bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ross procedure and aortic valve repair: long-term echocardiographic outcomes, quality of life and physical activity of different aortic valve surgery procedures
Authors: Bianco F , Colaneri M , Bucciarelli V , Surace FC , Iezzi FC , Primavera M , Biasi AC , Berton E , Baldoni M , Baldinelli A , Pozzi M , Gallina S 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
To compare long-term outcomes of aortic valve repair (AVr) and pulmonary autograft replacement (Ross procedure) in terms of echocardiographic parameters, quality of life (QoL), physical activity (PA).

Methods
In 2005-19, 129 patients (median age 22 [13, 33 IQR], 75% males) underwent aortic surgery in our Department: 40 were Ross (22 years [19, 51 IQR]), 67 AVr (17 years [1, 50 IQR]) and 22 aortic valve replacements (52 years [30, 80 IQR]). We focused on Ross and AVr. Retrospectively, relevant data were collected from medical records and phone re-calls. Physical activity (spontaneous and active) and QoL were assessed utilizing the IPAQ and SF-36 questionnaires. All patients underwent echocardiography pre/post-surgery and the follow-up lasted 12 ± 4 years.

Results
At the baseline, Ross patients had more aortic stenosis than insufficiency (P = 0.045). At the follow-up, Ross procedures presented more right-ventricle and aortic annulus dilatation (P = 0.002 and P = 0.030, respectively), but higher left-ventricular global longitudinal strain (LV GLS: 18 ± 3.2 % vs. 16 ± 3.3, P = 0.0027). Conversely, AVr experienced more re-do operations (Log-rank P = 0.005). Ross reported better QoL (SF-36: 0.8 ± 0.07 vs. 19 ± 0.4, P-0.045) and were also more active in daily PA (IPAQ ≥ 2500 Mets: 63.8% vs. 6%; P = 0.006). Ross patients practiced more sports activities than AVr (P = 0.011).

Conclusions
In a relatively small cohort of young and adults post aortic surgery patients, Ross procedures had better prognosis in terms of re-do operations; presented better ventricular function, as assessed by LV GLS. Ross patients had better long-term QoL and showed more spontaneous PA and involvement in sports activity.
The interplay of systemic atrial and ventricular function in patients with transposition of the great arteries after arterial switch operation
Authors: Schoeber A , Jerosch-Herold M , Wegner P , Voges I , Gabbert D , Pham HM , Scheewe J , Kramer HH , Rickers C 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background/Introduction: The role of systemic atrial (LA) function and its interplay with the systemic ventricle (LV) in patients with transposition of the great arteries (TGA) after arterial switch operation (ASO) is currently not well defined.

Purpose
Investigate the role of LA function and its interplay with the LV.

Methods
Between 2007 and 2018 patients with TGA corrected by ASO and control patients of comparable age, sex, height but without known cardiovascular disease were included in this prospective single centre analysis of 3 Tesla cardiac magnetic resonance cine imaging studies of atrial and ventricular function. Additionally, in TGA patients extracellular volume fraction (ECV) was assessed by T1 mapping and global longitudinal strain (GLS) by feature tracking.

Results
Overall, 81 TGA (16.3 [IQR 10.5-21.2] years, 32% female) and 30 control patients (11.9 [IQR 8.7-22.5] years, 63% female) were included in the current analysis. TGA patients had smaller LA maximum volume index, and reduced total atrial and conduit volume emptying. This resulted in a reduced LA reservoir and conduit function compared to controls. In TGA, a higher LA active/conduit and active/total ratio indicated impaired passive filling of the LV. (Table 1)
The median ECV was 28.3% (IQR 25.8-33.9) and the median GLS -24.2% (IQR -28.6- -20.4) in TGA patients. LA reservoir (Fig. 1A), conduit and contractile function showed a negative correlation with GLS (r=-0.470, p &lt; 0.001, r=-0.270, p = 0.022 and r=-0.257, p = 0.030, respectively). Interestingly, the LA active/conduit ratio (Fig. 1B) and the active/total ratio showed a positive correlation with ECV (r = 0.418, p = 0.002 and r = 0.339, p = 0.013, respectively).

