bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sudden cardiac death during scuba diving: a case report of a patient with unknown hypertrophic cardiomyopathy
Authors: Di Paolo Marco , Mezzetti Eleonora , Leoni Matteo , Scatena Andrea , Passino Claudio 
Published: May 2024

Abstract

Background
Scuba diving is a recreational activity usually considered at low impact on cardiovascular system. However, when diving, increased ambient pressure exerts several effects on the cardiovascular and pulmonary systems, mainly due to redistribution of peripheral blood into the central circulation. This phenomenon, also known as blood shift, may produce a significant overload on a non-healthy heart.

Case summary
We present the case of a female patient who experienced sudden cardiac death during scuba diving: post-mortem cardiac magnetic resonance and autopsy revealed that the patient was affected by previously unknown hypertrophic cardiomyopathy.

Discussion
Diving exposes the body to significant physiological changes that may overstress a diseased heart. This case suggests the need for some cardiovascular exams, such as an echocardiogram or, at least, an electrocardiogram, for screening cardiovascular abnormalities in subjects who wish to practice scuba diving.
An unusual cause of anterior wall ST-elevation myocardial infarction: a case report
Authors: Dindane Zouhir , Golgor Elena , Linke Axel , Mangner Norman 
Published: May 2024

Abstract

Background
Metastatic tumours, notably lung cancer, can cause conditions resembling acute myocardial infarctions (AMIs), contributing to the minor percentage of AMIs unrelated to coronary atherosclerosis. These instances necessitate specialized diagnostic and therapeutic approaches due to the distinct underlying pathology.

Case summary
We report a case of a 65-year-old male with metastatic lung cancer presenting with prolonged angina pectoris. Elevated troponin and creatine kinase levels led to emergency catheterization, revealing a total occlusion of the distal left coronary artery attributed to tumour infiltration. Intervention attempts were unsuccessful, and given the palliative context, other revascularization strategies were not pursued. Two-dimensional transthoracic echocardiogram depicted tumour invasion at the heart’s apex, confirming the diagnosis. The patient passed away shortly after receiving palliative radiation therapy.

Discussion
This case underscores the challenges in diagnosing and managing myocardial infiltrations from metastatic tumours mimicking AMI. It accentuates the importance of imaging studies for accurate diagnosis and the critical evaluation of intervention strategies, highlighting the need for focused palliative care in such complex scenarios.
Remote proctoring in complex percutaneous coronary intervention aided by mixed reality technology
Authors: Calic Slobodan , Jortveit Jarle , Andersen Jahn Otto , Eek Christian Hesbø 
Published: May 2024

Abstract

Aims
Percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs) has a lower success rate and a higher complication rate compared to PCI of non-occluded coronary arteries. Co-operation and supervision by a more experienced operator (proctoring) are associated with improved success of CTO procedures. This study aims to assess the feasibility of remote proctoring using web-based communication and mixed reality technology in CTO procedures.

Methods and results
The PCI operator was equipped with a Microsoft HoloLens 2 head-mounted display enabling visual and verbal interaction including holographic annotations with a remote proctor. Ten CTO procedures were performed by a single PCI operator assisted by a remote proctor. Audio and video communication was successfully established in all procedures. All procedures were possible to perform with a Microsoft HoloLens 2 head-mounted display. The PCI operator experienced the remote proctoring as useful.

Conclusion
Remote proctoring of CTO procedures using mixed reality technology was feasible. The impact of the method regarding procedural and patient outcomes needs to be assessed in new studies.
Artificial intelligence–enhanced electrocardiography analysis as a promising tool for predicting obstructive coronary artery disease in patients with stable angina
Authors: Park Jiesuck , Kim Joonghee , Kang Si-Hyuck , Lee Jina , Hong Youngtaek , Chang Hyuk-Jae , Cho Youngjin , Yoon Yeonyee E 
Published: May 2024

Abstract

Aims
The clinical feasibility of artificial intelligence (AI)-based electrocardiography (ECG) analysis for predicting obstructive coronary artery disease (CAD) has not been sufficiently validated in patients with stable angina, especially in large sample sizes.

