bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sharing roosts but not ectoparasites: high host-specificity in bat flies and wing mites of Miniopterus schreibersii and Rhinolophus ferrumequinum (Mammalia: Chiroptera)
Authors: Pejić Branka , Budinski Ivana , van Schaik Jaap , Blagojević Jelena 
Published: October 2021

Abstract
Schreiber’s bent-winged bat Miniopterus schreibersii and the greater horseshoe bat Rhinolophus ferrumequinum are widespread and common cavernicolous species across southern Europe that host numerous specialized ectoparasite species. The objective of this study was to characterize the species assemblage, genetic diversity, and host specificity of bat flies (Nycteribiidae, Diptera) and wing mites (Spinturnicidae, Acari) found on these bat hosts in Serbia and Bosnia and Herzegovina. Notably, while bat flies lay puparia on the cave walls and can thus be transmitted indirectly, wing mites require direct body contact for transmission. Morphological identification and sequencing of a 710-bp fragment of cytochrome oxidase I gene of 207 bat flies yielded 4 species, 3 on M. schreibersii and 1 on R. ferrumequinum. Sequencing of a 460-bp small subunit ribosomal RNA fragment, in all 190 collected wing mites revealed 2 species, 1 per host. In no case was a parasite associated with 1 host found on the other host. Species and genetic diversity of flies were higher in M. schreibersii, likely reflecting their host’s larger colony sizes and migratory potential. Mite species of both hosts showed similarly low diversity, likely due to their faster life history and lower winter survival. Our findings highlight a remarkably high host-specificity and segregation of ectoparasite species despite direct contact among their hosts in the roost, suggesting a defined host preference in the investigated ectoparasite species. Furthermore, the differences in ectoparasite genetic diversity exemplify the interplay between host and parasite life histories in shaping parasite population genetic structure.
Leveraging the potential of machine learning for assessing vascular ageing: state-of-the-art and future research
Authors: Bikia Vasiliki , Fong Terence , Climie Rachel E , Bruno Rosa-Maria , Hametner Bernhard , Mayer Christopher , Terentes-Printzios Dimitrios , Charlton Peter H 
Published: October 2021

AbstractVascular ageing biomarkers have been found to be predictive of cardiovascular risk independently of classical risk factors, yet are not widely used in clinical practice. In this review, we present two basic approaches for using machine learning (ML) to assess vascular age: parameter estimation and risk classification. We then summarize their role in developing new techniques to assess vascular ageing quickly and accurately. We discuss the methods used to validate ML-based markers, the evidence for their clinical utility, and key directions for future research. The review is complemented by case studies of the use of ML in vascular age assessment which can be replicated using freely available data and code.
Stroke prevention with direct oral anticoagulants in high-risk elderly atrial fibrillation patients at increased bleeding risk
Authors: Chao Tze-Fan , Chan Yi-Hsin , Chiang Chern-En , Tuan Ta-Chuan , Liao Jo-Nan , Chen Tzeng-Ji , Lip Gregory Y H , Chen Shih-Ann 
Published: October 2021

Abstract

Aims
Elderly atrial fibrillation (AF) patients with risk factors of bleeding are often considered ineligible for standard oral anticoagulants (OACs). The Edoxaban Low-Dose for EldeR CARE AF patients (ELDERCARE-AF) trial recently showed that edoxaban 15 mg/day was superior to placebo for preventing stroke or systemic embolism and did not result in a significantly higher incidence of major bleeding. Our aim was to investigate a real-world cohort of AF patients similar to the ELDERCARE-AF cohort, with regard to the impact of direct oral anticoagulant (DOAC) use compared to non-OAC use, in relation to clinical outcomes.

