bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel Approach for Controlled Pollination in Casuarina equisetifolia
Authors: Zhang Y. , Zhong C. L. , Chen Y. , Jiang Q. B. , Chen Z. , Nie S. , Pinyopusarerk K.
Published: June 2017

Casuarina equisetifolia is an important tree species in the tropical and subtropical zones of Asia, Africa and the Pacific. There is an increasing interest in producing intra- and inter-specific hybrids of casuarina species. Conventional bagging controlled pollination method yielded very low fruit set and poor seed germination. High temperature and humidity in the pollination bags appeared to have instigated unfavorable conditions for pollination and fertilization mechanism. In this study, a novel approach was developed by conducting pollination in closed chambers which functioned like pollination bags. Fruit set and seed germination rate increased from 7.0% to 89.9%, and 8.1% to 51.8% respectively compared with the conventional bagging controlled pollination method. Based on the results, a controlled pollination glasshouse with 10 separated chambers has been designed to produce multiple hybrid combinations in a single pollination procedure.
Genetic diversity of Picea likiangensis natural population at different altitudes revealed by EST-SSR markers
Authors: Cheng X. , Jiang Y. , Tang T. , Fan G. , Huang Xiaoxia
Published: June 2017

Altitude is thought to have greatly influenced current species distribution and their genetic diversity. However, it is unclear how different altitudes have affected the distribution and genetic diversity of Picea likiangensis, a dominant forestry species in the Qinghai-Tibetan Plateau region (QTP). In this study, we investigated the genetic diversity of Picea likiangensis populations which distributed in different altitudes of QTP using EST-SSR markers. The results suggested that this species has high genetic diversity at species level, with 100% of loci being polymorphic and an average Nei’s gene diversity (He) of 0.7186 and Shannon’s information index (I) of 1.5415. While the genetic diversity of Picea likiangensis at population level was lower than that at species level, with He and I being 0.6562 and 1.3742, respectively. The variation in genetic diversity of all four studied populations indicated a low-high-low pattern along the elevation gradients. The mid-elevation population (3050 m) was more genetically diverse than both low-elevation (2900 m) and high-elevation populations (3200 m and 3350 m). Nei’s genetic diversity (Fst= 0.0809) and AMOVA analysis (Phist = 0.1135) indicated that a low level of genetic differentiation among populations. Gene flow among populations was 2.8384, suggesting that high gene flow is a main factor leading to high levels of the genetic diversity among populations.
Cytogenetic polymorphism of english oak (Quercus robur L.) seedlings from areas with different levels of anthropogenic pollution
Authors: Kalaev V. N. , Popova A. A.
Published: June 2017

Cytogenetic polymorphism of English oak seedlings from areas with different levels of anthropogenic pollution was studied. In each studied area, groups of seedlings with low, intermediate, and high level of mutations have been identified. Mutable groups were characterised by a high level of mitotic pathologies, broad spectrum of such pathologies (e.g., chromosome agglutination, asymmetric and tripolar mitoses). Impact of trees location near the freeway leads to variability increase of cytogenetic properties and domination of intermediate-mutable groups of seedlings.
Identification of SNPs in candidate genes potentially involved in bud burst in European beech (Fagus sylvatica L.)
Authors: Müller Markus , Seifert S. , Finkeldey R.
Published: June 2017

European beech (Fagus sylvatica L.) is one of the most important deciduous tree species in Central Europe. Higher annual mean temperatures caused by climate change lead to earlier bud burst in spring and/or a delay of leaf senescence in autumn. Since earlier bud burst might increase the late frost risk, adaptive traits like bud burst may gain more importance in the future. Nevertheless, knowledge of the genetic background of leaf unfolding is still scarce for European beech. In the present study, we analyzed parts of ten different candidate genes for bud burst with a total length of 12,290 bp. Comparative sequencing with plant material of 12 different beech populations distributed over Germany revealed 116 SNPs (single nucleotide polymorphisms) and 20 indels. A subset of 46 SNPs was successfully used for genotyping of 100 offspring of a beech population in Germany confirming the suitability of the newly developed SNP set for population genetic studies. The provided data may be useful for further investigations of adaptation in F. sylvatica.
Use of genetic markers to build a new generation of Eucalyptus pilularis breeding population
Authors: Silva Paulo H. M. Da , Shepherd M. , Grattapaglia D. , Sebbenn A. M.
Published: June 2017

Tree improvement generally proceeds by incremental gains obtained from recurrent selection in large diverse populations but is slow due to long generation times and delay till trees reach assessment age. This places a premium upon extracting data from historic introductions used to found landraces when reinstating modern breeding programs. The value of such resources, however, may be degraded due to a lack of records on germplasm origins, pedigrees and early performance, but DNA technology may help recoup some of this value. Eucalyptus pilularis (subgenus Eucalyptus) is regarded as a premier hardwood plantation species for saw log and poles in Australia, but has not been used extensively despite early introductions and testing in many countries overseas. Here we use DNA fingerprinting to assess genetic diversity and inbreeding in historic introductions of E. pilularis to evaluate this resource in advance of a reinvigorated breeding effort for this species in Brazil. As expected, based on the available documentation for the introductions, genetic diversity relative to Australian reference populations does not appear to be compromised, and there was unlikely to be excessive inbreeding. Also, favorable, was the likelihood that further selections should not unduly increase the relationship in the next generation. Interestingly, we note the importance of testing widely adapted sources of germplasm when making introductions, as provenances which performed poorly in tests on productive sites in Australia, may have value when matched with lower fertility sites overseas.
La Crisis del Federalismo Argentino
Authors: Acevedo Miño Martin
Published: June 2017

