bluuebunny/crossref_metadata_2025 huggingface dataset:
The study of reef fish community in the outer islets of Sekotong Bay, Indonesia
Authors: Fitrianti V , Ghafari M I A
Published: April 2021

The northern region of Sekotong Bay is well known for its secluded, and it potentially provides a unique habitat for the coral reef ecosystem. There are only two islets located in that outermost area, namely Gili Rengit and Gili Layar. This study aims to describe the reef fish community structure in both islands. The study was conducted in the northern and southern parts of each islet using UVC (Underwater Visual Census) method along a 50×5 m belt transect. A total of 64 species of reef fish from 18 families were identified. The majority of fish found were resident obligate and dwellers. Moderate diversity index, as well as the low presence of indicator and targeted fish species, indicates the susceptible stability of reef fish community in the outer islet of Sekotong Bay.
Detection of surface deformation in opak fault Yogyakarta using quasi persistent scatter interferometry synthetic aperture radar
Authors: Yudinugroho M , Rokhmana C A
Published: April 2021

The Opak Fault is an active fault located in Yogyakarta. As an active fault, it leads to natural disasters, one of them being the Yogyakarta earthquake in 2006. Since then, Opak Fault surface deformation has not reoccured; hence measurement to detect this movement is essential. A widely used method in surface deformation measurement is Persistent Scatter Interferometry Synthetic Aperture Radar. A refined version of the PSI technique, the QPSI method, allows identifying and estimating targets undergoing movement through the reflectivity and amplitude stability of SAR waves. This study analyzed multi temporal Sentinel-1 Ascending and Descending data to analyze the Quasi-PSI performance in detecting surface deformation surrounding the Opak Fault. Results showed subsidence of the Opak Fault with a displacement accumulation up to -50mm throughout a period of 6 years. A majority of the surface deformation occurring in the area of interest lies at the border between Bantul Graben and the highlands of Gunung Kidul. Some of the surface displacements implied the presence of ongoing slope activity. In the area with a velocity displacement of -7 to -10 mm/year, a cumulative displacement greater than -50 mm was found. Furthermore, areas with a -2.5 to -5.5 mm/year velocity displayed a cumulative displacement ranging from -30 mm to – 40 mm. Surface deformation in the study area expressed an adequate result with a few sparse zones. Nonetheless, results from the ascending and descending modes present dissimilarity between results from several locations.
Detecting the surface temperature anomaly of the Anak Krakatau Volcano using Landsat-8 TIRS during 2018 eruption
Authors: Suwarsono  , Triyono D , Khomarudin MR , Rokhmatuloh
Published: April 2021

Geologically, Indonesia is located at the confluence of tectonic plates which causes many active volcanoes to appear in these regions. The existence of these active volcanoes has a consequence that volcanic eruptions will always be a threat to residents who live in volcanic areas. Anak Krakatau volcano is one of the active and dangerous volcanoes located in the Sunda Strait. The volcano will always be a threat to residents who live in coastal areas around the Sunda Strait. With regard to the hazard, it is important to understand the characteristic of the volcanism of Anak Krakatau volcano, especially the physical symptoms that appeared before and during the eruption. This study analyzes the surface temperature anomaly of the peak area of Anak Krakatau volcano in the 2018 eruption. The Brightness Temperature (BT) were measured from channel-10 of Landsat-8 TIRS (Thermal Infra-Red Scanner) time series during 2018. Then, we analyzed the anomalies. The analysis results showed that in the case of Anak Krakatau volcano, a type of submarine volcano in Indonesia, the eruptions that happened during 2018 have demonstrated changes in the surface temperature of the peak area, spatially and temporally. Time-series analysis of brightness temperature data is useful for understanding when the volcano is in its normal active phase and when it is closing to the eruption. Spatial brightness temperature data analysis is useful for detecting the location of the eruption center and the direction of the lava distribution. So, Landsat-8 TIRS data is useful to detect the eruption precursors in Anak Krakatau volcano, a type of submarine volcano in Indonesia, based on the surface temperature changes and anomalies of the peak area derived from this image data.
Measuring spatial accessibility of healthcare services using ARIA method, case study at Bandar Lampung City
Authors: Hijriani A , Putra R I
Published: April 2021

Accessibility of health services in Indonesia is still a problem. Health equity focuses on easy access and equitable distribution of health services and obtaining services with a standard quality set. Three dimensions of in-depth equity health can be divided into equity in health status, equity in health service use, and equity in health financing. The entire population is a health insurance participant. Health services that benefit packages include comprehensive services (preventive, promotive, curative, and rehabilitative). Government-owned health facilities must be provided, such as community health centers, clinics, doctors, hospitals, and financing paid by the government; the people who can afford it pay a premium. In this study, the accessibility of health services at hospitals and health centers in the city of Bandar Lampung was analyzed in geographic references by determining the distance and ranking health facilities ranging from very high to less accessibility value categories using the ARIA accessibility index calculation method. For hospital accessibility, Panjang district had the lowest index. Meanwhile, this district had a very high index for community health center accessibility compared to others. In health clinic accessibility, Teluk Betung Barat District had the lowest index, and Tanjung Karang Barat District had the highest index.
Detect the Water Flow Characteristic of the Tigris River by Using HFC-RAS Program
Authors: Dhafer Abed Ali , Maythem Jaafer Sumyah
Published: April 2021

