bluuebunny/crossref_metadata_2025_split huggingface dataset:
Real-world management and outcomes of 7 million patients with acute coronary syndrome according to clinical research trial enrolment status: a propensity matched analysis
Authors: Matetic Andrija , Mohamed Mohamed O , Roberts Derek J , Rana Jamal S , Alraies M Chadi , Patel Brijesh , Sauer Andrew J , Diaz-Arocutipa Carlos , Sattar Yasar , Van Spall Harriette G C , Mamas Mamas A 
Published: December 2021

Abstract

Aims
We aimed to determine whether clinical outcomes and invasive care of acute coronary syndrome (ACS) patients participating in trials differed from those of non-participants, particularly including those who were trial eligible.

Methods and results
We included all hospitalizations with a principal diagnosis of ACS in the US National Inpatient Sample between January 2004 and September 2015, stratified by trial enrolment and eligibility using the International Classification of Diseases, ninth revision. We conducted propensity score matching to investigate the following outcomes: all-cause mortality; major bleeding; stroke; composite of mortality, stroke, and cardiac complications [major adverse cardiovascular and cerebrovascular events (MACCEs)]; coronary angiography (CA); and percutaneous coronary intervention (PCI). A total of 7 091 179 weighted ACS hospitalizations were analysed, including 19 684 (0.3%) trial participants and 7 071 495 non-participants (3 485 514 of whom were trial eligible). Trial participants were more likely to receive CA [Δ% 28.73%, 95% confidence interval (CI) 27.22–30.24, P &lt; 0.001] and PCI (Δ% 27.13%, 95% CI 24.86–29.41, P &lt; 0.001), with decreased mortality (Δ% −3.51%, 95% CI −4.72 to −2.31, P &lt; 0.001), MACCEs (Δ% −3.04%, 95% CI −4.55 to −1.53, P &lt; 0.001), and bleeding (Δ% −0.89%, 95% CI −1.59 to −0.19, P = 0.013) compared with non-participants. After accounting for eligibility, trial participants were more likely to undergo CA (Δ% 22.78%, 95% CI 21.58–23.99, P &lt; 0.001) and PCI (Δ% 23.95%, 95% CI 21.77–26.13, P &lt; 0.001), and had no difference in mortality (Δ% −0.21%, 95% CI −0.65 to 0.24, P = 0.362).

Conclusion
Among ACS patients, trial enrolment was associated with significantly greater invasive care and lower mortality than among matched non-participants. Trial participants were more likely to be invasively managed even when compared with eligible non-participants, even though there was no difference in mortality.
Thoracic bilateral sympathectomy attenuates oxidative stress and prevents ventricular remodelling in experimental pulmonary hypertension
Authors: Coutinho e Silva Raphael dos Santos , Wiggenhauser Lucas Moritz , Simas Rafael , Zanoni Fernando Luiz , Medeiros Geisla , da Silva Fernanda Beatriz , Ogata Daniel Cury , Breithaupt-Faloppa Ana Cristina , Krenning Guido , Moreira Luiz Felipe Pinho 
Published: December 2021

Abstract

OBJECTIVES
Pulmonary arterial hypertension (PAH) is a cardiopulmonary disease that affects the pulmonary vasculature, leading to increased afterload and eventually right ventricular (RV) remodelling and failure. Bilateral sympathectomy (BS) has shown promising results in dampening cardiac remodelling and dysfunction in several heart failure models. In the present study, we investigated whether BS reduces pulmonary arterial remodelling and mitigates RV remodelling and failure.

METHODS
PAH was induced in male Wistar rats by intraperitoneal injection of monocrotaline. Rats were divided into 3 groups, involving untreated PAH (n = 15), BS-treated PAH (n = 13) and non-manipulated control rats (n = 13). Three weeks after PAH induction, the rats were anaesthetized and RV function was assessed via the pressure-volume loop catheter approach. Upon completion of the experiment, the lungs and heart were harvested for further analyses.

RESULTS
BS was found to prevent pulmonary artery remodelling, with a clear reduction in α-smooth muscle actin and endothelin-1 expression. RV end-systolic pressure was reduced in the BS group, and preload recruitable stroke work was preserved. BS, therefore, mitigated RV remodelling and cardiomyocyte hypertrophy and diminished oxidative stress.