Conclusion
Impaired LA function is frequent among patients with TGA following ASO. The impairment of LA function is linked to both LV dysfunction and fibrosis.
Table 1 Variable TGA (n = 81) Control (n = 30) p-value LAVI max.[ml/m&sup2;] 37.8 (29.9-42.9) 42.02 (38.3-51.6) 0.002 LAVI total emptying [ml/m&sup2;] 16.8 (13.7-20.8) 24.3 (20.6-29.4) &lt;0.001 LAVI conduit emptying [ml/m&sup2;] 10.3 (8.1-13.9) 17.5 (15.2-20.8) &lt;0.001 LAVI active [ml/m&sup2;] 6.7 (4.1-8.6) 6.4 (5.0-7.9) 0.984 LA-EF-reservoir [%] 46.6 (42.0-50.5) 57.2 (51.2-60.1) &lt;0.001 LA-EF-conduit [%] 28.1 (23.4-34.3) 42.5 (35.4-45.8) &lt;0.001 LA-EF-active [%] 24.11 (17.9-29.1) 25.7 (21.5-29.7) 0.339 LA active/conduit ratio 0.60 (0.41-0.90) 0.37 (0.28-0.44) &lt;0.001 LA active/total ratio 0.38 (0.29-0.47) 0.27 (0.22-0.30) &lt;0.001 Differences in left atrial function between TGA and control patients Abstract Figure. Fig. 1A and B
Effects of hormone replacement therapy on arterial stiffness, endothelial function and myocardial deformation in women with Turner syndrome
Authors: Ikonomidis I , Pavlidis G , Mavroidi I , Varoudi M , Thymis J , Kostelli G , Bamias A , Iliodromitis E , Peppa M 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background/Introduction: Turner syndrome (TS) is associated with congenital or acquired cardiovascular diseases.

Purpose
We investigated whether hormone replacement therapy (HRT) affects arterial elastic properties, endothelial function and myocardial deformation in women with TS.

Methods
In 25 women with TS (age: 29 ± 9years) we measured in the oestrogen phase of HRT cycle and 1 month after discontinuation of HRT: a)Pulse wave velocity (PWV-Complior), central systolic blood pressure (cSBP) and augmentation index (AI) of the aortic pulse wave, b)perfused boundary region (PBR) of the sublingual arterial microvessels, as a marker of endothelial glycocalyx thickness, c)carotid intima-media thickness (cIMT), d)flow-mediated dilatation (FMD) of the brachial artery and percentage difference of FMD (FMD%), and e)global LV longitudinal strain (GLS) and left atrium (LA) strain using speckle tracking echocardiography. Ten healthy subjects of similar sex, age and BMI served as control group.

Results
Compared to controls, women with TS under HRT had higher PWV (9.1 ± 2.4 vs. 7.5 ± 0.5m/s), AI (18 [7 to 27] vs. 5.8 [-10 to 19]%), cSBP (130 ± 15 vs. 121 ± 6mmHg), cIMT (0.66 ± 0.06 vs. 0.55 ± 0.05mm), FMD (7.2 ± 4 vs. 10 ± 2.3%) and lower LA volume index (14.3 ± 4 vs. 24 ± 13 mL/m²) and GLS (-18.8 ± 2.7 vs. -21.9 ± 1.5) (p &lt; 0.05 for all comparisons). PBR was negatively related with FMD% (r=-0.58, p = 0.022) in women with TS under HRT. One month after discontinuation of HRT, all women reduced PWV, AI, cSBP and increased FMD. There were no statistically significant changes in BMI, PBR, cIMT, LA volume index, LA strain and LV GLS (p &gt; 0.05 for all comparisons) (Table). The percent decrease of cSBP was associated with the percent decrease of PWV (r = 0.54) and inversely related with the percent increase of FMD (r=-0.57) (p &lt; 0.05 for all comparisons).

