bluuebunny/crossref_metadata_2025 huggingface dataset:
The Hubble Space Telescope UV Legacy Survey of Galactic Globular Clusters
Authors: Lucertini F. , Nardiello D. , Piotto G.
Published: December 2020

Aims. We present a new technique to estimate the relative ages of multiple stellar populations hosted by the following five globular clusters: NGC 104 (47 Tuc), NGC 6121 (M 4), NGC 6352, NGC 6362, and NGC 6723.

Methods. We used the catalogs of the database HST UV Globular Cluster Survey to create color-magnitude and two-color diagrams of the globular clusters. We identified the multiple populations within each globular cluster, and we divided these into two main stellar populations: POPa, or first generation; and POPb, which is composed of all the successive generations of stars. This new technique allows us to obtain an accurate estimate of the relative ages between POPa and POPb.

Results. The multiple populations of NGC 104 and NGC 6121 are coeval within 220 Myr and 214 Myr, while those of NGC 6352, NGC 6362, and NGC 6723 are coeval within 336 Myr, 474 Myr, and 634 Myr, respectively. These results were obtained combining all the sources of uncertainties.
Prevalence of magnetic reconnection in the near-Sun heliospheric current sheet
Authors: Phan T. D. , Lavraud B. , Halekas J. S. , Øieroset M. , Drake J. F. , Eastwood J. P. , Shay M. A. , Pyakurel P. S. , Bale S. D. , Larson D. , Livi R. , Whittlesey P. L. , Rahmati A. , Pulupa M. , McManus M. D. , Verniero J. L. , Bonnell J. W. , Schwadron N. A. , Stevens M. , Case A. W. , Kasper J. C. , MacDowall R. J. , Szabo P. A. , Koval A. , Korreck K. E. , Dudok de Wit T. , Malaspina D. , Goetz K. , Harvey P. R.
Published: December 2020

During three of its first five orbits around the Sun, Parker Solar Probe (PSP) crossed the large-scale heliospheric current sheet (HCS) multiple times and provided unprecedented detailed plasma and field observations of the near-Sun HCS. We report the common detections by PSP of reconnection exhaust signatures in the HCS at heliocentric distances of 29.5–107 solar radii during encounters 1, 4, and 5. Both sunward and antisunward-directed reconnection exhausts were observed. In the sunward reconnection exhausts, PSP detected counterstreaming strahl electrons, indicating that HCS reconnection resulted in the formation of closed magnetic field lines with both ends connected to the Sun. In the antisunward exhausts, PSP observed dropouts of strahl electrons, consistent with the reconnected HCS field lines being disconnected from the Sun. The common detection of reconnection in the HCS suggests that reconnection is almost always active in the HCS near the Sun. Furthermore, the occurrence of multiple long-duration partial crossings of the HCS suggests that HCS reconnection could produce chains of large bulges with spatial dimensions of up to several solar radii. The finding of the prevalence of reconnection in the HCS is somewhat surprising since PSP has revealed that the HCS is much thicker than the kinetic scales required for reconnection onset. The observations are also in stark contrast with the apparent absence of reconnection in most of the small-scale and much more intense current sheets encountered near perihelia, many of which are associated with “switchbacks”. Thus, the PSP findings suggest that large-scale dynamics, either locally in the solar wind or within the coronal source of the HCS (at the tip of helmet streamers), plays a critical role in triggering reconnection onset.
Planetesimal formation around the snow line
Authors: Hyodo Ryuki , Guillot Tristan , Ida Shigeru , Okuzumi Satoshi , Youdin Andrew N.
Published: December 2020

Context.Forming planetesimals is a major challenge in our current understanding of planet formation. Around the snow line, icy pebbles and silicate dust may locally pile up and form icy and rocky planetesimals via a streaming instability and/or gravitational instability. The scale heights of both pebbles and silicate dust released from sublimating pebbles are critical parameters that regulate the midplane concentrations of solids.

Aims.Here, using a realistic description of the scale height of silicate dust and that of pebbles, we wish to understand disk conditions for which a local runaway pile-up of solids (silicate dust or icy pebbles) occurs inside or outside the snow line.

Methods.We performed 1D diffusion-advection simulations that include the back-reaction (the inertia) to radial drift and diffusion of icy pebbles and silicate dust, ice sublimation, the release of silicate dust, and their recycling through the recondensation and sticking onto pebbles outside the snow line. We used a realistic description of the scale height of silicate dust obtained from a companion paper and that of pebbles including the effects of a Kelvin-Helmholtz instability. We study the dependence of solid pile-up on distinct effective viscous parameters for turbulent diffusions in the radial and vertical directions (αDrandαDz) and for the gas accretion to the star (αacc) as well as that on the pebble-to-gas mass flux (Fp/g).

Results.Using both analytical and numerical approaches, we derive the sublimation width of drifting icy pebbles which is a critical parameter to characterize the pile-up of silicate dust and pebbles around the snow line. We identify a parameter space (in theFp/g−αacc−αDz(=αDr) space) where pebbles no longer drift inward to reach the snow line due to the back-reaction that slows down the radial velocity of pebbles (we call this the “no-drift” region). We show that the pile-up of solids around the snow line occurs in a broader range of parameters forαacc= 10−3than forαacc= 10−2. Above a criticalFp/gvalue, the runaway pile-up of silicate dust inside the snow line is favored forαDr∕αacc≪ 1, while that of pebbles outside the snow line is favored forαDr∕αacc~ 1. Our results imply that a distinct evolutionary path in theαacc−αDr−αDz−Fp/gspace could produce a diversity of outcomes in terms of planetesimal formation around the snow line.
Greig Cephalopolysyndactyly Syndrome: Phenotypic Variability Associated with Variants in Two Different Domains of GLI3
Authors: Khan Hammal , Ahmed Sohail , Nawaz Sadia , Ahmad Wasim , Rafiq Muhammad Arshad ,   Abdullah
Published: December 2020

Background GLI3 is a transcriptional regulator of several genes involved in mammalian skeletal development. Mutations in the pleiotropic gene GLI3 may result in different inherited disorders including Greig cephalopolysyndactyly syndrome (GCPS). GCPS is characterized by mild to severe craniofacial and limb malformations.