Methods and results
A deep learning framework for the quantitative ECG (QCG) analysis was trained and internally tested to derive the risk scores (0–100) for obstructive CAD (QCGObstCAD) and extensive CAD (QCGExtCAD) using 50 756 ECG images from 21 866 patients who underwent coronary artery evaluation for chest pain (invasive coronary or computed tomography angiography). External validation was performed in 4517 patients with stable angina who underwent coronary imaging to identify obstructive CAD. The QCGObstCAD and QCGExtCAD scores were significantly increased in the presence of obstructive and extensive CAD (all P &lt; 0.001) and with increasing degrees of stenosis and disease burden, respectively (all Ptrend &lt; 0.001). In the internal and external tests, QCGObstCAD exhibited a good predictive ability for obstructive CAD [area under the curve (AUC), 0.781 and 0.731, respectively] and severe obstructive CAD (AUC, 0.780 and 0.786, respectively), and QCGExtCAD exhibited a good predictive ability for extensive CAD (AUC, 0.689 and 0.784). In the external test, the QCGObstCAD and QCGExtCAD scores demonstrated independent and incremental predictive values for obstructive and extensive CAD, respectively, over that with conventional clinical risk factors. The QCG scores demonstrated significant associations with lesion characteristics, such as the fractional flow reserve, coronary calcification score, and total plaque volume.

Conclusion
The AI-based QCG analysis for predicting obstructive CAD in patients with stable angina, including those with severe stenosis and multivessel disease, is feasible.
Joint shape/texture representation learning for cardiovascular disease diagnosis from magnetic resonance imaging
Authors: Chen Xiang , Xia Yan , Dall'Armellina Erica , Ravikumar Nishant , Frangi Alejandro F 
Published: May 2024

Abstract

Aims
Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide. Cardiac image and mesh are two primary modalities to present the shape and structure of the heart and have been demonstrated to be efficient in CVD prediction and diagnosis. However, previous research has been generally focussed on a single modality (image or mesh), and few of them have tried to jointly consider the image and mesh representations of heart. To obtain efficient and explainable biomarkers for CVD prediction and diagnosis, it is needed to jointly consider both representations.

Methods and results
We design a novel multi-channel variational auto-encoder, mesh-image variational auto-encoder, to learn joint representation of paired mesh and image. After training, the shape-aware image representation (SAIR) can be learned directly from the raw images and applied for further CVD prediction and diagnosis. We demonstrate our method on data from UK Biobank study and two other datasets via extensive experiments. In acute myocardial infarction prediction, SAIR achieves 81.43% accuracy, significantly higher than traditional biomarkers like metadata and clinical indices (left ventricle and right ventricle clinical indices of cardiac function like chamber volume, mass, and ejection fraction).

Conclusion
Our mesh-image variational auto-encoder provides a novel approach for 3D cardiac mesh reconstruction from images. The extraction of SAIR is fast and without need of segmentation masks, and its focussing can be visualized in the corresponding cardiac meshes. SAIR archives better performance than traditional biomarkers and can be applied as an efficient supplement to them, which is of significant potential in CVD analysis.
Role of supply chain intermediaries in steering hospital product choice: Group Purchasing Organizations and biosimilars
Authors: Dean Emma Boswell , Pierre Reekarl , Carter Samuel , Bond Amelia M 
Published: May 2024

Abstract
Over 95% of hospitals in the United States use pooling alliances, known as Group Purchasing Organizations (GPOs), to purchase medications, devices, and supplies. While GPOs create savings for hospitals through lowered prices and reduced administrative burden, critics allege that these supply chain intermediaries reduce competition, particularly if GPOs concentrate purchasing from larger, dominant manufacturers. Using a mixed-methods design, we studied whether GPOs influence hospital purchasing behavior and explored the contracting mechanisms used by GPOs. Focusing on 4 high-cost biologic molecules that face competition from generic-like biosimilars between 2015 and 2019, we found that biosimilar uptake was 16%–23% higher among Traditional Medicare patients in hospitals associated with 2 of the 3 top GPOs as compared with smaller GPOs. The increase in biosimilar use was driven by single biosimilar brands that varied by GPO. Based on qualitative interviews, these 2 GPOs used more aggressive contracting strategies to steer member hospitals to specific biosimilar brands. To date, the use of GPOs and these aggressive contracting strategies appear to have increased biosimilar use, suggesting savings for payers and patients. However, single-source GPO contracting could inhibit competition or create shortages in the long term. Transparency on GPO practices and pricing strategies is needed for further GPO evaluations.
Equivariant Cohomology and Conditional Oriented Matroids
Authors: Dorpalen-Barry Galen , Proudfoot Nicholas , Wang Jidong 
Published: May 2024

