bluuebunny/crossref_metadata_2025_split huggingface dataset:
The importance of scar border zone size in VT presentation and recurrence in post MI patients
Authors: Rademaker R , De Riva Silva M , Piers S R D , Wijnmaalen A P , Zeppenfeld K 
Published: May 2024

Abstract

Introduction
Available mapping data in post-myocardial infarction patients describe ventricular tachycardia (VT) re-entry circuit characteristics of slow VT, that are typically related to transmural scars. Fast VTs with cycle lengths close to the refractory period may be related to functional re-entry in the scar border zone. Functional re-entry related border zone VTs may be difficult to control by ablation.

Purpose
The aims of this study are (1) to describe electroanatomical voltage map (EAVM) characteristics in post myocardial infarction (MI) patients with spontaneous and inducible fast VTs and (2) to assess the relation between scar border zone size and ablation outcomes.

Methods
Consecutive post-MI patients undergoing VT ablation at a tertiary referral center from January 2012 to November 2018 were included. Fast VT was defined as a VT cycle length (VTCL) = ventricular refractory period + max. 30ms. Areas of scar border zone (using 0.5 – 2.1mV/3.0mV cut-offs (according to LV remodeling stage; LVEF&lt;47% and LV end-systolic volume index of &gt;50 ml/m2)) were measured on the EAVM and correlated with clinical outcomes.

Results
In total, 138 patients were included (86% male; left ventricular ejection fraction 35±10%; 86% remodeled LV). Twenty-three patients (17%) had ≥1 fast VT (mean VTCL 275±52ms) at presentation, mean VTCL of the remaining patients 397±88ms). The median scar border zone size was 27% [IQR 20-38] of the left ventricular endocardial surface. Patients who presented with a spontaneous fast VT had a larger border zone than patients with slower VT (32% [IQR 28 – 41] vs. 25% [IQR 16 – 36], p=0.01).
After ablation, 79 (57%) patients remained inducible for any VT, including 59/79 (75%) for a fast VT (median VTCL fast VT 260ms [IQR 236 -280]). Patients who remained inducible for fast VTs had a larger border zone than patients who remained inducible for slower VTs (35% [IQR 27 – 44] vs. 26% [IQR 20 – 36], p&lt;0.001).
During a median follow-up of 26 months [IQR 8 – 47], 45 patients (33%) had a VT recurrence (mean VTCL 357±98ms). Patients with a below median (27%) scar border zone area had a lower VT recurrence rate compared to patients with an above median scar border zone area (recurrence rate: 16/66 (24%) vs. 29/72 (40%), p=0.03). Kaplan-Meier survival analysis showed better free VT survival in the below median border zone patients (Log-rank: p&lt;0.05) (Figure 1).

Conclusion
Patients who present with spontaneous fast VTs or who remain inducible for fast VTs after ablation have larger scar border zones during EAVM compared to patients with presenting or remaining slower VTs. A larger border zone appeared to be associated with higher VT-recurrence rates. The scar border zone may play an important role as VT substrate for (fast) VTs and may not be easily targeted by current ablation techniques.VT-free survival stratified by median BZ
The effects of radiofrequency catheter ablation for atrial fibrillation on right ventricular function
Authors: Uhm J S , Kim M K , Park J W , Kim D , Yu H T , Kim T H , Joung B , Pak H N , Lee M H 
Published: May 2024

Abstract

Background
The effects of radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) on right ventricular (RV) function are not well known.

Methods
Patients who underwent RFCA for AF and underwent pre- and post-procedural echocardiography were enrolled. Fractional area change (FAC), RV free-wall longitudinal strain (RVFWSL), and RV 4-chamber strain (RV4CSL) were measured. Changes in FAC, RVFWSL, and RV4CSL before and after RFCA were compared among paroxysmal (PAF), persistent (PeAF), and long-standing persistent AF (LSPeAF) groups.

Results
A total of 164 participants (74 PAF, 47 PeAF, and 43 LSPeAF; age, 60.8±9.8 years; men, 74.4%) was enrolled. The patients with PeAF and LSPeAF had worse RV4CSL (p&lt;0.001) and RVFWSL (p&lt;0.001) than those with PAF and reference values. Improvements in RVFWSL and RV4CSL after RFCA were significant in the PeAF group compared with the PAF and LSPeAF groups (ΔRV4CSL, 8.4% [5.1–11.6] in PeAF vs. 1.0% [-1.0–4.1] in PAF, 1.9% [-0.2–4.4] in LSPeAF, p&lt;0.001; ΔRVFWSL, 9.0% [6.9–11.5] in PeAF vs. 0.9% [-1.4–4.9] in PAF, 1.0% [-1.0–3.6] in LSPeAF, p&lt;0.001).

