bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stenotic double‐orifice mitral valve after surgical repaired partial atrioventricular septal defect
Authors: Duran Karaduman Bilge , Torun Ayşe Nur , Ayhan Hüseyin , Keleş Telat , Bozkurt Engin 
Published: June 2020

AbstractDouble‐orifice mitral valve (DOMV) is an uncommon congenital anomaly account for 1% of congenital heart disease. However, accurate diagnosis and evaluation of valve stenosis or regurgitation and other concomitant congenital anomalies due to DOMV are required to obtain suitable treatment. Two‐ and three‐dimensional echocardiography can contribute valuable functional and anatomic information that can support to reach this goal. Here, we present a case of complete bridge‐type DOMV that causes mitral stenosis after surgical repair of the partial atrioventricular septal defect in childhood.
Impact of inferior caval valve implantation on severity of tricuspid regurgitation and right heart function
Authors: Mattig Isabel , Knebel Fabian , Hewing Bernd , Stangl Verena , Stangl Karl , Laule Michael , Dreger Henryk 
Published: June 2020

AimsSevere tricuspid regurgitation (TR) is a common finding in heart failure patients and associated with increased mortality. New interventional therapeutic options are needed as many heart failure patients are unfit for surgery. The TRICAVAL study compared valve implantation into the inferior vena cava (CAVI) with optimal medical therapy (OMT) in patients with severe TR. Here, we report details on the impact of CAVI on TR severity as well as right heart function and morphology.Methods and resultsWe randomized 28 patients with severe TR to CAVI (n = 14) with transfemoral implantation of an Edwards Sapien XT valve into the inferior vena cava or OMT (n = 14). Inclusion and exclusion criteria were based on anatomical and clinical parameters. Echocardiographic measurements were performed at baseline, at the first postoperative day and one, three, and twelve months after randomization. As proof of concept of an effective sealing of the inferior vena cava, we detected a significant decrease in systolic hepatic vein reflux volume (11.0 [6.2–21.9] mL vs 3.5 [0.6–8.5] mL, P = .016) and hepatic vein diameter (11.5 [10.0–14.8] mm vs 10.0 [9.3–11.8] mm, P = .034) at thirty‐day follow‐up. However, CAVI had no significant impact on TR, cardiac function, and morphology.ConclusionsCaval valve implantation significantly reduced systolic reflux into the hepatic veins but was not associated with an improvement in cardiac function, morphology, or TR severity.
Mitral annular plane systolic excursion and tricuspid annular plane systolic excursion for risk stratification of acute pulmonary embolism
Authors: Matos Jason D. , Balachandran Isabel , Heidinger Benedikt H. , Mohebali Donya , Feldman Stephanie A. , McCormick Ian , Litmanovich Diana , Manning Warren J. , Carroll Brett J. 
Published: June 2020

AbstractIntroductionRisk stratification for acute pulmonary embolism (PE) incorporates metrics of right ventricle (RV) function. Significant RV dysfunction influences left ventricular (LV) function, though LV function metrics are not utilized for stratifying outcomes in patients with PE. Mitral annular plane systolic excursion (MAPSE) is a linear echocardiographic (TTE) measure that evaluates longitudinal LV function and may aid in risk stratification for acute PE.MethodsUsing a single‐center database of patients with PE from 2007 to 2014, MAPSE was calculated for all TTE’s available with sufficient quality (n = 362). A MAPSE of ≥11 mm was used as a normal reference. Thirty‐day adverse outcomes were defined as administration of vasopressor, fibrinolytic therapy, open embolectomy, or 30‐day PE‐related mortality. Odds ratios (OR) and adjusted OR (AOR) were calculated using logistic regression analysis. Tricuspid annular plane systolic excursion (TAPSE) measurements were incorporated to determine the additive benefit of MAPSE.ResultsCompared with the reference MAPSE ≥ 11 mm and LVEF > 50%, patients with MAPSE < 11 mm and an LVEF > 50% had worse outcomes (AOR 2.94 [95% CI: 1.08–7.98], P = 0.035). Among patients with LVEF > 50%, the presence of both a MAPSE < 11 mm and TAPSE < 16 mm was associated with greater odds of adverse outcomes compared with isolated depressed TAPSE (AOR 10.75 [95% CI: 3.06–37.8], P < 0.01 vs AOR 1.68 [95% CI: 0.18–15.6], P = 0.65).ConclusionA depressed MAPSE, in patients with preserved LVEF, is associated with worse outcomes in patients with acute PE. The addition of MAPSE to TAPSE appears to have a greater prognostic value than either alone and may further aid in risk stratification, but for confirmation further prospective data are needed.
High mortality in COVID‐19 patients with mild respiratory disease
Authors: Masetti Chiara , Generali Elena , Colapietro Francesca , Voza Antonio , Cecconi Maurizio , Messina Antonio , Omodei Paolo , Angelini Claudio , Ciccarelli Michele , Badalamenti Salvatore , Canonica G. Walter , Lleo Ana , Aghemo Alessio ,   the for the Humanitas Covid‐19 Task Force
Published: June 2020

