bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoluminal Surgery and Next Steps
Authors: Ozgur Ilker , Gorgun Emre 
Published: January 2023

AbstractThe expansion of colorectal cancer screening programs predicts a remarkable increase in rectal cancer diagnosis and nonmalignant polyps. While most polyps are managed endoscopically, many patients are referred to surgery. Over 30 thousand patients with colon polyps undergo surgical resection annually in the United States. Most of these surgical resections typically report benign pathology but end up with organ loss. Such organ resections may enclose significant morbidity and mortality rates. On the other hand, advanced endoscopic interventions have significantly evolved and are gaining popularity due to claiming organ preservation with low morbidity and mortality. These procedures have the potential to develop further and, in no doubt, are becoming standard of care. There are recent articles reporting successful and feasible initial incorporation of robotic systems for submucosal dissection procedures. These developments confirm that endorobotic submucosal dissection and endorobotic surgery may soon become a reality for colorectal lesions. This article aims to discuss endoluminal surgery for colorectal lesions and future directions.
Dry sliding wear response of aluminium matrix composites (AMCs): a critical review
Authors: Pateriya Ambuj , Pradhan Mohan Kumar 
Published: January 2023

Abstract
Researchers were compelled to create composites as alternatives to the already used engineering materials due to the industrial desire for fresh, promising materials with superior mechanical and tribological properties. Due to their superior characteristics, aluminium matrix composites (AMCs) with the appropriate class of particulate/particle reinforcements have been shown to have a wide range of tribological applications. A thorough evaluation of the sliding wear response of aluminium matrix composites (AMCs) in a dry environment using a pin-on-disc wear tester has been attempted in this review study. A discussion regarding wear performance of Al monolithic alloy and its composites has been made with respect to varying process parameters (e.g. normal load, sliding distance, and speed) and the concentration of different particle reinforcements incorporated in the production of aluminium matrix composites. The existing paper provides a synergic presentation of the effects of various intrinsic and extrinsic variables on wear characteristics, leading to the novelty and uniqueness of this review article.
Interface engineering of an electrospun nanofiber-based composite cathode for intermediate-temperature solid oxide fuel cells
Authors: Kim Seo Ju , Woo Deokyoon , Kim Donguk , Lee Tae Kyeong , Lee Jaeyeob , Lee Wonyoung 
Published: January 2023

Abstract
Sluggish oxygen reduction reaction (ORR) kinetics are a major obstacle to developing intermediate-temperature solid-oxide fuel cells (IT-SOFCs). In particular, engineering the anion defect concentration at an interface between the cathode and electrolyte is important for facilitating ORR kinetics and hence improving the electrochemical performance. We developed the yttria-stabilized zirconia (YSZ) nanofiber (NF)-based composite cathode, where the oxygen vacancy concentration is controlled by varying the dopant cation (Y2O3) ratio in the YSZ NFs. The composite cathode with the optimized oxygen vacancy concentration exhibits maximum power densities of 2.66 and 1.51 W cm−2 at 700 and 600 °C, respectively, with excellent thermal stability at 700 °C over 500 h under 1.0 A cm−2. Electrochemical impedance spectroscopy and distribution of relaxation time analysis revealed that the high oxygen vacancy concentration in the NF-based scaffold facilitates the charge transfer and incorporation reaction occurred at the interfaces between the cathode and electrolyte. Our results demonstrate the high feasibility and potential of interface engineering for achieving IT-SOFCs with higher performance and stability.
The Geography of Nonviolence
Authors: Slate Nico 
Published: January 2023

Abstract
In the summer of 1954, the Highlander Folk School, a racially integrated institution located in the hills of Tennessee, hosted a series of workshops on the United Nations. Highlander’s UN workshops cultivated a grassroots globalism that aimed to connect the UN to local action on behalf of racial integration. Yet while the workshops helped raise awareness about the work of the UN, they failed to directly link such global awareness to local action and instead revealed the danger that a certain kind of global optimism would lead to local apathy. By contrast, Highlander’s radical integrationism, by challenging the borders of race, opened a space for other kinds of border crossing, particularly in regard to nonviolent civil disobedience. Audio recordings of Highlander’s workshops provide a rare perspective on the geography of nonviolence. By revealing the geographic imagination of local activists, these tapes allow us to reconceive the transnational history of the American civil rights movement as a grassroots endeavor.
307 The study design of a trial of dupilumab in adult patients with bullous pemphigoid (BP): LIBERTY-BP ADEPT
Authors: Murrell Dedee F , Joly Pascal , Werth Victoria P , Laws Elizabeth , Mannent Leda P , Beazley Bethany , Dubost-Brama Ariane , Shabbir Arsalan 
Published: January 2023

