bluuebunny/crossref_metadata_2025_split huggingface dataset:
A reflected feature space for CART
Authors: Wickramarachchi D. C. , Robertson B. L. , Reale M. , Price C. J. , Brown J. A. 
Published: October 2019

SummaryWe present an algorithm for learning oblique decision trees, called HHCART(G). Our decision tree combines learning concepts from two classification trees, HHCART and Geometric Decision Tree (GDT). HHCART(G) is a simplified HHCART algorithm that uses linear structure in the training examples, captured by a modified GDT angle bisector, to define splitting directions. At each node, we reflect the training examples with respect to the modified angle bisector to align this linear structure with the coordinate axes. Searching axis parallel splits in this reflected feature space provides an efficient and effective way of finding oblique splits in the original feature space. Our method is much simpler than HHCART because it only considers one reflected feature space for node splitting. HHCART considers multiple reflected feature spaces for node splitting making it more computationally intensive to build. Experimental results show that HHCART(G) is an effective classifier, producing compact trees with similar or better results than several other decision trees, including GDT and HHCART trees.
Early prediction of transition to durable mechanical circulatory support in patients undergoing peripheral veno‐arterial extracorporeal membrane oxygenation for critical cardiogenic shock
Authors: Prasad Amit , Brehm Christoph E. , Goldenberg Michael , Ghodsizad Ali , Koerner Michael M. , El‐Banayosy Aly , Singbartl Kai 
Published: October 2019

AbstractPeripheral veno‐arterial extracorporeal membrane oxygenation (pVA‐ECMO) has gained increasing value in the management of patients with critical cardiogenic shock (cCS), allowing time for myocardial recovery. Failure of myocardial recovery has life‐altering consequences: transition to durable mechanical circulatory support (dMCS), urgent heart transplantation, or withdrawal of support. Clinical factors controlling myocardial recovery under these circumstances remain largely unknown. Using a retrospective cohort, we developed a model for early prediction of transition to dMCS in patients undergoing pVA‐ECMO for cCS. To promote myocardial recovery, our clinical management centered around left ventricular pressure unloading, that is, targeting pulmonary capillary wedge pressures (PCWP) ≤18 mm Hg. We collected demographic data, laboratory findings, inotrope use, and two‐dimensional transthoracic echocardiography measurements, all limited to the first 72h of pVA‐ECMO (D1‐3). Out of 70 patients who were alive after pVA‐ECMO, 27 patients underwent implantation of dMCS. There was no significant difference in survival to hospital discharge between patients with or without transition to dMCS. Ejection fractionD1‐3(per 10% increase, OR 0.37 [0.17‐0.79]) and amount of inotropic supportD1‐3(OR 4.77 [1.6‐14.18]) but neither myocardial wall tension nor PCWP emerged as significant predictors of transition to dMCS. Optimism‐corrected c‐index (0.90 [0.89‐0.90]) revealed an excellent discriminative ability of our model. In summary, our model for early prediction of transition to dMCS in patients with cCS undergoing pVA‐ECMO identifies indicators of inotropic state as relevant factors. Absence of markers for myocardial oxygen consumption or left ventricular pressure loading allows us to hypothesize sufficient cardiac unloading in our cohort with PCWP‐targeted management.
In vitro study on the hemocompatibility of plasma electrolytic oxidation coatings on titanium substrates
Authors: Klein Mario , Kuhn Yasmin , Woelke Eva , Linde Torsten , Ptock Christoph , Kopp Alexander , Bletek Thomas , Schmitz‐Rode Thomas , Steinseifer Ulrich , Arens Jutta , Clauser Johanna C. 
Published: October 2019

