bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survival Outcome with Routine Clinical Use of 82Rb PET/CT Myocardial Blood Flow (MBF) Quantification
Authors: Wan S , Speechly-Dick ME , Menezes LJ , Endozo R , Bell R , Walker M , Ganeshan B , Dickson J , Kayani I , Groves AM 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): NIHR Biomedical Research Centre, University College London Hospitals

Background
The prognostic value of 82Rb PET/CT derived myocardial blood flow (MBF) is increasingly recognised in both general and specific cardiovascular populations.

Purpose
This study investigates the prognostic potential of MBF in a large cohort of patients undergoing routine 82Rb PET/CT examination.

Methods
1148 consecutive patients (687 males, mean age 64 +/- 12 years) whom had been referred for 82Rb PET/CT examination in a single centre were included in this study. All patients completed a stress 82Rb PET/CT with adenosine infusion, paired with a rest study. Dynamic PET acquisitions were performed in both. Cardiovascular risk factors were documented as per clinical routine. Images were checked for quality and analysed using a proprietary software by an experienced operator to derive MBF parameters. Overall survival was recorded following the study.

Results
Median follow-up period was 71 +/- 28 months. Mean survival was 121 (95% CI: 118-124) months. On univariate analysis, global myocardial flow reserve &lt;1.77 was associated with a higher all-cause mortality (p &lt; 0.001). Other parameters including higher age (&gt; =76 years), lower BMI (&lt;21), qualitative abnormality on the myocardial perfusion scan (MPS), low hyperaemic ejection fraction on the gated studies (stress &lt; 37 and rest &lt; 34). Patients being on cardiac glycosides and diuretics were also significant predictor of poor prognosis (p &lt; 0.001) on univariate analysis, presumably reflecting underlying arrhythmia and heart failure. A multivariate Cox regression analysis (step-wise Forward Wald), comprising of the above significant univariate markers, highlighted global myocardial flow reserve (HR: 2.6, 95%CI: 1.8-3.6, p &lt; 0.001), age (HR: 2.8, 95%CI: 2.0-3.9, p &lt; 0.001),, BMI (HR: 2.7, 95%CI: 1.7-4.1, p &lt; 0.001),, ejection fraction (stress - HR: 3.3, 95%CI: 2.3-4.8, p &lt; 0.001), MPS (HR: 1.5, 95%CI: 1.1-2.1, p = 0.024), and patients on diuretics (HR: 1.8, 95%CI: 1.2-2.5, p = 0.003) were independent predictors of overall survival (overall model: p &lt; 0.001)

Discussion
We show that high volume routinely derived MBF in patients undergoing 82Rb PET/CT is a strong predictor of mortality and independent of other risk factors. This has important clinical implication for measuring not only interventional treatment but also measuring the effect of lifestyle and medical strategies.
Comprehensive mechanical & metabolic imaging of abdominal aortic aneurysm with 4D flow/ FDG PET on an integrated PETMRI: a feasibility study
Authors: Wan S , Steeden J , Rega M , Hoy L , Walls D , Endozo R , Hoath J , Shortman R , Agu O , Menezes L , Muthurangu V , Groves AM 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): NIHR Biomedical Research Centre, University College London Hospitals.

Background
A number of non-invasive imaging derived parameters have been implicated in the development and progression of abdominal aortic aneurysm, although the mechanism, and relationships of many of these are yet to be precisely determined. Mechanical parameters can now be studied using 4D phase contrast magnetic resonance (PCMR), and inflammatory cellular activity can be detected with FDG PET.

Purpose
It may be postulated that inflammation of the aortic wall may be the intermediary at the tissue level linking mechanical wall shear stress (WSS) to aneurysm progression. It may be feasible to study 4D PCMR and FDG PET at the same patient visit on a PETMRI platform, with the potential to enhance temporal and spatial co-registration and improving the understanding of any relationship between these two parameters. Our study aims to assess feasibility of studying these on an integrated PETMRI system.

Methods
7 patients with known aortic aneurysm were recruited in a vascular ultrasound screening follow up clinic. During a single visit following 6 hours fasting, all patients underwent FDG injection and 60 minutes uptake period. With quiet breathing, list mode PET acquisition and concurrent 4D PCMR was acquired using stacks of spiral acquisition, with ECG trace information for retrospective gating. Images from the 4D PCMR and FDG PET were assessed qualitatively for image quality and visual matching.

