bluuebunny/crossref_metadata_2025 huggingface dataset:
Peritoneal Dialysis as an Option for Unplanned Dialysis Initiation in Patients with End-Stage Renal Disease and Diabetes Mellitus
Authors: Jin Haijiao , Ni Zhaohui , Che Xiajing , Gu Leyi , Zhu Mingli , Yuan Jiangzi , Huang Jiaying , Gu Aiping , Jin Yan , Yan Hao , Wang Qin , Yu Zanzhe , Zhou Wenyan , Fang Wei
Published: September 2018

Aims: This study aimed to compare the short-term complications and long-term prognosis between urgent-start peritoneal dialysis (PD) and hemodialysis (HD), and explore the safety and feasibility of PD in end-stage renal disease (ESRD) patients with diabetes. Methods: This retrospective study enrolled ESRD patients with diabetes who required urgent-start dialysis at a single center from January 2011 to December 2014. Short-term (30-day) dialysis-related complications and patient survival trends were compared between patients receiving PD and HD. Results: Eighty patients were included in the study, including 50 (62.5%) who underwent PD. The incidence of dialysis-related complications and complications requiring reinsertion during the first 30 days was significantly lower in PD patients. Logistic regression identified urgent-start HD as an independent risk factor for dialysis-related complications compared with urgent-start PD. The patient survival rate was higher in the PD compared to that in the HD group. Conclusions: PD may be acceptable, safe, and feasible for urgent-start dialysis in ESRD patients with diabetes.
Exploration of Hepatoprotective Effect of Gentiopicroside on Alpha-Naphthylisothiocyanate-Induced Cholestatic Liver Injury in Rats by Comprehensive Proteomic and Metabolomic Signatures
Authors: Han Han , Xu Lili , Xiong Kai , Zhang Tong  , Wang Zhengtao
Published: September 2018

Background/Aims: Cholestasis is the major cause of the accumulation of bile acids and results in liver damage, fibrosis, and failure. A growing number of studies have shown that gentiopicroside is a promising prospect that may protect the liver. However, its therapeutic mechanism has not yet been clarified. This study aimed to explore the effect and mechanism of gentiopicroside in cholestasis induced by alpha-naphthylisothiocyanate. Methods: We performed isobaric tags for relative and absolute quantification-based quantitative proteomics and metabolomics using liquid chromatography quadruple time-of-fight mass spectrometry and identified the expression of 73 metabolites and 84 proteins associated with cholestasis-related dysfunctions in the metabolism of bile acids, fatty acids, and glycerophospholipids. Results: Integrated analyses of proteomic and metabonomic studies showed altered pathways in cholestasis-induced liver injury involving increased activity of farnesoid X receptor/retinoid X receptor, bile acid biosynthesis, and peroxisome proliferator-activated receptor-α/retinoid X receptor-α. Gentiopicroside could reverse these metabolite, protein, and blood biochemical indices, as well as alleviate liver damage. The progressive changes in the proteins and genes may be correlated with cholestasis and were confirmed by western blot and quantitative realtime polymerase chain reaction. Conclusion: Gentiopicroside could be used to protect the liver in the presence of cholestasis.
In Silico Identification and in Vitro Analysis of B and T-Cell Epitopes of the Black Turtle Bean (Phaseolus Vulgaris L.) Lectin
Authors: He Shudong , Zhao Jinlong , Elfalleh Walid , Jemaà Mohamed , Sun Hanju  , Sun Xianbao , Tang Mingming , He Qian , Wu Zeyu , Lang Florian
Published: September 2018

Background/Aims: The incidence of lectin allergic disease is increasing in recent decades, and definitive treatment is still lacking. Identification of B and T-cell epitopes of allergen will be useful in understanding the allergen antibody responses as well as aiding in the development of new diagnostics and therapy regimens for lectin poisoning. In the current study, we mainly addressed these questions. Methods: Three-dimensional structure of the lectin from black turtle bean (Phaseolus vulgaris L.) was modeled using the structural template of Phytohemagglutinin from P. vulgaris (PHA-E, PDB ID: 3wcs.1.A) with high identity. The B and T-cell epitopes were screened and identified by immunoinformatics and subsequently validated by ELISA, lymphocyte proliferation and cytokine profile analyses. Results: Seven potential B-cell epitopes (B1 to B7) were identified by sequence and structure based methods, while three T-cell epitopes (T1 to T3) were identified by the predictions of binding score and inhibitory concentration. The epitope peptides were synthesized. Significant IgE binding capability was found in B-cell epitopes (B2, B5, B6 and B7) and T2 (a cryptic B-cell epitope). T1 and T2 induced significant lymphoproliferation, and the release of IL-4 and IL-5 cytokine confirmed the validity of T-cell epitope prediction. Abundant hydrophobic amino acids were found in B-cell epitope and T-cell epitope regions by amino acid analysis. Positively charged amino acids, such as His residue, might be more favored for B-cell epitope. Conclusion: The present approach can be applied for the identification of epitopes in novel allergen proteins and thus for designing diagnostics and therapies in lectin allergy.
Right Ventricular Strain and Dyssynchrony Assessment in Arrhythmogenic Right Ventricular Cardiomyopathy
Authors: Prati Giulio , Vitrella Giancarlo , Allocca Giuseppe , Muser Daniele , Buttignoni Sonja Cukon , Piccoli Gianluca , Morocutti Giorgio , Delise Pietro , Pinamonti Bruno , Proclemer Alessandro , Sinagra Gianfranco , Nucifora Gaetano
Published: September 2018

Background—

Analysis of right ventricular (RV) regional dysfunction by cardiac magnetic resonance (CMR) imaging in arrhythmogenic RV cardiomyopathy (ARVC) may be inadequate because of the complex contraction pattern of the RV. Aim of this study was to determine the use of RV strain and dyssynchrony assessment in ARVC using feature-tracking CMR analysis.

