bluuebunny/crossref_metadata_2025_split huggingface dataset:
Constraining the charge of the Galactic centre black hole
Authors: Zajaček Michal , Tursunov Arman , Eckart Andreas , Britzen Silke , Hackmann Eva , Karas Vladimír , Stuchlík Zdeněk , Czerny Bozena , Zensus J. Anton 
Published: October 2019

Abstract
In this contribution, we summarize our results concerning the observational constraints on the electric charge associated with the Galactic centre black hole – Sgr A*. According to the no-hair theorem, every astrophysical black hole, including supermassive black holes, is characterized by at most three classical, externally observable parameters – mass, spin, and the electric charge. While the mass and the spin have routinely been measured by several methods, the electric charge has usually been neglected, based on the arguments of efficient discharge in astrophysical plasmas. From a theoretical point of view, the black hole can attain charge due to the mass imbalance between protons and electrons in fully ionized plasmas, which yields about ~ 108 C for Sgr A*. The second, induction mechanism concerns rotating Kerr black holes embedded in an external magnetic field, which leads to electric field generation due to the twisting of magnetic field lines. This electric field can be associated with the induced Wald charge, for which we calculate the upper limit of ~ 1015 C for Sgr A*. Although the maximum theoretical limit of ~ 1015 C is still 12 orders of magnitude smaller than the extremal charge of Sgr A*, we analyse a few astrophysical consequences of having a black hole with a small charge in the Galactic centre. Two most prominent ones are the effect on the X-ray bremsstrahlung profile and the effect on the position of the innermost stable circular orbit.
Multiple anthropogenic drivers behind upward trends in organic carbon concentrations in boreal rivers
Authors: Asmala Eero , Carstensen Jacob , Räike Antti 
Published: October 2019

Abstract
Increases of riverine organic carbon concentrations have been observed across the northern hemisphere over the past few decades. These increases are the result of multiple environmental drivers, but the relative importance of the drivers is still unclear. We analyzed a dataset of >10 000 observations of riverine total organic carbon (TOC) concentrations and associated water chemistry and hydrological observations from 1993 to 2017. The observations span a ∼600 km north–south gradient from 30 individual river systems in Finland. Our data show significantly increasing TOC concentrations in 25 out of 30 systems, with an average increase from 12.0 to 15.1 mg l−1. The observed increase in riverine TOC concentrations led to an increase of 0.28 Mt in annual TOC load to the Baltic Sea from 1993 level to 2017 level. We analyzed the role of three putative environmental drivers of the observed TOC trends. Multiple regression analysis revealed that the most common driver was discharge, which alone explained TOC increases in 13 rivers, whereas pH and temperature were less important drivers (sole predictor in one and zero rivers, respectively). Different permutations of these three drivers were also found to be significant; the combination of discharge and pH being the most common (4 rivers). Land use was not in general linked with trends in TOC, except for the proportion of ditched land in the catchment, which was significantly correlated with increases in TOC concentration. Land use showed significant relationships with trends in discharge and pH. We also found that catchment characteristics are regulating the extent of these regional or global environmental changes causing the upward trends of riverine organic carbon.
Twisting and tweezing the spin wave: on vortices, skyrmions, helical waves, and the magnonic spiral phase plate
Authors: Jia Chenglong , Ma Decheng , Schäffer Alexander F , Berakdar Jamal 
Published: October 2019

Abstract
Spin waves are the low-energy excitations of magnetically ordered materials. They are key elements in the stability analysis of the ordered phase and have a wealth of technological applications. Recently, we showed that spin waves of a magnetic nanowire may carry a definite amount of orbital angular momentum components along the propagation direction. This helical, in addition to the chiral, character of the spin waves is related to the spatial modulations of the spin-wave phase across the wire. It, however, remains a challenge to generate and control such modes with conventional magnetic fields. Here, we make the first proposal for magnetic spiral phase plate by appropriately synthesizing two magnetic materials that have different speeds of spin waves. It is demonstrated with full-numerical micromagnetic simulations that despite the complicated structure of demagnetization fields, a homogeneous spin wave passing through the spiral phase plate attains the required twist and propagates further with the desired orbital angular momentum. While excitations from the ordered phase may have a twist, the magnetization itself can be twisted due to internal fields and forms what is known as a magnetic vortex. We point out the differences between both types of magnetic phenomena and discuss their possible interaction.
Effectiveness and safety of ferric carboxymaltose therapy in peritoneal dialysis patients: an observational study
Authors: Portolés-Pérez Jose , Durá-Gúrpide Beatriz , Merino-Rivas José Luis , Martín-Rodriguez Leyre , Hevia-Ojanguren Covadonga , Burguera-Vion Victor , Yuste-Lozano Claudia , Sánchez-García Luisa , Rodriguez-Palomares Jose Ramon , Paraiso Vicente ,   the GCDP Study Group
Published: October 2019

