bluuebunny/crossref_metadata_2025_split huggingface dataset:
Poster No. 137 A very evident pulmonary thrombus
Authors: Coelho Catarina Gonçalves , Saraiva Mariana , Luís Joana , Mendes Sofia Lázaro , Pitta Maria Luz , Martins Vítor Paulo 
Published: October 2022

Abstract

Clinical case
Female patient, 78 years-old, that complained of epigastric pain and intense fatigue for a week. While waiting in the urgency department, she became hypotensive, with refractory shock. Electrocardiogram showed sinus rhythm, 90 bpm, de novo right bundle block and infraST in the right precordial leads. The echocardiogram showed a dilated right ventricle (ratio RV/LV &gt; 1), with depressed function and major tricuspid regurgitation, RV/RA gradient of at least 55 mmHg. Left ventricle presented “D-shape”, preserved function and no segmental kinetic changes. The pulmonary artery was dilated and a serpentiform mass was visible, protruding through the pulmonary valve; similar masses were also visible in its branches. The diagnosis of pulmonary embolism (PE) was assumed and fibrinolysis was started, given there were no contra-indications.
One year before, she had an intermediate-risk PE in the context of COVID-19, with a similar echocardiographic presentation. She recovered RV function in the following months and stopped anticoagulation 3 months after that episode.

Discussion
PE can present with varying degrees of severity. Bedside echocardiography can be of major help in its diagnosis, especially in critical patients. The visualization of a thrombus in the pulmonary artery is rare, particularly in transthoracic echocardiogram. Echocardiogram is also useful for risk stratification and prognostic evaluation. This patient developed obstructive shock due to massive PE and the fibrinolytic treatment was paramount for her survival. A good echocardiogram helped in the differential diagnosis and enabled the Cardiologist to assist the patient in the best way.
Clinical Case 20—Recurrent intracoronary in-stent restenosis in a young woman
Authors: Cabral Margarida , Carvalho Mariana , Fernandes Sara , Carvalho Rita , Teixeira Tiago , Ruivo Catarina , de Sousa Pedro Jerónimo , Antunes Alexandre , Morais João 
Published: October 2022

Abstract

Clinical case
A 39-year-old smoker woman underwent a percutaneous coronary intervention with two Zotarolimus-eluting stents implantation due to right coronary artery occlusion in the context of ST-elevation myocardial infarction (MI). She was medicated with dual antiplatelet therapy and high-intensity statin and stopped smoking.
Nine months later, due to angina symptoms, cardiac catheterization with intravascular ultrasound showed severe restenosis, treated with a drug-coated balloon (DCB).
Two months later, she was admitted due to non-ST elevation MI and the cardiac catheterization presented thrombotic occlusion of previously implanted stents, treated with balloon dilatation. After two months, she remained with angina and a dobutamine stress echocardiogram showed inferior wall ischemia. The angiographic revision revealed proximal in-stent restenosis, treated with DCB.
About a year later, a fifth coronary angiography was performed due to recurrence of angina. Diffuse in-stent restenosis by neo-atherosclerosis was identified by optical coherence tomography. The lesion was treated with a cutting balloon and Everolimus-eluting stent implantation. The cholesterol-lowering treatment was optimized and the patient remained stable for some months. However, she is currently reporting recurrence of angina. Clinical management and guidance await Heart Team discussion.

Learning points
When the patient is making the (wrong?) diagnosis: a biographical approach to patients consulting for presumed Lyme disease
Authors: Lutaud Romain , Verger Pierre , Peretti-Watel Patrick , Eldin Carole 
Published: October 2022

Abstract

Background
Media coverage of Lyme disease (LD) has led to an increase in consultations for presumed LD in Europe. However, LD is confirmed in only 10%–20% of patients, with a significant number remaining in a diagnostic dead-end.

Objectives
To reach a deeper understanding of how patients themselves contribute to the diagnostic process. To describe the genesis of the LD hypothesis in care pathways.

Methods
In 2019, 30 patients from a prospective cohort consulting in the infectious diseases department at University Hospital in Marseille for presumed LD were recruited for semistructured interviews. The inclusion criteria were: suffering from subjective symptoms for 6 months, no clinical or paraclinical argument suggesting current LD. The patients’ medical trajectories were collected using a biographical approach.

