bluuebunny/crossref_metadata_2025_split huggingface dataset:
Blood ketone measurement as a test for dietary compliance in cardiac sarcoid patients undergoing 18f-fluorodeoxyglucose positron emission tomography
Authors: Clarke S , Alves F , Martins N , Ahmed M , Sanchez L , Donovan J , Kouranos V , Wechalekar K 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Imaging with 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) is used as part of diagnosis and monitoring response to therapy in patients with cardiac sarcoidosis. In order to supress myocardial uptake of 18F-FDG patients prepare with a low carbohydrate diet followed by an 18-hour overnight fast. Failure to comply with the protocol results in diffuse myocardial 18F-FDG uptake which confounds diagnostic interpretation.

Purpose
To assess if point of care blood ketones could be used as a marker of dietary compliance and association with suppression of myocardial 18F-FDG uptake on PET scan.

Method
Patients (n = 26, 57 ± 4 years, 65% Male) from a single centre were instructed to follow standard preparation protocol prior to 18F-FDG PET/CT. After confirmation of dietary compliance, blood glucose and blood ketones were recorded using point of care devices. Images were graded based on the pattern of myocardial 18F-FDG uptake.

Results
There was no clear correlation between blood ketones in relation to dietary compliance or myocardial 18F-fluorodeoxyglucose uptake. In those with myocardial 18F-FDG uptake maximum standardized uptake value (SUV max) within the myocardium ranged from 2.3 to 9.8 (Mean 5.3) and ketone from 0.1 – 0.7 (normal &lt;0.6).
Non-diabetic patients and those on steroids achieved adequate fasting glucose without significant rise in blood ketones. 60% of diabetic patients demonstrated mildly elevated ketones between 0.6-1.5mmol/L.

Conclusion
Current protocol with low carbohydrate diet and 18-hour fast achieves adequate quality of images in majority of patients, without significant change in blood ketones. Therefore, blood ketones cannot be used to confirm dietary compliance. Diabetic patients on insulin may benefit from ketone measurement due to risk of diabetic ketoacidosis.
18F-FDGPET/CT improves diagnostic certainty over the modified Duke Criteria in blood culture negative infective endocarditis
Authors: Primus C , Bvekerwa I , Clay TA , Mccue M , Wong K , Uppal R , Ambekar S , Das S , Bhattacharyya S , Davies LC , Woldman S , Menezes L 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Diagnosis of blood culture negative infective endocarditis (BCNIE) is challenging, with positive microbiology key in the modified Duke Criteria (mDC). ESC IE Guidelines (2015) recommend the use of 18F-FDG PET/CT (PET) in cases where transoesophageal echocardiography (TOE) is equivocal and where cardiac implantable device-related IE (CIDRE) is suspected. We explored the role of PET to improve diagnostic certainty in the challenging cohort of BCNIE.

Methods
Retrospective review of all suspected BCNIE patients undergoing PET (10/2015 to 01/2021). Myocardial suppression technique was used in all cases, and studies were assessed for valve/device avidity. Patients were classified as definite/possible/rejected IE by mDC pre- and post-PET, with incremental benefit assessed by net reclassification index (NRI) versus actual diagnosis. Actual diagnosis was defined by Endocarditis Team consensus or surgical specimen (where available) at a minimum of 2-months following index admission.

Results
PET was performed in 110/807 (13.6%) cases overall. BCNIE prevalence was 18% across the total cohort, with 25/110 (22.7%) PET studies in BCNIE patients (male = 17, mean age 65). (p = 0.16 for PET in BCNIE compared to overall). PET was undertaken in 8 CIDRE, 9 native IE (NVE) and 10 prosthetic IE (PVE); 2-patients had suspected CIDRE + PVE. TOE was performed in all cases, and surgery was required in 8/25 patients. IE was confirmed in 44% of cases.
PET sensitivity, specificity, positive and negative predictive values were 73%, 93%, 89% and 81%, respectively. Addition of PET to the mDC improved re-classification to definite or rejected IE, with NRI 0.633 (positive NRI 0.3; negative 0.333), and added weight to the original mDC classification in 14/25 (56%) of cases.

