bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are the nanobots nigh?
Authors: Moriarty Philip 
Published: December 2022

Abstract
This chapter describes the movie Star Trek’s replicator technology: a compact device that can conjure up virtually any material or object. In Star Trek, that raw material is pure energy and it is unclear how the energy-matter conversion process takes place, emphasizing the science fiction genre of the film. However, the chapter highlights a variety of synthetic nanostructures that resulted from raw chemical ingredients being broken down via chemical reactions. What is it about the replicator in Star Trek that makes it appear so ‘magical’ to 21st-century perspectives? For one, it is conjuring matter out of thin air and, second, the ‘on demand’ aspect of technology that seems other-worldly.
Combinations of Physical Activity, Sedentary Behavior, and Sleep Duration and Their Associations With Physical, Psychological, and Educational Outcomes in Children and Adolescents: A Systematic Review
Authors: Wilhite Katrina , Booker Bridget , Huang Bo-Huei , Antczak Devan , Corbett Lucy , Parker Philip , Noetel Michael , Rissel Chris , Lonsdale Chris , del Pozo Cruz Borja , Sanders Taren 
Published: December 2022

Abstract
We conducted a systematic review to evaluate combinations of physical activity, sedentary behavior, and sleep duration (defined as “movement behaviors”) and their associations with physical, psychological, and educational outcomes in children and adolescents. MEDLINE, CINAHL, PsychInfo, SPORTDiscus, PubMed, EMBASE, and ERIC were searched in June 2020. Included studies needed to 1) quantitatively analyze the association of 2 or more movement behaviors with an outcome, 2) analyze a population between 5 and 17 years of age, and 3) include at least an English abstract. We included 141 studies. Most studies included the combination of physical activity and sedentary behavior in their analyses. Sleep was studied less frequently. In combination, a high level of physical activity and a low level of sedentary behavior were associated with the best physical health, psychological health, and education-related outcomes. Sleep was often included in the combination that was associated with the most favorable outcomes. Sedentary behavior had a stronger influence in adolescents than in children and tended to be associated more negatively with outcomes when it was defined as screen time than when defined as overall time spent being sedentary. More initiatives and guidelines combining all 3 movement behaviors will provide benefit with regard to adiposity, cardiometabolic risk factors, cardiorespiratory fitness, muscular physical fitness, well-being, health-related quality of life, mental health, academic performance, and cognitive/executive function.
Functional reconstruction of the basal ganglia neural circuit by human striatal neurons in hypoxic–ischaemic injured brain
Authors: Ji Xiaoli , Zhou Yingying , Gao Qinqin , He Hui , Wu Ziyan , Feng Ban , Mei Yuting , Cheng Yan , Zhou Wenhao , Chen Yuejun , Xiong Man 
Published: December 2022

Abstract
Perinatal hypoxic–ischaemic encephalopathy is the leading cause of neonatal death and permanent neurological deficits, while the basal ganglia is one of the major nuclei that is selectively and greatly affected in the brains of hypoxic–ischaemic encephalopathy patients, especially in severe cases. Human embryonic stem cell-derived neurons have shown great potential in different types of brain disorders in adults. However, it remains unknown whether and how grafted human embryonic stem cell-derived neurons can repair immature brains with hypoxic–ischaemic encephalopathy.
Here, by administrating genetically labelled human embryonic stem cell-derived striatal neural progenitors into the ipsilateral striatum of hypoxic–ischaemic encephalopathy-injured mice, we found that the grafted cells gradually matured into GABA spiny projection neurons morphologically and electrophysiologically, and significantly rescued the area loss of hypoxic–ischaemic encephalopathy-injured brains. Intriguingly, using immunohistochemical staining combined with enhanced ascorbate peroxidase-based immunoelectron microscopy and rabies virus-mediated trans-synaptic tracing, we show that the grafts start to extend axonal projections to the endogenous target areas (globus pallidus externa, globus pallidus internus, substantia nigra), form synapses with host striatal, globus pallidus and nigra neurons, and receive extensive and stable synaptic inputs as early as 2 months post-transplantation. Importantly, we further demonstrated functional neural circuits re-established between the grafted neurons and host cortical, striatal and substantial nigra neurons at 3–6 months post-transplantation in the hypoxic–ischaemic encephalopathy-injured brain by optogenetics combined with electrophysiological recording. Finally, the transplanted striatal spiny projection neurons but not spinal GABA neurons restored the motor defects of hypoxic–ischaemic encephalopathy, which were reversed by clozapine-N-oxide-based inhibition of graft function.
These findings demonstrate anatomical and functional reconstruction of the basal ganglia neural circuit including multiple loops by striatal spiny projection neurons in hypoxic–ischaemic encephalopathy-injured immature brains, which raises the possibility of such a cell replacement therapeutic strategy for hypoxic–ischaemic encephalopathy in neonates.
The Impact of Sequestration on Artemisinin-Induced Parasite Clearance inPlasmodium falciparumMalaria in Africa
Authors: Fukuda Naoyuki , Balikagala Betty , Ueno Tsuyoshi , Anywar Denis A , Kimura Eisaku , Palacpac Nirianne Marie Q , Odongo-Aginya Emmanuel I , Ogwang Martin , Horii Toshihiro , Miida Takashi , Mita Toshihiro 
Published: December 2022