AbstractIntroductionSevere acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has infected 189 000 people in Italy, with more than 25 000 deaths. Several predictive factors of mortality have been identified; however, none has been validated in patients presenting with mild disease.MethodsPatients with a diagnosis of interstitial pneumonia caused by SARS‐CoV‐2, presenting with mild symptoms, and requiring hospitalization in a non‐intensive care unit with known discharge status were prospectively collected and retrospectively analysed. Demographical, clinical and biochemical parameters were recorded, as need for non‐invasive mechanical ventilation and admission in intensive care unit. Univariate and multivariate logistic regression analyses were used to identify independent predictors of death.ResultsBetween 28 February and 10 April 2020, 229 consecutive patients were included in the study cohort; the majority were males with a mean age of 60 years. 54% of patients had at least one comorbidity, with hypertension being the most commonly represented, followed by diabetes mellitus. 196 patients were discharged after a mean of 9 days, while 14.4% died during hospitalization because of respiratory failure. Age higher than 75 years, low platelet count (<150 × 103/mm3) and higher ferritin levels (>750 ng/mL) were independent predictors of death. Comorbidities were not independently associated with in‐hospital mortality.ConclusionsIn‐hospital mortality of patients with COVID‐19 presenting with mild symptoms is high and is associated with older age, platelet count and ferritin levels. Identifying early predictors of outcome can be useful in the clinical practice to better stratify and manage patients with COVID‐19.
Short‐term anticoagulation after acute cardioversion of early‐onset atrial fibrillation
Authors: Saglietto Andrea , De Ferrari Gaetano Maria , Gaita Fiorenzo , Anselmino Matteo 
Published: June 2020

AbstractBackgroundControversy exists regarding anticoagulation management following acute cardioversion in patients with early‐onset (<48 hours) atrial fibrillation without class I guideline indication for long‐term oral anticoagulation (CHA2DS2‐VASc 0‐1).Methods and resultsA random‐effect meta‐analysis of observational studies reporting 30‐day incidence of thromboembolic complications after cardioversion without post‐procedural oral anticoagulation therapy in patients at low‐moderate thromboembolic risk (CHA2DS2‐VASc 0‐1) was performed. Four studies were included, encompassing 3276 cardioversions. The analysis revealed that the pooled risk of 30‐day incidence of thromboembolic complications in this subset of patients is low (0.10%, 95% confidence interval: 0.00%‐0.30%).ConclusionsGiven these data, considering the bleeding risk unavoidably conferred by OAT, which is known to be higher in the first month from treatment onset, short‐term anticoagulation limited to 4 weeks post‐cardioversion of early‐onset (<48 hours) atrial fibrillation in patients with low‐moderate risk of stroke (CHA2DS2‐VASc 0‐1) may be omitted, at least in patients with high‐bleeding risk.
Impact of atrial fibrillation in critically ill patients admitted to a stepdown unit
Authors: Falsetti Lorenzo , Proietti Marco , Zaccone Vincenzo , Guerra Federico , Nitti Cinzia , Salvi Aldo , Viticchi Giovanna , Riccomi Francesca , Sampaolesi Mattia , Silvestrini Mauro , Moroncini Gianluca , Lip Gregory Y. H. , Capucci Alessandro 
Published: June 2020

