bluuebunny/crossref_metadata_2025_split huggingface dataset:
Temporal Trends in Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting: Insights From the Washington Cardiac Care Outcomes Assessment Program
Authors: Kataruka Akash , Maynard Charles C. , Kearney Kathleen E. , Mahmoud Ahmed , Bell Sean , Doll Jacob A. , McCabe James M. , Bryson Chistopher , Gurm Hitinder S. , Jneid Hani , Virani Salim S. , Lehr Eric , Ring Michael E. , Hira Ravi S. 
Published: May 2020

Background

Patient selection and outcomes for percutaneous coronary intervention (
PCI
) and coronary artery bypass grafting (
CABG
) have changed over the past decade. However, there is limited information on outcomes for both revascularization strategies in the same population. The study evaluated temporal changes in risk profile, procedural characteristics, and clinical outcomes for
PCI‐
and
CABG
‐treated patients.

Methods and Results

We analyzed all
PCI
and isolated
CABG
between 2005 and 2017 in nonfederal hospitals in Washington State. Descriptive analysis was performed to evaluate temporal changes in risk profile and, risk‐adjusted in‐hospital mortality. Over the study period, 178 474
PCI
and 36 592
CABG
procedures were performed.
PCI
and
CABG
volume decreased by 2.9% and 22.6%, respectively. Compared with 2005–2009, patients receiving either form of revascularization between 2014 and 2017 had a higher prevalence of comorbidities including diabetes mellitus and hypertension and dialysis. Presentation with ST‐segment–elevation myocardial infarction (17% versus 20%) and cardiogenic shock (2.4% versus 3.4%) increased for patients with
PCI
compared with CABG. Conversely, clinical acuity decreased for patients receiving
CABG
over the study period. From 2005 to 2017, mean National Cardiovascular Data Registry Cath
PCI
mortality score increased for patients treated with
PCI
(20.1 versus 22.4,
P
<0.0001) and decreased for patients treated with
CABG
(18.8 versus 17.8,
P
<0.0001). Adjusted observed/expected in‐hospital mortality ratio increased for
PCI
(0.98 versus 1.19,
P
<0.0001) but decreased for
CABG
(1.21 versus 0.74,
P
<0.0001) over the study period.

Conclusions

Clinical acuity increased for patients treated with
PCI
rather than
CABG
. This resulted in an increase in adjusted observed/expected mortality ratio for patients undergoing
PCI
and a decrease for
CABG
. These shifts may reflect an increased use of
PCI
instead of
CABG
for patients considered to be at high surgical risk.
Mitral Valve Surgical Volume and Transcatheter Mitral Valve Repair Outcomes: Impact of a Proposed Volume Requirement on Geographic Access
Authors: Vemulapalli Sreekanth , Prillinger Julie , Thourani Vinod , Yeh Robert W. 
Published: May 2020

Background

There is an open Centers for Medicare and Medicaid Services National Coverage Decision for Transcatheter Mitral Valve Repair (
TMV
r) and a recent multisociety consensus document suggesting that
TMV
r centers should achieve prespecified mitral valve replacement or repair (
MVR
r). Yet, little is known about the
MVR
r volume–
TMV
r outcome relationship.

Methods and Results

Using Centers for Medicare and Medicaid Services administrative claims from January 1, 2016 to December 31, 2018, we computed the Pearson correlation coefficient and performed multivariable hierarchical modeling to estimate the
MVR
r volume to
TMV
r outcome relationship for mortality and heart failure hospitalization. Additionally, we assessed the impact of the consensus recommendations on geographic access to care by hospital referral region. Total annualized
MVR
r volume was <11 to 1552 (median 96, interquartile range 53, 167). One‐year survival, 1‐year heart failure hospitalization after
TMV
r were not correlated with
MVR
r volume. After patient risk‐adjustment for age, sex, and significant Elixhauser Comorbidities, there remained no significant correlation between institutional
MVR
r volume and 1‐year mortality (estimate −0.010, SE 0.047,
P
=0.834) or heart failure hospitalization (estimate −0.011, SE 0.045,
P
=0.808) after
TMV
r. Raising the restriction on
TMV
r from 20 to 40
MVR
r/y results in ≈30 million individuals having to travel outside of their hospital referral region to undergo
TMV
r, with a disproportionate impact in the Midwest and Southeast.