The Tigris River has recently suffered from a significant decrease in water levels, in addition to the scarcity of drainage and the velocity of water entering the river from Syria, Turkey and Iran. These decreases in the levels leads gradually to drying of some parts of the banks, raising the level of the riverbed, and the appearance of dry areas in the middle of the river. This led to a decrease in the width of the river and hindering the movement of river navigation. Also, the decrease in water levels leads to an impact on the water levels needed by the liquefaction plants to secure the drinking water needed by the city of Baghdad. So, it is necessary to find a technique in which the flow characteristics of the Tigris River are revealed in periods of scarcity, in order to create planning solutions that increase the water height to levels that ensure uninterrupted water supply in the liquefaction plants all over the river. Therefore, this research aims to simulate the movement of water in the Tigris River to detect flow characteristics in times of scarcity by building a one-dimensional hydraulic model (for steady flow) using the HEC-RAS program. Where the simulation will be done based on the geometric data for the shape of the river, as well as the initial and boundary conditions that represent the levels and drainages of water for the river at periods of scarcity, in addition to identifying the values of the Manning coefficient. The model will produce results that are longitudinal and cross sections, flow charts, tables and values, on the basis of which planning solutions are proposed to raise the water level to the required level, restore the natural properties of flow, and examine the compatibility of the proposed solution with the reality of the situation. It was concluded that raising the water level would be by proposing an (Ungated Inline wirs) dam. The proposed dam was tested at a minimum level in times of scarcity, ensuring its ability to raise water levels to the height required for all liquefaction plants installed along the river that required a minimum level of 28.5 m.
Tourist development of heritage in Algeria: case of the Hypone site -ANNABA-
Authors: Ahmed Soufiane Sid , Alkinani Amer shakir , saddek Guerfia , Alrikabi Nada khaleefah
Published: April 2021

In a world where tourism has become the leading industry on the market, sustainable tourism has found its place and is becoming a major player in the network of traveling Internet users. Hospitality, solidarity and conviviality are essential are giving meaning to sharing. This “extra soul” has the capacity to enrich moments, places, attractions and heritage. Archaeological heritage sites constitute an important factor for the economic and social life of a large number of countries, the development policy came to emphasize the safeguard and the preservation of landscapes and natural or man-made sites, against the attacks which have impoverished the cultural heritage, this heritage which represents a historic imprint for future generations. Archaeological sites exert major tourist attractions. Successfully managed cultural tourism can capture the appeal of archaeological heritage and generate significant funds which will then be used to finance studies, conservation, maintenance and the presentation of this heritage to the public. This is how tourism has become, according to the World Tourism Organization (UNWTO), the world’s leading industry. Algeria contains archaeological sites which are classified as world cultural heritage by UNESCO. Unfortunately, reality shows that most of these sites are left to deteriorate without any real intervention. It is important to point out the importance of putting in place a work plan aimed at developing tourism that preserves archaeological sites considering social, environmental, cultural dimensions, etc. We will conduct this analysis based on a problem built around this main question: How to preserve our cultural heritage to achieve sustainable tourism? Through this research work, it is a question of examining the problem of integrating the conservation and enhancement of archaeological sites in the context of producing sustainable tourism for the city of Annaba and for Algeria. a global way.
Reality analysis of the state of spatial distribution of green areas using geographic information systems (GIS) – The holy city of Najaf as a case study
Authors: Kh Alrikabi Nada , Almosherefawi Osama J
Published: April 2021

Green areas are an essential component of city planning, as they serve as an outlet for them to spend their free time, in addition to the environmental role that these green areas play in improving the city’s climate by purifying the air and beautifying the city. The study’s problem is summarized in identifying the appropriateness of the current spatial distribution of green areas in the city of Najaf with the current population densities and the pattern in which green areas are distributed using GIS and knowing the per capita share of those green areas in the city, the research assumes that the inconsistency of spaces between regions Green and residential neighbourhoods need to conform to the standards for the individual share. The research also aims to know the reality of the green areas in the holy city of Najaf using GIS to take advantage of the capabilities provided by the program in the field of entering and analysing information related to its spatial distribution, as well as identifying the pattern in which the green areas are distributed in the city of Najaf, and come up with recommendations and proposals to address the existing imbalance. The research found that more than half of the neighbourhoods in the region do not conform to the standard followed in assessing the individual’s share, where the individual’s share ranged between (0.4-3.9) square meters, and there are neighbourhoods completely devoid of green areas, and this is due to poor planning in those areas. On the neighbourhood link index, the pattern of distribution of these green areas was aggregated to random. As for the Moran coefficient, its value departed from one frequently, indicating a weak spatial and random correlation of green areas, The area reached by the impact area of the green areas reached (5512) hectares, which is equivalent to (83.32%) of the total area of the Holy City of Najaf, and the neighbourhoods near the middle centre and surrounding it are the most intersecting neighbourhoods in the impact area.
Changes in Land Use and Its Impact on the Hierarchy of Roads in Ramadi City
Authors: Ahmed N A , Mahmood T S
Published: April 2021

