bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simultaneous Endovascular Aortic Repair Expands Transcatheter Aortic Valve Replacement Eligibility to Patients With Hostile Aortic Pathology
Authors: Lu Jeffrey , Zambetti Benjamin , Plant Joshua , Gupta Anuj , Nagarsheth Khanjan , Toursavadkohi Shahab 
Published: October 2024

Background In recent years, Transcatheter Aortic Valve Replacement (TAVR) has become a primary modality of therapy in moderate-high risk patients with symptomatic aortic stenosis. Although clinicians remain vigilant about screening for both aortic stenosis, many patients still, nevertheless, often present only when they are symptomatic. Unfortunately, when isolated TAVR is performed in the context of hostile aortic pathology, it has been reported that patients suffer from higher rates of complications such as rupture, dissection, or death post-operatively. Objectives To explore the utility of a simultaneous TAVR and endovascular aortic repair in addressing symptomatic aortic stenosis in challenging patients with hostile aortic pathology. Methods Retrospective case series within a tertiary care hospital between May 2017 and December 2023. Results A total of 11 patients underwent simultaneous endovascular aortic repair and TAVR. TAVR was performed first in 9/11 (82%) of the procedures while endovascular aortic repair was performed first in 2/11 procedures (18%). The median age was 84 years old (IQR = 77-86 years old). The median LOS was 3 days (IQR = 2-10 days). The median procedure time was 155 minutes (IQR = 111-202 minutes) and the median contrast amount was 100 CC (IQR = 65-139 CC). 2 patients (18%) experienced post-operative complications. Both of these patients required re-intervention. This cohort of patients did not experience any mortality at 30 days related to pertinent complications or adverse MACE events. All patients were transferred to the PACU and ultimately discharged home. Conclusions Extending TAVR eligibility to high-risk patients with hostile aortic pathology through the implementation of simultaneous endovascular aortic repair, performed via the same access site, is an effective strategy for management of symptomatic aortic stenosis in the context of extensive cardiovascular co-morbidities.
Cardiovascular, autonomic symptoms and quality of life in children with hypermobile Ehlers–Danlos syndrome
Authors: Hertel Amanda K , Black William R , Lytch Ashley , Cramer Emily , Malloy Walton Lindsey , Jones Jordan T 
Published: October 2024

Objectives: Hypermobile Ehlers–Danlos syndrome is a connective tissue disorder characterized by joint hypermobility and other systemic manifestations. Cardiovascular, autonomic symptoms and dysautonomia are frequently reported in adults with hypermobile Ehlers–Danlos syndrome and have been shown to have a negative impact on quality of life. However, there is scant literature on autonomic symptoms in pediatric patients with hypermobile Ehlers–Danlos syndrome. This study aims to characterize cardiovascular symptoms and diagnoses in pediatric patients with hypermobile Ehlers–Danlos syndrome and evaluate the impact of autonomic symptoms on quality of life. Methods: As part of a longitudinal study, a consecutive sample of 70 patients with Ehlers–Danlos syndromes were recruited at routine clinical care visits. Medical history was reviewed, demographics were obtained, and patient-reported outcomes were completed by the patients. Results: The average age of 70 patients was 15.8 years, and the majority were females (89%) and Caucasian (89%). The most common cardiovascular diagnoses were orthostatic intolerance (59%), dysautonomia (47%), and postural orthostatic tachycardia syndrome (21%). Most patients had an echocardiogram (77%), that was normal (82%). No patients had mitral valve prolapse, and only one patient had mild aortic root dilation (2%). Patient-reported outcomes revealed decreased quality of life associated with autonomic symptoms. Conclusions: This study shows that most children with hypermobile Ehlers–Danlos syndrome have cardiovascular and autonomic symptoms, which have a negative impact on quality of life. Few patients with hypermobile Ehlers–Danlos syndrome have structural abnormalities on echocardiogram, which suggests that the cardiovascular symptoms experienced by patients are not due to structural cardiovascular disease and possibly reflective of autonomic pathology, though further studies will need to confirm this. This study confirms that cardiovascular and symptoms are prevalent and have a dramatic impact on quality of life in pediatric and young adult patients diagnosed with hypermobile Ehlers–Danlos syndrome.
Predictors of Tdap vaccine acceptance in pregnancy before and after delivery
Authors: Toubiyan David , Fogel Joshua , Jacobs Allan J. 
Published: October 2024

