bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiopulmonary exercise testing in patients with pulmonary arterial hypertension and the new four strata risk prediction model
Authors: Papageorgiou J M , Kylhammar D , Hedman K 
Published: June 2024

Abstract

Background
Cardiopulmonary exercise testing (CPET) is an established tool for follow-up of patients with pulmonary arterial hypertension (PAH). Recent PAH guidelines recommend a four-strata risk evaluation model at follow-up, not including CPET data. It is unknown how measures obtained at CPET relate to these new risk categories in patients with PAH.

Purpose
To explore standard CPET variables in patients with PAH in relation to the recently suggested four-strata risk assessment categories in PAH.

Methods
A single-center, retrospective analysis of patients diagnosed with PAH group 1 who underwent CPET between years 2007-2022. Patients were categorized as: low risk, intermediate-low risk, intermediate-high risk or high risk based on natriuretic peptide (NT-ProBNP), six minute walking distance (6MWD) and World Health Organization functional class (WHO-FC).

Results
In total, 23 patients (18 female, age 59 (41,69) years) with complete CPET and clinical data allowing accurate risk categorization were included. Thirteen patients were categorized as low-risk, six as intermediate-low and four as intermediate-high risk with no patient as high risk.
Figure 1 depicts CPET parameters comparing low-risk group, intermediate-low and intermediate-high risk group. Significant differences between the groups were found regarding peak oxygen uptake (VO2-peak) and the ventilation-to-carbon dioxide relationship (VE/VCO2-slope). More specifically, differences were significant between low-risk group vs intermediate-high risk group for VO2-peak (p-value 0.023) and VE/VCO2-slope (p-value 0.043).

Conclusion
We present that the new four-strata risk evaluation model in PAH is associated with marked differences in CPET parameters. This calls for further research evaluating the possible value of using CPET data in adjunct to the clinically based model.
Analyzing aortic stenosis-related mortality before and after transcatheter aortic valve replacement approval: insights from CDC data
Authors: Ashri S , Barbash I M , Fefer P , Segev A , Fishman B , Gerber Y , Maor E 
Published: June 2024

Abstract

Background
In recent decades, Transcatheter Aortic Valve Replacement (TAVR) has revolutionized the treatment landscape for aortic stenosis (AS). This study aimed to investigate the shifts in AS-related mortality rates before and after the introduction of TAVR in the United States (US).

Methods
Mortality data for all US adults (1999- 2020) were retrieved from the CDC WONDER dataset, encompassing all US death certificates and their associated causes. We analyzed AS-related age-adjusted mortality rates (AAMR) per 100,000 persons, contextualized with the FDA's TAVR approval for high-risk patients in 2012 and intermediate-risk patients in 2016. These rates were compared with mitral regurgitation (MR)-related mortality.

Results
We observed 306,376 AS- and 52,049 MR-related deaths. The average annual AAMR (95% CI) shifted from 4.21 (4.14, 4.28) in 1999-2012 to 4.31 (4.24, 4.38) in the years 2013-2016 and to 3.69 (3.63, 3.75) in the years 2017-2020 (FIGURE). Mitral valve AAMR also declined, however more moderately. While in pre-approval period, AS-related mortality was higher in rural compared with urban areas [4.42 (4.25, 4.59) and 4.16 (4.08, 4.24), respectively], the AAMR decline was comparable for both from the time of TAVR approval for high-risk patients to its approval for intermediate-risk patients, with a decrease of ~0.62 deaths per 100,000 persons annually for both demographics. Gender-specific analysis revealed that prior to approval, males exhibited higher mortality rates compared to females [4.59 (4.47, 4.72) vs. 3.94 (3.86, 4.03)]. However, the decline in mortality rates among males outpaced that among females (0.75 and 0.54 deaths per 100,000 persons annually, respectively.

Conclusions
Mortality rates associated with aortic stenosis have declined over the past two decades, with a clear temporal connection to the integration of TAVR into practice. Importantly, this decline was consistent across genders and geographical areas, suggesting that TAVR may play a pivotal role in mitigating health disparities within the US population.
Severe mitral regurgitation requiring surgery: comparison of repair versus replacement
Authors: Debski M , Qadri S , Bhalraam U , Debska K , Zacharias J , Vassiliou V 
Published: June 2024

Abstract

Background
According to ACC/AHA, ESC/EACTS and NICE UK Guidelines for the Management of Valvular Heart Diseases, when surgery is considered for primary mitral valve disease and mitral valve repair is expected to be durable according to the Heart Team evaluation, mitral valve repair is preferred over replacement as it is associated with better survival [1-3]. When repair is not feasible, experts advocate for mitral valve replacement with preservation of the subvalvular apparatus. These guideline recommendations are based solely on observational studies. In secondary mitral valve regurgitation, the advantage of mitral valve repair is less clear [4].

