bluuebunny/crossref_metadata_2025 huggingface dataset:
Measurement of the characteristics of the Earth’s magnetic field using a smartphone magnetic sensor
Authors: Koblischka Michael R , Koblischka-Veneva Anjela
Published: May 2022

Several properties of Earth’s magnetic field (field vectors, time dependence) are measured in various locations using a smartphone/tablet magnetic sensor. To enable a proper use of the magnetic sensor as a classroom tool, the exact location of the sensor in the device and its resolution must be identified in a first step. Then, students may perform several measurements on their own, allowing a comparison of the recorded field vectors and a discussion of the possible deviations. We also show that long-time measurements of the local magnetic field are possible using the smartphone sensors, which can be compared to available internet data. All the information obtained enables a better understanding of the properties of the Earth’s magnetic field and of the requirements for real applications of magnetic sensor elements.
Active learning-guided exploration of parameter space of air plasmas to enhance the energy efficiency of NO
x
production
Authors: Shao Ketong , Pei Xuekai , Graves David B , Mesbah Ali
Published: May 2022

Low temperature, air plasmas have shown promise for production of NO
x
for nitrogen fixation. However, to make nitrogen fixation via air plasmas economically viable, a major challenge arises from reducing the energy cost of NO
x
generation, which is a complex function of a multitude of factors including the plasma discharge type, discharge operating parameters and presence of heterogeneous catalysts. This paper presents an active learning (AL) approach for exploring the multivariable and highly nonlinear parameter space of low temperature plasmas (LTPs) in a systematic and efficient manner. The proposed AL approach relies on Bayesian optimization, which is a data-driven optimization method that is particularly suited for optimizing black-box functions constructed from noisy observations. We demonstrate the AL approach for querying the parameter space of a DC pin-to-pin glow discharge in order to enhance the energy efficiency of NO
x
production. It is observed that, given a fixed experimental budget, AL consistently outperforms random search of the parameter space in terms of minimizing the energy cost or maximizing the rate of NO
x
generation in the presence of a constraint on discharge power. AL approaches can pave the way for automated and efficient exploration of the high-dimensional parameter space of LTPs, towards establishing insights into their complex behaviors.
Semi-active control of nonlinear smart base-isolated structures using MR damper: sensitivity and reliability analyses
Authors: Etedali Sadegh , Zamani Abbas-Ali
Published: May 2022

Semi-active control of base-isolated structures using magneto-rheological (MR) dampers is well studied in recent years. However, there is a study gap for sensitivity and reliability analyses assessment of the structure in the literature. Besides, the reliability analysis of the structures based on the importance of the building from a user perspective categorized into three groups including very high, high, and medium is an interesting topic that is considered in this study. Extension of the study for the case of uncontrolled base-isolated structures and controlled ones in both passive-off and passive-on modes of the MR dampers and tuning the command voltage of the MR dampers by a multi-objective modified clipped optimal (MOMCO) controller are also addressed in this paper in different seismic hazard regions with different peak ground accelerations. The Monte Carlo simulation-based Sobol’s indices and importance sampling (IS) method are applied for the sensitivity and reliability analyses. Studies are conducted on an eight-story nonlinear base-isolated structure. The sensitivity analyses show the main seismic responses are more influenced by the changing uncertainties of the stochastic ground acceleration; the mass, and stiffness of the structural model; and the yield force of the isolation system. MR dampers can significantly reduce the failure probabilities of the structures in different seismic hazard regions. By increasing seismic hazard, an increment is observed in failure probability. Enhancing the importance of the building from medium to very-high status leads to an increase in the failure probabilities of the structure in all cases. However, the performance of three control cases in reducing the failure probabilities of the structure is often increased. The MOMCO controller and passive-on mode represent fewer failure probabilities than the uncontrolled and passive-off mode in different seismic hazard regions and groups. However, the MOMCO gives the best performance in the reduction of failure probabilities.
Search for a lighter neutral custodial fiveplet scalar in the Georgi-Machacek model *
Authors: Wang Chu , Tao Jun-Quan , Shahzad M. Aamir , Chen Guo-Ming , Gascon-Shotkin S.
Published: May 2022

Many researches from both theoretical and experimental perspectives have been performed to search for a new Higgs Boson that is lighter than the 125

Higgs boson, which was discovered at the LHC in 2012. In this study, we explore the possibility of constraining a lighter neutral custodial fiveplet scalar

in the Georgi-Machacek (GM) model using the latest results of the search for a lighter Higgs boson decaying into two photons from LHC data. The custodial-singlet mass eigenstate h or H is considered to be the LHC observed 125

Higgs boson. A new set of constrained parameters that is favoured by low-mass

is proposed to generate events efficiently. The production of

from a scan based on the constrained parameters is compared to the latest results of the search for a lighter Higgs boson decaying into two photons by the CMS Collaboration after applying theoretical constraints from the GM model and constraints from all existing relevant experimental measurements, including the recent results of the Higgs boson searches by the LHC. Numerical analyses of the surviving GM parameter space are performed. The tendencies and correlations of the GM input parameters from phenomenological studies are summarized. In addition, the discovery potential of the other interesting decay channels of this low-mass neutral custodial fiveplet scalar are discussed.
Pulse amplification in a closed-loop Λ system with permanent dipole moments
Authors: Daloi Nilamoni , Das Partha , Dey Tarak Nath
Published: May 2022