AbstractBackgroundThe efficacy of intravenous (IV) ferric carboxymaltose (FCM) has been demonstrated in haemodialysis and non-dialysis studies, but evidence is lacking in patients undergoing peritoneal dialysis (PD).MethodsThis multicentre, retrospective study evaluated the effectiveness and safety of FCM in patients on PD over 12 months. We retrospectively reviewed the electronic medical records of PD patients who initiated FCM treatment between 2014 and 2017 across seven Spanish centres.ResultsNinety-one patients were included in the safety population (mean ± SD age 57.7 ± 15.0 years) and 70 in the efficacy population (mean age 50.9 ± 14.5 years). No hypersensitivity reaction, FCM discontinuation or dose adjustment due to a serious adverse event (SAE) was registered in the safety population. The most common non-SAEs reported were headache (four events), mild hypotension (three events) and hypertension (two events), among others. In the efficacy population (n = 70), 68.6% of patients achieved ferritin levels of 200–800 ng/mL, 78.4% achieved transferrin saturation (TSAT) &gt;20%, and 62.8% achieved TSAT &gt;20% and ferritin &gt;200 ng/mL after 12 months of FCM initiation (P &lt; 0.01). Haemoglobin (Hb) levels were maintained at &gt;11 g/dL with a lower dose of darbepoetin throughout the follow-up. The sub-analysis of patients naïve to IV iron and with absolute or relative iron deficiency (n = 51) showed that 76.5% reached ferritin &gt;200 ng/mL, 80.4% TSAT &gt;20% and Hb increased (1.2 g/dL) after 4 months of FCM treatment (P &lt; 0.01).ConclusionIn this multicentre, retrospective, real-world study conducted in the PD population, FCM was effective, safe and easy to administer during routine clinical visits.
An unusual case of fulminant leptospiral myocarditis: a case report
Authors: Khoo Chun Yuan , Ng Choon Ta , Zheng Shuwei , Teo Loon Yee 
Published: October 2019

Abstract

Background
Fulminant myocarditis secondary to leptospirosis is rare and associated with poor outcomes.

Case summary
We describe a 60-year-old gentleman with fulminant leptospiral myocarditis and profound cardiogenic shock requiring veno-arterial extracorporeal membrane oxygenator (VA-ECMO) support. He was given high-dose pulse steroids early on post-VA-ECMO implantation and achieved full recovery. To our knowledge, this is the first reported case of leptospiral myocarditis with multiorgan dysfunction successfully managed by VA-ECMO and high-dose pulse steroids.

Discussion
This case report highlights the potential benefits of steroids in the management of leptospiral myocarditis which requires further validation. Early aggressive supportive management with ECMO should be considered in patients with fulminant leptospiral myocarditis.
2980The effect of monoclonal antibodies against PCSK9 on circulating CD34+ progenitor cells interactions with platelets in patients with familial hypercholesterolemia
Authors: Tsouka A N , Liberopoulos E N , Rizos C V , Christopoulou E C , Elisaf M S , Tselepis A D 
Published: October 2019

Abstract

Introduction
Platelets interact with circulating CD34+ progenitor cells inducing their differentiation into endothelial progenitor cells (EPCs) and further promoting EPC maturation into endothelial cells, an important step for endothelial regeneration and angiogenesis. PSCK9 is a serine protease that may not only play a crucial role in binding to the low density lipoprotein receptor (LDL-R) increasing its endosomal and lysosomal degradation thus inhibiting its recycling to the cell surface, leading to increasing LDL-cholesterol levels in plasma, but may also exhibit several, independent on LDL-R, activities on a plethora of cell types, including platelets.

Purpose
We investigated whether monoclonal antibodies (mabs) against PCSK9 could affect platelet interaction with CD34+ cells as well as their differentiation into EPCs, in patients with Familial Hypercholestorelemia (FH).

