bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosis and treatment of a left atrial myxoma originating from an atrial septal defect closure device: a case report
Authors: Mastrangelo Angelo , Olivares Paolo , Giambuzzi Ilaria , Muratori Manuela , Alamanni Francesco , Bartorelli Antonio L 
Published: June 2023

Abstract

Background
Ostium secundum atrial septal defect (osASD) is a common congenital heart disease and transcatheter closure is the preferred treatment. Late device-related complications include thrombosis and infective endocarditis (IE). Cardiac tumours are exceedingly rare. The aetiology of a mass attached to an osASD closure device can be challenging to diagnose.

Case summary
A 74-year-old man with atrial fibrillation was hospitalized for evaluating a left atrial mass discovered incidentally 4 months earlier. The mass was attached to the left disc of an osASD closure device implanted 3 years before. No shrinkage of the mass was observed despite optimal intensity of anticoagulation. We describe the diagnostic workup and management of the mass that at surgery turned out to be a myxoma.

Discussion
A left atrial mass attached to an osASD closure device raises the suspect of device-related complications. Poor endothelialisation may promote device thrombosis or IE. Cardiac tumours (CT) are rare, and myxoma is the most common primary CT in adults. Although no clear relationship exists between the implantation of an osASD closure device and a myxoma, the development of this tumour is a possible occurrence. Echocardiography and cardiovascular magnetic resonance play a key role in the differential diagnosis between a thrombus and a myxoma, usually identifying distinctive mass features. Nevertheless, sometimes non-invasive imaging may be inconclusive, and surgery is necessary to make a definitive diagnosis.
Transseptal snaring technique as a bailout from valvuloplasty balloon entrapment within a self-expanding valve: a case report
Authors: Sugiyama Yoichi , Moriyama Noriaki , Viikilä Juho , Raatikainen Pekka 
Published: June 2023

Abstract

Background
Transcatheter aortic valve replacement (TAVR) has become the dominant treatment strategy for severe aortic stenosis in patients with high and intermediate surgical risk. Although complications are significant cause of increasing mortality after TAVR and bailout techniques have been well established, we still encounter a rare complication without widely accepted bailout option. We present a rare complication of valvuloplasty balloon entrapment to a self-expanding valve strut with successful bailout.

Case summary
A 71-year-old man complaining of dyspnoea underwent valve-in-valve TAVR for failed surgical aortic valve. However, he developed acute decompensated heart failure due to high residual aortic gradient (peak aortic velocity of 4.0 m/s and mean aortic gradient of 37 mmHg) on the 3rd day after TAVR. Computed tomography demonstrated underexpansion of transcatheter heart valve (THV) within the surgical valve. Therefore, urgent balloon valvuloplasty was performed. The balloon entrapment in the THV stent frame happened during the procedure. Percutaneous removal through transseptal approach using snaring technique was successfully performed.

Discussion
Balloon entrapment within a THV is a rare complication and potentially requires urgent surgical removal. To our knowledge, this is the first report utilizing the snaring technique through transseptal approach for balloon entrapment within a THV. Through the current report, we highlight the utility and effectiveness of the transseptal snaring technique with using a steerable transseptal sheath. Moreover, this case shows the importance of the multiprofessional approach to resolve unexpected complications.
A case report: transfemoral transcatheter aortic valve replacement with a dedicated valve system for severe aortic regurgitation in a patient with a left ventricular assist device
Authors: Goncharov Arseniy , Fox Henrik , Bleiziffer Sabine , Rudolph Tanja K 
Published: June 2023

