bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac evaluation of a child with stridor
Authors: Morrison Louise , McCrossan Brian A 
Published: August 2020

Abstract
This is the case of a 6-month-old boy who is diagnosed with, and treated for, a vascular ring, following several admissions to paediatric intensive care with difficult respiratory symptoms and ongoing failure to thrive. This case highlights the diagnostic challenge presented by these patients. Cardiovascular causes of paediatric airway compression are often under-recognized, with consequent delay in diagnosis. Although they are much less common than other causes of stridor, such as laryngomalacia or other tracheo-bronchial anomalies, chronic airway compression in childhood from vascular malformations carries significant morbidity and mortality. It is readily treatable and should not be overlooked. A high index of suspicion for mechanical compression should be maintained in small children with recurrent obstructive respiratory signs and symptoms or the older child presenting with dysphagia. The most prevalent vascular anomalies resulting in airway compression are a double aortic arch, right aortic arch with an aberrant left subclavian artery, innominate artery compression, left aortic arch with an aberrant right subclavian artery (rarely), and pulmonary artery sling. Rarely, complex congenital heart disease, itself leading to dilatation of the cardiac structures, may precipitate airway compromise, as in tetralogy of Fallot with an absent pulmonary valve syndrome or conditions with significant atrioventricular valve regurgitation causing left atrial enlargement. A dilated ascending aorta may compress the trachea, producing similar symptoms likewise with a cervical aortic arch with an aberrant sublclavian artery and ipsilateral ligamentum arteriosus. Such cases require a comprehensive diagnostic workup. Investigations include plain chest X-ray, echocardiogram, direct microlaryngoscopy and bronchoscopy, and CT angiography or cardiac MRI. A normal laryngoscopic examination should warrant further investigation in the presence of ongoing symptoms. An appreciation of aortic arch embryology is important in interpreting echocardiography and cross-sectional imaging in relation to the role of airway compression. Management often necessitates multidisciplinary collaboration among specialties, including ear, nose, and throat (ENT) specialists, paediatric cardiologists, respiratory physicians, intensivists, and cardiothoracic surgeons. Definitive treatment depends on the underlying pathology but usually involves surgical decompression or aortopexy. A proportion of patients will continue to exhibit symptoms following surgical release, due to ongoing weakness of the airway, and in severe cases may require ongoing respiratory support.
Coronary artery fistula
Authors: Duignan Sophie , Breatnach Colm , Kenny Damien 
Published: August 2020

Abstract
This is a case of a 14-year-old boy who attended the emergency department with fever, cough, and arthralgia. Examination revealed hepatomegaly and a continuous murmur. Blood cultures were positive on three separate occasions for meticillin-sensitive Staphylococcus aureus, and a diagnosis of infective endocarditis, with an intra-atrial thrombus complicating a coronary artery fistula, was made. The intracardiac thrombus was functioning as a septic nidus, and the patient had cavitating lung nodules likely representing septic emboli. The patient underwent thrombolytic therapy to eradicate the thrombus and recovered following a prolonged course of intravenous antibiotics and low-molecular weight heparin. Several months later, he electively underwent transcatheter device closure of the coronary artery fistula. This case discusses the definition and types of fistulae; the pathophysiology, presentation, and complications associated with this condition; the investigations and diagnosis; and finally the management options for patients with coronary artery fistulae. The nuances involved in the management of these cases are discussed, including the debate regarding indications for closure.
Ebstein’s anomaly
Authors: Vazquez-Garcia Laura , Rigby Michael 
Published: August 2020