Jurídicamente, el Estado federal supone la existencia de más de un centro territorial con capacidad normativa. En este esquema, se equilibran la unidad de un solo Estado con la pluralidad y autonomía de muchos otros1. La norma constitucional establece, como instrumento, un sistema descentralizado con sustento en la concepción federal que se intensifica con la democracia; este régimen federal supone una descentralización horizontal del poder y la descentralización importa una participación igualitaria de los Estados locales.
Independencia judicial en el estado social de derecho: aproximaciones a un estado del arte sobre el tema
Authors: Garcia Lozano Luisa , Abondano Lozano Carolina
Published: June 2017

La siguiente ponencia tiene como fin presentar a la comunidad académica la investigación“Independencia Judicial en el Estado Social de Derecho: Un análisis desde el Consejo Superior de la Judicatura de Colombia”, así como, un análisis preliminar del estado del arte sobre el tema. El texto se divide en tres apartados: conceptualización, períodos de estudio y producción sobre el tema, y conclusiones, en los cuales, se resaltan los aspectos fundamentales para poder hacer un estudio a profundidad determinado los vacios en el tema y re-direccionando la teoría a los contextos actuales.
Enfoques teóricos en el estudio de la administración y reforma a la justicia en Colombia
Authors: Ariza Santa Maria Rosembert , Rivera Rodriguez Ginna
Published: June 2017

Este texto busca delinear sintéticamente las gruesas líneas teóricas que enmarcan los estudios revisados de la literatura sobre administración de justicia y reforma judicial en Colombia en las dos últimas décadas.
La mediación y la capacidad necesaria para conocer el trabajo llevado a cabo por el mediador
Authors: Polo Maria
Published: June 2017

El informe de la mediación no está configurado - y por lo tanto no tiene derecho a una comisión - si las partes, mientras que después de haber concluido el acuerdo con la actividad de mediador, no han estado en posibilidad de  conocer y evaluar la actividad de este último. Esto sucede, en el caso en el que el mediador, con su comportamiento en partes engendra una falsa
representación de la calidad con la que participa en las negociaciones relativas a la
parte del trato.
La función social de los contratos en los sistemas económicos de mercado
Authors: Benneti Timm Luciano
Published: June 2017

El propósito de este trabajo es describir la situación actual en los escritos académicos brasileños y la jurisprudencia sobre la función social de los contratos (la primera parte aborda este tema) - identificar la función social del contrato bajo la visión del carácter distributivo de la "Justicia social", que es inherente al Estado Social. En segundo lugar, el documento sugiere un análisis crítico sobre el consenso que surge entre juristas y jueces brasileños sobre la función social, partiendo de una visión defendida por la escuela de análisis económico de la Ley.
La SAS en el derecho societario colombiano: de un institucionalismo de forma hacia un nuevo contractualismo
Authors: Morgestein Sánchez Wilson
Published: June 2017

Sin lugar a dudas, las disposiciones contenidas en la ley 1258 de 2008 constituyen una verdadera evolución del derecho de sociedades en Colombia, y esto es así por varias razones: (i) Porque intenta ponerse a la vanguardia que sobre el tema se ha venido desarrollando en el derecho comparado, (ii) Porque pretende brindar herramientas reales y efectivas a los empresarios de nuestro país, (iii) Por la novedad de un buen número de sus instituciones1 y, (iv) Porque sobre todo y, en mi opinión, la ley por medio de la cual se crea la sociedad por acciones simplificada en Colombia, constituye una propuesta de regreso al contrato2, intentando recuperar el derecho de sociedades para el derecho privado, como respuesta a la crisis de las teorías institucionalistas –formales, que nunca materiales-, del derecho de sociedades en nuestro país, que intentando subsanar los excesos del mercado, hicieron ceder el principio de la autonomía de la voluntad privada y afectaron la libertad individual3, ocasionando de paso un letargo en la forma de hacer y entender el derecho de sociedades, y afectando la promoción y el desarrollo de la empresa colombiana.
En el desarrollo del presente artículo se estudiarán los orígenes y antecedentes de la ley colombiana de sociedad por acciones simplificada, se realizará un análisis crítico de algunas de sus disposiciones, teniendo como referentes la legislación, la jurisprudencia y la doctrina que la antecedieron, luego se hará un breve estudio del principio de la autonomía de la voluntad privada, se abordará el concepto de interés social, para de esta forma estudiar las teorías contractualistas, institucionalistas y neo contractualistas del derecho de sociedades; sus antecedentes, noción, consecuencias y manifestaciones en la legislación societaria colombiana, para de esta manera determinar la constitucionalidad de las normas que integran la ley de SAS, la contribución que ofrece al desarrollo del derecho societario colombiano y el aporte que brinda al empresariado patrio, como consecuencia, principalmente, de habérsele otorgado a las disposiciones contenidas en la ley 1258 “… un carácter eminentemente dispositivo, de manera que pueden ser reemplazadas por otras previsiones pactadas por los accionistas”4, con lo cual pretendo demostrar que, la ley de sociedad por acciones simplificada en Colombia constituye una propuesta del nuevo contractualismo frente a un institucionalismo de forma.
La producción legislativa y el control político ¿hacia donde se inclina la balanza del equilibrio del poder político en Colombia?
Authors: Cortes Zambrano Sonia
Published: June 2017