Propagation of a weak Gaussian probe pulse through a closed-loop Λ system with permanent dipole moments (PDMs) is investigated in presence of a strong control field along with a third field. The presence of PDMs allows multiphoton excitation, which is otherwise forbidden. The PDMs modify the Rabi frequencies of the probe, control, and the third field inside the medium which noticeably affects the propagation of the probe pulse. The probe pulse is amplified during propagation with its Gaussian shape intact. Due to unprohibited two-photon excitation, it is possible to amplify a probe pulse whose frequency is twice the control field’s frequency, with the help of the third field.
International interlaboratory comparison of Raman spectroscopic analysis of CVD-grown graphene
Authors: Turner Piers , Paton Keith R , Legge Elizabeth J , de Luna Bugallo Andres , Rocha-Robledo A K S , Zahab Ahmed-Azmi , Centeno Alba , Sacco Alessio , Pesquera Amaia , Zurutuza Amaia , Rossi Andrea Mario , Tran Diana N H , L Silva Diego , Losic Dusan , Farivar Farzaneh , Kerdoncuff Hugo , Kwon Hyuksang , Pirart Jerome , Campos João Luiz E , Subhedar Kiran M , Tay Li-Lin , Ren Lingling , Cançado Luiz Gustavo , Paillet Matthieu , Finnie Paul , Yap Pei Lay , Arenal Raul , Dhakate Sanjay R , Wood Sebastian , Jiménez-Sandoval Sergio , Batten Tim , Nagyte Vaiva , Yao Yaxuan , Hight Walker Angela R , Martins Ferreira Erlon H , Casiraghi Cinzia , Pollard Andrew J
Published: May 2022

There is a pressing need for reliable, reproducible and accurate measurements of graphene’s properties, through international standards, to facilitate industrial growth. However, trustworthy and verified standards require rigorous metrological studies, determining, quantifying and reducing the sources of measurement uncertainty. Towards this effort, we report the procedure and the results of an international interlaboratory comparison (ILC) study, conducted under Versailles Project on Advanced Materials and Standards. This ILC focusses on the comparability of Raman spectroscopy measurements of chemical vapour deposition (CVD) grown graphene using the same measurement protocol across different institutes and laboratories. With data gathered from 17 participants across academia, industry (including instrument manufacturers) and national metrology institutes, this study investigates the measurement uncertainty contributions from both Raman spectroscopy measurements and data analysis procedures, as well as provides solutions for improved accuracy and precision. While many of the reported Raman metrics were relatively consistent, significant and meaningful outliers occurred due to differences in the instruments and data analysis. These variations resulted in inconsistent reports of peak intensity ratios, peak widths and the coverage of graphene. Due to a lack of relative intensity calibration, the relative difference reported in the 2D- and G peak intensity ratios (

I

2

D

/

I

G

) was up to 200%. It was also shown that the standard deviation for

Γ

2

D

values reported by different software packages, was 15× larger for Lorentzian fit functions than for pseudo-Voigt functions. This study has shown that by adopting a relative intensity calibration and consistent peak fitting and data analysis methodologies, these large, and previously unquantified, variations can be significantly reduced, allowing more reproducible and comparable measurements for the graphene community, supporting fundamental research through to the growing graphene industry worldwide. This project and its findings directly underpin the development of the ISO/IEC standard ‘DTS 21356-2—Nanotechnologies—Structural Characterisation of CVD-grown Graphene’.
A geometry-guided multi-beamlet deep learning technique for CT reconstruction
Authors: Lu Ke , Ren Lei , Yin Fang-Fang
Published: May 2022

Purpose. Previous studies have proposed deep-learning techniques to reconstruct CT images from sinograms. However, these techniques employ large fully-connected (FC) layers for projection-to-image domain transformation, producing large models requiring substantial computation power, potentially exceeding the computation memory limit. Our previous work proposed a geometry-guided-deep-learning (GDL) technique for CBCT reconstruction that reduces model size and GPU memory consumption. This study further develops the technique and proposes a novel multi-beamlet deep learning (GMDL) technique of improved performance. The study compares the proposed technique with the FC layer-based deep learning (FCDL) method and the GDL technique through low-dose real-patient CT image reconstruction. Methods. Instead of using a large FC layer, the GMDL technique learns the projection-to-image domain transformation by constructing many small FC layers. In addition to connecting each pixel in the projection domain to beamlet points along the central beamlet in the image domain as GDL does, these smaller FC layers in GMDL connect each pixel to beamlets peripheral to the central beamlet based on the CT projection geometry. We compare ground truth images with low-dose images reconstructed with the GMDL, the FCDL, the GDL, and the conventional FBP methods. The images are quantitatively analyzed in terms of peak-signal-to-noise-ratio (PSNR), structural-similarity-index-measure (SSIM), and root-mean-square-error (RMSE). Results. Compared to other methods, the GMDL reconstructed low-dose CT images show improved image quality in terms of PSNR, SSIM, and RMSE. The optimal number of peripheral beamlets for the GMDL technique is two beamlets on each side of the central beamlet. The model size and memory consumption of the GMDL model is less than 1/100 of the FCDL model. Conclusion. Compared to the FCDL method, the GMDL technique is demonstrated to be able to reconstruct real patient low-dose CT images of improved image quality with significantly reduced model size and GPU memory requirement.
Hydrogel and nanoparticle carriers for kidney disease therapy: trends and recent advancements
Authors: Gu Xurui , Liu Zhen , Tai Yifan , Zhou Ling-yun , Liu Kun , Kong Deling , Midgley Adam C , Zuo Xiao-cong
Published: May 2022

