bluuebunny/crossref_metadata_2025_split huggingface dataset:
146 Prognostic significance of unexplained left ventricular hypertrophy in patients undergoing carpal tunnel surgery
Authors: Porcari Aldostefano , Pagura Linda , Longo Francesca , Sfriso Enrico , Barbati Giulia , Murena Luigi , Longo Emiliano , Ramella Vittorio , Arnez Zoran Marij , Rapezzi Claudio , Merlo Marco , Sinagra Gianfranco 
Published: December 2021

Abstract

Aims
Carpal tunnel (CT) syndrome is a recognized red-flag of cardiac amyloidosis (CA) and increased cardiovascular (CV) morbidity. We designed this study to characterize the CV profile of patients with CT syndrome at the time of first surgery and to identify high-risk presentations.

Methods and results
We retrospectively reviewed 643 patients who underwent CT surgery between 2007 and 2019. Of them, 130 patients (77 years, 45% males, LVEF 62%) with available CV characterization within ±12 months from CT surgery were included. Abnormal loading conditions causing cardiac hypertrophy (LVH) were investigated to distinguish explained LVH (Ex-LVH) from unexplained LVH (Un-LVH). The primary outcome of the study was all-cause mortality. The secondary outcome measures were the occurrence of (i) new-onset heart failure (HF) or worsening HF requiring hospitalization (HHF) or (ii) pacemaker implantation. New-onset HF was defined as the development of HF signs and symptoms requiring an unplanned cardiologic examination or hospitalization. Median follow-up was 63 months [interquartile range (IQR): 30–95]. LVH was found in 65 (50%) patients, 33% of them presented Un-LVH. Compared to the others, Un-LVH patients were older (77, 75 vs. 70 years in Un-LVH, Ex-LVH, and non-LVH, respectively; P = 0.002), had higher rates of ECG-echo discrepancy (70%, 14.3% and 1.6%, respectively; P &lt; 0.001) and of echocardiographic findings of CA (24%, 7%, and 0%, P &lt; 0.001). Among Un-LVH patients, 9 (43%) experienced death and 7 (33%) developed HF at 3.8 and 2.4 years from CT surgery, respectively. Compared to the others, death and HF development rates were higher in Un-LVH patients both at unadjusted (P = 0.01 and P = 0.02, respectively) and adjusted analysis for age, gender, and renal insufficiency (P = 0.00038 and P = 0.050, respectively).

Conclusions
At the time of CT surgery, Un-LVH was found in more than 30% of patients with LVH and 24% of them showed echocardiographic features suggesting an underdiagnosed CA. Un-LVH was associated with higher all-cause mortality and HF development.
255 Tricuspid regurgitation in the community by routine echocardiography
Authors: Leonardi Denis , Siviero Valentina , Setti Martina , Maffeis Caterina , Fanti Diego , Springhetti Paolo , Cicoira Mariantonietta , Rossi Andrea , Ribichini Flavio , Benfari Giovanni 
Published: December 2021

Abstract

Aims
Tricuspid Regurgitation (TR) is quite frequent in the community and often overlooked in routine clinical practice. This study aims to convey the TR rate of diagnosis and impact on survival in a geographically defined population of an Italian referral centre, considering five different clinical contexts.

Methods
The study included consecutive outpatients with comprehensive echocardiography and complete clinical evaluation over 7 years of practice. Outpatients with TR greater than moderate were included, and the different clinical contexts evaluated: patients with concomitant significant mitral regurgitation (MR-TR), heart failure (HF-TR), previous open-heart surgery (postop-TR), pulmonary hypertension (PHTN-TR) and isolated TR (isolated-TR).

Results
Among all consecutive echocardiograms performed in routine practice (N=6797) in a geographically defined community, moderate or severe TR was found in 4.8% (N = 327; mean age 76±10, 56% female). Median follow-up was 6.1 [2.2–8.9] years. TR severity was an independent determinant of survival: risk ratio for mortality of severe TR vs. moderate was 1.72 [95% CI 1.06–2.77; P = 0.03] univariate and 1.76 [95% CI 1.02–3.01; P = 0.04] after adjusted for age, sex, MR, PHTN and EF. Only 2.8% of patients underwent tricuspid valve surgery during follow-up. Outpatients with MR-TR or HF-TR held the worst prognosis (Figure). As compared to isolated-TR, the mortality risk was 2.67 [95% CI 1.05–6.78; P = 0.04] for HF-TR and 2.04 [95% CI 1.00–4.14; P = 0.05] for MR-TR. Risk ratios for mortality vs. postop-TR were 3.66 [95% CI 1.19–11.26; P= 0.02] for HF-TR and 2.79 [95% CI 1.08–7.21; P = 0.03] for MR-TR. There was no interaction between the TR clinical context and the survival impact of TR (P=0.09).

