bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term effects of left atrial appendage isolation in surgical ablation of atrial fibrillation based on lesion set: a multi-centre propensity-score weighted study
Authors: Pyo Won Kyung , Kim Joon Bum , Cho Yang Hyun , Je Hyoung-Gon , Kim Hee Jung , Lee Seung Hyun 
Published: October 2024

BackgroundThis present study aimed to investigate the impact of left atrial appendage (LAA) isolation on adverse clinical outcomes, with a further stratified analysis by biatrial (BA) and left atrial lesion sets, in patients with atrial fibrillation (AF) undergoing surgical ablation (SA) concurrent with mitral valve (MV) surgery.MethodsWe evaluated 875 patients (aged 65.1±12.0 years) who underwent SA of AF concomitant to MV surgery, excluding those with mechanical prostheses requiring lifelong anticoagulation, between 2005 and 2017 in five tertiary cardiac centres in South Korea. Of these, 458 had isolated the LAA, whereas the remainder (n=417) had the LAA preserved. Comparative risk of stroke, mortality and AF recurrence was assessed between the groups, considering death as a competing event. Inverse-probability treatment weighting was used for baseline adjustment.ResultsDuring the median follow-up of 57.4 months (IQR, 32.5–92.4 months), the adjusted risk of long-term stroke was significantly lower in the patients who underwent LAA isolation compared with those who preserved the LAA (subdistribution HR (SHR), 0.28; 95% CI 0.15 to 0.51; p<0.001). However, there were no significant differences in the adjusted risk of mortality (HR, 0.85; 95% CI 0.57 to 1.27; p=0.429) or AF recurrence (SHR, 0.92; 95% CI 0.78 to 1.08; p=0.291) between LAA isolation and preservation. In the subgroup of patients who underwent BA ablation, LAA isolation was associated with a lower long-term risk of stroke and AF recurrence (SHR, 0.77; 95% CI 0.61 to 0.94; p=0.029) compared with LAA preservation.ConclusionsConcomitant LAA isolation during SA of AF in patients undergoing MV surgery was associated with a significantly lower risk of long-term stroke, but no survival benefit was observed.
Analysis of scalar fields with series convolution
Authors: Baysazan Emir , Birkandan Tolga , Ünver İsmail Eyüphan 
Published: October 2024

AbstractWave equations for some curved spacetimes may involve functions that prevent a solution in a closed form. In some cases, these functions can be eliminated by transformations and the solutions can be found analytically. In the cases where such transformations are not available, the infinite series expansions of these functions can be convoluted with the power series solution ansatz. We study such an example where the solution is based on a special function.
Comparison of Ultrathin- Versus Thin-Strut Stents in Patients With High Bleeding Risk PCI: Results From the COMPARE 60/80 HBR Trial: An Open-Label, Randomized, Controlled Trial
Authors: Smits Pieter C. , Tonino Pim A.L. , Hofma Sjoerd H. , van Kuijk Jan-Peter , Spano Fabrizio , Al Mafragi Amar , Pisters Ron , Polad Jawed , Bogaerts Kris , Oemrawsingh Rohit M. , Paradies Valeria 
Published: October 2024

BACKGROUND:
No randomized data exist on ultrathin-strut stents in patients at high bleeding risk (HBR) undergoing an abbreviated dual antiplatelet therapy after coronary stenting. The aim of this study was to compare the safety and effectiveness of the ultrathin-strut biodegradable-polymer sirolimus-eluting Supraflex Cruz stent with the thin-strut biodegradable-polymer sirolimus-eluting Ultimaster Tansei stent in patients at HBR with abbreviated dual antiplatelet therapy after stenting.

METHODS:
In the investigator-initiated, randomized, open-label COMPARE 60/80 HBR trial (Comparison of the Supraflex Cruz 60 Micron Stent Strut Versus the Ultimaster Tansei 80 Micron Stent Strut in HBR Percutaneous Coronary Intervention Population), 741 patients at HBR according to the Academic Research Consortium HBR criteria were randomized to receive either the ultrathin-strut biodegradable-polymer sirolimus-eluting Supraflex Cruz stent or thin-strut biodegradable-polymer sirolimus-eluting Ultimaster Tansei stent. Dual antiplatelet therapy was recommended according to the applicable guidelines and trial data for patients at HBR. The primary outcome was net adverse clinical events, the composite of cardiovascular death, myocardial infarction, target vessel revascularization, stroke, and major bleeding, and was powered for noninferiority with an absolute margin of 4.0% at 1-sided 2.5% alpha.

