bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survival and relapse patterns in patients of cranial vs extra-cranial oligometastases treated with stereotactic radiosurgery/stereotactic body radiation therapy and systemic therapy
Authors: Anand Anil Kumar , Kakkar Neha , Immanuel Vivek , Pannu Jyoti , Chaudhoory Amal Roy , Malhotra Heigrujam , Kumar Tarun 
Published: November 2024

Abstract

Objectives
To evaluate the outcome of patients with cranial (C) and extra-cranial (EC) oligometastases treated with stereotactic radiosurgery (SRS)/stereotactic body radiotherapy (SBRT) and standard of care systemic therapy.

Methods
During the period 2018-2022, patients who received SBRT or SRS for oligometastases (≤5 lesions) in addition to systemic therapy were evaluated. PET-CT was done to categorize them as C or EC oligometastases. Local control, distant progression, progression-free survival (PFS), overall survival (OS), and toxicity of the treatment were recorded.

Results
43 patients received SBRT/SRS to 88 oligometastatic lesions. Eighteen patients had C metastases, 23 had EC metastases and 2 patients had both. 40/43 patients had received systemic therapy. At a median follow-up of 13 months, median PFS was 14 months and 1 and 2 years OS was 83.2% and 67.4%. Local control with SRS was 92.8% and with SBRT was 86.3%. Distant failure in C vs EC oligometastases was seen in 12/14 vs 7/20 patients (P = 0.03). Median PFS was 30 months for EC and 6 months for C oligometastases (P = 0.003). 1 and 2 years OS was 89.6% and 82.7% for EC and 77.6% and 48.5% for C oligometastases (P = 0.21). One patient had grade 3 and 3 patients had grade 1 toxicity.

Conclusions
SRS and SBRT yielded high rates of local control with low toxicity. Compared to EC, patients with C oligometastases had higher distant relapses, poorer PFS, and a trend towards worse survival. More studies with separate enrolment of patients with C and EC oligometastases are needed.

Advances in knowledge
Outcome of patients with C oligometastases is poorer than EC metastases and hence the studies should be separately done in these 2 groups to assess the benefit of SRS/SBRT.
EEG hyperexcitability and hyperconnectivity linked to GABAergic inhibitory interneuron loss following traumatic brain injury
Authors: May Hazel G , Tsikonofilos Konstantinos , Donat Cornelius K , Sastre Magdalena , Kozlov Andriy S , Sharp David J , Bruyns-Haylett Michael 
Published: November 2024

Abstract
Traumatic brain injury represents a significant global health burden and has the highest prevalence among neurological disorders. Even mild traumatic brain injury can induce subtle, long-lasting changes that increase the risk of future neurodegeneration. Importantly, this can be challenging to detect through conventional neurological assessment. This underscores the need for more sensitive diagnostic tools, such as electroencephalography, to uncover opportunities for therapeutic intervention. Progress in the field has been hindered by a lack of studies linking mechanistic insights at the microscopic level from animal models to the macroscale phenotypes observed in clinical imaging. Our study addresses this gap by investigating a rat model of mild blast traumatic brain injury using both immunohistochemical staining of inhibitory interneurons and translationally relevant electroencephalography recordings. Although we observed no pronounced effects immediately post-injury, chronic time points revealed broadband hyperexcitability and increased connectivity, accompanied by decreased density of inhibitory interneurons. This pattern suggests a disruption in the balance between excitation and inhibition, providing a crucial link between cellular mechanisms and clinical hallmarks of injury. Our findings have significant implications for the diagnosis, monitoring, and treatment of traumatic brain injury. The emergence of electroencephalography abnormalities at chronic time points, despite the absence of immediate effects, highlights the importance of long-term monitoring in traumatic brain injury patients. The observed decrease in inhibitory interneuron density offers a potential cellular mechanism underlying the electroencephalography changes and may represent a target for therapeutic intervention. This study demonstrates the value of combining cellular-level analysis with macroscale neurophysiological recordings in animal models to elucidate the pathophysiology of traumatic brain injury. Future research should focus on translating these findings to human studies and exploring potential therapeutic strategies targeting the excitation-inhibition imbalance in traumatic brain injury.
Single-cell analysis reveals expanded CD8+ GZMKhigh T cells in CSF and shared peripheral clones in sporadic amyotrophic lateral sclerosis
Authors: Kim Hyo Jae , Ban Jae-Jun , Kang Junho , Im Hye-Ryeong , Ko Sun Hi , Sung Jung-Joon , Park Sung-Hye , Park Jong-Eun , Choi Seok-Jin 
Published: November 2024

Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that affects motor neurons in the brain and spinal cord. Despite the crucial role of aberrant immune responses in ALS pathogenesis, studies investigating immunological profiles in the cerebrospinal fluid (CSF) of patients with ALS have reported inconsistent findings. Herein, we explored the intrathecal adaptive immune response and features of circulating T cells between CSF and blood of patients with ALS using single-cell RNA and T-cell receptor (TCR) sequencing. This study comprised a total of 11 patients with apparently sporadic ALS and three controls with non-inflammatory diseases. We collected CSF from all participants, and for three patients with ALS, we additionally obtained paired samples of peripheral blood mononuclear cells (PBMCs). Utilizing droplet-based single-cell RNA and TCR sequencing, we analysed immunological profiles, gene expression characteristics and clonality. Furthermore, we examined T-cell characteristics in both PBMC and CSF samples, evaluating the shared T-cell clones across these compartments. In the CSF, patients with ALS exhibited a lower proportion of CD4+ T cells (45.2 versus 61.2%, P = 0.005) and a higher proportion of CD8+ GZMKhi effector memory T cells (TEMs) than controls (21.7 versus 16.8%, P = 0.060). Higher clonality was observed in CD8+ TEMs in patients with ALS compared with controls. In addition, CSF macrophages of patients with ALS exhibited a significant increase in chemokines recruiting CD8+ TEMs. Immunohistochemical analysis showed slightly higher proportions of T cells in the perivascular and parenchymal spaces in patients with ALS than in controls, and CD8+ TEMs co-localized with neurons or astrocytes in the motor cortices of patients with ALS. Clonally expanded CD8+ GZMKhi TEMs primarily comprised shared T-cell clones between CSF and PBMCs. Moreover, the shared CD8+ TEMs of PBMCs exhibited gene expression profiles similar to CSF T cells. Patients with ALS showed an increase in proportion and clonality of CD8+ GZMKhi TEMs and activated features of macrophages in CSF. The shared T-cell clone between CSF and blood was mainly composed of expanded CD8+ GZMKhi TEMs. In conclusion, single-cell immune profiling provided novel insights into the pathogenesis of ALS, characterized by activated macrophages and clonally expanded CD8+ T cells potentially communicating with the central nervous system and peripheral circulation.
Real World Virologic Outcomes in Patients With Elevated Body Mass Index Receiving Long Acting Cabotegravir/Rilpivirine
Authors: Maguire Christina , Rueve Kaitlyn , Farmer Eric , Huesgen Emily , Karaj Antoneta , Binkley Amanda , Mounzer Karam , Brizzi Marisa , Chary Pallavi , Sung Peter , Graziani Amy , Hiserodt Emily , Baron Jillian , Koenig Helen , Short William R 
Published: November 2024

Abstract

Background
The first long-acting injectable antiretroviral, cabotegravir/rilpivirine (LA-CAB/RPV), was approved by the Food and Drug Administration (FDA) in January 2021 for persons with human immunodeficiency virus (HIV) suppressed on their current regimen. Body mass index (BMI) ≥30 kg/m2 has been identified as a risk factor for virologic failure; however, data are limited due to small sample sizes. The aim of this study was to evaluate the impact of BMI on the efficacy of LA-CAB/RPV in a real-world setting.

Methods
A retrospective, multicenter cohort study was conducted from 22 January 2021 to 15 February 2023 in individuals who received LA-CAB/RPV every 4 (Q4w) or 8 weeks (Q8w). Individuals included were virologically suppressed on their current regimen, received at least 1 dose of LA-CAB/RPV, and had a follow-up viral load post initiation.

Results
A total of 374 individuals across 5 centers were included, with a BMI ≥30 kg/m2 in 148 (39.5%) individuals. Most individuals received a Q8w (68%) regimen, and the incidence of viral load ≥50 copies/mL was similar between those with BMI ≥30 kg/m2 (12%) as compared to those with BMI &lt;30 kg/m2 (9%) (incidence rate ratio [IRR] 1.31; 95% confidence interval [CI]: .69–2.46, P = .4). Confirmed virologic failure occurred in 0.8% of individuals overall, with 2 of the 3 cases occurring in those with BMI ≥30 kg/m2.