Conclusions
Significant TR is frequent in our community, comparable to key epidemiological studies. TR severity independently impacts survival in all clinical settings, and it is associated with an absolute high event-rate when present with concomitant MR or HF. These results give importance to early diagnosis with grading to be performed through accurate echocardiography and renew the interest in new and safe, less invasive percutaneous intervention to improve patients' survival.
508 Incidence and determinants of prosthesis-patient mismatch after transcatheter aortic valve replacement using predicted indexed effective orifice area
Authors: Cacia Michele Antonio , Sorrentino Sabato , Leo Isabella , Polimeni Alberto , Sabatino Jolanda , Salerno Nadia , Boccuto Fabiola , Carabetta Nicole , Bellantoni Antonio , Panuccio Giuseppe , Augusto Florinda Maria , Varano Ylenia , De Rosa Salvatore , Mongiardo Annalisa , Spaccarotella Carmen AnnaMaria , Indolfi Ciro 
Published: December 2021

Abstract

Aims
A small effective orifice area (EOA) by body surface area (BSA), defined as prosthesis–patient mismatch (PPM), is associated with elevated transprosthetic pressure gradients, less ventricular remodelling, and a worse prognosis. Calculating PPM by dividing the normal reference value of EOA for the model and size of the prosthetic valve (predicted PPM), instead of using the continuity equation has been recently confirmed as more accurate after trans catheter aortic valve intervention (TAVI), providing a stronger association with post-procedural haemodynamic outcomes. However, current evidence using this new definition is still limited, thus impairing generalizability. Accordingly, this analysis aims to extend such evidence providing incidence, and determinants of predicted PPM (PPMp) in an all-comers population undergoing TAVR with a high prevalence of self-expandable devices.

Methods
395 patients who underwent TAVI at our Institution from September 2008 to November 2020 were included in this analysis. PPMp was then classified as moderate if ≤ 0.85 cm2/m2 and severe if ≤ 0.65 cm2/m2 as well as moderate if ≤ 0.70 cm2/m2 and severe if ≤ 0.55 cm2/m2 for patients with a body mass index &gt; 30, as recommended by the Valve Academic Research Consortium-3 definition. The independent association between baseline clinical and procedural variables and the presence of moderate or severe PPMp was investigated with cross-sectional logistic regression analysis.

Results
11 patients (2.78%) had severe and 33 (8.35%) moderate PPMp. Patients with moderate or severe PPMp (m/s PPMp) were younger, female, with a higher prevalence of hypercholesterolaemia, prior aortic valve implantation and balloon expandable device and lower prevalence of chronic obstructive disease (COPD). Post-procedural mean gradient was higher in patients with m/s PPMp. The independent clinical and procedural correlates associated with higher likelihood of m/s PPMp were valve in valve procedure (ViV) and the use of a balloon-expandable device.

Conclusions
Moderate or severe PPMp was observed only in a small part of patients underwent TAVI, leading, however, a higher post-procedural mean gradient compared to those without PPMp. Balloon expandable devices and ViV were the strongest determinant of moderate or severe PPM.
531 Neuroimaging assessment of unilateral asymptomatic carotid artery stenosis: preliminary results of the carotid artery multi-modality imaging prognostic (camp) study
Authors: Masini Gabriele , Gargani Luna , Napoli Vinicio , Cosottini Mirco , Chiappino Dante , Orlandi Giovanni , D'Amelio Claudio , Totaro Porzia , Galeotti Giangiacomo , Palombo Carlo , De Caterina Raffaele 
Published: December 2021

Abstract

Aims
Doppler ultrasound (DUS), CT angiography (CTA), and contrast-enhanced MR angiography (CEMRA) are all recommended techniques to evaluate the significance of carotid artery stenosis, although they may give discordant results. Plaque ulcerations may be present, but their role is still controversial. We aimed at assessing the concordance and level of agreement, as well as the prevalence of characteristics related to plaque ulceration and association to patients’ characteristics among different imaging diagnostic techniques.

