bluuebunny/crossref_metadata_2025_split huggingface dataset:
European registry of type A aortic dissection (ERTAAD) - rationale, design and definition criteria
Authors: Biancari Fausto , Mariscalco Giovanni , Yusuff Hakeem , Tsang Geoffrey , Luthra Suvitesh , Onorati Francesco , Francica Alessandra , Rossetti Cecilia , Perrotti Andrea , Chocron Sidney , Fiore Antonio , Folliguet Thierry , Pettinari Matteo , Dell’Aquila Angelo M. , Demal Till , Conradi Lenard , Detter Christian , Pol Marek , Ivak Peter , Schlosser Filip , Forlani Stefano , Chetty Govind , Harky Amer , Kuduvalli Manoj , Field Mark , Vendramin Igor , Livi Ugolino , Rinaldi Mauro , Ferrante Luisa , Etz Christian , Noack Thilo , Mastrobuoni Stefano , De Kerchove Laurent , Jormalainen Mikko , Laga Steven , Meuris Bart , Schepens Marc , El Dean Zein , Vento Antti , Raivio Peter , Borger Michael , Juvonen Tatu 
Published: June 2021

Abstract
Background
Acute Stanford type A aortic dissection (TAAD) is a life-threatening condition. Surgery is usually performed as a salvage procedure and is associated with significant postoperative early mortality and morbidity. Understanding the patient’s conditions and treatment strategies which are associated with these adverse events is essential for an appropriate management of acute TAAD.

Methods
Nineteen centers of cardiac surgery from seven European countries have collaborated to create a multicentre observational registry (ERTAAD), which will enroll consecutive patients who underwent surgery for acute TAAD from January 2005 to March 2021. Analysis of the impact of patient’s comorbidities, conditions at referral, surgical strategies and perioperative treatment on the early and late adverse events will be performed. The investigators have developed a classification of the urgency of the procedure based on the severity of preoperative hemodynamic conditions and malperfusion secondary to acute TAAD. The primary clinical outcomes will be in-hospital mortality, late mortality and reoperations on the aorta. Secondary outcomes will be stroke, acute kidney injury, surgical site infection, reoperation for bleeding, blood transfusion and length of stay in the intensive care unit.

Discussion
The analysis of this multicentre registry will allow conclusive results on the prognostic importance of critical preoperative conditions and the value of different treatment strategies to reduce the risk of early adverse events after surgery for acute TAAD. This registry is expected to provide insights into the long-term durability of different strategies of surgical repair for TAAD.

Trial registration
ClinicalTrials.gov Identifier: NCT04831073.
Non-hotspot PIK3CA mutations are more frequent in CLOVES than in common or combined lymphatic malformations
Authors: Brouillard Pascal , Schlögel Matthieu J. , Homayun Sepehr Nassim , Helaers Raphaël , Queisser Angela , Fastré Elodie , Boutry Simon , Schmitz Sandra , Clapuyt Philippe , Hammer Frank , Dompmartin Anne , Weitz-Tuoretmaa Annamaria , Laranne Jussi , Pasquesoone Louise , Vilain Catheline , Boon Laurence M. , Vikkula Miikka 
Published: June 2021

Abstract
Background
Theragnostic management, treatment according to precise pathological molecular targets, requests to unravel patients’ genotypes. We used targeted next-generation sequencing (NGS) or digital droplet polymerase chain reaction (ddPCR) to screen for somatic PIK3CA mutations on DNA extracted from resected lesional tissue or lymphatic endothelial cells (LECs) isolated from lesions. Our cohort (n = 143) was composed of unrelated patients suffering from a common lymphatic malformation (LM), a combined lymphatic malformation [lymphatico-venous malformation (LVM), capillaro-lymphatic malformation (CLM), capillaro-lymphatico-venous malformation (CLVM)], or a syndrome [CLVM with hypertrophy (Klippel-Trenaunay-Weber syndrome, KTS), congenital lipomatous overgrowth-vascular malformations-epidermal nevi -syndrome (CLOVES), unclassified PIK3CA-related overgrowth syndrome (PROS) or unclassified vascular (lymphatic) anomaly syndrome (UVA)].

Results
We identified a somatic PIK3CA mutation in resected lesions of 108 out of 143 patients (75.5%). The frequency of the variant allele ranged from 0.54 to 25.33% in tissues, and up to 47% in isolated endothelial cells. We detected a statistically significant difference in the distribution of mutations between patients with common and combined LM compared to the syndromes, but not with KTS. Moreover, the variant allele frequency was higher in the syndromes.