El Trabajo presenta en sí mismo una reflexión en torno a La Producción Legislativa, como actividad desarrollada por el poder legislativo y de manera extraordinaria por el poder ejecutivo y el núcleo mismo del Derecho Constitucional Moderno, esto es, la idea de Control Político como garantía de la observancia del principio de separación y coordinación de los poderes del Estado, como requisito para la existencia de un auténtico régimen constitucional. El Proceso de Investigación desarrolla un análisis de la Producción Legislativa de 1991 a 2010, en los periodos presidenciales de Cesar Gaviria, Ernesto Samper, Andrés Pastrana y Álvaro Uribe, determinando quien en Colombia tiene mayor amplitud a la hora de producir Leyes si el Gobierno o el Congreso de la República, y da explicaciones en torno a éste fenómeno, Estudia además los casos de Control Político en Colombia en el mismo periodo 1991-2010: Mociones de Censura y Debates de Control Político, con el fin de establecer como opera el control Político en Colombia.
Detención preventiva administrativa: interpretación agónica
Authors: Urrea Jhomny
Published: June 2017

¿Está vigente la captura administrativa? En el foro se escuchan muchas interpretaciones pero pocos artículos académicos que aborden directamente el tema. A partir de la distinción entre una ratio formalista y una antiformalista se buscará responder a este interrogante. Se contará una historia de derecho constitucional y se construirá a partir de la sentencia C-024 de 1994 un dictum del cual los jueces puedan apartarse.
INSTRUMENTOS INTERNACIONALES DE COOPERACIÒN JUDICIAL EN MATERIA PENAL, EN LA LUCHA CONTRA LOS PRINCIPALES AGENTES DE CRIMINALIDAD EN EL DERECHO COLOMBIANO.
Authors: Sandoval Mesa Jaime
Published: June 2017

En el escenario de colombia, la cooperación judicial en materia penal ha sido una necesidad imperante en virtud de fenómenos de macrocriminalidad polìtica y de criminalidad transnacional de indudable connotaciòn internacional. El fenòmeno ha sido identificado en particular en dos corrientes que se manifiestan tanto en el conflicto armado colombiano de más de 4 décadas de ocurrencia, así como en su relación con los carteles de la droga de aproximadamente 3 décadas de su aparición. En este contexto las medidas judiciales en particular, la asistencia recìproca y la extradiciòn han sido una de las bases para combatir este tipo de delincuencia de gran impacto internacional a partir de la adopción de todas las convenciones e instrumentos adoptados por la comunidad de naciones, para combatir esta clase de fenómenos criminales. En último término las consecuencias actuales reflejan un Estado que pone a consideración a su jurisdicciòn, frente a la comunidad internacional, permitiendo la flexibilidad interna de sus principios en la bùsqueda de soluciones eficaces al respecto, sin perjuicio de que al final su autonomía sea seriamente cuestionada y sin que el problema tenga una final solución.
EL PAPEL DEL ESTADO FRENTE A LA POBREZA
Authors: Hernandez Diaz Carlos
Published: June 2017

El presente texto pretende abordar los problemas económicos de la pobreza visto desde los puntos de vista de la teoría de la justicia de Rawls, apoyándose en la propuesta de Amartya Sen de las acciones y algunas críticas que ayudarán a explicar mejor el problema desde la filosofía política.
La validez de los sistemas legales: Las teorías de la Norma Básica
Authors: Rodriguez Villabona Andres
Published: June 2017

La validez de los sistemas jurídicos es uno de los problemas que la teoría jurídica ha tratado con mayor frecuencia. Para abordarlo se ha propuesto la concepción de una norma por encima de las demás normas del ordenamiento jurídico, que ha recibido el nombre de norma básica, suprema, fundamental, última, etc., y que constituiría el criterio último de validez y explicaría la unidad del sistema. De esta forma, el objetivo específico de este artículo es examinar las teorías que explican el carácter jurídico de las reglas y del sistema proponiendo dicha norma básica. La primera parte de este trabajo estará consagrada a la presentación detallada y sintética des estas teorías, seguida de una comparación para determinar cuáles son sus aportes y sus méritos. Un análisis desde el punto de vista crítico de las teorías expuestas en la primera parte será el objeto de la segunda, análisis que se realizará a partir de los textos de algunos autores que han trabajado sobre estas teorías. Después de haber establecido los aciertos y el alcance de estas críticas, será posible evaluar algunas ideas para abordar el problema de la naturaleza del derecho como sistema jurídico.
El Necesario Reconocimiento del Principio de Justicia Contractual
Authors: Acosta Rodriguez Joaquin
Published: June 2017

