bluuebunny/crossref_metadata_2025_split huggingface dataset:
Women and men with coronary heart disease respond similarly to different aerobic exercise training modalities: a pooled analysis of prospective randomized trials
Authors: Trachsel Lukas-Daniel , Boidin Maxime , Henri Christine , Fortier Annik , Lalongé Julie , Juneau Martin , Nigam Anil , Gayda Mathieu 
Published: October 2020

We aimed to compare cardiopulmonary exercise test (CPET) parameters, cardiac adaptations, and proportion of responders after different aerobic training programs amongst women and men with coronary heart disease (CHD). Patients with CHD were evaluated with a CPET and echocardiography before and after 3 months of aerobic exercise training. Peak oxygen uptake exercise training response was assessed according to the median peak oxygen uptake change for post- versus pretraining in the whole cohort (stratification non/low responders (NLR) vs. high-responders) and normalized for lean body mass (LBM). Eighty-three CHD patients were included (19 women, 64 men; 27 patients with interval, 19 with continuous, and 37 with combination exercises). Peak oxygen uptake, peak workload normalized for LBM, pulmonary variables (i.e., ventilation and oxygen uptake efficiency slope), and O2 pulse were significantly lower in women versus men. These parameters improved similarly with training in both sexes (p < 0.05). There were no differences in the proportion of NLR among women and men with CHD (7/19 (37%) vs. 35/64 (55%), p = 0.1719). Left ventricular ejection fraction and mean peak early diastolic mitral annulus velocity improved similarly with training in both sexes (p < 0.05). Women and men with CHD have a similar exercise training response regarding key CPET and echocardiographic parameters. The proportion of responders is similar. ClinicalTrials.gov: NCT03414996, NCT02048696, NCT03443193. Novelty: Cardiopulmonary adaptations to exercise training are similar among CHD men and women. Proportion of peak oxygen uptake for non/low/high responders is similar in CHD men and women. Left ventricular systolic and diastolic function improved similarly after exercise training in CHD men and women.
Leakage-Aware Dynamic Thermal Management of 3D Memories
Authors: Siddhu Lokesh , Kedia Rajesh , Panda Preeti Ranjan 
Published: October 2020

3D memory systems offer several advantages in terms of area, bandwidth, and energy efficiency. However, thermal issues arising out of higher power densities have limited their widespread use. While prior works have looked at reducing dynamic power through reduced memory accesses, in these memories, both leakage and dynamic power consumption are comparable. Furthermore, as the temperature rises, the leakage power increases, creating a thermal-leakage loop. We study the impact of leakage power on 3D memory temperature and propose turning OFF specific memory channels to meet thermal constraints. Data is migrated to a 2D memory before closing a 3D channel. We introduce an analytical model to assess the 2D memory delay and use the model to guide data migration decisions. The above strategy is referred to asFastCooland provides an improvement of 22%, 19%, and 32% on average (up to 57%, 72%, and 82%) in performance, memory energy, and energy-delay product (EDP), respectively, on different workloads consisting of SPEC CPU2006 benchmarks.We further propose a thermal management strategy namedEnergy-Efficient FastCool (EEFC), which improves upon FastCool by selecting the channels to be closed by considering temperature, leakage, access rate, and position of various 3D memory channels at runtime. Our experiments demonstrate that EEFC leads to an additional improvement of up to 30%, 30%, and 51% in performance, memory energy, and EDP compared to FastCool. Finally, we analyze the effects of process variations on the efficiency of the proposed FC and EEFC strategies. Variation in the manufacturing process causes changes in the leakage power and temperature profile. Since EEFC considers both while selecting channels for closure, it is more resilient to process variations and achieves a lower application execution time and memory energy compared to FastCool.
Predictive Accuracy of Heart Failure-Specific Risk Equations in an Electronic Health Record-Based Cohort
Authors: Bavishi Aakash , Bruce Matthew , Ning Hongyan , Freaney Priya M. , Glynn Peter , Ahmad Faraz S. , Yancy Clyde W. , Shah Sanjiv J. , Allen Norrina B. , Vupputuri Suma X. , Rasmussen-Torvik Laura J. , Lloyd-Jones Donald M. , Khan Sadiya S. 
Published: October 2020

Background:
Guidelines recommend identification of individuals at risk for heart failure (HF). However, implementation of risk-based prevention strategies requires validation of HF-specific risk scores in diverse, real-world cohorts. Therefore, our objective was to assess the predictive accuracy of the Pooled Cohort Equations to Prevent HF within a primary prevention cohort derived from the electronic health record.

