bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of early substitution of subclinical hypothyroidism on cardiovascular function
Authors: Pandrc M , Kostovski V , Vranes D , Ristic A , Ciric J 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background / Aim
Current controversies related to the treatment of subclinical hypothyroidism (SCH) with thyrotropin (TSH) &lt; than 10 mU/L are based on the lack of evidence that levothyroxine therapy has beneficial effects. The aim of this study was to examine the effect a 3-month LT4 treatment on cardiovascular function in symptomatic SCH with TSH &lt; 10 mIU/L.

Methods
Electro and echocardiographic indices were measured in 35 patients with persistent symptomatic SCH before the intervention (TSH 7.0±2.1 mIU/L), and 3 months after the euthyroid state had been achieved.

Results
Significant reduction in PR (before: 0.16 ± 0.02, after: 0.15 ± 0.02; p&lt;0.001), QT (before: 389.58 ± 10.12, after: 383.54 ± 8.62; p&lt;0.001) and QT corrected (before: 428.77 ± 20.11, after: 411.77 ± 14.73; p&lt;0.001) intervals as well as increase in heart rate (p=0.001) were recorded in the group on levothyroxine therapy. The following parameters of the left and right ventricle were significantly decreased in the treatment group: left ventricular mass index (before: 76.81 ± 13.52, after: 70.62 ± 16.45; p&lt;0.001 respectively), ESV (before: 38.86 ± 9.6, after: 36.95 ± 9.25; p&lt;0.001), EDV (before: 114.83 ± 20.6, after: 108.43 ± 18; p&lt;0.001), MAPSE 2D (before: 1.67 (1.55-1.89), after: 1.53 (1.34-1.65); p&lt;0.001). systolic and diastolic time intervals: IVCT (before: 53.23 ± 11.07, after: 46.54 ± 11.13; p&lt;0.001), IVRT (before: 78.71 ± 11.35, after: 72.69 ± 10.1; p&lt;0.001), IVCT/ET (before: 0.18 ±0.04, after: 0.16 ±0.04; p&lt;0.001). The increase was recorded as fractional shortening (before: 39.40 (35.40-46.80), after: 42.40 (38.80-47.20), p&lt;0.001) and pressure rise in early systole (dP/dt: before: 2163.29 ± 454.48, after: 2385.17 ± 542.83; p&lt;0.001), right atrial wall thickness and diameters (RA long axis (before: 4.59 (4.18-5.11), after: 4.81 (4.31-5.70); p&lt;0.001) and short axis (before: 3.67 (3.16-3.87), after: 3.88 (3.38-4.14); p&lt;0.001)), wall thickness (before: 0.43 (0.40-0.46), after: 0.44 (0.40-0.48); p&lt;0.001). After the levothyroxine therapy, there was a statistically significant decrease in ESV and EDV (p&lt;0.001, p&lt;0.001 respectively). LT4 therapy significantly increased values of EF (p&lt;0.001) as well as global longitudinal circumferential and radial strains (p&lt;0.001, p&lt;0.001, p&lt;0.001 respectively). There is a moderate, positive, statistically significant correlation between the change in the titre of anti TPO antibodies and the change in global longitudinal strain values after the therapy (p = 0.027).

Conclusions
Our study confirmed an echocardiographic improvement of cardiac structure and function in treated individuals. The findings suggest electrocardiographic and echocardiographic screening in monitoring the therapeutic effect.
Coronary microvascular disease is associated with decreased nailfold capillary density in patients with ischemia and no obstructive coronary arteries
Authors: Sakalidis A , Dimitriadis K , Dri I , Leontsinis I , Mantzouranis E , Ntalakouras I , Iliakis P , Vlachakis P , Doundoulakis I , Soulaidopoulos S , Beneki I , Mavroudis A , Mpora M , Lazarou E , Tsioufis K 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Existing data support that coronary microcirculation impairment is common in patients with angina pectoris without obstructive coronary artery disease. There are insufficient data in the literature regarding possible generalized microangiopathy in the above population.