Results
All 7 patients completed the study. Overall image quality was adequate to good. There is qualitatively a good concordance with impression of positive correlation between wall shear stress and inflammatory signal (see attached image).

Conclusion
We have demonstrated feasibility of combined assessment of mechanical and metabolic imaging parameters using an integrated PETMRI system. Initial findings show there to be a broad concordance of wall shear stress and inflammatory signal in the abdominal aneurysm.
The prognostic role of PET myocardial perfusion imaging in patients with cardiac sarcoidosis: a systematic review
Authors: Ahmed AI , Tsehay A , Han Y , Alnabelsi T , Agrawal T , Kassi M , Aljizeeri A , Taylor A , Tleyjeh I , Al-Mallah MH 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Sarcoidosis is a multi-systemic inflammatory disease of unknown etiology. Cardiac Sarcoidosis (CS) has been reported in as much as 25% of patients with systemic involvement. 18Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) has a high diagnostic sensitivity/specificity in the diagnosis of CS.

Purpose
The aim of this review is to summarize evidence on the prognostic role of FDG PET.

Methods
Studies were identified by searching MEDLINE from inception to October 2020. Medical Subject Headings (MeSH) terms for sarcoidosis; cardiac and FDG PET imaging were used. Studies of any design assessing the prognostic role of FDG PET in patients with either suspected or confirmed cardiac sarcoidosis imaging done at baseline were included. Abnormal PET was defined as abnormal metabolism (presence of focal or focal-on-diffuse uptake of FDG) OR abnormal metabolism and a perfusion defect. Studies reporting any outcome measure were included. Pooled risk ratio for the composite outcome of MACE was done.

Results
A total of 6 studies were selected for final inclusion (515 patients, 53.4% women, 19.8% racial minorities.) Studies were institution based, retrospective in design and enrolled consecutive patients. All were observational in nature and published in English. All studies used a qualitative assessment of PET scans (abnormal FDG uptake with or without abnormal perfusion). Two studies assessed quantitative metrics (summed stress score in segments with abnormal FDG uptake, standardized uptake value and cardiac metabolic activity.) All studies reported Major Adverse Cardiovascular Events (MACE) as a composite outcome. After a mean follow up ranging from 1.4 to 4.1 years, there were a total of 105 MACE. All studies included death (either all-cause death or sudden cardiac death) and ventricular arrhythmia (ventricular tachycardia or ventricular fibrillation) as a component of MACE. Four of the six studies adjusted for several characteristics in their analysis. All four studies used Left Ventricular Ejection Fraction (LVEF). However, other adjustment variables were not consistent across studies. Five studies found a positive prognostic association with the primary outcome, two of which assessing right ventricular uptake.

Conclusion
Although available evidence indicates FDG PET can be used in the risk stratification of patients with CS, our findings show further studies are needed to quantify the effect in this patient group.
Should oral anticoagulants still be prescribed to patients with atrial fibrillation with a single stroke risk factor but at high bleeding risk? A nationwide cohort study
Authors: Chao Tze-Fan , Chan Yi-Hsin , Tuan Ta-Chuan , Liao Jo-Nan , Chen Tzeng-Ji , Lip Gregory Y H , Chen Shih-Ann 
Published: July 2021

Abstract

Aims
To investigate the co-distributions of stroke and bleeding risks in Asian patients with atrial fibrillation (AF) and the clinical benefits of oral anticoagulants (OACs) among AF patients with a single stroke risk factor but at high bleeding risk.

Methods and results
From 1 January 2001 to 31 December 2016, a total of 404 949 AF patients were retrospectively identified from Taiwan National Health Insurance Research Database. Stroke risk was assessed using the CHA2DS2-VASc score and was categorized into low risk (score = 0 for males and 1 for females), intermediate risk (i.e. a single non-sex stroke risk factor; score = 1 for males and 2 for females), and high risk (score ≥2 for males and ≥3 for females). A high risk of bleeding was defined as a HAS-BLED score ≥3. Around 57.5% of AF patients were at high risk for both stroke and bleeding, and most patients (97.6%) with a low stroke risk were also at low risk for bleeding. Around 18.3% of patients with a CHA2DS2-VASc score of 1 (males) or 2 (females) were at high bleeding risk, and the use of OACs in such patients was associated with a lower risk of composite adverse events of ischaemic stroke, intracranial haemorrhage, or mortality (4.19/100 person-years vs. 5.22/100 person-years, adjusted hazard ratio = 0.781, P = 0.04).

