bluuebunny/crossref_metadata_2025_split huggingface dataset:
Duration of dual antiplatelet therapy and stability of coronary heart disease: a 60 000-patient meta-analysis of randomised controlled trials
Authors: Bularga Anda , Meah Mohammed N , Doudesis Dimitrios , Shah Anoop S V , Mills Nicholas L , Newby David E , Lee Kuan Ken 
Published: August 2021

BackgroundDual antiplatelet therapy (DAPT) has important implications for clinical outcomes in coronary disease. However, the optimal DAPT duration remains uncertain.Methods and resultsWe searched four major databases for randomised controlled trials comparing long-term (≥12 months) with short-term (≤6 months) or shorter (≤3 months) DAPT in patients with coronary syndromes. The primary outcome was all-cause mortality. Secondary outcomes were any bleeding and major bleeding (safety), cardiac death, myocardial infarction, stent thrombosis, revascularisation and stroke (efficacy). Nineteen randomised controlled trials (n=60 111) satisfied inclusion criteria, 8 assessed ≤3 months DAPT. Compared with long-term (≥12 months), short-term DAPT (≤6 months) was associated with a trend towards reduced all-cause mortality (RR: 0.90, 95% CI: 0.80 to 1.01) and significant bleeding reduction (RR: 0.68, 95% CI: 0.55 to 0.83 and RR: 0.66, 95% CI: 0.56 to 0.77 for major and any bleeding, respectively). There were no significant differences in efficacy outcomes. These associations persisted in sensitivity analysis comparing shorter duration DAPT (≤3 months) to long-term DAPT (≥12 months) for all-cause mortality (RR: 0.91, 95% CI: 0.79 to 1.05). In subgroup analysis, short-term DAPT was associated with lower risk of bleeding in patients with acute or chronic coronary syndromes (RR: 0.66, 95% CI: 0.54 to 0.81 and RR: 0.53, 95% CI: 0.33 to 0.65, respectively), but higher risk of stent thrombosis in acute coronary syndrome (RR: 1.49, 95% CI: 1.02 to 2.17 vs RR: 1.25, 95% CI 0.44 to 3.58).ConclusionOur meta-analysis suggests that short (≤6 months) and shorter (≤3 months) durations DAPT are associated with lower risk of bleeding, equivalent efficacy and a trend towards lower all-cause mortality irrespective of coronary artery disease stability.
Protective lipid-lowering variants in healthy older individuals without coronary heart disease
Authors: Lacaze Paul , Riaz Moeen , Sebra Robert , Hooper Amanda J , Pang Jing , Tiller Jane , Polekhina Galina , Tonkin Andrew , Reid Chris , Zoungas Sophia , Murray Anne M , Nicholls Stephen , Watts Gerald , Schadt Eric , McNeil John J 
Published: August 2021

ObjectiveGenetic variants that disrupt the function of thePCSK9(proprotein convertase subtilisin kexin type 9) andAPOB(apolipoprotein B)genes result in lower serum low-density lipoprotein cholesterol (LDL-C) levels and subsequently confer protection against coronary heart disease (CHD). The objective of this study was to measure the prevalence and selective advantage of such variants among healthy older individuals without a history of CHD.MethodsWe performed targeted sequencing of thePCSK9andAPOBgenes in 13 131 healthy individuals without CHD aged 70 years or older enrolled into the ASPirin in Reducing Events in the Elderly trial. We detected variants in thePCSK9andAPOBgenes with predicted loss-of-function. We associated variant carrier status with serum LDL-C and total cholesterol (TC) levels at the time of study enrolment, adjusting for statin use.ResultsWe detected 22 different rarePCSK9/APOBcandidate variants with putative lipid-lowering effect, carried by 104 participants (carrier rate 1 in 126). Serum LDL-C and TC concentrations for rare PCSK9/APOB variant carriers were consistently lower than non-carriers. Rare variant carrier status was associated with 19.4 mg/dL (14.6%) lower LDL-C, compared with non-carriers (p≤0.001, adjusted for statin use). Statin prescriptions were less prevalent in rare variant carriers (16%) than non-carriers (35%). The more commonPCSK9R46L variant (rs11591147-T) was associated with 15.5 mg/dL (11.8%) lower LDL-C in heterozygotes, and 25.2 mg/dL (19.2%) lower LDL-C in homozygotes (both p≤0.001).ConclusionsLipid-lowering genetic variants are carried by healthy older individuals and contribute to CHD-free survival.Trial registration numberNCT01038583.
Pertussis toxin–induced inflammatory response exacerbates intracerebral haemorrhage and ischaemic stroke in mice
Authors: Zou Ming , Feng Yan , Xiu Yuwhen , Li Yan , Zhang Ying , Fan Junwan , Li Haowen , Cao Jingli , He Wenyan , Jin Wei-Na 
Published: August 2021