Methods and Results Here, we report clinical and molecular study of 3 families with GCPS originated in different regions of Pakistan. Sanger sequencing revealed two novel variants including a frameshift [c. 3790_3791InsC, p.(Gly1236Argfs*11)] and a missense [c.1692A>G, p.(His536Arg)], and one previously reported variant [c.1965_1966delAT, p.(His627Glufs*48)] located in 2 different domains of the GLI3.

Conclusion This study not only expanded spectrum of the mutations in the GLI3 but also highlighted phenotypic variability in the GCPS patients. This will facilitate diagnosis and genetic counseling of families with same and related disorders in the Pakistani population.
Lipoprotein(a) and Cardiovascular Outcomes in Patients with Previous Myocardial Infarction: A Prospective Cohort Study
Authors: Cao Ye-Xuan , Zhang Hui-Wen , Jin Jing-Lu , Liu Hui-Hui , Zhang Yan , Zhang Meng , Gao Ying , Guo Yuan-Lin , Wu Na-Qiong , Zhu Cheng-Gang , Dong Qian , Sun Jing , Wang Le-Feng , Gao Run-Lin , Li Jian-Jun
Published: December 2020

Lipoprotein(a) [Lp(a)] has been documented to be associated with atherothrombotic diseases. However, the prognostic impact of Lp(a) on long-term clinical outcomes among patients with previous myocardial infarction (MI) remains unclear. In this prospective cohort study, we consecutively enrolled 3,864 post-MI patients to assess the cardiovascular events (CVEs), including MI, ischemic stroke, and cardiac mortality. Lp(a) levels were determined using an immunoturbidimetry assay and the participants were categorized according to Lp(a) quartiles. The Cox proportional hazards model was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). During a median follow-up of 4.1 years, 331 (8.6%) CVEs were identified. Lp(a) was significantly higher in patients with CVEs (25.17 [11.13–47.83] vs. 18.18 [7.90–40.30] mg/dL, p = 0.001). The cumulative rates of CVEs and cardiac mortality were significantly higher in patients with high Lp(a) levels (both log-rank p < 0.001). Multivariate Cox regression analysis showed a significant correlation between Lp (a) levels treated as a natural logarithm-transformed continuous variable and increased CVEs (adjusted HR:1.22, 95% CI:1.09–1.35, p = 0.001) or cardiac mortality (HR:1.30, 95% CI:1.14–1.48, p < 0.001). The addition of Lp(a) to a prognostic model revealed a significant improvement in C-statistic, net reclassification, and integrated discrimination. In conclusion, elevated levels of Lp(a) were indeed associated with long-term worse outcomes in patients with prior MI, suggesting a novel hint that the measurement of Lp(a) might help in risk stratification and future management in those high-risk individuals.
Estudo anatômico dos ramos motores do nervo radial no antebraço
Authors: Caetano Edie Benedito , Vieira Luiz Angelo , Sabongi Neto João José , Caetano Maurício Benedito Ferreira , Picin Celis Piovesan , Silva Júnior Luiz Claudio Nascimento da
Published: December 2020

Objetivo Analisar as variações anatômicas dos ramos motores do nervo radial na região do cotovelo. Foram avaliadas a origem, curso, comprimento, ramificações, pontos motores e relações com estruturas vizinhas.

Materiais e Métodos Foram dissecados 30 membros de 15 cadáveres adultos, preparados por injeção intra-arterial de uma solução de glicerina e formol a 10%.

Resultados O primeiro ramo do nervo radial no antebraço foi para o músculo braquiorradial (BR), que se origina proximalmente à divisão do nervo radial em ramo superficial do nervo radial (RSNR) e nervo interósseo posterior (NIP) em todos os membros. Os ramos para o músculo extensor radial longo do carpo (ERLC) se desprenderam do nervo radial proximalmente à sua divisão em 26 membros, em 2, nos pontos de divisão, em outros 2, do NIP. Em seis, os ramos para os músculos BR e ERLC originavam-se de um tronco comum. Identificamos a origem do ramo para o músculo extensor radial curto do carpo (ERCC) no NIP em 14 membros, no RSNR em 12, e no nervo radial em apenas 4. O ramo para o músculo supinador originou-se do NIP em todos os membros.

