bluuebunny/crossref_metadata_2025_split huggingface dataset:
Education and gastroenterology fellow knowledge about endoscopic mucosal resection of colon adenomas: a survey-based study
Authors: Garg Shashank , Inamdar Sumant , Tharian Benjamin , Muniraj Thiruvengadam , Aslanian Harry R. 
Published: August 2021

Abstract
Background and study aims Endoscopic mucosal resection (EMR) is an effective way to remove large (> 2 cm) colon adenomas. Training about it has not been standardized in fellowship programs. This study was aimed at evaluating the education and knowledge of gastroenterology fellows about EMR of colorectal adenomas.
Methods Participation in this survey was offered to 1730 gastroenterology fellows in the United States during the academic year 2019 to 2020. The survey assessed endoscopic mucosal resection training and knowledge and was approved and administered by the American College of Gastroenterology.
Results A total of 163 fellows (9.4 %) completed the survey. Only 85 fellows (52.1 %) reported receiving formal education in endoscopic mucosal resection. Fellow confidence was lowest regarding knowing electrosurgery unit settings. Fewer fellows correctly identified Paris 0-IIb (79, 48.5 %; P < 0.0001) or NICE I (114, 69.9 %; P < 0.01) lesions as compared to other Paris and NICE III lesions, respectively. Only 73 (44.8 %) and 93 fellows (57.1 %) arranged steps of EMR in the correct order and identified the correct type of current used for resection, respectively. Training year, male sex, and provision of advanced endoscopy rotations during fellowship were associated with a higher knowledge score for EMR.
Conclusions Nearly half of all fellows reported no formal education in EMR and incorrectly ordered its steps. Adenoma assessment by Paris and NICE classifications and electrosurgery unit settings were the most prominent knowledge deficiencies. Incorporation of standardized training about EMR with inclusion of advanced endoscopy rotations appears to be an important educational opportunity during gastroenterology fellowship.
Effectiveness of hemostatic powders in lower gastrointestinal bleeding: a systematic review and meta-analysis
Authors: Facciorusso Antonio , Bertini Marco , Bertoni Michele , Tartaglia Nicola , Pacilli Mario , Ramai Daryl , Mohan Babu P. , Chandan Saurabh , Ambrosi Antonio , Sacco Rodolfo 
Published: August 2021

Abstract
Background and study aims There is limited evidence on the effectiveness of hemostatic powders in the management of lower gastrointestinal bleeding (LGIB). We aimed to provide a pooled estimate of their effectiveness and safety based on the current literature.
Patients and methods Literature review was based on computerized bibliographic search of the main databases through to December 2020. Immediate hemostasis, rebleeding rate, adverse events, and mortality were the outcomes of the analysis. Pooled effects were calculated using a random-effects model.
Results A total of 9 studies with 194 patients were included in the meta-analysis. Immediate hemostasis was achieved in 95 % of patients (95 % confidence interval [CI] 91.6 %–98.5 %), with no difference based on treatment strategy or bleeding etiology. Pooled 7- and 30-day rebleeding rates were 10.9 % (95 %CI 4.2 %–17.6 %) and 14.3 % (95 %CI 7.3 %–21.2 %), respectively. Need for embolization and surgery were 1.7 % (95 %CI 0 %–3.5 %) and 2.4 % (95 %CI 0.3 %–4.6 %), respectively. Overall, two patients (1.9 %, 95 %CI 0 %–3.8 %) experienced mild abdominal pain after powder application, and three bleeding-related deaths (2.3 %, 95 %CI 0.2 %–4.3 %) were registered in the included studies.
Conclusion Novel hemostatic powders represent a user-friendly and effective tool in the management of lower gastrointestinal bleeding.
Effects of Different Bleaching Agents on the Surface Topography and the Microhardness of Artificial Carious Lesions
Authors: Owda Rasha , Sancakli Hande Sar 
Published: August 2021