Methods and Results—

Thirty-two consecutive patients with ARVC referred to CMR imaging were included. Thirty-two patients with idiopathic RV outflow tract arrhythmias and 32 control subjects, matched for age and sex to the ARVC group, were included for comparison purpose. CMR imaging was performed to assess biventricular function; feature-tracking analysis was applied to the cine CMR images to assess regional and global longitudinal, circumferential, and radial RV strains and RV dyssynchrony (defined as the SD of the time-to-peak strain of the RV segments). RV global longitudinal strain (−17±5% versus −26±6% versus −29±6%;
P
<0.001), global circumferential strain (−9±4% versus −12±4% versus −13±5%;
P
=0.001), and global radial strain (18 [12–26]% versus 22 [15–32]% versus 27 [20–39]%;
P
=0.015) were significantly lower and SD of the time-to-peak RV strain in all 3 directions were significantly higher among patients with ARVC compared with patients with RV outflow tract arrhythmias and controls. RV global longitudinal strain >−23.2%, SD of the time-to-peak RV longitudinal strain >113.1 ms, and SD of the time-to-peak RV circumferential strain >177.1 ms allowed correct identification of 88%, 75%, and 63% of ARVC patients with no or only minor CMR criteria for ARVC diagnosis.

Conclusions—

Strain analysis by feature-tracking CMR helps to objectively quantify global and regional RV dysfunction and RV dyssynchrony in patients with ARVC and provides incremental value over conventional cine CMR imaging.
Absence of Myocardial Fibrosis Predicts Favorable Long-Term Survival in New-Onset Heart Failure
Authors: Gulati Ankur , Japp Alan G. , Raza Sadaf , Halliday Brian P. , Jones Daniel A. , Newsome Simon , Ismail Nizar A. , Morarji Kishen , Khwaja Jahanzaib , Spath Nick , Shakespeare Carl , Kalra Paul R. , Lloyd Guy , Mathur Anthony , Cleland John G.F. , Cowie Martin R. , Assomull Ravi G. , Pennell Dudley J. , Ismail Tevfik F. , Prasad Sanjay K.
Published: September 2018

Background:

Myocardial fibrosis, identified by late gadolinium enhancement cardiovascular magnetic resonance, predicts outcomes in chronic heart failure (HF). Its prognostic significance in new-onset HF and reduced left ventricular ejection fraction (LVEF) is unclear. We investigated whether the pattern and extent of fibrosis predict survival in new-onset HF and reduced LVEF of initially uncertain pathogenesis.

Methods and Results:

Of 120 consecutive patients with new-onset (<6 months) HF and reduced LVEF, 31 (26%) had infarct fibrosis, 25 (21%) had midwall fibrosis, and 64 (53%) had no fibrosis. During median follow-up of 8.9 years, 33 (28%) patients died. Patients with infarct fibrosis (hazard ratios [HR], 3.32; 95% CI, 1.46–7.58;
P
=0.004) or midwall fibrosis (HR, 2.99; 95% CI, 1.24–7.19;
P
=0.014) were more likely to die compared with those without fibrosis. On multivariable analysis, the pattern and extent of fibrosis were both associated with all-cause mortality (by fibrosis pattern: infarct: HR, 2.60; 95% CI, 1.08–6.27;
P
=0.033; midwall: HR, 2.64; 95% CI, 1.08–6.47;
P
=0.034; by fibrosis extent per 1%: HR, 1.07; 95% CI, 1.03–1.12;
P
<0.001). Fibrosis pattern also predicted composites of cardiovascular mortality or aborted sudden cardiac death (infarct: HR, 3.45; 95% CI, 1.20–9.90;
P
=0.022; midwall: HR, 6.59; 95% CI, 2.26–19.22;
P
<0.001), and all-cause mortality, HF hospitalization, or aborted sudden cardiac death (infarct: HR, 2.69; 95% CI, 1.26–5.76;
P
=0.011; midwall fibrosis: HR, 2.97; 95% CI, 1.37–6.45;
P
=0.006). Addition of fibrosis pattern to LVEF improved risk prediction for all-cause mortality (LVEF versus LVEF+fibrosis C statistic: 0.66 versus 0.71;
P
=0.033). Importantly, the absence of fibrosis heralded a favorable prognosis with an 85% survival rate over the duration of follow-up.

Conclusions:

The pattern and extent of myocardial fibrosis predict adverse outcomes in new-onset HF and reduced LVEF. In contrast, the absence of fibrosis portends a durable warranty period with a low incidence of adverse events. These findings support a role for late gadolinium enhancement cardiovascular magnetic resonance in the early risk stratification of patients with HF of uncertain pathogenesis.
Unselected Use of Ultrathin Strut Biodegradable Polymer Sirolimus-Eluting Stent Versus Durable Polymer Everolimus-Eluting Stent for Coronary Revascularization
Authors: Yamaji Kyohei , Zanchin Thomas , Zanchin Christian , Stortecky Stefan , Koskinas Konstantinos C. , Hunziker Lukas , Praz Fabien , Blöchlinger Stefan , Moro Christina , Moschovitis Aris , Seiler Christian , Valgimigli Marco , Billinger Michael , Pilgrim Thomas , Heg Dik , Windecker Stephan , Räber Lorenz
Published: September 2018

Background:

Biodegradable polymer sirolimus-eluting stents (BP-SESs) have been reported to be noninferior compared with durable polymer everolimus-eluting stents (DP-EES) in a randomized clinical trial. We sought to compare the efficacy and safety of an ultrathin strut BP-SES with a DP-EES in an all-comers population.

