bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multiple left-sided stenotic lesions: outcomes after mitral valve surgery. Arguments for abandoning the eponym ‘Shone syndrome’
Authors: Perrier Stephanie L , Jadhav Mangesh , d’Udekem Yves , Brink Johann , Konstantinov Igor E , Zannino Diana , Cheung Michael M , Brizard Christian P 
Published: February 2020

Abstract

OBJECTIVES
Management of patients with left ventricular inflow and outflow stenotic lesions can be challenging. Our purpose was to characterize such patients and review the long-term outcomes of those requiring mitral valve (MV) surgery.

METHODS
We performed a retrospective study of 40 patients with subaortic, aortic and/or arch stenotic lesion(s) who underwent MV surgery between 1985 and 2016.

RESULTS
Associated left-sided stenotic lesions included aortic valve stenosis in 20 patients (50%), subaortic stenosis in 19 (47.5%) patients, coarctation in 23 (57.5%) patients and hypoplastic aortic arch in 16 (40%) patients. Nineteen patients (47.5%) had a supravalvular mitral ring and 15 (37.5%) patients had a parachute MV. The overall mortality rate was 32.5% (13 patients) with a mean follow-up of 16.3 ± 1.8 years. Being &lt;6 months of age at the time of MV surgery (P = 0.02) and having had previous neonatal aortic valve and/or arch surgery (P = 0.01) were associated with death. The incidence of reoperation (95% confidence interval) at 1, 5, 10 and 15 years was 38% (23–53%), 54% (38–70%), 68% (53–84%) and 85% (72–98%), respectively.

CONCLUSIONS
Results after MV surgery for children with associated left-sided stenotic lesions are closely age-related. The need for mitral intervention shortly after the initial aortic valve and/or arch intervention was a predictor of dismal outcomes
Watch-and-wait strategy for type A intramural haematoma and acute aortic dissection with thrombosed false lumen of the ascending aorta: a Japanese single-centre experience
Authors: Kitamura Tadashi , Torii Shinzo , Miyamoto Takashi , Mishima Toshiaki , Ohkubo Hirotoki , Fujioka Shunichiro , Yakuwa Kazuki , Araki Haruna , Kondo Shin , Tamura Yoshimi , Tadokoro Yuki , Onishi Yoshihiko , Miyaji Kagami 
Published: February 2020

Abstract

OBJECTIVES
In this study, we investigated the early and midterm outcomes of initial watch-and-wait strategy for Stanford type A intramural haematoma and acute aortic dissection with thrombosed false lumen of the ascending aorta in patients with a maximum aortic diameter of ≤50 mm, pain score of ≤3/10 and no ulcer-like projection in the ascending aorta.

METHODS
Inpatient and outpatient records were retrospectively reviewed.

RESULTS
Of the 81 patients with type A intramural haematoma and acute aortic dissection with the thrombosed false lumen of the ascending aorta between April 2011 and April 2019, a watch-and-wait strategy was selected in 46 patients. The mean age of the patients was 68 years, and 22 (48%) patients were female. Ten patients underwent emergency pericardial drainage for cardiac tamponade at the time of presentation and 8 patients underwent aortic repair during hospitalization for new ulcer-like projection, re-dissection or rupture. In-hospital mortality occurred in 2 (4%) patients. During follow-up, survival at 1 and 2 years was 95% and 92%, respectively. There was no significant difference in survival or aortic events between patients in whom the watch-and-wait strategy and emergency surgical treatment were indicated.

CONCLUSIONS
The early and midterm outcomes of the initial watch-and-wait strategy were favourable for type A intramural haematoma and acute aortic dissection with the thrombosed false lumen of the ascending aorta in Japanese patients with a maximum aortic diameter of ≤50 mm, pain score of ≤3/10 and no ulcer-like projection. Further study is required to show the safety of this strategy.
Borders as opposed to so-called geography: which should be used to classify isolated ventricular septal defects?
Authors: Edgar Laura J , Anderson Robert H , Stickley John , Crucean Adrian 
Published: February 2020

Abstract

OBJECTIVES
Ventricular septal defects can be classified according to their borders or according to the fashion in which they open to the right ventricle, so-called geography. As yet, there is no consensus as to how they should be classified. In an attempt to achieve agreement, the International Society for Nomenclature of Congenital and Paediatric Heart Disease, in 2018, proposed a system incorporating both approaches. We have assessed the subjectivity of their suggested terms hoping to determine their suitability in the desired universal system for classification.

