bluuebunny/crossref_metadata_2025 huggingface dataset:
Acquired Angioedema due to C1-Inhibitor Deficiency: A Challenging Condition
Authors: Valle Solange Oliveira Rodrigues , Alonso Maria Luiza Oliva , Dortas Junior Sérgio Duarte , Goudouris Ekaterini Simões , de Carvalho Ana Luiza Ribeiro Bard , Capelo Albertina Varandas , Mansour Eli , Bernardes Ana Flávia , Leite Luiz Fernando Bacarini , Giavina-Bianchi Pedro , Aun Marcelo Vivolo , Ferriani Mariana Paes Leme , Arruda Luisa Karla , Grumach Anete Sevciovic
Published: March 2022

Background: Acquired deficiency of C1 inhibitor (AAE-C1-INH) is a very rare cause of recurrent angioedema, with few cases reported in the literature. We aimed to describe a series of patients with AAE-C1-INH who were diagnosed and received care at angioedema reference centers in Brazil, affiliated to the Brazilian Group of Studies on Hereditary Angioedema. Methods: Fourteen patients from 8 Brazilian Angioedema Reference Centers, diagnosed with AAE-C1-INH, were included in this study. Clinical data collected included sex, date of birth, date of onset of symptoms, date of diagnosis, plasma levels of antigenic and/or functional C1-INH, levels of C4 and C1q, location and treatment of angioedema attacks, long-term prophylaxis, associated diseases, and definitive treatment. Results: Fourteen patients were identified with AAE-C1-INH. Most patients (10/14; 71.4%) were female. The median age at onset of symptoms was 56.5 years (range, 14–74 years; interquartile range [IQR], 32–64 years), and median age at diagnosis was 58.0 years (range, 20–76 years; IQR, 38–65 years), with a median time until diagnosis of 2 years (range, 0–6 years; IQR, 1–3 years). The most common manifestations were cutaneous (face, eyelids, lips, trunk, hands, feet, and genitals). Most patient had low levels of C4 (13/14; 92.8%) and of antigenic C1-INH (8/14; 57.1%). Four had decreased functional activity of C1-INH (4/7; 57.1%) and C1q levels were low in 5 patients (5/12; 41.6%). Underlying diseases were identified in all 14 patients, with lymphoma of the splenic marginal zone and monoclonal gammopathy of undetermined significance being the most frequent. Nine patients (64.2%) needed long-term prophylactic treatment for recurrent angioedema and 5 patients (46.7%) required treatment for angioedema attacks. Most of them (12/14; 85.7%) had resolution of angioedema. Conclusion: Therapy of AAE-C1-INH aims to control symptoms; however, diagnosis and treatment of the underlying disease, when present, should be an important target and may lead to the resolution of angioedema in patients with AAE-C1-INH.
Simultaneous Vitreoretinal Surgery and Sclerokeratoplasty for Keratoglobus with Intraocular Hemorrhage and Extensive Corneal Rupture
Authors: Higashijima Fumiaki , Aoki Ren , Mikuni Masanori , Yoshimoto Takuya , Iwamoto Nanako , Ohta Manami , Ogata Tadahiko , Yamada Naoyuki , Kimura Kazuhiro
Published: March 2022

We reported a case of simultaneous vitrectomy and sclerokeratoplasty (SKP) performed for keratoglobus with extensive corneal rupture and intraocular hemorrhage caused by trauma. A 73-year-old woman was treated for keratoglobus and glaucoma. She was punched in both eyes, her right eye showed corneal rupture and the left eye showed prolapse of the ocular contents due to eyeball rupture. She immediately underwent corneal sutures in the right eye and resection of the prolapsed ocular contents in the left eye at a nearby ophthalmological clinic. Three days after the injury, the patient was referred to our clinic for vision recovery. The best corrected visual acuity of the right eye was measured by counting fingers. Her right eye presented severe corneal edema with a sutured corneal wound in the upper periphery, which was positive in the Seidel test. B-mode ultrasound revealed choroidal detachment and subchoroidal hemorrhage. Fourteen days after injury, simultaneous corneal suture and posterior sclerotomy were performed in the right eye, but corneal fragility and corneal opacity were prominent, and B-mode examination revealed prolonged vitreous hemorrhage and retinal detachment. Twenty-one days after injury, we performed simultaneous SKP and 25-G pars plana vitrectomy (PPV). In this procedure, we initially performed SKP followed by 25-G PPV without a keratoprosthesis or endoscope. The visibility of the fundus through the corneoscleral graft was good during vitrectomy. Three months after surgery, her corrected visual acuity improved to 10/1,000. Although there was mild corneal stromal edema and khodadoust line, there were no obvious fundus complications. Simultaneous SKP and PPV for keratoglobus with extensive corneal rupture and vitreous diseases may be a good option.
Vietnamese Version of Cornell Scale for Depression in Dementia at an Outpatient Memory Clinic: A Reliability and Validity Study
Authors: Huynh Tan Thanh , Nguyen Nguyen Tran Thanh , Nguyen Tien Dong Phuong , Tran Thang Cong
Published: March 2022

