bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of mitral repair combined with Cox-maze procedure for atrial functional mitral regurgitation with heart failure with recovered ejection fraction
Authors: Ye Qing , Zhao Yichen , Bai Chen , Liu Kemin , Zhao Cheng , Liu Yang , Li Yuqi , Wang Jiangang 
Published: August 2023

Abstract

OBJECTIVES
Atrial functional mitral regurgitation (AFMR) in patients with heart failure with recovered ejection fraction has received insufficient attention. This study analysed the prognosis and outcomes of mitral valve (MV) repair combined with the Cox-maze procedure.

METHODS
A prospective cohort study of patients with AFMR with left ventricular ejection fraction (LVEF) &lt;40% was conducted. All patients received guideline-directed medical therapy. Those with recovered ejection fraction underwent MV repair combined with the Cox-maze procedure. Mortality, atrial fibrillation (AF) recurrence, mitral regurgitation (MR) and postoperative tricuspid regurgitation were assessed using the inverse probability weighting (IPW) method.

RESULTS
In total, 312 patients were enrolled in this study between 2010 and 2019, 247 of whom underwent MV repair combined with the Cox-maze procedure [full recovery (LVEF &gt; 50%): n = 132, partial recovery (LVEF of 40–50%): n = 115]. IPW-adjusted survival of patients with LVEF ≥50% and LVEF 40–50% showed no significant difference [hazard ratio (HR): 2.18, 95% confidence interval: 0.46–10.38, P = 0.33]. However, patients with LVEF ≥50% had better IPW-adjusted long-term freedom from recurrent MR [HR: 2.44 (1.28–4.63), P = 0.0065] and AF recurrence [HR: 1.85 (1.06–3.21), P = 0.030] than those with LVEF of 40–50%.

CONCLUSIONS
MV repair combined with the Cox-maze procedure was effective and feasible in patients with severe AFMR with heart failure with recovered ejection fraction. Additionally, patients with LVEF ≥50% after guideline-directed medical therapy undergoing these combined procedures had better long-term freedom from recurrent AF and MR than those with LVEF of 40–50%.
Propagator and transfer matrices, Marchenko focusing functions and their mutual relations
Authors: Wapenaar Kees , Dukalski Marcin , Reinicke Christian , Snieder Roel 
Published: August 2023

SUMMARY
Many seismic imaging methods use wavefield extrapolation operators to redatum sources and receivers from the surface into the subsurface. We discuss wavefield extrapolation operators that account for internal multiple reflections, in particular propagator matrices, transfer matrices and Marchenko focusing functions. A propagator matrix is a square matrix that ‘propagates’ a wavefield vector from one depth level to another. It accounts for primaries and multiples and holds for propagating and evanescent waves. A Marchenko focusing function is a wavefield that focuses at a designated point in space at zero time. Marchenko focusing functions are useful for retrieving the wavefield inside a heterogeneous medium from the reflection response at its surface. By expressing these focusing functions in terms of the propagator matrix, the usual approximations (such as ignoring evanescent waves) are avoided. While a propagator matrix acts on the full wavefield vector, a transfer matrix (according to the definition used in this paper) ‘transfers’ a decomposed wavefield vector (containing downgoing and upgoing waves) from one depth level to another. It can be expressed in terms of decomposed Marchenko focusing functions. We present propagator matrices, transfer matrices and Marchenko focusing functions in a consistent way and discuss their mutual relations. In the main text we consider the acoustic situation and in the appendices we discuss other wave phenomena. Understanding these mutual connections may lead to new developments of Marchenko theory and its applications in wavefield focusing, Green’s function retrieval and imaging.
Expanding and Contracting the UN Guiding Principles: an Analysis of Recent Inter-American Human Rights Court Decisions
Authors: Smart Sebastián 
Published: August 2023