Conclusions
Hormone replacement treatment in women with TS deteriorates arterial stiffness and endothelial function probably due to increased central arterial blood pressure.
Women with Turner syndrome under HRT (n = 25) Women with Turner syndrome one month after discontinuation of HRT (n = 25) p-value PWV, m/s 9.1 ± 2.4 7.8 ± 1.7 0.028 Central SBP, mmHg 130 ± 15 123 ± 14 0.007 PBR, 5-25μm 2.11 ± 0.3 2.12 ± 0.2 0.983 cIMT, mm 0.66 ± 0.06 0.67 ± 0.06 0.947 FMD, % 7.2 ± 4 11.7 ± 6 0.042 LA strain, % 51 ± 12 54 ± 15 0.400 LV GLS, % -18.8 ± 2.7 -19.3 ± 2.3 0.594 Table
Assessment of the CHA2DS2-VASc score in predicting ischemic stroke and death in patients with acute myocardial infarction without atrial fibrillation
Authors: Marques A , Briosa A , Pereira AR , Alegria S , Grade Santos J , Rangel I , Joao I , Pereira H 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

onbehalf
on behalf of the investigators of the Portuguese Registry of Acute Coronary Syndromes

Introduction
The CHA2DS2-VASc score is used in clinical practice to stratify the risk of stroke in patients (pts) with atrial fibrillation (AF). Its usefulness in the population of pts with acute myocardial infarction without AF is not well known.

Objectives
To investigate whether CHA2DS2-VASc predicts ischemic stroke and death during hospital stay in pts with acute myocardial infarction without known AF. To determine independent predictors of ischemic stroke in this population.

Methods
A multicentre, retrospective study was performed during 01/10/2010-04/09/2019 period, and included all pts admitted due to acute myocardial infarction. Pts with previous AF, AF rhythm in the electrocardiogram at admission or AF during hospital stay were excluded. Statistical analysis with Kaplan-Mayer and Cox regression was applied.

Results
Of 29851 pts admitted with acute myocardial infarction, were included in our study 19218 pts (74% male, mean age of 65 ± 14 years).
During hospital stay, 78 (0.4%) pts had an ischemic stroke and 462 (2.4%) pts died.
The event-free survival analysis showed significant differences according to the CHA2DS2-VASc score at admission (log rank test p = 0.015 for ischemic stroke; log rank test p &lt; 0.001 for in-hospital mortality). (Figure)
The CHA2DS2-VASc score demonstrated a good predictive accuracy for in-hospital mortality (area under the ROC curve 0.69; 95% CI 0.67-0.72; p &lt; 0.001). The area under the ROC curve indicates that the CHA2DS2-VASc score performed modestly for ischemic stroke (0.62; 95% CI 0.56-0.68; p &lt; 0.001).
In univariate analysis, the factors that were positively associated with ischemic stroke during hospital stay were CHA2DS2-VASc, absence of previous therapy with statin, time between cardiac symptoms and hospital admission, absence of chest pain, Killip-Kimball class, cardiorespiratory arrest, complete left ventricular block and left ventricle ejection fraction &lt;50% (p &lt; 0.05).
After multivariate analysis, CHA2DS2-VASc≥3 (HR 2.25; 95% CI 1.37-3.71; p = 0.001), absence of chest pain (HR 3.17; CI 1.44-6.14, p &lt; 0.001) and previous therapy with statin (HR 0.39; 95% CI 0.22-0.67; p = 0.001) were independent predictors of ischemic stroke.