CONCLUSIONS
We showed that thoracic BS may be an important treatment option for PAH patients. Blockade of the sympathetic pathway can prevent pulmonary remodelling and protect the RV from oxidative stress, myocardial remodelling and function decay.
An external validation study of the Utah Bleeding Risk Score
Authors: Peivandi Armin , Welp Henryk , Scherer Mirela , Sindermann Jürgen R , Wagner Nana-Maria , Dell’Aquila Angelo M 
Published: December 2021

Abstract

OBJECTIVES
Gastrointestinal bleeding in patients with continuous-flow left ventricular assist devices (CF-LVAD) impairs quality of life and increases hospitalization rate. The Utah Bleeding Risk Score (UBRS) has been created to predict gastrointestinal bleeding (GIB) in patients on left ventricular assist device. We here aimed to externally validate UBRS on our cohort of CF-LVAD patients.

METHODS
Utah Bleeding Risk Score was calculated, GIB events summarized on follow-up and patients stratified into 3 risk groups. Predictive ability of UBRS was examined at 3 years and during whole support time and person time incidence rates correlated to UBRS. In a sub-analysis, single effects of UBRS variables on freedom from GIB were assessed.

RESULTS
A total of 111 CF-LVAD patients were included. The median UBRS was 2 (3–1). Receiver operating characteristic curve analysis showed an area under the curve of 0.519 (P = 0.758, 95% confidence interval = 0.422–0.615) at 3 years and an area under the curve of 0.515 (P = 0.797, 95% confidence interval = 0.418–0.611) during whole support time. No significant difference was observed in UBRS between bleeders and non-bleeders (P = 0.80). No significant difference in freedom from GIB was observed (P3 years = 0.7; Psupport-time = 0.816) and no independent significance regarding the freedom from bleeding at 3 years for any variable was observed. Coronary artery disease was associated with higher risk of GIB beyond the 3rd year (P = 0.048).

CONCLUSIONS
UBRS was not able to predict GIB and therefore not applicable in our cohort of patients. Coronary artery disease could lead to a higher risk for GIB during support time. An additional validation in a larger cohort is advisable.
‘Reform or revolution’, redux: Eduard Bernstein on the 1918–19 German Revolution
Authors: Ostrowski Marius S 
Published: December 2021

Abstract
The 1918–19 German Revolution forced an abrupt moment of decision among German socialists on the question of ‘social reform or revolution’. This article traces the arguments of Eduard Bernstein, the founder of ‘reformism’, on the lessons social democracy should draw from the events of the Revolution and the transition from the Kaiserreich to the Weimar Republic. It argues that Bernstein makes significant advances on his early reformism in his post-Revolution writings, and explores his refinement of the concept of ‘revolution’ as well as his critique of Bolshevism and the U.S.S.R. as a new ideological rival within the socialist movement.
Are NOACs as safe and efficient as VKA regarding thromboembolic prophylaxis and major bleeding in patients with surgical bioprosthesis and atrial fibrillation within 3 months of surgery?
Authors: Magro Pedro Lamares , Sousa-Uva Miguel 
Published: December 2021

Summary
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: ‘Are NOACs as safe and efficient as vitamin K antagonist regarding thromboembolic prophylaxis and major bleeding in patients with surgical bioprosthesis and atrial fibrillation within 3 months of surgery?’ Altogether more than 324 papers were found using the reported search, of which 6 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. The RIVER and ENAVLE trials showed non-inferiority of rivaroxaban (regarding mean time free from composite of death, major cardiovascular events or major bleeding at 12 months) and edoxaban (composite of death, clinical thromboembolic events or asymptomatic intracardiac thrombosis; and major bleeding) when compared with vitamin K antagonist. These studies include a low number of patients within 3 months of index surgery and overall low statistical power regarding this particular subgroup of patients. Data derived from lower evidence studies are compatible with the aforementioned findings. The available evidence suggests that non-vitamin K antagonist anticoagulants are as safe and as efficient as vitamin K antagonist regarding thromboembolic prophylaxis and bleeding event rates in patients with surgical bioprosthesis and atrial fibrillation within 3 months of bioprosthesis implantation. However, this evidence is derived from a limited number of studies with important methodological limitations. Expanding non-vitamin K antagonist anticoagulant recommendation to the early postoperative period warrants more confirmatory research.
Thoracoscopic pneumonectomy in patient with unilateral absence of the left pulmonary artery accompanied by the left lung cancer
Authors: Kononets Pavel V , Akhmedov Parvin I , Topol Konstantin Y 
Published: December 2021