Methods and Results:

Among 7640 consecutive patients who underwent percutaneous coronary intervention between March 2011 and June 2015, 4638 patients were exclusively treated with BP-SES (N=1896; 3137 lesions) or DP-EES (N=2742; 4468 lesions). After propensity score matching within strata of clinical indications, the final study population consisted of 2902 matched patients (BP-SES 2406 lesions and DP-EES 2368 lesions). The primary device-oriented composite end point (DOCE) included cardiac death, target vessel myocardial infarction, and target lesion revascularization at 1 year. BP-SES (6.9%) was noninferior to DP-EES (8.0%) with respect to device-oriented composite end point (hazard ratio [HR], 0.85; 95% CI, 0.65–1.11;
P
for noninferiority <0.001;
P
for superiority=0.24). No differences in cardiac death (BP-SES, 2.3% versus DP-EES, 3.0%; HR, 0.76; 95% CI, 0.49–1.20;
P
=0.25), myocardial infarction (BP-SES, 4.6% versus DP-EES, 4.6%; HR, 1.00; 95% CI, 0.71–1.40;
P
=0.99), or target lesion revascularization (BP-SES, 2.8% versus DP-EES, 2.5%; HR, 1.11; 95% CI, 0.71–1.74;
P
=0.65) were observed. The rate of periprocedural myocardial infarction was comparable between the 2 groups (2.1% versus 2.2%; HR, 0.97; 95% CI, 0.59–1.58;
P
=0.89). The rate of definite stent thrombosis was similarly low throughout 1 year (BP-SES, 0.8% versus DP-EES, 0.8%; HR, 1.00; 95% CI, 0.45–2.22;
P
=1.00).

Conclusions:

In a consecutively enrolled percutaneous coronary intervention population reflecting routine clinical practice, BP-SES was noninferior to DP-EES for device-oriented composite end point at 1 year.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02241291.
Concomitant Intra-Aortic Balloon Pump Use in Cardiogenic Shock Requiring Veno-Arterial Extracorporeal Membrane Oxygenation
Authors: Vallabhajosyula Saraschandra , O’Horo John C. , Antharam Phanindra , Ananthaneni Sindhura , Vallabhajosyula Saarwaani , Stulak John M. , Eleid Mackram F. , Dunlay Shannon M. , Gersh Bernard J. , Rihal Charanjit S. , Barsness Gregory W.
Published: September 2018

Background:

There are contrasting reports on the effectiveness of a concomitant intra-aortic balloon pump (IABP) in cardiogenic shock patients treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO). This study sought to compare short-term mortality in patients with cardiogenic shock treated with VA-ECMO with and without IABP.

Methods and Results:

We reviewed the published literature from 2000 to 2018 for studies evaluating adult patients requiring VA-ECMO for cardiogenic shock with concomitant IABP. Studies reporting short-term mortality were included. Meta-analysis of the association of IABP with mortality was performed using Mantel-Haenszel models. Subgroup analyses were performed in patients with cardiogenic shock complicating acute myocardial infarction (AMI) and postcardiotomy cardiogenic shock. Twenty-two observational studies with 4653 patients were included. These studies showed high heterogeneity for the total and postcardiotomy cardiogenic shock cohorts and low heterogeneity for the AMI cohort. Short-term mortality was not significantly different in patients with and without IABP 42.1% versus 57.8%; risk ratio, 0.80; 95% CI, 0.52–1.22;
P
=0.30. However, concomitant IABP with VA-ECMO was associated with lower mortality in patients with AMI (50.8% versus 62.4%; risk ratio, 0.56; 95% CI, 0.46–0.67;
P
<0.001). There was no difference in mortality in postcardiotomy cardiogenic shock and mixed causes for cardiogenic shock.

Conclusions:

In cardiogenic shock patients requiring VA-ECMO support, the use of IABP did not influence mortality in the total cohort. In patients with AMI, use of IABP with VA-ECMO was associated with 18.5% lower mortality in comparison to patients on VA-ECMO alone. Further randomized studies are warranted to corroborate these observational data.
Rate, Timing, Correlates, and Outcomes of Hemodynamic Valve Deterioration After Bioprosthetic Surgical Aortic Valve Replacement
Authors: Salaun Erwan , Mahjoub Haïfa , Girerd Nicolas , Dagenais François , Voisine Pierre , Mohammadi Siamak , Yanagawa Bobby , Kalavrouziotis Dimitri , Juni Peter , Verma Subodh , Puri Rishi , Coté Nancy , Rodés-Cabau Josep , Mathieu Patrick , Clavel Marie-Annick , Pibarot Philippe
Published: September 2018

Background:

The incidence of structural valve deterioration after bioprosthesis (BP) aortic valve replacement (AVR) established on the basis of reoperation may substantially underestimate the true incidence. The objective is to determine the rate, timing, correlates, and association between hemodynamic valve deterioration (HVD) and outcomes assessed by Doppler echocardiography after surgical BP AVR.

Methods:

A total of 1387 patients (62.2% male, 70.5±7.8 years of age) who underwent BP AVR were included in this retrospective study. Baseline echocardiography was performed at a median time of 4.1 (1.3–6.5) months after AVR. All patients had an echocardiographic follow-up ≥2 years after AVR (926 at least 5 years and 385 at least 10 years). HVD was defined by Doppler assessment as a ≥10 mm Hg increase in mean gradient or worsening of transprosthetic regurgitation ≥1/3 class. HVD was classified according to the timing after AVR: “very early,” during the first 2-years; “early,” between 2 and 5 years; “midterm,” between 5 and 10 years; and “long-term,” >10 years.

Results:

A total of 428 patients (30.9%) developed HVD. Among these patients, 52 (12.0%) were classified as “very early,” 129 (30.1%) as “early,” 158 (36.9%) as “midterm,” and 89 (20.8%) as “long-term” HVD. Factors independently associated with HVD occurring within the first 5 years after AVR were diabetes mellitus (
P
=0.01), active smoking (
P
=0.01), renal insufficiency (
P
=0.01), baseline postoperative mean gradient ≥15 mm Hg (
P
=0.04) or transprosthetic regurgitation ≥mild (
P
=0.04), and type of BP (stented versus stentless,
P
=0.003). Factors associated with HVD occurring after the fifth year after AVR were female sex (
P
=0.03), warfarin use (
P
=0.007), and BP type (
P
<0.001). HVD was independently associated with mortality (hazard ratio, 2.18; 95% CI, 1.86–2.57;
P
<0.001).

