bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distribution of Nitrate, Phosphate and N/P Ratio in Maninjau Lake, West Sumatra, Indonesia
Authors: Fachrul M F , Rinanti A , Hendrawan D I , Salsabil M A , Alreekabi N K 
Published: April 2021

Abstract
This research aim to study of spatial distribution of Nitrate and Phosphate concentration, and also N/P ratio in waters of Maninjau Lake (0°19’ S; 100°12’E)), West Sumatera Province, Indonesia, collected from 11 sampling points of water samples which were performed during 3 (three periods) May, June and July 2017. Other major sources of environmental nitrogen and phosphate are fertilizers and wastewater discharged from farms and livestock facilities, and sewage from residential areas which leak into lakes. The Nitrate and phosphate concentrations in Maninjau Lake waters, the results of the analysis found that Nitrate values ranged from 0.02-0.40 mg/L mg/L (quality standard 10 mg/L), while phosphate ranged from 0.12-0.54 mg/L mg/L (quality standard 0.2 mg / L). Nitrogen (N) and phosphorus (P) generally limit the main productivity in lakes. The N/P Ratio calculation results are known that 0.29-0.58, the value shows that there has been an excessive addition of phosphate elements into the waters, so that it appears that the N element is a limiting element that affects the biological conditions of ecosystems such as phytoplankton biomass, species composition which is likely to occur dominance of certain types. This situation is quite reasonable, considering that around the study site is a residential area that discharges household wastewater that uses detergents into the waters. Anthropogenic nitrogen and phosphorus supply to natural ecosystems has increased them in many lakes.
The urban development of castles within the historical cities of Iraq (Case study Hit Castle)
Authors: Amer Ibrahim Yasar , Abbas Shatha 
Published: April 2021

Abstract
The study of historical castles has a great impact on the urban and urban development of historical city centers and has a great importance in forming the urban body of these cities. Because of its impact on the social, economic, political, cultural and tourism levels in addition to its physical and spiritual importance to successive generations that link them with the cultural and social heritage. Historic castles suffer from a state of neglect, deterioration, vandalism and transgression that is a result of successive periods as a kind of negative effects of wars that happened in the country in successive periods. The work on studies and researches specialized in developing historical castles is one of the responsibilities of the local and global level. Which contributes to strengthening the role of moral standing of the castles cities community tourist attraction and raise the country’s economy. The choice of the historic castle of Hit to study in this research is due to its historical and urban depth. Which is the main seed in shaping the structure of the city of Hit with time, and what this city is witnessing today from an urban renaissance in Anbar Governorate. From seeing the studies and researches that dealt with the urban development strategies of the city, the research problem crystallized with (lack of architectural, urban and archaeological studies specialized in dealing with the method of urban development of the Citadel and the lack of clarity in determining its development strategy). The hypothesis of the research was formulated as (The urban development strategy of Hit Castle affects the integration of the castle with the surrounding urban fabric and its historical characteristics). Depending on putting theoretical terms on the development strategy by analyzing strategies for similar examples, and by comparing its terms and identifying its advantages and disadvantages, the optimal strategy for urban development is been chosen according to the index that will be extracted from the practical study of Hit Castle.
The Role of Colony Temperature in the Entrainment of Circadian Rhythms of Honey Bee Foragers
Authors: Giannoni-Guzmán Manuel A , Rivera-Rodriguez Emmanuel J , Aleman-Rios Janpierre , Melendez Moreno Alexander M , Pérez Ramos Melina , Pérez-Claudio Eddie , Loubriel Darimar , Moore Darrell , Giray Tugrul , Agosto-Rivera Jose L 
Published: April 2021