Abstract
Ebstein’s anomaly (EA) is a rare malformation of the tricuspid valve (TV), characterized by apical displacement of the annular attachments of the septal and inferior (mural) leaflets into the right ventricular (RV) cavity, with varying degrees of adherence to the underlying myocardium. The natural history is quite variable and depends on the severity and presence of associated arrhythmias, which plays a significant role with regard to the prognosis. Prenatal diagnosis is associated with higher perinatal mortality, as these usually represent the severe end of the disease spectrum. Different surgical strategies have been employed, although the cone operation, introduced in the past decade, has significantly changed the surgical approach and improved the outcomes of these patients. This chapter presents the case of a newborn with an antenatal diagnosis of EA who presented with severe cyanosis and major arrhythmias at birth requiring intensive care management for the first month of life. After some years of being relatively asymptomatic, he re-presented with recurrent arrhythmias and decreased exercise tolerance, requiring multiple interventions. His clinical course and management are presented, together with a detailed review of this disease from the anatomical aspects to its diagnosis and medico-surgical management.
Kawasaki disease
Authors: Alsaied Tarek , Tretter Justin T , Redington Andrew N 
Published: August 2020

Abstract
Kawasaki disease is the most common acquired heart disease in children in developed countries. Coronary involvement is reported in 30% of patients with no treatment and decreases to 5% with intravenous immunoglobulin treatment. Given the significant risk for coronary involvement, understanding the long-term prognosis is paramount to guide outpatient follow-up and treatment. This chapter presents the case of a 20-month-old child with Kawasaki disease and giant coronary aneurysms. The chapter reviews the diagnostic criteria and coronary imaging aspects, delves into the treatment options and prognosis, including immunoglobulin treatment.
Pulmonary hypertension associated with congenital heart disease
Authors: Coleman Ryan , Chartan Corey , Varghese Nidhy 
Published: August 2020

Abstract
The spectrum of pulmonary hypertension associated with congenital heart disease (PH-CHD) is broad and complex. The most common aetiologies are related to left-to-right shunts, resulting in volume loading of the pulmonary circulation (precapillary pulmonary hypertension) and left-sided obstructive disease (post-capillary pulmonary hypertension). However, in addition to these basic classifications are patients with absent pulmonary arteries, large septal defects, duct-dependent lesions, cardiomyopathies, and, perhaps the most challenging, patients with single ventricle physiology lacking a subpulmonic ventricle. It is therefore imperative that physicians taking care of children with PH-CHD are well versed not only in the different physiologies present in these children, but also in those that result from their respective surgical palliations as well and how these flows and pressures relate to their pulmonary vascular disease burden. This chapter presents the case of a child with trisomy 21 and congenital heart disease who presented late to medical care and required significant modulation of her pulmonary vascular bed to successfully undergo surgical correction. The child’s clinical course, an overview of PH-CHD and its diagnosis and management, and important therapeutic considerations are presented.
Metabolic syndrome and diabetes
Authors: Saely Christoph H. 
Published: August 2020

Abstract
The metabolic syndrome (MetS) and even more so diabetes confer a significantly increased risk of cardiovascular disease. A multifactorial approach is required to improve the prognosis of patients with the MetS or diabetes. Glucose control is essential to reduce microvascular diabetes complications and, over long periods of time, may also lower the risk of cardiovascular events in patients with diabetes. As in other patient populations, lowering low-density lipoprotein (LDL) cholesterol and treating arterial hypertension are paramount interventions to reduce cardiovascular event risk in patients with the MetS and diabetes. Most patients with diabetes must be considered at a very high risk of cardiovascular events, which qualifies them for low LDL cholesterol targets. Antiplatelet therapy is recommended for patients with the MetS or diabetes in secondary prevention; it may also be considered for primary prevention patients with diabetes who are at high or very high risk; it is not recommended for primary prevention in diabetes patients at moderate risk. Because the MetS or diabetes confers an extremely high risk of cardiovascular events once cardiovascular disease is established, it is extremely important to intervene early to prevent these patients from developing cardiovascular disease.
Heart transplantation
Authors: Gustafsson Finn , Rossing Kasper 
Published: August 2020