Achieving local therapeutic agent concentration in the kidneys through traditional systemic administration routes have associated concerns with off-target drug effects and toxicity. Additionally, kidney diseases are often accompanied by co-morbidities in other major organs, which negatively impacts drug metabolism and clearance. To circumvent these issues, kidney-specific targeting of therapeutics aims to achieve the delivery of controlled doses of therapeutic agents, such as drugs, nucleic acids, peptides, or proteins, to kidney tissues in a safe and efficient manner. Current carrier material approaches implement macromolecular and polyplex hydrogel constructs, prodrug strategies, and nanoparticle (NP)-based delivery technologies. In the context of multidisciplinary and cross-discipline innovations, the medical and bioengineering research fields have facilitated the rapid development of kidney-targeted therapies and carrier materials. In this review, we summarize the current trends and recent advancements made in the development of carrier materials for kidney disease targeted therapies, specifically hydrogel and NP-based strategies for acute kidney disease, chronic kidney disease, and renal cell carcinoma. Additionally, we discuss the current limitations in carrier materials and their delivery mechanisms.
A Matched Analysis of the Association Between Federally Mandated Smoke-Free Housing Policies and Health Outcomes Among Medicaid-Enrolled Children in Subsidized Housing, New York City, 2015–2019
Authors: Titus Andrea R , Mijanovich Tod N , Terlizzi Kelly , Ellen Ingrid G , Anastasiou Elle , Shelley Donna , Wyka Katarzyna , Elbel Brian , Thorpe Lorna E
Published: May 2022

Smoke-free housing policies are intended to reduce the deleterious health effects of secondhand smoke exposure, but there is limited evidence regarding their health impacts. We examined associations between implementation of a federal smoke-free housing rule by the New York City Housing Authority (NYCHA) and pediatric Medicaid claims for asthma, lower respiratory tract infections, and upper respiratory tract infections in the early post–policy intervention period. We used geocoded address data to match children living in tax lots with NYCHA buildings (exposed to the policy) to children living in lots with other subsidized housing (unexposed to the policy). We constructed longitudinal difference-in-differences models to assess relative changes in monthly rates of claims between November 1, 2015, and December 31, 2019 (the policy was introduced on July 30, 2018). We also examined effect modification by baseline age group (≤2, 3–6, or 7–15 years). In New York City, introduction of a smoke-free policy was not associated with lower rates of Medicaid claims for any outcomes in the early postpolicy period. Exposure to the smoke-free policy was associated with slightly higher than expected rates of outpatient upper respiratory tract infection claims (incidence rate ratio = 1.05, 95% confidence interval: 1.01, 1.08), a result most pronounced among children aged 3–6 years. Ongoing monitoring is essential to understanding long-term health impacts of smoke-free housing policies.
Antibiotic stability in portable elastomeric infusion devices: A systematic review
Authors: Esteban-Cartelle Beatriz , Vicente-Oliveros Noelia , Pérez Menéndez-Conde Covadonga , Serrano Dolores R , Martín-Dávila Pilar , Fortún-Abete Jesús , León-Gil Lourdes A , Álvarez-Díaz Ana
Published: May 2022

Purpose

Although outpatient parenteral antibiotic therapy (OPAT) can be a good approach to treatment of infections, a lack of data regarding antibiotic stability in portable elastomeric infusion devices restricts its safe, appropriate, and effective use. The objective of this work was to complete a systematic peer-reviewed analysis of published articles about antibiotic stability in elastomeric infusion devices that provide evidence supporting their use in OPAT.

A systematic review following PRISMA guidelines was conducted in January 2021 to identify published articles about antibiotic stability in portable elastomeric infusion devices. The databases used were PubMed, Embase, Web of Science, and a Cochrane database. A total of 1,615 original studies and conference communications were found. After title, abstract, and full-text review, 33 articles met the inclusion criteria. The data obtained included information about the stability of 30 different antibiotics. To our knowledge, this is the first review to summarize the available published data on the stability of antibiotics in portable elastomeric infusion devices. The results highlight the poor stability of some antibiotics in solution and the variability of the laboratory conditions in the included studies.

Conclusion

This systematic review can serve as a useful resource for healthcare professionals involved in providing OPAT using portable elastomeric infusion devices. However, further stability studies should be performed, especially high-quality studies simulating real-life time and temperature conditions.
Defining the Role for Topically Administered Tranexamic Acid in Panniculectomy Surgery
Authors: Weissler Jason M , Kuruoglu Doga , Salinas Cristina , Tran Nho V , Nguyen Minh-Doan T , Martinez-Jorge Jorys , Bite Uldis , Harless Christin A , Vijayasekaran Aparna , Sharaf Basel
Published: May 2022

Background

Abdominal panniculectomy after weight loss is a commonly performed procedure with high patient satisfaction yet continues to have a high post-operative complication profile. Several risk-reducing surgical approaches, such as preservation of Scarpa’s fascia, use of tissue adhesives, and progressive tension suture techniques have been described. However, the use of tranexamic acid (TXA) has not been previously reported in panniculectomy surgery.

