bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inverted left atrial appendage mimicking potential left atrial thrombus in an infant following cardiac surgery: a case report
Authors: Liaqath Ali Muhammad Najih , Bharucha Tara , Kaarne Markku , Hayes Nicholas 
Published: March 2024

AbstractBackgroundInverted left atrial appendage (iLAA) is an infrequent complication following cardiac surgery, seen both in children and adults. Following a recent encounter, this review article is aimed to remind the reader about its occurrence, clinical manifestations, differential diagnoses, and management options.Case summaryA 3-month-old baby underwent successful surgical repair of a large ventricular septal defect. Intraoperative epicardial echocardiogram at the end of the case demonstrated an unexpected left atrial mass, raising suspicion of a thrombus adjacent to the mitral valve. Urgent re-establishment of cardiopulmonary bypass and exploration of the left atrium did not reveal a thrombus, but this was subsequently identified as an iLAA. This completely resolved after manual external reduction of the appendage.DiscussionPublished literature is confined to case reports only, with most cases observed post-operatively, but some occurring spontaneously. Awareness of this unusual manifestation is particularly important in the intraoperative period as it can usually be addressed without the need for further cardiopulmonary bypass.
Pulmonary embolism with paradoxical embolization to right coronary artery in the presence of a large patent foramen ovale: a case report
Authors: Boberg Erik , Hedman Anders , Hollenberg Jacob 
Published: March 2024

Abstract

Background
Pulmonary embolism (PE) is the leading cause of in-hospital death and the third most frequent cause of cardiovascular death. The clinical presentation of PE is variable, and choosing the appropriate treatment for individual patients can be challenging.

Case summary
A 64-year-old man presented to hospital with acute chest pain, shortness of breath, and pulmonary oedema. Electrocardiogram revealed ST-elevation myocardial infarction. D-dimer was 18.8 mg/L fibrinogen equivalent units (FEU) (normal &lt;0.64), and troponin was 25 (normal 5–14 ng/L). After systemic thrombolysis, respiratory failure persisted, and the arterial blood gas showed PaO2 of 6.0 kPa (normal 10.5–13.5 kPa), with 100% oxygen delivery via high-flow nasal cannula. A computed tomography diagnosed bilateral lobar PE, and coronary angiogram showed multiple thrombus in the right coronary artery. A bubble study with thoracic echocardiogram revealed a large right–left inter-atrial shunt. The patient denied treatment with extracorporeal membrane oxygenation and surgical thrombectomy. With no access to percutaneous catheter-directed thrombectomy, the patient received three separate thrombolysis treatments followed by a continued infusion for 22 h. After 6 weeks in hospital, the patient was discharged to rehab.

Discussion
For a long time, PE has been largely seen as a medical disease. Intra-cardiac shunts such as patent foramen ovale can complicate thrombo-venous disease and introduce paradoxical shunts leading to arterial emboli and persistent hypoxaemia. Over recent years, modern percutaneous catheter-directed thrombectomy has been developed for both high-risk and intermediate to high-risk PEs. Thrombectomy might improve right ventricular function and haemodynamics, but there is lacking evidence from randomized trials on efficacy, safety, and long-term outcome.
An unusual case of recurrent haemoptysis after ablation for atrial fibrillation requiring pneumonectomy: a case report
Authors: Mattioni Giovanni , Orlandi Riccardo , Rubino Barbara , Garatti Andrea , Pastorino Ugo 
Published: March 2024

Abstract

Background
Pulmonary vein (PV) stenosis is a rare complication after catheter ablation for atrial fibrillation (AF). While there have been reported anecdotal cases of complete PV stenosis requiring pulmonary lobectomy, only one case of pneumonectomy has been documented so far.

Case summary
A 42-year-old man was referred to our Thoracic Surgery Unit for recurrent haemoptysis and exertional dyspnoea over the past 4 years and a recent finding of left PV occlusion. He suffered of relapsing AF that had almost five recurrences and that underwent a total of two percutaneous catheter ablations within a 7-year period. He also experienced a hospitalization for multifocal lobar pneumonia. Two attempts of percutaneous transluminal angioplasty (PTA) were unsuccessful. Due to the severity and the duration of PV occlusion, the previous PTA failure, the patient’s age, and his symptoms, a left pneumonectomy was performed. During the postoperative period, the patient experienced only mild anaemia effectively managed with blood transfusions. Five months after surgery, he has no recurrence of symptoms.