BackgroundStroke is a devastating disease, including intracerebral haemorrhage (ICH) and ischaemic stroke. Emerging evidences indicate that systemic inflammatory cascades after stroke contribute to brain damage. However, the direct effects and features of systemic inflammation on brain injury, especially comparing between ischaemic and haemorrhagic stroke, are still obscure.MethodsPertussis toxin (PT) was used to build a pro-inflammatory milieu after ICH and ischaemic stroke in mouse model. The neurodeficits, stroke lesion, immune response and blood–brain barrier (BBB) destruction were assessed.ResultsIn ICH mouse model, PT-induced systemic inflammation exacerbated neurological deficits, and enlarged haemorrhage lesion and perihaematomal oedema. We also found promoted leucocyte infiltration and inflammatory cytokine release into the brain after PT treatment. Moreover, the integrity of the BBB was further disrupted after receiving PT. Furthermore, we demonstrated that PT enhanced brain inflammation and aggravated stroke severity in middle cerebral artery occlusion mouse model.ConclusionsOur results suggest that PT increases inflammatory response that exacerbates brain injury after ICH or ischaemic stroke in mouse model.
Calibration of the Gerda experiment
Authors: Agostini M. , Araujo G. , Bakalyarov A. M. , Balata M. , Barabanov I. , Baudis L. , Bauer C. , Bellotti E. , Belogurov S. , Bettini A. , Bezrukov L. , Biancacci V. , Bossio E. , Bothe V. , Brudanin V. , Brugnera R. , Caldwell A. , Cattadori C. , Chernogorov A. , Comellato T. , D’Andrea V. , Demidova E. V. , Marco N. Di , Doroshkevich E. , Fischer F. , Fomina M. , Gangapshev A. , Garfagnini A. , Gooch C. , Grabmayr P. , Gurentsov V. , Gusev K. , Hakenmüller J. , Hemmer S. , Hiller R. , Hofmann W. , Huang J. , Hult M. , Inzhechik L. V. , Csáthy J. Janicskó , Jochum J. , Junker M. , Kazalov V. , Kermaïdic Y. , Khushbakht H. , Kihm T. , Kirpichnikov I. V. , Klimenko A. , Kneißl R. , Knöpfle K. T. , Kochetov O. , Kornoukhov V. N. , Krause P. , Kuzminov V. V. , Laubenstein M. , Lindner M. , Lippi I. , Lubashevskiy A. , Lubsandorzhiev B. , Lutter G. , Macolino C. , Majorovits B. , Maneschg W. , Manzanillas L. , Miloradovic M. , Mingazheva R. , Misiaszek M. , Moseev P. , Müller Y. , Nemchenok I. , Pandola L. , Pelczar K. , Pertoldi L. , Piseri P. , Pullia A. , Ransom C. , Rauscher L. , Riboldi S. , Rumyantseva N. , Sada C. , Salamida F. , Schönert S. , Schreiner J. , Schütt M. , Schütz A-K. , Schulz O. , Schwarz M. , Schwingenheuer B. , Selivanenko O. , Shevchik E. , Shirchenko M. , Shtembari L. , Simgen H. , Smolnikov A. , Stukov D. , Vasenko A. A. , Veresnikova A. , Vignoli C. , von Sturm K. , Wester T. , Wiesinger C. , Wojcik M. , Yanovich E. , Zatschler B. , Zhitnikov I. , Zhukov S. V. , Zinatulina D. , Zschocke A. , Zsigmond A. J. , Zuber K. , Zuzel G. ,   Gerda Collaboration
Published: August 2021

