bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of aerobic training periodisation on global and regional right ventricular strain in coronary heart disease
Authors: Trachsel Lukas D. , David Louis-Philippe , Gayda Mathieu , Boidin Maxime , Lalongé Julie , Juneau Martin , Nigam Anil , Henri Christine 
Published: July 2021

Linear aerobic training periodisation (LP) is recommended for patients with coronary heart disease (CHD). However, the effects of training periodisation on the right heart mechanics in patients with CHD have never been examined. This study aimed to explore the effects of LP and non-linear periodisation (NLP) on right heart mechanics. We prospectively randomised CHD patients to 12 weeks of aerobic training with LP or NLP. While there was a weekly increase in energy expenditure with LP, there was a steeper increase during the first 3 weeks, followed by a decrease in the fourth week with NLP. Echocardiography was performed at baseline and after the training period to assess the right ventricular free wall (RVFW) and right atrial strain. Thirty patients with CHD were included (NLP, n = 16; LP, n = 14). The traditional right and left heart parameters showed no significant time effects. There was a decrease of RVFW strain with time in both groups (+1.3 ± 0.9% with NLP, and +1.5 ± 0.8% with LP; p = 0.033). Mid-ventricular RVFW strain changed significantly with time (+2.0 ± 1.3% with NLP, and from +2.3 ± 1.2% with LP; p = 0.025). There was no time effect on the right atrial strain. In stable CHD patients, LP and NLP resulted in right ventricular strain decrements with a segment-specific pattern. This study was registered at ClinicalTrials.gov (identifier number: NCT03414996). Novelty: In stable coronary heart disease patients, both linear and non-linear aerobic training periodisation programs result in right ventricular strain decrements with time, particularly in the mid-ventricular segment. Traditional right and left heart parameters and right atrial strain showed no significant time effect in both 12 weeks aerobic training periodisation programs.
eBP
Authors: Bui Nam , Pham Nhat , Barnitz Jessica Jacqueline , Zou Zhanan , Nguyen Phuc , Truong Hoang , Kim Taeho , Farrow Nicholas , Nguyen Anh , Xiao Jianliang , Deterding Robin , Dinh Thang , Vu Tam 
Published: July 2021

Frequent blood pressure monitoring is the key to diagnosis and treatments of many severe diseases. However, the conventional ambulatory methods require patients to carry a blood pressure (BP) monitoring device for 24 h and conduct the measurement every 10--15 min. Despite their extensive usage, wearing the wrist/arm-based BP monitoring device for a long time has a significant impact on users' daily activities. To address the problem, we developed eBP to measure blood pressure (BP) from inside user's ear aiming to minimize the measurement's impact on users' normal activities although maximizing its comfort level.
The key novelty of eBP includes (1) a light-based inflatable pulse sensor which goes inside the ear, (2) a digital air pump with a fine controller, and (3) BP estimation algorithms that eliminate the need of blocking the blood flow inside the ear.
Through the comparative study of 35 subjects, eBP can achieve the average error of 1.8 mmHg for systolic (high-pressure value) and -3.1 mmHg for diastolic (low-pressure value) with the standard deviation error of 7.2 mmHg and 7.9 mmHg, respectively. These results satisfy the FDA's AAMI standard, which requires a mean error of less than 5 mmHg and a standard deviation of less than 8 mmHg.
Clinical Trials with Biologic Primary Endpoints in Immuno-oncology: Concepts and Usage
Authors: Isaacs James , Tan Aaron C. , Hanks Brent A. , Wang Xiaofei , Owzar Kouros , Herndon James E. , Antonia Scott J. , Piantadosi Steven , Khasraw Mustafa 
Published: July 2021

Abstract
Clinical trials that have a pharmacokinetic or a pharmacodynamic immunologic mechanism of action–based primary outcome could substantially improve the validity and efficiency of early development of immuno-oncology agents. Here, we outline different trial design options in this area, review examples from the literature and their unique immunologic aspects, and highlight how these trials have been underutilized. We illustrate how new technologies and translationally focused approaches can be successfully used to develop different classes of immunotherapeutic agents.
Identification of a unique barb from the dorsal body contour feathers of the Indian Pitta Pitta brachyura (Aves: Passeriformes: Pittidae)
Authors: Dey Prateek , Ray Swapna Devi , Sharma Sanjeev Kumaar , Pramod Padmanabhan , Singh Ram Pratap 
Published: July 2021