Conclusions

There is no relationship between
MVR
r volumes and
TMV
r outcomes. Additionally, adoption of an annual
MVR
r volume ≥40 for performance of
TMV
r disproportionately impacts geographic access in the Midwest and Southeast and their large black and Hispanic populations.
N8‐Acetylspermidine: A Polyamine Biomarker in Ischemic Cardiomyopathy With Reduced Ejection Fraction
Authors: Nayak Aditi , Liu Chang , Mehta Anurag , Ko Yi‐An , Tahhan Ayman S. , Dhindsa Devinder S. , Uppal Karan , Jones Dean P. , Butler Javed , Morris Alanna A. , Quyyumi Arshed A. 
Published: May 2020

Background

Patients with ischemic cardiomyopathy (
ICM
) have worse outcomes than those with coronary artery disease alone and those with non‐ICM. N8‐acetylspermidine (N8
AS
) is a polyamine that regulates ischemic cardiac apoptosis and resultant cardiac dysfunction. We hypothesized that N8
AS
is a mechanistic biomarker of adverse outcomes in patients with
ICM
.

Methods and Results

High‐resolution plasma metabolomics profiling and mass spectrometry were used to quantitate N8
AS
levels in a discovery cohort of 474 patients with coronary artery disease (age: 68±11 years, 12% black, 26% women): 154 with
ICM
, and 320 without
ICM
; and in an external validation cohort of 85 patients with ICM (age: 60±12 years, 37% black, 19% women). Patients without heart failure (
HF)
at baseline were followed for incident
HF
. The association between N8
AS
(log
2
‐transformed, standardized) and outcomes of all‐cause mortality and incident
HF
were examined using Cox regression. N8
AS
was higher (10.39 [interquartile range, 7.21–17.75] versus 8.29
nmol/L
[interquartile range, 5.91–11.42];
P
<0.001) in patients with ICM compared with patients who had coronary artery disease without
ICM
. Higher N8
AS
levels were associated with higher mortality in patients with ICM (hazard ratio [HR], 1.48; 95%
CI
, 1.19–1.85 per
SD
increase [
P
=0.001]), independent of B‐type natriuretic peptide, high‐sensitivity troponin I, and high‐sensitivity
C‐reactive protein
. Findings were validated in the independent cohort. Moreover, higher N8
AS
level was associated with incident
HF
in patients without
HF
at baseline (HR, 4.16; 95%
CI
, 1.41–12.25 per
SD
increase [
P
=0.01]).

Conclusions

Independent of traditional
HF
measures, higher N8
AS
levels are associated with higher mortality in patients with
ICM
and incident
HF
in those who have coronary artery disease without
HF
. N8
AS
is a novel mechanistic biomarker in
ICM
.
Retrospective Analysis of Clinical Genetic Testing in Pediatric Primary Dilated Cardiomyopathy: Testing Outcomes and the Effects of Variant Reclassification
Authors: Quiat Daniel , Witkowski Leora , Zouk Hana , Daly Kevin P. , Roberts Amy E. 
Published: May 2020

Background
Genetic testing in pediatric primary dilated cardiomyopathy (DCM) patients has identified numerous disease‐causing variants, but few studies have evaluated genetic testing outcomes in this population in the context of patient and familial clinical data or assessed the clinical implications of temporal changes in genetic testing results.

Methods and Results
We performed a retrospective analysis of all patients with primary DCM who presented to our institution between 2008 and 2018. Variants identified by genetic testing were reevaluated for pathogenicity on the basis of current guidelines for variant classification. A total of 73 patients with primary DCM presented to our institution and 63 (86%) were probands that underwent cardiomyopathy‐specific gene testing. A disease‐causing variant was identified in 19 of 63 (30%) of cases, with at least 9/19 (47%) variants occurring de novo. Positive family history was not associated with identification of a causal variant. Reclassification of variants resulted in the downgrading of a large proportion of variants of uncertain significance and did not identify any new disease‐causing variants.

