bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two near-infrared fluorescent probes based on dicyanoisfluorone for rapid monitoring of Zn2+ and Pb2+
Authors: Li Jia , Zhou Cuiping , Yang Hong , Wu Xiongzhi , Yan Liqiang 
Published: May 2022

Abstract
Zinc (Zn2+) and lead (Pb2+) ions in the environment have important effects on human health and environmental safety. Therefore, it is necessary to effectively detect them by a convenient and reliable analysis method. In this study, two near-infrared fluorescent probes for the fast determination of Zn2+ and Pb2+ were synthesized by a simple Schiff base reaction between the dicyanoisophorone skeleton and carbohydrazide derivatives. Among them, the probe with the thiophene-2-carbohydrazide group showed a selective fluorescence response to Zn2+ and Pb2+ with a maximum emission wavelength of 670 nm. And the detection limits of the probe for Zn2+ and Pb2+ were 1.59 nM and 1.65 nM, respectively. In contrast the probe modified by the furan-2-carbohydrazide group achieved quantitative detection of Zn2+, with a detection limit of 2.7 nM. These results were attributed to the fact that the probes bind to Zn2+ and Pb2+ in stoichiometric ratios of 1:1, blocking the intramolecular PET effect. Furthermore, these two probes can be recycled through the action of EDTA and have been successfully used to detect Zn2+ and Pb2+ in real water samples.
Fabrication of Cu-adhered silicon carbide particles and its effect on properties of Fe-based matrix composites
Authors: Jin Wubin , Zhou Yongmin 
Published: May 2022

Abstract
In present study, copper powders (Cu) and silicon carbide (SiC) particles were used to produce Cu-adhered SiC particles (Cu/SiC), which were used to reinforce Fe-based matrix materials to modify properties. The orthogonal experimental design was used to investigate the relationship between ball mill parameters and particle size. Next, the mixed powders were pressed at 500 MPa using a hydraulic press. Then, the green compacts were wrapped in graphite powders, and sintered using a resistance furnace. Metallurgical microscopy, scanning electron microscopy (SEM), energy-dispersive x-ray spectroscopy (EDS) and x-ray diffraction were employed to investigate the microstructures, element distribution, and phase of SiC-reinforced Fe-based matrix composites. The properties of the SiC-reinforced metal matrix composites were determined using the Microhardness test and Charpy pendulum impact test. The orthogonal experimental results indicated that the influence degree of milling parameters on particle size was the powder to ball ratio>milling time>milling speed. The milling parameters to obtain the smallest Cu/SiC particle were powder to ball ratio of 20:1, milling time of 15 h, and milling speed of 300 r min−1. However, the adhesive effect was bad. The properties test results indicated that Cu/SiC particles reinforced with Fe matrix composites had better properties. Furthermore, the hardness and impact toughness improved up to 239.97 HV0.5 and 12.1 KJ·m−2, respectively. Moreover, compared to raw SiC particles, the hardness and impact toughness increased by 12% and 15%, respectively. The improvement in properties was attributed to the Cu adhesion to the SiC surface, which effectively alleviated the difference in thermal expansion coefficient between SiC and Fe, and formed a chemical bond at the interface to improve the interfacial binding
Single-Molecule Sequencing Enables Long Cell-Free DNA Detection and Direct Methylation Analysis for Cancer Patients
Authors: Choy L Y Lois , Peng Wenlei , Jiang Peiyong , Cheng Suk Hang , Yu Stephanie C Y , Shang Huimin , Olivia Tse O Y , Wong John , Wong Vincent Wai Sun , Wong Grace L H , Lam W K Jacky , Chan Stephen L , Chiu Rossa W K , Chan K C Allen , Lo Y M Dennis 
Published: May 2022

Abstract

Background
Analysis of circulating tumor DNA has become increasingly important as a tool for cancer care. However, the focus of previous studies has been on short fragments of DNA. Also, bisulfite sequencing, a conventional approach for methylation analysis, causes DNA degradation, which is not ideal for the assessment of long DNA properties and methylation patterns. This study attempted to overcome such obstacles by single-molecule sequencing.

Methods
Single-molecule real-time (SMRT) sequencing was used to sequence plasma DNA. We performed fragment size and direct methylation analysis for each molecule. A methylation score concerning single-molecule methylation patterns was used for cancer detection.

