bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modeling the impact of the Omicron infection wave in Germany
Authors: Maier Benjamin F , Burdinski Angelique , Wiedermann Marc , Rose Annika H , Schlosser Frank , an der Heiden Matthias , Wichmann Ole , Harder Thomas , Brockmann Dirk 
Published: March 2023

Abstract
In November 2021, the first infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant of concern (VOC) B.1.1.529 (‘Omicron’) was reported in Germany, alongside global reports of reduced vaccine efficacy (VE) against infections with this variant. The potential threat posed by its rapid spread in Germany was, at the time, difficult to predict. We developed a variant-dependent population-averaged susceptible-exposed-infected-recovered infectious-disease model that included information about variant-specific and waning VEs based on empirical data available at the time. Compared to other approaches, our method aimed for minimal structural and computational complexity and therefore enabled us to respond to changes in the situation in a more agile manner while still being able to analyze the potential influence of (non-)pharmaceutical interventions (NPIs) on the emerging crisis. Thus, the model allowed us to estimate potential courses of upcoming infection waves in Germany, focusing on the corresponding burden on intensive care units (ICUs), the efficacy of contact reduction strategies, and the success of the booster vaccine rollout campaign. We expected a large cumulative number of infections with the VOC Omicron in Germany with ICU occupancy likely remaining below capacity, nevertheless, even without additional NPIs. The projected figures were in line with the actual Omicron waves that were subsequently observed in Germany with respective peaks occurring in mid-February and mid-March. Most surprisingly, our model showed that early, strict, and short contact reductions could have led to a strong ‘rebound’ effect with high incidences after the end of the respective NPIs, despite a potentially successful booster campaign. The results presented here informed legislation in Germany. The methodology developed in this study might be used to estimate the impact of future waves of COVID-19 or other infectious diseases.
Effect of different quilting techniques on seroma formation after breast surgery: retrospective study
Authors: van Zeelst Lotte J , van der Waal Dagmar C , Keemers-Gels Mariël E , van den Wildenberg Frits J H , Schlooz-Vries Margrethe S , Wijers Charlotte H W , de Wilt Johannes H W , Strobbe Luc J A 
Published: March 2023

Abstract

Background
Quilting, a technique in which skin flaps are sutured to the underlying muscle, reduces seroma after mastectomy and/or axillary lymph node dissection. The aim of this study was to assess the effect of different quilting techniques on the formation of clinically significant seroma.

Methods
This was a retrospective study including patients undergoing mastectomy and/or axillary lymph node dissection. Four breast surgeons applied the quilting technique based on their own discretion. Technique 1 was performed using Stratafix in 5–7 rows placed at 2–3 cm distance. Technique 2 was performed using Vicryl 2–0 in 4–8 rows placed at 1.5–2 cm distance. Technique 3 was performed using Vicryl 0/1 in 3 rows placed at 3–4 cm distance. Technique 4 was performed using Vicryl 0 in 4–5 rows placed at 1.5 cm distance. The primary outcome was clinically significant seroma.

Results
A total of 445 patients were included. Clinically significant seroma incidence was 4.1 per cent (six of 147) for technique 1, which was significantly lower than that for the other techniques (25.0 per cent (29 of 116), 29.4 per cent (32 of 109), and 33 per cent (24 of 73) for techniques 2, 3, and 4 (P &lt; 0.001) respectively). The duration of surgery was not significantly longer for technique 1 compared with the other three techniques. The length of hospital stay, number of additional visits to the outpatient clinic, and reoperations did not differ significantly between the four techniques.

Conclusion
Quilting using Stratafix and placing 5–7 rows with 2–3 cm distance between the stitches associates with low clinically significant seroma incidence without adverse effects.
Thalamocortical disconnection involved in pusher syndrome
Authors: Rosenzopf Hannah , Klingbeil Julian , Wawrzyniak Max , Röhrig Lisa , Sperber Christoph , Saur Dorothee , Karnath Hans-Otto 
Published: March 2023