Purpose
This study aims to compare outcomes of repair and replacement in all aetiologies of severe mitral regurgitation in a tertiary cardiothoracic centre.

Methods
We compared the outcomes of 1751 consecutive patients (median age 69 [IQR, 60-75) who underwent first MV repair (n=1249, 71%) or replacement (n=503, 29%) for mitral regurgitation between 2000 and 2021. Patients undergoing aortic valve replacement and those with MV stenosis or mixed MV disease were excluded. Coronary bypass was performed in 36% of patients and 23% required tricuspid repair. Median follow-up was 7.1 (IQR, 3.6-11.6) years. To balance the cohorts, we used genetic matching with replacement which yielded 419 pairs of patients well-matched across 27 covariates (Figure 1) [5].

Results
Comparing the outcomes of mitral valve replacement to repair in the matched sample, we observed more frequent blood transfusion (29% vs 21%, p=0.013), longer intensive care unit (median 1 day [IQR, 1-2] vs 1 [IQR, 1-1], p=0.027) and post-operative length of stay (10 [7-15] vs 9 days [IQR, 7-12], p=0.002) . Regarding complications, we observed a similar rate of multiorgan failure, pulmonary and gastrointestinal complications. On the other hand, there were more strokes and transient ischaemic attacks in the mitral replacement group (6.7% vs 0.6%, p&lt;0.001). In matched groups, MV replacement was associated with higher risk of mortality at 90-day (HR: 2.36, 95% CI: 1.31-4.25) and long-term follow-up (HR: 1.32, 95% CI 1.09-1.59) compared to MV repair (Figure 2). Repair was better in patients with degenerative mitral regurgitation, those &lt;= 70 years old and elective cases. Patients &gt; 70 years old, these with infective endocarditis, functional regurgitation and urgent cases had similar outcomes with either technique.

Conclusion
This study adds to the body of evidence supporting repair over replacement and broadens current understanding of early complications showing higher rate of cerebrovascular complications in MV replacement compared to repair. Balance before and after matching. Kaplan-Meier survival curves.
General Comment No. 25 on Children’s Rights in Relation to the Digital Environment: Implications for Children’s Right to Privacy and Data Protection in Africa
Authors: Ayalew Yohannes Eneyew , Verdoodt Valerie , Lievens Eva 
Published: June 2024

Abstract
The UN Committee on the Rights of the Child has published its much-awaited General Comment No. 25 on children’s rights in the digital environment in 2021. Much of the conversations since its adoption have centred on how General Comment No. 25 influences State behaviours in the western world or globally. Little attention has been given as to what General Comment No. 25 means for children’s right to privacy in Africa. This article seeks to explore the role of General Comment No. 25 in clarifying States’ obligations in respect of children’s rights to privacy and data protection in the digital era on the African continent. In doing so, this article first contextualises General Comment No. 25 in the broader context of the United Nations human rights system and analyses its recommendations on children’s right to privacy. Second, the article examines children’s right to privacy in Africa and analyses the specific features of the African human rights system that influence the understanding of this right. Finally, the article illuminates certain child-specific privacy and data protection measures that are being or have been included or discussed in the law-making processes and policy debates in a selection of African countries and links them to both General Comment No. 25 and the socio-cultural context of the continent.
Risk factors associated with multidrug-resistant tuberculosis in areas with a moderate tuberculosis burden
Authors: Mansoori Noormohamad , Pahlavanzadeh Bagher , Atarjalali Masoumeh 
Published: June 2024

