bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of symptomatic tracheal morbidities after fetoscopic endoluminal tracheal occlusion: a systematic review and meta-analysis
Authors: Tho Adam Lye Wye , Rath Chandra Prakash , Tan Jason Khay Ghim , Rao Shripada C 
Published: July 2023

BackgroundFetoscopic endoluminal tracheal occlusion (FETO) has been shown to improve survival of infants with congenital diaphragmatic hernia (CDH). However, there are concerns that FETO may lead to tracheomegaly, tracheomalacia and related complications.MethodsA systematic review was conducted to estimate the prevalence of symptomatic tracheal complications in infants who underwent FETO for CDH. Presence of one or more of the following was considered as tracheal complication: tracheomalacia, stenosis, laceration or tracheomegaly with symptoms such as stridor, effort-induced barking cough, recurrent chest infections or the need for tracheostomy, tracheal suturing, or stenting. Isolated tracheomegaly on imaging or routine bronchoscopy without clinical symptoms was not considered as tracheal morbidity. Statistical analysis was performed using the metaprop command on Stata V.16.0.ResultsA total of 10 studies (449 infants) were included (6 retrospective cohort, 2 prospective cohort and 2 randomised controlled trials). There were 228 infants who survived to discharge. Prevalence rates of tracheal complications in infants born alive were 6% (95% CI 2% to 12%) and 12% (95% CI 4% to 22%) in those who survived to discharge. The spectrum of severity ranged from relatively mild symptoms such as effort-induced barking cough to the need for tracheostomy/tracheal stenting.ConclusionA significant proportion of FETO survivors have symptomatic tracheal morbidities of varying severity. Units that are planning to adopt FETO for managing CDH should consider ongoing surveillance of survivors to enable early identification of upper airway issues. Inventing FETO devices that minimise tracheal injury is needed.
Incidental diagnosis of asymptomatic lipaemia retinalis in a patient with uncontrolled type 2 diabetes mellitus: ‘white lines’
Authors: Majeed Ghulam Mustafa , Valor Suárez Clara , Mann Samantha 
Published: July 2023

A man in his 60s presented for his medical retina clinic appointment, reporting increasing shortness of breath, aches and pains, and increasing insulin requirements during a difficult early lockdown. Wide-field colour fundus imaging (Optos Optomap) and an optical coherence tomography scan (Heidelberg Spectralis) revealed whitened and enlarged hyper-reflective vessels. Retinal colour photography also confirmed a creamy white discolouration of the vessels, which prompted the team to order a lipid profile. The profile showed a raised cholesterol level of 17.5 mmol/L (normal: <4mmol/L) and a marked elevated triglyceride level of 38.41 mmol/L (normal: <1.7 mmol/L).The clinical picture, alongside the biochemical results, suggested a diagnosis of secondary lipaemia retinalis due to poorly controlled diabetes. With aggressive treatment, the patient’s biochemistry and vessels returned to baseline.This rare condition should be taken as an indicator of a potential underlying life-threatening medical condition and the role an ophthalmologist has in initiating potential lifesaving intervention.
Clot composition and recanalization outcomes in mechanical thrombectomy
Authors: Nogueira Raul G , Pinheiro Agostinho , Brinjikji Waleed , Abbasi Mehdi , Al-Bayati Alhamza R , Mohammaden Mahmoud H , Souza Viana Lorena , Ferreira Felipe , Abdelhamid Hend , Bhatt Nirav R , Kvamme Peter , Layton Kennith F , Delgado Almandoz Josser E , Hanel Ricardo A , Mendes Pereira Vitor , Almekhlafi Mohammed A , Yoo Albert J , Jahromi Babak S , Gounis Matthew J , Patel Biraj , Arturo Larco Jorge L , Fitzgerald Sean , Mereuta Oana Madalina , Doyle Karen , Savastano Luis E , Cloft Harry J , Thacker Ike C , Kayan Yasha , Copelan Alexander , Aghaebrahim Amin , Sauvageau Eric , Demchuk Andrew M , Bhuva Parita , Soomro Jazba , Nazari Pouya , Cantrell Donald Robert , Puri Ajit S , Entwistle John , Polley Eric C , Frankel Michael R , Kallmes David F , Haussen Diogo C 
Published: July 2023