Abstract
Objectives The aim of this study was to evaluate the effects of in-office and at-home bleaching agent applications on the surface topography and microhardness of artificially demineralized enamel.
Materials and Methods A total of 224 enamel specimens were prepared using bovine sound central incisors. 4 mm × 4 mm enamel windows were exposed on the buccal surfaces covering the remaining surface with nail varnish. Samples were immersed in a demineralizing solution for 16 hours to produce artificial caries lesions, then divided into four groups according to the bleaching agent’s type and concentration. Group I; in-office bleaching 35% hydrogen peroxide (HP) (Whiteness HP Maxx; FGM, Brazil), Group II and Group III at-home bleaching 16 and 22% carbamide peroxide CP, respectively (Whiteness Perfect). Group IV; control (not bleached). The microhardness Vickers hardness number (VHN) was measured at the baseline, after demineralization, and after bleaching consequently. The micro-surface changes of the enamel surface after demineralization and bleaching were evaluated by scanning electron microscope (SEM).
Statistical Analysis Data were evaluated by the one-way analysis of variance (ANOVA) test followed by Post Hoc Tukey’s and Fisher’s least significant difference. Tow- sided p-values were considered statistically significant at p ≤ 0.05.
Results A significant reduction was noticed in the enamel microhardness after demineralization p < 0.05. However, there is no statistically significant difference between the mean VHN of the demineralized and bleached enamel (p > 0.001). SEM images showed significant changes on the surface of the demineralized enamel after bleaching (pattern type III).
Conclusions The low and high concentrations of HP and CP bleaching agents increased the demineralization severity of artificial caries lesions without significantly altering their microhardness values.
Preliminary Histological Evaluation of the Application of Ozone in the First Days of Orthodontic Force Induction in Animal Model
Authors: Faccini Melissa , Agostini Felipe , Drieu Tassio , Campos Francisco Ubiratan Ferreira de , Garcez Aguinaldo , Carinhena Glauber Fabre , Salmeron Samira , Casaroto Ana Regina , Valarelli Fabricio Pinelli , Freitas Karina Maria Salvatore 
Published: August 2021

Abstract
Objectives The aim of the study was to histologically evaluate the effect of ozone therapy on orthodontic force induction in an animal model.
Materials and Methods Twenty-four Wistar rats were divided into three groups (n = 8). A NiTi coil spring was installed from the maxillary first molar to the maxillary central incisor. G1 was control and G2/G3 received 1 mL of ozonated gas at concentrations of 10 and 60 µg/mL, in the buccal mucosa above the first molar roots. The animals were euthanized 3 and 5 days after the procedure. Histological sections were obtained, longitudinally of the first molar’ long axis, in the mesiodistal direction. The number of osteoclasts, osteoblasts, blood vessels, polymorphonuclear and mononuclear cells, formation of osteoid tissue and hyaline areas, and root resorption were evaluated with light microscope, in tension and pressure sides. Intergroup comparisons were performed with Kruskal–Wallis, Dunn, and Chi-square tests.
Results At 3-days pressure side, a greater number of osteoclasts was observed in ozone groups and greater number of blood vessels and polymorphonuclear cells were observed in G2. On the tension side, there was a significantly greater number of blood vessels, osteoblasts, and mononuclear cells in G2. At 5-days pressure side, there was a significantly greater number of osteoclasts in G2, blood vessels and osteoblasts in the ozone groups, and lesser number of polymorphonuclear cells in G3.
Conclusion Ozone therapy increased the number of osteoclasts on the pressure side and osteoblasts on tension side, in 10 µg/mL concentration, demonstrating histological parameters favorable to bone remodeling. The 60 µg/mL ozone concentration accelerated the periodontal ligament reorganization process.
Microscope-Assisted Arterial Anastomosis in Adult Living Donor Liver Transplantation: A Systematic Review and Meta-analysis of Outcomes
Authors: Ebner Peggy J. , Bick Katherine J. , Emamaullee Juliet , Stanton Eloise W. , Gould Daniel J. , Patel Ketan M. , Genyk Yuri , Sher Linda , Carey Joseph N. 
Published: August 2021

