bluuebunny/crossref_metadata_2025 huggingface dataset:
Purification of copper foils driven by single crystallization
Authors: Kou 寇 Jin-Zong 金宗 , Zhao 赵 Meng-Ze 孟泽 , Li 李 Xing-Guang 兴光 , He 何 Meng-Lin 梦林 , Yang 杨 Fang-You 方友 , Liu 刘 Ke-Hai 科海 , Cheng 成 Qing-Qiu 庆秋 , Ren 任 Yun-Long 云龙 , Liu 刘 Can 灿 , Fu 付 Ying 莹 , Wu 吴 Mu-Hong 慕鸿 , Liu 刘 Kai-Hui 开辉 , Wang 王 En-Ge 恩哥
Published: November 2023

High-purity copper (Cu) with excellent thermal and electrical conductivity, is crucial in modern technological applications, including heat exchangers, integrated circuits, and superconducting magnets. The current purification process is mainly based on the zone/electrolytic refining or anion exchange, however, which excessively relies on specific integrated equipment with ultra-high vacuum or chemical solution environment, and is also bothered by external contaminants and energy consumption. Here we report a simple approach to purify the Cu foils from 99.9% (3N) to 99.99% (4N) by a temperature-gradient thermal annealing technique, accompanied by the kinetic evolution of single crystallization of Cu. The success of purification mainly relies on (i) the segregation of elements with low effective distribution coefficient driven by grain-boundary movements and (ii) the high-temperature evaporation of elements with high saturated vapor pressure. The purified Cu foils display higher flexibility (elongation of 70%) and electrical conductivity (104% IACS) than that of the original commercial rolled Cu foils (elongation of 10%, electrical conductivity of ∼100% IACS). Our results provide an effective strategy to optimize the as-produced metal medium, and therefore will facilitate the potential applications of Cu foils in precision electronic products and high-frequency printed circuit boards.
Simultaneous guidance of electromagnetic and elastic waves via glide symmetry phoxonic crystal waveguides
Authors: Lei 雷 Lin-Lin 林霖 , He 何 Ling-Juan 灵娟 , Liao 廖 Qing-Hua 清华 , Liu 刘 Wen-Xing 文兴 , Yu 于 Tian-Bao 天宝
Published: November 2023

A phoxonic crystal waveguide with the glide symmetry is designed, in which both electromagnetic and elastic waves can propagate along the glide plane at the same time. Due to the glide symmetry, the bands of the phoxonic crystal super-cell degenerate in pairs at the boundary of the Brillouin zone. This is the so-called band-sticking effect and it causes the appearance of gapless guided-modes. By adjusting the magnitude of the glide dislocation the edge bandgaps, the bandgap of the guided-modes at the boundary of the Brillouin zone, can be further adjusted. The photonic and phononic guided-modes can then possess only one mode for a certain frequency with relatively low group velocities, achieving single-mode guided-bands with relatively flat dispersion relationship. In addition, there exists acousto–optic interaction in the cavity constructed by the glide plane. The proposed waveguide has potential applications in the design of novel optomechanical devices.
Spin Evolution of the Magnetar SGR J1935+2154
Authors: Ge Ming-Yu , Yang Yuan-Pei , Lu Fang-Jun , Zhou Shi-Qi , Ji Long , Zhang Shuang-Nan , Zhang Bing , Zhang Liang , Wang Pei , Lee Kejia , Zhu Weiwei , Li Jian , Hou Xian , Li Qiao-Chu
Published: November 2023

Fast radio bursts (FRBs) are short pulses observed in radio frequencies usually originating from cosmological distances. The discovery of FRB 200428 and its X-ray counterpart from the Galactic magnetar SGR J1935+2154 suggests that at least some FRBs can be generated by magnetars. However, the majority of X-ray bursts from magnetars are not associated with radio emission. The fact that only in rare cases can an FRB be generated raises the question regarding the special triggering mechanism of FRBs. Here we report long time spin evolution of SGR J1935+2154 until the end of 2022. According to ν and

ν

̇

, the spin evolution of SGR J1935+2154 could be divided into two stages. The first stage evolves relatively steady evolution until 2020 April 27. After the burst activity in 2020, the spin of SGR J1935+2154 shows strong variations, especially for

ν

̇

. After the burst activity in 2022 October, a new spin-down glitch with Δν/ν = (–7.2 ± 0.6) × 10−6 is detected around MJD 59876, which is the second event in SGR J1935+2154. At the end, spin frequency and pulse profile do not show variations around the time of FRB 200428 and radio bursts 221014 and 221021, which supply strong clues to constrain the trigger mechanism of FRBs or radio bursts.
Development of a multifunctional real-time data processing system for interferometers on EAST
Authors: Yao Y. , Zhang J. , Liu Y. , Ruan T. , Li W. , Lian H. , Wang S. , Zhang Y. , Lin B. , Jie Y. , Liu H.
Published: November 2023

In the latest campaign of EAST experiments, two new interferometers were installed, a dispersion interferometer (DI) based on a Carbon Dioxide laser and a solid source interferometer (SSI) based on microwave multiplier sources. To make them available for the Plasma Control System (PCS) system, each of them needs to be provided with a real-time processing system to extract the detector output signal and afterward obtain the electron density information through signal processing.

