bluuebunny/crossref_metadata_2025_split huggingface dataset:
Propensity matched comparison of TAVI and SAVR in intermediate-risk patients with severe aortic stenosis and moderate-to-severe chronic kidney disease: a subgroup analysis from the German Aortic Valve Registry
Authors: Mas-Peiro Silvia , Faerber Gloria , Bon Dimitra , Herrmann Eva , Bauer Timm , Bleiziffer Sabine , Bekeredjian Raffi , Böning Andreas , Frerker Christian , Beckmann Andreas , Möllmann Helge , Ensminger Stephan , Hamm Christian W. , Beyersdorf Friedhelm , Fichtlscherer Stephan , Walther Thomas ,   For the GARY-Executive Board
Published: September 2022

Abstract
Objective
We compared TAVI vs. SAVR in patients with moderate-to-severe chronic kidney disease (eGFR 15–60 ml/min/1.73 m2) for whom both procedures could possibly be considered (age ≤ 80 years, STS-score 4–8).

Background
According to both ACC/AHA and ESC/EACTS recent guidelines, aortic stenosis may be treated with either transcatheter (TAVI) or surgical (SAVR) aortic valve replacement in a subgroup of patients. A shared therapeutic decision is made by a heart team based on individual factors, including chronic kidney disease (CKD).

Methods
Data from the large nationwide German Aortic Valve Registry were used. A propensity score method was used to select 704 TAVI and 374 SAVR matched patients. Primary endpoint was 1-year survival. Secondary endpoints were clinical complications, including pacemaker implantation, vascular complications, myocardial infarction, bleeding, and the need for new-onset dialysis.

Results
One-year survival was similar (HR [95% CI] for TAVI 1.271 [0.795, 2.031], p = 0.316), with no divergence in Kaplan–Meier curves. In spite of post-procedural short-term survival being numerically higher for TAVI patients and 1-year survival being numerically higher for SAVR patients, such differences did not reach statistical significance (96.4% vs. 94.2%, p = 0.199, and 86.2% vs. 81.2%, p = 0.316, respectively). In weighted analyses, pacemaker implantation, vascular complications, and were significantly more common with TAVI; whereas myocardial infarction, bleeding requiring transfusion, and longer ICU-stay and overall hospitalization were higher with SAVR. Temporary dialysis was more common with SAVR (p < 0.0001); however, a probable need for chronic dialysis was rare and similar in both groups.

Conclusion
Both TAVI and SAVR led to comparable and excellent results in patients with moderate-to-severe CKD in an intermediate-risk population of patients with symptomatic severe aortic stenosis for whom both therapies could possibly be considered.
Incidence and predictors of radial artery occlusion following transradial coronary angiography: the proRadial trial
Authors: Schlosser Julia , Herrmann Laura , Böhme Tanja , Bürgelin Karlheinz , Löffelhardt Nikolaus , Nührenberg Thomas , Mashayekhi Kambis , Valina Christian M. , Neumann Franz-Josef , Hochholzer Willibald 
Published: September 2022

AbstractObjectivesThis study investigated the contemporary incidence and predictors of radial artery occlusion as well as the effectiveness of antithrombotic treatment for radial artery occlusion following transradial coronary angiography.BackgroundThe radial artery is the standard access for coronary angiography and even complex interventions. Postprocedural radial artery occlusion is still a common and significant complication.MethodsThis prospective study enrolled 2004 patients following transradial coronary angiography. After sheath removal, hemostasis was obtained in a standardized fashion. Radial artery patency was evaluated by duplex ultrasonography in all patients. In case of occlusion, oral anticoagulation was recommended and patients were scheduled for a 30-day follow-up including Doppler ultrasonography.ResultsA new-diagnosed radial occlusion was found in 4.6% of patients. The strongest independent predictors of radial occlusion were female sex and active smoking status. In the subgroup of patients with percutaneous coronary interventions, female sex followed by sheath size > 6 French were the strongest predictors of radial occlusion. 76 of 93 patients with radial occlusion received an oral anticoagulation for 30 days. However, reperfusion at 30 days was found in 32% of patients on oral anticoagulation.ConclusionThe incidence of radial artery occlusion following coronary angiography in contemporary practice appears with 4.6% to be lower as compared to previous cohorts. Female sex and smoking status are the strongest independent predictors of radial occlusion followed by procedural variables. The limited effectiveness of oral anticoagulation for treatment of radial artery occlusion suggests a primarily traumatic than thrombotic mechanism of this complication.Graphical abstract
Receptor clustering and pathogenic complement activation in myasthenia gravis depend on synergy between antibodies with multiple subunit specificities
Authors: Rose Natalie , Holdermann Sebastian , Callegari Ilaria , Kim Hyein , Fruh Isabelle , Kappos Ludwig , Kuhle Jens , Müller Matthias , Sanderson Nicholas S. R. , Derfuss Tobias 
Published: September 2022