METHODS
We examined 212 specimens held in the archive of Birmingham Women’s and Children’s Hospital. Each defect was described by 3 independent examiners on the basis of borders and their relationship to the landmarks of the right ventricle. The interobserver agreement was then calculated using Fleiss' method.

RESULTS
Calculations to assess interobserver agreement showed that the examiners were more likely to agree on the borders of the defects than their so-called geography (κ = 0.804 vs κ = 0.518). The landmarks of the right ventricle proved to be highly variable such that the application of ‘geographic’ terms to hearts with perimembranous defects proved particularly challenging.

CONCLUSIONS
Interobserver agreement is lower when using terms based on ‘geography’ as opposed to borders. Whilst providing important morphological detail, the terms based on right ventricular landmarks are highly subjective. They should not be prioritized in a universal system of classification. Instead, the defects can be classified simply by using ‘perimembranous’, ‘muscular’, or ‘doubly committed and juxta-arterial’ as first-order terms.
The haemochromatosis gene Hfe and Kupffer cells control LDL cholesterol homeostasis and impact on atherosclerosis development
Authors: Demetz Egon , Tymoszuk Piotr , Hilbe Richard , Volani Chiara , Haschka David , Heim Christiane , Auer Kristina , Lener Daniela , Zeiger Lucas B , Pfeifhofer-Obermair Christa , Boehm Anna , Obermair Gerald J , Ablinger Cornelia , Coassin Stefan , Lamina Claudia , Kager Juliane , Petzer Verena , Asshoff Malte , Schroll Andrea , Nairz Manfred , Dichtl Stefanie , Seifert Markus , von Raffay Laura , Fischer Christine , Barros-Pinkelnig Marina , Brigo Natascha , Valente de Souza Lara , Sopper Sieghart , Hirsch Jakob , Graber Michael , Gollmann-Tepeköylü Can , Holfeld Johannes , Halper Julia , Macheiner Sophie , Gostner Johanna , Vogel Georg F , Pechlaner Raimund , Moser Patrizia , Imboden Medea , Marques-Vidal Pedro , Probst-Hensch Nicole M , Meiselbach Heike , Strauch Konstantin , Peters Annette , Paulweber Bernhard , Willeit Johann , Kiechl Stefan , Kronenberg Florian , Theurl Igor , Tancevski Ivan , Weiss Guenter 
Published: February 2020

Abstract

Aims
Imbalances of iron metabolism have been linked to the development of atherosclerosis. However, subjects with hereditary haemochromatosis have a lower prevalence of cardiovascular disease. The aim of our study was to understand the underlying mechanisms by combining data from genome-wide association study analyses in humans, CRISPR/Cas9 genome editing, and loss-of-function studies in mice.

Methods and results
Our analysis of the Global Lipids Genetics Consortium (GLGC) dataset revealed that single nucleotide polymorphisms (SNPs) in the haemochromatosis gene HFE associate with reduced low-density lipoprotein cholesterol (LDL-C) in human plasma. The LDL-C lowering effect could be phenocopied in dyslipidaemic ApoE−/− mice lacking Hfe, which translated into reduced atherosclerosis burden. Mechanistically, we identified HFE as a negative regulator of LDL receptor expression in hepatocytes. Moreover, we uncovered liver-resident Kupffer cells (KCs) as central players in cholesterol homeostasis as they were found to acquire and transfer LDL-derived cholesterol to hepatocytes in an Abca1-dependent fashion, which is controlled by iron availability.

Conclusion
Our results disentangle novel regulatory interactions between iron metabolism, KC biology and cholesterol homeostasis which are promising targets for treating dyslipidaemia but also provide a mechanistic explanation for reduced cardiovascular morbidity in subjects with haemochromatosis.
Comparison of Pseudomonas aeruginosa strains reveals that Exolysin A toxin plays an additive role in virulence
Authors: Medina-Rojas Maria , Stribling William , Snesrud Erik , Garry Brittany I , Li Yuanzhang , Gann Patrick Mc , Demons Samandra T , Tyner Stuart D , Zurawski Daniel V , Antonic Vlado 
Published: February 2020

ABSTRACT

Background
Pseudomonas aeruginosa possesses an array of virulence genes ensuring successful infection development. A two-partner secretion system Exolysin BA (ExlBA) is expressed in the PA7-like genetic outliers consisting of ExlA, a pore-forming toxin and ExlB transporter protein. Presence of exlBA in multidrug-resistant (MDR) strains has not been investigated, particularly in the strains isolated from wounded soldiers.

