bluuebunny/crossref_metadata_2025_split huggingface dataset:
Blood Conservation during Open Heart Surgery: A Literature Review
Authors: Vertrees Roger A. , Engelman Richard M. , Johnson Joe W. , Auvil Jackson , Breyer Robert H. , Rousou John A. 
Published: September 2023

(J. Extra-Corpor. Technol. 18[4] p.198–207 Winter 1986, 74 refs.) Due to the increase of cardiac surgery and cardiopulmonary bypass procedures (CBP) in recent years, tremendous demands have been placed on local blood banking facilities. As a consequence, methods to conserve blood during CPB have proliferated. Indeed, through the many innovations in technique and technology, blood usage has been curtailed to a fraction of what it was less than a decade ago. Oschner et al. report that in 1981, on average, 1.8 units of blood were used per patient per hospital stay, in contrast to approximately 8 units used in 1975. The Cleveland Clinic reports that by the year 1983 average blood usage per patient per hospital stay had decreased to 0.8 units. These numbers show a sharp improvement over the 5-8 units of blood required simply to “prime the pump” in the late sixties and early seventies.
A number of technologies are responsible for this drastic reduction in homologous blood requirements during CPB. More efficient oxygenators, for example, have contributed to lengthened red cell survival. Improved biomaterials have substantially increased the survival of platelets and leukocytes. Prebyass autologous blood withdrawal techniques, which can protect up to 20% of the patient’s blood volume from the ravages of CPB, have been used. Autotrans-fusion devices, which reclaim blood that otherwise would be lost, process it, and then return it to the circulation in a usable form, have also found significant use. The development of molecules of heparin and protamine of increased purity has provided greater control over the coagulation cascade, especially when used in conjunction with activated clotting time and heparin-protamine titration tests. An important development in blood conservation has been that of hemodilution.
Broadband surface-emitting THz laser frequency combs with inverse-designed integrated reflectors
Authors: Senica Urban , Gloor Sebastian , Micheletti Paolo , Stark David , Beck Mattias , Faist Jérôme , Scalari Giacomo 
Published: September 2023

THz quantum cascade lasers (QCLs) based on double metal waveguides feature broadband and high-temperature devices for their use in spectroscopy and sensing. However, their extreme field confinement produces poor output coupling efficiencies and divergent far-fields. Here, we present a planarized THz QCL with an inverse-designed end facet reflector coupled to a surface-emitting patch array antenna. All the components have been optimized for octave-spanning spectral bandwidths between 2 and 4 THz and monolithically integrated on the same photonic chip. We demonstrate this experimentally on broadband THz QCL frequency combs, with measured devices showing a seven-fold improvement in slope efficiency compared to devices with a cleaved facet. They feature a peak power of up to 13.5 mW with surface emission into a narrow beam with a divergence of (17.0° × 18.5°), while broadband fundamental and harmonic comb states spanning up to 800 GHz are observed.
Imaging lattice reconstruction in homobilayers and heterobilayers of transition metal dichalcogenides
Authors: Rupp Anna , Göser Jonas , Li Zhijie , Bilgin Ismail , Baimuratov Anvar , Högele Alexander 
Published: September 2023

Abstract
Moiré interference effects influence profoundly the optoelectronic properties of vertical van der Waals structures. Here we systematically establish secondary electron imaging in a scanning electron microscope as a powerful technique for visualizing reconstruction of moiré lattices into registry-contrasting domains in vertical homobilayers and heteorbilayers of transition metal dichalcogenides (TMDs) with parallel and antiparallel alignment. With optimal parameters for contrast-maximizing imaging of high-symmetry registries, we identify distinct crystal realizations of WSe2 homobilayers and MoSe2–WSe2 heterostructures synthesized by chemical vapor deposition. In particular, we find evidence for a mutually exclusive competition between

R
h
X

and

R
h
M

registries, manifesting in complete reconstruction of bilayer crystals into one distinct registry or alternating large-area domains in

R
h
X

and

R
h
M

stacking. Our results have immediate implications for the optical properties of registry-specific excitons in layered stacks of TMDs, and demonstrate the general potential of secondary electron imaging for van der Waals twistronics.
Technical evaluation of a simulator for accurate reproduction of oscillometric blood pressure pulses, providing traceability for automated oscillometric sphygmomanometers
Authors: Mieke Stephan , Murray Alan 
Published: September 2023