AbstractMyasthenia gravis is an autoimmune disorder defined by muscle weakness and fatigability associated with antibodies against proteins of the neuromuscular junction (NMJ). The most common autoantibody target is the acetylcholine receptor (AChR). Three mechanisms have been postulated by which autoantibodies might interfere with neurotransmission: direct antagonism of the receptor, complement-mediated destruction of the postsynaptic membrane, and enhanced internalization of the receptor. It is very likely that more than one of these mechanisms act in parallel. Dissecting the mechanisms of autoantibody-mediated pathology requires patient-derived, monoclonal antibodies. Using membrane antigen capture activated cell sorting (MACACS), we isolated AChR-specific B cells from patients with myasthenia gravis, and produced six recombinant antibodies. All AChR-specific antibodies were hypermutated, including isotypes IgG1, IgG3, and IgG4, and recognized different subunits of the AChR. Despite clear binding, none of the individual antibodies showed significant antagonism of the AChR measured in an in vitro neuromuscular synapse model, or AChR-dependent complement activation, and they did not induce myasthenic signs in vivo. However, combinations of antibodies induced strong complement activation in vitro, and severe weakness in a passive transfer myasthenia gravis rat model, associated with NMJ destruction and complement activation in muscle. The strongest complement activation was mediated by combinations of antibodies targeting disparate subunits of the AChR, and such combinations also induced the formation of large clusters of AChR on the surface of live cells in vitro. We propose that synergy between antibodies of different epitope specificities is a fundamental feature of this disease, and possibly a general feature of complement-mediated autoimmune diseases. The importance of synergistic interaction between antibodies targeting different subunits of the receptor can explain the well-known discrepancy between serum anti-AChR titers and clinical severity, and has implications for therapeutic strategies currently under investigation.
Interobserver variability of cochlear duct measurements in pediatric cochlear implant candidates
Authors: Salkic Almir , Yildiz Erdem , Baumgartner Wolf-Dieter , Tokic Lejla , Uscuplic Sabrina , Sarihodzic Senada , Brkic Fuad , Harcinovic Alen , Liu David T. , Brkic Faris F. 
Published: September 2022

Abstract
Purpose
The objective of the study was to evaluate the proposed cochlear duct length estimation based on the cochlear ‘A value’. Furthermore, we assessed the interobserver variability between radiology and otolaryngology attending physicians and otolaryngology trainees.

Methods
Thirteen pediatric cochlear implant candidates were retrospectively analyzed by three otolaryngology physicians (attending physician, second year, and fourth year trainees) and a radiology attending. The cochlear duct length was calculated based on the formula of Grover et al. The differences in acquired measurements between observers were compared using the Wilcoxon matched signed-rank test.

Results
The differences in measurements between the attending otolaryngologist and radiologist were not statistically different, while several significant differences were observed with regard to measurements of attending doctors compared to both residents. In particular, a significant difference between the second year otolaryngology resident and otolaryngology and radiology attending was observed for one side (right ear p = 0.034 and p = 0.012, respectively). Moreover, the fourth year resident calculated significantly different cochlear duct measurements when compared to the attending otolaryngologist (left ear p = 0.014) and radiologist (right ear p = 0.047). Interestingly, differently experienced otolaryngology residents provided significantly different measurements for both ears.

