bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inappropriate shocks from a transvenous implantable defibrillator caused by atrial fibrillation and a missed atrial septal defect in a patient with a modified Bentall procedure
Authors: Kostopoulou Anna , Fountas Epameinontas , Karapanagiotou Olga , Kyrzopoulos Stamatis 
Published: October 2021

Abstract

Background
Inappropriate shocks have been reported in ∼1/3 of patients with implantable cardiac defibrillators (ICDs). We report an unusual case of inappropriate ICD shocks due to atrial fibrillation (AF) caused by a missed atrial septal defect (ASD) in a patient with a modified Bentall procedure.

Case summary
A 67-year-old Caucasian male, with an ICD and a history of a modified Bentall procedure 24 years ago, reported to our outpatient clinic with recurrent inappropriate ICD shocks due to episodes of fast AF. The transthoracic echocardiographic exam revealed two large aneurysms at the ostia of the coronary arteries. We performed further evaluation with transoesophageal echocardiogram and computed tomography (CT) angiography. The aneurysms measured on CT were 3.14 cm × 2.29 cm on the right ostium and 1.9 cm × 0.99 cm on the left. A large secundum type ASD of 1.5 cm, missed in all previous echocardiographic studies, was revealed. The therapeutic options of surgical closure of the ASD and repair of the aneurysms or a more conservative approach with percutaneous closure of the ASD and closer follow-up were discussed with the patient. The patient declined the surgical option due to high complication risk, and closure of the ASD with an Amplatzer device was performed 3 months later. A 3-year follow-up was uneventful.

Conclusion
It is of major importance to comprehensively and thoroughly assess patients before and after a surgical intervention to not miss other treatable conditions preoperatively and complications in the postoperative period.
3-Dimensional computed tomographic assessment predicts conduction block and paravalvular leakage after rapid-deployment aortic valve replacement
Authors: Park Sung Jun , Rhee Younju , Lee Chee-Hoon , Kim Ho Jin , Kim Joon Bum , Choo Suk Jung , Lee Jae Won 
Published: October 2021

Abstract

OBJECTIVES
Complications like complete atrioventricular block (CAVB) and paravalvular leakage (PVL) following rapid deployment aortic valve (AV) replacement (RDAVR) remain unresolved. Selecting an optimal size of the valve might be important to minimize the incidence of these complications. We sought to determine the impact of prosthesis size relative to the anatomic profile of the AV on the occurrence of CAVB or PVL after RDAVR.

METHODS
Preoperative computed tomographic (CT) images were evaluated in patients receiving RDAVR (INTUITY ELITE) between February 2016 and December 2019. The occurrence of CAVB requiring permanent pacemaker implantation and PVL (≥ mild) was evaluated. The relative size of implants against the cross-sectional dimensions of recipients’ AV annulus and left ventricular outflow tract (LVOT) were calculated.

RESULTS
Among 187 eligible patients, CAVB and PVL (≥ mild) occurred in 12 (6.4%) and 11 patients (5.9%), respectively. CAVB was associated with oversized RDAVR (RDAVR frame width minus average diameter of LVOT calculated from the cross-sectional area [ΔLVOTarea]: odds ratio, 2.05; 95% confidence interval, 1.28–3.30): this was with an area under the curve of 0.78 (P = 0.005). The projected probability of CAVB was &lt;3% when the ΔLVOTarea was &lt;1.3. In contrast, PVL was associated with under-sized RDAVR (RDAVR size divided by the longest diameter of AV annulus [index Annlong]: odds ratio, 0.64; 95% confidence interval, 0.51–0.79): This was with an area under curve of 0.94 (P &lt; 0.001).

CONCLUSIONS
CT parameters of the AV annulus and LVOT are highly reliable in the prediction of CAVB or PVL after RDAVR. Our data might justify CT-based sizing of prosthesis for RDAVR.
Statin therapy and lipoprotein(a) levels: a systematic review and meta-analysis
Authors: de Boer Lotte M , Oorthuys Anna O J , Wiegman Albert , Langendam Miranda W , Kroon Jeffrey , Spijker René , Zwinderman Aeilko H , Hutten Barbara A 
Published: October 2021

Abstract

Aims
Lipoprotein(a) [Lp(a)] is a causal and independent risk factor for cardiovascular disease (CVD). People with elevated Lp(a) are often prescribed statins as they also often show elevated low-density lipoprotein cholesterol (LDL-C) levels. While statins are well-established in lowering LDL-C, their effect on Lp(a) remains unclear. We evaluated the effect of statins compared to placebo on Lp(a) and the effects of different types and intensities of statin therapy on Lp(a).