Abstract
The presence of both isolated thalamic and isolated cortical lesions have been reported in the context of pusher syndrome—a disorder characterized by a disturbed perception of one’s own upright body posture, following unilateral left- or right-sided stroke. In recent times, indirect quantification of functional and structural disconnection increases the knowledge derived from focal brain lesions by inferring subsequent brain network damage from the respective lesion. We applied both measures to a sample of 124 stroke patients to investigate brain disconnection in pusher syndrome. Our results suggest a hub-like function of the posterior and lateral portions of the thalamus in the perception of one’s own postural upright. Lesion network symptom mapping investigating functional disconnection indicated cortical diaschisis in cerebellar, frontal, parietal and temporal areas in patients with thalamic lesions suffering from pusher syndrome, but there was no evidence for functional diaschisis in pusher patients with cortical stroke and no evidence for the convergence of thalamic and cortical lesions onto a common functional network. Structural disconnection mapping identified posterior thalamic disconnection to temporal, pre-, post- and paracentral regions. Fibre tracking between the thalamic and cortical pusher lesion hotspots indicated that in cortical lesions of patients with pusher syndrome, it is disconnectivity to the posterior thalamus caused by accompanying white matter damage, rather than the direct cortical lesions themselves, that lead to the emergence of pusher syndrome. Our analyses thus offer the first evidence for a direct thalamo-cortical (or cortico-thalamic) interconnection and, more importantly, shed light on the location of the respective thalamo-cortical disconnections. Pusher syndrome seems to be a consequence of direct damage or of disconnection of the posterior thalamus.
Exosome-transmitted miR-29a induces colorectal cancer metastasis by destroying the vascular endothelial barrier
Authors: Liu Keshu , Dou Rongzhang , Yang Chaogang , Di Ziyang , Shi Dongdong , Zhang Chunxiao , Song Jialin , Fang Yan , Huang Sihao , Xiang Zhenxian , Zhang Weisong , Wang Shuyi , Xiong Bin 
Published: March 2023

Abstract
Metastasis is the leading cause of colorectal cancer treatment failure and mortality. Communication between endothelium and tumor cells in the tumor microenvironment is required for cancer metastasis. Tumor-derived exosomes have been shown to increase vascular permeability by delivering microRNA (miRNA) to vascular endothelial cells, facilitating cancer metastasis. The mechanism by which Epithelial-mesenchymal transition (EMT) tumor cell-derived exosomes influence vascular permeability remains unknown. MicroRNA-29a (miR-29a) expression is up-regulated in colorectal cancer (CRC) tissues, which is clinically significant in metastasis. Exosomal miR-29a secreted by EMT-CRC cells has been found to decrease the expression of Zonula occlusion 1 (ZO-1), Claudin-5, and Occludin via targeting Kruppel-like factor 4 (KLF4). In vitro co-culture investigations further revealed that EMT-cancer cells release exosomal miR-29a, which alters vascular endothelial permeability. Furthermore, exosomal miR-29a promoted liver metastases in CRC mice. Our findings demonstrate that EMT-CRC cells may transport exosomal miR-29a to endothelial cells in the tumor microenvironment (TME). As a result, increased vascular permeability promotes the development and metastasis of CRC. Exosomal miR-29a has the potential to be a predictive marker for tumor metastasis as well as a viable therapeutic target for CRC.
Overfull: Too Large Aggregate Signatures Based on Lattices
Authors: Boudgoust Katharina , Roux-Langlois Adeline 
Published: March 2023

Abstract
The Fiat-Shamir with Aborts paradigm of Lyubashevsky has given rise to efficient lattice-based signature schemes. One popular implementation is Dilithium, which has been selected for standardization by the US National Institute of Standards and Technology (NIST). Informally, it can be seen as a lattice analog of the well-known discrete-logarithm-based Schnorr signature. An interesting research question is whether it is possible to combine several unrelated signatures, issued from different signing parties on different messages, into one single aggregated signature. Of course, its size should be significantly smaller than the trivial concatenation of all signatures. Ideally, the aggregation can be done offline by a third party, called public aggregation. Previous works have shown that it is possible to half-aggregate Schnorr signatures, but it was left open if the underlying techniques can be adapted to the lattice setting. In this work, we show that, indeed, we can use similar strategies to obtain a signature scheme allowing for public aggregation whose hardness is proven assuming the intractability of well-studied problems on module lattices. Unfortunately, our scheme produces aggregated signatures that are larger than the trivial solution of concatenating. This is due to peculiarities that seem inherent to lattice-based cryptography. Its motivation is thus mainly pedagogical.
Impact of frailty on the effectiveness and safety of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation: a nationwide cohort study
Authors: Grymonprez Maxim , Petrovic Mirko , De Backer Tine L , Steurbaut Stephane , Lahousse Lies 
Published: March 2023

Abstract

Aims
Data on non-vitamin K antagonist oral anticoagulants (NOACs) use in patients with atrial fibrillation (AF) and frailty are scarce. Therefore, the impact of frailty on AF-related outcomes and benefit–risk profiles of NOACs in patients with frailty were investigated.