Conclusions
RV function is impaired in patients with PeAF and LSPeAF than in those with PAF. RV function is more improved after RFCA in patients with PeAF than in those with PAF or LSPeAF.Changes of echocardiographic parameters
Low-dose dexmedetomidine sedation in patients undergoing electrophysiological study and ablation of supraventricular tachycardias in a same day setting
Authors: De Santis N , Vrenozaj R , Crocamo A , Bearzot L , Guidorossi A , Niccoli G , Ardissino D , Notarangelo M F 
Published: May 2024

Abstract

Background
Catheter ablation for supraventricular tachycardias (SVT) can frequently cause patient discomfort, anxiety or pain. Through the years different drugs have been employed to provide an optimal sedation without interfere with inducibility of tachyarrhythmia. Moreover, the increasing number of patients with this clinical condition and the growing demand of catheter ablation, makes same day discharge mandatory. For this purpose, drugs that guarantee minimal sedation and reduce adverse events should be used. Dexedetomidine (DEX) is a selective alpha-2 agonist with analgesic and sedating effect without significant respiratory depression. Its electrophysiological effects include the sinus node and atrioventricular (AV) node depression and an increased atrial refractoriness. Albeit there is a reduction of side effects of most commonly used sedation drugs, data on the efficacy and safety profile of DEX during SVT ablation of adult patients are unclear and conflicting.

Purpose
The aim of this study was to assess whether optimal sedation and patient’s comfort can be achieved with a low-dose DEX without interfering with electrophysiological parameters during catheter ablation of SVT in adult population.

Methods
This is a single-center prospective study. Study population consisted of patients undergoing mapping and catheter ablation of SVT from January to September 2023 divided into DEX group (periprocedural infusion of Dexedetomidine 0.07-0.11 mcg/kg/h without loading dose) and non-DEX group (midazolam 1-2 mg periprocedural). Clinical and procedural data were recorded for all patients, as well as all measurements taken during electrophysiological study.

Results
The study population was predominantly female (60%) with a mean age of 56 ± 13.7 years. Hypotension occurred in only one patient, in the DEX group. No cases of desaturation were observed in both groups. Most of the induced tachyarrhythmias were the slow-fast type of atrioventricular nodal reentrant tachycardia (75%), whereas atrioventricular reentrant tachycardia and atrial tachycardia were less common (7.1% and 7.1%). No significant differences were recorded in relation to AV node refractoriness, atrial refractoriness, anterograde and retrograde conduction. (Table 1) Isoproterenol was required to induce tachyarrhythmia in both groups. Arrhythmia inducibility and aberrancy in tachycardia was not significantly influenced by DEX. The jump phenomenon was recorded more frequently in the DEX group (86.4% vs. 46.7%; p=0.004). The mean duration of the procedure did not differ between the two groups. All patients were discharged on the same day after 3 hours of observation.

Conclusions
The use of low-dose Dexedetomidine was succesful in improving periprocedural patient comfort, without reducing tachyarrhythmia inducibility or major electrophysiological parameters.
Risk of death and thromboembolic events in patients with supraventricular arrhythmias admitted to the emergency department
Authors: Bucci T , Proietti R , Lip G Y H 
Published: May 2024

Abstract

Background
Few data are available on the risk of death and thromboembolism in patients with supraventricular tachycardia (SVT).

Purpose
To assess the risk of adverse events in SVT patients admitted to the emergency department (ED).

Methods
Retrospective study utilizing a global federated health research network (TriNetX). Based on the ICD codes recorded at the ED admission, patients were categorized in: SVT (I41.1), atrial fibrillation (AF, I48.0,1,2,91), atrial flutter (I48.3,4,92), and a control group with palpitations (R00.2) without arrhythmias (CTRL). Primary outcome was the 1-year risk of a composite of all-cause death and thromboembolism (ischemic stroke, transient ischemic attack, and peripheral arterial embolism). Secondary outcomes were the 1-year risk of each component of the composite outcome. Cox-regression analysis was used to produce hazard ratios (HRs) and 95% confidence intervals (CI) after 1:1 propensity score matching (PSM). The exploratory analysis was performed to assess the risk of first episode of thromboembolism. Other sensitivity analyses were performed to validate the results of the main analysis in patients ≥65 years, with multimorbidity, and not on oral anticoagulation (OAC).