Abstract
Unilateral absence of the pulmonary artery is a rare congenital cardiovascular anomaly. Unilateral absence of the pulmonary artery is often accompanied by cardiovascular disorders but also can occur in an isolated manner. We present a case of female patient, in which the absence of the left pulmonary artery was revealed and the left lower lobe adenocarcinoma was diagnosed.
Evaluation of the Association of Length of Stay in Hospital and Outcomes
Authors: Han Thang S , Murray Paul , Robin Jonathan , Wilkinson Peter , Fluck David , Fry Christopher H 
Published: December 2021

ABSTRACT

Background
There exist wide variations in healthcare quality within the National Health Service (NHS). A shorter hospital length of stay (LOS) has been implicated as premature discharge, that may in turn lead to adverse consequences. We tested the hypothesis that a short LOS might be associated with increased risk of readmissions within 28 days of hospital discharge and also post-discharge mortality.

Methods
We conducted a single-centred study of 32,270 (46.1% men) consecutive alive-discharge episodes (mean age = 64.0 years, standard deviation = 20.5, range = 18-107 years), collected between 01/04/2017 and 31/03/2019. Associations of LOS tertiles (middle tertile as a reference) with readmissions and mortality were assessed using observed/expected ratios, and logistic and Cox regressions to estimate odds (OR) and hazard ratios (HR) (adjusted for age, sex, patients’ severity of underlying health status and index admissions), with 95% confidence intervals (CI).

Results
The observed numbers of readmissions within 28 days of hospital discharge or post-discharge mortality were lower than expected (observed: expected ratio &lt;1) in patients in the bottom tertile (&lt;1.2 days) and middle tertile (1.2-4.3 days) of LOS, whilst higher than expected (observed: expected ratio &gt;1) in patients in the top tertile (&gt;4.3 days), amongst all ages. Patients in the top tertile of LOS had increased risks for one readmission: OR = 2.32 (95%CI = 1.86-2.88) or ≥2 readmissions: OR = 6.17 (95%CI = 5.11-7.45), death within 30 days: OR = 2.87 (95%CI = 2.34-3.51), and within six months of discharge: OR = 2.52 (95%CI = 2.23-2.85), and death over a 2-year period: HR = 2.25 (95%CI = 2.05-2.47). The LOS explained 7.4% and 15.9% of the total variance (r2) in one readmission and ≥2 readmissions, and 9.1% and 10.0% of the total variance in mortality with 30 days and within six months of hospital discharge, respectively. Within the bottom, middle and top tertiles of the initial LOS, the median duration from hospital discharge to death progressively shortened from 136, 126 to 80 days, whilst LOS during readmission lengthened from 0.4, 0.9 to 2.8 days, respectively.

Conclusion
Short LOS in hospital was associated with favourable post-discharge outcomes such as early readmission and mortality, and with a delay in time interval from discharge to death and shorter LOS in hospital during readmission. These findings indicate that timely discharge from our hospital meets the aims of the NHS-generated national improvement programme, Getting It Right First Time (GIFTR).
A national longitudinal study evaluating the activity of cefditoren and other antibiotics against non-susceptible Streptococcus pneumoniae strains during the period 2004–20 in Spain
Authors: Sempere Julio , González-Camacho Fernando , Domenech Mirian , Llamosí Mirella , Del Río Idoia , López-Ruiz Beatriz , Gimeno Mercedes , Coronel Pilar , Yuste Jose 
Published: December 2021

Abstract

Background
Surveillance studies including antibiotic resistance and evolution of pneumococcal serotypes are critical to evaluate the susceptibility of commonly used antibiotics and the contribution of conjugate vaccines against resistant strains.

Objectives
To determine the susceptibility of clinical isolates of Streptococcus pneumoniae with reduced susceptibility to penicillin to a panel of antibiotics during the period 2004–20 and characterize the impact of pneumococcal conjugate vaccines in the evolution of resistant serotypes.

Methods
We selected 3017 clinical isolates in order to determine the minimal inhibitory concentration to penicillin, amoxicillin, cefotaxime, erythromycin, levofloxacin and oral cephalosporins, including cefditoren, cefixime and cefpodoxime.

