bluuebunny/crossref_metadata_2025_split huggingface dataset:
The SSP 2020: The Revised School Success Profile
Authors: Bowen Natasha K , Lucio Robert , Patak-Pietrafesa Michele , Bowen Gary L 
Published: January 2020

AbstractTo support student success effectively, school teams need information on known predictors of youth behavior and academic performance. In contrast to measures of behavioral and academic outcomes that are commonly relied on in schools, the School Success Profile (SSP) for middle and high school students provides comprehensive information on predictors of outcomes that reside in students’ neighborhoods, schools, peer systems, and families. This article presents the SSP 2020, a newly revised version of the SSP that is now freely available to schools and researchers. The online, self-report SSP 2020 retains the strengths of the SSP but is shorter and simpler. Revised group- and individual-level reports are automatically generated once SSP data are collected. The SSP 2020 dashboard allows users to request reports on numerous demographic subgroups. A comprehensive prevention road map walks teams through each step of an evidence-informed decision-making process based on SSP 2020 data. Resources embedded in the road map include information on evidence-informed prevention strategies for SSP dimensions with corresponding brief assessments and fidelity checklists. School social workers are encouraged to take the lead in bringing the SSP 2020 to school teams charged with promoting student behavioral and academic success.
63 Effect of 100-km ultramarathon on N-terminal pro-B-type natriuretic peptide variation
Authors: How C , Li L , Kao W 
Published: January 2020

Abstract

Introduction
The change in N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels follows strenuous endurance exercise-imposed paradox. Our previous reports showed significant body weight (BW) loss with dehydration was common in ultramarathon runners. The aim of this study is to investigate whether the dehydration and renin-angiotensin-aldosterone system activation possibly contribute to exercise-induced NT-proBNP release.

Methods
Twenty-six participants who finished a 100-km ultramarathon in Taiwan were enrolled. For each participant, blood samples and spot urine samples were collected one week before the race, as well as immediately and 24 hours after the finish. Body weight change was recorded to monitor the hydration status.

Results
Prolonged endurance exercise led to a substantial increase in NT-pro-BNP. Compared to pre-race values, NT-pro-BNP levels significantly increased immediately after the race (24.3 ± 20.2 to 402.9 ± 305.9 pg/mL, p &lt; 0.05) and maintained the lasting high levels till 24 hours after the race finished (143.7 ± 126.1 pg/mL, p &lt; 0.05). The fractional excretion of sodium values were all below 1% in three different time points. The 100-km ultramarathon resulted in significant BW loss, and elevated of renin and aldosterone levels. However, only 24 hours after the race, there was a positive significantly relationship between NT-proBNP and aldosterone levels, but negative significantly relationship between NT-proBNP and BW increase during the recovery phase.

Conclusions
Results of this study showed the mechanism of NT-proBNP release immediate following the race were multifaceted. However, during the recovery phase, rehydration might lead to the decrease of NT-proBNP in the volume depletion state.
66 Simple bedside cardiovascular autonomic examinations for predicting chronotropic incompetence
Authors: Rusnanta F , Rizal A 
Published: January 2020

Abstract

Background
Simple bedside cardiovascular autonomic reflex test (CARTs) are usually used to determine cardiovascular autonomic neuropathy (CAN). CAN may contribute to chronotropic incompetence (CI) which is the inability of the heart rate (HR) to rise in proportion to an increase in metabolic demand. Determination of CI is widely based on measurement of maximum HR during exercise testing. This study aimed to evaluate the role of CARTs to determine CI.

Methods
We included in 105 patients using a derivation and validation sampling ratio of 2:1. CARTs were performed for analyzing heart rate variation during three parasymphathetic standard tests (deep breathing, lying to standing, Valsava maneuver) and two sympathetic standard tests (systolic blood pressure from lying to standing and diastolic blood pressure during handgrip maneuver). Variables independently associated with CI in multivariable analysis in the derivation set were assigned points based on their respective odds ratios.