Conclusão O conhecimento da anatomia dos ramos motores do nervo radial é importante quando se realizam procedimentos cirúrgicos na região, como a abordagem do terço proximal e da cabeça do rádio, a liberação das síndromes compressivas do nervo interósseo posterior e do túnel radial, as transferências nervosas distais, e para entender a ordem de recuperação da função muscular após uma lesão nervosa.
Fratura em sinostose rádio-umeral: Descrição de dois casos clínicos
Authors: Oliveira Ricardo Kaempf de , Brunelli João Pedro Farina , Aita Márcio Aurelio , Delgado Serrano Pedro José
Published: December 2020

Sinostose é um termo genérico utilizado para indicar a união de dois ossos originalmente separados. No cotovelo, a sinostose rádio-umeral ou longitudinal causa importante incapacidade, que varia a depender da função da mão, da posição do cotovelo, da mobilidade das articulações adjacentes e da função do membro contralateral. Estima-se que um pouco mais de 150 pacientes foram descritos até hoje com essa deformidade, sendo mais frequente em portadores de deficiência de formação ulnar ou podendo fazer parte de síndromes como de Antley-Bixler e de Hermann. Devido à rigidez causada pela ausência da articulação do cotovelo, que resulta na formação de um osso mais longo com a fusão do úmero no rádio, presume-se que fratura nessa topografia não seja incomum. No entanto, pela raridade dessa patologia, tal lesão apresenta apenas duas descrições prévias na literatura. Relatamos os casos de dois pacientes com fratura do osso único formado pela sinostose entre o úmero e o rádio portadores de falha de formação ulnar do tipo IV de Bayne. Ambos os pacientes foram tratados de forma cirúrgica e evoluíram bem. Salientamos a necessidade do tratamento adequado para não comprometer as atividades da vida de um paciente já adaptado à deformidade, evitando piorar a função de um membro já alterado.
Avaliação da reprodutibilidade das classificações Lauge-Hansen, Danis-Weber e AO para fraturas do tornozelo
Authors: Ramos Lucas Sacramento , Gonçalves Henrique Mansur , Freitas Anderson , Oliveira Marcio de Paiva , Lima Diogo Marcelino Santos , Carmargo Welvis Soares
Published: December 2020

Objetivo Avaliar a reprodutibilidade intra- e interobservador das classificações de Lauge-Hansen, Danis-Weber e Arbeitsgemeinschaft für Osteosynthesefragen (AO) para as fraturas de tornozelo, e a influência do estágio de formação dos participantes na avaliação.

Métodos Foram selecionadas radiografias de 30 pacientes com fratura de tornozelo nas incidências anteroposterior (AP), perfil e AP verdadeiro. Todas as imagens foram avaliadas por 11 participantes em diferentes estágios de formação profissional (cinco residentes e seis cirurgiões ortopédicos), em dois momentos distintos. Analisou-se a concordância inter- e intraobservador por meio do coeficiente Kappa ponderado. O teste t de Student para amostras pareadas foi aplicado para verificar se havia diferença significativa no grau de concordância interobservador entre os instrumentos.

Resultado Observou-se que existe concordância significativa em todas as classificações quando da análise intraobservador isolada. Existe concordância interobservador altamente significativa de grau moderado a ótimo na classificação de Danis-Weber (p ≤ 0,0001). A classificação de Danis-Weber apresentou, em média, grau de concordância significativamente maior que as outras classificações (p ≤ 0,0001).

Conclusão A classificação de Danis-Weber se mostrou a mais reprodutiva entre os instrumentos avaliados, e a pouca experiência do avaliador não influencia negativamente a reprodutibilidade das classificações das fraturas do tornozelo. Nível de Evidência II, Estudos Diagnósticos - Investigação de um Exame para Diagnóstico.
Rare Clinical Onset of Nontraumatic Intracavernous Aneurysm of the Internal Carotid Artery: A Diagnostic and Therapeutic Challenge
Authors: Emanuelli Enzo , Baldovin Maria , Zanotti Claudia , Munari Sara , Denaro Luca , Saratziotis Athanasios
Published: December 2020

While the so-called pseudoaneurysms can result from arterial injury during trans-sphenoidal surgery or after a trauma, spontaneous aneurysms of cavernous–internal carotid artery (CICA) are rare. Symptoms vary and the differential diagnosis with other, more frequent, sellar lesions is difficult. We describe three cases of misdiagnosed CICA spontaneous aneurysm. In two cases the onset was with neuro-ophthalmological manifestations, classifiable as “cavernous sinus syndrome.” The emergency computed tomography scan did not show CICA aneurysm and the diagnosis was made by surgical exploration. The third patient came to our attention with a sudden severe unilateral epistaxis; endonasal surgery revealed also in this case a CICA aneurysm, eroding the wall and protruding into the sphenoidal sinus. When the onset was with a cavernous sinus syndrome, misdiagnosis exposed two patients to potential serious risk of bleeding, while the patient with epistaxis was treated with embolization, using coils and two balloons. Intracavernous nontraumatic aneurysms are both a diagnostic and therapeutic challenge, because of their heterogeneous onset and risk of rupture, potentially lethal. Intracavernous aneurysms can be managed with radiological follow-up, if asymptomatic or clinically stable, or can be surgically treated with endovascular or microsurgical techniques.
Evaluation of Primary and Secondary Free Flap Desyndactylization Techniques in Hand and Digit Reconstruction: A Systematic Review
Authors: Gehring Michael B. , Iorio Matthew L.
Published: December 2020

Objective Injuries of the hand often require free flap reconstruction. To minimize flap loss, evidence exists to surgically syndactylize digits when repairing multiple injuries, with delayed flap division, or desyndactylization. However, evidence suggests that division of the flap at the time of inset can be accomplished with minimal negative effect. The purpose of this study was to evaluate outcomes, following hand reconstruction with free flaps utilizing either acute or staged desyndactylization techniques.

Methods A systematic review utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed. Articles that described the use of a free flap for surgically syndactylized digits or multilobed flaps for coverage of multiple digits were included.