To obtain interferometer data quickly and reliably, a unified hardware template was applied to both interferometers. Three main parts are included in this hardware template — digitization, digital signal processing, and output modules. In particular, the digitization section uses a multi-channel Analog-to-Digital Convertor (ADC) to acquire the signals that need to be calculated. The digital signal processing part is implemented by an FPGA, which is the hardware basis of this multifunctional template that can be used for multiple interferometers. This section includes two main parts, wrapped density signal extraction and signal unwrapping. For DI it is a phase calculation based on the intensity ratio, while for SSI it is a phase calculation by means of FFT or phase demodulation. Both computational approaches form independent IP cores to build systems quickly, while these IP cores provide parameter interfaces to adapt to different application scenarios. The output module provides a variety of data transmission methods, including fiber optic transmission and Digital-Analog-Convertor (DAC) based analog transmission, to interface with PCS or other subsequent systems.

This data processing system template has been applied to each of the above two interferometers and valid data were obtained in a recent EAST experiment campaign. It demonstrates the usefulness of the template and provides a reference for the design of data processing systems on future devices.
Global hotspots in soil moisture-based drought trends
Authors: Řehoř Jan , Trnka Miroslav , Brázdil Rudolf , Fischer Milan , Balek Jan , van der Schrier Gerard , Feng Song
Published: November 2023

Decreasing soil moisture and increasing frequency and intensity of soil drought episodes are among the frequently discussed consequences of ongoing global climate change. To address this topic, a water balance model SoilClim forced by climate reanalysis ERA5-Land was applied on a global scale to analyze the spatiotemporal variability of changes in soil moisture anomalies. The results revealed that the soil relative available water (AWR) significantly decreased on 31.1% of global non-glaciated land and significantly increased on 5.3% of such global non-glaciated land in 1981–2021. Decreasing AWR trends were detected over all continents and were particularly pronounced in South America, which experienced significant drying on more than half of the continent. The main drought ‘hotspots’ were identified in equatorial Africa, a large part of South America, the Midwest United States, and in a belt extending from eastern Europe to eastern Asia. A seasonal analysis of region-specific patterns further suggested drying in Europe in summer but an absence of a drying trend in winter. These results were supported by an analysis of the area affected by percentile-based drought on individual continents, revealing statistically significant increasing trends of 5th- and 10th-percentile droughts on all continents except Australia at an annual scale. Nevertheless, summer and autumn drought frequency increases were also detected in Australia. The seasonal trends were the most rapid in South America and Europe (except in winter). The distributions of AWR values, evaluated by Z scores, shifted remarkably toward drier conditions during the 2001–2021 period, particularly in South America and Asia. These results underscore the alarming increase in soil drought on a global scale, highlighting the need for effective drought management strategies.
Highly compliant biomimetic scaffolds for small diameter tissue-engineered vascular grafts (TEVGs) produced via melt electrowriting (MEW)
Authors: Weekes Angus , Wehr Gabrielle , Pinto Nigel , Jenkins Jason , Li Zhiyong , Meinert Christoph , Klein Travis J
Published: November 2023

Biofabrication approaches toward the development of tissue-engineered vascular grafts (TEVGs) have been widely investigated. However, successful translation has been limited to large diameter applications, with small diameter grafts frequently failing due to poor mechanical performance, in particular mismatched radial compliance. Herein, melt electrowriting (MEW) of poly(ϵ-caprolactone) has enabled the manufacture of highly porous, biocompatible microfibre scaffolds with physiological anisotropic mechanical properties, as substrates for the biofabrication of small diameter TEVGs. Highly reproducible scaffolds with internal diameter of 4.0 mm were designed with 500 and 250 µm pore sizes, demonstrating minimal deviation of less than 4% from the intended architecture, with consistent fibre diameter of 15 ± 2 µm across groups. Scaffolds were designed with straight or sinusoidal circumferential microfibre architecture respectively, to investigate the influence of biomimetic fibre straightening on radial compliance. The results demonstrate that scaffolds with wave-like circumferential microfibre laydown patterns mimicking the architectural arrangement of collagen fibres in arteries, exhibit physiological compliance (12.9 ± 0.6% per 100 mmHg), while equivalent control geometries with straight fibres exhibit significantly reduced compliance (5.5 ± 0.1% per 100 mmHg). Further mechanical characterisation revealed the sinusoidal scaffolds designed with 250 µm pores exhibited physiologically relevant burst pressures of 1078 ± 236 mmHg, compared to 631 ± 105 mmHg for corresponding 500 µm controls. Similar trends were observed for strength and failure, indicating enhanced mechanical performance of scaffolds with reduced pore spacing. Preliminary in vitro culture of human mesenchymal stem cells validated the MEW scaffolds as suitable substrates for cellular growth and proliferation, with high cell viability (>90%) and coverage (>85%), with subsequent seeding of vascular endothelial cells indicating successful attachment and preliminary endothelialisation of tissue-cultured constructs. These findings support further investigation into long-term tissue culture methodologies for enhanced production of vascular extracellular matrix components, toward the development of the next generation of small diameter TEVGs.
Modelling the magnetization data of Fe3O4 nanoparticles above blocking temperature
Authors: Kaur Navneet
Published: November 2023