Conclusions
Most patients with an common or combined lymphatic malformation with or without overgrowth harbour a somatic PIK3CA mutation. However, in about a quarter of patients, no such mutation was detected, suggesting the existence of (an)other cause(s). We detected a hotspot mutation more frequently in common and combined LMs compared to syndromic cases (CLOVES and PROS). Diagnostic genotyping should thus not be limited to PIK3CA hotspot mutations. Moreover, the higher mutant allele frequency in syndromes suggests a wider distribution in patients’ tissues, facilitating detection. Clinical trials have demonstrated efficacy of Sirolimus and Alpelisib in treating patients with an LM or PROS. Genotyping might lead to an increase in efficacy, as treatments could be more targeted, and responses could vary depending on presence and type of PIK3CA-mutation.
Comparison of renal histopathology and gene expression profiles between severe COVID-19 and bacterial sepsis in critically ill patients
Authors: Volbeda Meint , Jou-Valencia Daniela , van den Heuvel Marius C. , Knoester Marjolein , Zwiers Peter J. , Pillay Janesh , Berger Stefan P. , van der Voort Peter H. J. , Zijlstra Jan G. , van Meurs Matijs , Moser Jill 
Published: June 2021

AbstractBackgroundThe mechanisms driving acute kidney injury (AKI) in critically ill COVID-19 patients are unclear. We collected kidney biopsies from COVID-19 AKI patients within 30 min after death in order to examine the histopathology and perform mRNA expression analysis of genes associated with renal injury.MethodsThis study involved histopathology and mRNA analyses of postmortem kidney biopsies collected from patients with COVID-19 (n = 6) and bacterial sepsis (n = 27). Normal control renal tissue was obtained from patients undergoing total nephrectomy (n = 12). The mean length of ICU admission-to-biopsy was 30 days for COVID-19 and 3–4 days for bacterial sepsis patients.ResultsWe did not detect SARS-CoV-2 RNA in kidney biopsies from COVID-19-AKI patients yet lung tissue from the same patients was PCR positive. Extensive acute tubular necrosis (ATN) and peritubular thrombi were distinct histopathology features of COVID-19-AKI compared to bacterial sepsis-AKI. ACE2 mRNA levels in both COVID-19 (fold change 0.42,p = 0.0002) and bacterial sepsis patients (fold change 0.24,p < 0.0001) were low compared to control. The mRNA levels of injury markers NGAL and KIM-1 were unaltered compared to control tissue but increased in sepsis-AKI patients. Markers for inflammation and endothelial activation were unaltered in COVID-19 suggesting a lack of renal inflammation. Renal mRNA levels of endothelial integrity markers CD31, PV-1 and VE-Cadherin did not differ from control individuals yet were increased in bacterial sepsis patients (CD31 fold change 2.3,p = 0.0006, PV-1 fold change 1.5,p = 0.008). Angiopoietin-1 mRNA levels were downregulated in renal tissue from both COVID-19 (fold change 0.27,p < 0.0001) and bacterial sepsis patients (fold change 0.67,p < 0.0001) compared to controls. Moreover, low Tie2 mRNA expression (fold change 0.33,p = 0.037) and a disturbed VEGFR2/VEGFR3 ratio (fold change 0.09,p < 0.0001) suggest decreased microvascular flow in COVID-19.ConclusionsIn a small cohort of postmortem kidney biopsies from COVID-19 patients, we observed distinct histopathological and gene expression profiles between COVID-19-AKI and bacterial sepsis-AKI. COVID-19 was associated with more severe ATN and microvascular thrombosis coupled with decreased microvascular flow, yet minimal inflammation. Further studies are required to determine whether these observations are a result of true pathophysiological differences or related to the timing of biopsy after disease onset.
An exploratory study of embitterment in traumatized refugees
Authors: Spaaij Julia , Schick Matthis , Bryant Richard A. , Schnyder Ulrich , Znoj Hansjörg , Nickerson Angela , Morina Naser 
Published: June 2021

