bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reconstructing Historical Exposures to Respirable Dust and Respirable Silica in the Taconite Mining Industry for 1955–2010
Authors: Shao Yuan , Hwang Jooyeon , MacLehose Richard F , Alexander Bruce H , Mandel Jeffrey H , Raynor Peter C , Ramachandran Gurumurthy 
Published: October 2021

Abstract
The goal of this study was to reconstruct the historical respirable silica (RS) and respirable dust (RD) exposures of workers in the Minnesota taconite industry from 1955 to 2010 as part of several epidemiological studies for assessing the association between exposure to components of taconite dusts and the development of respiratory diseases. A job-exposure matrix (JEM) was developed that uses 9127 RS and 19 391 RD occupational hygiene historical measurements. Historical RS and RD data were extracted from several sources and were grouped into seven mines and then into eight departments [Concentrating, Crushing, Janitor, Mining, Office/control room, Pelletizing, Shop (mobile), and Shop (stationary)]. Within each department, we applied a two-level random-intercept regression model which assumes that the natural log of Y (RD or RS concentration) changes over time at a constant rate. Among all predicted RD and RS values, we found that larger RD values were located in the following departments: Crushing, Concentrating, Pelletizing, and Shop (mobile). Larger RS values were located only in either Crushing or Shop (mobile). The annual rates of change for historical RD and RS exposures were between −3.3 and 3.2%. The silica percentage in the dust varied by mine/department with the highest value of 29.3% in Mine F (Crushing) and the lowest value of 2.1% in Mine B (Pelletizing). The predicted historical RD and RS arithmetic mean exposures ranged between &lt;0.075 and 3.14 mg m−3, and between &lt;0.005 and 0.36 mg m−3, respectively. The result of this study is a JEM by mine, department, and year for RD and RS for epidemiological studies.
Genetic mutation analysis of 22 patients with congenital absence of vas deferens: a single-center study
Authors: Tan Mao-Qing , Huang Wu-Jian , Lan Feng-Hua , Xu Yong-Jun , Zheng Mei-Yu , Tang Ying 
Published: October 2021

Abstract
Congenital absence of the vas deferens (CAVD), a congenital malformation of the male reproductive system, causes obstructive azoospermia and male infertility. Currently, the cystic fibrosis transmembrane conductance regulator (CFTR) has been recognized as the main pathogenic gene in CAVD, with some other genes, such as adhesion G-protein-coupled receptor G2 (ADGRG2), solute carrier family 9 isoform 3 (SLC9A3), sodium channel epithelial 1 subunit beta (SCNN1B), and carbonic anhydrase 12 (CA12), being candidate genes in the pathogenesis of CAVD. However, the frequency and spectrum of these mutations, as well as the pathogenic mechanisms of CAVD, have not been fully investigated. Here, we sequenced all genes with potentially pathogenic mutations using next-generation sequencing and verified all identified variants by Sanger sequencing. Further bioinformatic analysis was performed to predict the pathogenicity of mutations. We described the distribution of the p.V470M, poly-T, and TG-repeat CFTR polymorphisms and identified novel missense mutations in the CFTR and SLC9A3 genes, respectively. Taken together, we identified mutations in the CFTR, ADGRG2, SLC9A3, SCNN1B, and CA12 genes in 22 patients with CAVD, thus broadening the genetic spectrum of Chinese patients with CAVD.
Vocal embellishment in 18th-century Naples: solfeggio patterns in pre-composed cadenzas in sacred pieces by Gennaro and Gaetano Manna
Authors: Boaro Eric 
Published: October 2021

Abstract
The last 20 years have been crucial for 18th-century musicology. Robert Gjerdingen’s studies have focused on a key feature of 18th-century music that has completely changed our understanding of the Baroque repertory: schematic thinking. Yet discovering its traces still constitutes a demanding task. This article aims to contribute to and broaden this field of research by analysing a particular group of 18th-century Neapolitan manuscripts of sacred music through the lens of solfeggio. Related scores for the use of individual interpreters include summary annotations of pre-composed vocal cadenzas, perhaps added by the singers themselves. If analysed through solfeggio theory, it appears that these are built over simple solfeggio patterns, suggesting that early 18th-century Neapolitan vocal improvisation was conceived schematically. The article will substantiate this claim through three case studies in the form of sacred compositions by Gennaro and Gaetano Manna: ‘Et vos inferni furiae’, ‘O quam silva’ and the Oratorio a 4 per i morti (1770).
Impact of center-volume on outcomes in myocardial infarction complicated by cardiogenic shock – a CULPRIT-SHOCK sub-study
Authors: Clemmensen P , Schrage B N , Zeymer U , Montalecot G , Windecker S , Serpytis P , Stepinska J , Savonitto S , Desch S , Fuernau G , Huber K , Noc M , Ouarrak T , Blankenberg S , Thiele H ,   Culprit-Shock Investigators
Published: October 2021

Abstract

Background
Little is known about the impact of center-volume on outcomes in acute myocardial infarction complicated by cardiogenic shock (AMI-CS). The aim of this study was to investigate the association between center-volume, treatment strategies and subsequent outcome in patients with AMI-CS.

