bluuebunny/crossref_metadata_2025_split huggingface dataset:
A review on bovine hydroxyapatite; extraction and characterization
Authors: Moradi Ali , Pakizeh Majid , Ghassemi Toktam 
Published: December 2021

AbstractHigh rate of bone grafting surgeries emphasizes the need for optimal bone substitutes. Biomaterials mimicking the interconnected porous structure of the original bone with osteoconductive and osteoinductive capabilities have long been considered. Hydroxyapatite (HA), as the main inorganic part of natural bone, has exhibited excellent regenerative properties in bone tissue engineering. This manuscript reviews the HA extraction methods from bovine bone, as one of the principal biosources. Essential points in the extraction process have also been highlighted. Characterization of the produced HA through gold standard methods such as XRD, FTIR, electron microscopies (SEM and TEM), mechanical/thermodynamic tests, and bioactivity analysis has been explained in detail. Finally, future perspectives for development of HA constructs are mentioned.
Multi-layer structure formation of relativistic electron beams in plasmas
Authors: WANG Xiaojuan , HU Zhanghu , WANG Younian 
Published: December 2021

Abstract
A two-dimensional electromagnetic particle-in-cell simulation model is proposed to study the density evolution and collective stopping of electron beams in background plasmas. We show here the formation of the multi-layer structure of the relativistic electron beam in the plasma due to the different betatron frequency from the beam front to the beam tail. Meanwhile, the nonuniformity of the longitudinal wakefield is the essential reason for the multi-layer structure formation in beam phase space. The influences of beam parameters (beam radius and transverse density profile) on the formation of the multi-layer structure and collective stopping in background plasmas are also considered.
On absolute weighted arithmetic mean summability of infinite series and Fourier series
Authors: Bor Hüseyi̇n 
Published: December 2021

Quite recently, we have obtained two main theorems dealing with absolute weighted arithmetic mean summability factors of infinite series and trigonometric Fourier series [C. R. Math. Acad. Sci. Paris 359 (2021), pp. 323–328]. In this paper, we have generalized these theorems for a general summability method. We have also obtained some new and known results for certain absolute summability methods.
Evaluating replicability in microbiome data
Authors: Clausen David S , Willis Amy D 
Published: December 2021

SummaryHigh-throughput sequencing is widely used to study microbial communities. However, choice of laboratory protocol is known to affect the resulting microbiome data, which has an unquantified impact on many comparisons between communities of scientific interest. We propose a novel approach to evaluating replicability in high-dimensional data and apply it to assess the cross-laboratory replicability of signals in microbiome data using the Microbiome Quality Control Project data set. We learn distinctions between samples as measured by a single laboratory and evaluate whether the same distinctions hold in data produced by other laboratories. While most sequencing laboratories can consistently distinguish between samples (median correct classification 87% on genus-level proportion data), these distinctions frequently fail to hold in data from other laboratories (median correct classification 55% across laboratory on genus-level proportion data). As identical samples processed by different laboratories generate substantively different quantitative results, we conclude that 16S sequencing does not reliably resolve differences in human microbiome samples. However, because we observe greater replicability under certain data transformations, our results inform the analysis of microbiome data.
Impact of enhanced recovery protocols after pancreatoduodenectomy: meta-analysis
Authors: Kuemmerli Christoph , Tschuor Christoph , Kasai Meidai , Alseidi Adnan A , Balzano Gianpaolo , Bouwense Stefan , Braga Marco , Coolsen Mariëlle , Daniel Sara K , Dervenis Christos , Falconi Massimo , Hwang Dae Wook , Kagedan Daniel J , Kim Song Cheol , Lavu Harish , Liang Tingbo , Nussbaum Daniel , Partelli Stefano , Passeri Michael J , Pecorelli Nicolò , Pillai Sastha Ahanatha , Pillarisetty Venu G , Pucci Michael J , Su Wei , Sutcliffe Robert P , Tingstedt Bobby , van der Kolk Marion , Vrochides Dionisios , Wei Alice , Williamsson Caroline , Yeo Charles J , Zani Sabino , Zouros Efstratios , Abu Hilal Mohammed 
Published: December 2021