Las nuevas realidades políticas y económicas ameritan repensar las categorías básicas del derecho de contratos, especialmente sus principios generales. A tal punto, que es imprescindible reconocer que los principios y tendencias que dominan la teoría posmoderna del contrato en algunos ámbitos se complementan, pero de manera indudable en otros aspectos se contradicen ampliamente. Para solventar la presente problemática, debe tenerse presente que la noción de Principios Generales del Derecho así como la naturaleza relativa del imperativo de seguridad jurídica se enmarcan dentro de la más pura tradición romanista. En realidad, esta contradicción genera una tensión entre los imperativos de libertad y justicia contractual.
The concept of necessity under the GATT and national regulatory autonomy
Authors: Salinas Alcaraz Isabel
Published: June 2017

The intrusive effects of the WTO on Members regulatory freedom have been a growing concern since the establishment of the WTO Dispute Settlement System (DSS). An assessment of the WTO case law exposes that the Appellate Body (AB) has introduced some elements within the
necessity test under GATT (General Agreement on Tariffs and Trade) article XX which do not find support in the text of the agreement and are potentially invasive of countries regulatory autonomy. This paper examines the evolution of the WTO case law in relation to the necessity concept within GATT 1994. Finally, an adjustment in the application of the necessity test to make it more consistent with the GATT text and to achieve greater balance between free trade and WTO members’ regulatory autonomy is suggested.
Los límites de la teoría del equilibrio como alternativa de solución a la cuestión de la prevalencia del poder del Alto Tribunal de lo Constitucional en Colombia
Authors: Guarin Ramirez Edgar , Aldana Rojas Javier
Published: June 2017

Este artículo aborda la cuestión respecto de si la teoría del equilibrio de poderes constituye
un soporte epistemológico que contribuya de manera real y efectiva a la superación de la
problemática suscitada por la prevalencia del poder del alto tribunal de lo constitucional en
Colombia. A través del análisis de algunos fallos, se muestra que, en Colombia, la última
palabra respecto de asuntos de trascendencia para la vida nacional es pronunciada por el juez constitucional, quien ha asumido como propias competencias que, por mandato constitucional
o legal, son de las otras ramas del poder público. Para solucionar la afectación del orden político
que genera este hecho, se apela a la teoría del equilibrio de poderes; sin embargo, en la práctica,
esta teoría evidencia limitaciones, de cuyo análisis se ocupa el texto. En su lugar, se propone
hablar de armonía del poder, en el que las diferencias se acoplan y concurren hacia una finalidad
común.
Acercamiento criminológico al estudio de la Delincuencia Económica en Granma - Cuba
Authors: Huertas Diaz Omar , Martínez Gamboa René
Published: June 2017

En la presente investigación se propone analizar la criminalidad económica y las distintas
teorizaciones y conceptualizaciones que desde la criminología se han realizado alrededor de
esta temática. Como se verá, los delitos económicos no encuentran fundamentos sociológicos
o criminológicos en las razones dadas a la delincuencia tradicional. Estos delitos, también
llamados de “cuello blanco”, tienen determinadas características que los diferencian del resto de
la delincuencia, y quienes los cometen no responden al patrón habitual del delincuente. Por ello, se toma como objetivo general caracterizar criminológicamente la delincuencia económica de
la sociedad cubana actual, a partir de los estudios sociológicos realizados por varias instituciones
al respecto. A tenor del problema científico que lo motiva, definido mediante la siguiente
interrogante: ¿Cuáles son las principales características que presenta la delincuencia económica
en la sociedad cubana actual? Utilizando a este fin los métodos siguientes: Método de Análisis
y Síntesis, Análisis Lógico, Histórico Jurídico, Método Sociológico, Método Dialéctico
Materialista. Como técnica de investigación fue empleada la revisión bibliográfica de los
materiales que se consideraron más actualizados sobre el tema. Se presenta como fundamental
resultado una caracterización del fenómeno de la delincuencia económica desde el punto de
vista criminológico.
Una reflexión sobre el paradigma de la integralidad en el transporte público de Bogotá
Authors: González Trujillo Juan Manuel
Published: June 2017

El presente artículo expone los resultados de la investigación que tuvo por finalidad
analizar el paradigma de la integralidad en el transporte público en Bogotá, a partir
de un enfoque cualitativo-descriptivo basado tanto en estudios de revisión documental
sobre el tema, como en entrevistas semiestructuradas a fuentes institucionales. La
finalidad de la reflexión que se expone aquí es comprender la desarticulación en la
planificación y gestión del transporte público masivo, en distintos niveles, respecto
del paradigma de la integralidad, y sustentar la necesidad de intensificar esfuerzos
para fortalecerlo.
A Short History and Description of Drosophila melanogaster Classical Genetics: Chromosome Aberrations, Forward Genetic Screens, and the Nature of Mutations
Authors: Kaufman Thomas C
Published: June 2017

The purpose of this chapter in FlyBook is to acquaint the reader with the Drosophila genome and the ways in which it can be altered by mutation. Much of what follows will be familiar to the experienced Fly Pusher but hopefully will be useful to those just entering the field and are thus unfamiliar with the genome, the history of how it has been and can be altered, and the consequences of those alterations. I will begin with the structure, content, and organization of the genome, followed by the kinds of structural alterations (karyotypic aberrations), how they affect the behavior of chromosomes in meiotic cell division, and how that behavior can be used. Finally, screens for mutations as they have been performed will be discussed. There are several excellent sources of detailed information on Drosophila husbandry and screening that are recommended for those interested in further expanding their familiarity with Drosophila as a research tool and model organism. These are a book by Ralph Greenspan and a review article by John Roote and Andreas Prokop, which should be required reading for any new student entering a fly lab for the first time.
DISTRIBUTION PATTERN OF UNDERWATER ILLUMINANCE FOR SQUID NET FISHERIES IN MALAYSIA
Authors: Ibrahim Sakri , Ambak Mohd. Azrmi , Sarno Khalid , Zakaria Mohamad Zaidi , Shahardin Zainal Ashirin , Hajisamae Sukree
Published: June 2017