AbstractBackgroundThe emergence of multidrug-resistant tuberculosis (MDR-TB) or rifampicin-resistant (RR) TB poses a significant challenge for TB control initiatives on a global scale. This study’s aim was to estimate the incidence of MDR-/RR-TB and identify the risk factors associated with their incidence in four provinces in northern Iran.MethodsDrug susceptibility testing was conducted using the proportion method on Lowenstein–Jensen media. The demographic and clinical data were collected from the Iranian TB registry.ResultsAmong 1083 individuals diagnosed with TB, 27 (2.5%) were identified as having MDR-/RR-TB, while 73 cases (6.7%) were any drug resistant (ADR). The statistical analysis revealed a significant association between marital status and MDR-/RR-TB (p=0.003). In addition, significant associations were observed between ADR-TB and gender (p=0.035) and previous treatment for TB (p=0.02).ConclusionsOur findings provide important information on the drug resistance pattern of Mycobacterium tuberculosis strains, as well as risk factors in northern Iran. Given the identified risk factors, creative approaches to promote treatment adherence in TB patients, particularly divorced/widowed women and individuals with a previous history of TB treatment, are required.
Population size and movement ecology of intertidal gastropods on rocky shores and seawalls in Singapore
Authors: Yeo Hannah H J , Loke Lynette H L , Todd Peter A 
Published: June 2024

ABSTRACTIncreasing coastal development and global warming have resulted in large-scale habitat changes, with artificial coastal structures replacing extensive tracts of natural shores. In Singapore, for example, more than 63% of the natural coastline has been replaced by seawalls. Multiple studies from both temperate and tropical regions have compared species diversity supported by these artificial structures with natural rocky shores. Few, however, have estimated and compared the population size and movement of common intertidal species between these two habitat types. Using mark–recapture techniques, this study investigated: (1) the population size of three common gastropod genera (Nerita spp., Trochus spp. and Turbo spp.) and (2) differences in displacement of Nerita spp. and Trochus spp., two common species found on natural rocky shores and seawalls in Singapore. The results of our mark–recapture surveys indicated that seawalls supported large densities of Nerita spp.—more than 50 times greater than that on adjacent rocky shores. The mark–recapture data also revealed that movement of the gastropod species differed between the two habitats, with individuals on seawalls generally travelling longer distances.
Mucormycosis in Diabetes
Authors: Das Shukla , Rai Gargi , Gupta Chhavi , Gupta Neelima , Arora Vipin , Singh Praveen Kumar , Mohapatra Subhashree , Ansari Mohammad Ahmad , Hakami Zaki H. , Dar Sajad Ahmad 
Published: June 2024

Abstract
Fungal infections are a major health challenge especially in immunocompromised patients. Mucormycosis, a severe, frequently fatal fungal infection, has a unique predisposition to infect patients with diabetes. The infection is caused by organisms belonging to the order Mucorales, among which Rhizopus species are the most common. Uncontrolled diabetes complicated by diabetic ketoacidosis is one of the major risk factors for upsurge in mucormycosis cases. The defense mechanisms, involving macrophages and neutrophils for phagocytosis, are compromised in diabetes. In 2 cases of rhino-orbital-cerebral mucormycosis with underlying diabetes, we observed a marked immune imbalance, with elevated Th17 and diminished T regulatory cells. Recovery of CD4+CD25+ T cells after treatment indicated a favorable phenotype outcome; though high circulating CD4+CD161+ can be detrimental to the patient predisposing to future relapse(s). Mucorale specific T cells contributing to human immune responses against the fungi can be investigated to identify a surrogate diagnostic marker of invasive mucormycosis.
Characterization of zebrafish coagulation cofactors Fviii and Fv mutants and modeling hemophilia A and factor V deficiency
Authors: Dhinoja Sanchi , De Maria Anthony , Qaryoute Ayah Al , Jagadeeswaran Pudur 
Published: June 2024