Conclusion
Among patients with acute myocardial infarction without known atrial fibrillation, the CHA2DS2-VASc score was associated with risk of ischemic stroke and death during hospital stay. This score may be useful for estimating the risk of stroke and in-hospital mortality in these population without known atrial fibrillation.
Abstract Figure.
Community-based health workers implementing universal access to HIV testing and treatment: lessons from South Africa and Zambia—HPTN 071 (PopART)
Authors: Viljoen Lario , Mainga Tila , Casper Rozanne , Mubekapi-Musadaidzwa Constance , Wademan Dillon T , Bond Virginia A , Pliakas Triantafyllos , Bwalya Chiti , Stangl Anne , Phiri Mwelwa , Yang Blia , Shanaube Kwame , Bock Peter , Fidler Sarah , Hayes Richard , Ayles Helen , Hargreaves James R , Hoddinott Graeme , Seeley J , Donnell D , Floyd S , Mandla N , Bwalya J , Sabapathy K , Eshleman S H , Macleod D , Moore A , Vermund S H , Hauck K , Shanaube K 
Published: February 2021

Abstract
The global expansion of HIV testing, prevention and treatment services is necessary to achieve HIV epidemic control and promote individual and population health benefits for people living with HIV (PLHIV) in sub-Saharan Africa. Community-based health workers (CHWs) could play a key role in supporting implementation at scale. In the HPTN 071 (PopART) trial in Zambia and South Africa, a cadre of 737 study-specific CHWs, working closely with government-employed CHW, were deployed to deliver a ‘universal’ door-to-door HIV prevention package, including an annual offer of HIV testing and referral services for all households in 14 study communities. We conducted a process evaluation using qualitative and quantitative data collected during the trial (2013–2018) to document the implementation of the CHW intervention in practice. We focused on the recruitment, retention, training and support of CHWs, as they delivered study-specific services. We then used these descriptions to: (i) analyse the fidelity to design of the delivery of the intervention package, and (ii) suggest key insights for the transferability of the intervention to other settings. The data included baseline quantitative data collected with the study-specific CHWs (2014–2018); and qualitative data from key informant interviews with study management (n = 91), observations of CHW training events (n = 12) and annual observations of and group discussions (GD) with intervention staff (n = 68). We show that it was feasible for newly recruited CHWs to implement the PopART intervention with good fidelity, supporting the interpretation of the trial outcome findings. This was despite some challenges in managing service quality and CHW retention in the early years of the programme. We suggest that by prioritizing the adoption of key elements of the in-home HIV services delivery intervention model—including training, emotional support to workers, monitoring and appropriate remuneration for CHWs—these services could be successfully transferred to new settings.
Antifungal activity of nikkomycin Z against Candida auris
Authors: Bentz Meghan L , Nunnally Natalie , Lockhart Shawn R , Sexton D Joseph , Berkow Elizabeth L 
Published: February 2021

Abstract

Background
Nikkomycin Z is a competitive inhibitor of chitin synthase—an enzyme needed for synthesis of the fungal cell wall. Nikkomycin Z shows promise as a treatment for coccidioidomycoses and mixed activity has been described against other fungi and yeast. To our knowledge, it has not previously been tested against the emerging fungal pathogen Candida auris.

Objectives
To determine the in vitro activity of nikkomycin Z against C. auris.

Methods
Nikkomycin Z was tested by broth microdilution against a panel of 100 isolates of genetically diverse C. auris from around the world.

Results
Nikkomycin Z showed mixed activity against the tested isolates, with an MIC range of 0.125 to &gt;64 mg/L. The MIC50 and MIC90 were 2 and 32 mg/L, respectively.

Conclusions
These findings suggest nikkomycin Z has in vitro activity against some, but not all isolates of C. auris.
ReducedTrypanosoma cruzi-specific humoral response and enhanced T cell immunity after treatment interruption with benznidazole in chronic Chagas disease
Authors: Castro Eiro Melisa D , Natale María A , Alvarez María G , Shen Huifeng , Viotti Rodolfo , Lococo Bruno , Bua Jacqueline , Nuñez Myriam , Bertocchi Graciela L , Albareda María C , Cesar Gonzalo , Tarleton Rick L , Laucella Susana A 
Published: February 2021