AbstractBackgroundUp to 30% of patients with the left ventricular assist device (LVAD) develop moderate to severe aortic regurgitation (AR) within the first year. Surgical aortic valve replacement (SAVR) is the treatment of choice in patients with native AR. However, the high perioperative risk in patients with LVAD might prohibit surgery and choice of therapy is challenging.Case summaryWe report on a 55-year-old female patient with a severe AR 15 months after implantation of LVAD due to advanced heart failure (HF) as a consequence of ischaemic cardiomyopathy. Surgical aortic valve replacement was discarded due to high surgical risk. Thus, the decision was made to evaluate a transcatheter aortic valve replacement (TAVR) with the TrilogyXTä prothesis (JenaValve Technology, Inc., CA, USA). Echocardiographic and fluoroscopic control showed an optimal valve position with no evidence of valvular or paravalvular regurgitation. The patient was discharged 6 days later in a good general condition. At the 3-month follow-up, the patient showed noteworthy symptomatic improvement with no sign of HF.DiscussionAortic regurgitation is a common complication among advanced HF patients treated with LVADSystems and associated with a deterioration in the quality of life and worsen clinical prognosis. The treatment options are limited to percutaneous occluder devices, SAVR, off-label TAVR, and heart transplantation. With the approval of the TrilogyXT JenaValve system, a novel dedicated TF-TAVR option is now available. Our experience demonstrates the technical feasibility and safety of this system in patients with LVAD and AR resulting in effective elimination of AR.
Predicting left ventricular hypertrophy from the 12-lead electrocardiogram in the UK Biobank imaging study using machine learning
Authors: Naderi Hafiz , Ramírez Julia , van Duijvenboden Stefan , Pujadas Esmeralda Ruiz , Aung Nay , Wang Lin , Anwar Ahmed Chahal Choudhary , Lekadir Karim , Petersen Steffen E , Munroe Patricia B 
Published: June 2023

Abstract

Aims
Left ventricular hypertrophy (LVH) is an established, independent predictor of cardiovascular disease. Indices derived from the electrocardiogram (ECG) have been used to infer the presence of LVH with limited sensitivity. This study aimed to classify LVH defined by cardiovascular magnetic resonance (CMR) imaging using the 12-lead ECG for cost-effective patient stratification.

Methods and results
We extracted ECG biomarkers with a known physiological association with LVH from the 12-lead ECG of 37 534 participants in the UK Biobank imaging study. Classification models integrating ECG biomarkers and clinical variables were built using logistic regression, support vector machine (SVM) and random forest (RF). The dataset was split into 80% training and 20% test sets for performance evaluation. Ten-fold cross validation was applied with further validation testing performed by separating data based on UK Biobank imaging centres. QRS amplitude and blood pressure (P &lt; 0.001) were the features most strongly associated with LVH. Classification with logistic regression had an accuracy of 81% [sensitivity 70%, specificity 81%, Area under the receiver operator curve (AUC) 0.86], SVM 81% accuracy (sensitivity 72%, specificity 81%, AUC 0.85) and RF 72% accuracy (sensitivity 74%, specificity 72%, AUC 0.83). ECG biomarkers enhanced model performance of all classifiers, compared to using clinical variables alone. Validation testing by UK Biobank imaging centres demonstrated robustness of our models.

Conclusion
A combination of ECG biomarkers and clinical variables were able to predict LVH defined by CMR. Our findings provide support for the ECG as an inexpensive screening tool to risk stratify patients with LVH as a prelude to advanced imaging.
Sodium–glucose cotransporter 2 inhibitors vs. sitagliptin in heart failure and type 2 diabetes: an observational cohort study
Authors: Fu Edouard L , Patorno Elisabetta , Everett Brendan M , Vaduganathan Muthiah , Solomon Scott D , Levin Raisa , Schneeweiss Sebastian , Desai Rishi J 
Published: June 2023

Abstract

Aims
The effectiveness of sodium–glucose cotransporter 2 inhibitors (SGLT2i) in patients with heart failure (HF) in routine clinical practice is not extensively studied. This study aimed to evaluate the comparative effectiveness of SGLT2i vs. sitagliptin in older adults with HF and type 2 diabetes and to investigate whether there were any differences between agents within the SGLT2i class or for reduced and preserved ejection fraction.