Results
The diagnosis of LD was primarily triggered by identification with personal testimonies found on the Internet. Most of patients were leading their own diagnostic investigation. The majority of participants were convinced they had LD despite the lack of medical evidence and the scepticism of their referring GP.

Conclusion
GPs should first systematically explore patients’ aetiologic representations in order to improve adherence to the diagnosis especially in the management of medically unexplained symptoms. Long COVID-19 syndrome challenge offers an opportunity to promote active patient involvement in diagnosis.
Reclassification of a likely pathogenic Dutch founder variant in KCNH2; implications of reduced penetrance
Authors: Copier Jaël S , Bootsma Marianne , Ng Chai A , Wilde Arthur A M , Bertels Robin A , Bikker Hennie , Christiaans Imke , van der Crabben Saskia N , Hol Janna A , Koopmann Tamara T , Knijnenburg Jeroen , Lommerse Aafke A J , van der Smagt Jasper J , Bezzina Connie R , Vandenberg Jamie I , Verkerk Arie O , Barge-Schaapveld Daniela Q C M , Lodder Elisabeth M 
Published: October 2022

AbstractBackground: Variants in KCNH2, encoding the human ether a-go-go (hERG) channel that is responsible for the rapid component of the cardiac delayed rectifier K+ current (IKr), are causal to long QT syndrome type 2 (LQTS2). We identified eight index patients with a new variant of unknown significance (VUS), KCNH2:c.2717C &gt; T:p.(Ser906Leu). We aimed to elucidate the biophysiological effect of this variant, to enable reclassification and consequent clinical decision-making. Methods: A genotype–phenotype overview of the patients and relatives was created. The biophysiological effects were assessed independently by manual-, and automated calibrated patch clamp. HEK293a cells expressing (i) wild-type (WT) KCNH2, (ii) KCNH2-p.S906L alone (homozygous, Hm) or (iii) KCNH2-p.S906L in combination with WT (1:1) (heterozygous, Hz) were used for manual patching. Automated patch clamp measured the variants function against known benign and pathogenic variants, using Flp-In T-rex HEK293 KCNH2-variant cell lines. Results: Incomplete penetrance of LQTS2 in KCNH2:p.(Ser906Leu) carriers was observed. In addition, some patients were heterozygous for other VUSs in CACNA1C, PKP2, RYR2 or AKAP9. The phenotype of carriers of KCNH2:p.(Ser906Leu) ranged from asymptomatic to life-threatening arrhythmic events. Manual patch clamp showed a reduced current density by 69.8 and 60.4% in KCNH2-p.S906L-Hm and KCNH2-p.S906L-Hz, respectively. The time constant of activation was significantly increased with 80.1% in KCNH2-p.S906L-Hm compared with KCNH2-WT. Assessment of KCNH2-p.S906L-Hz by calibrated automatic patch clamp assay showed a reduction in current density by 35.6%. Conclusion: The reduced current density in the KCNH2-p.S906L-Hz indicates a moderate loss-of-function. Combined with the reduced penetrance and variable phenotype, we conclude that KCNH2:p.(Ser906Leu) is a low penetrant likely pathogenic variant for LQTS2.
Variability in straying behaviour among repeat spawning anadromous brown trout (Salmo trutta) followed over several years
Authors: Källo Kristi , Baktoft Henrik , Birnie-Gauvin Kim , Aarestrup Kim 
Published: October 2022

Abstract
Natal homing, a strategy in which individuals return to breed in the same river as they were born, is prevalent among salmonids. However, some individuals may not return to their natal river, and instead stray to non-natal rivers. To date, there is limited documentation on patterns of straying among iteroparous salmonids that have returned to spawn over multiple years. In this study, 21538 out-migrating juvenile anadromous brown trout (Salmo trutta L.) were tagged over two years with passive integrated transponder (PIT) tags, and followed as they returned to either their natal or three non-natal rivers in a fjord system, over multiple years. In total, 206 individuals were detected returning for more than one year, of which 43% were strayers. A divergence in migratory strategies among strayers was documented: a smaller proportion of strayers were only detected in non-natal rivers, while the majority (67%) displayed high variability in their migratory patterns as they were detected in both their natal and non-natal rivers, sometimes within the same reproductive season. This study documents high variability in the migratory patterns of repeat spawners and high probability for them to stray, and suggests that straying is an important life-history strategy possibly affecting individual fitness.
Retrograde type A aortic dissection: a different evil
Authors: Lopez-Marco Ana , Adams Benjamin , Oo Aung Ye 
Published: October 2022