AbstractBackgroundInterruption of benznidazole therapy due to the appearance of adverse effects, which is presumed to lead to treatment failure, is a major drawback in the treatment of chronic Chagas disease.MethodsTrypanosoma cruzi-specific humoral and T cell responses, T cell phenotype and parasite load were measured to compare the outcome in 33 subjects with chronic Chagas disease treated with an incomplete benznidazole regimen and 58 subjects treated with the complete regimen, during a median follow-up period of 48 months.ResultsBoth treatment regimens induced a reduction in the T. cruzi-specific antibody levels and similar rates of treatment failure when evaluated using quantitative PCR. Regardless of the regimen, polyfunctional CD4+ T cells increased in the subjects, with successful treatment outcome defined as a decrease of T. cruzi-specific antibodies. Regardless of the serological outcome, naive and central memory T cells increased after both regimens. A decrease in CD4+ HLA-DR+ T cells was associated with successful treatment in both regimens. The cytokine profiles of subjects with successful treatment showed fewer inflammatory mediators than those of the untreated T. cruzi-infected subjects. High levels of T cells expressing IL-7 receptor and low levels of CD8+ T cells expressing the programmed cell death protein 1 at baseline were associated with successful treatment following benznidazole interruption.ConclusionsThese findings challenge the notion that treatment failure is the sole potential outcome of an incomplete benznidazole regimen and support the need for further assessment of the treatment protocols for chronic Chagas disease.
Factors affecting the home range of Dinaric-Pindos brown bears
Authors: De Angelis Daniele , Huber Djuro , Reljic Slaven , Ciucci Paolo , Kusak Josip 
Published: February 2021

Abstract
Studying how animals interact with their environment is fundamental to informing conservation and management efforts, especially when examining large, wide-ranging carnivores in human-dominated landscapes. We hypothesized that the home ranges of bears are configured to exploit supplemental food (corn) and avoid people. In 2004–2016, we tracked 10 brown bears from the Dinaric-Pindos population using GPS telemetry, then used Brownian bridge movement models to estimate their home ranges. We related seasonal home range size to circadian period and density of supplemental feeding sites using generalized linear mixed-effect models. We also used ecological-niche factor analysis to study habitat composition within home range core areas in study areas characterized by different levels of human encroachment. We found that home range size was inversely related to density of supplemental feeding sites, and bears had larger home ranges at night (x̅ = 103.3 ± 72.8 km2) than during the day (x̅ = 62.3 ± 16.6 km2). Our results also revealed that bears living in more human-influenced areas concentrated their use far from human settlements and agricultural lands but stayed close to supplemental feeding sites. Our data suggest that bears alter their space-use patterns at the home range level in response to anthropogenic land use and food availability.
Causes and Consequences of Bacteriophage Diversification via Genetic Exchanges across Lifestyles and Bacterial Taxa
Authors: Moura de Sousa Jorge A , Pfeifer Eugen , Touchon Marie , Rocha Eduardo P C 
Published: February 2021

Abstract
Bacteriophages (phages) evolve rapidly by acquiring genes from other phages. This results in mosaic genomes. Here, we identify numerous genetic transfers between distantly related phages and aim at understanding their frequency, consequences, and the conditions favoring them. Gene flow tends to occur between phages that are enriched for recombinases, transposases, and nonhomologous end joining, suggesting that both homologous and illegitimate recombination contribute to gene flow. Phage family and host phyla are strong barriers to gene exchange, but phage lifestyle is not. Even if we observe four times more recent transfers between temperate phages than between other pairs, there is extensive gene flow between temperate and virulent phages, and between the latter. These predominantly involve virulent phages with large genomes previously classed as low gene flux, and lead to the preferential transfer of genes encoding functions involved in cell energetics, nucleotide metabolism, DNA packaging and injection, and virion assembly. Such exchanges may contribute to the observed twice larger genomes of virulent phages. We used genetic transfers, which occur upon coinfection of a host, to compare phage host range. We found that virulent phages have broader host ranges and can mediate genetic exchanges between narrow host range temperate phages infecting distant bacterial hosts, thus contributing to gene flow between virulent phages, as well as between temperate phages. This gene flow drastically expands the gene repertoires available for phage and bacterial evolution, including the transfer of functional innovations across taxa.
Reducing Superfluous Opioid Prescribing Practices After Brain Surgery: It Is Time to Talk About Drugs
Authors: Asmaro Karam , Fadel Hassan A , Haider Sameah A , Pawloski Jacob , Telemi Edvin , Mansour Tarek R , Chandra Ankush , Bazydlo Michael , Robin Adam M , Lee Ian Y , Air Ellen L , Rock Jack P , Kalkanis Steven N , Schwalb Jason M 
Published: February 2021