Purpose
The aim of this study is to evaluate whether patients with coronary microvascular dysfunction (CMD) compared to individuals without angina are characterized by a different level of capillary density in the nailfold capillary microscopy.

Methods
We examined 21 patients [9 female, 39%, mean age: 61.2±9.9 years, mean office blood pressure (BP) : 139/86±18/10 mmHg] and 25 CMD patients (16 female, 64%, mean age : 57.9±4.8 years, average office BP: 127/77±18/10 mmHg). In the group of patients with chronic angina pectoris CMD was defined by a standardized systematic protocol in which coronary flow reserve (CFR) and index of microvascular resistance (IMR) were measured in the left anterior descending coronary artery using a temperature/pressure sensor-tipped guidewire. CMD patients were classified into 2 groups, the structural and the functional endotype, based on commonly used cut-offs (impaired CFR &lt; 2.5, increased IMR ≥ 25). Functional CMD was defined as abnormal CFR in combination with normal IMR and structural CMD as abnormal CFR with abnormal IMR.
In addition, the assessment of skin microcirculation was performed by capillaroscopy, a non-invasive technique to evaluate small vessels of the microcirculation in the nailfold, using stereomicroscope in all patients.

Results
In CMD group, mean CFR and IMR were 1.6 ± 0.9 and 43.9± 30 IU, respectively. Of the 25 patients with abnormal CFR, 8 (32%) had normal IMR consistent with functional CMD endotype, and 17 (68%) had abnormal IMR consistent with structural endotype.
Capillary density in patients with CMD was significantly decreased compared to that of asymptomatic participants (9 vs 10.86 vessels/mm, p=0.04). The difference in capillary density between the two groups was statistically significant after adjustment for multiple comparisons (p&lt;0.05). No significant difference was found in body mass index, renal function, medical history of dyslipidemia, diabetes mellitus and smoking status between the two groups (p&lt;0.05).

Conclusion
Patients with CMD compared to individuals without angina are characterized by decreased nailfold capillary density. These results suggest that there is a correlation between microcirculatory impairment at the level of the coronary microcirculation and the peripheral vascular beds.
Anticoagulation for post-discharge thromboprophylaxis after hospitalisation for Covid-19
Authors: Costa G , Leal D , Cascais J , Goncalves L , Teixeira R 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Patients hospitalised with COVID-19 are at risk for thrombotic events after discharge; the role of extended thromboprophylaxis in this population is unknown.

Objective
Evaluate the incidence of post-discharge thromboembolic and bleeding events and the role of thromboprophylaxis among COVID-19 patients.

Methods
We systematically searched PubMed, Embase and Cochrane databases, in March 2022, for interventional and observational studies.

Results
A total of 3 studies were included, providing a total 1569 patients, 325 in post-discharge anticoagulation and 1271 no discharge anticoagulation. In terms of outcomes assessed, both groups had similar symptomatic venous thrombotic events (pooled OR 0.43 [0.05, 3.79], P=0.14, I2=50%) and combined symptomatic and asymptomatic events pooled OR 0.63 [0.14, 2.79], P=0.54, I2=34%). Regarding bleeding events, no statistically significant difference was observed in all bleeding (major and non-major) events (pooled OR 2.85 [0.71, 11.43], P=0.14, I2=50%).

Conclusion
According to our meta-analysis, in patients hospitalized with COVID-19, extended thromboprophylaxis does not provide additional clinical benefit.
Triptan-induced takotsubo syndrome: a case report
Authors: Somers-Edgar Tiffany Joy , Shah Jignesh , Kueh Anthony , Kasargod Prabhakar Chethan 
Published: May 2023

Abstract

Background
Takotsubo syndrome (TS) is a clinical condition mimicking acute coronary syndrome characterized by reversible acute systolic dysfunction. TS is typically associated with a catecholaminergic surge resulting from physical or emotional stress while some pharmacologic agents may act as a trigger.