Abstract
In 2021, the Inter-American Court of Human Rights (IACtHR) decided two cases for advancing the increasing jurisprudence on the implementation of human rights and business standards, yet there is still a gap to fill. Despite the important development with regards to the State obligation to supervise business operations, the decisions do not introduce further definitions of companies’ responsibilities on human rights nor the potential of creating mandatory remedies standards for private agents. Through the analysis of the 2021 case law, this article concludes that the IACtHR has been increasingly using the UN Guiding Principles to argue for its rulings but has missed the opportunity to generate greater accountability for companies and private actors in its decision-making.
Surgical approach to coexistent inguinal endometriosis and inguinal hernial defect: a case report
Authors: Almagushi Nouf , Almadhi Leen , Aljomah Nadia , Albabtain Ibrahim 
Published: August 2023

Abstract
The presence of ectopic endometrial and myometrial tissue is referred to as endometriosis. The majority of cases of inguinal endometriosis are linked to prior uterine surgery. We present a 39-year-old female presented to the general surgery clinic in June 2013 with mild right inguinal pain and swelling. Enhanced computed tomography scan of the abdominal and pelvis revealed an elongated cystic mass in the right groin region. Diagnostic laparoscopy was performed and the uterus, both ovaries, and pouch of Douglas were examined. Two endometrial deposits were detected: on in the superoposteriar part of the uterus and another below the base of the right fallopian tube. In addition to the right inguinal hernia, a cystic lesion was noted on the surface of the round ligament. The entire round ligament, including the canal of Nuck, and cyst were dissected and excised completely. The right inguinal hernia was repaired.
Pleomorphic dermal sarcoma: it might be rare but it exists
Authors: Seretis Konstantinos , Klaroudas Antonios , Galani Vasiliki , Papathanakos Georgios , Varouktsi Anna , Mitselou Antigoni , Batistatou Anna , Lampri Evangeli 
Published: August 2023

Abstract
Pleomorphic dermal sarcoma (PDS) is a rare mesenchymal tissue tumor. Its differential diagnosis from similar tumors, such as low differentiated squamous cell carcinoma, fibrosarcoma, desmoplastic melanoma, atypical fibroxanthoma (AFX), may be difficult, as they have similar clinical and histological presentation. We present a case of an 83-year-old man exhibiting an exophytic scalp lesion. Excision of the lesion was performed, ensuring clear surgical margins and pathologic examination revealed an invasive pleomorphic dermal sarcoma. This case highlights a rare case of a large pleomorphic dermal sarcoma, and it discusses the histological, molecular features, its differential diagnosis and management of PDS.
Surgical management of isolated caecal varices presenting with massive lower gastrointestinal haemorrhage: a case report and review of the literature
Authors: Qian Wanyang , Mac Curtain Benjamin M , Trivedi Anand 
Published: August 2023

Abstract
Caecal varices are extremely rare with poorly defined management due to paucity of data. A 52-year-old man was diagnosed with a 3-day history of melena with a background of chronic liver disease and non-steroidal anti-inflammatory use. Investigations revealed anaemia with haemoglobin of 62 g/L, liver function derangement (Gamma-glutamyl transferase 251 U/L, alanine transaminase 40 U/L, bilirubin 84 umol/L, alkaline phosphatase 85 U/L), coagulopathy (International Normalized Ratio 1.6) and acute kidney injury (Creatinine 285 umol/L). Gastroscopy demonstrated no signs of upper gastrointestinal bleeding or portal hypertension. A large volume haematochezia occurred necessitating resuscitation with massive transfusion protocol, and colonoscopy was abandoned in favour of computerized tomography (CT) angiography, which revealed a large varix feeding the caecum. Urgent laparotomy and a right hemicolectomy was performed with application of abdominal vacuum dressing. The hemicolectomy sample was opened on back table demonstrating large caecal varix causing intraluminal bleeding. The patient was stabilized in intensive care, and a further laparotomy was performed 2 days later where an end ileostomy was formed. Caecal varices have been reported in literature with management via trans-jugular intrahepatic portosystemic shunt, endoscopically or conservatively with beta-blockade. Here we present, to the best of the author’s knowledge, the first reported case of successful surgical management of caecal varices.
Possible circumstellar interaction origin of the early excess emission in thermonuclear supernovae
Authors: Hu Maokai , Wang Lifan , Wang Xiaofeng , Wang Lingzhi 
Published: August 2023

