bluuebunny/crossref_metadata_2025_split huggingface dataset:
EAPCI Position Statement on Invasive Management of Acute Coronary Syndromes during the COVID-19 pandemic
Authors: Chieffo Alaide , Stefanini Giulio G , Price Susanna , Barbato Emanuele , Tarantini Giuseppe , Karam Nicole , Moreno Raul , Buchanan Gill Louise , Gilard Martine , Halvorsen Sigrun , Huber Kurt , James Stefan , Neumann Franz-Josef , Möllmann Helge , Roffi Marco , Tavazzi Guido , Mauri Ferré Josepa , Windecker Stephan , Dudek Dariusz , Baumbach Andreas 
Published: May 2020

AbstractThe coronavirus disease 2019 (COVID-19) pandemic poses an unprecedented challenge to healthcare worldwide. The infection can be life threatening and require intensive care treatment. The transmission of the disease poses a risk to both patients and healthcare workers. The number of patients requiring hospital admission and intensive care may overwhelm health systems and negatively affect standard care for patients presenting with conditions needing emergency interventions. This position statements aims to assist cardiologists in the invasive management of acute coronary syndrome (ACS) patients in the context of the COVID-19 pandemic. To that end, we assembled a panel of interventional cardiologists and acute cardiac care specialists appointed by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and from the Acute Cardiovascular Care Association (ACVC) and included the experience from the first and worst affected areas in Europe. Modified diagnostic and treatment algorithms are proposed to adapt evidence-based protocols for this unprecedented challenge. Various clinical scenarios, as well as management algorithms for patients with a diagnosed or suspected COVID-19 infection, presenting with ST- and non-ST-segment elevation ACS are described. In addition, we address the need for re-organization of ACS networks, with redistribution of hub and spoke hospitals, as well as for in-hospital reorganization of emergency rooms and cardiac units, with examples coming from multiple European countries. Furthermore, we provide a guidance to reorganization of catheterization laboratories and, importantly, measures for protection of healthcare providers involved with invasive procedures.
Characteristics and outcomes of patients hospitalized for COVID-19 and cardiac disease in Northern Italy
Authors: Inciardi Riccardo M , Adamo Marianna , Lupi Laura , Cani Dario S , Di Pasquale Mattia , Tomasoni Daniela , Italia Leonardo , Zaccone Gregorio , Tedino Chiara , Fabbricatore Davide , Curnis Antonio , Faggiano Pompilio , Gorga Elio , Lombardi Carlo M , Milesi Giuseppe , Vizzardi Enrico , Volpini Marco , Nodari Savina , Specchia Claudia , Maroldi Roberto , Bezzi Michela , Metra Marco 
Published: May 2020

Abstract

Aims
To compare demographic characteristics, clinical presentation, and outcomes of patients with and without concomitant cardiac disease, hospitalized for COVID-19 in Brescia, Lombardy, Italy.

Methods and results
The study population includes 99 consecutive patients with COVID-19 pneumonia admitted to our hospital between 4 March and 25 March 2020. Fifty-three patients with a history of cardiac disease were compared with 46 without cardiac disease. Among cardiac patients, 40% had a history of heart failure, 36% had atrial fibrillation, and 30% had coronary artery disease. Mean age was 67 ± 12 years, and 80 (81%) patients were males. No differences were found between cardiac and non-cardiac patients except for higher values of serum creatinine, N-terminal probrain natriuretic peptide, and high sensitivity troponin T in cardiac patients. During hospitalization, 26% patients died, 15% developed thrombo-embolic events, 19% had acute respiratory distress syndrome, and 6% had septic shock. Mortality was higher in patients with cardiac disease compared with the others (36% vs. 15%, log-rank P = 0.019; relative risk 2.35; 95% confidence interval 1.08–5.09). The rate of thrombo-embolic events and septic shock during the hospitalization was also higher in cardiac patients (23% vs. 6% and 11% vs. 0%, respectively).

Conclusions
Hospitalized patients with concomitant cardiac disease and COVID-19 have an extremely poor prognosis compared with subjects without a history of cardiac disease, with higher mortality, thrombo-embolic events, and septic shock rates.
Characteristics and clinical significance of myocardial injury in patients with severe coronavirus disease 2019
Authors: Shi Shaobo , Qin Mu , Cai Yuli , Liu Tao , Shen Bo , Yang Fan , Cao Sheng , Liu Xu , Xiang Yaozu , Zhao Qinyan , Huang He , Yang Bo , Huang Congxin 
Published: May 2020

Abstract

Aims
To investigate the characteristics and clinical significance of myocardial injury in patients with severe coronavirus disease 2019 (COVID-19).