The aim of this study is to characterize zebrafish coagulation cofactors fviii and fv mutant fish and assess if they phenocopy classical hemophilia A and factor V deficiency in humans.
The embryos from fviii and fv zebrafish heterozygote mutants generated by ENU mutagenesis were purchased from the ZIRC repository. They were reared to adulthood and genotyped. The heterozygote male and female were crossed to get homozygote, heterozygote, and wild-type fish. Functional kinetic coagulation assays and bleeding assays were performed on normal and mutant adult fish, and venous laser injury assays were performed on the larvae.
The DNA from fviii and fv mutants were sequenced to confirm if they have a premature stop codon in exon 19, and in exon 2, respectively, and in both mutants, the amino acid glutamine is replaced with a stop codon. Homozygous and heterozygous 5 days post fertilization (dpf) larvae for fviii and fv deficient mutants exhibited prolonged time to occlusion after venous laser injury compared to wild-type controls. The homozygous and heterozygous fviii adult mutants showed modest bleeding and delayed fibrin formation in the kinetic partial thromboplastin time (kPTT) assay with their plasma. fv homozygous larvae had poor survival beyond 12 dpf. However, heterozygous fv mutants exhibited heavy bleeding and prolonged fibrin formation in the kPTT and kPT assay compared with wild-type siblings.
Our characterization showed fviii and fv mutants from ZIRC phenocopied to a considerable extent classical hemophilia A and factor V deficiency in humans, respectively. These models should be useful in studying and developing novel drugs that reverse the phenotype and in generating suppressor mutations to identify novel factors that compensate for these deficiencies.
Efficacy and relative safety of caplacizumab in immune-mediated thrombotic thrombocytopenic purpura: a systematic review and meta-analysis
Authors: Peng Jia-Ying , Wang Si-Yang , Chen Miao-Qi , Liu Cheng-Xin , Zhao Yi-Ting , Xu Tong-Shan , Wu Qian-Long 
Published: June 2024

Immune-mediated thrombotic thrombocytopenia purpura (iTTP) is a rare microvascular disease characterized by severe disseminated microvascular thrombose-bleeding syndrome. Caplacizumab has been approved for the treatment of iTTP in combination with Plasma Exchange (PE) and immunosuppressive therapy, but its role in iTTP therapy remains uncertain. Therefore, we conducted a meta-analysis to investigate the safety and efficacy of caplacizumab for the treatment of patients with iTTP. We searched electronic databases (PubMed, Embase, Cochrane Library, and Scopus) and reference lists of relevant articles to find articles published from 2015 to 2022. The time to normalization of the platelet count of the group caplacizumab is shorter than the group placebo (SMD = −0.72; 95% CI −0.88 to −0.56; P < 0.05). Caplacizumab reduced the incidence of mortality (OR = 0.41; 95% CI 0.18–0.92; P < 0.05), exacerbations (OR = 0.10; 95% CI 0.05–0.18; P < 0.05), and recurrence (OR = 0.17; 95% CI 0.06–0.50; P < 0.05). However, the bleeding events in the caplacizumab group were higher than those in the placebo group, especially severe bleeding events. There was no difference in ADAMTS13 activity and thromboembolic events between the two groups. Our analysis indicated that caplacizumab is effective and well tolerated for the treatment of iTTP.

SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42022362370.
Beyond one-size-fits-all in cardiogenic shock: impella, extracorporeal membrane oxygenation or tailored use of mechanical circulatory support?
Authors: Rob Daniel , Belohlavek Jan 
Published: June 2024

Purpose of review
This article offers an overview of recent randomized controlled trials (RCTs) testing the efficacy of veno-arterial extracorporeal membrane oxygenation (VA ECMO) and microaxial flow pump (mAFP) in treating cardiogenic shock, including findings from the DanGer shock trial. It summarizes the clinical implications and limitations of these studies and key decision-making considerations for cardiogenic shock device use.

Recent findings
Despite important limitations in all published RCTs, the routine use of VA ECMO for acute myocardial infarction related cardiogenic shock did not demonstrate benefit and should be reserved for selected patients with extreme forms of cardiogenic shock. Conversely, mAFP (Impella CP) appears promising for cardiogenic shock due to ST elevation myocardial infarction. A stepwise approach – initial mAFP use for cardiogenic shock with left ventricular failure, supplemented by VA ECMO if mAFP is inadequate or if severe right ventricular failure is present – may be preferable, but requires validation through RCTs. High complication rates in device arms underscore the need for careful patient selection, preventive strategies, education for centers and operators, and further research.