Objectives

To improve the safety and predictability of this procedure, the authors investigate whether the use of topically administered TXA during panniculectomy surgery reduces seroma, hematoma, and drain duration.

Methods

Consecutive patients who underwent panniculectomy (January 2010 to January 2022) were retrospectively reviewed. Outcome measures included hematoma requiring surgical evacuation, seroma requiring percutaneous aspiration, and drain duration. Patients with thromboembolic diseases and those taking anticoagulation/antiplatelet medications were excluded. Patients who had received TXA were compared with a historical control group who had not received TXA.

Results

A total of 288 consecutive patients were included. Topical TXA was administered in 56 (19.4%) cases. The mean (standard deviation [SD]) follow-up was 43.9 (37.4) months (3.7 years). The median (range) resection weight was 2.6 kg (0.15-19.96 kg). Regarding seroma and hematoma formation, the use of TXA did not reduce the likelihood of developing seroma or hematoma (odds ratio [OR] = 1.7, 95% CI [0.56- 4.8], P = 0.38 and OR = 2.1, 95% CI [0.4-11.8], P = 0.42), respectively. The mean (SD) duration of drains was slightly lower in the TXA group (18.1 [12.1] days vs 19.8 [13.9] days); however, this difference was not statistically significant, albeit clinically significant.

Conclusions

As the use of TXA in plastic surgical procedures continues to expand, the utility of TXA in panniculectomy and abdominoplasty has not been elucidated. Although previous studies report hematoma and seroma risk reduction, the use of TXA was not associated with a statistically significant reduction in seroma, hematoma, or drain duration following panniculectomy surgery. Prospective, randomized controlled studies on the use of TXA in body contouring are needed.

Level of Evidence: 3
MarkerGenie: an NLP-enabled text-mining system for biomedical entity relation extraction
Authors: Gu Wenhao , Yang Xiao , Yang Minhao , Han Kun , Pan Wenying , Zhu Zexuan
Published: May 2022

Motivation

Natural language processing (NLP) tasks aim to convert unstructured text data (e.g. articles or dialogues) to structured information. In recent years, we have witnessed fundamental advances of NLP technique, which has been widely used in many applications such as financial text mining, news recommendation and machine translation. However, its application in the biomedical space remains challenging due to a lack of labeled data, ambiguities and inconsistencies of biological terminology. In biomedical marker discovery studies, tools that rely on NLP models to automatically and accurately extract relations of biomedical entities are valuable as they can provide a more thorough survey of all available literature, hence providing a less biased result compared to manual curation. In addition, the fast speed of machine reader helps quickly orient research and development.

Results

To address the aforementioned needs, we developed automatic training data labeling, rule-based biological terminology cleaning and a more accurate NLP model for binary associative and multi-relation prediction into the MarkerGenie program. We demonstrated the effectiveness of the proposed methods in identifying relations between biomedical entities on various benchmark datasets and case studies.

Availability and implementation

MarkerGenie is available at https://www.genegeniedx.com/markergenie/. Data for model training and evaluation, term lists of biomedical entities, details of the case studies and all trained models are provided at https://drive.google.com/drive/folders/14RypiIfIr3W_K-mNIAx9BNtObHSZoAyn?usp=sharing.

Supplementary information

Supplementary data are available at Bioinformatics Advances online.
BioExcel Building Blocks REST API (BioBB REST API), programmatic access to interoperable biomolecular simulation tools
Authors: Bayarri Genís , Andrio Pau , Hospital Adam , Orozco Modesto , Gelpí Josep Lluís
Published: May 2022

Motivation

The BioExcel Building Blocks (BioBB) library offers a broad collection of wrappers on top of common biomolecular simulation and bioinformatics tools. The possibility to access the library remotely and programmatically increases its usability, allowing individual and sporadic executions and enabling remote workflows.

Results

BioBB REST API extends and complements the BioBB library offering programmatic access to the collection of biomolecular simulation tools included in the BioExcel Building Blocks library. Molecular Dynamics setup, docking, structure modeling, free energy simulations and flexibility analyses are examples of functionalities included in the endpoints collection. All functionalities are accessible through standard REST API calls, voiding the need for tool installation.

Availability and implementation

All the information related to the BioBB REST API endpoints is accessible from https://mmb.irbbarcelona.org/biobb-api/. Links to extended documentation, including OpenAPI endpoints specification and examples, Read-The-Docs documentation and a complete workflow tutorial can be found in the Supplementary Table S1.

Supplementary information

Supplementary data are available at Bioinformatics online.
DFBP: a comprehensive database of food-derived bioactive peptides for peptidomics research
Authors: Qin Dongya , Bo Weichen , Zheng Xin , Hao Youjin , Li Bo , Zheng Jie , Liang Guizhao
Published: May 2022

Motivation

Food-derived bioactive peptides (FBPs) have demonstrated their significance in pharmaceuticals, diets and nutraceuticals, benefiting public health and global ecology. While significant efforts have been made to discover FBPs and to elucidate the underlying bioactivity mechanisms, there is lack of a systemic study of sequence–structure–activity relationship of FBPs in a large dataset.