Methods and results
From 1 January 2012 to 31 December 2016, 15 183 AF patients aged ≥80 years (mean age 86.63 years [SD 4.79]; 48.7% male) with a congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, and prior stroke or transient ischemic attack (CHADS2) score ≥2 who met the enrolment criteria (generally similar to ELDERCARE-AF) were identified from the Taiwan National Health Insurance Research Database. Patients were categorized into two groups according to their stroke prevention strategies, i.e. without OACs (n = 9084) and DOACs (n = 6099). Patients receiving DOACs were further stratified into reduced-dose- or full-dose-regimen groups. Compared with the non-OAC group as a reference, DOAC use (whether at reduced dose or full dose) was associated with a lower risk of ischaemic stroke (adjusted hazard ratio [aHR] 0.77, 95% confidence interval [CI] 0.67–0.88) and all-cause mortality (aHR 0.39, 95% CI 0.37–0.42), while the risks of intracranial haemorrhage and major bleeding were similar. The risks of composite outcomes of ‘ischaemic stroke or mortality’ (aHR 0.42, 95% CI 0.40–0.45) and ‘ischaemic stroke or major bleeding or mortality’ (aHR 0.49, 95% CI 0.46–0.52) were significantly lower with DOAC use. When compared with the non-OAC group as the reference group, DOACs (whether reduced dose or full dose) showed a positive net clinical benefit. The results were generally consistent even after propensity matching.

Conclusion
In routine clinical care, DOACs (whether reduced or full dose) were associated with a lower risk of ischaemic stroke, mortality, and the composite endpoint, when compared with non-OAC use in high-risk elderly AF patients at increased bleeding risk. Our findings provide complementary ‘real-world’ data to support the generalizability of the results of the ELDERCARE-AF trial to other DOACs in daily clinical practice.
Commemorating the Crusading Past in Late Medieval England: The Worksop Priory Tabula
Authors: Doherty James 
Published: October 2021

Abstract
Memory has featured prominently in recent scholarship on the crusades. In particular, the remembrance of crusaders by their descendants and associated ecclesiastical institutions in the high Middle Ages has attracted considerable attention; however, few studies have concentrated on the commemoration of crusaders in the later Middle Ages. This article examines a late fifteenth-century genealogical poem, which was produced for public display on a tablet at Worksop Priory (Nottinghamshire) and contains unique information about members of the Furnival family on the Barons’ Crusade (1239–41), in order to explore how and why medieval institutions preserved memories of crusaders into the late Middle Ages. It argues that, although inaccurate in its crusade narrative, the poem provides invaluable insights into the mechanisms of aristocratic family memory in medieval England; and it focuses on the important role of material prompts in the process of commemoration. Specifically, it suggests that an effigy of Sir Thomas de Furnival was erected at Worksop soon after his death away from home in 1241. In the absence of a written record, this cenotaph acted as a prompt to an oral narrative tradition which informed the Worksop poet when he came to compose his genealogical work. This study is, therefore, an analysis of crusade memory, but it is also an examination of the presentation of a crusade narrative to a public audience, an opportunity to unravel the confused history of three crusading brothers, and an attempt to understand the response of a medieval community that had suffered losses in overseas ventures.
Prognostic value of atrial fibrillation in COVID-19 admitted patients
Authors: Santos Sanchez A , Gonzalez-Recio P E , Sanchez-Corral E , Jimenez-Nacher J J 
Published: October 2021

Abstract

Introduction/Background
COVID-19 is the disease caused by SARS-Cov2. Various prognostic factors have been studied and described. Atrial fibrillation (AF) is an arrhythmia associated with increased complications and mortality in acute situations. The onset of AF in patients hospitalized for COVID-19 could associate a worse prognosis during admission and in the short term.

Purpose
The objective of this study is to evaluate the adverse events in the population admitted for COVID-19 that develops AF as well as its possible prognostic value.

Methods
Retrospective, cohort study on 391 patients admitted for COVID-19 in a tertiary hospital. Descriptive and comparative analysis between those with new onset AF versus those who had AF previously in terms of: baseline characteristics, In hospital mortality, bleeding and thrombotic phenomena. Follow-up during three months after discharge. Univariate and multivariate analysis of in-hospital and three-months mortality is also performed.

Results
391 patients were included. 21 of them developed AF. These patients are older, more hypertensive and with more history of cardiopathy. At admission, they presented higher mortality (52.4% vs 19.7%; p&lt;0.001) and bleeding (19% vs 8.4%; p&lt;0.001), also compared to those with previous AF (not significant). New onset AF is not an independent predictor of in-hospital mortality, but rather an independent predictor of three-month mortality. In-hospital mortality predictors are: age &gt;70 years, BCRSS scale &gt;2 points, and severe hypotension. Three-month mortality predictors are: high-sensitive T-troponin &lt;50ng/dl, age &gt;70 years, BCRSS scale &gt;2, creatinine &gt;1.5 mg/dl and new-onset AF.