Conclusions:

HVD as identified by Doppler echocardiography occurred in one third of patients and was associated with a 2.2-fold higher adjusted mortality. Diabetes mellitus and renal insufficiency were associated with early HVD, whereas female sex, warfarin use, and stented BPs (versus stentless) were associated with late HVD.
ADAM23 in Cardiomyocyte Inhibits Cardiac Hypertrophy by Targeting FAK‐AKT Signaling
Authors: Xiang Mei , Luo Hongbo , Wu Jia , Ren Lingyun , Ding Xiangchao , Wu Chuangyan , Chen Jiuling , Chen Shanshan , Zhang Hao , Yu Lu , Zou Yanqiang , Xu Heng , Ye Ping , Chen Manhua , Xia Jiahong
Published: September 2018

Background

Cardiac hypertrophy has been recognized as an important independent risk factor for the development of heart failure and increases the risk of cardiac morbidity and mortality. A disintegrin and metalloprotease 23 (ADAM23), a member of ADAM family, is involved in cancer and neuronal differentiation. Although ADAM23 is expressed in the heart, the role of ADAM23 in the heart and in cardiac diseases remains unknown.

Methods and Results

We observed that ADAM23 expression is decreased in both failing human hearts and hypertrophic mice hearts. Cardiac‐specific conditional ADAM23‐knockout mice significantly exhibited exacerbated cardiac hypertrophy, fibrosis, and dysfunction, whereas transgenic mice overexpressing ADAM23 in the heart exhibited reduced cardiac hypertrophy in response to pressure overload. Consistent results were also observed in angiotensin
II
‐induced neonatal rat cardiomyocyte hypertrophy. Mechanistically, ADAM23 exerts anti‐hypertrophic effects by specifically targeting the focal adhesion kinase‐protein kinase B (FAK‐AKT) signaling cascade. Focal adhesion kinase inactivation by inhibitor (
PF
‐562271) greatly reversed the detrimental effects in ADAM23‐knockout mice subjected to aortic banding.

Conclusion

Altogether, we identified ADAM23 as a negative regulator of cardiac hypertrophy through inhibiting focal adhesion kinase‐protein kinase B signaling pathway, which could be a promising therapeutic target for this malady.
Breastfeeding History and Risk of Stroke Among Parous Postmenopausal Women in the Women's Health Initiative
Authors: Jacobson Lisette T. , Hade Erinn M. , Collins Tracie C. , Margolis Karen L. , Waring Molly E. , Van Horn Linda V. , Silver Brian , Sattari Maryam , Bird Chloe E. , Kimminau Kim , Wambach Karen , Stefanick Marcia L.
Published: September 2018

Background

Stroke is the third leading cause of death among US Hispanic and non‐Hispanic black women aged 65 and older. One factor that may protect against stroke is breastfeeding. Few studies have assessed the association between breastfeeding and stroke and whether this association differs by race and ethnicity.

Methods and Results

Data were taken from the Women's Health Initiative Observational Study with follow‐up through 2010; adjusted hazard ratios for stroke subsequent to childbirth were estimated with Cox regression models accounting for left and right censoring, overall and stratified by race/ethnicity. Of the 80 191 parous women in the Women's Health Initiative Observational Study, 2699 (3.4%) had experienced a stroke within a follow‐up period of 12.6 years. The average age was 63.7 years at baseline. Fifty‐eight percent (n=46 699) reported ever breastfeeding; 83% were non‐Hispanic white, 8% were non‐Hispanic black, 4% were Hispanic, and 5% were of other race/ethnicity. After adjustment for nonmodifiable potential confounders, compared with women who had never breastfed, women who reported ever breastfeeding had a 23% lower risk of stroke (adjusted hazard ratio=0.77; 95% confidence interval 0.70‐0.83). This association was strongest for non‐Hispanic black women (adjusted hazard ratio=0.52; 95% confidence interval 0.37‐0.71). Further, breastfeeding for a relatively short duration (1‐6 months) was associated with a 19% lower risk of stroke (adjusted hazard ratios=0.81; 95% confidence interval 0.74‐0.89). This association appeared stronger with longer breastfeeding duration and among non‐Hispanic white and non‐Hispanic black women (test for trend
P<
0.01).

Conclusions

Study results show an association and dose‐response relationship between breastfeeding and lower risk of stroke among postmenopausal women after adjustment for multiple stroke risk factors and lifestyle variables. Further investigation is warranted.
Plasma Cystathionine and Risk of Incident Stroke in Patients With Suspected Stable Angina Pectoris
Authors: Dhar Indu , Svingen Gard F.T. , Ueland Per M. , Lysne Vegard , Svenningsson Mads M. , Tell Grethe S. , Nygård Ottar K.
Published: September 2018

Background

Cystathionine is an intermediate product in the transsulfuration pathway and formed during the B6‐dependent conversion of methionine to cysteine. Elevated plasma cystathionine has been related to atherosclerosis, which is a major etiological factor for ischemic stroke. However, the role of cystathionine in stroke development is unknown. Therefore, we prospectively assessed the association of circulating levels of cystathionine with risk of total and ischemic stroke.

Methods and Results

Two‐thousand thirty‐six patients (64% men; median age, 62 years) undergoing coronary angiography for suspected stable angina pectoris were included. Stroke cases were identified by linkage to the CVDNOR (Cardiovascular Disease in Norway) project. Hazard ratios with confidence intervals (95% confidence interval) were estimated by using Cox‐regression analyses. During 7.3 years of median follow‐up, 124 (6.1%) incident strokes were ascertained, which comprised 100 cases of ischemic stroke. There was a positive association of plasma cystathionine with risk of total stroke and ischemic stroke. Comparing the fourth versus the first cystathionine quartiles, age‐ and sex‐adjusted hazard ratios (95% confidence interval) were 2.11 (1.19–3.75) and 2.56 (1.31–4.99) for total and ischemic stroke, respectively. Additional adjustment for major stroke risk factors only slightly attenuated the associations, which tended to be stronger in patients without previous or existing atrial fibrillation at baseline (hazard ratio [95% confidence interval], 2.43 [1.27–4.65] and 2.88 [1.39–5.98] for total and ischemic stroke, respectively).

