published: November 2020

AbstractVector boson fusion proposed initially as an alternative channel for finding heavy Higgs has now established itself as a crucial search scheme to probe different properties of the Higgs boson or for new physics. We explore the merit of deep-learning entirely from the low-level calorimeter data in the search for invisibly decaying Higgs. Such an effort supersedes decades-old faith in the remarkable event kinematics and radiation pattern as a signature to the absence of any color exchange between incoming partons in the vector boson fusion mechanism. We investigate among different neural network architectures, considering both low-level and high-level input variables as a detailed comparative analysis. To have a consistent comparison with existing techniques, we closely follow a recent experimental study of CMS search on invisible Higgs with 36 fb$$^{-1}$$

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1

data. We find that sophisticated deep-learning techniques have the impressive capability to improve the bound on invisible branching ratio by a factor of three, utilizing the same amount of data. Without relying on any exclusive event reconstruction, this novel technique can provide the most stringent bounds on the invisible branching ratio of the SM-like Higgs boson. Such an outcome has the ability to constraint many different BSM models severely.
Chapter 2 Structural development of the Arabian Intrashelf Basin region
Authors: Wilson A. O. 
Published: November 2020

Abstract
This chapter summarizes the tectonic events that have affected the region of the Arabian Intrashelf Basin and the development of the intrashelf basin. Precambrian–Infracambrian fault systems provided a structural framework, which was later reactivated during the Late Paleozoic. Further development along the structural trends continued in the Triassic and Early Jurassic with the development of an Early Jurassic tectonically controlled intrashelf basin. The accommodation space was filled with Dhruma Formation carbonates by the early Bathonian, resulting in a broad and fairly flat platform. A crucial factor is how suppressed tectonism was during the Mid- and Late Jurassic. The intrashelf basin developed on the broad, tectonically stable Tethyan passive margin continental shelf 200--300 km distant from the Tethyan outer shelf edge. During the Mid- and Late Jurassic, this tectonic stability provided the foundation for a broad, stable Tethyan continental shelf region at least 1000 × 1200 km in area, far removed from siliciclastic sources, within which the huge Arabian Intrashelf Basin formed and the sequences of carbonate rocks and evaporites that created the Jurassic hydrocarbon system were deposited. Tectonism during the Mid- to Late Jurassic evolution of the Arabian Intrashelf Basin initially included only moderate subsidence. There was subtle uplift along some of the structural trends in the Late Jurassic and uplift and westwards structural tilt along the Tethys oceanic margin. Relatively stable tectonism continued after the Jurassic and was a major factor in the accumulation of the vast reserves of Jurassic sourced oil. Tectonic stability prevented major faulting and structural compartmentalization of the basin features, which provided large areas for hydrocarbon migration as the large and broad anticlines developed into the huge structural traps. The lack of major faulting limited the movement of burial fluids, preserving the early formed porosity and the regionally extensive seals. The present day structures primarily developed from the Late Cretaceous to Miocene as the Tethys Ocean closed.
Chapter 5 Interpretation of the origin and evolution of the Arabian Intrashelf Basin and the development of the Dhruma Atash, Tuwaiq and Hanifa sequences
Authors: Wilson A. O. 
Published: November 2020

Abstract
This is the first of two chapters in which the data presented in the first four chapters of this Memoir are reviewed and interpreted. A summary cross-section across the basin from the Saudi outcrop to Abu Dhabi and the Tethyan margin is used to summarize the regional setting and sequences as interpreted in this Memoir. The key points illustrated by the summary cross-section are stated and discussed in the first part of this chapter. Two different interpretations for the eastern margin of the intrashelf basin are reviewed. In the first of these interpretations, the margin with the deeper waters of the Tethys Ocean shelf is adjacent to the intrashelf basin rim in Abu Dhabi, whereas in the second, preferred in this Memoir, a broad, shallow Tethyan shelf platform (200–300 km wide) extends from the intrashelf basin rim to the Tethys continental shelf edge. The implications of Late Jurassic exposure and erosion on the adjacent Tethyan shelf are discussed. The development of the Arabian Intrashelf Basin during the Callovian–late Oxfordian (the Tuwaiq Mountain Formation, the source rock and the Hanifa intervals and associated sequences) is interpreted and discussed with illustrations, including step-by-step facies maps. The interpretation integrates depositional, eustatic and tectonic factors in the evolution of the intrashelf basin. The interpretation in this Memoir is that the Arabian Intrashelf Basin began with isostatic and extensional subsidence on top of a broad Dhruma Atash Member platform, which had largely filled the accommodation space up to the wave base and to near sea-level. It developed fully into an intrashelf basin during the deposition of the Callovian Tuwaiq sequence, with rising sea-levels coincident with a productive shallow water carbonate factory resulting in a rim of shallow water carbonate. An end-Callovian to early Oxfordian lowstand terminated the Tuwaiq sequence on the basin rim. During the lowstand, restricted conditions in the basin deposited the rich Lower Hanifa source rock as a lowstand systems tract. As more normal conditions returned in a subsequent sequence, the source rock facies graded upwards into Hanifa reservoir facies, which partially filled the basin. Hanifa progradation was terminated by another lowstand during which a subaqueous gypsum/anhydrite marker bed was deposited in at least part of the remnant basin. Earlier interpretations of these sequences are also discussed.
Impact of Vein of Marshall Ethanol Infusion on Mitral Isthmus Block
Authors: Nakashima Takashi , Pambrun Thomas , Vlachos Konstantinos , Goujeau Cyril , André Clémentine , Krisai Philipp , Ramirez F. Daniel , Kamakura Tsukasa , Takagi Takamitsu , Nakatani Yosuke , Kitamura Takeshi , Takigawa Masateru , Roux Jean-Rodolphe , Cheniti Ghassen , Tixier Romain , Chauvel Remi , Welte Nicolas , Duchateau Josselin , Sacher Frédéric , Cochet Hubert , Hocini Mélèze , Haïssaguerre Michel , Jaïs Pierre , Derval Nicolas 
Published: November 2020