Results
CI group showed significantly lower values of among three parasympathetic standard tests (p &lt; 0.05) but not significantly among two sympathetic standars tests. Valsava maneuver (OR 0.1, p &lt; 0.001, 95%CI 0.001-0.004), deep breathing (OR 0.91, p = 0.025, 95% CI 0.836-0.988), and handgrip maneuver (OR 0.85, p = 0.01, 95% CI 0.744-0.961) were found to be an independent risk factor for CI from multivariate regression analysis. The accuracy of different CART parameters in the prediction of CI was described by the receiver operating curve (ROC) analysis. Regarding logistic regression model, we constructed formula of 15 - ([12 x Valsava maneuver] + [0.1 x deep breathing] + [0.2 x handgrip maneuver]) which will show negative and positive results indicating CI and non-CI, respectively. The resulting score showed good calibration and discriminatory capacity in the derivation (Hosmer-Lemeshow x² 10.051, p = 0.186, AUC = 0.878). The difference between AUCs in the derivation and validation sets was Δ = 0.122 (p = 0.174).

Conclusion
The decrease in heart rate variations during Valsava maneuver and deep breathing and in diastolic blood pressure during handgrip maneuver seems to be related to development of CI. Formula of CARTs score is a useful tool for predicting CI.
Final score sheet based on formula Total score CI probability &lt;-0.1 High probaility 0.2-0.6 Intermediate probability &gt;0.6 Low probability
149 Acute effects on left ventricular systolic and diastolic function of a post-implant echocardiographic biventricular pacemaker optimization protocol following cardiac resynchronization therapy
Authors: Barbier P , Guglielmo M , Agalbato C , Viscone I , Savioli G 
Published: January 2020

Abstract

Background
Cardiac resynchronization therapy (CRT) has demonstrated efficacy in at least 60% of patients with left ventricular (LV) failure and guideline-based indication to CRT. Whereas lack of response to CRT in up to a third of patients is multifactorial, a relevant factor is thought to be inadequate biventricular pacemaker (BIV) optimization (OPT) of either the intraventricular (VVd) or atrioventricular (AVd) delay

Purpose
In this echocardiographic observational study, we compared the acute effects on LV contractility, output, and diastolic function of BIV intra-implant QRS duration-based (OPTq) and post-implant Doppler echocardiography-based (OPTe) OPT of VVd and AVd.

Methods
In 160 patients with ischemic (n = 86) or idiopathic (n = 74) dilated cardiomyopathy, guideline-based different de novo CRT systems were implanted followed by immediate OPTq. Post-implant (10 days) OPTe was performed measuring: transmitral velocity-time integral (MVFi), % diastolic filling time (MVFt%), and E/A ratio, LV outflow integral (LVOTi), ejection time (LVOTt), and stroke volume (SV), isovolumic contraction (IVCT) and relaxation (IVRT) times, and LV myocardial performance index (MPI). The protocol included, sequentially: 1) Doppler measurements with OPTq settings; 2) measurements (separated by 3’ intervals) during a range (80/200 ms) of AVd with synchronous VVd; 3) algorithm-based AVd selection (at least 2 of following: increase in MVFi or SV, decrease in MPI); 4) measurements, with set AVd, during range of VVd: LV-first (-20, -40ms); RV-first (20, 40ms); synchronous; 5) VVd selection based on same algorithm used for AVd selection. Results. At OPTq, 58.6% of patients were set synchronous, 38.6% LV-first and 3% RV-first, with a 126 ± 29 mean AVd. This increased to 137 ± 36 after OPTe, when 49.1% were set synchronous, 38% LV-first and 12.4% RV-first, resulting in modifications of AVd and VVd in 59% and 36% of patients. Further, gain in SV with OPTe, compared to OPTq, was 8.3% (p&lt;.001), paralleled by an increase in MVFi (21.2 ± 8 cm vs 20.5 ± 8, p&lt;.001) and decrease in E/A (1.25 vs 1.45, p&lt;.001). The greatest increase in SV with OPTe was found in patients in whom both AVd and VVd were modified (n = 48; 81 ± 26 ml vs 71 ± 23, p&lt;.001) vs. patients without modifications (n = 42), or with change of either AVd or VVd (n = 70; 77 ± 20 vs 72 ± 20, p&lt;.01). Only in the first patient group both MVFi (22 ± 9 vs 20 ± 9, p&lt;.001) and MVFt% (52 ± 7 vs 49 ± 8, p=.004) increased, along with a decrease in MPI (.82±.31 vs .92 ± 36, p=.007) and IVRT (144 ± 51 vs 156 ± 62, p=.02.

