bluuebunny/crossref_metadata_2025 huggingface dataset:
To the question of non-harmonic force oscillations and moment by the vibration generator
Authors: Vasiliev A M , Bredihin S A , Andreev V K
Published: February 2021

In the article, a vibration exciter is considered, containing four unbalances rotating around parallel axes, the axis of rotation of which are located on a common base, rigidly connected with the working body. The imbalances rotate uniformly and in pairs have the same angular velocity in the opposite direction. The conditions are formulated to ensure excitation of a rectilinearly oscillating force and rotation conditions by the vibration exciter. The purpose of the created dibaleans is to inform the working body of the machine of non-harmonic oscillations. The dependence of the force excited by the vibration exciter on the angle of rotation of the unbalance is determined. As a result of the studies, it was found that a centrifugal vibration exciter with four unbalances rotating in pairs with the same angular velocities can be used depending on the mutual phasing of the unbalances to excite non-harmonic oscillations of either force or moment.
A File Distribution Mechanism based on Netty Communication Framework
Authors: Huang Yingzhen , Liu Zheyuan , Qian Rongxin , Gu Weikai , Guo Zhongyi
Published: February 2021

The efficiency of file distribution in large-scale data processing platform is essential besides system security. Traditional CIFS file sharing method cannot meet the requirement due to its lack of security and ability to distribute fragile files. This paper introduces an innovated file distribution mechanism based on Netty framework. It utilizes zero-copy mode provided by Netty, along with multi-thread asynchronous communication. Experiment shows that it outperforms CIFS in real-time applications.
Fabrication and Evaluation of the Mechanical Behavior of Geopolymer Compounds Using Waste from the Mining and Construction Industry
Authors: Huamán-Mamani FA , Mayta-Ponce DL , Rodríguez-Guillén GP
Published: February 2021

Geopolymers are lately being considered a group of revolutionary materials, due to their good mechanical properties, chemical stability, fire resistance and diversity of applications where they can be used. For the synthesis of geopolymers, a great variety of types of natural and artificial raw materials (residues from other industries) can be used, which allows obtaining materials with very specific applications. Two of the most important industries in Peru are also those that generate greater environmental degradation, mainly due to the waste they generate. The mining industry has a negative impact on the environment, generating a large amount of inorganic waste, while the construction industry does the same, generating large amounts of demolition waste. Both, mining and demolition waste, constitute a serious environmental problem, since currently they are only deposited without any alternative use. Therefore, our research proposes the use of geopolymeric technology for the use of mining and demolition waste in the manufacture of geopolymeric concrete with mechanical strengths similar to that of Portland cement concrete.
Influence of the Activating Solution and Aggregates in the Physical and Mechanical Properties of Volcanic Ash Based Geopolymer Mortars
Authors: Calderón Nataly , Vargas María , Almirón Jonathan , Bautista Asunción , Velasco Francisco , Tupayachy-Quispe Danny
Published: February 2021

The physical, mechanical and microstructural properties of volcanic ash based geopolymer mortars by alkaline activation (with NaOH and Na(OH) + Na2SiO3 solutions) using different aggregates (Peruvian sand and standard sand) were studied. For the synthesis of geopolymers, a liquid:solid ratio of 0.1 and an ash:sand ratio of 1:1 were selected, and 25% of sodium silicate was added to the Na(OH) solution. The samples were compacted, toughened and cured at 80°C for 48 h. The dissolution of volcanic ash particles and the formation of the geopolymeric matrix increase with Na(OH)+Na2SiO3 solution and standard sand while the local sand promotes better geopolymerization with NaOH solution. The compression strength of volcanic ash based geopolymer mortar reported values from 18.93 MPa to 23.28 MPa at 6 months of curing, which determines the use of these geopolymers as a construction material.
Application of Glass and Fan Shells to a Clay Soil to Increase its Mechanical Properties
Authors: Jara Heiner Lopez , Barrionuevo Brandon Bravo , Fernández Díaz Carlos
Published: February 2021

Improving the mechanical properties of a clayey soil is one of the best options to avoid future structural failures in buildings and is cheaper than replacing all the material. Therefore, this article proposes the use of recycled glass and fan shells as reinforcement materials. This article presents an experimental study to evaluate the mechanical properties of a pure and mixed soil. The clay soil was mixed with 7% of glass (PV) and with 3%, 6%, 10%, 12% and 15% of Fan Shells (PCA) duly crushed and passed through sieve #100. Tests of sieve granulometry, sedimentation granulometry, Atterberg limits, modified proctor and drained consolidated direct cut were performed. This allowed comparing all the data obtained and defining the optimal percentage of the mixture in which the clay improves its mechanical properties. According to the tests carried out, the proportion that has 7% glass and 6% Fan Shells has better results because there is an improvement in its dry density from 1,784 g / cm3 to 1,847 g / cm3, its moisture content increases from 9.4% to 12.1%. In addition, its friction angle improves from 28.9 ° to 32 ° and cohesion from 0.05 kg / cm2 to 0.1 kg / cm2. These results verify that the properties of the clay soil are improved.
A Qualitative Study to Identify Characteristics of a Desirable Training Program for Prevention of Occupational Skin Disease
Authors: Zack Bethany , Arrandale Victoria H , Holness D Linn
Published: February 2021

Background

Training and education may be effective strategies for the prevention of work-related contact dermatitis. While there is some information in the literature related to skin-specific training experiences, there is very little information available on workers’ preferences related to content and format and to barriers and facilitators to training.

Objectives

To understand workers’ experiences and preferences for workplace training and barriers and facilitators to training.