BackgroundMechanical thrombectomy (MT) has become standard for large vessel occlusions, but rates of complete recanalization are suboptimal. Previous reports correlated radiographic signs with clot composition and a better response to specific techniques. Therefore, understanding clot composition may allow improved outcomes.MethodsClinical, imaging, and clot data from patients enrolled in the STRIP Registry from September 2016 to September 2020 were analyzed. Samples were fixed in 10% phosphate-buffered formalin and stained with hematoxylin-eosin and Martius Scarlett Blue. Percent composition, richness, and gross appearance were evaluated. Outcome measures included the rate of first-pass effect (FPE, modified Thrombolysis in Cerebral Infarction 2c/3) and the number of passes.ResultsA total of 1430 patients of mean±SD age 68.4±13.5 years (median (IQR) baseline National Institutes of Health Stroke Scale score 17.2 (10.5–23), IV-tPA use 36%, stent-retrievers (SR) 27%, contact aspiration (CA) 27%, combined SR+CA 43%) were included. The median (IQR) number of passes was 1 (1–2). FPE was achieved in 39.3% of the cases. There was no association between percent histological composition or clot richness and FPE in the overall population. However, the combined technique resulted in lower FPE rates for red blood cell (RBC)-rich (P<0.0001), platelet-rich (P=0.003), and mixed (P<0.0001) clots. Fibrin-rich and platelet-rich clots required a higher number of passes than RBC-rich and mixed clots (median 2 and 1.5 vs 1, respectively; P=0.02). CA showed a trend towards a higher number of passes with fibrin-rich clots (2 vs 1; P=0.12). By gross appearance, mixed/heterogeneous clots had lower FPE rates than red and white clots.ConclusionsDespite the lack of correlation between clot histology and FPE, our study adds to the growing evidence supporting the notion that clot composition influences recanalization treatment strategy outcomes.
Tracking persistent postoperative opioid use: a proof-of-concept study demonstrating a use case for natural language processing
Authors: Seng Eri C , Mehdipour Soraya , Simpson Sierra , Gabriel Rodney A 
Published: July 2023

BackgroundLarge language models have been gaining tremendous popularity since the introduction of ChatGPT in late 2022. Perioperative pain providers should leverage natural language processing (NLP) technology and explore pertinent use cases to improve patient care. One example is tracking persistent postoperative opioid use after surgery. Since much of the relevant data may be ‘hidden’ within unstructured clinical text, NLP models may prove to be advantageous. The primary objective of this proof-of-concept study was to demonstrate the ability of an NLP engine to review clinical notes and accurately identify patients who had persistent postoperative opioid use after major spine surgery.MethodsClinical documents from all patients that underwent major spine surgery during July 2015–August 2021 were extracted from the electronic health record. The primary outcome was persistent postoperative opioid use, defined as continued use of opioids greater than or equal to 3 months after surgery. This outcome was ascertained via manual clinician review from outpatient spine surgery follow-up notes. An NLP engine was applied to these notes to ascertain the presence of persistent opioid use—this was then compared with results from clinician manual review.ResultsThe final study sample consisted of 965 patients, in which 705 (73.1%) were determined to have persistent opioid use following surgery. The NLP engine correctly determined the patients’ opioid use status in 92.9% of cases, in which it correctly identified persistent opioid use in 95.6% of cases and no persistent opioid use in 86.1% of cases.DiscussionAccess to unstructured data within the perioperative history can contextualize patients’ opioid use and provide further insight into the opioid crisis, while at the same time improve care directly at the patient level. While these goals are in reach, future work is needed to evaluate how to best implement NLP within different healthcare systems for use in clinical decision support.
PET Imaging of Nectin-4: A Promising Tool for Personalized/Precision Oncology
Authors: Jiang Dawei , Lan Xiaoli , Cai Weibo 
Published: July 2023

SummaryIn a recent study, the authors developed a nectin-4–targeting bicyclic peptide–based radiotracer, 68Ga-N188, for PET imaging of advanced urothelial cancer. Preclinical investigation and first-in-human study in 14 patients demonstrated excellent specificity and sensitivity of 68Ga-N188 in detecting metastases. These promising results support 68Ga-N188 as a companion diagnostic for future personalized cancer therapy.See related article by Duan et al., p. 3395
Inhibition of Microsomal Prostaglandin E2 Synthase Reduces Collagen Deposition in Melanoma Tumors and May Improve Immunotherapy Efficacy by Reducing T-cell Exhaustion
Authors: Fukuda Yasunari , Kim Sun-Hee , Bustos Matias A. , Cho Sung-Nam , Roszik Jason , Burks Jared K. , Kim Hong , Hoon Dave S.B. , Grimm Elizabeth A. , Ekmekcioglu Suhendan 
Published: July 2023