Results
We identified 37,793 SVT patients (58.5±19.2 years, 55.8% females), 239,490 AF patients (70±19.2 years, 47.3% females), 20,674 atrial flutter patients (68.6±15.1, 15.1% females), and 89,152 CTRL (43.5±17.8 years, 60.1% females). Before PSM, in SVT patients the mean age and the prevalence of cardiovascular risk factors was lower than AF and atrial flutter patients but higher than CTRL. After PSM, no difference was found among the three groups. After PSM, the risk of composite outcome in SVT patients was higher compared to CTRL (HR 2.80, 95%CI 2.61-3.00), similar to atrial flutter patients (HR 0.98, 95%CI 0.94-1.03), and a lower compared to AF patients (HR 0.85, 95%CI 0.82-0.88) (Figure 1). These results were consistent also for the secondary outcomes, for the risk of the first thromboembolic event (Figure 2), and in all the sensitivity analyses.

Conclusion
SVT patients have a risk of death and thromboembolism comparable to those with atrial flutter, but lower than AF. Further studies are needed to evaluate the possible beneficial effect of OAC in this clinical context.Figure 1Figure 2
Arrhythmic risk stratification in non-ischemic cardiomyopathy using cardiovascular magnetic resonance
Authors: Zegard A , Hammersley D , Androulakis E , Jones R , Okafor O , Mach L , Lota A , De Marvao A , Guha K , Tayal U , Pennell D , Halliday B , Qiu T , Prasad S , Leyva F 
Published: May 2024

Abstract

Background
Myocardial fibrosis (MF) is an essential component of the arrhythmic substrate for ventricular arrhythmias (VAs).

Aims
To determine whether total myocardial fibrosis (TF) and gray zone fibrosis (GZF), assessed using cardiovascular magnetic resonance, are better than LVEF in predicting ventricular arrhythmias in patients with non-ischemic cardiomyopathy (NICM).

Methods and results
Patients with NICM in a derivation cohort (n=866) and a validation cohort (n=848) underwent quantification of TF and GZF. The primary composite endpoint was sudden cardiac death (SCD) or VAs (ventricular fibrillation or sustained ventricular tachycardia). The primary endpoint was met by 52/866 (6.0%) patients in the derivation cohort (follow-up of 7.5 years [interquartile range, IQR] 5.2-9.3). In competing risk analyses, MF on visual assessment (MFVA) predicted the primary endpoint (hazard ratio [HR] 5.83, 95% confidence intervals [CI] 3.15-10.8). Quantified MF measures permitted categorization into 3 risk groups: a TF &gt;0 ≤ 10 g was associated with an intermediate risk (HR: 4.03 [95% CI 1.99-8.16]) and a TF &gt; 10g with the highest risk (HR: 9.17 [95% CI 4.64-18.1]) compared to no MFVA (lowest risk) (Figure). Similar trends were observed in the validation cohort. Categorization into 3 risk groups was achievable using TF or GZF in combination or in isolation. In contrast, LVEF&lt;35% was a poor predictor of the primary endpoint (validation cohort HR:1.99, 95% CI 0.99-0.41).

Conclusions
MFVA is a strong predictor of SCD and VAs in NICM. TF and GZF mass added incremental value to MFVA. In contrast, LVEF was not useful in arrhythmic risk stratification.
What Can IIAs Contribute to Regulating Cross-border Data Transfer: A Threshold Analysis
Authors: Zhang Qianwen 
Published: May 2024

Abstract
States are using legislation to regulate cross-border data transfer, which has raised new concerns that international investment agreements (IIAs) may be used to protect foreign investment. According to current IIA texts and arbitration practices, some data is likely to be regarded as ‘investment’, but indefinite data ownership and invisibility ‘in the territory’ make use traditional IIA structures to regulate cross-border data transfer uncertain. What IIAs can contribute to regulating cross-border data transfer has a significant impact on the protection of foreign investments. IIAs need to be reformed to keep their vitality in the face of the challenges brought by digital technology. As a response, they can clarify essential concepts, including when is data an ‘investment’ and who is the ‘investor’ that is entitled to bring claims. Considering the distinct data realms, IIA reform is more likely to be initiated through bilateral or regional negotiations among States with similar cultures or complementary interests.
Normal Completions of Toric Varieties Over Rank One Valuation Rings and Completions of Γ-Admissible Fans
Authors: Friedenberg Netanel 
Published: May 2024