Well-consideration should be given to the change in land use since it has a significant impact on the hierarchy of roads in terms of traffic congestion, traffic accidents, and low efficiency of roads as they serve traffic volumes higher than what has been planned for the master plans of cities. Therefore, this research investigates the impact of change in land uses on the hierarchy of roads in Ramadi city by utilizing Geographically Weighted Regression (GWR) in the Geographic Information System (GIS) to analyze the relationship between changes in land uses and road class according to the functional classification system of Ramadi city. The GWR analysis method was adopted because it provides an accurate description of the study area and takes into account the spatial dimension of the phenomenon. It was concluded that all classes of roads (major arterial, minor arterial, collector, and local roads) have a linear relationship with changes in land uses. Moreover, results show that the secondary arterial roads are the most affected by changes in land uses while the local roads are uselessly affected.
Climatic Treatments for Housing in the Traditional Holy Cities: A Comparison between Najaf and Yazd Cities
Authors: Jasim Ihsan A. , Farhan Sabeeh L. , Al-Maliki Laheab A. , AL-Mamoori Sohaib K.
Published: April 2021

The hot, dry environmental conditions prevailing in Al-Najaf and Yazd cities - a modern old problem-must be studied with some detail to come up with new solutions to adapt to the current environmental conditions of the two cities. the research aims to compare the methods used by the residents of Al-Najaf and Yazd cities to handle the hard-environmental conditions in the past and the way to adapt to them. Eight criteria were compared and discussed to investigate the ways and methods to improve the environmental situation in the two cities. The research concluded that there is a great similarity in the environment of the two cities, as well as the environment responding to the treatments that human life adapts. This necessitates the need to preserve the environmental design vocabulary for these two cities (Yazd and Najaf) such as the central courtyard of the aligned residential units to soften the atmosphere within the one unit and increase the family bonding.in addition to preserving the side Shanasheel and local privacy. Yazd city overpass Al-Najaf city by maintaining climate treatments for the historical centre and developing them in line with the development of building methods and construction materials.
Urban Centralization and Its Effect on the Kinetic Nodes of the Passengers in the Path of Transferring Bayaa-Bab Al-Moazam
Authors: Ali K S , Abid N M
Published: April 2021

In urban areas, there are many centres containing activities, events and residents. They may be main or secondary centres. However, there are centres related to urban transport. We also assume that there are urban centres called kinetic nodes that differ from each other along the transport line. In this paper, we aim to identify the causes of the discrepancy between these kinetic nodes. The problem is to find a solution to identify transmission stations that are more important than others along the al-Baya – Bab al-Moazam transport line.
Developing and establishing a geospatial database of the religious endowments in Hilla, Iraq
Authors: Husain Hashim Ali , Zakariya Jasim Oday , Mejbel Salih Mohammed
Published: April 2021

The religious endowments (according to religious and legal contracts) are one of the important sources that acquire historical, cultural and economic importance in all countries of the world. For optimal management of real estate (non-transferable assets) of religious endowments, the proposed study introduces a new technical method for management, and under this method, a geospatial database is constructed: (satellite images, digital maps, and field survey data enhanced with GPS coordinates). Real estate that belongs to a religious institution in Iraq (Shiite endowment in Hilla city) will be investigated as a case study for the proposed research. In this proposed study, methods of statistical and spatial analysis are employed on the spatial database provided by Geographic Information Systems, in order to better manage and invest these properties.
The American Kestrel (Falco sparverius) genoscape: implications for monitoring, management, and subspecies boundaries
Authors: Ruegg Kristen C , Brinkmeyer Michaela , Bossu Christen M , Bay Rachael A , Anderson Eric C , Boal Clint W , Dawson Russell D , Eschenbauch Amber , McClure Christopher J W , Miller Karl E , Morrow Lance , Morrow Jill , Oleyar M David , Ralph Bill , Schulwitz Sarah , Swem Ted , Therrien Jean-Francois , Van Buskirk Rich , Smith Thomas B , Heath Julie A
Published: April 2021

Identifying population genetic structure is useful for inferring evolutionary process and comparing the resulting structure with subspecies boundaries can aid in species management. The American Kestrel (Falco sparverius) is a widespread and highly diverse species with 17 total subspecies, only 2 of which are found north of U.S./Mexico border (F. s. paulus is restricted to southeastern United States, while F. s. sparverius breeds across the remainder of the U.S. and Canadian distribution). In many parts of their U.S. and Canadian range, American Kestrels have been declining, but it has been difficult to interpret demographic trends without a clearer understanding of gene flow among populations. Here we sequence the first American Kestrel genome and scan the genome of 197 individuals from 12 sampling locations across the United States and Canada in order to identify population structure. To validate signatures of population structure and fill in sampling gaps across the U.S. and Canadian range, we screened 192 outlier loci in an additional 376 samples from 34 sampling locations. Overall, our analyses support the existence of 5 genetically distinct populations of American Kestrels—eastern, western, Texas, Florida, and Alaska. Interestingly, we found that while our genome-wide genetic data support the existence of previously described subspecies boundaries in the United States and Canada, genetic differences across the sampled range correlate more with putative migratory phenotypes (resident, long-distance, and short-distance migrants) rather than a priori described subspecies boundaries per se. Based on our results, we suggest the resulting 5 genetically distinct populations serve as the foundation for American Kestrel conservation and management in the face of future threats.
Asynchronous parallel Bayesian optimization for AI-driven cloud laboratories
Authors: Frisby Trevor S , Gong Zhiyun , Langmead Christopher James
Published: April 2021

