bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intracranial haemorrhage in adult patients on venoarterial extracorporeal membrane oxygenation
Authors: Lüsebrink Enzo , Zimmer Sebastian , Schrage Benedikt , Dabboura Salim , Majunke Nicolas , Scherer Clemens , Aksoy Adem , Krogmann Alexander , Hoffmann Sabine , Szczanowicz Lukasz , Binzenhöfer Leonhard , Peterss Sven , Kühn Christian , Hagl Christian , Massberg Steffen , Schäfer Andreas , Thiele Holger , Westermann Dirk , Orban Martin ,   for the ICH-VA-ECMO Investigator Group, Kupka Danny , Schmid Teresa , Mauthe Katharina , Joskowiak Dominik , Kääb Stefan , Petzold Tobias , Orban Mathias , Parhofer Klaus G 
Published: January 2022

Abstract

Aims
Intracranial haemorrhage (ICH) is one of the most serious complications of adult patients treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO) and is associated with increased morbidity and mortality. However, the prevalence and risk factors of ICH in this cohort are still insufficiently understood. We hypothesized that a considerable proportion of patients undergoing VA-ECMO support suffer from ICH and that specific risk factors are associated with the occurrence of ICH. Therefore, the purpose of this study was to further investigate the prevalence and associated mortality as well as to identify risk factors for ICH in VA-ECMO patients.

Methods and results
We conducted a retrospective multicentre study including adult patients (≥18 years) treated with VA-ECMO in cardiac intensive care units (ICUs) at five German clinical sites between January 2016 and March 2020, excluding patients with ICH upon admission. Differences in baseline characteristics and clinical outcome between VA-ECMO patients with and without ICH were analysed and risk factors for ICH were identified. Among the 598 patients included, 70/598 (12%) developed ICH during VA-ECMO treatment. In-hospital mortality in patients with ICH was 57/70 (81%) and 1-month mortality 60/70 (86%), compared to 332/528 (63%) (P = 0.002) and 340/528 (64%) (P &lt; 0.001), respectively, in patients without ICH. Intracranial haemorrhage was positively associated with diabetes mellitus [odds ratio (OR) 2, 95% confidence interval (CI) 1.11–3.56; P = 0.020] and lactate (per mmol/L) (OR 1.06, 95% CI 1.01–1.11; P = 0.020), and negatively associated with platelet count (per 100 G/L) (OR 0.32, 95% CI 0.15–0.59; P = 0.001) and fibrinogen (per 100 mg/dL) (OR 0.64, 95% CI 0.49–0.83; P &lt; 0.001).

Conclusion
Intracranial haemorrhage was associated with a significantly higher mortality rate. Diabetes mellitus and lactate were positively, platelet count, and fibrinogen level negatively associated with the occurrence of ICH. Thus, platelet count and fibrinogen level were revealed as potentially modifiable, independent risk factors for ICH. The findings address an area with limited data, provide information about risk factors and the epidemiology of ICH, and may be a starting point for further investigations to develop effective strategies to prevent and treat ICH.
Price Floors and Externality Correction*
Authors: Griffith Rachel , O’Connell Martin , Smith Kate 
Published: January 2022

Abstract
We evaluate the impact of a price floor for alcohol introduced in Scotland in 2018, using a difference-in-differences strategy with England as a control group. We show that the policy led to the largest reductions in alcohol units purchased among the heaviest drinkers—the group who, at the margin, are likely to create the largest externalities from drinking. The price floor is well targeted at heavy drinkers because they buy a much greater fraction of their units from cheap products and switched away from these products strongly, with only limited substitution towards more expensive products. We show that if the marginal external cost of drinking is at least moderately higher for heavy than lighter drinkers, then a price floor outperforms an ethanol tax. However, more flexible tax systems can achieve similar reductions in externalities to the price floor, but avoid the large transfers from public funds to the alcohol industry that arise under the floor.
Prognostic impact of secondary prevention after coronary artery bypass grafting—insights from the TiCAB trial
Authors: Heer Tobias , von Scheidt Moritz , Boening Andreas , Heyken Clarissa , Gusmini Friederike , de Waha Antoinette , Kuna Constantin , Fach Andreas , Grothusen Christina , Oberhoffer Martin , Knosalla Christoph , Walther Thomas , Danner Bernhard C , Misfeld Martin , Wimmer-Greinecker Gerhard , Siepe Matthias , Grubitzsch Herko , Joost Alexander , Schaefer Andreas , Conradi Lenard , Cremer Jochen , Hamm Christian , Lange Rüdiger , Radke Peter W , Schulz Rainer , Laufer Günther , Grieshaber Philippe , Attmann Tim , Schmoeckel Michael , Meyer Alexander , Ziegelhöffer Tibor , Hambrecht Rainer , Sandner Sigrid E , Kastrati Adnan , Schunkert Heribert , Zeymer Uwe 
Published: January 2022

Abstract

OBJECTIVES
There are disparities in the adherence to guideline-recommended therapies after coronary artery bypass graft (CABG). We therefore sought to evaluate the effect of guideline-adherent medical secondary prevention on 1-year outcome after CABG.