Discussion
When the PV stenosis is complete, PTA may face high failure and recurrence rates. In this setting, anatomical pulmonary resections may represent a valid option to allow symptom relief and resolution.
Secundum atrial septal defect closure in adults in the UK
Authors: English Kate M , Espuny-Pujol Ferran , Franklin Rodney C , Crowe Sonya , Pagel Christina 
Published: March 2024

Abstract

Aims
To examine determinants of access to treatment, outcomes, and hospital utilization in patients undergoing secundum atrial septal defect (ASD) closure in adulthood in England and Wales.

Methods and results
Large retrospective cohort study of all adult patients undergoing secundum ASD closures in England and Wales between 2000/01 and 2016/17. Data were from population-based official data sets covering congenital heart disease procedures, hospital episodes, and death registries. Out of 6541 index closures, 79.4% were transcatheter [median age 47 years, interquartile range (IQR) 34–61] and 20.6% were surgical (40 years, 28–52). The study cohort was predominantly female (66%), with socioethnic profile similar to the general population. Mortality in hospital was 0.2% and at 1 year 1.0% [95% confidence interval (CI) 0.8–1.2%]. Risk of death was lower for transcatheter repairs, adjusting for age, sex, year of procedure, comorbidities, and cardiac risk factors [in-hospital adjusted odds ratio 0.09, 95% CI 0.02–0.46; 1-year adjusted hazard ratio 0.5, 95% CI 0.3–0.9]. There was excess mortality 1 year after ASD closure compared with matched population data. Median (IQR) peri-procedural length of stay was 1.8 (1.4–2.5) and 7.3 (6.2–9.2) days for transcatheter and surgical closures, respectively. Hospital resource use for cardiac reasons started the year before repair (median two inpatient and two outpatient-only days) and decreased post-repair (zero inpatient and one outpatient days during the first 2 years).

Conclusion
This national study confirms that ASD closure in adults, by surgical or transcatheter methods, is provided independently of ethnic or socioeconomic differences, it is low (but not no) risk, and appears to reduce future cardiac hospitalization even in older ages.
Solitary fibrous tumours of the pleura: do we need a different perspective on malignancy?
Authors: Dörr Niels Michael , Krüger Marcus , Möller Miriam , Zinne Norman , Toennies Mario , Schega Olaf , Ritter Christoph , Decker Steffen , Hölsken Antje , Schütte Wolfgang , Biancosino Christian 
Published: March 2024

AbstractOBJECTIVESSolitary fibrous tumours of the pleura (SFTP) are historically considered to be benign soft tissue neoplasms. However, a clinical relevant number of these neoplasms have malignant histological features. The objective of this study was to evaluate the percentage of SFTP presenting unfavourable clinical behaviour in order to predict negative long-term outcome.METHODSA retrospective review of 74 patients treated at 4 hospitals between 1990 and 2013 was performed. The median follow-up was 10 years (range: 1–20 years). Risk of tumour recurrence and metastases (unfavourable clinical behaviour) with regard to histology using the Kaplan–Meier and Cox proportional hazards methods.RESULTSThe mean age was 61 years (SD 12.75 years). There were 31 male patients (58%) and 43 female patients (42%). Tumour size ranged from 1 to 30 cm (mean 9.09 cm; SD 6.22 cm). Complete resection (R0) was achieved by minimally invasive thoracoscopic resection in 29% and thoracotomy in 57%; 25% of SFTPs showed histological evidence of malignancy, according to England criteria. Recurrence occurred in 21% and 10% of patients had metastases; 83% of patients with metastases and 39% of patients with recurrence died within 5 years. The median recurrence-free survival for histologically benign SFTP was not reached, compared to 8 years for malignant SFTP. The five-year overall survival rate was 84%. Mitotic rate ≥1/10 HPF, high cellularity, nuclear atypia, Ki-67 level &gt;5% and poorly circumscribed (sessile) growth pattern were associated with poor long-term outcome.CONCLUSIONSPathological differentiation of SFTP morphology into pedunculated, well circumscribed and poorly circumscribed (sessile) growth pattern is recommended. Due to the misleading classification into histologically benign and malignant, all unpedunculated SFTP should be classified as potentially aggressive. Lifelong follow-up is mandatory.
Sex-dependent effect of socioeconomic status on cardiovascular event risk in a population-based cohort of patients with type 2 diabetes
Authors: Enguita-Germán Mónica , Tamayo Ibai , Librero Julián , Ballesteros-Domínguez Asier , Oscoz-Villanueva Ignacio , Galbete Arkaitz , Arnedo Laura , Cambra Koldo , Gorricho Javier , Moreno-Iribas Conchi , Millán-Ortuondo Eduardo , Ibáñez-Beroiz Berta 
Published: March 2024