Results

Here, we construct a database of food-derived bioactive peptides (DFBP), containing a total of 6276 peptide entries in 31 types from different sources. Further, we develop a series of analysis tools for function discovery/repurposing, traceability, multifunctional bioactive exploration and physiochemical property assessment of peptides. Finally, we apply this database and data-mining techniques to discover new FBPs as potential drugs for cardiovascular diseases. The DFBP serves as a useful platform for not only the fundamental understanding of sequence–structure–activity of FBPs but also the design, discovery, and repurposing of peptide-based drugs, vaccines, materials and food ingredients.

Availability and implementation

DFBP service can be accessed freely via http://www.cqudfbp.net/. All data are incorporated into the article and its online supplementary material.

Supplementary information

Supplementary data are available at Bioinformatics online.
Effect of robot-assisted gait training on the biomechanical properties of burn scars: a single-blind, randomized controlled trial
Authors: Cho Yoon Soo , Joo So Young , Seo Cheong Hoon
Published: May 2022

Background

Robot-assisted gait training (RAGT) is more effective in the range of motion (ROM) and isometric strength in patients with burns than conventional training. However, concerns have been raised about whether RAGT might negatively affect the scars of patients with burns. Therefore, we investigated the effects of RAGT-induced mechanical load on the biomechanical properties of burn scars.

Methods

This was a single-blind, randomized clinical trial conducted on inpatients admitted to the Department of Rehabilitation Medicine between September 2020 and August 2021. RAGT was conducted for 30 min per day, five days a week for 12 weeks and the control group received conventional gait training for 12 weeks. The pre-training ROM of lower extremity joints was evaluated and the levels of melanin, erythema, trans-epidermal water loss, scar distensibility and elasticity were assessed before training and at 4 and 12 weeks after training. Finally, 19 patients in the gait assistance robot (GAR) group and 20 patients in the control group completed the 12-week trial and all evaluations.

Results

There were no significant differences in the epidemiologic characteristics, pre-training ROM of joints and pre-training biomechanical properties of the burn scar between the groups (p > 0.05 for all). None of the patients experienced skin abrasion around the burn scar where the fastening belts were applied or musculoskeletal or cardiovascular adverse events during the training. Scar thickness significantly increased in both groups (p = 0.037 and p = 0.019) and scar distensibility significantly decreased in the control group (p = 0.011) during the training. Hysteresis was significantly decreased in the GAR group during the training (p = 0.038). The GAR and control groups showed significant difference in the change in the values of hysteresis between pre-training and 12 weeks after training (p = 0.441 and p = 0.049).

Conclusions

RAGT significantly decreased hysteresis in hypertrophic burn scars and did not cause a significant decrease in skin distensibility. Moreover, no skin complications around the burn scars were detected during RAGT.

Trial registration

This study registered on the Clinical Research Information Service (KCT0005204).
Temporal irreversibility of neural dynamics as a signature of consciousness
Authors: de la Fuente Laura Alethia , Zamberlan Federico , Bocaccio Hernán , Kringelbach Morten , Deco Gustavo , Perl Yonatan Sanz , Pallavicini Carla , Tagliazucchi Enzo
Published: May 2022

Dissipative systems evolve in the preferred temporal direction indicated by the thermodynamic arrow of time. The fundamental nature of this temporal asymmetry led us to hypothesize its presence in the neural activity evoked by conscious perception of the physical world, and thus its covariance with the level of conscious awareness. We implemented a data-driven deep learning framework to decode the temporal inversion of electrocorticography signals acquired from non-human primates. Brain activity time series recorded during conscious wakefulness could be distinguished from their inverted counterparts with high accuracy, both using frequency and phase information. However, classification accuracy was reduced for data acquired during deep sleep and under ketamine-induced anesthesia; moreover, the predictions obtained from multiple independent neural networks were less consistent for sleep and anesthesia than for conscious wakefulness. Finally, the analysis of feature importance scores highlighted transitions between slow ($\approx$20 Hz) and fast frequencies (>40 Hz) as the main contributors to the temporal asymmetry observed during conscious wakefulness. Our results show that a preferred temporal direction is manifest in the neural activity evoked by conscious mentation and in the phenomenology of the passage of time, establishing common ground to tackle the relationship between brain and subjective experience.
Application of Taguchi OA and Box–Behnken Design for the Implementation of DoE-based AQbD Approach to HPTLC Method for Simultaneous Estimation of Azilsartan and Cilnidipine
Authors: Prajapati Pintu , Tailor Pratik , Shahi Abhinandan , Acharya Aneri , Shah Shailesh
Published: May 2022

