bluuebunny/crossref_metadata_2025 huggingface dataset:
Biochanin A Mitigates Atherosclerosis by Inhibiting Lipid Accumulation and Inflammatory Response
Authors: Yu Xiao-Hua , Chen Jiao-Jiao , Deng Wen-Yi , Xu Xiao-Dan , Liu Qi-Xian , Shi Meng-Wen , Ren Kun
Published: November 2020

Biochanin A (BCA), a dietary isoflavone extracted from red clover and cabbage, has been shown to antagonize hypertension and myocardial ischemia/reperfusion injury. However, very little is known about its role in atherogenesis. The aim of this study was to observe the effects of BCA on atherosclerosis and explore the underlying mechanisms. Our results showed that administration of BCA promoted reverse cholesterol transport (RCT), improved plasma lipid profile, and decreased serum proinflammatory cytokine levels and atherosclerotic lesion area in apoE-/- mice fed a Western diet. In THP-1 macrophage-derived foam cells, treatment with BCA upregulated ATP-binding cassette (ABC) transporter A1 (ABCA1) and ABCG1 expression and facilitated subsequent cholesterol efflux and diminished intracellular cholesterol contents by activating the peroxisome proliferator-activated receptor γ (PPARγ)/liver X receptor α (LXRα) and PPARγ/heme oxygenase 1 (HO-1) pathways. BCA also activated these two signaling pathways to inhibit the secretion of proinflammatory cytokines. Taken together, these findings suggest that BCA is protective against atherosclerosis by inhibiting lipid accumulation and inflammatory response through the PPARγ/LXRα and PPARγ/HO-1 pathways. BCA may be an attractive drug for the prevention and treatment of atherosclerotic cardiovascular disease.
PLK1 and NOTCH Positively Correlate in Melanoma and Their Combined Inhibition Results in Synergistic Modulations of Key Melanoma Pathways
Authors: Su Shengqin , Chhabra Gagan , Ndiaye Mary A. , Singh Chandra K. , Ye Ting , Huang Wei , Dewey Colin N. , Setaluri Vijayasaradhi , Ahmad Nihal
Published: November 2020

Melanoma is one of the most serious forms of skin cancer, and its increasing incidence coupled with nonlasting therapeutic options for metastatic disease highlights the need for additional novel approaches for its management. In this study, we determined the potential interactions between polo-like kinase 1 (PLK1, a serine/threonine kinase involved in mitotic regulation) and NOTCH1 (a type I transmembrane protein deciding cell fate during development) in melanoma. Employing an in-house human melanoma tissue microarray (TMA) containing multiple cases of melanomas and benign nevi, coupled with high-throughput, multispectral quantitative fluorescence imaging analysis, we found a positive correlation between PLK1 and NOTCH1 in melanoma. Furthermore, The Cancer Genome Atlas database analysis of patients with melanoma showed an association of higher mRNA levels of PLK1 and NOTCH1 with poor overall, as well as disease-free, survival. Next, utilizing small-molecule inhibitors of PLK1 and NOTCH (BI 6727 and MK-0752, respectively), we found a synergistic antiproliferative response of combined treatment in multiple human melanoma cells. To determine the molecular targets of the overall and synergistic responses of combined PLK1 and NOTCH inhibition, we conducted RNA-sequencing analysis employing a unique regression model with interaction terms. We identified the modulations of several key genes relevant to melanoma progression/metastasis, including MAPK, PI3K, and RAS, as well as some new genes such as Apobec3G, BTK, and FCER1G, which have not been well studied in melanoma. In conclusion, our study demonstrated a synergistic antiproliferative response of concomitant targeting of PLK1 and NOTCH in melanoma, unraveling a potential novel therapeutic approach for detailed preclinical/clinical evaluation.
Electrocardiographic Screening in the First Days of Life for Diagnosing Long QT Syndrome: Findings from a Birth Cohort Study in Germany
Authors: Simma Alexander , Potapow Antonia , Brandstetter Susanne , Michel Holger , Melter Michael , Seelbach-Göbel Birgit , Apfelbacher Christian , Kabesch Michael , Gerling Stephan ,   the KUNO Kids Study Group
Published: November 2020

Introduction: Newborn sudden infant death syndrome (SIDS) has failed to decrease in the last decades, and a third of the neonatal cases occurred within the first 6 days of life. The long QT syndrome (LQTS) is a genetic disease with a prevalence of 1 in 2,000 live births and contributes to almost 10% of SIDS cases. Early identification of LQTS through electrocardiogram (ECG) screening is likely to reduce mortality. Methods and Results: In this ongoing prospective study we evaluated 2,251 ECGs from newborns participating in the KUNO Kids birth cohort study between July 2015 and July 2018. ECGs were recorded at a mean age of 2.0 days (IQR 0 days). The QT interval was corrected for heart rate using Bazett’s formula (QTc). A QTc between 451 and 460, 461–470, and >470 ms was measured in 23 (1.0), 14 (0.6), and 62 (2.8%) participants, respectively. Fourteen neonates (0.62%) were admitted and monitored because their initial QTc was ≥500 ms. In 2 genetically analyzed participants, a mutation was found. One disease-causing for LQTS type 1 and the other of unclear significance. Cascade screening revealed affected members in both families. Conclusion: A standardized neonatal ECG screening in the first days of life is able to identify neonates with a relevant transient form of prolonged QT intervals and to aid diagnosing congenital LQTS.
Artificial Intelligence-Based Polyp Detection in Colonoscopy: Where Have We Been, Where Do We Stand, and Where Are We Headed?
Authors: Wittenberg Thomas , Raithel Martin
Published: November 2020