RESULTS:

Between September 2020 and August 2022, 371 patients were randomized to the ultrathin-strut biodegradable-polymer sirolimus-eluting Supraflex Cruz stent and 370 patients to the thin-strut biodegradable-polymer sirolimus-eluting Ultimaster Tansei stent at 11 sites in the Netherlands. At 1 year, the primary outcome was observed in 56 (15.4%) patients in the ultrathin-strut biodegradable-polymer sirolimus-eluting Supraflex Cruz stent group and 61 (17.1%) in the thin-strut biodegradable-polymer sirolimus-eluting Ultimaster Tansei stent group (risk difference, −1.65%; upper boundary of the 1-sided 95% CI, 3.74;
P
=0.02 for noninferiority at a 0.025 significance level and
P
=0.55 for 2-sided superiority at a 0.05 significance level).

CONCLUSIONS:
Among patients at HBR with abbreviated dual antiplatelet therapy post-stenting, the use of an ultrathin-strut biodegradable-polymer sirolimus-eluting Supraflex Cruz stent was noninferior compared with the use of a thin-strut biodegradable-polymer sirolimus-eluting Ultimaster Tansei stent.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT04500912.
Determinants of Timely Access to Recanalization Treatments and Outcomes in Pediatric Ischemic Stroke
Authors: Tudorache Raluca , Kossorotoff Manoëlle , Kerleroux Basile , Denier Christian , Naggara Olivier , Boulouis Grégoire ,   the KID-CLOT Group
Published: October 2024

BACKGROUND:
Timely revascularization in acute arterial ischemic stroke (AIS) is paramount for optimal outcomes. However, factors causing treatment delays in pediatric AIS remain understudied. We investigated determinants affecting the time from symptom onset or last-known-well to the start of recanalization treatment in pediatric AIS.

METHODS:
We conducted an ancillary analysis of the French KID-CLOT study (The National Retrospective Study of Recanalization Treatments in Pediatric Arterial Ischemic Stroke), considering patients with pediatric AIS receiving recanalization treatments (IV thrombolysis IVT and mechanical thrombectomy) from 2015 to 2018. The study assessed prehospital triage’s impact, direct versus transferred admissions, and unit type (pediatric versus adult) on treatment delay and clinical outcomes using modified Rankin Scale at 1 year.

RESULTS:

Among 68 patients (median age, 11 [IQR, 4–16]; initial PedNIHSS, 13 [IQR, 7–19]), treatment modalities were IVT (n=31), and mechanical thrombectomy (n=23), and IVT+mechanical thrombectomy (n=14). Prehospital triage significantly reduced last-known-well to treatment delay (overall, 229 versus 270 minutes;
P
=0.01), most notably for and mechanical thrombectomy (
P
<0.001). There was no substantial delay difference between direct and transferred admissions, or between unit types, although a trend favored adult units (370.3 versus 436.73 minutes;
P
=0.06). Prehospital triage correlated with improved outcomes, with a shift to lower modified Rankin Scale scores (
P
=0.021).

CONCLUSIONS:
For pediatric AIS treated with reperfusion therapy, prehospital triage emerges as a pivotal factor in reducing treatment delays and enhancing outcomes. These findings underscore the need for a dedicated prehospital stroke protocol for children.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03887143.
Post-Cold War Era UN Collaboration with Non-UN Military for Conflict Management in Africa
Authors: Arai Nobuhiro 
Published: October 2024

Abstract
This research explores the factors associated with the success or failure of European Union (EU) military bridging operations supporting United Nations (UN) peacekeeping in Africa. This study defines the success of eufor bridging operations as those in which a subsequent UN mission was able to continue operations after assuming responsibilities from eufor. This raises two factors associated with success and failure: integration and adaptation. Two hypotheses are formulated regarding the respective parameters for achieving bridging operations goals that lead to their success. To examine the hypotheses, this study conducts a comparative analysis with two EU bridging operations, one in the Democratic Republic of Congo as a success case and the other in Chad and the Central African Republic as a failure. This study aims to produce new knowledge in the field of peacekeeping operations, practical policies, and general considerations on the ground. It also seeks to further understanding of bridging operations and develop better opportunities for designing future operations.
Efficacy of a Culturally Adapted Emotion Recognition Training Program in Improving Facial Emotion Recognition in Persons with Schizophrenia
Authors: Thonse Umesh , Behere Rishikesh V. , Frommann Nicole , Praharaj Samir Kumar , Sharma Podila Sathya Venkata Narasimha 
Published: October 2024