Methods and results
Using Medicare claims data (April 2013 to December 2019), 16 253 SGLT2i initiators vs. 43 352 initiators of sitagliptin aged ≥65 years with type 2 diabetes and HF were included. The primary outcome was a composite of all-cause mortality, hospitalization for HF or urgent visit requiring intravenous diuretics; secondary outcomes included its individual components. Propensity score fine stratification weighted Cox regression was used to adjust for 100 pre-exposure characteristics. Mean age was 74 years; 49.8% were women. Initiation of SGLT2i vs. sitagliptin was associated with a lower risk of the primary composite outcome [adjusted hazard ratio (HR) 0.72; 95% confidence interval 0.67–0.77]. The adjusted HRs were 0.70 (0.63–0.78) for all-cause mortality, 0.64 (0.58–0.70) for hospitalization for HF, and 0.77 (0.69–0.86) for urgent visit requiring intravenous diuretics. Similar associations with the primary composite outcome were observed for all three agents within the SGLT2i class, for reduced and preserved ejection fraction, and subgroups based on demographics, comorbidities, and other HF treatments. Bias-calibrated HRs for the primary endpoint using negative and positive control outcomes ranged between 0.81 and 0.89, suggesting that the observed benefit could not be fully explained by residual confounding.

Conclusion
In routine US clinical practice, SGLT2i demonstrated robust clinical effectiveness in older adults with HF and type 2 diabetes compared with sitagliptin, with no evidence of heterogeneity across the SGLT2i class or across ejection fraction.
Lifestyle patterns, genetic susceptibility, and risk of valvular heart disease: a prospective cohort study based on the UK Biobank
Authors: Jia Chenglin , Zeng Yu , Huang Xuan , Yang Huazhen , Qu Yuanyuan , Hu Yao , Chen Wenwen , Yang Xiaoyan 
Published: June 2023

Abstract

Aims
Genetic and lifestyle factors are both major contributors to valvular heart disease (VHD). However, it is still uncertain whether genetic susceptibility alters the association between lifestyle and VHD. We aimed to investigate the association between lifestyle and VHD in different genetic risk backgrounds.

Methods and results
A prospective cohort study was carried out on 499 341 participants without VHD at baseline. The assessment of lifestyle included smoking, alcohol consumption, diet, activity, and sleep. Genetic susceptibility was separately measured by polygenic risk scores (PRSs) and family history of cardiovascular disease (CVD). Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95%CIs) between lifestyle and VHD, as well as aortic stenosis (AS). During a median follow-up of 10.8 years, 12 983 incident VHD cases were diagnosed (incidence rate 2.46 per 1000 person-years), including 3527 AS cases (incidence rate 0.66 per 1000 person-years). The risk of VHD and AS decreased with healthier lifestyles (P value for trend &lt;0.001). Compared to individuals with a unhealthy lifestyle, the HRs of VHD in intermediate and healthy lifestyle groups were 0.81 (0.76–0.86) and 0.81 (0.76–0.87). The negative association between healthy lifestyle and VHD events was independent of genetic risk (P for interaction between healthy lifestyle scores and PRSs/family history of CVD was 0.723/0.763). Similar findings were obtained in analyses of AS, and a stronger negative association was found.

Conclusion
Our study reveals that adherence to a healthy lifestyle is significantly associated with a reduced risk of VHD especially AS, irrespective of genetic susceptibility.

Summary
Based on a cohort of around 490 000 participants, the study investigated the association between lifestyle and VHD under different stratifications of genetic risk. The study found that a healthy lifestyle was associated with a lower risk of VHD, particularly AS, independent of genetic risk. Our findings suggest that advance interventions for lifestyle may be an effective way to reduce the global burden of VHD.
Remodeling male coercion and the evolution of sexual autonomy by mate choice
Authors: Snow Samuel S , Prum Richard O 
Published: June 2023

AbstractModels of sexual conflict over mating, including conflict over indirect benefits of mate choice, have generally presumed that female resistance to male coercion must involve direct confrontation, which can lead to sexually antagonistic coevolutionary arms-races. We built a quantitative model examining the largely ignored possibility that females may evolve new, additional mate preferences for new male traits that undermine male capacity to coerce. Thus, females may “remodel” the coercive capacity of the male phenotype in order to enhance their own sexual autonomy—a novel alternative mechanism by which females may avoid arms-races. We demonstrate that evolutionary “remodeling” is possible, in spite of costs to males, because females that prefer males with protective, autonomy-enhancing traits (traits correlated with lower coercion effectiveness) are likelier to gain indirect benefits of having attractive mates. Our analysis reveals new possibilities for the evolution of systems of sexual conflict over indirect benefits, showing that autonomy-enhancing male traits can act as a “public good,” benefiting all females regardless of mating preferences, leading to oscillatory dynamics; and that preferences for more protective male traits will often be favored relative to preferences for less protective traits, potentially leading to an evolutionary “snowball” of expanding sexual autonomy.
Epidemiology of invasive meningococcal disease and its sequelae: a population-based study in Italian primary care, 2000–2019
Authors: Lapi Francesco , Marconi Ettore , Vetrano Davide L , Rossi Alessandro , Lagolio Erik , Baldo Vincenzo , Cricelli Claudio 
Published: June 2023