METHODS
Data were taken from the randomized ‘Ticagrelor in CABG’ trial. From April 2013 until April 2017, patients who underwent CABG were included. For the present analysis, we compared patients who were treated with optimal medical secondary prevention with those where 1 or more of the recommended medications were missing.

RESULTS
Follow-up data at 12 months were available in 1807 patients. About half (54%) of them were treated with optimal secondary prevention. All-cause mortality [0.5% vs 3.5%, hazard ratio (HR) 0.14 (0.05–0.37), P &lt; 0.01], cardiovascular mortality [0.1% vs 1.7%, HR 0.06 (0.01–0.46), P = 0.007] and major adverse events [6.5% vs 11.5%, HR 0.54 (0.39–0.74), P &lt; 0.01] were significantly lower in the group with optimal secondary prevention. The multivariable model for the primary end point based on binary concordance to guideline recommended therapy identified 3 independent factors: adherence to guideline recommended therapy [HR 0.55 (0.39–0.78), P &lt; 0.001]; normal renal function [HR 0.99 (0.98–0.99), P = 0.040]; and off-pump surgery [HR 2.06 (1.02–4.18), P = 0.045].

CONCLUSIONS
Only every second patient receives optimal secondary prevention after CABG. Guideline adherent secondary prevention therapy is associated with lower mid-term mortality and less adverse cardiovascular events after 12 months.
Risk factors for mortality after cardiovascular surgery in patients with functional single ventricle and right isomerism
Authors: Hirose Keiichi , Ikai Akio , Ito Hiroki , Ishidou Motonori , Nakatani Eiji , Sakamoto Kisaburo 
Published: January 2022

Abstract

OBJECTIVES
Cardiac malformations are a major component of heterotaxy syndrome that results in significant mortality and morbidity, especially in patients with a single ventricle and right isomerism (RI). The goal of this study was to evaluate the mortality after cardiovascular surgery in patients with a functional single ventricle and RI over a long follow-up period (∼40 years) and to determine the predicted risk factors for mortality.

METHODS
We performed a retrospective review of the medical records of 129 consecutive patients with functional single ventricle and RI who underwent pulmonary flow control operations at Mt. Fuji Shizuoka Children’s Hospital between 1979 and 2020. To evaluate mortality rates, the patients were divided into 2 groups (era 1: 1979–1999 and era 2: 2000–2020) based on the date of the first-stage palliation.

RESULTS
The estimated survival rate at 10 years was 36.4% in era 1 and 57.8% in era 2. The estimated survival rate improved significantly (P = 0.0268) between the 2 eras. The rate of Fontan procedure completion was also significantly better in the current era (P = 0.0392; 22/59 in era 1 and 38/66 in era 2). In the multivariable analysis, the date of the first-stage palliation was the only predictor of mortality.

CONCLUSIONS
The mortality rate after cardiovascular surgery in patients with a functional single ventricle and RI has improved over the past 20 years; however, it still remains high. This improvement may be attributed to our current surgical strategy and clinical management; however, further investigations are needed to prove this observation.
National evaluation of risk factors for unplanned readmission after lung resection
Authors: Pons Aina , Guirao Ángela , Fibla Juan J , Carvajal Carlos , Embun Raúl , Sánchez David , GEVATS  , Hernández Jorge 
Published: January 2022

Abstract

OBJECTIVES
Unplanned readmission is defined as the return to inpatient hospitalization within 30 days after discharge. Worldwide, its incidence after lung resection ranges between 8% and 50%, and it has been shown to impact both patient recovery and healthcare resources. Our goal was to identify the risk factors to prioritize early follow-ups.

METHODS
We analysed data from the database of the Grupo Español de Cirugía Torácica Video-Asistida from 33 thoracic surgery departments over 15 months. Standard tests were used to compare the different risk groups. Our goal was to present the most relevant explanatory variables for readmission.