Methods
We screened whole genome sequences of 2439 MDR- P. aeruginosa strains for the presence of exlBA. We compiled all exlBA positive strains and compared them with a diversity set for demographics, antimicrobial profiles and phenotypic characteristics: surface motility, biofilm formation, pyocyanin production and hemolysis. We compared the virulence of strains with comparable phenotypic characteristics in Galleria mellonella.

Results
We identified 33 exlBA-positive strains (1.5%). These strains have increased antibiotic resistance, they are more motile, produce more robust biofilms and have comparable pyocianin production with the diversity set despite the phenotypic differences within the group. In in vivo infection models, these strains were less virulent than Type III Secretion System (T3SS) positive counterparts.

Conclusions
exlBA-positive strains are wide spread among the PA7-like outliers. While not as virulent as strains possessing T3SS, these strains exhibit phenotypic features associated with virulence and are still lethal in vivo.
The Influence of Family and Friend Confidants on Marital Quality in Older Couples
Authors: Zhaoyang Ruixue , Martire Lynn M 
Published: February 2020

Abstract

Objectives
Relationships with confidants play an important role in older adults’ health and well-being. Particularly, family and friend confidants could significantly support or interfere with older adults’ marital relationships. This study used a dyadic approach to examine the influence of the structural features of both spouses’ family and friend confidant networks on older couples’ marital quality over 5 years.

Methods
Analyses used dyadic data from Wave 2 (2010–2011) and Wave 3 (2015–2016) interviews of the National Social Life, Health, and Aging Project (NSHAP), a nationally representative sample of community-dwelling older adults. Longitudinal actor–partner interdependence models were used to examine the influence of spouses’ family and friend confidant networks on couples’ marital quality.

Results
Having a larger friend confidant network or closer connections with friend confidants predicted greater marital quality for wives and husbands 5 years later. Larger family confidant networks of both spouses predicted greater marital quality for wives over time. However, husbands reported worse marital quality over time if wives reported having closer connections with their own family confidants at baseline.

Discussion
This study demonstrates the importance of family and friend confidant networks for older couples’ marital quality and highlights the benefits of having a larger or closer friend confidant network. Future research should examine mechanisms that account for the effects of spouses’ family and friend confidant networks on older couples’ marital quality.
Effectiveness and safety of minimally invasive Ivor Lewis and McKeown oesophagectomy in Chinese patients with stage IA–IIIB oesophageal squamous cell cancer: a multicentre, non-interventional and observational study
Authors: Zhang Tong , Hou Xiaobin , Li Yin , Fu Xiangning , Liu Lunxu , Xu Lin , Liu Yang 
Published: February 2020

Abstract

OBJECTIVES
To compare the long-term overall survival and outcomes of patients with oesophageal squamous cell cancer treated with minimally invasive McKeown or Ivor Lewis oesophagectomy.

METHODS
A multicentre, non-interventional, retrospective, observational study was performed in oesophageal squamous cell cancer patients pathologically confirmed with stage IA–IIIB middle or lower thoracic tumours who underwent minimally invasive oesophagectomy between 1 January 2010 and 30 June 2017 in 7 hospitals in China. Cox proportional hazards models assessed factors associated with overall survival and disease recurrence. The primary outcome was overall survival and cancer recurrence; the secondary outcomes included number of lymph nodes resected, 30-day mortality and postoperative complications.

RESULTS
A total of 1540 patients were included (950 McKeown, 590 Ivor Lewis). The mean age was 61.6 years, and 1204 were male. The mean number of lymph nodes removed during the McKeown procedure was 21.2 ± 11.4 compared with 14.8 ± 8.9 in Ivor Lewis patients (P &lt; 0.001). The 5-year overall survival rates were 67.9% (McKeown) and 55.0% (Ivor Lewis). McKeown oesophagectomy was associated with improved overall survival (Ivor Lewis versus McKeown hazard ratio 1.36, 95% confidence interval 1.11–1.66; P = 0.003), particularly in patients with stage T3 tumours (middle thoracic oesophagus). However, postoperative complications occurred more frequently following McKeown oesophagectomy (42.2% vs 17.6% Ivor Lewis; P &lt; 0.001).

CONCLUSIONS
Minimally invasive McKeown oesophagectomy was associated with improved overall survival and a decreased risk of disease recurrence, while Ivor Lewis patients had fewer postoperative complications. McKeown oesophagectomy may represent the optimal technique for patients with stage T3 tumours.