Motivation

The recent emergence of cloud laboratories—collections of automated wet-lab instruments that are accessed remotely, presents new opportunities to apply Artificial Intelligence and Machine Learning in scientific research. Among these is the challenge of automating the process of optimizing experimental protocols to maximize data quality.

Results

We introduce a new deterministic algorithm, called PaRallel OptimizaTiOn for ClOud Laboratories (PROTOCOL), that improves experimental protocols via asynchronous, parallel Bayesian optimization. The algorithm achieves exponential convergence with respect to simple regret. We demonstrate PROTOCOL in both simulated and real-world cloud labs. In the simulated lab, it outperforms alternative approaches to Bayesian optimization in terms of its ability to find optimal configurations, and the number of experiments required to find the optimum. In the real-world lab, the algorithm makes progress toward the optimal setting.

Data availability and implementation

PROTOCOL is available as both a stand-alone Python library, and as part of a R Shiny application at https://github.com/clangmead/PROTOCOL. Data are available at the same repository.

Supplementary information

Supplementary data are available at Bioinformatics online.
TITAN: T-cell receptor specificity prediction with bimodal attention networks
Authors: Weber Anna , Born Jannis , Rodriguez Martínez María
Published: April 2021

Motivation

The activity of the adaptive immune system is governed by T-cells and their specific T-cell receptors (TCR), which selectively recognize foreign antigens. Recent advances in experimental techniques have enabled sequencing of TCRs and their antigenic targets (epitopes), allowing to research the missing link between TCR sequence and epitope binding specificity. Scarcity of data and a large sequence space make this task challenging, and to date only models limited to a small set of epitopes have achieved good performance. Here, we establish a k-nearest-neighbor (K-NN) classifier as a strong baseline and then propose Tcr epITope bimodal Attention Networks (TITAN), a bimodal neural network that explicitly encodes both TCR sequences and epitopes to enable the independent study of generalization capabilities to unseen TCRs and/or epitopes.

Results

By encoding epitopes at the atomic level with SMILES sequences, we leverage transfer learning and data augmentation to enrich the input data space and boost performance. TITAN achieves high performance in the prediction of specificity of unseen TCRs (ROC-AUC 0.87 in 10-fold CV) and surpasses the results of the current state-of-the-art (ImRex) by a large margin. Notably, our Levenshtein-based K-NN classifier also exhibits competitive performance on unseen TCRs. While the generalization to unseen epitopes remains challenging, we report two major breakthroughs. First, by dissecting the attention heatmaps, we demonstrate that the sparsity of available epitope data favors an implicit treatment of epitopes as classes. This may be a general problem that limits unseen epitope performance for sufficiently complex models. Second, we show that TITAN nevertheless exhibits significantly improved performance on unseen epitopes and is capable of focusing attention on chemically meaningful molecular structures.

Availability and implementation

The code as well as the dataset used in this study is publicly available at https://github.com/PaccMann/TITAN.

Supplementary information

Supplementary data are available at Bioinformatics online.
Efficacy and Safety of Albendazole and High-Dose Ivermectin Coadministration in School-Aged Children Infected With Trichuris trichiura in Honduras: A Randomized Controlled Trial
Authors: Matamoros Gabriela , Sánchez Ana , Gabrie José Antonio , Juárez Marisa , Ceballos Laura , Escalada Andrés , Rodríguez Carol , Martí-Soler Helena , Rueda María Mercedes , Canales Maritza , Lanusse Carlos , Cajal Pamela , Álvarez Luis , Cimino Rubén O , Krolewiecki Alejandro
Published: April 2021

Background

The efficacy of currently available anthelminthics against Trichuris trichiura infections is significatively lower than for other soil-transmitted helminths. The combination of ivermectin (IVM) and albendazole (ALB) has shown significant improvements in efficacy.

Methods

Safety and efficacy randomized controlled clinical trial comparing 3 experimental regimens against ALB monotherapy for the treatment of T. trichiura infections in northern Honduras. Infected children were randomized to 4 treatment arms: arm 1, single-dose ALB (400 mg); arm 2, single-dose ALB (400 mg) plus IVM (600 μg/kg); arm 3, ALB (400 mg) for 3 consecutive days; or arm 4, ALB (400 mg) plus IVM (600 μg/kg) for 3 consecutive days. Efficacy was measured based on the egg reduction and cure rates, both assessed 14–21 days after treatment, using the Kato-Katz method. Safety was evaluated by analyzing the frequency and severity of adverse events.