AbstractPassively levitated ventricular assist devices (VADs) are vulnerable to impeller‐housing contact and could benefit from surface coatings that improve wear resistance. Such coatings can be manufactured by plasma electrolytic oxidation (PEO), but their suitability for blood‐contact applications needs further investigation. We therefore compared blood–surface interactions of polished titanium grade 5 (Ti Gr 5), as a general VAD reference material, uncoated ground titanium grade 4 (Ti Gr 4) and two commercially available PEO coatings on Ti Gr 4. In n = 4 static platelet adhesion tests, material samples were incubated with platelet‐rich plasma (PRP) and consecutively analyzed for adhesive platelets by immunofluorescence microscopy. Additionally, PRP supernatant of incubated material samples was analyzed for changes in antithrombin III and fibrinogen concentrations by turbodimetry and enzyme‐linked immunosorbent assay, respectively. We could not find any significant differences between the materials in the analyzed hemocompatibility markers (P > .05). Thus, we conclude that PEO coatings might offer a similar hemocompatibility to that of polished Ti Gr 5 and uncoated Ti Gr 4. Nevertheless, future studies should investigate blood–surface interactions of PEO coatings under realistic VAD‐related flow conditions to better evaluate their potential for VAD applications.
Surgical device exchange provides improved clinical outcomes compared to medical therapy in treating continuous‐flow left ventricular assist device thrombosis
Authors: Koda Yojiro , Kitahara Hiroto , Kalantari Sara , Chung Bow , Smith Bryan , Raikhelkar Jayant , Kim Gene , Sarswat Nitasha , Sayer Gabriel , Onsager David , Song Tae , Uriel Nir , Jeevanandam Valluvan , Ota Takeyoshi 
Published: October 2019

AbstractThe purpose of this study is to compare clinical outcomes of left ventricular assist device (LVAD) patients with device thrombosis who underwent device exchange (DE) or medical therapy (MT) alone. Consecutive patients undergoing LVAD implant between July 2008 and December 2017 were included. Device thrombosis was diagnosed with comprehensive assessments including ramp test, laboratory data, device parameters, and clinical presentations. First, MT was initiated in all patients. After MT, DE was considered if device thrombosis was refractory to initial MT, and it caused end‐organ impairment and/or hemodynamic instability. Among 319 consecutive LVAD patients, 43 patients (13.5%) were diagnosed with device thrombosis. DE was performed in 28 patients (DE group); device explant was performed in 1 patient. MT was continued in 14 patients (MT group). In‐hospital mortality was significantly lower in the DE group than the MT group (3.6% [1/28] vs. 28.6% [4/14], P = .0184). One‐year survival was significantly better in the DE group (74.0% vs. 30.1%; log‐rank = .001), and freedom from cerebrovascular accident (CVA) at 1 year was greater in the DE group (87.1% vs. 47.7%; log‐rank = .004). DE was associated with improved 1‐year survival and fewer CVAs. Surgical intervention, if feasible, is recommended for LVAD device thrombosis.
Population pharmacokinetics of vancomycin in obesity: Finding the optimal dose for (morbidly) obese individuals
Authors: Smit Cornelis , Wasmann Roeland E. , Goulooze Sebastiaan C. , Wiezer Marinus J. , van Dongen Eric P.A. , Mouton Johan W. , Brüggemann Roger J.M. , Knibbe Catherijne A.J. 
Published: October 2019

AimsFor vancomycin treatment in obese patients, there is no consensus on the optimal dose that will lead to the pharmacodynamic target (area under the curve 400–700 mg h L−1). This prospective study quantifies vancomycin pharmacokinetics in morbidly obese and nonobese individuals, in order to guide vancomycin dosing in the obese.MethodsMorbidly obese individuals (n = 20) undergoing bariatric surgery and nonobese healthy volunteers (n = 8; total body weight [TBW] 60.0–234.6 kg) received a single vancomycin dose (obese: 12.5 mg kg−1, maximum 2500 mg; nonobese: 1000 mg) with plasma concentrations measured over 48 h (11–13 samples per individual). Modelling, internal validation, external validation using previously published data and simulations (n = 10.000 individuals, TBW 60–230 kg) were performed using NONMEM.ResultsIn a 3‐compartment model, peripheral volume of distribution and clearance increased with TBW (both p < 0.001), which was confirmed in the external validation. A dose of 35 mg kg−1 day−1 (maximum 5500 mg/day) resulted in a > 90% target attainment (area under the curve > 400 mg h L−1) in individuals up to 200 kg, with corresponding trough concentrations of 5.7–14.6 mg L−1 (twice daily dosing). For continuous infusion, a loading dose of 1500 mg is required for steady state on day 1.ConclusionIn this prospective, rich sampling pharmacokinetic study, vancomycin clearance was well predicted using TBW. We recommend that in obese individuals without renal impairment, vancomycin should be dosed as 35 mg kg−1 day−1 (maximized at 5500 mg/day). When given over 2 daily doses, trough concentrations of 5.7–14.6 mg L−1 correspond to the target exposure in obese individuals.
Maternal comorbidity index and severe maternal morbidity during delivery hospitalizations in Texas, 2011‐2014
Authors: Salahuddin Meliha , Mandell Dorothy J. , Lakey David L. , Ramsey Patrick S. , Eppes Catherine S. , Davidson Christina M. , Ortique Carla F. , Patel Divya A. 
Published: October 2019