Conclusion
For AF patients with an intermediate risk of stroke (i.e. a single non-sex stroke risk factor) but at high bleeding risk, the use of OACs was still significantly associated with a better overall clinical outcome.
A Bookshop of Their Own: Reading and Print in Chartism, 1838–1850
Authors: Hall Robert G 
Published: July 2021

Abstract
To become a Chartist was to enter the world that print had made; to do so, most working men and women relied on a national network of sympathetic publishers, printers and booksellers. At the centre of this Chartist print culture was the bookshop. For some time now, historians have recognised the important contributions of booksellers as Chartist leaders and organisers; however, the role of bookshops in shaping Chartist reading practices and experiences has not really been explored. There has also been a tendency in studies of Chartism and print to focus primarily on the selling and reading of the Northern Star and to underestimate the importance of almanacs, pamphlets and ephemera (such as posters and advertisements). In this article I take as my subject Chartist print in its multiplicity of forms and argue that Chartist bookshops affected the production, circulation and the reading of texts in several different ways. As retailers and publishers, Chartist booksellers provided the working classes with a diverse mix of cheap publications, Chartist and non-Chartist alike, in many different forms; the bookshop itself came to serve as a free and democratic reading site for these publications. Of an inclusive nature, Chartist bookshops were places where oral and print cultures met and where readers read and discussed all kinds of different texts and ideas. In these and other ways, Chartist booksellers challenged many of the practices and conventions of the respectable book trades and at times crossed over into illegal and seditious activities.
Commissural repositioning in bicuspid aortic valve repair: an in vitro acute model to explore and explain different results
Authors: Romagnoni Claudia , Contino Monica , Jaworek Michal , Rosa Rubina , Salurso Eleonora , Perico Francesca , Gelpi Guido , Vismara Riccardo , Fiore Gianfranco Beniamino , Mangini Andrea , Antona Carlo 
Published: July 2021

Abstract

OBJECTIVES
Commissural orientation &lt;160° is a recognized risk factor for bicuspid aortic valve repair failure. Based on this observation, repairing this subtype of aortic valve by reorienting the 2 commissures at 180° has recently been proposed.

METHODS
Nine porcine hearts with aortic annulus diameters of 25 mm were selected. A pathological model of a Sievers 1 bicuspid aortic valve was obtained by suturing the coaptation line between the left and right leaflets. Each heart underwent reimplantation procedures both in the native (120°) and the reoriented (180°) configuration. After the operation, each sample was tested on a pulse duplicator at rest (heart rate 60 beats per min) and with mild exercise (heart rate 90 beats per min) conditions.

RESULTS
No statistically significant difference was noted in mean and peak transvalvular aortic gradients between the 2 configurations at rest (18.6 ± 5 vs 17.5 ± 4 for the mean aortic gradient; 42.8 ± 12.7 vs 36.3 ± 5.8 for the peak aortic gradient) but the group with the 120°-oriented commissures had significantly higher mean transaortic gradients compared to the group with the 180°-oriented commissures at initial exercise stress conditions (30.1 ± 9.1 vs 24.9 ± 3.8; p value 0.002).

CONCLUSIONS
The 180° commissural reorientation of the asymmetrical bicuspid aortic valve does not improve the transvalvular aortic gradient in an acute model at rest conditions, but it could do so under stress situations. Even if it is surgically more complex and time-consuming, this approach could be a good strategy to improve long-term results, particularly in young patients.
In-frame deletion of SPECC1L microtubule association domain results in gain-of-function phenotypes affecting embryonic tissue movement and fusion events
Authors: Goering Jeremy P , Wenger Luke W , Stetsiv Marta , Moedritzer Michael , Hall Everett G , Isai Dona Greta , Jack Brittany M , Umar Zaid , Rickabaugh Madison K , Czirok Andras , Saadi Irfan 
Published: July 2021