Conclusions
Clinical genetic testing identifies a causal variant in one third of pediatric patients with primary DCM. Variant reevaluation significantly decreased the number of variants of uncertain significance, but a large burden of variants of uncertain significance remain. These results highlight the need for periodic reanalysis of genetic testing results, additional investigation of genotype‐phenotype correlations in DCM through large, multicenter genetic studies, and development of improved tools for functional characterization of variants of uncertain significance.
Religion and the Creation of Normal Appearance
Authors: Trinidad Jose Eos 
Published: May 2020

Abstract
Religions in prison often help individuals with their internal coping with prison life and with external benefits from participation in religious groups. However, less is known about religion’s role that extend beyond the individual and affect the whole of prison society. Through in-depth interviews in a Philippine prison, the research finds that religious groups have both a normative and a normalizing function. In a sense, these Christian groups help inmates create expectations with each other and provide a semblance of normal life in a constrained prison. The article suggests that the appearance of normality, rather than the fact of normality, happens as Christian groups provide inmates with forms of self-determination and continuance of their life from outside.
Ties and Identities
Authors: Saracino Doriano 
Published: May 2020

Abstract
Immigration from the Global South is a recent phenomenon in Italy, which is turning from a prevalently homogenous Catholic country into a multi-faith one. This transformation is evident too in prisons, where people from different religious traditions share space. The long road from religious diversity to social acceptance of differences is difficult. The public debate concerns essentially Muslim inmates, and the arguments swing from ‘securitarian’ views to an inclusive approach as an alternative way to prevent radicalisation. The lack of meaningful relationships between inmates of different faiths and their religious communities can be a serious obstacle to social reinsertion. An analysis of the Italian prison system with statistical data and qualitative research enables us to outline a model of the evolution of the penitentiary systems.
Recovery Over Time and Prognostic Factors in Treated Patients with Post-Infectious Olfactory Dysfunction: A Retrospective Study
Authors: Ogawa Takao , Nakamura Keigo , Yamamoto Sayuri , Tojima Ichiro , Shimizu Takeshi 
Published: May 2020

Objectives: The aims of the present study were to clarify the time-course of olfactory recovery and the prognostic factors in PIOD patients treated with Toki-shakuyaku-san (TSS). Methods: A retrospective cohort study of patients with PIOD was conducted by reviewing patients’ medical records. This study included patients who received TSS or a combination of TSS and zinc sulfate. Olfactory function was examined by T&T olfactometer at each 3-monthly follow-up visit. Patients with normal and mild olfactory dysfunction were excluded. Gender, age, treatment, duration of disease until the first visit and olfactory function scores of the T&T olfactometer at the first visit were analyzed as candidate clinical predictors of recovery. Results: A total of 82 PIOD patients with ages ranging from 16 to 79 years were included. The mean duration of follow-up was 14.5 months (range 3-45 months). The number of patients with olfactory recovery increased for 24 months and the cumulative recovery rate was 77.3%. In about 60% of patients, olfactory recovery occurred within 6 months. Multivariate analysis showed that younger age (<65 years) and residual olfactory function were significantly associated with good olfactory recovery. Conclusions: We revealed recovery rates over time in patients with PIOD. The recovery of olfactory function often occurred during the early period (≤6 months). However, the number of patients with olfactory recovery increased for a long-term of 24 months after the first visit. Residual olfactory function and younger age were prognostic factors exactly. TSS may be a useful therapeutic agent for patients with PIOD. We believe that these results provide important information that is useful for counseling patients with PIOD.
Combined static and dynamic functional connectivity signatures differentiating bipolar depression from major depressive disorder
Authors: Pang Yajing , Zhang Huangbin , Cui Qian , Yang Qi , Lu Fengmei , Chen Heng , He Zongling , Wang Yifeng , Wang Jiaojian , Chen Huafu 
Published: May 2020