Methods:

We retrospectively identified patients between the ages of 30 to 79 years in a multi-center integrated healthcare system, free of cardiovascular disease, with available data on HF risk factors, and at least 5 years of follow-up. We applied the Pooled Cohort Equations to Prevent HF tool to calculate sex and race-specific 5-year HF risk estimates. Incident HF was defined by the
International Classification of Diseases
codes. We assessed model discrimination and calibration, comparing predicted and observed rates for incident HF.

Results:

Among 31 256 eligible adults, mean age was 51.4 years, 57% were women and 11% Black. Incident HF occurred in 568 patients (1.8%) over 5-year follow-up. The modified Pooled Cohort Equations to Prevent HF model for 5-year risk prediction of HF had excellent discrimination in White men (C-statistic 0.82 [95% CI, 0.79–0.86]) and women (0.82 [0.78–0.87]) and adequate discrimination in Black men (0.69 [0.60–0.78]) and women (0.69 [0.52–0.76]). Calibration was fair in all race-sex subgroups (χ
2
<20).

Conclusions:
A novel sex- and race-specific risk score predicts incident HF in a real-world, electronic health record-based cohort. Integration of HF risk into the electronic health record may allow for risk-based discussion, enhanced surveillance, and targeted preventive interventions to reduce the public health burden of HF.
BRD4 (Bromodomain-Containing Protein 4) Interacts with GATA4 (GATA Binding Protein 4) to Govern Mitochondrial Homeostasis in Adult Cardiomyocytes
Authors: Padmanabhan Arun , Alexanian Michael , Linares-Saldana Ricardo , González-Terán Bárbara , Andreoletti Gaia , Huang Yu , Connolly Andrew J. , Kim Wonho , Hsu Austin , Duan Qiming , Winchester Sarah A.B. , Felix Franco , Perez-Bermejo Juan A. , Wang Qiaohong , Li Li , Shah Parisha P. , Haldar Saptarsi M. , Jain Rajan , Srivastava Deepak 
Published: October 2020

Background:
Gene regulatory networks control tissue homeostasis and disease progression in a cell type–specific manner. Ubiquitously expressed chromatin regulators modulate these networks, yet the mechanisms governing how tissue specificity of their function is achieved are poorly understood. BRD4 (bromodomain-containing protein 4), a member of the BET (bromo- and extraterminal domain) family of ubiquitously expressed acetyl-lysine reader proteins, plays a pivotal role as a coactivator of enhancer signaling across diverse tissue types in both health and disease and has been implicated as a pharmacological target in heart failure. However, the cell-specific role of BRD4 in adult cardiomyocytes remains unknown.

Methods:
We combined conditional mouse genetics, unbiased transcriptomic and epigenomic analyses, and classic molecular biology and biochemical approaches to understand the mechanism by which BRD4 in adult cardiomyocyte homeostasis.

Results:

Here, we show that cardiomyocyte-specific deletion of
Brd4
in adult mice leads to acute deterioration of cardiac contractile function with mutant animals demonstrating a transcriptomic signature characterized by decreased expression of genes critical for mitochondrial energy production. Genome-wide occupancy data show that BRD4 enriches at many downregulated genes (including the master coactivators
Ppargc1a, Ppargc1b
, and their downstream targets) and preferentially colocalizes with GATA4 (GATA binding protein 4), a lineage-determining cardiac transcription factor not previously implicated in regulation of adult cardiac metabolism. BRD4 and GATA4 form an endogenous complex in cardiomyocytes and interact in a bromodomain-independent manner, revealing a new functional interaction partner for BRD4 that can direct its locus and tissue specificity.

Conclusions:
These results highlight a novel role for a BRD4-GATA4 module in cooperative regulation of a cardiomyocyte-specific gene program governing bioenergetic homeostasis in the adult heart.
Quasi-Equilibrium and Weak Temperature Gradient Balances in an Equatorial Beta-Plane Model
Authors: Ahmed Fiaz , Neelin J. David , Adames Ángel F. 
Published: October 2020