Abstract
BP is a rare autoimmune skin-blistering disorder with a profound negative impact on quality of life, associated with burdensome morbidity and possible mortality. There is a need for effective targeted therapies with a demonstrated safety profile for BP. Dupilumab is a fully human monoclonal antibody that blocks the shared receptor component for interleukin (IL)-4 and IL-13, key and central drivers of type 2 inflammation that may play a role in BP. Published case series describes the use of dupilumab in patients with BP, but it has not been formally assessed in a clinical trial for BP. We describe the design of the LIBERTY-BP ADEPT trial (NCT04206553) that aims to investigate the efficacy and safety of dupilumab in achieving sustained remission off oral corticosteroids (OCS) in patients with moderate-to-severe BP. LIBERTY-BP ADEPT is a global, randomized, double-blind, placebo-controlled, parallel-group study consisting of a 35-day screening period, a 52-week double-blind treatment period and a 12-week follow-up period. Inclusion criteria include age 18–90 years and clinical features of BP with a confirmed diagnosis based on histopathology, immunopathology, and serology. Exclusion criteria include previous treatment with IL-4 or IL-13 antagonists or systemic or medium-to-high potency topical corticosteroids within 7 days of the baseline visit. All patients receive standard OCS to control disease activity at the start of the treatment period. Post randomization, after 2 weeks of sustained remission, OCS is to be gradually tapered and discontinued as long as disease control is maintained. The primary endpoint is the proportion of patients achieving sustained remission at week 36. Key secondary endpoints include total cumulative OCS dose, percent change in weekly average daily Peak Pruritus Numerical Rating Scale (NRS) score, and proportion of patients with improved daily Peak Pruritus NRS score ≥4 from baseline to week 36. LIBERTY-BP ADEPT aims to enroll 98 patients; enrollment is ongoing and will include more than 17 sites in Europe. BP shares pathophysiological pathways with type 2 inflammatory diseases mediated by IL-4 and IL-13. The ongoing LIBERTY-BP ADEPT study is the first randomized, controlled trial designed to evaluate the efficacy and safety of dupilumab in patients with moderate-to-severe BP.
Plasma amyloid-β42/40 and apolipoprotein E for amyloid PET pre-screening in secondary prevention trials of Alzheimer’s disease
Authors: Cullen Nicholas C , Janelidze Shorena , Stomrud Erik , Bateman Randall J , Palmqvist Sebastian , Hansson Oskar , Mattsson-Carlgren Niklas 
Published: January 2023

AbstractThe extent to which newly developed blood-based biomarkers could reduce screening costs in secondary prevention trials of Alzheimer’s disease is mostly unexplored. We collected plasma amyloid-β42/40, apolipoprotein E ε4 status and amyloid PET at baseline in 181 cognitively unimpaired participants [the age of 72.9 (5.3) years; 61.9% female; education of 11.9 (3.4) years] from the Swedish BioFINDER-1 study. We tested whether a model predicting amyloid PET status from plasma amyloid-β42/40, apolipoprotein E status and age (combined) reduced cost of recruiting amyloid PET + cognitively unimpaired participants into a theoretical trial. We found that the percentage of cognitively unimpaired participants with an amyloid PET + scan rose from 29% in an unscreened population to 64% [(49, 79); P &lt; 0.0001] when using the biomarker model to screen for high risk for amyloid PET + status. In simulations, plasma screening also resulted in a 54% reduction of the total number of amyloid PET scans required and reduced total recruitment costs by 43% [(31, 56), P &lt; 0.001] compared to no pre-screening when assuming a 16× PET-to-plasma cost ratio. Total savings remained significant when the PET-to-plasma cost ratio was assumed to be 8× or 4×. This suggests that a simple plasma biomarker model could lower recruitment costs in Alzheimer’s trials requiring amyloid PET positivity for inclusion.
The use of hatch score for the prediction of post operative atrial fibrillation (poaf) after coronary artery bypass graft: a meta-analysis
Authors: Ramos O S 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background and Aims
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in post-cardiac surgery. It is associated with substantial morbidity and mortality, thus portending a significant burden to patients and the health economy. A HATCH score is a handy tool in predicting new onset atrial fibrillation which consists of (Hypertension &lt;1 point&gt;, Age &gt;75 years old &lt;1 point&gt;, transient ischemic attack or stroke &lt;2 points&gt;, chronic obstructive pulmonary disease [COPD] &lt;1 point&gt;, and heart failure &lt;2 points&gt;. In this study, the authors aimed to determine the role of HATCH score in predicting the occurrence of post-operative atrial fibrillation (PoAF) who had undergone coronary artery bypass graft surgery.