Abstract

Background
Invasive meningococcal disease (IMD) is a severe infectious disease. Although effective preventive and therapeutical strategies are available, the fatality rate remains high in the general population, with an occurrence of meningococcal-related severe sequelae involving 10–20% of survivors. Given the crucial role of general practitioners in recognizing and preventing IMD and its related sequelae, we aim to assess the burden of these conditions in primary care.

Methods
Using an Italian primary care database, the incidence rate of IMD was calculated in the period 2000–2019 by capturing the first diagnosis registered during follow-up. As far as meningococcal-related sequelae are concerned, we identified and clinically evaluated each potential sequela during the first 3 months, from 3 to 12 months, and up to 36 months.

Results
Among 508 patients diagnosed with IMD, 403 (incidence rate: 0.24 per 10,000 person-years) comprised those diagnosed with IMD in patients aged 15 years or older. We ascertained 104 sequelae (20.4%); 76% of them occurred in those aged 25 or older; 42, 27, and 35 were assessed as short-, medium-, or long-term sequelae, respectively. Overall, 4.7% of IMD patients reported physical sequelae, while 12.2% and 5.7% of patients reported neurological and psychological sequelae, respectively.

Conclusion
Our study showed that a substantial proportion of IMD and related sequelae occur in individuals aged over 25, with a non-negligible burden for healthcare systems. As for the paediatric population, effective communication on the relevance of meningococcal vaccination in adults should be proficiently fostered.
Proportionality, Stringency and Utility in the Jurisprudence of the European Court of Human Rights
Authors: Letwin Jeremy 
Published: June 2023

Abstract
I argue that a form of indirect utilitarianism can provide a sufficiently plausible justification for three crucial elements of the ECtHR’s doctrine of proportionality to be taken seriously as an account of this doctrine. I show how indirect utilitarianism can account for the relation between moral rights and Convention rights, the resistance to trade-offs that is a particular property of Convention rights and the nature of the public interest against which rights must be balanced. I argue that the indirect utilitarian account provides a coherent interpretation of the Court’s jurisprudence concerning: (i) aims that express moralistic external preferences and their legitimacy; (ii) balancing and the doctrine of the ‘essence of rights’; and (iii) the Court’s reasoning in Dickson v UK. I conclude by exploring the further work needed to establish more firmly this account’s plausibility as an interpretation of the Court’s doctrine of proportionality as a whole.
Molnupiravir Use and 30-Day Hospitalizations or Death in a Previously Uninfected Nonhospitalized High-risk Population With COVID-19
Authors: Butt Adeel A , Yan Peng , Shaikh Obaid S , Omer Saad B , Mayr Florian B , Talisa Victor B 
Published: June 2023

Abstract

Background
Clinical benefit of molnupiravir (MPV) in coronavirus disease 2019 (COVID-19)–infected subpopulations is unclear.

Methods
We used a matched cohort study design to determine the rate of hospitalization or death within 30 days of COVID-19 diagnosis among MPV treated and untreated controls. Participants were nonhospitalized, previously uninfected Veterans with a first confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection between 1 January and 31 August 2022, who were prescribed MPV within 3 days of COVID-19 diagnosis, and matched individuals who were not prescribed MPV.

Results
Among 1459 matched pairs, the incidence of hospitalization/death was not different among MPV treated versus untreated controls (48 vs 44 cases; absolute risk difference [ARD], 0.27; 95% confidence interval [CI], −.94 to 1.49). No benefit was observed among those &gt;60 or ≤60 years old (ARD, 0.27; 95% CI, −1.25 to 1.79 vs ARD, −0.29; 95% CI, −1.22 to 1.80), those with specific comorbidities, or by vaccination status. A significant benefit was observed in asymptomatic but not in symptomatic persons (ARD, −2.80; 95% CI, −4.74 to −.87 vs ARD, 1.12; 95% CI −.31 to 2.55). Kaplan-Meier curves did not show a difference in proportion of persons who were hospitalized or died among MPV treated compared with untreated controls (logrank P = .7).