Abstract
Background Living donor liver transplantation (LDLT) has expanded the availability of liver transplant but has been associated with early technical complications including the devastating complication of hepatic artery thrombosis (HAT), which has been reported to occur in 14% to 25% of LDLT using standard anastomotic techniques. Microvascular hepatic artery reconstruction (MHAR) has been implemented in an attempt to decrease rates of HAT. The purpose of this study was to review the available literature in LDLT, specifically related to MHAR to determine its impact on rates of posttransplant complications including HAT.
Methods A systematic review was conducted using PubMed/Medline and Web of Science. Case series and reviews describing reports of microscope-assisted hepatic artery anastomosis in adult patients were considered for meta-analysis of factors contributing to HAT.
Results In all, 462 abstracts were screened, resulting in 20 studies that were included in the meta-analysis. This analysis included 2,457 patients from eight countries. The pooled rate of HAT was 2.20% with an overall effect size of 0.00906.
Conclusion Systematic literature review suggests that MHAR during LDLT reduces vascular complications and improves outcomes posttransplant. Microvascular surgeons and transplant surgeons should collaborate when technical challenges such as small vessel size, short donor pedicle, or dissection of the recipient vessel wall are present.
The Role of Fibrin(ogen) in Wound Healing and Infection Control
Authors: Kearney Katherine J. , Ariëns Robert A.S. , Macrae Fraser L. 
Published: August 2021

AbstractFibrinogen, one of the most abundant plasma proteins playing a key role in hemostasis, is an important modulator of wound healing and host defense against microbes. In the current review, we address the role of fibrin(ogen) throughout the process of wound healing and subsequent tissue repair. Initially fibrin(ogen) acts as a provisional matrix supporting incoming leukocytes and acting as reservoir for growth factors. It later goes on to support re-epithelialization, angiogenesis, and fibroplasia. Importantly, removal of fibrin(ogen) from the wound is essential for wound healing to progress. We also discuss how fibrin(ogen) functions through several mechanisms to protect the host against bacterial infection by providing a physical barrier, entrapment of bacteria in fibrin(ogen) networks, and by directing immune cell function. The central role of fibrin(ogen) in defense against bacterial infection has made it a target of bacterial proteins, evolved to interact with fibrin(ogen) to manipulate clot formation and degradation for the purpose of promoting microbial virulence and survival. Further understanding of the dual roles of fibrin(ogen) in wound healing and infection could provide novel means of therapy to improve recovery from surgical or chronic wounds and help to prevent infection from highly virulent bacterial strains, including those resistant to antibiotics.
Clopidogrel versus Ticagrelor in CYP2C19 Loss-of-Function Allele Noncarriers: A Real-World Study in China
Authors: Zhang Yunnan , Zhang Yi , Shi Xiujin , Lin Baidi , Han Jialun , Wang Yifan , Yan Jialin , Peng Wenxing , Li Wenzheng , Zheng Ze , Lin Yang 
Published: August 2021

Abstract
Objective This article compares the clinical outcomes of clopidogrel and ticagrelor in patients with acute coronary syndrome (ACS) without cytochrome P450 (CYP)2C19 loss-of-function (LOF) alleles and investigates whether clopidogrel could be an alternative P2Y12 inhibitor without increasing the risk of ischemic events.
Methods Patients were divided into the clopidogrel-treated group and the ticagrelor-treated group. Inverse probability of treatment weighting (IPTW) calculated by propensity scores was used to adjust confounding covariates. The primary outcome was major adverse cardiovascular or cerebrovascular events (MACCEs) within 12 months. The secondary outcomes were MACCEs plus unstable angina, and clinically significant bleeding events.
Results Finally, 2,199 patients were included. Of them, 1,606 were treated with clopidogrel, and 593 were treated with ticagrelor. The mean age of the original cohort was 59.92 ± 9.81 years. During the 12-month follow-up period, MACCEs occurred in 89 patients (4.0%). No significant differences were observed in MACCEs (IPTW-adjusted hazard ratio [HR], 0.87; 95% confidence interval [CI], 0.65–1.18), MACCEs plus unstable angina (IPTW-adjusted HR, 1.20; 95% CI, 0.91–1.59), or clinically significant bleeding events (IPTW-adjusted HR, 0.81; 95% CI, 0.53–1.23) between the clopidogrel- and ticagrelor-treated groups.
Conclusion In patients with ACS without CYP2C19 LOF alleles, clopidogrel was not associated with a higher risk of MACCEs when compared with ticagrelor. The main findings of this study support use of clopidogrel in CYP2C19 LOF noncarriers as an alternative P2Y12 inhibitor, which may reduce medical expenses and adverse reactions caused by more potent P2Y12 inhibitors in these patients.
Prevention of Venous Thromboembolism in Microvascular Surgery Patients Using Weight-Based Unfractionated Heparin Infusions
Authors: Bertolaccini Corinne M. , Prazak Ann Marie B. , Goodwin Isak A. , Kwok Alvin , Mendenhall Shaun D. , Rockwell W. Bradford , Agarwal Jayant , Pannucci Christopher J. 
Published: August 2021