AbstractBackgroundSevere maternal morbidity (SMM) prevalence was 194.0 per 10 000 deliveries in Texas in 2015. Chronic, behavioral, and pregnancy‐induced conditions, as captured by a maternal comorbidity index, increase the risk for delivery‐related morbidity and mortality. The objective of the study was to examine the association between maternal comorbidity index and SMM among delivery hospitalizations in Texas.MethodsDelivery‐related hospitalizations among Texan women aged 15‐49 years were identified using the 2011‐2014 Texas all‐payer inpatient hospitalization public use data files (n = 1 434 441). The primary outcome of interest was SMM, based on the Alliance for Innovation on Maternal Health's coding scheme. The exposure of interest was a maternal comorbidity index. Multivariable logistic regression model was used to examine the association between maternal comorbidity index and SMM.ResultsSMM prevalence remained consistent between 2011 and 2014 (196.0‐197.0 per 10 000 deliveries, P > .05; n = 1 434 441). Nearly 40% of delivery‐related hospitalizations had a maternal comorbidity index of at least 1, and the proportion of deliveries in the highest risk category of comorbidity index (≥5) increased by 12.0% from 2011 to 2014. SMM prevalence was highest among the youngest and oldest age groups. With each unit increase in maternal comorbidity index, the odds of SMM increase was 1.43 (95% CI 1.42‐1.43).ConclusionsMaternal comorbidity index is associated with SMM; however, the low predictive power of the model suggests that other, unmeasured factors may influence SMM in Texas. These findings highlight a need to understand broader contextual factors (practitioner, facility, systems of care, and community) that may be associated with SMM to reduce maternal morbidity and mortality in Texas.
UDP‐Glucuronosyltransferase (UGT)‐mediated attenuations of cytochrome P450 3A4 activity: UGT isoform‐dependent mechanism of suppression
Authors: Miyauchi Yuu , Tanaka Yoshitaka , Nagata Kiyoshi , Yamazoe Yasushi , Mackenzie Peter I. , Yamada Hideyuki , Ishii Yuji 
Published: October 2019

Background and PurposeCytochrome P450 (CYP, P450) 3A4 is involved in the metabolism of 50% of drugs and its catalytic activity in vivo is not explained only by hepatic expression levels. We previously demonstrated that UDP‐glucuronosyltransferase (UGT) 2B7 suppressed CYP3A4 activity through an interaction. In the present study, we target UGT1A9 as another candidate modulator of CYP3A4.Experimental ApproachWe prepared co‐expressed enzymes using the baculovirus‐insect cell expression system and compared CYP3A4 activity in the presence and absence of UGT1A9. Wistar rats were treated with dexamethasone and liver microsomes were used to elucidate the role of CYP3A–UGT1A interactions.Key ResultsUGT1A9 and UGT2B7 interacted with and suppressed CYP3A4. Kinetic analyses showed that both of the UGTs significantly reduced Vmax of CYP3A4 activity. In addition, C‐terminal truncated mutants of UGT1A9 and UGT2B7 still retained the suppressive capacity. Dexamethasone treatment induced hepatic CYP3As and UGT1As at different magnitudes. Turnover of CYP3A was enhanced about twofold by this treatment.Conclusion and ImplicationsThe changes of kinetic parameters suggested that UGT1A9 suppressed CYP3A4 activity with almost the same mechanism as UGT2B7. The luminal domain of UGTs contains the suppressive interaction site(s), whereas the C‐terminal domain may contribute to modulating suppression in a UGT isoform‐specific manner. CYP3A–UGT1A interaction seemed to be disturbed by dexamethasone treatment and the suppression was partially cancelled. CYP3A4–UGT interactions would help to better understand the causes of inter/intra‐individual differences in CYP3A4 activity.
Beclomethasone dipropionate, formoterol fumarate and glycopyrronium bromide: Synergy of triple combination therapy on human airway smooth muscleex vivo
Authors: Rogliani Paola , Matera Maria Gabriella , Facciolo Francesco , Page Clive , Cazzola Mario , Calzetta Luigino 
Published: October 2019