Nanoparticles of Fe3O4 are prepared by simple co-precipitation method. The sample is characterized using an x-ray diffractometer, transmission electron microscope, and vibrating sample magnetometer. The x-ray diffraction pattern of the sample clearly shows that it is a single-phase magnetite. The transmission electron micrograph shows that the sample has a narrow distribution in particle size with average particle size of 9.9 nm. The SAED pattern only shows the diffraction planes correspond to magnetite and no other phase impurity is detected. The calculated thickness of the magnetic disordered shell due to the reduction in particle size is found to be 1.7 nm. The magnetization of the sample is measured as a function of temperature and applied magnetic field. The zero-field cooled and field cooled curves of the sample are measured in the presence of 250 Oe applied magnetic field and both the curves bifurcate at 170 K. The peak in the zero-field curve indicates that the sample has a blocking temperature of around 100 K. The magnetization as a function of applied magnetic field data at 200, 225, 250, 275 and 300 K are measured (up to ±20 kOe). These magnetization data are used for the fitting to analyze the magnetic behavior of Fe3O4 nanoparticles. . The magnetization of nanoparticles systems is influenced by several factors such as particle size distribution, disordered surface, magnetocrystalline anisotropy, magnetic moment distribution and magnetic interactions. The ignorance of such factors while analyzing the magnetization data leads to discrepancies in the results. The surface effects are sensitive to the reduction in particle size leading to the spin frustrations on the surface suggesting a magnetic disordered layer which affect the magnetic behavior of nanoparticles. This work presents the analysis of the magnetization data in an appropriate magnetization expression which takes into consideration the effect of magnetic moment distribution. This distribution in the magnetic moment is found to be significantly influenced the magnetization analysis and affected by the magnetic disordered surface which accounts for the presence of magnetic anisotropy and magnetic interactions on the particles surface. The results and observations are discussed in detail.
Evidential deep learning for trustworthy prediction of enzyme commission number
Authors: Han So-Ra , Park Mingyu , Kosaraju Sai , Lee JeungMin , Lee Hyun , Lee Jun Hyuck , Oh Tae-Jin , Kang Mingon
Published: November 2023

The rapid growth of uncharacterized enzymes and their functional diversity urge accurate and trustworthy computational functional annotation tools. However, current state-of-the-art models lack trustworthiness on the prediction of the multilabel classification problem with thousands of classes. Here, we demonstrate that a novel evidential deep learning model (named ECPICK) makes trustworthy predictions of enzyme commission (EC) numbers with data-driven domain-relevant evidence, which results in significantly enhanced predictive power and the capability to discover potential new motif sites. ECPICK learns complex sequential patterns of amino acids and their hierarchical structures from 20 million enzyme data. ECPICK identifies significant amino acids that contribute to the prediction without multiple sequence alignment. Our intensive assessment showed not only outstanding enhancement of predictive performance on the largest databases of Uniprot, Protein Data Bank (PDB) and Kyoto Encyclopedia of Genes and Genomes (KEGG), but also a capability to discover new motif sites in microorganisms. ECPICK is a reliable EC number prediction tool to identify protein functions of an increasing number of uncharacterized enzymes.
FormulationAI: a novel web-based platform for drug formulation design driven by artificial intelligence
Authors: Dong Jie , Wu Zheng , Xu Huanle , Ouyang Defang
Published: November 2023

Today, pharmaceutical industry faces great pressure to employ more efficient and systematic ways in drug discovery and development process. However, conventional formulation studies still strongly rely on personal experiences by trial-and-error experiments, resulting in a labor-consuming, tedious and costly pipeline. Thus, it is highly required to develop intelligent and efficient methods for formulation development to keep pace with the progress of the pharmaceutical industry. Here, we developed a comprehensive web-based platform (FormulationAI) for in silico formulation design. First, the most comprehensive datasets of six widely used drug formulation systems in the pharmaceutical industry were collected over 10 years, including cyclodextrin formulation, solid dispersion, phospholipid complex, nanocrystals, self-emulsifying and liposome systems. Then, intelligent prediction and evaluation of 16 important properties from the six systems were investigated and implemented by systematic study and comparison of different AI algorithms and molecular representations. Finally, an efficient prediction platform was established and validated, which enables the formulation design just by inputting basic information of drugs and excipients. FormulationAI is the first freely available comprehensive web-based platform, which provides a powerful solution to assist the formulation design in pharmaceutical industry. It is available at https://formulationai.computpharm.org/.
Impaired visual-motor functional connectivity in first-episode medication-naïve patients with major depressive disorder
Authors: Hu Yongbo , Li Shiyi , Li Jin , Zhao Youjin , Li Meiling , Cui Weigang , Peng Xiaolong , Dong Zaiquan , Zhang Lianqing , Xu Haizhen , Gao Li , Huang Xiaoqi , Kuang Weihong , Gong Qiyong , Liu Hesheng
Published: November 2023

The perceptual dysfunctions have been fundamental causes of cognitive and emotional problems in patients with major depressive disorder. However, visual system impairment in depression has been underexplored. Here, we explored functional connectivity in a large cohort of first-episode medication-naïve patients with major depressive disorder (n = 190) and compared it with age- and sex-matched healthy controls (n = 190). A recently developed individual-oriented approach was applied to parcellate the cerebral cortex into 92 regions of interest using resting-state functional magnetic resonance imaging data. Significant reductions in functional connectivities were observed between the right lateral occipitotemporal junction within the visual network and 2 regions of interest within the sensorimotor network in patients. The volume of right lateral occipitotemporal junction was also significantly reduced in major depressive disorder patients, indicating that this visual region is anatomically and functionally impaired. Behavioral correlation analysis showed that the reduced functional connectivities were significantly associated with inhibition control in visual-motor processing in patients. Taken together, our data suggest that functional connectivity between visual network and sensorimotor network already shows a significant reduction in the first episode of major depressive disorder, which may interfere with the inhibition control in visual-motor processing. The lateral occipitotemporal junction may be a hub of disconnection and may play a role in the pathophysiology of major depressive disorder.
Early growth response 1 as a podocyte injury marker in human glomerular diseases
Authors: Okabe Masahiro , Koike Kentaro , Yamamoto Izumi , Tsuboi Nobuo , Matsusaka Taiji , Yokoo Takashi
Published: November 2023

Background

In human glomerular diseases, visualizing podocyte injury is desirable since podocytes do not regenerate and podocyte injury leads to podocyte loss. Herein, we investigated the utility of immunostaining for early growth response 1 (EGR1), which is expressed in injured podocytes from the early stages of injury in animal experiments, as a podocyte injury marker in human glomerular diseases.