Methods

Following ethics approval, 24 patients with work-related contact dermatitis participated in semi-structured interviews obtaining information on training experiences, perceived training effectiveness, desired training characteristics, and barriers and facilitators to training. An inductive thematic analysis was used to identify themes.

Results

Though many workers had received general workplace health and safety training, none reported training about skin exposure and disease prevention. Examples of what the workers perceived as good training included first aid training, while Workplace Hazardous Materials Information System training was felt to be ineffective. Desired content of training for preventing skin exposures included information on the hazards, short- and long-term health impacts, and potential symptoms and personal protective equipment. They desired multi-modal presentation (e.g. in-person and online supplement), hands-on training with visual content and suggested the use of personal stories and negative messaging. Training that could be applied outside the workplace was also valued. Barriers and facilitators to implementation included factors related to the training program itself, the organization, and the regulatory landscape.

Conclusions

These findings can help to shape more effective workplace training programs for skin protection.
Intraarterial Degradation of Calcium Hydroxylapatite Using Sodium Thiosulfate – An In Vitro and Cadaveric Study
Authors: Yankova Mariya , Pavicic Tatjana , Frank Konstantin , Schenck Thilo L , Beleznay Kate , Gavril Diana L , Green Jeremy B , Voropai Daria , Robinson Deanne Mraz , Cotofana Sebastian
Published: February 2021

Background

The most severe complications following soft tissue filler injections result from the intraarterial administration of the filler product. Although hyaluronic acid–based filler can be trans-arterially dissolved with hyaluronidase, no information is available on calcium hydroxylapatite (CaHA)-based fillers.

Objective

The authors sought to test whether CaHA-based fillers can be trans-arterially dissolved by sodium thiosulfate (STS) when evaluated in cadaveric and in vitro models.

Methods

Human cadaveric facial arterial segments were each filled with 0.2 cc of commercially available CaHA product and submerged for 24 hours in 4 different STS-containing solutions: 10 cc STS (300 mg/cc) (pure, 1:1 dilution, 1:2 dilution), 0.9% saline and 10 cc STS (300 mg/cc), and 300 IU (bovine) hyaluronidase in a 1:1 ratio.

Results

Intraarterial CaHA was detected in human facial artery segments after 24 hours independent of the STS concentration employed. Submerging the arterial segments in STS (300 mg/cc) and 300 IU (bovine) hyaluronidase (1:1 ratio) also did not dissolve the intraarterial CaHA product. Gray scale analyses did show, however, that increasing concentrations of STS resulted in increased disintegration of CaHA in an in vitro experimental setting.

Conclusions

The results of this study indicate that STS is limited in its potential to dissolve intraarterial CaHA of cadaveric human facial arteries, despite the fact that it appears effective when in direct contact with the CaHA. Adverse events caused by intraarterial administration of CaHA-based fillers still lack a suitable antidote.
Quality of Patient-Reported Outcome Studies Utilizing the BREAST-Q: A Systematic Review
Authors: Har-Shai Lior , Ofek Sar-El , Brandstetter Addy , Cohen Keren H , Shay Tamir , Amir Avraham , Ad-El Dean D
Published: February 2021

Background

Patient-reported outcome (PRO) studies are essential in the assessment of surgical procedures in plastic surgery. One accepted and validated questionnaire is the BREAST-Q.

Objectives

The aim of this study was to assess the quality of PRO studies in plastic surgery utilizing the BREAST-Q questionnaire.

Methods

This study involved 2 steps: (1) a systematic review of 23 key criteria assessing the quality of survey research in studies utilizing the BREAST-Q that were published between 2015 and 2018; (2) a review of current guidance for survey research in journals related to plastic surgery and breast surgery which were included in the systematic review.

Results

Seventy-nine studies were included in the systematic review. Many key criteria were poorly reported: 51.9% of the studies did not provide a defined response rate and almost 90% did not provide a method for analysis of nonresponse error; 67.1% lacked a description of the sample’s representativeness of the population of interest, and 82.3% did not present a sample size calculation. The methods used to analyze data were not described in 11.4% of the papers; in 27.8% the data analysis presented could not allow replication of the results. Of the 16 journals in the fields of plastic surgery and breast surgery for which the “instructions to authors” were reviewed, 15 (93.7%) did not provide any guidance for survey reporting.

Conclusions

The majority of key criteria are underreported by authors publishing their survey research in peer-reviewed journals in the fields of plastic and breast surgery. There is an urgent need to construct well-developed reporting guidelines for survey research in plastic surgery, and particularly in breast surgery.

Level of Evidence: 4
Varietal differences in flavonoid and antioxidant activity in Japanese soybean accessions
Authors: Arifin Hana Akari , Hashiguchi Takuyu , Nagahama Kiyoko , Hashiguchi Masatsugu , Muguerza Melody , Sakakibara Yoichi , Tanaka Hidenori , Akashi Ryo
Published: February 2021

Soybean seeds contain many antioxidants, including flavonoids and other phytochemicals. Isoflavone is a phytoestrogen that mimics estrogenic effects on target tissues and also exerts antioxidant activity by sequestering free radicals. Despite many cultivars developed to date, varietal differences in flavonoid content and antioxidant activity in Japanese soybean accessions remain less well characterized. Here, we evaluated the seed content of isoflavones, total flavonoids, and total phenolics in 26 soybean accessions. Next, the antioxidant activity of each accession was examined using antioxidant responsive element (ARE) linked to a luciferase reporter in human HepG2 stable cells. The relative ARE luciferase activity rate of all soybean accessions varied up to 4-fold which ranged from 1.00 to 4.02; and 22 accessions exhibited significant antioxidant activities. Correlation analysis indicated that the level of total isoflavone moderately correlated with antioxidant activity.
Downregulation of IRAK3 by miR-33b-3p relieves chondrocyte inflammation and apoptosis in anin vitroosteoarthritis model
Authors: Tao Tao , Zhang Yunkun , Wei Hui , Heng Ke
Published: February 2021

