bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pathological response to neoadjuvant chemoradiotherapy for oesophageal squamous cell carcinoma in Eastern versus Western countries: meta-analysis
Authors: Gao Xing , Overtoom Hidde C G , Eyck Ben M , Huang Shi-Han , Nieboer Daan , van der Sluis Pieter C , Lagarde Sjoerd M , Wijnhoven Bas P L , Chao Yin-Kai , van Lanschot Jan J B 
Published: May 2024

Abstract

Objective
Locally advanced oesophageal squamous cell carcinoma can be treated with neoadjuvant chemoradiotherapy or chemotherapy followed by oesophagectomy. Discrepancies in pathological response rates have been reported between studies from Eastern versus Western countries. The aim of this study was to compare the pathological response to neoadjuvant chemoradiotherapy in Eastern versus Western countries.

Methods
Databases were searched until November 2022 for studies reporting pCR rates after neoadjuvant chemoradiotherapy for oesophageal squamous cell carcinoma. Multi-level meta-analyses were performed to pool pCR rates separately for cohorts from studies performed in centres in the Sinosphere (East) or in Europe and the Anglosphere (West).

Results
For neoadjuvant chemoradiotherapy, 51 Eastern cohorts (5636 patients) and 20 Western cohorts (3039 patients) were included. Studies from Eastern countries included more men, younger patients, more proximal tumours, and more cT4 and cN+ disease. Patients in the West were more often treated with high-dose radiotherapy, whereas patients in the East were more often treated with a platinum + fluoropyrimidine regimen. The pooled pCR rate after neoadjuvant chemoradiotherapy was 31.7% (95% c.i. 29.5% to 34.1%) in Eastern cohorts versus 40.4% (95% c.i. 35.0% to 45.9%) in Western cohorts (fixed-effect P = 0.003). For cohorts with similar cTNM stages, pooled pCR rates for the East and the West were 32.5% and 41.9% respectively (fixed-effect P = 0.003).

Conclusion
The pathological response to neoadjuvant chemoradiotherapy is less favourable in patients treated in Eastern countries compared with Western countries. Despite efforts to investigate accounting factors, the discrepancy in pCR rate cannot be entirely explained by differences in patient, tumour, or treatment characteristics.
Optimal scheduling of flexible grid-side resources and auxiliary service cost allocation model considering renewable-energy penetration
Authors: Bai Bin , Xiao Yanli , Zhao Rui , Ju Xin , Liu Shangke 
Published: May 2024

Abstract
Renewable energy has penetrated power grid enterprises on a large scale. Due to the intermittency and volatility of renewable energy generation, it is necessary to build new flexible grid-side resources to ensure the safe and stable operation of the power grid, which will cause great pressure on cost allocation for power grid enterprises. This article considers four types of flexible grid-side resources and constructs a dual-level configuration optimization model for flexible grid-side resources under the penetration of renewable energy. Based on the configuration results, the cost scale of flexible grid-side resources is estimated and an improved ancillary service cost allocation model based on the Shapley value method is proposed to smooth the allocation of ancillary service costs in the cost of flexible grid-side resources between the two main bodies of renewable energy and load. The calculation results show that, when the penetration rate of renewable-energy power is 30% and 35%, respectively, the cost of flexible grid-side resources is 9.606 billion yuan and 21.518 billion yuan, respectively. The proportion of ancillary service costs allocated to load is relatively high—about five times that of the ancillary service costs allocated to renewable energy—and the higher the penetration rate of renewable energy, the higher the proportion of ancillary service costs allocated to renewable energy.
Associations Between Antiretroviral Regimen and Changes in Blood Pressure: Results From the D2EFT Study
Authors: Nyein Phyo Pyae , Petoumenos Kathy , Borok Margaret , Eriobu Nnakelu , Kumarasamy Nagalingeswaran , Avihingsanon Anchalee , Azwa Iskandar , Dao Sounkalo , Cisse Mohamed , Dharan Nila J , Hanson Josh , Matthews Gail V 
Published: May 2024

Abstract
In this randomized controlled study, individuals taking dolutegravir+darunavir/ritonavir had greater increases in systolic and diastolic blood pressure than those taking 2 nucleoside reverse-transcriptase inhibitors+darunavir/ritonavir at week-48. The difference remained significant after controlling for confounding factors, including weight gain.
Levels of high-sensitive troponin T and mid-regional pro-adrenomedullin after COVID-19 vaccination
Authors: Mockel M , Pudasaini S , Le N H , Huscher D , Holert F , Kurth F , Lau P T , Hillus D , Sander L E 
Published: May 2024

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Federal Ministry of Education and Research.