Abstract
We give a cohomological interpretation of the Heaviside filtration on the Varchenko–Gelfand ring of a pair $({\mathcal{A}},{\mathcal{K}})$, where ${\mathcal{A}}$ is a real hyperplane arrangement and ${\mathcal{K}}$ is a convex open subset of the ambient vector space. This builds on work of the first author, who studied the filtration from a purely algebraic perspective, as well as work of Moseley, who gave a cohomological interpretation in the special case where ${\mathcal{K}}$ is the ambient vector space. We also define the Gelfand–Rybnikov ring of a conditional oriented matroid, which simultaneously generalizes the Gelfand–Rybnikov ring of an oriented matroid and the aforementioned Varchenko–Gelfand ring of a pair. We give purely combinatorial presentations of the ring, its associated graded, and its Rees algebra.
Hemagglutinin Stalk-Specific Fc-Mediated Functions Are Associated With Protection Against Influenza Illness After Seasonal Influenza Vaccination
Authors: Motsoeneng Boitumelo M , Dhar Nisha , Nunes Marta C , Krammer Florian , Madhi Shabir A , Moore Penny L , Richardson Simone I 
Published: May 2024

Abstract

Background
Future vaccine candidates aim to elicit antibodies against the conserved hemagglutinin stalk domain. Understanding the protective mechanism of these antibodies, which mediate broad neutralization and Fc-mediated functions, following seasonal vaccination is critical.

Methods
Plasma samples were obtained from pregnant women with or without HIV-1 enrolled in a randomised trial (138 trivalent inactivated vaccine [TIV] and 145 placebo recipients). Twenty-three influenza cases were confirmed within 6 months postpartum. We measured H1 stalk-specific antibody-dependent cellular phagocytosis (ADCP), complement deposition (ADCD) and cellular cytotoxicity (ADCC) at enrolment and 1-month postvaccination.

Results
Lower H1 stalk-specific ADCP and ADCD activity was detected for participants with confirmed influenza compared with individuals without illness 1-month postvaccination. Pre-existing ADCP scores ≥250 reduced the odds of A/H1N1 infection (odds ratio [OR], 0.11; P = .01) with an 83% likelihood of risk reduction. Following TIV, ADCD scores of ≥25 and ≥15 significantly reduced the odds against A/H1N1 (OR, 0.10; P = .01) and non-group 1 (OR, 0.06; P = .0004) influenza virus infections, respectively. These ADCD scores were associated with &gt;84% likelihood of risk reduction.

Conclusions
Overall, H1 stalk-specific Fc effector function correlates with protection against influenza illness following influenza vaccination during pregnancy. These findings provide insight into the protective mechanisms of hemagglutinin stalk antibodies.

Clinical Trials Registration
NCT01306669 and NCT01306682 (ClinicalTrials.gov).
Emotions in the Frontline. Notes on Interpretive Research in Conflict Areas
Authors: Tinti Alessandro 
Published: May 2024

AbstractIn line with the call for greater engagement with the affective and emotional dimensions of conducting research in conflict and post-conflict settings, this article addresses the methodological implications of incorporating emotionally sensed knowledge into the research process. It argues that emotions serve as fundamental heuristic keys for entering the field and acquiring situated knowledge. By reflecting upon practical challenges and ethical concerns encountered during field research in Iraq, the article aims to challenge disciplinary practices that promote emotional self-censorship and provide guidance to young researchers navigating the messy contingencies of fieldwork. The neglect of emotions in positivist approaches is examined in relation to the political economy of knowledge production, suggesting that prevailing emotional silence may lead to harmful research practices and threatens epistemological pluralism.
A system-wide approach to digital equity: the Digital Access Coordinator program in primary care
Authors: Rodriguez Jorge A , Zelen Michelle , Szulak Jessica , Moore Katie , Park Lee 
Published: May 2024

Abstract

Introduction
The transition to digital tools prompted by the pandemic made evident digital disparities. To address digital literacy gaps, we implemented a system-wide digital navigation program.