Interleukin-1 receptor-associated kinase-3 (IRAK3) has a distinctive role in regulating inflammation. However, the functional role of IRAK3 and regulatory mechanism underlying the pathogenesis of osteoarthritis (OA) remain unclear. Here, we first found that IRAK3 was upregulated, while miR-33b-3p was downregulated in the cartilage of OA patients and IL-1β-induced CHON-001 cells. IRAK3 was confirmed as the direct target of miR-33b-3p and negatively regulated by miR-33b-3p. There was an inverse correlation between IRAK3 mRNA expression and miR-33b-3p expression in OA cartilage tissues. The in vitro functional experiments showed that miR-33b-3p overexpression caused a remarkable increase in viability, a significant decrease in inflammatory mediators (IL-1β and TNF-α), and apoptosis in IL-1β-induced CHON-001 cells. Importantly, IRAK3 knockdown imitated, while overexpression reversed the effects of miR-33b-3p on IL-1β-induced inflammation and apoptosis in CHON-001 cells. Collectively, miR-33b-3p significantly alleviated IL-1β-induced inflammation and apoptosis by downregulating IRAK3, which may serve as a promising target for OA.
Taxonomy and phylogenetics ofAlliumsectionDecipientia(Amaryllidaceae): morphological characters do not reflect the evolutionary history revealed by molecular markers
Authors: Friesen Nikolai , Smirnov Sergei V , Leweke Mathias , Seregin Alexey P , Fritsch Reinhard M
Published: February 2021

Phylogenetic and phylogeographic patterns in Allium section Decipientia (subgenus Melanocrommyum) were analysed, including most species of this section and representative species of most other sections of the monophyletic Allium subgenus Melanocrommyum. We constructed a molecular phylogenetic tree based on predominantly non-coding sequences from nuclear ribosomal RNA and four plastid regions. In Allium section Decipientia, 2n = 16 and 2n = 20 chromosomes were confirmed and, in part, newly reported. All plants with 2n = 20 form a clade that is sister to the European A. decipiens and A. quercetorum with 2n = 16 in the ITS analysis and are genetically distant from the Eurasian steppe species with 16 chromosomes, A. tulipifolium and A. robustum. The plastid analysis does not reveal a clear relationship between these three monophyletic groups. The karyotype of A. tulipifolium is similar to those of other members of subgenus Melanocrommyum, but only preliminary chromosomal dimensions could be presented for the species with 2n = 20 chromosomes. The latter group comprises A. grande, A. subscabrum, A. viridulum and the newly described taxa A. koksuense and A. lepsicum. Allium tulipifolium and A. robustum have been placed in a new section Tulipifolia, and all species with 2n = 20 have been placed in a new subsection, Viceniprason, of section Decipientia. A nomenclatorial conspectus and a key for determination of the members of Allium sections Decipientia and Tulipifolia are also provided. According to the time divergence estimation, subgenus Melanocrommyum diversified c. 25 Mya in the late Oligocene. The split between most species of the section Decipientia and other taxa in this subgenus was estimated as early Miocene, which furthermore diversified into two sister clades in mid Miocene. Allium decipiens split off from the ancestors of the 2n = 20 species also in the mid Miocene. Further branching in this species group is of rather young age, and occurred within the last 6 Myr (late Miocene to late Pliocene and Pleistocene).
Continental palynomorphs from the Dabaa Formation, North-Western Desert, Egypt: a contribution to the reconstruction of the vegetation on the southern shores of the Tethys Ocean during the Early Oligocene
Authors: El Atfy Haytham , El Beialy Salah Y , El Khoriby Essam M , Uhl Dieter
Published: February 2021

The Eocene–Oligocene transition period was marked by one of the most abrupt and severe global environmental changes in the Cenozoic record, and this had a marked influence on the evolution of a number of animal and plant groups and entire ecosystems. This study documents continental palynomorphs recovered from the sedimentary rocks of the Dabaa Formation (Qattara area, North-Western Desert, Egypt) located on the southern shore of the Tethys Ocean and dated as Late Eocene–Early Oligocene. The botanical affinities, (phyto)ecology and distribution of the vegetation during the Eocene–Oligocene of the study area are discussed. The recorded assemblages are well preserved and comprise diverse lineages of algae, spores and pollen. They were identified, illustrated and assigned to 46 families encompassing chlorococcalean algae, lycopods, ferns, gymnosperms and angiosperms. The studied assemblages demonstrate the development of tropical vegetation, including tropical deciduous forest, grassland and (semi-)arid tropical shrubland, in which angiosperms were one of the main representatives; additionally open, drier habitats might have existed in the hinterland. Our data have been combined with previous megafossil and palynological evidence to assess and refine vegetation changes during the Early Oligocene time window in Egypt and across North Africa. Vegetation was a mosaic of different vegetation belts that ran more-or-less parallel to the coastline of the Tethys Ocean under the variable geographical influence of lagoons and streams. It is assumed that the belt of tropical forest along the coast of the Tethys Ocean narrowed during the Oligocene in parallel to climatic deterioration following the Eocene–Oligocene boundary, which may have also led to the fractionation of forest habitats.
Simultaneous Determination of Abamectin and Closantel in Veterinary Formulation by Validated HPLC Method
Authors: Abd Elhalim Emad M , Amin Mohamed A , Ali Mohamed A
Published: February 2021