Results
A substantial proportion of plasma DNA was longer than 1 kb with a median of 16% in hepatocellular carcinoma (HCC) patients, hepatitis B virus carriers, and healthy individuals. The longest plasma DNA molecule in the HCC patients was 39.8 kb. Tumoral cell-free DNA (cfDNA) was generally shorter than nontumoral cfDNA. The longest tumoral cfDNA was 13.6 kb. Tumoral cfDNA had lower methylation levels compared with nontumoral cfDNA (median: 59.3% vs 76.9%). We developed and analyzed a metric reflecting single-molecule methylation patterns associated with cancer, named the HCC methylation score. HCC patients displayed significantly higher HCC methylation scores than those without HCC. Interestingly, compared to using short cfDNA (area under the receiver operating characteristic [ROC] curve, AUC: 0.75), the use of long cfDNA molecules greatly enhanced the discriminatory power (AUC: 0.91).

Conclusions
A previously unidentified long cfDNA population was revealed in cancer patients. The presence and direct methylation analysis of these molecules open new possibilities for cancer liquid biopsy.
Modification of reconstruction of left ventricular outflow tract, aortic root and the intervalvular fibrous body for extensive infective endocarditis: a single-centre experience
Authors: El-Sayed Ahmad Ali , Salamate Saad , Amer Mohamed , Abdullaahi Abdisalan , Bayram Ali , Sirat Sami , Bakhtiary Farhad 
Published: May 2022

Abstract

OBJECTIVES
Extensive infective endocarditis (IE) stays a serious life-threatening disease with high mortality and morbidity. The aim of this study is to analyse our experience with our modified surgical technique for extensive IE during the last 4 years.

METHODS
Between March 2017 and February 2021, all patients with extensive IE required our modified technique consisting of a radical surgical resection of all infected cardiac tissues, the replacement of infected valves and a reconstruction of the intervalvular fibrous body, the aortic root and the left ventricular outflow tract with modified elephant trunk were included in this study.

RESULTS
Our modified technique was performed on 41 patients during the study period. The age median was 74 [interquartile range (IQR): 66.5–76.5] and 61.0% (n = 25) were female. Thirty-three patients (80.5%) were in New York Heart Association Class III–IV and 7 patients (17.1%) in cardiogenic shock. The median logistic European system for cardiac operative risk evaluation II as predicted risk of mortality was 35% (IQR: 28–78%). The median cardiopulmonary bypass time and cross-clamping time were 126 (IQR: 86.5–191) and 78 (IQR: 55.5–108) min, respectively. Intraoperative mortality and 30-day mortality were 4.8% (2 patients) and 19.5% (8 patients), respectively. Low cardiac output with necessity for mechanical support, stroke and new renal dialysis developed in 9.8% (4 patients), 17.1% (7 patients) and 22.0% (9 patients), respectively. New pacemaker implantation was noted in 39.0% (16 patients). Intensive care stay and hospital stay had medians of 6 (IQR: 5–12) and 14 (IQR: 12.5–20.5) days, respectively. One-year mortality and 4-year mortality were 34.1% (14 patients) and 39.0% (16 patients), respectively. Kaplan–Meier survival estimates were 60.3% (95% confidence interval: 46.2–78.6%) at 3 years.

CONCLUSIONS
Our modified technique can be performed in patients with extensive IE with acceptable early and mid-term morbidity and mortality. We believe that this technique is an available option for this ill-fated group of patients.
C2 STEREOTACTIC ABLATIVE RADIOTHERAPY (STAR) IN PATIENTS WITH ICD AND ARRHYTHMIC STORMS
Authors: Molon G , Costa A , Bonapace S , Marinelli A , Alongi F , Giaj Levra N , Sicignano G , Cuccia F 
Published: May 2022

Abstract

Background
The current therapy of recurrent ventricular tachycardia (VT) and arrhythmic storms is the radiofrequency catheter ablation (RFCA). The first experiences of stereotaxic radioablation of arrhythmia (STAR) as an alternative in patients (pts) with defibrillator (ICD) and Arrhythmic Storms are emerging. However, a standardized method for STAR is not yet available and many issues are still under discussion. We present the preliminary results of STAR in the pts of our Center.