Results
The antibiotics with the lowest proportion of resistant strains from 2004 to 2020 were cefditoren (&lt;0.4%), followed by cefotaxime (&lt;5%), penicillin (&lt;6.5%) and levofloxacin (&lt;7%). Among oral cephalosporins, cefixime was the cephalosporin with the highest MIC90 (32 mg/L) and MIC50 (8–16 mg/L) throughout the study, followed by cefpodoxime with highest values of MIC90 (4 mg/L) and MIC50 (2 mg/L) for the majority of the study period. In contrast, cefditoren was the cephalosporin with the lowest MIC90 (1 mg/L) and MIC50 (0.25–0.5 mg/L).

Conclusions
Cefditoren was the antibiotic with the highest proportion of susceptible strains. Hence, more than 80% of the clinical strains were susceptible to cefditoren throughout the period 2004–20. The proportion of resistant isolates to cefditoren and cefotaxime was scarce, being less than 0.4% for cefditoren and lower than 5% for cefotaxime, despite the increased rates of serotypes not covered by the 13-valent pneumococcal conjugate vaccine.
Basic structure and cytocompatibility of giant membrane vesicles derived from paraformaldehyde-exposed human cells
Authors: Okada Saya , Fukai Yuta , Tanoue Yuki , Nasser Hesham , Fukuda Takaichi , Ikeda Terumasa , Saitoh Hisato 
Published: December 2021

Abstract
Exposure of cultured mammalian cells to paraformaldehyde (PFA) is an effective approach to induce membrane blebs, which is followed by their detachment from the cellular cortex to yield giant membrane vesicles in extracellular spaces. Although PFA-induced giant vesicles have attracted significant interest in the field of cell membrane dynamics, their biochemical components and cytocompatibility remain largely unknown. In this report, we exposed human cervical cancer HeLa cells to PFA under metal-free buffer conditions to produce giant vesicles. We analyzed the components and structure of the purified PFA-induced giant vesicles. Co-culturing PFA-induced giant vesicles with exponentially growing HeLa cells resulted in docking of a significant number of the giant vesicles to the cell surface with seemingly no cytotoxicity. Intriguingly, we found that pre-treatment of HeLa cells with peptide-N-glycosidase and neuraminidase was effective in facilitating cellular uptake of constituents residing inside the vesicles. The results revealed further details about the effect of PFA on cell membranes and provide insights for studying the interaction between PFA-induced giant vesicles and cultured cells.
Professions, work, and digitalization: Technology as means to connective professionalism
Authors: Pareliussen Bjarne , Æsøy Vilmar , Giskeødegård Marte F 
Published: December 2021

Abstract
Developments within digital technology are often seen as an enabler, allowing professions to connect to outside players for competence and new ways of performing their professional work. At the same time, it is often seen as a threat, challenging professional claims to competence and status. This article explores how the implementation of new digital technology affects a profession. The empirical data are from a case study from the maritime industry that focuses on ship engineers and the implementation of an advanced sustainable fuel system and a subsequent new business model to enable its operationalization. Our findings indicate that digital technology created pressure on the profession when their existing competencies did not cover the maintenance of this new technology. The solution for the shipowner to mend the competency gap was more digital technology, specifically technology that enabled more connectivity toward the outside world. This article shows how the profession of the ship engineer was able to connect to outside partners so they could gain competence and incorporate the new digital technology in their professional work. These relations shape the professional work of the ship engineers and move the profession toward connective professionalism. The contribution of this paper is the identification of mechanisms like the pressure to connect to outside actors, removal of barriers, and the observed value of the professional work. These mechanisms are essential to understanding connective professionalism.
Sustainable development goals and the European Cohesion Policy: an application to the autonomous Region of Sardinia
Authors: Cavalli Laura , Sanna Sandro , Alibegovic Mia , Arras Filippo , Cocco Gianluca , Farnia Luca , Manca Emanuela , Mulas Luisa F , Onnis Marco , Ortu Sandro , Romani Ilenia G , Testa Marta 
Published: December 2021