Hypertension is the most prominent disease found in people due to stressful routines and the working environment. The fixed-dose combination (FDC) of azilsartan medoxomil (AZL) and cilnidipine (CLN) is used for the treatment of hypertension. According to the green chemistry approach, organic solvents should be minimized in the development of the analytical method for the safety of the environment. The high-performance thin-layer chromatographic (HPTLC) method required less amount of organic solvent for the analysis of the drug. Hence, it was thought of interest to develop an accurate and robust HPTLC method for the estimation of AZL and CLN in their FDC. The development of the method was carried out by the implementation of the analytical quality by design approach using the Taguchi orthogonal array and BBD for regulatory compliance as per the upcoming ICH Q14 guideline. The analytical design space and control strategy was framed for the lifecycle management of the method. The chromatographic separation was performed using silica gel GF254 and toluene ethylacetate–methanol (6.5 + 1.5 + 2.0, v/v). The method was applied for the assay of FDC and results were found in compliance with the labeled claim. The developed method was also applied for the estimation of spiked human plasma and the recovered amount of drugs was found in the range of 80–85%.
Oral Swab Specimens Tested With Xpert MTB/RIF Ultra Assay for Diagnosis of Pulmonary Tuberculosis in Children: A Diagnostic Accuracy Study
Authors: Cox Helen , Workman Lesley , Bateman Lindy , Franckling-Smith Zoe , Prins Margaretha , Luiz Juaneta , Van Heerden Judi , Ah Tow Edries Lemese , Africa Samantha , Allen Veronica , Baard Cynthia , Zemanay Widaad , Nicol Mark P , Zar Heather J
Published: May 2022

Background

Microbiologic diagnosis of childhood tuberculosis may be difficult. Oral swab specimens are a potential noninvasive alternative to sputum specimens for diagnosis.

Methods

This was a prospective diagnostic accuracy study of oral swab specimens (buccal and tongue) for pulmonary tuberculosis diagnosis in children (aged ≤ 15 years) in 2 South African hospital sites. Children with cough of any duration as well as a positive tuberculin skin test result, tuberculosis contact, loss of weight, or chest radiograph suggestive of pulmonary tuberculosis were enrolled. Two induced sputum specimens were tested with Xpert MTB/RIF (or Xpert MTB/RIF Ultra) assay and liquid culture. Oral swab specimens were obtained before sputum specimens, frozen, and later tested with Xpert MTB/RIF Ultra. Children were classified as microbiologically confirmed tuberculosis, unconfirmed tuberculosis (receipt of tuberculosis treatment), or unlikely tuberculosis according to National Institutes of Health consensus definitions based on sputum microbiologic results.

Results

Among 291 participants (median age [interquartile range], 32 [14–73] months), 57 (20%) had human immunodeficiency virus (HIV), and 87 (30%) were malnourished; 90 (31%) had confirmed pulmonary tuberculosis (rifampicin resistant in 6 [7%] ), 157 (54%), unconfirmed pulmonary tuberculosis, and 44 (15%), unlikely tuberculosis. A single oral swab specimen was obtained from 126 (43%) of the participants (tongue in 96 and buccal in 30) and 2 swab specimens from 165 (57%) (tongue in 110 and buccal in 55). Sensitivity was low (22% [95% confidence interval, 15%–32%]) for all swab specimens combined (with confirmed pulmonary tuberculosis as reference), but specificity was high (100% [91%–100%]). The highest sensitivity was 33% (95% confidence interval, 15%–58%) among participants with HIV. The overall yield was 6.9% with 1 oral swab specimen and 7.2% with 2.

Conclusions

Use of the Xpert MTB/RIF Ultra assay with oral swab specimens provides poor yield for microbiologic pulmonary tuberculosis confirmation in children.
Peritoneal catheter insertion: combating barriers through policy change
Authors: Jha Vivekanand , Abrahams Alferso C , Al-Hwiesh Abdullah , Brown Edwina A , Cullis Brett , Dor Frank J M F , Mendu Mallika , Ponce Daniela , Divino-Filho José Carolino
Published: May 2022

Barriers to accessing home dialysis became a matter of life and death for many patients with kidney failure during the coronavirus disease 2019 (COVID-19) pandemic. Peritoneal dialysis (PD) is the more commonly used home therapy option. This article provides a comprehensive analysis of PD catheter insertion procedures as performed around the world today, barriers impacting timely access to the procedure, the impact of COVID-19 and a roadmap of potential policy solutions. To substantiate the analysis, the article includes a survey of institutions across the world, with questions designed to get a sense of the regulatory frameworks, barriers to conducting the procedure and impacts of the pandemic on capability and outcomes. Based on our research, we found that improving patient selection processes, determining and implementing correct insertion techniques, creating multidisciplinary teams, providing appropriate training and sharing decision making among stakeholders will improve access to PD catheter insertion and facilitate greater uptake of home dialysis. Additionally, on a policy level, we recommend efforts to improve the awareness and feasibility of PD among patients and the healthcare workforce, enhance and promulgate training for clinicians—both surgical and medical—to insert PD catheters and fund personnel, pathways and physical facilities for PD catheter insertion.
Renal artery stenting in the correct patients with atherosclerotic renovascular disease: time for a proper renal and cardiovascular outcome study?
Authors: Theodorakopoulou Marieta P , Karagiannidis Artemios G , Ferro Charles J , Ortiz Alberto , Sarafidis Pantelis A
Published: May 2022