Results One hundred sixty-one articles were reviewed with 34 fulfilling inclusion criteria. One hundred seventeen patients underwent 145 free flap reconstructions. Traumatic avulsions (49%) were the most common injuries, followed by burns (11%). Twenty-one (62%) papers described surgical syndactylization of digits, which were later desyndactylized and five (15%) papers included reconstruction of more than one digit with multilobed free flaps. Eight papers (24%) described both techniques. Overall, 100% of included flaps survived. Total complication rate was 6%, with six complications (67%) occurring in flaps with primary syndactylization.

Conclusion Hand defects often require free flaps for reconstruction. Although free flaps for the reconstruction of digital defects is technically demanding, they result in better outcomes. With available evidence indicating complications rates less than those of staged desyndactylization, multidigit reconstruction with multilobed free flaps may be a more desirable technique.
Regulation of membrane NMDA receptors by dynamics and protein interactions
Authors: Petit-Pedrol Mar , Groc Laurent
Published: December 2020

Understanding neurotransmitter system crosstalk in the brain is a major challenge in neurobiology. Several intracellular and genomic cascades have been identified in this crosstalk. However, the discovery that neurotransmitter receptors are highly diffusive in the plasma membrane of neurons, where they form heterocomplexes with other proteins, has profoundly changed our view of neurotransmitter signaling. Here, we review new insights into neurotransmitter crosstalk at the plasma membrane. We focus on the membrane organization and interactome of the ionotropic glutamate N-methyl-D-aspartate receptor (NMDAR) that plays a central role in excitatory synaptic and network physiology and is involved in the etiology of several major neuropsychiatric disorders. The nanoscale organization and dynamics of NMDAR is a key regulatory process for glutamate synapse transmission, plasticity, and crosstalk with other neurotransmitter systems, such as the monoaminergic ones. The plasma membrane appears to be a prime regulatory compartment for spatial and temporal crosstalk between neurotransmitter systems in the healthy and diseased brain. Understanding the molecular mechanisms regulating membrane neurotransmitter receptor crosstalk will likely open research avenues for innovative therapeutical strategies.
Lipid metabolism and cancer
Authors: Bian Xueli , Liu Rui , Meng Ying , Xing Dongming , Xu Daqian , Lu Zhimin
Published: December 2020

Dysregulation in lipid metabolism is among the most prominent metabolic alterations in cancer. Cancer cells harness lipid metabolism to obtain energy, components for biological membranes, and signaling molecules needed for proliferation, survival, invasion, metastasis, and response to the tumor microenvironment impact and cancer therapy. Here, we summarize and discuss current knowledge about the advances made in understanding the regulation of lipid metabolism in cancer cells and introduce different approaches that have been clinically used to disrupt lipid metabolism in cancer therapy.
Chapter 18 the bishop of barchester is crushed
Authors: Trollope Anthony
Published: December 2020

Who inquires why it is that a little greased flour rubbed in among the hair on a footman’s head,—just one dab here and another there,—gives such a tone of high life to the family! And seeing that the thing is so easily done, why...
Chapter 35 lily dale writes two words in her book
Authors: Trollope Anthony
Published: December 2020

John Eames saw nothing more of Lily Dale till he packed up his portmanteau, left his mother’s house, and went to stay for a few days with his old friend Lady Julia; and this did not happen till he had been above a week...
Chapter 42 mr toogood travels professionally
Authors: Trollope Anthony
Published: December 2020

Mr Toogood paid another visit to Barsetshire, in order that he might get a little further information which he thought would be necessary before despatching his nephew upon the traces of Dean Arabin and his wife. He went down to Barchester after his work...
Chapter 48 the softness of sir raffle buffle
Authors: Trollope Anthony
Published: December 2020

We have seen that John Eames was prepared to start on his journey search of the Arabins, and have seen him after he had taken farewell of his office and of his master there, previous to his departure; but that matter of his departure...
Chapter 49 near the close
Authors: Trollope Anthony
Published: December 2020

I wonder whether any one will read these pages who has never known anything of the bitterness of a family quarrel? If so, I shall have a reader very fortunate, or else very cold-blooded. It would be wrong to say that love produces...
Chapter 56 the archdeacon goes to framley
Authors: Trollope Anthony
Published: December 2020

By some of those unseen telegraphic wires which carry news about the country and make no charge for the conveyance, Archdeacon Grantly heard that his son the major was at Framley. Now in that itself there would have been nothing singular. There had been...
Chapter 58 the cross-grainedness of men
Authors: Trollope Anthony
Published: December 2020

By the time that the archdeacon reached Plumstead his enthusiasm in favour of Grace Crawley had somewhat cooled itself; and the language which from time to time he prepared for conveying his impressions to his wife, became less fervid as he approached his home....
Chapter 63 two visitors to hogglestock
Authors: Trollope Anthony
Published: December 2020

The cross-grainedness of men is so great that things will often be forced to go wrong, even when they have the strongest possible natural tendency of their own to go right. It was so now in these affairs between the archdeacon and his son....
Chapter 74 the crawleys are informed
Authors: Trollope Anthony
Published: December 2020

Major Grantly made an early start, knowing that he had a long day’s work before him. He had written over-night to Mr Toogood, naming the hour at which he would reach the Dragon, and was there punctual to the moment. When the attorney came...
Chapter 83 mr crawley is conquered
Authors: Trollope Anthony
Published: December 2020

It was more than a week before the archdeacon received a reply from Mr Crawley, during which time the dean had been over at Hogglestock more than once, as had also Mrs Arabin and Lady Lufton the younger,—and there had been letters written without...
Chapter 84 conclusion
Authors: Trollope Anthony
Published: December 2020

It now only remains for me to gather together a few loose strings, and tie them together in a knot, so that my work may not become untwisted. Early in July, Henry Grantly and Grace Crawley were married in the parish church...
Majority of Most-Cited Articles in Top Plastic Surgery Journals Do Not Receive Funding
Authors: Asserson Derek B , Janis Jeffrey E
Published: December 2020

Background

Plastic surgery faculty, residencies, and institutions are frequently judged on the quantity and quality of their research output. Some of the most impressive individuals in the specialty receive financial support in the form of grants and payments to help with research ideas.

