bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of a Rapid Phenotypic Susceptibility Platform for Gram-Negative Bloodstream Infections With Paired Antimicrobial Stewardship Intervention: Is the Juice Worth the Squeeze?
Authors: Robinson Evan D , Stilwell Allison M , Attai April E , Donohue Lindsay E , Shah Megan D , Hill Brandon K , Elliott Zachary S , Poulter Melinda , Brewster Frankie , Cox Heather L , Mathers Amy J 
Published: February 2021

Abstract

Background
Implementation of the Accelerate PhenoTM Gram-negative platform (RDT) paired with antimicrobial stewardship program (ASP) intervention projects to improve time to institutional-preferred antimicrobial therapy (IPT) for Gram-negative bacilli (GNB) bloodstream infections (BSIs). However, few data describe the impact of discrepant RDT results from standard of care (SOC) methods on antimicrobial prescribing.

Methods
A single-center, pre-/post-intervention study of consecutive, nonduplicate blood cultures for adult inpatients with GNB BSI following combined RDT + ASP intervention was performed. The primary outcome was time to IPT. An a priori definition of IPT was utilized to limit bias and to allow for an assessment of the impact of discrepant RDT results with the SOC reference standard.

Results
Five hundred fourteen patients (PRE 264; POST 250) were included. Median time to antimicrobial susceptibility testing (AST) results decreased 29.4 hours (P &lt; .001) post-intervention, and median time to IPT was reduced by 21.2 hours (P &lt; .001). Utilization (days of therapy [DOTs]/1000 days present) of broad-spectrum agents decreased (PRE 655.2 vs POST 585.8; P = .043) and narrow-spectrum beta-lactams increased (69.1 vs 141.7; P &lt; .001). Discrepant results occurred in 69/250 (28%) post-intervention episodes, resulting in incorrect ASP recommendations in 10/69 (14%). No differences in clinical outcomes were observed.

Conclusions
While implementation of a phenotypic RDT + ASP can improve time to IPT, close coordination with Clinical Microbiology and continued ASP follow up are needed to optimize therapy. Although uncommon, the potential for erroneous ASP recommendations to de-escalate to inactive therapy following RDT results warrants further investigation.
Fine-scale conditions across mangrove microhabitats and larval ontogeny contributes to the thermal physiology of early stage brachyurans (Crustacea: Decapoda)
Authors: Vorsatz L D , Pattrick P , Porri F 
Published: February 2021

AbstractMost marine ectotherms require the successful completion of a biphasic larval stage to recruit into adult populations. Recruitment of larvae into benthic habitats largely depends on biological interactions and favourable environmental conditions such as the inescapable diurnal thermal and tidal exposures. Hence, assessing how different taxa metabolically respond to variations in temperature is imperative to understand the community and ecosystem dynamics at both local and global scales. The present study aimed to investigate the effects of acute temperature variation on the physiology of stage-specific brachyuran larvae collected from different microhabitats at two mangrove forests in South Africa. Results indicate that the conditions within microhabitats, which larvae experience, likely influence their physiology, based on respirometry, to short-term acute temperature exposures. Furthermore, the larval thermal optimum shifted ontogenetically to become increasingly eurythermic as individuals developed from stage I zoea through to megalopa. Mangrove crab larvae in their early stages are hence increasingly vulnerable to acute temperature exposures, which could be particularly harmful to the persistence of populations if thermally stressful events increase in magnitude and frequency.
Does automated left ventricular ejection fraction assessment available on handheld ultrasound devices represent improvement in the diagnostic accuracy?
Authors: Filipiak D , Kasprzak JD , Szymczyk E , Wejner-Mik P , Wdowiak-Okrojek K , Lipiec P 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Purpose
To assess the accuracy of an algorithm for automated measurement of the left ventricular ejection fraction (LVEF) available on handheld ultrasound device (HUD).

Methods
112 patients admitted to the cardiology department, who were referred for the conventional echocardiographic examination, underwent additional assessment performed with HUD (Vscan Extend, GE Vingmed Ultrasound, Horten, Norway). In each case 4 – chamber apical view was obtained and LVEF was calculated by means of the LVivo software. Imaging quality was assessed in a 4-grade scale. Subsequently, during the examination performed with the use of the stationary echocardiograph the three-dimensional (3D) measurement of LVEF was recorded.