Methods
In this subanalysis of the randomized CULPRIT-SHOCK trial, study sites were categorized based on the annual volume of AMI-CS into low/intermediate/high volume centers (&lt;50; 50–100;&gt;100 cases/year). Subjects from the study/compulsory registry with available volume data were included. Baseline/procedural characteristics, overall treatment and 1-year all-cause mortality were compared across categories.

Results
N=1032 patients were included in this study (537 treated at low-volume, 240 at intermediate-volume and 255 at high volume centers). Baseline risk profile of patients across the volume categories was similar, although high volume centers included more older patients. Low/intermediate-volume centers had more resuscitated patients (57.5%/58.8% vs. 42.2%; p&lt;0.01), and more patients on mechanical ventilation in comparison to high volume centers. Mechanical circulatory support differed with more use in low/intermediate-volume centers and overall lower use in high-volume centers (30.7%/36.7% vs. 19.2%; p&lt;0.001). There were no differences in reperfusion success despite considerable differences in adjunctive pharmacological/device therapies (figure 1). There was no difference in 1-year all-cause mortality across volume categories (51.1% vs. 56.5% vs. 54.4%; p=0.34).

Conclusion
In this study of patients with AMI-CS, considerable differences in adjunctive medical and mechanical support therapies was observed. However, we could not detect an impact of center volume on reperfusion success or mortality.

Funding Acknowledgement
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): The CULPRIT-SHOCK trial was funded by European Union, Seventh Framework Programme (FP7/2007-2013) Grant agreement n°602202, German Heart Research Foundation Treatment according to center volumeLong-term survival
Underuse of reperfusiontherapy in STEMI with cardiogenic shock. Results of the EORP ACVC EAPCI STEMI registry of the ESC
Authors: Zeymer U , Ludman P , Danchin N , Kala P , Gale C , Maggioni A , Weidinger F 
Published: October 2021

Abstract

Aims
To determine the current state of the use of reperfusion and adjunctive therapies and in-hospital outcomes in ESC member and affiliated countries for patients with ST segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS).

Methods and results
ESC EORP prospective international cohort study of admissions with STEMI within 24 hours of symptom onset (196 centers; 26 ESC member and 3 affiliated countries). Of 11462 patients enrolled, 448 (3.9%) had CS. Patients without compared to patients with CS, more frequently received primary PCI (72.5% versus 65.2%) and fibrinolysis (19.0 versus 15.9%) and less frequently had no reperfusion therapy (8.5% versus 19.0%). Mechanical support devices (IABP 11.2%, ECMO 0.7%, other 1.1%) were used infrequently in CS. BARC 2–5 bleeding complications (10.1% versus 3.0%, p&lt;0.01) and stroke (4.2% versus 0.9%, p&lt;0.01) occurred more frequently in patients with CS. In-hospital mortality was ten-fold higher (35.5% versus 3.1%) in patients with CS. Mortality in patients with CS in the groups with PCI, fibrinolysis and no reperfusion therapy were 27.4%, 36.6% and 62.4%, respectively.

Conclusions
In this multi-national registry patients with STEMI complicated by CS less frequently receive reperfusion therapy than patients with STEMI without CS. Early mortality in patients with CS not treated with primary PCI is very high. Therefore strategies to improve clinical outcome in STEMI with CS are needed.

Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): ESC EORP
Racial disparities in the use of mechanical circulatory support devices in cardiogenic shock
Authors: Raheja H , Waheed M , Harris C , Patel N , Hashmi A , Kundal S , Patel J , Malik B , Frankel R , Shani J 
Published: October 2021

Abstract

Background
Racial bias has always been a concern for healthcare. Lack of guideline directed utilization of mechanical circulatory support (MCS) devices in cardiogenic shock (CS) may lead to implicit and racial bias.

Purpose
To identify the racial differences in the use of mechanical circulatory support in cardiogenic shock and its association with outcomes.