Background: Facial emotion recognition (FER) deficits are being considered as core features of social cognitive deficits in schizophrenia, associated with socio-occupational dysfunction. Social cognition intervention programs have been shown to improve these deficits; however, there are no such intervention strategies in India. In this study, we aim to examine the efficacy of Training of Affect Recognition – Indian Version (TAR-IV) to enhance the FER abilities of people with schizophrenia. Methods: In an open-label experimental design, 36 participants with schizophrenia underwent 12 sessions of TAR-IV as an add-on to treatment as usual (TAU), while 29 participants with schizophrenia continued TAU (pharmacological treatment with or without occupational therapy and vocational rehabilitation services). Clinical and functional assessments were done using the positive and negative syndrome scale (PANSS) and socio-occupational functioning scale. Emotion recognition abilities were assessed on the tool for recognition of emotions in neuropsychiatric disorders at baseline, post-intervention, and follow-up (two to three months post-intervention). Results: The intervention group showed significant improvements in FER ( P = .001) and socio-occupational functioning ( P = .008) after receiving the TAR-IV, which remained significant at two months follow-up. A lower age of onset and poorer neurocognitive function at baseline predicted greater changes in emotion recognition ability following the intervention. Conclusions: This study demonstrated the efficacy of TAR-IV, the Indian adaptation of social cognition intervention, in improving emotion recognition abilities and socio-occupational functioning in patients with schizophrenia. These findings need to be replicated in randomized controlled trials.
Positioning method of track irregularities in high-speed turnout area based on multi-resolution analysis
Authors: Sun Xu , Qin Lusheng , Wang Ping 
Published: October 2024

The assessment and evaluation of complex track geometry parameters (TGP) in turnout areas present challenges for track recording cars due to uncertainties in their positioning on short sections. To obtain precise and reliable measured TGP in the turnout area, a multi-resolution technology based on maximal overlap discrete wavelet transform (MODWT) is used to perform multi-layer decomposition of the longitudinal level. By utilizing the zero-phase characteristic of MODWT, the TGP can be determined by aligning the decomposed weld spacings with their corresponding theoretical lengths. The positioning error is assessed through statistical analysis of measured TGP and numerical simulation using a virtual track inspection method. Finally, a 70 m length of TGP, including the entire turnout section, was extracted with a positioning error of no more than 1.5 m.
Application of Contact Angle Measurement to Wettability, Surface Energy and Adhesion Properties of Polymers
Authors: Sutherland I. , Heath R.J. 
Published: October 2024

A good understanding of the physical and chemical properties of the surfaces of materials is required, to ensure that the correct combination of materials are joined, to form a strong and long term adhesive bond. For the purposes of both research and in-process quality control techniques, the surface free energy of a polymer can be determined from the contact angle measurement of a pure liquid drop on that polymer, and so in turn, understand the adhesion potential of that solid surface. The thermodynamic principles are discussed in this review, and used to develop some mathematical descriptions of contact angle. Outlines of important experimental techniques, along with methods for interpreting data are given. One of the objectives of this paper is to give a clear understanding of the theory and practice of these methods, to demonstrate that they can be used readily as both research and quality control tools, and so can be employed more commonly by the polymer industry. A number of case studies are described, in which the contact angle method has been used to investigate surfaces and effects of surface treatments. This includes studies of surface treated polyolefins to be printed or painted, and oxidised carbon fibres to enhance their reinforcing properties. This data is shown to have a good correlation with surface chemical analysis methods.
Psychological and physiological benefits of horticultural therapy for Chinese older adults
Authors: Xiaoyi Li , Hassan Ahmad , Tao Jiang , Deshun Zhang 
Published: October 2024