Results
Ultimately 96 (53 men, mean age 63 ± 11) patients were enrolled into the study group In the remaining 16 cases (14%) 3D image quality was not sufficient to allow the calculation of the LVEF. LVivo software was unsuccessful in calculating LVEF in all these 16 patients and in additional 20 patients, who remained in the study group due to satisfactory 3D image quality.
The quality of images acquired with the use of HUD was assessed as optimal in 25 (26%) patients, good in 37 (39%), acceptable in 24 (25%), poor in 10 (10%).
The average LVEF value was 46%±14 with the 3D LVQ measurements and 48%±14 using the LVivo software. The correlation coefficient between the LVEF values obtained with the two methods was r = 0,92; (P &lt; 0,0001). Using paired samples t-test we found that the difference between these two techniques was not significant (mean difference 4,5± 3,4%; P = 0,35).
LVivo software EF assessment is based on a single apical view and for this reason we have assumed that the differences in EF can be larger in patients with regional wall motion abnormalities, in whom LVEF values derived from different apical views can significantly vary. For this reason the group of patients with history of myocardial infarction (40pts, 42%) was analysed separately and we found that the difference between LVivo and 3D LVEF was also not statistically significant (mean difference 6,1± 3,3%; P= 0,14). The correlation coefficient equalled r = 0,78; (P &lt; 0,0001).

Conclusion
The LVivo software despite its limitations is capable of the accurate LVEF measurement when the acquired views are of at least good imaging quality. Such expanded capabilities of HUDs can potentially lead to the overall improvements of the diagnostic accuracy of the ultrasonographic examinations, particularly when in hands of the non-expert echocardiographers.
3D ultrasound coronarography: first proof of concept study on isolated beating rat hearts
Authors: Demeulenaere O , Mateo P , Sandoval P , Villemain O , Tanter M , Papadacci C , Pernot M 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Bettencourt Foundation
Background/Introduction
We demonstrated recently that Ultrafast ultrasound Doppler imaging can image the intramyocardial coronary circulation in beating hearts of large animals and patients [1]. Yet, ultrasound spatial resolution remains limited by wave physics and coronaries smaller than ∼100 µm could not be imaged. Ultrasound Localization Microscopy (ULM) [2] was recently introduced to tackle this issue and exploit the micrometric localization of microbubble contrast agents at ultrafast frame rate in order to image blood flows in micrometer vessels.
Purpose
The objective of this work was to demonstrate that 3D ultrafast ultrasound with contrast agents can provide the full 3D mapping of the coronary microcirculation with quantitative flow velocity on a beating rat heart.
Methods
Acquisitions were performed on ex vivo rat hearts (n = 5) with retrograde perfusion (Langendorff
model). A flow of a Krebs–Henseleit solution mixed with a diluted microbubbles solution (0.22%) was perfused at controlled pressure into the coronary arteries (between 5 and 15 mL/min). We used a 32 × 32 elements, 8-MHz matrix-array ultrasound transducer connected to a 1024-channel programmable ultrasound scanner. An ultrafast Doppler imaging sequence consisting of 9 plane waves was transmitted at a PRF of 20 kHz during 270 ms and repeated 40 times. After beamforming and SVD clutter filtering, the microbubbles were localized and tracked in 3D. Flow velocity were mapped at baseline and after infusion of Adenosine (10e-5 µMol) at constant coronary perfusion pressure (120 mm Hg). Eventually, the hearts were fixed using formaldehyde perfusion and imaged by µCT after injection of radio opaque agent.
Results
We successfully imaged the coronary blood flows of entire rat hearts. It revealed the entire vasculature from large main coronaries arteries (cross section up to 1 mm) to small arterioles (smaller than 40 µm). Coronary flow velocities ranged from [1 – 50] cm/s depending on the arteries diameter. Velocity estimates were validated in vitro in tubes of Ø0.58mm and were in good agreement with theoretical values of a Poiseuille’s flow (relative ratio of 10% for maximum velocities). After Adenosine infusion, perfusion flow rates increased 102% ± 50% (p &lt; 0.05) on average. Eventually, anatomy revealed by 3D ultrasound coronarography was in accordance with the anatomy revealed by the µCT.
Conclusion(s)
We demonstrated the feasibility of 3D ultrasound coronarography on isolated beating rat hearts. This technique has the potential to become a novel imaging tool to investigate the coronary micro-circulation and quantify non-invasively the Coronary Flow Reserve (CFR).
Abstract Figure. Ultrasound coronarography
Comparison between two anticoagulant regimens to prevent thrombosis in atrial fibrillation: an analysis mediated by transesophageal echocardiography
Authors: Fusini L , Maltagliati AC , Alimento ML , Italiano G , Pepi M , Tamborini G , Galli CA 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background. Atrial fibrillation (AF) is the most common cardiac arrhythmia causing left atrial appendage thrombosis (LAA-T) which can result in cerebral and systemic embolism. Nowadays, both vitamin K antagonists (VKA) and Direct Oral Anti Coagulants (DOAC) are effective for the prevention of ischaemic stroke in AF. Transesophageal echocardiography (TEE) is the best method to detect LAA-T in AF. However, data on the prevalence of LAA-T are lacking.
Purpose. The aim of the study was 1) to evaluate the prevalence of LAA-T in patients affected by AF, receiving different anticoagulation regimens and candidates to cardioversion or catheter ablation 2) to correlate the presence of LAA-T with clinical and echocardiographic data.
Methods. This is an observational, single-center study including 796 patients (73% male) with AF. TEE before cardioversion or catheter ablation was performed in all patients. Patients with mechanical prosthetic valve and severe mitral stenosis were excluded. Patients were divided in 2 groups according to anticoagulation regimen: Group 1 including patients on DOAC (dabigatran, rivaroxaban, apixaban, edoxaban) and Group 2 including patients on VKA at therapeutic dose.