A study oIr the distribution pattern of underwater illuminance for squid net fisheries inMalaysiu rvas condueted fronr April to Septenrber, 1996 in sheltered waters of Kapas Island off the coast of Terengganu.
Observational study evaluating online procedural skills
Authors: Vallabhaneni Pramodh , Jenkins Christopher , James-Ellison Michelle , Mason Brendan Willys , Edwards Dawn
Published: June 2017

This article was migrated. The article was not marked as recommended. ABSTRACTIntroductionE- Learning has gained popularity amongst doctors in training. We undertook an observational study assessing the quality of online resources for intra osseous (IO) needle insertion. Methods IO needle insertion videos were identified using "You-Tube". 21 pre-defined essential criteria were agreed by the study group based on the Advanced Paediatric Life Support recommendations, considered to be gold standard. Each video was independently scored 0-21 for quality.Results 34 IO videos, 14 manual and 20 electrical were identified. The quality score for the 34 videos, based on the mean score from the 4 raters, ranged from 5.5 to 17.5, mean 11.7, median 12.25. The inter observer variability was 0.76 , 95% confidence intervals 0.65 to 0.86.ConclusionOnline resources can have a substandard educational content. To avoid developing poor practice a standard resource for procedural skills in the curriculum should be developed and endorsed by the Royal College of Paediatrics and Child Health (RCPCH).
Motivations and repercussions regarding crack consumption: the collective discourse of users of a Psychosocial Care Center
Authors: Carvalho Milca Ramaiane da Silva , Silva Janaina Raquel de Souza , Gomes Nadirlene Pereira , Andrade Magna Santos , Oliveira Jeane Freitas de , Souza Márcia Rebeca Rocha de
Published: June 2017

Abstract Aim: To identify the motivations and repercussions related to crack consumption by people attending a Centro de Atenção Psicossocial Álcool e Drogas (CAPS AD) (Psychosocial Care Center Alcohol and Drugs) in Bahia. Method: This is a qualitative study developed with eight crack users attending a CAPS AD in a city of Bahia. Interviews, whose content was organized by the technique of the Collective Subject Discourse, were conducted in October and November 2013. Results: The study reveals that the curiosity and the desire to belong to peer groups are events that motivate crack experimentation, and its consumption triggers aggressive and paranoid behavior, depression, financial losses and family and friends abandonment. Conclusion: Given the consequences to social relations and health, actions to prevent the use and consumption of crack are necessary, particularly in order to intervene on the motivations that prompt the first use and relapse.
Weibo sentiments and stock returns v1
Authors: Xu Yingying , Zhixin Liu not provided , Jichang Zhao not provided , Chi-wei Su not provided
Published: June 2017

We describe how to use the wavelet analysis to calculate the relationship between microblog sentiments and stock returns. All necessary data and codes are provided here.
Definition and Classification of Heart Failure
Authors: Lainscak Mitja , Spoletini Ilaria , Coats Andrew
Published: June 2017

A review of the definition and classification of heart failure, updated since the recent 2016 European Society of Cardiology guidelines for the diagnosis and treatment of acute and chronic heart failure. Heart failure is defined by the European Society of Cardiology (ESC) as a clinical syndrome characterised by symptoms such as shortness of breath, persistent coughing or wheezing, ankle swelling and fatigue, that may be accompanied by the following signs: jugular venous pressure, pulmonary crackles, increased heart rate and peripheral oedema. However, these signs may not be present in the early stages and in patients treated with diuretics. When apparent, they are due to a structural and/or functional cardiac abnormality, leading to systolic and/or diastolic ventricular dysfunction, resulting in a reduced cardiac output and/or elevated intra- cardiac pressures at rest or during stress. According to the most recent ESC guidelines the initial evaluation of patients with suspected heart failure should include a clinical history and physical examination, laboratory assessment, chest radiography, and electrocardiography. Echocardiography can confirm the diagnosis. Beyond detecting myocardial abnormality, other impairments such as abnormalities of the valves, pericardium, endocardium, heart rhythm, and conduction may be found. The identification of the underlying aetiology is pivotal for the diagnosis of heart failure and its treatment. The authors review the definitions and classifications of heart failure.