Material and method
Pts with ICDs and Arrhythmic Storms, excluded from RFCA, were referred to STAR. Diagnostics performed were Electrophysiological study (EPS) using 3D electroanatomical mapping (3DEAM) using CardioInsightTM vest (Medtronic, Minneapolis, MN), cardio–CT scan and 18F–fluorine–2–deoxy–D–glucose positron emission tomography (18FDG – PET scan) in order to identify the target area of the ventricle. In all pts a sustained monomorphic VT was induced during EPS, and 3DEAM was used to identify the exit point of the VT (Fig. 1). In all cases, a 3 mm thick 4D CT scan was used (Fig. 2) with the aid of an abdominal thermoplastic mask. Each patient was treated with a TrueBeam Linac (Varian Medical Systems, Palo Alto, CA). The prescription of the dose from 21 to 25 Gy in a single delivery. Ethics committee approval was obtained prior to each treatment.

Results
From January 2020 to March 2021, 6 patients (5 M, 1 F), mean age 78 years (58–80) were treated with STAR. The median delivered dose was 25 Gy (range 21–25 Gy). In follow–up (FU) one patient died from end–stage heart failure after 30 days. At a median FU of 13 months, STAR treatment efficacy was observed in 3/5 patients, in whom no defibrillator activation was recorded. 2/5 patients had recurrence of TV, 2 and 6 months after STAR. No severe acute toxicity was recorded after radiotherapy.

Conclusions
Arrhythmic stereotaxic radioablation appears to be a safe and effective therapy in PTS with ICDs and arrhythmic storms. Completely non–invasive diagnostics and therapy make it very interesting and ambitious. Additional data is needed to improve the definition of the target zone and to standardize it in patients not eligible for RFCA.
C3 A RARE AND ATYPICAL CASE OF ICD POCKET HEMATOMA CONTAINING PSEUDOCHYLOUS
Authors: Maffè S , Paffoni P , Bergamasco L , Facchini E , Prenna E , Careri G , Franchetti Pardo N , Paino A , Dellavesa P 
Published: May 2022

Abstract
Subcutaneous hematoma is a complication in 2–9% of cardiac device implants.In most cases, it is drained or spontaneously reabsorbed; if untreated, there is a risk of infection.While cases of chylothorax and pseudochylothorax are rare, no previous cases of accumulation of chyliform material in the subcutaneous pockets of cardiac devices have ever been documented.We present the case of a 60–year–old man with antibody syndrome antiphospholipids, rheumatoid arthritis, previous acute anterior myocardial infarction and aorto–coronary by–pass surgery, paroxysmal atrial fibrillation, in oral anticoagulant therapy. In 2020, the patient underwent primary prophylactic dual–chamber ICD implantation (EF 33%) at another center, complicated by the formation of a large pocket hematoma, which required drainage and evacuation. In the following weeks, the patient noticed the reappearance of a large swelling in the ICD pocket; however, as it was painless and not troublesome, he did not seek medical attention. After 7 months he came to our observation with signs of heart failure. Clinical examination revealed a large swelling in the left pectoral area (Fig. 1), extending to the nipple, soft, not painful, not hot or red.The patient had no signs of infection (normal ESR, CRP, procalcitonin and WBC). We decided to drain the hematoma, given the size. At the level of the defibrillator pocket, we made a small incision, from wich 100ml of gold–colored, odorless liquid leaked out (Fig. 2), with no evidence of blood material in the pocket. The ICD–case was then wrapped in a rifampicin–releasing antibacterial bag and reinserted into the subcutaneous pocket, without further complications. The chemical–physical examination revealed a cloudy, gold–colored liquid, density of 1020, pH 8.5, high protein content (&gt;400g/l), absence of glucose.Microscopic examination shows isolated leukocytes, rare erythrocytes immersed in mucoid material; this was not pus, as culture testing was negative for bacterial growth. The cholesterol concentration was 704mg/dl, triglycerides 80mg/dl (plasma cholesterol values were 91mg/dl, triglycerides 48mg/dl). The cytological analysis showed a carpet of foamy macrophages filled with cholesterol crystals (Fig. 3). Such evidence supports the diagnosis of pseudochilous, formed from the evolution of an untouched hematoma in a fibrous subcutaneous pocket for more than 6 months.This is the first case in which the presence of chyliform material is documented in an ICD pocket.
C4 PERMANENT HIS BUNDLE PACING USING STYLET–DRIVEN LEAD IN PATIENTS WITH RIGHT ATRIOMEGALY: A SINGLE–CENTER EXPERIENCE
Authors: Marinaccio L , Giacopelli D , Rocchetto E , Vetta F , Marchese D 
Published: May 2022

Abstract

Background
His bundle pacing (HBP) is becoming an increasing widespread approach for physiological pacing. However, successful HBP procedure could be hampered by limited implantation tools especially in challenging anatomies. We aimed to report our experience with HBP technique using a novel stylet–driven lead system in patients with right atriomegaly.