AbstractConvective quasi-equilibrium (QE) and weak temperature gradient (WTG) balances are frequently employed to study the tropical atmosphere. This study uses linearized equatorial beta-plane solutions to examine the relevant regimes for these balances. Wave solutions are characterized by moisture–temperature ratio (q–T ratio) and dominant thermodynamic balances. An empirically constrained precipitation closure assigns different sensitivities of convection to temperature (εt) and moisture (εq). Longwave equatorial Kelvin and Rossby waves tend toward the QE balance with q–T ratios of εt:εq that can be ~1–3. Departures from strict QE, essential to both precipitation and wave dynamics, grow with wavenumber. The propagating QE modes have reduced phase speeds because of the effective gross moist stability meff, with a further reduction when εt > 0. Moisture modes obeying the WTG balance and with large q–T ratios (>10) emerge in the shortwave regime; these modes exist with both Kelvin and Rossby wave meridional structures. In the υ = 0 case, long propagating gravity waves are absent and only emerge beyond a cutoff wavenumber. Two bifurcations in the wave solutions are identified and used to locate the spatial scales for QE–WTG transition and gravity wave emergence. These scales are governed by the competition between the convection and gravity wave adjustment times and are modulated by meff. Near-zero values of meff shift the QE–WTG transition wavenumber toward zero. Continuous transitions replace the bifurcations when meff < 0 or moisture advection/WISHE mechanisms are included, but the wavenumber-dependent QE and WTG balances remain qualitatively unaltered. Rapidly decaying convective/gravity wave modes adjust to the slowly evolving QE/WTG state in the longwave/shortwave regimes, respectively.
On the Formation Mechanism of the Seasonal Persistence Barrier
Authors: Jin Yishuai , Liu Zhengyu , He Chengfei , Zhao Yuchu 
Published: October 2020

AbstractThe mechanism of the seasonal persistence barrier (SPB) is studied in the framework of an autoregressive (AR) model. In contrast to the seasonal variance, whose minimum is modulated mainly by the minimum growth rate or noise forcing, the SPB is caused primarily by the declining growth rate or increasing noise forcing, instead of the minimum/maximum of the growth rate or noise forcing. In other words, the SPB is caused by the declining signal-to-noise ratio (SNR) rather than the weakest SNR. In a weakly damped system, the phase of the SPB is delayed from that of declining SNR by about a season. The mechanism is further applied to explain the observed SST variability in the tropical and North Pacific. For the tropical Pacific, the spring SPB could be caused by the decreasing growth rate from September to March and weak annual mean damping rate, instead of the minimum growth rate in spring. Over the North Pacific, the increasing noise forcing from March to June may lead to the summer SPB. Our mechanism provides a null hypothesis for understanding the SPB of climate variability.
Management of the Embedded Tracheoesophageal Prosthesis: Retrograde Removal and Replacement
Authors: Burks Ciersten A. , Feng Allen L. , Deschler Daniel G. 
Published: October 2020

Objective: To describe the retrograde removal of a tracheoesophageal (TE) prosthesis embedded in the common wall between the trachea and esophagus with preservation of the original tracheoesophageal puncture (TEP) tract with subsequent placement of new tracheoesophageal prosthesis for voice restoration. Methods: The Blom-Singer TEP Set (InHealth Technologies, Carpinteria, CA) was used to facilitate this procedure. The coated wire leader cable was threaded through the small opening in the posterior tracheal wall and into the lumen of the old TE prosthesis. The wire was pulled through the mouth in retrograde fashion - bringing the old TE prosthesis out with it and dilating the existing TEP tract. A new prosthesis was then placed over the end of the wire and returned through the stoma, delivering the prosthesis through the TE tract and into the stoma. Results: Safe, voice restoration with avoidance of need for multiple procedures. Conclusion: Removal of an embedded prosthesis and simultaneous replacement of a new prosthesis was safely and efficiently achieved using a retrograde technique which maintained the patency of the prior TE tract and restored voice.
Minocycline as adjunctive treatment for major depressive disorder: Pooled data from two randomized controlled trials
Authors: Zazula Robson , Husain Muhammad Ishrat , Mohebbi Mohammadreza , Walker Adam J , Chaudhry Imran B , Khoso Ameer B , Ashton Melanie M , Agustini Bruno , Husain Nusrat , Deakin JFW , Young Allan H , Berk Michael , Kanchanatawan Buranee , Ng Chee H , Maes Michael , Berk Lesley , Singh Ajeet B , Malhi Gin S , Dean Olivia M 
Published: October 2020