Background and PurposeCombining inhaled corticosteroids (ICSs), long‐acting β2‐adrenoceptor agonists (LABAs) and long‐acting muscarinic antagonists (LAMAs) is recommended to treat severe forms of asthma and chronic obstructive pulmonary disease (COPD). Clinical benefits have been demonstrated for ICS/LABA/LAMA combinations. This study characterized the interaction between the ICS beclomethasone dipropionate, the LABA formoterol fumarate and the LAMA glycopyrronium bromide in human airways.Experimental ApproachHuman passively sensitized airways and bronchi from COPD donors were stimulated with histamine or carbachol. Tissues were incubated overnight with beclomethasone and then treated with formoterol and glycopyrronium, alone or in triple combination. The interaction was assessed by using Bliss Independence and Unified Theory theorems.Key ResultsBeclomethasone/formoterol/glycopyrronium combination synergistically relaxed medium bronchi and small airways. Beclomethasone/formoterol/glycopyrronium combination at 100:6:12.5 combination ratio was a balanced drug mixture leading to very strong synergistic effect on relaxation of medium bronchi (Combination Index: from 0.042 to 0.96) and middle to very strong synergy in small airways (Combination Index: from 0.018 to 0.310). The synergy was related with the activation of intracellular glucocorticoid receptors and Gsαsubunit G‐protein of β2‐adrenoceptors, leading to the modulation of cyclic AMP‐dependent PKA pathway.ConclusionTriple beclomethasone/formoterol/glycopyrronium combination induces synergistic bronchorelaxant effect in medium and small human airways, at least inex vivoexperiments. Further research is needed to confirm these findings in clinical studies in patients with asthma or COPD.
Circulating β cell-specific CD8+ T cells restricted by high-risk HLA class I molecules show antigen experience in children with and at risk of type 1 diabetes
Authors: Yeo L , Pujol-Autonell I , Baptista R , Eichmann M , Kronenberg-Versteeg D , Heck S , Dolton G , Sewell A K , Härkönen T , Mikk M-L , Toppari J , Veijola R , Knip M , Ilonen J , Peakman M 
Published: October 2019

SummaryIn type 1 diabetes (T1D), autoreactive cytotoxic CD8+ T cells are implicated in the destruction of insulin-producing β cells. The HLA-B*3906 and HLA-A*2402 class I genes confer increased risk and promote early disease onset, suggesting that CD8+ T cells that recognize peptides presented by these class I molecules on pancreatic β cells play a pivotal role in the autoimmune response. We examined the frequency and phenotype of circulating preproinsulin (PPI)-specific and insulin B (InsB)-specific CD8+ T cells in HLA-B*3906+ children newly diagnosed with T1D and in high-risk HLA-A*2402+ children before the appearance of disease-specific autoantibodies and before diagnosis of T1D. Antigen-specific CD8+ T cells were detected using human leucocyte antigen (HLA) class I tetramers and flow cytometry was used to assess memory status. In HLA-B*3906+ children with T1D, we observed an increase in PPI5–12-specific transitional memory CD8+ T cells compared to non-diabetic, age- and HLA-matched subjects. Furthermore, PPI5–12-specific CD8+ T cells in HLA-B*3906+ children with T1D showed a significantly more antigen-experienced phenotype compared to polyclonal CD8+ T cells. In longitudinal samples from high-risk HLA-A*2402+ children, the percentage of terminal effector cells within the InsB15–24-specific CD8+ T cells was increased before diagnosis relative to samples taken before the appearance of autoantibodies. This is the first study, to our knowledge, to report HLA-B*3906-restricted autoreactive CD8+ T cells in T1D. Collectively, our results provide evidence that β cell-reactive CD8+ T cells restricted by disease-associated HLA class I molecules display an antigen-experienced phenotype and acquire enhanced effector function during the period leading to clinical diagnosis, implicating these cells in driving disease.
Corporate governance and correlation in corporate defaults
Authors: Fernando Jayasuriya M.R. , Li Leon , Hou Yang (Greg) 
Published: October 2019

AbstractResearch Question/IssueThis study examines the effect of weak corporate governance in terms of concentrated ownership, low board effectiveness, low financial transparency and higher shareholder rights on default correlation when firms have different credit qualities.Research Findings/InsightsUsing historical default data in the United States from 2000 to 2015, we find that the degree of default correlation increases disproportionately for firms with concentrated ownership, low board effectiveness, low financial transparency and disclosures, and higher shareholder rights. More importantly, the effect of weak corporate governance on default correlation is high during a financial crisis.Theoretical/Academic ImplicationsThis is one of the first studies testing the impact of corporate governance on the correlation in corporate defaults. It indicates new avenues of research for both corporate governance and credit risk management in relation to why joint default probabilities vary among firms.Practitioner/Policy ImplicationsOur results imply that good corporate governance is essential for credit risk management because poor corporate governance may increase individual default risk and create the domino effect of credit defaults. Practitioners and policy makers should enhance control over poor governance practices to reduce the probabilities of default. Moreover, the impact of corporate governance on correlation in corporate defaults is more pronounced in financial crises and warrants consideration from policy makers to take steps toward cushioning its effects.
Treatment of originally coloured wools with garlic stem extracts and zinc chloride to ensure anti‐bacterial properties with limited colour changes
Authors: Yılmaz Fazlıhan , Aydınlıoğlu Ömer , Benli Hüseyin , Kahraman Gamze , Bahtiyari Muhammed İbrahim 
Published: October 2019