A rapid and accurate high-performance liquid chromatographic method was developed for the determination of both abamectin and closantel in the veterinary formulation. The chromatographic separation was conducted on an Agilent 1200 with a UV detector using Waters C18 (4.6 mm × 50 mm; 2.7 μm). The mobile phase consisted of acetonitrile:water (80:20 v/v) adjusts pH 3.0 using diluted phosphoric acid. The flow rate of 1.5 mL min−1 was used. An injection volume of 10 μL was used The calibration curve of abamectin B1b was linear with a correlation coefficient (r2) = 0.9996; over a concentration range of 2.0–8.0 μg/mL, abamectin B1a was linear with a correlation coefficient (r2) = 0.9997; over a concentration range of 8.0–32.0 μg/mL; with a retention time of 2.18 and 3.72 minutes for avermectin B1b and avermectin B1a, respectively. While the calibration curve of closantel was linear with a correlation coefficient (r2) = 0.99929; over a concentration range of 250.0–1,000.0 μg/mL for; with a retention time of 5.84 minutes. Correlation coefficient was r2 ≥ 0.999. The relative standard deviation was found to be ≤ 2. The proposed method was validated and successfully applied for the simultaneous determination of abamectin and closantel in the veterinary formulation.
Embolization of the thoracic duct in patients with iatrogenic chylothorax
Authors: Bazancir Laser Arif , Jensen Ruben Juhl , Frevert Susanne Christiansen , Ryom Philip , Achiam Michael Patrick
Published: February 2021

Chylothorax is leakage of lymphatic fluid accumulating in the pleural cavity due to the thoracic duct’s (TD) trauma or obstructions. It generally occurs as a traumatic complication after general thoracic surgery procedures (0.4%), especially after esophagectomy (4.7–8.6%). Traditionally, surgical intervention is performed if conservative management fails, but reports of high mortality (2.1%) and morbidity (38%) have led to the development of a minimally invasive percutaneous treatment method; TD embolization (TDE). The records of all patients treated for chylothorax with TDE from April 2015 to June 2019 were reviewed. Only patients with iatrogenic chylothorax were included. The outcomes measures are defined as a technical and a clinical success. A technical success, is defined as the ability to perform the embolization procedure, thereby injecting embolizing material Histoacryl with or without coils. A clinical success is defined as a complete cessation of lymphatic leakage into the pleural cavity without surgical intervention and, therefore, a cured patient. Lymphography was performed in all patients, and visualization of cisterna chyli was achieved in 14/17 patients (82.4%). Of the 17 patients included, 15 patients were successfully embolized and cured of chylothorax (88.2%). Successfully embolized patients had a median discharge time of 7 days. Most patients reported postprocedural pain, which was dealt with using conventional pain medication. TDE seems like a safe percutaneous treatment technique with a high clinical success rate in iatrogenic chylothorax patients which can be readily implemented if the clinical experience is available..
Is the right ventricular function affected by permanent pacemaker?
Authors: Bachani N , Bagchi A , Sinkar K , Jadwani JP , Panicker GK , Bansal R , Mahajan A , Lokhandwala Y
Published: February 2021

Funding Acknowledgements

Type of funding sources: None.

Background

The effect of right ventricular (RV) pacing on left ventricular (LV) function has been extensively evaluated, and so has the effect of the RV pacing lead on tricuspid valve function. However, the effects on RV function per se have not been evaluated systematically.

Purpose

We aimed to assess the RV dimensions and RV function six months after dual chamber pacemaker implantation

performed for atrioventricular (AV) block by detailed echocardiography, including three-dimensional (3D) echocardiography.

Method

All adult patients undergoing dual chamber pacemaker from January 2018 to March 2019 for symptomatic AV block with a structurally normal heart were included in the study. They underwent pre-procedure detailed echocardiography specifically directed at measuring RV dimensions and function [including 3D RV ejection fraction (EF)] and a repeat detailed echocardiogram at six-month follow-up, by the same echocardiographer. The echocardiographic parameters at baseline and after six-month follow-up were compared.

Results

All patients had more than 75% ventricular pacing in these six months. At six-month follow-up, there was no significant change in LVEF, while there was a mild decrease in RVEF as outlined in the Table 1. While there was some overlap between RVEF range of values at baseline and after six months, 23 (38.3%) patients showed a drop in RVEF by >5%.

Conclusion

Our study shows a change in several RV function parameters in a majority of patients six months after

pacemaker implantation for AV block.

RV Function at six month follow-up Parameters Pre-procedure Six-Month Follow-up p value (Paired t-test) PASP (mm Hg) 20.2 ± 1.3 26.1 ± 12.2 <0.001 FAC (%) 42.6 ± 3.4 39.4 ± 6 <0.001 TAPSE (mm) 18.4 ±3.8 15.6 ± 4.7 <0.001 RIMP 0.66 ± 0.09 0.61 ± 0.11 0.003 RV E/E’ 9.4 ± 2.1 7.7 ± 2.1 <0.001 RV S’ 13.6 ± 2.4 10.7 ± 2.4 <0.001 RVEF % [By 3D Echocardiography] 47.7± 5.1 44.9 ± 7.4 <0.001 TR Jet Area (cm2) 0.03 ± 0.26 0.55 ± 0.96 <0.001 RV= Right Ventricle; RA= Right Atrium; RVOT = Right Ventricular Outflow Tract; PASP = Pulmonary Artery Systolic Pressure; FAC= Fractional Area Change; TAPSE= Tricuspid Annular Plane Systolic Excursion; RIMP = Right Ventricular Index of Myocardial Performance; TR = Tricuspid Regurgitation S’ = Peak Systolic Annular Velocity; RVEF = Right Ventricular Ejection Fraction; 3D = Three Dimensional Abstract Figure. Change in RVEF in 6 months
Association of atrial strain ratio with invasive pulmonary hemodynamics in rheumatic mitral stenosis
Authors: Kaur V , Manouras A , Venkateshvaran A
Published: February 2021

Funding Acknowledgements

Type of funding sources: None.