Abstract

BACKGROUND
Opioids are prescribed routinely after cranial surgery despite a paucity of evidence regarding the optimal quantity needed. Overprescribing may adversely contribute to opioid abuse, chronic use, and diversion.

OBJECTIVE
To evaluate the effectiveness of a system-wide campaign to reduce opioid prescribing excess while maintaining adequate analgesia.

METHODS
A retrospective cohort study of patients undergoing a craniotomy for tumor resection with home disposition before and after a 2-mo educational intervention was completed. The educational initiative was composed of directed didactic seminars targeting senior staff, residents, and advanced practice providers. Opioid prescribing patterns were then assessed for patients discharged before and after the intervention period.

RESULTS
A total of 203 patients were discharged home following a craniotomy for tumor resection during the study period: 98 who underwent surgery prior to the educational interventions compared to 105 patients treated post-intervention. Following a 2-mo educational period, the quantity of opioids prescribed decreased by 52% (median morphine milligram equivalent per day [interquartile range], 32.1 [16.1, 64.3] vs 15.4 [0, 32.9], P < .001). Refill requests also decreased by 56% (17% vs 8%, P = .027) despite both groups having similar baseline characteristics. There was no increase in pain scores at outpatient follow-up (1.23 vs 0.85, P = .105).

CONCLUSION
A dramatic reduction in opioids prescribed was achieved without affecting refill requests, patient satisfaction, or perceived analgesia. The use of targeted didactic education to safely improve opioid prescribing following intracranial surgery uniquely highlights the ability of simple, evidence-based interventions to impact clinical decision making, lessen potential patient harm, and address national public health concerns.
Correction of frameshift mutations in the atpB gene by translational recoding in chloroplasts of Oenothera and tobacco
Authors: Malinova Irina , Zupok Arkadiusz , Massouh Amid , Schöttler Mark Aurel , Meyer Etienne H , Yaneva-Roder Liliya , Szymanski Witold , Rößner Margit , Ruf Stephanie , Bock Ralph , Greiner Stephan 
Published: February 2021

Abstract
Translational recoding, also known as ribosomal frameshifting, is a process that causes ribosome slippage along the messenger RNA, thereby changing the amino acid sequence of the synthesized protein. Whether the chloroplast employs recoding is unknown. I-iota, a plastome mutant of Oenothera (evening primrose), carries a single adenine insertion in an oligoA stretch [11A] of the atpB coding region (encoding the β-subunit of the ATP synthase). The mutation is expected to cause synthesis of a truncated, nonfunctional protein. We report that a full-length AtpB protein is detectable in I-iota leaves, suggesting operation of a recoding mechanism. To characterize the phenomenon, we generated transplastomic tobacco lines in which the atpB reading frame was altered by insertions or deletions in the oligoA motif. We observed that insertion of two adenines was more efficiently corrected than insertion of a single adenine, or deletion of one or two adenines. We further show that homopolymeric composition of the oligoA stretch is essential for recoding, as an additional replacement of AAA lysine codon by AAG resulted in an albino phenotype. Our work provides evidence for the operation of translational recoding in chloroplasts. Recoding enables correction of frameshift mutations and can restore photoautotrophic growth in the presence of a mutation that otherwise would be lethal.