bluuebunny/crossref_metadata_2025 huggingface dataset:
Refinement Economic Management Method Based on Management Accounting
Authors: Lun Xi , Wang Tian , Zhang Mi , Wang Yining
Published: April 2022

The economic strength of a country is the external manifestation of its comprehensive national strength. In order to increase a country’s international influence, it must strengthen its own economic development. China’s economy is in a period of rapid development. At this stage, enterprise development is an important factor in promoting steady economic growth. However, economic management plays an important role in the development of an enterprise. Therefore, how to use effective economic management methods to promote the development of enterprises is very important. This method helps to enhance the competitiveness of enterprises and improve the economic efficiency of enterprises. This approach needs to get people’s attention. For productive enterprises, the biggest problem is that the economic benefits are not up to expectations. In addition, spending costs are always well over budget. In fact, this has a lot to do with business management. Before the market, economic system was reformed. The comprehensive management of productive enterprises is mostly extensive management. This makes the economic costs of certain links and details out of control. Therefore, effective management of the economy of a productive enterprise is critical. Although productive enterprises cannot be said to be highly profitable, their economic benefits are at least achievable. For productive enterprises, the most effective management method for the economy is refined management. This article starts from the perspective of improving the speed of enterprise development. Specifically, the starting point is to promote the improvement of the country’s comprehensive national strength. The article analyzes the inherent relationship between economic management and enterprise development, hoping it can provide positive help for China’s social and economic progress.
Application Effect of Combining Image‐Text Communication‐Based Healthcare Education with Shifting of Attention on Child Patients Undergoing Inguinal Hernia Repair under General Anesthesia
Authors: Chen Sandong , Liang Wanshun , Wang Shuai , Jia Yingping
Published: April 2022

Objective. To analyze the application effect of image‐text communication‐based healthcare education combined with shifting of attention on child patients undergoing inguinal hernia repair under general anesthesia. Methods. A total of 110 child patients with inguinal hernia treated in our hospital from January 2020 to January 2022 were selected as the study subjects and divided into the control group (CG, routine intervention measures) and the research group (RG, image‐text communication‐based healthcare education combined with shifting of attention) according to their preoperative intervention plans, with 55 cases each. After surgery, the child patients’ psychological status, crying and shouting situation, and occurrence of complications were evaluated to compare and analyze the intervention effect of the two groups. Results. The child patients’ positive rate and anxiety incidence rate of psychological status evaluation were obviously lower in RG than in CG (P < 0.05), and the daily frequency of crying and shouting was significantly lower in RG than in CG (P < 0.05); the single time of crying and shouting was significantly shorter in RG than in CG (P < 0.05); after surgery, child patients in the two groups had different degrees of infections, subcutaneous emphysema, and scrotal edema, but the total incidence rate of these complications was obviously lower in RG than in CG (P < 0.05); after surgery, no significant between‐group difference in child patients’ FLACC scores immediately after being transferred to the ward was observed (P > 0.05), and at postoperative 1 h, 3 h, and 5 h, the FLACC scores of RG were obviously lower than those of CG (P < 0.05); and according to the investigation results, the total satisfaction and number of very satisfied parents in RG were greatly higher than those in CG (P < 0.05). Conclusion. Before child patients undergoing inguinal hernia repair under general anesthesia, implementing image‐text communication‐based healthcare education combined with shifting of attention can effectively improve the child patients’ postoperative psychological status and crying and shouting situation and is conducive to preventing postoperative infections, pain, and other complications and promoting postoperative recovery. The combined intervention has potential utility in reducing child patients’ high‐risk adverse reactions during the perioperative period and ensuring smooth operation, which is generally recognized by the child patients’ family members.
Three‐Dimensional Reconstruction of a CT Image under Deep Learning Algorithm to Evaluate the Application of Percutaneous Kyphoplasty in Osteoporotic Thoracolumbar Compression Fractures
Authors: Li Jiameng , Xiang Zhong , Zhou Jiaqing , Zhang Meng
Published: April 2022

In order to investigate the therapeutic evaluation of percutaneous kyphoplasty (PKP) for the treatment of osteoporotic thoracolumbar compression fractures by three‐dimensional (3D) reconstruction of computed tomography (CT) based on the deep learning V‐Net network, the traditional V‐Net was optimized first and a new and improved V‐Net was proposed. The introduced U‐Net, V‐Net, and convolutional neural network (CNN) were compared in this study. Then, 106 patients with osteoporotic thoracolumbar compression fractures were enrolled, and 128 centrums were divided into the test group with 53 cases of PKP and the control group with 53 cases of percutaneous vertebroplasty (PVP) according to different surgical protocols. All patients underwent CT scan based on the improved V‐Net, and data of centrum measurement indicators, pain score, and therapeutic evaluation results of the modified Macnab were collected. The Dice coefficient of the improved V‐Net was observably higher than that of U‐Net, V‐Net, and CNN, while the Hausdorff distance was lower than that of U‐Net, V‐Net, and CNN (P < 0.05). The anterior height, central height, and posterior height of the centrum were significantly higher than those in the control group after operation (3, 5, and 7 days), while the Cobb angle of vertebral kyphosis was significantly lower than that in the control group (P < 0.05). The score of visual analog scale (VAS) and analgesic use score of patients in the test group were markedly lower than those in the control group (3, 5, and 7 days after operation), P < 0.05. Besides, the excellent and good rate of the test group was remarkably higher than that of the control group, P < 0.05. Hence, the improved V‐Net had better quality of segmentation and reconstruction than the traditional deep learning network. Compared with PVP, PKP was helpful in restoring the height of the centrum in patients with osteoporotic thoracolumbar compression fractures and correct kyphosis, with better analgesic effect safety.
RANGE EXPANSION OF Parachromis managuensis (GÜNTHER, 1867) (PERCIFORMES, 4 CICHLIDAE) IN JAVA, INDONESIA
Authors: Hasan Veryl , Faqih Abdul Rahem , Maftuch Maftuch
Published: April 2022