Conclusions

In patients with suspected stable angina pectoris, plasma cystathionine was independently related to increased risk of total stroke and, in particular, ischemic stroke.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
00354081.
INCA (Peru) Study: Impact of Non‐Invasive Cardiac Magnetic Resonance Assessment in the Developing World
Authors: Menacho Katia , Ramirez Sara , Segura Pedro , Nordin Sabrina , Abdel‐Gadir Amna , Illatopa Violeta , Bhuva Anish , Benedetti Giulia , Boubertakh Redha , Abad Pedro , Rodriguez Bertha , Medina Felix , Treibel Thomas , Westwood Mark , Fernandes Juliano , Walker John Malcolm , Litt Harold , Moon James C.
Published: September 2018

Background

Advanced cardiac imaging permits optimal targeting of cardiac treatment but needs to be faster, cheaper, and easier for global delivery. We aimed to pilot rapid cardiac magnetic resonance (
CMR
) with contrast in a developing nation, embedding it within clinical care along with training and mentoring.

Methods and Results

A cross‐sectional study of
CMR
delivery and clinical impact assessment performed 2016–2017 in an upper middle‐income country. An International partnership (clinicians in Peru and collaborators from the United Kingdom, United States, Brazil, and Colombia) developed and tested a 15‐minute
CMR
protocol in the United Kingdom, for cardiac volumes, function and scar, and delivered it with reporting combined with training, education and mentoring in 2 centers in the capital city, Lima, Peru, 100 patients referred by local doctors from 6 centers. Management changes related to the
CMR
were reviewed at 12 months. One‐hundred scans were conducted in 98 patients with no complications. Final diagnoses were cardiomyopathy (hypertrophic, 26%; dilated, 22%; ischemic, 15%) and 12 other pathologies including tumors, congenital heart disease, iron overload, amyloidosis, genetic syndromes, vasculitis, thrombi, and valve disease. Scan cost was $150 USD, and the average scan duration was 18±7 minutes. Findings impacted management in 56% of patients, including previously unsuspected diagnoses in 19% and therapeutic management changes in 37%.

Conclusions

Advanced cardiac diagnostics, here
CMR
with contrast, is possible using existing infrastructure in the developing world in 18 minutes for $150, resulting in important changes in patient care.
Hemodynamic Patterns Identified by Impedance Cardiography Predict Mortality in the General Population: The PREVENCION Study
Authors: Medina‐Lezama Josefina , Narvaez‐Guerra Offdan , Herrera‐Enriquez Karela , Morey‐Vargas Oscar L. , Bolaños‐Salazar Juan Francisco , Abugattas Juan P. , Zea‐Diaz Humberto , Chirinos‐Revilla Jose L. , Fernandez‐Sivincha Jenny G. , Delgado‐Lazo Victor , Chirinos Diana A. , Townsend Raymond R. , Chirinos Julio A.
Published: September 2018

Background

Blood pressure is determined by the interactions between the heart and arterial properties, and subjects with identical blood pressure may have substantially different hemodynamic determinants. Whether arterial hemodynamic indices quantified by impedance cardiography (
ICG
), a simple operator‐independent office procedure, independently predict all‐cause mortality in adults from the general population, and specifically among those who do not meet criteria for American College of Cardiology/American Heart Association stage 2 hypertension, is currently unknown.

Methods and Results

We studied 1639 adults aged 18 to 80 years from the general population. We used
ICG
to measure hemodynamic parameters and metrics of cardiac function. We assessed the relationship between hemodynamic parameters measured at baseline and all‐cause mortality over a mean follow‐up of 10.9 years. Several
ICG
parameters predicted death. The strongest predictors were total arterial compliance index (standardized hazard ratio=0.38; 95% confidence interval=0.31–0.46;
P
<0.0001) and indices of cardiac contractility: velocity index (standardized hazard ratio=0.45; 95% confidence interval=0.37–0.55;
P
<0.0001) and acceleration index (standardized hazard ratio=0.44; 95% confidence interval=0.35–0.55;
P
<0.0001). These remained independently predictive of death after adjustment for multiple confounders, as well as systolic and diastolic blood pressure. Among subjects without stage 2 hypertension (n=1563), indices of cardiac contractility were independently predictive of death and identified a subpopulation (25% of non‐stage‐2 hypertensives) that demonstrated a high 10‐year mortality risk, equivalent to that of stage 2 hypertensives.

Conclusions

Hemodynamic patterns identified by
ICG
independently predict mortality in the general population. The predictive value of
ICG
applies even in the absence of American College of Cardiology/American Heart Association stage 2 hypertension and identifies higher‐risk individuals who are in earlier stages of the hypertension continuum.
Prior Direct Oral Anticoagulant Therapy is Related to Small Infarct Volume and No Major Artery Occlusion in Patients With Stroke and Non‐Valvular Atrial Fibrillation
Authors: Sakamoto Yuki , Okubo Seiji , Sekine Tetsuro , Nito Chikako , Suda Satoshi , Matsumoto Noriko , Nishiyama Yasuhiro , Aoki Junya , Shimoyama Takashi , Kanamaru Takuya , Suzuki Kentaro , Mishina Masahiro , Kimura Kazumi
Published: September 2018

Background

The aims of the present study were to investigate the relationships between prior direct oral anticoagulant (
DOAC
) therapy and infarct volume and the site of arterial occlusion in patients with acute ischemic stroke and non‐valvular atrial fibrillation.