Background Gardening as a leisure activity has been shown to be potentially beneficial for older adults, this study aimed to assess the physiological and psychological impacts of a specific horticultural activity, watering indoor plants, compared with playing a computer game - the Klondike Solitaire Card Game. Methods This crossover study included 100 older adults recruited from a nursing care facility for older people in Shanghai, China. They were allocated to either engage in watering indoor plants (horticultural group) or playing a computer game (control group). For the inclusion criteria, screening for cognitive function was conducted to exclude those with severe cognitive impairments, thereby focusing on those capable of participating fully in the study activities. Brainwave activities, blood pressure, and psychological states were measured through pre- and post-test questionnaires to evaluate the physiological and psychological effects. Results The activity of watering indoor plants was associated with significant reductions in both systolic and diastolic blood pressure, in contrast to the computer game activity. Additionally, participants in the horticultural group showed increased brainwave mean values, indicating heightened relaxation and focus, while decreases were observed in the control group. The experimental group reported reduced anxiety scores, along with increased feelings of comfort and relaxation, and also exhibited significantly higher meditation levels, which indicates a profound mental relaxation effect. Conclusion Our findings suggest that engaging in indoor horticultural activities, such as watering houseplants for 10 minutes, can reduce mental and physical stress levels in older adults.
Microvascular Reconstructions in Elderly Patients With Oral Squamous Cell Carcinoma - Too Old for Surgical Treatment?
Authors: Radermacher Anne , Horn Dominik , Fehrenz Michael , Semmelmayer Karl , Ristow Oliver , Engel Michael , Hoffmann Jürgen , Freier Kolja , Moratin Julius 
Published: October 2024

Study Design Retrospective cohort study. Objective A major risk factor for oral squamous cell carcinoma (OSCC) is advanced age. Ablative surgery combined with microvascular reconstruction has become routine for OSCC. Nevertheless, there is an interdisciplinary debate about the appropriateness of surgery combined with prolonged general anesthesia in the elderly. In the present study, the ablative and microvascular strategies in OSCC were evaluated in terms of oncologic safety and surgical morbidity in relation to age. Methods A total of 345 patients with primary OSCC who underwent ablative tumor surgery and neck dissection according to the German national guideline for OSCC together with microvascular reconstruction from September 2010 to October 2017 were examined. General clinical data was analyzed descriptively with a special focus on perioperative morbidity of an elderly (≥70y) subgroup of 56 patients. Oncological outcome was estimated using Log Rank testing and Kaplan Meier plotting. Results Estimated 5 year overall survival (OS) and disease-free survival (DFS) was 69.6% (≥70y) vs. 76.7% (<70y) and 62.9% (≥70y) vs. 78.2% (<70y) respectively with no significant difference between the 2 age groups. In multivariate cox regression, only initial stage of disease revealed significant impact on OS. Analysis of perioperative death/complications, flap loss, operation time, dependence on tracheostomy and hospitalization revealed no significant differences between the 2 groups. Conclusions Tumor surgery including neck dissection in combination with primary microvascular reconstruction is a safe therapy in patients of advanced age. This results in excellent oncological outcome with no significant disadvantages in terms of perioperative morbidity, hospitalization or flap failure.
Time is nephron: Daratumumab plus CyBorD in newly-diagnosed multiple myeloma with cast nephropathy: A report of five cases
Authors: Fajnzylber Jesse , Khan Abdullah S , Dima Danai , Khouri Jack , Brooks Taylor R , Anwer Faiz 
Published: October 2024

Background: Renal failure is a common complication of multiple myeloma, often due to overproduction of light chains. Case presentation: Light chain cast nephropathy in newly-diagnosed multiple myeloma is associated with inferior outcomes. Proteasome inhibitors and immunomodulatory drugs with therapeutic plasma exchange can rapidly reduce light chain levels and confer remission; however, optimal delivery of these agents is limited by decreased renal function, and plasma exchange is often limited to tertiary centers. Conclusion: These cases highlight the utility of daratumumab with cyclophosphamide, bortezomib, and dexamethasone for acute renal failure in newly-diagnosed multiple myeloma and a clinical diagnosis of cast nephropathy.
Comparison of surgical and conservative therapy in older patients with distal radius fracture: a prospective randomized clinic al trial
Authors: Haslhofer David J. , Froschauer Stefan M. , Gotterbarm Tobias , Schmidt Manfred , Kwasny Oskar , Holzbauer Matthias 
Published: October 2024

Abstract
Introduction
The distal radius fracture is considered the most common fracture in humans. For fractures classified as Arbeitsgemeinschaft für Osteosynthese (AO) 23-C1 + C2, there is no consensus on treatment in older patients due to inconsistent study results. The aim of this study was to compare conservative and surgical treatment in relation to wrist function and satisfaction in patients older than 65 years.