Methods
Consecutive patients with right atrium (RA) volume &gt;25 mL/m2 in men and &gt;21 mL/m2 in women who underwent permanent HBP for standard indications were enrolled from March 2020 to March 2021. The tool of first choice for HBP attempt was a stylet–driven lead (Solia S 60, Biotronik) delivered via a dedicated introducer sheath (Selectra 3D, Biotronik). The acute, 1–month and 6–month procedural success rate was assessed.

Results
We enrolled 24 patients (median age 75 [70–79] years, 85% men) with an average RA volume of 50.7±7.8 mL/m2. At implant, conduction system pacing using stylet–driven lead was achieved in 21 patients (87%): 12 (50%) selective HBP, 6 non–selective HBP (25%) and 3 left bundle branch area pacing (12.5%). In the 3 failures, HBP was further attempted with a different system with final procedural success in 2 cases. In the successful cases, there was a significant reduction of QRS duration between paced and spontaneous beats (152.5 (130–167.5) ms vs 130 (122.5– 137.5) ms, p = 0.003). No lead dislodgment nor significant pacing threshold increase was observed at 1–month (1.30±0.76 V@0.4 vs. 1.32±0.80 V@0.4ms, p &gt; 0.9) and 6–month follow–up (1.30±0.76 V@0.4 vs. 1.38±0.97 V@0.4ms, p = 0.66).

Conclusions
In our experience, the novel stylet–driven lead system showed high implant success rates and capture threshold stability also in patients with right atriomegaly.
C10 IN–HOSPITAL MANAGEMENT AND OUTCOMES OF ELECTRICAL STORM: SINGLE CENTER RETROSPECTIVE STUDY
Authors: Di Fusco S , Pignalberi C , Spinelli A , Matteucci A , Aquilani S , Pandozi C , Imperoli G , Colivicchi F 
Published: May 2022

Abstract

Background
Electrical storm (ES) is a condition characterized by the recurrence of malignant ventricular arrhythmia and is associated with significant morbidity and mortality. The aim of this study was to report the pharmacological and non–pharmacological interventions used to treat ES during hospitalization in an arrhythmia reference center.

Methods
We reviewed the medical record of patients consecutively admitted for ES in the intensive care unit of our center over a period of 6 years. Data on diagnostic tests and therapies used during hospitalization to manage these patients were retrospectively collected.

Results
Over the study period, 85 patients ((86% male, mean age 74±10 years) were admitted to the intensive care unit of our center for ES. Patient clinical, electrocardiographic, echocardiographic, and laboratory characteristics at hospitalization are reported in Table 1. Twenty–five patients had electrolytic disorders that required intravenous infusion of potassium and/or magnesium. Most patients (53%) were treated with at least one antiarrhythmic drug administered intravenously (Table 2). The most commonly used antiarrhythmic drug was amiodarone (38%). Twenty patients (24%) required more than one antiarrhythmic drug administered intravenously. Twenty–four patients (28%) underwent coronary angiography and seven patients (8%) required percutaneous coronary intervention (PCI). Twenty patients (24%) were treated with catheter ablation of the ventricular tachycardia during the index hospitalization, none of these also required PCI during the hospitalization. Six patients (7%) died during hospitalization after 9±10 days from ES onset, their mean left ventricle ejection fraction was 28% and none of them underwent ablation or PCI during the index hospitalization.