Background: In Vietnam, there has been, currently, no standardized tool for depression assessment for people with dementia (PWD). Cornell Scale for Depression in Dementia (CSDD) is a widely studied and used scale for PWD worldwide. Objectives: The aim of this study was to standardize the Vietnamese version of the CSDD (V-CSDD) in depression assessment in PWD through reliability and validity examination. Methods: V-CSDD was rated in terms of reliability and validity with gold standard regarding “major depressive episode” and “major depressive-like episode” of DSM-5. Cronbach’s α, ICC, exploratory factor analysis (EFA), and receiver operating characteristic analysis were performed. Results: V-CSDD was found to have a high internal consistency reliability (Cronbach’s α = 0.80), inter-rater reliability at sound ranking (ICC = 0.89; 95% CI = 0.81–0.94), maximum cut-off mark of 13 (sensitivity = 70%, specificity = 92%), and EFA, which suggested that V-CSDD may comprise 5 factors. Conclusions: Results indicate the V-CSDD to be a reliable and valid assessment and to be beneficial in classifying and diagnosing depression in dementia outpatients in clinical contexts.
The Clinical Tumor Lysis Syndrome in a Patient with Mixed Phenotype Acute Leukemia Undergoing Induction with Venetoclax and Azacitidine: A Case Report
Authors: Drozd-Sokolowska Joanna , Mądry Krzysztof , Siewiorek Kinga , Feliksbrot-Bratosiewicz Magdalena , Stokłosa Tomasz , Gierej Beata , Stefaniak Agnieszka , Paszkowska-Kowalewska Małgorzata , Sokołowski Jacek , Sankowski Bartłomiej , Basak Grzegorz Władysław
Published: March 2022

A combination of azacitidine and venetoclax (AZA-VEN) has been approved for the treatment of adult treatment-naïve acute myeloid leukemia (AML) patients, ineligible for intensive chemotherapy. The protocol may also constitute an alternative for the treatment of patients with mixed phenotype acute leukemia (MPAL), for which no established treatment guidelines exist. It may be anticipated, that alike in AML or chronic lymphocytic leukemia, the treatment of MPAL may be complicated by the tumor lysis syndrome (TLS). No case of TLS in MPAL after VEN has been however reported so far. Here, we present a case of a patient with MPAL, who received AZA-VEN. The patient had a substantial bulk of disease with generalized lymphadenopathy and increased white blood cell count. Despite preventive measures, the patient developed the clinical TLS, which was successfully treated. Based on the current case and other published cases, the incidence of TLS after AZA-VEN was established at 17%.
Viscum album L. Therapy in Oncology: An Update on Current Evidence
Authors: Thronicke Anja , Schad Friedemann , Debus Marion , Grabowski Jan , Soldner Georg
Published: March 2022

Background: A majority of oncological patients apply add-on white-berry European mistletoe (Viscum album L., VA) extracts to reduce disease- and treatment-related symptoms and to improve health-related quality of life (HRQL). VA extracts exert various antitumor, pro-apoptotic, anti-proliferative, and immunomodulatory effects. Two current meta-analyses attribute life-prolonging and HRQL-improving properties to additive VA therapy. The aim of the present update was to review the current knowledge on VA extracts in clinical oncology. Hereby, we concentrated on studies with the highest clinical relevance in the field of lung, gastric, colorectal and pancreatic, gynaecological, as well as breast cancer applying the anthroposophical mistletoe preparations. Summary: The present update provides a brief overview regarding the use of VA preparations in clinical oncology reviewing current guidelines, systematic reviews, randomized controlled and real-world data studies. We have searched the pubmed.gov database of the National Library of Medicine with the search terms “mistletoe” and “cancer.” We found good evidence of add-on VA therapy to improve the HRQL of patients with breast cancer (American Society of Clinical Oncology – endorsed Society for Integrative Oncology guideline) and of HRQL-improving and survival-prolonging properties of VA therapy in pancreatic cancer. In the field of gastrointestinal, gynaecological, and lung cancer, new or updating integrative and/or oncological guidelines should consider clear recommendations on integrative therapies including VA therapy. Nevertheless, further clinical and real-world data trials need to be performed in this field. Key Messages: Evidence for add-on VA treatment for the improved management of cancer and cancer-related side effects is accumulating. Patients with breast cancer: good evidence for add-on VA therapy to improve the HRQL of oncological patients. Patients with pancreatic cancer: good evidence for add-on VA to improve HRQL and prolong survival. Patients with gastrointestinal, gynaecological, and lung cancer: update of guidelines is recommended with regards to integrative oncological therapies including add-on VA.
Serological survey of Neospora caninum and Toxoplasma gondii in shelter-housed cats infected with feline immunodeficiency virus, Brazil
Authors: Reche-Júnior Archivaldo , Daniel Alexandre Gonçalves Teixeira , Tadini Bruna Stefania , Santana Erica , Filgueira Kilder Dantas , Gargano Ronaldo Gomes , Sellera Fábio Parra , Pena Hilda Fátima de Jesus , Gennari Solange Maria
Published: March 2022

Felines play a leading role in the epidemiology of Toxoplasma gondii infection, but there is scarce information about the epidemiology of Neospora caninum, particularly in feline immunodeficiency virus (FIV)-infected cats. Cats seropositive to T. gondii do not usually show symptoms unless they are immunosuppressed, such as FIV-infected cats. The same relationship remains poorly known for N. caninum, although it has been associated with neurological disorders in HIV-infected people. Since FIV-infected cats are prone to develop encephalitis of unknown etiology, this study aimed to evaluate the presence of specific antibodies to T. gondii and N. caninum in a shelter for stray cats naturally infected with FIV. A total of 104 serum samples from cats living in a shelter, located in São Paulo city (Brazil), was assessed for T. gondii and N. caninum specific antibody by indirect fluorescent-antibody test (IFAT). Of the 104 cats, 25 (24%) were infected with FIV and, aside from these, 8 (32%) had antibodies against T. gondii (titers from 16 to 128). Only 1 (4%) of the FIV infected cats had antibodies against N. caninum, which was the first record of coinfection. Among the FIV-naïve cats, 11 (14%) were positive for T. gondii (titers from 16 to 256) and only 1 (1.2%) had antibodies against N. caninum. Serologically positive reactions to T. gondii and N. caninum were not correlated with age or sex (p>0.05), and there was no correlation between FIV and the occurrence of anti-T. gondii or anti-N. caninum antibodies (p>0.05). Further studies encompassing larger cat populations from different origins and locations are essential to clarify the prevalence of T. gondii and N. caninum antibodies in FIV-positive cats.
Depressive Symptoms and Incident Hospitalization for Heart Failure: Findings From the REGARDS Study
Authors: Khodneva Yulia , Goyal Parag , Levitan Emily B. , Jackson Elizabeth A. , Oparil Suzanne , Sterling Madeline R. , Cherrington Andrea L. , Durant Raegan , Safford Monika M.
Published: March 2022

Background

Depressive symptoms are risk factors for several forms of cardiovascular disease including coronary heart disease (CHD). However, it is unclear whether depressive symptoms are associated with incident heart failure (HF), including hospitalization for HF overall or by subtype: HF with preserved (HFpEF) or reduced ejection fraction (HFrEF).