Conclusions
MPV was not associated with a reduction in hospitalization or death within 30 days of COVID-19 diagnosis. A subgroup of patients presenting without symptoms experienced a benefit.
Seroprofiling of Antibodies Against Endemic Human Coronaviruses and Severe Acute Respiratory Syndrome Coronavirus 2 in a Human Immunodeficiency Virus Cohort in Lesotho: Correlates of Antibody Response and Seropositivity
Authors: Brown Jennifer A , Hauser Anthony , Abela Irene A , Pasin Chloé , Epp Selina , Mohloanyane Tsepang , Nsakala Bienvenu L , Trkola Alexandra , Labhardt Niklaus D , Kouyos Roger D , Günthard Huldrych F 
Published: June 2023

Abstract

Background
Serological data on endemic human coronaviruses (HCoVs) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in southern Africa are scarce. Here, we report on (1) endemic HCoV seasonality, (2) SARS-CoV-2 seroprevalence, and (3) correlates of SARS-CoV-2 seropositivity and strength of SARS-CoV-2 and endemic HCoV serological responses among adults living with human immunodeficiency virus (HIV).

Methods
Plasma samples were collected from February 2020 to July 2021 within an HIV cohort in Lesotho. We used the AntiBody CORonavirus Assay (ABCORA) multiplex immunoassay to measure antibody responses to endemic HCoV (OC43, HKU1, NL63, and 229E) and SARS-CoV-2 antigens.

Results
Results for 3173 samples from 1403 adults were included. Serological responses against endemic HCoVs increased over time and peaked in winter and spring. SARS-CoV-2 seropositivity reached &gt;35% among samples collected in early 2021 and was associated with female sex, obesity, working outside the home, and recent tiredness or fever. Positive correlations were observed between the strength of response to endemic HCoVs and to SARS-CoV-2 and between older age or obesity and the immunoglobulin G response to SARS-CoV-2.

Conclusions
These results add to our understanding of the impact of biological, clinical, and social/behavioral factors on serological responses to coronaviruses in southern Africa.
Managerial Contracting: A Preliminary Study
Authors: Bernstein Lisa , Peterson Brad 
Published: June 2023

AbstractImportant types of contractual relationships—among them those between integrated product manufacturers and their suppliers—are neither fully transactional nor fully relational. The agreements that govern these relationships incorporate highly detailed written terms that focus not only on what is promised but also on the details of how it is to be achieved and how suppliers’ actions will be monitored and responded to over the life of the agreement. Together with the implicit relational contracts that support their operation, these provisions create an economic hybrid that lies between markets and hierarchies, a set of relatively standard institutional arrangements that give buyers the right (but not the obligation) to exercise a package of quasi-integration rights that enables them to obtain many of the most important benefits of vertical integration while simultaneously reaping most of the core benefits of outsourcing. The contract provisions used to govern these relationships are termed here “managerial provisions” because they employ the techniques of intra-firm hierarchy that managers use to organize relationships and increase productivity within firms. This article focuses on a subset of these provisions, namely those that are analogous to the eighteen management practices that the World Management Survey (WMS) reveals are closely associated with persistent performance differences across similarly situated enterprises. After documenting the convergence between these practices and the terms of procurement contracts, the article suggests that the contract governance regime these practices create is well designed to support the creation and maintenance of cooperative relationships, strengthen the force of network governance, and scaffold the emergence of the type of inter-firm process-based trust that is associated with better supplier performance. More generally, this article concludes that in the modern economy, where the value of so many types of contracts—from research and development alliances to business process outsourcing agreements and beyond—depends on employees of the contracting entities working together much as if they worked for a single firm, lawyers would be well advised to look to the broad array of managerial techniques successfully used within firms (not only those based on WMS practices) to develop new ways to better govern transactions between firms.