Background/Introduction
To increase vaccine safety, adverse events of COVID-19 vaccines are continuously monitored. This also includes rare complications of the cardiovascular system. However, it has so far been scarcely investigated whether chronic and subtle, clinically inapparent myocardial and/or vascular injury occurs in a COVID-19 vaccinated population on a broader basis.

Purpose
The aim of this study was to analyse chronic and subclinical adverse effects of COVID-19 vaccines on the cardiovascular system. Vaccine-associated myocardial involvement was examined by measuring high-sensitive troponin T (hsTnT) while mid-regional pro-adrenomedullin (MR-proADM) levels were evaluated to assess endothelial dysfunction.

Methods
This was a prospective observational study with a vulnerable population of healthcare workers (HCWs) and elderly (&gt; 70 years) patients who were vaccinated with either the ChAdOx1 nCov-19 adenoviral vector vaccine (AZ) and the BNT162b2 mRNA vaccine (BNT), or with BNT/BNT between the 12th of January and 30th of November 2021 (Figure 1). HsTnT and MR-proADM was measured in blood samples at three visits (V1: 1st baseline, immediately before vaccination; V2: 3-4 weeks after 1st vaccination; V3: 3-4 weeks after 2nd vaccination). HsTnT levels were further compared with a healthy reference cohort.

Results
120 participants were included (V1=119, V2=120, V3=120). 50 (41.7%) received AZ/BNT. 70 (58.3%) were vaccinated with BNT/BNT of whom 20 (16.7%) were elderly and 50 (41.7%) were HCWs. Median hsTnT levels were at 4ng/L, 5ng/L and 4ng/L (V1-V3) for AZ/BNT and at 6ng/L, 6ng/L and 6ng/L (V1-V3) for BNT/BNT, respectively (Figure 2). Levels of MR-proADM were 0.43nmol/L, 0.46nmol/L and 0.44nmol/L (V1-V3) in the AZ/BNT cohort and 0.49nmol/L, 0.43nmol/L and 0.49nmol/L in the BNT/BNT group. Change of hsTnT and MR-proADM values between visits did not show significant increases. Two cases had a transient (7ng/L, 19ng/L, 5ng/L; male, 29 years) or permanent (15ng/L, 21ng/L, 25ng/L; male, 37 years) increase in hsTnT levels, exceeding the upper reference limit (≥ 14ng/L). Compared to the reference population (n=300), median hsTnT was significantly higher at all visits for both vaccination groups (p&lt;0.05), without significant differences between the AZ/BNT and BNT/BNT cohorts.

Conclusion(s)
With two individual exceptions, no overall chronic myocardial injury or endothelial involvement was observed up to 4 weeks after the 2nd SARS-CoV-2 vaccination when comparing hsTnT and MR-proADM after both vaccinations to baseline values.Figure 1Vaccination scheme.Figure 2.hsTnT values at V1-V3.
Predicting survival with scales for in-hospital extracorporeal cardiopulmonary resuscitation
Authors: Alonso Fernandez De Gatta M , Hernandez Martos A V , Diego Nieto A , Gonzalez Cebrian M , Toranzo Nieto I , Barrio Rodriguez A , Gonzalez Calle D , Merchan Gomez S , Martin Herrero F , Sanchez P L 
Published: May 2024

Abstract

Funding Acknowledgements
None.

Background
Extracorporeal cardiopulmonary resuscitation (ECPR) is a rescue option in cardiac arrest (CA) refractory to advanced life support. Patient selection is challenging, and anecdotal scores are specific to this situation.

Purpose
Our objective was to analyse the usefulness of different scales used in shock and venoarterial extracorporeal membrane oxygenator (VA-ECMO) support in in-hospital ECPR.

Methods
Retrospective analysis of consecutive ECPR cases in a referal center. The ECPR alert includes in-hospital cardiologist/intensivist, on-call interventional cardiologist/cardiac surgeon for cannulation, and on-call perfusionist. We analysed hospital survival based on our own and other literature-based mortality scales calculated prior to VA-ECMO implantation: SCAI, INTERMACS, CardShock, CSS, SAVE-ECMO, RESCUE-IHCA.