Abstract
Oscillometric blood pressure measurement devices are not directly traceable to primary standards. Currently, device accuracy is measured by comparison between a sample device and reference measurements in a clinical trial. We researched in this study the potential for an alternative evaluation with a simulator. Our research simulator was studied for repeatability and accuracy in delivering simulated blood pressure pulses. Clinical cuff pressure measurements were obtained, along with simultaneous recordings of oscillometric pulse waveforms, spanning the clinical range of cuff pressures, pulse intervals and pulse shapes. Oscillometric pulse peak amplitudes ranged from 1.1 to 3.6 mmHg. Simulated repeatability results showed an average Standard Deviation (SD) for pulse peaks of 0.018 mmHg; 1.0% of peak amplitudes. Comparing simulated pulse shapes, the average repeat SD was 0.015 mmHg; 0.8% of the normalised pulse shapes. The simulated accuracy results had a mean error of − 0.014 ± 0.042 mmHg with a mean accuracy of 97.8%. For pulse shape the corresponding values were − 0.104 ± 0.071 mmHg with a mean accuracy of 95.4%. The correlation between the reference and simulated pulse shapes ranged from 0.991 to 0.996 (all p < 0.00003), with a mean 0.994. We conclude that oscillometric pulses can be reproduced with high repeatability and high accuracy with our research simulator. The extended uncertainty U(p

sim
) = 0.3 mmHg for the simulated pulses is dominated by the uncertainty (64%) of the clinical reference data. These results underpin the potential of the simulator to become a secondary standard for millions of oscillometric sphygmomanometers.
The Prevalence of Undiagnosed Ptosis Among Candidates for Upper Eyelid Blepharoplasty
Authors: Eshraghi Bahram , Pourazizi Mohsen , Taghian Akbar , Chaibakhsh Samira , Aghajani Ali 
Published: September 2023

Abstract

Background
Because upper eyelid blepharoplasty has become a popular aesthetic facial surgery, surgeons should be aware that age-related changes in the eyelid are not confined to skin laxity and orbital fat prolapse.

Objectives
This study was designed to assess the prevalence of undiagnosed ptosis among blepharoplasty candidates as one of the causes of unsatisfactory surgical results.

Methods
From December 2018 to December 2022, blepharoplasty candidates were meticulously assessed for their upper eyelid and eyebrow position. Patients who were aware of their ptosis were excluded, and the other patients were classified as mild, moderate, or severe ptotic based on margin reflex distance 1. The eyebrow height was also assessed in the mid-pupillary line to assess the relationship between the severity of ptosis and eyebrow asymmetry.

Results
The authors found that 13.7% of the 2530 blepharoplasty candidates in this study had undiagnosed ptosis. Most of these patients had mild ptosis (85.5%), and they were significantly older than nonptotic patients. The rate of prevalence of ptosis was significantly higher in patients with eyebrow asymmetry (75.3% vs 3.7%); however, the severity of ptosis was not associated with the severity of eyebrow asymmetry.

Conclusions
Ptosis should be cautiously looked for and addressed for treatment in candidates for upper blepharoplasty. In most patients with masked ptosis, the severity of eyelid drooping is mild and could remain undiagnosed until after the surgery and cause unsatisfactory aesthetic results. The presence of eyebrow asymmetry could be a key feature to unmask an undiagnosed ptosis.

Level of Evidence: 3
HiFun: homology independent protein function prediction by a novel protein-language self-attention model
Authors: Wu Jun , Qing Haipeng , Ouyang Jian , Zhou Jiajia , Gao Zihao , Mason Christopher E , Liu Zhichao , Shi Tieliu 
Published: August 2023