Results
Group 1 included 369 patients (46%), Group 2 427 (54%). Age, CHA2DS2-VASc score, sex and pathology distribution (lone FA, hypertension, valve disease, ischemic cardiomyopathy, dilated cardiomyopathy, hypertrophic cardiomyopathy) were similar in the 2 groups. The overall prevalence of LAA-T was 43 cases (5%). Similar percentage of LAA-T was found regardless of anticoagulation regimen (Group 1: 16 cases, 4%; Group 2: 27 cases, 6%, p = 0.220). No difference in LAA-T prevalence was detected within Group 1 for different DOACs (p = 0.547). Patients with LAA-T were more frequently older (p = 0.023), female (p = 0.001), with higher CHA2DS2-VASc score (p = 0.002), affected by hypertrophic cardiomyopathy (p = 0.019), valve disease or bioprostetic valve (p = 0.001) regardless of anticoagulation regimen. A total of 697 patients (88%) were scheduled for cardioversion or catheter ablation. Cardioversion was successful in 667 patients (95%) without any ischemic event. Only 1 patient (0.1%) undergoing catheter ablation had a major ischemic event.

Conclusions
Efficacy of anticoagulation with VKA and DOAC is similar in preventing LAA-T in patients with AF. However, despite optimal adherence to a therapeutic regimen, several clinical factors (age, gender, high CHA2DS2-VASc score, hypertrophic cardiomyopathy and valvular disease) were associated with higher prevalence of LAA-T. TEE guided approach to cardioversion may prevent the risk of embolic events regardless of anticoagulation regimen used.
Evaluation of non-invasive myocardial work in tako-tsubo cardiomyopathy
Authors: Meimoun P , Vernier A , Stracchi V , Gabrion P , Vibou G , Lachambre P , Clerc J 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Tako-tsubo cardiomyopathy (TTC) is characterized by the presence of transient left ventricular (LV) wall motion abnormalities (WMA). However, whether systolic performance fully recover is unclear. Non-invasive myocardial work (MW) is a new index of global and regional myocardial performance which has never been described in this setting. Objective: to assess global and regional MW in typical TTC (apical variant). Methods: fifty patients with typical TTC (mean age, 77 ± 10 years, 47 women) were prospectively enrolled and underwent a transthoracic Doppler echocardiography within 24 hours of admission and a median of 32 days at follow-up (FU). MW is derived from the non-invasive strain-pressure loop obtained from the 2D strain data, integrating in its calculation the non-invasive brachial arterial pressure. Constructive MW (CMW), MW index (MWI), MW efficiency (MWE), and wasted work (WW) were measured. Hospital complications (HC) were defined as a composite of heart failure, right ventricular extension, and LV apical thrombus. A control group of 24 patients matched for age and sex without overt cardiovascular disease served as a comparative group. Results: In the TTC group, global and regional MW improved significantly between the two examinations (global, regional apical and medial CMW, MWI, MWE, WW, and regional basal CMW, and MWI, all p &lt; 0.01). The acute apical –basal gradient of MW inverted at FU. In TTC, global CMW and MWI were significantly correlated to acute LV systolic function parameters and their change, and were significantly impaired in patients with HC (n = 13) (all, p &lt; 0.01). At FU, despite total recovery of WMA, global and regional MW was significantly reduced in TTC by comparison to the control group (p &lt; 0.01 for all components), although hemodynamics, LV ejection fraction, and 2D global longitudinal strain were similar (all, p = NS). Conclusion: Global and regional myocardial performance is transiently impaired in typical TTC and significantly associated to HC. And despite total recovery of WMA, subtle dysfunction of myocardial performance persist at FU.
