bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous large-bore aspiration embolectomy with veno-arterial extracorporal membrane oxygenation support or standby in patients with high-risk pulmonary embolism and contraindications to thrombolysis: a preliminary single centre experience
Authors: Kucher Nils , Ouda Ahmed , Voci Davide , Barco Stefano , Micieli Evy , Münger Mario , Pleming William , Grigorean Alexandru , Sromicki Juri , Schmiady Martin Oliver , Holy Erik W 
Published: February 2023

AbstractAimsLarge-bore catheter aspiration embolectomy reduces thrombus burden and right ventricle strain and improves haemodynamics after pulmonary embolism (PE). Sparse data are available for patients with high-risk PE and contraindications to thrombolysis or thrombolysis failure, particularly if veno-arterial extracorporal membrane oxygenation (VA-ECMO) is required.Methods and resultsAll patients with acute high-risk PE and contraindications to thrombolysis undergoing FlowTriever® percutaneous embolectomy and VA-ECMO circulatory support (or standby) at the University Hospital Zurich between April 2021 and August 2022 were retrospectively analysed. The primary outcome was the combination of recurrent PE, heart failure hospitalization, and all-cause death at 30 days. The analysis included 15 patients: mean age was 63.1 years and 14 (93%) were men. Overall, four (27%) patients presented with cardiac arrest, eight (53%) with ongoing obstructive shock, and three (20%) with persistent arterial hypotension. Veno-arterial extracorporal membrane oxygenation was implanted prior to aspiration embolectomy in eight (53%) patients. Three of seven patients without initial VA-ECMO support experienced periprocedural cardiac arrest, of whom two received ECMO support before completion of embolectomy. Veno-arterial extracorporal membrane oxygenation weaning was successful in all patients after a mean of 5.4 days. There was one periprocedural death in a patient who did not receive VA-ECMO support following a periprocedural cardiac arrest. The primary outcome at 30 days occurred in five (33.3%; 95% confidence interval 13.0–61.3%) patients.ConclusionThis study provides preliminary evidence for the feasibility of percutaneous large-bore aspiration embolectomy in combination with VA-ECMO support (or standby) in patients with high-risk PE and contraindications to thrombolysis.
Differences between cardiac troponin I vs. T according to the duration of myocardial ischaemia
Authors: Espinosa Aaron Shekka , Hussain Shafaat , Al-Awar Amin , Jha Sandeep , Elmahdy Ahmed , Kalani Mana , Kakei Yalda , Zulfaj Ermir , Aune Emma , Poller Angela , Bobbio Emanuele , Thoirleifsson Sigurdur , Zeijlon Rickard , Gudmundursson Thorstein , Wernbom Mathias , Lindahl Bertil , Polte Christian L , Omerovic Elmir , Hammarsten Ola , Redfors Björn 
Published: February 2023

Abstract

Aims
Cardiac troponin T (cTnT) and troponin I (cTnI) are expressed as an obligate 1:1 complex in the myocardium. However, blood levels of cTnI often rise much higher than that of cTnT in myocardial infarction (MI), whereas cTnT is often higher in patients with stable conditions such as atrial fibrillation. Here we examine high-sensitive (hs) cTnI and hs-cTnT after different durations of experimental cardiac ischaemia.

Methods and results
hs-cTnI, hs-cTnT, and the hs-cTnT/hs-cTnI ratio were measured in plasma samples from rats before and at 30 and 120 min after 5, 10, 15, and 30 min of myocardial ischaemia. The animals were killed after 120 min of reperfusion, and the infarct volume and volume at risk were measured. hs-cTnI, hs-cTnT, and the hs-cTnT/hs-cTnI ratio were also measured in plasma samples collected from patients with ST-elevation myocardial infarction (STEMI). hs-cTnT and hs-cTnI increased over 10-fold in all rats subjected to ischaemia. The increase of hs-cTnI and hs-cTnT after 30 min was similar, resulting in a hs-cTnI/hs-cTnT ratio around 1. The hs-cTnI/hs-cTnT ratio was also around 1 in blood samples collected at 120 min in rats subjected to 5 or 10 min of ischaemia where no localized necrosis was observed. In contrast, the hs-cTnI/hs-cTnT ratio at 2 h was 3.6–5.5 after longer ischaemia that induced cardiac necrosis. The large hs-cTnI/hs-cTnT ratio was confirmed in patients with anterior STEMI.