AbstractIn this study, the objective was to ensure anti‐bacterial properties for originally coloured wools with naturally sourced garlic stem extracts. In addition, zinc chloride‐based treatment was also carried out. The aim was to retain the original colours of the wool fibres during these treatments. The effects of both treatments were evaluated in terms of colour changes in the wool fibres. It was found that the colour changes caused by the treatments were high in white/ecru fibres but more limited in black fibres. The colour differences between the treated and untreated black fibres were near 1; they were also quite high in white/ecru fibres. The anti‐bacterial properties of the treated wool fibres against two bacteria species, one gram‐negative and one gram‐positive, were also investigated. It was observed that zinc chloride‐based treatment ensured significant anti‐bacterial efficiencies against the bacteria tested and 99.9% bacterial reduction in all cases. However, the anti‐bacterial effects of garlic stem extract‐based treated wool fibres were limited. It was observed that treatment of wool fibres with garlic stem extracts resulted in no anti‐bacterial efficiency against Escherichia coli but did provide some anti‐bacterial capability against Staphylococcus aureus. The highest bacterial reduction of S. aureus was 80.7% in originally brown‐coloured wool fibre.
Looking back on 25 years of the PSAD study group
Authors: Snoek F. J. 
Published: October 2019

AbstractThe year 2020 marks the 25th anniversary of the Psychosocial Aspects of Diabetes (PSAD) study group of the European Association for the Study of Diabetes. At the time, psychosocial diabetes research in Europe was steadily growing, but not well recognized. By establishing an official European Association for the Study of Diabetes study group, PSAD, for which purpose some hurdles had to be overcome, diabetes psychology became more visible and accessible to the scientific diabetes community. Over the years the PSAD study group has been successful in promoting the quality of research in the field through scientific meetings, mentoring, postgraduate education and publications. Looking back we can conclude that starting the PSAD study group signified an important moment in time, where researchers were joining forces to further the quality of the science, raise awareness of the importance of psychosocial aspects and promote the dissemination of psychological interventions in diabetes care.
Echocardiographic features of Fabry cardiomyopathy—Comparison with hypertrophy‐matched sarcomeric hypertrophic cardiomyopathy
Authors: Militaru Sebastian , Jurcuț Ruxandra , Adam Robert , Roşca Monica , Ginghina Carmen , Popescu Bogdan A. 
Published: October 2019

AbstractBackgroundThe concept of “red flags” has been particularly useful in the etiologic diagnosis of cardiomyopathies such as Fabry disease, as early detection is often essential for treatment response and outcomes. The present study sought to describe the echocardiographic features that may differentiate Fabry cardiomyopathy from sarcomeric hypertrophic cardiomyopathy (HCM).MethodsForty patients with left ventricular (LV) hypertrophy were prospectively included and divided into two groups: the Fabry group (20) and the sarcomeric HCM group (20). The two groups were matched for LV hypertrophy (similar maximum wall thickness and indexed LV mass) and age. All patients underwent full echocardiographic evaluation including ventricular strain analysis.ResultsThe Fabry group had significantly lower LV ejection fraction (63 ± 7 vs 72 ± 7%, P = .001) and higher LV end‐systolic diameter (28 ± 7 vs 22 ± 5 mm, P = .004). LV hypertrophy in Fabry patients was more often concentric, with a significantly lower interventricular septum/posterior wall ratio (1.22 ± 0.63 vs 1.55 ± 0.66, P = .001). Fabry patients had more reduced regional longitudinal strain in the inferolateral part of the LV (−9 ± 5 vs –16 ± 7%), and RV free wall longitudinal strain was also worse in Fabry patients (−23 ± 6 vs –28 ± 5%, P = .027).ConclusionThese parameters are promising echocardiographic features to identify patients with Fabry cardiomyopathy and may help for the detection and subsequent management of these patients.