ABSTRACT
Type Ia supernovae (SNe Ia) arise from the thermonuclear explosion in binary systems involving carbon–oxygen white dwarfs (WDs). The pathway of WDs acquiring mass may produce circumstellar material (CSM). Observing SNe Ia within a few hours to a few days after the explosion can provide insight into the nature of CSM relating to the progenitor systems. In this paper, we propose a CSM model to investigate the effect of ejecta−CSM interaction on the early-time multiband light curves of SNe Ia. By varying the mass-loss history of the progenitor system, we apply the ejecta−CSM interaction model to fit the optical and ultraviolet (UV) photometric data of eight SNe Ia with early excess. The photometric data of SNe Ia in our sample can be well matched by our CSM model except for the UV-band light curve of iPTF14atg, indicating its early excess may not be due to the ejecta−CSM interaction. Meanwhile, the CSM interaction can generate synchrotron radiation from relativistic electrons in the shocked gas, making radio observations a distinctive probe of CSM. The radio luminosity based on our models suggests that positive detection of the radio signal is only possible within a few days after the explosion at higher radio frequencies (e.g. ∼250 GHz); at lower frequencies (e.g. ∼1.5 GHz), the detection is difficult. These models lead us to conclude that a multimessenger approach that involves UV, optical, and radio observations of SNe Ia a few days past explosion is needed to address many of the outstanding questions concerning the progenitor systems of SNe Ia.
The evolution of the Milky Way’s thin disc radial metallicity gradient with K2 asteroseismic ages
Authors: Willett Emma , Miglio Andrea , Mackereth J Ted , Chiappini Cristina , Lyttle Alexander J , Elsworth Yvonne , Mosser Benoît , Khan Saniya , Anders Friedrich , Casali Giada , Grisoni Valeria 
Published: August 2023

ABSTRACT
The radial metallicity distribution of the Milky Way’s disc is an important observational constraint for models of the formation and evolution of our Galaxy. It informs our understanding of the chemical enrichment of the Galactic disc and the dynamical processes therein, particularly radial migration. We investigate how the metallicity changes with guiding radius in the thin disc using a sample of red giant stars with robust astrometric, spectroscopic, and asteroseismic parameters. Our sample contains 668 stars with guiding radii 4 &lt; Rg &lt; 11 kpc and asteroseismic ages covering the whole history of the thin disc with precision ${\approx} 25 {{\, \rm per\ cent}}$. We use MCMC analysis to measure the gradient and its intrinsic spread in bins of age and construct a hierarchical Bayesian model to investigate the evolution of these parameters independently of the bins. We find a smooth evolution of the gradient from ≈−0.07 dex kpc−1 in the youngest stars to ≈−0.04 dex kpc−1 in stars older than 10 Gyr, with no break at intermediate ages. Our results are consistent with those based on asteroseismic ages from CoRoT, with that found in Cepheid variables for stars younger than 1 Gyr, and with open clusters for stars younger than 6 Gyr. For older stars we find a significantly lower metallicity in our sample than in the clusters, suggesting a survival bias favouring more metal-rich clusters. We also find that the chemical evolution model of Chiappini '09 is too metal poor in the early stages of disc formation. Our results provide strong new constraints for the growth and enrichment of the thin disc and radial migration, which will facilitate new tests of model conditions and physics.
On the origin of planetary-mass objects in NGC 1333
Authors: Parker Richard J , Alves de Oliveira Catarina 
Published: August 2023

ABSTRACT
The dominant formation mechanism of brown dwarfs and planetary-mass objects (PMOs) in star-forming regions is presently uncertain. Do they form like stars, via the collapse and fragmentation of cores in giant molecular clouds, or do they form like planets in the discs around stars and are ejected via dynamical interactions? In this paper, we quantify the spatial distribution of substellar objects in NGC 1333, in particular focusing on PMOs that have been the target of recent deep imaging observations. We find that these objects have a spatial distribution that is indistinguishable from the stars, and more massive brown dwarfs. We also analyse N-body simulations and find that a population of ejected planets would have a significantly different spatial and kinematic distribution from stars, and brown dwarfs that also formed through gravitational collapse and fragmentation. We therefore conclude that the low-mass substellar objects in NGC 1333 formed more like stars than planets, although we predict that a population of hitherto undetected ejected PMOs may be lurking in this and other star-forming regions.
Challenges faced by nurses engaged in rheumatology care in Japan
Authors: Fusama Mie , Nakahara Hideko , Gregg Misuzu , Kuroe Yuriko , Urata Yukitomo , Kawahata Kimito , Kawahito Yutaka , Kojima Masayo , Sugihara Takahiko , Hashimoto Motomu , Miyamae Takako , Murashima Atsuko , Mori Masaaki , Yajima Nobuyuki , Matsui Toshihiro 
Published: August 2023