Methods
We conducted a systematic review and meta-analysis of three studies. The study included patients undergoing cardiac surgery and using HATCH score as a predicting tool for post-operative atrial fibrillation.

Results
A total of 3 trials eligible for inclusion in our systematic review, giving a total of 908 participants. All three trials used the HATCH score to predict PoAF. The study was done retrospectively. The pooled RR’s showed an important risk for PoAF in patients with a HATCH score of 2 or more, indicating an approximately 2-fold greater risk (RR: 2.86 [95% CI 2.27-3.59], p = 0.00001.

Conclusion
This study investigated the development of PoAF with reference to the HATCH score. The study demonstrated a correlation of having a high HATCH score and PoAF who had undergone coronary artery bypass surgery.
Implementation of point-of-care INR testing to improve effectiveness of anticoagulation clinic
Authors: Mohammad I N 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Oral Vitamin K antagonist (VKA) is still widely used for anticoagulation. Anticoagulation clinics are set up to monitor patients’ INR and adjust their VKA doses accordingly. Anticoagulation clinic in our centre introduced point-of-care (POC) INR testing in June 2021 to improve the effectiveness of the clinic.

Purpose
This audit was done to evaluate the effectiveness of anticoagulation since the introduction of the POC INR test into the clinic workflow.

Methods
This was a retrospective, cross-sectional, cohort audit study. The study period was from 1st June 2021 to 31st July 2022. List of patients who attended the clinic from 1st – 31st January 2022 was taken from the clinic log and their electronic medical records were reviewed for the study period. Only patients who have been established on VKA for at least 3 months were included in the audit. The data collected included their basic demographics, indication for VKA, any complications / death during the study period and if their VKA had been stopped and why and serial INRs from the POC INR test during the study period. The time in therapeutic range (TTR) is calculated by Rosendaal method and all the results analysed on Microsoft Excel. The audit standard for safe and effective anticoagulation was a TTR ≥ 70%. Results were compared to an audit done previously for the centre’s anticoagulation clinic done in 2020.

Results
207 patients were included in this audit. Male patients accounted for 53.6% of the study population. Their ages ranged from 22 years to 102 years with a median age of 67 years. Majority of the patients were on VKA as stroke prevention for their atrial fibrillation (AF) (79.7%), followed by metallic valve replacement (13%). The median TTR for patients with AF had improved from 40.8% in 2020 to 51.05% in 2020-21 study period and this difference is significant (p = 0.017). Patients getting effective anticoagulation also improved from 23.26% in 2020 to 26.79% during this audit period. 13% of the study population developed complications on VKA in which 2.9% of patients developed gastrointestinal bleed and 1% developed intracranial haemorrhage. There were 4 fatalities, none were from gastrointestinal bleeding, intracranial haemorrhage or stroke. 10% of patients had their VKA changed to a novel oral anticoagulant (NOAC) as they were identified to have poor TTR during clinic review.

Conclusions
The introduction of POC INR test has proven to make significant improvement in patient’s median TTR for patients with AF. However, more efforts need to be made to further improve effectiveness of anticoagulation in our patients such as converting them to a NOAC if eligible or more thorough counselling and more frequent INR checks.
Characteristics and outcomes of patients presenting with out of hospital cardiac arrest to a regional hospital
Authors: Sklavos T , Nguyen S , Sutcliffe S 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Out of hospital cardiac arrest (OHCA) carries a high rate of mortality and can be due to cardiac or non-cardiac causes. We reviewed consecutive patients presenting with OHCA to the emergency department of a regional hospital in Australia, between January 2019 and March 2022. Medical records were reviewed to assess presenting rhythm, final diagnosis, risk factors known at time of presentation, results of cardiac investigations and survival to hospital discharge.