Conclusions
Based on these results, cochlear duct length measurement according to the proposed method may be a reliable and cost-effective method. Indeed, otolaryngology training may be sufficient to provide measurements comparable to radiologists. On the other hand, additional efforts should be invested during otolaryngology training in terms of the evaluation of radiological imaging which may increase the capabilities of otolaryngology residents in this regard.
Maintenance therapy improves the survival outcomes of patients with metastatic nasopharyngeal carcinoma responding to first-line chemotherapy: a multicentre, randomized controlled clinical study
Authors: Lu Ying , Huang Haixin , Yang Hui , Hu Xiaohua , Liu Meilian , Huang Changjie , Feng Xianbin , Chen Xishan , Jiang Zhou 
Published: September 2022

Abstract
Purpose
To explore the safety and role of tegafur/gimeracil/oteracil (S1) maintenance therapy (MT) in metastatic nasopharyngeal carcinoma (NPC) patients after response to first-line chemotherapy and to assess outcome-associated biomarkers.

Methods
This was a multicentre, open-label, randomized controlled study involving metastatic NPC patients recruited (from May 2015 to May 2019) at five hospitals in China. The participants were randomized to S1-MT (receiving S1 MT until disease progression or intolerance) or non-MT (followed up until disease progression) groups. The primary endpoint was the progression-free survival (PFS). The secondary endpoints were the overall survival (OS), the correlation between EBV-DNA, serum amyloid A (SAA) status, and outcomes after the first-line chemotherapy, and safety.

Results
The median follow-up was 24.3 months; 88 and 95 participants were evaluable in the S1-MT and non-MT groups, respectively. Compared with non-MT, S1-MT prolonged PFS (16.9 vs. 9.3 months, P < 0.001) and OS (33.6 vs. 20.6 months, P < 0.001). Regardless of their EBV-DNA status after first-line chemotherapy, participants were able to benefit from S1 MT, but EBV-DNA-positive participants benefited more significantly (PFS: HR = 0.600, 95% CI = 0.373–0.965, P = 0.035; OS: HR = 0.393, 95% CI = 0.227–0.681, P = 0.001). MT only improved PFS and OS in patients with an SAA decline after first-line chemotherapy (PFS: HR = 0.570, 95% CI = 0.350–0.919, P = 0.021; OS: HR = 0.404, 95% CI = 0.230–0.709, P = 0.002). The median S1 treatment was 23 cycles. Grade 1–2 skin pigmentation, oral mucositis, and hand and foot syndrome were the main adverse reactions.

Conclusion
For metastatic NPC patients with first-line chemotherapy response, S1 MT can improve PFS and OS, with good tolerability. EBV-DNA and SAA can better help us identify patients who can benefit from MT after standard treatment.

Trial registration
The study protocol was registered at the Chinese Clinical Trial Registry (ChiCTR-IOR-16007939).
Epigenetic inactivation of DNA repair genes as promising prognostic and predictive biomarkers in urothelial bladder carcinoma patients
Authors: Mohanad Marwa , Yousef Hend F. , Bahnassy Abeer A. 
Published: September 2022

AbstractWe sought to examine epigenetic inactivation of DNA damage repair (DDR) genes as prognostic and predictive biomarkers for urothelial bladder cancer (UBC) as there are currently no reliable prognostic biomarkers that identify UBC patients who would benefit from chemotherapy. Genome-wide DNA methylome using the cancer genome atlas-bladder cancer (TCGA-BLCA) datasets (primary tumors = 374 and normal tissues = 37) was performed for 154 DDR genes. The most two significant differentially methylated genes, Retinoblastoma binding protein 8 (RBBP8)and MutS homologue 4(MSH4), between primary tumors and normal tissues of TCGA–BLCA were validated by methylation-specific PCR (MSP) in UBC (n = 70) compared to normal tissues (n = 30).RBBP8andMSH4expression was measured using qRT-PCR. We developed a predictive model for therapeutic response based on theRBBP8- andMSH4-methylation along with patients’ clinical features.Then, we assessed the prognostic significance ofRBBP8andMSH4.RBBP8-andMSH4methylation and corresponding gene downregulation significantly associated with muscle-invasive phenotype, prolonged progression-free survival (PFS) and increased susceptibility to cisplatin chemotherapy in UBC. Promoter methylation ofRBBP8andMSH4was positively correlated with each other and with their corresponding gene repression. The best machine-learning classification model predicted UBC patients’ response to cisplatin-based chemotherapy with an accuracy of 90.05 ± 4.5%. Epigenetic inactivation ofRBBP8andMSH4in UBC could sensitize patients to DNA-damaging agents. A predictive machine-learning modeling approach based on the clinical features along withRBBP8-andMSH4-methylation might be a promising tool for stratification of UBC responders from nonresponders to chemotherapy.
Implementation of the “No ICU – Unless” approach in postoperative neurosurgical management in times of COVID-19
Authors: Qasem Lina-Elisabeth , Al-Hilou Ali , Zacharowski Kai , Funke Moritz , Strouhal Ulrich , Reitz Sarah C. , Jussen Daniel , Forster Marie Thérèse , Konczalla Juergen , Prinz Vincent Matthias , Lucia Kristin , Czabanka Marcus 
Published: September 2022