The arachidonic acid pathway participates in immunosuppression in various types of cancer. Our previous observation detailed that microsomal prostaglandin E2 synthase 1 (mPGES-1), an enzyme downstream of cyclooxygenase 2 (COX-2), limited antitumor immunity in melanoma; in addition, genetic depletion of mPGES-1 specifically enhanced immune checkpoint blockade therapy. The current study set out to distinguish the roles of mPGES-1 from those of COX-2 in tumor immunity and determine the potential of mPGES-1 inhibitors for reinforcing immunotherapy in melanoma. Genetic deletion of mPGES-1 showed different profiles of prostaglandin metabolites from that of COX-2 deletion. In our syngeneic mouse model, mPGES-1–deficient cells exhibited similar tumorigenicity to that of COX-2–deficient cells, despite a lower ability to suppress PGE2 synthesis by mPGES-1 depletion, indicating the presence of factors other than PGE2 that are likely to regulate tumor immunity. RNA-sequencing analysis revealed that mPGES-1 depletion reduced the expressions of collagen-related genes, which have been found to be associated with immunosuppressive signatures. In our mouse model, collagen was reduced in mPGES-1–deficient tumors, and phenotypic analysis of tumor-infiltrating lymphocytes indicated that mPGES-1–deficient tumors had fewer TIM3+ exhausted CD8+ T cells compared with COX-2–deficient tumors. CAY10678, an mPGES-1 inhibitor, was equivalent to celecoxib, a selective COX-2 inhibitor, in reinforcing anti-PD-1 treatment. Our study indicates that mPGES-1 inhibitors represent a promising adjuvant for immunotherapies in melanoma by reducing collagen deposition and T-cell exhaustion.

Significance:
Collagen is a predominant component of the extracellular matrix that may influence the tumor immune microenvironment for cancer progression. We present here that mPGES-1 has specific roles in regulating tumor immunity, associated with several collagen-related genes and propose that pharmacologic inhibition of mPGES-1 may hold therapeutic promise for improving immune checkpoint–based therapies.
Contributions to the taxonomy of the Brazilian Leurus Townes, 1946 (Hymenoptera: Ichneumonidae, Metopiinae)
Authors: Moleiro Henrique Pereira , Onody Helena Carolina , Camacho Gabriela Procópio , Penteado-Dias Angélica Maria , Gutierrez Mabel Alvarado , Ballón-Estacio Ricardo Javier , Santos Alvaro Doria dos 
Published: July 2023

Leurus Townes, 1946 is a small genus of Metopiinae (Hymenoptera: Ichneumonidae), consisting of 13 described species distributed in the Neotropics and the Nearctic region. The present work aims to contribute to the taxonomic knowledge of Leurus in Brazil. A total of 109 specimens were identified and 15 literature records were analyzed. The genus geographical occurrence was evaluated according to data obtained from the literature and labels of analyzed specimens. Five species of Leurus were identified for the Brazilian fauna: L. angustignathus, L. caeruliventris, L. discus, L. gracius and L. nostrus. New municipality records of occurrence were made for L. angustignathus in the state of São Paulo, L. caeruliventris in the states of Bahia, Distrito Federal, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Paraná, Piauí and Rondônia; for, L. discus in the state of Alagoas and São Paulo, and L. gracius in the state of Minas Gerais, Rio de Janeiro, and São Paulo. Females of L. angustignathus and L. gracius were described for the first time in the present study. The genitalia of males of L. caeruliventris, L. discus and L. gracius were described and illustrated for the first time.
Two new species of Asphondylia Loew, 1850 (Diptera, Cecidomyiidae) on Asteraceae from Brazil
Authors: Maia Valéria Cid , Mendonça Milton de Souza , Mascarenhas Bernardo José de Araújo 
Published: July 2023