Methods
The Digital Access Coordinator (DAC) program consists of 12 multilingual navigators who support patients in enrolling and using the patient portal and digital tools. We implemented the program in our primary care network which consists of 1.25 million patients across 1211 clinicians.

Results
From May 2021 to November 2022, the DACs completed outreach to 16 045 patients. Of the 13 413 patients they reached, they successfully enrolled 8193 (61%) patients in the patient portal. Of those patients they enrolled, most patients were of Other race, Hispanic ethnicity, and were English-speaking (44%) and Spanish-speaking patients (44%). Using our embedded model, we increased enrollment across 7 clinics (mean increase: 21.3%, standard deviation: 9.2%). Additionally, we identified key approaches for implementing a digital navigation program.

Conclusion
Organizations can support patient portal enrollment, a key part of digital health equity, by creating and prioritizing digital navigation programs.
Validation of the AgraStrip® Pro Total Aflatoxin WATEX® Method for Detection of Total Aflatoxins in Corn and Peanut Paste: AOAC Performance Tested MethodSM 032402
Authors: Kraus Sonja , Cvak Barbara , Fidalgo Luis 
Published: May 2024

Abstract

Background
To protect public and animal health against risks provoked by aflatoxins contained therein, maximum limits for aflatoxins are defined. Limit values vary depending on the intended use and regulatory authority, therefore quantitative detection is essential.

Objective
Validation of a one-step competitive lateral flow immunochromatographic assay for quantitative screening of total aflatoxin (B1, B2, G1, and G2) in corn and peanut paste for the high-sensitivity range (0–50 µg/kg).

Methods
Corn or peanut paste test portions are water-based extracted and prepared for testing within 15 min. The AgraStrip® Pro Total Aflatoxin WATEX® test method quantifies the concentration of aflatoxins in the sample. Selectivity, robustness, product consistency, and stability testing were performed in addition to matrix testing.

Results
No cross-reactivity was detected against possible interferants. Corn resulted in a LOD and LOQ of 0.9 and 2.8 µg/kg and overall recoveries between 74 and 108%. Peanut paste resulted internally in a LOD and LOQ of 0.8 and 2.3 µg/kg and recoveries between 86 and 98%. Stability testing showed no influence of the age of the respective lot on the result. Robustness testing demonstrated that varying the amount of water used for extraction, extraction time, and delay between extract dilution and analysis did not significantly affect the result. Due to supply chain issues, a change to the outer cartridge required an increase in the test aliquot size, which had no effect on method performance.

Conclusion
The test kit was validated for the determination of total aflatoxins in corn and peanut paste. Recovery and precision met the requirements laid down in Codex Alimentarius CXG 71–2009 and acceptable robustness, selectivity, and product consistency and stability were demonstrated.

Highlights
The AgraStrip Pro Total Aflatoxin WATEX test kit in the high sensitivity range (0–50 µg/kg) was approved by the AOAC AOAC Research Institute (PTM number 032402).
Program Evaluation of Cognitive Behavioral Therapy in Burn Survivors
Authors: Rothbauer Mikki , Pasek Zuzanna , Dalrymple Kirsten A , Wewerka Sandi S , Adams Nell 
Published: May 2024

Abstract
Mental health is a component of care that should be addressed for patients with burns while they are hospitalized. Unfortunately, dedicated burn psychotherapists are rare in burn centers in the United States (US), and it can take months for patients to be seen by a mental health professional after referral. Our burn center has a dedicated licensed clinical social worker who sees patients within 2 business days of referral. She uses cognitive behavioral therapy (CBT), which is designed to alleviate symptoms of anxiety, depression, and acute stress by modifying the individual’s maladaptive thoughts. To evaluate the timely use of CBT as a treatment for depression in patients with burns, we measured depressive symptoms before and after psychotherapy. Burn clinic nurses administered the Patient Health Questionnaire (PHQ-9) depression screener as part of standard care. We computed difference scores to determine the change in PHQ-9 scores at both group and individual levels. At a group level, psychotherapy significantly improved symptoms of depression, indicated by a decreased mean PHQ-9 score. On an individual level, half of the patients (50.7%) experienced a meaningful improvement in their symptoms, indicated by a change in their PHQ-9 depression category, while 35.6% showed no change. Although it was not an effective solution for all patients in this study, timely use of CBT could be an important component of burn care for many and should be considered as part of standard care in burn centers across the US.
Iron and bones: effects of iron overload, deficiency and anemia treatments on bone
Authors: von Brackel Felix N , Oheim Ralf 
Published: May 2024