Methods and results
We conducted a systematic review and meta-analysis of randomized trials with a statin and placebo arm. Medline and EMBASE were searched until August 2019. Quality assessment of studies was done using Cochrane risk-of-bias tool (RoB 2). Mean difference of absolute and percentage changes of Lp(a) in the statin vs. the placebo arms were pooled using a random-effects meta-analysis. We compared effects of different types and intensities of statin therapy using subgroup- and network meta-analyses. Certainty of the evidence was determined using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). Overall, 39 studies (24 448 participants) were included. Mean differences (95% confidence interval) of absolute and percentage changes in the statin vs. the placebo arms were 1.1 mg/dL (0.5–1.6, P &lt; 0.0001) and 0.1% (−3.6% to 4.0%, P = 0.95), respectively (moderate-certainty evidence). None of the types of statins changed Lp(a) significantly compared to placebo (very low- to high-certainty evidence), as well as intensities of statin therapy (low- to moderate-certainty evidence).

Conclusion
Statin therapy does not lead to clinically important differences in Lp(a) compared to placebo in patients at risk for CVD. Our findings suggest that in these patients, statin therapy will not change Lp(a)-associated CVD risk.
Effect of sodium-glucose cotransporter-2 inhibitors on cardiac remodelling: a systematic review and meta-analysis
Authors: Zhang Nan , Wang Yueying , Tse Gary , Korantzopoulos Panagiotis , Letsas Konstantinos P , Zhang Qingpeng , Li Guangping , Lip Gregory Y H , Liu Tong 
Published: October 2021

AbstractAimsTo examine the effects of sodium-glucose cotransporter-2 inhibitors (SGLT2i) on cardiac remodelling in patients with type 2 diabetes mellitus (T2DM) and/or heart failure (HF), and to explore the subsets of patients who may have greater benefit from SGLT2i therapy.Methods and resultsFour electronic databases were searched for randomized controlled trials (RCTs) that evaluated the effects of SGLT2i on parameters reflecting cardiac remodelling in patients with T2DM and/or HF. Standardized mean differences (SMDs) or mean differences (MDs) were pooled. Subgroup analyses were performed according to the baseline HF and T2DM, HF type, SGLT2i agent, follow-up duration, and imaging modality. A total of 13 RCTs involving 1251 patients were analysed. Sodium-glucose cotransporter-2 inhibitors treatment significantly improved left ventricular (LV) ejection fraction [SMD, 0.35; 95% confidence interval (CI) (0.04, 0.65); P = 0.03], LV mass [SMD, −0.48; 95% CI (−0.79, −0.18); P = 0.002], LV mass index [SMD, −0.27; 95% CI (−0.49, −0.05); P = 0.02], LV end-systolic volume [SMD, −0.37; 95% CI (−0.71; −0.04); P = 0.03], LV end-systolic volume index [MD, −0.35 mL/m2; 95% CI (−0.64, −0.05); P = 0.02], and E-wave deceleration time [SMD, −0.37; 95% CI (−0.70, −0.05); P = 0.02] in the overall population. Subgroup analyses showed that the favourable effects of SGLT2i on LV remodelling were only significant in HF patients, especially HF with reduced ejection fraction (HFrEF), regardless of glycaemic status. Among the four included SGLT2i, empagliflozin was associated with a greater improvement of LV mass, LV mass index, LV end-systolic volume, LV end-systolic volume index, LV end-diastolic volume, and LV end-diastolic volume index (all P &lt; 0.05).ConclusionsSodium-glucose cotransporter-2 inhibitors treatment significantly reversed cardiac remodelling, improving LV systolic and diastolic function, LV mass and volume, especially in patients with HFrEF and amongst those taking empagliflozin compared with other SGLT2i. Reversed remodelling may be a mechanism responsible for the favourable clinical effects of SGLT2i on HF.
Environment-driven reprogramming of gamete DNA methylation occurs during maturation and is transmitted intergenerationally in Atlantic Salmon
Authors: Wellband Kyle , Roth David , Linnansaari Tommi , Curry R Allen , Bernatchez Louis 
Published: October 2021