Results

Of 176 children randomized to 1 of the 4 treatment arms, 117 completed treatment and follow-up. The egg reduction rates for arms 1, 2, 3, and 4 were 47.7%, 96.7%, 72.1%, and 100%, respectively; with P values <.001 for comparisons between IVM groups and ALB-only arms. The cure rates were 4.2%, 88.6%, 33.3%, and 100%, respectively. A total of 48 adverse events (85.4% mild) were reported in 36 children.

Conclusions

The combined use of ALB and high-dose IVM is a highly effective and well tolerated treatment for the treatment of T. trichiura infections, offering significantly improved treatment for the control of this infection.

Clinical Trials Registration

NCT04041453.
Reorganization of chromatin architecture during prenatal development of porcine skeletal muscle
Authors: Yuan Renqiang , Zhang Jiaman , Wang Yujie , Zhu Xingxing , Hu Silu , Zeng Jianhua , Liang Feng , Tang Qianzi , Chen Yaosheng , Chen Luxi , Zhu Wei , Li Mingzhou , Mo Delin
Published: April 2021

Myofibres (primary and secondary myofibre) are the basic structure of muscle and the determinant of muscle mass. To explore the skeletal muscle developmental processes from primary myofibres to secondary myofibres in pigs, we conducted an integrative three-dimensional structure of genome and transcriptomic characterization of longissimus dorsi muscle of pig from primary myofibre formation stage [embryonic Day 35 (E35)] to secondary myofibre formation stage (E80). In the hierarchical genomic structure, we found that 11.43% of genome switched compartment A/B status, 14.53% of topologically associating domains are changed intradomain interactions (D-scores) and 2,730 genes with differential promoter–enhancer interactions and (or) enhancer activity from E35 to E80. The alterations of genome architecture were found to correlate with expression of genes that play significant roles in neuromuscular junction, embryonic morphogenesis, skeletal muscle development or metabolism, typically, NEFL, MuSK, SLN, Mef2D and GCK. Significantly, Sox6 and MATN2 play important roles in the process of primary to secondary myofibres formation and increase the regulatory potential score and genes expression in it. In brief, we reveal the genomic reorganization from E35 to E80 and construct genome-wide high-resolution interaction maps that provide a resource for studying long-range control of gene expression from E35 to E80.
Impact of the implantation of one MitraClip on the mitral valve anatomy: NTR vs. XTR
Authors: Kassar M
Published: April 2021

Funding Acknowledgements

Type of funding sources: None.

Introduction

Percutaneous mitral repair using MitraClips (MC) for severe symptomatic regurgitation (MR) has emerge as an alternative treatment for selected high risk surgical patients. Despite the high number of cases treated with both iterations of the MC, the small NTR and the big XTR, the impact of the device size on the mitral valve area (MVA), the morphology of the annulus, the severity of the MR and the use of multiple device is still unknown.

Methods

High quality volume focused on the MV were acquired during each intervention. Using a dedicated 3-D analysis software the dimensions of the annulus, the MVA and the 3-D vena contracta area (VCA) were evaluated before and after clipping. After implantation, the area of both orifices were measured independently and summed.

Results

A total of 120 patients were included, 63 received a NTR and 57 a XTR. Before clipping, XTR cases had bigger MVA (5.9+/-1.7 vs. 4.9+/-1.3 cm2, p .001), a trend toward bigger VCA (0.56+/-0.7 vs. 0.51+/-0.9 cm2, p .073) and no difference in the anteroposterior (AP, 3.5 [3.1-4] vs. 3.5 [3.3-3.8] cm, p .47) and the lateromedial (LM, 4.2 [3.8-4.5] vs. 4.3 [4.0-4.5] cm) diameter of the annulus compared to NTR cases. One MC implantation produced a significant decrease of all these parameters but only MVA was significantly more reduce by XTR (Figure 1). The patients receiving a NTR as first MC did not need more often a second clip (31/63 vs. 26/57, p .072).

Conclusions

On average, both devices produce a MVA reduction of more than 50% and an indirect annuloplasty mainly in the anteroposterior direction. The use of an XTR as first MC do not decrease the probability of the necessity of a second one. All these parameters should be carefully taken into account when defining the implantation strategy. Abstract Figure.
Impact of various types of microvascular injury on area at risk in patients with primary myocardial infarction with ST segment elevation (STEMI)
Authors: Alekseeva Y , Vyshlov EV , Mochula OV , Ussov VY , Markov VA , Ryabov VV
Published: April 2021

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Grants Council of the Russian President for state support of young Russian scientists and state support of leading scientific schools of the Russian Federation

CMR can quantify the area at risk (AAR). It includes both salvaged and infarcted myocardium. Furthermore, CMR permits to determine with high sensitivity the presence of microvascular injury phenomena: intramyocardial haemorrhage (IMH) and microvascular obstruction (MVO) in patients with STEMI. There is not enough known about the relation of AAR and different types of microvascular injury.

Aim. To analyze the correlation between the risk zone and the phenomena of microvascular injury in patients with primary STEMI .