Conclusion
Both hs-cTnI and hs-cTnT increased similarly after brief periods of ischaemia that did not cause overt necrosis, whereas the hs-cTnI/hs-cTnT ratio tended to increase following longer ischaemia that induced substantial necrosis. A low hs-cTnI/hs-cTnT ratio around 1 may signify non-necrotic cTn release.
Number of calcified aortic valve leaflets: natural history and prognostic value in patients undergoing haemodialysis
Authors: Kurasawa Shimon , Okazaki Masaki , Imaizumi Takahiro , Kondo Toru , Hishida Manabu , Nishibori Nobuhiro , Takeda Yuki , Kasuga Hirotake , Maruyama Shoichi 
Published: February 2023

Abstract

Aims
Aortic valve calcification in aortic sclerosis, a precursor of aortic stenosis (AS), is not always present in all three leaflets; how calcification develops in each leaflet is unknown. We aimed to investigate the natural history of calcification development in each aortic valve leaflet and the prognostic value of the number of calcified leaflets.

Methods and results
In a retrospective multicentre cohort study of patients undergoing haemodialysis without AS, we observed calcification development in each aortic valve leaflet using echocardiography. We investigated the association between the number of calcified leaflets and AS development and mortality using time-to-event analysis. Among the 1507 patients (mean age, 66 years; 66% male) included in the longitudinal echocardiography analysis, 709 (47%) had aortic sclerosis at baseline: one-leaflet calcified, 370 (52%); two-leaflet calcified, 215 (30%); and three-leaflet calcified, 124 (17%). The median time for one calcified leaflet increase was 3–4 years, and 251 (17%) patients developed AS during a median 3.2-year follow-up. The increased number of calcified aortic valve leaflets was associated with developing AS; compared with that of one-leaflet calcified, the adjusted hazard ratios (aHRs) [95% confidence intervals (CIs)] of two- and three-leaflet calcified were 2.12 (1.49–3.00) and 4.43 (3.01–6.52), respectively; the aHR (95% CI) per one calcified leaflet increase was 2.24 (1.96–2.55). It was also associated with all-cause mortality; the aHR (95% CI) per one calcified leaflet increase was 1.18 (1.08–1.27).

Conclusion
The number of calcified aortic valve leaflets strongly predicted AS development and even mortality in patients undergoing haemodialysis, suggesting the usefulness of assessing calcification for each valve leaflet separately using echocardiography.
Ventilator-assisted transcatheter edge-to-edge mitral valve repair for severe atrial functional mitral regurgitation: a case report
Authors: Masumoto Akiko , Yamamoto Hiroyuki , Takahashi Nobuyuki , Onishi Tetsuari , Takaya Tomofumi 
Published: February 2023