The Jaguar cichlid, Parachromis managuensis (Günther, 1867), is native to Central America, with introduc­tions reported from West Java and Central Java Provinces of Indonesia. On 7-8 January 2019, sixteen specimens of P. managuensis were collected from Karangkates, the largest hydropower reservoir in East Java Province of Indonesia. A description of the morphological characters of specimens is provided.
MOLD DIVERSITY OF WREATHED HORNBILL (Rhyticeros undulatus) NEST IN MOUNT UNGARAN
Authors: Rahayuningsih Margareta , Revandi Yanuar , Bintari Siti Harnina
Published: April 2022

Wreathed Hornbill (Rhyticeros undulates) is known to build nests in three cavities where they managed to live and breed. This edifice is predicted to contain various molds needed to maintain micro-environmental steadiness. This study was aimed to identify molds diversity in the Wreathed Hornbill’s nest, using samples collected from empty structure with no bird activity. The samples were obtained from the Kalisidi and Nglimut observation stations on two occasions, i.e., in 2016 and 2017. Furthermore, the samples comprised cover soil, wood and inner material, which were collected aseptically and placed in sterile Ziplock plastic bags. These samples were then diluted in sterilized distilled water to attain 10-3 mg/ mL, and subsequently inoculated on Potato Dextrose Agar (PDA), Malt Extract Agar (MEA) and Czapek Dox Agar (CDA). The inoculants were incubated at 37 °C, followed by the observation of mold colony after the 11th day. The results identified seven and nine species of molds in the Kalisidi and Nglimut observation stations, respectively. The most abundant species was Penicillium sp. which was found in composted nest materials for the whole observation periods.
GENETIC VARIABILITY OF ARROWROOT (MARANTA ARUNDINACEA L.) IN YOGYAKARTA PROVINCE, INDONESIA BASED ON ISSR ANALYSIS
Authors: Pratama Bernardinus , - Purnomo , Daryono Budi Setiadi
Published: April 2022

The cultivation of arrowroot (Maranta arundinacea L.) in Indonesia, particularly in Yogyakarta Province has a great potential to be developed. This study aims to determine the genetic variability and analyze the intraspecific relation of arrowroot using Inter Simple Sequence Repeats (ISSR) markers as basic informations for considerations in the character selection of arrowroot cultivation in Yogyakarta. Exploratory survey method was occured in Gunungkidul, Kulon Progo, Sleman, and Bantul Districts to collect cultivar accessions. Accessions were replanted in Sawitsari Research Station. DNA isolation from the leaves of 7 moths old accessions was done using CTAB buffer solution. The DNA fingerprinting analysis was carried out using the result of DNA amplification with 4 ISSR markers. The polymorphism data then used for phenetic analysis using UPGMA algorithm and Baroni-Urbani Busser similarity coefficient to form dendrogram. Total of 5 local cultivars were found, identified as ‘Sili’, ‘Sembowo’,’ Sugo’, ‘Kebo’, and ‘Teropng’, each showed distinct rhizome morphological characters. The ISSR-PCR analysis resulted high polymorphism with 68,17% polymorphism mean and mean of polymorphic band was 6,75. Dendrogram resulted 4 clusters in 80% similarity index. Cluster A, B.I., and B.II.b consisted of ‘Sili’, ‘Teropong’, and ‘Kebo’ cultivars, respectively, while the cluster B.II.a gathered ‘Sugo’and ‘Sembowo’ cultivars.
Proclus on the Forms as Paradigms in "Plato’s Parmenides: the Neoplatonic Response to Aristotle and Alexander of Aphrodisias’ Criticisms"
Authors: Mouzala Melina
Published: April 2022

This paper sets out to analyze Proclus’ exegesis of Socrates’ suggestion in Parmenides 132d1-3 that Forms stand fixed as patterns (παραδείγματα), as it were, in the nature, with the other things being images and likenesses of them. Proclus’ analysis of the notion of being pattern reveals the impact of the Aristotelian conception of the form as paradigm on his views, as we can infer from Alexander of Aphrodisias’ and Simplicius’ explanation of the paradigmatic character of the Aristotelian form. Whereas Aristotle and Alexander of Aphrodisias refute the efficient causality of the Platonic Forms and support that μέθεξις is just a metaphor, Syrianus, Proclus and Asclepius defend the Platonic theory, and specifically Proclus, who brings to the fore the multilateral role of the Forms as patterns with regard to the secondary things of this realm.[1]

 

[1] An earlier version of this paper was presented at the Symposium Platonicum XII: Plato’s Parmenides, organized by the International Plato Society, Paris, 15-19 July 2019.
Contradiction, Being, and Meaning in Aristotle’s Metaphysics Gamma
Authors: Massie Pascal
Published: April 2022

This paper focuses on Aristotle’s discussion of PNC in Metaphysics Gamma and argues that the argument operates at three different levels: ontological, doxastic, and semantic through the invocation of three philosophical personae: the first one (the philosopher) can only state what is otherwise unprovable, the second one (a geometer) can only confirm that we should trust PNC, the third one (a sophistical opponent) denies PNC and must be silenced. Aristotle cannot prove what is beyond proof. This situation results in a fundamental ambiguity in the figure of the philosopher. The Metaphysics is written from the standpoint of an investigative thinker who admits her puzzlement before a question that will forever remain open and imagines another philosopher who has achieved a god-like insight into the first principles of all things. The path from the first figure to the second one, however, remains an enigmatic leap.
Argumentos y Explicaciones en De Caelo 2
Authors: Mié Fabián , Berrón Manuel
Published: April 2022