Background: In the past, image-based computer-assisted diagnosis and detection systems have been driven mainly from the field of radiology, and more specifically mammography. Nevertheless, with the availability of large image data collections (known as the “Big Data” phenomenon) in correlation with developments from the domain of artificial intelligence (AI) and particularly so-called deep convolutional neural networks, computer-assisted detection of adenomas and polyps in real-time during screening colonoscopy has become feasible. Summary: With respect to these developments, the scope of this contribution is to provide a brief overview about the evolution of AI-based detection of adenomas and polyps during colonoscopy of the past 35 years, starting with the age of “handcrafted geometrical features” together with simple classification schemes, over the development and use of “texture-based features” and machine learning approaches, and ending with current developments in the field of deep learning using convolutional neural networks. In parallel, the need and necessity of large-scale clinical data will be discussed in order to develop such methods, up to commercially available AI products for automated detection of polyps (adenoma and benign neoplastic lesions). Finally, a short view into the future is made regarding further possibilities of AI methods within colonoscopy. Key Messages: Researchofimage-based lesion detection in colonoscopy data has a 35-year-old history. Milestones such as the Paris nomenclature, texture features, big data, and deep learning were essential for the development and availability of commercial AI-based systems for polyp detection.
Abstract 12888: Discrepancy of Aortic Valve Endocarditis in Patients With Bicuspid and Tricuspid Aortic Valve
Authors: Le Tan , Caceres Juan , Brown Bailey , Makkinejad Alexander , St. Pierre Emma , Ren Tom , Clemence Jeffrey , Wu Xiaoting , Kim Karen M , Patel Himanshu J , Deeb G. Michael , Yang Bo
Published: November 2020

Introduction:
It’s unknown if patients with Bicuspid Aortic Valve (BAV) endocarditis behave differently compared to Tricuspid Aortic Valve (TAV), and if BAV patients are more susceptible to aortic valve endocarditis.

Hypothesis:
We aimed to distinguish BAV and TAV infectious endocarditis, including the short and long-term outcomes after surgical treatment.

Methods:
From 1997-2017, 336 patients underwent surgical treatment for aortic valve endocarditis, including 63(19%) BAV, which is 10-20 times higher than the BAV incidence in the general population (1-2%), and 273(81%) TAV endocarditis.

Results:
Postoperatively, the BAV group had significant shorter intubation time, and less renal failure on dialysis compared to TAV group. There was no compelling difference in postoperative stroke, sepsis, pacemaker requirement and in-hospital mortality [3/65(4.6%) vs. 19/283(6.7%)] between groups. The 10-year survival was better in the BAV group than the TAV group (62% vs. 33%, p=0.004) (Figure). The significant risk factors for late mortality were renal failure on dialysis [hazard ratio (HR)=2], intravenous drug user (HR=2.4), congestive heart failure (HR=1.6), previous coronary artery bypass (HR=1.8) and liver disease (HR=2.4), all p<0.05, but not TAV (HR=1.6, p=0.14).

Conclusions:
In conclusion, BAV patients have a higher likelihood of infectious endocarditis requiring surgery at a younger age than TAV patients, but similar outcomes. Strong consideration of utilizing prophylactic antibiotics and early surgical treatment for BAV patients, to lower the likelihood of aortic valve endocarditis.
Abstract 13212: Cardiovascular Benefits of Apabetalone: A Meta-analysis
Authors: Li Hang Long , Feng Qi , Fei Yue , cheung bernard
Published: November 2020

Introduction:
Apabetalone is a novel drug that reduces inflammation and thrombosis by inhibiting bromodomain and extra-terminal proteins (BET). Three phase II trials suggested benefits whereas the recent phase III BETonMACE trial did not. To reconcile these differences, we performed a meta-analysis of all trials on apabetalone.

Methods:
MEDLINE, EMBASE, Cochrane Library, and
ClinialTrials.gov
were searched for randomized controlled trials of apabetalone up to May 05, 2020. The outcomes of interest were major adverse cardiovascular events (MACE) and hospitalization for heart failure. The secondary outcomes were death, myocardial infarction (MI), coronary revascularization, high-density lipoprotein (HDL) and apolipoprotein A-I (apoA-I). Pooled risk ratios (RRs) or mean differences (MD) in a fixed-effects model were generated using the “
meta
” package in R (version 3.6.3).

Results:
Four trials (median follow-up 3-26.5 months) with altogether 3223 patients were included. All patients had coronary artery disease and received standard statin therapy. Apabetalone significantly reduced MACE (RR 0.78, 95% CI: 0.63-0.96) and hospitalization for heart failure (RR 0.48, 95% CI: 0.33-0.70) compared to placebo (Fig.). No significant differences were observed for death (RR 0.87, 95% CI: 0.63-1.21), MI (RR 0.82, 95% CI: 0.62-1.10), or coronary revascularization (RR 0.67, 95% CI: 0.31-1.49). Apabetalone increased ApoA-I (MD 2.82%, 95% CI: 1.36-4.28) and HDL (MD 0.04%, 95% CI: 0.02-0.07).

Conclusions:
Although the BETonMACE trial failed to demonstrate significant benefits, our meta-analysis shows that apabetalone reduces MACE and hospitalization for heart failure in patients with coronary artery disease. Larger outcome trials are urgently needed to investigate the benefits of epigenetic modulation through BET protein inhibition.
Abstract 13724: Myocardial Tissue Sensitization With Heat-activated Liposomal Doxorubicin Will Result in Enhanced Lesion Progression After Radiofrequency Ablation
Authors: Nguyen Duy T , Zheng Lijun , Schuller Joseph , Sauer William
Published: November 2020

Introduction:
Chronic durable lesions after radiofrequency ablation (RFA) of myocardial tissue remain difficult to achieve. Tissue exposed to RFA will often recover electrical activity despite initial dormancy. Heat sensitive liposomes (HSL) carrying doxorubicin has been shown to enhance RF destruction of tumors.