Conclusions
The data from this real-world cohort demonstrates no difference in virologic outcomes for individuals with BMI ≥30 kg/m2 as compared to those with BMI &lt;30 kg/m2 suggesting that higher BMI alone should not preclude use of LA-CAB/RPV in eligible individuals.
Microbiological Trends, in-hospital Outcomes, and Mortality in Infective Endocarditis: A Swiss Nationwide Cohort Study
Authors: Buergler Helene , Gregoriano Claudia , Laager Rahel , Mueller Beat , Schuetz Philipp , Conen Anna , Kutz Alexander 
Published: November 2024

Abstract

Background
The epidemiology of infective endocarditis (IE) is evolving, driven by an aging population and increased use of endovascular devices, and is associated with significant morbidity and mortality. This study aims to evaluate changes in microbiological trends and clinical outcomes in patients with IE over the past decade in Switzerland.

Methods
This nationwide cohort study analyzed in-hospital claims data from patients hospitalized with IE in Switzerland between 2012 and 2021. We assessed incidence rates per 100 000 hospitalizations, categorizing them by common pathogens. The outcomes included in-hospital and 6-month mortality, admission to the intensive care unit, and length of hospital stay.

Results
Among 15 255 hospitalizations with IE, the annual number of cases increased from 1361 in 2012 to 1636 in 2021. The most frequently diagnosed pathogens were Staphylococcus aureus (increasing from 19.8% to 30.0%, Ptrend &lt; .01) and Streptococcus species (from 17.6% to 24.4%, Ptrend &lt; .01). Infective endocarditis caused by Staphylococcus aureus was associated with the highest in-hospital (19.9%) and 6-month mortality (30.3%), and intensive care unit admission rates (44.2%), with no relevant changes over time. The longest length of hospital stay was observed in hospitalizations with IE caused by Enterococcus species (mean 23.9 days) and S. aureus (23.8 days).

Conclusions
This nationwide cohort study showed an increase in IE hospitalizations from 2012 to 2021, primarily from S. aureus and Streptococcus species. Predominantly, S. aureus was associated with adverse outcomes that remained consistently high over time compared to other or unidentified pathogens.
Predictors of Persistent Fever Among Patients With Suspected Infective Endocarditis: Think Outside the box
Authors: Stavropoulou Elisavet , Monney Pierre , Tzimas Georgios , Ianculescu Nicoleta , Tozzi Piergiorgio , Kirsch Matthias , Guery Benoit , Papadimitriou-Olivgeris Matthaios 
Published: November 2024

Abstract

Background
Fever is common in infective endocarditis (IE), yet little is known about fever duration in such patients. We aim to identify predictors of persistent fever in patients with suspected IE.

Methods
This study was conducted at the Lausanne University Hospital, Switzerland, from January 2014 to June 2023. All patients with suspected IE being febrile upon presentation were included. Fever (&gt;38°C) was considered persistent if it continued for at least 96 hours from antimicrobial treatment initiation. A case was classified as IE by the Endocarditis Team.

Results
Among 1399 episodes with suspected IE, persistent fever was observed in 260 (19%) episodes. IE was diagnosed in 536 (41%) episodes, of which 82 (15%) had persistent fever. Among episodes with suspected IE, persistent bacteremia/candidemia for 96 hours (P &lt; .001), spondylodiscitis (P = .039), intrabdominal infection (P = .001) were associated with persistent fever. Conversely, bacteremia by streptococci (P = .049), or enterococci (P = .001), source control performed withing 96 hours (P = .015) and appropriate antimicrobial treatment within 48 hours (P = .018) were associated with early defervescence. No association between persistent fever and infective endocarditis was found (P = .207). Among 536 IE episodes, persistent bacteremia/candidemia for 96 hours (P &lt; .001), and native bone and joint infection (P = .020) were associated with persistent fever. Conversely, bacteremia by streptococci or enterococci (P = .001; adjusted odds ratio [aOR] 0.25, 95% confidence interval [CI] .11–.58) were associated with early defervescence.