Abstract
Retrograde type A aortic dissection (RTAAD) can be spontaneous or secondary to the instrumentation of the descending and thoraco-abdominal aorta. It has anatomical differences compared to antegrade type A aortic dissection that impact the management and prognosis. Treatment is not standardized. We report our approach to spontaneous RTAAD in our institution between 2018 and 2022 (n = 15). The mean age was 60.1 years and 93% were male. Aortic valve, coronary arteries and supra-aortic trunks were spared by the dissection in 80% of the cases; distal extension to iliacs was common and lower limb malperfusion was present in 4 cases (27%). The ascending aorta was dilated at presentation in 60% of the cases. Emergency surgery with arch/FET replacement was offered to 11 patients (73%); 3 patients (20%) received a limited proximal aortic repair; 1 patient was treated conservatively. Overall mortality was 47% (100% for limited proximal repair and 22% for those who received arch/FET). We advocate for aggressive treatment of RTAAD excluding the primary entry tear to prevent immediate- and mid-term complications.
The Stratified Homotopy Type of the Reductive Borel–Serre Compactification
Authors: Ørsnes Jansen Mikala 
Published: October 2022

Abstract
We identify the exit path $\infty $-category of the reductive Borel–Serre compactification as the nerve of a $1$-category defined purely in terms of rational parabolic subgroups and their unipotent radicals. As immediate consequences, we identify the fundamental group of the reductive Borel–Serre compactification, recovering a result of Ji–Murty–Saper–Scherk, and we obtain a combinatorial incarnation of constructible complexes of sheaves on the reductive Borel–Serre compactification as elements in a derived functor category.
The Future of Sino-Russian Relations in the Russian Far East: A Stable but Not Impervious Equilibrium
Authors: Stanko John C 
Published: October 2022

Abstract
This paper contributes to the ongoing debate on the nature of Sino-Russian relations by applying a multi-vector framework to examine the tenability of the so-called strategic partnership between Russia and China in the Russian Far East (RFE). Addressing a growing body of literature that seeks to move beyond single-factor evaluations of the dyadic relationship, I embrace the principles of analytic eclecticism, borrowing from Voskressenki's (Alexei D. Voskressenski, Russia and China: A Theory of Inter-State Relations [London, 2003]) multifactor framework to advance an argument for intertwining the three dominant international relations research traditions—realism, liberalism, and constructivism—to conduct a more comprehensive evaluation of the current equilibrium in the RFE, rather than assuming in advance the most pertinent lens. This in turn allows for more effective application of international relations theory to Sino-Russian studies. To accomplish my aim, I incorporate data pertaining to economic, geopolitical, and ideational factors. From these data, I find that the relationship in the RFE is in a state of stable equilibrium, with the most important vectors contributing to the balance for each side at present, geopolitical considerations for Moscow and ideational concerns for Beijing, being conducive to cooperation. The short-term potential for conflict is thus minimal, but a shock in the form of increasing Chinese nationalist hostility toward Russia or continued territorial belligerence by Russia internationally would severely endanger the status quo. By applying a similar approach to other dimensions of the Sino-Russian relationship, scholars can gain greater traction in assessing the robustness of the continually evolving bilateral partnership between these two large and important neighbors.
Climate change and health informatics: pilot survey of perspectives across the field
Authors: Sarabu Chethan , Deonarine Andrew , Leitner Stefano , Fayanju Oluseyi , Fisun Myroslava , Nadeau Kari 
Published: October 2022

Abstract

Objective
Establish a baseline of informatics professionals’ perspectives on climate change and health.

Materials and Methods
Anonymized survey sent to 9 informatics listservs March 31, 2022 to April 15, 2022.

Results
N = 85 participants completed part or all of survey. Majority of participants worked at hospitals with 1000+ employees (73%) in urban areas (60%) in the United States. Respondents broadly reported general understanding of climate change and health (51%), but 71% reported unfamiliarity with technologies that could help clinicians and informaticians address the impacts of climate change. Seventy-one percent of surveyed wanted climate-driven environmental health information included in EHRs. Seventy-six percent of respondents reported that informaticians should be involved in institutional decarbonization. Seventy-eight percent of respondents felt that it was extremely, very, or moderately important to receive education on climate change.