Abstract
Honey bees utilize their circadian rhythms to accurately predict the time of day. This ability allows foragers to remember the specific timing of food availability and its location for several days. Previous studies have provided strong evidence toward light/dark cycles being the primary Zeitgeber for honey bees. Work in our laboratory described large individual variation in the endogenous period length of honey bee foragers from the same colony and differences in the endogenous rhythms under different constant temperatures. In this study, we further this work by examining the temperature inside the honey bee colony. By placing temperature and light data loggers at different locations inside the colony we measured temperature at various locations within the colony. We observed significant oscillations of the temperature inside the hive, that show seasonal patterns. We then simulated the observed temperature oscillations in the laboratory and found that using the temperature cycle as a Zeitgeber, foragers present large individual differences in the phase of locomotor rhythms for temperature. Moreover, foragers successfully synchronize their locomotor rhythms to these simulated temperature cycles. Advancing the cycle by six hours, resulting in changes in the phase of activity in some foragers in the assay. The results are shown in this study highlight the importance of temperature as a potential Zeitgeber in the field. Future studies will examine the possible functional and evolutionary role of the observed phase differences of circadian rhythms.
Modeling human peri-implantation placental development and function
Authors: Zhou J , West R C , Ehlers E L , Ezashi T , Schulz L C , Roberts R M , Yuan Y , Schust D J 
Published: April 2021

Abstract
It is very difficult to gain a better understanding of the events in human pregnancy that occur during and just after implantation because such pregnancies are not yet clinically detectable. Animal models of human placentation are inadequate. In vitro models that utilize immortalized cell lines and cells derived from trophoblast cancers have multiple limitations. Primary cell and tissue cultures often have limited lifespans and cannot be obtained from the peri-implantation period. We present here two contemporary models of human peri-implantation placental development: extended blastocyst culture and stem-cell derived trophoblast culture. We discuss current research efforts that employ these models and how such models might be used in the future to study the “black box” stage of human pregnancy.
Prognostic value of depressed cardiac index after STEMI: a phase-contrast magnetic resonance study
Authors: Schwaiger J , Reinstadler SJ , Holzknecht M , Tiller C , Reindl M , Lechner I , Lamina C , Mayr A , Graziadei I , Bauer A , Metzler B , Klug G 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Aims
An invasively measured Cardiac Index (CI) of ≤2.2 l/min/m² is one of the strongest prognostic indicators after ST-elevation myocardial infarction, however knowledge is mainly based on invasive evaluations performed in the pre-stent era. Velocity-encoded Phase Contrast Cardiac Magnetic Resonance (PC-CMR) allows non-invasive determination of CI.

Methods
In this prospective study CMR was performed in 406 stable and contemporarily revascularized patients a median of 3 days after STEMI. Forward stroke volume was assessed at the level of the ascending aorta by PC-CMR. Left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) were determined by cine CMR. Major adverse cardiac events (MACE) were defined as the composite of death, myocardial infarction or hospitalization for heart failure.

Results
Median CI was 2.52 l/min/m², 27% of patients had ≤2.2 l/min/m². Median LVEF was 53%, median GLS was -12.2%. During a median follow-up of 13.6 (12.1;62.9) months, 38 patients (8.7%) experienced a MACE. A depressed CI was significantly associated with MACE after adjustment for GLS and LVEF (HR = 2.55 (95%CI 1.10—5.28); p = 0.01), markers of myocardial injury (HR = 2.18, 95%CI 1.10-4.30, p = 0.02) and clinical parameters (HR = 2.42, 95%CI 1.19-4.90, p = 0.01). Adding CI to a model including LVEF and GLS led to significant discrimination improvement (0.55 [95%CI 0.18 - 0.91]; p = 0.003).

Conclusions
A CI of 2.2 l/min/m² or less as measured by PC-CMR was present in 27% of clinically stable patients after STEMI, which strongly and independently predicted medium-term MACE. The prognostic value of a depressed CI was superior and incremental to LVEF and GLS. Abstract Figure. Graphical Abstract
Prediction of atrial fibrillation and sudden cardiac death in type 2 diabetic patients on insulin: a territory-wide observational cohort study
Authors: Lee S , Jeevaratnam K , Liu T , Chang D , Wu WKK , Wong ICK , Lip GYH , Tse G 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
With the global shift towards a more personalized approach in the management of diabetes, there is an increasing interest in exploring the application of new parameters, such as HbA1c and lipid variability, to better monitor disease progression and evaluate the prognosis. Given that metabolic abnormalities may exacerbate the risk of adverse outcomes in patients with type 2 diabetes mellitus, patients who are partially or fully dependent on insulin are more likely to have severe disease and may be at higher risks of arrhythmias.

Purpose
The aim of the present study aims was to assess the predictive value of HbA1c and lipid variability towards ventricular tachycardia (VT), ventricular fibrillation (VF), or SCD, as well as incident AF in type 2 diabetic patients receiving insulin therapy.