Hypothesis:
We sought to evaluate whether HSL doxorubicin will improve myocardial RFA lesion durability.

Methods:
Using an in vivo porcine model, 3 linear RF ablations per animal were performed by blinded operators in the right atrium after systemic HSL doxorubicin infusion or saline control: posterior (20W), septal (30W), and lateral (40W). Each line was created under standardized 3D mapping settings with inter-lesion distances of 4-6 mm to intentionally simulate linear RF gaps. Voltage mapping was performed immediately after ablation (Day 0) and after 2 weeks of survival. Comparisons were made in linear low voltage areas (LVA) from Day 0 to 2 weeks. Pathological staining of porcine RA ablation was also performed to assess for histological linear gaps.

Results:
There was no immediate difference in Day 0 LVA < 0.5 mV after ablation for HSL and controls. However, a significant increase in LVA < 0.5 mV was observed at 2 weeks in HSL animals (figure) with lesion progression in 3/5, compared to 0/4 controls, p< 0.05. There were fewer gaps identified with voltage remapping and on histology for HSL subjects compared to controls.

Conclusions:
RFA with concurrent HSL doxorubicin will be more durable and result in lesion progression with fewer linear gaps over time. Further confirmatory studies are needed.
Abstract 14569: Direct Oral Anticoagulants in the Treatment of Acute Venous Thromboembolism in Obese Patients: A Systematic Review With Meta-analysis
Authors: Mai Vicky , Marceau-Ferron Emmanuelle , BERTOLETTI Laurent , Lacasse Yves , Bonnet Sebastien , Lega Jean-Christophe , Provencher Steeve
Published: November 2020

Background:
Obesity is a real burden and its prevalence is constantly increasing. High body weight is a risk factor for developing venous thromboembolism (VTE). Direct oral anticoagulants’ (DOAC) pharmacokinetics and pharmacodynamics are affected by obesity. Their efficacy and safety in obese (BMI ≥30kg/m
2
) and morbidly obese (BMI ≥40kg/m
2
) patients are still unclear in the treatment of VTE.

Objectives:
To compare the efficacy and safety of DOAC with vitamin K antagonist (VKA)/low molecular weight heparin (LMWH) in the acute treatment of VTE in obese and morbidly obese patients. The primary efficacy outcome was VTE recurrences. The safety outcomes were major bleeding (MB) and clinically relevant non-MB (CRNMB). All-cause mortality was also assessed.

Hypothesis:
We hypothesized that DOAC would present the same efficacy and safety for the treatment of acute VTE in obese and morbidly obese patients compared to VKA/LMWH.

Methods:
A systematic literature search (MEDLINE, EMBASE, CENTRAL, Web of Science) was conducted from inception to April 15
th
2020, identifying trials studying DOAC in the treatment of acute VTE in obese patients. Studies were included if one of the outcomes was reported. Two independent reviewers performed the study selection, data extraction, risk of bias assessment and strength of body evidence evaluation using the GRADE methodology. Analyses were conducted using the Mantel-Haenszel method based on a random-effect model. Relative risks (RR) were estimated for the effect measure with 95% confidence intervals.

Results:
From 1240 citations screened, we included 21 studies (58,590 patients). VTE recurrences was similar with DOAC compared to VKA/LMWH in obese patients (risk ratio (RR): 1.03; 95%CI 0.93-1.15; p=0.55) and morbidly obese patients (RR 1.06; 95CI 0.94-1.19; p=0.35). DOAC was associated with a reduction in MB in obese patients (RR 0.57; 95%CI 0.34-0.94; p=0.03) and morbidly obese patients (RR 0.71; 95%CI 0.50-1.00; p=0.05) compared to VKA/LMWH. In obese patients, no difference was observed in CRNMB with DOAC compared to VKA/LMWH.

Conclusion:
DOAC is as effective in reducing VTE and is associated with less MB compared to VKA/LMWH in obese and morbidly obese patients.
Abstract 14927: Effects of Low Intensity Resistance Exercise Under Kaatsu Condition on Skeletal Muscle Size and Its Safety inCardiovascular Surgery Patients
Authors: hironaga ogawa , SHIBASAKI IKUKO , Fukuda Hirotsugu , Toyoda Shigeru , Uematsu Azusa , YASUDA Tomohiro , Inoue Teruo , Nakajima Toshiaki
Published: November 2020

Introduction:
Surgery for cardiovascular disease is often accompanied by sarcopenia and physical frailty, and improvement of muscle mass, muscle strength, and ADL, is often difficult only with cardiac rehabilitation using aerobic exercise. The resistance training under moderately restricted muscle blood flow, named as KAATSU, induces muscle hypertrophy and strengthens muscle through low intensity exercise. However, it remains uninvestigated whether KAATSU resistance training using low intensity load (KAATSU-RE) increases muscle strength, and induces hypertrophy in patients early after cardiovascular surgery.

Hypothesis:
To investigate the effects of KAATSU-RE on skeletal muscle strength, hypertrophy and its safety in patients early after cardiovascular surgery.

Methods:
Nine patients early after cardiac surgery were included in this study (seven males, age 54 ± 18 years, BMI 23.0 ± 3.7 kg/m
2
, AVR 5 cases, MVP 3, Bentall operation 1). The patients performed leg extension exercise (20~30% 1RM) under KAATSU condition two times/week for three months. Training started after 200 m walking early after the operation. Skeletal muscle mass index (SMI) was evaluated using bioelectrical impedance analysis (BIA). The anterior mid-thigh thickness (MTH) was measured using B mode transverse ultrasound images. Physical functions (isometric knee extension peak torque, handgrip strength, and walking speed) were also measured at three points, i.e. baseline (before operation), ~7 days early after operation, and ~3 months after the training.