Conclusion
PET improves diagnostic certainty when combined with mDC in the evaluation of patients with BCNIE across NVE, PVE and CIDRE.
A case report of transcatheter mitral valve repair in patient with severe acute mitral regurgitation, cardiogenic shock, and left atrial appendage thrombus as a rescue therapy: facing all enemies at once!
Authors: Alachkar Mhd Nawar , Schröder Jörg , Autschbach Rüdiger , Almalla Mohammad 
Published: July 2021

Abstract

Background
Transcatheter mitral valve repair (TMVR) in patients with severe acute mitral regurgitation (MR) and high surgical risk has been described. Moreover, the use of cerebral protection device (CPD) during TMVR in patients without evidence of intracardiac thrombus has been investigated. To the best of our knowledge, TMVR as a rescue therapy in a patient with acute ischaemic MR, cardiogenic shock, and left atrial appendage (LAA) thrombus with concurrent use of CPD has not been reported.

Case summary
A 59-year-old female with subacute lateral myocardial infarction caused by subacute stent thrombosis after stent implantation in the left circumflex artery 3 weeks previously presented with acute heart failure due to acute severe MR at a peripheral hospital. The patient was transferred to our tertiary centre for operative mitral valve repair. Transoesophageal echocardiogram revealed the presence of LAA thrombus. During the admission, the patient developed an electrical storm and cardiogenic shock. Because of the extremely high surgical risk and the lack of other therapeutic options, the patient was treated with TMVR (MitraClip™, Abbott Structural Heart Devices, Santa Clara, CA, USA) with the use of CPD (Sentinel™; Boston scientific) as a rescue therapy. After the procedure, the clinical and haemodynamic conditions of the patient improved significantly, and she could be discharged home without any neurological sequelae.

Conclusion
TMVR with concurrent use of CPD as a rescue therapy may be considered in non-operable patients with cardiogenic shock caused by acute severe MR and evidence of LAA thrombus when no other therapy options are possible.
Efficacy and safety of dronedarone across age and sex subgroups: apost hocanalysis of the ATHENA study among patients with non-permanent atrial fibrillation/flutter
Authors: Curtis Anne B , Zeitler Emily P , Malik Aysha , Bogard Andrew , Bhattacharyya Nidhi , Stewart John , Hohnloser Stefan H 
Published: July 2021

AbstractAimsAge and sex may impact the efficacy of antiarrhythmic drugs on cardiovascular outcomes and arrhythmia recurrences in patients with atrial fibrillation (AF). We report on a post hoc analysis of the ATHENA study (NCT00174785), which examined cardiovascular outcomes in patients with non-permanent AF treated with dronedarone vs. placebo.Methods and resultsEfficacy and safety of dronedarone were assessed in patients according to age and sex. Baseline characteristics were comparable across subgroups, except for cardiovascular comorbidities, which were more frequent with increasing age. Dronedarone significantly reduced the risk of cardiovascular hospitalization or death due to any cause among patients 65–74 [n = 1830; hazard ratio (HR) 0.71, 95% confidence interval (CI) 0.60–0.83; P &lt; 0.0001] and ≥75 (n = 1925; HR 0.75, 95% CI 0.65–0.88; P = 0.0002) years old and among males (n = 2459; HR 0.74, 95% CI 0.64–0.84; P &lt; 0.00001) and females (n = 2169; HR 0.77, 95% CI 0.67–0.89; P = 0.0002); outcomes were similar for time to AF/AFL recurrence. Among patients aged &lt;65 years (n = 873), cardiovascular hospitalization or death due to any cause with dronedarone vs. placebo was associated with an HR of 0.89 (95% CI 0.71–1.11; P = 0.3). The incidence of all treatment-emergent adverse events (TEAEs) and TEAEs leading to treatment discontinuation was comparable among males and females, and increased with increasing age.ConclusionsThese results support the use of dronedarone for the improvement of clinical outcomes among patients aged ≥65 years and regardless of sex.
Patient and clinician perspectives of factors that influence the delivery of alcohol brief interventions in Australian primary care: a qualitative descriptive study
Authors: Sturgiss Elizabeth , Lam Tina , Russell Grant , Ball Lauren , Gunatillaka Nilakshi , Barton Chris , Tam Chun Wah Michael , O’Donnell Renee , Chacko Elizabeth , Skouteris Helen , Mazza Danielle , Nielsen Suzanne 
Published: July 2021

Abstract

Background
Brief interventions (BIs) delivered in primary care can reduce harmful alcohol consumption. Yet, clinicians do not routinely offer BIs to reduce harmful alcohol use.

Objective
We explored the perspectives of clinicians and patients about the use of alcohol BIs during consultations in Australian primary care.