Methods
The territory-wide retrospective observational study consists of type 2 diabetic patients prescribed with insulin, who attended publicly funded clinics and hospitals in Hong Kong between January 1st, 2009 to December 31st, 2009. Variability in total cholesterol, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), triglyceride, and HbA1c were assessed through their standard deviation (SD) and coefficient of variation (CV) for patients with at least three measurements of the respective indices. Univariate and multivariate Cox regression analysis was used to predict for the primary outcomes- incident SCD and AF.

Results
A total of 23329 patients (mean ± SD age: 64 ± 14 years old; 51% male; mean HbA1c 8.6 ± 1.3%) were included. In total, 2512 and 1846 patients experienced incident SCD and AF respectively over the course of follow-up. On multivariate analysis, higher HbA1c variability (SD: hazard ratio [HR]: 1.45, 95% confidence interval [CI] 1.21-1.75; p &lt; 0.0001) and triglyceride variability (SD: HR: 1.36, 95%CI: 1.24-1.49; p &lt; 0.0001) were associated with increased of SCD risk. By contrast, only the increase in LDL-C variability was predictive of AF (SD: HR 2.95, 95%CI 1.37-6.39; p= 0.006).

Conclusions
Higher HbA1c variability and lipid variability were associated with increased of SCD risk while only higher LDL-C variability was predictive of incident AF. Therefore, poor glucose control and variability in lipid parameters in diabetic patients are associated with SCD and incident AF. These observations suggest the need to re-evaluate the extent of glycemic control required for outcome optimization.
Sustained ventricular tachycardia in cardiogenic shock
Authors: Santos H , Vieira T , Fernandes J , Pinto R , Proenca T , Ferreira AR , Rios M , Honrado T 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Cardiogenic shock (CS) and the presence of sustained ventricular tachycardia (VT) are indicators of worse prognosis in hospitalized patients. In patients severely ill, like patients with CS, the registration of VT can be a stressful situation as well a life threatening condition.

Purpose
Evaluate the impact of cardiovascular previous history, clinical signs and diagnosis procedures at admission as predictors of VT in CS patients.

Methods
Single-centre retrospective study, engaging patients hospitalized for CS between 1/01/2014-30/10/2018. 222 patients with CS are included, 19 of them presented VT. Chi-square test, T-student test and Mann-Whitney U test were used to compare categorical and continuous variables. Multiple linear regression analysis was performed to evaluate predictors of new-onset AF in CS patients.

Results
CS patients without VT and with VT presented similar age, sex, cardiovascular history (namely arterial hypertension, diabetes, dyslipidemia, obesity, smoker status, alcohol intake, previous acute coronary syndrome, history of angina, previous cardiomyopathy), neoplasia history, cardiac arrest during the CS, clinical signs at admission (like heart rate, blood pressure, respiratory rate), blood results (hemoglobin, leucocytes, troponin, creatinine, C-Reactive protein), left ventricular ejection fraction and the culprit lesion. Curiously, history of previous stroke was higher in the group of VT in CS patients with a 6.9% (p = 0.021). Curiously, VT in CS patient had not impact in mortality rates. Multiple logistic regression reveals that previous stroke was a predictor of VT in CS patients (odds ratio 4.337, confident interval 1.363-13.799, p = 0.013).

Conclusions
History of previous stroke was a predictor of sustained VT in CS patients. The presence of this ventricular arrhythmia can have a hemodynamic impact, however, seems not influenced mortality rates.
Nocturnal hypertension in acute heart failure patients: 24 hours blood pressure pattern
Authors: Gonzalez Gonzalez AM , Garcia-Bellon AM , Cano-Garcia M , Vivancos-Delgado R 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
It is well defined the prognosis value of the abnormalities in the circadian variation in hypertensive patients. In the phisiopathology of heart failure, neurohumoral mechanism plays an important role. Nevertheless, the circadian variation in nonhypertensive heart failure patients has not been well evaluated.

Purpose
Our aim was to evaluate 24-h blood pressure patterns and the prevalence of nocturnal hypertension in patients admitted with acute heart failure.

Methods
We studied 122 patients with a clinical diagnosis of AHF. We permormed a 24-h ambulatory blood pressure monitoring as well as an echocardiogram and anaytical test.