Objectives

The authors sought to discern if funding directly correlates to greater impact in the top plastic surgery journals as measured by citations.

Methods

Using the Web of Science database, the authors identified the 50 most-cited articles in each of the top plastic surgery journals from January 1975 to August 2020. The articles were scanned for funding sources and categorized as industry, federal, foundational, and institutional, while stratifying by decade.

Results

Between 16 journals, 13.3% of the most-cited articles received funding, 2.6% of which came from industry, 5.4% from government, 4.4% from foundations, and 0.86% from institutions. The percentage of most-cited articles and the proportion that received funding were both correlated with decade (P = 0.0017 and P = 0.043, respectively). However, only the percentage of articles was found to significantly increase over time (P = 0.0068).

Conclusions

Although funding leads to meaningful publications, this study showed that financial support is not required to have an influence in plastic surgery research.
Design and characteristic analysis of vibration feeding system for coal-gas dust-removal medium
Authors: Liu Bing , He Lixin , Zhao Xianglong , Qin Qiang , Guo Yi
Published: December 2020

A vibration feeder is a piece of equipment for rationing and conveying powder, particle and block materials. In order to test the regeneration performance of de-dusting medium for high-temperature coal gas, a set of de-dusting medium-feeding systems was designed quantitatively. The de-dusting medium-feeding system is used in the gasification process for cleaning coal gas. The system is mainly composed of a hopper unit, control unit and feeding unit. In order to optimize the feeding stability of the coal-gas dust-removal medium vibration feeding system, the setting and scope of the following design factors and operating factors are investigated. Specifically, it includes the influence of gate-valve-opening adjustment of the control unit on the feeding stability of a vibrating feeding system; the influence of the gap size of the dipleg of the control unit on the feeding sensitivity of the vibration system; the influence of the particle size of the de-dusting medium on the operating range of the vibrating feeding system; the influence of the digitization of the working-current indicator of electromagnetic vibrating feeders on measurement variation and the process variation of a vibration feeding system. This vibration feeding system can realize the function of precise and quantitative feeding of the de-dusting medium, which can meet the design requirements of subsequent experimental research.
Working and Reference Memory Tasks Trigger Opposed Long-Term Synaptic Changes in the Rat Dentate Gyrus
Authors: Missaire Mégane , Fraize Nicolas , Comte Jean-Christophe , Truchet Bruno , Parmentier Régis , Salin Paul-Antoine , Malleret Gaël
Published: December 2020

Long-term storage of information into memory is supposed to rely on long-term synaptic plasticity processes. The detection of such synaptic changes after training in long-term/reference memory (RM) tasks has yet been scarce, variable and only studied on a short time scale. Short-term or working memory (WM) is largely known to depend on persistent neuronal activity or short-term plasticity. However, processing information into WM could also involve long-term synaptic changes that could be responsible for the erasure/forgetting of items previously stored in WM and acting as proactive interference. In order to study long-term synaptic changes associated with RM or WM, we trained chronically implanted rats in 3 different radial maze tasks: a classical RM task and 2 WM tasks involving different levels of proactive interference. Synaptic responses in the dentate gyrus were recorded during 2 × 24 h in freely moving rats after training. We found that consolidation of long-term information leads first to a delayed synaptic potentiation, occurring 9 h after RM training that is replaced by a synaptic depression once the RM rule is fully acquired. In contrast, optimal information processing into WM triggers a synaptic depression immediately after training and lasting 3 h that could act as a mechanism for interference erasure/forgetting.
Intentions for Doing Good Matter for Doing Well: The Negative Effects of Prosocial Incentives
Authors: Cassar Lea , Meier Stephan
Published: December 2020

Many firms consider prosocial initiatives to be an effective tool to motivate workers. However, despite some initial supportive evidence, little is known about when and how prosocial incentives work. Our field experiment shows that the instrumental use of prosocial incentives to increase effort can backfire. The negative effect is particularly strong for performance-based prosocial incentives, which are, by construction, more instrumental than unconditional incentives, and for the workers who do not care about the charitable cause. These findings highlight some serious limitations of prosocial incentives: firms’ perceived intentions and the pool of employees will be crucial for their effectiveness.
Serial assessment of HeartMate 3 pump position and inflow angle and effects on adverse events
Authors: Shih Hueyjong , Butler Caley , Melehy Andrew , Ning Yuming , Kurlansky Paul , Kaku Yuji , Yuzefpolskaya Melana , Colombo Paolo C , Sayer Gabriel T , Uriel Nir , Naka Yoshifumi , Takeda Koji
Published: December 2020

OBJECTIVES

This study analyses the position of the HeartMate 3 left ventricular assist device on serial radiographs to assess positional change and possible correlation with adverse events.

METHODS

We retrospectively analysed 59 left ventricular assist device recipients who had serial chest radiographs at 1 month, 6 months and 12 months post-implantation between November 2014 and June 2018. We measured pump angle, pump-spine distance and pump-diaphragm depth and investigated their relationship to a composite outcome of heart failure readmission, low flow alarms, stroke or inflow/outflow occlusion requiring surgical repositioning through recurrent event survival modelling.