 
Clinical Diagnosis In Heart Failure
Authors: Spoletini Ilaria , Vitale Cristiana
Published: June 2017

A contemporary review of the diagnosis of heart failure as part of a special heart failure issue. The 2016 ESC heart failure guidelines have provided updated evidence-based recommendations for the clinical diagnosis of heart failure. This article summarises the diagnostic process in the case of a patient presenting with acute dyspnoea and suspected acute heart failure, and summarises the diagnostic elements that should be assessed in a patient with non-acute onset. The role of clinical and laboratory testing is discussed.
Medical Treatment of Heart Failure with Reduced Ejection Fraction – Improving Clinical Status and Functional Capacity
Authors: Vitale Cristiana , Rosano Giuseppe
Published: June 2017

A contemporary review of treatments that have been shown to improve functional capacity in patients with Heart Failure and reduced Ejection Fraction (HFrEF).  The improvement of functional capacity is one of the main goals of treatment in patients with HFrEF. In the past, despite significant effects on exercise capacity some drugs (e.g. ibopamine, flosequinan) have shown detrimental effects on long- term outcomes in patients with HFrEF. It is perhaps notable that both of these drugs had shown signals of increased safety concerns during the earlier clinical phases of their development. The challenge is to encourage a timely identification of effective treatments that can enhance functional performance in HF without the more difficult and more expensive path to prove all drugs also reduce mortality. It is valuable to have approved and effective treatments that can do the first without the need for the second in all cases, provided adequate safety can be assured. Ivabradine, trimetazidine, ferric carboxymaltose and diuretics have consistently shown to improve functional capacity and symptoms in patients with HFrEF because of their effect on long term prognosis these drugs should always be considered in patients with heart failure. Diuretics improve functional capacity and should be prescribed in patients with signs and symptoms of congestions. Cardiac resynchronisation therapy improves functional capacity in patients with HFrEF in whom it is appropriately applied (QRS >130/150 msec according to morphology).
Approach to the Treatment of Heart Failure With Preserved Ejection Fraction and Mid- Range Ejection Fraction
Authors: Jankowska Ewa A , Coats Andrew JS , Anker Stefan D
Published: June 2017

In this article we discuss the treatment of heart failure (HF) with preserved ejection fraction (HFpEF) and of HF with mid-range ejection fraction (HFmrEF) as has received considerable interest since the publciation of the 2016 European Society of Cardiology (ESC) heart failure guidelines. Since clinical trials on HFpEF have included also patients with HFmrEF, due to the lack of an agreed definition, the ESC recommendations here described apply to both phenotypes. As a consequence of the recent characterisation of this HF syndrome, it is expected that upcoming research will provide data specifically regarding HFmrEF and tailored recommendations will be developed in the future.
The Management of Co-Morbidities in Patients with Heart Failure - Iron Deficiency
Authors: Von Haehling Stephan , Jankowska Ewa , Anker Stefan D
Published: June 2017

Co-morbidities have been recognised as playing a crucial role in the progress of the older patient with HF in particular. The 2016 ESC/HFA HF guidelines stress the signiﬁcance of co-morbidities more than any previous guidelines have. Iron deﬁciency is a co-morbidity, that has received very little attention until the last decade, as evidence has accumulated both for the signiﬁcance of this co-morbidity and the emergence of safe effective therapies that appear to offer signiﬁcant beneﬁts to the HF population who suffer this co-morbidity.
Treatment of Patients in the Vulnerable Phase (at Discharge or Early after Discharge)
Authors: Lopatin Yuri M. , Rosano Giuseppe MC
Published: June 2017

The clinical course of heart failure includes a period in which the patient is at increased risk of death or rehospitalisation for HF. This period is termed the “vulnerable phase” and occurs during the peri-acute HF phase, due to microenvironmental changes in the cardiovascular system. Typically, the vulnerability phase starts from the onset of an acute HF event leading to admission, continues through a peri-discharge period and lasts up to 6 months after discharge.These poor post-discharge outcomes also represent a significant socioeconomic burden. This articles reviews treatments that are beneficial in this important phase.
Implantable Cardioverter-Defibrillators and Cardiac Resynchronization Therapy in the Treatment of Heart Failure with Reduced Ejection Fraction
Authors: Spoletini Ilaria , Coats Andrew
Published: June 2017

It has been long acknowledged that electrical-conduction disturbances may be both a cause of heart failure and a consequence of it. In fact, many patients with heart failure have an asynchronous contraction pattern of the heart muscle that further reduces the heart ability to pump blood. Electrical disturbances may therefore result in progressive left ventricular dysfunction, due to the added effects of HF-related electrical dyssynchrony. For this reason, device therapy may play a key role in the management of patients with heart failure and reduced ejection fraction (HFrEF). In particular, Implantable Cardioverter- Defibrillators (ICD) and Cardiac Resynchronization Therapy (CRT) may improve ejection fraction by reestablishing mechanical synchrony, possibly reversing symptoms and signs of heart failure, in addition to the more obvious role of ICD in terminating ventricular arrhythmias that threaten sudden death. Recommendations on device therapy from the current guidelines on heart failure management put out by the ESC/HFA in 2016 update our understanding of the evidence base for the use of ICD and CRT in HFrEF. We review these recommendations and the evidence behind them.
Management of Arrhythmias in Heart Failure
Authors: Spoletini Ilaria , Coats Andrew
Published: June 2017