Background: Tdap vaccine receipt in the immediate postpartum period has not been well studied. Objectives: We study factors associated with Tdap vaccine receipt during both pregnancy and the immediate postpartum period. Design: Retrospective study of 2844 pregnant patients that delivered. Methods: Factors from demographics, medical history, previous obstetric history, prenatal care, and previous vaccination history were included. Results: 39.7% of patients received the Tdap vaccine, 39.5% received the Tdap vaccine prior to delivery, and 20.8% received the Tdap vaccine between delivery and discharge. Increased age (relative risk ratio (RRR): 0.98, 95% CI: 0.96, 0.99, p = 0.01) and lower number of prenatal care visits of fewer than 11 (RRR: 0.51, 95% CI: 0.41, 0.64, p < 0.001) were associated with decreased likelihood of vaccine receipt before delivery. Spanish language (before: RRR: 2.35, 95% CI: 1.69, 3.25, p < 0.001; after: RRR: 1.68, 95% CI: 1.13, 2.49, p = 0.01) and South Asian languages (before: RRR: 1.55, 95% CI: 1.03, 2.32, p = 0.04; after: RRR: 1.69, 95% CI: 1.06, 2.69, p = 0.03) had similar patterns for increased likelihood of Tdap vaccine receipt before and after delivery. Race/ethnicity of Hispanic (RRR:1.84, 95% CI: 1.31, 2.59, p = 0.001), Asian (RRR:1.65, 95% CI: 1.22, 2.22, p = 0.001), and receipt of influenza vaccine during current pregnancy (RRR: 1.58, 95% CI: 1.31, 1.91, p < 0.001) were associated with increased likelihood before delivery. Conclusion: Prenatal Tdap vaccination is the best way to prevent infection with B. pertussis. Postpartum Tdap vaccination provides some protection for those declining prenatal vaccination. We recommend that clinicians recognize that there are different patterns for Tdap vaccine receipt before and after delivery and tailor Tdap vaccine counseling based on these patterns.
Zuranolone for the Treatment of Postpartum Depression
Authors: St. Onge Erin , Patel Priti , Whitner Chardae 
Published: October 2024

Objective To review the safety, efficacy, and tolerability of zuranolone for the treatment of postpartum depression. Data Sources: A literature search was conducted through PubMed using the following terms: zuranolone, postpartum depression, perinatal depression, SAGE-217, and allopregnanolone analogue. Study Selection and Data Extraction Articles describing the pharmacology, pharmacokinetics, efficacy, safety, and/or tolerability of zuranolone were included in this review. Data Synthesis Zuranolone is an allopregnanolone analogue that works through modulation of the GABAA receptor. Clinical trials have demonstrated that compared with placebo, zuranolone is effective in treating patients with postpartum depression. Common adverse events associated with zuranolone include fatigue, somnolence, headache, dizziness, diarrhea, sedation, upper respiratory tract infection, and nausea. Conclusions: Pharmacotherapeutic options to treat postpartum depression include selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors, with the medication brexanolone (the first allopregnanolone analogue) reserved for severe postpartum depression. Zuranolone, the newest medication in its class, is without the same limitations as brexanolone, thus affording providers an additional easy-to-use option for treating postpartum depression.
Acetamiprid elicits oxidative stress, pro-inflammatory response, and cellular proliferation in human bronchial epithelial cells in vitro and in silico: alleviative implications of the mixture of heat-killed Lactobacillus strains
Authors: Arafa Samah S. , Elnoury Heba A. , Badr El-Din Sahar , Abdel Sattar Shimaa , Sakr Mohamed A. , Ghanem Sahar K. , Ahmed Omnia S. , Khalil Doaa M. , Ghorab Mohamed A. , Salama Rasha A. , Abdelkader Afaf 
Published: October 2024

Abstract
Background
Acetamiprid (ACE), a neonicotinoid insecticide, has been extensively used to control pests in agricultural and industrial environments. It has been reported that ACE is detrimental to the lungs. Nevertheless, the extent to which the activation of oxidative stress, inflammation, and cellular proliferation contributes to the pulmonary toxicity induced by ACE exposure remains insufficiently understood. This study explored the mechanism of toxicological consequences after ACE exposure in bronchial epithelial cells (BEAS-2B cells). The research also examined the potential ameliorative effects of the mixture of heat-killed Lactobacillus delbrueckii and Lactobacillus fermentum (HKL) on the toxicities of ACE.