Background:
Achieving bidirectional mitral isthmus (MI) block using radiofrequency catheter ablation (RFCA) alone is challenging, and MI reconnection is common. Adjunctive vein of Marshall (VOM) ethanol infusion (VOM-Et) can facilitate acute MI block. However, little is known about its long-term success. This study sought to evaluate the impact of adjunctive VOM-Et on MI block achievement and durability compared with RFCA alone.

Methods:
Patients undergoing the first attempt of posterior MI ablation were grouped according to their MI block index strategy: adjunctive VOM-Et and RFCA alone. Rates of acute MI block and MI reconnection observed during repeat procedures were compared between the 2 groups.

Results:

The VOM-Et group consisted of 152 patients (63.8±9.4 years) undergoing adjunctive VOM-Et for MI block. The RFCA group consisted of 110 patients (60.9±9.2 years) undergoing MI ablation using RFCA alone. Acute MI block was more frequently achieved in the VOM-Et group (98.7% [150/152] versus 63.6% [70/110];
P
<0.001) with shorter RFCA duration (5.00 [3.00–7.00] versus 19.0 [13.6–22.0] minutes;
P
<0.001). Of the 220 patients with MI block achieved during the index procedure, 81 underwent a repeat procedure during follow-up (VOM-Et group: 23.3% [35/150] versus RFCA group: 65.7% [46/70], respectively;
P
<0.001). A significantly greater number of patients exhibited durable MI block in the VOM-Et group (62.9% [22/35] versus 32.6% [15/46], respectively;
P
=0.008).

Conclusions:
Beyond facilitating acute MI block, VOM-Et is associated with greater lesion durability as evidenced by higher rates of MI block during repeat procedures.
Early Onset of Coronary Artery Calcification in Women With Previous Preeclampsia
Authors: Benschop Laura , Brouwers Laura , Zoet Gerbrand A. , Meun Cindy , Boersma Eric , Budde Ricardo P.J. , Fauser Bart C.J.M. , de Groot Christianne M.J. , van der Schouw Yvonne T. , Maas Angela H.E.M. , Velthuis Birgitta K. , Linstra Katie M. , Kavousi Maryam , Duvekot Johannes J. , Franx Arie , Steegers Eric , van Rijn Bas B. , Roeters van Lennep Jeanine E. ,   on behalf of the CREW Consortium
Published: November 2020

Background:
Preeclampsia, coronary artery calcification (CAC), and atherosclerotic plaque are risk factors for the development of cardiovascular disease. We determined at what age CAC becomes apparent on coronary computed tomography after preeclampsia and to what extent modifiable cardiovascular risk factors were associated.

Methods:
We measured cardiovascular risk factors, CAC by coronary computed tomography, and coronary plaque by coronary computed tomography angiography in 258 previously preeclamptic women aged 40-63. Results were compared to 644 age- and ethnicity-equivalent women from the Framingham Heart Study with previous normotensive pregnancies.

Results:
Any CAC was more prevalent after preeclampsia than after a normotensive pregnancy (20% versus 13%). However, this difference was greatest and statistically significant only in women ages 45 to 50 (23% versus 10%). The degree of CAC advanced 4× faster between the ages of 40 to 45 and ages 45 to 50 in women with a history of preeclampsia (odds ratio, 4.3 [95% CI, 1.5–12.2] versus odds ratio, 1.2 [95% CI, 0.6–2.3]). Women with a preeclampsia history maintained greater advancement of CAC with age into their early 60s, although this difference declined after the perimenopausal years. Women with a previous normotensive pregnancy were 4.9 years (95% CI, 1.8–8.0) older when they had similar CAC scores as previously preeclamptic women. These observations were not explained by the greater prevalence of cardiovascular disease risk factors, and the higher Framingham Risk Scores also observed in women with a history of preeclampsia.

Conclusions:
Previously preeclamptic women have more modifiable cardiovascular risk factors and develop CAC ≈5 years earlier from the age of 45 years onwards compared to women with normotensive pregnancies. Therefore, women who experienced preeclampsia might benefit from regular cardiovascular screening and intervention before this age.

Registration:

URL:
https://www.trialregister.nl/trial/5406
; Unique identifier: NTR5531.
‘An Arabic Qurʾān, That You Might Understand’
Authors: Connolly Magdalen M. , Posegay Nick 
Published: November 2020

Abstract
The Arabic-script Qurʾān fragments of the Cairo genizah collections have not yet drawn much interest among Arabic and genizah scholars. This paper aims to bring them to the attention of a broader audience by presenting the palaeographic features (§ 3) and vocalisation systems (§ 4) of eleven Arabic-script Qurʾān fragments from the Cambridge University Library’s Taylor-Schechter Arabic collection. While the focus of this paper is the physical appearance of these Qurʾān leaves, their presence in the Cairo genizah (§ 1.1)—a Jewish ‘storeroom’ for retired sacred texts—is also tentatively explored (§ 1.2, § 5).