Atherosclerotic renovascular disease (ARVD) represents the most common type of renal artery stenosis. In the last decade, a few large trials failed to demonstrate the superiority of standard medical therapy plus percutaneous transluminal renal angioplasty (PTRA) compared with medical therapy alone in lowering blood pressure levels or preventing adverse renal and cardiovascular outcomes in patients with ARVD. However, this issue remains controversial and an ongoing debate focusses on the benefits that selected patients could experience from renal revascularization procedures. In this regard, several pieces of observational data show that PTRA is associated with future cardiorenal benefits in patients presenting with high-risk ARVD phenotypes. Such evidence resulted in a progressive shift in relevant recommendations, with most recent not-graded suggestions supporting that revascularization should be offered in these high-risk subjects. Existing evidence clearly calls for a properly designed randomized controlled trial with selected patients presenting high-risk ARVD phenotypes, in order to confirm the superiority of PTRA versus non-invasive management in this patient group and objectively guide everyday clinical practice.
Atrial fibrillation and acute coronary syndromes in nonagenarians
Authors: Echarte-Morales JULIO , Minguito Carazo CARLOS , Cepas-Guillen PL , Martinez Gomez E , Llagostera MARC , Flores Umanzor E , Borrego Rodriguez JAVIER , Fernandez Valledor ANDREA , Viana Tejedor ANA , Rodriguez Santamarta MIGUEL , Vidal PABLO , Quiroga XAVIER , Freixa XAVIER , Sabate MANEL , Fernandez-Vazquez FELIPE
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Atrial fibrillation (AF) is the most common arrhythmia in the elderly. Age increases both thromboembolic risk and bleeding complications. However, these patients are not anticoagulated on many occasions. AF in the context of acute coronary syndrome (ACS) increases the complexity of the management of these patients and they are underrepresented in clinical trials.

Purpose

The objective of the study was to analyze the impact of AF in nonagenarian patients at 12 months. Other objectives were to evaluate the therapeutic strategy for ACS and AF and to compare clinical events according to AF subtype and treatment at discharge.

Methods

A retrospective, multicenter and observational study was carried out, in which all nonagenarian patients admitted for ACS and AF (prevalent or incident) between 2005 and 2018 were consecutively included. Patients with type 2 myocardial infarction were excluded. Baseline characteristics were analyzed and mortality at 12 months was analyzed in all patients and according to AF subtype (incident AF was considered when occurred during admission and prevalent AF was considered in patients with previous history of AF)

Results

680 patients with a mean age of 92.6 ± 2.4 years were analyzed. Patients with AF more frequently presented chronic kidney disease (CKD) and non-ST-segment elevation acute coronary syndrome (Non-STEMI) and arterial hypertension (HBP) (Table 1). Mortality rate was similar in patients with previous AF and those without history of AF (Figure 1 A). 21.6% (147) of the patients had AF at admission, of which only 47.7% of the patients were previously anticoagulated. Treatment at discharge is shown in Figure 1 B. Mortality at 1 year according to discharge treatment and AF subtype are represented in figures 1C and 1D.

Conclusions

This is the largest registry of ACS and AF in this population. Patients with prevalent AF had more frequent Non-STEMI and comorbidities, with a similar mortality to AF subgroup at 1 year. Previous AF was no related to higher mortality in this cohort. Half of the patients were not anticoagulated at discharge. OAC was not associated with prognostic benefit in our series.
An unusual cause of a haemothorax following pacemaker implantation: A case report
Authors: Saunderson Christopher E. D. , Hogarth Andrew J. , Papaspyros Sotiris , Tingerides Costa , Tayebjee Muzahir H.
Published: May 2022

Background

Haemothoraces are a reported but extremely rare complication of pacemaker implantation. Haemothoraces can be a consequence of lead perforation through the right ventricle (RV) and pericardium into the pleural space, direct lung or vascular injury during access.

Case summary

A 72-year-old woman presented 24 h after a pacemaker implantation with chest pain and shortness of breath. Computed tomography of the chest confirmed perforation of the RV lead into the left pleural cavity with a large left sided haemothorax. Following percutaneous drainage of the left sided haemothorax, the patient became haemodynamically unstable necessitating emergent sternotomy. During surgery, the extra-cardiac portion of the pacing lead was cut, the RV repaired and a large haematoma evacuated from the left pleural space. Despite this, the patient remained hypotensive, and further exploration showed a bleeding intercostal artery that had been lacerated by the pacing lead. This was treated by electrocautery, and the patient’s haemodynamic status improved. The RV lead remnant was removed transvenously via the subclavian vein, and the patient was left with a single chamber atrial pacemaker.

Discussion

Prompt recognition of RV lead perforation and its associated sequalae, often utilising multi-modality imaging, is vital to enable transfer to a centre with cardiac surgical expertise. In this case, the perforating RV lead lacerated an intercostal artery, and this was only identified at the time of surgery. In order to minimize the risk of perforation, multiple fluoroscopic views should be used, and care should be taken during helix deployment.
Transient injection site reaction to alirocumab during immune system activation: a case series
Authors: Bär Sarah , Räber Irene , Koskinas Konstantinos C. , Schlapbach Christoph , Räber Lorenz
Published: May 2022

Background

Injection site reactions (ISRs) are known side effects of the proprotein convertase subtilisin kexin 9 (PCSK9) inhibitor alirocumab. Transient ISR to alirocumab after a long phase of good tolerability have not been reported previously.