Results
Following 14 days of exposure to ACE at 0.5 and 1 μM, oxidative stress was induced, as evidenced by the decreased levels of reduced glutathione, catalase, glutathione peroxidase, and superoxide dismutase, along with increased levels of malondialdehyde. Also, ACE exposure results in overexpression and raised protein levels of the IL-25, NF-κB1, NF-κB2, IL-33, TSLP, and NF-κB target genes, which induce inflammatory responses. In addition, ACE boosted Ki-67-positive BEAS-2B cells. The molecular docking of ACE with target genes and their proteins demonstrated a potent binding affinity, further supported by the presence of hydrophobic contacts, electrostatic interactions, and hydrogen bonds. The post-treatment of HKL following the ACE (1 μM) exhibited its antioxidant, anti-inflammatory, and antiproliferative activities in suppressing ACE-induced toxicity.

Conclusions
Our research revealed that ACE toxicity in BEAS-2B cells is caused by driving oxidative stress, pro-inflammatory response, and cellular proliferation. This study would give us a strategy to alleviate ACE-induced lung impairment by heat-killed probiotic supplements. As a result, dietary supplements that contain these microorganisms may potentially be beneficial in countries with high levels of pesticide contamination.
The future of AI clinicians: assessing the modern standard of chatbots and their approach to diagnostic uncertainty
Authors: Huang Ryan S. , Benour Ali , Kemppainen Joel , Leung Fok-Han 
Published: October 2024

Abstract
Background
Artificial intelligence (AI) chatbots have demonstrated proficiency in structured knowledge assessments; however, there is limited research on their performance in scenarios involving diagnostic uncertainty, which requires careful interpretation and complex decision-making. This study aims to evaluate the efficacy of AI chatbots, GPT-4o and Claude-3, in addressing medical scenarios characterized by diagnostic uncertainty relative to Family Medicine residents.

Methods
Questions with diagnostic uncertainty were extracted from the Progress Tests administered by the Department of Family and Community Medicine at the University of Toronto between 2022 and 2023. Diagnostic uncertainty questions were defined as those presenting clinical scenarios where symptoms, clinical findings, and patient histories do not converge on a definitive diagnosis, necessitating nuanced diagnostic reasoning and differential diagnosis. These questions were administered to a cohort of 320 Family Medicine residents in their first (PGY-1) and second (PGY-2) postgraduate years and inputted into GPT-4o and Claude-3. Errors were categorized into statistical, information, and logical errors. Statistical analyses were conducted using a binomial generalized estimating equation model, paired t-tests, and chi-squared tests.

Results
Compared to the residents, both chatbots scored lower on diagnostic uncertainty questions (p < 0.01). PGY-1 residents achieved a correctness rate of 61.1% (95% CI: 58.4–63.7), and PGY-2 residents achieved 63.3% (95% CI: 60.7–66.1). In contrast, Claude-3 correctly answered 57.7% (n = 52/90) of questions, and GPT-4o correctly answered 53.3% (n = 48/90). Claude-3 had a longer mean response time (24.0 s, 95% CI: 21.0-32.5 vs. 12.4 s, 95% CI: 9.3–15.3; p < 0.01) and produced longer answers (2001 characters, 95% CI: 1845–2212 vs. 1596 characters, 95% CI: 1395–1705; p < 0.01) compared to GPT-4o. Most errors by GPT-4o were logical errors (62.5%).

Conclusions
While AI chatbots like GPT-4o and Claude-3 demonstrate potential in handling structured medical knowledge, their performance in scenarios involving diagnostic uncertainty remains suboptimal compared to human residents.
Cardiac MRI in infarct-like myocarditis: transmural extension of late gadolinium enhancement is associated with worse outcomes
Authors: Isaak Alexander , Wirtz Johannes , Kravchenko Dmitrij , Mesropyan Narine , Bischoff Leon M. , Bienert Simon , Weinhold Leonie , Pieper Claus C. , Attenberger Ulrike , Öztürk Can , Zimmer Sebastian , Kuetting Daniel , Luetkens Julian A. 
Published: October 2024

Abstract
Objectives
To assess the prognostic value of cardiac MRI (CMR) parameters for the occurrence of major adverse cardiac events (MACE) in patients with infarct-like myocarditis.

Methods
In this retrospective single-center study, patients with CMR-confirmed acute myocarditis with infarct-like presentation were identified (2007–2020). Functional and structural parameters were analyzed including late gadolinium enhancement (LGE). The primary endpoint was the occurrence of MACE up to 5 years after discharge.