Results
Out of 222 VA-ECMO implanted, we included 66 ECPR cases between 2014-oct 2023. Baseline, admission and ECPR characteristics are collected in the table.
Overall in-hospital survival was 16.7% (n=11) (cerebral performance cathegory 1-2).
We developed a sumative mortality scale including factors related to survival in our population and the literature (lactate &gt;10.05, &gt;60 minutes CA, peripheral arterial disease (PAD), and on-call time for ECPR alert activation) (figure A). This scale was significantly related to survival to discharge (figure A).
Regarding the scales and their association with survival, only RESCUE-IHCA showed a trend towards statistical significance (16 [15] points in survivors vs 19 [15] in died patients, p=0.096). The remaining scores showed no relationship with survival to discharge: SAVE-ECMO -15,73±4.8 in survivors vs -14,07±4.1 in died patients (p= 0.301), CSS 10,09±1.9 vs 10.40±2.7 (p=0.651), CardShock 4.82±1.3 vs 5.27±1.2 (p=0.287). INTERMACS (all patients 1) and SCAI classification (all patients stage E) are not valid for discriminating survival in this situation.
We compared the scales using the ROC curve for hospital survival, and we found that our own scale had the best discriminatory ability (Figure B).

Conclusions
Scales developed for shock or VA-ECMO support were not significantly related to survival in patients undergoing in-hospital ECPR. The specific ECPR scale RESCUE-IHCA, and our own scale developed in this population showed better discriminatory ability in survival to discharge.Table.Baseline, admission and ECPRFigure.A: Own scale. B: ROC curves
Current post-resuscitation management of out-of-hospital cardiac arrest patients admitted to intensive cardiovascular care units
Authors: Andrea Riba R , Loma-Osorio P , Sanz-Girgas E , Garcia-Garcia C , Soriano T , Sionis A , Llao I , Pastor P , Izquierdo-Ribas M , Moreno E , Roca-Guerrero C , Lopez-Sobrino T , Ortiz-Perez J T , Freixa X , De Diego O 
Published: May 2024

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Consell Català de Resucitació 2022.

Background
Out-of-hospital cardiac arrest (OHCA) accounts the 50% of cardiovascular deaths. Neuroprognostication must be done in a multimodal approach as recommended by ILCOR guidelines but its application in real life is challenging.

Aim
To investigate current post-resuscitation care and neurological prognostication of OHCA patients admitted to a mediterranean Intensive Cardiac Care Unit (ICCU) during the 2020s.

Methods
PCR-Cat was a prospective observational multicenter registry. OHCA patients admitted to the ICCU of 8 catalan hospitals were included from October/2020 to December/2021. Post-OHCA management in the ICCU was analyzed including neuroprognostication tools and targeted temperature management (TTM) approach. Patients were classified into 2 groups according to main outcome at 6-month follow-up: good (CPC 1-2, GO) or poor outcome (death or CPC 3-4, PO).

Results
288 patients were included, mean age 61.45 ± 13.76 and only 17.36% were female. GO at 6-month follow-up occurred in 48.95% of patients. Total medium time until ROSC was 28 min and first rhythm was shockable in 80%. An emergent coronary angiography was done in 68.9% and during any moment of the hospitalization in 83.5% (PCI 56.5%). There was no association between the presence and type of significant coronary artery disease and the main outcome. TTM was applied in 65.33% and the target temperature was 33ºC in 71.76%, 34ºC in 3.53%, 35ºC in 2.35% and 36ºC in 22.35%, with no statistically significant differences between the GO and PO groups. The neuronal specific enolase (NSE) was determined in 57 % of patients at 24 hours, 45% at 48h and 57% at 72 h. Myoclonus were statistically significant more frequent in patients with PO (51.20% vs. 7.52%, p&lt;0.001). Almost one electroencephalogram was performed in 60.4% of patients, somato-sensorial evoked potentials in 53.01%, a cerebral computed tomography in 57.75% and a cerebral magnetic resonance imaging in 19.38%. As expected, an abnormal result of all those neurological tests, when performed, were related to poor outcome (Table 1). In-hospital mortality was 46%. Main cause of death was neurological in 72.90%. The percentage of CPC 1-2 increased throughout the follow-up period (Figure 1).

Conclusions
Although ILCOR guidelines clearly indicate the use of a multimodal approach for neuroprognostication, in real-life setting, the conventional tests for neurological evaluation are used in a differently in every center, depending on their expertise and facility of resources.Figure 1
Intra-abdominal hypertension in acute decompensated heart failure - an overlooked piece in the puzzle of diuretic resistance
Authors: Lagosz P , Biegus J , Zymlinski R 
Published: May 2024

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Wroclaw Medical University, Insitute of Heart Diseases, Wroclaw, Poland.

Introduction
Intra-abdominal pressure (IAP) is a frequently overlooked aspect in clinical assessment which can have a significant impact on organ dysfunction in patients with acute decompensated heart failure (ADHF).