AbstractThe GERmanium Detector Array (Gerda) collaboration searched for neutrinoless double-$$\beta $$
β
decay in $$^{76}$$

76

Ge with an array of about 40 high-purity isotopically-enriched germanium detectors. The experimental signature of the decay is a monoenergetic signal at $$Q_{\beta \beta }$$

Q

β
β

$$=2039.061(7)$$

=
2039.061
(
7
)

keV in the measured summed energy spectrum of the two emitted electrons. Both the energy reconstruction and resolution of the germanium detectors are crucial to separate a potential signal from various backgrounds, such as neutrino-accompanied double-$$\beta $$
β
decays allowed by the Standard Model. The energy resolution and stability were determined and monitored as a function of time using data from regular $$^{228}$$

228

Th calibrations. In this work, we describe the calibration process and associated data analysis of the full Gerda dataset, tailored to preserve the excellent resolution of the individual germanium detectors when combining data over several years.
New canonical analysis for higher order topologically massive gravity
Authors: Escalante Alberto , Aguilar Jorge Hernández 
Published: July 2021

AbstractA detailed Gitman–Lyakhovich–Tyutin analysis for higher-order topologically massive gravity is performed. The full structure of the constraints, the counting of physical degrees of freedom, and the Dirac algebra among the constraints are reported. Moreover, our analysis presents a new structure into the constraints and we compare our results with those reported in the literature where a standard Ostrogradski framework was developed.
Worldline numerics applied to custom Casimir geometry generates unanticipated intersection with Alcubierre warp metric
Authors: White Harold , Vera Jerry , Han Arum , Bruccoleri Alexander R. , MacArthur Jonathan 
Published: July 2021

AbstractWhile conducting analysis related to a DARPA-funded project to evaluate possible structure of the energy density present in a Casimir cavity as predicted by the dynamic vacuum model, a micro/nano-scale structure has been discovered that predicts negative energy density distribution that closely matches requirements for the Alcubierre metric. The simplest notional geometry being analyzed as part of the DARPA-funded work consists of a standard parallel plate Casimir cavity equipped with pillars arrayed along the cavity mid-plane with the purpose of detecting a transient electric field arising from vacuum polarization conjectured to occur along the midplane of the cavity. An analytic technique called worldline numerics was adapted to numerically assess vacuum response to the custom Casimir cavity, and these numerical analysis results were observed to be qualitatively quite similar to a two-dimensional representation of energy density requirements for the Alcubierre warp metric. Subsequently, a toy model consisting of a 1 $$\upmu $$
μ
m diameter sphere centrally located in a 4 $$\upmu $$
μ
m diameter cylinder was analyzed to show a three-dimensional Casimir energy density that correlates well with the Alcubierre warp metric requirements. This qualitative correlation would suggest that chip-scale experiments might be explored to attempt to measure tiny signatures illustrative of the presence of the conjectured phenomenon: a real, albeit humble, warp bubble.
Is non-particle dark matter equation of state parameter evolving with time?
Authors: Ghose Souvik , Bhadra Arunava 
Published: August 2021

AbstractRecently, the so-called Hubble Tension, i.e. the mismatch between the local and the cosmological measurements of the Hubble parameter, has been resolved when non-particle dark matter is considered which has a negative equation of state parameter ($$\omega \approx -\,0.01$$

ω
≈
-

0.01

). We investigate if such a candidate can successfully describe the galactic flat rotation curves. It is found that the flat rotation curve feature puts a stringent constraint on the dark matter equation of state parameter $$\omega $$
ω
and $$\omega \approx -\,0.01$$