Methods
National Inpatient Database from 2015–2018 using ICD 10 codes was used. Patients &gt;18 years of age admitted for cariogenic shock were included.

Results
Among 1,021,274 patients hospitalized for cardiogenic shock, overall MCS was utilized in 11.4% (N=116,539). Use of MCS for patients stratified by race was 12.2% white (N=85543), 8% Blacks (N=14688), 11.3% Hispanics (N=11067), 13.8% Asian (N=4417), 12.3% Native American (N=825). IABP was the most commonly used MCS device, followed by Impella, ECMO and LVAD. Overall odds of MCS insertion was significantly higher in white population [1.18 (1.13–1.23) &lt;0.001] and significantly lower in Blacks [0.65 (0.61–0.69) &lt;0.001] and Hispanics [0.89 (0.83–0.97) 0.004]. Among black patients with CS requiring MCS, odds of LVAD insertion were similar compared to other races [1.03 (0.89–1.19) 0.714], while odds of all other types of MCS devices including ECMO [0.83 (0.72–0.95) 0.009], IABP [0.63 (0.59–0.68) &lt;0.001] and Impella [0.61 (0.54–0.70) &lt;0.001] were significantly lower compared to other races. This trend also holds true for patients with CS associated with acute myocardial infarction. Among all patients with CS, the odds of mortality were significantly lower among white patients [0.92 (0.90–0.95) &lt;0.001], on the contrary, odds of mortality were significantly higher in Blacks [1.06 (1.02–1.10) 0.001] and Asians [1.11 (1.02–1.20) 0.012]. Interestingly, when only comparing patients who underwent MCS utilization for CS, odds of mortality were similar in black population compared to other races. [1.03 (0.91–1.17) 0.636].

Conclusion(s)
There still exist significant racial differences in the use of mechanical circulatory devices for cardiogenic shock potentially leading to significantly higher mortality in black population compared to whites. This difference in mortality is mitigated with equal use of MCS devices in cardiogenic shock among all races.

Funding Acknowledgement
Type of funding sources: None.
Effectiveness of chest compressions skill training in the prone position: comparison of two methods
Authors: Peixoto E , Batista R E A , Okuno M F P , Baptista R C N , Campanharo C R V , Lopes J L 
Published: October 2021

Abstract

Introduction
The current pandemic caused by the new coronavirus (COVID-19), has become challenging for the health system.1 Pulmonary complication take patients to require ventilatory support and one of the interventions performed to improve then oxygenation is the prone position.2 In view of the current reality of patients with COVID-19 in a prone position, it is necessary to train cardiopulmonary resuscitation in this position.3 Purpose: To compare the effectiveness of two training methods, video and self-instructional guide, in the ability of chest compressions in prone position.

Methods
This is a randomized clinical trial. The sample consisted of nurses, nursing technicians, physiotherapists and residents of the intensive care and emergency unit of a public hospital. Randomization was performed in blocks of four using the Random @ system. Group 1 (G1) consisted of professionals who watched a validated video while practicing chest compression on a low-fidelity mannequin placed in the prone position. Group 2 (G2) consisted of professionals who practiced compression guided by a previously validated self-instructional guide. The study's outcome was the performance of chest compressions skills assessed before and after interventions, using a previously validated instrument. The study was approved by the Research Ethics Committee (no. 4.016.959).

Results
Ninety-one professionals participated in the study (45 from group 1 and 46 from group 2). It was observed that there was an improvement in hand positioning (G1 pre: 16 professionals correctly and post: 31 (p0.001); G2 pre: 20 correct and post: 20 (p0.781), of body positioning (G1 pre: 32 professionals hit and post: 41; G2 pre: 32 hit and post: 39) and the frequency of compressions G1 pre: 10 professionals hit and post: 19 (p0.017); G2 pre: 13 hit and post: 16 (p0.363)) after the interventions. Statistically, when applying the test within each group, a p-value of 0.0003 was obtained in G1 (video) and 0.512 in G2 (self-instructional guide). Thus, we can infer that only group 1 (video) had a change when we compared the two moments.

Conclusion
The video associated with simulation was more effective than the self-instructional guide and can be used as an attractive and dynamic teaching tool.

Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) CPR in prone position
Performance of risk scores for coronary artery disease in patients with chest pain in urgent primary care
Authors: Manten A , Kleton M , Smits I H , Rietveld R P , Lucassen W A M , Harskamp R E 
Published: October 2021

Abstract

Background and introduction
Chest pain is a common symptom for contacting out-of-hours primary care. One of the critical tasks of general practitioners (GPs) is to swiftly rule out possible life-threatening conditions. Easy-to-use clinical risk scores may help in adequate risk stratification.