Materials and methods. The study included 60 patients with primary STEMI, admitted within the first 12 hours after the onset of disease, who underwent stenting of the infarct-associated coronary artery. Exclusion criteria: pulmonary edema, cardiogenic shock, estimated glomerular filtration rate <30 mL/min/1,73 m2 or dialysis, severe comorbidity, acute psychotic disorders and inability to undergo or contra-indications for CMR. Each patient included in the study underwent CMR imaging at day 2 post-STEMI. The AAR extent was quantified on short-axis T2-STIR images. MVO and IMH were assessed using late gadolinium enhancement and T2-weighted CMR imaging.

Results. It was demonstrated that the AAR occupies 12% (7,8-17,7%) of the total myocardium. Evidence of microvascular injury phenomena was present in 41 patients (68.3%), the combination of MVO and IMH - in 22 patients (36.6%). The isolated IMH phenomenon was visualized in 9 patients (15%). The isolated MVO phenomenon was visualized in 10 patients (16,7%). Relation between of size of ARR, MVO and IMH areas is demonstrated in Table 1. A comparison study showed that the ARR was larger in patients a combination of IMH and MVO. Patients with isolated IMH and isolated MVO had an ARR similar with to a group without microvascular injury. Correlation analysis showed a moderate direct correlation between the IMH and MVO sizes, and ARR (R = 0,42; p = 0,0007 and R = 0,55, p = 0,000004). 

Conclusions. The analysis of the influence of different microvascular injury phenotypes on the ARR of the myocardium as assessed by CMR in the early postinfarction period in patients with primary STEMI has shown that the combination of IMH with MVO associate with a large ARR. Correlations between the IMH and MVO sizes and increased ARR have been demonstrated. Table 1. CMR parametersArea at risk, %No phenomena MVO and IMH, n = 198,1 (5-17)Isolated MVO, n = 1010,1 (9-13)Isolated IMH, n = 911 (8-12)Combination of IMH and MVO, n = 2217,3 (10-27)
Major impact of left auricular cardiopathy when associated to supraventricular ectopy?
Authors: Marques Pires C , Silva AR , Medeiros P , Campos I , Oliveira C , Flores R , Mane F , Carvalho FM , Santos M , Alves JN , Rocha S , Antunes N , Marques J , Pinho J , Ferreira C
Published: April 2021

Funding Acknowledgements

Type of funding sources: None.

INTRODUCTION

Left atrial cardiopathy (LAC) is an independent predictor of atrial fibrillation (FA) and embolic stroke. It is more frequent in patients with embolic stroke of undetermined source (ESUS) than in non-embolic strokes. The current definition doesn’t include supraventricular ectopy.

AIM

The aim of this work was to describe the importance of LAC in ESUS and to study the impact of adding the number of atrial premature complexes per hour (APC/h) to LAC criteria.

METHODS

Retrospective analysis of 123 ESUS patients (pts) admitted to Neurology service from 2014 to 2019.

LAC was defined according to two criteria (LAC2: severe left atrial enlargement or p-wave terminal force in lead V1 [PTFV1] >5000 µV*ms) or 3 criteria (LAC3: additionally, >30 APC/h).

Survival analysis for the occurrence of AF, stroke recurrence and death according to LAC2 and LAC3. Diagnostic test performance analysis for each criterion with ROC curves.

RESULTS

43 (35%) of the ESUS pts had LAC2.

Pts with LAC2 (35.0%) were older (p = 0.007), more frequently had hypertension (p = 0.004) and lower total cholesterol levels (p = 0.044) than patients without LAC2.

The incidence of AF (median follow-up 21 months, IQR = 9-35) was higher both in LAC2 (p = 0.038) and LAC3 (p = 0.001).

There were no differences in stroke recurrence or death between patients with or without LAC2 or 3.

Among the 3 atrial dysfunction criteria included in LAC3 definition, the number of APC/h was associated with a higher area under the curve for the occurrence of AF (AUC = 0.822).

Cox regression revealed that PTFV1 > 5000 µV·ms (HR = 5.12, IC95%=1.28-20.56, p = 0.021) and >30 APC/h (HR = 13.02, IC95%=3.57-47.56) were independent predictors of AF.

In addition, the single predictor of the composite endpoint (occurrence of AF, stroke recurrence and death) was >30 APC/h (HR = 5.2, p < 0,001).

CONCLUSION

In ESUS pts, the subgroup with LAC2 had different clinical characteristics and a higher AF incidence.

APC/h were also independently associated with AF incidence and had better diagnostic test performance than the other criteria.

In sum, APC/h inclusion as a diagnostic criterion for LAC should be considered and may help in a better therapeutic approach.
Association of SCN5A gene polymorphism with dilated cardiomyopathy
Authors: Chernova A , Nikulina SY , Kuznecova OO
Published: April 2021

Funding Acknowledgements

Type of funding sources: Public Institution(s). Main funding source(s): Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Aim. To evaluate the Association of rs1805124 polymorphism of the SCN5A gene with dilated idiopathic cardiomyopathy (DCMP) and myocardial dilation of ischemic origin (DMI).

Subjects and methods. The study included patients with ICMP and MD IG in the number of 221 people. The average age of the subjects was in the range of 55.30 ± 9.69 years.