Methods and results
Sixty-one patients with unilateral asymptomatic carotid artery stenosis (40–60% detected by DUS), enrolled in the ongoing CAMP study were prospectively evaluated with CEMRA and CTA. The level of agreement was calculated by the weighed kappa test. Plaque ulceration was defined as an intimal defect larger than 1 mm in width or 2 mm in depth, detected by CTA and/or CEMRA. Concordance rate was 71% for DUS–CTA, 51% for DUS–CEMRA, and 66% for CTA–CEMRA. Concordance among all noninvasive techniques was only 45%. Compared with DUS, the stenosis was downgraded by CTA in 17% and by CEMRA in 32% of cases. There was a moderate agreement between DUS–CTA {weighed kappa 0.49 [95% confidence interval (CI): 0.31–0.67]}, while agreement between DUS–CEMRA and CTA–CEMRA was fair [weighed kappa 0.15 (95% CI: −0.01–0.31) and 0.38 (95% CI: 0.14–0.62), respectively]. An ulcerated plaque was present in 39% of patients at CTA and/or CEMRA; compared with patients with non-ulcerated plaques, those with an ulcerated plaque had higher levels of C-reactive protein (CRP), and a trend to higher levels of high sensitivity cardiac troponin (cTn) T (Table), whereas the degree of stenosis was similar.

Conclusions
CTA and CEMRA tend to report a lower degree of stenosis compared with DUS. Concordance and level of agreement was higher for DUS and CTA. Plaque ulceration is common and is associated with a significant higher level of systemic inflammation, as detected by CRP and, possibly, cTn.
805 Educational programme based on bottom-up learning approach
Authors: Spaccarotella Carmen , Giordano Salvatore , Esposito Giovanni , Sinagra Gianfranco , Indolfi Ciro 
Published: December 2021

Abstract
A substantial part of the training programme for cardiologists in training includes several hours per week of face-to-face teaching. Since the pandemic's beginning, most of these activities in the universities have been conducted virtually using one of the available secure and reliable video platforms.
The proven standard educational method is top-down education. The teacher guides the instruction, focuses on what the students ‘need to know’, and transmits the knowledge to the fellows, then verifies the learning. Unfortunately, this method does not stimulate critical, creative ability and does not always represent what the fellows ‘want to know’.
A new additional model of education in the Board of Cardiology of the Magna Graecia University and the University of Trieste has been designed to develop education from the bottom up. The topics that have been chosen are those of the training programme in Cardiology and necessary to complete the training period.
A participants list of 60 fellows in training and a panellist list of 3 teachers were then created. The first topic was ‘Myocarditis’. Next, each fellow was asked about one topic/question (Figure 1) (see additional data). All participants then had to vote for the best five from the pool of 60 questions. Therefore, a pyramid of priorities was made between the topics/questions and assigned to the three panellists, based on specific expertise, 3 days before the event (see additional data). Then a 1, 15 H zoom session was opened at 7:00 AM, and all participants were invited.
In the digital session, the fellow authors of the first 15 questions read the question by his/herself, then the moderator entrusted the answer to one of the expert panellists.
With this approach, the student started with a question of the selected topic, performs self-directed research or experimentation, and, finally, arrives at explicit knowledge. The general rule of this approach is that participants are the producers and advantages of this method are to teach students how to seek knowledge on their own, even outside the virtual event.
In conclusion, this bottom-up educational programme presented can be a valuable teaching aid in the training trajectory of the new generation of physicians. 805 Figure 1.
Hmga2 deficiency is associated with allometric growth retardation, infertility, and behavioral abnormalities in mice
Authors: Lee Mi Ok , Li Jingyi , Davis Brian W , Upadhyay Srijana , Al Muhisen Hadil M , Suva Larry J , Clement Tracy M , Andersson Leif 
Published: December 2021