Conclusions
In episodes with suspected IE, persistent fever was associated with spondylodiscitis, inappropriate antimicrobial treatment and absence of source control interventions. Among IE patients, persistent fever was associated with native bone and joint infections.
Frailty and sarcopenia metabolomic signatures in kidney transplant candidates: the FRAILMar study
Authors: Madrid-Gambin Francisco , Pérez-Sáez María José , Gómez-Gómez Alex , Haro Noemí , Redondo-Pachón Dolores , Dávalos-Yerovi Vanessa , Marco Ester , Crespo Marta , Pozo Oscar J , Pascual Julio ,   for the FRAILMar Study Group, Pérez-Sáez María José , Chamoun Betty , Redondo Dolores , Barbosa Francesc , Cao Higini , Collado Silvia , Buxeda Anna , Burballa Carla , Crespo Marta , Pascual Julio , Faura Anna , Vera María , Bach Anna , Pedreira Guillermo , Junyent Ernestina , Folgueiras Montserrat , Castillo Yolanda , Martínez Aida , Fernández Marisol , Barbero Eva , Fernández Noelia , Calvo Alicia , Carazo Jesús , Frances Albert , Cecchini Lluis , Marco Ester , Muñoz Elena , Delcros-Forestier Lou , de Valderrama Delky Meza , Morgado Andrea , Nogués Xavier , Rodríguez-Mañas Leocadio , Vázquez Olga , Muns María Dolores , Gárriz Miguel , Gómez María Polo , Hurtado Sara , López Maite , Ribera Laura , Guino Margarita , Roca Ramón , Calls Jordi , Rovira Alicia , Mora Josep , Ibrik Omar , Liria Florentina , López Thaïs , Almirall Jaume , Moya Carmen , Moreno Fátima , de Arellano Manel Ramírez , Rubio Sandra , Cidraque Ignacio , Pájaro Carlota , Garra Núria , Galcerán Josep , Fenollar Marina , Outón Sara , Jara Josep , García Rosa , Manresa Mònica 
Published: November 2024

ABSTRACT

Background
Sarcopenia and frailty are often overlooked in assessing kidney transplant (KT) candidates with chronic kidney disease (CKD), potentially leading to poor post-transplant outcomes. This study aimed to identify metabolites associated with frailty and sarcopenia in KT candidates from the FRAILMar study.

Methods
Between June 2016 and June 2020, we evaluated frailty and sarcopenia in 173 KT candidates using the Physical Frailty Phenotype and EGWSOP-2 criteria, respectively. Seventy-five metabolic markers from targeted pathways, previously linked to CKD, sarcopenia or frailty, were measured in serum samples. These markers were analyzed using adjusted and weighted generalized linear models. Metabolomic data were integrated with multi-modal data, such as comorbidities, using a factor-based integration algorithm to identify metabolic phenotypes.

Results
Increased metabolites related to energy metabolism and essential amino acids were associated with frailty, mainly Krebs cycle intermediates. Sarcopenic KT candidates showed lower levels of aromatic amino acids, and lower protein/muscle metabolism, energy metabolism and neurotransmission compared with non-sarcopenic patients. Unsupervised multi-modal integration revealed a high-risk metabolic phenotype characterized by the presence of sarcopenia, diabetes mellitus and low body mass index, with alterations in branched-chain amino acids and high activity of lactate dehydrogenase enzyme.

Conclusions
Frailty and sarcopenia are common among KT candidates, and their metabolic status reveals notable disruptions in energy and amino acid metabolism. These findings highlight the value of a detailed metabolic assessment to more accurately evaluate patient health status prior to transplantation.
Quadricuspid pulmonary valve with pulmonary hypertension: a case report
Authors: Li Wenting , Zhang Yang , Cui Xiaopei , Ji Qiushang 
Published: November 2024

Abstract

Background
The quadricuspid pulmonary valve (QPV) is a relatively rare heart congenital anomaly. It is usually asymptomatic and incidentally detected.

Case summary
A 52-year-old woman presented with paroxysmal palpitations and chest tightness after exertion. After a series of examinations, we finally diagnosed her with QPV and pulmonary hypertension. The symptoms have improved significantly with medications, and subsequently, the patient was discharged.

Discussion
This case demonstrated the crucial role of multimodality imaging in evaluating the non-invasive depiction of pulmonary valve disease.
Research on atrial fibrillation diagnosis in electrocardiograms based on CLA-AF model
Authors: Si Jiajia , Bao Yiliang , Chen Fengling , Wang Yue , Zeng Meimei , He Nongyue , Chen Zhu , Guo Yuan 
Published: November 2024

Abstract

Aims
The electrocardiogram (ECG) is the primary method for diagnosing atrial fibrillation (AF), but interpreting ECGs can be time-consuming and labour-intensive, which deserves more exploration.