AbstractBackgroundLimited data are available on the clinical course of patients with history of atrial fibrillation (AF) when admitted in an intensive care environment. We aimed to describe the occurrence of major adverse events in AF patients admitted to a stepdown care unit (SDU) and to analyse clinical factors associated with outcomes, impact of dicumarolic oral anticoagulant (OAC) therapy impact and performance of clinical risk scores in this setting.Materials and methodsSingle‐centre, observational retrospective analysis on a population of subjects with AF history admitted to a SDU. Therapeutic failure (composite of transfer to ICU or death) was considered the main study outcome. Occurrence of stroke and major bleeding (MH) was considered as secondary outcomes. The performance of clinical risk scores was evaluated.ResultsA total of 1430 consecutive patients were enrolled. 194 (13.6%) reported the main outcome. Using multivariate logistic regression, age (odds ratio [OR]: 1.03, 95% confidence interval [CI]: 1.01‐1.05), acute coronary syndrome (OR:3.10, 95% CI: 1.88‐5.12), cardiogenic shock (OR:10.06, 95% CI: 5.37‐18.84), septic shock (OR:5.19,95%CI:3.29‐18.84), acute respiratory failure (OR:2.49, 95% CI: 1.67‐3.64) and OAC use (OR: 1.61, 95% CI: 1.02‐2.55) were independently associated with main outcome. OAC prescription was associated with stroke risk reduction and to both MH and main outcome risk increase. CHA2DS2‐VASc (c‐index: 0.545, P = .117 for stroke) and HAS‐BLED (c‐index:0.503, P = .900 for MH) did not significantly predict events occurrence.ConclusionsIn critically ill AF patients admitted to a SDU, adverse outcomes are highly prevalent. OAC use is associated to an increased risk of therapeutic failure, clinical scores seem unhelpful in predicting stroke and MH, suggesting a highly individualized approach in AF management in this setting.
Impact of adrenomedullin levels on clinical risk stratification and outcome in subarachnoid haemorrhage
Authors: Gracia Arnillas Maria Pilar , Alvarez‐Lerma Francisco , Masclans Jose‐Ramón , Roquer Jaume , Soriano Carolina , Manzano Demian , Zapatero Ans , Diaz Yolanda , Duran Xavi , Castellví Andrea , Cuadrado Elisa , Ois Angel 
Published: June 2020

AbstractPurposeTo use classification tree analysis to identify risk factors for nonsurvival in a neurological patients with subarachnoid haemorrhage (SAH) and to propose a clinical model for predicting of mortality.MethodsProspective study of SAH admitted to a Critical Care Department and Stroke Unit over a 2‐year period. Middle region of pro‐ADM plasma levels (MR‐proADM) was measured in EDTA plasma within the first 24 hours of hospital admission using the automatic immunofluorescence test. A regression tree was made to identify prognostic models for the development of mortality at 90 days.ResultsNinety patients were included. The mean MR‐proADM plasma value in the samples analysed was 0.78 ± 0.41 nmol/L. MR‐proADM plasma levels were significantly associated with mortality at 90 days (1.05 ± 0.51 nmol/L vs 0.64 ± 0.25 nmol/L; P < .001). Regression tree analysis provided an algorithm based on the combined use of clinical variables and one biomarker allowing accurate mortality discrimination of three distinct subgroups with high risk of 90‐day mortality ranged from 75% to 100% (AUC 0.9; 95% CI 0.83‐0.98).ConclusionsThe study established a model (APACHE II, MR‐proADM and Hunt&Hess) to predict fatal outcomes in patients with SAH. The proposed decision‐making algorithm may help identify patients with a high risk of mortality.
Multi‐parametric system for risk stratification in mitral regurgitation: A multi‐task Gaussian prediction approach
Authors: Tse Gary , Zhou Jiandong , Lee Sharen , Liu Yingzhi , Leung Keith Sai Kit , Lai Rachel Wing Chuen , Burtman Anthony , Wilson Carly , Liu Tong , Li Ka Hou Christien , Lakhani Ishan , Zhang Qingpeng 
Published: June 2020