The main concern of this paper is the problem of method in De Caelo (Book 2 and some related treatises), which has been recently invigorated by the supposition of Aristotle’s acceptance of two standards of justification. Whereas the φυσικῶς argument comes close to demonstrative knowledge, the εὐλόγως argument relies on more general assumptions and allegedly points towards argumentative justification (sometimes associated with dialectic). With a view to better understanding how empirical criteria for theories, teleological principles, and the resolution of difficulties are laid down to provide as much causal explanations  as possible, we take side here in the debate about the very purpose of Aristotle’s using of justification by argument in scientific contexts. Our main claim is that although only reasonable proofs can be  worked out in empirically underdetermined domains, this in no way amounts to endorsing an alternative to the norms of inquiry Aristotle upholds in natural science.
Los Antecedentes Presocráticos de la Teoría Estoica de Conflagración
Authors: Salles Ricardo
Published: April 2022

In this paper, I explore the Presocratic antecedents of the Stoic theory of conflagration and argue that, even though three central theses of this theory have solid antecedents in Presocratic physics, the logical connection between them is a Stoic innovation. I label the Presocratics who hold these theses ‘Anaximandreans’ and include in this group Anaximander himself , Heraclitus and Diogenes of Apollonia, and reveal that Anaximenes, Democritus and Antiphon share with them central meteorological and cosmological assumptions.
Abstract 11897: Prevalence of Abnormalities of Mineral Metabolism in Patients With Stable Coronary Artery Disease According to Renal Function
Authors: Gaebelt Hans P , Martinez-milla Juan , Pello Ana M , Lopez-Castillo Marta , Acena Alvaro , Cristobal Carmen , Nieves Tarin , Huelmos Ana , Gonzalez Casaus Maria L , Gutierrez Landaluce Carlos , lorenzo oscar , Canovas Ester , Kallmeyer Andrea , Alonso Joaquin , tunon Jose
Published: April 2022

Background:
Disturbances of mineral metabolism (MM) are present in pts. with stable coronary artery disease (SCAD) and average renal function. However, differences in these abnormalities in pts. with or without renal disease have not been reported previously. Purpose To describe the differences in MM markers (phosphate, calcidiol, parathormone [PTH], fibroblast growth factor23 [FGF23] and klotho) in patients with SCAD and estimated glomerular filtration rate (eGFR)<60 ml/min/1.73 m2 (LGFR) vs pts. with eGFR≥60 ml/min/1.73 m2 (HGFR).

Methods:
We analyzed MM parameters in 964 patients with SCAD in five hospitals of Spain. Patients were divided in two subgroups: LGFR and HGFR. Total death was assessed during follow-up. eGFR was calculated by the Chronic Kidney Disease Epidemiology Collaboration equation.

Results:
There were 790 pts. with HGFR and 174 with LGFR. Pts with LGFR were older and had more incidence of hypertension, diabetes, peripheral artery disease, history of cerebrovascular attack and prior coronary artery by-pass graft than those with HGFR. Left ventricular ejection fraction<40%, and previous diagnoses of heart failure, and atrial fibrillation were also more common in LGFR pts. Phosphate, FGF23 and PTH plasma levels were higher in LFGR pts., while klotho levels were lower in this subgroup. Calcidiol plasma levels did not show significant differences between both subgroups. During follow-up (median 5.1 years), death by any cause was more frequent in patients with LGFR vs HGFR (17.2% vs 5.7%, respectively; p<0.001).

Conclusion:
Pts. with SCAD and eGFR<60 ml/min/1.73 m2 show lower klotho plasma levels, higher levels of phosphate, FGF23, and PTH, and increased mortality than those with eGFR≥60 ml/min/1.73 m2.
Abstract 12001: Atrial Fibrillation Induces Ventricular Dysfunction via Altered Ca
2+
Handling and Oxidative CaMKII Activation in the Human Heart
Authors: Pabel Steffen , Knierim Maria , Stehle Thea , Alebrand Felix , Paulus Michael , Sieme Marcel , Herwig Melissa , Koertl Thomas , Wenner Brisca , Ljubojevic-Holzer Senka , Dybkova Nataliya , Sedej Simon , Scherr Daniel , Brochhausen Christoph , Hasenfuss Gerd , Maier Lars S , Hamdani Nazha , Streckfuss-Bömeke Katrin , Sossalla Samuel
Published: April 2022

Introduction:
The effects of atrial fibrillation (AF) on left ventricular (LV) function are poorly understood. Clinical data indicate that the arrhythmic component of AF may contribute to LV dysfunction. This study investigated the effects of AF on the human LV.

Methods and Results:
LV myocardium from patients with preserved LV function (EF>50%) with sinus rhythm (SR, n=31) or rate-controlled AF (n=24) obtained during surgery for aortic stenosis was studied. Clinical data were mostly balanced without changes in LV function and remodeling. LV myocardium from SR and AF patients showed no changes in fibrosis. In functional studies, systolic Ca
2+
transient amplitude of human LV cardiomyocytes (CM) was reduced in AF patients, while diastolic Ca
2+
levels and Ca
2+
transient kinetics were unaltered. These results were confirmed in LV CM from non-failing donors with AF (n=4) vs. SR (n=8). In addition, normofrequent AF was simulated
in vitro
using arrhythmic or rhythmic electrical culture pacing (both at 60 bpm). After 24h of AF-simulation, human LV CM from non-failing donors (n=9) showed also an impaired Ca
2+
transient amplitude. For a standardized chronic AF-simulation, human iPSC-CM (n=22 differentiations/5 individuals) were tested. 7 days of AF-simulation caused reduced systolic Ca
2+
transient amplitude and sarcoplasmic reticulum Ca
2+
load, which could be explained by an increased diastolic Ca
2+
leak. Mechanistically, oxidative stress markers were higher in the LV of AF patients. Ca
2+
/calmodulin-dependent protein kinase IIδ (CaMKII) was found to be more oxidized at Met281/282 in the LV of AF patients leading to an increased CaMKII activity. Thus, RyR2 phosphorylation was elevated, which likely underlies the depression of LV Ca
2+
handling in AF. In translational contractility experiments of human ventricular trabecula from patients with heart failure (n=8),
in vitro
AF-simulation for 8h worsened systolic and diastolic contractile function.