ω
≈
-

0.01

is not consistent with flat rotational curves, observed around the galaxies. However, a dynamic $$\omega $$
ω
of non-particle dark matter may overcome the Hubble tension without affecting the flat rotation curve feature.
Coarse groups, and the isomorphism problem for oligomorphic groups
Authors: Nies André , Schlicht Philipp , Tent Katrin 
Published: July 2021

Let [Formula: see text] denote the topological group of permutations of the natural numbers. A closed subgroup G of [Formula: see text] is called oligomorphic if for each n, its natural action on n-tuples of natural numbers has only finitely many orbits. We study the complexity of the topological isomorphism relation on the oligomorphic subgroups of [Formula: see text] in the setting of Borel reducibility between equivalence relations on Polish spaces. Given a closed subgroup [Formula: see text] of [Formula: see text], the coarse group [Formula: see text] is the structure with domain the cosets of open subgroups of G, and a ternary relation [Formula: see text]. This structure derived from G was introduced in [A. Kechris, A. Nies and K. Tent, The complexity of topological group isomorphism, J. Symbolic Logic 83(3) (2018) 1190–1203, Sec. 3.3 ]. If G has only countably many open subgroups, then [Formula: see text] is a countable structure. Coarse groups form our main tool in studying such closed subgroups of [Formula: see text]. We axiomatize them abstractly as structures with a ternary relation. For the oligomorphic groups, and also the profinite groups, we set up a Stone-type duality between the groups and the corresponding coarse groups. In particular, we can recover an isomorphic copy of G from its coarse group in a Borel fashion. We use this duality to show that the isomorphism relation for oligomorphic subgroups of [Formula: see text] is Borel reducible to a Borel equivalence relation with all classes countable. We show that the same upper bound applies to the larger class of closed subgroups of [Formula: see text] that are topologically isomorphic to oligomorphic groups.
Mathematical Modeling and Mutational Analysis Reveal Optimal Therapy to Prevent Malignant Transformation in Grade II IDH-Mutant Gliomas
Authors: Aoki Kosuke , Suzuki Hiromichi , Yamamoto Takashi , Yamamoto Kimiyo N. , Maeda Sachi , Okuno Yusuke , Ranjit Melissa , Motomura Kazuya , Ohka Fumiharu , Tanahashi Kuniaki , Hirano Masaki , Nishikawa Tomohide , Shimizu Hiroyuki , Kitano Yotaro , Yamaguchi Junya , Yamazaki Shintaro , Nakamura Hideo , Takahashi Masamichi , Narita Yoshitaka , Nakada Mitsutoshi , Deguchi Shoichi , Mizoguchi Masahiro , Momii Yasutomo , Muragaki Yoshihiro , Abe Tatsuya , Akimoto Jiro , Wakabayashi Toshihiko , Saito Ryuta , Ogawa Seishi , Haeno Hiroshi , Natsume Atsushi 
Published: July 2021

AbstractIsocitrate dehydrogenase-mutant low-grade gliomas (IDHmut-LGG) grow slowly but frequently undergo malignant transformation, which eventually leads to premature death. Chemotherapy and radiotherapy treatments prolong survival, but can also induce genetic (or epigenetic) alterations involved in transformation. Here, we developed a mathematical model of tumor progression based on serial tumor volume data and treatment history of 276 IDHmut-LGGs classified by chromosome 1p/19q codeletion (IDHmut/1p19qcodel and IDHmut/1p19qnoncodel) and performed genome-wide mutational analyses, including targeted sequencing and longitudinal whole-exome sequencing data. These analyses showed that tumor mutational burden correlated positively with malignant transformation rate, and chemotherapy and radiotherapy significantly suppressed tumor growth but increased malignant transformation rate per cell by 1.8 to 2.8 times compared with before treatment. This model revealed that prompt adjuvant chemoradiotherapy prolonged malignant transformation-free survival in small IDHmut-LGGs (≤ 50 cm3). Furthermore, optimal treatment differed according to genetic alterations for large IDHmut-LGGs (&gt; 50 cm3); adjuvant therapies delayed malignant transformation in IDHmut/1p19qnoncodel but often accelerated it in IDHmut/1p19qcodel. Notably, PI3K mutation was not associated with malignant transformation but increased net postoperative proliferation rate and decreased malignant transformation-free survival, prompting the need for adjuvant therapy in IDHmut/1p19qcodel. Overall, this model uncovered therapeutic strategies that could prevent malignant transformation and, consequently, improve overall survival in patients with IDHmut-LGGs.Significance:A mathematical model successfully estimates malignant transformation-free survival and reveals a link between genetic alterations and progression, identifying precision medicine approaches for optimal treatment of IDH-mutant low-grade gliomas.
Harmonisation of Pharmaceutical Take-Back Systems in the EU
Authors: Mitkidis Kateřina , Obolevich Viktoria , Chrysochou Polymeros , Mitkidis Panagiotis 
Published: July 2021