AbstractBackgroundThis individual-patient data meta-analysis investigated the effects of enhanced recovery after surgery (ERAS) protocols compared with conventional care on postoperative outcomes in patients undergoing pancreatoduodenectomy.MethodsThe Cochrane Library, MEDLINE, Embase, Scopus, and Web of Science were searched systematically for articles reporting outcomes of ERAS after pancreatoduodenectomy published up to August 2020. Comparative studies were included. Main outcomes were postoperative functional recovery elements, postoperative morbidity, duration of hospital stay, and readmission.ResultsIndividual-patient data were obtained from 17 of 31 eligible studies comprising 3108 patients. Time to liquid (mean difference (MD) −3.23 (95 per cent c.i. −4.62 to −1.85) days; P &lt; 0.001) and solid (−3.84 (−5.09 to −2.60) days; P &lt; 0.001) intake, time to passage of first stool (MD −1.38 (−1.82 to −0.94) days; P &lt; 0.001) and time to removal of the nasogastric tube (3.03 (−4.87 to −1.18) days; P = 0.001) were reduced with ERAS. ERAS was associated with lower overall morbidity (risk difference (RD) −0.04, 95 per cent c.i. −0.08 to −0.01; P = 0.015), less delayed gastric emptying (RD −0.11, −0.22 to −0.01; P = 0.039) and a shorter duration of hospital stay (MD −2.33 (−2.98 to −1.69) days; P &lt; 0.001) without a higher readmission rate.ConclusionERAS improved postoperative outcome after pancreatoduodenectomy. Implementation should be encouraged.
245 Arrhythmogenic cardiomyopathy in children according to ‘padua criteria’: single paediatric centre experience
Authors: Cicenia Marianna , Cantarutti Nicoletta , Adorisio Rachele , Silvetti Massimo Stefano , Secinaro Aurelio , Ciancarella Paolo , Di Mambro Corrado , Magliozzi Monia , Novelli Antonio , Amodeo Antonio , Baban Anwar , Drago Fabrizio 
Published: December 2021

Abstract

Aims
Arrhythmogenic cardiomyopathy (ACM) is a rare disease in children. The purpose of this study is to describe the main features of our paediatric patients with ACM providing a contribution for diagnostic work-up and therapeutic decisions.

Methods and results
Eligibility criteria of the study was ACM diagnosed at age &lt;18 years old. We enrolled 21 patients (mean age at diagnosis 13.9 ± 2 years). Holter monitoring showed premature ventricular complexes (PVCs) burden of 7.9 ± 10% (range: 1–35%). Exercise testing showed suppression of PVCs during exercise in most patients (44.4%). Cardiac magnetic resonance was performed in 17/21 (81%) patients. Right ventricular (RV) dilatation, segmental wall motion abnormalities, and late gadolinium enhancement of both ventricles were the predominant features. Genetic results were available in 19/21 patients. 3/19 (15.8%) had compound heterozygous variants, 3/19 (15.8%) digenic variants, and 6/19 (31.6%) a single variant. EPS was performed in 15/21 (75%). Ventricular tachycardia was inducible in 3/15 (20%) and ventricular fibrillation occurred in 1/15 (6.7%). Implantable cardiac defibrillators (ICDs) were implanted in 15 patients (71.4%). ICD therapies were released in two patients during follow-up (2009–2021). No patients died suddenly.

Conclusions
Paediatric ACM can be diagnosed in the majority of cases secondary to: incidental finding of minor arrhythmias or due to positive family history. PVCs burden is not elevated and exercise-induced arrhythmias occur in a minority of patients. ICD may be indicated in most patients even if follow-up during the paediatric age can be reassuring. Multicentric observation is highly needed to derive conclusions in children.
536 Intraoperative predictors of long-term pacing threshold improvement in leadless pacemakers
Authors: Mitacchione Gianfranco , Schiavone Marco , Arabia Gianmarco , Salghetti Francesca , Cerini Manuel , Gasperetti Alessio , Viecca Murizio , Curnis Antonio , Forleo Giovanni 
Published: December 2021

Abstract

Aims
Micra-VR transcatheter pacing system (TPS) has shown strong stability of electrical parameters over time. Nevertheless, a small percentage of patients develops high pacing threshold (PT) (&gt;1 V@0.24 ms) which can decrease the longevity of battery. Our study sought to investigate the intraoperative electrical parameters able to predict device electrical performances during the time.