Case summary
Here, we report a case of TS secondary to rizatriptan, used for treatment of acute migraine. A 67-year-old woman with a history of dyslipidemia, type II diabetes, and migraine was admitted with chest heaviness shortly after taking rizatriptan for migraine. Deepening T wave inversion was seen in multiple territories on electrocardiogram and hs-troponin T was elevated. Cardiac imaging including echocardiogram coronary angiography and cardiac magnetic resonance imaging was consistent with a diagnosis of TS.

Discussion
In this case, there was no emotional trigger for TS described. Given the compelling temporal correlation between the onset of typical chest pain and medication use, a diagnosis of TS secondary to rizatriptan was made.
MitraClip detachment after electrical cardioversion: a case report
Authors: Yagel Oren , Planer David , Elitzur Yair , Be'eri Ronen , Elbaz-Greener Gabby 
Published: May 2023

Abstract

Background
Transcatheter edge-to-edge repair (TEER) repair is a minimally invasive procedure used for patients with severe mitral regurgitation (MR). Cardioversion is indicated for haemodynamically unstable patients with narrow complex tachycardia and is generally considered safe post-mitral clip. We present a patient who underwent cardioversion post-TEER with a single leaflet detachment (SLD).

Case summary
An 86-year-old female with severe MR underwent TEER with a MitraClip that reduced MR severity to mild. During the procedure, the patient experienced tachycardia, and cardioversion was performed successfully. However, immediately after the cardioversion, the operators noticed recurrent severe MR with a posterior leaflet clip detachment. Deployment of a new clip adjacent to the detached one was obtained.

Discussion
Transcatheter edge-to-edge repair is a well-established method for treating severe MR in patients who are not suitable for surgical intervention. However, complications can arise during or after the procedure, such as clip detachment as in this case. Several mechanisms can explain SLD. We presumed that in the current case, immediately after cardioversion, there was an acute (post-pause) increase in left ventricle end-diastolic volume and thus in the left ventricle systolic volume with more vigorous contraction, possibly pulling apart the leaflets and detaching the freshly applied TEER device. This is the first report of SLD related to electrical cardioversion after TEER. Even though electrical cardioversion is considered safe, SLD can occur in this setting.
An assessment of the performance of the Mexican health system between 2000 and 2018
Authors: Gómez-Dantés Octavio , Fuentes-Rivera Evelyn , Escobar Joaquín , Serván-Mori Edson 
Published: May 2023

AbstractThis paper offers a comprehensive picture of the performance of the Mexican health system during the period 2000–18. Using high-quality and periodical data from the Organization for Economic Cooperation and Development, the World Bank, the Institute for Health Metrics and Evaluation and Mexico’s National Survey of Household Income and Expenditure, we assess the evolution of seven types of indicators (health expenditure, health resources, health services, quality of care, health care coverage, health conditions and financial protection) over a period of 18 years during three political administrations. The reform implemented in Mexico in the period 2004–18―which includes the creation of ‘Seguro Popular’―and other initiatives helped improve the financial protection levels of the Mexican population, expressed in the declining prevalence of catastrophic and impoverishing health expenditures, and various health conditions (consumption of tobacco in adults and under-five, maternal, cervical cancer and human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) mortality rates). We conclude that policies intended to move towards universal health coverage should count on strong financial mechanisms to guarantee the consistent expansion of health care coverage and the sustainability of reform efforts. However, the mobilization of additional resources for health and the expansion of health care coverage do not guarantee by themselves major improvements in health conditions. Interventions to deal with specific health needs are also needed.
Ethics and Epistemic Injustice in the Global South: A Response to Hopman’s Human Rights Exceptionalism as Justification for Covert Research
Authors: Kaur Kirandeep , Grama Ben , Roy Chaudhuri Nairita , Recalde-Vela Maria Jose 
Published: May 2023