Results
Over the study period, 107 patients presented with cardiac arrest, with an average age of 67 years (range 29 to 95 years). Most patients were male (70, 67%), although in those with a non-cardiac cause identified only 53% were male. An underlying cardiac cause was identified in 50 (47%), a non-cardiac cause was identified in 18 (17%), and 39 (36%) had no identifiable cause. The most common cardiac causes were ST-elevation myocardial infarction (18, 36%), followed by non-ischaemic cardiomyopathy (9, 18%) and scar-related arrhythmia (7, 14%). Overall, ischaemic heart disease was responsible for 31 (62%) cases. Coronary angiography was performed in 36 (72%) of cardiac cases. Those who were diagnosed with ST-elevation myocardial infarction had an average time from presentation to coronary angiography of 61 minutes while the average was 38 hours for all patients presenting with OHCA. The most common presenting rhythm was ventricular fibrillation (39, 38%). The overall mortality rate was 61% for all OHCA. Among those with a cardiac cause, a non-cardiac cause or no cause identified for the OHCA, the mortality rates were 32%, 87% and 87% respectively. Data published by the regional Ambulance Service show that the survival to discharge from hospital of 39% in our regional hospital is comparable with state-wide outcomes.

Discussion
These data reflect the significant mortality and wide spectrum of disease underlying OHCA, and thus the challenge of managing patients presenting with OHCA. Cardiac disease accounts for almost half of all cases of OHCA, and also encompasses a wide spectrum of disease. However, the mortality in patients with OHCA due to an underlying cardiac cause, while still significant, is better than those patients in whom no cardiac cause is identified.
HbA1c variability is associated with adverse outcomes in heart failure patients with and without diabetes
Authors: Xu X , Ren Q W , Yiu K H 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Glycemic control is an important clinical issue in the management of patients with heart failure (HF). Variability of Glycated hemoglobin A1c (HbA1c) has been proven to be a predictor of cardiovascular events. However, previous studies mainly focused on general population and patients with coronary artery disease, while less is known about the effect of long-term HbA1c variability on clinical outcomes in HF patients.

Purpose
To evaluate the association of HbA1c variability and the risk of all-cause mortality and rehospitalization in patients with HF irrespective of their diabetic status.

Methods
By using the data from the well-validated Clinical Data Analysis Reporting System (CDARS), HF patients from 2003-2020 who had more than 3 times HbA1c measurements after the diagnosis of HF were included (N=65950, mean age was 66.5±12.0 years and 39409 (52.9%) were male). Average successive variability (ASV) ( average absolute difference between successive values), standard deviation (SD) of HbA1c were calculated. Hazard ratio (HR) of all-cause mortality and HF rehospitalization were estimated using competing risk regression with Cox proportional-hazard model.

Results
During a median follow-up of 7.2 years, 52446 (79.5%) patients developed HF rehospitalization and 34508 (52.3%) died. After adjusting for confounders, each unit change of HbA1c ASV or SD was significantly associated with higher risk of all-cause mortality, as well as higher risk of HF-rehospitalization (Figure 1). Among the study population, 48673 (73.8%) was diabetic while the remaining 17277 (26.2%) were non-diabetic. Interestingly, HbA1c variability had a stronger impact to non-diabetic compared to diabetic patients (P for interaction &lt;0.001) in predicting all-cause mortality and HF rehospitalization (Table 1).

Conclusion
In patients with HF, a greater HbA1c variability was associated with an increased risk of HF rehospitalization and all-cause mortality. Such effect was stronger in non-diabetic compared with diabetic. HbA1c variability, irrespective of baseline diabetic status, should be evaluated in HF patients for better risk-stratification.
Efficacy of sodium glucose cotransporter 2 inhibitors for heart failure with preserved and mildly reduced ejection fraction: a systematic review and meta-analysis
Authors: Cordovez R A B , Rivera K A , Denila R W , Patricio M D 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
SGLT2 inhibition has been a breakthrough approach in the treatment for heart failure. A most recent trial of Dapagliflozin has shown its robust benefit in patients with HFpEF and HFmrEF. However, the positive outcomes of other SGLT2i have yet to be elucidated to establish its class effect.

Purpose
We evaluated the cardiovascular outcomes of SGLT2i for HFpEF and HFmrEF.