Use of myocardial work for multiparametric detection of subclinical anthracycline cardiotoxicity in breast cancer patients
Authors: Di Lisi D , Manno G , Immordino FA , Intravaia R , Calcullo D , Alagna G , Lunetta M , Russo A , Novo G 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
The aim of our study was to assess subclinical cardiac effects of anthracyclines (ANTs) in women treated for breast cancer (BC).

Methods
We enrolled 46 female patients with BC undergoing adjuvant treatment with anthracycline-containing chemotherapy (CT) followed by taxane (paclitaxel/docetaxel). Patients underwent physical examination, electrocardiogram (ECG) and standard transthoracic echocardiography (TTE) including evaluation of diastolic and systolic function, measured as left ventricular ejection fraction (LVEF), left ventricular global longitudinal strain (GLS) and myocardial work (MW) expressed as global work index (GWI), global constructive work (GCW), global work waste (GWW), and global work efficiency (GWE). The parameters were measured at baseline (T0) and at 3 months (T1) and 6 months (T2) follow up.

Results
All patients completed the chemotherapy cycles. No significant cardiovascular adverse events were observed during treatment. Neither 2D left ventricular ejection fraction (LVEF) nor E/e’ ratio evaluation at TDI were significantly changed after treatment. Conversely, GLS was significantly reduced at T1 and T2 since baseline (GLS - 19,99 % IQR -20,6 -19,3 % at T0 vs -17,88 % IQR -18,8 -16,9 % at T1, p&lt; 0,00 1 and -16,71 % IQR 17,6 -15,7 % at T2, p&lt; 0,001). Consensually, a significant reduction in myocardial work was also measured (GWI 2115 mmHg% IQR 1888 – 2342 mmHg% at T0 vs 1714 mmHg% IQR 1557 – 1870 mmHg% at T1, p&lt; 0,0001 and 1694 mmHg% IQR 1482 – 1907 mmHg% at T2, p&lt; 0,0001).

Conclusion
Our study demonstrates that evaluation of myocardial work allows very early detection of subclinical cardiac damage induced by chemotherapy, consensually to the reduction of the GLS. A multiparametric assessment of the myocardial function, including myocardial work and GLS, could improve the accuracy of risk stratification of cardiotoxicity in patients undergoing ANTs treatment.
Characterization of 18-fluorodeoxyglucose uptake pattern in infective endocarditis after transcatheter aortic valve implantation
Authors: San S , Itii IE , Lim PL 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18-FDG-PET/CT) has been included in the modified Duke criteria to improve the diagnosis of prosthetic valvular endocarditis. However, accuracy of 18-FDG-PET/CT have only been validated in patients with a surgical prosthesis and limited data exist for infective endocarditis related to transcatheter aortic valve implantation (IE-TAVI).

Methods
The study prospectively included 45 patients who underwent 18-FDG-PET/CT after TAVI. The population was divided in two groups. The control group included 31 consecutive patients who perfomed a 18-FDG-PET/CT at one after TAVI implantation. The endocarditis group included 14 consecutive patients admitted for IE-TAVI suspicion. The final diagnosis of IE-TAVI was established by the Endocarditis-Team after 3-month follow-up.