Conclusions
New onset AF appears in 5,3% of these hospitalized patients, who have greater comorbidity, bleeding and in-hospital mortality as well as three-months mortality. New onset AF is not an independent predictor of in-hospital mortality but rather an independent predictor of mortality during the first three months after discharge

Funding Acknowledgement
Type of funding sources: None. Table 1Figure 1. ROC curves
Risk of atrial fibrillation in young adults aged 20 to 39 years with isolated diastolic, isolated systolic, and systolic-diastolic hypertension: a nationwide population-based study
Authors: Lee S R , Han K D , Choi E K , Ahn H J , Oh S , Lip G Y H 
Published: October 2021

Abstract

Background
There is limited evidence regarding the comparative risks of incident atrial fibrillation (AF) associated with stage 1 isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic-diastolic hypertension (SDH), especially amongst young adults aged 20–39 years.

Purpose
To evaluate the association between early-stage of hypertension and AF in young adults aged 20–39 years.

Methods
From the Korean nationwide health screening database, 2,958,544 subjects aged 20–39 years who were not prescribed antihypertensive medication at the index examination in 2009 were included. Subjects were categorized into eight groups according to the 2017 American College of Cardiology/American Heart Association blood pressure (BP) guidelines: normal BP, elevated BP, stage 1 IDH, stage 1 ISH, stage 1 SDH, stage 2 IDH, stage 2 ISH, and stage 2 SDH. The primary outcome was new-onset AF during follow-up.

Results
During a median follow-up of 8.3 years, 7,347 subjects had incident AF (incidence rate, 0.3 per 1,000 person-years). Compared to the normal BP group, stage 1 IDH (adjusted hazard ratio [aHR], 1.160; 95% confidence interval [CI], 1.086–1.240) and stage 1 SDH (1.250; 1.165–1.341) were associated with higher risks of incident AF, but not stage 1 ISH. Stage 2 IDH, ISH, and SDH were associated with higher risks of incident AF by 24%, 37%, and 61%, respectively (Figure).

Conclusion
Among young adults, stage 1 IDH and SDH were associated with higher risks of incident AF compared to normal BP. The risk of incident AF with stage 2 IDH was similar to that of stage 1 SDH. Optimal BP control including diastolic BP is crucial for preventing new-onset AF, even amongst young adults.

Funding Acknowledgement
Type of funding sources: None.
Device for modeling of intra-arterial circulation: application in experimental cardiology
Authors: Germanova O , Germanov V A , Shchukin Y V , Germanov A V , Galati G 
Published: October 2021

Abstract

Purpose of study
Using an original device for modeling of intra-arterial blood circulation, to study the features of intravascular hemodynamics with a regular heart rhythm and with various rhythm disturbances.

Material and methods
We used an original device developed by us to simulate intra-arterial circulation (Document of invention No. RU 202780 U1). The main part of the device is a glass tube of a rotameter with a length of 365 mm, an inlet end with a diameter of 20 mm, an outlet end of 16.5 mm, which is a model of an arterial vessel. Flexible silicone tubes are attached to the rotameter on both sides, with free ends connected to an electric pump, with various modes of operation (imitation of pulse waves with regular rhythm, premature ventricular contractions (PVCs), atrial fibrillation (AF). An aqueous solution of glycerin was introduced into a closed system diluted with water corresponding to the viscosity of the blood. A 5 mm long silk thread was alternately installed inside the tube, an intravascular piezoelectric crystal pressure probe connected to an oscilloscope. Also it was injected inside the tube a dye - clerical ink.

Results
With electric pump, we simulated the spreading of the pulse wave in regular heart rate, PVCs and AF. We observed the effect of a pressure wave (deflection of a silk thread, the appearance of a turbulent flow when using a dye) on the walls of the rotameter, with the formation of standing, reflected waves during the PVCs and AF. The pressure probe registered an increase in pressure inside the tube during the spread of the 1st post-extrasystolic contraction wave up to 58%, the wave after a long pause of more than 2 seconds with AF by 44% compared to the regular rhythm.

Conclusion
A device for modeling of intra-arterial circulation allows a wide range of experimental work in cardiology, normal and pathological physiology, and biophysics.