Two new species of Asphondylia inducing galls on Asteraceae are described, A. gaucha from the state of Rio Grande do Sul and A. mineira from the state of Minas Gerais. Their host plants are Vernonanthura discolor (Sprengel) H. Rob., and V. polyanthes (Sprengel) Vega & Dematteis, respectively, both native to Brazil. Illustrations of relevant morphological characters are provided. The new species are compared with congeneric Neotropical species. The types are deposited in the Entomological Collection of the Museu Nacional/Universidade Federal do Rio de Janeiro.
Final 3-Year Outcomes of a Randomized Trial Comparing a Self-Expanding to a Balloon-Expandable Transcatheter Aortic Valve
Authors: Lanz Jonas , Möllmann Helge , Kim Won-Keun , Burgdorf Christof , Linke Axel , Redwood Simon , Hilker Michael , Joner Michael , Thiele Holger , Conzelmann Lars , Conradi Lenard , Kerber Sebastian , Thilo Christian , Toggweiler Stefan , Prendergast Bernard , Husser Oliver , Stortecky Stefan , Deckarm Sarah , Künzi Arnaud , Heg Dik , Walther Thomas , Windecker Stephan , Pilgrim Thomas ,   on behalf of the SCOPE I Investigators
Published: July 2023

BACKGROUND:
In the SCOPE I trial (Safety and Efficacy of the Symetis ACURATE Neo/TF Compared to the Edwards SAPIEN 3 Bioprosthesis), transcatheter aortic valve implantation with the self-expanding ACURATE neo (NEO) did not meet noninferiority compared with the balloon-expandable SAPIEN 3 (S3) device regarding a composite end point at 30 days due to higher rates of prosthetic valve regurgitation and acute kidney injury. Data on long-term durability of NEO are scarce. Here, we report whether early differences between NEO and S3 translate into differences in clinical outcomes or bioprosthetic valve failure 3 years after transcatheter aortic valve implantation.

METHODS:
Patients with severe aortic stenosis were randomized to transfemoral transcatheter aortic valve implantation with NEO or S3 at 20 European centers. Clinical outcomes at 3 years are compared using Cox proportional or Fine-Gray subdistribution hazard models by intention-to-treat. Bioprosthetic valve failure is reported for the valve-implant cohort.

RESULTS:

Among 739 patients, 84 of 372 patients (24.3%) had died in the NEO and 85 of 367 (25%) in the S3 group at 3 years. Comparing NEO with S3, the 3-year rates of all-cause death (hazard ratio, 0.98 [95% CI, 0.73–1.33]), stroke (subhazard ratio, 1.04 [95% CI, 0.56–1.92]), and hospitalization for congestive heart failure (subhazard ratio, 0.74 [95% CI, 0.51–1.07]) were similar between the groups. Aortic valve reinterventions were required in 4 NEO and 3 S3 patients (subhazard ratio, 1.32 [95% CI, 0.30–5.85]). New York Heart Association functional class ≤II was observed in 84% (NEO) and 85% (S3), respectively. Mean gradients remained lower after NEO at 3 years (8 versus 12 mm Hg;
P
<0.001).

CONCLUSIONS:
Early differences between NEO and S3 did not translate into significant differences in clinical outcomes or bioprosthetic valve failure throughout 3 years.

REGISTRATION:

URL:
https://clinicaltrials.gov
, Unique identifier: NCT03011346.
Outcomes With Percutaneous Debulking of Tricuspid Valve Endocarditis
Authors: Zhang Robert S. , Alam Usman , Maqsood Muhammad H. , Xia Yuhe , Harari Rafael , Keller Norma , Elbaum Lindsay , Rao Sunil V. , Alviar Carlos L. , Bangalore Sripal 
Published: July 2023

BACKGROUND:
In patients with tricuspid valve infective endocarditis, percutaneous debulking is a treatment option. However, the outcomes of this approach are less well known.

METHODS:
We performed a retrospective analysis of all patients who underwent percutaneous vegetation debulking for tricuspid valve infective endocarditis from August 2020 to November 2022 at a large academic tertiary care public hospital. The primary efficacy outcome was procedural success defined by clearance of blood cultures. The primary safety outcome was any procedural complication. For the composite outcome of in-hospital mortality or heart block, outcomes were compared (sequential noninferiority and superiority) with published surgical outcomes data.

RESULTS:

Of the 29 patients with tricuspid valve infective endocarditis who underwent percutaneous debulking, the average age was 41.3±10.1 years, all patients had septic pulmonary emboli with 27 (93.1%) patients having cavitary lung lesions before the procedure. For the efficacy outcomes, 28 patients (96.6%) had clearance of cultures after their procedure, mean white blood cell count significantly decreased from 16.8±1.4×10
3
to 12.6±1.0×10
3
per µL (
P
<0.01), and mean body temperature significantly decreased from 99.8F ±0.30 to 98.3F ±0.20 (
P
<0.001) post-procedure. For safety outcomes, there were no procedural complications (0%). Two patients (6.9%) died during the follow-up period, both during the index hospitalization due to severe necrotizing pneumonia. When compared with published data on surgical outcomes, percutaneous debulking was noninferior and superior for the composite of in-hospital death or heart block (noninferiority,
P
<0.001; superiority,
P
=0.016).