Background. Symptomatic rheumatic mitral stenosis (MS) results in elevation in left atrial (LA) pressure that is passively transmitted to derange pulmonary hemodynamics and subsequently elevate right ventricular afterload. We studied associations between LA to right atrial reservoir strain ratio (LA-RAs) and invasive pulmonary hemodynamics in addition to the ratio’s ability to identify subjects with elevated pulmonary vascular resistance (PVR).

Methods.  Consecutive MS subjects undergoing right heart catheterization (RHC) and percutaneous transvenous mitral commissurotomy (PTMC) were enrolled. Subjects with atrial fibrillation, >mild mitral regurgitation, concomitant aortic valve or ischemic heart disease were excluded. LA-RAs was assessed by speckle-tracking echocardiography and stratified into high or low LA-RAs subgroups based on mean value. Correlations with invasive pulmonary hemodynamics was studied. ROC analysis was performed to identify pulmonary hypertension (PH) and PVR > 3 Wood Units.

Results. 110 subjects were analysed (age: 32 ± 8; 72% female). LA and RA reservoir strain was feasible in 88 (80%) and 83 (75%) subjects respectively. Patients with low LA-RAs demonstrated more severe MS (0.8 ± 0.1 vs. 1.0 ± 0.2cm2), higher mean pulmonary artery (43 ± 13 vs. 33 ± 13mmHg) and capillary wedge pressure (28 ± 6 vs.23 ± 16mmHg) as compared with high LA-RAs (p < 0.001 for all). LA-RAs was associated with invasive PA systolic (r=-0.30;p = 0.05), diastolic (r=-0.28;p = 0.02) and mean (r=-0.33; p = 0.002) pressures, demonstrated modest ability to identify elevated PVR (AUC = 0.65;p = 0.03) and strong ability to identify PH (AUC = 0.75; p < 0.001). LA-RAs significantly increased after PTMC (0.43 ± 0.1 to 0.52 ± 0.1;p < 0.001).

Conclusions. The novel atrial strain ratio is associated with measures of invasive pulmonary hemodynamics and demonstrates ability to identify PH and elevated PVR in MS.
Diagnostic utility of right atrial reservoir strain to identify elevated right atrial pressure in heart failure
Authors: Miah N , Ljung-Faxen U , Lund LH , Venkateshvaran A
Published: February 2021

Funding Acknowledgements

Type of funding sources: None.

Background. Accurate non-invasive estimation of right atrial pressure (RAP) is essential to assess volume status and optimize therapy in heart failure (HF). This study aimed to evaluate the utility of right atrial reservoir strain (RASr) assessed by speckle-tracking echocardiography to identify elevated RAP in HF and compare diagnostic performance with the recommendation-based estimate employing inferior vena cava size and collapsibility (RAPIVC).

Methods. Association between RASr and invasive RAP (RAPInvasive) was examined in 103 HF subjects that underwent standard echocardiography with speckle-tracking strain analysis directly followed by right heart catheterization. The discriminatory ability of RASr to identify RAPInvasive > 7mmHg was evaluated and compared with RAPIVC.

Results. RASr demonstrated a significant association with RAPInvasive (β = -0.41, p < 0.001) and strong discriminatory ability to identify subjects with RAPInvasive > 7mmHg (AUC = 0.78; 95% CI 0.68-0.87; p < 0.001). At a cut-off value of -15%, RASr demonstrated 78% sensitivity, 72% specificity, 72% positive predictive value and 77% negative predictive value to identify elevated RAPInvasive. In comparison, RAPIVC (AUC = 0.71) demonstrated 89% sensitivity, 32% specificity, 55% positive predictive value and 77% negative predictive value with high false positive rate. In subjects with intermediate RAPIVC (8mmHg), RASr maintained significant diagnostic ability to identify elevated RAPInvasive (AUC = 0.69; 95% CI 0.52 to 0.85, p = 0.03).

Conclusions. RASr demonstrates strong ability to identify elevated RAP and may be useful  as a novel noninvasive estimate of RAP in HF management.
Optical coherence tomography detection of vulnerable plaques at high risk of developing acute coronary syndrome
Authors: Kubo Takashi , Ino Yasushi , Mintz Gary S , Shiono Yasutsugu , Shimamura Kunihiro , Takahata Masahiro , Terada Kosei , Higashioka Daisuke , Emori Hiroki , Wada Teruaki , Kashiwagi Manabu , Tanimoto Takashi , Tanaka Atsushi , Hozumi Takeshi , Akasaka Takashi
Published: February 2021

Aims

The ability of optical coherence tomography (OCT) to detect plaques at high risk of developing acute coronary syndrome (ACS) remains unclear. The aim of this study was to evaluate the association between non-culprit plaques characterized as both lipid-rich plaque (LRP) and thin-cap fibroatheroma (TCFA) by OCT and the risk of subsequent ACS events at the lesion level.