Funding Acknowledgement
Type of funding sources: None.
Resting ECG measurements can identify abnormalities in children with catecholaminergic polymorphic ventricular tachycardia
Authors: Fridman M D , Tofighi T , Fan C P S , Hamilton R M 
Published: October 2021

Abstract

Background
Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) is a rare inherited disease characterized by exercise- or emotionally-triggered life-threatening ventricular arrhythmias. The resting ECG is considered to be normal and diagnosis has depended on exercise testing that is difficult acutely post-arrest or in young children.

Purpose
To identify resting ECG abnormalities in children with CPVT through assessment of measurement matrix parameters compared to a cohort of normal children.

Methods
A discovery cohort of 65 CPVT patients from the Electrophysiology program were identified. After excluding those on antiarrhythmics or in an arrhythmia at the time of their baseline ECG, 31 cases were matched 3:1 by age and sex with 93 healthy controls. Each individual had baseline ECG parameters and 180 machine-derived ECG amplitudes and durations (measurement matrix) measured. Statistical differences between ECG measures were assessed using Student's T-Test adjusted with a False Detection Rate of 1%. Significant measures were processed in a machine-learning algorithm to derive a Tree Model to differentiate individuals with and without CPVT.

Results
No significant differences were detected between CPVT patients who had and did not have a cardiac arrest. Comparing the CPVT and control cohorts, significant repolarization differences were seen in the amplitudes of lateral (I, negative aVR, V5, V6) and anterior leads (V2, V3, V4) at the J-point, ST midpoint, ST endpoint, and T-wave. Specifically, individuals with CPVT had significantly lower mean amplitudes in all aforementioned leads except aVR where the mean amplitudes were higher. These data were then used to create a Tree Model of the discovery cohort displayed in Figure 1 with a resulting R2 of 0.74, sensitivity of 0.81, and specificity of 0.98.

Conclusions
Baseline differences in repolarization are detectable in the left and anterior chest leads using machine-derived measurements of baseline ECGs in patients with CPVT, which may guide clinical suspicion when evaluating the resting ECG. These results warrant further analysis including testing of the Tree Model with a validation cohort.

Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Scholar Award from the Ted Rogers Centre for Heart Research, Toronto, Ontario, Canada to Trainee Dr. Taraneh TofighiCanadian Institute for Health Research Figure 1. CPVT Tree Model
Beat-to-beat P-wave analysis outperforms conventional P-wave indices in identifying patients with a history of paroxysmal atrial fibrillation, during sinus rhythm
Authors: Tachmatzidis D , Filos D , Tsarouchas A , Mouselimis D , Bakogiannis C , Antoniadis A , Chouvarda I , Lazaridis C , Triantafyllou C , Fragkakis N , Maglaveras N , Vassilikos V 
Published: October 2021

Abstract

Introduction
Atrial fibrillation (AF) is the most common arrhythmia and is associated with high risk of morbidity and mortality. In many patients, AF is of episodic character (paroxysmal AF – PAF), which makes the identification of these patients during sinus rhythm (SR) challenging.

Purpose
The aim of the present study is to compare the performance of beat-to-beat P-wave analysis with P-wave indices used as predictors of PAF, such as P-wave duration, area, voltage, axis, terminal force in V1, inter-atrial block or orthogonal type, in identifying patients with history of PAF during sinus rhythm.

Methods
Standard 12-lead ECG and 10-minute orthogonal ECG recordings were obtained from 40 consecutive patients with short history of PAF under no antiarrhythmic medication and 60 age- and sex- matched healthy controls. The P-waves on the 10-minute recordings were analyzed on a beat-to-beat basis and classified as belonging to a primary or secondary morphology according to previous study. Wavelet transform used to further analyze P-wave orthogonal signals of main morphology on a beat-to-beat basis.

Results
38 out of 327 studied features were found to differ significantly among the two groups. These features were tested for their diagnostic ability and receiver operating characteristic curves were ploted. Only 3 of them performed adequetly, with an area under curve (AUC) above 0.65; Two of them came from morphology analysis (percentage of beats following main morphology in axis X and Y) and one from wavelet analysis (max energy in high frequency zone -Y axis). Among standard P-wave indices, P-wave area in lead II was the one with the highest AUC (0.64).

Conclusion
Novel indices derived from beat-to-beat analysis outperform stadard P-wave markers in identifying patients with PAF history during sinus rhythm.