RESULTS
A total of 174 of 2808 patients (6%) underwent unplanned readmission after a lobectomy. Of all the preoperative individual characteristics, only lung function was found to be a risk factor for readmission [forced expiratory volume in 1 s &lt; 80%, risk ratio (RR) 1.78, P &lt; 0.001; diffusing capacity of carbon monoxide &lt;60%, RR 1.6, P = 0.02; and VO2 &lt; 20 ml/kg/min, RR 1.59, P = 0.02]. The tumour’s characteristics and the stage of the disease did not have an influence on the readmission rates. In the readmitted cohort, an open approach or thoracotomy was associated with more frequent readmissions (RR 1.77; P &lt; 0.001). Strong adhesions (RR 1.81; P &lt; 0.001) or adhesions occupying more than half of the hemithorax (RR 1.73, P &lt; 0.001) were also found to be risk factors for readmission and for longer operative times. A length of stay of &gt;10 days after a lobectomy was found to be a risk factor for readmission (RR 1.9).

CONCLUSIONS
We identified preoperative, intraoperative and postoperative risk factors for readmission. This information can be a useful tool to help with the prioritization of early follow-ups, especially in centres with high workloads.
Intermediate-term outcomes of deferred Norwood strategy
Authors: Hoashi Takaya , Imai Kenta , Okuda Naoki , Komori Motoki , Kurosaki Kenichi , Ichikawa Hajime 
Published: January 2022

Abstract

OBJECTIVE
The aim of this study was to assess outcomes of the deferred Norwood strategy, i.e. planned Norwood following routine bilateral pulmonary artery banding and ductal stenting or continuous prostaglandin E1 administration.

METHODS
Forty-five patients with hypoplastic left heart syndrome and its variants treated with the deferred Norwood strategy between 2012 and 2021 were enrolled. Mid-term outcomes were retrospectively reviewed. The median follow-up period after Norwood in hospital survivors was 4.6 years (interquartile range: 1.9, 6.8).

RESULTS
Fourteen patients (31.1%) had no risk factors. The median age and weight at Norwood were 1.8 months (0.9, 3.5) and 3.1 kg (2.7, 3.6). Transplant-free survival at 6 years was 84.5%. Birth weight ≤2.5 kg and systemic atrioventricular valve (SAVV) regurgitation ≥ moderate after birth were not risk factors for mortality; body weight at Norwood ≤2.5 kg, however, was a risk factor [hazard ratio (HR), 11.3; 95% confidence interval (CI), 1.2–11; P = 0.036]. Twenty-two (48.9%) underwent Fontan with no mortalities, and 7 (15.5%) are awaiting Fontan. Freedom from SAVV surgery at 5 years was 53.1%. SAVV regurgitation ≥ moderate after birth was a risk factor for SAVV surgery (HR, 16; 95% CI, 3.6–71; P &lt; 0.001); however, ductal stenting had a protective effect against SAVV surgery (HR, 0.09; 95% CI, 0.01–0.68; P = 0.019). Freedom from both surgical and catheter-based pulmonary artery intervention at 3 years was 27.1%

CONCLUSIONS
Although deferred Norwood provided acceptable intermediate-term survival, the Fontan completion rate was unsatisfactory. SAVV surgery and pulmonary artery intervention were frequently required.
Performance of prolonged air leak scoring systems in patients undergoing video-assisted thoracoscopic surgery segmentectomy
Authors: Gonzalez Michel , Karenovics Wolfram , Bédat Benoît , Forster Celine , Sauvain Marc-Olivier , Triponez Frédéric , Christodoulou Michel , Krueger Thorsten , Perentes Jean Yannis 
Published: January 2022

Abstract

OBJECTIVES
We assessed the accuracy of 3 validated lobectomy scoring systems to predict prolonged air leak (PAL) in patients undergoing video-assisted thoracoscopic surgery (VATS) segmentectomy.

METHODS
We reviewed all consecutive patients who had a VATS segmentectomy between January 2016 and October 2020. We determined PALs on postoperative day 5. These findings were correlated with the calculated Brunelli (gender, age, body mass index [BMI], forced expiratory volume in 1 s &lt; 80 and pleural adhesion), Epithor (gender, location, dyspnoea score, BMI, type of resection and pleural adhesion) and European Society of Thoracic Surgeons (ESTS) (gender, BMI and forced expiratory volume in 1 s) scores of each patient.