AbstractBackgroundWe hypothesized that a multi‐parametric approach incorporating medical comorbidity information, electrocardiographic P‐wave indices, echocardiographic assessment, neutrophil‐to‐lymphocyte ratio (NLR) and prognostic nutritional index (PNI) calculated from laboratory data can improve risk stratification in mitral regurgitation (MR).MethodsPatients diagnosed with mitral regurgitation between 1 March 2005 and 30 October 2018 from a single centre were retrospectively analysed. Outcomes analysed were incident atrial fibrillation (AF), transient ischemic attack (TIA)/stroke and mortality.ResultsThis study cohort included 706 patients, of whom 171 had normal inter‐atrial conduction, 257 had inter‐atrial block (IAB) and 266 had AF at baseline. Logistic regression analysis showed that age, hypertension and mean P‐wave duration (PWD) were significant predictors of new‐onset AF. Low left ventricular ejection fraction (LVEF), abnormal P‐wave terminal force in V1 (PTFV1) predicted TIA/stroke. Age, smoking, hypertension, diabetes mellitus, hypercholesterolaemia, ischemic heart disease, secondary mitral regurgitation, urea, creatinine, NLR, PNI, left atrial diameter (LAD), left ventricular end‐diastolic dimension, LVEF, pulmonary arterial systolic pressure, IAB, baseline AF and heart failure predicted all‐cause mortality. A multi‐task Gaussian process learning model demonstrated significant improvement in risk stratification compared to logistic regression and a decision tree method.ConclusionsA multi‐parametric approach incorporating multi‐modality clinical data improves risk stratification in mitral regurgitation. Multi‐task machine learning can significantly improve overall risk stratification performance.
Environmental persistence of equid herpesvirus type‐1
Authors: Saklou Nadia T. , Burgess Brandy A. , Ashton Laura V. , Morley Paul S. , Goehring Lutz S. 
Published: June 2020

AbstractBackgroundEquid herpesvirus type 1 (EHV‐1) is ubiquitous in equine populations causing respiratory disease, and complications including late‐term abortion and neurological disease. Eradication of EHV‐1 from housing environments that typically contain unsealed wood and porous bedding materials can be challenging. However, consideration should be given to take advantage of the viral envelope's susceptibility to environmental conditions.ObjectiveTo determine environmental persistence of EHV‐1 on materials and in environmental conditions commonly found in equine facilities. We hypothesised that environmental conditions and materials would limit environmental persistence of EHV‐1 in horse housing environments.Study designExperimental study.MethodsStandard inoculum of EHV‐1 strain OH03 was applied to leather, polyester‐cotton fabric, two bedding materials (pinewood shavings and wheat straw) and polystyrene (plastic), and placed under three different environmental conditions (4°C, indoors and outdoors). Virus titration and quantitative PCR (qPCR) were performed at six time points between 0 and 48 hours and the number of plaque‐forming units (PFUs) was determined.ResultsViable EHV‐1 was recovered up to 48 hours from all material‐environmental condition combinations, with persistence decreasing over time. In general, outdoor environment had the greatest impact, irrespective of material tested, followed by indoor environment and 4°C. On average, wood shavings had the greatest impact on persistence, followed by leather, straw, fabric and polystyrene.Main limitationsThe inoculum used in this study was not in a milieu consistent with nasal secretions. As such, virus particles may have been more sensitive to the materials and/or environmental conditions evaluated.ConclusionsEnvironmental factors had variable effects on environmental persistence. Although there were significant reductions in PFUs within the first 3 hours, irrespective of environment‐material evaluated, viable virus was still recovered at 48 hours likely representing a transmission risk. Barrier precautions should be used to prevent spread of EHV‐1 from unrecognised environmental reservoirs.
Phosphorylation status of BolA affects its role in transcription and biofilm development
Authors: Galego Lisete , Barahona Susana , Romão Célia V. , Arraiano Cecília M. 
Published: June 2020