Results
In the control group, 77% (n = 24/31) of patients did not present 18-FDG uptake at one month. 18-FDG uptake was more observed in patients with a conduction abnormality after TAVI (71% [n = 5/7] vs. 17% [n = 4/24], p = 0.01). In the endocarditis group, 18-FDG-PET/CT was positive in all definite-IE (n = 7) and one with rejected-IE (n = 7). Interestingly, the latter patient presented conduction abdormality after TAVI. The SUVmax and the SUV ratio were similar in definite-IE and positive control examinations. In contrast, all uptakes in definite-IE were focal with small spots of uptake (&lt;25% of the aortic valve circumference) whereas 18-FDG uptake was large and unique (&gt;50% of the aortic valve circumference) in control and rejected-IE.

Conclusion
Positive 18-FDG-PET/CT examination is uncommon one month after TAVI procedure and the 18-FDG uptake pattern can be easily differentiated from definite-IE. These results indicate that 18-FDG-PET/CT may be used before the 3 months after TAVI procedure to accurately identify IE-TAVI.
Abstract Figure.
From Social Assistance to Self-Sufficiency: Low Income Work as a Stepping Stone
Authors: Boschman Sanne , Maas Ineke , Vrooman J Cok , Kristiansen Marcus H 
Published: February 2021

Abstract
Welfare reforms often focus on stimulating employment among benefit recipients, based on the theoretical mechanism that the performance of low income work will serve as a stepping stone towards financial self-sufficiency. Alternative theories, however, argue that the acceptance of low income work will reduce job search intensity and can signal low productivity, and therefore will not enable people to support themselves. Using longitudinal administrative data and discrete time linear probability models, we follow all social assistance recipients in the Netherlands from 2010 to 2015, and analyse whether, and for whom, low income work functions as a stepping stone towards sustainable self-sufficiency. We find that social assistance recipients are more likely to become self-sufficient when they are active in low income work. This stepping stone effect applies in particular to benefit recipients with limited work experience, a higher educational level, a shorter duration of welfare receipt and to those who belong to the native Dutch majority. The type of employment also matters: low income work through temporary employment agencies is found to be the most effective stepping stone towards self-sufficiency.
Genome-wide quantitative trait loci mapping on Verticillium wilt resistance in 300 chromosome segment substitution lines from Gossypium hirsutum × Gossypium barbadense
Authors: Rashid Md Harun or , Li Peng-tao , Chen Ting-ting , Palanga Koffi Kibalou , Gong Wan-kui , Ge Qun , Gong Ju-wu , Liu Ai-ying , Lu Quan-wei , Diouf Latyr , Sarfraz Zareen , Jamshed Muhammad , Shi Yu-zhen , Yuan You-lu 
Published: February 2021

Abstract
Cotton Verticillium wilt (VW) is a devastating disease seriously affecting fiber yield and quality, and the most effective and economical prevention measure at present is selection and extension of Gossypium varieties harboring high resistance to VW. However, multiple attempts to improve the VW resistance of the most widely cultivated upland cottons have made little significant progress. The introduction of chromosome segment substitution lines (CSSLs) provide the practical solutions for merging the superior genes related with high yield and wide adaptation from Gossypium hirsutum and VW resistance and the excellent fiber quality from Gossypium barbadense. In this study, 300 CSSLs were chosen from the developed BC5F3:5 CSSLs constructed from CCRI36 (G. hirsutum) and Hai1 (G. barbadense) to conduct quantitative trait locus (QTL) mapping of VW resistance, and a total of 40 QTL relevant to VW disease index (DI) were identified. Phenotypic data were obtained from a 2-year investigation in two fields with two replications per year. All the QTL were distributed on 21 chromosomes, with phenotypic variation of 1.05%–10.52%, and 21 stable QTL were consistent in at least two environments. Based on a meta-analysis, 34 novel QTL were identified, while 6 loci were consistent with previously identified QTL. Meanwhile, 70 QTL hotspot regions were detected, including 44 novel regions. This study concentrates on QTL identification and screening for hotspot regions related with VW in the 300 CSSLs, and the results lay a solid foundation not only for revealing the genetic and molecular mechanisms of VW resistance but also for further fine mapping, gene cloning and molecular designing in breeding programs for resistant cotton varieties.