Results
In total, 130 patients (mean age, 40 ± 19 years; 97 men, 75%) with infarct-like myocarditis were included. CMR was conducted a median of 3 days (interquartile range [IQR], 1–5) after symptom onset. MACE occurred in 18/130 patients (14%) during a median follow-up of 19.3 months (IQR, 4.5–53). The median extent of LGE was 7% (IQR, 4–10). LGE affected the subepicardium in 111/130 patients (85%), the midwall in 45/130 patients (35%), and both the subepicardium and midwall in 27/130 patients (21%). Transmural extension of non-ischemic LGE lesions was observed in 15/130 patients (12%) and septal LGE in 42/130 patients (32%). In univariable Cox regression analysis, a significant association was found between the occurrence of MACE and both, quantified LGE extent and transmural LGE pattern. In multivariable analysis, transmural extension of LGE was an independent predictor for MACE (hazard ratio, 6.34; 95% confidence interval: 2.29–17.49; p < 0.001). Patients with the transmural extension of LGE had a shorter event-free time on Kaplan–Meier analysis (log-rank p < 0.001).

Conclusions
MACE occurred in 14% of patients with infarct-like myocarditis during follow-up. A transmural extension of non-ischemic LGE was associated with a worse long-term prognosis.

Critical relevance statement
CMR-based assessment of transmural extension of non-ischemic LGE holds the potential to serve as an easily assessable marker for risk stratification in patients with infarct-like myocarditis.

Key Points

The prognostic value of CMR was studied in patients with infarct-like myocarditis.

The extent of LGE and transmural extension were linked to adverse cardiac events.

Transmural non-ischemic LGE can serve as an easily assessable prognostic marker.

Graphical Abstract
Beyond resorption: osteoclasts as drivers of bone formation
Authors: Xiang Qianfeng , Li Lei , Ji Wei , Gawlitta Debby , Walboomers X Frank , van den Beucken Jeroen J.J.P. 
Published: October 2024

AbstractEmerging evidence illustrates that osteoclasts (OCs) play diverse roles beyond bone resorption, contributing significantly to bone formation and regeneration. Despite this, OCs remain mysterious cells, with aspects of their lifespan—from origin, fusion, alterations in cellular characteristics, to functions—remaining incompletely understood. Recent studies have identified that embryonic osteoclastogenesis is primarily driven by osteoclast precursors (OCPs) derived from erythromyeloid progenitors (EMPs). These precursor cells subsequently fuse into OCs essential for normal bone development and repair. Postnatally, hematopoietic stem cells (HSCs) become the primary source of OCs, gradually replacing EMP-derived OCs and assuming functional roles in adulthood. The absence of OCs during bone development results in bone structure malformation, including abnormal bone marrow cavity formation and shorter long bones. Additionally, OCs are reported to have intimate interactions with blood vessels, influencing bone formation and repair through angiogenesis regulation. Upon biomaterial implantation, activation of the innate immune system ensues immediately. OCs, originating from macrophages, closely interact with the immune system. Furthermore, evidence from material-induced bone formation events suggests that OCs are pivotal in these de novo bone formation processes. Nevertheless, achieving a pure OC culture remains challenging, and interpreting OC functions in vivo faces difficulties due to the presence of other multinucleated cells around bone-forming biomaterials. We here describe the fusion characteristics of OCPs and summarize reliable markers and morphological changes in OCs during their fusion process, providing guidance for researchers in identifying OCs both in vitro and in vivo. This review focuses on OC formation, characterization, and the roles of OCs beyond resorption in various bone pathophysiological processes. Finally, therapeutic strategies targeting OCs are discussed.
Manipulowanie przeszłością jako praxis. Przykład Katalonii.
Authors: Kubiaczyk Filip 
Published: October 2024