CONCLUSIONS:
Percutaneous debulking is feasible, effective, and safe in treating patients with tricuspid valve infective endocarditis refractory to medical therapy.
Graft Failure After Coronary Artery Bypass Grafting and Its Association With Patient Characteristics and Clinical Events: A Pooled Individual Patient Data Analysis of Clinical Trials With Imaging Follow-Up
Authors: Gaudino Mario , Sandner Sigrid , An Kevin R. , Dimagli Arnaldo , Di Franco Antonino , Audisio Katia , Harik Lamia , Perezgrovas-Olaria Roberto , Soletti Giovanni , Fremes Stephen E. , Hare David L. , Kulik Alexander , Lamy Andre , Peper Joyce , Ruel Marc , ten Berg Jurrien M. , Willemsen Laura M. , Zhao Qiang , Wojdyla Daniel M. , Bhatt Deepak L. , Alexander John H. , Redfors Bjorn 
Published: July 2023

BACKGROUND:
Graft patency is the postulated mechanism for the benefits of coronary artery bypass grafting (CABG). However, systematic graft imaging assessment after CABG is rare, and there is a lack of contemporary data on the factors associated with graft failure and on the association between graft failure and clinical events after CABG.

METHODS:
We pooled individual patient data from randomized clinical trials with systematic CABG graft imaging to assess the incidence of graft failure and its association with clinical risk factors. The primary outcome was the composite of myocardial infarction or repeat revascularization occurring after CABG and before imaging. A 2-stage meta-analytic approach was used to evaluate the association between graft failure and the primary outcome. We also assessed the association between graft failure and myocardial infarction, repeat revascularization, or all-cause death occurring after imaging.

RESULTS:

Seven trials were included comprising 4413 patients (mean age, 64.4±9.1 years; 777 [17.6%] women; 3636 [82.4%] men) and 13 163 grafts (8740 saphenous vein grafts and 4423 arterial grafts). The median time to imaging was 1.02 years (interquartile range [IQR], 1.00–1.03). Graft failure occurred in 1487 (33.7%) patients and in 2190 (16.6%) grafts. Age (adjusted odds ratio [aOR], 1.08 [per 10-year increment] [95% CI, 1.01–1.15];
P
=0.03), female sex (aOR, 1.27 [95% CI, 1.08–1.50];
P
=0.004), and smoking (aOR, 1.20 [95% CI, 1.04–1.38];
P
=0.01) were independently associated with graft failure, whereas statins were associated with a protective effect (aOR, 0.74 [95% CI, 0.63–0.88];
P
<0.001). Graft failure was associated with an increased risk of myocardial infarction or repeat revascularization occurring between CABG and imaging assessment (8.0% in patients with graft failure versus 1.7% in patients without graft failure; aOR, 3.98 [95% CI, 3.54–4.47];
P
<0.001). Graft failure was also associated with an increased risk of myocardial infarction or repeat revascularization occurring after imaging (7.8% versus 2.0%; aOR, 2.59 [95% CI, 1.86–3.62];
P
<0.001). All-cause death after imaging occurred more frequently in patients with graft failure compared with patients without graft failure (11.0% versus 2.1%; aOR, 2.79 [95% CI, 2.01–3.89];
P
<0.001).

CONCLUSIONS:
In contemporary practice, graft failure remains common among patients undergoing CABG and is strongly associated with adverse cardiac events.
The Right to a Court in Cases of Administrative Liability of a Penal Character in the Field of the Protection of Financial Markets and Competition in German, French and English Law
Authors: Blachnio-Parzych Anna , Podhalicz Mateusz , Stawińska-Artecka Weronika 
Published: July 2023

Abstract
The right to a court (right to a fair trial) is regarded as a foundation of the rule of law. With regard to liability for offenses which do not belong to the so-called core of criminal law, the European Court of Human Rights has accepted the adjudication on this liability by an administrative authority. However, the requirement of compliance with Article 6 (1) of the European Convention on Human Rights is designed to ensure full judicial review of the administrative authority’s decision(s). The aim of the article is to examine whether and how the solutions adopted in German, French and English law meet the standards in relation to administrative liability of a penal character. This study will concentrate on the character of the administrative authorities’ decisions regarding such liability and the scope of judicial review of such administrative decisions in the field of the protection of financial markets and competition.