Conclusions
These preliminary results point to a significant incremental role of post-implant OPTe to enhance LV output, contractility, and diastolic function in patients with CRT. The prognostic role of OPTe-determined AVd and VVD changes remains to be determined.
P13 Safety and efficacy of sacubitril-valsartan initiation during and after acute decompensated heart failure with reduced ejection fraction
Authors: Tan C T , Koh K T , Onn Y Y , Ho K H , Said A , Mohd Amin N H , Shu F E P , Khiew N Z , Cham Y L , Fong A Y Y , Ong T K , Eng S Y , Lee Z Y , Madzlan N 
Published: January 2020

Abstract

Background
The PIONEER-HF trial has demonstrated the safety of Sacubitril-Valsartan initiation during acute decompensated heart failure (ADHF) compared to Enalapril. The efficacy outcome was also addressed by the surrogate end point of reduction in NT-proBNP. However, the safety and efficacy of Sacubitril-Valsartan initiation during ADHF compared to initiation after ADHF was unknown.

Objectives
(1) To compare the safety and efficacy of Sacubitril-Valsartan initiation during ADHF(inpatient) to initiation after ADHF(outpatient). (2) To explore the echocardiogram parameters associated with Sacubitril-Valsartan initiation during ADHF(inpatient) versus after ADHF(outpatient).

Methods
We enrolled patients diagnosed with heart failure with reduced ejection fraction (HFrEF) initiated on Sacubitril-Valsartan from February 2017 to December 2018. The baseline characteristics, echocardiogram parameters (changes in LVEF and positive remodeling), composite safety outcomes (hypotension, interruption of Sacubitril-Valsartan and worsening of renal function), and efficacy outcomes (cardiac death, readmission for heart failure) were compared.

Results
Thirty-seven patients were identified out of which 21 patients started Entresto after ADHF (outpatient group) and 16 patients during ADHF (inpatient group). The median follow-up duration was 196 days (IQR: 105 to 328days). The baseline characteristics were similar between the 2 groups. Outpatient groups achieved a significantly higher maximally tolerable dose of Sacubitril-Valsartan compared to inpatient group (median 400mg/day versus 200mg/day, p = 0.008) despite a similar starting dose (median 100mg/day versus 100mg/day, p = 0.127). The composite efficacy outcomes were similar between the 2 groups (4.8% versus 18.8%, p = 0.296). The composite safety outcome was similar between the groups (18.8% versus 4.8%, HR5.70 p = 0.054, 95%CI 0.967 to 33.60). Both groups achieved a significant improvement in LVEF after initiation of Sacubitril-Valsartan therapy: mean LVEF 23.44 ± 7.88% to 34.30 ± 13.88% (p = 0.001) in outpatient group; mean LVEF 22.99 ± 11.31% to 38.81 ± 13.91% (p = 0.002) in inpatient group. Reverse remodeling (reduction of LVESV≥15%) was similar between the 2 groups (61.9% versus 50.0%, p = 0.506).

Conclusions
Among patients with HFrEF in ADHF, initiation of Sacubitril-Valsartan therapy during or after ADHF led to similar safety and efficacy. Overall, there was a significant improvement in LVEF and positive remodeling of the LV regardless of the timing of initiation of therapy.
P14 Use of bromocriptine for the treatment of peripartum cardiomyopathy: a meta-analysis of randomized controlled trials
Authors: Villanueva D L , Villanueva M C , Llanes E J 
Published: January 2020

Abstract

Background
Peripartum cardiomyopathy is a rare, pregnancy associated cause of left ventricular heart failure in previously healthy women. It remains an important cause of cardiac-related maternal morbidity and mortality worldwide. Half of the patients will recover left ventricular function after 6 months. However, in the remainder of patients who do not recover cardiac function, they will require advanced heart failure therapies. Bromocriptine, a dopamine agonist which inhibits prolactin release, has demonstrated improvement in left ventricular recovery and clinical outcome. We sought to determine the effect of adding Bromocriptine to standard heart failure therapy on the improvement and recovery of left ventricular function of these patients.
Inclusion Criteria. Studies were included if they satisfied the following criteria:1) Randomized Controlled Trials; 2) Pregnant patients who fulfilled the criteria for diagnosis of peripartum cardiomyopathy and 3) Reported data on improvement in left ventricular ejection fraction and clinical outcomes.

Methods
Using PUBMED, Clinical Key, Science Direct, Scopus, and Cochrane databases, a search for eligible studies was conducted from June to December 31, 2018. The quality of each study was evaluated using the Cochrane Risk of Bias Tool. The primary outcome of interest is on the effect of Bromocriptine on the improvement of left ventricular function and clinical outcomes among these patients. Review Manager 5.3 was utilized to perform analysis of random effects for continuous outcomes.