Earlier research on feather morphology emphasized comprehensively on the body contour feather than various other types of feathers. Therefore, we conducted a systematic study on all feather types of the Indian Pitta Pitta brachyura, a passerine bird native to the Indian subcontinent. Feather barbs from wing contour, tail contour, body contour, semiplume, down, powder down, and bristle feathers were retrieved from the bird and observed under a light microscope. Primary flight feathers from the right and left wing were longest (85.17 mm and 87.32 mm, respectively), whereas bristle feathers were the shortest (5.31 mm). The mean barb length was observed to be the highest (11.37±0.47 mm) in the wing feather followed by body contour (8.31±0.39 mm), semiplume (8.27±0.22 mm), tail feather (7.85±0.50 mm), down (6.45±0.21 mm), powder down (6.04±0.23 mm), and bristle (2.70±0.07 mm). Pearson correlation was found positive for barb length and feather length of down feathers (r= 0.996, p ≤0.05). We observed a novel type of barb the first time from dorsal body contour feather having plumulaceous barbules at the base followed by pennaceous barbules. This unique barbule arrangement is termed ‘sub-plumulaceous’ as it is distinct and analogous to known ‘sub-pennaceous’ type arrangement found absent in passerines.
Estimating the Posttest Probability of Long QT Syndrome Diagnosis for Rare
KCNH2
Variants
Authors: Kozek Krystian , Wada Yuko , Sala Luca , Denjoy Isabelle , Egly Christian , O’Neill Matthew J. , Aiba Takeshi , Shimizu Wataru , Makita Naomasa , Ishikawa Taisuke , Crotti Lia , Spazzolini Carla , Kotta Maria-Christina , Dagradi Federica , Castelletti Silvia , Pedrazzini Matteo , Gnecchi Massimiliano , Leenhardt Antoine , Salem Joe-Elie , Ohno Seiko , Zuo Yi , Glazer Andrew M. , Mosley Jonathan D. , Roden Dan M. , Knollmann Bjorn C. , Blume Jeffrey D. , Extramiana Fabrice , Schwartz Peter J. , Horie Minoru , Kroncke Brett M. 
Published: July 2021

Background:

The proliferation of genetic profiling has revealed many associations between genetic variations and disease. However, large-scale phenotyping efforts in largely healthy populations, coupled with DNA sequencing, suggest variants currently annotated as pathogenic are more common in healthy populations than previously thought. In addition, novel and rare variants are frequently observed in genes associated with disease both in healthy individuals and those under suspicion of disease. This raises the question of whether these variants can be useful predictors of disease. To answer this question, we assessed the degree to which the presence of a variant in the cardiac potassium channel gene
KCNH2
was diagnostically predictive for the autosomal dominant long QT syndrome.

Methods:

We estimated the probability of a long QT diagnosis given the presence of each
KCNH2
variant using Bayesian methods that incorporated variant features such as changes in variant function, protein structure, and in silico predictions. We call this estimate the posttest probability of disease. Our method was applied to over 4000 individuals heterozygous for 871 missense or in-frame insertion/deletion variants in
KCNH2
and validated against a separate international cohort of 933 individuals heterozygous for 266 missense or in-frame insertion/deletion variants.

Results:
Our method was well-calibrated for the observed fraction of heterozygotes diagnosed with long QT syndrome. Heuristically, we found that the innate diagnostic information one learns about a variant from 3-dimensional variant location, in vitro functional data, and in silico predictors is equivalent to the diagnostic information one learns about that same variant by clinically phenotyping 10 heterozygotes. Most importantly, these data can be obtained in the absence of any clinical observations.