Abstract
Heart transplantation remains the treatment of choice for end-stage heart failure refractory to conventional treatment. Long-term outcome is excellent, and median survival currently exceeds 13 years. The main causes of death late after transplantation are cardiac allograft vasculopathy and cancer. Medical therapy after transplantation is complex, including immunosuppressive therapy to reduce the risk of graft rejection and prophylaxis against viral and protozoal infections, as well as adjunctive therapy to treat common comorbidities, for instance hypertension. Pharmacological therapy of comorbid conditions requires specific consideration to clinically important interactions with immunosuppressive drugs.
Cardiomyopathy
Authors: Boffa Giovanni 
Published: August 2020

Abstract
Hypertrophic cardiomyopathy (HCM) is characterized by the presence of increased left ventricular (LV) wall thickness that is not explained by loading conditions. The LV diastolic function is impaired in the majority of patients, and resting or provocable LV outflow tract obstruction is often present. The management of HCM is directed towards minimizing symptoms, improving LV diastolic function, and reducing LV outflow tract obstruction. Beta-blockers reduce myocardial oxygen demand and improve LV filling via their negative chronotropic and inotropic effects. Moreover, they decrease LV outflow tract obstruction. The calcium channel blockers verapamil and diltiazem can be used when beta-blockers are contraindicated or ineffective. Diuretics improve dyspnoea in patients with increased pulmonary capillary pressure, and their use is mandatory if signs of fluid retention are present. The role of non-pharmacological treatment (surgery, electrical and mechanical device implantation) is important in specific groups of patients. Dilated cardiomyopathy is defined by the presence of LV dilatation and systolic dysfunction in the absence of abnormal loading conditions or coronary artery disease. Treatment of symptomatic patients should follow the therapeutic algorithm proposed by European Society of Cardiology guidelines on heart failure. First-line treatment includes diuretics, angiotensin-converting enzyme (ACE) inhibition (or angiotensin receptor blockade), beta-blockade, and aldosterone antagonism. The complex neprilysin inhibitor sacubitril/valsartan is recommended to replace ACE inhibitors in patients who remain symptomatic despite optimal treatment. The If channel inhibitor ivabradine should be considered for patients in sinus rhythm and with a resting heart rate of &gt;70 bpm. ICD implantation with cardiac resynchronization function, LV assist devices, and heart transplantation are indicated in selected patients.
Those extra moments
Authors: Felton Jean Spencer 
Published: August 2020

Abstract
Dedicated to the memory of the late Pilot Officer William C Gunnyeon, RAF (1929–53) In Those extra moments Jean Spencer Felton briefly explores the limited time between doctors and patients, the lack of weight given to emotional, familial, or other situational contexts influencing wellness, and the power of asking about and listening to the patient’s broader life problems.
DDA 1995, 2005 or 605?
Authors: Sayed Hanaa 
Published: August 2020

Abstract
In DDA 1995, 2005 or 605? Hanaa Sayed briefly explores the Five Pillars of Islam and how they catered to those with disabilities thousands of years prior to modern laws preventing workplace disability discrimination (Disability Discrimination Act 1995 (DDA, 1995)).
Why I became an occupational physician …
Authors: McCallum R. Ian 
Published: August 2020

Abstract
Why I became an occupational physician … briefly explores the reasons and influences behind R. Ian McCallum’s decision to pursue a career in occupational medicine. It takes us through his early specialization in lung diseases, move to a new department of Industrial Health, and research in a wide variety of topics, including pneumoconiosis, lead poisoning, antimony toxicology, compressed air disease, and the long-term effects of diving.
Tales of Kieran: The occupational physician’s odyssey 4—Vanadium
Authors: Hunter J.A. 
Published: August 2020

Abstract
In Tales of Kieran: The occupational physician’s odyssey 4: Vanadium J.A. Hunter briefly explores the humorous encounters with his occupational physician friend Kieran. This article recounts Kieran’s new interest in vanadium poisoning after finding out a colleague had been burning Venezuelan bitumen.
Fifty years ago: ‘Parameters of occupational health in America’
Authors: Wright H. Beric 
Published: August 2020