Abstract
Protein function prediction based on amino acid sequence alone is an extremely challenging but important task, especially in metagenomics/metatranscriptomics field, in which novel proteins have been uncovered exponentially from new microorganisms. Many of them are extremely low homology to known proteins and cannot be annotated with homology-based or information integrative methods. To overcome this problem, we proposed a Homology Independent protein Function annotation method (HiFun) based on a unified deep-learning model by reassembling the sequence as protein language. The robustness of HiFun was evaluated using the benchmark datasets and metrics in the CAFA3 challenge. To navigate the utility of HiFun, we annotated 2 212 663 unknown proteins and discovered novel motifs in the UHGP-50 catalog. We proved that HiFun can extract latent function related structure features which empowers it ability to achieve function annotation for non-homology proteins. HiFun can substantially improve newly proteins annotation and expand our understanding of microorganisms’ adaptation in various ecological niches. Moreover, we provided a free and accessible webservice at http://www.unimd.org/HiFun, requiring only protein sequences as input, offering researchers an efficient and practical platform for predicting protein functions.
SnapHiC-D: a computational pipeline to identify differential chromatin contacts from single-cell Hi-C data
Authors: Lee Lindsay , Yu Miao , Li Xiaoqi , Zhu Chenxu , Zhang Yanxiao , Yu Hongyu , Chen Ziyin , Mishra Shreya , Ren Bing , Li Yun , Hu Ming 
Published: August 2023

AbstractSingle-cell high-throughput chromatin conformation capture technologies (scHi-C) has been used to map chromatin spatial organization in complex tissues. However, computational tools to detect differential chromatin contacts (DCCs) from scHi-C datasets in development and through disease pathogenesis are still lacking. Here, we present SnapHiC-D, a computational pipeline to identify DCCs between two scHi-C datasets. Compared to methods designed for bulk Hi-C data, SnapHiC-D detects DCCs with high sensitivity and accuracy. We used SnapHiC-D to identify cell-type-specific chromatin contacts at 10 Kb resolution in mouse hippocampal and human prefrontal cortical tissues, demonstrating that DCCs detected in the hippocampal and cortical cell types are generally associated with cell-type-specific gene expression patterns and epigenomic features. SnapHiC-D is freely available at https://github.com/HuMingLab/SnapHiC-D.
An improved framework for detecting discrete epidemiologically meaningful partitions in hierarchically clustered genetic data
Authors: Jacobson David K , Low Ross , Plucinski Mateusz M , Barratt Joel L N 
Published: September 2023

Abstract

Motivation
Hierarchical clustering of microbial genotypes has the limitation that hierarchical clusters are nested, where smaller groups of related isolates exist within larger groups that get progressively larger as relationships become increasingly distant. In an epidemiologic context, investigators must dissect hierarchical trees into discrete groupings that are epidemiologically meaningful. We recently described a statistical framework (Method A) for dissecting hierarchical trees that attempts to minimize investigator bias. Here, we apply a modified version of that framework (Method B) to a hierarchical tree constructed from 2111 genotypes of the foodborne parasite Cyclospora, including 639 genotypes linked to epidemiologically defined outbreaks. To evaluate Method B’s performance, we examined the concordance between these epidemiologically defined groupings and the genetic partitions identified. We also used the same epidemiologic clusters to evaluate the performance of Method A, plus two tree-dissection methods (cutreeHybrid and cutreeDynamic) available within the Dynamic Tree Cut R package, in addition to the TreeCluster method and PARNAS.

Results
Compared to the other methods, Method B, TreeCluster, and PARNAS were the most accurate (99.4%) in identifying genetic groups that reflected the epidemiologic groupings, noting that TreeCluster and PARNAS performed identically on our dataset. CutreeHybrid identified groups reflecting patterns in the wider Cyclospora population structure but lacked finer, strain-level discrimination (Simpson’s D: cutreeHybrid=0.785). CutreeDynamic displayed good strain discrimination (Simpson’s D = 0.933), though lacked sensitivity (77%). At two different threshold/radius settings TreeCluster/PARNAS displayed similar utility to Method B. However, Method B computes a tree-dissection threshold automatically, and the threshold/radius settings used when executing TreeCluster/PARNAS here were computed using Method B. Using a TreeCluster threshold of 0.045 as recommended in the TreeCluster documentation, epidemiologic utility dropped markedly below that of Method B.