Methods and results
AF patients initiating anticoagulation between 2013 and 2019 were included using Belgian nationwide data. Frailty was assessed with the Claims-based Frailty Indicator. Among 254 478 anticoagulated AF patients, 71 638 (28.2%) had frailty. Frailty was associated with higher all-cause mortality risks [adjusted hazard ratio (aHR) 1.48, 95% confidence interval (CI) (1.43–1.54)], but not with thromboembolism or bleeding. Among subjects with frailty (78 080 person-years of follow-up), NOACs were associated with lower risks of stroke or systemic embolism (stroke/SE) [aHR 0.77, 95%CI (0.70–0.86)], all-cause mortality [aHR 0.88, 95%CI (0.84–0.92)], and intracranial bleeding [aHR 0.78, 95%CI (0.66–0.91)], a similar major bleeding risk [aHR 1.01, 95%CI (0.93–1.09)], and higher gastrointestinal bleeding risk [aHR 1.19, 95%CI (1.06–1.33)] compared with VKAs. Major bleeding risks were lower with apixaban [aHR 0.84, 95%CI (0.76–0.93)], similar with edoxaban [aHR 0.91, 95%CI (0.73–1.14)], and higher with dabigatran [aHR 1.16, 95%CI (1.03–1.30)] and rivaroxaban [aHR 1.11, 95%CI (1.02–1.21)] compared with VKAs. Apixaban was associated with lower major bleeding risks compared with dabigatran [aHR 0.72, 95%CI (0.65–0.80)], rivaroxaban [aHR 0.78, 95%CI (0.72–0.84)] and edoxaban [aHR 0.74, 95%CI (0.65–0.84)], but mortality risk was higher compared with dabigatran and edoxaban.

Conclusion
Frailty was an independent risk factor of death. Non-vitamin K antagonist oral anticoagulants had better benefit–risk profiles than VKAs in patients with frailty, especially apixaban, followed by edoxaban.
Left atrial function and not volume predicts mid-to-late atrial fibrillation after mitral valve repair
Authors: van Kampen Antonia , Nagata Yasufumi , Huang Alex Lin-I , Mohan Navyatha , Dal-Bianco Jacob P , Hung Judy W , Borger Michael A , Levine Robert A , Sundt Thoralf M , Melnitchouk Serguei 
Published: March 2023

Abstract

OBJECTIVES
Patients undergoing surgical mitral valve repair (MVr) for degenerative mitral regurgitation are at risk of even late postoperative atrial fibrillation (AF). Left atrial (LA) function has been shown superior to LA volume in evaluating the risk of AF in diverse cardiac conditions. We therefore investigated the prognostic value of LA function and volume in predicting mid-to-late postoperative AF after MVr (&gt;30 days postoperatively).

METHODS
We retrospectively identified all patients who underwent MVr for degenerative mitral regurgitation between 2012 and 2019 at our institution. Exclusion criteria were preoperative AF, concomitant procedures, re-operations, missing or insufficiently processable preoperative echocardiograms and missing follow-up. LA function and volume measurements were conducted using speckle-tracking strain echocardiographic analysis. Postoperative LA function was measured in a subgroup with sufficient postoperative echocardiograms.

RESULTS
We included 251 patients, of whom 39 (15.5%) experienced AF in the mid-to-late postoperative period. Reduced LA strain parameters and more than mild preoperative tricuspid regurgitation were independently associated with mid-to-late postoperative AF. LA volume index had no association with mid-to-late postoperative AF in univariable analysis and did not improve the performance of multivariable models. Patients with mid-to-late AF exhibited diminished improvement in LA function after surgery.

CONCLUSIONS
In MVr patients, LA function (but not volume) showed independent predictive value for mid-to-late postoperative AF. Including LA function into surgical decision-making and approach may identify patients who will benefit from earlier intervention with the aim to prevent irreversible LA damage with consequent risk of postoperative AF.
Reduction in inappropriate therapies through device programming in subcutaneous implantable defibrillator patients: data from clinical practice
Authors: Rordorf Roberto , Viani Stefano , Biffi Mauro , Pieragnoli Paolo , Migliore Federico , D’Onofrio Antonio , Nigro Gerardo , Francia Pietro , Ferrari Paola , Dello Russo Antonio , Bisignani Antonio , Ottaviano Luca , Palmisano Pietro , Caravati Fabrizio , Pisanò Ennio , Pani Antonio , Botto Giovanni Luca , Lovecchio Mariolina , Valsecchi Sergio , Vicentini Alessandro 
Published: March 2023

Abstract

Aims
In subcutaneous implantable cardioverter defibrillator (S-ICD) recipients, the UNTOUCHED study demonstrated a very low inappropriate shock rate on programming a conditional zone between 200 and 250 bpm and a shock zone for arrhythmias &gt;250 bpm. The extent to which this programming approach is adopted in clinical practice is still unknown, as is its impact on the rates of inappropriate and appropriate therapies.