AbstractFollowing elective craniotomy, patients routinely receive 24-h monitoring in an intensive care unit (ICU). However, the benefit of intensive care monitoring and treatment in these patients is discussed controversially. This study aimed to evaluate the complication profile of a “No ICU – Unless” strategy and to compare this strategy with the standardized management of post-craniotomy patients in the ICU. Two postoperative management strategies were compared in a matched-pair analysis: The first cohort included patients who were managed in the normal ward postoperatively (“No ICU – Unless” group). The second cohort contained patients routinely admitted to the ICU (control group). Outcome parameters contained detailed complication profile, length of hospital and ICU stay, duration to first postoperative mobilization, number of unplanned imaging before scheduled postoperative imaging, number and type of intensive care interventions, as well as pre- and postoperative modified Rankin scale (mRS). Patient characteristics and clinical course were analyzed using electronic medical records. The No ICU – Unless (NIU) group consisted of 96 patients, and the control group consisted of 75 patients. Complication rates were comparable in both cohorts (16% in the NIU group vs. 17% in the control group; p = 0.123). Groups did not differ significantly in any of the outcome parameters examined. The length of hospital stay was shorter in the NIU group but did not reach statistical significance (average 5.8 vs. 6.8 days; p = 0.481). There was no significant change in the distribution of preoperative (p = 0.960) and postoperative (p = 0.425) mRS scores in the NIU and control groups. Routine postoperative ICU management does not reduce postoperative complications and does not affect the surgical outcome of patients after elective craniotomies. Most postoperative complications are detected after a 24-h observation period. This approach may represent a potential strategy to prevent the overutilization of ICU capacities while maintaining sufficient postoperative care for neurosurgical patients.
Immediate dental implant placement in post-extraction-infected sites decontaminated with Er,Cr:YSGG laser: a retrospective cohort study
Authors: Crippa Rolando , Aiuto Riccardo , Dioguardi Mario , Nieri Michele , Peñarrocha-Diago María , Peñarrocha-Diago Miguel , Angiero Francesca 
Published: September 2022

AbstractDental implants placed in fresh extraction alveoli provide several advantages, including shorter treatment periods and improved patient comfort. After a compromised tooth extraction, the Er,Cr:YSGG laser can considerably reduce bacterial concentration. The objective of this controlled study conducted after at least 1 year of follow-up was to compare the use of immediate post-extraction implants in infected sites treated with laser (test group) versus conventional implants in edentulous sites (control group) through an analysis of pre- and post-operative radiographs. The study was based on a series of patients treated between 2014 and 2019, with a 1-year minimum follow-up, and up to over 4 years. An analysis of the clinical history of the treated patients and pre- and post-operative radiographs was performed to evaluate the implant success and to measure the marginal bone level (MBL). Overall, 149 implants were studied. There was only one failure in the test group (1%) and no failures in the control group. The test group gained 0.1 mm of the MBL compared to the baseline, while the control group lost 0.1 mm of the MBL. The difference between the two groups of only 0.2 mm was not statistically significant (P = 0.058). Immediate dental implants in infected sockets debrided and decontaminated using Er,Cr:YSGG laser do not appear to enhance the likelihood of failure; however, peri-implantitis and associated problems must be avoided by following a certain set of protocols and procedures.
Disentangling arthropod and plant resources consumed by Orius spp. in peach and alfalfa crops by metagenomic analysis
Authors: Batuecas Iván , Alomar Oscar , Castañé Cristina , Piñol Josep , Gallardo-Montoya Lorena , Agustí Nuria 
Published: September 2022