RESULTS

Between 1 and 6 months, the absolute pump-spine distance changed by 10.00 mm (P < 0.01) and the absolute pump-diaphragm depth changed by 18.80 mm (P < 0.01). These parameters did not change significantly between 6 and 12 months post-implantation. Pump angle did not change significantly over any period. Twenty-six patients experienced the composite outcome; in these patients, the median 1-month pump angle was 66.2° (interquartile range 54.5–78.0) as compared to 59.0° (interquartile range 47.0–65.0) in the 33 patients who did not have adverse events (P = 0.04). Pump depth and pump-spine distance at 1 month were not associated with the composite outcome. Change in pump depth between 1 and 6 months [hazard ratio (HR) 1.019; 95% confidence interval (CI) 1.000–1.039] and between 6 and 12 months (HR 1.020; 95% CI 1.000–1.040) were weakly associated with the composite outcome.

CONCLUSIONS

Larger pump angles are associated with the composite outcome of position-related adverse events. Pump depth movement is weakly associated with the composite outcome.
339 Interplay between COVID-19, pollution, and weather features on changes in the incidence of acute coronary syndromes in early 2020
Authors: Griffo Simone , Gaspardone Achille , Danesi Alessandro , Ferranti Fabio , Mariano Enrica , Rotolo Francesco , Musto Carmine , Di Giosa Alessandro , Marchegiani Giada , Zoccai Giuseppe Biondi , Versaci Francesco
Published: December 2020

Aims

Coronavirus disease 2019 (COVID-19) has caused an unprecedented change in the apparent epidemiology of acute coronary syndromes (ACS). However, the interplay between this disease, changes in pollution, climate, and aversion to activation of emergency medical services represents a challenging conundrum. We aimed at appraising the impact of COVID-19, weather, and environment features on the occurrence of ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) in a large Italian region and metropolitan area.

Methods and results

Italy was hit early on by COVID-19, such that state of emergency was declared on January 31, 2020, and national lockdown implemented on March 9, 2020, mainly because the accrual of cases in Northern Italy. In order to appraise the independent contribution on changes in STEMI and NSTEMI daily rates of COVID-19, climate and pollution, we collected data on these clinical events from tertiary care cardiovascular centers in the Lazio region and Rome metropolitan area. Multilevel Poisson modeling was used to appraise unadjusted and adjusted effect estimates for the daily incidence of STEMI and NSTEMI. The sample included 1448 STEMI and 2040 NSTEMI, with a total of 2882 PCI spanning 6 months. Significant reductions in STEMI and NSTEMI were evident already in early February 2020 (all P < 0.05), concomitantly with COVID-19 spread and institution of national countermeasures. Changes in STEMI and NSTEMI were inversely associated with daily COVID-19 tests, cases, and/or death (P < 0.05). In addition, STEMI and NSTEMI incidences were associated with daily NO2, PM10, and O3 concentrations, as well as temperature (P < 0.05). Multi-stage and multiply adjusted models highlighted that reductions in STEMI were significantly associated with COVID-19 data (P < 0.001), whereas changes in NSTEMI were significantly associated with both NO2 and COVID-19 data (both P < 0.001).

Conclusion

Reductions in STEMI and NSTEMI in the COVID-19 pandemic may depend on different concomitant epidemiologic and pathophysiologic mechanisms. In particular, recent changes in STEMI may depend on COVID-19 scare, leading to excess all-cause mortality, or effective reduced incidence, whereas reductions in NSTEMI may also be due to beneficial reductions in NO2 emissions in the lockdown phase.
234 The role of preprocedural assessment of aortic valve calcium volume for the optimization of percutaneous aortic bioprosthesis implantation (TAVI)
Authors: Attisano Tiziana , Ferraioli Mario , Silverio Angelo , Bellino Michele , Esposito Luca , Di Muro Francesca Maria , Baldi Cesare , Coscioni Enrico , Galasso Gennaro
Published: December 2020

Aims

Paravalvular leaks (PVL) and conduction disorders requiring permanent pacemaker implantation (PPI) in patients with severe Aortic Valvular Stenosis (SA) undergoing percutaneous aortic valve prosthesis (TAVI) still have a significant and unacceptable incidence for patients at medium and low surgical risk, who represent, with increasing scientific evidence, the prevalent population. The appearance of these complications seems to be related to clinical, anatomical and procedural factors, which influence the decision-making process of the type and size of bioprosthesis to be implanted. Particular attention has been paid to the role of the volume of calcium present at the native aortic valve (VCA) as a predictor of these complications, in order to optimize the percutaneous procedure. The VCA can be quantified using algorithms derived from Multilayer Computed Computed Axial Tomography (MSCT), an examination that has become a pivotal element in the evaluation of the patient's eligibility for TAVI.The aim of our study was to document the pre-procedural added value of VCA in terms of possible containment of adverse events and how much it may affect the choice of the type of bioprosthesis to be implanted.

Methods and results

111 patients underwent TAVIs at the Interventional Cardiology Unit of the AOU S. Giovanni di Dio and Ruggi D'Aragona, between 2017 and 2020, subsequently divided into 2 groups: group A (self-expandable bioprosthesis, Medtronic Evolut R or Evolut Pro) and group B (balloon expandable bioprosthesis, Edward Sapien 3).The clinical, electrocardiographic, echocardiographic and anatomical parameters of the enrolled patients were analyzed, and the VCA in the preprocedural phase was quantified for each of them, using an algorithm extracted from the MSCT reading software, OsiriX (OsiriX-MD v.2.8.2 64-bit).