Conclusions:
Here we could firstly show that AF impairs human LV function via increased oxidative stress and CaMKII activity in different patient populations and models. Thus, this translational study demonstrates the detrimental effects and mechanisms of AF in the absence of tachycardia on the human LV.
Abstract 12002: Predictors of ICD Implantation in Patients With Normal or Low-Normal Systolic Function and Coronary Heart Disease at Baseline
Authors: Cuk Natasha , Wu Min , Moorthy Vinayaga , Pester Julie , Cheng Susan , Chugh Sumeet S , Cook Nancy R , Albert Christine M
Published: April 2022

Introduction:
Few post-MI or CHD patients fulfill guideline-based criteria for ICD implantation; however, limited data exist regarding the proportion and predictors of patients who subsequently undergo ICD implantation during long term follow-up.

Methods:
PREDETERMINE [NCT01114269] is an ongoing, prospective, multicenter cohort of adults with CHD and mild-moderate left ventricular dysfunction (LVEF=35-50%) and/or history of MI not meeting guideline criteria for primary prevention ICD at inclusion based on LVEF and NYHA. ICD implantation events/indications were captured. Multivariable Cox regression was used to estimate the hazard ratios for the outcome of ICD implantation using demographic, clinical, ECG, and biomarker parameters as prespecified covariates.

Results:
In 5738 patients (mean age=64.4, 76.2% male, mean LVEF=52.1%), 293 ICD implantations (5.1%) occurred over a median follow-up of 7.3 years. Of these, 217 were for primary prevention, 65 for secondary prevention, and 11 for unclear indications. In age-adjusted models, patients who received an ICD differed according to several clinical, ECG, and biomarker parameters [Table]. After multivariable adjustment, male sex, HTN, prior CABG, contiguous Q waves on ECG, QRS duration > 110 ms, and NT-proBNP levels were directly associated with ICD implantation, while age, LVEF and CRP were negatively associated [Table]. In multivariable models, ICD implantation was associated with a trend towards reduced mortality (HR=0.80; 95% HR, 0.62-1.03, P=0.08).

Conclusion:
In this long-term prospective cohort of CHD patients without ICD indications at baseline, 5% of the population underwent ICD implantation, which was associated with a trend toward reduced mortality. Several clinical factors were independently associated with ICD implant and may assist in the identification of subgroups of CHD patients at risk for worsening LV dysfunction and/or sustained ventricular arrhythmias.
Abstract 12006: Smooth Muscle Cell Embryologic Origin Does Not Define Propensity for Phenotype Modulation in Murine Marfan Syndrome Aortic Root Aneurysm
Authors: Pedroza Albert J , Dalal Alex R , Shad Rohan , Yokoyama Nobu , Nakamura Ken , Fischbein Michael P
Published: April 2022

Introduction:
Vascular smooth muscle cells (SMC) undergo phenotype modulation (silenced contractile genes and activated proteolytic/synthetic genes) in Marfan syndrome (MFS) aortic aneurysm. Aortic root SMCs develop from the second heart field (SHF) proximally and neural crest (NC) distally. We hypothesize that both developmental lineage and hemodynamic factors dictate SMC vulnerability to phenotype change, promoting focal aortic root aneurysm.

Methods/Results:
Aortic roots from adult MFS and littermate control mice (n=4 each sex) with a knockin fluorescent SHF tracing construct (

Nkx2-5
cre

) were sorted for lineage-resolved single cell RNA sequencing (scRNAseq). Modulated SMCs (modSMC) were enriched in MFS vs. controls (18.1% of all SMCs vs. 2.2%) and originated from both SHF (15.5%) and NC (20.2%) lineages, ruling out complete lineage specificity. NC-derived modSMCs expressed more aggrecan (
Acan
) and sclerostin (
Sost
) while small proteoglycans decorin (
Dcn
) and lumican (
Lum
) were enriched in SHF modSMCs. Insulin-like growth factor binding protein-2 (
Igfbp2
) was a lineage-independent modSMC marker. RNA
in situ
hybridization localized
Igfbp2
+ SMCs within SHF/NC overlap in the aortic root. To study regional SMC propensity for modulation due to hemodynamic stresses, we generated aortic pressure overload via 27-gauge transverse aortic arch constriction (TAC) or sham surgery on healthy

Myh11
cre

/

Rosa
tdT

(SMC-traced) mice. TAC induced mild root dilation
vs
. sham (1.93±0.07 mm
vs.
1.69±0.09 mm, n=4, p<0.01). scRNAseq showed SMC phenotype modulation comparable to MFS in TAC mice and spatially concentrated in the aortic root.

Conclusions:
Embryologic origin does not dictate aortic SMC propensity for pathologic phenotype change in MFS but does promote distinct ECM proteoglycan gene activation. Aortic pressure overload incites root SMC modulation, suggesting hemodynamic effects may promote regional susceptibility to SMC-mediated aortic remodeling.
Abstract 12010: Index Patients With Hypertrophic Cardiomyopathy and a Normal Genetic Investigation of Recognized HCM Genes Do Rarely Have Affected Relatives
Authors: Nielsen Soren K , Hansen Frederikke G , Fischer Thomas A , Madsen Trine , Klausen Ib C , Møller Dorthe S , Jensen Morten S , Lassen Jens F , Rasmussen Torsten Bloch B , Mogensen Jens
Published: April 2022

Introduction:
The occurrence of hypertrophic cardiomyopathy (HCM) in relatives to HCM index patients with a normal genetic investigation of recognized HCM genes is largely unknown. It was the aim to determine the number of relatives with HCM among index patients with a normal genetic investigation.