Methods
Semi-structured interviews and focus groups (face-to-face and virtual) were undertaken with 34 general practitioners, eight practice nurses and 17 patients. Field notes were made from audio-recordings and themes were identified using a descriptive qualitative approach with the field notes as the point of data analysis.

Results
Participants identified barriers within the consultation, practice setting and wider healthcare system plus across the community which reduce the delivery of BIs in primary care including: Australian drinking norms; inconsistent public health messaging around alcohol harm; primary care not recognized as a place to go for help; community stigma towards alcohol use; practice team culture towards preventive health, including systems for recording alcohol histories; limitations of clinical software and current patient resources.

Conclusion
Multiple layers of the healthcare system influence the use of BIs in primary care. Identified facilitators for embedding BIs in primary care included: (i) raising community and clinician awareness of the health harms of alcohol, (ii) reinforcing a primary care culture that promotes prevention and, (iii) supportive resources to facilitate discussion about alcohol use and strategies to reduce intake. Alcohol BIs in primary care could be further supported by community public health messages about alcohol use.
Contribution of crystal orientation and grain boundary compliance to low shear velocity observed near base of polar ice sheets
Authors: Sayers Colin M 
Published: July 2021

SUMMARYSeismic shear wave velocity (S-velocity) shows a decrease towards the base of ice sheets in Antarctica and Greenland that is not accompanied by a corresponding decrease in compressional velocity (P-velocity). This decrease has been interpreted as arising from liquid water below the melting point (pre-melt water) at grain boundaries, but the lack of a corresponding decrease in P-velocity has not been explained. Representing grain boundaries as displacement discontinuities allows the change in P- and S-velocities to be written as functions of the normal and shear compliance of the grain boundaries. This allows the normal-to-shear compliance ratio of the grain boundaries to be constrained, and seismic anisotropy resulting from a partial orientation of grain boundaries to be estimated. This approach demonstrates that the observed reduction in S-velocity with no significant decrease in P-velocity near the base of ice sheets in Antarctica and Greenland can be explained by pre-melt water at small aperture grain boundaries. Such water may enable sliding along the grain boundaries and so may enhance creep of ice near the base of ice sheets. If stress state is anisotropic the aperture of water-containing grain boundaries may vary with azimuth, with the most open grain boundaries oriented with strikes perpendicular to least compressive stress. Microcracks and fractures may be treated also as displacement discontinuities and, together with oriented grain boundaries, may contribute to shear wave splitting as observed in West Antarctica in a fast-moving ice stream.
A novel zebrafish model for intermediate type spinal muscular atrophy demonstrates importance of Smn for maintenance of mature motor neurons
Authors: Tay Shermaine Huiping , Ellieyana Erna Nur , Le Yao , Sarusie Menachem Viktor , Grimm Clemens , Ohmer Jürgen , Mathuru Ajay S , Fischer Utz , Winkler Christoph 
Published: July 2021

Abstract
A deficiency in Survival Motor Neuron (SMN) protein results in motor neuron loss in spinal muscular atrophy (SMA) patients. Human SMN is encoded by SMN1 and SMN2 that differ by a single C6T transition in a splice regulatory region of exon 7. In SMN2, exon 7 is skipped leading to an unstable protein, which cannot compensate for SMN1 loss in SMA patients. The disease severity of human SMA (Types 1–4) depends on the levels of SMN protein, with intermediate levels leading to delayed disease onset and extended life expectancy in Type 2 patients. We used homology directed repair (HDR) to generate a zebrafish mutant with intermediate Smn levels, to mimic intermediate, hSMN2 dependent forms of SMA. In the obtained smnA6Tind27 mutant zebrafish, Smn protein formed oligomers but protein levels dropped significantly at juvenile stages. Motor neurons and neuromuscular junctions (NMJ) also formed normally initially but motor neuron loss and locomotor deficiencies became evident at 21 days. Subsequent muscle wasting and early adult lethality also phenocopied intermediate forms of human SMA. Together, our findings are consistent with the interpretation that Smn is required for neuromuscular maintenance, and establish the smnA6Tind27 zebrafish mutant as a novel model for intermediate types of SMA. As this mutant allows studying the effect of late Smn loss on motor neurons, neuromuscular junctions, and muscle at advanced stages of the disease, it will be a valuable resource for testing new drugs targeted towards treating intermediate forms of SMA.
EphA2 Is a Lung Epithelial Cell Receptor for Pneumocystis β-Glucans
Authors: Kottom Theodore J , Schaefbauer Kyle , Carmona Eva M , Limper Andrew H 
Published: July 2021

