bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tricuspid edge-to-edge repair for tricuspid valve prolapse and flail leaflet: feasibility in comparison to patients with secondary tricuspid regurgitation
Authors: Dannenberg Varius , Bartko Philipp E , Andreas Martin , Bartunek Anna , Goncharov Arseniy , Gerçek Muhammed , Friedrichs Kai , Hengstenberg Christian , Rudolph Volker , Ivannikova Maria 
Published: October 2023

Abstract

Aims
Transcatheter tricuspid edge-to-edge repair (T-TEER) has gained widespread use for the treatment of tricuspid regurgitation (TR) in symptomatic patients with high operative risk. Although secondary TR is the most common pathology, some patients exhibit primary or predominantly primary TR. Characterization of patients with these pathologies in the T-TEER context has not been systematically performed.

Methods and results
Patients assigned to T-TEER by the interdisciplinary heart team were consecutively recruited in two European centres over 4 years. Echocardiographic images were evaluated to distinguish between primary and secondary causes of TR. Both groups were compared concerning procedural results. A total of 339 patients were recruited, 13% with primary TR and 87% with secondary TR. Patients with primary TR had a smaller right ventricle (basal diameter 45 vs. 49 mm, P = 0.004), a better right ventricular function (fractional area change 45 vs. 41%, P = 0.001), a smaller right (28 vs. 34 cm2, P = 0.021) and left (52 vs. 67 mL/m2, P = 0.038) atrium, and a better left ventricular ejection fraction (60 vs. 52%, P = 0.005). The severity of TR was similar in primary and secondary TR at baseline (TR vena contracta width pre-interventional 13 ± 4 vs. 14 ± 5 mm, P = 0.19), and T-TEER significantly reduced TR in both groups (TR vena contracta width post-interventional 4 ± 3 vs. 5 ± 5 mm, P = 0.10). These findings remained stable after propensity score matching. Complications were similar between both groups.

Conclusion
T-TEER confers equally safe and effective reduction of TR in patients with primary and secondary TR.
The German Code of Crimes Against International Law at Twenty
Authors: Bock Stefanie 
Published: October 2023

Abstract
More than 20 years ago — on 30 June 2002 and thus one day prior to the Rome Statute of the International Criminal Court — the German Code of Crimes Against International Law (CCAIL) entered into force and since then allows for the national prosecution of the international core crimes. The most far-reaching innovation of the CCAIL is its broad jurisdictional reach. It is based on the principle of universal jurisdiction and empowers the German judicial authorities to prosecute genocide, crimes against humanity and war crimes even when they are committed abroad and have no specific link to Germany. After some initial hesitation, Germany today plays an active role in the international fight against impunity for core crimes. Prominent examples are the Koblenz torture trial against former members of the Assad Regime, the conviction of Taha Al-J. for genocide against members of the Yazidi community by the Higher Regional Court of Frankfurt and the decision of the Federal Court of Justice on the irrelevance of functional immunities. Sometimes, however, the Higher Regional Courts do not seem to be sufficiently aware of the international dimension and meaning of the cases. This negatively affects the trial management and the communication of the Courts with the (international) public.
EBV-Encoded MicroRNA-BART17-3p Targets DDX3X and Promotes EBV Infection in EBV-Associated T/Natural Killer–Cell Lymphoproliferative Diseases
Authors: Jin Jin , Sun Ting , Zhang Man , Cheng Jiali , Gu Jia , Huang Liang , Xiao Min , Zhou Jianfeng , Luo Hui 
Published: October 2023

Abstract

Background
Epstein-Barr virus (EBV) persistently infects T/natural killer (NK) cells causing an array of refractory EBV-associated T/NK-cell lymphoproliferative disorders. EBV-encoded microRNAs are important regulators for EBV latent infection and tumorigenesis. However, the roles of most EBV microRNAs in EBV-infected T/NK cells remain poorly understood.