Methods:
Clinical and genetic investigations were performed in consecutive index patients with HCM. Genetic investigations by next-generation sequencing were made in 116 recognized and likely HCM genes, and sequence variants were classified according to American College of Medical Genetics and Genomics criteria. First-degree relatives were invited for clinical investigations, including echocardiography and ECG-recording.

Results:
A total of 453 HCM index patients underwent clinical and genetic investigations, of whom 60% (270/453) did not carry pathogenic/likely pathogenic variants. Clinical investigations in 751 of their relatives identified 38 relatives (5%) who fulfilled HCM diagnostic criteria, and during five years of follow-up, two relatives developed HCM. In 88% of families (237/270), no relatives were affected. Affected relatives were older than healthy relatives, (56 years vs. 44 years p<0.01), characterized by more comorbidity in terms of treatment for hypertension (31% vs. 18% p=0.05) and more frequently had coronary heart disease (14% vs. 1% p<0.01). Risk calculations of sudden cardiac death were low (<4%/5 years) in 76% (29/38) of affected relatives based on the European Society of Cardiology recommendations. Six relatives were considered at high risk of SCD and received a prophylactic implantable cardioverter-defibrillator (ICD), but none experienced any ICD shock therapy. Adverse events were observed in four affected relatives; three experienced SCD, and one developed end-stage heart failure.

Conclusions:
HCM index patients with normal genetic investigations rarely had affected relatives. Those affected were older at disease onset and had more comorbidity, suggesting that inheritance is polygenic/multifactorial. Discontinuation of follow-up could be considered in unaffected families, as disease development among healthy relatives was rarely seen, and few experienced adverse disease complications and sudden death.
Abstract 12024: Galectin 4 Is Associated With Incident Stroke - The Malmö Preventive Project Study
Authors: Jujic Amra , Molvin John , Pareek Manan , MELANDER Olle , Lennart Råstam , Lindblad Ulf , Daka Bledar , Holmes Hannes , Duarte Joao , Meissner Anja , Leosdottir Margret , Nilsson Peter , Hecht Olsen Michael , Magnusson Martin
Published: April 2022

Introduction:
Galectin-4 (Gal-4) is a small protein in the gastrointestinal tract. It has been implicated in diabetes mellitus, incident coronary events, incident heart failure as well as all-cause and cardiovascular mortality. However, possible associations of Gal-4 with stroke have not yet been examined.

Hypothesis:
We explored if Gal-4 is associated with prevalent and incident stroke in a large population cohort.

Methods:
Gal-4 was analyzed by the proximity extension assay technique in 1737 participants from a subsample of the population-based Malmö Preventive Project (mean age 67 years, 29% women). Stroke was defined as all strokes (ischemic, hemorrhagic and undefined). Multivariable logistic regression models were applied for prevalent stroke (n=72). Prior to analyses of incident stroke, cases of prevalent stroke were excluded. Multivariate Cox regression models were applied for incident stroke.

Results:
Gal-4 levels were significantly higher in subjects with prevalent stroke (p=0.003) than in subjects free from prevalent stroke. Gal-4 (per doubling of concentration) was significantly associated with prevalent stroke in age and sex adjusted models (odds ratio 1.49; 95% confidence interval (1.04-2.14); p=0.032), but the associations was no longer significant upon further adjustment for traditional risk factors for stroke (OR 1.22 (0.82-1.82), p=0.339). Further, each doubling in Gal-4 concentration was associated with higher risk of incident stroke (n=1604; 327 events; median follow up time 12.6 (interquartile range 10.0-13.6) years; hazard ratio 1.24 (1.02-1.49); p=0.027) in a model adjusted for BMI, systolic blood pressure, triglycerides, HDL-cholesterol, smoking, diabetes, prevalent coronary events and anti-hypertensive treatment.

Conclusions:
In a large population cohort, Gal-4 was associated with incident stroke during a follow-up of 12 years, further implicating a role of Gal-4 in both cardiovascular and metabolic disease.
Abstract 12031: Out of Pocket Expenditure for In-Patient Care of Cardiovascular Disease in India: A Gender-Based Analysis Using National Sample Survey Data
Authors: Duggal Bhanu , PAL SUPARNA , Duggal Mona
Published: April 2022

Introduction:
This study aims to examine the out-of-pocket expenditure (OOPE) pattern for hospitalisation in cardiovascular diseases (CVD) from a gender perspective.

Methods:
This study is based on 75
th
round National Sample Survey (NSS) data (2017-2018), conducted by Government of India, covering the sample of 1,13,823 households from all States and Union Territories of India. NSS data considers CVD as Hypertension (HTN) and Heart Disease (HD). The sample size of hospitalisation cases in HTN and HD are 1418 and 4726 respectively based on 365 days recall period from the date of survey. Here, average OOPE per hospitalisation is estimated as μ Medical expenditure includes costs on doctor’s fee, medicine, diagnostic tests, bed charges, and other medical expenses. To analyse the data statistical and econometric tools like, multivariate regression, t test, χ2 test, ANOVA are used.

Results:
Multivariate analysis confirms that average OOPE per hospitalisation of CVD is significantly lower for female than male (β = -0.233, p = 0.000, CI: -0.348, -0.118) even after controlling socio-economic and demographic factors including place of residence, age, education, income status (Monthly Per capita Consumption Expenditure ,MPCE), social groups, occupation of the household, zones, marital status, household size, and, possession of health insurance. The average OOPE for male is significantly higher than the female, 1.6 and 1.7 times for HD and HTN respectively. For HD, this gap increases with the increase in education level. Across the six zones, average OOPE in both HTN and HD is higher for male than the female except Eastern zone. This gender gap in OOPE is more common among married and widow/divorced as compared to the single.

Conclusion:
Gender disparity prevails in OOPE for cardiovascular disease, which needs attention at the policy level go achieve the development goals.