Methods

This study included 102 patients with biopsy-proven glomerular diseases between 2018 and 2021. The proportion of EGR1 expression in podocytes (%EGR1pod) was analyzed in relation to clinical and histopathological features, including glomerular and urinary podocyte-specific markers.

Results

%EGR1pod correlated significantly with the urinary protein:creatinine ratio, urinary nephrin and podocin mRNA levels, and glomerular podocin staining (rho = 0.361, 0.514, 0.487 and –0.417, respectively; adjusted P = .002, <.001, <.001 and <.001, respectively). Additionally, %EGR1pod correlated with cellular/fibrocellular crescents (rho = 0.479, adjusted P <.001). %EGR1pod was high in patients with glomerulonephritis, such as immunoglobulin A nephropathy (IgAN), lupus nephritis and antineutrophil cytoplasmic antibody–associated glomerulonephritis, and in those with podocytopathies, such as membranous nephropathy and primary focal segmental glomerulosclerosis, while %EGR1pod was low in patients with minimal change disease. In a subgroup analysis of IgAN, %EGR1pod was higher in Oxford C1 patients than in C0 patients. However, unexpectedly, patients with higher %EGR1pod were more prone to attain proteinuria remission, suggesting that EGR1 in the context of IgAN reflects reversible early injury.

Conclusions

Our findings indicate that EGR1 is a promising potential marker for identifying active early podocyte injury in human glomerular diseases.
How Social Justice Shapes Youth Development: Centering Youth Voice across Shifts in Out-of-School Time
Authors: Osai Esohe R , Campbell Shanyce L , Greer James W
Published: November 2023

Out-of-school time (OST) has great significance as a youth development space that can support students’ exploration of social justice. Such opportunities for exploration are especially important in times of social distress and upheaval, such as those experienced during the school shutdowns and racial unrest associated with the global pandemic. Framed in a context of inequities for educationally marginalized youth, this qualitative case study provides a glimpse into the OST experiences of students before and after the onset of COVID-19. Authors explore navigating justice-related topics with youth in both an in-person and virtual format of the OST program. In addition to interviewing youth participants, the authors use a critical reflexivity approach to examine experiences facilitating OST spaces that serve youth of color. Findings point to the importance of youth-driven programming that centers youth voice and reimagines engagement for youth in OST programs. The discussion highlights implications for education and social work professionals in the service of social justice youth development outcomes.
Olive extract enriched with hydroxytyrosol improves cardiac and vascular function in patients with stable coronary artery disease: a double-blind, placebo-controlled trial
Authors: Katogiannis K , Ikonomidis I , Chania C , Tsoumani M , Brinia E , Pavlidis G , Thymis J , Tsilivarakis D , Kountouri A , Korakas E , Lambadiari V , Skaltsounis L , Tsetis I , Iliodromitis E K , Andreadou I
Published: November 2023

Aims

We investigated the effect of olive extract enriched with hydroxytyrosol, on vascular and myocardial function markers in patients with stable coronary artery disease (SCAD).

Methods

In a prospective, cross-over, double-blind, placebo-controlled, clinical trial, 30 patients with stable CAD were randomly assigned to an oral supplement containing olive oil extract enriched with hydroxytyrosol (OOHT) or placebo for one month and then were crossed over to the alternate treatment (placebo or OOHT for one more month). We measured a) perfused boundary region (PBR) of the sublingual arterial microvessels (increased PBR indicates reduced endothelial glycocalyx thickness), b) flow-mediated dilation (FMD), c) Coronary Flow Reserve (CFR) and markers of LV diastolic function by Doppler echocardiography d) Pulse Wave Velocity (PWV) e) oxidative/nitrosative stress and inflammatory biomarkers and blood lipids at baseline and after one month treatment.

Results

Treatment with OOHT improved PBR, FMD, CFR and PWV compared to baseline (1.81±0.35 vs 1.77±0.40 μm p=0.04 3.71±2.12 vs 6.51±2.31%, p<0.001;2.37±0.40 vs 2.45±0.41, p=0.030 and 11.03±1.81 vs 11.78±2.34 m/sec, p=0.002), while there was no effect after placebo (p>0.05). Compared to baseline, treatment with OOHT reduced malondialdehyde (MDA) a marker of lipid peroxidation (2.10±1.37 vs 1.69±0.83 mmol/lt, p=0.045), oxidized LDL, triglycerides, PCSK9 and CRP blood levels (p<0.05) in contrast to placebo. There was a parallel improvement of E’ of the mitral annulus and deceleration time of the E wave of mitral inflow after OOHT (p<0.05) but not after placebo.