Abstract
This article investigates the risk of epistemic injustice in conducting sociolegal research in Global South contexts. Diving into the ethical imperatives of honouring knowledge, agency, and voice, we challenge extractive research practices and reframe participants as active, legitimate bearers of knowledge.
Covert research is a highly controversial research practice which bypasses the right to informed consent of participants. Marieke Hopman’s article titled ‘Covert Qualitative Research as a Method to Study Human Rights Under Authoritarian Regimes’ advocates for covert research in the field of human rights, provided this covert research passes her proposed ‘ethical test’. We argue that this test permits and requires practices of knowledge-making which unjustly silence, undervalue, and exclude the capacity of systematically marginalised communities to produce knowledge claims.
Hopman’s ethical test requires researchers to translate participants’ testimonies and situated knowledge into a doctrinal human rights framework, which comes with certain onto-epistemological assumptions which may not be shared by participants. Her approach frustrates research participants’ agency in choosing their own epistemic projects. Finally, her test exacerbates structural inequalities between the Global North and Global South by reinforcing unequal power relations.
We advocate for a situated ethics approach to mitigate epistemic injustice in socio-legal research in the Global South. Cross-cultural ethical dialogue between western and non-hegemonic ethics on a non-hierarchical and equal basis can contribute to building ‘intercultural ethics’. Reflexivity – where researchers critically examine their worldviews and social position throughout the research process – can ensure greater accountability and integrity. Reciprocity – building mutual research relationships and producing research useful to the researched – can help shift the power imbalance between the researcher and researched.
The Cartel Trial: Issues of Dishonesty and Jury Nullification
Authors: Stephan Andreas 
Published: May 2023

Abstract
The case of R v Stringer and Dean provides a unique insight into issues of dishonesty and possible jury nullification in offences designed to control corporate misbehaviour. The jury were unconvinced of the defendants’ dishonest state of mind in the first (and to date only) case to be tried under the UK’s cartel offence. This was despite no attempt being made to dispute the existence of the cartel or present evidence in their defence. The paper asks whether the trial highlights flaws in the concept of dishonesty or reflects a broader problem of jury nullification in offences relating to corporate misconduct. It concludes that although dishonesty is unpredictable and can be easily challenged in the context of business misconduct, there is also a significant danger that juries question the legitimacy of treating cartels and other forms of business misconduct as crime, regardless of how an offence is designed.
Education for individual fulfilment as social: grappling with obstructions to growth
Authors: Fraser-Burgess Sheron 
Published: May 2023

ABSTRACT
In placing education at the centre, as The Main Enterprise of the World, Philip Kitcher has undertaken a monumental task. He has come to the field of philosophy of education captivated by the importance of its substantive preoccupations for the advancement of democratic aims. Accordingly, his book argues that the most salient obstruction to preparing citizens who will contribute to society is the seeming irreconcilability of the demands of industry, on the one hand, and of students’ personal growth, on the other. In spite of his desire to accommodate diverse accounts of the human good, and his recognition of the formative role of culture, broadly conceived, there are strains in his account of human fulfilment deriving from the disjunction of the self and others. It is not evident, on his Deweyan onto-epistemology, that there is adequate attention to the imprint on an individual, and on the beliefs they come to form, of proximal social groups. The nature of the balance between ‘in-group’ and ‘out-group’ influences, between those that are near and those that are far, can profoundly affect the plausibility of Kitcher's account of a socially based sense of fulfilment.
The economic and epistemic division of labour: on Philip Kitcher’s The Main Enterprise of the World
Authors: Kotzee Ben 
Published: May 2023

Abstract
In The Main Enterprise of the World, Philip Kitcher identifies an over-specialized and over-loaded curriculum as a particular affliction of education in our time. Kitcher criticizes a narrow view of education on which it is conceived as being no more than job training and proposes a more humane set of educational goals to be pursued in school. For Kitcher, the problem of the narrowness of the economic aims of education and the problem of the over-loaded curriculum are connected and, in Chapter 2 of the book, he presents a thoroughgoing critique of educational specialization as a distinguishing feature of education today. He holds that the economic value of education cannot capture education's full value and that true education should build children and young people's capacities for meaningful life and work. In this paper, I discuss Kitcher's critique of educational specialization. I note that Kitcher draws most of his inspiration from considerations about what makes a human life go well and therefore situates his thinking about education in the realm of ethics, rather than in his home discipline of the philosophy of science. Defending educational specialization, I turn to some of Kitcher's earlier work in the philosophy of science to show that the epistemic division of labour calls for a considerable degree of specialization in educational curricula on epistemic, rather than on economic, grounds.
Polyamidoamine dendrimer decorated graphene oxide as a pH-sensitive nanocarrier for the delivery of hydrophobic anticancer drug quercetin: a remedy for breast cancer
Authors: Matiyani Monika , Rana Anita , Pal Mintu , Dokwal Sumit , Sahoo Nanda Gopal 
Published: May 2023