Methods
On the basis of a search of the doRiNA database and the BiBiServ2-RNAhybrid website, we predicted that EBV-miR-BART17-3p targeted DDX3X, and we verified the hypothesis by dual-luciferase reporter assay and cell function experiments. In addition, we collected 50 EBV-positive T-, B-, and NK-cell samples from the peripheral blood of EBV-positive cases to examine the role of EBV-miR-BART17-3p in the disease.

Results
We found that EBV-miR-BART17-3p directly targeted DDX3X and downregulated DDX3X expression. By analyzing EBV-positive cell samples from cell lines and patients, we found that EBV-miR-BART17-3p was highly expressed only in EBV-positive NK cells and that the overexpression was significantly related to high EBV loads in EBV-infected NK cells. Furthermore, we found that EBV-miR-BART17-3p downregulated the RIG-I–like receptor antiviral pathway and promoted the expression of EBV-encoded proteins in EBV-infected NK cells by targeting DDX3X.

Conclusions
Our study showed that EBV-miR-BART17-3p was abundantly expressed in EBV-infected NK cells and inhibited the important antivirus immune responses of hosts by targeting DDX3X of the RIG-I–like receptor pathway. These findings could help us gain insights into the pathogenic mechanisms underlying EBV-associated T/NK-cell lymphoproliferative disorders and find the potential therapeutic target.
Transonic galactic wind model including stellar feedbacks and application to outflows in high/low-z galaxies
Authors: Igarashi Asuka , Mori Masao , Nitta Shin-ya 
Published: October 2023

Abstract
Galactic winds play a crucial role in the ejection of the interstellar medium (ISM) into intergalactic space. This study presents a model that classifies possible transonic solutions of galactic winds in the gravitational potential of the dark matter halo and stellar component under spherically symmetric and steady assumptions. Our model includes injections of mass and energy resulting from supernova feedback along a flow line. The mass flux in galactic winds is a critical factor in determining the acceleration process of the flow and revealing the impact of galactic winds on galaxy evolution. We apply the transonic galactic wind model to the observed outflow velocities of star-forming galaxies to estimate the mass flux. Dividing the mass flux by the star formation rate (SFR) yields the mass loading rate (and mass loading factor), which indicates the entrainment effect of the ISM by the hot gas flow. Our results demonstrate that the mass loading rate is inversely correlated with galaxy mass and SFR. In less massive galaxies (stellar mass ∼107−8 M⊙), the mass loading rate exceeds unity, indicating effective ejection of the ISM into intergalactic space. However, in massive galaxies (stellar mass ∼1010−11 M⊙), the mass loading rate falls below unity, meaning that the mass flux cannot exceed the injected mass by supernovae, thus resulting in ineffective ejection of the ISM.
Phenomenal Concepts, Direct Reference, and the Problem of Double Aspect
Authors: Zhong Lei 
Published: October 2023

Abstract
Synthetic physicalism—understood as the view that while mental concepts are distinct from physical concepts, mental properties are nonetheless identical to physical properties—is the dominant type of reductive physicalism in the philosophy of mind. With a focus on phenomenal concepts, this article examines two competing versions of synthetic physicalism: the demonstrative approach and the constitutive approach, both of which attempt to cash out the common idea that phenomenal concepts directly refer to phenomenal properties. I aim to argue that the synthetic physicalist is impaled on a dilemma in addressing what I call the problem of double aspect: the mental-physical conceptual distinction seems to imply property dualism at a new level. Either she adopts the demonstrative approach or she goes for the constitutive approach, but neither option is acceptable.
Erectile dysfunction in copper and cobalt miners: a cross-sectional study in the former Katanga province, Democratic Republic of the Congo
Authors: Musa Obadia Paul , Pyana Kitenge Joseph , Carsi Kuhangana Trésor , Kalenga Ilunga Georges , Billen Jaak , Kayembe-Kitenge Tony , Haufroid Vincent , Mukalay wa Mukalay Abdon , Ris Laurence , Banza Lubaba Nkulu Célestin , Nemery Benoit , Enzlin Paul 
Published: October 2023

Abstract

Background
The African Copperbelt is a site of intense artisanal and industrial mining and refining of copper and cobalt.