Conclusion
ES management in a reference center involves a comprehensive approach that includes multiple pharmacological and non–pharmacological interventions. Furthermore, our study confirms the severe prognosis associated with hospitalization due to ES.
C19 REMOTE MONITORING OF IMPLANTABLE CARDIAC DEVICES: ANALYSIS AND CHARACTERISATION OF ONE CENTRE‘S ACTIVITY SINCE THE START OF THE COVID–19 PANDEMIC
Authors: Campacci F , Biancoli S , Mazzotti A , Mattarocchia B , Cavezzi P , Orlati C , Biserni R , Galvani M , Bandini A 
Published: May 2022

Abstract

Introduction
The COVID–19 outbreak has accelerated the diffusion of remote monitoring (RM) in patients with Cardiac Implantable Electronic Devices (CIEDs). The primary objective of this analysis was to characterize the number of remotely monitored CIEDs in our centre since the start of the programme (November 2017) by comparing the number of patients monitored before and after the beginning of the pandemic (1 March 2020). The secondary objective was to quantify the number of scheduled hospital visits following the introduction of RM as an alternative to traditional outpatient monitoring from the first scheduled remote follow–up (1 November 2020) to the end the observation period (30 November 2021).

Materials and Methods
All patients with CIED compatible with RM technology (860 patients) were included. Information regarding CIED was obtained from CardioRef software (3A Sistemi, Castel San Pietro Terme, BO) and from the informative system in use in our Cardiology Department Log80 (Log80, Forlì, FC). All data were collected and analysed using Microsoft Excel software (Office 365 version).

Results
Seven hundred sixty–eight patients were provided with RM devices, which represent the 89.3% of monitorable CIEDs. Fig. 1 shows the number of RM patients characterised by type: pacemaker (PM), implantable cardiac defibrillator (ICD) and loop recorder (LR). The number of RM patients has substantially increased in the months following the start of the pandemic. Moreover, during the 13 months observation period, hospital visits decreased by an average of 42%, excluding the period July–August 2021, during which no scheduled follow–up visits in our centre are performed (Fig. 2).

Discussion
Our RM activity, which started only for ICD and LR patients, was extended since March 2020 to PM patients, increasing from 125 to 768 MR patients. This has reduced the time spent by the patient and the caregiver in travelling to the hospital, attending for the visit. As a consequence, also the consumption of healthcare resources accordingly decreased, as documented by the 42% reduction in hospital visits. This result was achieved through the setting up of a multi–professional working group (doctor, nurses, biomedical engineer) dedicated to the daily management of incoming transmissions and phone interviews.
C33 PERCUTANEOUS CLOSURE OF MITRAL PARAVALVULAR LEAK (PVL): WHEN REVERSAL MAKES ALL THE DIFFERENCE
Authors: Manca F , Cocco D , Siotto P , Melis M , Fele G , Corda M , Loi B 
Published: May 2022

Abstract
PVL is a complication associated with the implantation of a prosthetic valve. Since surgical re–intervention has a high operative risk, percutaneous closure (PC) has emerged due to its reduced invasiveness and the development of dedicated materials. We describe the case of a 66–year–old man with a mechanical oscillating disc mitral prosthesis who was admitted for acute heart failure. An echo showed a left ventricle with normal motion and a postero–medial mitral PVL with significant regurgitation. A transoesophageal echo confirmed the PVL in the 5 o’clock viewing portal with severe regurgitation. After optimising the medical therapy and with no change in echo findings, a cardiac catheterisation showed persistent post–capillary pulmonary hypertension, and therefore PC of the PVL was scheduled. Given the postero–medial location of the PVL, a transseptal puncture was performed using a 8.5 Fr Agilis introducer (Terumo) with telescoping system of a 6 r. JR4 catheter. The PVL was passed through with a Terumo 0.035 J–shaped guide, but without managing to advance the catheter beyond the leak. The guide was therefore advanced into the abdominal aorta and an arteriovenous circuit was created, which allowed the catheter to be advanced beyond the PVL and a closure device (AVPIII 14/5,Abbott St.Jude) was positioned with anterograde placement, with a distal disc on the ventricular side. Obliteration of the PVL, interference with the prosthetic disc and high transprosthetic gradients were observed despite several attempts to relocate the AVP, which was therefore removed. A second procedure was performed at a distance, creating a similar arteriovenous circuit by using a long introducer (110cm–Cook) which was advanced from the femoral artery beyond the leak in the opposite direction. An AVPIII (12/5) with a distal disc on the atrial side was positioned, this time with retrograde placement, with effective closure of the PVL and minimal residual regurgitation, without interference with the prosthesis. The course was free of complications; after one month the echo confirmed the result. Transcatheter closure of the PVL is a complex procedure, but relatively safe in experienced hands. This case is of particular interest due to the difficulty presented by the location of the PVL, which required measures of high technical complexity and because it describes a possible complication of the procedure, which was resolved by the simple reversal of the placement of the device.