BolA has been characterized as an important transcriptional regulator, which is induced in stationary phase of growth, and in response to several stresses. In Escherichia coli, its cellular function is associated with cell wall synthesis and division, morphology, permeability, motility and biofilm formation. Phosphorylation has been widely described as one of the most important events involved in the modulation of the activity of many transcription factors. In the present work, we have demonstrated in vivo and by mass spectrometry that BolA is phosphorylated in four highly conserved protein positions: S26, S45, T81 and S95. S95 is located in the C terminus unstructured region of the protein, and the other three sites are in the DNA‐binding domain. These positions were mutated to nonphosphorylated residues, and their effects were investigated on different known BolA functions. Using northern blot experiments, we showed that the regulation of the expression of these Ser/Thr BolA mutants is performed at the post‐translational level. Western blot results revealed that the stability/turnover of the mutated BolA proteins is differently affected depending on the dephosphorylated residue. Moreover, we provide evidences that phosphorylation events are crucial in the modulation of BolA activity as a transcription factor and as a regulator of cell morphology and biofilm development. Here, we propose that phosphorylation affects BolA downstream functions and discuss the possible significance of these phosphoresidues in the protein structure, stability, dimerization and function as a transcription factor.
Legacy of Amazonian Dark Earth soils on forest structure and species composition
Authors: de Oliveira Edmar Almeida , Marimon‐Junior Ben Hur , Marimon Beatriz Schwantes , Iriarte José , Morandi Paulo S. , Maezumi S. Yoshi , Nogueira Denis S. , Aragão Luiz E. O .C. , da Silva Izaias Brasil , Feldpausch Ted R. 
Published: June 2020

AbstractAimAmazonian forests predominantly grow on highly weathered and nutrient poor soils. Anthropogenically enriched Amazonian Dark Earths (ADE), traditionally known as Terra Preta de Índio, were formed by pre‐Columbian populations. ADE soils are characterized by increased fertility and have continued to be exploited following European colonization. Here, we evaluated the legacy of land‐use and soil enrichment on the composition and structure in ADE and non‐ADE (NDE) forests.LocationEastern and southern Amazonia.Time periodPre‐Columbia – 2014.MethodsWe sampled nine pairs of ADE and adjacent NDE forest plots in eastern and southern Amazonia. In each plot, we collected soil samples at 0–10 and 10–20 cm depth and measured stem diameter, height, and identified all individual woody plants (palms, trees and lianas) with diameter ≥ 10 cm. We compared soil physicochemical properties, vegetation diversity, floristic composition, aboveground biomass, and percentage of useful species.ResultsIn the nine paired plots, soil fertility was significantly higher in ADE soil. We sampled 4,191 individual woody plants representing 404 species and 65 families. The floristic composition of ADE and NDE forests differed significantly at both local and regional levels. In southern Amazonia, ADE forests had, on average, higher aboveground biomass than other forests of the region, while in eastern Amazonia, biomass was similar to that of NDE forests. Species richness of both forest types did not differ and was within the range of existing regional studies. The differences in composition between large and small diameter tree recruits may indicate long‐term recovery and residual effects from historical land‐use. Additionally, the proportion of edible species tended to be higher in the ADE forests of eastern and southern Amazonia.Main conclusionsThe marked differences in soil fertility, floristic composition and aboveground biomass between ADE and NDE forests are consistent with a small‐scale long‐term land‐use legacy and a regional increase in tree diversity.
What are Headache Smartphone Application (App) Users Actually Looking for in Apps: A Qualitative Analysis of App Reviews to Determine a Patient Centered Approach to Headache Smartphone Apps
Authors: Minen Mia T. , Gumpel Tyler , Ali Seher , Sow Fatoumata , Toy Kaitlyn 
Published: June 2020

BackgroundMany headache smartphone applications (apps) are commercially available. A Modified Delphi Study aimed to determine specialists’ expectations of what a headache app should entail but consumer expectations of headache apps have not been evaluated extensively.ObjectiveTo evaluate publicly available reviews of headache apps to understand app features that motivate the consumers to use apps.MethodsThe Google Play and Apple App Stores were systematically searched for headache/migraine diary apps with 10+ consumer reviews. A maximum of 300 “Most Helpful” reviews for each app were extracted. Four coders coded reviews and resolved discrepancies. Themes and subthemes were created based on codes used 5+ times.ResultsAbout 15 apps met the study criteria (9 Android, 6 IOS). 945 reviews were coded. Four themes emerged: (1) App allows users to track headache characteristics, potential triggers, and treatments; (2) App usability; (3) Personalization and features to assess trends in data are key motivators for app use; (4) Ease with exportation and viewing data is critical.DiscussionA user‐centered design with the ability to (1) customize key features including headache characteristics, potential triggers, and treatments, (2) assess trends in data, and (3) view and export data would best optimize headache smartphone applications based on consumer preference.