Purpose
To evaluate the diagnostic performance of the Marburg Heart Score (MHS) [1], INTERCHEST [2], Gencer rule [3], and Bruins-Slot rule [4] and compare these scores with unaided clinical judgement among patients with chest pain who are evaluated in urgent primary care.

Methods
A retrospective, cohort study of patients aged ≥18 years who were evaluated for chest pain at a regional primary care facility in Alkmaar, the Netherlands. The reference standard for the diagnostic performance of risk scores and unaided GP assessment involved a composite endpoint of the occurrence of death from any cause, acute coronary syndrome or coronary revascularization (=major adverse cardiac events; MACE) up to six weeks after initial contact. Diagnostic test properties were evaluated using C-statistics, sensitivity, specificity, positive and negative predictive values (PPV/NPV) and referral rates.

Results
Out study population involved 664 consecutive patients, of whom 4.8% (n=32) had a MACE event. C-statistics were 0.85 [95%-confidence interval (CI): 0.78–0.92], 0.77 [95%-CI: 0.69–0.84], 0.72 [95%-CI: 0.63–0.81], and 0.72 [95%-CI: 0.63–0.81] for MHS, INTERCHEST, Gencer and Bruins-Slot respectively. Optimal diagnostic accuracy was found for MHS ≥2 (sensitivity=81.3%, specificity=67.1%, PPV=11.1%, NPV=98.6%), INTERCHEST ≥2 (sensitivity=87.5%, specificity=78.8%, PPV=17.3%, NPV=99.1%), Gencer ≥2 (sensitivity 84.4%, specificity=37.8%, PPV 6.4%, NPV=98.0%), and Bruins-Slot ≥2 (sensitivity=90.6%, specificity=40.8%, PPV=7.2%, NPV 98.9%). Physicians referred 157 patients (23.6%) and missed 6 out of 32 MACEs (sensitivity=81.3%, specificity=79.3%, PPV 16.6%, NPV 98.8%). Using INTERCHEST with a referral threshold of ≥2 points, 4 MACEs would have been missed and 162 patients (24.4%) referred. The other risk scores resulted in far higher referral rates.

Conclusion
The currently available clinical risk scores are safe for use in a low-risk population of patients with chest pain, but do not outperform unaided clinical judgement. Only the INTERCHEST score appears to somewhat improve risk stratification.

Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): ZonMW-HGOG Components clinical decision rulesPerformance risk scores regarding MACE
Comparison of risk prediction models in infarct-related cardiogenic shock
Authors: Freund A , Poess J , De Waha-Thiele S , Meyer-Saraei R , Fuernau G , Zeymer U , Feistritzer H J , Rubini M , Oldroyd K , Windecker S , Montalescot G , Schneider S , Baran D , Desch S , Thiele H 
Published: October 2021

Abstract

Background
Several prediction models have been developed to allow accurate risk assessment and provide better treatment guidance in patients with infarct-related cardiogenic shock (CS). However, comparative data between these models are still scarce.

Objectives
To externally validate different risk prediction models in infarct-related CS and compare their predictive value in the early clinical course.

Methods
The Simplified Acute Physiology Score (SAPS)-II Score, the CardShock score, the IABP-SHOCK II score and the Society for Cardiovascular Angiography and Intervention (SCAI) classification were each externally validated in a total of 1055 patients with infarct-related CS enrolled into the randomized CULPRIT-SHOCK trial or the corresponding registry. Discriminative power was assessed by comparing area under the curves (AUC) in case of continuous scores.

Results
In direct comparison of the continuous scores in a total of 161 patients, the IABP-SHOCK II score revealed best discrimination (AUC=0.74), followed by the CardShock score (AUC=0.69) and the SAPS-II score, giving only moderate discrimination (AUC=0.63). All of the three scores revealed acceptable calibration by Hosmer-Lemeshow test. The SCAI classification as a categorical predictive model displayed good prognostic assessment for the highest risk group (stage E), but showed poor discrimination between stages C and D with respect to short-term-mortality.

Conclusion
Based on the present findings, the IABP-SHOCK II score appears to be the most suitable of the examined models for immediate risk prediction in infarct-related CS. Prospective evaluation of the models, further modification or even development of new scores might be necessary to reach higher levels of discrimination.