Abstract
This series provides a selection of articles from the past. In Fifty years ago: ‘Parameters of occupational health in America’ H. Beric Wright briefly explores the short supply of occupational specialists in the UK and America, how to attract and train the right doctors, and how to progress in the field and maintain high standards.
Fifty years ago: ‘A poisons information service’
Authors: Goulding Roy 
Published: August 2020

Abstract
This series provides a selection of articles from the past. In Fifty years ago: ‘A poisons information service’ the author briefly explores a service set up in the 1960s to offer advice on medicinal, veterinary, agricultural, horticultural, and household poisoning, and after some debate, industrial poisoning.
Why I became an occupational physician …
Authors: Goodall Henry N. 
Published: August 2020

Abstract
Why I became an occupational physician … briefly explores the reasons and influences behind Henry N. Goodall’s decision to pursue a career in occupational medicine. It takes us through his beginnings in general practice and A&E, move to Ford Motor Company and Atos Healthcare, and training under Ewan Macdonald and Monty Brill.
Why I became an occupational physician …
Authors: Aldridge John 
Published: August 2020

Abstract
Why I became an occupational physician … briefly explores the reasons and influences behind John Aldridge’s decision to pursue a career in occupational medicine. It takes us through his various appointments in institutions such as the Royal Armoured Corps, Cambridge Hospital in Aldershot, Queen Alexandra Hospital in Millbank, and the Military Hospital in Tripoli in Libya, before becoming interested in occupational mental health.
Tales of Kieran: The occupational physician’s odyssey 8—The HAVS and the Have Nots
Authors: Hunter J.A. 
Published: August 2020

Abstract
In Tales of Kieran: The occupational physician’s odyssey 8: The HAVS and the Have Nots J.A. Hunter briefly explores the humorous encounters with his occupational physician friend Kieran. This article recounts Hunter’s discovery of Kieran with a large collection of hand photos and a magnifying glass.
Transient gravitational waves from pulsar post-glitch recoveries
Authors: Yim Garvin , Jones D I 
Published: August 2020

ABSTRACT
This work explores whether gravitational waves (GWs) from neutron star (NS) mountains can be detected with current second-generation and future third-generation GW detectors. In particular, we focus on a scenario where transient mountains are formed immediately after an NS glitch. In a glitch, an NS’s spin frequency abruptly increases and then often exponentially recovers back to, but never quite reaches, the spin frequency prior to the glitch. If the recovery is ascribed to an additional torque due to a transient mountain, we find that GWs from that mountain are marginally detectable with Advanced LIGO at design sensitivity and is very likely to be detectable for third-generation detectors such as the Einstein Telescope. Using this model, we are able to find analytical expressions for the GW amplitude and its duration in terms of observables.
TESS light curves of γ Cas stars
Authors: Nazé Yaël , Rauw Gregor , Pigulski Andrzej 
Published: August 2020

ABSTRACT
γ Cas stars constitute a subgroup of Be stars showing unusually hard and bright X-ray emission. In search for additional peculiarities, we analysed the TESS light curves of 15 γ Cas analogues. Their periodograms display broad frequency groups and/or narrow isolated peaks, often superimposed over red noise. The detected signals appear at low frequencies, with few cases of significant signals beyond 5 d−1 (and all of them are faint). The signal amplitudes, and sometimes the frequency content, change with time, even in the absence of outburst events. On the basis of their optical photometric variability, γ Cas stars reveal no distinctive behaviour and thus appear similar to Be stars in general.
People
Authors: Miller Kenneth P. 
Published: August 2020

Abstract
Chapter 3 argues that demography is not, by itself, “destiny.” The two states’ demographic characteristics cannot fully explain their political polarization. Based on Census-level categories, the two states look much alike. Among other similarities, they are the nation’s most populous states and both are highly urbanized and majority-minority. In both Texas and California, the white share of the population has plunged; the percentage of African Americans has remained relatively steady; the number of Asians has increased rapidly; and Hispanics have achieved the greatest population gains—now nearly 40 percent of both states. Although growing racial diversity contributed to California’s conversion to the Democratic Party, it has not yet produced similar results in Texas. Whites vote very differently in the two states, and, to a lesser degree, so do Hispanics. Demography alone is not political destiny—other factors are at play.
How California Turned Blue
Authors: Miller Kenneth P. 
Published: August 2020