AbstractAn epigenetic basis for transgenerational plasticity in animals is widely theorized, but convincing empirical support is limited by taxa-specific differences in the presence and role of epigenetic mechanisms. In teleost fishes, DNA methylation generally does not undergo extensive reprogramming and has been linked with environmentally induced intergenerational effects, but solely in the context of early life environmental differences. Using whole-genome bisulfite sequencing, we demonstrate that differential methylation of sperm occurs in response to captivity during the maturation of Atlantic Salmon (Salmo salar), a species of major economic and conservation significance. We show that adult captive exposure further induces differential methylation in an F1 generation that is associated with fitness-related phenotypic differences. Some genes targeted with differential methylation were consistent with genes differential methylated in other salmonid fishes experiencing early-life hatchery rearing, as well as genes under selection in domesticated species. Our results support a mechanism of transgenerational plasticity mediated by intergenerational inheritance of DNA methylation acquired late in life for salmon. To our knowledge, this is the first-time environmental variation experienced later in life has been directly demonstrated to influence gamete DNA methylation in fish.
Clustering of Sex-Biased Genes and Transposable Elements in the Genome of the Medaka FishOryzias latipes
Authors: Dechaud Corentin , Miyake Sho , Martinez-Bengochea Anabel , Schartl Manfred , Volff Jean-Nicolas , Naville Magali 
Published: October 2021

AbstractAlthough genes with similar expression patterns are sometimes found in the same genomic regions, almost nothing is known about the relative organization in genomes of genes and transposable elements (TEs), which might influence each other at the regulatory level. In this study, we used transcriptomic data from male and female gonads of the Japanese medaka Oryzias latipes to define sexually biased genes and TEs and analyze their relative genomic localization. We identified 20,588 genes expressed in the adult gonads of O. latipes. Around 39% of these genes are differentially expressed between male and female gonads. We further analyzed the expression of TEs using the program SQuIRE and showed that more TE copies are overexpressed in testis than in ovaries (36% vs. 10%, respectively). We then developed a method to detect genomic regions enriched in testis- or ovary-biased genes. This revealed that sex-biased genes and TEs are not randomly distributed in the genome and a part of them form clusters with the same expression bias. We also found a correlation of expression between TE copies and their closest genes, which increases with decreasing intervening distance. Such a genomic organization suggests either that TEs hijack the regulatory sequences of neighboring sexual genes, allowing their expression in germ line cells and consequently new insertions to be transmitted to the next generation, or that TEs are involved in the regulation of sexual genes, and might therefore through their mobility participate in the rewiring of sex regulatory networks.
Staging a Monarchical-federal Order: Wilhelm I as German Emperor
Authors: Sterkenburgh Frederik Frank 
Published: October 2021

Abstract
This article argues that the German emperor Wilhelm I drew on self-staging, symbolic acts and monarchical federalism to establish himself as the new polity’s figurehead after 1871. By drawing on cultural approaches to political history, this article demonstrates that because the imperial office was embedded in a federal context and institutional and geographical dominance was therefore ruled out, Wilhelm used travel, ceremonial and speeches to appeal to the German population via their regional monarchs for popular support. In so doing, Wilhelm deliberately cultivated the empire’s monarchical-federal political structure to accommodate the German states’ differing responses to the king of Prussia now being German emperor and the nascent popular cult around his persona. In addition, this article argues that Wilhelm’s aim was not just to generate popular support for himself, but also to provide a monarchical understanding of the polity and oppose other political centres of gravity, in particular the Reichstag and its parliamentary understanding of the German Empire. As such, this article demonstrates that self-staging and symbolic acts provided the first Kaiser with a distinct political agency, thereby challenging scholars’ assumptions of Bismarck’s personal and political dominance. It shows that Germany’s composite nationhood was not a limitation to Wilhelm’s establishing the Hohenzollern dynasty as Germany’s imperial monarchy, but rather that his self-staging, symbolic acts and monarchical federalism were crucial for this purpose. It thus questions the historiographical notion that this shift did not happen until Wilhelm II’s 1888 accession and his German-national conception of his public persona, the office and the German Empire.
Retirement Type and Cognitive Functioning in Japan
Authors: Mizuochi Masaaki , Raymo James M 
Published: October 2021

Abstract

Objectives
A growing literature examines the effect of retirement on cognitive function, but pays little attention to how this relationship may depend upon the nature of retirement. Of particular importance is the growing prevalence of gradual retirement characterized by continued employment—either with a new employer or with the same employer—after retiring from a career job.