Results
122 patients. Mean age: 63 ± 10. Males: 75%. Mean BMI: 30 ± 6 Kg/m2. Associated risk factors: 56,6% hypertension, 40 % dyslipidemia, 34,7% Diabetes, 29,3% obesity, 22,9% smoking. The etiology of HF: ischemic 41,2%;hypertensive 22,7%; dilated cardiomyopathy 20,9%;valvular 8,3%; others 6,9%.Therapeutic regimen applied: RAS blockers 93,4%; betablockers 85,7%; loop diuretic 81%; spironolactone 42,3%; statins 68,4%; antiplatelet/anticoagulant drugs 89%.
The 24 h ABPM measurements are in table 1
The majority of AHF patients (80,4%) have an abnormal pattern of ABPM: Dipper 19,6%, non-dipper 51,1%, riser 0%.The prevalence of nocturnal hypertension was 22,8%.

Conclusions
In our area, AHF patients have optimal control of BP , however, the normal circadian variation in blood pressure is altered in most of them. In addition, nocturnal hypertension is very common in heart failure patients. Ambulatory blood pressure monitoring may be helpful in identified this altered patterns (which could be unrecognized) and may be used to optimise heart failure therapy, and could be a prognosis marker in this patient group. Table 124 hoursDaytimeNightimeSysolic BP107,7 ± 13,8109,6 ± 14,2104,5 ± 14,5Diastolic BP64,4 ± 7,866,4 ± 8,860,4 ± 7,6
Timing and mode of in-hospital death in a contemporary population with acute myocardial infarction
Authors: Sa Mendes G , Ferreira J , Tralhao A , Trabulo M , Almeida M , Mendes M 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Although presenting features and early complications of acute myocardial infarction (AMI) are clear to the medical community, little is known about the timing and mode of in-hospital death. The purpose of this study is to characterize the timing and mode of in-hospital death following AMI.

Methods
We analysed in-hospital deaths among 4800 patients with AMI admitted in a single tertiary centre between 2006 and 2019. Baseline demographic and clinical characteristics, the type of AMI, treatments, the timing and mode of death data were collected. The mode of death, analysed by two independent clinicians in case of doubt, was classified as cardiovascular, which included cardiac and non-cardiac causes, or non-cardiovascular death.

Results
A total of 194 (4%) patients (pts) aged 76 [68-81] years and 61% males died during the hospital stay in the study period of 10 years. ST segment elevation AMI (STEMI) was the most frequent (70%), mostly of the anterior wall (2/3 of STEMI). Most (48%) of the 194 patients presented in Killip Kimball class IV (48%), and 16% presented in cardiorespiratory arrest. The majority (69%) had undergone myocardial revascularization during hospitalization.
Most deaths occurred earlier (median 48 [5-240] hours). Overall, 40% patients died within 24 hours after admission, 12% died during the second day, 19% during days 3–7, 19% during days 8–30, and 10% after day 30 (Figure 1).
Cardiovascular (82%) was the most common mode of death, mainly due to cardiac causes (76%) (Figure 2). Re-infarction and bleeding accounted for 3% and 5% of deaths, respectively. The median time delay to death is different according to mode of death (1,4 [0,1-4,9] days for CV death and 19 [7,8- 47,7] days for non-CV death, p = 0,001), whereas the timing and mode of death were similar in STEMI and non-STEMI.

Conclusion
In this contemporary single-centre population with AMI, the majority of in-hospital deaths occurred early after admission. The largest proportion of modes of death was pump failure. Early diagnosis and treatment may be critical to improve survival after AMI. Abstract Figure. Timing and mode of early death after ACS
Benefit and Harm of Extended Dual Antiplatelet Therapy After PCI in high-risk TWILIGHT-like patients with acute coronary syndrome
Authors: Wang HY , Zhang R , Cai ZX , Dou KF 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Recent emphasis on reduced duration and/or intensity of antiplatelet therapy following PCI irrespective of indication for PCI may fail to account for the substantial risk of subsequent nontarget lesion events in acute coronary syndrome (ACS) patients. This study sought to investigate the beneﬁts and risks of extended-term (&gt;12-month) DAPT as compared with short-term DAPT in high-risk "TWILIGHT-like" ACS patients undergoing PCI.