Fig:Distribution of OOPE per hospitalisation between Male and Female across Socio-economic strata ( in INR '000.)
Abstract 12039: Assessing the Applicability of Three Heart Failure Randomised Controlled Trials by Calibration to Scottish Registry
Authors: WEI LILI , Shah Anoop , Cleland John G , Lewsey Jim , McAllister David
Published: April 2022

Intro:
Randomised controlled trials are the gold standard method for assessing treatment effects. However, those who participate in trials of heart failure (HF) are usually highly selected (by the protocol, investigators and patient-choice) and, on average, younger and with fewer comorbidities than those encountered in clinical practice. Trials can be
calibrated
to better reflect routine clinical practice by re-estimating treatment effects after adjusting for differences in characteristics between trial and target populations, whilst maintaining the principle of randomisation.

Methods:
Using individual-level participant data, we calibrated 2 trials of HF with predominantly reduced left ventricular ejection fraction (HFrEF) - COMET (100% HFrEF) and DIG (87% HFrEF) and 1 trial of HF with preserved left ventricular ejection fraction TOPCAT - to 8,012 HF patients from a Scottish HF register using two methods - one regression-based and one using inverse propensity score weighting (IPSW).

Results:
Compared to register patients, trial participants had lower furosemide doses and were younger (mean (standard deviation) age 73 (12) years vs 62 (11), 64 (11) and 69 (10) years) with higher eGFR (59 (23) vs 67 (21), 62 (21) and 68 (18) ml/min/1.73m
2
for register vs COMET, DIG and TOPCAT respectively). For each trial, effect estimates from uncalibrated and calibrated analyses were similar (Figure 1; e.g. odds ratios in COMET for all-cause mortality were 0.83 (0.74, 0.93), 0.71 (0.58, 0.88) and 0.97 (0.72, 1.27) in the uncalibrated, IPSW and regression-based analyses). The calibrated estimates for all three trials were at most 1.5-fold less precise (i.e., 1.5-fold wider 95% confidence intervals) than the standard estimates.

Conclusions:
Calibration may be used to estimate the applicability of trial findings to populations typically encountered in clinical settings, with only small reductions in the precision of the effect estimates, and without breaking randomisation.
Abstract 12042: Does Gender Impact the Outcomes of Durable Left Ventricular Assist Device Implantation in Patients With Advanced Heart Failure- Latest Outcomes From Nationwide Inpatient Sample (2015-2018)
Authors: Kurpad Krishna Prasad , Sohal Sumit , Mehta Harsh , Hawthorne Keith A , Montgomery Matthew , Kapoor Saurabh , Cohen Marc
Published: April 2022

Introduction:
Women make up approximately 50% of the patients living with heart failure but remain underrepresented in clinical trials and advanced heart failure therapies. This disparity exists among the durable left ventricular assist device (LVAD) recipients, with men receiving more LVADs than women but whether this gap is due to differences in outcomes or not, remain unresolved. Our aim was to study the in-hospital outcomes of LVAD recipients and compare them between the male and female groups.

Methods:
Using Nationwide Inpatient Sample (NIS) for years 2015-2018, all patients who underwent LVAD implantation during the hospitalization were identified. Cohort was divided into two groups, males and females. Baseline characteristics, comorbidities, in-hospital outcomes were compared between both the groups. Statistical significance was assigned at p<0.05. Analysis was performed using STATA.

Results:
A total of 7,185 patients underwent LVAD implantation between 2015-2018 out of which only 1,515 (21.09%) patients were female. Baseline characteristics are compared in table 1. The in-hospital mortality was numerically higher in females as compared to males but was not statistically significant (8.91% vs 7.94%, p=0.57). Similarly, both groups had similar length of stay (38.26 ±2.16 days vs a 34.09±0.80 days, p=0.06) and cost of stay ($918,047.7±446,613.2 vs $947,554.7±29686.7, p=0.54). After multivariable analysis, female sex was not predictive of inpatient mortality (OR: 1.26, 95% CI (0.70-2.24), p=0.43). The bleeding, infectious and thromboembolic outcomes (Table 2) were similar between males and females.

Conclusions:
Females continue to be underrepresented among the patients receiving LVAD despite having similar outcomes and complication rate after implantation. This suggests underutilization of life saving therapy among the female patients and the need for efforts to close this gender gap.
Abstract 12044: Predictors of Engagement With a Remotely Delivered Cardiovascular Disease Risk Reduction Intervention
Authors: Madujibeya Ifeanyi , Chung Misook L , Miller Jennifer , Rayens Mary Kay , Feltner Frances J , Moser Debra K
Published: April 2022

Introduction:
Videoconferencing (VC) technology is one approach to increasing access to interventions targeting cardiovascular disease (CVD) risk reduction among rural dwellers, particularly caregivers of those with chronic illnesses. It is important to understand factors affecting engagement with such interventions in order to improve engagement. We examined demographic, clinical, psychological, and technological factors that predicted engagement with VC-based interventions.

Method:
We used data from the intervention group (n=131) in a randomized controlled trial of a CVD risk reduction intervention. Engagement was defined as the number of interventions or booster sessions (total 26 possible) completed per participant. Depressive symptoms and caregiving stress were measured with the Patient Health Questionnaire and Zarit Burden Interview respectively. Negative binomial regression with backward stepwise regression was used to determine predictors of engagement.

Result:
Among participants (mean age = 54.83 ± 13.8 years, 79.4% female) the mean engagement rate was 17.08 ± 7.2 sessions. Higher level of depressive symptoms (incidence rate (IR) = 0.98 ,
p
< .05) was associated with decreased engagement. Higher caregiving burden (IR= 1.008,
p
< .01) and, employment status (working in the home or retired compared to. employment outside the home IR: 1.25,
p
< .03) were associated with increased engagement. The association between age and engagement rate was dependent on level of technical problems ( IR = 1.02, p < .00 ), and financial status (average vs. low IR = 1.02, p < .02, high vs. low IR = 1.04,
p
< .00) (Fig. 1).