Aim
We aimed to investigate factors that are possibly associated with erectile dysfunction (ED) in metal miners in the former Katanga province of the Democratic Republic of the Congo.

Methods
In a cross-sectional study of 138 miners and 139 controls (bakers), we administered questionnaires to obtain sociodemographic and occupational data and to assess male sexual function (International Index of Erectile Function [IIEF]) and marital relation quality (Revised Dyadic Adjustment Scale). Furthermore, we measured trace metals in blood and urine, as well as testosterone and thyroid hormones in serum.

Outcomes
Outcomes included the prevalence of questionnaire-derived ED and the relation of ED with individual characteristics, serum testosterone, and environmental factors.

Results
Miners were on average 4 years older than bakers (mean ± SD, 37.5 ± 6.9 vs 33.3 ± 5.7 years). Miners had significantly lower scores than bakers on the IIEF (median [IQR], 66 [49-73] vs 73 [66-74]) and the 3 domains of the Revised Dyadic Adjustment Scale (consensus, satisfaction, cohesion). Free testosterone was significantly lower in miners than bakers (ng/dL; 8.11 [6.90–10.10] vs 10.52 [8.83-12.58]; P ˂ .001). In miners, sex hormone–binding globulin correlated positively with blood Pb and urinary Cd. In a multivariable analysis, mild to moderate ED or moderate ED (IIEF–erectile function score ≤18) was significantly associated with having a mining-related job (adjusted odds ratio [aOR], 2.6; 95% CI, 1.3-5.3), work seniority ˃5 years (aOR, 2.3; 95% CI, 1.1-4.6), alcohol consumption (aOR, 2.8; 95% CI, 1.2-6.7), and aphrodisiacs use (aOR, 4.2; 95% CI, 2.2-8.0). Mediation analysis showed that marital relationship partially mediated the relation between work seniority &gt;5 years in mining and ED.

Clinical Implications
The high prevalence of ED found in artisanal mine workers indicates that work-related factors should be considered as possibly contributing, directly or indirectly, to sexual dysfunction in men.

Strengths and Limitations
Strengths include being the first epidemiologic study documenting ED with validated questionnaires and its possible determinants, including exposure to toxic metals, among young artisanal miners vs a suitable control group. Limitations are the cross-sectional design with convenience sampling and absence of objective confirmation of ED.

Conclusion
As compared with controls, miners reported poorer sexual function and lower quality of their marital relationship, and they had lower free testosterone levels, which may be due to their high exposure to trace metals.
Prevalence and Impact of Feeding-Related Events on Hospital Stay in Preterm and Term Newborns
Authors: Macias Rebecca , Peterson Debora , Korkis Leah , Edson Rachel , Gall Robert 
Published: October 2023

Background:
Nursing assessment of milk flow regulation and associated apnea, bradycardia, and desaturation (ABD events) contribute to considerations for the discharge of newborns from the acute care setting. Research regarding infant feeding-related (FR) events (sucking and swallowing difficulties) and ABD events in moderate to late-preterm and full-term infants is lacking.

Purpose:
This study observes the impact of FR and ABD events during feeding on hospital length of stay (LOS) and healthcare utilization (cost) in moderate-to-late preterm newborns, as well as full-term infants.

Methods:
In a retrospective study, bottle-fed infants admitted to the level II specialty care nursery of an academic community hospital in Southern California were observed for FR and ABD events. Statistical analyses were used to determine the impact of FR events on adjusted LOS, to evaluate the interaction between FR event status and adjusted LOS on total hospital charges, and to assess the statistical independence between FR events and diagnostic-related group severity.

Results:
The full sample of patient records included 308 infants born between 32- and 44-week gestational age between April 1, 2018, and October 31, 2022. LOS was twice as long in infants who had FR events. Total median charges were higher in the group with FR events at $160,165 versus $64,380 with non-FR events.