Results:
SMI and MTH decreased significantly from 7 ± 1.1, and 2.5 ± 0.4 cm preoperatively to 6.7 ± 1.0, and 2.2 ± 0.3 cm approximately 1 week after surgery. Approximately 3 months after the training, they increased significantly to 7.6 ± 0.8 and 3 ± 0.4 cm. During the rehabilitation period, hemodynamic deterioration and side effects including subcutaneous hemorrhage were not observed, and all the patients completely finished the study.

Conclusions:
These results suggest that KAATSU training safely increased muscle mass in patients in the early perioperative period of cardiovascular surgery. KAATSU training appears to be a promising and effective method for cardiac rehabilitation in patients with cardiovascular surgery.
Abstract 15083: Exercise Left Ventricular Ejection Fraction Predicts Long-term Brain Natriuretic Peptide Levels in Patients Undergoing Surgery for Severe Secondary Ischemic Mitral Regurgitation
Authors: Fino Carlo , Piazza Isabelle , Vito Domenico Bruno , Pibarot Philippe , Iacovoni Attilio , Merlo Maurizio , Magne Julien , Terzi Amedeo , Pozzi Andrea , Caputo Massimo , Senni Michele , Simon Caterina , Ferrero Paolo
Published: November 2020

Background and Objective:
Surgical treatment of severe secondary ischemic mitral regurgitation (IMR) may improve symptoms and functional capacity, however there are few data on its effect on long-on the evolution of heart failure. Time-course changes in brain natriuretic peptide (BNP) are a good marker of the heart failure status and outcomes. We investigated the association between the exercise stress echocardiographic (ESE) parameters and the changes in brain natriuretic peptide (BNP) following surgery for secondary IMR.

Methods:
We prospectively analyzed data on 50 patients (median age: 67, 61-64 y; EF: 35, 34-40%), undergoing mitral valve annuloplasty or replacement and coronary artery bypass graft (CABG). A valve annuloplasty with undersized ring was performed in 20 patients (40%) and a replacement in 30 (60%). A six minute walking test (6-MWT), BNP levels and ESE were performed at 1 year and at median follow-up (FU) of 6 years (4-7).

Results:
BNP level was: 388 (329-441) pg/ml before surgery, 175 (142-743) pg/ml at 1 y, and 123 (100-979) pg/ml at last FU (p=0.2). The relative changes of BNP from baseline to last FU significantly correlated with exercise tricuspid annulus plane systolic excursion (TAPSE) at last FU (r= -0.7, p<0.001), with preoperative and FU exercise LVEF, respectively ( r=-0.7 p= 0.01) (r=-0.93, p<0.001).On multivariable analysis, preoperative exercise EF was strongly and independently associated with independent BNP levels at last FU and with the changes in BNP from baseline to last FU.

Conclusions:
Despite surgical treatment of severe secondary IMR, BNP levels progressively increased over time in nearly 50% of the patients. Lower preoperative and 1-year FU exercise-stress EF was associated with increased levels of BNP during FU..
Abstract 15431: Childhood Passive Smoke Exposure is Associated With Subclinical Left Ventricular Dysfunction in Adulthood - Childhood Determinants of Adult Health Study
Authors: Ezegbe Chigozie , Magnussen Costan , BUSCOT Marie-Jeanne , Marwick Thomas H , Dwyer Terence , Neil Amanda , Venn Alison , Gall Seana L
Published: November 2020

Introduction:
Prolonged childhood passive smoke exposure may affect adult cardiovascular health but there are few studies of cardiac function. Subclinical left ventricular dysfunction detected by global longitudinal strain (GLS) is predictive of the subsequent development of heart failure. We investigated the association of passive smoke exposure during childhood with GLS in adults.

Methods:
Data were from the Childhood Determinants of Adult Health (CDAH) study 34-year follow-up (2014-19). Three measures of passive smoking (severity of exposure index [SEI], cumulative years of exposure [CYE], total household smokers [THS]) were derived retrospectively from a validated questionnaire. GLS was measured in clinics using a Siemens Acuson SC2000 ultrasound machine and 4V1c transducer with speckle tracking analysis. Linear regression adjusted for confounding factors (age, gender, childhood socioeconomic position, childhood smoking, adult smoking status, parental education level) examined the association between childhood passive smoke exposure and GLS in adulthood.

Results:
Among 781 participants (mean age 45.2 ± 2.5 SD years, 52.6% females, 54.2% exposed to passive smoking), GLS showed a decrease (β
adjusted
-0.17% 95% CI -0.32%, -0.02%) per SD of SEI (range: 0-318, mean 24.2 ± 35.8 SD). CYE (range: 0-106, mean 10.4 ± 13.9 SD) was associated with a decrease in GLS (β
adjusted
-0.18% 95% CI -0.33%, -0.05%) per SD of exposure. For each THS in childhood (range: 0-5, mean 0.9 ± 1.0 SD), there was a decrease in GLS (β
adjusted
-0.20% 95% CI -0.36%, -0.05%).