A univariate logistic regression analysis was performed for the risk of developing the composite event of significant PVL and IPP.In Group B, no significant variables were found, while in Group A, the VCA (OR: 1.001; 95% CI, 1.000-1.002; p < 0.043) and incomplete left branch block (OR: 5.781; 95% CI, 0.013-32.988; p < 0.048) were significant. Subsequently, these two variables were tested in a multivariate regression model according to which only the VCA emerged as an independent predictor for the composite event (OR: 1.001; 95% CI, 1.000-1.002; p < 0.039).

Conclusion

VCA is significantly associated with the risk of moderate to severe PVL and rhythm disturbances requiring PPI, in the group of patients in whom a self-expandable bioprosthesis was implanted, unlike patients who received a balloon-expandable bioprosthesis where this association is not significant.
265 Incidence, determinants and prognostic relevance of HS-troponin and natriuretic peptides elevation at admission in hospitalized COVID-19 pneumonia patients
Authors: Arcari Luca , Luciano Michelangelo , Cacciotti Luca , Musumeci Maria Beatrice , Spuntarelli Valerio , Pistella Eleonora , Martolini Dario , Manzo Daniele , Pucci Mariateresa , Marone Claudio , Melandri Serena , Ansalone Gerardo , Santini Claudio , Martelletti Paolo , Volpe Massimo , De Biase Luciano
Published: December 2020

Aims

myocardial involvement in the course of Coronavirus disease 2019 (COVID-19) pneumonia has been reported, though not fully characterized yet. Aim of the present study is to undertake a joint evaluation of hs-Troponin and natriuretic peptides (NP) in patients hospitalized for COVID-19 pneumonia.

Methods and results

in this multicenter observational study, we analyzed data from n = 111 COVID-19 patients admitted to dedicated “COVID-19” medical units. Hs-Troponin was assessed in n = 103 patients and NP in n = 82 patients on admission; subgroups were identified according to values beyond reference range. increased hs-Troponin and NP were found in 38% and 56% of the cases respectively. As compared to those with normal cardiac biomarkers, these patients were older, had higher prevalence of cardiovascular diseases (CVD) and more severe COVID-19 pneumonia by higher CRP and D-dimer and lower PaO2/FIO2. Two-dimensional echocardiography performed in a subset of patients (n = 24) showed significantly reduced left ventricular ejection fraction in patients with elevated NP only (p = 0.02), whereas right ventricular systolic function (tricuspid annular plane systolic excursion) was significantly reduced both in patients with high hs-Troponin and NP (p = 0.022 and p = 0.03 respectively). On multivariable analysis, independent associations were found of hs-Troponin with age, PaO2/FIO2 and D-dimer (B = 0.419, p = 0.001; B=-0.212, p = 0.013 and B = 0.179, p = 0.037 respectively), and of NP with age and previous CVD (B = 0.480, p < 0.001 and B = 0.253, p = 0.001 respectively). In patients with in-hospital mortality (n = 23, 21%) hs-Troponin and NP were both higher (p = 0.001 and p = 0.002 respectively), while increasing hs-troponin and NP were associated with worse in-hospital prognosis [OR 4.88 (95% CI 1.9-12.2), p = 0.001 (adjusted OR 3.1 (95% CI 1.2-8.5), p = 0.025) and OR 4.67 (95% CI 2-10.8), p < 0.001 (adjusted OR 2.89 (95% CI 1.1-7.9), p = 0.04) respectively]. Receiver operator characteristic curves showed good ability of hs-Troponin and NP in predicting in-hospital mortality (AUC = 0.869 p < 0.001 and AUC = 0.810, p < 0.001 respectively).

Conclusion

myocardial involvement at admission is common in COVID-19 pneumonia and associated to worse prognosis, suggesting a role for cardiac biomarkers assessment in COVID-19 risk stratification. Independent associations of hs-Troponin with markers of disease severity and of NP with underlying CVD might point towards existing different mechanisms leading to their elevation in this setting.
370 The CO-existence of KCNQ1 and TNNI3 genes mutations supports the genetic origin of QTC abnormalities in hypertrophic cardiomyopathy
Authors: Cava Francesco , Cristiano Ernesto , Lo Monaco Maria , Musumeci Maria Beatrice , Savio Camilla , Petrucci Simona , Rubattu Speranza Donatella , Piane Maria , Autore Camillo
Published: December 2020

Hypertrophic cardiomyopathy (HCM) and Long QT Syndrome (LQTS) are inherited diseases characterized by a wide genetic heterogeneity. Based on the separate incidence of these pathologies and on the absence of linkage, the occurrence of both diseases in the same individual has an incidence of about 1/250000. We describe a rare case report of a 24 years-old patient with maternal familiarity for type 1 LQTS (mother carrier of KCNQ1 c.1781G>A) and paternal familiarity for HCM (father carrier of TNNI3 c.592C>G mutation) who inherited both gene mutations and was diagnosed with HCM and LQTS later in adolescence, after clinical and genetic evaluations.
447 Pathology of conduction tissue in cardiac amyloid: correlation with arrhythmic manifestations
Authors: Alfarano Maria , Chimenti Cristina , Verardo Romina , Galea Nicola , Francone Marco , Miraldi Fabio , Frustaci Andrea
Published: December 2020

Aims

Pathology of conduction tissue (CT) and relative arrhythmic manifestations in living subjects with cardiac amyloid (CA) have never been reported.