Methods and Results

Among 26 268 HF‐free participants in the REGARDS (Reasons for Geographic And Racial Differences in Stroke) study, a prospective biracial cohort of US community‐dwelling adults ≥45 years, baseline depressive symptoms were defined as a score ≥4 on the 4‐item Center for Epidemiologic Studies Depression scale. Incident HF hospitalizations were expert‐adjudicated and categorized as HFpEF (EF ≥50%) and HFrEF, including mid‐range EF (EF<50%). Over a median of 9.2 [IQR 6.2–10.9] years of follow‐up, there were 872 incident HF hospitalizations, 526 among those without CHD and 334 among those with CHD. The age‐adjusted HF hospitalization incidence rates per 1000 person‐years were 4.9 (95% CI 4.0–5.9) for participants with depressive symptoms versus 3.2 (95% CI 3.0–3.5) for those without depressive symptoms (
P
<0.001). For overall HF, the elevated risk became attenuated after controlling for covariates. When HFpEF was assessed separately, depressive symptoms were associated with incident hospitalization after controlling for all covariates (hazard ratio [HR] 1.48, 95% CI 1.00–2.18) among those without baseline CHD. In contrast, depressive symptoms were not associated with incident HFrEF hospitalizations.

Conclusions

Among individuals free of CHD at baseline, depressive symptoms were associated with incident hospitalization for HFpEF, but not for HFrEF, or among those with baseline CHD.
Deoxycholic Acid and Coronary Artery Calcification in the Chronic Renal Insufficiency Cohort
Authors: Jovanovich Anna , Cai Xuan , Frazier Rebecca , Bundy Josh D. , He Jiang , Rao Panduranga , Lora Claudia , Dobre Mirela , Go Alan , Shafi Tariq , Feldman Harold I. , Rhee Eugene P. , Miyazaki Makoto , Isakova Tamara , Chonchol Michel , Appel Lawrence J. , Chen Jing , Lash James P. , Nelson Robert G. , Rahman Mahboob , Rao Panduranga S , Shah Vallabh O. , Townsend Raymond R. , Unruh Mark L.
Published: March 2022

Background

Deoxycholic acid (DCA) is a secondary bile acid that may promote vascular calcification in experimental settings. Higher DCA levels were associated with prevalent coronary artery calcification (CAC) in a small group of individuals with advanced chronic kidney disease. Whether DCA levels are associated with CAC prevalence, incidence, and progression in a large and diverse population of individuals with chronic kidney disease stages 2 to 4 is unknown.

Methods and Results

In the CRIC (Chronic Renal Insufficiency Cohort) study, we evaluated cross‐sectional (n=1057) and longitudinal (n=672) associations between fasting serum DCA levels and computed tomographic CAC using multivariable‐adjusted regression models. The mean age was 57±12 years, 47% were women, and 41% were Black. At baseline, 64% had CAC (CAC score >0 Agatston units). In cross‐sectional analyses, models adjusted for demographics and clinical factors showed no association between DCA levels and CAC >0 compared with no CAC (prevalence ratio per 1‐SD higher log DCA, 1.08 [95% CI, 0.91–1.26). DCA was not associated with incident CAC (incidence per 1‐SD greater log DCA, 1.08 [95% CI, 0.85–1.39]) or CAC progression (risk for increase in ≥100 and ≥200 Agatston units per year per 1‐SD greater log DCA, 1.05 [95% CI, 0.84–1.31] and 1.26 [95% CI, 0.77–2.06], respectively).

Conclusions

Among CRIC study participants, DCA was not associated with prevalent, incident, or progression of CAC.
Switching to Versus Addition of Incretin‐Based Drugs Among Patients With Type 2 Diabetes Taking Sodium‐Glucose Cotransporter‐2 Inhibitors
Authors: Lau Kristy T. K. , Wong Carlos K. H. , Au Ivan C. H. , Lau Wallis C. Y. , Man Kenneth K. C. , Chui Celine S. L. , Wong Ian C. K.
Published: March 2022

Background

Evidence is limited in comparing treatment modification by substitution or add‐on of glucose‐lowering medications in patients with type 2 diabetes. This observational study aims to compare switching versus add‐on of incretin‐based drugs among patients with type 2 diabetes on background sodium‐glucose cotransporter‐2 inhibitors (SGLT2i).

Methods and Results

This population‐based, retrospective cohort study was conducted using the IQVIA Medical Research Data, including adults with type 2 diabetes on background SGLT2i from 2005 to 2020. New users of incretin‐based drugs were allocated into the “Switch” group if they had discontinued SGLT2i treatment, or the “Add‐on” group if their background SGLT2i was continued. Baseline characteristics of patients were balanced between groups. Study outcomes were all‐cause mortality, cardiovascular diseases, kidney diseases, hypoglycemia, and ketoacidosis. Patients were observed from the index date of initiating incretin‐based drugs until the earliest of an outcome event, death, or data cut‐off date. Changes in anthropometric and metabolic parameters were also compared between groups from baseline to 12‐month follow‐up. A total of 2888 patients were included, classified into “Switch” (n=1461) or “Add‐on” group (n=1427). Median follow‐up was 18 months with 5183 person‐years. Overall, no significant differences in the risks of study outcomes were observed between groups; however, patients in the “Add‐on” group achieved significantly greater reductions in glycated hemoglobin, weight, percentage weight loss, and systolic blood pressure than their “Switch” counterparts.