AbstractBackgroundAtrial functional mitral regurgitation (AFMR) is an entity of mitral regurgitation (MR) in atrial fibrillation (AF) with dilated left atrium (LA) and/or normal left ventricular function. Transcatheter edge-to-edge mitral valve repair with MitraClip is reportedly an effective therapy for AFMR. However, performing MitraClip for patients with such condition is challenging because of its characteristic morphology.Case summaryAn 80-year-old man with permanent AF and severe MR was hospitalized for heart failure with preserved ejection fraction. On echocardiography, a marked dilation of the LA caused the anterior mitral leaflet to flatten along the mitral annulus (MA) plane. The posterior mitral leaflet was tethered towards the posterior left ventricle, thus producing a coaptation gap of 6.5 mm between the leaflets. Given his high surgical risk, MitraClip therapy was performed, but leaflet grasping was difficult because of the notable coaptation gap. When positive end-expiratory pressure (PEEP) was applied by mechanical ventilation, the MA gradually decreased in diameter. Under 20 cm H2O of PEEP, the coaptation gap decreased to 0 mm, which finally enabled the grasping of the leaflets. The clip was deployed, thus leaving only mild MR. Thereafter, the patient had an uneventful clinical course.DiscussionIn patients with AFMR, the sagittal dilation of the MA and asymmetry in the tethering angles of the leaflets often produce a marked coaptation gap, which poses a challenge in MitraClip therapy. In our patient, the ventilator-assisted technique effectively reduced the coaptation gap between the leaflets, thus leading to successful results.
Chest pain and Raynaud’s phenomenon after COVID-19 vaccination in a patient previously diagnosed with systemic lupus erythematosus: a case report
Authors: Kawano Hiroaki , Umeda Masataka , Okano Shinji , Kudo Takashi 
Published: February 2023

AbstractBackgroundCardiovascular events, including pericarditis, myocarditis, and myocardial ischaemia, have been reported as complications following COVID-19 vaccination.Case summaryA 28-year-old Japanese woman diagnosed 10 years earlier with systemic lupus erythematosus and antiphospholipid syndrome was admitted to our hospital because of chest pain and Raynaud’s phenomenon. She had received a second dose of the COVID-19 BNT162b2 mRNA vaccine 28 days earlier. 123I-β-methyl iodophenyl pentadecanoic acid (BMIPP) and 201thallium dual myocardial single-photon emission computed tomography demonstrated mildly reduced perfusion of BMIPP in the mid-anterior wall of the left ventricle. Coronary angiography revealed normal coronary arteries; additionally, an endomyocardial biopsy was performed. Histopathological evaluation revealed a normal myocardium without cell infiltration. However, immunostaining for the severe acute respiratory coronavirus (SARS-CoV)/severe acute respiratory coronavirus 2 (SARS-CoV-2) spike protein was positive in the small intramural coronary arteries. The administration of azathioprine (50 mg/day) and amlodipine (5 mg/day) and increases in her prednisolone (10 mg/day) and aspirin doses led to improvements in the symptoms of the patient.DiscussionOur data lead us to speculate that two events in the timeline of the patient, namely, receiving COVID-19 vaccination and the presence of SARS-CoV/SARS-CoV-2 spike protein in small intramural coronary arteries, may be related to the myocardial microangiopathy observed in this patient.
Bleeding and thrombotic events in post-cardiotomy extracorporeal life support
Authors: Schaefer Anne-Kristin , Latus Michaela , Riebandt Julia , Goliasch Georg , Bernardi Martin H , Laufer Günther , Zimpfer Daniel , Wiedemann Dominik 
Published: February 2023