Availability and implementation
Relevant code and data are publicly available. Source code (Method B) and instructions for its use are available here: https://github.com/Joel-Barratt/Hierarchical-tree-dissection-framework.
Venous bicarbonate and CKD progression: a longitudinal analysis by the group-based trajectory model
Authors: D'Arrigo Graziella , Gori Mercedes , Leonardis Daniela , Tripepi Giovanni , Mallamaci Francesca , Zoccali Carmine 
Published: September 2023

ABSTRACT

Background
Metabolic acidosis accelerates chronic kidney disease (CKD) progression towards kidney failure in animal models. Clinical trials testing the effect of bicarbonate on kidney outcomes are underpowered and/or of suboptimal quality. On the other hand, observational studies testing the same hypothesis are generally based on bicarbonate measured at a single time point.

Methods
We studied the longitudinal relationship between repeated venous bicarbonate levels and a predefined composite renal outcome (a ≥30% estimated glomerular filtration rate reduction, dialysis or transplantation) by using group-based trajectory model (GBTM) analysis. The GBTM analysis was used to classify patients based on individual bicarbonate levels over time. The relationship between trajectory groups and renal outcomes was investigated using crude and adjusted Cox regression models. A total of 528 patients with stage 2–5 CKD were included in the analysis.

Results
The GBTM analysis identified four distinct trajectories of bicarbonate levels: low, moderate, moderate-high and high. During the follow-up period, 126 patients experienced the combined renal endpoint. The hazard rate of renal events decreased dose-dependently from the lowest to the highest bicarbonate trajectory. After adjusting for potential confounders, there was a 63% risk reduction for the composite renal endpoint for patients in the high trajectory category compared with those in the low trajectory category.

Conclusion
The study found that higher bicarbonate trajectories were associated with a lower risk of adverse renal outcomes in CKD patients. These results suggest that strategies to maintain higher bicarbonate levels may benefit patients with CKD. However, further high-quality randomised trials are needed to confirm these findings and recommend bicarbonate supplementation as a strategy to delay CKD progression.
392. PLANNING IS THE KEY—ESOPHAGECTOMY WITH COLONIC INTERPOSITION FOLLOWING: WHIPPLE’S, LEFT LOWER LOBECTOMY, RIGHT PLEURECTOMY AND COLONIC SURGERY
Authors: Sivarajan Sri , Kulasegaran Suheelan , Kumar Bhaskar 
Published: August 2023

Abstract
Link to Video: https://www.dropbox.com/s/wpr3s097g50oadl/Colonic%20interposition%20%28ISDE%20SUBMISSION%29.mp4?dl=0.
Description of Video:
We report our learnings from a complex surgical case of Ivor Lewis esophagectomy with colonic conduit in a patient who had undergone multiple previous abdominal and thoracic operations. This seventy-two-year-old man was found to have an esophageal adenocarcinoma (T4N0M0) in the distal esophagus with a significant surgical background: Whipple’s procedure for pancreatic cancer; Left lower lobectomy for lung cancer; Right pneumonectomy for recurrent pneumothoraces and a defunctioning stoma for chemotherapy associated anal fistula. To our knowledge, no such case of colonic interposition for esophagectomy has been reported in the literature for a patient with such extensive surgical history.
This presented significant surgical and anaesthetic challenges which are explored in the video. Principally the need for extensive planning to anticipate risk and modify procedural steps to account for these accordingly. For example, the operation began with a right thoracotomy, given the possibility that dense adhesions from previous surgery could obstruct safe dissection and subsequently the procedure could be aborted before any critical steps were made. Additionally, we consider the importance of involving other surgical specialities to aid with safe dissection and delineation of anatomy. Each of the key operative steps are described and paired with real-time video footage. Post-operatively we describe how the risk of anastomotic leak given a high-risk anastomosis may be reduced through pre-emptive Endoluminal Vacuum therapy. We also discuss the importance of recognising and managing feculent aspiration pneumonia which is common following this surgery.
Discussion of this case and our operative approach would serve to highlight how surgery remains a feasible option for patients despite complex anatomy and surgical history; provided risks are anticipated and appropriately managed.
Trans-catheter mitral valve-in-valve replacement in a patient on venoarterial extracorporeal membrane oxygenation: a case report
Authors: Bainiwal Jassimran Singh , Ham Jeremy-Ann , Aksoy Olcay 
Published: September 2023

Abstract

Background
Bioprosthetic mitral valves on average have a median durability between 8 and 10 years. After the failure of a bioprosthetic valve, surgical replacement is often indicated. However, the options for those patients at high or prohibitive surgical risks are limited. Here, we describe a case of a successful trans-catheter mitral valve-in-valve (TMViV) replacement on venoarterial extracorporeal membrane oxygenation (VA-ECMO).