Patients with heart failure (HF) often develop ventricular and supraventricular arrhythmias, due in large part to electrical conduction abnormalities of the heart in this syndrome. Cardiac remodeling and neurohumoral activation typical of HF create a substrate that increases the risk of developing arrhythmias and/or worsening pre- existing arrhythmias. Advances in our understanding of the underlying pathophysiological mechanisms of HF have reinforced the importance of neurohumoral, mechanical and inflammatory processes as progressively more severe pump dysfunction occurs. This combination increases the likelihood of arrhythmias, both atrial and ventricular, such that ventricular arrhythmias are found in up to 80% of patients with severe HF, conferring additional risk of mortality and morbidity, in particular via an increased risk of sudden cardiac death. Arrhythmias are also responsible for an increased risk of rehospitalisation in one-third of HF patients. The high risk of arrhythmias should always be considered during the clinical management of all HF patients, due their association with worse prognosis and increased mortality. In particular, HF and atrial fibrillation mutually worsen the impact of each other. Treatment of atrial fibrillation in the setting of HF includes a variety of approaches such as drugs, devices and ablation. Restoration of sinus rhythm is not superior to optimal rate control, and the deleterious effects of antiarrhythmic drugs should be considered. Finally, cardiac function, symptoms, and quality of life may improve with catheter-based ablative therapies in appropriately selected patients with HF.
Other Devices for Heart Failure – Cardiac Contractility Modulation (CCM)
Authors: Coats Andrew
Published: June 2017

Substantial advances in the medical treatment of HFrEF have improved survival and cardiac function in these patients. However despite the use of optimal medical therapy (OMT) and the use of recommended devices in those in whom they are indicated, persistent symptoms limit activity and adversely affect lifestyle in a substantial number of patients. For these patients newer devices other than ICD and CRT may offer an improvement in symptoms and/or survival. This paper reviews the evidence for the use of CCM and discusses in which patients it may be considered as recommended in the recent guidelines. CCM is an established treatment in the management of moderate to severely symptomatic heart failure with reduced EF and normal QRS duration. CCM impulse delivery is associated with acute improvements in cardiac contractility. Chronic changes include reversion from fetal to adult gene expression profiles in the heart, improved calcium handling, restorative ventricular remodeling, and improved cardiac function. The recent 2016 ESC/HFA guidelines for the management of heart failure considered that most of these newer devices had insufficient clinical trial data for a formal recommendation, but in the case of one, cardiac contractility modulation (CCM) the guidelines describe CCM as being something to be considered in selected patients with HF. This is based on a demonstrated improvement in exercise tolerance (peak VO2) and quality of life (by Minnesota LWHF questionnaire, MLWHFQ) produced by CCM in an individual patient data meta- analysis of all the randomised controlled trials of CCM.
The Potential of Devices for HFpEF
Authors: Coats Andrew , Anker Stefan
Published: June 2017

The 2016 ESC/HFA HF guidelines list the very many drug and device therapies that are proven to be beneficial in terms of life prolongation and hospitalisation prevention for HFrEF. The list of recommended therapies or devices for HFpEF and HFmrEF is limited to diuretics and the management of comorbidities and so far there is no clinical evidence for an electrical or mechanical device for HFpEF. The Cardiac Contractility Modulation (CCM) device that may have a role in selected HFrEF and HFmrEF patients has been reviewed in another paper in this issue but here we survey the results so far of a novel device for patients with HFpEF. Despite lagging many years behind HFrEF, HFpEF patients are now being targeted with novel devices with the potential to improve symptoms, improve quality of life, reduce hospitalization and delay progression of the syndrome. The front-runner is a novel inter-atrial left atrial pressure decompression device the Corvia IASD, which currently enrolling patients in a randomized trial. This device is a CE-marked investigational, non- surgical transcatheter implant designed to provide continuous and dynamic decompression of the left atrium, in an effort to reduce symptoms, HF hospitalizations, and improve quality of life as well as potentially slowing the progression of HFpEF.
The Management of Diabetic Patients with Heart Failure
Authors: Rosano Giuseppe , Seferovic Petar
Published: June 2017

Patients with diabetes mellitus have an increased risk of developing heart failure and diabetes mellitus is highly prevalent amongst patients with heart failure, especially those with HFpEF. Diabetic patients with heart failure have an increased mortality and an increased risk of hospitalisations and the use of certain anti- diabetic agents increase the risk of mortality and hospitalisation in heart failure. Conversely, newer therapeutic agents have shown a significant reduction of mortality, morbidity and risk of developing heart failure in diabetic patients with proven cardiovascular disease. This highly important area is reviewed in this paper.
The Management of Heart Failure in Kidney and Urinary Tract Syndromes
Authors: Lopatin Yuri , Coats Andrew JS
Published: June 2017

Kidney dysfunction and other related abnormalities are extremely common in all HF syndromes, both because of the similarity of risk factors and the similarity of demography of the two types of patients but also because of the common renal effects of agents used for the treatment of HF. Important renal syndromes for the HF patient include including chronic kidney disease, acute kidney injury, cardio-renal syndrome, and prostatic obstruction. In HF (all types including  HFrEF, HFmrEF and especially HFpEF) chronic kidney disease (CKD) frequently co-exists and almost as frequently complicates the HF management. The two groups of syndromes share many risk factors (diabetes, hypertension, hyperlipidaemia) and often interact to worsen the prognosis of each other in a way that makes the patient with combined HF and renal disease at extremely high risk. This article reviews this common co-morbidity and how to manage it.
The Management of Co-Morbidities in Patients with Heart Failure – Angina and Coronary Disease
Authors: Spoletini Ilaria , Seferovic Petar
Published: June 2017