AbstractBackgroundRefugees and asylum seekers are frequently exposed to violence, human rights violations and unstable living conditions before, during, and after their displacement. Elevated prevalence rates of psychiatric disorders in forcibly displaced persons are well documented. However, less is known about other problems related to common refugee experiences, such as embitterment, moral injury, and diminished self-efficacy, and how they are related to trauma exposure and post-migration living difficulties.MethodsA cross-sectional sample of 71 refugees and asylum seekers in treatment were examined regarding exposure to potentially traumatic events, post-migration living difficulties, moral injury appraisals, self-efficacy, and embitterment.ResultsElevated levels of embitterment were reported by 68% of participants. The regression analysis revealed that greater moral injury appraisals and low levels of self-efficacy were significantly associated with higher levels of embitterment.ConclusionThe results provide first insights into embitterment and associated factors in refugee populations. Furthermore, they highlight the significance of moral transgressions and low levels of self-efficacy emerging from displacement and traumatic experiences for the development of mental health problems in a clinical sample of refugees. The findings have implications for future research, policy development and clinical practice.
Children's Oncology Group Phase III Trial of Reduced-Dose and Reduced-Volume Radiotherapy With Chemotherapy for Newly Diagnosed Average-Risk Medulloblastoma
Authors: Michalski Jeff M. , Janss Anna J. , Vezina L. Gilbert , Smith Kyle S. , Billups Catherine A. , Burger Peter C. , Embry Leanne M. , Cullen Patricia L. , Hardy Kristina K. , Pomeroy Scott L. , Bass Johnnie K. , Perkins Stephanie M. , Merchant Thomas E. , Colte Paul D. , Fitzgerald Thomas J. , Booth Timothy N. , Cherlow Joel M. , Muraszko Karin M. , Hadley Jennifer , Kumar Rahul , Han Yuanyuan , Tarbell Nancy J. , Fouladi Maryam , Pollack Ian F. , Packer Roger J. , Li Yimei , Gajjar Amar , Northcott Paul A. 
Published: June 2021

PURPOSE Children with average-risk medulloblastoma (MB) experience survival rates of ≥ 80% at the expense of adverse consequences of treatment. Efforts to mitigate these effects include deintensification of craniospinal irradiation (CSI) dose and volume. METHODS ACNS0331 (ClinicalTrials.gov identifier: NCT00085735 ) randomly assigned patients age 3-21 years with average-risk MB to receive posterior fossa radiation therapy (PFRT) or involved field radiation therapy (IFRT) following CSI. Young children (3-7 years) were also randomly assigned to receive standard-dose CSI (SDCSI; 23.4 Gy) or low-dose CSI (LDCSI; 18 Gy). Post hoc molecular classification and mutational analysis contextualized outcomes according to known biologic subgroups (Wingless, Sonic Hedgehog, group 3, and group 4) and genetic biomarkers. Neurocognitive changes and ototoxicity were monitored over time. RESULTS Five hundred forty-nine patients were enrolled on study, of which 464 were eligible and evaluable to compare PFRT versus IFRT and 226 for SDCSI versus LDCSI. The five-year event-free survival (EFS) was 82.5% (95% CI, 77.2 to 87.8) and 80.5% (95% CI, 75.2 to 85.8) for the IFRT and PFRT regimens, respectively, and 71.4% (95% CI, 62.8 to 80) and 82.9% (95% CI, 75.6 to 90.2) for the LDCSI and SDCSI regimens, respectively. IFRT was not inferior to PFRT (hazard ratio, 0.97; 94% upper CI, 1.32). LDCSI was inferior to SDCSI (hazard ratio, 1.67%; 80% upper CI, 2.10). Improved EFS was observed in patients with Sonic Hedgehog MB who were randomly assigned to the IFRT arm ( P = .018). Patients with group 4 MB receiving LDCSI exhibited inferior EFS ( P = .047). Children receiving SDCSI exhibited greater late declines in IQ (estimate = 5.87; P = .021). CONCLUSION Reducing the radiation boost volume in average-risk MB is safe and does not compromise survival. Reducing CSI dose in young children with average-risk MB results in inferior outcomes, possibly in a subgroup-dependent manner, but is associated with better neurocognitive outcome. Molecularly informed patient selection warrants further exploration for children with MB to be considered for late-effect sparing approaches.
Scaling of oscillatory kinematics and Froude efficiency in baleen whales
Authors: Gough William T. , Smith Hayden J. , Savoca Matthew S. , Czapanskiy Max F. , Fish Frank E. , Potvin Jean , Bierlich K. C. , Cade David E. , Di Clemente Jacopo , Kennedy John , Segre Paolo , Stanworth Andrew , Weir Caroline , Goldbogen Jeremy A. 
Published: June 2021