Abstract
Patients with autosomal dominant SPECC1L variants show syndromic malformations, including hypertelorism, cleft palate and omphalocele. These SPECC1L variants largely cluster in the second coiled-coil domain (CCD2), which facilitates association with microtubules. To study SPECC1L function in mice, we first generated a null allele (Specc1lΔEx4) lacking the entire SPECC1L protein. Homozygous mutants for these truncations died perinatally without cleft palate or omphalocele. Given the clustering of human variants in CCD2, we hypothesized that targeted perturbation of CCD2 may be required. Indeed, homozygotes for in-frame deletions involving CCD2 (Specc1lΔCCD2) resulted in exencephaly, cleft palate and ventral body wall closure defects (omphalocele). Interestingly, exencephaly and cleft palate were never observed in the same embryo. Further examination revealed a narrower oral cavity in exencephalic embryos, which allowed palatal shelves to elevate and fuse despite their defect. In the cell, wild-type SPECC1L was evenly distributed throughout the cytoplasm and colocalized with both microtubules and filamentous actin. In contrast, mutant SPECC1L-ΔCCD2 protein showed abnormal perinuclear accumulation with diminished overlap with microtubules, indicating that SPECC1L used microtubule association for trafficking in the cell. The perinuclear accumulation in the mutant also resulted in abnormally increased actin and non-muscle myosin II bundles dislocated to the cell periphery. Disrupted actomyosin cytoskeletal organization in SPECC1L CCD2 mutants would affect cell alignment and coordinated movement during neural tube, palate and ventral body wall closure. Thus, we show that perturbation of CCD2 in the context of full SPECC1L protein affects tissue fusion dynamics, indicating that human SPECC1L CCD2 variants are gain-of-function.
Roles and outcomes of thoracoscopic anatomic lung subsegmentectomy for lung cancer
Authors: Kato Hirohisa , Oizumi Hiroyuki , Suzuki Jun , Suzuki Katsuyuki , Takamori Satoshi 
Published: July 2021

Abstract OBJECTIVESWe performed sublobar resections, including thoracoscopic segmentectomy and subsegmentectomy for small lung cancers, and analysed the results of indications and outcomes of thoracoscopic subsegmentectomy.METHODSBetween March 2005 and May 2020, 357 consecutive patients underwent thoracoscopic anatomic sublobar resections for lung cancer, including 68 patients undergoing subsegmentectomy. These patients were compared with 289 patients who underwent segmentectomy during the same period.RESULTSSubsegmentectomies included mono-/bi-/tri-subsegmentectomies for 34/23/11 of 68 patients, respectively. The median tumour size was 13.5 mm, significantly smaller than tumours in patients who underwent a segmentectomy (P &lt; 0.001). Tumours obtained by mono-subsegmentectomy (11.0 mm) were significantly smaller than bi-/tri-subsegmentectomy (P = 0.028). The proportion of ground-glass opacity-dominant tumours obtained by subsegmentectomy (85.3%) was higher than that obtained by segmentectomy. The proportion of intentional cases satisfying the criteria for sublobar resection was higher than that of segmentectomy cases. Although tumour locations in 40 patients were not identified during surgery, tumours were correctly resected in 39 patients without tumour markers. The median operative time and blood loss were 167 min and 13 ml, significantly shorter and less, respectively, in subsegmentectomy than in segmentectomy patients (P = 0.005, P = 0.006). Duration of drainage and hospitalization were 1 and 5 days, respectively, for subsegmentectomy patients; complications occurred in 6 (8.8%). Outcomes were similar to those of the segmentectomy patients. Although 4 subsegmentectomy patients died of other diseases, none showed cancer recurrence during a mean follow-up of 50 months.CONCLUSIONSThoracoscopic subsegmentectomy can be used for patients with ground-glass opacity-dominant lung cancers &lt;1.5 cm if adequate margins can be secured.
Late surgical conversion of failed Multilayer Flow Modulator stenting in thoraco-abdominal aneurysms
Authors: Salvati Simone , Bilman Victor , Melloni Andrea , Baccellieri Domenico , Kahlberg Andrea , Melissano Germano , Chiesa Roberto , Bertoglio Luca 
Published: July 2021

