bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intravenous Heme Arginate Induces HO-1 (Heme Oxygenase-1) in the Human Heart
Authors: Andreas Martin , Oeser Claudia , Kainz Frieda-Maria , Shabanian Shiva , Aref Tandis , Bilban Martin , Messner Barbara , Heidtmann Julian , Laufer Guenther , Kocher Alfred , Wolzt Michael 
Published: October 2018

Objective—
HO-1 (heme oxygenase-1) induction may prevent or reduce ischemia-reperfusion injury. We previously evaluated its in vivo induction after a single systemic administration of heme arginate in peripheral blood mononuclear cells. The current trial was designed to assess the pharmacological tissue induction of HO-1 in the human heart with heme arginate in vivo.

Approach and Results—

Patients planned for conventional aortic valve replacement received placebo (n=8), 1 mg/kg (n=7) or 3 mg/kg (n=9) heme arginate infused intravenously 24 hours before surgery. A biopsy of the right ventricle was performed directly before aortic cross-clamping and after cross-clamp release. In addition, the right atrial appendage was partially removed for analysis. HO-1 protein and mRNA concentrations were measured in tissue samples and in peripheral blood mononuclear cells before to and up to 72 hours after surgery. No study medication-related adverse events occurred. A strong, dose-dependent effect on myocardial HO-1 mRNA levels was observed (right ventricle: 7.9±5.0 versus 88.6±49.1 versus 203.6±148.7;
P
=0.002 and right atrium: 10.8±8.8 versus 229.8±173.1 versus 392.7±195.7;
P
=0.001). This was paralleled by a profound increase of HO-1 protein concentration in atrial tissue (8401±3889 versus 28 585±10 692 versus 29 022±8583;
P
<0.001). Surgery and heme arginate infusion significantly increased HO-1 mRNA concentration in peripheral blood mononuclear cells (
P
<0.001). HO-1 induction led to a significant increase of postoperative carboxyhemoglobin (1.7% versus 1.4%;
P
=0.041). No effect on plasma HO-1 protein levels could be detected.

Conclusions—
Myocardial HO-1 mRNA and protein can be dose-dependently induced by heme arginate. Protective effects of this therapeutic strategy should be evaluated in upcoming clinical trials.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT02314780.
Rotors Detected by Phase Analysis of Filtered, Epicardial Atrial Fibrillation Electrograms Colocalize With Regions of Conduction Block
Authors: Podziemski Piotr , Zeemering Stef , Kuklik Pawel , van Hunnik Arne , Maesen Bart , Maessen Jos , Crijns Harry J. , Verheule Sander , Schotten Ulrich 
Published: October 2018

Background:
Several recent studies suggest rotors detected by phase mapping may act as main drivers of persistent atrial fibrillation. However, the electrophysiological nature of detected rotors remains unclear. We performed a direct, 1:1 comparison between phase and activation time mapping in high-density, epicardial, direct-contact mapping files of human atrial fibrillation.

Methods:
Thirty-eight unipolar electrogram files of 10 s duration were recorded in patients with atrial fibrillation (n=20 patients) using a 16×16 electrode array placed on the epicardial surface of the left atrial posterior wall or the right atrial free wall. Phase maps and isochrone wave maps were constructed for all recordings. For each detected phase singularity (PS) with a lifespan of >1 cycle length, the corresponding conduction pattern was investigated in the isochrone wave maps.

Results:
When using sinusoidal recomposition and Hilbert Transform, 138 PSs were detected. One hundred and four out of 138 PSs were detected within 1 electrode distance (1.5 mm) from a line of conduction block between nonrotating wavefronts detected by activation mapping. Far fewer rotating wavefronts were detected when rotating activity was identified based on wave mapping (18 out of 8219 detected waves). Fourteen out of these 18 cases were detected as PSs in phase mapping. Phase analysis of filtered electrograms produced by simulated wavefronts separated by conduction block also identified PSs on the line of conduction block.