Co-morbidities are particularly relevant in the management of HF as they may confound HF diagnosis, worsen symptomatology, impact quality of life and aggravate the prognosis. According to the most recent European Society of Cardiology (ESC) guidelines, treatment of co- morbidities is an essential element of the comprehensive care of HF. Angina and coronary artery disease (CAD), in particular are common disorders associated with HF. The pharmacological and surgical management of angina according to the ESC guidelines is reviewed in this article.
The Management of Co-Morbidities in Patients with Heart Failure – Hypertension
Authors: Stewart Coats Andrew J , Rosano Giuseppe MC , Lopatin Yuri M.
Published: June 2017

The 2016 ESC/HFA HF guidelines carry an important section on the treatments of co- morbidities in HF. Foremost of these in terms of frequency and its relevance to the aetiology of HF, especially HFpEF is hypertension. In this artcile we will review what the recent guidelines say about the management of hypertension in the setting of HF, both HFrEF and HFpEF and expand on some of the practical advice.
Valvular Heart Disease in Heart Failure
Authors: Rosano Giuseppe
Published: June 2017

Structural valvular heart disease may be the cause of heart failure or may worsen the clinical status of patients with heart failure. Heart failure may also develop in patients treated with valve surgery. Patients with heart failure with valvular heart disease are at increased risk of events including sudden cardiac death. Before considering intervention (surgical or percutaneous) all patients should receive appropriate medical and device therapy taking into account that vasodilators must be used with caution in patients with severe aortic stenosis. Numerous percutaneous and/or hybrid procedures have been introduced in the past few years and they are changing the management of valvular heart disease. In patients with heart failure and valvular heart disease, either primary or functional, the whole process of decision-making should be staged through a comprehensive evaluation of the risk– benefit ratio of different treatment strategies and should be made by a multidisciplinary ‘heart team’ with a particular expertise in valvular heart disease. The heart team should include heart failure cardiologists, cardiac surgeons/structural valve interventionists, imaging specialists, anaesthetists, geriatricians and intensive care specialists. This article will review recent developments and distill practical guidance in the management of this important heart failure co-morbidity.
The Management of Co-Morbidities in Patients with Heart Failure – Lung Disorders
Authors: Coats Andrew
Published: June 2017

The 2016 ESC/HFA HF guidelines carry an important section on the treatments of co- morbidities in HF. One of the most common and most confusing, in terms of overlapping symptoms and interfering treatments is the presence of significant lung disorders. In this article is reviewed what the recent guidelines say about the management of lung disorders in the setting of HF, both HFrEF and HFpEF and expand on some of the practical advice.
The Management of Co-Morbidities in Patients with Heart Failure – Obstructive Sleep Apnoea
Authors: Coats Andrew
Published: June 2017

Heart failure (HF) patients are older and frequently present with multiple co-morbidities. Co- morbidities worsen patient symptoms and may contribute to the progression of heart failure, increase mortality or limit the therapeutic response to treatment. Obstructive sleep apnoea (OSA) affects 2–4% of the adult population world-wide and is associated with similar risk factors to HF, meaning it is a frequent finding in HF patients, including HFrEF, HFmrEF and HFpEF. OSA has consistently been shown to be associated with hypertension, coronary artery disease, arrhythmias, heart failure, and stroke. A thorough understanding of the diagnosis and treatment options of OSA is of paramount importance to the practising HF clinician. Patients may present to the HF specialist having been diagnosed by a formal sleep study or may be suspected of OSA because of symptoms of snoring, reports of obstructed breathing by the sleep partner or day-time sleepiness. The mainstay of treatment for OSA is a positive airway pressure mask which can be used in mild moderate and severe OSA. The need for therapy should be discussed with the patient and if the AHI is above 15/hr then treatment is indicated to reduce this to below 15. This is a consensus recommendation and no adequately powered clinical trials have shown this improves either mortality or the risk of disease progression. Other options are discussed
The Management of Co-Morbidities in Patients with Heart Failure – Central Sleep Apnoea
Authors: Coats Andrew JS , Shewan Louise G , Abraham William T
Published: June 2017

Despite many therapeutic advances, heart failure (HF) remains challenging to treat and continues to be associated with high rates of morbidity and mortality. There is an ongoing need to identify co-morbidities that either contribute to the progression of heart failure or limit the therapeutic response to treatment. One area under active investigation is the treatment of central sleep apnoea (CSA). CSA has consistently been shown to be associated with a worse prognosis in HF patients. Thus, understanding how to diagnose and treat CSA is of paramount importance to the HF clinician. Without treatment, HF patients continue to be at risk for the devastating consequences of CSA. Prognosis is very poor with studies consistently demonstrating poor outcomes among HF patients with CSA. Over the course of the night, each discrete event contributes to increased nor- epinephrine levels and hypoxia which are associated with progressive heart failure and arrhythmias. Initial therapeutic options utilized therapies which were developed for obstructive sleep apnoea with limited success or even harm. ASV is now contraindicated in HF patients with an EF < 45% leaving only 2 potential treatment options: CPAP and transvenous phrenic nerve stimulation. Data from the recently presented (post ESC guidelines) trial on transvenous phrenic nerve stimulation demonstrated efficacy without the need for patient compliance or any safety concerns. It is expected that additional studies in CSA will continue to demonstrate the full impact of treating this important co-morbidity on patients with HF.