RESULTS
A total of 453 patients (mean age: 66.5 years, female/male sex ratio: 226/227) underwent a VATS segmentectomy for malignant (n = 400) and non-malignant (n = 53) disease. Postoperative cardiopulmonary complications and in-hospital mortality rates were 19.6% and 0.4%, respectively. Median chest tube drainage duration and hospital stay were 2 (interquartile range: 1-4) and 4 (interquartile range: 3-7) days, respectively. On day 5, the prevalence of PAL was 14.1%. The ESTS, Brunelli and Epithor scores for the treated population were, respectively, class A (6.8%), class B (3.2%), class C (10.8%) and class D (28.2%); very low and low (0%), moderate (5%), high (6.3%) and very high (21%); and class A (7%), class B (13.2%), class C (24%) and class D (27.8%). All scores correlated with PAL (p ≤ 0.001). The areas under the receiver operating characteristic (ROC) curve were 0.686, 0.680 and 0.644, respectively.

CONCLUSIONS
All 3 scoring systems were correlated with PAL &gt; 5 days following the VATS segmentectomies. ESTS scores seem easier to introduce in clinical practice, but validation by a multicentre cohort is mandatory.
A classification of abdominal lymphatic perfusion patterns after Fontan surgery
Authors: Schroeder Christian , Moosmann Julia , Cesnjevar Robert , Purbojo Ariawan , Rompel Oliver , Dittrich Sven 
Published: January 2022

Abstract

OBJECTIVES
Complications after Fontan surgery have been associated with arise and classification of abnormal thoracic lymphatic perfusion pattern. This study compiles abnormal abdominal lymphatic perfusion patterns and investigates their impact on serum protein readings.

METHODS
We performed a retrospective analysis of patients who underwent magnetic resonance imaging with T2-weighted lymphatic imaging and serum protein measurements 6 months after having Fontan surgery. The abdominal lymphatic images were classified according to the anatomical lymphatic drainage patterns into 2 categories: (1) para-aortic (types 1–4); (2) portal-venous (types 1–3). Thoracic lymphatic images were classified (types 1–4) as described earlier.

RESULTS
A total of 71 patients were included in the study. Para-aortic lymphatic perfusion patterns were classified as type 1 in 4, type 2 in 13, type 3 in 37 and type 4 in16 out of 71 patients. Portal-venous lymphatic perfusion patterns were classified as type 1 in 20, type 2 in 10 and type 3 in 41 patients. Thoracic lymphatic perfusion patterns were classified as type 1 in 8, type 2 in 11, type 3 in 39 and type 4 in 13 patients. The serum protein level was 66 (interquartile range: 7.5) g/l (&lt; standard value in 37%). Higher-grade para-aortic (p = 0.0062), portal-venous (p = 0.022) and thoracic (p = 0.011) lymphatic abnormalities were correlated with lower total serum protein levels. Higher ratings of para-aortic lymphatic abnormalities were significantly associated with higher ratings of portal-venous abnormalities (p &lt; 0.0001). Ratings of para-aortic and portal-venous classifications were correlated with the thoracic classification (p &lt; 0.001).

CONCLUSIONS
Abnormal abdominal lymphatic perfusion patterns can be classified according to anatomical structures with increasing severity. Higher grade abdominal and thoracic lymphatic perfusion patterns are associated with lower serum protein values.
Early- and longer-term outcomes of David versus Florida sleeve procedure: propensity-matched comparison
Authors: Holubec Tomas , Rashid Hiwad , Hecker Florian , Karimian-Tabrizi Afsaneh , Miskovic Alexandra , Hlavicka Jan , Zacek Pavel , Van Linden Arnaud , Moritz Anton , Walther Thomas 
Published: January 2022

Abstract

OBJECTIVES
The aim of this study was to compare short- and longer-term outcomes of David (DV) versus Florida sleeve (FS) procedure in patients requiring valve-sparing aortic root replacement.

METHODS
Between January 1996 and December 2020 285 patients received a DV procedure (median age 60 years; 26% females) and 57 patients underwent an FS procedure (median age 64 years; 19% females) in our department. Propensity score matching using patient characteristics led to 58 (DV) versus 57 (FS) patients. End points were defined as primary: freedom from aortic valve and/or aortic root-related reoperation and freedom from aortic regurgitation ≥moderate and secondary: early and late survival.