Abstract
When medicines enter the environment, they harm living species and ecosystems. Improper disposal of household pharmaceutical waste increases the concentration of pharmaceuticals in the environment and thus their detrimental impacts. Since 2004, the EU has obliged its Member States to establish ‘an appropriate collection system’ for unused and/or expired medication. However, as no implementation guidelines exist, large differences in the systems and their use remain. Pressure for adoption of guidelines harmonising the systems across the EU has been increasing. We address the question whether such harmonisation could mitigate pharmaceutical pollution, and which regulatory measures would be appropriate. To answer this, we conduct a comparative investigation of the systems’ regulation and an empirical study of citizens’ beliefs and behaviour across four European countries. We find a potential for increasing the effectiveness of pharmaceutical take-back systems through their harmonisation and conclude that the EU has the competence and tools to regulate this.
Management of Patellar Instability: A Network Meta-analysis of Randomized Control Trials
Authors: Hurley Eoghan T. , Colasanti Christopher A. , Anil Utkarsh , McAllister Delon , Matache Bogdan A. , Alaia Michael J. , Strauss Eric J. , Campbell Kirk A. 
Published: August 2021

Background: Multiple surgical options exist for the treatment of patellar instability; however, the most common procedures involve either a reconstruction of the medial patellofemoral ligament (MPFL) or a repair/plication of the MPFL and medial soft tissues. Purpose: To perform a network meta-analysis of the randomized controlled trials (RCTs) in the literature to compare MPFL reconstruction, MPFL repair, and nonoperative management for patellar instability. Study Design: Systematic review and network meta-analysis; Level of evidence, 1. Methods: The literature search was performed based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RCTs comparing MPFL reconstruction, MPFL repair, and nonoperative management for patellar instability were included. Clinical outcomes included recurrent instability (including both dislocations and subluxations), redislocation, and Kujala score. Clinical outcomes were compared using a frequentist approach to network meta-analysis, with statistical analysis performed using the statistical software R. The treatment options were ranked using P scores. Results: There were 13 RCTs with a total of 789 patients, all with a minimum follow-up of 24 months. There were 150 patients treated using MPFL reconstruction, 353 treated using MPFL repair, and 286 treated nonoperatively. Overall, MPFL reconstruction had the highest P score (0.9967) and resulted in a significantly lower recurrence rate than did MPFL repair (odds ratio [OR], 0.42; 95% CI, 0.07-0.72) and nonoperative management (OR, 0.09; 95% CI, 0.03-0.32). In addition, MPFL repair resulted in a significantly lower recurrence rate than did nonoperative management (OR, 0.42; 95% CI, 0.25-0.70). MPFL reconstruction had the highest P score (0.9651) and resulted in a significantly higher Kujala score than did nonoperative management (mean difference, 10.45; 95% CI, 0.41-20.49) but not MPFL repair (mean difference, 0.15; 95% CI, 0.03-0.68). Subgroup analysis revealed that MPFL reconstruction had the highest P score for all outcomes in those with first-time dislocation. Conclusion: The current study demonstrated that MPFL reconstruction results in the lowest rate of recurrent patellar instability and best functional outcomes as measured using the Kujala score.
Anomalous Aortic Origin of a Coronary Artery Repair Through an Anterior Minithoracotomy
Authors: Nellis Joseph R. , Drysdale Nicolas D. , Evans Megan A. , Habermann Alyssa C. , Meza James M. , Andersen Nicholas D. , Daneshmand Mani A. , Turek Joseph W. 
Published: August 2021