Conclusion:
Childhood passive smoke exposure, independent of own smoking, was associated with a reduction in GLS, a measure of subclinical cardiac dysfunction. Each 1% decrease in GLS has been associated with 12% higher risk of cardiovascular morbidity and mortality in low-risk general population. There are potential long-term consequences to cardiac function from childhood passive smoke exposure.
Abstract 15440: Bleeding Complications May Outweigh the Risk of Thrombosis in Patients With End-stage Liver Disease Taking Dual Antiplatelet Therapy After Percutaneous Coronary Intervention
Authors: Natour Sami J , Kyaw May Myint Thanda , Busuttil Ronald W , Tobis Jonathan M , Honda Henry M
Published: November 2020

Introduction:
Randomized trials have demonstrated the safety and efficacy of one month of dual antiplatelet therapy (DAPT) after placement of drug-eluting stents in patients with high bleeding risk. Patients with end-stage liver disease (ESLD) are underrepresented in these trials. Patients who undergo percutaneous coronary intervention (PCI) in preparation for orthotopic liver transplantation (OLT) exhibit a high incidence of bleeding complications on DAPT. The rates of bleeding versus thrombotic complications in ESLD patients placed on DAPT following PCI are poorly described.

Methods:
We retrospectively collected data from 61 patients who were evaluated for OLT between 2016 and 2019 and underwent PCI prior to listing. Bleeding events were classified using the Bleeding Academic Research Consortium (BARC) definitions and included if the following criteria were met: events occurred in the setting of DAPT, were non-procedural in etiology, and occurred during the time following PCI and prior to OLT. Ischemic complications were evaluated by the incidence of myocardial infarction (MI), stent thrombosis, in-stent restenosis (>50%) and all-cause mortality at 1 year follow-up.

Results:
A total of 55/61 patients (90%) were placed on DAPT following PCI. Among them, 21/55 patients (38%) bled while taking DAPT, including 15 patients (27%) with BARC types 3-5 first-time bleeding events and 10 patients (18%) requiring early discontinuation of therapy. The median time to first bleeding event was 8 days (range 1 to 477 days, 85
th
percentile 17 days). Among ischemic complications, MI occurred in 11/55 patients (20%) however only one patient had a type 1 MI with the remaining being type 2 in etiology. There were no episodes of stent thrombosis and 2 episodes of in-stent restenosis during the 1 year follow-up. A total of 12/55 patients (22%) went on to receive OLT and 18/55 (33%) passed away by 1 year post-PCI.

Conclusions:
Patients with ESLD exhibit a high rate of clinically significant bleeding on DAPT when compared to overall thrombotic events. The majority of bleeds occurred within the first month after PCI. These findings illustrate the need for larger studies to assess the safety of single instead of dual antiplatelet therapy in patients with ESLD who receive PCI.
Abstract 15472: The Utility of Isoproterenol Testing in Pediatric Patients Following Atrioventricular Nodal Reentry Ablation
Authors: Samad Tahmina , Silver Eric S , Liberman Leonardo
Published: November 2020

Intro:
AVNRT is a common mechanism of SVT in pediatric patients. Catecholamines such as isoproterenol (ISO) are routinely given during post ablation (ABL) testing to confirm acute success. In light of its recent significant cost increase, the aim of our study was to determine if ISO is necessary in all pediatric patients after AVNRT ablation to ensure acute procedural success.

Method:
Retrospective study of patients <21 years with AVNRT from 1/06-12/18 who had undergone catheter ablation. We excluded patients with congenital heart disease (CHD), prior ABL, without inducible tachycardia (presumed AVNRT), unsuccessful ABL and those who required ISO to induce tachycardia (TACHY) prior to ABL lesions. All patients were tested after ABL without ISO and if AVNRT was not induced they were retested while on ISO.

Result:
We identified 232 patients with AVNRT of whom 65 (28%) met the study criteria; 123 (53%) were excluded for requiring ISO to induce AVNRT prior to ABL, 23 (10%) for CHD, 12 (5%) with presumed AVNRT and 9 (4%) with an unsuccessful ABL. The average age was 14.4 yrs (±3.5) and 54% were female. All patients received anesthesia, 40/65 were intubated (62%). Evidence of slow pathway conduction (Spath) (AH jump with atrial extrastimulus testing, presence of AV nodal echo beats or PR>RR) was seen in 35/65 patients (54%). Patients were divided into 2 groups: group 1 (n= 57, 88%) consisted of patients without inducible TACHY post ABL while receiving ISO, group 2 (n = 8, 12%) of patients in whom TACHY was inducible with ISO thus required further ABL. There was no difference between the groups with regards to sex, age, intubation status, prior use of antiarrhythmic meds, or in the incidence of Spath (31/57, 54% vs. 4/8, 50%, p=1). Four of the 8 patients in group 2 with no evidence of Spath had inducible TACHY with ISO.

Conclusion:
We found that 12% of pediatric patients who did not require ISO to induce AVNRT prior to ABL had inducible TACHY only with ISO after AVNRT ABL. Presence of dual AV nodal physiology after ABL lesions did not predict inducibility of AVNRT on ISO, and 50% of the patients with no evidence of slow pathway conduction by conventional testing had inducible AVNRT with ISO. ISO testing is useful in all pediatric patients to test for inducibility following catheter ablation of AVNRT.
Abstract 16334: An Artificial Intelligence Derived Method for Instantaneous Detection of Elevated Left Ventricular End Diastolic Pressure
Authors: Pahlevan Niema M , Alavi Rashid , Ramos Melissa , Hindoyan Antreas , Matthews Ray V
Published: November 2020

Introduction:
Instantaneous, non-invasive detection of an elevated left ventricular end-diastolic pressure (LVEDP) offers a significant benefit in diagnosis and treatment of heart failure. We recently proposed a systems approach, called cardiac triangle mapping (CTM), that uses intrinsic frequencies (IFs) of the arterial waveform and pre-ejection period (PEP) to map the global ventricular function (Pahlevan et al. Fluids 4.1 (2019): 16). Here, we tested the hypothesis that an elevated LVEDP can be detected using ECG and arterial pressure waveform by applying an artificial neural network (ANN) combined with CTM approach.