Abstract
We show that any normal toric variety over a rank one valuation ring admits an equivariant open embedding in a normal toric variety which is proper over the valuation ring, after a base-change by a finite extension of valuation rings. If the value group $\Gamma $ is discrete or divisible then no base-change is needed. We give explicit examples that show that existing methods do not produce such normal equivariant completions. Our approach is combinatorial and proceeds by showing that $\Gamma $-admissible fans admit $\Gamma $-admissible completions. In order to show this we prove a combinatorial analog of Noetherian reduction, which we believe will be of independent interest.
Activity of ceftolozane/tazobactam and imipenem/relebactam against Gram-negative clinical isolates collected in Mexico—SMART 2017–2021
Authors: Karlowsky James A , Lob Sibylle H , Siddiqui Fakhar , Polis Thales , Vallejo Jose L , Young Katherine , Motyl Mary R , Sahm Daniel F 
Published: May 2024

Abstract

Objectives
To investigate the activities of ceftolozane/tazobactam and imipenem/relebactam against Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa isolated from hospitalized patients in Mexico in 2017–2021.

Methods
MICs were determined by CLSI broth microdilution and interpreted using CLSI M100 breakpoints. β-Lactamase genes were identified in ceftolozane/tazobactam-, imipenem/relebactam-, and/or imipenem-non-susceptible isolates.

Results
Ceftolozane/tazobactam and imipenem/relebactam inhibited 89% and 99% of E. coli isolates (n = 2337), and 87% and 94% of K. pneumoniae isolates (n = 1127). Sixty-four percent of E. coli and 47% of K. pneumoniae had an ESBL non-carbapenem-resistant Enterobacterales (ESBL non-CRE) phenotype. Eighty-six percent and 91% of ESBL non-CRE E. coli and K. pneumoniae were ceftolozane/tazobactam susceptible, and 99.9% and 99.8% were imipenem/relebactam susceptible. Ceftolozane/tazobactam was the most active agent studied against P. aeruginosa (n = 1068; 83% susceptible), 9–28 percentage points higher than carbapenems and comparator β-lactams excluding imipenem/relebactam (78% susceptible). Ceftolozane/tazobactam remained active against 35%–58%, and imipenem/relebactam against 32%–42%, of P. aeruginosa in meropenem-, piperacillin/tazobactam-, and cefepime-non-susceptible subsets. The majority of isolates of ceftolozane/tazobactam-non-susceptible E. coli carried an ESBL, whereas among ceftolozane/tazobactam-non-susceptible K. pneumoniae and P. aeruginosa, the majority carried carbapenemases. The most prevalent carbapenemase observed among E. coli (estimated at 0.7% of all isolates), K. pneumoniae (4.8%) and P. aeruginosa (10.0%) was an MBL. Almost all imipenem/relebactam-non-susceptible E. coli and K. pneumoniae carried MBL or OXA-48-like carbapenemases, whereas among imipenem/relebactam-non-susceptible P. aeruginosa, 56% carried MBL or GES carbapenemases.

Conclusions
Ceftolozane/tazobactam and imipenem/relebactam may provide treatment options for patients infected with β-lactam-non-susceptible Gram-negative bacilli, excluding isolates carrying an MBL- or OXA-48-like carbapenemase.
Natural language processing systems for extracting information from electronic health records about activities of daily living. A systematic review
Authors: Wieland-Jorna Yvonne , van Kooten Daan , Verheij Robert A , de Man Yvonne , Francke Anneke L , Oosterveld-Vlug Mariska G 
Published: May 2024

Abstract

Objective
Natural language processing (NLP) can enhance research on activities of daily living (ADL) by extracting structured information from unstructured electronic health records (EHRs) notes. This review aims to give insight into the state-of-the-art, usability, and performance of NLP systems to extract information on ADL from EHRs.

Materials and Methods
A systematic review was conducted based on searches in Pubmed, Embase, Cinahl, Web of Science, and Scopus. Studies published between 2017 and 2022 were selected based on predefined eligibility criteria.

Results
The review identified 22 studies. Most studies (65%) used NLP for classifying unstructured EHR data on 1 or 2 ADL. Deep learning, combined with a ruled-based method or machine learning, was the approach most commonly used. NLP systems varied widely in terms of the pre-processing and algorithms. Common performance evaluation methods were cross-validation and train/test datasets, with F1, precision, and sensitivity as the most frequently reported evaluation metrics. Most studies reported relativity high overall scores on the evaluation metrics.