Abstract
Iron is a vital trace element and exerts opposing effects on bone in both iron overload and iron deficiency situations. Remarkably, iron supplementation through intravenous infusion in patients with iron deficiency can also have detrimental effects on bone in special cases. The diverse mechanisms underlying these effects and their manifestations contribute to the complexity of this relationship. Iron overload impacts both bone resorption and formation, accelerating bone resorption while reducing bone formation. These effects primarily result from the direct action of reactive oxygen species (ROS), which influence the proliferation, differentiation, and activity of both osteoclasts and osteoblasts differently. This imbalance favors osteoclasts and inhibits the osteoblasts. Simultaneously, multiple pathways, including bone morphogenic proteins, RANK ligand, and others, contribute to these actions, leading to a reduction in bone mass and an increased susceptibility to fractures. In contrast, iron deficiency induces low bone turnover due to energy and co-factor deficiency, both of which require iron. Anemia increases the risk of fractures in both men and women. This effect occurs at various levels, reducing muscular performance and, on the bone-specific level, decreasing bone mineral density. Crucially, anemia increases the synthesis of the phosphaturic hormone iFGF23, which is subsequently inactivated by cleavage under physiological conditions. Thus, iFGF23 levels and phosphate excretion are not increased. However, in specific cases where anemia has to be managed with intravenous iron treatment, constituents—particularly maltoses—of the iron infusion suppress the cleavage of iFGF23. As a result, patients can experience severe phosphate wasting and, consequently, hypophosphatemic osteomalacia. This condition is often overlooked in clinical practice and is often caused by ferric carboxymaltose. Ending iron infusions or changing the agent, along with phosphate and vitamin D supplementation, can be effective in addressing this issue.
Numerical investigation of mixed convective flow of micropolar Casson fluid with Cattaneo–Christov heat flux model on an inclined vertical stretching surface
Authors: Khan Muhammad Naveed , Alhuthali Abdullah M S , Amjad Ayesha , Saqlain Muhammad , Yar Mohammad , Alshammry Nizal , Elkotb Mohamed Abdelghany 
Published: May 2024

Abstract
It is vitally critical to understand the dynamics of the non-Newtonian fluids model from an engineering and industrial perspective. Many industrial and technical activities, such as the extrusion of polymer sheets, the manufacturing of paper, and the development of photographic films, require non-Newtonian fluids. Energy transportation has numerous industrial applications, and classical heat and mass transfer laws do not accurately anticipate thermal and solute relaxation times. This study applies the modified Ohm law to heat and mass transport, utilizing Fick’s and generalized Fourier concepts. And the primary purpose of this study is to explore the characteristics of heat and mass transport in the magnetohydrodynamics-mixed convective flow involving a micropolar Casson fluid across the vertically inclined starching surface with multiple slip effects. Moreover, the study considers additional factors like thermal radiation, heat generation, chemical reactions, and the influence of thermophoretic to analyze both energy and nanoparticle concentration aspects comprehensively. To simplify the flow analysis, the original flow model is transformed into a couple of ordinary differential equations (ODEs) by employing relevant similarity transformations. These ODEs establish a system that is solved numerically by using the Bvp4c solver through MATLAB. It is worth noticing that a more substantial estimation of the thermal and concentration relaxation parameters decays the fluid temperature and nanoparticle concentration, respectively, and the growth of the material parameter reduces the drag force, which consequently augmenting the fluid velocity. Furthermore, the enhancement occurs in the skin friction due to greater estimation of the micropolar parameter, while the Casson fluid parameter causes the opposite trend.