Purpose
To investigate prevalence and dynamics of IAP in patients with ADHF and its impact on diuretic response.

Methods
30 patients admitted for ADHF, class III or IV in New York Heart Association classification were enrolled into a prospective, observational pilot study. In every individual serial transurethral IAP measurements, blood and urine samples were taken upon admission, on the second and the third day of hospitalization.

Results
The study showed 63.3% prevalence of intra-abdominal hypertension (IAH) defined as IAP ≥ 12 mmHg upon admission, while only roughly 13% presented overt signs of abdominal congestion. Patients diagnosed with IAH upon admission had significantly poorer diuresis in the first day of hospitalization, despite receiving similar doses of loop diuretics (p = 0.038). Moreover, IAP was negatively correlated with urine output (p = 0.011) and positively correlated with urine osmolality (p = 0.033), while there was no relationship between IAP and natriuresis. There was a significant reduction of IAP among patients with IAH treated according to the European Society of Cardiology guidelines.

Conclusions
The investigation revealed an exepctionally high prevalence of elevated IAP among patients hospitalized for ADHF and highlights the limitations of physical examination in assessing abdominal congestion, as most patients remain asymptomatic. The observed poorer diuresis in patients diagnosed with IAH and the established association between IAP and the reduced urinary output, despite achieving target levels of natriuresis, add another piece to the puzzle of understanding the phenomenon of diuretic resistance in ADHF and set directions for future studies.
Coronary manual thrombectomy - a 12-year single centre experience
Authors: Rocha De Almeida A , Carias De Sousa M , Neves D , Congo K , Patricio L 
Published: May 2024

Abstract

Funding Acknowledgements
None.

Background/Introduction
Coronary manual thrombectomy is not routinely recommended, due to the risk of stroke, as supported by some dedicated clinical trials. It is, however, a simple and delicate technique that gives the opportunity to improve angioplasty results by decreasing thrombus burden and potentially improving stent apposition and decreasing no-reflow phenomenon, protecting coronary microcirculation.

Purpose
To describe a single-centre experience on coronary manual thrombectomy, regarding clinical context, anatomic/technical features, procedure success and in-hospital occurrence of stroke.

Methods
Retrospective study of procedures in which coronary manual thrombectomy was performed from 2009 to 2021. Procedure and patient characteristics were analyzed and related with hospital records of new stroke diagnosis.

Results
Manual thrombectommy was performed on 1136 procedures, in 1111 patients (77% male). As expected, the vast majority of cases were acute coronary syndromes: STEMI (1031 cases; 90,8%) and NSTEMI (78; 6,9%). The device used was predominantly 6F (81,7%). Most frequent reference diameters were 3,0mm (529; 46,6%) and 3,5mm (244; 21,5%). The vessel was initially completely occluded in about two thirds of the cases (747; 65,8%) and the left anterior descending artery was the most frequent culprit (541; 47,7%), followed by the right coronary (386; 33,9%). Revascularization was considered completely successful in 1017 (89,5%) of cases. There were no cases of new stroke diagnosis during admission in these patients.

Conclusions
Coronary manual thrombectomy should not be routinely performed, as recommended by international guidelines. However, fear of stroke should not hamper its use whenever the benefits seem clear, such as the presence of a flow-limiting thrombus in a culprit artery, with a retrievable size and good catheter engagement of the coronary artery. In this relatively large sample, we report a good single centre experience with this technique, with no clinical stroke occurrence during admission.
Differences in mortality between patients with cardiogenic shock due to STEMI treated with PCI vs thrombolysis
Authors: Fonseca Robles R , Gopar Nieto R , Arias Mendoza M , Gonzalez Pacheco H , Loaisiga Saenz A , Araiza Garaygordobil D , Sierra Lara Martinez J , Mendoza Garcia S , Arzate Ramirez A , Altamirano Castillo A , Briseno De La Cruz J , Baeza Herrera L , Montanez Orozco A , Diaz Herrera B , Tovar Jimenez A 
Published: May 2024

Abstract

Funding Acknowledgements
None.

Introduction
STEMI is complicated with cardiogenic shock (CS) in approximately 5-10% of cases and mortality is about 40% at 30-day and 50% at 1 year worldwide. In Mexico the incidence of CS in STEMI that received revascularization therapy (PCI or thrombolysis) is between 4.4-4.8%. In our country, pharmacoinvasive strategy (PIs) is the preferred modality due to the lack of PCI centers and demographics.

Purpose
To demonstrate differences in total ischemia time and 30-day in-hospital mortality in patients treated with PIs or PCI.