Conclusions

Initiating incretin‐based drugs as add‐on among patients with type 2 diabetes on background SGLT2i was associated with risks of clinical end points comparable to switching treatments, in addition to better glycemic and weight control observed with the combination approach.
Low Risk of Dementia in Patients With Newly Diagnosed Atrial Fibrillation and a Clustering of Healthy Lifestyle Behaviors: A Nationwide Population‐Based Cohort Study
Authors: Park Sang‐Hyeon , Lee So‐Ryoung , Choi Eue‐Keun , Lee HuiJin , Chung Jaewook , Choi JungMin , Han Minju , Ahn Hyo‐Jeong , Kwon Soonil , Lee Seung‐Woo , Han Kyung‐Do , Oh Seil , Lip Gregory Y. H.
Published: March 2022

Background

Limited data are available on the clinical impact of healthy lifestyle behaviors on the risk of dementia in patients with new‐onset atrial fibrillation (AF). Here, we aimed to evaluate the association between a combination of healthy lifestyle behaviors and the risk of incident dementia in patients with AF.

Methods and Results

Using the Korean National Health Insurance database between 2009 and 2016, we identified 199 952 adult patients who were newly diagnosed as AF without dementia. Patients were categorized into 4 groups by healthy lifestyle behavior score (HLS) with 1 point each being assigned for no current smoking, alcohol abstinence, and regular exercise. The HLS 0, 1, 2, and 3 groups included 4.4%, 17.4%, 53.4%, and 24.8% of the patients, respectively. We performed an inverse probability of treatment weighting to balance covariates between HLS groups. The HLS 1, 2, and 3 groups were associated with a lower risk of dementia compared with the HLS 0 group (hazard ratio [HR], 0.769; 95% CI, 0.704–0.842 for HLS 1; HR, 0.770; 95% CI, 0.709–0.836 for HLS 2; and HR, 0.622; 95% CI, 0.569–0.679 for HLS 3). The risk of dementia showed a tendency to decrease with an increase in HLS (
P
‐for‐trend <0.001).

Conclusions

A clustering of healthy lifestyle behaviors was associated with a significantly lower risk of dementia in patients with new‐onset AF. These findings support the promotion of a healthy lifestyle within an integrated care approach to AF patient management.
Information Extraction From Electronic Health Records to Predict Readmission Following Acute Myocardial Infarction: Does Natural Language Processing Using Clinical Notes Improve Prediction of Readmission?
Authors: Brown Jeremiah R. , Ricket Iben M. , Reeves Ruth M. , Shah Rashmee U. , Goodrich Christine A. , Gobbel Glen , Stabler Meagan E. , Perkins Amy M. , Minter Freneka , Cox Kevin C. , Dorn Chad , Denton Jason , Bray Bruce E. , Gouripeddi Ramkiran , Higgins John , Chapman Wendy W. , MacKenzie Todd , Matheny Michael E.
Published: March 2022

Background

Social risk factors influence rehospitalization rates yet are challenging to incorporate into prediction models. Integration of social risk factors using natural language processing (NLP) and machine learning could improve risk prediction of 30‐day readmission following an acute myocardial infarction.

Methods and Results

Patients were enrolled into derivation and validation cohorts. The derivation cohort included inpatient discharges from Vanderbilt University Medical Center between January 1, 2007, and December 31, 2016, with a primary diagnosis of acute myocardial infarction, who were discharged alive, and not transferred from another facility. The validation cohort included patients from Dartmouth‐Hitchcock Health Center between April 2, 2011, and December 31, 2016, meeting the same eligibility criteria described above. Data from both sites were linked to Centers for Medicare & Medicaid Services administrative data to supplement 30‐day hospital readmissions. Clinical notes from each cohort were extracted, and an NLP model was deployed, counting mentions of 7 social risk factors. Five machine learning models were run using clinical and NLP‐derived variables. Model discrimination and calibration were assessed, and receiver operating characteristic comparison analyses were performed. The 30‐day rehospitalization rates among the derivation (n=6165) and validation (n=4024) cohorts were 15.1% (n=934) and 10.2% (n=412), respectively. The derivation models demonstrated no statistical improvement in model performance with the addition of the selected NLP‐derived social risk factors.

Conclusions

Social risk factors extracted using NLP did not significantly improve 30‐day readmission prediction among hospitalized patients with acute myocardial infarction. Alternative methods are needed to capture social risk factors.
Tubastatin A Improves Post‐Resuscitation Myocardial Dysfunction by Inhibiting NLRP3‐Mediated Pyroptosis Through Enhancing Transcription Factor EB Signaling
Authors: Xu Jiefeng , Zhao Xue , Jiang Xiangkang , He Lu , Wu Xinjie , Wang Jiangang , Chen Qijiang , Li Yulin , Zhang Mao
Published: March 2022

Background

Myocardial dysfunction is the leading cause of early death following successful cardiopulmonary resuscitation (CPR) in people with cardiac arrest (CA), which is potentially driven by cell pyroptosis mediated by NOD‐like receptor pyrin domain 3 (NLRP3) inflammasome. Recently, histone deacetylase 6 (HDAC6) inhibition was shown to exert effective myocardial protection against regional ischemia/reperfusion injury. In this study, we investigated whether tubastatin A, a specific histone deacetylase 6 inhibitor, could improve postresuscitation myocardial dysfunction through the inhibition of NLRP3‐mediated cell pyroptosis and its modulation mechanism.