Conclusions:
We show how variant-specific features can inform a prior probability of disease for rare variants even in the absence of clinically phenotyped heterozygotes.
Contrast‐Induced Nephropathy in Patients Undergoing Staged Versus Concomitant Transcatheter Aortic Valve Implantation and Coronary Procedures
Authors: Venturi Gabriele , Pighi Michele , Lunardi Mattia , Mainardi Andrea , Del Sole Paolo Alberto , Tavella Domenico , Setti Martina , Pesarini Gabriele , Benini Annachiara , Ferrero Valeria , Scarsini Roberto , Ribichini Flavio 
Published: July 2021

Background
The impact of staged versus concomitant coronary procedures on renal function in patients with aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) remains unclear.

Methods and Results

Three‐hundred thirty‐nine patients undergoing coronary procedures and TAVI as a staged strategy (160, 47.2%) or concomitant strategy (179, 52.8%) were retrospectively analyzed. Contrast‐induced acute kidney injury (CI‐AKI) occurred in 49 patients in the staged strategy group (30.6%) and in 18 patients (10.1%) in the concomitant strategy group (
P
<0.001). Among the staged strategy group, 25 (15.6%) patients developed CI‐AKI after coronary angiography or percutaneous coronary intervention, 17 (10.6%) after TAVI, and 7 (4.3%) after both the procedures. Staged strategy was associated with a higher risk of CI‐AKI (odds ratio, 3.948;
P
<0.001) after adjustment for multiple confounders and regardless of the baseline renal function (
P
for interaction=0.4) when compared with the concomitant strategy. At a median follow‐up of 24.0 months (3.0–35.3), CI‐AKI was not associated with sustained renal injury (
P
=0.794), irrespective of the adopted strategy. The concomitant strategy did not impact the overall early safety at 30 days follow‐up after TAVI compared to the staged strategy (
P
=0.609).

Conclusions
Performing coronary procedures with a staged strategy before TAVI was associated with a higher risk of CI‐AKI compared with a concomitant strategy. Moreover, a concomitant strategy did not increase the risk of procedure‐related complications.
Balancing Benefits and Risks of Long-Term Antiplatelet Therapy in Noncardioembolic Transient Ischemic Attack or Stroke
Authors: Hilkens Nina A. , Algra Ale , Diener Hans Christoph , Bath Philip M. , Csiba László , Hacke Werner , Kappelle L. Jaap , Koudstaal Peter J. , Leys Didier , Mas Jean-Louis , Sacco Ralph L. , Greving Jacoba P. ,   on behalf of the Cerebrovascular Antiplatelet Trialists’ Collaborative Group
Published: July 2021

Background and Purpose:
Lifelong treatment with antiplatelet drugs is recommended following a transient ischemic attack or ischemic stroke. Bleeding complications may offset the benefit of antiplatelet drugs in patients at increased risk of bleeding and low risk of recurrent ischemic events. We aimed to investigate the net benefit of antiplatelet treatment according to an individuals’ bleeding risk.

Methods:

We pooled individual patient data from 6 randomized clinical trials (CAPRIE [Clopidogrel Versus Aspirin in Patients at Risk of Ischemic Events], ESPS-2 [European Stroke Prevention Study-2], MATCH [Management of Atherothrombosis With Clopidogrel in High-Risk Patients], CHARISMA [Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance], ESPRIT [European/Australasian Stroke Prevention in Reversible Ischemia Trial], and PRoFESS [Prevention Regimen for Effectively Avoiding Second Strokes]) investigating antiplatelet therapy in the subacute or chronic phase after noncardioembolic transient ischemic attack or stroke. Patients were stratified into quintiles according to their predicted risk of major bleeding with the S
2
TOP-BLEED score. The annual risk of major bleeding and recurrent ischemic events was assessed per quintile for 4 scenarios: (1) aspirin monotherapy, (2) aspirin-clopidogrel versus aspirin or clopidogrel monotherapy, (3) aspirin-dipyridamole versus clopidogrel, and (4) aspirin versus clopidogrel. Net benefit was calculated for the second, third, and fourth scenario.

Results:
Thirty seven thousand eighty-seven patients were included in the analyses. Both risk of major bleeding and recurrent ischemic events increased over quintiles of predicted bleeding risk, but risk of ischemic events was consistently higher (eg, from 0.7%/y (bottom quintile) to 3.2%/y (top quintile) for major bleeding on aspirin and from 2.5%/y to 10.2%/y for risk of ischemic events on aspirin). Treatment with aspirin-clopidogrel led to more major bleedings (0.9%–1.7% per year), than reduction in ischemic events (ranging from 0.4% to 0.9/1.0% per year) across all quintiles. There was no clear preference for either aspirin-dipyridamole or clopidogrel according to baseline bleeding risk.