ABSTRACT

Objectives
This study aimed to identify the challenges faced by nurses engaged in rheumatology care in Japan.

Methods
We conducted a questionnaire survey of nurses in Japan in 2020 on challenges experienced in rheumatology care. The participants were nurses certified by the Japan Rheumatism Foundation. Participants’ answers were coded and categorized based on relevant phrases and words. Content analysis was performed on the findings.

Results
Responses were collected from 162 participants, and a total of 228 issues were identified. Eighteen categories with 56 subcategories emerged from the data analysis, which were grouped into five types of challenges: (1) communication, (2) understanding, (3) expertise, (4) system, and (5) collaboration. In particular, the results highlighted deficiencies in needs-based multidisciplinary team care.

Conclusion
This study elucidated issues experienced by rheumatology nurses in clinical settings in Japan. Furthermore, this investigation revealed the necessity of patient-centred multidisciplinary team care, including health professionals, patients, and other relevant individuals. This study provided practical directions to facilitate the implementation of effective care focused on improving patients’ quality of life.
BSBM-15 SYSTEMIC AND LOCAL IMMUNE RESPONSES FOLLOWING STEREOTACTIC RADIOSURGERY TO BRAIN METASTASES FROM HER2-AMPLIFIED BREAST CANCER
Authors: Sia Joseph , D'Souza Criselle , Castle Becky , Huang Yu-Kuan , Siva Shankar , Neeson Paul 
Published: August 2023

Abstract

BACKGROUND
Brain metastases (BMs) afflict 30-50% of HER2-amplified breast cancer (HER2-BC) patients. Stereotactic radiosurgery (SRS) is a highly effective focal treatment for BMs. Extracranial radiotherapy can promote anti-tumor immune responses that synergize with immunotherapy, but whether this applies to the brain microenvironment remains unclear. Here, we examined blood and BM samples from HER2-BC patients in the TROG 16.02 translational sub-study for immunological effects of SRS (ACTRN12616001265460).

METHODS
Blood samples from 10 patients taken pre- and 7-14 days post-SRS to intact HER2-BC BMs or post-resection BM cavities were analyzed by mass and flow cytometry for immune cell and cytokine modulation. One patient received pre-operative SRS for a BM that recurred 6 months after resection, followed by re-resection of the BM 7 days post-SRS. Tumors from pre- and post-SRS timepoints in this patient were analyzed by bulk RNAseq and immunohistochemistry.

RESULTS
Monocytes, CD8+ T effector memory and regulatory T cells were enriched in blood post-SRS, while conventional dendritic cells, CD4+ T early and CD4+ TEMRA cells were diminished. Stem cell factor (SCF) concentration, a growth factor important for monocyte production, was elevated in plasma post-SRS. In the tumor, SRS upregulated gene signatures for monocyte/macrophage processes (including SCF gene transcript levels), antigen presentation, and T cell activation. Cell type deconvolution from RNAseq suggested an SRS-induced loss of metastatic tumor cells and enrichment of macrophages and CD4+ T cells. Immunohistochemistry corroborated the influx of CD68+ macrophages and CD3+ T cells into tumor and brain regions post-SRS, with spatial co-localization evident between the cell types. Furthermore, the pre-SRS immune-excluded phenotype in tumor regions was no longer observed post-SRS.