Methods and Results

Healthy male white domestic swine were used to establish the model of CA/CPR in vivo, and the H9c2 cardiomyocyte hypoxia/reoxygenation model was used to simulate the CA/CPR process in vitro. Consequently, tubastatin A inhibited NLRP3 inflammasome activation, decreased proinflammatory cytokines production and cell pyroptosis, and increased cell survival after hypoxia/reoxygenation in H9c2 cardiomyocytes in vitro. In addition, tubastatin A increased the acetylated levels of transcription factor EB and its translocation to the nucleus, and its protective effect above was partly abrogated by transcription factor EB short interfering RNA after hypoxia/reoxygenation in H9c2 cardiomyocytes. Similarly, tubastatin A promoted cardiac transcription factor EB nuclear translocation, inhibited NLRP3‐mediated cell pyroptosis, and mitigated myocardial dysfunction after CA/CPR in swine.

Conclusions

The inhibition of histone deacetylase 6 activity by tubastatin A limited NLRP3 inflammasome activation and cell pyroptosis probably through the enhancement of transcription factor EB signaling, and therefore improved myocardial dysfunction after CA/CPR.
Fine Fibrillatory Wave as a Risk Factor for Heart Failure Events in Patients With Atrial Fibrillation: The Fushimi Atrial Fibrillation (AF) Registry
Authors: Kawaji Tetsuma , Ogawa Hisashi , Hamatani Yasuhiro , Kato Masashi , Yokomatsu Takafumi , Miki Shinji , Abe Mitsuru , Akao Masaharu ,   the Fushimi AF Registry investigators
Published: March 2022

Background

The clinical significance of fibrillatory wave on electrocardiography during atrial fibrillation (AF) is poorly understood. The aim of the current study was to explore the association of fine fibrillatory wave with heart failure (HF) in AF.

Methods and Results

The current study enrolled 2442 patients with AF whose baseline ECG during AF rhythm was available from a community‐based prospective survey, the Fushimi AF Registry. The impact of fine fibrillatory wave, defined as the amplitude of fibrillatory waves <0.1 mV, on the primary composite HF end point (a composite of hospitalization attributable to HF or cardiac death) was examined. Fine fibrillatory wave was observed in 589 patients (24.1%). Patients with fine fibrillatory wave were older, and had a higher prevalence of sustained AF, preexisting HF, and larger left atrial diameter than those with coarse fibrillatory wave. During the median follow‐up duration of 5.9 years, the cumulative incidence of the primary composite HF end point was significantly higher in patients with fine fibrillatory wave than in those with coarse fibrillatory wave (5.3% versus 3.6% per patient‐year, log‐rank
P
<0.001). The higher risk associated with fine fibrillatory wave was consistent even for individual components of the primary composite HF end point. On multivariable analysis, fine fibrillatory wave became an independent predictor for the primary composite HF end point (hazard ratio, 1.31; 95% CI, 1.07–1.61;
P
=0.01).

Conclusions

Compared with coarse fibrillatory wave, fine fibrillatory wave was more prevalent in patients with a larger left atrial diameter or those with sustained AF and was independently associated with a higher risk of HF events.

Registration

URL:
https://www.umin.ac.jp/ctr/
; Unique identifier: UMIN000005834.
PSG7 and 9 (Pregnancy‐Specific β‐1 Glycoproteins 7 and 9): Novel Biomarkers for Preeclampsia
Authors: Kandel Manju , MacDonald Teresa M. , Walker Susan P. , Cluver Catherine , Bergman Lina , Myers Jenny , Hastie Roxanne , Keenan Emerson , Hannan Natalie J. , Cannon Ping , Nguyen Tuong‐Vi , Pritchard Natasha , Tong Stephen , Kaitu’u‐Lino Tu’uhevaha J.
Published: March 2022

Background

Preeclampsia is pregnancy specific, involving significant maternal endothelial dysfunction. Predictive biomarkers are lacking. We evaluated the biomarker potential, expression, and function of PSG7 (pregnancy‐specific β‐1 glycoprotein 7) and PSG9 (pregnancy‐specific β‐1 glycoprotein 9) in preeclampsia.

Methods and Results

At 36 weeks gestation preceding term preeclampsia diagnosis, PSG7 and PSG9 (in Australian cohorts of n=918 and n=979, respectively) were significantly increased before the onset of term preeclampsia (PSG7,
P
=0.013; PSG9,
P
=0.0011). In samples collected at 28 to 32 weeks from those with preexisting cardiovascular disease and at high risk of preeclampsia (Manchester Antenatal Vascular Service, UK cohort, n=235), both PSG7 and PSG9 were also significantly increased preceding preeclampsia onset (PSG7,
P
<0.0001; PSG9,
P
=0.0003) relative to controls. These changes were validated in the plasma and placentas of patients with established preeclampsia who delivered at <34 weeks gestation (PSG7,
P
=0.0008; PSG9,
P
<0.0001). To examine whether PSG7 and PSG9 are associated with increasing disease severity, we measured them in a cohort from South Africa stratified for this outcome, the PROVE (Preeclampsia Obstetric Adverse Events) cohort (n=72). PSG7 (
P
=0.0027) and PSG9 (
P
=0.0028) were elevated among patients who were preeclamptic with severe features (PROVE cohort), but not significantly changed in those without severe features or with eclampsia. In syncytialized first trimester cytotrophoblast stem cells, exposure to TNFα (tumor necrosis factor α) or IL‐6 (interleukin 6) significantly increased the expression and secretion of PSG7 and PSG9. In contrast, when we treated primary endothelial cells with recombinant PSG7 and PSG9, we only observed modest changes in
Flt‐1
(FMS‐like tyrosine kinase‐1) expression and
Plgf
(placental growth factor) expression, and no other effects on proangiogenic/antiangiogenic or endothelial dysfunction markers were observed.