Case summary

A 55-year-old woman (Patient 1) and a 77-year-old man (Patient 2) were treated with alirocumab for the management of dyslipidaemia. Both patients tolerated the treatment without side effects for 7 and 2 months, respectively. After an upper respiratory tract infection in Patient 1 and a first COVID-19 vaccination in Patient 2, both patients suddenly developed ISR with erythema, calor, and itching upon 2 (Patient 1) and 1 (Patient 2) subsequent injection(s), respectively. Symptoms resolved with local steroids, oral antihistamines, and cooling. After termination of the presumed immune system activated state, alirocumab was well tolerated again in both patients without recurrence of any ISR upon repeated applications.

Discussion

These are the first cases to report transient ISR to a PCSK9 inhibitor, possibly triggered by activation of the immune system, after prolonged good tolerability. Based on the transient and benign nature of the reaction, such patients should be encouraged to continue supervised treatment, as tolerability may return after resolution of the pro-inflammatory state.
A case report of profound atrioventricular block in an endurance athlete: how far do you go?
Authors: Abela Mark , Bonello John , Sammut Mark Adrian
Published: May 2022

Background

Athletes presenting with 1st-degree atrioventricular block (AVB) on 12-lead electrocardiogram (ECG) may present a diagnostic conundrum, especially when significantly prolonged and associated with higher degrees of block. A pragmatic stepwise approach to the evaluation of these patients is, therefore, crucial.

Case summary

A 19-year-old waterpolo player was referred for assessment of a 1st-degree heart block and one isolated episode of syncope. All other cardiac investigations were within normal limits except for a 24-h ambulatory ECG which showed Mobitz 1 AVB and episodes of 2:1 block occurring in the context of Wenchebach. An electrophysiological study (EPS) was performed which effectively excluded infranodal conductive tissue disease, confirming physiological intranodal block.

Discussion

The increase in vagal tone is one of the physiological adaptations to an increased demand in cardiac output in athletes, which explains the presence of 1st-degree AVB in up to 7.5% of athletes. The presence of 2:1 AVB on 24 h ECG raises doubts whether the 1st-degree AVB on resting ECG is pathological or physiological, especially considering this particular patient had suffered an episode of syncope. When this diagnostic uncertainty persists despite non-invasive investigations, including cardiopulmonary exercise testing, invasive EPS may be required to assess the refractoriness of the AV node and at what level within the cardiac conductive system block occurs. The electrophysiological study can effectively rule out infranodal disease by confirming physiological intranodal block using incremental atrial pacing.
Transcatheter aortic valve implantation with a balloon-expandable prosthesis in a patient with single coronary artery: a case report
Authors: Furugen Makoto , Furugen Azusa , Yamazaki Kenji , Doi Hirosato
Published: May 2022

Background

Single coronary artery is a rare coronary artery anomaly with an incidence of <0.03%. The coexistence of coronary artery anomalies with severe aortic stenosis is extremely rare. Due to the singularity of the coronary artery orifice, the most concerning risk of transcatheter aortic valve implantation (TAVI) in such patients is coronary occlusion, which may very well be life-threatening.

Case summary

An 83-year-old female complaining of chest pain was referred to our hospital for severe aortic stenosis. The multi-slice computed tomography showed a congenital single coronary artery originating from the right sinus of Valsalva. The left coronary artery branched off of the right coronary artery, and passed between the aorta and main pulmonary artery. The heart team of the hospital decided to perform TAVI via femoral artery with a balloon-expandable prosthesis, with coronary angioplasty devices on standby in case of coronary occlusion. The TAVI procedure was performed successfully without coronary occlusion.

Discussion

Although there have been some case reports of TAVI in patients with single coronary artery, little is known about the safety of TAVI in such cases, and which device (such as the balloon-expandable or the self-expandable prosthesis) is preferable. From this particular case, and accumulation of past and various TAVI experience, the balloon-expandable prosthesis can be a safe device choice in carefully selected patients with coronary artery anomalies.
Bilateral mini-thoracotomy for combined minimally invasive direct coronary artery bypass and mitral valve repair
Authors: Squiccimarro Enrico , Margari Vito , Paparella Domenico
Published: May 2022

Consistent evidence recognizes minimally invasive valve surgery as the top-tier surgical approach for heart valve pathology. Conversely, the overall adoption of minimally invasive coronary surgery remains low. Notwithstanding, excellent clinical outcomes have been recently reported, further consolidating a technique that addresses major concerns associated with the traditional approach for the most frequently performed cardiac operation, including sternal dehiscence (i.e sternal sparing) and stroke (i.e. no-touch aorta), but that also guarantees a reduced resort to blood transfusions, diminished pain and faster recovery. More to the point, the suitability of minimally invasive strategies for combined coronary and valve procedures remains debateable. Almost no reports of such combined procedures are available in literature and the very few published experiences appear scarce and heterogeneous about the surgical access (i.e. single versus bilateral mini-thoracotomy). However, bilateral mini-thoracotomy has been proposed as a feasible and safe strategy for different cardiac operations like surgical ablation and left ventricular assist device implantation, but also for isolated multivessel minimally invasive coronary surgery. Here, we describe the feasibility of combined minimally invasive mitral valve and coronary surgery performed through bilateral mini-thoracotomy and we report outcomes of our initial series of 3 cases.