Conclusion:
Depressive symptoms, older age in those with low financial status, and working outside the home were associated with low engagement rate with VC-based intervention targeting CVD-risk reduction among rural caregivers. Thus, tailoring such interventions to address these factors is essential in improving engagement in remote interventions.
Abstract 12046: Can We Better Predict Type a Aortic Dissection?
Authors: Sharma Varun , Kang Miae , Prakash Minesh , Ganesh Jegatheesan , Patel Nishith , El Gamel Adam
Published: April 2022

Introduction:
Type A aortic dissection is seen as a progression of aneurysmal dilation, but 60% of patients in the iRAD registry had a maximum aortic diameter (MAD) < 55mm.

Hypothesis:
We theorized that a simplified marker for vessel instability (aortic ratios) and shear stress may improve predictability of dissection compared to maximal aortic diameter (MAD) alone.

Methods:
Retrospective cohort analysis of all patients who underwent open ascending aortic intervention at Waikato Hospital, New Zealand between 2014-2019, comparing dissection and non-dissection patients. MAD measured in mm; vessel instability as a ratio of MAD to 9 standardized points using ACCF/AHA guidelines; shear stress using MAD to height ratio. Reciever-operator-curve analysis to determine cut-off values for all markers; correlation with dissection assessed using logistic regression for propensity matched cohorts.

Results:
An entire cohort of 215 patients, 78 (36.3%) dissection patients, the median age at intervention 63.3 years, 52 (24.2%) females, with dissection and non-dissection patients well matched for size (Figure 1a). A diameter of >55mm was only seen in the 33.3% of dissections (n=26/78, Figure 1b), and was not a predictor of dissection (OR 1.88, 95%CI 0.64-5.51). Sinus of Valsalva (SoV) to MAD ratio above 1.06 (cut-off value) was associated with OR 4.49 of dissection (95%CI 1.46-13.81); other vessel instability and shear stress ratios weren’t significant (Figure 1c). Compared to MAD, SoV:MAD ratio had greater sensitivity (0.33 vs. 0.73), lower number-needed-to-treat (17.9 vs. 2.7) and superior area-under-curve in ROC analysis (0.54 vs. 0.71) (Figure 1d).

Conclusions:
Aortic diameter remains poorly correlated to aortic dissection; SoV:MAD ratio has greater sensitivity, discrimination, and is better correlated with dissection.
Abstract 12053: Age is a Predictor of Right Atrial Drivers in Human Persistent Atrial Fibrillation
Authors: Buck Benjamin , Mikhailov Aleksei , LI Ning , Kalyanasundaram Anuradha , Hansen Brian , Zakharkin Stanislav , Hummel John , Fedorov Vadim V
Published: April 2022

Introduction:
Persistent atrial fibrillation (perAF) may be maintained by localized extra-pulmonary vein (PV) drivers. Most clinical studies have focused on left atrial (LA) sources ablation, but right atrial (RA) arrhythmogenic substrate, due to certain comorbidities, may also maintain perAF.

Hypothesis:
Patient (Pt)-specific characteristics and comorbidities may predict occurrence of RA AF drivers.

Methods:
Consecutive Pts (n=105) underwent driver ablation in addition to PV isolation for perAF after panoramic multi-electrode mapping (MEM) at a single medical center. Logistic regression (LR) models were used to characterize the relationship between Pt characteristics and presence of AF drivers in each atrium. LR was used to predict 12-month AF-free survival.

Results:
Pts were 63.1±9.9 years old, 24.8% female, 21.9% in HF, 76.2% had HTN, 24.8% had DM, 22.9% had CAD and 59.0% had OSA. MEM identified a mean of 1.6±1.2 LA drivers and 1.4±1.2 RA drivers per Pt. Forty two Pts had drivers in both LA and RA, 19 in RA only, and 26 in LA only. Older age was a predictor of RA drivers presence (p=0.06), factors that predicted presence of LA drivers were female gender (p=0.19), HTN (p=0.03), and comorbidity score (p = 0.07). CHADS
2
-VASc score and LVEF predicted both LA and RA drivers. Following ablation, 75% of the Pts sustained sinus rhythm after 6 months, 70% after 12 months and 72% after 18 months. AF recurrence within 12 months of ablation was associated with DM (p=0.03), BMI (p=0.03) and RV systolic pressure (p=0.07). Presence of RA drivers was not associated with the 12 and 18-months freedom from AF.

Conclusions:
In this cohort of perAF patients, older age and higher CHADS
2
-VASc score predicted RA driver occurrence. These preliminary findings suggest that patient-specific clinical characteristics may uniquely impact LA vs RA myocardium by promoting development of chamber-specific arrhythmogenic structural and functional substrates of AF drivers.
Abstract 12061: Myocardial Scar and Revascularization on Mortality in Ischemic Cardiomyopathy:Late Gadolinium Enhancement Cardiac Magnetic Resonance Study
Authors: Park Hanbit , Kang Do-Yoon , Ahn Jung-Min , Yang Dong Hyun , Koo Hyun Jung , Kang Joon-Won , Lee Pil Hyung , Lee Sang Eun , Kim Min-Seok , Kang Soo-Jin , Park Dukwoo , Lee Seung-Whan , Kim Young-Hak , Lee Cheol Whan , Kim Ho Jin , Kim Joon Bum , Jung Sung-Ho , Choo Suk Jung J , Chung Cheol- Hyun , LEE Jae Won , Kim Jae-Joong , Park Seong-Wook , Park Seung-jung
Published: April 2022

Background:
Myocardial viability test to guide revascularization remains uncertain in patients with ischemic cardiomyopathy. We aimed to evaluate the different impacts of revascularization on cardiac mortality according to the extent of myocardial scar assessed by cardiac magnetic resonance with late gadolinium enhancement (LGE-CMR) in patients with ischemic cardiomyopathy.