Conclusions

Circulating PSG7 and PSG9 are increased before preeclampsia onset and among those with established disease with their production and release potentially driven by placental inflammation.
Association of Night‐to‐Night Adherence of Continuous Positive Airway Pressure With Day‐to‐Day Morning Home Blood Pressure and Its Seasonal Variation in Obstructive Sleep Apnea
Authors: Hoshide Satoshi , Yoshida Tetsuro , Mizuno Hiroyuki , Aoki Hiroyoshi , Tomitani Naoko , Kario Kazuomi
Published: March 2022

Background

The aim of this study was to investigate the association between night‐to‐night adherence to continuous positive airway pressure (CPAP) therapy and both home blood pressure (BP) level on the following day and seasonal variation in home BP in patients with obstructive sleep apnea.

Methods and Results

We analyzed 105 participants who had been diagnosed with obstructive sleep apnea (average apnea‐hypopnea index, 49.7±18.4 per hour) and who were already receiving CPAP therapy. Home BP (twice every morning and evening) and CPAP adherence data were automatically transmitted to a server for 1 year. A mixed‐effects model for repeated measures analysis was used to examine associations of night‐to‐night good CPAP adherence with day‐to‐day home BP within the same patient after adjusting for covariates. The average number of days in which patients achieved both CPAP adherence and morning or evening home BP measurement was 206.6±122.7 days (21 487 readings) and 191.2±126.3 days (20 170 readings), respectively. Good CPAP adherence (>4 hours per night of use) was achieved on the evening or morning before home BP measurements (86.8% and 86.9%, respectively). After adjustment for confounders, good CPAP adherence was negatively associated with morning home systolic BP (β, −0.663;
P
=0.004) and diastolic BP (β, −0.829;
P
<0.001). Morning home systolic BP in winter in the individuals with good CPAP adherence was significantly lower than that in individuals without such adherence (
P
<0.05). These associations were not found in evening home BP.

Conclusions

Good adherence to CPAP therapy was negatively associated with morning home BP on the following day in patients with obstructive sleep apnea. The association was remarkable in the winter season.
Impact of Shunting Practice Patterns During Carotid Endarterectomy for Symptomatic Carotid Stenosis
Authors: Squizzato Francesco , Siracuse Jeffrey J. , Shuja Fahad , Colglazier Jill , Balachandran Wilkins Parvathi , Goodney Philip P. , Sands Brooke Benjamin , DeMartino Randall R.
Published: March 2022

Background:

We aimed to assess the effect of surgeons’ shunting practice and shunt use on the early outcomes of carotid endarterectomy (CEA) in recently symptomatic patients.

Methods:

We conducted a retrospective observational study based on a multicenter national prospective database. The Vascular Quality Initiative database (2010–2019) was queried for CEAs performed within 14 days after an ipsilateral stroke or transient ischemic attack. Surgeons were gauged as routine shunters if they shunted in >95% of CEAs, otherwise were classified as selective shunters. In-hospital stroke and death rates were compared between routine and selective shunters, stratifying by type of index event (transient ischemic attack versus stroke) and timing of CEA (≤2 versus >2 days).

Results:

Thirteen thousand four hundred sixty-nine CEAs were performed after a transient ischemic attack (43%) or stroke (57%), 3186 (24%) by routine shunters, and 10 283 (76%) by selective shunters. Comparing routine and selective shunters, in-hospital stroke (1.9% versus 2.4%;
P
=0.09) and death (0.4% versus 0.5%;
P
=0.73) rates were similar. A lower stroke rate (1.5% versus 4.2%;
P
=0.02) was achieved by routine shunters for CEA performed <2 days after an ischemic stroke. Among selective shunters, a higher stroke rate occurred in case of shunt use (2.9% versus 2.3%;
P
<0.01), mainly due to cases presenting with stroke (3.5% versus 2.4%;
P
<0.01) but not transient ischemic attack (1.8% versus 1.5%;
P
=0.57). Awake anesthesia was adopted in 7.8% of cases by selective shunters and in 0.8% by routine shunters, without impact on the perioperative stroke rate (1.8% versus 2.3%;
P
=0.349).

Conclusions:

In this large national cohort, the overall outcomes of CEA were similar between routine and selective shunters. A lower postoperative stroke rate was achieved by routine shunters in CEA performed <2 days after an ischemic stroke. Among selective shunters, intraoperatively indicated shunting determined an increased stroke rate, likely due to intraoperative hypoperfusion. These data may guide the decision regarding timing of CEA and shunting intention in symptomatic patients.
Association of the 24‐Hour National Institutes of Health Stroke Scale After Mechanical Thrombectomy With Early and Long‐Term Survival
Authors: Kurmann Christoph C. , Beyeler Morin , Grunder Lorenz , Lang Matthias F. , Piechowiak Eike I. , Meinel Thomas R. , Jung Simon , Hoffmann Angelika , Seiffge David J. , Heldner Mirjam R. , Dobrocky Tomas , Mordasini Pasquale , Arnold Marcel , Gralla Jan , Fischer Urs , Kaesmacher Johannes
Published: March 2022

Background

The National Institutes of Health Stroke Scale (NIHSS) obtained 24 hours after ischemic stroke is a good indicator for functional outcome and early mortality, but the correlation with long‐term survival is less clear. We analyzed the correlation of the NIHSS after 24 hours (24h NIHSS) and early clinical neurological development after mechanical thrombectomy with early and long‐term survival as well as its predictive power on survival.

Methods

We reviewed a prospective observational registry for all patients undergoing mechanical thrombectomy between January 2010 and December 2018. Vital status was extracted from the Swiss Population Registry. Adjusted hazard ratio (aHR) and crude hazard ratios were calculated using Cox regression. To assess predictive power of the 24h NIHSS, different Random Survival Forest models were evaluated.