Methods and results

In 17 out of 45 consecutive patients with CA, a left ventricular (LV) endomyocardial biopsy included CT sections. Extensive clinical examination, non-invasive (resting ECG, Holter monitoring, echocardiography), and invasive cardiac studies (selective coronary angiography, LV angiography, and LV endomyocardial biopsy) were performed in all patients. Cardiac magnetic resonance (CMR) was performed in 12 of the 17 patients (70%). CT was identified by Aschoff-Monckeberg histologic criteria associated to positive immunostaining for HCN4. Degree of CT infiltration was defined as mild when ≤ 30% of CT area was replaced by fibrous tissue and Congo red+ material, moderate in 30–70% CT area involvement and severe in > 70% CT cell area replacement. CT infiltration was correlated with ventricular arrhythmias, echocardiographic LV maximal wall thickness (MWT) and type of amyloid protein identified by myocardial immunohistochemistry. CMR confirmed the presence of cardiac hypertrophy with preserved systolic function in all but one patient. LGE was present in all patients, predominantly with diffuse (5/11) or subendocardial (4/11) pattern compared to focal (2/11). In 7/11 patients T1 mapping sequences have been acquired; nT1 and ECV were increase in all patients (nT1: 1171 ± 61 ms; ECV: 59.9 ± 7.5%). Mild CT involvement was observed in 5 cases; moderate in 3; severe compromise in 9. CT involvement was associated with a parallel infiltration of CT artery. CT infiltration correlated with severity of arrhythmias (Spearman rho = 0.8, P < 0.001) but not with age, MWT or type of amyloid protein. In particular, major ventricular tachyarrhythmias requiring pharmacologic treatment or ICD implantation occurred in 7 patients with severe, 1 patient with moderate and none with mild CT infiltration. Pacemaker implantation was required in 3 patients with complete CT area replacement.

Conclusion

CA associated arrhythmias correlate with severity of CT infiltration. CT involvement is independent from type and severity of CA suggesting a variable affinity of amyloid protein to CT.
Noncommutative Counting Invariants and Curve Complexes
Authors: Dimitrov George , Katzarkov Ludmil
Published: December 2020

In our previous paper, viewing $D^b(K(l))$ as a noncommutative curve, where $K(l)$ is the Kronecker quiver with $l$-arrows, we introduced categorical invariants via counting of noncommutative curves. Roughly, these invariants are sets of subcategories in a given category and their quotients. The noncommutative curve-counting invariants are obtained by restricting the subcategories to be equivalent to $D^b(K(l))$. The general definition, however, defines a larger class of invariants and many of them behave properly with respect to fully faithful functors. Here, after recalling the definition, we focus on the examples and extend our studies beyond counting. We enrich our invariants with the following structures: the inclusion of subcategories makes them partially ordered sets and considering semi-orthogonal pairs of subcategories as edges amounts to directed graphs. It turns out that the problem for counting $D^b(A_k)$ in $D^b(A_n)$ has a geometric combinatorial parallel - counting of maps between polygons. Estimating the numbers counting noncommutative curves in $D^b({\mathbb P}^2)$ modulo the group of autoequivalences, we prove finiteness and that the exact determining of these numbers leads to a solution of Markov problem. Via homological mirror symmetry, this gives a new approach to this problem. Regarding the structure of a partially ordered set mentioned above, we initiate intersection theory of noncommutative curves focusing on the case of noncommutative genus zero. The above-mentioned structure of a directed graph (and related simplicial complex) is a categorical analogue of the classical curve complex, introduced by Harvey and Harrer. The paper contains pictures of the graphs in many examples and also presents an approach to Markov conjecture via counting of subgraphs in a graph associated with $D^b({{\mathbb{P}}}^2)$. Some of the results proved here were announced in a previous work.
A Phase 1/2 Randomized, Placebo-Controlled Trial of Romidespin in Persons With HIV-1 on Suppressive Antiretroviral Therapy
Authors: McMahon Deborah K , Zheng Lu , Cyktor Joshua C , Aga Evgenia , Macatangay Bernard J , Godfrey Catherine , Para Michael , Mitsuyasu Ronald T , Hesselgesser Joseph , Dragavon Joan , Dobrowolski Curtis , Karn Jonathan , Acosta Edward P , Gandhi Rajesh T , Mellors John W
Published: December 2020

Background

Romidepsin (RMD) is a histone deacetylase inhibitor reported to reverse HIV-1 latency. We sought to identify doses of RMD that were safe and induced HIV-1 expression.

Methods

Enrollees had HIV-1 RNA <40 copies/mL on antiretroviral therapy. Measurements included RMD levels, plasma viremia by single-copy HIV-1 RNA assay, HIV-1 DNA, cell-associated unspliced HIV-1 RNA (CA-RNA), acetylation of histone H3-lysine-9 (H3K9ac+), and phosphorylation of transcription factor P-TEFb. Wilcoxon tests were used for comparison.

Results

In the single-dose cohorts 1–3, 43 participants enrolled (36 participants 0.5, 2, 5 mg/m 2 RMD; 7 placebo) and 16 enrolled in the multidose cohort 4 (13 participants 5 mg/m 2 RMD; 3 placebo). One grade 3 event (neutropenia) was possibly treatment related. No significant changes in viremia were observed in cohorts 1–4 compared to placebo. In cohort 4, pharmacodynamic effects of RMD were reduced proportions of CD4+ T cells 24 hours after infusions 2–4 (median, −3.5% to −4.5%) vs placebo (median, 0.5% to 1%; P ≤ .022), and increased H3K9ac+ and phosphorylated P-TEFb in CD4 + T cells vs placebo (P ≤ .02).

Conclusions

RMD infusions were safe but did not increase plasma viremia or unspliced CA-RNA despite pharmacodynamic effects on CD4 + T cells.

Clinical Trials Registration

NCT01933594.