Implications for Practice and Research:
Increased knowledge in the epidemiology and nursing care of infants experiencing milk flow regulation and associated ABD events is critical for informing practices and guidelines related to the prevention of related morbidities.
Peripherally Inserted Central Catheter-Related Skin Injury in Patients with a Chest Tumor: Characteristics and Risk Factors
Authors: Wang Yan , Miao Miao , Xu Min-Shan , Wan Guang-Ming 
Published: October 2023

ABSTRACT

OBJECTIVE
To investigate the characteristics and risk factors of skin injury in patients with chest tumors who have peripherally inserted central catheters (PICCs).

METHODS
This study included a total of 252 patients with chest tumors with PICC placement who were treated from March 2018 to December 2021 in a tertiary hospital in Shanghai, China. Investigators used univariate analysis and multivariate logistic regression to identify the risk factors.

RESULTS
Among the included patients, 40.8% had skin injuries (n = 103). Skin injury occurred between 2 and 361 days after PICC placement, with a median time of 56.0 days (interquartile range, 20.75–99.25 days). Skin injury may occur during catheter retention and be concentrated in the first 3 months after PICC placement; the occurrence trajectory of skin injury exhibits a downward trend. Logistic regression analysis shows that skin injury is more likely to occur if the patient has a history of smoking, allergy history, use of recombinant human endostatin, or an excessive duration of catheter retention.

CONCLUSIONS
The incidence of PICC-related skin injury in patients with chest tumors remains high. Medical practitioners should be aware of its characteristics and risk factors and adopt effective solutions early to mitigate the occurrence of skin injury and improve patients’ safety.
Personal Protective Equipment-Related Problems Experienced by Healthcare Workers, Solutions, and Recommendations: A Qualitative Study
Authors: Çakar Vildan , Karadağ Ayişe , Bugan Berna , Kılıç Havanur , Demir Ayşe Sılanur 
Published: October 2023

ABSTRACT

OBJECTIVE
To understand the problems experienced by healthcare workers (HCWs) who used personal protective equipment (PPE) on their face during the COVID-19 pandemic, their interventions to prevent these problems, and their recommendations for improving the quality of PPE.

METHODS
This descriptive and qualitative study included HCWs (N = 29) from health institutions at different levels in Turkey. Researchers collected data using a semistructured data collection form (13 items) and in-depth individual interviews. Data were analyzed with descriptive statistics and qualitative inductive content analysis.

RESULTS
Of the 29 participants, 15 (51.7%) were women, and 18 (62.1%) were nurses. Participants’ answers regarding problems related to PPE use were grouped into four main categories, answers regarding the prevention of these problems were grouped into three main categories, and answers regarding improving the quality of PPE were grouped into three main categories. Skin concerns were the most commonly reported problems related to PPE, and interventions to prevent these problems primarily related to skin protection and care. Recommendations to improve the quality of PPE focused on using materials for masks and face shields that reduce pressure and friction; participants also suggested that face shields be produced in sterile and disposable packages.

CONCLUSIONS
This research indicates that HCWs need support and they are able to create individual solutions for the problems with PPE that they experience. Skin-friendly PPE that ensures the safety and comfort of HCWs should be produced, and hospitals should develop policies for institutional use to prevent PPE injury.
Is Childhood Immune Thrombocytopenia Associated With Acquired Toxoplasmosis? An Unusual Case of Infection That Led to Acute ITP in a Greek Male Toddler and Implications for Guidelines
Authors: Stogiannis Dimitris , Blanas Kostas , Tsapra Eleni , Theodora Marianna 
Published: October 2023

Introduction:
Childhood immune thrombocytopenic purpura (ITP) is a heterogeneous immune-mediated process triggered by infections, vaccines, allergies and parasites. Currently, there is little evidence in the literature beyond case reports of an association with Toxoplasma gondii (T. gondii).

Methods:
The authors describe the unusual case of an earlier healthy 2.5-year-old Greek boy who developed acute ITP with a life-threatening platelet count a few days after a T. gondii infection. Evidence for the infection onset was found incidentally 3 months after the initial admission to the hospital and only after any other plausible cause of thrombocytopenia was excluded, according to diagnosis guidelines.