Methods
Randomized controlled trials on SGLT2i versus placebo in patients with left ventricular ejection fraction of more than 40% reporting CV outcomes were searched using Pubmed, CENTRAL, and ScienceDirect. Primary outcome was the composite of hospitalization for heart failure or CV death. Secondary outcomes were the individual HHF, CV death, as well as all-cause mortality. Pooled hazard ratios with 95% confidence intervals were used as effect estimates using fixed-effects model.

Results
Seven studies were included with a total of 16,713 patients. In the combined HFmrEF and HFpEF population, there was a significant reduction in composite of cardiovascular death and heart failure hospitalization in the SGLT2i group (HR 0.80, 95% CI 0.74-0.87, p&lt;0.00001) compared to placebo, driven by a significant reduction in heart failure hospitalization (HR 0.75, 95% CI 0.68-0.83, p&lt; 0.00001). In the distinct HFpEF population, there was a significant reduction in composite of cardiovascular death and heart failure hospitalization in the SGLT2i group (HR 0.77, 95% CI 0.67-0.87, p&lt;0.0001) compared to placebo.

Conclusion
SGLT2i provides significant risk reduction in HF hospitalization or CV death among patients with HFpEF compared to placebo.
Key comorbidities and laboratory findings: insights from first prospective, observational and Multi-Center Malaysia Heart Failure (MYHF) registry
Authors: Mohd Ghazi A , Abdul Ghapar A K , Abdul Malek A M , Ross N T , Zainal Abidin I , Mat Lawi F , Foo Y W , Mahadevan G , Muthusamy T S , Queck G T , Cham Y L , Abdul Wahab M J , Mohamed M S , Zainal Abidin S K , Wan Ahmad W A 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Novartis Corporation Sdn Bhd

Background
In real world settings, factors that may affect prognosis of HF patients include comorbidities, lack of guideline-directed medical therapies (GDMT) and laboratory findings in particular elevated cardiac biomarkers.

Purpose
This report aimed to provide insights into these important clinical characteristics in hospitalized HF patients.

Methods
MYHF registry is a prospective, observational study of symptomatic HF patients (NYHA II-IV) hospitalized in 18 tertiary care centers in Malaysia over a period of 3 years starting in 2019. The key comorbidities, GDMT and natriuretic peptides (NP) utilization in hospitalized HF patients enrolled in MYHF Registry will be analyzed.

Results
A total of 2,717 patients, mean age 60.17 years (SD 13.62) and predominantly males (66.8%) were recruited. Mean left ventricular ejection fraction (LVEF) was 36.5% (SD 15.3); with 64.6% HFrEF (LVEF ≤40%), 21.6% HFpEF (LVEF ≥50%) and 11.3% HFmrEF (LVEF 41-49%). Hypertension was the most common comorbidity (71.5%), followed by diabetes (59.8%), ischemic heart disease (55.9%), dyslipidemia (46.6%) and chronic kidney disease (30.9%). At admission, mean SBP was 137.6 mmHg (SD 29), with 5.9% and 42.6% of patients with SBP &lt; 100 mmHg and ≥ 140 mmHg, respectively. Mean HbA1c value was 7.56% (SD 2.0). Mean total cholesterol and LDL-C were 4.30 mmol/L (SD 1.66) and 2.62 mmol/L (SD 1.34), respectively. At admission, mean serum creatinine was 145.76 umol/L (SD 119.64) and 1 out of 2 patients (55.1%) had eGFR &lt;60 mL/min/1.73 m2. Utilization of natriuretic peptide as biomarker was low (16.5%), with NTproBNP being more commonly used (81.5%). Half (49.2%) of patients with NT-proBNP measured had values &gt;=5000 pg/ml. Hospitalization has been known to provide good opportunity for GDMT optimization. Although about two third (59.2%) of patients in this registry had previous history of heart failure hospitalization, only 33.7% of patients were on dual GDMT (ACEi/ARB/ARNI +BB) and 1 out of 10 (13.5%) were on triple GDMT (ACEi/ARB/ARNI+BB+MRA) during admission.

Conclusions
Hospitalized HF patients in MYHF registry are generally young, with high prevalence of co-morbidities, worse laboratory findings and had under-utilization of GDMT. The knowledge gained will be crucial for guiding management of HF patients to improve the prognosis.