Niniejszy artykuł recenzyjny dotyczy książki Cataluña, La historia que no fue. Mentiras, ficciones, manipulaciones y ocultaciones, w której autor podjął się zadania odkłamania historii Katalonii, tj. ukazania deformacji, fikcji, manipulacji i zatajeń występujących w publikacjach katalońskich historyków i pseudohistoryków. Skala tych kłamstw i zniekształceń katalońskiej przeszłości jest tak duża, że wszystkie razem składają się na historię Katalonii, która de facto nigdy nie miała miejsca, a zmanipulowane opowieści nie odnoszą się do żadnej realnie istniejącej rzeczywistości, lecz przypominają Baudrillardowski symulakr. Mimo to, za sprawą zręcznych i przebiegłych manipulatorów przeszłością, którzy nie wahają się propagować i udostępniać swoich tez w mediach, w tym zwłaszcza społecznościowych, stają się one realnym zagrożeniem dla historii akademickiej. Ustawiczne powtarzanie zmanipulowanych treści w przestrzeni publicznej, przy jednoczesnej bierności akademików może bowiem sprawić, że z czasem nabiorą one statusu ontologicznego. W artykule przedstawiano najważniejsze tezy autora zawarte w książce oraz przykłady manipulatorskich praktyk. Podjęto też dyskusję z niektórymi z nich korygując je i/lub rozwijając. Niniejszy artykuł został też pomyślany jako apel do historyków akademickich, aby nie wahali się włączać do swojej narracji i poddawać krytyce tez głoszonych przez zawodowych historyków-manipulatorów i pseudohistoryków.
role of nutritional treatment in postsurgical convalescence process
Authors: Rzeska Ewa , Jurasz Karolina , Podgórska Dominika , Cymer Radosław , Sanecki Miłosz , Tomczyk Karolina , Chojnacka Natalia , Klarycki Jakub 
Published: October 2024

The article discusses the importance of adequate nutrition for patients suffering from serious illnesses, such as those requiring surgery. Despite medical advances, malnutrition remains a challenge for practitioners. The authors described the importance of nutritional support for patients in critical care, short bowel syndrome and after bariatric surgery. The text highlights the difficulties and challenges of nutritional treatment, such as malnutrition, overweight, and the need to adapt nutritional practices to the latest guidelines and research. The article also emphasizes the importance of educating patients about the benefits of nutritional treatment and the need for access to dietary counseling at every stage of the disease. The role of artificial intelligence in nutritional treatment and the need for further research and innovation in this area are also addressed. The paper describes the different methods of nutrition - enteral and parenteral, their advantages and risks, and notes the need for an individualized approach to each patient, taking into account their condition, age, gender, height and weight. Ultimately, the article emphasizes the importance of access to health care and education to increase the effectiveness of nutrition treatment.
Whitlow, felon and paronychia - a clinical review of superficial hand infections
Authors: Domański Mikołaj , Wierzejska Natalia , Kopczyńska Barbara , Czyżniewska Oliwia , Czupryńska Karolina , Otręba Karina , Szałajska Julia , Wojcieszek Maria 
Published: October 2024

Paronychia, felon and herpetic whitlow are common superficial hand infections. Although having similarities there are many differences between clinical presentation and treatment. Paronychia can present as acute and chronic condition. Treatment options varies from medical to surgical therapy. Formed abscesses may require drainage and possible antibiotic course. Herpetic whitlow is rare manifestation of hand infection with unique treatment options. Chronic infections differs in etiology and clinical presentation and need specialized treatment. Role of noninfectious causes should always be considered, including malignancy if no adequate treatment response is gained. Making correct diagnosis, followed by adequate treatment will prevent huge range of complications. Article reviews common hand infections, presentation, diagnosis and treatment strategies.
Exploration of user satisfaction in using the newly redesigned MoliCare Premium Men Pad: in-home use study
Authors: Sanaeifar Niuosha , Buch Tamara , Debler Moritz , Kesselmeier Rüdiger , Canales Sara , Meer Michael 
Published: October 2024

Background: Men frequently underestimate the significance of urinary incontinence and fail to disclose their condition owing to embarrassment and the associated social stigma. Therefore, successful incontinence management with absorbent products helps individuals cope with the emotional and social challenges arising from incontinence, including visible urine leakage, frequent urination, unpleasant odours, and isolation. Aim: To assess the most essential performance features of the newly developed MoliCare Premium Men Pad. Methods: Computer-assisted personal interviews were conducted to obtain the opinions and satisfaction levels of 69 male users with incontinence in Germany regarding different performance characteristics of the newly designed MoliCare Premium Men Pad after using the product. Findings: All performance characteristics of the new MoliCare Premium Men Pad design received positive ratings from all interviewees. Notably, 90% of participants were ‘highly satisfied’ and ‘satisfied’ with the new MoliCare design. Conclusions: The new MoliCare SkinGuard absorbent core technology, anti-leakage guards, and well-engineered product design provide protection, discretion, and comfort to individuals with incontinence. The newly developed MoliCare Premium Men Pad is specifically tailored to meet the primary needs of male pad users and help them maintain a normal lifestyle.