Discussion
General consensus on need to engage informaticians in climate change response, but gaps identified in knowledge dissemination and tools for adaptation and mitigation.

Conclusion
Informaticians broadly concerned about climate change and want to be engaged in efforts to combat it, but further education and tool development needed.
Determination of Ethanol Content in Water Kefir Using Headspace Gas Chromatography With Mass Spectrometry Detection: Matrix Extension and Methanol Characterization
Authors: Sy Hong , Chan Michael , Finley Jamie 
Published: October 2022

Abstract

Background
Water kefir is a fermented beverage using water, sugar, and cultured microorganism grains as the primary ingredients. Ethanol may be present at varying levels within the final product due to the fermentation process, so it is vital to have a validated method to meet regulatory, quality, and safety requirements.

Objective
This study describes using water kefir as a matrix for the evaluation of the previously validated method employing headspace gas chromatography mass spectrometry (HS-GCMS) detection for ethanol in kombucha. The study objective is to demonstrate the method originally using kombucha is also fit for the analysis of water kefir. This method will also evaluate the determination of methanol within the water kefir samples.

Method
The matrix extension study was performed as per the AOAC INTERNATIONAL guidance documents outlined in Appendix K: Guidelines for Dietary Supplements and Botanicals using HS-GCMS for ethanol determination. Ethanol determination in each water kefir sample is quantified against an external standard calibration curve. The same instrumentation is used for methanol characterization.

Results
RSDr and HorRat values obtained for from the study demonstrated acceptable precision with RSDr values of 1.03 to 6.68% and HorRat values determined to be between 0.23 and 1.52 for ethanol determination within kefir samples. Similarly, acceptable values of RSDr ranging from 1.45 to 3.39% and HorRat ranging from 0.25 to 0.49 were observed with methanol determination. For methanol determination, the limit of detection (LOD) and limit of quantification (LOQ) determined for the method in this study to be 16 and 21 ppm, respectively. The methanol spike recovery study gave overall recoveries ranging from 89 to 91%, demonstrating acceptable method accuracy.

Conclusions
The results of this study demonstrate the previously validated HS-GCMS method for ethanol determination in kombucha can also be used to quantify ethanol in water kefir samples. The method is also suitable for the determination of methanol within water kefir samples.

Highlights
A straightforward method has been adapted to include the the quantification of ethanol and methanol in fermented beverages such as Water Kefir samples.
The Uncertainty Profile Used for Full Validation of the HPLC Method to Determine 22 Azo Amines in Fabrics
Authors: Ait Lhaj Raja , Saffaj Taoufiq , Belmir Hamza , Ihssane Bouchaib 
Published: October 2022

Abstract

Background
Azo dyes are synthetic dyes that can degrade to carcinogenic amines, therefore determining their exact concentration is crucial.

Objective
The purpose of this study is to demonstrate that an HPLC method may be used to quantify 22 azo dye amines in a textile matrix.

Methods
The HPLC–DAD (Diode Array Detector) technique for measuring 22 amines in a textile matrix was tested using a new graphical statistical strategy based on the building of β-content, γ-confidence tolerance intervals, which allows for good qualimetry of analytical procedures. In this way, we established the approach's ability to perform a full validation of the analytical technique as well as its ability to estimate measurement uncertainty in a simple and uncomplicated way with minimum effort, utilizing only the data collected during the analytical validation.

Results
The findings suggest that this technique can properly assess the validity of the HPLC method for simultaneous determination of 22 amines, with 67–90% of compliance results falling within acceptable limits.

Conclusion
Using the uncertainty profile methodology, the full validation of an HPLC method for the determination of 22 azo amines in a textile matrix was successfully established.