Funding Acknowledgement
Type of funding sources: None. ROC curves of most significant featuresAUC characteristics of P-wave indices
A new method for ECG recording in the prone position
Authors: Cobos Gil M A , Diz J , Islas F 
Published: October 2021

Abstract

Introduction
Prone ventilation is frequently used in critical patients. ECG is usually recorded transposing the precordial positions to the back (Fig. 1A). The resultant precordial leads are unpredictably different from the supine ECG and difficult to interpret.
According to the dipole theory and the concept of mirror image electrocardiogram, each precordial point has an antipodal area where a mirror precordial lead can be recorded. Fig. 1B shows the location of the antipodal areas for the precordial points

Purpose
Based on this theoretical background we propose to use these antipodal areas to record inverted precordial leads (mirror leads M1 – M6) with diagnostic and monitoring potential.

Patients and methods
We have placed the precordial electrodes in the corresponding antipodal area for each precordial point (Fig. 1B) and we have recorded prone ECG in 20 subjects (10 healthy volunteers, 10 cardiac patients) The resultant ECGs (leads M1-M6) were compared with the standard supine ECGs (v1-V6).

Results
Mirror leads show low amplitude (especially V2-V4) compared to standard precordials, but are qualitatively quite similar (but inverted) to the supine precordial leads (Fig. 2).

Conclusion
We proposed a new method to obtain ECGs in prone patients. The resultant precordial leads are comparable to the standard precordial leads.

Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
High frame rate speckle tracking echocardiography to assess diastolic function
Authors: Papangelopoulou K , Orlowska M , Bezy S , Petrescu A , Werner A , Ramalli A , Voigt J U , D'hooge J 
Published: October 2021

Abstract

Background
Left ventricular (LV) strain rate (SR) during isovolumic relaxation (SRIVR) and early diastolic filling (SRe) has previously been shown to correlate with the invasive gold standard for LV diastolic function (i.e. the time constant of LV pressure decay tau). However, the translation of these biomarkers to the clinic has been hampered by technical limitations. Indeed, conventional speckle tracking (STE) is limited by its temporal resolution, whereas tissue Doppler imaging (TDI) is angle-dependent, labor-intensive and thus rarely used clinically nowadays.

Purpose
The aim of this study was to show that these limitations could be overcome by using a recently proposed STE algorithm operating on high frame rate (HFR) imaging data.

Methods
37 subjects (age: 64±12, 81% male) were included in the study; 16 had cardiac amyloidosis, 12 were undergoing clinically indicated left and/or right heart cardiac catheterization and 9 were healthy volunteers. Since the sequence of left ventricular activation and thus the repolarization process (i.e. relaxation) starts at mid septum, we measured SRIVR and SRe in the mid septal segment in an apical 4 chamber view using a commercially available clinical system with: (1) TDI (frame rate (FR) ∼142 Hz); (2) STE (FR ∼65 Hz). Moreover, subjects were scanned with HD-PULSE, an experimental high frame ultrasound scanner (FR ∼915 Hz) and then a manually placed contour was tracked during the cardiac cycle by a custom-made 2D HFR STE algorithm, to compute and extract SRIVR and SRe from the mid septum. Since TDI is considered the reference method to assess SR, conventional as well as HFR STE values were correlated against the TDI SR values.

Results
In 3 subjects, SRIVR could not be reliably assessed with the clinical STE approach, which we attributed to the relatively low temporal resolution of the images; all other measurements could be made in all subjects. For both biomarkers, HFR STE values correlated better with the TDI reference measurements than the clinical STE estimates (Fig.1). The latter estimates showed a systematic underestimation (bias −0.19 1/s (p&lt;0.01) and −0.46 1/s (p&lt;0.01) for SRIVR and SRe respectively) while no significant bias was observed for the HFR STE values. Similarly, the limits of agreement of the HFR STE values were narrower (−0.45 to +0.54 1/s and −0.94 to +0.86 1/s) than those of the clinical STE measurements (−0.85 to +0.48 1/s and −1.32 to +0.41 1/s).

Conclusions
These results show that HFR STE offers a reliable way to assess novel biomarkers of diastolic function in a user-friendly manner and can therefore facilitate their incorporation to the clinical practice.

Funding Acknowledgement
Type of funding sources: None.