Abstract

Background
Socioeconomic status (SES) factors often result in profound health inequalities among populations, and their impact may differ between sexes. The aim of this study was to estimate and compare the effect of socioeconomic status indicators on incident cardiovascular disease (CVD)-related events among males and females with type 2 diabetes (T2D).

Methods
A population-based cohort from a southern European region including 24,650 patients with T2D was followed for five years. The sex-specific associations between SES indicators and the first occurring CVD event were modeled using multivariate Fine-Gray competing risk models. Coronary Heart Disease (CHD) and stroke were considered secondary outcomes.

Results
Patients without a formal education had a significantly higher risk of CVD than those with a high school or university education, with adjusted hazard ratios (HRs) equal to 1.24 (95%CI: 1.09–1.41) for males and 1.50 (95%CI: 1.09–2.06) for females. Patients with &lt;18 000€ income had also higher CVD risk than those with ≥18 000€, with HRs equal to 1.44 (95%CI: 1.29–1.59) for males and 1.42 (95%CI: 1.26–1.60) for females. Being immigrant showed a HR equal to 0.81 (95%CI: 0.66–0.99) for males and 1.13 (95%CI: 0.68–1.87) for females. Similar results were observed for stroke, but differed for CHD when income is used, which had higher effect in females.

Conclusion
Socioeconomic inequalities in CVD outcomes are present among T2D patients, and their magnitude for educational attainment is sex-dependent, being higher in females, suggesting the need to consider them when designing tailored primary prevention and management strategies.
From Doughnut Economics to Doughnut Jurisprudence: A Human Rights Perspective
Authors: Buser Andreas 
Published: March 2024

Abstract
Earth system science indicates the existence of planetary boundaries. Several of these ecological limits have been transgressed, raising serious human rights concerns. Concurrently, persistent poverty and significant economic disparities continue to challenge societies and human rights law and scholarship. How to reform economies to respect planetary boundaries and at the same time address deprivation and socio-economic inequalities is the subject of a rich ‘degrowth’ literature. Surprisingly, this literature received minimal attention from human rights scholarship. Building upon Raworth’s influential concept of Doughnut Economics, this paper aims to bridge this gap by investigating whether human rights can encompass ecological limits (outer circle of the doughnut) and how these limits relate to social priorities embodied in human rights law (inner circle of the doughnut). To do so, the paper is structured along two sub-sections. The first section examines the relevance of core planetary boundaries, particularly biosphere integrity and climate change, within the context of human rights law. In the second section, the paper addresses the relationship between the inner and outer circle of doughnut economics from a human rights perspective. Drawing on critical literature, the article problematizes the ‘growth paradigm’ in human rights practice but also offers alternative readings. In this final part of the article, the author demonstrates how central doctrines of ESC rights, such as progressive realization and non-retrogression, could be interpreted in a way agnostic of economic growth.
Randomized comparison of oblique and perpendicular stabilizers for minimally invasive repair of pectus excavatum
Authors: Tedde Miguel L , De Carvalho Rafael Lucas Costa , De Campos Jose Ribas Milanez , Da Silva Diego Arley Gomes , Okumura Erica Mie , Guilherme Gustavo Falavigna , Marchesi Alana Cozzer , Petrizzo Paulla , Souto Maior Barbara Siqueira , Pego-Fernandes Paulo Manuel 
Published: March 2024

Abstract

OBJECTIVES
Bar dislocation is one of the most feared complications of the minimally invasive repair of pectus excavatum.