Methods and results

In 1378 patients who underwent OCT, 3533 non-culprit plaques were analysed for the presence of LRP (maximum lipid arc > 180°) and TCFA (minimum fibrous cap thickness < 65 μm). The median follow-up period was 6 years [interquartile range (IQR): 5–9 years]. Seventy-two ACS arose from non-culprit plaques imaged by baseline OCT. ACS was more often associated with lipidic plaques that were characterized as both LRP and TCFA vs. lipidic plaques that did not have these characteristics [33% vs. 2%, hazard ratio 19.14 (95% confidence interval: 11.74–31.20), P < 0.001]. The sensitivity and specificity of the presence of both LRP and TCFA for predicting ACS was 38% and 97%, respectively. A larger maximum lipid arc [1.01° (IQR: 1.01–1.01°)], thinner minimum fibrous cap thickness [0.99 μm (IQR: 0.98–0.99 μm)], and smaller minimum lumen area [0.78 mm2 (IQR: 0.67–0.90 mm2), P < 0.001] were independently associated with ACS.

Conclusion

Non-culprit plaques characterized by OCT as both LRP and TCFA were associated with an increased risk of subsequent ACS at the lesion level. Therefore, OCT might be able to detect vulnerable plaques.
Radiofrequency ablation of ventricular tachycardia in Anderson–Fabry disease: a case series
Authors: Mills Mark T , Nelson Thomas A , Kelland Nicholas F , Sahu Jonathan , Lee Justin , Lewis Nigel , Hiwot Tarekegn , Kyriacou Andreas L
Published: February 2021

Background

Cardiac involvement in Anderson–Fabry disease (AFD) can lead to arrhythmia, including ventricular tachycardia (VT). The literature on radiofrequency ablation (RFA) for the treatment of VT in AFD disease is limited.

Case summary

We discuss RFA of drug-refractory VT electrical storm in three males with AFD. The first patient (53 years old) had extensive involvement of the inferolateral left ventricle (LV) demonstrated with cardiac magnetic resonance imaging (CMRI), with a left ventricular ejection fraction (LVEF) of 35%. Two VT ablation procedures were performed. At the first procedure, the inferobasal endocardial LV was ablated. Furthermore, VT prompted a second ablation, where epicardial and endocardial sites were ablated. The acute arrhythmia burden was controlled but he died 4 months later despite appropriate implantable cardioverter-defibrillator therapies for VT. The second patient (67 years old) had full-thickness inferolateral involvement demonstrated with CMRI and LVEF of 45%. RFA of several endocardial left ventricular sites was performed. Over a 3-year follow-up, only brief non-sustained VT was identified, but he subsequently died of cardiac failure. Our third patient (69 years old), had an LVEF of 35%. He had RFA of endocardial left ventricular apical disease, but died 3 weeks later of cardiac failure.

Discussion

RFA of drug-refractory VT in AFD is feasible using standard electrophysiological mapping and ablation techniques, although the added clinical benefit is of questionable value. VT storm in the context of AFD may be a marker of end-stage disease.
Combined ablation for paroxysmal atrial fibrillation and drug-refractory hypertrophic obstructive cardiomyopathy: a case report
Authors: Akita Keitaro , Suwa Kenichiro , Urushida Tsuyoshi , Maekawa Yuichiro
Published: February 2021

Background

Hypertrophic obstructive cardiomyopathy (HOCM) is sometimes concomitant with atrial fibrillation (AF) and exacerbates heart failure symptoms. Although optimal medication for the reduction of left ventricular outflow tract (LVOT) obstruction and the maintenance of sinus rhythm should be considered, it is difficult to control the symptoms permanently.

Case summary

A 45-year-old man, diagnosed with HOCM, presented with progressive dyspnoea on exertion, which significantly deteriorated during episodes of paroxysmal AF, despite optimal medical therapy. On echocardiography, we found LVOT obstruction with a peak pressure gradient of 98 mmHg, concomitant with redundant mitral valve leaflets, which caused significant systolic anterior motion (SAM). Since he declined open surgery, we selected a combination of catheter interventions, AF ablation, and alcohol septal ablation (ASA). After the AF ablation, the occurrence of AF significantly decreased, and there was no recurrence after the ASA. By 6 months, the plasma N-terminal pro-B-type natriuretic peptide level had decreased from 1022 to 124 pg/mL, the peak pressure gradient of LVOT decreased from 98 to 12 mmHg, and the left atrium volume decreased from 203 to 178.4 mL. The improvement in the SAM was visualized on echocardiography and was haemodynamically corroborated by the four-dimensional (4D)-flow cardiac magnetic resonance (CMR).

Discussion

The treatment of drug-refractory HOCM concomitant with paroxysmal AF needs both septal reduction and the maintenance of sinus rhythm, which can be accomplished through transcatheter interventions. Moreover, the detailed intra-ventricular haemodynamic assessment in HOCM patients can be explored using the 4D-flow CMR.
Profound repolarization abnormalities after cylindrical battery ingestion: a case report
Authors: Huttelmaier Moritz Till , Lengenfelder Björn , Bauer Wolfgang Rudolf , Fischer Thomas Horst
Published: February 2021

Background

Cardiac arrhythmias are a serious complication in patients admitted due to intoxication in suicidal attempts. Upon admission, detailed information about the specific kind of intoxication are frequently missing. The differential diagnoses of electrocardiogram (ECG) changes such as elevation of T-waves, prolongation of the QT-interval or elevation of ST-segments in this special subgroup of patients comprise drug-induced electrolyte disorders or direct toxic effects on cardiac excitation and repolarization.