Methods
We use data from men and women aged 50 or older in the Japanese Study of Aging and Retirement to examine the effects of full retirement, partial retirement with the same employer, and partial retirement with a new employer on cognitive function. Our analyses consider the moderating role of career job complexity and exploit distinctive features of the Japanese public pension and mandatory retirement systems to estimate the causal effect of retirement type on cognition.

Results
Results indicate that partial retirement with the same employer has a significant and adverse effect on cognitive function (relative to those not yet retired). In contrast, those who experienced either full retirement or partial retirement with a new employer were, on average, no different from those still in their career job. Partial retirement with a new employer has a beneficial effect on cognition among those who had a high-complexity career job.

Discussion
Results are consistent with the idea that novel work exposures and experiences have a beneficial effect on cognition. They also suggest that ongoing policy efforts to promote partial retirement with the same employer may have unexpected adverse implications for cognitive health.
Denoising modulo samples: k-NN regression and tightness of SDP relaxation
Authors: Fanuel Michaël , Tyagi Hemant 
Published: October 2021

Abstract
Many modern applications involve the acquisition of noisy modulo samples of a function $f$, with the goal being to recover estimates of the original samples of $f$. For a Lipschitz function $f:[0,1]^d \to {{\mathbb{R}}}$, suppose we are given the samples $y_i = (f(x_i) + \eta _i)\bmod 1; \quad i=1,\dots ,n$, where $\eta _i$ denotes noise. Assuming $\eta _i$ are zero-mean i.i.d Gaussian’s, and $x_i$’s form a uniform grid, we derive a two-stage algorithm that recovers estimates of the samples $f(x_i)$ with a uniform error rate $O\big(\big(\frac{\log n}{n}\big)^{\frac{1}{d+2}}\big)$ holding with high probability. The first stage involves embedding the points on the unit complex circle, and obtaining denoised estimates of $f(x_i)\bmod 1$ via a $k$NN (nearest neighbor) estimator. The second stage involves a sequential unwrapping procedure which unwraps the denoised mod $1$ estimates from the first stage. The estimates of the samples $f(x_i)$ can be subsequently utilized to construct an estimate of the function $f$, with the aforementioned uniform error rate. Recently, Cucuringu and Tyagi proposed an alternative way of denoising modulo $1$ data, which works with their representation on the unit complex circle. They formulated a smoothness regularized least squares problem on the product manifold of unit circles, where the smoothness is measured with respect to the Laplacian of a proximity graph $G$ involving the $x_i$’s. This is a nonconvex quadratically constrained quadratic program (QCQP) hence they proposed solving its semidefinite program (SDP) based relaxation. We derive sufficient conditions under which the SDP is a tight relaxation of the QCQP. Hence under these conditions, the global solution of QCQP can be obtained in polynomial time.
The role of IL-4 derived from follicular helper T (TFH) cells and type 2 helper T (TH2) cells
Authors: Kubo Masato 
Published: October 2021

AbstractIL-4 is known to be the quintessential regulatory cytokine, playing a role in a vast number of immune and non-immune functions. This cytokine is commonly secreted by type 2 helper T (TH2) cells and follicular helper T (TFH) cells after antigenic sensitization. TH2 cells have been classically thought to be the major contributor to B-cell help as a source of IL-4 responsible for class-switch recombination to IgG1 in mice (IgG4 in humans) and to IgE in mice and humans. Recent in vivo observations have shown that IgE and IgG1 antibody responses are mainly controlled by IL-4-secreting TFH cells but not by classical TH2 cells. IL-4 is distinctively regulated in these two T-cell subsets by the GATA-3-mediated HS2 enhancer in TH2 cells and the Notch-mediated conserved non-coding sequence 2 (CNS-2) enhancer in TFH cells. Moreover, the IL-4 derived from TFH cells has an essential role in germinal center (GC) formation in the secondary lymphoid organs during humoral immune responses.
Evaluation of the in vitro activity of ceftaroline, ceftazidime/avibactam and comparator antimicrobial agents against clinical isolates from paediatric patients in Kuwait: ATLAS data 2012–19
Authors: Al-Sweih Noura , Jamal Wafaa , Mokaddas Eiman , Habashy Nervana , Kurdi Ayman , Mohamed Naglaa 
Published: October 2021

Abstract

Objectives
To report antimicrobial resistance data for Gram-positive and Gram-negative pathogens isolated from paediatric patients in three hospitals in Kuwait during 2012–19.