AbstractOBJECTIVESHaemorrhagic and thrombotic complications are known obstacles in extracorporeal life support (ECLS), and patients requiring post-cardiotomy (PC)-ECLS are particularly prone. The objective of this study was to characterize the incidence, type and clinical relevance of bleeding and thrombotic events in patients on PC-ECLS.METHODSA total of 504 patients receiving PC-ECLS between 2000 and 2021 at a single centre were included in a retrospective analysis. Incidence and type of haemorrhagic and thrombotic complications in patients on PC-ECLS were assessed. Overall survival was compared, and perioperative risk factors for bleeding and thrombotic events were assessed by binary logistic regression.RESULTSOf the 504 patients requiring PC-ECLS, 196 patients (38.9%) had 235 bleeding events [surgical site: n = 135 (26.8%); cannulation site: n = 68(13.4%); requiring surgical revision: n = 39 (7.7%); cannulation site change: n = 17 (3.4%); fatal cannulation site bleeding: n = 4(0.8%); intracranial haemorrhage: n = 11 (2.1%); gastrointestinal haemorrhage: n = 8 (1.6%); pulmonary haemorrhage: n = 8 (1.6%); and intra-abdominal/retroperitoneal haemorrhage: n = 5 (1%)]. Overall mortality was higher in patients with major bleeding complications than in patients without bleeding complications (P &lt; 0.0001).A total of 74 patients (14.7%) had 84 thrombotic events [ischaemic stroke, n = 39 (7.7%); cannula/circuit thrombosis, n = 26 (5.2%); peripheral embolism, n = 11 (2.2%); device exchange for haemolysis, n = 8 (1.6%)]. Another 246 patients (48.8%) had at least 1 haemocompatibility-related adverse event. Preoperative dual antiplatelet therapy [adjusted odds ratio (OR): 1.83, 95% confidence interval (CI): 1.063–3.137] and ECLS duration (adjusted OR: 1.14, 95% CI: 1.086–1.197) were identified as independent risk factors for haemorrhage. Prior stroke/transient ischaemic attack (adjusted OR: 1.91, 95% CI: 1.08–3.83) and ECLS duration (adjusted OR: 1.09, 95% CI: 1.04–1.15) were identified as risk factors for thrombotic events.CONCLUSIONSBleeding complications in patients on ECLS are common and significantly impair survival. Nearly half of the patients were affected by any haemocompatibility-related event.
Childhood adversity and risk of later labor market marginalization in young employees in Sweden
Authors: Björkenstam Emma , Helgesson Magnus , Mittendorfer-Rutz Ellenor 
Published: February 2023

AbstractBackgroundThe present study examined the independent and combined effects of childhood adversity (CA) and occupational class on the risk of future labor market marginalization (LMM) in young employees in Sweden. Occupational class (non-manual/manual workers) was also explored as a potential mediator.MethodsThis population-based longitudinal cohort study included 556 793 employees, 19–29 years, residing in Sweden in 2009. CAs included parental death, parental mental and somatic disorders, parental separation, household public assistance, single-parent household and residential instability. Measures of LMM included long-term unemployment (LTU), long-term sickness absence (LTSA) and disability pension. Estimates of risk of each LMM measure, between 2010 and 2016 were calculated as hazard ratios (HRs) with 95% confidence intervals (CIs), using a Cox regression analysis.ResultsThose exposed to CA had an elevated risk for all measures of LMM. Manual workers with a history of household public assistance had the highest risk estimates compared to non-manual workers with no CAs [adjusted HR spanning from 1.59 (LTSA) to 2.50 (LTU)]. Regardless of occupational class, the risk of LMM grew higher with increasing number of CAs (e.g. adjusted HR of LMM in manual workers with 3+ CAs: 1.87, 95% CI: 1.81–1.94). These patterns persisted after adjustments for a range of confounders, including psychiatric and somatic morbidity. Last, we found a small but significant mediating effect of occupational class in the association between CA and LMM.ConclusionsInformation on CAs are important determinants of LMM in young adults, and especially in manual workers.
The first consultation for low mood in general practice: what do patients find helpful?
Authors: Morgan Ian , Dowrick Chris , Macdonald Sara , Wilkes Scott , Watson Stuart 
Published: February 2023

Abstract

Background
Recent evidence suggests that the first consultation with a general practitioner (GP) for symptoms of depression may be more than just a vehicle for assessment and management planning (as current guidelines imply).

Objectives
To identify what patients find helpful, or otherwise, in their first consultation for low mood with a GP.

Methods
A cross-sectional questionnaire and interview study of patients with low mood who had recently consulted their GP, in the North of England. Patients were asked to complete a questionnaire regarding the consultation, and a Patient Health Questionnaire-9 (PHQ-9), within 2 weeks. They were also invited to take part in a face–face interview with a researcher. Both sources of data were subjected to qualitative thematic analysis.