Abstract
Paramount to the implementation of the 2030 Agenda and the effective tackling of the 17 sustainable development goals (SDGs) is the cooperation and coordination of the different levels of government—i.e. the supranational, national and local levels. This is due to the very nature of the SDGs, which are multi-dimensional and intended to guide and boost sustainable development at multiple scales. The European Union (EU) demonstrated a full commitment to the Agenda, making sustainable development a top priority. In fact, the five strategic objectives of the EU are modelled on the principles of the 2030 Agenda and the Cohesion Policy, EU’s most transversal policy, is designed to give a direct contribution to the tackling of the 17 SDGs. Introducing a new methodology to evaluate the sustainability of operational programmes co-financed by the EU, the following paper aims to contribute to the building literature around the question of monitoring public investments regarding sustainability criteria. By matching the 169 targets of the 2030 Agenda with the 143 intervention fields of the Cohesion Policy, with specific reference to Sardinia’s European Regional Development Fund and European Social Fund 2014–2020 Regional Operational Programmes, the present work introduces the key features of the model developed and its first results. The model could be of valuable support to policymakers who now have an innovative tool to monitor investments’ coherence with the sustainability standards of the 2030 Agenda.
Detectability of electromagnetic counterparts from neutron star mergers: prompt emission versus afterglow
Authors: Mohan Sreelekshmi , Saleem M , Resmi Lekshmi 
Published: December 2021

ABSTRACT
Electromagnetic observations of the first binary neutron star (BNS) merger detected in gravitational waves, GW170817, have established that relativistic jets can be successfully launched in BNS mergers. Typically, such jets produce emission in two phases: γ-ray prompt emission and multiwavelength afterglow. Because of relativistic beaming and the jet’s angular structure, the detectability of both these counterparts is dependent on the angle (θ${\rm v}$) between the observer’s line of sight and the jet axis. We compare the detectability of prompt and afterglow emission from off-axis jets, assuming standard detector thresholds such as that of Fermi Gamma-ray Burst Monitor (GBM), Chandra, and Jansky Very Large Array (VLA). We find that for top-hat jets, afterglow is a more likely counterpart than the prompt emission even with unfavourable afterglow parameters. For structured jets with a Gaussian profile, prompt emission is more promising than the afterglows at extreme viewing angles, under the assumption that the total energy emitted in the prompt phase equals the kinetic energy of the outflow. Assuming a Gaussian jet profile, we forecast the population of γ-ray detections and find that extreme viewing angle events like GRB 170817A will be rare. In our simulated sample, the observed isotropic equivalent energy in γ-rays is moderately correlated with the viewing angle, such that a low Eiso,γ is almost always associated with a high off-axis viewing angle.
Planet Hunters TESS IV: a massive, compact hierarchical triple star system TIC 470710327
Authors: Eisner N L , Johnston C , Toonen S , Frost A J , Janssens S , Lintott C J , Aigrain S , Sana H , Abdul-Masih M , Arellano-Córdova K Z , Beck P G , Bordier E , Cannon E , Escorza A , Fabry M , Hermansson L , Howell S B , Miller G , Sheyte S , Alhassan S , Baeten E M L , Barnet F , Bean S J , Bernau M , Bundy D M , Di Fraia M Z , Emralino F M , Goodwin B L , Hermes P , Hoffman T , Huten M , Janíček R , Lee S , Mazzucato M T , Rogers D J , Rout M P , Sejpka J , Tanner C , Terentev I A , Urvoy D 
Published: December 2021

ABSTRACTWe report the discovery and analysis of a massive, compact, hierarchical triple system (TIC 470710327) initially identified by citizen scientists in data obtained by NASA’s Transiting Exoplanet Survey Satellite (TESS). Spectroscopic follow-up observations obtained with the hermes spectrograph, combined with eclipse-timing variations (ETVs), confirm that the system is comprised of three OB stars, with a compact 1.10 d eclipsing binary and a non-eclipsing tertiary on a 52.04 d orbit. Dynamical modelling of the system (from radial velocity and ETVs) reveal a rare configuration wherein the tertiary star (O9.5-B0.5V; 14–17 M⊙) is more massive than the combined mass of the inner binary (10.9–13.2 M⊙). Given the high mass of the tertiary, we predict that this system will undergo multiple phases of mass transfer in the future, and likely end up as a double neutron star gravitational wave progenitor or an exotic Thorne–Żytkow object. Further observational characterization of this system promises constraints on both formation scenarios of massive stars as well as their exotic evolutionary end-products.