We divided the patients into 2 groups: the first – patients diagnosed with idiopathic dilatation cardiomyopathy and the second-patients with myocardial dilatation of ichemic origin. The number of patients in the first group was 111, including 99 men (89.2%) and 12 women (10.8%). The average age of patients in this group is 51.73 ± 9.74 years, in men 51.00 ± 8.96 years, in women 57.75 ± 3.71 years.

The second group included patients with myocardial dilatation of ischemic origin. Their number is 110 people, including 100 men (91.5%) and 10 women (8.5%). The average age of respondents is 58.68 ± 8.38 years, for men 58.29 ± 8.46 years, for women 62.90 ± 6.29 years.

The control group included patients who had no manifestations of cardiovascular diseases. Their number is 121 people (average age 53.6 ± 4.8 years).

The patients underwent laboratory and instrumental studies, as well as molecular and genetic studies of the A/G polymorphism of the SCN5A gene (rs 1805124). All patients underwent coronary angiography. Based on the anamnesis data and instrumental studies, those patients who could be said to have no risk factors for the development of dilatation of the heart cavities were identified in the first group. And those patients who were reliably diagnosed with CHD were in the second group, that is, dilatation of the heart cavities is due to a previous myocardial infarction, existing angina pectoris.

Results. In the group with DCMP 51.4% of patients were carriers of the common homozygous AA genotype, the heterozygous AG genotype-40.5%, and the rare homozygous GG genotype-8.1%. In the control group 63.3% of patients were identified as carriers of a homozygous genotype by a common allele, and 33.5% were carriers heterozygous genotype, and homozygous genotype for a rare allele – 3.2%. The analysis revealed a statistically significant decrease in the frequency of carrying the homozygous AA genotype in patients with DCMP compared to the control group of the rs1805124 polymorphism of the SCN5A gene. In the group with DM IG, there was no association with the rs1805124 polymorphism of the SCN5A gene.

Conclusion. A statistically significant Association of rs1805124 of the SCN5A gene with DCMP was found. The Association of DM IG c rs1805124 could not be confirmed.
Flow manipulation and the association with myocardial contractility during extracorporeal life support (FLAME)
Authors: Ma SKT , Sin WC , Ngai CW , Wong ASK , Chan WM , Ng PY
Published: April 2021

Funding Acknowledgements

Type of funding sources: None.

Background

Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is an advanced technique in extracorporeal life support (ECLS) used to support extreme circulatory failure including patients with cardiac arrest and cardiogenic shock refractory to conventional support. It is a long-standing belief that peripheral V-A ECMO poses increased afterload to the inured heart, but conventional echocardiographic measurements are often insensitive in detecting subtle changes in loading conditions.

Purpose

This study aimed to evaluate the effects of varying blood flow during peripheral V-A ECMO on intrinsic myocardial contractility, using detailed echocardiographic assessment including speckle tracking echocardiography (STE).

Methods

Adult patients with acute cardiogenic shock who were supported by peripheral V-A ECMO from April 2019 to September 2020 were recruited. Serial hemodynamic and cardiac performance parameters were measured by transthoracic echocardiogram (TTE) within 48 hours after implementation of V-A ECMO, at different levels of extracorporeal blood flow – 100%, 120% and 50% of target blood flow (TBF).

Results

A total of 30 patients were included. 22 (71%) were male, and the mean (SD) age was 54 (13) years. The major indications for V-A ECMO were myocardial infarction (19, 63% patients), and myocarditis (5, 17%). With a decrease in extracorporeal blood flow from 100% to 50% of TBF, mean arterial pressure (MAP) dropped from 76+/-3 to 64+/-3mmHg (p <0.001), and cardiac index (CI) increased from 0.89+/-0.13 to 1.27+/-0.18L/min/m2 (p < 0.001). All indices of left ventricular contractility improved at a lower extracorporeal blood flow: the myocardial contractility measured by global longitudinal peak systolic strain (GLPSS) improved from -3+/-0.7% to -5+/-0.8% (p < 0.001); left ventricular ejection fraction (LVEF) increased from 21.5+/-2.6% to 30.9+/-2.7% (p < 0.001) and 19.7+/-3.1% to 28.4+/-3.2% (p < 0.001) by biplane and linear methods, respectively; left ventricular index of myocardial performance (LIMP) improved from 1.51+/-0.12 to 1.03+/-0.09 (p < 0.001). Similar findings were reproduced when comparing left ventricular contractility at extracorporeal blood flows of 120% and 50% of TBF.

Conclusions

The ECMO blood flow rate in peripheral V-A ECMO is inversely related to myocardial contractility, and is quantifiable by myocardial strain measured by STE.
Comparison between ultrafiltration and loop diuretics to neurohormonal and kidney parameters in cardiorenal syndrome type 1: a meta-analysis of randomized controlled trials
Authors: Putra BP , Putra FN
Published: April 2021

Funding Acknowledgements

Type of funding sources: None.

Introduction

Acute heart failure can affect the kidney, which is known as cardiorenal syndrome (CRS) type 1 that may worsen renal function and increase mortality. Ultrafiltration (UF) and loop diuretics are CRS type 1 treatment modalities mainly in improving congestion. Renin-angiotensin-aldosterone system (RAAS) is one of the key role mechanisms in type-1 CRS patients. Previous studies showed inconclusive neurohormonal and kidney parameters outcome comparisons between UF and loop diuretics in type-1 CRS patients.