CONCLUSION
Systemic and local immunological changes in this homogenous patient cohort receiving SRS to HER2-BC BMs suggest a radiation-induced adaptive immune response intracranially, involving the monocyte-macrophage lineage as antigen presenting cells, that should be further explored.
BSLD-01 DYNAMIC CONTROL OF CSF FOR PERSONALIZED CNS DRUG DELIVERY FOR LEPTOMINGEAL DISEASE
Authors: Kumthekar Priya , Benatti Hector Ribeiro , Taghian Toloo , Nagpal Seema , Gormley William , Baker William , Patel Rajan , Brown Emma , Glicksman Marcie , Gray-Edwards Heather 
Published: August 2023

Abstract

BACKGROUND
Appropriate drug distribution is needed for effective treatment of brain metastases and leptomeningeal disease. Lack of proper drug bioavailability in the CNS contributes to the poor outcome in these patients. EnClear Therapies has developed a device delivering intrathecal therapeutics utilizing the dynamic control of CSF flow through an external pump. Herein, we look at intrathecal drug delivery of methotrexate with EnClear’s system and its impact of drug concentration in CNS tissue in sheep and non-human primates.

METHODS
EnClear’s system utilizes two implantable catheters (lateral ventricle and lumbar thecal sac) and an extracorporeal pump that controls the speed and direction of CSF flow. Software continuously monitors and reports the output from sensor arrays for pressure, respiration, and heart rate. Imaging studies were used to track the CSF flow characteristics during the use of EnClear’s system. Data from administration of methotrexate followed by the use of EnClear’s system was compared to the current standard of delivery, intracerebroventricular or lumbar intrathecal administration. Methotrexate levels were measured with LC/MS in CSF, blood, and multiple CNS and peripheral tissues.

RESULTS
There was a two-fold increase in methotrexate levels in multiple regions of the brain including deeper brain structures including the striatum using EnClear's system, compared to traditional lumbar intrathecal and intracerebroventricular delivery. Higher peak levels of methotrexate were reached in the CSF with the use of EnClear’s system, with simultaneous reduction in the peripheral nerves and systemic tissues – a potential source of toxicity.

CONCLUSIONS
In large animal studies, EnClear’s system has for the first time, demonstrated increased brain parenchymal drug levels via intrathecal delivery. Drug delivery with this novel device has shown improved distribution throughout the CNS and leptomeninges as compared to traditional intrathecal drug delivery and decreased peripheral distribution.
BSLD-02 ELUCIDATING LEPTOMENINGEAL MICROENVIRONMENT CUES THAT PROMOTE METASTASIS AND CHEMOTHERAPY RESISTANCE IN HIGH-RISK MEDULLOBLASTOMA
Authors: Reinecke James , Garcia Leyre Jimenez , Roberts Ryan 
Published: August 2023

Abstract
Medulloblastoma is a molecularly heterogenous brain tumor of the cerebellum and is a leading cause of pediatric cancer mortality due to its propensity for leptomeningeal metastasis. Leptomeningeal metastasis occurs in over 20-30% of patients despite age- and risk- adapted chemoradiation therapy. The mechanisms responsible for medulloblastoma metastasis and therapy resistance remain incompletely understood. The leptomeninges represent a fundamentally distinct microenvironment from the primary cerebellar tumor. We hypothesized that unique signaling inputs from the cellular and extracellular milieu of the leptomeninges drive distinct medulloblastoma biology that leads to resistance to current standard of care therapy. We tested this hypothesis using Group 3-MYC amplified (Grp3-MA) cell lines given their high metastatic potential. Primary tumors grow within a glycosaminoglycan (hyaluronan) rich matrix while leptomeningeal metastases grow in a laminar fashion attached to leptomeningeal (pial) cells that were enriched for laminins, collagens, and fibronectin. Analogously, Grp3-MA cells grow in suspension at steady state, but subpopulations readily adhere to a leptomeningeal membrane mimetic in vitro. This attachment required integrin beta 1 (ITGB1) and promoted chemotherapy resistance. We additionally have created a novel co-culture model wherein medulloblastoma cells grow as adherent clusters on a layer of primary leptomeningeal cells in an ITGB1 dependent manner. We are using this co-culture platform to perform single cell RNA sequencing and ligand receptor analysis to understand how cell-cell communication between leptomeningeal cells and medulloblastoma cells promotes tumor cell growth. Collectively, our studies demonstrate that cues from the leptomeningeal microenvironment alter medulloblastoma cell behavior and are attractive targets for developing novel therapies against metastasis.