Methods and Results

From March 2011 through November 2016, consecutive patients with acute ischemic stroke in the middle cerebral artery territory and non‐valvular atrial fibrillation were recruited. The infarct volume was assessed semi‐automatically using initial diffusion‐weighted imaging, and the arterial occlusion site was evaluated on magnetic resonance angiography. The effect of prior
DOAC
treatment on the site of arterial occlusion was assessed by multivariate ordinal logistic regression analysis. A total of 330 patients (149 women; median age 79 [quartiles 71–86] years; median National Institutes of Health Stroke Scale score 11 [4–21]) were enrolled. Of these, 239 were on no anticoagulant, 40 were undertreated with a vitamin K antagonist (
VKA
), 22 were sufficiently treated with
VKA
(
PT
‐
INR
≥1.6), and 29 were on a
DOAC
before the acute ischemic stroke. The infarct volume on admission differed among the groups (median 14.5 [2.0–59.8] cm
3
in patients with no anticoagulation, 24.8 [2.1–63.0] in undertreated
VKA
, 1.3 [0.3–13.5] in sufficient
VKA
, and 2.3 [0.5–21.0] in
DOAC
,
P
=0.001). Multivariate analysis showed that prior
DOAC
treatment was independently and negatively associated with more proximal artery occlusion (odds ratio [OR] 0.34,
P
=0.015), compared with no anticoagulant.

Conclusions

DOAC
treatment before the event was associated with smaller infarct volume and decreased risk of greater proximal artery occlusion in acute ischemic stroke patients with non‐valvular atrial fibrillation, compared with no anticoagulation.
Atrial Fibrillation and Risk of Cancer: A Danish Population‐Based Cohort Study
Authors: Vinter Nicklas , Christesen Amanda M. S. , Fenger‐Grøn Morten , Tjønneland Anne , Frost Lars
Published: September 2018

Background

Atrial fibrillation (
AF
) and cancer are frequent diseases worldwide. The timewise association between the diagnosis of
AF
and a subsequent diagnosis of cancer may clarify whether a mutual cause exists, and may also guide clinicians about time windows of high risk of cancer occurrence.

Methods and Results

We conducted a population‐based cohort study among 26 222 men and 28 879 women free of
AF
and cancer at baseline based on the Danish Diet, Cancer and Health study. The participants were followed for the development of
AF
(the Danish National Patient Registry) and subsequent cancer (the Danish Cancer Registry) until 2013. We used Cox proportional hazard models with new‐onset
AF
as time‐dependent exposure. The men (median age 56 years) and women (median age 56 years) were followed for medians of 16.7 and 19.6 years, respectively.
AF
was associated with higher risks of any type of cancer (men: hazard ratio [
HR
] 1.41, 95% confidence interval [
CI
], 1.26–1.58; women:
HR
1.15, 95%
CI
, 1.02–1.32), and for men only, lung (
HR
1.66, 95%
CI
, 1.19–2.30), and colorectal cancer (
HR
1.37, 95%
CI
, 1.02–1.85). Within the initial 90 days following the diagnosis of
AF
, the risks of any type of cancer (men:
HR
2.89, 95%
CI
, 2.10–3.98; women:
HR
3.72, 95%
CI
, 2.49–5.56), lung (men:
HR
7.70, 95%
CI
, 4.34–13.68; women:
HR
7.98, 95%
CI
, 3.96–16.09), and colorectal cancer (men:
HR
3.35, 95%
CI
, 1.03–10.90; women:
HR
5.91, 95%
CI
, 2.44–14.29) were higher for men and women.

Conclusions

A diagnosis of
AF
is associated with a higher incidence rate of cancer among men and women. The cancer incidence rate is particularly elevated within 90 days after the diagnosis of
AF
.
Impact of the Myosin Modulator Mavacamten on Force Generation and Cross‐Bridge Behavior in a Murine Model of Hypercontractility
Authors: Mamidi Ranganath , Li Jiayang , Doh Chang Yoon , Verma Sujeet , Stelzer Julian E.
Published: September 2018

Background

Recent studies suggest that mavacamten (Myk461), a small myosin‐binding molecule, decreases hypercontractility in myocardium expressing hypertrophic cardiomyopathy‐causing missense mutations in myosin heavy chain. However, the predominant feature of most mutations in cardiac myosin binding protein‐C (
cMyBPC
) that cause hypertrophic cardiomyopathy is reduced total
cMyBPC
expression, and the impact of Myk461 on
cMyBPC
‐deficient myocardium is currently unknown.

Methods and Results

We measured the impact of Myk461 on steady‐state and dynamic cross‐bridge (
XB
) behavior in detergent‐skinned mouse wild‐type myocardium and myocardium lacking cMyBPC (knockout (KO)).
KO
myocardium exhibited hypercontractile
XB
behavior as indicated by significant accelerations in rates of
XB
detachment (k
rel
) and recruitment (k
df
) at submaximal Ca
2+
activations. Incubation of
KO
and wild‐type myocardium with Myk461 resulted in a dose‐dependent force depression, and this impact was more pronounced at low Ca
2+
activations. Interestingly, Myk461‐induced force depressions were less pronounced in
KO
myocardium, especially at low Ca
2+
activations, which may be because of increased acto‐myosin
XB
formation and potential disruption of super‐relaxed
XB
s in
KO
myocardium. Additionally, Myk461 slowed k
rel
in
KO
myocardium but not in wild‐type myocardium, indicating increased
XB
“
on
” time. Furthermore, the greater degree of Myk461‐induced slowing in k
df
and reduction in
XB
recruitment magnitude in
KO
myocardium normalized the
XB
behavior back to wild‐type levels.

Conclusions

This is the first study to demonstrate that Myk461‐induced force depressions are modulated by
cMyBPC
expression levels in the sarcomere, and emphasizes that clinical use of Myk461 may need to be optimized based on the molecular trigger that underlies the hypertrophic cardiomyopathy phenotype.
Plasma Soluble Human Elastin Fragments as an Intra‐Aneurysmal Localized Biomarker for Ruptured Intracranial Aneurysm
Authors: Nakagawa Daichi , Zanaty Mario , Hudson Joseph , Teferi Nahom , Ishii Daizo , Allan Lauren , Jabbour Pascal , Ortega‐Gutierrez Santiago , Samaniego Edgar A. , Hasan David M.
Published: September 2018

Background

Fragmentation of the tunica media is a hallmark of intracranial aneurysm formation, often leading to aneurysmal progression and subsequent rupture. The objective of this study is to determine the plasma level of elastin fragments in the lumen of ruptured versus unruptured human intracranial aneurysms.