Clinical trial registration: clinicaltrial.gov
NCT03428074
Safety and efficacy of digital chest drainage units compared to conventional chest drainage units in cardiac surgery
Authors: Saha Shekhar , Hofmann Sandra , Jebran Ahmad Fawad , Waezi Narges , Kutschka Ingo , Friedrich Martin G , Niehaus Heidi 
Published: February 2020

Abstract

OBJECTIVES
The use of digital chest drainage units (CDUs) has become increasingly common in thoracic surgery due to several advantages. However, in cardiac surgery, its use is still limited in favour of conventional analogue CDUs. In order to investigate the potential benefit of digital CDUs in cardiac surgery, we compared the safety and efficacy of both systems in patients undergoing cardiac surgery at our centre.

METHODS
We retrospectively investigated 265 consecutive patients who underwent cardiac surgery at our institution between June 2017 and October 2017. These patients were divided into 2 groups: patients with analogue (A, n = 65) and digital CDUs (D, n = 200). Postoperative outcome was analysed and compared between both groups. In addition, the ‘user experience’ was evaluated by means of a questionnaire.

RESULTS
The median age of the cohort was 70 years (P = 0.167), 25.3% of patients were female (P = 0.414). There were no differences in terms of re-explorative surgery or use of blood products. Nor was there a difference in the overall amount of fluid collected. However, during the first 6 h, more fluid was collected by the digital CDUs. The overall rate of technical failure was 0.4%. We observed a significantly higher rate of clotting in the tubing system of the digital CDUs (P = 0.042). Concerning the user experience, the digital CDUs were associated with a more favourable ease of use on the regular wards (P &lt; 0.001). With regard to the overall user experience, the digital CDUs outperformed the analogue systems (P = 0.002).

CONCLUSIONS
Digital CDUs can be safely and effectively applied in patients after cardiac surgery. Due to the improved patient mobility and simplified chest tube management, the use of digital CDUs may be advantageous for patients after cardiac surgery. However, the issue of clotting of the tubing systems should be addressed by further technical improvements.
Singularities of Divisors of Low Degree on Simple Abelian Varieties
Authors: Pareschi Giuseppe 
Published: February 2020

Abstract
It is known by the results of Kollár, Ein, Lazarsfeld, Hacon, and Debarre that effective divisors representing principal and other low-degree polarizations on complex abelian varieties have mild singularities. In this note, we extend these results to all polarizations of degree $&lt;g$ on simple $g$-dimensional abelian varieties, settling a conjecture of Debarre and Hacon.
220 MHz Nuclear Magnetic Resonance Studies of Amygdalin and Some Related Compounds
Authors: Turczan John W , Medwick Thomas , Plank William M 
Published: February 2020

Abstract
A study of amygdalin, isoamygdalin, vicianin, amygdalinamide, amygdalinic acid, prunasin, sambunigrin, taxiphyllin, dhurrin, and holocalin has been carried out by nuclear magnetic resonance (NMR) spectrometry. Using 220 MHz spectra, the glycosides were studied in dimethylsulfoxide-d6 solution and in the presence of DO and D2O. Generally the assignments permit the following classification: The non-hydroxylic protons (including the anomeric protons) and the hydroxylic protons occur in the region from about 3.0 to 5.3 ppm; the aglycone methine hydrogen falls at about 6 ppm except for amygdalinamide and amygdalinic acid; the phenyl hydrogens are in the region of about 7 ppm. The chemical shifts and coupling constants for both OH6 and two H6 are independent of the aglycone stereochemistry, whereas the effect of the epimeric nature of the aglycone may be seen in terms of the carbohydrate portion resonances. The nature of the aglycone group may be classified as R or S, depending on the methine proton resonance. These studies should be very useful in the application of NMR to the recognition of aglycone stereochemistry and identification of amygdalin and other related cyanogenetic glycosides.
Standardized Assay for Clostridium botulinum Toxins
Authors: Schantz Edward J , Kautter Donald A 
Published: February 2020

Abstract
To improve the accuracy and precision of the mouse assay for botulinum toxins found in foods and body fluids, a stable reference standard of botulinum toxin has been developed. It contains 100 ng crystalline type A botulinum toxin/ml 0.05M pH 4.2 sodium acetate buffer which contains 3 mg bovine serum albumin and 2 mg gelatin/ml. The albumin and gelatin stabilize the toxin. For distribution to laboratories carrying out the assay, 0.5 ml of the standard is sealed in 1 ml glass vials. The standard reference toxin, used as directed, enables the assayer to establish the response of laboratory mice, under a specific set of conditions, to a definite amount of toxin and to express the toxin content of an unknown in terms of ng toxin/g or ml food or body fluid. The mouse assay by itself is not specific for botulinum toxin, but when used in conjunction with specific antisera for identification and typing, it is the most reliable test available.
Analysis of Synthetic Fibers by Diamond Cell and Sapphire Cell Infrared Spectrophotometry
Authors: Read Leonard K , Kopec Robert J 
Published: February 2020