Methods and results
Patients (pts) implanted with Micra-VR TPS from March 2018 to January 2021 were prospectively considered at the Cardiology Department of Spedali Civili Hospital (Brescia) and Luigi Sacco Hospital (Milan). R-wave sensing amplitude (mV), pacing impedance (Ohm), and PT (V@0.24 ms) were recorded twice: upon Micra final positioning, and after removal of the delivery system. All pts received a follow-up visit at 1- and 12-month after discharge. Electrical parameters were recorded at each visit. A total of 93 pts underwent Micra-VR implantation were enrolled. When compared to the first assessment, R-wave amplitude increased of 19.1% at second control performed after 13 ± 4 min (+1.71 ± 0.2 mV, 95% CI: 1.4–2.02; P &lt; 0.001). Conversely, PT significantly decreased of 22.1% at 12-month follow-up respect to baseline (−0.22 ± 0.03 V, 95% CI: −0.13 to − 0.31; P &lt; 0.001) (Figure 1). Among patients with high PT, acute increase of R-wave sensing of 1.5 mV after 14 ± 4 min significantly predicted PT normalization (≤1 V@0.24 ms) 12 months post-implant (R = 0.72, 95% CI: 0.13–0.33, P &lt; 0.001) (Figure 2), with a sensitivity of 87.5% (95% CI: 0.61–0.98) and a specificity of 88.8% (95% CI: 0.51–0.99) (Figure 3).

Conclusions
A 1.5 mV increase in R-wave amplitude at implant time is predictive of PT normalization (&lt;1.0 V/0.24 ms) at 12-month FU. This finding may have practical implications for device repositioning in case of HPT at implant. This parameter could be considered for acute device repositioning, particularly in HPT patients.

536 Figure
679 Pharmacokinetics of direct oral anticoagulants in patient with atrial fibrillation and extreme obesity
Authors: Giannetti Laura , Pezzullo Enrica , D’Aquino Marco Malvezzi Caracciolo , Scognamiglio Gabriella , Parente Erika , Uccello Ambra , Fabiani Dario , Natale Francesco , Golino Paolo , Russo Vincenzo 
Published: December 2021

Abstract

Aims
Direct oral anticoagulants (DOACs) are recommended in preference to vitamin K antagonists (VKAs) for stroke prevention in patients with atrial fibrillation (AF) eligible for oral anticoagulation therapy; however, data and clinical experiences supporting the use of DOACs in patients with a body mass index ≥40 kg/m2 or weight &gt;120 kg remain limited. The aim of this study was to evaluate the pharmacokinetic properties of DOACs in patients with AF and extreme obesity.

Methods and results
We enrolled all consecutive patients with AF and extreme obesity undergoing treatment with DOACs followed up at Monaldi Hospital, Naples, Italy. To determine peak plasma and trough levels of DOACs, plasma samples were collected at 2nd, 4th, 6th, and 12th hours from the last dose intake in patients receiving apixaban and dabigatran and at the 2nd, 4th, 6th, and 24th hours in those receiving edoxaban and rivaroxaban. The DOACs’ peak and trough plasma levels obtained from our study population were compared with those sourced from pharmacokinetic studies among patients without obesity, defined as a normal reference range in the literature. If at least 1 peak or trough plasma level was found below or above the normal reference ranges, the patients were classified as having out-of-range DOAC plasma levels. Study population was then divided into in-range and out-of-range groups. Baseline characteristics, including DOAC treatment, were compared between the two groups. Univariate and multivariate logistic regression analyses were performed to identify baseline variables associated with DOACs’ plasma concentration out of the expected range. A total of 58 patients [mean (SD) age, 70.93 (8.73) years; 40% female] with extreme obesity [mean (SD) body mass index, 44.43 (3.54) kg/m2] and AF while undergoing DOAC treatment was included in the present study. In nine patients (15.5%), the DOAC plasma concentrations were out of the expected ranges (out-of-range group);, indicating a greater likelihood of edoxaban 30 mg treatment (33% vs. 2%; P &lt; 0.01) and inappropriate DOAC underdosing (56% vs. 4%; P &lt; 0.005) compared with the in-range group. According to the multivariate logistic analysis (P = 0.0011), the inappropriate DOAC underdosing (hazard ratio = 29.37; P = 0.0002) was an independent predictor of DOAC plasma levels out of the expected ranges.

Conclusions
Patients with extreme obesity and AF who were receiving DOAC therapy had DOAC plasma concentrations in the expected range. The inappropriate DOAC underdosing seems to be the only independent clinical factor associated with a plasma concentration of the drug out of the expected range.
629 CPVT and complete atrio-ventricular block: two faces of the same coin?
Authors: Petrungaro Mattia , Nesti Martina , Cavaretta Elena , Palamà Zefferino , Scarà Antonio , Martino Annamaria , Robles Antonio Gianluca , De Maio Melissa , Romano Silvio , Penco Maria , Calò Leonardo , Sciarra Luigi 
Published: December 2021

Abstract

Aims
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an electrical genetic disease characterized by induction of malignant ventricular arrhythmias during adrenergic stress in structurally normal hearts. CPVT is correlated to syncope or sudden cardiac death (SCD). Usually, it is caused by an autosomal dominant mutation in the cardiac ryanodine receptor (RyR2), an essential gene for Ca2+ homeostasis.