Case summary

In this clinical report of a 27-year-old male patient, we present a case of unusual ECG alterations mimicking ST-elevation, high amplitude, biphasic T-waves and prolongation of QT-interval. These changes of surface ECG were induced by ingestion of cylindrical batteries in a suicidal attempt and immediately normalized after removal of batteries by esophagogastroduodenoscopy.

Discussion

There is limited literature describing changes in surface ECG in patients having ingested cylindrical batteries. We propose two hypotheses for the occurrence of these changes after ingestion of cylindrical batteries: (i) Cardiac movement within the perturbation field induced by the batteries causes electrical changes on a time scale of the heart rate which are above the threshold of the high pass filter. (ii) The batteries’ electrotonic potential affects the membrane currents of cardiac myocytes, not inducing an action potential but generating repolarization abnormalities. Individual factors, such as body constitution and localization of the batteries within the stomach, determine the interindividual characteristics of repolarization abnormalities.
Gastroenteritis and cardiogenic shock in a healthcare worker: a case report of COVID-19 myocarditis confirmed with serology
Authors: Sivalokanathan Sanjay , Foley Michael , Cole Graham , Youngstein Taryn
Published: February 2021

Background

Coronavirus disease 2019 (COVID-19) myocarditis is emerging as a component of the hyperactive inflammatory response secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Isolated gastrointestinal symptoms are uncommon presenting features in adults with COVID-19 myocarditis. The availability of antibody testing is a valuable addition to the confirmation of COVID-19, when repeated reverse transcriptase–polymerase chain reaction of nasopharyngeal swabs are negative.

Case summary

A young healthcare worker presented with dizziness and pre-syncope, 4 weeks after his original symptoms that included fever, lethargy, and diarrhoea. Despite 2 weeks of isolation, followed by a quiescent spell, his symptoms had returned. Shortly after, he presented in cardiogenic shock (left ventricular ejection fraction 25%), that required vasopressor support, at the height of the COVID-19 pandemic. Cardiac magnetic resonance imaging suggested florid myocarditis. Three nasopharyngeal swabs (Days 1, 3, and 5) were negative for SARS-CoV-2, but subsequent serology (Day 13) confirmed the presence of SARS-CoV-2 IgG. Treatment with intravenous immunoglobulin and glucocorticoids led to full recovery.

Discussion

Our case study highlights the significance of the use of the available serological assays for diagnosis of patients presenting late with SARS-CoV-2. Importantly, it supports further research in the use of immunomodulatory drugs for the hyperinflammatory microenvironment induced by COVID-19.
Case report: a patient with thyroid storm, refractory cardiogenic shock, and cardiac arrest treated with Lugol's iodine solution and veno-arterial extra corporal membrane oxygenation support
Authors: Voll Marianne , Øystese Kristin Astrid , Høiskar Erik , Johansen Odd , Nyvold Cecilie , Norheim Ingrid , von Lueder Thomas G , Andersen Geir Øystein
Published: February 2021

Background

Thyroid storm is a life-threatening condition. Refractory cardiogenic shock and cardiac arrest are rare complications of thyroid storm and the treatment options are limited.

Case summary

A 35-year- old woman treated for Grave’s disease was admitted with thyrotoxicosis complicated by infection and neutropenia caused by thionamide treatment. After treatment including beta-blockers, steroids, and Lugol’s iodine solution, she went into cardiac arrest. Echocardiography after resuscitation demonstrated severe biventricular heart failure. The patient was in refractory cardiogenic shock with recurrent cardiac arrest and mechanical circulatory support with a veno-arterial extra corporal membrane oxygenation (V-A ECMO) circuit was established. After 2 days on V-A ECMO and supportive treatment with iodine solution, glucocorticosteroids, and levosimendan, her myocardial function recovered and thyroid hormone levels were normalized. Veno-arterial extra corporal membrane oxygenation was discontinued, and the patient was treated with early total thyroidectomy. The patient made a full recovery with no neurological/cognitive impairment, as assessed after 4 weeks.

Discussion

Adverse reactions to standard treatment of hyperthyroidism contributed to this patient’s development of thyroid storm and the following refractory cardiogenic shock. When she was critically unstable, levosimendan improved myocardial function while inotropic support with dobutamine was ineffective, likely due to prolonged beta-antagonist administration. Temporary support with V-A ECMO, until effective lowering of thyroid hormone levels and improvement in myocardial function were obtained, was life-saving in this young patient and may be considered in refractory cardiogenic shock caused by thyroid storm.
A telomere-to-telomere assembly of Oscheius tipulae and the evolution of rhabditid nematode chromosomes
Authors: Gonzalez de la Rosa Pablo Manuel , Thomson Marian , Trivedi Urmi , Tracey Alan , Tandonnet Sophie , Blaxter Mark
Published: February 2021