Abstract OBJECTIVESThe aim of this study was to report the outcomes of open or hybrid repair of failed thoraco-abdominal aortic aneurysm endovascular treatment with Multilayer Flow Modulator (MFM) stents.METHODSAll patients who underwent open or hybrid repair of a failed MFM aortic treatment were retrospectively analysed. Perioperative and postoperative data, as well as midterm survival, were assessed.RESULTSBetween 2013 and 2020, 39 patients received an open or hybrid conversion after endovascular treatment. Five of them [13%; 4 males; median age 68 years (interquartile range 66–76)] were previously treated with aortic MFM stents (Cardiatis, Isnes, Belgium). Among these, the median interval between index repair and conversion was 84 months (interquartile range 75–84). The median aneurysm diameter was 9.6 cm (interquartile range 8–10). Renovisceral vessels steno-occlusion was highly prevalent: 2 renal arteries were occluded; 3 coeliac trunks, 2 renal arteries and 1 superior mesenteric artery had a &gt;70% ostial stenosis. Open standard thoraco-abdominal aneurysm conversion was performed in 3 fit patients, while a hybrid approach with visceral debranching and tube endografting was performed in 2 high-risk patients. Two patients (2 open repairs) died intraoperatively, and 1 (hybrid repair) postoperatively. The 2 successfully treated patients are alive at 4- and 34-month follow-up, respectively, with patent visceral branches.CONCLUSIONSOpen or hybrid thoraco-abdominal aortic aneurysm treatment after failed endovascular aortic repair with MFM stents might be the only surgical option to address sac enlargements and ruptures or branch-related failures. However, both procedures had a poor prognosis due to both the impaired preoperative patient’s status and the surgical complexity in the presented series.
Computational drug repositioning of atorvastatin for ulcerative colitis
Authors: Bai Lawrence , Scott Madeleine K D , Steinberg Ethan , Kalesinskas Laurynas , Habtezion Aida , Shah Nigam H , Khatri Purvesh 
Published: July 2021

AbstractObjectiveUlcerative colitis (UC) is a chronic inflammatory disorder with limited effective therapeutic options for long-term treatment and disease maintenance. We hypothesized that a multi-cohort analysis of independent cohorts representing real-world heterogeneity of UC would identify a robust transcriptomic signature to improve identification of FDA-approved drugs that can be repurposed to treat patients with UC.Materials and MethodsWe performed a multi-cohort analysis of 272 colon biopsy transcriptome samples across 11 publicly available datasets to identify a robust UC disease gene signature. We compared the gene signature to in vitro transcriptomic profiles induced by 781 FDA-approved drugs to identify potential drug targets. We used a retrospective cohort study design modeled after a target trial to evaluate the protective effect of predicted drugs on colectomy risk in patients with UC from the Stanford Research Repository (STARR) database and Optum Clinformatics DataMart.ResultsAtorvastatin treatment had the highest inverse-correlation with the UC gene signature among non-oncolytic FDA-approved therapies. In both STARR (n = 827) and Optum (n = 7821), atorvastatin intake was significantly associated with a decreased risk of colectomy, a marker of treatment-refractory disease, compared to patients prescribed a comparator drug (STARR: HR = 0.47, P = .03; Optum: HR = 0.66, P = .03), irrespective of age and length of atorvastatin treatment.Discussion & ConclusionThese findings suggest that atorvastatin may serve as a novel therapeutic option for ameliorating disease in patients with UC. Importantly, we provide a systematic framework for integrating publicly available heterogeneous molecular data with clinical data at a large scale to repurpose existing FDA-approved drugs for a wide range of human diseases.
Complex abdominal wall reconstruction after massive resection due to neoplastic invasion: a case report
Authors: Piltcher-da-Silva Rodrigo , Hütten Débora Oliveira , Locks-Coelho Lucas Dorídio , Piltcher-Recuero Mariana , Volkweis Bernardo Silveira , Tarta Cláudio , Appel Márcia Luiza , Cavazzola Leandro Totti 
Published: July 2021

Abstract
Complex reconstructions of the abdominal wall, necessary after resection of neoplasms, infection or trauma, are a challenge for the surgical team. Although ovarian carcinoma is commonly presented with peritoneal carcinomatosis and invasion of adjacent organs, it rarely can invade the abdominal wall. Invasion of the abdominal wall was documented on ultrasound and abdominal computed tomography. Surgery was discussed and performed in a multidisciplinary team and consisted of wide en bloc excision and reconstruction with open intraperitoneal onlay mesh with inorganic polypropylene-coated mesh (Bard/BD Sepramesh), a midweight macroporous mesh and abdominoplasty. Postoperative course was uneventful and the patient showed good evolution 1 year after the procedure. Our report highlights the main objectives in complex reconstructions, the importance of a multidisciplinary team and discusses the characteristics that the mesh must have in order to achieve the desired goal.