Methods
All consecutive patients fulﬁlling the "TWILIGHT-like" criteria undergoing PCI from January 2013 to December 2013 were identiﬁed from the prospective Fuwai PCI Registry. High-risk "TWILIGHT-like" patients were deﬁned by at least 1 clinical and 1 angiographic feature based on TWILIGHT trial selection criteria. The present analysis evaluated 4,875 high-risk "TWILIGHT-like" patients with ACS who were event-free at 12 months after PCI. The primary outcome was the composite of all-cause death, myocardial infarction (MI), or stroke at 30 months while BARC type 2, 3, or 5 bleeding was key secondary outcome.

Results
Extended DAPT compared with shorter DAPT reduced the composite outcome of all-cause death, MI, or stroke by 63% (1.5% vs. 3.8%; HRadj: 0.374, 95% CI: 0.256 to 0.548; HRmatched: 0.361, 95% CI: 0.221-0.590). The HR for cardiovascular death was 0.049 (0.007 to 0.362) and that for MI 0.45 (0.153 to 1.320) and definite/probable stent thrombosis 0.296 (0.080-1.095) in propensity-matched analyses. Rates of BARC type 2, 3, or 5 bleeding (0.9% vs. 1.3%; HRadj: 0.668 [0.379 to 1.178]; HRmatched: 0.721 [0.369-1.410]) did not differ significantly in patients treated with DAPT &gt; 12-month or DAPT ≤ 12-month. The effect of long-term DAPT on primary and key secondary outcome across the proportion of ACS patients with 1-3, 4-5, or 6-9 risk factors showed a consistent manner (Pinteraction &gt; 0.05).

Conclusion
Among high-risk "TWILIGHT-like" patients with ACS after PCI, long-term DAPT reduced ischemic events without increasing clinically meaningful bleeding events as compared with short-term DAPT, suggesting that extended DAPT might be considered in the treatment of ACS patients who present with a particularly higher risk for thrombotic complications. Abstract Figure.
Cardiovascular outcomes of clopidogrel and aspirin vs ticagrelor and aspirin in geriatric population with acute coronary syndrome-a systematic review and meta analysis
Authors: Abdul Razzack A , Pothuru S , Hussain N , Adeel Hassan S , Panday P , M Lapenas T , Sattar Y 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
The current guidelines of the European Society of Cardiology recommends dual antiplatelet treatment (DAPT) including a new-generation P2Y12-inhibitor ticagrelor and aspirin for patients with acute coronary syndrome (ACS) with or without ST segment elevation (STEMI). However, the efficacy and safety profile of standard DAPT regimen clopidogrel and aspirin (CDAPT) vs. new DAPT regiment ticagrelor and aspirin (TDAPT) is controversial in geriatric population with age &gt;70 years given this population is a high risk for bleeding due to frailty and recurrent of ACS.

Objective

To assess the efficacy and safety of DAPT regimens including CDAPT or TDAPT for elderly patients &gt;70 years presenting with ACS with or without ST-segment elevation.

Methods
Electronic databases (PubMed, Embase, Scopus, Cochrane) were searched from inception to November 28th, 2020. Using a generic invariance weighted fixed effects model, Hazard ratios (HRs) and their 95% confidence intervals (CIs) from individual studies were converted to Log HRs and corresponding standard errors, which were then pooled. The primary outcome was major adverse cardiac and cerebrovascular events (MACCE)and was defined as a composite of death, myocardial reinfarction and stroke. The secondary outcome was any major bleeding events.
Results- A total of four studies with 18365 participants was included in our analysis.Mean age was 79.4 and 79.2 in the CDAPT and TDAPT groups respectively. Average follow up period was 12 months. There is no difference in MACCE among CDAPT and TDAPT( HR 0.93, 95%CI 0.86-1.01;P = 0.10). However, TDAPT is associated with high risk of major bleeding as compared to CDAPT (HR 1.15, 95%CI 1.02-1.29; P = 0.02) (Figure 1). We had no publication bias in our results (Egger’s regression p &gt; 0.05).
Conclusion- Amongst geriatric patients aged 70 years or older with ACS with or without STEMI, TDAPT has the same MACCE as compared to CDAPT while TDAPT can have high major bleeding. Abstract Figure. A)MACCE B)Major Bleeding events