Conclusions:
PSs identified by phase analysis of filtered epicardial electrograms colocalize with conduction block lines identified by activation mapping. Detection of PSs using phase analysis has a low specificity for identifying rotating wavefronts during human atrial fibrillation using activation mapping.
Effect of Ascertainment Bias on Estimates of Patient Mortality in Inherited Cardiac Diseases
Authors: Nannenberg Eline A. , van Rijsingen Ingrid A.W. , van der Zwaag Paul A. , van den Berg Maarten P. , van Tintelen J. Peter , Tanck Michael W.T. , Ackerman Michael J. , Wilde Arthur A.M. , Christiaans Imke 
Published: October 2018

Background:

Accurate estimates of survival are indispensable for cardiologists, clinical geneticists, and genetic counselors dealing with families with an inherited cardiac disease. However, a bias towards a more severe disease with a worse outcome in the first publications may not accurately represent the actual survival forecast. We, therefore, evaluated the effect of ascertainment bias on survival in 3 different inherited cardiac diseases (idiopathic ventricular fibrillation,
SCN5A
overlap syndrome, and arrhythmogenic cardiomyopathy) caused by a founder mutation.

Methods:

We collected mortality data from mutation-positive subjects with either
DPP6
-associated idiopathic ventricular fibrillation,
SCN5A
overlap syndrome, and
PLN
-R14del-mediated arrhythmogenic cardiomyopathy >2 to 10 years of ongoing clinical/cascade genetic screening.

Results:

The median age of survival in
DPP6
mutation-positive subjects increased from 44.6 years in the original cohort from 2008 (n=60; 95% CI, 36.8–52.4 years) to 68.2 years in the extended cohort from 2012 (n=235; 95% CI, 64.6–71.7 years;
P
<0.001). In the
SCN5A
overlap syndrome, survival increased from 56.1 years in 1999 (n=86; 95% CI, 48.0–64.2 years) to 69.7 years in 2009 (n=197; 95% CI, 61.3–78.2 years;
P
=0.049). In
PLN
-R14del positive patients, the median age of survival increased from 63.5 years in 2010 (n=89; 95% CI, 59.1–68.0 years) to 65.2 years in 2012 (n=370; 95% CI, 62.0–68.3 years;
P
=0.046).

Conclusions:
The median age of survival in 3 different inherited cardiac diseases with an established pathogenic substrate significantly increased once genetic testing and cascade screening extended, after the first publication that elucidated the discovery of the disease-susceptibility gene/mutation. This underscores the direct and negative influence of ascertainment bias on survival forecasts and the importance of ongoing clinical/genetic follow-up to establish the most accurate disease prognosis for genetically mediated heart diseases.
Use of Oral Anticoagulation in Eligible Patients Discharged With Heart Failure and Atrial Fibrillation
Authors: Luo Nancy , Xu Haolin , Jneid Hani , Fonarow Gregg C. , Lopes Renato D. , Piccini Jonathan P. , Curtis Anne B. , Russo Andrea M. , Lewis William R. , Matsouaka Roland A. , Granger Christopher B. , Mentz Robert J. , Al-Khatib Sana M. 
Published: October 2018

Background:
Stroke prophylaxis in patients with atrial fibrillation (AF) and heart failure (HF) in the era of direct oral anticoagulants is not well characterized. Using data from American Heart Association Get With The Guidelines–AFIB, we sought to evaluate oral anticoagulation (OAC) use at discharge among AF patients with concomitant HF.

Methods and Results:

AF patients with a diagnosis of HF hospitalized from January 2013 to March 2017 were included. We compared patient characteristics and use of OAC at discharge among patients with reduced (redundant ejection fraction [EF], EF≤40%), borderline (40%<EF<50%), and preserved (EF≥50%) EF using multivariable mixed logistic regression models. Among 10 883 patients with AF and HF, 1790 (16.4%) had a reported contraindication to anticoagulation and were excluded from further analysis. Among 9093 patients eligible for OAC, 3499 (38.5%) had HF with reduced EF, 1062 (11.7%) had HF with borderline EF, and 4532 (49.8%) had HF with preserved EF. The median CHA
2
DS
2
-VASc score was 5 (Q1, Q3; 3, 6) among all patients and higher among those with HF with preserved EF than HF with reduced EF (5 [4, 6] versus 4 [3, 5];
P
<0.0001). The proportion of eligible patients discharged on OAC was 94.9%, with 43.6% discharged on warfarin and 50.7% discharged on direct oral anticoagulants. A higher proportion of patients with HF with reduced EF and HF with borderline EF were discharged on direct oral anticoagulants than with HF with preserved EF, but the difference was small (52.8%, 53.1% versus 48.5%, respectively;
P
=0.0002). EF group was not significantly associated with a patient’s OAC use at discharge.