Discussion
NLP systems are valuable for the extraction of unstructured EHR data on ADL. However, comparing the performance of NLP systems is difficult due to the diversity of the studies and challenges related to the dataset, including restricted access to EHR data, inadequate documentation, lack of granularity, and small datasets.

Conclusion
This systematic review indicates that NLP is promising for deriving information on ADL from unstructured EHR notes. However, what the best-performing NLP system is, depends on characteristics of the dataset, research question, and type of ADL.
The anti-suit injunctions in patent litigation in China: what role for judicial self-restraint?
Authors: Svetlicinii Alexandr , Xie Fali 
Published: May 2024

Abstract
Starting from 2020, the Chinese courts have actively participated in the jurisdictional battles for the standard essential patent (SEP) disputes, a pivotal development marked by the Supreme People’s Court’s inaugural SEP-related anti-suit injunction (ASI) in Huawei v Conversant. Subsequently, lower courts in China have emulated this approach by issuing ASIs targeting SEPs in the domain of information and communication technology. The present study highlights the features of the Chinese ‘act preservation measures’ by comparing them with the typical ASIs originally developed in the common law jurisdictions. This comparison reveals significant divergence in the factors considered by Chinese courts issuing ASIs, particularly in the context of cross-border patent litigation. The study aims at elucidating potential defenses that the respondents in SEP litigation may employ to contest the issuance of ASIs in Chinese judicial proceedings, with particular attention accorded to the principles of comity and public interest. The article concludes that the invocation of international comity and public interest in SEP litigation will encounter a formalistic assessment by the Chinese judiciary due to potential conflicts with statutory provisions and the lack of a more context-specific analysis. As a result, in the absence of supra-national mechanisms that would address the problem of parallel litigation, there appears to be little room for judicial self-restraint.
Risk factor analysis of vertebral fractures requiring surgery in patients with ankylosing spondylitis
Authors: Kai Kazuhiro , Fujiwara Toshifumi , Akasaki Yukio , Tsushima Hidetoshi , Hara Daisuke , Arisumi Shinkichi , Tsurui Ryosuke , Yasumoto Keitaro , Saiwai Hirokazu , Kawaguchi Kenichi , Yamada Hisakata , Nakashima Yasuharu 
Published: May 2024

ABSTRACT

Objectives
This study aimed to determine the risk factors for vertebral fractures requiring surgery in patients with ankylosing spondylitis (AS).

Methods
We included 60 patients with AS diagnosed by using the modified New York criteria and who were treated in our department from April 2004 to March 2019. We evaluated age, sex, disease duration, C-reactive protein, erythrocyte sedimentation rate, ankylosed sacroiliac joint, bamboo spine, number of ankylosed vertebrae, and treatment (nonsteroidal anti-inflammatory drugs, prednisolone, conventional synthetic disease-modifying antirheumatic drugs, biological disease-modifying antirheumatic drugs, and spine surgery for vertebral fracture) at the final follow-up of the nonsurgical group and the preoperative follow-up of the surgical group.

Results
At the final follow-up, the mean age was 49 years, 46 patients (75%) were male, and the mean disease duration was 27 years. Additionally, 8 (13.3%) and 43 patients (71%) underwent surgical and medical treatments, respectively. The group of surgery for vertebral fracture had significantly higher C-reactive protein levels, which was also significantly associated with vertebral fracture surgery by multivariate analysis.

Conclusions
C-reactive protein was identified as a risk factor for vertebral fractures requiring surgery. Control of systemic inflammation in patients with AS may reduce the risk of vertebral fractures requiring surgery.
Axion Detection with Quantum Hall Effect
Authors: Iwazaki Aiichi 
Published: May 2024

Abstract
Plateau–plateau transition in the integer quantum Hall effect is a phase transition between metal and insulator. The behavior describing how the width ΔB of the transition changes with temperature and frequency of radiations imposed has been explored extensively. It decreases with the decrease of temperature and frequency, but saturates at a critical temperature or frequency. We have recently discussed the effect of axion dark matter on the saturation. The axion generates radiations under a strong magnetic field in the experiment of the quantum Hall effect. The radiations play a similar role to that of radiations imposed externally. In this paper we discuss in detail how the width behaves in relation to temperature and frequency under the effect of axion dark matter. We show that the axion effect can be observable in low temperatures roughly below 100 mK. According to our detailed analysis of the saturation, we find that the critical frequency of saturation observed in the previous experiment strongly suggests axion mass ma = (0.95∼0.99) × 10−5 eV.