Case summary
We describe a case of a 39-year-old female with a history notable for systemic lupus erythematosus, severe pulmonary arterial hypertension (now mixed pre and post) thought to be secondary to prior substance use, and infective endocarditis complicated by severe mitral stenosis status post-bioprosthetic mitral valve replacement who presented with symptoms of acute hypoxic respiratory failure secondary to severe bioprosthetic mitral valve stenosis. The patient had a prolonged hospital course complicated by a pulseless electrical activity arrest, (continuous renal replacement therapy) for acute renal failure, and hypertonic saline due to cerebral oedema. Due to her significant co-morbidities and haemodynamic instability with acute kidney injury and recent neurologic insult, the patient was thought not to be a good surgical candidate. However, given her young age and overall improved neurologic status, it was thought the patient could benefit from a TMViV with bi-ventricular support given her right- and left-sided heart failure and was placed on VA-ECMO in anticipation of a TMViV procedure for circulatory support. The patient underwent a successful TMViV replacement using a trans-septal approach with a 26 mm SAPIEN 3 valve and atrial septal defect closure with a 14 mm Amplatzer device on hospital Day 12. The patient was successfully de-cannulated from VA-ECMO on hospital Day 13. The patient had a prolonged hospital course but eventually had renal recovery and tracheostomy de-cannulation. A trans-thoracic echocardiogram prior to discharge was notable for a well-functioning valve and normal ejection fraction. The patient was discharged to a nursing home for further rehabilitation.

Discussion
The gold standard for bioprosthetic mitral valve stenosis is surgical replacement of the valve. However, the options for those at high or prohibitive surgical risk are lacking. Recent studies have demonstrated TMViV is a safe alternative to surgical mitral valve redo cases in high-risk patients. To our knowledge, there are limited data on trans-catheter valve placement while on VA-ECMO. Successful implantation in our patient suggests that TMViV in a stenotic bioprosthesis is feasible in very high-risk patients with the use of VA-ECMO to support haemodynamics.
Adenosine sensitive left ventricular summit ventricular tachycardia in a pre-adolescent: case report
Authors: Ferns Sunita J , Scheinman Melvin 
Published: September 2023

Abstract

Background
Sustained forms of tachycardia especially from the left ventricular summit are rare. Adenosine sensitive outflow tachycardias, especially from the left ventricular summit, are rarer still. These arrhythmias may be exercise or stress induced as they are facilitated by catecholamines and characteristically terminate with adenosine, vagal manoeuvres, and beta-blockers. The surface 12-lead electrocardiogram can be used to localize the anatomic site of origin before catheter ablation; however, prediction of the precise origin may still be challenging due to the intimate and complex anatomy of the outflow tracts.

Case summary
A 12-year-old female presented to an emergency room with frequent runs of wide complex tachycardia that terminated with adenosine but would spontaneously reinitiate. After three additional temporary terminations with adenosine and because of an inability to completely eliminate tachycardia, she was started on an esmolol infusion that resulted in an abrupt termination of tachycardia. At follow-up, she reported breakthrough episodes of tachycardia with exercise, especially associated with beta-blocker non-compliance. The rest of her cardiac testing was normal apart from an anomalous right coronary artery origin from the left coronary sinus. Given the increased frequency of symptomatic palpitations and medication non-compliance, she underwent an electrophysiology study. During the study, a ventricular tachycardia was successfully mapped to an epicardial focus at the left ventricle summit and was successfully ablated.

Discussion
The response of this patient’s ventricular tachycardia to adenosine suggests a triggered mechanism. To our knowledge, this is the first unambiguous example of left ventricular tachycardia due to cAMP-mediated triggered activity in this age group.