Methods and results
We enrolled 671 eligible hospitalized patients with severe COVID-19 from 1 January to 23 February 2020, with a median age of 63 years. Clinical, laboratory, and treatment data were collected and compared between patients who died and survivors. Risk factors of death and myocardial injury were analysed using multivariable regression models. A total of 62 patients (9.2%) died, who more often had myocardial injury (75.8% vs. 9.7%; P &lt; 0.001) than survivors. The area under the receiver operating characteristic curve of initial cardiac troponin I (cTnI) for predicting in-hospital mortality was 0.92 [95% confidence interval (CI), 0.87–0.96; sensitivity, 0.86; specificity, 0.86; P &lt; 0.001]. The single cut-off point and high level of cTnI predicted risk of in-hospital death, hazard ratio (HR) was 4.56 (95% CI, 1.28–16.28; P = 0.019) and 1.25 (95% CI, 1.07–1.46; P = 0.004), respectively. In multivariable logistic regression, senior age, comorbidities (e.g. hypertension, coronary heart disease, chronic renal failure, and chronic obstructive pulmonary disease), and high level of C-reactive protein were predictors of myocardial injury.

Conclusion
The risk of in-hospital death among patients with severe COVID-19 can be predicted by markers of myocardial injury, and was significantly associated with senior age, inflammatory response, and cardiovascular comorbidities.
Klotho modulates electrical activity and calcium homeostasis in pulmonary vein cardiomyocytes via PI3K/Akt signalling
Authors: Hung Yuan , Chen Yao-Chang , Huang Shih-Yu , Lu Yen-Yu , Lin Yung-Kuo , Kao Yu-Hsun , Lin Wei-Shiang , Chen Shih-Ann , Chen Yi-Jen 
Published: May 2020

Abstract

Aims
Klotho, a potential antiageing protein has remarkable cardiovascular effects, which is lower in the patients with chronic kidney disease (CKD). Chronic kidney disease increases the risk of atrial fibrillation, majorly triggered by pulmonary vein (PV) arrhythmogenesis. This study investigated whether klotho protein can modulate PV electrical activity and the underlying potential mechanisms.

Methods and results
A conventional microelectrode and whole-cell patch clamp were used to investigate the action potentials and ionic currents in isolated rabbit PV tissue preparations and single cardiomyocytes before and after klotho administration. Phosphoinositide 3-kinase (PI3K)/Akt signalling was studied using western blotting. Klotho significantly reduced PV spontaneous beating rates in PV tissue preparations at 1.0 and 3.0 ng/mL (but not at 0.1 and 0.3 ng/mL). In the presence of the Akt inhibitor (10 µM), klotho (1.0 and 3.0 ng/mL) did not change PV electrical activities. Klotho (1.0 ng/mL) significantly decreased the late sodium current (INa-Late) and L-type calcium current (ICa-L), similar to the Akt inhibitor (10 µM). Western blots demonstrated that klotho (1.0 ng/mL)-treated PV cardiomyocytes had less phosphorylation of Akt (Ser473) compared with klotho-untreated cardiomyocytes. Compared with control PVs, klotho at relatively lower concentrations (0.1 and 0.3 ng/mL) significantly reduced beating rates and decreased the amplitudes of delay afterdepolarizations in CKD PVs.

Conclusion
Klotho modulated PV electrical activity by inhibiting PI3K/Akt signalling, which may provide a novel insight into CKD-induced arrhythmogenesis.
Magnetic characteristics of Guangshan loess from northern piedmont of Dabie Mountains, east-central China
Authors: Han Yan , Liu Xiuming , Zhao Guoyong , Zhang Zhenke , Lü Bin , Chen Qu 
Published: May 2020