Results
We identified 2 randomized controlled trials of 58 pregnant patients diagnosed with peripartum cardiomyopathy, showing that among those who received Bromocriptine on top of standard heart failure therapy, there is a significant improvement in the left ventricular ejection fraction at 6 months [mean difference 15.14 (95% CI, 6.53 to 23.75) p &lt;0.05] compared to standard heart failure therapy alone. It was also observed that those who received Bromocriptine had better clinical outcomes.

Conclusion
The addition of Bromocriptine on top of standard heart failure therapy significantly improved the left ventricular ejection fraction of patients with peripartum cardiomyopathy at 6 months post-partum. This novel therapy may be considered to improve the management of these patients.
P26 Soluble programed cell death ligand-1 is associated with acute coronary syndrome
Authors: Fujisue K , Yamamoto E , Sueta D , Takae M , Nishihara T , Oike F , Komorida T , Usuku H , Takashio S , Sakamoto K , Kaikita K , Tsujita K 
Published: January 2020

Abstract

Background
Immune checkpoint by programmed cell death (PD)-1 and its ligand (PD-L1) play crucial role in T cell tolerance toward vascular wall antigens. PD-L1 is widely expressed on a number of cells including immune cells and vascular endothelium. It was reported that increased expression of PD-L1 in dendritic cells implicates upregulated inflammation in atherosclerotic lesions that is associated with plaque instability. Although plaque rupture in coronary atherosclerosis is an important pathogenesis of acute coronary syndrome (ACS), the association between PD-L1 and ACS is still unknown.

Purpose
We hypothesize that circulating PD-L1 might be associated with ACS, reflecting endothelial damage and coronary plaque rupture. To elucidate this hypothesis, we compared serum levels of soluble PD-L1 (sPD-L1) in stable coronary artery disease (CAD) patients with those in ACS patients.

Methods
Serum levels of sPD-L1 were measured by using commercially available ELISA kit (Human PD-L1/B7-H1 DuoSet, R&D Systems) in consecutive patients with CAD admitted to our University Hospital from February 2016 to March 2017. Patients with any malignant disease or severe inflammatory disease were excluded from this study. Serum levels of sPD-L1 and clinical backgrounds were compared between stable-CAD and ACS patients.

Results
In total, 269 patients with CAD were enrolled (28 cases [10.4 %] with ACS and 241 cases [89.6 %] with stable-CAD). PD-L1 had no correlation to C-reactive protein, cardiac troponin, and classical atherosclerotic risks such as age, body mass index, estimated glomerular filtration rate, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol, and hemoglobin A1c. Although age, sex, history of smoking, and the prevalences of hypertension, diabetes mellitus and dyslipidemia were comparable between both groups, the level of LDL-C was significantly higher in patients with ACS compared with those with stable-CAD (94.0 [77.0–112.0] mg/dL vs. 78.5 [65.0–97.0] mg/dL, P = 0.008). Also serum level of sPD-L1 was significantly increased in patients with ACS compared with those with stable-CAD (106.1 [60.9–157.7] pg/mL vs. 64.8 [30.9–102.5] pg/mL, P = 0.003). Univariate logistic regression analysis identified that serum levels of both sPD-L1 and LDL-C were independently associated with ACS. Moreover, multivariable logistic regression analysis with factors from univariate analysis identified that serum level of sPD-L1 was significantly and independently associated with ACS (odds ratio: 1.006, 95 % confidence interval: 1.001–1.012, P = 0.03).

Conclusions
This is the first study to elucidate that the increased serum levels of sPD-L1 was associated with ACS. This study suggests that sPD-L1 could be a risk marker and therapeutic target for ACS.
P32 Do meteorological factors influence the occurrence of acute aortic dissection?A ten-year retrospective institutional review
Authors: Usui R , Yoshizumi T , Oshima H , Usui A 
Published: January 2020

Abstract

Purpose
Some studies have reported a relationship between meteorological factors and the occurrence of acute aortic dissection (AAD). Nevertheless, the results of the studies are heterogeneous. Furthermore, whether the absolute values or fluctuation of meteorological factors influence the occurrence of AAD remains controversial. The aim of this study was to determine the meteorological factors associated with the occurrence of AAD.