Methods and results
We assessed ICD programming on implantation and during follow-up in a cohort of 1468 consecutive S-ICD recipients in 56 Italian centres. We also measured the occurrence of inappropriate and appropriate shocks during follow-up. On implantation, the median programmed conditional zone cut-off was set to 200 bpm (IQR: 200–220) and the shock zone cut-off was 230 bpm (IQR: 210–250). During follow-up, the conditional zone cut-off rate was not significantly changed, while the shock zone cut-off was changed in 622 (42%) patients and the median value increased to 250 bpm (IQR: 230–250) (P &lt; 0.001). UNTOUCHED-like programming of detection cut-offs was adopted in 426 (29%) patients immediately after device implantation, and in 714 (49%, P &lt; 0.001) at the last follow-up. UNTOUCHED-like programming was independently associated with fewer inappropriate shocks (hazard ratio 0.50, 95%CI 0.25–0.98, P = 0.044), and had no impact on appropriate and ineffective shocks.

Conclusions
In recent years, S-ICD implanting centres have increasingly programmed high arrhythmia detection cut-off rates, at the time of implantation in the case of new S-ICD recipients, and during follow-up in the case of pre-existing implants. This has contributed significantly to reducing the incidence of inappropriate shocks in clinical practice.
Rordorf: Programming of the S-ICD

Clinical Trial Registration
URL: http://clinicaltrials.gov/Identifier: NCT02275637
Impact of peri-procedural management of direct oral anticoagulants on pocket haematoma after cardiac electronic device implantation: the StimAOD multicentre prospective study
Authors: Martin Anne-Céline , Weizman Orianne , Sellal Jean-Marc , Algalarrondo Vincent , Amara Walid , Bouzeman Abdeslam , Gandjbakhch Estelle , Lellouche Nicolas , Louembe Jules , Menet Aymeric , Roumegou Pierre , Treguer Frederic , Godier Anne , Boveda Serge , Garcia Rodrigue , Marijon Eloi 
Published: March 2023

Abstract

Aims
The study aims to investigate the impact of direct oral anticoagulant (DOAC) management on the incidence of pocket haematoma in patients undergoing pacemaker or implantable cardioverter–defibrillator implantation.

Methods and results
All consecutive patients receiving DOAC and undergoing cardiac electronic device implantation were included in a large multicentre prospective observational study (NCT 03879473). The primary endpoint was clinically relevant haematoma within 30 days after implantation. Overall, 789 patients were enrolled [median age 80 (IQR 72–85) years old, 36.4% women, median CHA2DS2-VASc score 4 (IQR 0–8)], of which 632 (80.1%) received a pacemaker implantation. Antiplatelet therapy was combined with DOAC in 146 patients (18.5%). Direct oral anticoagulants (DOACs) were interrupted 52 (IQR 37–62) h before the procedure and resumed 31 (IQR 21–47) h later. Ninety-six percent of the patients had at least 12 h DOAC interruption before the procedure, and 78% had at least 12 h DOAC interruption after the procedure. Overall, anticoagulation was interrupted for 72 (IQR 48–96) h. Pre- or post-procedural heparin bridging was used in 8.2% and 3.9%, respectively. Timing of DOAC interruption of resumption was not associated with clinically relevant haematoma. Clinically relevant haematoma occurred in 26 patients (3.3%), and thromboembolic events occurred in 5 patients (0.6%).

Conclusion
In this large real-life registry where most patients had DOAC interruption, clinically relevant haematoma was rare. Despite DOAC interruption and high CHA2DS2-VASc score, thromboembolic events occurred seldomly, highlighting that bleeding exceeds thromboembolic risk in this peri-procedural period. Future research is needed to identify risk factors for clinically relevant haematoma and meaningfully guide clinicians in optimizing DOAC management.
Twenty-year experience of atrial fibrillation ablation: a single-centre cohort study
Authors: Bottoni Nicola , Quartieri Fabio , Iori Matteo , Battista Antonella , Navazio Alessandro , Brignole Michele 
Published: March 2023

Abstract

Aims
While several studies in the literature have reported results of catheter ablation of AF, few is known regarding outcome for more than 10 years.