Conclusions:
Among patients with a transient ischemic attack or ischemic stroke included in clinical trials of antiplatelet therapy, the risk of recurrent ischemic events and of major bleeding increase in parallel. Antiplatelet treatment cannot be individualized solely based on bleeding risk assessment.
The Role of Visual and Auditory Communication in the Performance of a Joint Team Task
Authors: Werner Adam F. , Gorman Jamie C. 
Published: July 2021

Objective This study examines visual, auditory, and the combination of both (bimodal) coupling modes in the performance of a two-person perceptual-motor task, in which one person provides the perceptual inputs and the other the motor inputs. Background Parking a plane or landing a helicopter on a mountain top requires one person to provide motor inputs while another person provides perceptual inputs. Perceptual inputs are communicated either visually, auditorily, or through both cues. Methods One participant drove a remote-controlled car around an obstacle and through a target, while another participant provided auditory, visual, or bimodal cues for steering and acceleration. Difficulty was manipulated using target size. Performance (trial time, path variability), cue rate, and spatial ability were measured. Results Visual coupling outperformed auditory coupling. Bimodal performance was best in the most difficult task condition but also high in the easiest condition. Cue rate predicted performance in all coupling modes. Drivers with lower spatial ability required a faster auditory cue rate, whereas drivers with higher ability performed best with a lower rate. Conclusion Visual cues result in better performance when only one coupling mode is available. As predicted by multiple resource theory, when both cues are available, performance depends more on auditory cueing. In particular, drivers must be able to transform auditory cues into spatial actions. Application Spotters should be trained to provide an appropriate cue rate to match the spatial ability of the driver or pilot. Auditory cues can enhance visual communication when the interpersonal task is visual with spatial outputs.
Social value in public enterprises from the perspective of Creating Shared Value (CSV): The case of the Korea Expressway Corporation
Authors: Kim Yongwon , Kim Hyeon-joung 
Published: July 2021

Numerous scholars have noted social issues such as inequality and insufficient social capital as limitations of efficiency-oriented neoliberal development strategies. In this context, the Moon Jae-in administration in South Korea declared social value as the core value of the state. Therefore, public institutions are required to prioritize social value. Beyond ideological discussions, these social and policy changes suggest the need for concrete discussions on how to practically realize social value. Public institutions have strengthened their social responsibility, contributing to local communities and low-income groups. However, companies often consider social responsibility a cost, which impedes growth. As public enterprises, a type of public institution, have the characteristics of a company, their inherent goals of profitability or entrepreneurship may be limited by enhancing publicness to realize social value. Therefore, public enterprises face the challenge of realizing social value in a way that benefits both society and business. To devise measures to realize social value by strengthening publicness while ensuring profitability, this study focuses on Creating Shared Value (CSV), which benefits both companies and society. Publicness and profitability, two values that public enterprises pursue, are discussed, and Corporate Social Responsiblilty (CSR) is compared with the CSV perspective, which aims to benefit both. This study devises measures from the CSV perspective for realizing social value in the Korea Expressway Corporation, a public enterprise. Implications for other public enterprises are highlighted. Points for practitioners As the need for public institutions to solve social issues has increased, public enterprises face the challenge of realizing social value while ensuring profitability. In this context, this study took the CSV approach and conducted a case study on the Korea Expressway Corporation to present plans for public enterprises to create social value by fulfilling their purpose. By suggesting a process and detailed projects from the CSV perspective, this study will help practitioners to create social value tailored to the characteristics of each public enterprise.
Investigation and management of papillary thyroid microcarcinoma – a Scottish regional case series and literature review
Authors: Davies Timothy , Royce William , Crosbie Robin , Townsley Richard 
Published: July 2021