RESULTS
Thirty-day mortality was 2% (DV) and 0% (FS) (P = 0.319). There was 1 early stroke in each group (P = 0.990). Follow-up was complete in 99% with only 1 patient (FS) lost. The 5- and 10-year freedom from aortic valve and/or aortic root related reoperation was 98 ± 2% and 96 ± 3% in the DV group and 92 ± 5% and 84 ± 9% in the FS group, respectively (P = 0.095). The 5- and 10-year freedom from aortic regurgitation ≥moderate was 88 ± 5% and 80 ± 8% in the DV group and 92 ± 5% and 78 ± 1% in the FS group, respectively (P = 0.782). The 5- and 10-year survival rates were 93 ± 4% and 82 ± 6% (DV) vs 75 ± 7% and 67 ± 10% (FS), respectively (P = 0.058). No case of endocarditis (DV) and 3 cases of endocarditis (FS) (P = 0.055) were observed during follow-up.

CONCLUSIONS
Both DV and FS resulted in similar early and longer-term outcomes with a trend to slightly better performance and survival in the DV group. Florida sleeve procedure might be an alternative approach for patients with higher-risk profiles requiring valve-sparing aortic root replacement.
Longitudinal Trajectories of Quality of Life Among People With Mild-to-Moderate Dementia: A Latent Growth Model Approach With IDEAL Cohort Study Data
Authors: Clare Linda , Gamble Laura D , Martyr Anthony , Sabatini Serena , Nelis Sharon M , Quinn Catherine , Pentecost Claire , Victor Christina , Jones Roy W , Jones Ian R , Knapp Martin , Litherland Rachael , Morris Robin G , Rusted Jennifer M , Thom Jeanette M , Collins Rachel , Henderson Catherine , Matthews Fiona E 
Published: January 2022

Abstract

Objectives
We aimed to examine change over time in self-rated quality of life (QoL) in people with mild-to-moderate dementia and identify subgroups with distinct QoL trajectories.

Methods
We used data from people with mild-to-moderate dementia followed up at 12 and 24 months in the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort study (baseline n = 1,537). A latent growth model approach examined mean change over time in QoL, assessed with the QoL-AD scale, and investigated associations of baseline demographic, cognitive, and psychological covariates with the intercept and slope of QoL. We employed growth mixture modeling to identify multiple growth trajectories.

Results
Overall mean QoL scores were stable and no associations with change over time were observed. Four classes of QoL trajectories were identified: 2 with higher baseline QoL scores, labeled Stable (74.9%) and Declining (7.6%), and 2 with lower baseline QoL scores, labeled Stable Lower (13.7%) and Improving (3.8%). The Declining class had higher baseline levels of depression and loneliness, and lower levels of self-esteem and optimism, than the Stable class. The Stable Lower class was characterized by disadvantage related to social structure, poor physical health, functional disability, and low psychological well-being. The Improving class was similar to the Stable Lower class but had lower cognitive test scores.

Discussion
Understanding individual trajectories can contribute to personalized care planning. Efforts to prevent decline in perceived QoL should primarily target psychological well-being. Efforts to improve QoL for those with poorer QoL should additionally address functional impairment, isolation, and disadvantage related to social structure.
Revisit the theory of Earth rotation—anatomy of the Liouville equation
Authors: Fang Ming , Hager Bradford H , Liao Xinhao , Zhou Yonghong , Xu Xueqing 
Published: January 2022

SUMMARY
By anatomizing the classic Liouville equation (LE), an alternative theoretical framework is established for the Earth polar motion where the turbulent time derivative of the fluid forcing, Lforce, is eliminated. The observed polar motion is found a lumped signal of two physical variables, one of which is the forced polar motion, mforce, that balances out the fluid forcing through a simple algebraic identity. The second component is the inertial polar motion, minert, which conserves the total angular momentum by the restoring power of the equatorial bulge. Aside from its numerical difficulties, the time derivative dLforce/dt has proved to be a redundant artefact that mixes the physical signals in the solution of the LE. By an analytical appraisal, we find that for non-Chandler forced polar motions, the dLforce/dt term in the excitation function of the classic LE is 100 per cent responsible for the forced term, mforce, and contributes 0.3 per cent of the inertial term, minert. The Chandler signal originates exclusively from the inertial polar motion minert. The artefact dLforce/dt perturbs the true Chandler signal from the classic LE by 0.3 per cent. Anatomy of the LE allows us to show that a linearized mechanism for the Chandler Wobble excitation is valid, since the linearized governing equation for the inertial polar motion minert stands as part of the exact solution of the full nonlinear equation. Anatomized polar motion equations are also considered in the presence of ocean tides, under the lunisolar torque, and on an elastically deformable Earth. Inaccuracies and misinterpretations associated with the classic LE under those circumstances are clarified in formulating the anatomized polar motion equation group.