Methods:
This study included 46 patients (12 females, age 39-90 (66.4±9.9), BMI 20.2-36.8 (27.6±4.1)) who were scheduled for a clinical left heart catheterization or coronary angiogram at the Keck Medical Center of USC. Exclusion criteria were valvular heart disease, atrial fibrillation, or left bundle branch block. Invasive LVEDP and aortic pressure waveforms were measured using a 3F Millar transducer tipped catheter with simultaneous 3 channel ECG. The IFs were computed from pressure waveforms. PEPs were calculated as the time difference between the beginning of QRS and the uprising of the pressure waveform. A 3-layer network consisted of 6 input, 6 hidden and one output nodes was developed. LVEDP=18 mmHg was used as the cut-off for a binary outcome. Data from 34 patients were used to design the ANN (27 for training, 7 for validation). The model was tested on 12 additional patients.

Results:
Our results showed a specificity of 87% and a sensitivity of 96% in detecting an elevated LVEDP (Fig.1).

Conclusions:
Here, we demonstrated the proof-of-concept that an AI model based on reduced-order parameters (extracted from arterial waveform and ECG) can instantaneously detect an elevated LVEDP. Although our hemodynamic measurements were done invasively, all variables that are required for this AI-LVEDP calculation can be collected noninvasively.
Observation and Simulation of a Bifurcating Thunderstorm over Beijing
Authors: Dou Jingjing , Bornstein Robert , Miao Shiguang , Sun Jianning , Zhang Yizhou
Published: November 2020

The aim of this study was the analysis and simulation of the life cycle of a bifurcating thunderstorm that passed over Beijing, China, on 22 July 2015. Data from 150 surface weather sites and an S-band radar were used in conjunction with WRF simulations that used its multilevel Building Environment Parameterization (BEP) urbanization option. The Urban-case simulation used Beijing land-use information, and the NoUrban one replaced all urban areas by croplands. The Urban case correctly simulated both the observed weak 10-m winds over Beijing (<1.0 m s−1) and the weak 2-m urban heat island (<0.5°C). Observed radar and rain gauge data, as well as the Urban-case results, all showed precipitation bifurcation around Beijing, with maximum accumulations in convergent flow areas on either side of the city. The Urban case also reproduced the observed precipitation minima over the urban area and in a downwind rain shadow. The observations and Urban-case results both also showed bifurcated flow, even when the storm was still upwind of Beijing. The subsequent bifurcated precipitation areas thus each moved along a preexisting flow branch. Urban-case vertical sections showed downward motion in the divergence areas over the urban core and upward motions over the lateral convergence zones, both up to 6 km. Given that the NoUrban case showed none of these features, these differences demonstrate how the impact of cities can extend upward into deep local convection. Additional case-study simulations are needed to more fully understand urban storm bifurcation mechanisms in this and other storms for cities in a variety of climates.
Polarimetric Radar Variables in Snowfall at Ka- and W-Band Frequency Bands: A Comparative Analysis
Authors: Matrosov Sergey Y.
Published: November 2020

Dual-frequency millimeter-wavelength radar observations in snowfall are analyzed in order to evaluate differences in conventional polarimetric radar variables such as differential reflectivity (ZDR) specific differential phase shift (KDP) and linear depolarization ratio (LDR) at traditional cloud radar frequencies at Ka and W bands (~35 and ~94 GHz, correspondingly). Low radar beam elevation (~5°) measurements were performed at Oliktok Point, Alaska, with a scanning fully polarimetric radar operating in the horizontal–vertical polarization basis. This radar has the same gate spacing and very close beam widths at both frequencies, which largely alleviates uncertainties associated with spatial and temporal data matching. It is shown that observed Ka- and W-band ZDR differences are, on average, less than about 0.5 dB and do not have a pronounced trend as a function of snowfall reflectivity. The observed ZDR differences agree well with modeling results obtained using integration over nonspherical ice particle size distributions. For higher signal-to-noise ratios, KDP data derived from differential phase measurements are approximately scaled as reciprocals of corresponding radar frequencies indicating that the influence of non-Rayleigh scattering effects on this variable is rather limited. This result is also in satisfactory agreement with data obtained by modeling using realistic particle size distributions. Observed Ka- and W-band LDR differences are strongly affected by the radar hardware system polarization “leak” and are generally less than 4 dB. Smaller differences are observed for higher depolarizations, where the polarization “leak” is less pronounced. Realistic assumptions about particle canting and the system polarization isolation lead to modeling results that satisfactorily agree with observational dual-frequency LDR data.
The dynamic course of psychological outcomes following the Victorian Black Saturday bushfires
Authors: Bryant Richard A , Gibbs Lisa , Colin Gallagher H , Pattison Phillipa , Lusher Dean , MacDougall Colin , Harms Louise , Block Karen , Ireton Greg , Richardson John , Forbes David , Molyneaux Robyn , O’Donnell Meaghan
Published: November 2020

Objectives:

To profile the long-term mental health outcomes of those affected by the 2009 Black Saturday bushfires and to document the course of mental health since the disaster.

Method:

The longitudinal Beyond Bushfires study included 1017 respondents (Wave 1; 3–4 years after the fires), 736 (76.1%) at Wave 2 (5 years after the fires) and 525 (51.6%) at Wave 3 (10 years after the fires). The survey indexed fire-related and subsequent stressful events, probable posttraumatic stress disorder, major depressive disorder, alcohol use, severe distress and receipt of health services for mental health problems.