Funding Acknowledgement
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): European Union, German Centre for Cardiovascular Research Survival probabilities continuous scoresSurvival probabilities SCAI
Duration of resuscitation efforts and long-term prognosis following in-hospital cardiac arrest (IHCA)
Authors: Yonis H , Winkel B , Andersen M P , Wissenberg M , Kober L , Gislason G , Larsen J M , Folke F , Pedersen C T , Sogaard P , Kragholm K 
Published: October 2021

Abstract

Background
The decision to terminate resuscitation efforts can be challenging. Notably, the association between duration of resuscitation and long-term survival and functional outcomes after in-hospital cardiac arrest (IHCA) is unknown.

Purpose
To examine 30-day and 1-year survival stratified by duration of resuscitation efforts. Further, to report long term outcome (1-year survival) without anoxic brain damage or nursing home admission among 30-day IHCA survivors.

Methods
We included all patients with IHCA from 13 Danish hospitals between January 1st, 2013 to December 31st, 2015. Patients were only included if there was clinical indication for a resuscitation attempt. Data on IHCA was obtained from the DANARREST database, which was linked to national registries to retrieve information on patient characteristics, survival, anoxic brain damage and nursing home admission. Patients were stratified into four groups (A-D) according to quartiles of duration of resuscitation efforts: Group A (&lt;5 minutes), group B (5–11 minutes), group C (12–20 minutes) and group D (≥21 minutes).
Using multivariable regression analysis, outcomes were standardized for patient age, sex, Charlson Comorbidity Index, witnessed arrest, monitored arrest, cardiopulmonary resuscitation (CPR) prior to arrival of the in-hospital cardiac arrest team and defibrillation.

Results
The study population comprised of 1868 patients, median age was 74 (1st-3rd quartile [Q1-Q3] 65–81 years) and 65.0% were men. In total, 52.1% (n=973) of the patients achieved return of spontaneous circulation (ROSC). The overall median duration of resuscitation was 12 min (Q1-Q3 5–21 min).
The standardized absolute chance of 30-day survival was 63.6% (95% CI 58.0%-69.0%) for group A, 34.0% (95% CI 29.7%-38.2%) for group B, 14.1% (95% CI 10.7%-17.5%) for group C and 9.0% (95% CI 6.8%-11.8%) for group D. Similarly, the chance of 1-year survival was highest for group A (51.5%; 95% CI 46.3%-56.7%) gradually decreasing to 7.0% (95% CI 4.5%-9.5%) in group D (Fig. 1).
Among 30-day survivors of an IHCA, the standardized absolute chance of survival without anoxic brain damage or nursing home admission within one-year post-arrest was highest for patients resuscitated in group A (83.2%; 95% CI 78.4%-88.1%), decreasing to 72.3% (95% CI 64.5%-80.0%) in group B, 68.3% (95% CI 55.3%-81.2%) in group C and 71.1% (95% CI 54.2%-88.0%) in group D (Fig. 2).

Conclusion
Short time to ROSC after in-hospital cardiac arrest is associated with better long-term prognosis. However, the majority of 30-day survivors are alive 1-year post-arrest without anoxic brain damage and without need for nursing home admission despite prolonged resuscitation.

Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
Epidemiology of infective endocarditis in Portugal, a populational study
Authors: Santos De Sousa C , Nogueira P , Pinto F J 
Published: October 2021

Abstract

Introduction
Infective endocarditis (IE) diagnosis and management continues to be a challenge.

Purpose
Describe temporal trends on the incidence of infective endocarditis, its clinical and outcome results, in Portugal.

Methods
A nationwide retrospective temporal trend study on the incidence and clinical characterization of patients hospitalized with infective endocarditis – 2010 to 2018, in Portugal.

Results
7574 hospitalized patients with infective endocarditis from 2010 to 2018 in Portuguese public hospitals. Predominantly men (56.9%), and 47.1% were between 60 and 79 years old. The most frequent infectious agents involved were Staphylococcus (16.4%) and Streptococcus (13.6%). During hospitalization, 12.4% of patients underwent heart valve surgery and 20% of the total cohort died. The annual incidence of infective endocarditis was 8.31 per 100,000 habitants, being higher in men and increased with age. In-hospital mortality rate significantly increased, the strongest independent predictors being ischemic or hemorrhagic stroke, sepsis, acute renal failure and older age.

Conclusions
In Portugal, between 2010 and 2018, the incidence of infective endocarditis presented a general growth trend with a deceleration in the most recent years. A significant rate of in-hospital complications, a mildly lower than expected stable surgical rate and a still high and growing mortality rate were noted.

Funding Acknowledgement
Type of funding sources: None.