Abstract
Background Unfractionated heparin infusions are commonly used in microvascular surgery to prevent microvascular thrombosis. Previously, fixed-dose heparin infusions were believed to provide sufficient venous thromboembolism (VTE) prophylaxis; however, we now know that this practice is inadequate for the majority of patients. Anti-factor Xa (aFXa) level is a measure of unfractionated heparin efficacy and safety. This study evaluated the pharmacodynamics of weight-based dose heparin infusions and the impacts of real-time aFXa-guided heparin dose adjustments.
Methods This prospective clinical trial enrolled adult microvascular surgery patients who received a weight-based heparin dose following a microsurgical procedure. Steady-state aFXa levels were monitored, and patients with out-of-range levels received dose adjustments. The study outcomes assessed were aFXa levels at a dose of heparin 10 units/kg/hour, time to adequate aFXa level, number of dose adjustments required to reach in-range aFXa levels, and clinically relevant bleeding and VTE at 90 days.
Results Twenty-one patients were prospectively recruited, and usable data were available for twenty patients. Four of twenty patients (20%) had adequate prophylaxis at a heparin dose of 10 units/kg/hour. Among patients who received dose adjustments and achieved in-range aFXa levels, the median number of dose adjustments was 2 and the median weight-based dose was 11 units/kg/hour. The percentage of patients with in-range levels was significantly increased (65 vs. 15%, p = 0.0002) as a result of real-time dose adjustments. The rate of VTE at 90 days was 0%, and clinically relevant bleeding rate at 90 days was 15%.
Conclusion Weight-based heparin infusions at a rate of 10 units/kg/hour provide a detectable level of anticoagulation for some patients following microsurgical procedures, but most patients require dose adjustment to ensure adequate VTE prophylaxis.
Covalently linked hydrogen bond donors: The other side of molecular frustration in deep eutectic solvents
Authors: Recker Elizabeth A. , Hardy David , Anderson Grace I. , Mirjafari Arsalan , Wagle Durgesh V. 
Published: August 2021

In this work, we investigated the effects of a single covalent link between hydrogen bond donor species on the behavior of deep eutectic solvents (DESs) and shed light on the resulting interactions at molecular scale that influence the overall physical nature of the DES system. We have compared sugar-based DES mixtures, 1:2 choline chloride/glucose [DES(g)] and 1:1 choline chloride/trehalose [DES(t)]. Trehalose is a disaccharide composed of two glucose units that are connected by an α-1,4-glycosidic bond, thus making it an ideal candidate for comparison with glucose containing DES(g). The differential scanning calorimetric analysis of these chemically close DES systems revealed significant difference in their phase transition behavior. The DES(g) exhibited a glass transition temperature of −58 °C and behaved like a fluid at higher temperatures, whereas DES(t) exhibited marginal phase change behavior at −11 °C and no change in the phase behavior at higher temperatures. The simulations revealed that the presence of the glycosidic bond between sugar units in DES(t) hindered free movement of sugar units in trehalose, thus reducing the number of interactions with choline chloride compared to free glucose molecules in DES(g). This was further confirmed using quantum theory of atoms in molecule analysis that involved determination of bond critical points (BCPs) using Laplacian of electron density. The analysis revealed a significantly higher number of BCPs between choline chloride and sugar in DES(g) compared to DES(t). The DES(g) exhibited a higher amount of charge transfer between the choline cation and sugar, and better interaction energy and enthalpy of formation compared to DES(t). This is a result of the ability of free glucose molecules to completely surround choline chloride in DES(g) and form a higher number of interactions. The entropy of formation for DES(t) was slightly higher than that for DES(g), which is a result of fewer interactions between trehalose and choline chloride. In summary, the presence of the glycosidic bond between the sugar units in trehalose limited their movement, thus resulting in fewer interactions with choline chloride. This limited movement in turn diminishes the ability of the hydrogen bond donor to disrupt the molecular packing within the lattice structure of the hydrogen bond acceptor (and vice versa), a crucial factor that lowers the melting point of DES mixtures. This inability to move due to the presence of the glycosidic bond in trehalose significantly influences the physical state of the DES(t) system, making it behave like a semi-solid material, whereas DES(g) behaves like a liquid material at room temperature.
Broadband X-ray generation by large krypton clusters under the effect of relativistic femtosecond laser pulses
Authors: Semenov T.A. , Ivanov K.A. , Lazarev A.V. , Tsymbalov I.N. , Volkov R.V. , Zhvaniya I.A. , Dzhidzhoev M.S. , Savel’ev A.B. , Gordienko V.M. 
Published: August 2021