Objective: Bipolar disorder in the depressive phase (BDd) may be misdiagnosed as major depressive disorder (MDD), resulting in poor treatment outcomes. To identify biomarkers distinguishing BDd from MDD is of substantial clinical significance. This study aimed to characterize specific alterations in intrinsic functional connectivity (FC) patterns in BDd and MDD by combining whole-brain static and dynamic FC. Methods: A total of 40 MDD and 38 BDd patients, and 50 age-, sex-, education-, and handedness-matched healthy controls (HCs) were included in this study. Static and dynamic FC strengths (FCSs) were analyzed using complete time-series correlations and sliding window correlations, respectively. One-way analysis of variance was performed to test group effects. The combined static and dynamic FCSs were then used to distinguish BDd from MDD and to predict clinical symptom severity. Results: Compared with HCs, BDd patients showed lower static FCS in the medial orbitofrontal cortex and greater static FCS in the caudate, while MDD patients exhibited greater static FCS in the medial orbitofrontal cortex. BDd patients also demonstrated greater static and dynamic FCSs in the thalamus compared with both MDD patients and HCs, while MDD patients exhibited greater dynamic FCS in the precentral gyrus compared with both BDd patients and HCs. Combined static and dynamic FCSs yielded higher accuracy than either static or dynamic FCS analysis alone, and also predicted anhedonia severity in BDd patients and negative mood severity in MDD patients. Conclusion: Altered FC within frontal–striatal–thalamic circuits of BDd patients and within the default mode network/sensorimotor network of MDD patients accurately distinguishes between these disorders. These unique FC patterns may serve as biomarkers for differential diagnosis and provide clues to the pathogenesis of mood disorders.
Effects of rosuvastatin and zoledronic acid in combination on the recovery of senile osteoporotic vertebral compression fracture following percutaneous vertebroplasty
Authors: Li Hong , Wang Yu , Wang Rui , Yue Lei , Chen Shunlun , Li Chunde 
Published: May 2020

Objectives This study analyzed the effects of rosuvastatin and zoledronic acid in combination on patient recovery following percutaneous vertebroplasty (PVP) that was performed to treat senile osteoporotic vertebral compression. Methods Senile patients with osteoporotic vertebral compression fracture (n = 120) were included in this retrospective study, and they were classified into two groups. Those in the control group (n = 60) were treated with PVP + caltrate and those in the observation group (n = 60) received this treatment with combined zoledronic acid and rosuvastatin. Between-group comparisons were made at both pre- and post-treatment regarding bone density, type I procollagen peptide (CTX) and bone-specific alkaline phosphatase (BAP) levels, visual analog scale (VAS) score, Oswestry Disability Index (ODI) score, and adjacent centrum refracture. Results Bone density was higher and BAP and CTX levels as well as ODI and VAS scores were lower at post-treatment in the observation group compared with the control group. The refracture rate in the observation group was lower compared with the control group. Conclusion Treatment with a combination of rosuvastatin and zoledronic acid following PVP can improve the condition of senile osteoporotic vertebral compression fracture and patient’s functional status, and it can also alleviate pain.
Comparison of clinical and oncologic effectiveness between flexible 3-dimensional and bidimensional video-thoracoscopic surgery for lung cancer
Authors: Pardolesi Alessandro , Rolli Luigi , Scanagatta Paolo , Duranti Leonardo , Tavecchio Luca , Pastorino Ugo 
Published: May 2020

Background: Three-dimensional (3D) vision systems are available for video-assisted thoracic surgery (VATS). It is unclear whether 3D-VATS is superior to bidimensional (2D) VATS systems. Methods: We analyzed patients who received 3D-VATS ( n = 171) or 2D-VATS ( n = 228) lobectomy in a single institutional retrospective comparative study of 399 patients with resectable lung cancer conducted from June 2012 to December 2017. The operative and perioperative data were compared between the 2 groups. Results: Operative time, length of hospital stay, number of dissected lymph nodes, and rate of postoperative complications were similar in both groups. In the 3D group, there was no conversion to thoracotomy for intraoperative major vascular injuries, while conversion to an open procedure for uncontrolled bleeding was recorded in 4 (1.7%) patients in the 2D group. Reoperation for hemostasis and/or aerostasis occurred in 6 (2.6%) patients of the 2D group ( p = 0.04). Conclusion: Nonrandomized comparison of different surgical approaches is challenging. In our experience, 3D-VATS was safe and effective and offered excellent operative perception and sensitivity, enabling safer dissection of hilar structures. The 3D-VATS system helped skilled surgeons beyond the boundaries of more oncologically aggressive surgery.
Real-world efficacy and safety of pembrolizumab in patients with non-small cell lung cancer: a retrospective observational study
Authors: Cavaille François , Peretti Mathieu , Garcia Marie Eve , Giorgi Roch , Ausias Nathalie , Vanelle Patrice , Barlesi Fabrice , Montana Marc 
Published: May 2020