Results:

Relative to their status 3–4 years after the fires, there were reduced rates of fire-related posttraumatic stress disorder (6.2% vs 12.2%), general posttraumatic stress disorder (14.9% vs 18.7%) and severe distress (4.4% vs 7.5%) at 10 years. There were comparable rates between Wave 1 and Wave 3 for depression (10.9% vs 8.3%) and alcohol abuse (21.8% vs 18.5%). Of people in high-affected regions, 22.1% had posttraumatic stress disorder, depression or severe distress at Wave 3. One-third to one-half of participants who reported probable posttraumatic stress disorder or depression at any assessment did not display the disorder at the next assessment. Worsening of mental health at Wave 3 was associated with the extent of property loss, exposure to recent traumatic events or recent stressful life events. Only 24.6% of those with a probable disorder had sought professional help for this in the previous 6 months.

Conclusion:

Approximately one-fifth of people from high-affected areas have a probable psychological disorder a decade after the fires. Mental health appears to fluctuate for those who are not consistently resilient, apparently as a result of ongoing stressors. The observation that most people with probable disorder are not receiving care highlights the need for further planning about managing long-term mental health needs of disaster-affected communities.
Multiple dimensions of sleep are consistently associated with chronically elevated depressive symptoms from late pregnancy to 3 years postnatal in Indigenous and non-Indigenous New Zealand women
Authors: Ladyman Clare , Signal T Leigh , Sweeney Bronwyn , Jefferies Mona , Gander Philippa , Paine Sarah-Jane , Huthwaite Mark
Published: November 2020

Introduction:

Poor sleep and depressive symptoms are common throughout the perinatal period, but little is known about the extended time course of depression and the sleep dimensions associated with these trajectories.

Objective:

This study investigated different depression trajectories in New Zealand Māori and non-Māori women from late pregnancy to 3 years postnatal. Relationships between multiple dimensions of sleep and these depression trajectories were also investigated.

Methods:

Data from 856 women (30.6% Māori and 69.4% non-Māori) from the longitudinal Moe Kura cohort study were used. Depressive symptoms and multiple dimensions of sleep (quality, duration, latency, continuity and daytime sleepiness) were collected at 36 weeks’ gestation, 12 weeks postnatal and 3 years postnatal. Trajectory analysis was completed using latent class analysis.

Results:

Latent class analysis revealed two distinct groups of depressive symptom trajectories: ‘chronic high’ and ‘stable mild’ for both Māori and non-Māori women. Māori women in both trajectories were more likely than non-Māori women to have clinically significant depressive symptoms at every time point. Poorer sleep quality, latency, continuity and greater daytime sleepiness were consistently associated with the chronic high depressive symptom trajectory at all three time points, after controlling for sociodemographic factors.

Conclusion:

A significant proportion of Māori and non-Māori women experience chronically high depressive symptoms during the perinatal period and the following years. Across this extended time frame, Māori women have a higher probability of experiencing clinically significant depressive symptoms compared to non-Māori women. These persistent patterns of depressive symptoms occur concurrently with multiple dimensions of poor sleep. Given the well-described impact of maternal depression on the mother, child, family and community, this highlights the importance of healthcare professionals asking about mothers’ sleep quality, continuity, latency and daytime sleepiness as potential indicators of long-term mood outcomes.
The Politics of Ethnic Identity in Sub-Saharan Africa
Authors: Green Elliott
Published: November 2020

Recent literature suggests that African Presidents tend to target co-ethnics with patronage, especially in non-democracies. Coupled with evidence on the role of incentives in driving ethnic identity change, I propose that a change in the ethnic identity of the President should lead to an increase in the proportion of people identifying with the President’s ethnic group. I use survey data from fourteen African countries with Presidential transitions to show that ethnic Presidential change leads to an upwards shift in the percentage of respondents identifying with the new ruling ethnic group in non-democracies, and that this shift increases with the level of autocracy. I also show that countries where citizens perceive more ethnic favoritism see higher levels of ethnic switching. Within-survey evidence from Zambia demonstrates that this shift is immediate, and case study evidence from early modern China suggests that this phenomenon is not limited to Sub-Saharan Africa.
Occupational stress, mental health, and self-efficacy among community mental health workers: A cross-sectional study during COVID-19 pandemic
Authors: Sun Yaoyao , Song Haidong , Liu Hong , Mao Fangxiang , Sun Xiaohua , Cao Fenglin
Published: November 2020

Background:

During the COVID-19, community mental health care workers (CMHWs) faced much heavier workloads, which make them vulnerable to mental problems.

Aim:

This study aims to investigate coronavirus disease-related occupational stress and its single and cumulative effect on mental health and self-efficacy among CMHWs.

Methods:

A quick-response online cross-sectional survey WA conducted during the coronavirus disease outbreak. A total of 536 CMHWs were recruited in March 2020, in China. Demographics, occupational stress, depression, anxiety, positive and negative emotions, and self-efficacy were collected. Logistic regression analysis was employed to test the single and cumulative effect of occupational stress on mental health and self-efficacy.

Results:

CMHWs did not show high level of depression or anxiety in this study. Those who provided service for suspected people who were quarantined reported higher risk of depression and anxiety. Staying out for more than 3 days was a risk factor of depression while cleaning/sterilising streets or communities was a protective factor of depression. Those who received psychiatric training showed higher positive emotion and self-efficacy, and providing psychological assistance online increased the self-efficacy. CMHWs with two different types of work had 0.996 times more risk of depression than those with only one type of work.