Abstract
Pneumocystis species interaction with myeloid cells is well known, especially in macrophages; however, how the organism binds to lung epithelial cells is incompletely understood. Ephrin type-A receptor 2 (EphA2) has been previously identified as a lung epithelial pattern recognition receptor that binds to fungal β-glucans. Herein, we also report that EphA2 can also bind Pneumocystis β-glucans, both in isolated forms and also on exposed surfaces of the organism. Furthermore, binding of Pneumocystis β-glucans resulted in phosphorylation of the EphA2 receptor, which has been shown to be important for downstream proinflammatory response. Indeed, we also show that interleukin 6 cytokine is significantly increased when lung epithelial cells are exposed to Pneumocystis β-glucans, and that this response could be blocked by preincubation with a specific antibody to EphA2. Our study presents another Pneumocystis lung epithelial cell receptor with implications for initial colonization and possible therapeutic intervention.
Do new housing units in your backyard raise your rents?
Authors: Li Xiaodi 
Published: July 2021

Abstract
There is a growing debate about whether new housing units increase rents for immediately surrounding apartments. Some argue new market-rate development produces a supply effect, which should alleviate the demand pressure on existing housing units and decrease their rents. Others contend that new development will attract high-income households and new amenities, generating an amenity effect and driving up rents. I contribute to this debate by estimating the impact of new high-rises on nearby residential rents, residential property sales prices and restaurant openings in New York City. To address the selection bias that developers are more likely to build new high-rises in fast-appreciating areas, I restrict the sample to residential properties near approved new high-rises and exploit the plausibly exogenous timing of completion conditional upon the timing of approval. I provide event study evidence that within 500 ft, for every 10% increase in the housing stock, rents decrease by 1%; and for every 10% increase in the condo stock, condo sales prices decrease by 0.9%. In addition, I show that new high-rises attract new restaurants, which is consistent with the hypothesis about amenity effects. However, I find that the supply effect dominates the amenity effect, causing net reductions in the rents and sales prices of nearby residential properties.
Analysis of Circulating Immune Biomarkers by Race in Men With Metastatic Castration-Resistant Prostate Cancer Treated With Sipuleucel-T
Authors: Hawley Jessica E , Pan Samuel , Kandadi Harini , Chaimowitz Matthew G , Sheikh Nadeem , Drake Charles G 
Published: July 2021

Abstract
Among racial subgroups, Black men have the highest prostate cancer–specific death rate, yet they also exhibit prolonged overall survival compared with White men when treated with standard therapies, including sipuleucel-T. Differential immune responses may play a role in these observations. We compared circulating immune markers from 54 men (18 Black and 36 White) with metastatic castrate-resistant prostate cancer who received sipuleucel-T and were enrolled on an immune monitoring registry. Markers included longitudinal serum cytokine concentrations, humoral responses, and cellular immunity from baseline until 52 weeks after sipuleucel-T administration. Black men had statistically significantly higher median concentrations of TH2-type (interleukin [IL]-4, IL-10, and IL-13) and inflammatory cytokines (IL-2, IL-12, and IL-6) compared with prostate-specific antigen-matched White men both at baseline and 52 weeks after sipuleucel-T (2-sided P &lt; .05). No differences by race were seen in either the antigen-specific T-cell response or the humoral responses to the immunizing antigen PA2024 and select secondary antigens.
Flavonoids and saponins from Passiflora edulis f. edulis leaves (purple passion fruit) and its potential anti-inflammatory activity
Authors: Urrego Norman , Sepúlveda Paula , Aragón Marcela , Ramos Freddy A , Costa Geison M , Ospina Luis F , Castellanos Leonardo 
Published: July 2021

Abstract

Objectives
The objective of this work was to evaluate the anti-inflammatory activity of the aqueous extract, fractions and major compounds, which are isolated and identified from Passiflora edulis f. edulis (purple passion fruit) leaves extract.

Methods
For the isolation of the major compounds, reversed-phase chromatography and normal phase countercurrent chromatography were used. The separation was followed by thin layer chromatography and HPLC-DAD-ELSD. One-dimensional and two-dimensional NMR and ESI-TOF-MS/MS were used for structural elucidation. The anti-inflammatory activity was evaluated on a TPA multiple dose model of skin chronic inflammation in mice. Additionally, myeloperoxidase (MPO) and nitric oxide synthase (NOS) activity assays were performed as possible mechanisms of action studies.