Methods and Results

One hundred consecutive patients with/without ruptured saccular intracranial aneurysms undergoing endovascular coiling or stent‐assisted coiling were recruited. Blood samples were collected from the lumen of intracranial aneurysm using a microcatheter. The tip of the microcatheter was placed inside the aneurysm's sac in close proximity to the inner wall of the dome. Plasma levels of elastin fragments were measured using an
ELISA
‐based method. Mean plasma level of soluble human elastin fragments was significantly greater in ruptured aneurysms when compared with nonruptured aneurysms (102.0±15.5 versus 39.3±9.6 ng/mL;
P
<0.001). Mean plasma level of soluble human elastin fragments did not have significant correlation with age, sex, size, or aneurysm location.

Conclusions

The present study revealed that a significantly higher concentration of soluble human elastin fragments in the lumen of ruptured intracranial aneurysms when compared with nonruptured ones.
Aerobic Exercise Training and Inducible Inflammation: Results of a Randomized Controlled Trial in Healthy, Young Adults
Authors: Sloan Richard P. , Shapiro Peter A. , McKinley Paula S. , Bartels Matthew , Shimbo Daichi , Lauriola Vincenzo , Karmally Wahida , Pavlicova Martina , Choi C. Jean , Choo Tse‐Hwei , Scodes Jennifer M. , Flood Pamela , Tracey Kevin J.
Published: September 2018

Background

Consensus panels regularly recommend aerobic exercise for its health‐promoting properties, due in part to presumed anti‐inflammatory effects, but many studies show no such effect, possibly related to study differences in participants, interventions, inflammatory markers, and statistical approaches. This variability makes an unequivocal determination of the anti‐inflammatory effects of aerobic training elusive.

Methods and Results

We conducted a randomized controlled trial of 12 weeks of aerobic exercise training or a wait list control condition followed by 4 weeks of sedentary deconditioning on lipopolysaccharide (0, 0.1, and 1.0 ng/mL)‐inducible tumor necrosis factor‐α (TNF‐α) and interleukin‐6 (IL‐6), and on toll‐like receptor 4 in 119 healthy, sedentary young adults. Aerobic capacity by cardiopulmonary exercise testing was measured at study entry (T1) and after training (T2) and deconditioning (T3). Despite a 15% increase in maximal oxygen consumption, there were no changes in inflammatory markers. Additional analyses revealed a differential longitudinal aerobic exercise training effect by lipopolysaccharide level in inducible
TNF
‐α (
P
=0.08) and IL‐6 (
P
=0.011), showing T1 to T2 increases rather than decreases in inducible (lipopolysaccharide 0.1, 1.0 versus 0.0 ng/mL)
TNF‐
α (51% increase,
P
=0.041) and IL‐6 (42% increase,
P
=0.11), and significant T2 to T3 decreases in inducible
TNF‐
α (54% decrease,
P
=0.007) and IL‐6 (55% decrease,
P
<0.001). There were no significant changes in either group at the 0.0 ng/mL lipopolysaccharide level for
TNF‐
α or IL‐6.

Conclusions

The failure to support the primary hypotheses and the unexpected post hoc findings of an exercise‐training–induced proinflammatory response raise questions about whether and under what conditions exercise training has anti‐inflammatory effects.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
01335737.
The Transition Debate Today
Authors: Rutar Tibor
Published: September 2018

Spencer Dimmock has produced a convincing restatement, defence and update of Robert Brenner’s influential work on the origin of capitalism in England. The book productively engages with many Marxist and non-Marxist critics of the so-called ‘Brenner Thesis’, and presents fresh secondary and primary evidence in favour of it. This review sketches the theoretical background of Brenner’s intervention, summarises Dimmock’s take on Brenner, and comments on a few notable contemporary critiques of Brenner’s general framework which are not explicitly engaged with by Dimmock.
Chroakolemma gen. nov. (Leptolyngbyaceae, Cyanobacteria) from soil biocrusts in the semi-desert Central Region of Mexico
Authors: BECERRA-ABSALÓN ITZEL , JOHANSEN JEFFREY R. , MUÑOZ-MARTÍN M. ANGELES , MONTEJANO GUSTAVO
Published: September 2018

Twelve strains of Leptolyngbya-like filaments were isolated from biological soil crust samples from two localities in the Central Region of Mexico. The strains were morphologically distinguished from most Synechococcalean species by the obligate presence of a blackish sheath. Phylogenetic analysis based on 16S rRNA gene sequence placed all strains into a strongly supported single clade sister to Scytolyngbya. The genetic identity between our strains and all other Synechococcales, including Scytolyngbya, was less than 95%, and the strains were further distinguished by morphology and terrestrial ecology. The conserved domains of the 16S-23S ITS region had secondary structures distinct from all other closely related genera, which included Scytolyngbya, Stenomitos, Chamaethrix, and Pantanalinema. Based on the combination of morphological, molecular, and ecological evidence, we here describe two species: Chroakolemma opaca gen. et sp. nov. and C. pellucida gen. et sp. nov. Based on the ability to form blackish sheaths, these two species are morphologically similar to Leptolyngbya edaphica, Chamaethrix vaginata and Trichocoleus badius. The latter two species have been sequenced and are phylogenetically distant from Chroakolemma. Leptolyngbya edaphica is a soil species described from Russia and shares other morphological similarities with Chroakolemma, including wide sheaths, coiled filaments, pale blue-green trichomes, and constricted cross-walls. We consider these characteristics diagnostic of Chroakolemma, and accordingly propose Chroakolemma edaphica comb. nov.
Arnica angustifolia (Asteraceae, Madieae), a new generic record for China
Authors: LI HUI-MIN , ZENG YOU-PAI , REN CHEN , YANG QIN-ER
Published: September 2018