Patients and methods
Patients with FH (n=11, 8 men and 3 women, mean age 53±10 years) being under statin/ezetimibe therapy (40mg statin/ 10mg ezetimibe) participated in the study. Patients exhibited resisting high LDL-cholesterol levels, therefore following the existing guidelines, they received mab against PCSK9 (7 evolocumab, 140mg/ml and 4 alirocumab, 150mg/ml) every two weeks. Blood samples were drawn before and after 4 doses of the antibody i.e. after two months (Follow-up). In addition to the patients' serum lipid profile, the endothelial phenotype of CD34+ (membrane expression levels of KDR which is a receptor for VEGF and an endothelial phenotype marker) on CD34+ cells (CD34+-KDR+ cells) and the formation of platelet-CD34+ (CD61+-CD34+) and platelet-KDR+ (CD61+-KDR+) conjugates were also determined by flow cytometry on whole blood after dual labelling with anti-VEGFR-R2/KDR-PE, anti-CD61-PerCP and anti-CD34-FITC. The results were expressed as the %gated of CD34+-KDR+ cells, as well as CD61+-CD34+ and CD61+-KDR+ conjugates.

Results
The baseline LDL-cholesterol levels were significantly reduced from 172±43 mg/dl to 51±17 at follow-up, p=0.0001. Importantly, the formation of CD61+-CD34+ and CD61+-KDR+ conjugates were increased from baseline to follow-up (from 1.39±1.3 to 2.23±2.8, p=0.037) and (from 2.91±4.2 to 5.92±6.01, p=0.014), respectively. The membrane expression of KDR on CD34+ cells was also increased from 0.79±0.9 to 1.36±0.90, p=0.042, which reflects the increase in the CD34+ endothelial phenotype.

Conclusion
We show for the first time that the mabs against PCSK9, significantly increase the CD34+ endothelial phenotype in FH patients, which may at least partially attributed to the increase in the platelet interaction with CD34+ cells (platelet-CD34+ conjugates). The underlying mechanisms as well as the consequences of this effect at the clinical level for these patients are under investigation.
3039Vulnerability of carotid atherosclerosis: relationship with plaque location, plaque eccentricity and vessel remodeling patterns. Insight from the the MAGNETIC observational study
Authors: Catalano O , Cerabolini C , Eshja E , Bendotti G , De Salvo M , Aloi T L , Ferrari Bardile A , Frascaroli M , Zanaboli D , Tibollo V , Bellazzi R , Poggi P , Pedretti R F E 
Published: October 2019

Abstract

Carotid atherosclerosis is a cause of brain ischemic events. Cardiovascular magnetic resonance (CMR) can assess plaque vulnerability. We investigated atherosclerosis vulnerability in relation to plaque location, eccentricity and vessel remodeling. Methods-Baseline CMR evaluations of the MAGNETIC observational study, were analyzed. We quantitated with MRI-Plaque View™, vessel lumen/wall and vulnerable plaque components of a 32-mm segment of common carotid artery (12 mm), bulb (8 mm) and internal carotid artery (12 mm). Lipid-rich necrotic core [LRNC], fibrous cap [CAP] and intraplaque hemorrhage [IPH] were expressed as percent of wall area. Results-A data-set of 8080 sections of adequate quality in 260 patients (198 male [76%], median age 71 years [65–76]), were analyzed. Patients were on therapy with antiplatelet, ACE-inhibitors/ARB and statins (196–229 out of 260 [75–88%]). We found significant differences in plaque composition according to longitudinal and circumferential location, eccentricity and vessel remodeling (table). At multivariate regression analysis, including classical RF and atherosclerotic burden, we found an independent association of: LRNC and IPH with longitudinal location, eccentricity and positive remodeling, and of CAP with eccentricity (p<0.001 for all).
Lipid-rich necrotic core Fibrous cap Intraplaque hemorrhage Longitudinal distribution Common carotid artery 4% [1–10] p<0.001 6% [4–11] p<0.001 0% [0–3] p<0.001 Carotid bulb 7% [3–13] 9% [5–13] 1% [0–4] Internal carotid artery 3% [0–10] 7% [4–11] 0% [0–1] Circunferenzial location Antero-medial 4% [0–11] p<0.001 7% [4–12] p=0.07 0% [0–2] p<0.001 Antero-lateral 6% [1–12] 8% [5–12] 1% [0–4] Postero-lateral 5% [0–11] 7% [4–12] 0% [0–3] Postero-medial 5% [0–11] 7% [4–12] 0% [0–1] Plaque eccentricity Concentric 3% [0–9] p<0.001 7% [4–11] p<0.001 0% [0–2] p<0.001 Eccentric 9% [4–15] 9% [5–13] 1% [0–4] Remodelling pattern Negative 4% [0–10] p<0.001 7% [4–11] p<0.001 0% [0–2] p<0.001 Positive 7% [3–13] 8% [5–13] 1% [0–4] Plaque eccentricity was defined as eccentricity index (EI = [maximum wall thickness − minimum wall thickness]/maximum wall thickness) in the highest quartile. Positive remodeling was defined as remodeling index (= [vessel cross-sectional area − reference area]/cross-sectional area) in the highest quartile.