Background: Randomized controlled clinical trials that have investigated minocycline as an adjunctive treatment for major depressive disorder have proved promising. Data from two studies were pooled to evaluate more definitively whether the addition of minocycline to standard treatment for major depressive disorder leads to an improvement of depressive symptoms when compared with placebo. Methods: Both studies were multi-site, double-blinded, placebo-controlled trials of minocycline 200 mg/day added to treatment as usual during a 12-week period. The primary outcome measure was change in depressive symptoms (Montgomery–Asberg Depression Rating Scale in Dean et al. and Hamilton Depression Rating Scale in Husain et al.). Secondary outcomes were change in depression severity (Montgomery–Asberg Depression Rating Scale for Dean et al. and 9-item Patient Health Questionnaire in Husain et al.), anxiety severity (Hamilton Anxiety Rating Scale in Dean et al. and Generalized Anxiety Disorder 7-item scale in Husain et al.) and functional status, which were also evaluated as potential mediators on the primary outcome. Results: A total of 112 participants were included in the pooled data (Dean et al., n = 71; Husain et al., n = 41). A significant change from baseline to week 12 was noted in depressive symptoms – differential change (Placebo vs Minocycline): 9.0, 95% confidence interval = [4.2, 13.9], Cohen’s D (95% confidence interval): 0.71 [0.29, 1.14], p < 0.001 – anxiety severity – differential change (Placebo vs Minocycline): 0.38, confidence interval = [0.00, 0.75], Cohen’s D (95% confidence interval): 0.41 [0.00, 0.82], p = 0.050) and functional status – differential change (Placebo vs Minocycline): 1.0, 95% confidence interval = [0.4, 1.5], Cohen’s D (95% confidence interval): 0.76 [0.34, 1.19], p = 0.001). Duration of illness, current use of benzodiazepine and pain medication were identified as moderators, whereas functional status as a mediator/predictor. Conclusion: The improvement of depressive symptoms, anxiety severity and functional status is promising and suggests that minocycline has potential as an adjunctive treatment for major depressive disorder. However, further studies are warranted to confirm therapeutic effects of minocycline in major depressive disorder. Trial registrations: NCT02263872, registered October 2014, and ACTRN12612000283875, registered March 2012.
More continuous flow, better learning? The effect of aortic valve opening in patients with left ventricular assist device
Authors: Karahan Mehmet , Kocabeyoglu Sinan Sabit , Kervan Umit , Sert Dogan Emre , Erdogan Bakar Emel , Aygun Emre , Tola Muharrem , Demirkan Burcu , Mungan Semra , Catav Zeki , Pac Mustafa 
Published: October 2020

Purpose: The aim of this study was to analyze neurocognitive function in patients who underwent continuous flow left ventricular assist device (LVAD) implantation. Material and Method: This cross-sectional study included three groups: LVAD ( n = 31), heart failure patients ( n = 26), and healthy volunteers ( n = 27). The Rey Auditory-Verbal Learning Test (RAVLT), Judgement of Line Orientation Test (JLOT), Trail Making Test (TMT), Stroop Color-Word Interference Test (SCWIT), Verbal Fluency Test (VFT), Symbol-Digit Modality Test (SDMT) were used to assess the neurocognitive functions. Data were analyzed at a median 12 (3–47) months after LVAD implantation. The LVAD patients were also divided by aortic valve opening (AVO) into three subgroups as “closed” ( n = 9), “1–6” ( n = 8) and “7–10” ( n = 14) opening per ten beats and data were re-analyzed accordingly. Results: There was no significant difference among the groups according to SCWIT, JLOT, SDMT, TMT, and VFT scores. Post-hoc analyzes of RAVLT scores showed significant differences between the LVAD and the other two groups in favor of the LVAD group. Also, the patients with AVO “7–10” the response times were longer and learning scores were found to be lower than those without AVO. Conclusion: With continuous-flow LVAD, neurocognitive functions were not impaired. The learning performance was better in cases where there was no AVO and flow was completely device dependent. We may speculate that neurocognitive functions are not worsening with continuous cerebral blood flow and even it may improve learning performance.
Exploring the Impact of Health Care Provider Cultural Competence on New Immigrant Health-Related Quality of Life: A Cross-Sectional Study of Canadian Newcomers
Authors: Zghal Afef , El-Masri Maher , McMurphy Suzanne , Pfaff Kathryn 
Published: October 2020