Results

We included 957 patients (median follow‐up 1376 days). Patients with lower 24h NIHSS and major early neurological improvement had substantially better survival rates. We observed significantly higher aHR for death in patients with 24h NIHSS 12 to 15 (aHR, 1.78; 95% CI, 1.1–2.89), with 24h NIHSS 16 to 21 (aHR, 2.54, 95% CI, 1.59–4.06), and with 24h NIHSS >21 (aHR, 5.74; 95% CI, 3.47–9.5). The 24h NIHSS showed the best performance predicting mortality (receiver operating characteristic area under the curve at 3 months [0.85±0.034], at 1 year [0.82±0.029], at 2 years [0.82±0.031], and at 5 years [0.83±0.035]), followed by NIHSS change.

Conclusions

Patients with acute ischemic stroke achieving a low 24h NIHSS or major early neurological improvement after mechanical thrombectomy had markedly lower long‐term mortality. Furthermore, 24h NIHSS had the best predictive power for early and long‐term survival in our machine learning–based prediction.
Seven new species of phytoseiid mites (Acari: Mesostigmata) from Tripura, north-eastern India
Authors: KAR ANAMIKA , KARMAKAR KRISHNA
Published: March 2022

Tripura is a north eastern hilly state of India, and so far only 27 species of Phytoseiidae have been reported from the state. During the present survey 250 specimens were collected belonging to seven new species, namely Euseius tripuraensis sp. nov., Euseius spontaneum sp. nov., Euseius tripurii sp. nov., Phytoseius birbikrami sp. nov., Phytoseius khowaiensis sp. nov., Phytoseius baramuracus sp. nov., and Typhlodromus (Anthoseius) sonajhuriae sp. nov.
Taxonomic studies on the genera Meges Pascoe, 1866 and Pseudomeges Breuning, 1944 from China (Coleoptera, Cerambycidae, Lamiinae, Lamiini)
Authors: BI WEN-XUAN , CHEN CHANG-CHIN , LIN MEI-YING
Published: March 2022

The genus Meges Pascoe, 1866 stat. res. is resurrected from synonyms of Monochamus Dejean, 1821 and is made a senior synonym of Magninia Clermont, 1932 syn. nov. Meges currently contains two species, i.e. Meges gravidus (Pascoe, 1858) and Meges tonkineus (Clermont, 1932) comb. nov. The male of the latter species is described for the first time. A related genus Pseudomeges Breuning, 1944 is investigated for comparison and Pseudomeges aureus Bi, Chen & Lin sp. nov. (金斑伪侎天牛, Jîn bân wěi mǐ tiân niú) is described from Yunnan, China. New localities are reported. Illustrations of habitus, endophallic structures and major diagnostic features for all involved taxa are provided.
Rediscovery and redescription of Callicarpa chazaliei Versluys, 1899 (Cnidaria: Hydrozoa) in the southwestern Atlantic Ocean
Authors: DE MOURA ANDREZA CAMPOS , CAMPOS FELIPE FERREIRA , PÉREZ CARLOS DANIEL
Published: March 2022

The genus Callicarpa Fewkes, 1881 presently comprises two species of Leptothecate hydroids. Herein we redescribe one of these, C. chazaliei Versluys, 1899, originally described from Florida and known elsewhere only from Venezuela. With the only morphological account of this species being that of the original description, a detailed redescription and illustrations of it are provided. Specimens were collected in the Potiguar Basin off the coast of Rio Grande do Norte, Brazil, at a depth of 65 m, during a project focusing on the characterization and monitoring of an oil extraction basin.
Mitogenomic features of three species of Entomobryoidea (Collembola) from China
Authors: GODEIRO NERIVANIA NUNES , XU CONG , ZHANG GUOQIANG , ZHANG FENG
Published: March 2022

Three novel mitogenomes of Entomobryoidea were assembled and annotated. Sequences final lengths were 14,683 bp for Alloscopus bannaensis, 14,884 bp for Sinhomidia bicolor, and 14,794 bp for Coecobrya sp., including 13 PCGs, 22 tRNA, and 2 rRNA genes. To confirm the morphological identifications, maximum likelihood and Bayesian analyses were performed and the species were placed in the correct phylogenetic position, except A. bannaensis which support value was low to confirm its placement. All three mitogenomes are the first ones published for these genera, the genetic data generated here will be useful for further phylogenetic analyses of the group Collembola.
The Impact of Delays in Interfaculty Transfer on Outcomes in Elderly Trauma Patients
Authors: Quinn Seth A. , Edwards Jacob D. , Buccini Peter , Parmley Michael K. , Leonard Kenji , Irish William , Toschlog Eric A.
Published: March 2022

Background

Delay to definitive treatment is a significant and persistent challenge to trauma systems across the United States, especially in rural communities with limited resources. We hypothesized that elderly trauma patients with delay in transfer would have increased morbidity and mortality. This study evaluates the relationship between inter-facility transfer time and outcomes in elderly trauma patients, and the validity of the 4-hour dwell time as a performance improvement benchmark.

Methods

The National Trauma Registry and Emergency Medical Services Database were queried from January 2010 to January 2018. Inclusion criteria included age ≥65, blunt mechanism, and transfer from another facility. Correlation analysis was used to evaluate the association between clinical and demographic variables and transfer time. Multicollinearity was evaluated using the variance inflation factor.

Results

1535 patients were identified. This cohort was further subdivided into 4 cohorts based on dwell time: 0-1.5 hours (n = 384), ≥1.5-1.9 hours (n = 379), 1.9-<2.5 hours (n = 383), and ≥2.5 hours (n = 388). Analysis revealed that shorter dwell time was associated with male gender ( P = .0039), higher ISS (injury severity score) ( P < .0001), lower RTS (revised trauma score) ( P < .0001), higher pre-hospital arrest ( P = .0066), lower initial GCS (Glasgow Coma Scale) ( P = .0012), higher mortality, longer ICU, and ventilator length of stay ( P < .0001). Longer dwell times were associated with discharge from the hospital to home or skilled nursing facility as well as lower mortality ( P < .0001).