Conclusions
Carotid atherosclerotic plaque vulnerability seems to be independently associated with longitudinal location, plaque eccentricity and vessel positive remodeling.

Acknowledgement/Funding
Bayer AG, Leverkusen, Germany
3042Gender differences in the prevalence of a normal IMT with increasing severity of carotid disease
Authors: Matangi M , Cases M , Brouillard D , Armstrong D , Johri A 
Published: October 2019

Abstract

Background
The ARIC group has shown that increasing IMT is only predictive of increased cardiovascular (CV) risk in males (M). Plaque is predictive of increased CV risk in both M and females (F).

Purpose
To determine the prevalence of a normal IMT (<1.00mm) in M and F with evidence of carotid plaque. Plaque score (PS) was used as a measure of severity of disease.

Methods
Our database was searched for patients with all the required data, IMT, PS and plaque area. IMT was measured with automatic edge detection software, PS was calculated using the Rotterdam method and plaque area was measured in the carotid bulb and ICA bilaterally. Only the first carotid study was used in the analysis. PS of 0–6 were used to estimate plaque severity. ANOVA and the Fisher's exact test were used to detect differences between groups. A p value of <0.05 was considered significant.

Results
There were 5981 patients, 3062 M and 2919 F with an average age of 62.1±11.3 years. Table I. indicates that with increasing PS, age, IMT and plaque area all increase, with a reciprocal decrease in the proportion of patients with a normal IMT. Of 3829 patients with carotid plaque 1355 (35.4%) had an IMT <1.00mm. There were clear gender differences with a much higher prevalence of a normal IMT in F with carotid plaque than M, 776 of 1772 (43.8%) versus 579 of 2057 (28.1%), p<0.0001, Fisher's exact test. This gender difference applies to most groups with increasing plaque burden except those with the most severe disease (PS “5–6”).
Table 1 PS “0” PS “1” PS “2” PS “3” PS “4” PS “5–6” N 2152 896 1209 792 562 370 ANOVA Age 57.6±12.2 60.4±9.2 63.0±9.5 66.5±9.3 67.8±8.9 71.5±8.8 <0.0001 IMT 0.94±0.32 1.00±0.23 1.08±0.29 1.30±0.55 1.51±0.75 2.77±0.88 <0.0001 Plaque area 0 16.5±11.6 35.1±20.0 58.6±29.9 91.0±43.1 130.4±61.3 <0.0001 Males 1005 424 627 422 331 253 IMT <1.00mm 671 222 226 77 50 4 Percentage 66.8% 52.4% 36.0% 18.2% 15.1% 1.6% Females 1147 472 582 370 231 117 IMT <1.00mm 879 293 288 136 57 2 Percentage 76.6% 62.1% 49.5% 36.8% 24.6% 1.7% Fisher's test <0.0001 <0.005 <0.0001 <0.0001 <0.0001 NS PS = Carotid ÷ 6 segments, assigned “0” or “1” if plaque is absent or present.

Conclusions
Significantly more women with carotid plaque have a normal IMT. This may explain why IMT fails to be predictive of CV risk in women.
3078Usefulness of a semi-quantitative and layer-specific assessment of the relative apical sparing pattern of longitudinal strain for the identification of cardiac amyloidosis
Authors: Saito M , Imai M , Wake D , Higaki R , Sumimoto T , Inaba S 
Published: October 2019

Abstract

Background
The relative apical sparing pattern (RASP) of left ventricular longitudinal strain (LS) is determined using a strain polar map, while global longitudinal strain is measured using speckle-tracking echocardiography, and it is frequently associated with cardiac amyloidosis (CA). However, the definition of visual RASP is ambiguous, and this leads to insufficient reproducibility, whereas quantitative RASP takes time and leads to difficulty in the clinical application. Generally, amyloid predominantly accumulates in the endo-myocardial layer. As such, layer-specific analysis of RASP may more accurately identify CA. Therefore, the aims of this study were to explore the reproducible and easy definition of RASP for identifying CA and investigate the effect of layer-specific analysis on the assessment.