METHODS
Prospective randomized parallel-group clinical trial intending to assess whether oblique stabilizers can reduce bar displacement in comparison with regular stabilizers used in minimally invasive repair of pectus excavatum. Additionally, we evaluated pain, quality of life and other postoperative complications. Participants were randomly assigned to surgery with perpendicular (n = 16) or oblique stabilizers (n = 14) between October 2017 and September 2018 and followed for 3 years. Bar displacements were evaluated with the bar displacement index. Pain scores were evaluated through visual analogue scale and quality of life through the Pectus Excavatum Evaluation Questionnaire.

RESULTS
Control group average displacement index was 17.7 (±26.7) and intervention group average displacement index was 8.2 (±10.9). There was 1 reoperation in each group that required correction with 2 bars. Bar displacement was similar among groups (P = 0.12). No other complications were recorded. There was no statistically significant difference on pain score. There was a significant difference between pre- and postoperative composite scores of the participants’ body image domain and psycho-social aspects in both groups. The difference between the pre- and postoperative participants’ perception of physical difficulties was greater and statistically significant in the intervention group.

CONCLUSIONS
There was no statistical difference in the use of perpendicular or oblique stabilizers, but the availability of different models of stabilizers during the study suggested that this can be advantageous. The trial is registered at ClinicalTrials.gov, number NCT03087734.
Double-branched stent graft and four-stage deployment in total arch repair: safety and feasibility evaluation in porcine models
Authors: Wang Chenhao , Li Wenfan , Yang Peng , Lu Chen , Zhang Yu , Wang Haiyue , Xiao Zhenghua , Hu Jia 
Published: March 2024

Abstract

OBJECTIVES
The primary objective of this research was to evaluate the safety and feasibility of an innovative double-branched stent graft system employing four-stage deployment technology for aortic arch repair in porcine models.

METHODS
The double-branched stent graft system consisted of a proximal polyester artificial blood vessel, the main and double-branched stent grafts and a delivery system. We utilized 12 healthy pigs as experimental animals (6 per group). Postimplantation, samples were collected at 90 and 180 days after the operations. Preoperative and postoperative imaging and intraoperative arterial blood gas analyses were performed. After the pigs were euthanized, the implanted product, surrounding tissue and major organs were collected for pathological analysis.

RESULTS
The technical success rate of the stent graft implants was 100% (12/12). All animals survived to the experimental end point. Perioperative assessments showed intact stent grafts, and imaging features at the end of the follow-up period revealed neither endoleak nor device migration. No major adverse cardiovascular events were observed during the postoperative follow-up period. Pathological examinations confirmed the satisfactory biocompatibility of the stent graft.

CONCLUSIONS
This innovative double-branched stent graft system with four-stage deployment technology was affirmed as a safe and feasible option for aortic arch repair in accordance with our preclinical evaluation with porcine models.
Genome-wide association study of osteoporosis identifies genetic risk and interactions with Dietary Approaches to Stop Hypertension diet and sugar-sweetened beverages in a Hispanic cohort of older adults
Authors: Fouhy Liam E , Lai Chao-Qiang , Parnell Laurence D , Tucker Katherine L , Ordovás José M , Noel Sabrina E 
Published: March 2024

Abstract
Osteoporosis (OP) and low bone mass can be debilitating and costly conditions if not acted on quickly. This disease is also difficult to diagnose as the symptoms develop unnoticed until fracture occurs. Therefore, gaining understanding of the genetic risk associated with these conditions could be beneficial for health-care professionals in early detection and prevention. The Boston Puerto Rican Osteoporosis (BPROS) study, an ancillary study to the Boston Puerto Rican Health Study (BPRHS), collected information regarding bone and bone health. All bone measurements were taken during regular BPROS visits using dual-energy X-ray absorptiometry. The OP was defined as T-score ≤ −2.5 (≥2.5 SDs below peak bone mass). Dietary variables were collected at the second wave of the BPRHS via a food frequency questionnaire. We conducted genome-wide associations with bone outcomes, including BMD and OP for 978 participants. We also examined the interactions with dietary quality on the relationships between genotype and bone outcomes. We further tested if candidate genetic variants described in previous GWAS on OP and BMD contribute to OP risk in this population. Four variants were associated with OP: rs114829316 (IQ motif containing J gene), rs76603051, rs12214684 (melanin-concentrating hormone receptor 2 gene), and rs77303493 (Ras and Rab interactor 2 gene), and 2 variants were associated with BMD of lumbar spine (rs11855618, cingulin-like 1 gene) and hip (rs73480593, NTRK2), reaching the genome-wide significance threshold of P ≤ 5E-08. In a gene–diet interaction analysis, we found that 1 SNP showed a significant interaction with the overall Dietary Approaches to Stop Hypertension (DASH) score, and 7 SNPs with sugar-sweetened beverages (SSBs), a major contributor to the DASH score. This study identifies new genetic markers related to OP and BMD in older Hispanic adults. Additionally, we uncovered unique genetic markers that interact with dietary quality, specifically SSBs, in relation to bone health. These findings may be useful to guide early detection and preventative care.
CD44 expression on murine hepatic stellate cells promotes the induction of monocytic and polymorphonuclear myeloid-derived suppressor cells
Authors: Hagenstein Julia , Burkhardt Simon , Sprezyna Paulina , Tasika Elena , Tiegs Gisa , Diehl Linda 
Published: March 2024