Abstract

Objectives
The aim of this study was to investigate the potential of poly(amido amine) (PAMAM) dendrimer decorated graphene oxide (GO) based nanocarrier for targeted delivery of a hydrophobic anticancer drug, quercetin (QSR).

Methods
GO-PAMAM was successfully synthesized by covalent bonding between GO and NH2-terminated PAMAM dendrimer (zero generation). To investigate drug loading performance, QSR was loaded on the surface of GO as well as GO-PAMAM. Further, the release behaviour of QSR-loaded GO-PAMAM was studied. Finally, an in-vitro sulforhodamine B assay was performed in HEK 293T epithelial cells and MDA MB 231 breast cancer cells.

Key findings
It was observed that GO-PAMAM shows higher QSR loading capacity compared to GO. Also, synthesized nanocarrier exhibits controlled as well as pH-responsive release of QSR and the amount of QSR released at pH 4 was approximately two times higher than the release at pH 7.4. Furthermore, GO-PAMAM was found to be biocompatible for HEK 293T cells, and a high cytotoxic effect was observed for QSR-loaded GO-PAMAM on MDA MB 231 cells.

Conclusions
The present investigation highlights the potential application of synthesized hybrid materials as a nanocarrier with excellent loading and controlled releasing efficiency for the delivery of the hydrophobic anticancer drug.
A rare case report: low grade appendiceal mucinous neoplasm (LAMN) located under the left costal margin, the gastric level and the transverse colon
Authors: Maloku Halit 
Published: May 2023

Abstract
We report a case with a low-grade appendiceal mucinous neoplasm, located under the left costal margin, the gastric level and the transverse colon. The mucinous appendiceal neoplasm has caused intussusception of the appendix in the cecum, completely dislocating the cecum on the left side of the upper abdomen. In such cases, it is important to diagnose prior to surgical treatment to avoid mucocele perforation and intraoperative dissemination. The patient underwent a right hemicolectomy procedure, completely removing the mass according to oncological principles. The atypical localization of the cecum leads to difficulty in diagnosing the mucinous neoplasm of the appendix. It is important to know the diagnosis before the operation to plan the right course of treatment.
Improved recovery of SARS-CoV-2 from wastewater through application of RNA and DNA stabilising agents
Authors: Bell Stephen H , Allen Danielle M , Reyne Marina I , Lock Jonathan F W , Fitzgerald Arthur , Levickas Ashley , Lee Andrew J , Bamford Connor G G , Gilpin Deirdre F , McGrath John W 
Published: May 2023

Abstract
Wastewater Based Epidemiology (WBE) has become an integral part of the public health effort to track the levels of SARS-CoV-2 within communities. Detection of SARS-CoV-2 in wastewater can be challenging due to relatively low levels of virus within the sample. The wastewater matrix is also comprised of commercial and domestically derived contaminants, as well as RNases, all of which can adversely affect RT-qPCR analysis. To improve SARS-CoV-2 detection within wastewater samples we investigated both the effect of template dilution (as a means to reduce RT-qPCR inhibition) and sample stabilisation via addition of DNA/RNA Shield™ and/or RNA Later™ (to prevent RNA degradation via RNases) as a means to improve viral fragment detection. Using both methodologies, a significant improvement in SARS-CoV-2 detection from wastewater samples was observed. No adverse effects of stabilising agent addition on downstream Next-Generation Sequencing workflows were detected.