Conclusions

Olive extract enriched with hydroxytyrosol improves endothelial and arterial function likely by reducing oxidative and inflammatory burden leading to improved LV diastolic function after one month of treatment in patients with stable CAD.
Reduction in the risk of major adverse limb events with ezetimibe versus placebo in addition to statin therapy: insights from the IMPROVE IT trial
Authors: Bonaca M , Giugliano R P , Cannon C P , Park J G , Murphy S A , Creager M A , Braunwald E , Sabatine M S
Published: November 2023

Background/Introduction

Patients with peripheral artery disease (PAD) are at risk of developing progressive symptoms leading to revascularization as well as major adverse limb events such as critical limb ischemia and amputation. Recently, two trials of PCSK9 inhibitors, which lower both LDL-C and Lp(a) have demonstrated reductions in MALE and peripheral revascularization. Whether this benefit is present for other LDL-C lowering therapies has not been well described.

Purpose

To evaluate whether LDL-C lowering with ezetimibe reduces the risk of adverse limb events.

Methods

IMPROVE-IT randomized 18,144 patients with acute coronary syndrome (ACS), including 1,005 with PAD, to ezetimibe or placebo on top of statin and followed for a median of 6 years. Two vascular specialists blinded to treatment allocation independently reviewed all adverse events to categorize limb outcomes including critical limb ischemia (CLI), and related amputation as well as progressive symptoms leading to lower extremity revascularization (worsening PAD). Total limb outcomes over follow up were compared by treatment groups using negative binomial regression and relative risks (RR) are presented.

Results

A total of 397 patients had worsening symptoms (in 346 PAD patients) and 43 developed CLI (in 36 patients) during follow up. The risk of total PAD events (CLI or worsening symptoms) was lower with ezetimibe versus placebo (RR 0.77, 95% CI 0.62 – 0.96, p=0.018) with a consistent trend for both components (Figure Panel A). When evaluating the relationship of achieved LDL-C at 1-month post-randomization and the risk of first PAD event, there appeared to a linear relationship extending to an LDL-C less than 25 mg/dL (Figure Panel B).

Conclusion

Further lowering of LDL-C with ezetimibe on top of statin therapy in patients with ACS was associated with a lower risk of adverse limb events over long-term follow up including CLI and progressive disease leading to revascularization. These data support the importance of intensive lipid lowering therapies in improving limb outcomes in patients with atherosclerotic vascular disease. In addition, these data support LDL-C as a treatment target for optimizing outcomes in patients with peripheral artery disease.Figure Panel AFigure Panel B
Global epidemiology of lower-extremities artery disease in the 21st century (2000-2021): a systematic review and meta-analysis
Authors: Adou C , Magne J , Gazere N , Aboyans V
Published: November 2023

Objectives

The epidemiology of cardiovascular diseases and risk factors are evolving. In this meta-analysis our objectives were (1) to determine the prevalence of lower-extremities artery disease (LEAD) in the general population worldwide and by region in the 21st century and (2) to identify the risk factors associated with LEAD in the general population and by region in this period.

Methods

We performed a systematic literature review through PubMed, Cochrane, Scopus, Science Direct and Google Scholar databases, restricted to studies in general population performed between 01/2000 and 09/2021 on LEAD, defined by a low ankle brachial index (≤ 0.90). The Newcastle-Ottawa Scale was used to evaluate the quality of the articles before data extraction. A meta-analysis on the association of LEAD with cardiovascular risk factors was conducted. Due to high heterogeneity, random effect model was applied.

Results

Among 1418 references extracted, 42 articles (129,376 participants) were retained. Overall, the global prevalence in adults, mostly ≥ 40 years of age, was higher prevalence in women than in men (9.7%, 95%CI:6.4-13.0, vs. 7.9%, 95%CI:5.2-10.7) with an increase in prevalence with age in both genders (Figure). The highest prevalence was found in Europe (12.7%, 95%CI: 5.3-20.1) and the lowest in North America (5.6%, 95%CI: 2.5-8.6). Significant associations were found between LEAD and current tobacco smoking (odds-ratio (OR)=1.9, 95%CI:1.4-2.5) and past smoking (OR= 1.6, 95%CI:1.3-1.9) versus never smoking. Significant association was found between the prevalence of LEAD and diabetes (OR=2.3, 95%CI:2.0-2.8) with the strongest association in South-Center Asia (OR= 5.8, 95%CI:1.2-28.1). Hypertension was significantly associated with LEAD (OR=2.3, 95%CI: 1.9-2.8) and in particular in South America (OR=4.0, 95%CI:0.9-18.0). Finally, obesity and total cholesterol level (>240 mg/dL) were also significantly associated with LEAD (OR=1.4, 95%CI:1.2-1.8 and OR=2.2, 95%CI:1.0 -5.3, respectively).

Conclusion

This meta-analysis highlights the high prevalence of LEAD with significant differences between men and women and the increasing importance of the metabolic syndrome in recent decades, with some variation by gender and global region.Prevalence of LEAD by age and gender
Restarting anticoagulation after chronic subdural hematoma neurosurgical evacuation: a prospective observationaL
Authors: Marchetti G , Bernardini F , Zoli M , Mazzatenta D
Published: November 2023

Introduction

Management of anticoagulation (AC) in patients with chronic subdural hematoma (cSDH) lacks evidences, with uncertainties regarding outcomes after neurosurgical intervention. In patients with atrial fibrillation the interruption of an anticoagulant therapy can be a risk of thromboembolic event within the first 90 days.

Purpose

We aimed to define safety and effectiveness of AC resumption in a single center cohort undergoing neurosurgical intervention for cSDH.