Results:
The boy underwent 3 intravenous immunoglobulin treatments within a trimester, a period during which his alarming platelets count levels led to housebound activities. A quite slow recovery was only ignited after the third treatment, which was administered in conjunction with a mild antibiotic medication for the T. gondii infection. Full recovery was obtained 9 months after the initial admission, although the boy’s potential scored high in clinical prediction models for developing transient ITP.

Conclusion:
There is a need for more research on ITPs with no obvious cause to investigate a causal association with toxoplasmosis. Currently, testing for diseases of greater rarity and of higher diagnostic cost than T. gondii is included in the ITP guidelines. Hence, routinely testing for toxoplasmosis when considering potential childhood ITP triggers and infection treatment complementary to treating the ITP might be the key to accelerating the healing process and improving the quality of life of otherwise confined children.
Current knowledge and availability of machine learning across the spectrum of trauma science
Authors: Gauss Tobias , Perkins Zane , Tjardes Thorsten 
Published: October 2023

Purpose of review
Recent technological advances have accelerated the use of Machine Learning in trauma science. This review provides an overview on the available evidence for research and patient care. The review aims to familiarize clinicians with this rapidly evolving field, offer perspectives, and identify existing and future challenges.

Recent findings
The available evidence predominantly focuses on retrospective algorithm construction to predict outcomes. Few studies have explored actionable outcomes, workflow integration, or the impact on patient care. Machine Learning and data science have the potential to simplify data capture and enhance counterfactual causal inference research from observational data to address complex issues. However, regulatory, legal, and ethical challenges associated with the use of Machine Learning in trauma care deserve particular attention.

Summary
Machine Learning holds promise for actionable decision support in trauma science, but rigorous proof-of-concept studies are urgently needed. Future research should assess workflow integration, human-machine interaction, and, most importantly, the impact on patient outcome. Machine Learning enhanced causal inference for observational data carries an enormous potential to change trauma research as complement to randomized studies. The scientific trauma community needs to engage with the existing challenges to drive progress in the field.
A case of successful hormone therapy for refractory hypotension following viral encephalitis: Case report
Authors: Zhang Congcong , Zhang Jiangshan , Liao Zhongkai 
Published: October 2023

Rationale:
Refractory hypotension is a life-threatening condition that can result from various causes. We report a rare case of refractory hypotension following herpes simplex virus type 1 encephalitis that was successfully treated with hormone therapy.

Patient concerns:
The patient was a 66-year-old male who was admitted to the hospital because of fever, chills, convulsions, and impaired consciousness. He developed respiratory failure and was intubated. Cerebrospinal fluid metagenomic sequencing confirmed herpes simplex virus type 1 infection. He received piperacillin-tazobactam for anti-infection, acyclovir for antiviral therapy, and dexamethasone for anti-inflammatory therapy. He had repeated episodes of hypotension despite fluid resuscitation and vasopressor therapy.

Diagnosis:
The diagnosis of herpes simplex virus type 1 encephalitis complicated by refractory hypotension was based on the patient’s epidemiological history, clinical manifestations, laboratory tests, and imaging studies. Cerebrospinal fluid examination was the most important diagnostic method, which could detect viral nucleic acids. Head magnetic resonance imaging showed a large recent lesion in the right temporal-parietal and insular lobes.

Interventions:
The treatment of refractory hypotension mainly included anti-infection, antiviral, anti-inflammatory, and hormone therapy. Hormone therapy used methylprednisolone shock treatment until tapering withdrawal. Other treatments included fluid resuscitation, vasopressors, anticonvulsants, etc.

Outcomes:
The patient’s blood pressure stabilized after receiving methylprednisolone shock treatment, and his mean arterial pressure increased from 73 mm Hg to 92 mm Hg within 24 hours. Three months later, the patient’s blood pressure was normal without medication, and he had a good social and physical recovery.

Lessons:
This case illustrates the possible role of hormone therapy in restoring blood pressure in patients with refractory hypotension following viral encephalitis. It suggests that adrenal insufficiency or autonomic dysfunction may be involved in the pathophysiology of this condition. Further studies are needed to confirm the efficacy and safety of hormone therapy in this setting.