Methods
A total of 40 patients with CA diagnosed by biopsy and technetium pyrophosphate scintigraphy were compared with 120 control patients matched for mean left ventricular wall thickness (40 aortic stenosis, 40 hypertrophic cardiomyopathy, and 40 hypertensive heart disease). We compared the discriminative abilities of three definitions of RASP (visual, quantitative, and semi-quantitative). According to a previous paper, visual RASP was defined as visual reduction of LS in the basal and middle LS segments (light red or blue) relative to the apical LS (red). Quantitative RASP was calculated using the following formula: average apical LS/(average basal LS + average mid-ventricle LS), then binarized by the optimal cut-off value for predicting CA. Semi-quantitative RASP was defined as reduction of LS (≥-10%) in five or more segments out of the basal six segments, relative to apical LS (≤-15%). Sample cases are shown in Figure (left). Visual and semi-quantitative RASP were independently assessed by two blinded sonographers. The RASP at the endo-myocardial and all layers was evaluated using customized software. The concordance was assessed using the kappa statistic, whereas the discriminative ability was assessed using receiver operating characteristic curve analysis.

Results
The concordance of visual RASP was modest but its semi-quantitative RASP was perfect (Table right). The discriminative ability of semi-quantitative RASP at each layer was significantly better than that of visual RASP and close to that of the binary quantitative RASP. Additionally, the discriminative abilities of visual (p=0.10) and semi-quantitative (p=0.11) RASP at the endo-myocardial layer appeared to be better than those at all layers.

Conclusions
The assessment method of semi-quantitative RASP is easy and highly reproducible. Furthermore, it accurately discriminates CA. In addition, assessment at the endo-myocardial layer potentially improves the discriminative ability.
3080Postsystolic shortening yields novel and independent prognostic information on cardiovascular events and mortality in patients with type 2 diabetes
Authors: Brainin P , Jensen M T , Biering-Soerensen T , Moegelvang R , Fritz-Hansen T , Vilsboell T , Rossing P , Joergensen P G 
Published: October 2019

Abstract

Background
Cardiovascular disease is the leading cause of death and disability in patients with type 2 diabetes. We aimed to evaluate if postsystolic shortening, a marker of impaired myocardial function, may provide prognostic information on cardiovascular events and mortality in patients with type 2 diabetes.

Method
We prospectively studied 783 patients with diabetes type 2 (63% male, age 65 [58, 70] years; HbA1c 54 [48, 65] mmol/mol; diabetes duration 11 [6, 17] years) who underwent speckle tracking echocardiography. Patients with left bundle branch block, atrial fibrillation and a history of heart failure and myocardial infarction were excluded. The primary endpoint was the composite of incident heart failure, myocardial infarction and cardiovascular death. The secondary endpoint was all-cause death. We defined the postsystolic index (PSI) as: [100x (maximum strain in cardiac cycle – peak systolic strain)/ (maximum strain in cardiac cycle)].

Results
During the median follow-up of 4.9 years [4.2, 5.3], 87 patients (11%) reached the primary endpoint and 80 (10%) died from any cause. Each 1% increase in the PSI was associated with the primary (HR 1.07 95% CI 1.02–1.13, P<0.001, Fig A) and secondary endpoint (HR 1.09 95% CI 1.04–1.14, P<0.001, Fig B). After adjusting for age, sex, hypertension, smoking, duration of diabetes, cholesterol, eGFR, left ventricular ejection fraction and mass index, E/A-ratio, deceleration time and left atrial volume index, the PSI remained an independent predictor of both endpoints; primary (HR 1.07 per 1% increase 95% CI 1.01–1.14, P=0.028) and secondary endpoint (HR 1.07 per 1% increase, 95% CI 1.01–1.14, P=0.022).
PSI and the endpoints

Conclusion
In patients with type 2 diabetes, assessment of PSI yields novel and independent prognostic information on cardiovascular events and mortality. Hence, PSI may offer guidance on risk stratification in patients with type 2 diabetes.