Summary
Recent trials offer insights into mechanical circulatory support in cardiogenic shock, but their real-world applicability is limited. Despite potential benefits, the use of VA ECMO and mAFP is associated with significant complication rates, emphasizing the need for personalized use.
Unveiling factors influencing the duration of arbitration practice in the Tanzania construction industry
Authors: Luvara Valentine George Mruma , Benjamin Moses 
Published: June 2024

PurposeMost construction projects are undertaken with the incentive of some form of profit which in business attracts disputes that key disputing parties intend to resolve through mechanisms such as arbitration as early as possible so that they may advance with other activities associated with the project. However, this intention is regularly unfulfilled, disappointing the parties with late arbitration resolution. This study, therefore, explored the duration influencing factors (DIFs) facing arbitration practice in the Tanzania construction industry.Design/methodology/approachA concurrent convergence mixed methods approach was used where a total of 12 DIFs were identified from the literature, and data were then collected from 39 construction arbitrators, 8 semi-structured interviews and 4 documentary reviews. Descriptive and inferential statistics were employed for quantitative data and directed content analysis for the qualitative data.FindingsResults show that contrary to most people’s convictions, delays in arbitration are regularly caused by the disputing parties rather than the arbitrating party or the authority. The study identified cooperation amongst the tribunal parties, poor accuracy and submission of documents and material evidences, late payment of arbitration fees, and skills, experience, reputation and profession of the arbitrator to be the most critical factors that cause late arbitration resolution.Originality/valueThe use of mixed methods concurrent triangulation convergence approach provides a unique contribution to knowledge by highlighting how the efficacy of arbitration in time performance could be further developed through understanding the critical factors that drive the proceedings duration in the Tanzania construction industry.
Study of hooked fiber in cotton yarn based on tracer fiber method
Authors: Chu Xiangting , Gao Jian , Zhang Hongdou , Lu Huiwen , Liu Xinjin , Su Xuzhong 
Published: June 2024

PurposeThrough the tracer fiber method, we strive to more accurately obtain the hook degree, straightening degree, percentage and other characteristic indexes. In order to intuitively represent the hook state from sliver to yarn, and feed back production information in combination with quality test.Design/methodology/approachTaking the cotton fiber as an example, the hooked fibers were studied by using the tracer fiber method. Tracer fibers were made from cotton-type viscose fibers. Tracer fibers and combed cotton fibers were uniformly mixed for many times and used to produce the card sliver, semi-drawn sliver, drawn sliver, roving and yarn. With the help of ZF-20D ultraviolet analyzer, geometric parameters of hooked fibers were measured, and characterization indexes were calculated. And hook indexes and quality indexes were compared.FindingsBy redefining and reclassifying hooked fibers, the change of hooked fibers in the process was tracked and characterized carefully. Some hooks in card sliver are straightened but not eliminated, and will form longer zero-angled hooks in the subsequent process. The straightening degree and number of zero-angled hooks affect the evenness CV mainly.Originality/valueThe characterization of hooked fibers is important for reducing hooked fibers and spinning high quality yarns. There is no uniform standard for the characterization of hooked fibers at present. Most studies are about relationship between process and hook in carding and drawing. There is no research on hooked fibers in the whole spinning process. In the paper, hooked fibers were redefined and reclassified, the change of hooked fibers in the process was tracked and characterized carefully.
Thriving in diversity: the role of inclusive leadership and workplace inclusion in enhancing satisfaction with life among Indian IT employees
Authors: Jha Indu Nath , Pal Durba , Sarkar Subhadip 
Published: June 2024

Purpose In the dynamic landscape of the modern business world, the pursuit of employee well-being and satisfaction with life (SWL) has gained prominence. Yet, few studies exist on SWL among Indian working professionals. This study aims to investigate the impact of inclusive leadership (IL) on the employees’ SWL. Moreover, employing a mediation approach, the study also reveals the mediating role of workplace inclusion (WI) and career satisfaction (CS) in the relationship between IL and SWL.Design/methodology/approach The study involves a cross-sectional quantitative approach, drawing upon a sample of 279 professionals belonging to the Indian IT sector by administering standardized questionnaires. Data were analyzed using PLS through SmartPLS4.0 software.Findings The findings reveal a fully complementary mediating role of WI and CS in the IL–SWL relationship, supporting the hypothesized mediation model.Research limitations/implications This finding implies that leaders, with their inclusive behavior, can significantly influence employees’ SWL when accompanied by a sense of inclusiveness and CS among employees. The study offers valuable insights for organizations and leaders seeking to enhance employee satisfaction in the IT sector, emphasizing the significance of career-focused and inclusive practices in the workplace through leadership to promote a fulfilling workplace.Originality/value This study represents a pioneering effort to integrate the relationship between IL and SWL within the Indian context, going beyond the existing literature on WI and SWL. Additionally, the research model explores the influence of WI and CS in the IL–SWL relationship, a novel approach that has not been previously investigated.