Background: Pembrolizumab, a humanized immunoglobulin monoclonal antibody directed against the programmed cell death 1 receptor, demonstrated robust efficacy and a manageable safety profile across multiple tumor types in clinical trials. Aim: To investigate the efficacy and safety of first-line pembrolizumab for patients with non-small cell lung cancers (NSCLCs) in clinical practice. Methods: In this observational monocentric retrospective study, 38 patients with PD-L1 >50% were enrolled between November 2017 and November 2018. Results: The global median overall survival was 11.08 months (95% confidence interval [CI], 5.98–not reached) and the global median progression-free survival was 6 months (95% CI, 3–not reached). In the univariate analysis, clinical performance status score and the development of immune-related adverse events were the only 2 clinical factors significantly correlated with overall survival. Conclusion: The results of the present study suggest that pembrolizumab seems less effective in the real-life population than in the pivotal clinical trials in patients with NSCLC but remains an effective treatment option for patients with NSCLC. Longer follow-up is needed.
Return to Sport Following High Tibial Osteotomy With Concomitant Osteochondral Allograft Transplantation
Authors: Liu Joseph N. , Agarwalla Avinesh , Christian David R. , Garcia Grant H. , Redondo Michael L. , Yanke Adam B. , Cole Brian J. 
Published: May 2020

Background: Young patients with symptomatic chondral defects in the medial compartment with varus malalignment may undergo opening wedge high tibial osteotomy (HTO) with concomitant osteochondral allograft transplantation (OCA) (HTO + OCA). Although patients have demonstrated favorable outcomes after HTO + OCA, limited information is available regarding return to sporting activities after this procedure. Purpose: To evaluate (1) the timeline to return to sports (RTS), (2) patient satisfaction, and (3) reasons for discontinuing sporting activity after HTO + OCA, and to identify predictive factors of RTS. Study Design: Case series; level of evidence, 4. Methods: Consecutive patients who underwent HTO + OCA for varus deformity and medial femoral condyle focal chondral defects with a minimum 2-year follow-up were retrospectively reviewed. Patients completed a subjective sports questionnaire, satisfaction questionnaire, visual analog scale for pain, and Single Assessment Numerical Evaluation. Results: Twenty-eight patients with a mean age of 36.97 ± 7.52 years were included at mean follow-up of 6.63 ± 4.06 years. Fourteen patients (50.0%) required reoperation during the follow-up period, with 3 (10.7%) undergoing knee arthroplasty. Twenty-four patients participated in sports within 3 years before surgery, with 19 patients (79.2%) able to return to at least 1 sport at a mean 11.41 ± 6.42 months postoperatively. However, only 41.7% (n = 10) were able to return to their preoperative level. The most common reasons for sports discontinuation (n = 20; 83.3%) were a desire to prevent further damage to the knee (70.0%), persistent pain (55.0%), persistent swelling (30.0%), and fear (25.0%). Conclusion: In young, active patients with varus deformity and focal medial femoral condyle chondral defects, HTO + OCA enabled 79.2% of patients to RTS by 11.41 ± 6.42 months postoperatively. However, only 41.7% of patients were able to return to their preinjury level or better. It is imperative that patients be appropriately educated to manage postoperative expectations regarding sports participation after HTO + OCA.
Denial and oncological pathology: Case report of a massive testicular cancer
Authors: Pizzuto G , Barale M , Sedigh O , Frea B 
Published: May 2020

Literature: The cancer of testicles represents 1% of male neoplasms and 5% of urological malignant neoplasm. Its incidence has been growing in Western societies. Cancer of testicles usually presents as an increase of consistence in one testicles and absence of pain, as a casual ultrasound scan finding, or it could be highlighted by a scrotal injury. The surgical treatment is either radical orchiectomy or radical orchiectomy plus retroperitoneal lymph node dissection. Case presentation: The case presented concerns a 48-year-old male with a history of left testicular trauma and subsequent hypotrophy. Over the next 4 years, the patient developed a testicle size increase up to 15 cm in diameter. At diagnosis, he had retroperitoneal lymphadenopathy. The patient was, after surgery, referred to the oncology department. Conclusion: The awareness of the male population respect to testicular cancer and its screening methods (e.g. self-examination) is essential to make the diagnosis at an early stage. It is also essential to psychologically support patients undergoing surgical and/or pharmacological therapy due to risk of determining anxiety or depression compared to the whole population.