Methods

Consecutive patients undergoing neurosurgical intervention for evacuation of cSDH and taking anticoagulants due to atrial fibrillation were included and followed-up over time (3 to 30 months) to define evolution of cSDH thickness depending on AC restart. Secondary outcomes included: (i)ischemic stroke and major bleeding (including intracerebral hemorrhage, ICH), assessed at each visit, and (ii) recurrent cSDH needing neurosurgical re-intervention.

Results

Overall, we included 47 consecutive patients, mean age 82.5±7.8 years. Previous trauma emerged in 68% of cases. Patients received warfarin (n=30, 64%), low molecular weight heparin (LMWH, n=6, 13%) or direct oral anticoagulants (DOAC, n=11, 23%). Oral AC was stopped before neurosurgery (7.9±16.7 days before intervention), and 42 (89%) underwent AC reversal. Mean cSDH thickness was 2.3±0.6 cm, midline shift was detected in 94% of patients. All patients survived surgical procedure and completed a minimum of 3-month follow-up. Over a mean 8-month follow-up (range 3-29), cSDH thickness substantially decreased (baseline 2.3±0.6 cm vs follow-up 0.7±0.6 cm, p<0.001). Restarting anticoagulation after chronic subdural hematoma neurosurgical evacuation: a prospective observational. Overall, 26 patients (55.3%) restarted AC, 15 with DOAC, 8 with warfarin, 3 with LMWH. Compared to no AC, AC resumption was not associated with changes in cSDH thickness (0.7±0.7 cm vs 0.9±0.6 cm, p=0.4) or modified Rankin scale at follow-up (2.6±1 vs 2±1.3, p=0.3). Four patients restarting AC had cSDH recurrence requiring re-intervention vs 0 in those avoiding AC (p=0.11); 3 of 4 were post-traumatic. No peri-interventional complications occurred. No ischemic stroke or major bleeding was detected during AC withdrawal.

Conclusions

The study has obviously limitations due to its preliminary nature. Even though, resumption of anticoagulation after neurosurgical intervention for cSDH seems safe, with no significant increase in recurrence rate and cSDH width over time. Longitudinal data from prospectively collected larger cohorts are needed to guide management.
Peripheral blood cell characteristics are independently related to major adverse cardiovascular events after carotid endarterectomy
Authors: Overmars M , Mekke J M , Van Solinge W W , De Jager S C A , Hulsbergen-Veelken C A R , Hoefer I E , De Kleijn D P V , De Borst G J , Van Der Laan S W , Haitjema S
Published: November 2023

Background

Patients who underwent carotid endarterectomy (CEA) still have a residual risk of 13% of developing a major adverse cardiovascular event (MACE) within 3 years. Inflammatory processes leading up to MACE are not fully understood. Therefore, we examined blood cell characteristics (BCCs), possibly reflecting inflammatory processes, in relation to MACE to identify BCCs that may contribute to an increased risk.

Methods

We analyzed 75 pretreatment BCCs from the Sapphire analyzer, and clinical data from the AtheroExpress biobank in relation to MACE after CEA using Random Survival Forests, and a Generalized Additive Survival Model. To understand biological mechanisms, we related the identified variables to intraplaque hemorrhage (IPH).

Results

Of 783 patients, 97 (12%) developed MACE within 3 years after CEA. Red blood cell distribution width (RDW) (HR 1.23 [1.02, 1.68], p = 0.022), CV of lymphocyte size (LACV) (HR 0.78 [0.63, 0.99], p = 0.043), neutrophil complexity of the intracellular structure (NIMN) (HR 0.80 [0.64, 0.98], p = 0.033), mean neutrophil size (NAMN) (HR 0.67 [0.55, 0.83], p < 0.001), mean corpuscular volume (MCV) (HR 1.35 [1.09, 1.66], p = 0.005), eGFR (HR 0.65 [0.52, 0.80], p < 0.001); and HDL (HR 0.62 [0.45, 0.85], p = 0.003) were related to MACE. NAMN was related to IPH (OR 0.83 [0.71 - 0.98], p = 0.02).

Conclusions

This is the first study to present a higher RDW and MCV and lower LACV, NIMN and NAMN as biomarkers reflecting inflammatory processes that may contribute to an increased risk of MACE after CEA.Variables associated with secondary MACE
Increased arterial stiffness in patients with ischemia and no obstructive coronary artery disease
Authors: Sakalidis A , Dimitriadis K , Leontsinis I , Dri E , Mantzouranis E , Bora M , Karanikola A E , Iliakis P , Vlachakis P , Siafi E , Beneki E , Tsioufis P , Manta E , Soulaidopoulos S , Tsioufis C
Published: November 2023

Introduction

Recent studies have shown that patients with angina pectoris and no obstructive coronary artery disease are a heterogeneous population with an elevated risk of major adverse cardiovascular events. The current literature lacks evidence regarding the possible association between arterial stiffness and coronary microvascular dysfunction (CMD).

Purpose

The aim of this study is to determine whether arterial stiffness is increased among patients with CMD compared to hypertensive control group.

Methods

We examined 25 patients [10 female, 40%, mean age: 60.7±9.6 years, mean office blood pressure (BP) : 141/88±17/9 mmHg] and 35 CMD patients (22 female, 63%, mean age : 62.4±4.9 years, average office BP: 129/79±15/10 mmHg). In the group of patients with chronic angina, CMD was defined by a standardized systematic protocol in which coronary flow reserve (CFR) and index of microvascular resistance (IMR) were measured in the left anterior descending coronary artery using a temperature/pressure sensor-tipped guidewire. In addition, in all participants, arterial stiffness was assessed using aortic augmentation index (AIx), derived from the analysis of central pulse waveforms, recorded by applanation tonometry directly from the radial artery.