SUMMARY
The loess from the northern piedmont of the Dabie Mountains is in a transition area between loess from the Chinese Loess Plateau, the Quaternary red soils of southern China and the Xiashu loess. Despite its significant location, the study has been inadequate. In this study, the Guangshan section in the northern piedmont of the Dabie Mountains was selected for investigation. Environmental magnetism, geochemistry, colour reflectance and optical diffuse reflection spectroscopy analyses were applied to detect the magnetic variations in the loess. The results showed that (1) the magnetic minerals consisted mainly of magnetite, maghemite, hematite and goethite, which are the same as those in the Quaternary loess from the Chinese Loess Plateau, the Xiashu loess and the Quaternary red soils of southern China. The average magnetic particles were in the pseudo-single domain, like those of the Chinese Loess Plateau loess. (2) Unit III of the Guangshan section (2.4–4 m), with high chemical index of alteration and low Ba-index, was demonstrated as the most strongly developed palaeosol in the whole section, in agreement with field observations (more Fe-Mn films and weakly vermiculated development). However, it exhibited minimal susceptibility values and the lowest concentration of fine ferrimagnetic minerals. Simultaneously, the unit had low hematite to goethite ratio (Hm/Gt), suggesting that the pedogenic environment was humid; and it also had high values of b* and Gt%, implying that there was more goethite. Therefore, we can conclude that excessive soil moisture and intensive pedogenesis dissolved the fine ferrimagnetic minerals originally produced by pedogenesis and transformed them into goethite. These results could help to trace the palaeoclimatic evolution of the study area and clarify the magnetic variations of loess in different climates throughout China.
XKS splitting-based upper-mantle deformation in the Jiaodong Peninsula records the boundary between the North China Craton and South China Block
Authors: Wu Chenglong , Xu Tao , Ai Yinshuang , Dong Weiyu , Li Long 
Published: May 2020

SUMMARYThe Jiaodong Peninsula consists of the Jiaobei massif and the Northern Sulu UHP massif. These are separated by the Wulian suture zone (WSZ), a key region for understanding the collision between the North China Craton (NCC) and South China Block (SCB). To interpret this collisional zone, a broad-band seismic profile of 20 stations was installed across the WSZ. Shear wave splitting analysis of teleseismic data revealed a contrast in the splitting patterns beneath different structural zones of the Jiaodong Peninsula. The anisotropic structures of the Jiaobei massif and Northern Sulu UHP massif can be explained by a single anisotropic layer model with WNW-ESE or E-W oriented fast directions. In the WSZ, splitting parameters exhibit pronounced variation in backazimuths indicating a two-layer anisotropy pattern. The lower layer exhibits a WNW-ESE fast direction consistent with that observed in the other two regions. Because the fast direction is generally parallel to the present-day direction of Pacific plate subduction, the anisotropy most likely represents asthenospheric return flow in the big mantle wedge caused by Pacific plate subduction. The upper layer exhibits an NE fast direction, that is, parallel to faulting associated with the WSZ. The lithosphere may preserve fossilized anisotropy induced by the Late Triassic collision of the NCC and SCB even after subsequent destruction and thinning from the Late Mesozoic to Cenozoic. We infer that the WSZ represents a lithospheric-scale structural boundary between the NCC and SCB.
Consequences of access to water from managed aquifer recharge systems for blood pressure and proteinuria in south-west coastal Bangladesh: a stepped-wedge cluster-randomized trial
Authors: Naser Abu Mohd , Doza Solaiman , Rahman Mahbubur , Unicomb Leanne , Ahmed Kazi M , Anand Shuchi , Selim Shahjada , Shamsudduha Mohammad , Narayan KM Venkat , Chang Howard , Clasen Thomas F , Gribble Matthew O , Luby Stephen P 
Published: May 2020

Abstract

Background
Drinking-water salinity has been associated with high blood pressure (BP) among communities in south-west coastal Bangladesh. We evaluated whether access to water from managed aquifer recharge (MAR)—a hydrogeological intervention to lower groundwater salinity by infiltrating rainwater into the aquifers—can reduce community BP.

Methods
We conducted a stepped-wedge cluster-randomized trial with five monthly visits between December 2016 and April 2017 in 16 communities. At each visit following baseline, four communities were randomized to access MAR water. Systolic BP was the primary outcome, measured during each visit using Omron® HEM–907 devices. We also measured participants’ 24-hour urinary sodium and households’ drinking- and cooking-water salinity each visit. We used multilevel regression models to estimate the effects of MAR-water access on participants’ BP. The primary analysis was intention-to-treat.