Abstract
The high mobility group AT-hook 2 (HMGA2) protein works as an architectural regulator by binding AT-rich DNA sequences to induce conformational changes affecting transcription. Genomic deletions disrupting HMGA2 coding sequences and flanking noncoding sequences cause dwarfism in mice and rabbits. Here, CRISPR/Cas9 was used in mice to generate an Hmga2 null allele that specifically disrupts only the coding sequence. The loss of one or both alleles of Hmga2 resulted in reduced body size of 20% and 60%, respectively, compared to wild-type littermates as well as an allometric reduction in skull length in Hmga2−/− mice. Both male and female Hmga2−/− mice are infertile, whereas Hmga2+/− mice are fertile. Examination of reproductive tissues of Hmga2−/− males revealed a significantly reduced size of testis, epididymis, and seminal vesicle compared to controls, and 70% of knock-out males showed externalized penis, but no cryptorchidism was observed. Sperm analyses revealed severe oligospermia in mutant males and slightly decreased sperm viability, increased DNA damage but normal sperm chromatin compaction. Testis histology surprisingly revealed a normal seminiferous epithelium, despite the significant reduction in testis size. In addition, Hmga2−/− mice showed a significantly reduced exploratory behavior. In summary, the phenotypic effects in mouse using targeted mutagenesis confirmed that Hmga2 is affecting prenatal and postnatal growth regulation, male reproductive tissue development, and presents the first indication that Hmga2 function is required for normal mouse behavior. No specific effect, despite an allometric reduction, on craniofacial development was noted in contrast to previous reports of an altered craniofacial development in mice and rabbits carrying deletions of both coding and noncoding sequences at the 5′ part of Hmga2.
Genome sequence of the English grain aphid,Sitobion avenaeand its endosymbiontBuchnera aphidicola
Authors: Byrne Stephen , Schughart Maximilian , Carolan James C , Gaffney Michael , Thorpe Peter , Malloch Gaynor , Wilkinson Tom , McNamara Louise 
Published: December 2021

AbstractThe English grain aphid, Sitobion avenae, is a major agricultural pest of wheat, barley and oats, and one of the principal vectors of barley yellow dwarf virus leading to significant reductions in grain yield, annually. Emerging resistance to and increasing regulation of insecticides has resulted in limited options for their control. Using PacBio HiFi data, we have produced a high-quality draft assembly of the S. avenae genome; generating a primary assembly with a total assembly size of 475.7 Mb, and an alternate assembly with a total assembly size of 430.8 Mb. Our primary assembly was highly contiguous with only 326 contigs and a contig N50 of 15.95 Mb. Assembly completeness was estimated at 97.7% using BUSCO analysis and 31,007 and 29,037 protein-coding genes were predicted from the primary and alternate assemblies, respectively. This assembly, which is to our knowledge the first for an insecticide resistant clonal lineage of English grain aphid, will provide novel insight into the molecular and mechanistic determinants of resistance and will facilitate future research into mechanisms of viral transmission and aphid behavior.
Both Binding Strength and Evolutionary Accessibility Affect the Population Frequency of Transcription Factor Binding Sequences in Arabidopsis thaliana
Authors: Schweizer Gabriel , Wagner Andreas 
Published: December 2021

Abstract
Mutations in DNA sequences that bind transcription factors and thus modulate gene expression are a source of adaptive variation in gene expression. To understand how transcription factor binding sequences evolve in natural populations of the thale cress Arabidopsis thaliana, we integrated genomic polymorphism data for loci bound by transcription factors with in vitro data on binding affinity for these transcription factors. Specifically, we studied 19 different transcription factors, and the allele frequencies of 8,333 genomic loci bound in vivo by these transcription factors in 1,135 A. thaliana accessions. We find that transcription factor binding sequences show very low genetic diversity, suggesting that they are subject to purifying selection. High frequency alleles of such binding sequences tend to bind transcription factors strongly. Conversely, alleles that are absent from the population tend to bind them weakly. In addition, alleles with high frequencies also tend to be the endpoints of many accessible evolutionary paths leading to these alleles. We show that both high affinity and high evolutionary accessibility contribute to high allele frequency for at least some transcription factors. Although binding sequences with stronger affinity are more frequent, we did not find them to be associated with higher gene expression levels. Epistatic interactions among individual mutations that alter binding affinity are pervasive and can help explain variation in accessibility among binding sequences. In summary, combining in vitro binding affinity data with in vivo binding sequence data can help understand the forces that affect the evolution of transcription factor binding sequences in natural populations.
Tumors Are Evolutionary Island-Like Ecosystems
Authors: Chroni Antonia , Kumar Sudhir 
Published: December 2021