Methods
This was a retrospective observational study of patients that arrived to the emergency room and coronary care unit of the National Institute of Cardiology from January 2018 to March 2023 with CS due to STEMI at presentation, who received reperfusion therapy (PCI or PIs) during the first 12 hours of symptom onset.

Results
We included 61 patients with CS due to STEMI at presentation, 60.7% received PIs and 39.3% underwent PCI. The prevalence of type 2 diabetes was 38%, hypertension was 28% and obesity was 10% with no significant differences between groups, however the presence of CKD differed significantly with approximately 3% in PCI group versus 0% in PIs group. 21% were smokers and 13% previous smokers. Only 8 patients (13.1%) had a previous MI, 5 patients (8.2%) had previous angioplasty and 4 patients (6.6%) had previous HF.
The first medical contact (FMC) occurred at a median of 120 minutes (IQR 75-240 min) overall. For patients undergoing PIs, the FMC was 120 minutes (IQR 70-185 min), whereas for those undergoing PCI, it was 185 minutes (IQR 87-300 min). The total ischemia time was 270 minutes (IQR 180-470 min) overall, with a median of 229 minutes (IQR 163-405 min) for PIs and 396 minutes (IQR 267-592 min) for PCI. The 30-day in-hospital mortality rate was 27.9% overall, significantly lower at 18.9% in the PIs group compared to 41.7% in the PCI group (p=0.01). The average length of hospital stay was 8 days for the PIs population, slightly longer than the 6.5 days observed in the PCI group (p=0.09).

Conclusion
In this real-world retrospective analysis conducted in our center in a middle-income country showed that PIs impacted positively in 30-day in-hospital mortality of patients who arrived with CS due to STEMI at presentation compared to those that underwent PCI. This effect seems to be secondary to shorter ischemic times since symptom onset due to the use of a prompt reperfusion therapy.
Gender differences in KAsH score in acute myocardial infarction
Authors: Paula S , Figueiredo M , Santos M , Almeida S , Almeida L 
Published: May 2024

Abstract

Funding Acknowledgements
None.

Introduction
Risk stratification at admission in patients with myocardial infarction (MI) is crucial in the prognosis assessment. KAsH score is a useful and simple tool to predict in-hospital mortality.

Objective
To evaluate KAsH score predictive power according to gender in patients (P) who suffered MI (either STEMI or NSTEMI)

Methods
Based on a single-center retrospective study, data collected from P admitted in the Cardiology department with MI between 2016 and 2019. P without or uncompleted data were excluded. We compared 2 groups: Group 1 (G1) – male patients; Group 2 (G2) – female patients. Major adverse cardiac events (MACE) were defined as the composite of nonfatal stroke, nonfatal myocardial infarction and cardiovascular death. Statistical analysis used T test, chi-square, logistic regression and ROC curve analysis.

Results
Among the 611 P admitted with MI mean age was 66.6±12.7 years old and 64.8% were male. G1 was younger (64.7 ±12.8 years vs 64.7±12.8, p&lt;0.001). The groups were similar regarding the other variables that compose the KAsH score, namely Killip-Kimbal class (p=0.668), systolic blood pressure (p=0.378), and heart rate (p=0.265). The mean KAsH categorization was 1.48 for G1 and 1.54 for G2 (p=0.05). The groups were also similar regarding other (CV) factors namely arterial hypertension, diabetes mellitus, dyslipidaemia, smoking and previous MI. In general, KAsH score was able to predict in-hospital mortality in our sample p=0.03, OR 2.45, CI 1.09-5.55 but with poor accuracy (AUC 0.355). However, the score did not predict 1 year mortality (p=0.337) or 1 year readmission (p=0.943). Regarding the groups, KAsH score did not predict in-hospital mortality for G1 (p=0.465) but it did predict the occurrence of MACE events, p=0.01, OR 2.20, CI 1.20-4.09, AUC 0.634.
Considering G2 KAsH score predicted in-hospital mortality p=0.02, OR 4.10, CI 1.24-13.87 but with poor accuracy (AUC 0.211). It also predicted the occurrence of MACE events p=0.001, OR 4.61, CI 1.83-11.63 with fair accuracy (AUC 0.77). Such as in G1 the score did not predict 1 year mortality or readmission (p=0.178)

Conclusion
In our center, KAsH score performed better in female patients in predicting in-hospital mortality and MACE events. The score also predicted MACE events in male patients, but did not predict in-hospital mortality. More studies are needed to validate additional variables to the score and to validate KAsH score as a long-term prognostic tool.