Abstract
A rapid, simple, and nondestructive method of sample preparation and analysis is described for the infrared spectrophotometric analysis of synthetic fibers. This method uses a combined diamond cell and sapphire cell technique that yields highly resolved spectra with microgramsize fiber samples. From these highly resolved spectra, the generic type of fiber can be readily determined. Although the fiber sample has been physically crushed, it is not destroyed during the analysis and can be further examined by other analytical methods.
High Pressure Liquid Chromatographic Separation and Quantisation of Chlordiazepoxide. HC1 and Two of Its Related Compounds
Authors: Zagar John B , Van Lenten Frank J , Chrekian George P 
Published: February 2020

Abstract
A method is described for the separation and quantitative determination of chlordiazepoxide. HC1 and 2 related compounds, 7-chloro-l-3-dihydro-5-phenyl-2H-1, 4-benzodiazepin-2-one-4-oxide (CBO) and 2-amino-5-chIorobenzophenone (ACB), by high pressure liquid chromatography. The 3 compounds are separated on a reverse phase microparticulate column packing, using a mobile phase of acetonitrile and aqueous ammonium acetate. Bulk powders or capsule formulations are quantitated by direct comparison of their peak heights to those of appropriate reference standards. Data are presented showing the limit of detectability for the related compounds to be less than 80 ng CBO/ml and less than 40 ng ACB /ml. Based on peak heights, the relative standard deviation for the precision for chlordiazepoxide. HC1 is 0.42%. Recoveries from laboratory-prepared samples for chlordiazepoxide. HC1 were 99.4%; CBO, 102.4%; and ACB, 99.7%.
Spectrophotometric Determination of Vitamin A in Oils and Fats
Authors: Kamangar Teymour , Fawzf Ahmad B 
Published: February 2020

Abstract
A spectrophotometric method for determining vitamin A based on interaction with 50% trichloroacetic acid solution in dichloromethane was developed. The blue reaction product had a maximum absorption at 620 nm and obeyed Beer's law over the concentration range of 0.5-5.0 μg retinol/ml solution. The molar absorptivity of the reaction product was 1.58 × 105. As much as 100 μg vitamin D2, and β-carotene up to 12 times the vitamin A concentration, did not interfere with the determination. The results obtained from the determination of vitamin A in cod liver oil and butter showed excellent agreement with the Carr-Price method, 43.013 (d).
Instrumental Infrared Estimation of Fat, Protein, and Lactose in Milk: Collaborative Study
Authors: Biggs Delmar A 
Published: February 2020

Abstract
Thirty-six milks pre-analyzed by accepted standard methods were analyzed with Milkoscan instruments at 6 laboratories. Using pairs comparisons as described by Youden, precision errors for fat were about 0.033% for the first and 0.022% for the second of duplicate tests, indicating a carry-over effect for the first tests. Precision errors for protein were about 0.021 % for both tests. Systematic errors for fat were about 0.17% with calibrations based on reference analyses at each laboratory but were reduced to about 0.044% with calibrations by reference analyses from one laboratory. With homogenized milks, systematic errors for fat increased to about 0.07% and were larger at high fat levels. This effect could be minimized by changing the wavelength of maximum transmission for the fat filter. Systematic errors of about 0.067% for protein were reduced to about 0.03% with calibrations based on common reference analyses. Satisfactory calibrations for lactose were obtained with the 2 Milkoscan 203 models with standard errors of estimate of 0.034 and 0.033%. Results for homogenized and unhomogenized milk were diferent for most instruments, indicating the need to calibrate for them separately.
High Pressure Liquid Chromatographic Determination of Nitrofurazone in Milk
Authors: Vilim Arnost B , Macintosh Agnes I 
Published: February 2020

Abstract
A rapid high pressure liquid chromatographic (HPLC) screening method for the quantitative determination of nitrofurazone in milk has been developed. The drug is extracted with ethyl acetate from a 2.0 ml milk serum sample, the organic layer is evaporated to dryness, and the residue is dissolved in the mobile phase and injected into the liquid chromatograph. A reverse phase μBondapak C18 column is used with monitoring at 365 nm. The detection limit is 5 ppb and recoveries are 57—67%. Mass spectroscopic confirmation of the HPLC nitrofuran peak is described.