Background and aims Papillary thyroid microcarcinoma is defined as papillary thyroid cancer with a diameter of ≤1 cm. Despite its prevalence, there is wide variation in practice in the investigation and management of patients with papillary thyroid microcarcinoma throughout the UK and internationally. The primary aim of this paper is to describe the experience of investigation and management in a Scottish health board over the past 10 years. Methods and results Retrospective analysis of thyroidectomy and hemithyroidectomy resection samples from March 2009 to March 2020. 532 specimens were reviewed and 20 patients with PTMC were identified. 12 patients had an incidental finding of PTMC. Median U score- 3, Median Thy score- 2.5 for dominant or radiologically suspicious nodules. 8 specimens demonstrated aggressive histopathological features. 1 patient with positive nodal disease in the neck and 0 patients with positive nodal disease in the thorax on CT Neck and Chest. Conclusion Here we report the first UK Cohort describing the radiological investigation and management of papillary thyroid microcarcinoma. The results of our study are in accordance with a recent meta-analysis which found 4% nodal disease and 0.025% distant metastasis at time of presentation in patients with PTMC.
Excess of visceral adipose tissue with or without aortic elongation leads to a steeper heart position
Authors: Kauhanen S Petteri , Saari Petri , Korpela Tarmo , Liimatainen Timo , Vanninen Ritva , Hedman Marja 
Published: July 2021

Background The heart’s position determined as the heart–aorta angle (HAA) has been demonstrated to associate with ascending aortic (AA) dilatation. Visceral adipose tissue (VAT) and aortic elongation may shift the heart to the steeper position. Purpose To investigate whether VAT and aortic length influence the HAA. Material and Methods We examined 346 consecutive patients (58.4% men; mean age = 67.0 ± 14.1 years) who underwent aortic computed tomography angiography (CTA). HAA was measured as the angle between the long axis of the heart and AA midline. The amount of VAT was measured at the level of middle L4 vertebra from a single axial CT slice. Aortic length was measured by combining four anatomical segments in different CTA images. The amount of VAT and aortic length were determined as mild with values in the lowest quartile and as excessive with values in the other three quartiles. Results A total of 191 patients (55.2%) had no history of aortic diseases, 134 (38.7%) displayed AA dilatation, 8 (2.3%) had abdominal aortic aneurysm (AAA), and 13 (3.8%) had both AA dilatation and AAA. There was a strong nonlinear regression between smaller HAA and VAT/height, and HAA and aortic length/height. Median HAA was 124.2° (interquartile range 119.0°–130.8°) in patients with a mild amount of VAT versus 120.5° (interquartile range 115.4°–124.7°) in patients with excessive VAT ( P < 0.001). Conclusion An excessive amount of VAT and aortic elongation led to a steeper heart position. These aspects may possess clinical value when evaluating aortic diseases in obese patients.
Significance of the prostate central gland and total gland volume ratio in the diagnosis of prostate cancer patients in the prostate specific antigen grey zone
Authors: Guo Zhui-Feng , Yang Fan , Lu Xu-Wei , Wu Jia-Wen , He Chang , Han Cong-Hui 
Published: July 2021

Objective To explore the significance of the prostate central gland to total gland volume ratio (PVc/PV) in the diagnosis of prostate cancer (PCa) in patients with prostate specific antigen (PSA) levels in the grey zone (4–10 ng/ml). Methods This retrospective study enrolled patients that had undergone prostate biopsy. The volume of the prostate and the central prostate gland were measured. The differences in PSA, the ratio of free to total PSA (f/tPSA), PSA density (PSAD) and PVc/PV between the PCa and non-PCa groups were compared. Receiver operating characteristic curve analysis for PCa and clinically significant PCa (csPCa) diagnosis were calculated according to PSA (reference), f/tPSA, PSAD and PVc/PV. Results This study enrolled 136 patients. There was no significant difference in PSA and f/tPSA between the PCa and non-PCa groups, while there were significant differences in PSAD and PVc/PV. The area under the curve values of PVc/PV for PCa or csPCa diagnosis were 0.876 and 0.933, respectively; and for PSAD, they were 0.705 and 0.790, respectively. These were significantly different compared with the PSA curve, whereas f/tPSA showed no significant difference from the PSA curve. Conclusion PVc/PV could be a predictor of PCa when PSA is between 4–10 ng/ml.