Methods
In vitro activity of antimicrobials against isolates from documented infections was determined using CLSI broth microdilution method and breakpoints at a central laboratory. Enterobacterales and Pseudomonas aeruginosa isolates were screened for β-lactamases using multiplex PCR assays. Phenotypic determination of resistance in Haemophilus influenzae and Gram-positive isolates was performed using standard methodologies.

Results
Among 515 Enterobacterales isolates, 29.3% were ESBL-positive; susceptibility was highest to amikacin, ceftazidime/avibactam and meropenem (≥97.4%), regardless of ESBL status. CTX-M-15 was identified in 87.1% of ESBL-positive Escherichia coli and 84.2% of ESBL-positive Klebsiella pneumoniae isolates. Of 111 P. aeruginosa isolates, 9.9% were MDR and 12.6% meropenem-resistant (MEM-R). Amikacin and ceftazidime/avibactam had the highest susceptibility rates in the overall group (≥92.8%), with reduced rates among MDR and MEM-R isolates. All 269 MRSA and 180 MSSA isolates were susceptible to daptomycin, linezolid, teicoplanin, tigecycline and vancomycin. All MSSA and 99.3% of MRSA were ceftaroline susceptible. All 168 pneumococcal isolates were susceptible to ceftaroline, linezolid, tigecycline and vancomycin. H. influenzae and Streptococcus pyogenes ceftaroline susceptibility rates were ≥93.3% and ≥95.6%.

Conclusions
Most isolates of Enterobacterales (including resistant phenotypes) and P. aeruginosa from Kuwait during 2012–19 were susceptible to ceftazidime/avibactam. Ceftaroline was active against most Gram-positive isolates, including resistant phenotypes, and ESBL-negative Enterobacterales. These results indicate that novel antibiotics such as ceftazidime/avibactam and ceftaroline represent valuable treatment options for paediatric infections, including those caused by MDR organisms.
Three Smart and Original Spectrophotometric Data Processing Ratio Techniques for Resolving the Partial Overlapped Spectra of the Binary Antiviral Mixture Daclatasvir/Sofosbuvir: Application to Combined Dosage Form Darvoni® Tablets
Authors: Fayed Ahmed S , Hegazy Maha A , Kamel Ebraam B , Eissa Maya S 
Published: October 2021

Abstract

Background
The combination of daclatasvir (DCV) and sofosbuvir (SFV) is now widely used as an ideal treatment for hepatitis C virus (HCV) infection. For this purpose, simple, sensitive, rapid, and smart spectrophotometric methods were developed and validated for the determination of these drugs in their combined dosage form.

Objective
Development of smart, sensitive, low-cost spectrophotometric methods for the determination of DCV and SFV in their combined dosage form.

Methods
Ratio subtraction (RS), amplitude modulation (AM), and mean-centering spectrophotometric methods were established and validated for the estimation of SFV in the presence of DCV without previous separation, using a unified regression equation.

Results
A linearity range of 2.5–25.0 µg/mL was confirmed for the direct measurement of DCV at 316 nm (because there is no interference from SFV. Linearity was confirmed over a concentration range of 10.0–80.0 µg/mL for SFV. The current methods were established according to the ICH recommendations, and specificity was examined by testing synthetic mixtures of both drugs. They were tested on their tablet dosage form, and a good recovery was obtained.

Conclusion
The current methods proved to be simple, specific, and economical. A statistical study of the current ratio approaches and published methods showed there was no apparent statistical variation.

Highlights
Both antiviral agents can be quantified in the presence of each other by the current methods, which is a significant time- and cost-saving benefit of the developed methods. This benefit is even more important in the case of the combined dosage form (Darvoni® tablets) for the pharmaceutical market.