AbstractBackgroundArtemisinin-resistant Plasmodium falciparum is spreading in Southeast Asia and Africa. In vivo susceptibility to artemisinin is studied by looking at the rate of decline of peripheral parasitemia (parasite clearance half-life). However, parasites that are adhered/sequestered to the endothelium and undetectable in the peripheral blood are not considered in the estimation of parasite clearance. Here, we evaluated the influence of sequestration on in vivo artemisinin efficacy in Uganda, where artemisinin resistance is spreading.MethodsWe analyzed 133 patients with P. falciparum malaria included in an in vivo study on artemisinin efficacy in northern Uganda in 2018 and 2019. The parasite clearance half-life was estimated from peripheral parasitemia after artemisinin monotherapy. P. falciparum histidine-rich protein 2 (PfHRP2) was measured in pretreatment plasma. The number of sequestered parasites was estimated from PfHRP2 concentration and peripheral parasitemia.ResultsThe estimated number of sequestered parasites per plasma volume ranged from 0 to 2 564 000/μL. Inflammation, thrombocytopenia, and dyslipidemia were significantly associated with sequestration independent of peripheral parasitemia. The median parasite clearance half-lives were 1.65 hours in patients infected with Pfkelch13 wild-type parasites (n = 104) and 3.95 hours in those with A675V artemisinin-resistant mutant (n = 18). In the multivariable model for the wild-type population, 1 000 000/μL of sequestered parasites were estimated to delay parasite clearance by 16.8% (95% confidence interval, 5.1%–28.5%), although it was not clear in the A675V population.ConclusionsIn patients with P. falciparum malaria without artemisinin-resistant mutations, intensive sequestration delays parasite clearance after treatment, which may contribute to reduced artemisinin efficacy.
Writing Development in DHH Students: A Bimodal Bilingual Approach
Authors: Gärdenfors Moa 
Published: December 2022

AbstractThis article describes the lexical and syntactic development of written narratives in 24 deaf and hard-of-hearing (DHH) students aged between 8 and 18 and takes into account how their varying linguistic backgrounds may predict their written performance. All participants use spoken Swedish, but the study also considers their proficiency in Swedish Sign language, which ranged from zero to fluent. Their narrative texts were analyzed in regard to syntax and lexicon, which demonstrated a strong developmental trend in which increased age predicted more complex texts. Age of acquisition did not predict any writing outcome, which is suggested to occur because all participants were exposed to language early, that is, within the critical time window for language acquisition. Sign language proficiency showed a tendency to predict adjective density and number of clauses, which encourages future research in this area, especially since this connection argues for the benefits of early access to a language and the positive relationship between sign language proficiency and writing.
824 HEMODYNAMIC EFFECTS OF LEVOSIMENDAN IN PATIENTS WITH ACUTE HEART FAILURE AND SEVERE RENAL FAILURE
Authors: Baldetti Luca , Romagnolo Davide , Peveri Beatrice , Frias André , Calvo Francesco , Gramegna Mario , Pazzanese Vittorio , Sacchi Stefania , Ajello Silvia , Scandroglio Anna Mara 
Published: December 2022

Abstract

Background
The inodilator levosimendan has shown improved outcomes in acute heart failure (AHF) and cardiac surgery. Its hemodynamic effect is persistent, owing to a long (70-80 hours) elimination half-life of its active metabolites. No robust data is available of the use of levosimendan in patients with severe renal failure (SRF), thus its use is contraindicated in patients with estimated glomerular filtration rate (eGFR≤30 mL/min).

Hypothesis
Different pharmacokinetics due to renal failure may alter levosimendan active metabolites elimination, causing more pronounced hemodynamic effects. We aimed to characterize the hemodynamic effect of levosimendan in a real-world cohort of SRF patients.