Conclusions:
In the context of American Heart Association Get With The Guidelines–AFIB, a quality improvement program, the rate of use of OAC at discharge in eligible AF patients with HF was almost 95%. To our knowledge, these rates represent some of the highest use of appropriate anticoagulation for patients in a national registry to date.
Transcatheter Mitral Valve Replacement in Patients With Previous Aortic Valve Replacement
Authors: Cheung Anson , Webb John , Schaefer Ulrich , Moss Robert , Deuschl Florian G. , Conradi Lenard , Denti Paolo , Latib Azeem , Kiaii Bob , Bagur Rodrigo , Ferrari Enrico , Moccetti Marco , Biasco Luigi , Blanke Philippe , Ben-Gal Yanai , Banai Shmuel 
Published: October 2018

Background:
Transcatheter mitral valve replacement (TMVR) may mature to become a therapeutic option for high-risk patients with severe mitral regurgitation (MR), particularly in patients at high or prohibitive surgical risk. MR patients with preexisting aortic valve prosthesis have been excluded from most TMVR trials because of the potential risks of left ventricular outflow tract obstruction or interaction between the TMVR anchoring mechanism and the aortic prosthesis. We describe the procedural and short-term outcomes of transapical TMVR with the Tiara valve in patients experiencing severe symptomatic MR with previous aortic valve replacement (AVR).

Methods and Results:
Twelve consecutive high surgical risk patients (11 men; mean age, 75±6 years) with aortic valve prosthesis and severe MR underwent TMVR with Tiara valve. Aortic valves were mechanical in 5 and biological in 7 patients, while 1 patient had previously undergone implantation of a transcatheter valve within a failed bioprosthetic surgical valve. Six patients (50%) had undergone redo surgical aortic valve replacement. Clinical characteristics of the group include prior mitral valve repair in 2, prior coronary bypass grafting surgery in 5, chronic atrial fibrillation in 7, renal failure in 9, and pacemaker/cardiac resynchronization device in 9 patients. Mean Society of Thoracic Surgery score and EuroSCORE II were 10.5±4.4 and 12.4±3.7, respectively. Mean baseline left ventricular ejection fraction was 35.5±5.3% (range, 30%–45%). The Tiara valve was implanted uneventfully in all patients. Device migration or left ventricular outflow tract obstruction was not observed. No patient required conversion to open heart surgery or periprocedural hemodynamic support. Procedural success was 100% with no death, MI, stroke, major bleeding, or access site complications at 30 days. MR was eliminated in all 12 patients immediately after implantation.

Conclusions:
Transapical mitral valve replacement with the Tiara valve in high-risk patients with severe MR and aortic valve prostheses is technically feasible and can be performed safely.
Seinura caverna n. sp. (Tylenchomorpha: Aphelenchoididae), an androdioecious species isolated from bat guano in a calcareous cave
Authors: Kanzaki Natsumi , Ekino Taisuke , Masuya Hayato 
Published: October 2018

SummaryA new species of a predator aphelenchoidid,Seinura cavernan. sp., is described and illustrated. The new species was isolated from bat guano collected from a calcareous cave in Japan. The new species is characterised by its three-lined lateral field, secretory-excretory pore at the level of the posterior two-thirds of the metacorpus, a long post-uterine sac, hermaphrodite tail shape elongate conoid with a filiform tip, and an androdioecious reproductive mode. The new species is typologically and biologically close toS. steineri, but is distinguished by its longer post-uterine sac, slightly longer stylet and slightly larger median bulb. The comparisons with other morphologically similar species,i.e.,S. chertkovi,S. tenuicaudataandS. steineri, are discussed. A molecular phylogenetic analysis based on two small and large subunit ribosomal RNA genes revealed that the new species is located at the basal position of clade 3 of the Aphelenchoididae, clearly separate fromS. demani, its congener with unclear rectum and anus, which is located at the derived position, suggesting that further generic revision is necessary for the genus.Aphelenchoides liin. comb. (=Seinura lii) is proposed.
Topographic Influence on Baroclinic Instability and the Mesoscale Eddy Field in the Northern North Atlantic Ocean and the Nordic Seas
Authors: Trodahl Marta , Isachsen Pål Erik 
Published: October 2018