Objective The benefits of minimally invasive adult cardiac surgery are well established. Nevertheless, minimally invasive congenital cardiac procedures, even for adult patients, are uncommon. In 2018, we started repairing anomalous aortic origin of a coronary artery (AAOCA) through a 5 cm anterior minithoracotomy when possible to improve cosmesis and avoid sternal precautions. We hypothesized this approach was safe and reliable. Methods A 5 cm incision was made in the right second intercostal space. The incision was carried down to the pericardium while preserving the internal mammary artery. With the pericardium in view, the second and third ribs were disarticulated. Central cardiopulmonary bypass was established, and the repair was carried out based on the patient’s anatomy. The technique was modified to a left anterior minithoracotomy for 1 patient who required pulmonary artery translocation. At any point, if the dissection or repair was not progressing appropriately, the minimally invasive exposure was converted to a partial or traditional median sternotomy. Results Between June 2018 and June 2019, 11 patients underwent minimally invasive anomalous coronary repair. Four patients (3 with body mass index >30) were converted to traditional sternotomy due to poor visualization. Postoperatively, 1 patient required coronary artery bypass after 335 days, due to extensive collaterals and stable angina. Otherwise, at a median follow-up of 437 days (IQR 340 to 480), patients had resumed baseline activity without recurrent symptoms. Conclusions Minimally invasive AAOCA repair may be appealing, although surgeons should be cautious given the high conversion rate.
Factors Associated With Achilles Tendon Rupture in Women’s Collegiate Gymnastics
Authors: Bonanno Joseph , Cheng Jennifer , Tilley Dave , Abutalib Zafir , Casey Ellen 
Published: July 2021

Background: Achilles injury risk in women’s collegiate gymnastics is 10-fold higher than in all other collegiate sports. This study aims to identify risk factors for Achilles tendon ruptures in collegiate female gymnasts. Hypothesis: Gymnasts with Achilles tendon ruptures will be more likely to report early gymnastics specialization, elite-level training before college, and performance of high-difficulty skills on floor and vault. Study Design: Cross-sectional study. Level of Evidence: Level 4. Methods: Anonymous surveys were distributed to current and former collegiate female gymnasts, aged 18 to 30 years, via coaches, athletic trainers, Twitter, and ResearchMatch. Information about Achilles tendon ruptures, gymnastics-related injuries, sport specialization, event/skills participation, and medication use were collected. Results: A total of 581 gymnasts were included. One hundred gymnasts (17.2%; 95% CI: 14.1%-20.3%) reported Achilles tendon ruptures during collegiate training or competition. Most ruptures (91%) occurred on floor exercise; 85.7% of these occurred during back tumbling-take-off. Compared with gymnasts without ruptures during college, a greater percentage of gymnasts with ruptures competed at a Division I program, trained elite, competed difficult vaults and floor passes before and during college, competed in all 4 events during college, identified as Black/African American, and used retinoid medications. Conclusion: Achilles tendon ruptures are more common in women’s collegiate gymnastics than other sports. Competing at the elite level, performing difficult floor and vault skills, and competing in all 4 events may increase the risk for an Achilles tendon rupture. Potential nontraining risk factors include retinoid exposure and Black/African American race. Future studies regarding the mechanisms of Achilles tendon ruptures in female collegiate gymnasts are warranted. Clinical Relevance: Collegiate gymnasts who compete at the elite level, perform high levels of difficulty on floor and vault, and compete in all 4 events may be at increased risk for Achilles tendon ruptures.