Methods
We reviewed patients who received levosimendan (12.5 mg) for AHF or cardiogenic shock in our CICU (N=132), excluding those without invasive hemodynamics (n=85), and those without data before and during levosimendan infusion (n=11), a total of 36 patients were finally included in this analysis. We compared hemodynamics before and during levosimendan infusion in the study cohort with CKD-EPI eGFR≤30 mL/min/1.73 m2 or CRRT and those without.

Results
Patients with low eGFR (n=11) were older, they had similar LVEF and invasive hemodynamics before levosimendan infusion to the higher eGFR cohort. Visual inspection of the LOESS regression plots (Figure) revealed an higher drop in mean arterial pressure (MAP) and diastolic arterial pressure (DAP) in the low eGFR cohort. The maximum drop was observed at day 4 from levosimendan initiation, invasive hemodynamics at this timepoint revealed a lower DAP (44.6±8.8 vs 62.6±11.9 mmHg; p=0.014) and a tendentially lower MAP (73.6±5.5 vs 84.4±11.5 mmHg; p=0.079) while systolic arterial pressure (125.0±24.6 vs 121.3±21.8 mmHg; p=0.779), cardiac index (2.1±0.5 vs 2.5±0.7 L/m2; p=0.211), and mean pulmonary arterial pressure (25.8±8.3 vs 24.8±9.6 mmHg; p=0.844) did not differ between groups. In-hospital death was not different in the two cohorts (27.3 vs 16.0%; p=0.650).

Conclusions
Patient with eGFR≤30 mL/min/1.73 m2 demonstrated a higher drop in DAP and MAP four days after levosimendan infusion start, without impact on hospital mortality. These findings may suggest a more pronounced hemodynamic effect of levosimendan in patients with SRF, possibly due to altered pharmacokinetics of its active metabolites.
854 SODIUM NITROPRUSSIDE IN ACUTE HEART FAILURE: EFFECTS ON LV AFTERLOAD AND VENTRICULO-ARTERIAL COUPLING
Authors: Baldetti Luca , Gagliardi Maria Felicia , Boccellino Antonio , Calvo Francesco , Pazzanese Vittorio , Gramegna Mario , Sacchi Stefania , Cappelletti Alberto 
Published: December 2022

Abstract

Background
Acute heart failure (AHF) with left ventricle (LV) dysfunction is characterized by a condition of afterload mismatch without preload reserve. LV ejection fraction (LVEF) and stroke volume (SV) become thus dependent on the afterload. Owing to its arteriolar vasodilator properties, sodium nitroprusside (SNP) may reduce LV afterload and result particularly beneficial in this setting, improving LV ejection and ventriculo-arterial coupling (VAC).

Hypothesis
We aimed to assess the effect of SNP on LV afterload (arterial elastance, Ea), LV contractility (end-systolic elastance, Ees) and VAC (Ea/Ees ratio) in AHF patients.

Methods
Patients with AHF receiving SNP were prospectively enrolled and underwent Ea and Ees estimation with a single-beat echocardiographic method, before and after SNP infusion. The method was described by Chen et al (J Am Coll Cardiol, 2001) and Kelly et al (Circulation, 1992). Echocardiography was analyzed by a physician blinded to the images timing.

Results
A total of 36 AHF patients [69% male, age 70 (68, 76) years] received SNP infusion and were enrolled. Patients were admitted for acute coronary syndrome (47%) and for worsening heart failure (53%). SNP median dose was low: 0.30 (0.21-0.57) mcg/kg/min.
SNP led to a trend to SBP reduction [140 (131-150) vs 158 (140-168) mmHg; p=0.002]. Heart rate did not change: 84 (75, 92) vs 83 (72, 94) bpm; p=0.800. Afterload (Ea) was reduced following SNP infusion: 2.2 (1.9, 2.7) vs 2.8 (2.4, 3.4) mmHg/mL; p&lt;0.001. LV contractility (Ees) was unchanged: 1.3 (0.8, 2.2) vs 1.5 (0.9, 3.4) mmHg/mL; p=0.13. End-diastolic volume did not change: 148 (110, 205) vs 146 (108, 213) mL; p=0.880. These effects led to an increased SV: 56 (47, 67) vs 50 (38, 56) mL; p&lt;0.001; p&lt;0.001 and, subsequently to an increased EF [40 (30, 50) vs 30 (20, 40)%; p&lt;0.001]. The VAC did not significantly change after SNP infusion: 1.5 (0.9-2.8) vs 1.6 (0.9-2.7); p=0.64.