Arnica, the only genus within subtribe Arnicinae under tribe Madieae of the Asteraceae, is a circumboreal genus of 29 species mainly distributed in western North America, with a few in Europe and Asia. Here we report the occurrence of the genus in China for the first time. A population of Arnica angustifolia subsp. angustifolia was discovered in Qinghe County, Xinjiang. Our identification is confirmed by evidence from ITS/ETS sequence data.
Review of the Indo-West Pacific genus Inimicus (Synanceiidae: Choridactylinae)
Authors: INABA TOMOKI , MOTOMURA HIROYUKI
Published: September 2018

The stinger genus Inimicus Jordan & Starks, 1904 (family Synanceiidae), distributed in the Indo-West Pacific, is characterized by having two free pectoral-fin rays. Examination of the original descriptions and 420 specimens, including all available type specimens, of the genus resulted in the recognition of nine valid species: Inimicus brachyrhynchus (Bleeker, 1874) (recorded from Hong Kong and Singapore), I. caledonicus (Sauvage, 1878) (distributed in Andaman Sea and western Pacific Ocean), I. cuvieri (Gray, 1835) (Andaman Sea and western Pacific Ocean), I. didactylus (Pallas, 1769) (western Pacific), I. filamentosus (Cuvier, 1829) (western Indian Ocean), I. gruzovi Mandrytsa, 1991 (Coral Sea), I. japonicus (Cuvier, 1829) (East Asia), I. sinensis (Valenciennes, 1833) (eastern Indian and western Pacific oceans), and I. smirnovi Mandrytsa, 1990 (southwestern Pacific Ocean). Inimicus joubini (Chevey, 1927), previously considered a valid species, is herein regarded as a junior synonym of I. japonicus. Another 10 nominal species are confirmed to be synonymized with the nine species. A revised diagnosis for each species and a key to all the species are provided.
A new species of myxozoa in the skeletal striated musculature of Rhamdia quelen (Quoy & Gaimard) (Siluriforme: Pimelodidae) Amazonian fish, Marajó island, Brazil
Authors: ABRUNHOSA JACQUELINE , SINDEAUX-NETO JOSE L. , SANTOS SIDNEY , HAMOY IGOR , MATOS EDILSON
Published: September 2018

A new myxozoan was found parasitizing the freshwater catfish, Rhamdia quelen (Quoy & Gaimard), in the Marajó island, Amazon region, Brazil. The new species is described based on the results of morphological and molecular analyses. The parasite is approximately 1.5 mm in diameter and develops in the musculature of the host in the form of spherical, whitish cysts, which are visible macroscopically between the epaxial and hypaxial layers. When ruptured, these cysts produced ellipsoidal spores with a mean length of 11.4 μm (10.7–12.6) and width of 7.2 μm (6.4–7.9). Anomalous spores with a caudal elongation, vesicles in the peripheral portion of the spore and ornamentation of the valves were also observed. The results of the phylogenetic analysis of sequences of the 18S rDNA gene using Bayesian Inference indicated clear differences among the Myxobolus species that reinforced the taxonomic position of the parasite, confirming its status as a new species, denominated Myxobolus arariensis n. sp.
The Climatology of the Atmospheric Boundary Layer in Contemporary Global Climate Models
Authors: Davy Richard
Published: September 2018

Here, we present the climatology of the planetary boundary layer depth in 18 contemporary general circulation models (GCMs) in simulations of the late-twentieth-century climate that were part of phase 5 of the Coupled Model Intercomparison Project (CMIP5). We used a bulk Richardson methodology to establish the boundary layer depth from the 6-hourly synoptic-snapshot data available in the CMIP5 archives. We present an ensemble analysis of the climatological mean, diurnal cycle, and seasonal cycle of the boundary layer depth in these models and compare it to the climatologies from the ECMWF ERA-Interim reanalysis. Overall, we find that the CMIP5 models do a reasonably good job of reproducing the distribution of mean boundary layer depth, although the geographical patterns vary considerably between models. However, the models are biased toward weaker diurnal and seasonal cycles in the boundary layer depth and generally produce much deeper boundary layers at night and during the winter than are found in the reanalysis. These biases are likely to reduce the ability of these models to accurately represent other properties of the diurnal and seasonal cycles, and the sensitivity of these cycles to climate change.
Beyond Threshold Approaches to Extreme Heat: Repositioning Adaptation as Everyday Practice
Authors: Oppermann Elspeth , Strengers Yolande , Maller Cecily , Rickards Lauren , Brearley Matt
Published: September 2018

One of climate change’s most certain impacts is increasingly frequent and extreme heat. Heat management and climate adaptation policies generally utilize temperature and humidity thresholds to identify what constitute “extreme” conditions. In the workplace, such thresholds can be used to trigger reductions in work intensity and/or duration. In regions that routinely exceed proposed thresholds, however, this approach can be deeply problematic and raises critical questions about how frequently exposed populations already manage and mitigate the effects of extreme heat. Drawing on social practice theories, this paper repositions everyday engagements with extreme heat in terms of practices of work. It finds that bodies absorb and produce heat through practices, challenging the view that extreme heat is an “external” risk to which bodies are “exposed”. This theoretical starting point also challenges the utility of threshold-based adaptation strategies by demonstrating how heat is actively coproduced by living, performing bodies in weather. This argument is exemplified through a case study of outdoor, manual workers in Australia’s monsoon tropics, where work practices were adapted to reduce thermal load. More specifically, we find that workers “weather” work and “work” the weather to enable work to be done in extreme conditions. Our analysis of everyday heat adaptation draws attention to the generative capacities of bodies and unsettles two established separations: 1) that between climatic exposure and sensitivity, calling for a more embodied, experiential, and performed perspective and 2) that between climatic impacts and (mal)adaptation, calling for an understanding of climate adaptation, as located in everyday practices, in the management of bodies in weather.