Methods
Two hundred eighty-two consecutive patients (male, n = 178; female, n = 104; average age, 68 years) admitted to our hospital for AAD in the 10 years from September 1st 2008 were included in this study. One hundred fifty-seven patients had type A dissection. The correlation between the clinical data and the local meteorological data over the same period (provided by the National Meteorological Agency) was analyzed. We compared the following factors on days of AAD occurrence and non-occurrence: minimum and maximum temperature, minimum and maximum temperature difference between day of occurrence and previous day, difference between maximum and minimum temperature, atmospheric pressure and atmospheric pressure difference between day of occurrence and previous day (Δatmospheric pressure), and minimum and maximum temperature difference from climatological standard normal (CSN). Cutoff values were determined by ROC curve analyses and odds ratios (ORs) were calculated by a logistic regression analysis of meteorological factors with statistically significant differences.

Results
ignificant differences between the days of AAD occurrence and non-occurrence were observed for minimum and maximum temperature (p &lt; 0.0001), atmospheric pressure (p &lt; 0.0001) and Δatmospheric pressure (p = 0.0286), minimum temperature difference from CSN (p &lt; 0.0001), and maximum temperature difference from CSN (p = 0.0010).
The cutoff values were as follows: minimum temperature, 4°C; maximum temperature, 15.1°C; atmospheric pressure, 1008.9hPa; Δatmospheric pressure, 0.4hPa; minimum temperature difference from CSN, 1°C; and maximum temperature difference from CSN, -0.2°C.
The univariate logistic regression model showed revealed the following significant predictors of the occurrence of AAD; minimum temperature (OR2.42, p &lt; 0.0001), maximum temperature (OR2.23, p &lt; 0.0001), air pressure (OR1.75, p &lt; 0.0001), Δatmospheric pressure (OR 1.44, p = 0.0030), minimum temperature difference from CSN (OR1.80, p &lt; 0.0001) and maximum temperature difference from CSN (OR1.58, p = 0.0003). However, only minimum temperature (OR1.60, 95% CI 1.00-2.53, p = 0.0478) and maximum temperature difference from CSN (OR1.45, 95% CI 1.11-1.89, p = 0.0062) remained significant in the multivariate analysis.

Conclusion
Meteorological factors, especially a minimum temperature under 4°C strongly influenced the occurrence of AAD. A maximum temperature difference from CSN of over -0.2°C was also a significant predictor of AAD.
P108 Clinical effect of tricuspid regurgitation caused by pacemaker lead
Authors: Shaikh M M , Aljabri S , Nadar S K 
Published: January 2020

Abstract

Aim
It is known that the presence of cardiac pacemaker leads across the tricuspid valve (TV) can lead to tricuspid regurgitation (TR). However the clinical implications of this are not known. The aim of this study was to evaluate the progression of TR in patients with pacemaker leads across the TV and assess the clinical effect on Right ventricular function.

Methods
Patients who had undergone cardiac device implantation (either pacemaker or implantable cardiac defibrillators) in our institution over a 5 years period were identified. Those who had an echo (for any indication) pre and post device implantation were included in this study and their data assessed. Clinical information was obtained from medical records

Results
A total of 65 patients (mean age 70 + 13 years, 31 (48%) male and 34 (52%)female) were enrolled in the study. The median follow up after implantation was 12 (12-24) months. At baseline 29 patients had TR before implantation which increased to 51 (78%) during follow up, indicating that 22 patients developed new TR. Of those with pre existing TR, 17 had worsening of TR by at least one grade. RV function as measured by TAPSE had decreased from 1.87+ 0.44 to 1.68 +0.42 p = 0.002 . Six patients developed RV dilatation during follow up. 18 patients had developed signs of Right heart failure (either breathlessness with raised jugular venous pressure or pedal oedema or both), of which 13 had only new pedal oedema. There was no difference in comorbidities or the percentage of pacing in the groups that had worsening of TR or RV dilatation.

Conclusion
There is definite worsening or development of new TR in patients with a pacing lead across the TV. This is associated with an increase in the incidence of right heart failure suggesting that this is not benign. However there does not appear to be any specific risk factor identified that is responsible for this.
Changes after pacemaker implantation Pre pacemaker Post pacemaker p value Presence of TR (n) 29 51 0.018 RV dilatation(n) 5 11 0.01 TAPSE (mm) 1.87 + 0.44 1.68 + 0.42 0.002 Presence of pedal oedema(n) 5 13 0.01 TR grade grade 0 Grade 1 Grade2 Grade 3 Grade 4 36 9 16 3 0 14 3 31 16 2 0.008 TR- tricuspid regurgition, TAPSE- Tricuspid annular plane systolic excursion; RV- right ventricle