Methods and results
We collected ECG data from 6590 patients as YY2023, classified as Normal, AF, and Other. Convolutional Neural Network (CNN), bidirectional Long Short-Term Memory (BiLSTM), and Attention construct the AF recognition model CNN BiLSTM Attention-Atrial Fibrillation (CLA-AF). The generalization ability of the model is validated on public datasets CPSC2018, PhysioNet2017, and PTB-XL, and we explored the performance of oversampling, resampling, and hybrid datasets. Finally, additional PhysioNet2021 was added to validate the robustness and applicability in different clinical settings. We employed the SHapley Additive exPlanations (SHAP) method to interpret the model’s predictions. The F1-score, Precision, and area under the ROC curve (AUC) of the CLA-AF model on YY2023 are 0.956, 0.970, and 1.00, respectively. Similarly, the AUC on CPSC2018, PhysioNet2017, and PTB-XL reached above 0.95, demonstrating its strong generalization ability. After oversampling PhysioNet2017, F1-score and Recall improved by 0.156 and 0.260. Generalization ability varied with sampling frequency. The model trained from the hybrid dataset has the most robust generalization ability, achieving an AUC of 0.96 or more. The AUC of PhysioNet2021 is 1.00, which proves the applicability of CLA-AF. The SHAP values visualization results demonstrate that the model’s interpretation of AF aligns with the diagnostic criteria of AF.

Conclusion
The CLA-AF model demonstrates a high accuracy in recognizing AF from ECG, exhibiting remarkable applicability and robustness in diverse clinical settings.
Guidelines at a crossroad: comparing European and American guidelines regarding the use of imaging in peripheral vascular arterial disease and aortic disease
Authors: Liga Riccardo , Hostalrich Aurelien , Gimelli Alessia , Ricco Jean-Baptiste 
Published: November 2024

Abstract
This review examines the differences and similarities between the European and American guidelines concerning the use of imaging in the diagnosis and management of peripheral arterial disease (PAD) and aortic disease. PAD and aortic conditions contribute significantly to global cardiovascular morbidity and mortality; yet, they are often underdiagnosed and undertreated. Imaging plays a critical role in addressing this gap, with the European Society of Cardiology and American Cardiac Society offering different approaches to diagnostic and interventional imaging modalities. The review highlights that while both guidelines endorse duplex ultrasound as the first-line imaging method for PAD, discrepancies arise in the use of advanced modalities such as computed tomography angiography and magnetic resonance angiography. The European guidelines adopts a more conservative approach, reserving these advanced techniques for specific clinical scenarios, whereas the American guidelines places a stronger emphasis on comprehensive imaging for all patients with suspected PAD. The review also compares the guidelines on aortic disease, noting consensus on the role of computed tomography angiography and magnetic resonance angiography for aortic aneurysm diagnosis, but with differences in the emphasis on transoesophageal echocardiography, which is more strongly recommended by the American guidelines for acute cases. The manuscript calls for harmonization of these guidelines to streamline clinical practice and improve patient outcomes.
On the adjoint state method for the gradient computation in full waveform inversion: a complete mathematical derivation for the (visco-)elastodynamics approximation
Authors: Métivier L , Brossier R 
Published: November 2024

SUMMARY
High-resolution seismic imaging at all scales using full waveform inversion is now routinely used in the industry and in the academy. One key element for the success of this approach is a numerical method, named adjoint state method, originally designed for optimization problems constrained by partial differential equations, a category to which full waveform inversion belongs. This method provides an efficient way to compute the gradient of the full waveform inversion misfit function, which is the most computationally demanding task in the implementation of full waveform inversion. While well known, the complete and rigorous mathematical derivation of the adjoint state method for full waveform inversion remains missing in the scientific bibliography. The aim of this study is to remedy this lack. The derivation is performed in general settings, that is in the elastodynamics approximation, with and without considering viscosity. Through the calculus, the mechanism of the adjoint state strategy makes clear the connection between the incident and adjoint fields, especially regarding their initial and boundary conditions. The impact of introducing the viscosity is carefully analysed. The resulting gradient formulas are analysed and shown to be consistent with already published ones. The generic approach which is adopted also makes it possible to derive misfit function gradients with respect to other quantities than the subsurface mechanical parameters, for instance with respect to the initial or the boundary conditions, which could be of interest for specific applications where the reconstructed parameters are not only volumetric mechanical parameters but boundary parameters or initial field values.