Abstract
This paper presents a phenomenological analysis of thermodynamic parameters of a pulsed supersonic gas jet in a conical nozzle. Conditions have been found out for the condensation and formation of large krypton clusters resulting from phase transitions during adiabatic expansion of gas through the nozzle into vacuum. We have identified the phase state of the large clusters (submicron droplets consisting of ∼107 monomers) forming in the jet and obtained a high yield of X-rays from a cluster nanoplasma produced by femtosecond laser pulses of relativistic intensity I. It has been shown that, at I ≈ 3 × 1018 W cm−2, a nanoplasma consisting of large krypton clusters emits a broadband X-ray spectrum in the range 5 – 100 keV. The integrated laser to X-ray energy conversion efficiency achieved is ∼10−5 (400 nJ), and the efficiency of characteristic Kα line (12.6 keV) generation is ∼1.5 × 10−6 (68 nJ), which corresponds to a quantum yield of ∼3 × 108 photons s−1 (4π)−1, with a contrast of ∼25 relative to bremsstrahlung background.
Electron acceleration in intense laser – solid interactions at parallel incidence
Authors: Shen X.F. , Pukhov A.M. , Perevalov S.E. , Soloviev A.A. 
Published: August 2021

Abstract
Using multidimensional particle-in-cell simulations, we show that an electron beam with a huge space charge can be accelerated to high energies by irradiating the edge of a solid density target with an intense femtosecond laser pulse at parallel incidence. The process of energy gain of each electron is divided into two parts: the transverse laser field and the longitudinal field of the excited surface plasma wave (SPW). It is shown that the longitudinal field of the SPW dominates the acceleration of the major part of electrons. This process leads to generation of a highly collimated electron beam with a huge space charge.
Breaking of a nonlinear wake wave excited by a laser pulse during its interaction with a semi-infinite plasma
Authors: Kuznetsov S.V. 
Published: August 2021

Abstract
Analytical methods are used to study the properties of a wake wave excited by a relativistic laser pulse passing through a blurred boundary of a homogeneous plasma. It is found that on the plasma density plateau near its boundary, the wake wave is not regular and its phase velocity depends on the spatial coordinate. It is shown that the breaking of a wake wave is a threshold process in terms of the electron oscillation energy; the influence of the transition layer parameters on the process of wake wave breaking is determined.
No more glowing in the dark: how deep learning improves exposure date estimation in thermoluminescence dosimetry
Authors: Mentzel F , Derugin E , Jansen H , Kröninger K , Nackenhorst O , Walbersloh J , Weingarten J 
Published: August 2021

Abstract
The time- or temperature-resolved detector signal from a thermoluminescence dosimeter can reveal additional information about circumstances of an exposure to ionising irradiation. We present studies using deep neural networks to estimate the date of a single irradiation with 12 mSv within a monitoring interval of 42 days from glow curves of novel TL-DOS personal dosimeters developed by the Materialprüfungsamt NRW in cooperation with TU Dortmund University. Using a deep convolutional network, the irradiation date can be predicted from raw time-resolved glow curve data with an uncertainty of roughly 1–2 days on a 68% confidence level without the need for a prior transformation into temperature space and a subsequent glow curve deconvolution (GCD). This corresponds to a significant improvement in prediction accuracy compared to a prior publication, which yielded a prediction uncertainty of 2–4 days using features obtained from a GCD as input to a neural network.