AbstractAgricultural intensification is affecting the biological control of insect pests, an important component for sustainable crop production. To understand the changing patterns of insect abundance within an agroecosystem, it is necessary to disentangle the trophic interactions between species, and metabarcoding is an excellent alternative to show them. In the Ebro Basin (NE Iberian Peninsula), agricultural landscapes are composed of a mosaic of crops scattered with natural and semi-natural habitats, where the presence of Orius spp., used as biocontrol agents, is well known. To shed light on their predatory role in this area, a previously developed metabarcoding multi-primer method has been used to study the arthropod and plant most frequently resources consumed by some field-collected Orius, sampled at different dates in a peach and an alfalfa adjacent crop. Their high-throughput sequencing (HTS) analysis showed the consumption of 15 arthropod and 12 plant taxa. Eight of them were consumed by O. laevigatus, six by O. majusculus and 23 by O. niger. The obtained results showed that HTS is a powerful tool in studies of trophic interactions in agroecosystems. Among the detected arthropods, other natural enemies were present, showing a certain degree of intraguild predation, which has been demonstrated by developing a new added strategy in the bioinformatic analysis. Detected plant consumption indicates that Orius forages on several plant species, showing their movement from them to the sampled crops. These plants could have a potential role in attracting or maintaining these predators in both crops in biological control strategies.
Analysis of inter and intra-front operations in multi-modal multi-objective optimization problems
Authors: Javadi Mahrokh , Mostaghim Sanaz 
Published: September 2022

AbstractMany real-world multi-objective optimization problems inherently have multiple multi-modal solutions and it is in fact very important to capture as many of these solutions as possible. Several crowding distance methods have been developed in the past few years to approximate the optimal solution in the search space. In this paper, we discuss some of the shortcomings of the crowding distance-based methods such as inaccurate estimates of the density of neighboring solutions in the search space. We propose a new classification for the selection operations of Pareto-based multi-modal multi-objective optimization algorithms. This classification is based on utilizing nearby solutions from other fronts to calculate the crowding values. Moreover, to address some of the drawbacks of existing crowding methods, we propose two algorithms whose selection mechanisms are based on each of the introduced types of selection operations. These algorithms are called NxEMMO and ES-EMMO. Our proposed algorithms are evaluated on 14 test problems of various complexity levels. According to our results, in most cases, the NxEMMO algorithm with the proposed selection mechanism produces more diverse solutions in the search space in comparison to other competitive algorithms.
Limited diversity and QCA solution types: assumptions and their consequences
Authors: Glaesser Judith 
Published: September 2022

AbstractLimited diversity is a term employed in the context of Ragin’s Qualitative Comparative Analysis (QCA), but it describes a phenomenon which is widespread in social contexts: cases are usually not distributed evenly across all the possible combinations of factors linked to some outcome. Instead, they are often clustered together. To deal with limited diversity, the three solution types parsimonious, intermediate, and complex (or conservative) solution have been proposed. There is an ongoing debate as to the merits of each solution type. This paper contributes to the debate by focussing on what the implications of choosing each solution type are. In making this choice, researchers have to make certain assumptions, and the paper discusses what these are and how they vary depending on which solution type is being implemented, drawing on invented examples and examples from published work to bring out the consequences of these assumptions. It concludes that it is not obvious that any one solution type is superior, certainly not to the degree that the others always have to be ruled out. They rely on different kinds of assumptions and models of causation. Thus, depending on the research situation, it may be helpful to analyse different scenarios, including one(s) where we assume that our initial assumptions are wrong. Ideally, researchers are able to take steps to reduce or eliminate limited diversity since none of the existing solution types are without problems. However, since this is not always possible, it is best to be aware of the consequences of choices.