AbstractIntegration of ecological and evolutionary features has begun to understand the interplay of tumor heterogeneity, microenvironment, and metastatic potential. Developing a theoretical framework is intrinsic to deciphering tumors’ tremendous spatial and longitudinal genetic variation patterns in patients. Here, we propose that tumors can be considered evolutionary island-like ecosystems, that is, isolated systems that undergo evolutionary and spatiotemporal dynamic processes that shape tumor microenvironments and drive the migration of cancer cells. We examine attributes of insular systems and causes of insularity, such as physical distance and connectivity. These properties modulate migration rates of cancer cells through processes causing spatial and temporal isolation of the organs and tissues functioning as a supply of cancer cells for new colonizations. We discuss hypotheses, predictions, and limitations of tumors as islands analogy. We present emerging evidence of tumor insularity in different cancer types and discuss their relevance to the islands model. We suggest that the engagement of tumor insularity into conceptual and mathematical models holds promise to illuminate cancer evolution, tumor heterogeneity, and metastatic potential of cells.
Spatial variations of the effective elastic thickness and internal load fraction in the Cascadia subduction zone
Authors: Yu Chuanhai , Xu Min , Kirby Jon F , Shi Xiaobin , Jiménez-Díaz Alberto 
Published: December 2021

SUMMARYThe effective elastic thickness (Te) can reflect lateral change of rheological properties from subducting plate to overlying plate, and aid in understanding the relationship between geodynamic evolution and regional tectonic response to accumulated forces by plate convergence. The internal load fraction (F), calculated simultaneously with Te, is an index for subsurface mass distribution. Here we introduce high-resolution maps of Te and F in the Cascadia subduction zone by analysing the coherence between gravity anomaly and topography using a fan wavelet method. The general Te pattern correlates well with the overall tectonic characteristics. The diverse Te pattern along the forearc zone offshore North America indicates different mechanical coupling states of the slabs between the northern and southern parts. The central subducting plate is locally decoupled from the overlying plate due to a group of subducted seamounts. The F pattern shows intriguing correlations with the full locked zone (high F) and the location of episodic tremor and slip (low F) along the forearc area. F may also be a good indicator for the location of a fluid/melt upwelling in the volcanic arc area. Seismicity is more likely to occur in areas of low Te or steep Te gradient. The long-term mechanical state of lithosphere will affect or even control the temporal variations of plates during multiple seismic cycles.
Interrogating probabilistic inversion results for subsurface structural information
Authors: Zhang Xin , Curtis Andrew 
Published: December 2021

SUMMARYThe goal of a scientific investigation is to find answers to specific questions. In geosciences, this is typically achieved by solving an inference or inverse problem and interpreting the solution. However, the answer obtained is often biased because the solution to an inverse problem is non-unique and human interpretation is a biased process. Interrogation theory provides a systematic way to find optimal answers by considering their full uncertainty estimates and by designing an objective function that defines desirable qualities in the answer. In this study, we demonstrate interrogation theory by quantifying the size of a particular subsurface structure. The results show that interrogation theory provides an accurate estimate of the true answer, which cannot be obtained by direct, subjective interpretation of the solution mean and standard deviation. This demonstrates the value of interrogation theory. It also shows that fully nonlinear uncertainty assessments may be critical in order to address real-world scientific problems; this goes some way towards justifying their computational expense.
Investigation of energy and economic parameters of photovoltaic cells in terms of different tracking technologies
Authors: Alayi Reza , Sevbitov Andrey , Assad Mamdouh El Haj , Akhmadeev Ravil , Kosov Mikhail 
Published: December 2021

Abstract
The utilization of photovoltaic (PV) cells has greatly expanded due to the simplicity of technology and cheapness compared to other solar technologies. However, due to the change in the position of the sun, it has reduced the production capacity and electrical efficiency of this technology as the reduction of production capacity to supply electricity has increased investment costs. In this research, modeling of silicon crystal PV cell with the aim of influencing the types of solar trackers on the amount of power produced by PV cell and economic parameters has been done, which is intended for the following four modes: without solar tracker, horizontal tracker, vertical tracker and two-axes tracker. The highest output power is related to the two-axes tracker with a value of 9586 kWh/yr, which for this technology has a maximum output power of 4.35 kW. Also, the cost of energy produced by this technology is $ 0.875/kWh.