Introduction: New immigrants underutilize health care because of multiple barriers. Although culturally competent health care improves access, it is typically assessed by providers, not newcomers whose perceptions matter most. Methodology: Surveys that included measures of cultural competence and health-related quality of life (QOL) were completed by 117 new immigrants in Windsor, Ontario, Canada. A series of stepwise linear regression analyses were conducted to identify independent predictors of QOL and its four domains: physical health, psychological, social relationships, and environment. Results: Our adjusted results suggest that experiences of discrimination was negatively associated with overall QOL (β = −.313; p < .001) and its psychological (β = −.318; p < .001), social (β = −.177; p = .048), and environmental (β = −.408; p < .001) domains. Discussion: Discrimination negatively influences new immigrant QOL. Provider cultural competency training should emphasize the influence of provider discrimination on immigrant health and explore learners’ values and biases.
Exploring patient education unmet needs for rare and complex connective tissue and musculoskeletal diseases: A survey of health care providers’ and patients’ expectations in Europe
Authors: Farhat Meryem-Maud , Cornet Alain , Frank Charissa , Galetti Ilaria , Grunert Juergen , Guimarães Vera , Vieira Ana , Hachulla Eric 
Published: October 2020

Objective The European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases involves health care providers (HCPs) from 8 European countries and 7 patients’ representatives of European Patient Advocacy Groups. The objective was to evaluate current practice and unmet needs for patient education (PE) in Europe. Methods A questionnaire was sent to HCP members asking about the PE practices and another, to enquire about their needs, was sent to patients’ associations in the different countries. Results The questionnaire was completed by 33 HCPs. Half had no specific staff members dedicated to PE. For HCPs with dedicated staff, 83.3% (n = 11) considered that care providers were insufficient to meet patients’ needs. Most of HCPs would like to see the practice of PE standardized. Sixty eight percent (n = 1093) of patients suffering from connective tissue diseases completed the questionnaire had never heard about PE. Most of them were interested in taking part in a PE program. Discussion Our survey revealed a strong interest in PE among patients and HCP and heterogeneity of practice. PE appeared important for both HCPs and patients. An online course for medical students in Europe will be developed in partnership with EULAR to respond to these unmet needs.
MONARCH plus: abemaciclib plus endocrine therapy in women with HR+/HER2– advanced breast cancer: the multinational randomized phase III study
Authors: Zhang Qing Yuan , Sun Tao , Yin Yong Mei , Li Hui Ping , Yan Min , Tong Zhong Sheng , Oppermann Christina P. , Liu Yun Peng , Costa Romulo , Li Man , Cheng Ying , Ouyang Qu Chang , Chen Xi , Liao Ning , Wu Xin Hong , Wang Xiao Jia , Feng Ji Feng , Hegg Roberto , Kanakasetty G.B. , Coccia-Portugal Maria A. , Han Ru Bing , Lu Yi , Chi Hai Dong , Jiang Ze Fei , Hu Xi Chun 
Published: October 2020

Aim: To compare the efficacy, safety, and tolerability of abemaciclib plus endocrine therapy (ET) versus ET alone in postmenopausal women with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer (ABC) from China, Brazil, India, and South Africa. Methods: This randomized, double-blind, phase III study was conducted between 9 December 2016 and 29 March 2019. Postmenopausal women with HR-positive, HER2-negative ABC with no prior systemic therapy in an advanced setting (cohort A) or progression on prior ET (cohort B) received abemaciclib (150 mg twice daily) or placebo plus: anastrozole (1 mg/day) or letrozole (2.5 mg/day) (cohort A) or fulvestrant (500 mg per label) (cohort B). The primary endpoint was progression-free survival (PFS) in cohort A, analyzed using the stratified log-rank test. Secondary endpoints were PFS in cohort B (key secondary endpoint), objective response rate (ORR), and safety. This interim analysis was planned after 119 PFS events in cohort A. Results: In cohort A, 207 patients were randomly assigned to the abemaciclib arm and 99 to the placebo arm. Abemaciclib significantly improved PFS versus placebo (median: not reached versus 14.7 months; hazard ratio 0.499; 95% confidence intervals (CI) 0.346–0.719; p = 0.0001). ORR was 65.9% in the abemaciclib arm and 36.1% in the placebo arm ( p < 0.0001, measurable disease population). In cohort B, 104 patients were randomly assigned to the abemaciclib arm and 53 to the placebo arm. Abemaciclib significantly improved PFS versus placebo (median: 11.5 versus 5.6 months; hazard ratio 0.376; 95% CI 0.240–0.588; p < 0.0001). ORR was 50.0% in the abemaciclib arm and 10.5% in the placebo arm ( p < 0.0001, measurable disease population). The most frequent grade ⩾3 adverse events in the abemaciclib arms were neutropenia, leukopenia, and anemia (both cohorts), and lymphocytopenia (cohort B). Conclusion: The addition of abemaciclib to ET demonstrated significant and clinically meaningful improvement in PFS and ORR, without new safety signals observed in this population. Trial Registration: ClinicalTrials.gov identifier: NCT02763566.