Results

In the CMD group, mean CFR and IMR were 1.3±0.9 and 45.7±35, respectively. Out of the 35 CMD patients with abnormal CFR 12 of them (34%) had a normal value of IMR, indicating functional microvascular dysfunction. On the other hand, 23 patients (66%) had an abnormal IMR, indicating structural microvascular dysfunction. In CMD group compared to asymptomatic controls, AIx was found significantly higher (35.6±10.5 vs 25.1±12.1%, p=0.03). This difference in AIx between groups was found to be statistically significant after adjustment for age, gender and levels of BP (p<0.05). Moreover, no significant differences were found in body mass index, renal function, history of dyslipidemia, diabetes mellitus and smoking status between the two groups (p=NS for all).

Conclusion

CMD patients are characterized by increased arterial stiffness in comparison with asymptomatic controls, independently of demographic and hemodynamic confounders. These results indicate that impairment of the microvasculature is associated with large artery stiffening. Thus, potential clinical benefit could be derived from specific therapies targeting AIx in patients with CMD.
Circulating intermediate monocytes increase after elective percutaneous coronary intervention
Authors: Merinopoulos I , Bhalraam U , Holmes T , Tsampasian V , Corballis N , Gunawardena T , Sawh C , Maart C , Wistow T , Ryding A , Eccleshall S , Smith J , Vassiliou V
Published: November 2023

Introduction

Inflammation plays a central role in the pathogenesis of atherosclerosis and in the sequelae of percutaneous coronary intervention (PCI). Previous work demonstrated that intermediate monocytes (CD14++CD16+) are associated with adverse cardiovascular events, yet monocyte subset response following elective PCI has not been described. This study explores the changes in monocyte subset and humoral response after elective PCI.

Methods

In this prospective study we recruited patients undergoing elective PCI for stable angina due to de novo coronary artery disease, either with DES or DCB utilised at the discretion of the operator. We excluded patients with significant renal impairment or any significant inflammatory condition on immunosuppression. All patients provided written, informed consent. Patients had blood tests at baseline (prior to PCI), four hours, two weeks and two months later. Analyses were performed in terms of monocyte subsets (classical CD14++CD16-, intermediate CD14+CD16+ and non-classical CD14+CD16++), gene expression of CD14+ leucocytes and humoral biomarkers.

Results

Some 30 patients were recruited in the study; two patients were lost to follow-up and two patients were excluded as they had raised baseline (pre-PCI) troponin; therefore 26 patients were included in analysis. Intermediate monocytes decreased significantly four hours after PCI, were recovered at two weeks, and increased significantly at two months post elective, uncomplicated PCI (Fig 1). The classical monocytes appeared to follow the opposite pattern to intermediate monocytes while the non-classical monocytes did not change significantly, suggesting that there was a shift from classical to intermediate monocytes and vice versa. Subgroup analysis showed that the intermediate monocytes remained significantly elevated in the DES group but not in the DCB group (Fig 2). Gene expression analysis of CD14+ leucocytes showed that IL18 had decreased expression at two weeks, CXCR4 and IL1β decreased at two months, while pentraxin 3 increased at two weeks and two months. In terms of humoral biomarkers, hsTnI remained elevated up to two weeks post PCI while IL6 and TNFα remained elevated till two months post PCI.

Conclusion

Intermediate monocytes, a highly proatherogenic monocyte subset, increase significantly two months following elective, uncomplicated PCI. They remain significantly elevated in the DES group but not in the DCB group suggesting that the PCI strategy could be one of the ways to modulate the inflammatory response post PCI and improve patient outcomes.Monocyte response after PCIMonocyte response after DCB(A) or DES(B)
Comparison of percutaneous coronary intervention versus medication in dialysis patients with coronary artery disease
Authors: Xie E , Ye Z , Li Y , Shen N , Gao Y , Zheng J
Published: November 2023

Background

There is a lack of evidence for the optimal management of dialysis patients complicated with coronary artery disease (CAD). Based on the favorable results from patients with normal or near-normal kidney function, percutaneous coronary intervention (PCI) has extended to patients on maintenance dialysis. However, it is unknown whether this extrapolation is accurate.

Purpose

We sought to investigate the benefits of PCI in dialysis patients with CAD.

Methods

Between January 2015 and June 2021, 455 617 consecutive cardiac catheterizations from 30 cardiac centers in China were reviewed retrospectively through medical records. Patients with normal coronary anatomy, those who did not receive dialysis therapy or received dialysis for less than 3 months, those who received coronary artery bypass grafting, repeat admissions, and those with less than one year of follow-up were excluded. Patients were followed up via telephone interviews or clinic visits until June 2022. The primary outcome of interest was 1-year all-cause mortality, and the secondary outcome of interest was 1-year cardiac death. Cox proportional hazards regression model was used to assess the association of PCI with outcomes. Inverse probability of treatment weighting was used to control for imbalances in patient characteristics.