Abstract
In chronic inflammation, regulatory immune cells, such as regulatory T cells and myeloid-derived suppressor cells, can develop. Local signals in the inflamed tissue, such as cytokines and eicosanoids, but also contact-dependent signals, can promote myeloid-derived suppressor cell development. In the liver, hepatic stellate cells may provide such signals via the expression of CD44. Myeloid-derived suppressor cells generated in the presence of hepatic stellate cells and anti-CD44 antibodies were functionally and phenotypically analyzed. We found that both monocytic and polymorphonuclear myeloid-derived suppressor cells generated in the presence of αCD44 antibodies were less suppressive toward T cells as measured by T-cell proliferation and cytokine production. Moreover, both monocytic and polymorphonuclear myeloid-derived suppressor cells were phenotypically altered. Monocytic myeloid-derived suppressor cells mainly changed their expression of CD80 and CD39, and polymorphonuclear myeloid-derived suppressor cells showed altered expression of CD80/86, PD-L1, and CCR2. Moreover, both polymorphonuclear and monocytic myeloid-derived suppressor cells lost expression of Nos2 messenger RNA, whereas monocytic myeloid-derived suppressor cells showed reduced expression of TGFb messenger RNA and polymorphonuclear myeloid-derived suppressor cells reduced expression of Il10 messenger RNA. In summary, the presence of CD44 in hepatic stellate cells promotes the induction of both monocytic and polymorphonuclear myeloid-derived suppressor cells, although the mechanisms by which these myeloid-derived suppressor cells may increase suppressive function due to interaction with CD44 are only partially overlapping.
Generalized dynamics equation with causal symmetry
Authors: Chen ChiYi 
Published: March 2024

ABSTRACT
The particle dynamics equation’s formal logic is examined in the context of classical mechanics to investigate the nature of inertial forces. First, a fresh perspective on the dual dependence of the inertial reference frame and inertial force in Newtonian dynamics is presented. The causal relationship between the two sides of Newton’s second law is found to be asymmetrical and inconsistent. Secondly, a more general particle dynamics equation, applicable in any translational frame of reference without additional assumptions, is introduced. Essentially, Newton’s second law is only an extreme case of the newly generalized dynamics equation since in Newton’s second law an entire term of the forces acting on the reference object is omitted. The nature of inertial force is unveiled as the mass-ratio weighted real force acting on the reference object. This qualitative explanation is entirely naturalistic as the reference frame’s acceleration depends directly on the acceleration of its reference object(s), and the acceleration of every reference object depends directly on the forces acting on this reference object.
A two-sample tree-based test for hierarchically organized genomic signals
Authors: Neuvial Pierre , Randriamihamison Nathanaël , Chavent Marie , Foissac Sylvain , Vialaneix Nathalie 
Published: March 2024

Abstract
This article addresses a common type of data encountered in genomic studies, where a signal along a linear chromosome exhibits a hierarchical organization. We propose a novel framework to assess the significance of dissimilarities between two sets of genomic matrices obtained from distinct biological conditions. Our approach relies on a data representation based on trees. It utilizes tree distances and an aggregation procedure for tests performed at the level of leaf pairs. Numerical experiments demonstrate its statistical validity and its superior accuracy and power compared to alternatives. The method’s effectiveness is illustrated using real-world data from GWAS and Hi-C data.