Abstract
This chapter describes California’s transformation into a deep blue state. For many years, the Republican Party was the dominant force in California politics. Yet the state was never overwhelmingly conservative. It was a leader of the national Progressive movement of the early twentieth century and for decades continued to support a range of liberal policies even under Republican governors. Democrats began to gain ground in the 1950s and the two parties were highly competitive in the four decades between 1958 and 1998. In the 1990s, California began to shift from a competitive two-party system to Democratic control. Changes in the state’s demographics, economy, and culture contributed to this transformation. Once the parties polarized along ideological lines, California more naturally aligned with the party of the left. Democrats have now gained near total control over California, making it the nation’s most consequential blue state.
Rival Models
Authors: Miller Kenneth P. 
Published: August 2020

Abstract
This chapter discusses how gaining one-party control of state government (also known as a “trifecta”) has allowed the governing coalitions in Texas and California to develop their contrasting policy models. The Texas Republican coalition includes business interests, libertarians, and social conservatives. These groups are unified in their commitment to small government, low taxes, and light regulations, but sometimes divide over social issues. In California, the governing Democratic coalition includes organized labor, environmentalists, social progressives, and advocates of minority rights. This coalition broadly agrees on the state’s fusion of progressive economic, social, and environmental goals, but sometimes disagrees on how to manage trade-offs between them. The chapter compares these coalitions’ effectiveness in shaping state policy and describes how both states have intensified their efforts to influence federal policy, especially through federal litigation.
Energy and Environment
Authors: Miller Kenneth P. 
Published: August 2020

Abstract
This chapter examines the deep Texas-California divide over energy and environmental policies. The modern Texas economy was built on energy, and the state remains the nation’s leading producer. The state’s development of fracking has revolutionized the oil and gas industry and has helped the nation break its dependence on foreign oil. Texas has also increased its production of renewable energy, but believes the global economy will rely for the foreseeable future on fossil fuels and resists restrictions on these resources. California, by contrast, has become a global leader in the fight against climate change. It has aggressively regulated carbon emissions and mandated a massive switch to renewable energy sources. California is the only state that can impose emissions regulations more strict than federal standards. As power has shifted in Washington, California has alternated between translating its environmental policies into federal law and defending its policies from federal challenge.
Social Issues
Authors: Miller Kenneth P. 
Published: August 2020

Abstract
More than any other policy area, social issues have polarized Texas and California and the camps they represent. These topics provide fodder for the nation’s culture wars. Many such issues are framed in the language of rights and are difficult to resolve through normal political give-and-take. After briefly discussing the range of social issues that divide the two states, the chapter narrows its focus to three: abortion, guns, and LGBT rights. Texas and California have polarized on these topics and, to the extent permitted by federal law, have translated their opposing views into sharply contrasting policies. The states’ discretion on these topics has been limited, however, by Supreme Court interpretations of federal constitutional rights. The chapter concludes by discussing the alternatives for addressing social issues that divide the nation along ideological and sectional lines, comparing the options of uniformity and pluralism.
State of the Rivalry
Authors: Miller Kenneth P. 
Published: August 2020

Abstract
The closing chapter assesses the rival models and looks to the future of the competition. The Texas Model has achieved great success stimulating broad-based economic growth and opportunity, yet may not be able to meet the basic needs of a diversifying population. Conversely, the California Model has advanced progressive goals, but has imposed heavy costs on residents and businesses and may not be sustainable. Looking forward, the nation’s political polarization will likely persist for some time, with Texas and California remaining on opposite sides of the partisan divide. Texas’s political future is increasingly uncertain, but its underlying conservative political culture will likely prevent it from aligning with the national Democratic Party. If so, the two states and their respective allies will continue to pursue divergent policy agendas. The book concludes with a discussion of the value of diverse models and a call for a respectful approach to the rivalry.