Key findings and conclusions
The study of the butanolic fraction mainly showed the presence of saponins and flavonoids. Three minor flavonoids were detected; and three known saponins, cyclopassiflosides IX, XI and III were isolated and identified. This is the first unequivocal report of the presence of these compounds in P. edulis f. edulis leaves. The most favourable results of anti-inflammatory activity were obtained for the flavonoid-rich fraction. All the fractions and isolated compounds evaluated, presented high percentages of inhibition of nitric oxide synthase activity.
Wheat grain yield decreased over the past 35 years, but protein content did not change
Authors: Bloom Arnold J , Plant Richard E 
Published: July 2021

Abstract
The extent to which rising atmospheric CO2 concentration has already influenced food production and quality is uncertain. Here, we analyzed annual field trials of autumn-planted common wheat in California from 1985 to 2019, a period during which the global atmospheric CO2 concentration increased 19%. Even after accounting for other major factors (cultivar, location, degree-days, soil temperature, total water applied, nitrogen fertilization, and pathogen infestation), wheat grain yield and protein yield declined 13% over this period, but grain protein content did not change. These results suggest that exposure to gradual CO2 enrichment over the past 35 years has adversely affected wheat grain and protein yield, but not grain protein content.
The subtlety of Ly α photons: changing the expected range of the 21-cm signal
Authors: Reis Itamar , Fialkov Anastasia , Barkana Rennan 
Published: July 2021

ABSTRACT
We present the evolution of the 21-cm signal from cosmic dawn and the epoch of reionization in an upgraded model including three subtle effects of Ly α radiation: Ly α heating, CMB heating (mediated by Ly α photons), and multiple scattering of Ly α photons. Taking these effects into account, we explore a wide range of astrophysical models and quantify the impact of these processes on the global 21-cm signal and its power spectrum. We find that Ly α heating raises the gas temperature by up to $\mathcal {O}(100)$ degrees (CMB heating adds a few more degrees) in models with weak X-ray heating, thus suppressing the predicted 21-cm signals. Varying the astrophysical parameters broadly in an attempt to cover the full plausible range of models, we find that in the upgraded model the absorption trough of the global signal reaches a lowest possible floor of −165 mK at redshifts z ≈ 15−19. This is in contrast with the predictions for a pure adiabatically cooling Universe, for which the deepest possible absorption is a monotonically decreasing function of cosmic time and is −178 mK at z = 19 and −216 mK at z = 15, dropping to even lower values at lower redshifts. With Ly α and CMB heating included we also observe a strong suppression in the low-redshift power spectra, with the maximum possible power (evaluated over the ensemble of models) attenuated by a factor of 6.6 at z = 9 and K = 0.1 Mpc−1. Finally, we find that at high redshifts corresponding to cosmic dawn, the multiple scattering of Ly α photons leads to an amplification of the power spectrum by a factor of ∼2−3 in all models.
The physical properties of γ-ray-quiet flat-spectrum radio quasars: why are they undetected by Fermi-LAT?
Authors: Deng Xue-Jiao , Xue Rui , Wang Ze-Rui , Xi Shao-Qiang , Xiao Hu-Bing , Du Lei-Ming , Xie Zhao-Hua 
Published: July 2021

ABSTRACT
During a decade of operation of the Fermi-Large Area Telescope (LAT), thousands of blazars have been detected in the γ-ray band. However, there are still numbers of blazars that have not been detected in the γ-ray band. In this work, we focus on investigating why some flat-spectrum radio quasars (FSRQs) are undetected by Fermi-LAT. By cross-matching the Candidate Gamma-ray Blazars Survey catalogue with the Fourth Catalog of Active Galactic Nuclei Detected by the Fermi-LAT, we select 11 γ-ray-undetected (γ-ray-quiet) FSRQs as our sample and collect their quasi-simultaneous multiwavelength data. In the framework of the conventional one-zone leptonic model, we investigate their underlying physical properties and study the possibility that they are undetected in the γ-ray by modelling their quasi-simultaneous spectral energy distributions. In contrast to a smaller bulk Lorentz factor suggested by previous works, our results suggest that the dissipation region located relatively far away from the central super-massive black hole is more likely to be the reason why some γ-ray-quiet FSRQs are undetected by Fermi-LAT.