Results
In total, 2911 person-visits were conducted in communities randomized to have MAR-water access and 2834 in communities without MAR-water access. Households without MAR-water access predominantly used low-salinity pond water and 42% (range: 26–50% across visits) of households exclusively consumed MAR water when access was provided. Communities randomized to MAR-water access had 10.34 [95% confidence interval (CI): 1.11, 19.58] mmol/day higher mean urinary sodium, 1.96 (95% CI: 0.66, 3.26; p = 0.004) mmHg higher mean systolic BP and 1.44 (95% CI: 0.40, 2.48; p = 0.007) mmHg higher mean diastolic BP than communities without MAR-water access.

Conclusions
Our findings do not support the scale-up of MAR systems as a routine drinking-water source, since communities that shifted to MAR water from the lower-salinity pond-water source had higher urinary sodium and BP.
Patients With Natural Killer (NK) Cell Chronic Active Epstein-Barr Virus Have Immature NK Cells and Hyperactivation of PI3K/Akt/mTOR and STAT1 Pathways
Authors: Howe Matthew K , Dowdell Kennichi , Kuehn Hye Sun , Li Qingxue , Hart Geoffrey T , Garabedian Doreen , Liepshutz Kelly , Hsu Amy P , Su Hua , Niemela Julie E , Stoddard Jennifer L , Uzel Gulbu , Shereck Evan , Schulz Laura , Feldman Tatyana , Rosenzweig Sergio D , Long Eric O , Dropulic Lesia , Cohen Jeffrey I 
Published: May 2020

Abstract

Background
Chronic active Epstein-Barr virus (CAEBV) presents with high levels of viral genomes in blood and tissue infiltration with Epstein-Barr virus (EBV)–positive lymphocytes. The pathogenesis of CAEBV is poorly understood.

Methods
We evaluated 2 patients with natural killer (NK) cell CAEBV and studied their NK cell phenotype and signaling pathways in cells.

Results
Both patients had increased numbers of NK cells, EBV predominantly in NK cells, and immature NK cells in the blood. Both patients had increased phosphorylation of Akt, S6, and STAT1 in NK cells, and increased total STAT1. Treatment of 1 patient with sirolimus reduced phosphorylation of S6 in T and B cells, but not in NK cells and did not reduce levels of NK cells or EBV DNA in the blood. Treatment of both patients’ cells with JAK inhibitors in vitro reduced phosphorylated STAT1 to normal. Patients with T- or B-cell CAEBV had increased phosphorylation of Akt and S6 in NK cells, but no increase in total STAT1.

Conclusions
The increase in phosphorylated Akt, S6, and STAT1, as well as immature NK cells describe a new phenotype for NK cell CAEBV. The reduction of STAT1 phosphorylation in their NK cells with JAK inhibitors suggests a novel approach to therapy.
Immune Profiling Panel: A Proof-of-Concept Study of a New Multiplex Molecular Tool to Assess the Immune Status of Critically Ill Patients
Authors: Tawfik Dina M , Vachot Laurence , Bocquet Adeline , Venet Fabienne , Rimmelé Thomas , Monneret Guillaume , Blein Sophie , Montgomery Jesse L , Hemmert Andrew C , Pachot Alexandre , Moucadel Virginie , Yugueros-Marcos Javier , Brengel-Pesce Karen , Mallet François , Textoris Julien 
Published: May 2020

Abstract

Background
Critical illness such as sepsis is a life-threatening syndrome defined as a dysregulated host response to infection and is characterized by patients exhibiting impaired immune response. In the field of diagnosis, a gap still remains in identifying the immune profile of critically ill patients in the intensive care unit (ICU).

Methods
A new multiplex immune profiling panel (IPP) prototype was assessed for its ability to semiquantify messenger RNA immune-related markers directly from blood, using the FilmArray System, in less than an hour. Samples from 30 healthy volunteers were used for the technical assessment of the IPP tool. Then the tool was clinically assessed using samples from 10 healthy volunteers and 20 septic shock patients stratified using human leukocyte antigen–DR expression on monocytes (mHLA-DR).

Results
The IPP prototype consists of 16 biomarkers that target the immune response. The majority of the assays had a linear expression with different RNA inputs and a coefficient of determination (R2) &gt; 0.8. Results from the IPP pouch were comparable to standard quantitative polymerase chain reaction and the assays were within the limits of agreement in Bland–Altman analysis. Quantification cycle values of the target genes were normalized against reference genes and confirmed to account for the different cell count and technical variability. The clinical assessment of the IPP markers demonstrated various gene modulations that could distinctly differentiate 3 profiles: healthy volunteers, intermediate mHLA-DR septic shock patients, and low mHLA-DR septic shock patients.