Discussion

Longer dwell time was inversely related to outcome. More severely injured patients were rapidly transferred. This represents a mature rural trauma system. In addition, dwell time should be scrutinized as a meaningful indicator within a performance improvement program.
Quantification of Lanthanides in a Molten Salt Reactor Surrogate Off-Gas Stream Using Laser-Induced Breakdown Spectroscopy
Authors: Andrews Hunter B. , Myhre Kristian G.
Published: March 2022

To enable the deployment of molten salt reactor technology, the development of off-gas treatment systems and advanced monitoring tools capable of operating with high temperatures and radiation fields while delivering near real-time information is necessary. This study aims to fulfill this requirement and proposes laser-induced breakdown spectroscopy (LIBS) for monitoring molten salt aerosol streams. A sheath gas measuring method was developed to protect optical elements from aerosol particles and to ensure a relatively constant aerosol stream for measurement. An aqueous system was studied to demonstrate the utility of LIBS for monitoring possible fission products in an aerosol stream: Gd, Nd, and Sm up to 2000 parts per million (ppm). A calibration model was built using partial least squares (PLS) regression with five, six, and nine latent variables for Gd, Nd, and Sm, respectively. This calibration model successfully estimated the concentrations of three test samples, which were validated with inductively charged plasma optical emission spectroscopy measurements at a 99.9% confidence interval. To enhance these models, a genetic algorithm was used to filter the spectra before entering the PLS model, thereby limiting the spectral features being regressed to those with greater correlations to concentration. This allowed for the number of latent variables used in the PLS models to be reduced to four, three, and three for Gd, Nd, and Sm, respectively. Lastly, the genetic algorithm-filtered PLS models were used to predict the concentrations of the aerosol stream on a real-time dataset and resulted in a 73%, 18%, and 25% improvement in root mean squared error of prediction compared to the original PLS models developed.
Improvement of the mechanical properties of cementitious composites by the novel synthesized borophene nanosheets
Authors: Karapınar Işıl Sanrı , Pehlivan Ahmet Onur , Özsoy Özbay Ayşe Elif , Yazgan Ahmet Utku , Taşaltın Nevin , Karakuş Selcan
Published: March 2022

This study is the first investigation focused on the preparation of novel synthesized borophene nanosheets and their use in cementitious composites. The two-dimensional β borophene was prepared by a facile and low-cost sonication process including ultrasonic cavitations. To understand the effect of the novel synthesized borophene nanosheets, varying ratios of 0, 0.5, 1, 2, 3, and 5 wt% of cement were incorporated in cement composites and improvements on the mechanical strength, workability, and toughness were identified. Also, for the microstructure evaluation, several advanced characterization techniques including SEM, EDS, XRD, and TGA were presented and the relationship between the microstructure and mechanical properties of cementitious composites modified with borophene nanosheets was discussed. As a result of this study, with the incorporation of the borophene nanosheets, clear improvements were achieved for the 28 day compressive and flexural strengths of the specimens within a range of 5–19% and 4–13%, respectively. The findings also indicated that borophene nanosheets contributed to the formation of a denser microstructure of the corresponding cement composites. Thus, within this study, the utility of as-prepared borophene nanosheets in cementitious composites is proved and proposed as a two-dimensional potential nanomaterial candidate to be used in cementitious composites.
Rural development and transformation of the rice sector in Myanmar: Introduction of best management practices for sustainable rice agriculture
Authors: Wehmeyer Helena , Malabayabas Arelene , San Su Su , Thu Aung Myat , Tun Myat Su , Thant Aye Aye , Connor Melanie
Published: March 2022

Myanmar has experienced considerable economic and social changes since its political transition in the early 2010s. Its agriculture sector has demonstrated rapid intensification and modernization. Agricultural best management practices (BMPs), e.g., drum seeders and laser land levelling, were introduced to rice farmers in Bago Region in 2012 to increase sustainable production and counter negative environmental impacts. The objective of this study was to determine the socioeconomic and agronomic changes due to the adoption of BMPs between adopters and non-adopters. Using a digital survey questionnaire application to collect household data, 200 farmers in eight villages were interviewed in 2012 and 2017. Data were analysed using uni- and multivariate statistics. Mediation analysis was utilized to evaluate the effect of the farmer group on rice yields. Overall, all farmers in this study experienced substantial positive changes over the course of five years in line with the national development efforts. Differences among adopters and non-adopters were not significant, but notable distinctions existed between cropping patterns. Rice-pulse farmers had higher yields ( + 0.4 t/ha), yet rice-rice farmers had larger cultivation areas, received higher agricultural credits, and had superior income levels. Nevertheless, rice yields remained low (<4 t/ha). Education was found to be an important predictor of yield. Hence, this factor is crucial for accelerating agricultural development in Myanmar. Improving extension services and knowledge transfer are necessary to expand the dissemination of sustainable BMPs and make farmers more resilient against the negative implications of climate change.
Development and Validation of the Counter-Empathy Scale
Authors: Jie Jing , Wang Yang
Published: March 2022

Counter-empathy refers to an emotional response that is valence-opposite from the emotional state of another individual. Screening for counter-empathy characteristics is of great significance for social psychology, clinical psychology, and criminal psychology research. Unfortunately, until now, there has been no specific scale to measure counter-empathy, creating a main bottleneck in counter-empathy research. We developed and validated a new instrument to measure counter-empathy: the Counter-Empathy Scale (CES). We tested the CES in a survey of 1265 Chinese college students. Both exploratory factor analysis and confirmatory factor analysis revealed a clear two-factor structure (feeling annoyed with others’ happiness and taking pleasure in others’ pain) for the CES. The CES is internally consistent, test-retest stable, and acceptable in terms of criterion-related validity. In conclusion, the CES is a promising instrument to assess counter-empathy.