ABSTRACT
High efficiency lunate-tail swimming with high-aspect-ratio lifting surfaces has evolved in many vertebrate lineages, from fish to cetaceans. Baleen whales (Mysticeti) are the largest swimming animals that exhibit this locomotor strategy, and present an ideal study system to examine how morphology and the kinematics of swimming scale to the largest body sizes. We used data from whale-borne inertial sensors coupled with morphometric measurements from aerial drones to calculate the hydrodynamic performance of oscillatory swimming in six baleen whale species ranging in body length from 5 to 25 m (fin whale, Balaenoptera physalus; Bryde's whale, Balaenoptera edeni; sei whale, Balaenoptera borealis; Antarctic minke whale, Balaenoptera bonaerensis; humpback whale, Megaptera novaeangliae; and blue whale, Balaenoptera musculus). We found that mass-specific thrust increased with both swimming speed and body size. Froude efficiency, defined as the ratio of useful power output to the rate of energy input ( Sloop, 1978), generally increased with swimming speed but decreased on average with increasing body size. This finding is contrary to previous results in smaller animals, where Froude efficiency increased with body size. Although our empirically parameterized estimates for swimming baleen whale drag were higher than those of a simple gliding model, oscillatory locomotion at this scale exhibits generally high Froude efficiency as in other adept swimmers. Our results quantify the fine-scale kinematics and estimate the hydrodynamics of routine and energetically expensive swimming modes at the largest scale.
Evaluation of a personal professional mentor scheme for newly qualified nurses
Authors: Austin Charlotte , Halpin Yvonne 
Published: June 2021

Background: Newly qualified nurses are known to experience a range of feelings and fears in the first transitional 12 months post-qualifying, with absence and turnover among potential outcomes. Aim: To evaluate the personal professional mentor role and scheme, a new pastoral support initiative, from the perspective of participating newly qualified nurses. Methods: Newly qualified paediatric nurses (n=10), who had been assigned a personal professional mentor (an experienced nurse who worked elsewhere in their employing NHS Trust), completed a semi-structured interview. The data were analysed using thematic analysis. Findings: The personal professional mentor counteracted some aspects of transition isolation for the newly qualified nurses. They were an independent, accessible, experienced confidant and a welcome new supportive role. Conclusion: Pairing experienced nurses with newly qualified nurses provided a new type of workplace support during transition. Inexpensive to set up and run, it is an easy addition to any portfolio of support strategies.
Modulation bandwidth enhanced self-injection locking laser with an external high-Q microring reflector
Authors: Shao Shuai , Li Jiachen , Wu Yunhao , Yang Sigang , Chen Hongwei , Chen Minghua 
Published: June 2021

We propose and demonstrate a hybrid modulation bandwidth enhanced self-injection locking laser by butt coupling a commercial distributed feedback laser with an external high-Q silicon nitride microring reflector (MRR). The MRR keeps the laser in strong self-injection locking state with photon–photon resonance, which can realize direct modulation bandwidth enhanced and stable narrow linewidth single-mode output. With the further optimization of MRR parameters, the 3-dB modulation bandwidth and the linewidth of the hybrid laser are enhanced to 15.28 GHz from 7.70 GHz and narrowed to 4 kHz from 600 kHz, respectively. This work makes full use of the advantages of self-injection and integrated photonic technology, which has potential applications in many fields.
Adaptive intensity transformation-based phase retrieval with high accuracy and fast convergence
Authors: Xiang Meng , Zhou Peijian , Ye Bolin , Fu Songnian , Xu Ou , Li Jianping , Peng Di , Wang Yuncai , Qin Yuwen 
Published: June 2021

Phase-retrieval (PR) receivers can reconstruct complex-valued signals from two de-correlated intensity measurements, without the assistance of any optical carriers. However, both the calculation complexity with hundreds of iterations and the limited PR accuracy prevent it from being applied to high-speed photonic interconnections. Here we propose and demonstrate a PR receiver based on adaptive intensity transformation, with the capability of both fast convergence and high accuracy. Then we numerically reconstruct 56 GBaud QPSK signals after the 80 km standard single-mode fiber transmission by using our proposed PR receiver with only 50 iterations. In comparison with the recently reported PR receiver with the phase reset, our proposed PR receiver can reduce the required optical signal-to-noise ratio by 1.95 and 1.89 dB, in terms of 20% soft-decision and 7% hard-decision forward-error correction, respectively.
Time to recovery from COVID-19 and its predictors among patients admitted to treatment center of Wollega University Referral Hospital (WURH), Western Ethiopia: Survival analysis of retrospective cohort study
Authors: Tolossa Tadesse , Wakuma Bizuneh , Seyoum Gebre Dejene , Merdassa Atomssa Emiru , Getachew Motuma , Fetensa Getahun , Ayala Diriba , Turi Ebisa 
Published: June 2021

Introduction
Despite its alarming spread throughout the world, no effective drug and vaccine is discovered for COVID-19 so far. According to WHO, the recovery time from COVID-19 was estimated to be 2 weeks for patients with mild infection, and 3 to 6 weeks for those with serious illnesses. A studies regarding the median recovery time and its predictors are limited globally and specifically in Ethiopia. Therefore, the aim of this study was to estimate the median time to recovery from COVID-19 and its predictors among COVID-19 cases admitted to WURH, Western Ethiopian.