Eukaryotic chromosomes have phylogenetic persistence. In many taxa, each chromosome has a single functional centromere with essential roles in spindle attachment and segregation. Fusion and fission can generate chromosomes with no or multiple centromeres, leading to genome instability. Groups with holocentric chromosomes (where centromeric function is distributed along each chromosome) might be expected to show karyotypic instability. This is generally not the case, and in Caenorhabditis elegans, it has been proposed that the role of maintenance of a stable karyotype has been transferred to the meiotic pairing centers, which are found at one end of each chromosome. Here, we explore the phylogenetic stability of nematode chromosomes using a new telomere-to-telomere assembly of the rhabditine nematode Oscheius tipulae generated from nanopore long reads. The 60-Mb O. tipulae genome is resolved into six chromosomal molecules. We find the evidence of specific chromatin diminution at all telomeres. Comparing this chromosomal O. tipulae assembly with chromosomal assemblies of diverse rhabditid nematodes, we identify seven ancestral chromosomal elements (Nigon elements) and present a model for the evolution of nematode chromosomes through rearrangement and fusion of these elements. We identify frequent fusion events involving NigonX, the element associated with the rhabditid X chromosome, and thus sex chromosome-associated gene sets differ markedly between species. Despite the karyotypic stability, gene order within chromosomes defined by Nigon elements is not conserved. Our model for nematode chromosome evolution provides a platform for investigation of the tensions between local genome rearrangement and karyotypic evolution in generating extant genome architectures.
Genome ofSuperficieibacter maynardsmithii, a novel, antibiotic susceptible representative ofEnterobacteriaceae
Authors: Batisti Biffignandi Gherard , Gibbon Marjorie J , Corbella Marta , Thorpe Harry A , Merla Cristina , Castelli Michele , Kallonen Teemu , Pegrum Katie , Brisse Sylvain , Corander Jukka , Marone Piero , Feil Edward J , Sassera Davide
Published: February 2021

During a citywide microbiological screening project in Pavia (Italy) a bacterial strain isolated from the surface of an Automated Teller Machine was classified as a Klebsiella sp. by MALDI-TOF spectrometry, and shown to be susceptible to the most antimicrobial classes by phenotypic testing. After Illumina genome sequencing and subsequent assembly, a high-quality draft genome was obtained (size = 5,051,593 bp, N50 = 615,571 bp, largest contig = 1,328,029 bp, N_contig = 17, GC content = 51.58%, coverage = 141.42), absence of antimicrobial resistance genes was confirmed, but the strain resulted to be highly divergent from all Klebsiella, and more related to other Enterobacteriaceae. The higher values of 16S rRNA identity were with members of the genera Citrobacter, Salmonella, and “Superficieibacter.” An ortholog-based phylogenomic analysis indicated a sister group relationship with “Superficieibacter electus,” in a distinct clade from other members of the Enterobacteriaceae family. In order to evaluate whether the novel genome represents a new species of “Superficiebacter,” average nucleotide identity (ANI) and Hadamard analysis were performed on a dataset of 78 Enterobacteriaceae. The novel genome showed an ANI of 87.51% with S. electus, which compared on identity values between other members of the family, clearly indicates that the genome represents a new species within the genus “Superficieibacter.” We propose for the new species the name “Superficieibacter maynardsmithii.”
Interaction of replication factor Sld3 and histone acetyl transferase Esa1 alleviates gene silencing and promotes the activation of late and dormant replication origins
Authors: Tanaka Seiji
Published: February 2021

DNA replication in eukaryotes is a multi-step process that consists of three main reactions: helicase loading (licensing), helicase activation (firing), and nascent DNA synthesis (elongation). Although the contributions of some chromatin regulatory factors in the licensing and elongation reaction have been determined, their functions in the firing reaction remain elusive. In the budding yeast Saccharomyces cerevisiae, Sld3, Sld7, and Cdc45 (3–7–45) are rate-limiting in the firing reaction and simultaneous overexpression of 3–7–45 causes untimely activation of late and dormant replication origins. Here, we found that 3–7–45 overexpression not only activated dormant origins in the silenced locus, HMLα, but also exerted an anti-silencing effect at this locus. For these, interaction between Sld3 and Esa1, a conserved histone acetyltransferase, was responsible. Moreover, the Sld3–Esa1 interaction was required for the untimely activation of late origins. These results reveal the Sld3–Esa1 interaction as a novel level of regulation in the firing reaction.
The impacts of cytoplasmic incompatibility factor (cifA and cifB) genetic variation on phenotypes
Authors: Shropshire J Dylan , Rosenberg Rachel , Bordenstein Seth R
Published: February 2021

Wolbachia are maternally transmitted, intracellular bacteria that can often selfishly spread through arthropod populations via cytoplasmic incompatibility (CI). CI manifests as embryonic death when males expressing prophage WO genes cifA and cifB mate with uninfected females or females harboring an incompatible Wolbachia strain. Females with a compatible cifA-expressing strain rescue CI. Thus, cif-mediated CI confers a relative fitness advantage to females transmitting Wolbachia. However, whether cif sequence variation underpins incompatibilities between Wolbachia strains and variation in CI penetrance remains unknown. Here, we engineer Drosophila melanogaster to transgenically express cognate and non-cognate cif homologs and assess their CI and rescue capability. Cognate expression revealed that cifA;B native to D. melanogaster causes strong CI, and cognate cifA;B homologs from two other Drosophila-associated Wolbachia cause weak transgenic CI, including the first demonstration of phylogenetic type 2 cifA;B CI. Intriguingly, non-cognate expression of cifA and cifB alleles from different strains revealed that cifA homologs generally contribute to strong transgenic CI and interchangeable rescue despite their evolutionary divergence, and cifB genetic divergence contributes to weak or no transgenic CI. Finally, we find that a type 1 cifA can rescue CI caused by a genetically divergent type 2 cifA;B in a manner consistent with unidirectional incompatibility. By genetically dissecting individual CI functions for type 1 and 2 cifA and cifB, this work illuminates new relationships between cif genotype and CI phenotype. We discuss the relevance of these findings to CI’s genetic basis, phenotypic variation patterns, and mechanism.