Conclusion
In this report on consecutive AHF, low-dose SNP did not significantly affect VAC but led to a significant reduction in LV afterload and to a significant increase in SV and LVEF.
108 PHEOCHROMOCYTOMA-INDUCED CARDIOGENIC SHOCK: A MULTICENTRE ANALYSIS OF CLINICAL PROFILES, MANAGEMENT AND OUTCOMES
Authors: Angelis Elena De , Bochaton Thomas , Ammirati Enrico , Tedeschi Andrea , Polito Maria Vincenza , Pieroni Maurizio , Merlo Marco , Van De Heyning Caroline M , Cipriani Alberto , Camilli Massimiliano , Sanna Tommaso , Cabassi Aderville , Piepoli Massimo F , Sinagra Gianfranco , Bonnefoy-cudraz Eric , Ravera Amelia , Hayek Ahmad 
Published: December 2022

Abstract

Aims
There is still uncertainty on the management of patients with pheochromocytoma-induced CS (PICS), as only a few clinical cases have been reported. The aim of this study is to investigate the clinical presentation, management, and outcome of patients with PICS.

Methods
We collected retrospectively 18 patients without previously known pheochromocytoma with histologically proven PICS admitted to 8 European hospitals.

Results
Among the 18 patients with a mean age of 50 years, 50% were men. The main clinical features at presentation were pulmonary congestion (83%) and cyclic fluctuation of hypertension crises and hypotension (72%). On echocardiography, mean left ventricular ejection fraction (LVEF) was 25% with an atypical-Takotsubo pattern (basal/midventricular) in 50%. Laboratory exams showed increased inflammatory markers, in particular, the mean white blood count was 21.9*109/L. Inotropes/vasopressors were started in all patients and a temporary mechanical circulatory support (t-MCS) was required in 11 (61.1%) patients. All patients underwent surgical removal of the pheochromocytoma but 4 (22.2%) on t-MCS. Echocardiogram (16/17 patients) revealed a mean LVEF of 55% at discharge. Only one patient required heart transplantation (5.5%), and all patients were alive at a median follow-up of 679 days.

Conclusions
In patients with PICS, characteristically, an atypical Takotsubo pattern was observed in almost half of the cases. Although the use of exogenous catecholamine can be perceived as deleterious, we showed a fairly good mid-term prognosis with rapid improvement of LVEF in most, even if adrenalectomy often occurred on t-MCS.
609 LUPUS IN SHEEP'S CLOTHING: A CARDIAC TAMPONADE DUE TO ACUTE POLYSIEROSITIS IN A SLE PATIENT.
Authors: Alberti Giorgia , Dotto Alberto , Roccabruna Alessandra , Zagarese Giorgia , Piccolo Solange , Cubich Mattia , Prati Daniele , Pazzi Sara , Gambaro Alessia , Butturini Caterina , Scarsini Roberto , Ferrero Valeria , Tavella Domenico , Ribichini Flavio Luciano 
Published: December 2022

Abstract
This case describes a cardiac tamponade in systemic lupus erythematosus (SLE), an uncommon but life-threatening condition that needs prompt recognition.
A 33-year-old woman with therapy-resistant SLE presented to the Emergency Department with chest pain and fever for 3 days. She was hemodynamically stable, the ECG showed signs of pericarditis and echocardiography showed a minimal pericardial effusion. Pericarditis was diagnosed and the patient was admitted to the Cardiology Ward. Seven hours later her symptoms deteriorated, presenting hemodynamic instability with hypotension and tachycardia. The ECG showed low QRS voltage and electrical alternans, echocardiography confirmed cardiac tamponade. The patient underwent an emergency pericardiocentesis with 220 mL of serous citrine liquid removed and immediate regression of symptoms. The cytology exam revealed inflammatory cells with no evidence of malignancy, blood culture and effusion fluid's tests came back negative. A Thoraco-abdominal CT revealed also bilateral pleural effusion (not present at the admission) and ascites. Signs, symptoms and medical history suggested SLE flare-up and high-dose oral glucocorticoid therapy was started.
Our report highlights a rare presentation of life-threatening polyserositis in SLE flare-up. Although pericarditis and pericardial effusion are frequently-reported SLE's cardiovascular complications, rapid development of cardiac tamponade is far from common. Acute cardiac tamponade, like in our case, is an indication for emergency pericardial drainage to restore an adequate cardiac output.
We describe an out of ordinary case of a patient in whom an accurate and timely diagnosis of SLE–related cardiac tamponade has been live–saving.
819 PSEUDO-MOBITZ VAGAL ATRIOVENTRICULAR BLOCK: TWO CASE REPORTS IN YOUNG HEALTHY MEN
Authors: Bonanno Salvatore , Cocuzza Federica , Carciotto Gabriele , Marco Paride Di , Ferrara Nicola , Vetta Giampaolo , Caminiti Rodolfo , Parlavecchio Antonio , Crea Pasquale , Dattilo Giuseppe , Luzza Francesco , Carerj Scipione , Micari Antonio , Di Bella Gianluca 
Published: December 2022