Methods and results
Our case series refers to: a man (59 years) who came to our attention for a clinical check-up 4 years after implanting bicameral pacemaker at the age of 55 years for complete AV block; and his three sons (E. female 27 years; D. male 25 years; and B. female 17 years) who had evidence of polymorphic non-sustained ventricular tachycardia (NSVT) with increasing effort during stress test. The three sons performed cardiac MRI and underwent genetic test. All three were found to be carriers of the same microdeletion of the RYR 2 gene (1q43- extended for about 49 kb) at the genetic test. They also have non-compacted myocardium at cardiac MRI. The father was also found to be a carrier of the same genetic microdeletion, while the mother was negative to the genetic test. The man was diagnosed to be a carrier of the mutation 4 years after pacemaker implantation.

Conclusions
Mutation of the RyR2 may have different phenotypic expressions and can be correlated to various clinical manifestations. CPVT is the most common one, and its prompt identification is crucial to prevent subjects from sport-related risks and to plan an efficient therapy. Our case series provides evidence for a careful consideration of such a genetic disorder even in presence of a major AV conduction disease in a relatively young subject. In the present case series, no major adverse events occurred. However, we can, in the aftermath, speculate that if a genetic disorder had been suspected when AV block occurred, a timely diagnosis could have been made earlier also for the sons.
211 Impact of smoking habits on baseline and on-treatment platelet reactivity in STEMI patients treated with third generation P2Y12
Authors: Canonico Mario Enrico , Scudiero Fernando , Sanna Giuseppe Damiano , Avvedimento Marisa , Leone Attilio , Saba Pier Sergio , Esposito Giovanni , Parodi Guido 
Published: December 2021

Abstract

Aims
Smoking habit is a well-known risk factor for cardiovascular disease. High on-treatment platelet reactivity has been associated with high risk of ischaemic events in STEMI patients. The relationship between platelet reactivity and smoking habit was investigated only in few studies, and the impact of smoke on platelet reactivity in STEMI patients treated with 3rd generation P2Y12 inhibitor is still lacking. This study aim to assess the impact of smoking habits on baseline and on-treatment platelet reactivity in STEMI patients treated with 3rd generation P2Y12 inhibitor.

Methods
Overall, 429 STEMI patients were enrolled in this study. Patients were divided into two groups according to smoking habit. Platelet reactivity was assessed by VerifyNow at baseline and after 3rd generation P2Y12 inhibitor (ticagrelor or prasugrel) loading dose (LD). Blood samples were obtained at baseline (T0), and after 1 h (T1), 2 h (T2), 4w6 h (T3) and 8–12 h (T4) after LD.

Results
The mean age of the enrolled population was 62 ± 12 and male rate was 75%. Patients with smoking habit were younger (75.8% vs. 38.9%, P &lt; 0.001 for age &lt;65 years), with higher prevalence of family history of CAD, while with a lower rate hypertension (43.4% vs. 65.9%, P &lt; 0.001) and previous myocardial infarction (5.3% vs. 11.4%, P = 0.022). Smoker patients had lower platelet reactivity either at baseline [T0: 249 (205–285) vs. 284 (230–324), P &lt; 0.001] or at 2 h after the LD [T2: 107 (18–279) vs. 136 (51–260), P = 0.003]. Similarly, Smoker patients experienced a lower rate of in-hospital composite adverse event of death, Re-infarction, stroke or acute kidney injury (1.6% vs. 12.4%; P≤0.001). Multivariate analysis demonstrated that left ventricular ejection fraction at admission (OR = 0.916, 95% CI 0.865–0.969; P = 0.002), and platelet reactivity at baseline (OR = 1.013, 95% CI 1.002–1.024; P = 0.024) were independent predictors of in-hospital composite adverse event.

Conclusions
Smoker status is associated with lower platelet reactivity either at baseline or after LD and with a better short-term prognosis in STEMI patients treated by dual antiplatelet therapy with ticagrelor or prasugrel.
745 Meta-analysis comparing the safety and efficacy of ticagrelor monotherapy after a short course of ticagrelor-based dual antiplatelet therapy versus standard therapy in complex percutaneous coronary interventions
Authors: Condello Francesco , Sturla Matteo , Terzi Riccardo , Polimeni Alberto , Stefanini Giulio 
Published: December 2021

Abstract

Aims
Current guidelines recommend dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor for 6–12 months after percutaneous coronary intervention (PCI). A shorter duration ticagrelor-based DAPT followed by ticagrelor monotherapy can significantly reduce bleeding events while preserving anti-ischaemic effects in patients undergoing conventional PCI. Whether this strategy can be safely and effectively applied to those patient that undergo ‘complex’ PCI is uncertain.