Conclusion:

The potential cumulative effect of occupation stress suggested that reasonable job assignment and organisational support are necessary safeguards for CMHWs.
Nuclear F-actin Cytology in Oral Epithelial Dysplasia and Oral Squamous Cell Carcinoma
Authors: McRae M.P. , Kerr A.R. , Janal M.N. , Thornhill M.H. , Redding S.W. , Vigneswaran N. , Kang S.K. , Niederman R. , Christodoulides N.J. , Trochesset D.A. , Murdoch C. , Dapkins I. , Bouquot J. , Modak S.S. , Simmons G.W. , McDevitt J.T.
Published: November 2020

Oral cavity cancer has a low 5-y survival rate, but outcomes improve when the disease is detected early. Cytology is a less invasive method to assess oral potentially malignant disorders relative to the gold-standard scalpel biopsy and histopathology. In this report, we aimed to determine the utility of cytological signatures, including nuclear F-actin cell phenotypes, for classifying the entire spectrum of oral epithelial dysplasia and oral squamous cell carcinoma. We enrolled subjects with oral potentially malignant disorders, subjects with previously diagnosed malignant lesions, and healthy volunteers without lesions and obtained brush cytology specimens and matched scalpel biopsies from 486 subjects. Histopathological assessment of the scalpel biopsy specimens classified lesions into 6 categories. Brush cytology specimens were analyzed by machine learning classifiers trained to identify relevant cytological features. Multimodal diagnostic models were developed using cytology results, lesion characteristics, and risk factors. Squamous cells with nuclear F-actin staining were associated with early disease (i.e., lower proportions in benign lesions than in more severe lesions), whereas small round parabasal-like cells and leukocytes were associated with late disease (i.e., higher proportions in severe dysplasia and carcinoma than in less severe lesions). Lesions with the impression of oral lichen planus were unlikely to be either dysplastic or malignant. Cytological features substantially improved upon lesion appearance and risk factors in predicting squamous cell carcinoma. Diagnostic models accurately discriminated early and late disease with AUCs (95% CI) of 0.82 (0.77 to 0.87) and 0.93 (0.88 to 0.97), respectively. The cytological features identified here have the potential to improve screening and surveillance of the entire spectrum of oral potentially malignant disorders in multiple care settings.
Outcome Assessment for a Telemedicine-Based Second Opinion Program for Midwest China
Authors: Mao Ayan , Meng Yueli , Wang Qing , Du Enhuan , Dong Pei , Yan Xiaoling , Wang Kun , Yang Yujie , Hu Guangyu , Qiu Wuqi
Published: November 2020

Through an examination of the records of a telemedicine-based second opinion program in county-level hospitals in central and western China, the impact of this service on the diagnosis and treatment of cancer-related diseases was analyzed and evaluated. In this study, all 135 cancer-related cases were included in the analysis. The basic characteristics of the patients were described, the opinions of the original and second diagnosis and treatment were compared, the rate of consistency between them was calculated, the therapeutic regimens were analyzed and the differences between groups were tested. In 94.07% of the cases, the reason for the doctor’s request for second opinion service was to assist in the formulation of therapeutic regimen. 64.44% of cases were confirmed with the diagnosis and 17.78% therapeutic regimen by the second opinion service. 126 cases obtained improved therapeutic regimens, and there were statistically significant differences in treatment methods in the diagnosis changed group. Comparing with other international SO studies, the diagnostic consistency rate obtained in this study was lower but not the lowest. The therapeutic consistency rate was quite low, due to the high proportion of original therapeutic regimens missing. This telemedicine-based second opinion program has brought beneficial improvements to the diagnosis and treatment of cancer-related diseases in county-level hospitals in central and western China.
Do International Interventions Prolong Civil Conflicts? The Effect of Ex Ante Expectations
Authors: Watanabe Tsukasa
Published: November 2020

Many studies have found that third-party intervention tends to prolong the duration of civil conflict. However, some studies have suggested that mere expectations of external intervention can prolong conflict duration even in the absence of actual intervention. Therefore, the effects of external interventions in prolonging the duration of civil conflicts remain unclear. This study examines the direct effect of third-party intervention on the duration of civil conflict by controlling for the indirect effect of expectations of external intervention. The probabilities of intervention were estimated, and the direct effect of interventions was tested by controlling for the effect of ex ante expectations. The empirical findings were as follows: (1) Third-party intervention has no direct effect of prolonging the duration of a conflict when expectations are controlled for, and (2) Third-party intervention may have an indirect effect of shortening conflict duration, which contradicts the findings of previous studies.
Hold the Torch: Shining a Light on the Lives of Black Management Faculty
Authors: Miller Toyah L. , Wesley Curtis L. , Bell Myrtle P. , Avery Derek R.
Published: November 2020

In light of recent heightened attention to equity, justice, and race in society and organizations, in this commentary, we focus on the experiences of Black management faculty from job search to promotion and tenure. In formulating our ideas, we draw from diversity research conducted within and outside of the management field, including research on minority faculty, coupled with experiences of our own and of Black colleagues. We discuss race-based disparities in such areas as mentoring, social networks, job market experiences, classroom management and student evaluations of teaching, and service demands. We offer suggestions for allies to pursue equity, justice, and inclusion in management departments and business schools.
Georg Simmel 2020 – Beyond the First Centenary of His Death
Authors: Cantó-Milà Natàlia
Published: November 2020

2018 marked the centenary of Georg Simmel’s death, coinciding with the publication of several monographs dealing with his oeuvre and legacy. The four monographs discussed here deal with Simmel from the perspective of scholars who have specialized in cultural and sociological theory and/or philosophy whilst addressing the intellectual and social challenges of our times. These problems, questions and even anxieties are beyond those Simmel ever knew or could have envisioned, despite his extraordinary capacity to detect tendencies and to analyse potentialities in his own present.