Conclusions
The use of IPP showed great potential for the development of a fully automated, rapid, and easy-to-use immune profiling tool. The IPP tool may be used in the future to stratify critically ill patients in the ICU according to their immune status. Such stratification will enable personalized management of patients and guide treatments to avoid secondary infections and lower mortality.
T-Cell Subset Counts in Peripheral Blood Can Be Used as Discriminatory Biomarkers for Diagnosis and Severity Prediction of Coronavirus Disease 2019
Authors: Jiang Mei , Guo Yang , Luo Qing , Huang ZiKun , Zhao Rui , Liu ShuYuan , Le AiPing , Li JunMing , Wan LaGen 
Published: May 2020

Abstract
This study evaluated the significance of lymphocyte subset detection in peripheral blood in the diagnosis and prognosis of coronavirus disease 2019 (COVID-19). Our results revealed that CD3+ T cells, CD4+ T cells, CD8+ T cells, and natural killer cells were significantly decreased in patients with COVID-19. These patients had a relatively slight decrease in CD4+ T cells but a severe decrease in CD8+ T cells. The significantly elevated CD4/CD8 ratio was observed in COVID-19 patients. T-cell subset counts were related to the severity and prognosis of COVID-19, suggesting that the counts of CD8+ T and CD4+ T cells can be used as diagnostic markers of COVID-19 and predictors of disease severity.
Salivary microRNAs are potential biomarkers for the accurate and precise identification of inflammatory response after tail docking and castration in piglets
Authors: Lecchi Cristina , Zamarian Valentina , Gini Chiara , Avanzini Chiara , Polloni Alessia , Rota Nodari Sara , Ceciliani Fabrizio 
Published: May 2020

Abstract
The present study aimed to investigate whether acute pain associated with castration and tail docking of male piglets may modulate the expression of salivary microRNAs (miRNAs) and to explore their potential use as biomarkers. Thirty-six healthy 4-d-old piglets (Hermitage × Duroc) were randomly assigned to three groups: the first group (12 piglets) has been pretreated with anesthetic and anti-inflammatory drugs (ANA) and then castrated and tail docked; the second one (12 piglets) has been castrated and tail docked without any drugs (CONV); the third one (12 piglets) has been only handled (SHAM). Saliva was collected 10 min before (control group) and 30 to 45 min after the procedures. Salivary cortisol has been quantified. The expression concentrations of seven miRNAs, namely miR-19b, miR-27b-3p, miR-215, miR-22-3p, miR-155-5p, hsa-miR-365-5p, and hsa-miR-204, were measured and assessed as potential biomarkers of pain by quantitative Polimerase Chain Reaction using TaqMan probes. The area under the receiver operating curve (AUC) was used to evaluate the diagnostic performance of miRNAs. The concentration of salivary cortisol increased after treatment in CONV and ANA, while no significant variation was observed in the SHAM group. The comparative analysis demonstrated that the concentrations of salivary miR-19b (P = 0.001), miR-27b (P = 0.042), and miR-365 (P &lt; 0.0001) were significantly greater in CONV as compared with pretreatment. The AUC of pretreatment vs. CONV and CONV vs. ANA were excellent for miR-19b and miR-365 and fair for miR-27b. Combining two miRNAs, namely miR-19b and miR-365, in a panel increased the efficiency of distinguishing between pre- and post-treatment groups. No differences have been identified between SHAM and ANA groups. mRNA potential targets of differentially expressed-miRNA were investigated, and genes related to pain and inflammation were identified: miR-19b potentially modulates TGF-beta and focal adhesion pathways, miR-365 regulates cytokines expression (i.e., IL-1, Tumor Necross Factor-alpha, and IL-8 cytokine), and miR-27b regulates macrophage inflammatory protein pathways (i.e., MIP1-beta). In conclusion, we demonstrated that the abundance of miR-19b, miR-27b, and miR-365 increases in the saliva of piglets castrated and tail docked without the administration of pain-relieving drugs. Further studies are needed to assess their potential during routine husbandry procedures and to extend their assessment in other stressful events, such as weaning or chronic pain.