Methods
We performed a systematic search of randomized controlled trials comparing a short course of ticagrelor-based DAPT vs. standard DAPT in patients undergoing complex PCI. A mixed-effects Poisson regression model with random intervention effects was used to estimate the pooled incidence rate ratios (IRR) with 95% confidence intervals (CI).

Results
Out of 10 689 studies screened, three were identified for a total of 4176 participants on ticagrelor monotherapy after a short course of ticagrelor based DAPT, and 4209 on standard DAPT. Overall, the pooled analysis showed a strong evidence that compared to standard treatment, ticagrelor monotherapy after a short course of ticagrelor-based DAPT (1–3 months) reduced the risk of cardiovascular death [IRR 0.52; CI (0.28–0.96); P = 0.04; I2 = 0%], all-cause death [IRR 0.65; CI (0.49–0.86); P = 0.003; I2 = 0%], and any bleeding events [IRR 0.62; CI (0.47–0.81); P &lt; 0.001; I2 = 44%]. Weak evidence was found of an association between the experimental strategy and a lower risk of myocardial infarction [IRR 0.79; CI (0.61–1.01); P = 0.06; I2 = 0%]. Instead, no significant difference in the risk of major bleeding [IRR 0.72; CI (0.48–1.08); P = 0.11; I2 = 61%], definite or probable stent thrombosis [IRR 0.77; CI (0.34–1.75); P = 0.53; I2 = 0%] and ischaemic stroke [IRR 0.83; CI (0.25–2.73); P = 0.76; I2 = 0%] was observed. We speculate that the observed mortality benefits might be related to the reduction of any bleeding events, mainly dictated by minor bleeding reduction, since major bleeding did not seem to be decreased in the shorter regimen group.

Conclusion
Among patients undergoing complex PCI, ticagrelor monotherapy after a short course of ticagrelor-based DAPT significantly reduced bleeding risk without increasing ischaemic risk. As complex PCI procedures are being increasingly performed nowadays, and more comorbid patients are being treated, more studies are required to confirm and explain these findings. This could lead to optimization of antiplatelet therapy across a broad spectrum of patients.
244 Prevalence and clinical predictors of inappropriate direct oral anticoagulant dosage in octagenarians with atrial fibrillation
Authors: Carbone Andreina , Santelli Francesco , Bottino Roberta , Attena Emilio , Mazzone Carmine , Parisi Valentina , D'Andrea Antonello , Golino Paolo , Nigro Gerardo , Russo Vincenzo 
Published: December 2021

Abstract

Aims
Older age is associated with inappropriate dose prescription of direct oral anticoagulants. The aim of our study was to describe the prevalence and the clinical predictors of inappropriate DOACs dosage among octogenarians in real-world setting.

Methods
Data for this study were sourced from the multicentre prospectively maintained Atrial Fibrillation (AF) Research Database (NCT03760874). AF patients aged ≥80 who received DOACs treatment 253 patients were selected. Participants were categorized as appropriate dosage, overdosage, or underdosage. Underdosage and overdosage were respectively defined as administration of a lower or higher DOAC dose than recommended in the EHRA consensus.

Results
A total of 178 patients (71%) received appropriate DOACs dose and 75 patients (29%) inappropriate DOACs dose; among them 19 patients (25.6%) were overdosed and 56 (74.4%) were underdosed. Subgroup analysis demonstrated that underdosage was independently associated with male gender [OR = 3.15 (95% IC 1.45–6.83); P &lt; 0.01], coronary artery disease [OR = 3.6 (95% IC 1.41–9.1); P&lt; 0.01] and body mass index [OR = 1.27 (1.14–1.41); P &lt; 0.01]. Overdosage was independently associated with diabetes mellitus [OR = 18 (3.36–96); P &lt; 0.01], with age [OR = 0.76 (95% IC; 0.61–0.96); P &lt; 0.05], BMI [OR = 0.77 (0.11; 0.62–0.97); P &lt; 0.05] and with previous bleedings [OR = 6.4 (0.7; 1.43–28) P &lt; 0.05]. There wasn’t significant difference in thromboembolic, major bleeding events and mortality among different subgroups. Underdosage group showed a significatively lower survival compared with appropriate dose group (P &lt; 0.001).

Conclusion
In our analysis, nearly one-third of octogenarians with AF received an inappropriate dose of DOAC. Several clinical factors increased the risk of DOACs’ overdosage (diabetes mellitus Type II) or underdosage (male gender, coronary artery disease and higher body mass index). Octogenarians with inappropriate DOACs underdosage showed less survival.