Methods
This was a hospital-based retrospective cohort study conducted among 263 adult patients admitted with COVID-19 in WURH treatment center from March 29, 2020 through September 30, 2020. Epidata version 3.2 was used for data entry, and STATA version 14 for analysis. A Cox proportional hazard regression model was fitted to determine factors associated with recovery time. A variable with P-value ≤ 0.25 at bivariable Cox regression analysis were selected for multivariable Cox proportional model. Multivariable Cox regression model with 95% CI and Adjusted Hazard Ratio (AHR) was used to identify a significant predictor of time to recovery from COVID-19 at P-value < 0.05.

Results
The mean age of patient was 36.8 (SD± 10.68) years. At the end of follow up, two hundred twenty seven observations were developed an event (recovered) with median time to recovery of 18 days with IQR of 10–27 days. The overall incidence rate of recovery was of 4.38 per 100 (95% CI: 3.84, 4.99) person-days observations. Being older age (AHR = 1.59, 95% CI: 1.02, 2.49), presence of fever on admission (AHR = 1.78, 95% CI: 1.21, 2.62), and comorbidity (AHR = 0.56, 95% CI, 0.34, 0.90) were found to have statistically significant association with recovery time.

Conclusion and recommendations
In general, the median recovery time of patients with COVID-19 cases was long, and factors such as older age group, presence of fever, and comorbidity was an independent predictors of delayed recovery from COVID-19. Intervention to further reduce recovery time at treatment center has to focus on patients those shows symptoms and with comorbidities.
Effect of distal access catheter tip position on angiographic and clinical outcomes following thrombectomy using the combined stent-retriever and aspiration approach
Authors: Baek Sang Hun , Kim Sanghyeon , Kang Myongjin , Choi Jae-Hyung , Kwon Hee Jin , Kim Dong Won 
Published: June 2021

Purpose
Mechanical thrombectomy using the stent-retriever in conjunction with the distal access catheter may improve the rates of successful revascularization and clinical outcomes in patients with acute stroke. We aimed to compare two different thrombectomy techniques, according to the position of the distal access catheter tip in the combined stent-retriever and aspiration approach.

Methods
In this retrospective study, patients with middle cerebral artery occlusion treated with the combined technique were divided into two groups based on the tip position of the distal access catheter: distal group (catheter placed adjacent to the thrombus) and proximal group (catheter placed in the cavernous segment of the internal carotid artery below the ophthalmic artery). Baseline characteristics, angiographic results, and clinical outcomes were compared.

Results
Eighty-three patients (distal group, n = 45; proximal group, n = 38) were included. Higher complete reperfusion was observed in the distal group (unweighted analysis: 66.7% vs. 42.1%, p = 0.025; weighted analysis: 74.0% vs. 28.8%; p = 0.002). In the multivariate analysis, the distal tip position was independently associated with complete reperfusion (unweighted analysis: aOR, 4.10; 95% CI, 1.40–11.98; p = 0.01; weighted analysis: aOR, 5.20; 95% CI, 1.72–15.78; p = 0.004). The distal group also showed more favorable clinical outcomes and early neurological improvement (unweighted analysis: 62.2% vs. 55.3%; p = 0.521, 60% vs. 50%; p = 0.361, respectively; weighted analysis: 62.7% vs. 61.1%; p = 0.877, 66% vs. 45.7%; p = 0.062, respectively). However, more arterial dissections were observed in the distal group (8.9%, n = 4 vs. 2.6%, n = 1; p = 0.36). In the distal group, one patient with vascular injury died due to complications. No cases of emboli in new territory were observed.

Conclusions
Distal tip position of the distal access catheter has a significant impact on reperfusion in patients with acute ischemic stroke. However, there was also a higher rate of vascular injury as the catheter was advanced further. If advancement to the target lesion is too difficult, placing it in the cavernous internal carotid artery may be a viable method without complications.