Methods and results
The complete population of patients who underwent AF ablation in the years 2002–2021 in the department of cardiology of the hospital of Reggio Emilia has been analysed. The last follow-up was made in the second half of 2022. During this period the technique of ablation remained relatively unchanged as well the physicians performing ablation. Primary endpoint was the recurrence of symptomatic AF, defined as AF that caused symptoms that were defined by the patient as able to alter their quality of life. 669 patients underwent catheter ablation and 618 were followed until 2022. Median age of the patients was 58 ± 9 years and 521 (78%) were male. There were 407 (61%) of patients with paroxysmal AF, 167 (25%) with persistent AF and 95 (14%) with long-lasting AF. A total of 838 procedures were performed, with a mean of 1.25 per patient. 163 (26%) patients had 2 procedures and 6 had 3 ablations. Periprocedural complications occurred in 4.8% of procedures. Follow-up data were available for 618 patients (92.4%). The median follow-up duration was 6.6 years (IQR 3.2–10.8). The estimated recurrence rate of symptomatic AF was 26% at 10 years, 54% at 15 years and 82% at 20 years. The recurrence rate was similar in patients who had performed one procedure and in those who had performed 2 or 3 procedures. Progression to permanent AF occurred in 112 patients (18%). The major events that occurred during the follow-up consisted of total mortality in 4.5%, heart failure in 3.1% and TIA/stroke in 2.4%.

Conclusion
Symptomatic AF tends to recur during long-term follow-up despite one or more procedures. Catheter ablation seems able to reduce the rate of symptomatic recurrences and to delay the time of their occurrence. These findings are consistent with the knowledge that an age-dependent progressive structural atriomiopathy is the basis for the development of AF.
Phenotypic plasticity under the effects of multiple environmental variables
Authors: Hudak Abigail , Dybdahl Mark 
Published: March 2023

Abstract
Organisms exposed to major environmental change face atypical and stressful conditions across multiple environmental variables, yet studies of phenotypically plastic responses historically focus on one environmental variable at a time. Evaluating multivariate plasticity of traits across different, simultaneously varying environmental variables provides new insights into the fate of populations amidst environmental changes. We aimed to investigate plasticity in multivariate environments by (a) examining the individual and joint effects of two environmental variables and (b) calculating genotype-by-environment interactions and genetic correlations of character states to investigate potential evolutionary constraints. We performed a lab controlled-environment experiment under a full factorial design of low and high temperatures and salinities with multiple maternal lineages of a parthenogenetic freshwater snail, Potamopyrgus antipodarum. Our results revealed that predictions of plastic trait responses among multivariate environments may be unexpected due to nonadditive effects of environmental variables and varying magnitudes and orientations of genetic correlations among fitness-related traits. Considering multivariate environments provides deeper insight and advancement of understanding trait evolution by revealing trait patterns that would otherwise be missed in univariate studies.
Contribution of the capsular polysaccharide layer to antibiotic resistance in bifidobacteria
Authors: Argentini Chiara , Tarracchini Chiara , Alessandri Giulia , Longhi Giulia , Milani Christian , van Sinderen Douwe , Ventura Marco , Turroni Francesca 
Published: March 2023

AbstractBifidobacteria have been shown to produce exopolysaccharides (EPS), which are polymeric structures composed of various carbohydrates, commonly containing glucose, galactose, and rhamnose. EPS are produced by different bifidobacterial taxa commonly identified in the human gut, such as Bifidobacterium breve and Bifidobacterium longum subsp. longum, and have been suggested to modulate the interaction of bifidobacterial cells with other members of the human gut microbiota as well as with their host. In this study, we evaluated if bifidobacterial EPS production of four selected EPS-producing strains is associated with enhanced resistance to antibiotic treatments through MIC analysis when compared to bacterial cultures that do not produce exopolysaccharides. Our results showed that an increase in EPS production by modifying the growth medium with different carbon sources, i.e. glucose, galactose or lactose and/or by applying stressful conditions, such as bile salts and acidity, is associated with a tolerance enhancement of bifidobacterial cells toward various beta-lactam antibiotics. In addition, after analyzing the production of EPS at the phenotypic level, we explored the genes involved in the production of these structures and evaluated their expression, in presence of various carbon sources, using RNAseq. Overall, this study provides preliminary experimental evidence showing how bifidobacterial EPS modifies the level of susceptibility of these bacteria towards antibiotics.