Results
Thirty-seven questionnaires were returned; 5 interviews took place. The majority of participants felt better after consulting a GP for the first time for low mood. The factors most commonly cited as helpful were “being listened to” and “understanding or empathy from the GP.” Others included “admitting the problem,” “being reassured of normality,” and “being provided with optimism or hope for change.” The most commonly reported difficulty was the patients’ struggle to express themselves. Patients often felt that GP follow-up was inadequate.

Conclusions
These results suggest that the therapeutic benefit of the GP consultation is under-recognized in current guidelines. The results of our study will provide crucial information as to how such consultations can be tailored to improve patient satisfaction.
Quasi-2-D Bayesian inversion of central loop transient electromagnetic data using an adaptive Voronoi parametrization
Authors: Peng Ronghua , Yogeshwar Pritam , Liu Yajun , Hu Xiangyun 
Published: February 2023

SUMMARYCentral loop transient electromagnetic (TEM) data are often interpreted by conventional 1-D or quasi-2-D inversion techniques. For example, the lateral constrained inversion (LCI) is a powerful technique for quick interpretation of central loop TEM data, and can produce spatially consistent resistivity images for profile data by assuming spatial correlation between adjacent model parameters. Such quasi-2-D techniques are very powerful in cases multidimensional effects are small or negligible. However, the inverse solution of conventional LCI methods strongly depends on subjective interpreter choices such as the model regularization and the imposed lateral constraints. Due to inherent non-linearity and nonuniqueness of the TEM inverse problems, this can result in biased model parameters and their estimated model uncertainties. We present a transdimensional Markov chain Monte Carlo method for the quasi-2-D inversion of TEM data using a Bayesian inference framework. We term the approach quasi-2-D, since the model is parametrized in 2-D with unstructured Voronoi cells, whereas the TEM response at each station is predicted using a 1-D forward solution to make the problem computationally affordable. During the inversion, the number of Voronoi cells as well as their positions and resistivities are variable. Accordingly, the level of model complexity is automatically determined by the framework and adapted to the spatial resolution of the data, thus avoiding the need for subjective model regularization or spatial constraints. The approach is validated using synthetic data and compared to 1-D Bayesian and conventional Gauss Newton inversion techniques. The application to dense field data from a floating TEM survey leads to a consistent subsurface image with unbiased uncertainty estimates and a plausible depth of investigation. The quantitative uncertainty information provided by the Bayesian framework is beneficial in identifying resolution.
MUC5AC Genetic Variation Is Associated With Tuberculous Meningitis Cerebral Spinal Fluid Cytokine Responses and Mortality
Authors: Sabo Michelle C , Thuong Nguyen T T , Chang Xuling , Ardiansyah Edwin , Tram Trinh T B , Hai Hoang T , Nghia Ho D T , Bang Nguyen D , Dian Sofiati , Ganiem A Rizal , Shaporifar Shima , Kumar Vinod , Li Zheng , Hibberd Martin , Khor Chiea Chuen , Thwaites Guy E , Heemskerk Dorothee , van Laarhoven Arjan , van Crevel Reinout , Dunstan Sarah J , Shah Javeed A 
Published: February 2023

Abstract

Background
The purpose of this study was to assess if single nucleotide polymorphisms (SNPs) in lung mucins MUC5B and MUC5AC are associated with Mycobacterium tuberculosis outcomes.

Methods
Independent SNPs in MUC5B and MUC5AC (genotyped by Illumina HumanOmniExpress array) were assessed for associations with tumor necrosis factor (TNF) concentrations (measured by immunoassay) in cerebral spinal fluid (CSF) from tuberculous meningitis (TBM) patients. SNPs associated with CSF TNF concentrations were carried forward for analyses of pulmonary and meningeal tuberculosis susceptibility and TBM mortality.