Abstract
We reported the cases of two young men with II degree AV block. The first one was a 17 yo asymptomatic boy, soccer player, undergoing 24 hours Holter-ECG for sporadic RVOT ventricular extrasystoles at resting ECG. During the night, an apparent Mobitz type 2 II degree AV block was observed. Detailed analysis showed: Sinusal bradycardia at 50 bpm;Absence of prolongation of P-R intervals before the pause;The pause is longer than double the basic P-P interval;Prolongation of P-P interval in the beats before the pause.
The second case was also a young man suffering by atypical episodes of palpitations. The 24h Holter-ECG showed, during the night, an apparent Mobitz type 2 II degree AV block. Also in this case analysis of the tracing highlighted a) progressive slowing of sinus cycle length before the pause b) pause longer than double of sinus cycle and c) absence of prolongation of P-R intervals before the pause.
Vagally mediated atrioventricular block and pseudo-Mobitz atrioventricular block.
Vagally mediated AV block can have heterogeneous presentation: Wenckebach type, pseudo-Mobitz type II, 2:1, advanced-degree, complete AV block or a combination of different types of AV block and ventricular asystole. The mechanism is mediated by a vagal input, which depresses contemporarily sinus node and AV junction. The site of vagally mediated AV block is usually within the AV node. Generally, it results in a Wenckebach II degree AV block associated with sinus bradycardia, which occurs more often during the night in young/trained people. So the blocked P wave is generally preceded by Wenckebach phenomenon. However, in some patients the prolongation of the P-R interval is not present and the AV block appears abruptly. In these cases, Mobitz type II AV block may be erroneously diagnosed if sinus slowing is ignored. A differential diagnosis between true Mobitz II AV block and pseudo-Mobitz II block is essential for clinical purposes. Simultaneous slowing of the sinus rate and a pause longer than the double of the sinus cycle length indicate clearly a vagal mechanism, ruling out true Mobitz type 2 AV block, especially in young asymptomatic healthy men. In case of doubt, an electrophysiological study may be indicated.
578 LONG-TERM OUTCOME OF VENTRICULAR TACHYCARDIA CATHETER ABLATION IN PATIENTS WITH CHRONIC CORONARY TOTAL OCCLUSION
Authors: Flore Francesco , Narducci Maria Lucia , Niccoli Giampaolo , Ballacci Federico , Giordano Federica , Perna Francesco , Bencardino Gianluigi , Montone Rocco Antonio , Pelargonio Gemma , Crea Filippo 
Published: December 2022

Abstract

Background
Chronic coronary total occlusions (CTO) are considered an emerging predictor of ventricular arrhythmias (VAs) but currently there are only few data on arrhythmic outcomes in patients affected by CTO undergoing radiofrequency catheter ablation of VAs.

Objective
This study sought to evaluate the impact of unrevascularized CTO on the recurrence of VAs after catheter ablation.

Methods
This was a single-center retrospective study that enrolled 120 patients, between 2015 and 2020. All patients were admitted for ventricular tachycardia (VT) or high premature ventricular contractions (PVCs) burden (&gt;25% detected by Holter ECG), without evidence of acute coronary syndrome; they underwent coronary angiography, electrophysiology (EP) study and three-dimensional electroanatomic mapping (3D-EAM) followed by VAs ablation.

Results
Twenty-eight patients (23%) of 120 patients showed CTO at coronary angiography. At baseline, CTO group presented with higher prevalence of hypertension, chronic renal disease, systolic ventricular dysfunction, secondary prevention ICD implantation, higher rate of low abnormal activities by 3D-EAM compared to the non-CTO group. At a median follow-up of 15 months (range 1-96 months) after catheter ablation, the only independent predictor of VAs recurrence was the presence of moderate to severe left ventricular (LV) dysfunction (p=0.02).

Conclusion
The presence of CTO does not predict VAs recurrence after catheter ablation which is instead predicted by LV dysfunction.