Methods
In this prospective randomized clinical trial, patients aged older than 65 years who suffered an isolated AO-classified C1 or C2 distal radius fracture were randomized to surgical treatment using palmar plate osteosynthesis or conservative treatment. Patient-rated wrist evaluation (PRWE) score and disabilities of arm, shoulder, and hand (DASH) was assessed 3, 6 and 12 months post-interventionally. Satisfaction, range of motion (ROM) and pain scores were evaluated at 6 weeks and 3, 6 and 12 months post-interventionally.

Results
A total of 80 patients with a mean age of 77.3 years (± 6.1 years) in the conservative group and 72.5 years (± 5.3 years) in the surgery group were included. Both the PRWE score, and the DASH score showed a statistically significant difference between the two groups after 3 months, 6 months and 12 months (p < 0.001). Patients in the surgical cohort showed a statistically significant higher satisfaction at the 6-week, 6-month and 12-month follow-up (p < 0.001 6 weeks + 12 months; p = 0.004 6 months).

Conclusion
In this prospective randomized study, surgical treatment proved to be superior to conservative treatment in terms of the primary outcome variable PRWE score. Satisfaction was significantly better in the surgical group.
Endometrial regeneration cell-derived exosomes loaded with siSLAMF6 inhibit cardiac allograft rejection through the suppression of desialylation modification
Authors: Xu Yini , Ren Shaohua , Wang Hongda , Qin Yafei , Liu Tong , Sun Chenglu , Xiao Yiyi , Shao Bo , Zhang Jingyi , Chen Qiang , Zhao Pengyu , Yang Guangmei , Liu Xu , Wang Hao 
Published: October 2024

Abstract
Backgrounds
Acute transplant rejection is a major component of poor prognoses for organ transplantation. Owing to the multiple complex mechanisms involved, new treatments are still under exploration. Endometrial regenerative cells (ERCs) have been widely used in various refractory immune-related diseases, but the role of ERC-derived exosomes (ERC-Exos) in alleviating transplant rejection has not been extensively studied. Signaling lymphocyte activation molecule family 6 (SLAMF6) plays an important role in regulating immune responses. In this study, we explored the main mechanism by which ERC-Exos loaded with siSLAMF6 can alleviate allogeneic transplant rejection.

Methods
C57BL/6 mouse recipients of BALB/c mouse kidney transplants were randomly divided into four groups and treated with exosomes. The graft pathology was evaluated by H&E staining. Splenic and transplanted heart immune cell populations were analyzed by flow cytometry. Recipient serum cytokine profiles were determined by enzyme-linked immunosorbent assay (ELISA). The proliferation and differentiation capacity of CD4+ T cell populations were evaluated in vitro. The α-2,6-sialylation levels in the CD4+ T cells were determined by SNA blotting.

Results
In vivo, mice treated with ERC-siSLAMF6 Exo achieved significantly prolonged allograft survival. The serum cytokine profiles of the recipients were significantly altered in the ERC-siSLAMF6 Exo-treated recipients. In vitro, we found that ERC-siSLAMF6-Exo considerably downregulated α-2,6-sialyltransferase (ST6GAL1) expression in CD4+ T cells, and significantly reduced α-2,6-sialylation levels. Through desialylation, ERC-siSLAMF6 Exo therapy significantly decreased CD4+ T cell proliferation and inhibited CD4+ T cell differentiation into Th1 and Th17 cells while promoting regulatory T cell (Treg) differentiation.

Conclusions
Our study indicated that ERC-Exos loaded with siSLAMF6 reduce the amount of sialic acid connected to α-2,6 at the end of the N-glycan chain on the CD4+ T cell surface, increase the number of therapeutic exosomes endocytosed into CD4+ T cells, and inhibit the activation of T cell receptor signaling pathways, which prolongs allograft survival. This study confirms the feasibility of using ERC-Exos as natural carriers combined with gene therapy, which could be used as a potential therapeutic strategy to alleviate allograft rejection.