Highlights
The development and evaluation of an efficient HPLC technique for the simultaneous determination of 22 azo amines in a textile matrix have been completed. The total reliability of the analytical procedure was established by evaluating its measurement uncertainty at each concentration level using the suggested uncertainty profile approach and confirming proportions 67 to 90% of compliance.
The effect of moderate energy and protein restriction during gilt development on changes in body weight and backfat depth and subsequent lactation performance
Authors: Gregory Nicole , Farmer Chantal , Friendship Robert M , Huber Lee-Anne 
Published: October 2022

Abstract
Eighty-eight gilts [initial body weight (BW) 49.8 ± 0.8 kg] were recruited to determine the effects of moderate energy and protein restriction during the development period on changes in BW and backfat depth (BF) and subsequent lactation performance. Gilts were randomly assigned to one of four feeding programs: 1) standard commercial diet fed ad libitum (CON), 2) standard commercial diet fed 10% or 3) 20% below ad libitum, or 4) a high–fiber diet fed ad libitum [2.5 times more fiber (neutral detergent fiber) than the commercial diet to dilute net energy and crude protein by approximately 20% and 13%, respectively; FIB]. The gilts were housed individually and received the feeding programs between 90 and 190 (breeding) d of age and standard gestation and lactation diets thereafter. Litters were standardized to 12 ± 1 pigs within 48 h of farrowing; weaning occurred at 20.0 ± 0.4 d of age. Gilts that received the 20% restricted program had lower overall average daily feed intake (ADFI) during the development period (2.64 ± 0.04 kg; P &lt; 0.05) versus all other feeding programs and gilts that received the 10% restricted program had lower ADFI than FIB and CON, which were not different (2.96 vs. 3.44 and 3.47 ± 0.04 kg for 10%, FIB and CON, respectively; P &lt; 0.05). Plasma free fatty acid (FFA) concentrations on day 180 of age were lower for gilts that received the 10% and 20% restricted programs compared to gilts that received the FIB and CON programs, which were not different (97 and 86 vs. 220 and 149 ± 29 µEq/L, respectively; P &lt; 0.05). Plasma concentrations of glucose, urea, prolactin, and IGF-1 were not different among feeding programs on day 180 of age. At breeding, gilts that received the FIB and 10% programs had lower BW and BF versus CON (145.7 and 144.8 vs. 155.2 ± 0.9 kg and 14.4 and 14.8 vs. 16.5 ± 0.2 mm for BW and BF, respectively; P &lt; 0.05) but greater BW than gilts that received the 20% restricted program (137.9 kg; P &lt; 0.05). The BW and BF of gilts did not differ at the end of gestation or at weaning. The ADFI of sows during lactation and offspring birth weight and growth rate during lactation and the 5-wk nursery period were not influenced by gilt development feeding program. Therefore, a high-fiber feeding program could be used in group-housing gilt-development scenarios, where feed is offered ad libitum, to control BW and BF prior to breeding without influencing milk production in the subsequent lactation period.
Real-World Data on Cutaneous Recurrences Following Neonatal Herpes Simplex Virus Disease
Authors: Kimberlin David W 
Published: October 2022

Abstract
Though primarily used to improve neurodevelopmental outcomes, suppressive oral acyclovir therapy following neonatal herpes simplex virus disease also decreases cutaneous recurrences. Skin recurrences can still occur, however, and understanding their frequency is helpful in managing patients with this rare disease.
Orbits and action changes during star-clump encounters responsible for the origin of exponential discs in dwarf galaxies
Authors: Wu Jian , Struck Curtis , Elmegreen Bruce G , D’Onghia Elena 
Published: October 2022

ABSTRACT
Previous studies found that stellar scattering by massive clumps can lead to the formation of exponential profiles in galaxy discs, but details on how a star is moved around have not been fully explained. We use a gadget-2 simulation where an exponential profile forms from an initially Gaussian disc in about 4 Gyr for a low-mass galaxy like a dwarf irregular. We find that nearly all large angular momentum changes of stars are caused by star-clump encounters with the closest approach less than 0.5 kpc. During star-clump encounters, stars may increase their random motions, resulting in an increase in the average radial and vertical actions of the whole stellar population. The angular momentum change and the radial action change of an individual star are influenced by the direction from which the star approaches a clump. A star initially at a higher galactic radius relative to the scattering clump usually gets pulled inwards and loses its angular momentum during the encounter, and one at a lower radius tends to shift outwards and gains angular momentum. The increase in the radial action is the largest if a star encounters a clump from the azimuthal direction, and is the smallest from a radial approach. The angular momentum change due to encounters has an inward bias when the clump profile has a steep radial decline, and a shallow decline can make the bias outwards. The stellar profile evolution towards an exponential seems to occur regardless of the direction of the bias.