Methods:
A total of 404 consecutive patients with significant coronary artery disease and an ejection fraction ≤35% were assessed by LGE-CMR before revascularization. Of them, 306 patients underwent revascularization and 98 patients received medical treatment alone. The primary outcome was cardiac death.

Results:
During a median follow-up of 6.3 years, cardiac death occurred in 158 (39.1%) patients. Revascularization was associated with a significantly lower risk of cardiac death than medical treatment alone in the overall population (adjusted hazard ratio [aHR], 0.29; 95% confidence interval [CI], 0.19-0.45; P < 0.001). There was a significant interaction between the number of segments with 76%-100% transmural LGE and revascularization on the risk of cardiac death (P = 0.037 for interaction). In patients with limited myocardial scar (< 6 segments with 76%-100% transmural LGE, N = 354), revascularization had a significantly lower risk of cardiac death than medical treatment alone (aHR, 0.24; 95% CI, 0.15-0.37; P < 0.001); in patients with extensive myocardial scar (≥ 6 segments with 76-100% transmural LGE, N = 50), there was no significant difference between revascularization and medical treatment alone regarding the risk of cardiac death (aHR, 1.33; 95% CI, 0.46-3.80; P = 0.60).

Conclusions:
Assessment of myocardial scar by LGE-CMR may be helpful in the decision-making process for revascularization in patients with ischemic cardiomyopathy.
Abstract 12063: Impact of Atrial Fibrillation on Outcomes in Hospitalized Cardiac Amyloidosis Patients
Authors: Ajibawo Temitope , Okunowo Oluwatimilehin , Okunade Adeniyi S
Published: April 2022

Background and Objectives:
Atrial fibrillation (AF) is associated with significant mortality and morbidity. However, the impact of AF on outcomes in patients hospitalized for cardiac amyloidosis (CA) is not well-defined. The main aim of the study is to assess the impact of AF on in-hospital mortality, and in-hospital outcomes including utilization of procedures in CA patients

Methods:
Patients (age ≥ 18 years) with a primary diagnosis of CA were identified using ICD-9 diagnostic codes from the National Inpatient Sample (2007 to 2014). Then, we compared in-hospital outcomes between the AF group and propensity score-matched group without AF.

Results:
AF occurred in 671(20.6%) of the CA patients. In comparison to those without AF, AF with CA did not experience any statistically significant difference in terms of in-hospital mortality (11.0% vs 12.1%; OR 0.89 95% CI 0.84-1.25,p=0.5008), acute kidney injury (30.8 % vs 29.1%; OR 1.09 95% CI 0.86-1.37 p=0.4849), sepsis (4.3% vs 6.0%; OR 0.71 95% CI 0.45-1.12 p= 0.1370), stroke (11.8% vs 12.2 %; OR 0.97 95% CI 0.69 -1.36 p= 0.8651), acute DVT/PE (2.5% vs 4.2 %; OR 0.59 95% CI 0.31-1.14 p=0.1149), and respiratory complications (10.2% vs 10.6%; OR 0.96 95% CI 0.66-1.38 p=0.8059). There was also no difference with regards to length of stay (6 days vs 5 days; p=0.5329) and median total hospital costs (42833 vs $38346; p=0.1785). Cardiac biopsies were performed in more AF with CA patients (11.5% vs 7.7; OR 1.55 95% CI 1.03-2.32) compared to without AF

Conclusion:
AF was not associated with a higher risk of in-hospital mortality and complications in CA hospitalization patients. However, there was higher rate of in-hospital cardiac biopsies in AF
Abstract 12067: Prospective Utility of ST2 in Patients Hospitalized With Acute Decompensated Heart Failure
Authors: Li Brian , Dowley Michaela , Langley Samantha , Hardy-Wallace Amy , Cliffe Paraic , whiting Stephen , Phen Pat , Harris Stuart , Barbagallo Rossella , Dungu Jason , Savage Henry Oluwasefunmi O
Published: April 2022

Introduction:
The soluble ST2 (sST2) biomarker is upregulated in response to myocardial strain, remodeling and fibrosis, and may play a role in risk stratification of patients with decompensated Heart Failure with a Reduced Ejection Fraction (HFrEF). The widely accepted prognostic sST2 cut-off for chronic HF is 35ng/ml. What this value would be for acute HF is debated.

Objectives:
To determine the prognostic value of sST2 in patients admitted with acute decompensated HFrEF.

Methods:
Between January 2020 and June 2021, consecutive patients hospitalized with HFrEF had sST2 measured at admission (within 24 hours) and at recompensation, as part of the INST2ANT-HF study (UK REC no:19/EE/0269). To determine an appropriate prognostic cut-off, we evaluated the median sST2 in our group as a potential threshold. The primary outcome was mortality at one year. Cumulative incidences, and the relationship between several clinical variables were tested in a Cox multivariate model for the primary outcome and comparisons between groups for events was performed using the χ2 test.

Results:
In the first 34 consecutive patients (Male 64%, AF 38%) with complete follow up (FU) data, median (IQR) FU was 405 (262-438)days. Median (IQR) age, 77 (60-85)years, mean (SD) EF, 27.9(±12.1). Median (IQR) eGFR, 62 (50-83)ml/min/1.73m
2
. Median (IQR) admission sST2 was 68 (43-91)ng/ml and admission NTproBNP was 7307 (5019-12809)ng/L. The primary endpoint occurred more frequently in patients with admission sST2>68ng/ml (p<0.01) (Fig.1).

Conclusion:
Our data suggests that in an unselected population of patients admitted with acute decompensated HFrEF, an admission sST2 value >68ng/ml has important prognostic value. Patients with high sST2 values on presentation require close follow up and a lower threshold for consideration of advanced HF therapies. A higher sST2 prognostic cut-off compared to CHF patients may hence be required for risk stratification.