Purpose

This study has the purpose to compare the effect of UF and loop diuretics to neurohormonal and renal parameters in type-1 CRS patients.

Methods

We did comprehensive searching using predefined keywords in online databases of Pubmed, ScienceDirect, EMBASE, and The Cochrane Library to screen all relevant literature until November 2020. We included all randomized controlled trials (RCTs) that compared the neurohormonal and renal parameters between UF and loop diuretics in type-1 CRS patients, not on chronic dialysis therapy and have serum creatinine (SCr) below 3 mg/dL. The neurohormonal parameters analysed in this study are changes of N-terminal pro-brain natriuretic peptide (NT-proBNP), plasma renin activity (PRA), and serum aldosterone, while the renal parameters analysed are changes of SCr, Cystatin-C, and dialysis dependency. We used Cochrane Risk-of-bias tools for accessing bias risk. We performed analysis to provide standard mean difference (SMD) for laboratory parameters and risk ratio (RR) for dialysis dependency with 95% confidence interval (CI) using fixed-effect heterogeneity test.

Results

We included 11 RCTs met our inclusion criteria. The UF groups showed more NT-proBNP decline compared with the diuretics groups although not statistically significant (SMD = -0.02, 95% CI -0.22 to 0.17, p = 0.80, I²=0%). The UF group showed RAAS activity increment, which are significantly difference in PRA (SMD = 0.38, 95% CI 0.12 to 0.63, p = 0.004, I²=54%) but no significance in aldosterone change (SMD = 0.09, 95% CI -0.17 to 0.34, p = 0.50, I²=0%). Surprisingly, the UF group tends to have incremental dialysis dependency risk although not statistically significant (pooled RR = 1.28, 95% CI 0.73 to 2.26, p = 0.39, I²=0%). The diuretics group shows more significant SCr improvement (SMD = 0.23, 95% CI 0.08 to 0.38, p = 0.003, I²=41%), yet no significance Cystatin-C improvement (SMD = 0.21, 95% CI -0.02 to 0.43, p = 0.07, I²=0%).

Conclusions

There is no significant difference between ultrafiltration and loop diuretics to neurohormonal and kidney parameters change in type-1 CRS patients although loop diuretics administration shows more benefits. However, further trials are needed to establish the comparison.
Alternative methods to assess cardiac index: different parameters for physicians when swan-ganz catheter is not available
Authors: Cimatti A , Blanco M , Mrad S , Cohen Arazi H , Iamevo R
Published: April 2021

Funding Acknowledgements

Type of funding sources: Private hospital(s). Main funding source(s): Sanatorium Mitre

Introduction

invasive hemodynamic monitoring with Swan-Ganz catheter (SGC) has been the gold standard to determine the cardiac index. However, in many centres is not always available, and the Fick method is also validated for that purpose, but without the same accuracy. There are other used laboratory parameters; nonetheless there is lack of evidence about its association with the cardiac index. We aim to describe the association between these parameters and the patient"s hemodynamic condition. 

Objectives

to assess the association between hemodynamic parameters obtained by SGC and data obtained with a jugular central venous catheter, in critically ill cardiac patients hospitalised in the Intensive Care Unit. 

Methods

prospective, double-blind, observational study, conducted from September 2019 to November 2020. A total of 45 patients with SGC were enrolled. We measured cardiac output and cardiac index (by thermodilution method and Fick estimated method), other hemodynamic parameters, lactic acid, central venous oxygen saturation (CVO2) and venous-to-arterial carbon dioxide difference (VACO2). The variables were analysed with t-test, Wilcoxon and chi2, as appropriate. Statistical significance was assumed when p was less than .05.

Results

we analysed 45 patients (mean age 58 years; 87% men; 23% postoperative cardiac surgery subjects; mean ejection fraction 30%). We registered a 6% in-hospital mortality and the mean in-hospital stay was 19 days (IQR 25-75: 8-25). We observed a significative correlation between impaired cardiac index (≤2.2 L/min/m2) obtained by SGC and Fick method (r 0.43; p= .0041). Elevated lactic acid and reduced CVO2 were not well correlated with impaired cardiac index (r 0.51, CI 95%: 0.32-0.71; r 0.30, CI 95%: 0.13-0.48; respectively). Among patients with impaired cardiac index, all of them had a VACO2 over 7 mmHg. The c-statistic to predict impaired cardiac index using VACO2 over 7 mmHg was 0.66 (CI 95%: 0.48-0.84), correlation not observed for the CVO2 values. Elevated lactic acid (≤1.9 mmol/L) was only associated with noradrenaline infusion over 0.7 g/kg/min (c-statistic 0.55; p= .0002).

Conclusions

when invasive hemodynamic monitoring with SGC is not available, the VACO2 value over 7 mmHg (obtained with a central venous catheter) appeared to be a better predictor of impaired cardiac index than the determination of CVO2. The Fick method was an acceptable replacement of the invasive monitoring. Also, noradrenaline infusion over 0.7 g/kg/min, but not cardiac index or other laboratory parameters, showed a better correlation with elevated lactic acid.