Results

Of 1 119 patients who met the final criteria, 799 (71.4%) received PCI. The mean age was 61.9±10.6 years, and 828 (74.0%) were male. Compared with medically treated patients, patients in the PCI group were more likely to present with a high Gensini score, be with multivessel diseases, and receive dual antiplatelet and statin therapy. Overall, 201 (16.4%) all-cause deaths were documented, with 153 (13.7%) cardiac deaths. Patients treated with PCI experienced significantly lower cumulative rates of 1-year all-cause deaths (15.5% vs. 24.1%, log-rank p<0.001) as well as cardiac deaths (11.5% vs. 19.1%, p<0.001). Multivariate analyses showed that PCI was independently associated with a lower risk of either all-cause deaths (hazard ratio 0.48, 95% confidence interval 0.36-0.64, p<0.001) or cardiac mortality (hazard ratio 0.45, 95% confidence interval 0.30-0.61, p<0.001). These findings were further confirmed in the inverse probability of treatment weighting cohort.

Conclusion

This cohort study found that in real-world practice, among dialysis with CAD, use of PCI was associated with significantly lower risks for 1-year all-cause death or cardiac mortality compared with medical management. Further prospective studies are needed to confirm these findings.
Distal radial artery palpability and cannulation success for coronary procedures
Authors: Tsigkas G , Apostolos A , Moulias A , Papageorgiou A , Vasilagkos G , Pappelis K , Grapsas N , Aminian A , Sgueglia G , Davlouros P
Published: November 2023

Background

Distal transradial access (DRA) is increasingly performed for coronary angiography and interventions, due to lower incidence of radial artery occlusion, faster hemostasis and decreased local complications rate. However, higher rates of crossover to other access sites remains the major limitation of DRA and the optimal technique for achieving successful cannulation remains under investigation.

Purpose

Aim of our analysis is to explore whether a palpable distal radial artery is associated with higher successful cannulation.

Methods

We conducted a patient-level pooled analysis using data from two randomized-controlled trials (RCT) on DRA. All patients with available data on distal radial artery palpation and cannulation’s success were included in our analysis.

Results

A total of 435 patients were included in our analysis; 84 and 351 from the two studies, respectively. Demographic characteristics, pharmacotherapy details and procedural indications did not differ between the two groups (palpable versus non – palpable DRA), except BMI, which was significantly increased in non – palpable DRA group (27.3 versus 28.3 kg/m2, p=0.034). A palpable DRA was found in 313 (72%) patients. Successful cannulation did not significantly differ between the patients with a palpable and a non-palpable DRA (81.5% versus 80.3%, p=0.78) Furthermore, a multivariable analysis excluded any interactions with demographic characteristics, pharmacotherapy details and indications of procedure.

Conclusions

Our analysis showed that a non-palpable distal radial artery is not associated with lower cannulation success rates. Accordingly, the palpation of the DRA may not be required for achieving better cannulation results. As these findings have been obtained among experienced operators, further research is required to validate the generalizability of our results.
Platelet reactivity and activated clotting time predict haemorrhagic site complications in patients with chronic coronary syndromes undergoing percutaneous coronary intervention
Authors: Ramotowski B , Lewandowski P , Slomski T , Maciejewski P , Budaj A
Published: November 2023

Background/Introduction

Same-day discharge has become a standard of care for patients with chronic coronary syndromes (CCS) treated with ad hoc percutaneous coronary interventions (PCI). QuickClot Radial kaolin-based haemostatic device may shorten haemostasis time and reduce the incidence of vascular site complications. Besides unfractionated heparin (UFH) and aspirin (ASA), an ad hoc procedure demands a loading dose of clopidogrel. Dynamic changes in platelets and thrombotic activity may influence the outcomes at vascular sites. Rapid "point-of-care" testing measures the effects of anticoagulation but the optimal threshold during and after PCI still requires further research.

Purpose

We investigated the effect of a standard dose of UFH and a loading dose of clopidogrel measured with point-of-care devices: Hemochron activated clotting time device (ACT), VerifyNow P2Y12 test on on-site outcomes.

Methods

We conducted a prospective, observational study of consecutive patients with CCS who qualified for ad hoc PCI. Patients were on chronic ASA therapy, received 100 IU/kg UFH, and a 600 mg loading dose of clopidogrel. ACT was measured before and 10 min, 2 h, and 6 h after the administration of UFH and clopidogrel, respectively, and the VerifyNow P2Y12 test measured after 2 and 6 h. A QuickClot haemostatic pad with gradually released compression for up to 2 h was used in all patients. Ultrasonographic assessment of artery diameter and patency was performed before and 6 h after the procedure. Bleeding (BARC criteria) or local haematoma (EASY scale) were observed regularly until hospital discharge.

Results

Forty patients were enrolled in the study. The mean±SD age was 68.8±8.8 years, 30 (75%) patients were men, 13 (35%) had diabetes, 38 (95%) hypertension, 16 (40%) previous myocardial infarction, and 15 (37,5%) were active smokers. Patients received a median [interquartile range (IQR)] 8000 [7000-9000] IU of UFH and 600 mg of clopidogrel. All of the radial arteries remained patent during observation; local bleeding (BARC 2) was observed in 11 (27,5%) and haematomas (EASY 1 and 2) in 11 (27,5%) patients. Patients with bleeding had lower platelet activity measured with platelet reactivity units (PRU) after 2 h (122.5± 51 vs 158.7± 43, p= 0.04) and higher ACT (s) (216.9 ±40 vs. 184.6±28 s, p=0.006). An ACT >196 s, measured 2 h after the procedure, predicted the occurrence of bleeding or haematoma (AUC 0.72; 95%CI 0.56-0.85, p=0.008).

Conclusion

Lower platelet activity and higher ACT after PCI were associated with higher risk of haemorrhagic site complications. "Point-of-care" measures post PCI in CCS patients may be clinically applicable.