Results
MUC5AC SNP rs28737416 T allele was associated with lower CSF concentrations of TNF (P = 1.8 × 10−8) and IFN-γ (P = 2.3 × 10−6). In an additive genetic model, rs28737416 T/T genotype was associated with higher susceptibility to TBM (odds ratio [OR], 1.24; 95% confidence interval [CI], 1.03–1.49; P = .02), but not pulmonary tuberculosis (OR, 1.11, 95% CI, .98–1.25; P = .10). TBM mortality was higher among participants with the rs28737416 T/T and T/C genotypes (35/119, 30.4%) versus the C/C genotype (11/89, 12.4%; log-rank P = .005) in a Vietnam discovery cohort (n = 210), an independent Vietnam validation cohort (n = 87; 9/87, 19.1% vs 1/20, 2.5%; log-rank P = .02), and an Indonesia validation cohort (n = 468, 127/287, 44.3% vs 65/181, 35.9%; log-rank P = .06).

Conclusions
MUC5AC variants may contribute to immune changes that influence TBM outcomes.
Passenger vehicle interior decontamination by low concentration hydrogen peroxide vapor following a wide area biological contamination incident
Authors: Oudejans Lukas , Richter William , Sunderman Michelle , Calfee M Worth , Mickelsen R Leroy , Hofacre Kent , Keyes Patrick , Lee Sang Don 
Published: February 2023

AbstractAimsTo assess low concentration hydrogen peroxide (LCHP) (H2O2) vapor dispersed with a home humidifier for its ability to decontaminate vehicle interiors contaminated with Bacillus anthracis surrogate Bacillus atrophaeus spores.Methods and resultsEfficacy of a vaporized 3% H2O2 solution was evaluated for liquid volumes, on/off vehicle heating, ventilation, and air conditioning (HVAC) system operations, and temperatures that ranged from 5 to 27°C. Survival of the spores was assessed by quantification of remaining viable spores with efficacy quantified in terms of mean log10 reduction. Decontamination efficacy after the 6-day dwell time increased when the 3% H2O2 liquid volume was doubled, increasing from 4-of-10 to 10-of-10 nondetects (zero colonies counted using standard dilution and filter plating) inside the vehicle cabin. Recirculating cabin air through the HVAC system during decontamination decreased efficacy to 6-of-10 non-detects. While no 6-log10 reduction in viable spores was observed on the cabin filter with the cabin filter kept in place, a 6-log10 reduction was achieved after its removal and placement in the cabin during treatment.ConclusionsResults from this study allow for informed decisions on the use of LCHP vapor as an effective decontamination approach for vehicle interiors.
Multi-attention-based soft partition network for vehicle re-identification
Authors: Lee Sangrok , Woo Taekang , Lee Sang Hun 
Published: February 2023

AbstractVehicle re-identification helps in distinguishing between images of the same and other vehicles. It is a challenging process because of significant intra-instance differences between identical vehicles from different views and subtle inter-instance differences between similar vehicles. To solve this issue, researchers have extracted view-aware or part-specific features via spatial attention mechanisms, which usually result in noisy attention maps or otherwise require expensive additional annotation for metadata, such as key points, to improve the quality. Meanwhile, based on the researchers’ insights, various handcrafted multi-attention architectures for specific viewpoints or vehicle parts have been proposed. However, this approach does not guarantee that the number and nature of attention branches will be optimal for real-world re-identification tasks. To address these problems, we proposed a new vehicle re-identification network based on a multiple soft attention mechanism for capturing various discriminative regions from different viewpoints more efficiently. Furthermore, this model can significantly reduce the noise in spatial attention maps by devising a new method for creating an attention map for insignificant regions and then excluding it from generating the final result. We also combined a channel-wise attention mechanism with a spatial attention mechanism for the efficient selection of important semantic attributes for vehicle re-identification. Our experiments showed that our proposed model achieved a state-of-the-art performance among the attention-based methods without metadata and was comparable to the approaches using metadata for the VehicleID and VERI-Wild datasets.