AbstractA weak planetary vorticity gradient and weak density stratification in the northern North Atlantic and Nordic seas lead to time-mean currents that are strongly guided by bottom topography. The topographic steering sets up distinct boundary currents with strong property fronts that are prone to both baroclinic and barotropic instability. These instability processes generate a macroturbulent eddy field that spreads buoyancy and other tracers out from the boundary currents and into the deep basins. In this paper we investigate the particular role played by baroclinic instability in generating the observed eddy field, comparing predictions from linear stability calculations with diagnostics from a nonlinear eddy-permitting ocean model hindcast. We also look into how the bottom topography impacts instability itself. The calculations suggest that baroclinic instability is a consistent source of the eddy field but that topographic potential vorticity gradients impact unstable growth significantly. We also observe systematic topographic effects on finite-amplitude eddy characteristics, including a general suppression of length scales over the continental slopes. Investigation of the vertical structure of unstable modes reveal that Eady theory, even when modified to account for a bottom slope, is unfit as a lowest-order model for the dynamics taking place in these ocean regions.
Cloud Trails past Bermuda: A Five-Year Climatology from 2012 to 2016
Authors: Johnston Michael C. , Holloway Christopher E. , Plant Robert S. 
Published: October 2018

Abstract
Cloud trails are primarily thermally forced bands of cloud that extend downwind of small islands. A novel algorithm to classify conventional geostationary visible-channel satellite images as cloud trail (CT), nontrail (NT), or obscured (OB) is defined. The algorithm is then applied to the warm season months of five years at Bermuda comprising 16 400 images. Bermuda’s low elevation and location make this island ideal for isolating the role of the island thermal contrast on CT formation. CTs are found to occur at Bermuda with an annual cycle, peaking in July, and a diurnal cycle that peaks in midafternoon. Composites of radiosonde observations and ERA-Interim data suggest that a warm and humid low-level environment is conducive for CT development. From a Lagrangian perspective, wind direction modulates CT formation by maximizing low-level heating on local scales when winds are parallel to the long axis of the island. On larger scales, low-level wind direction also controls low-level humidity through advection.
Screening for depression with the Edinburgh Postnatal Depression Scale and finding borderline personality disorder
Authors: Judd Fiona , Lorimer Stephanie , Thomson Richard H , Hay Angela 
Published: October 2018

Objective: The aim of the study was to explore the range of psychiatric diagnoses seen in pregnant women who score above the ‘cut-off’ on the Edinburgh Postnatal Depression Scale when this is used as a routine screening instrument in the antenatal period. Method: Subjects were all pregnant women referred to and seen by the Perinatal Consultation-Liaison Psychiatry Team of a tertiary public hospital over a 14-month period. Edinburgh Postnatal Depression Scale score at maternity ‘booking-in’ visit, demographic and clinical data were recorded and diagnoses were made according to Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria following clinical interview(s) and review of documented past history. Data were analysed using descriptive statistics. Results: A total of 200 patients who had completed the Edinburgh Postnatal Depression Scale were seen for assessment; 86 (43%) scored ⩾13 on Edinburgh Postnatal Depression Scale. Of those scoring 13 or more on Edinburgh Postnatal Depression Scale, 22 (25.6%) had a depressive disorder. In total, 12 patients (14%) had an anxiety disorder, 14 (16.3%) had borderline personality disorder and 13 (15.1%) had a substance use disorder. An additional 23 women (26.7%) had two or more borderline personality traits. Conclusion: Psychiatric assessment of women who scored 13 or more on the Edinburgh Postnatal Depression Scale at routine antenatal screening identified a significant number with borderline personality disorder or borderline personality traits rather than depressive or anxiety disorders. Clinical Practice Guidelines note the importance of further assessment for all women who score 13 or more on the Edinburgh Postnatal Depression Scale. The findings here suggest that this assessment should be made by a clinician able to identify personality pathology and organise appropriate and timely interventions.
Antipsychotic polypharmacy in the treatment of schizophrenia in China and Japan
Authors: Qiu Hong , He Yong , Zhang Yongjing , He Minfu , Liu Jin , Chi Rui , Si Tianmei , Wang Huaning , Dong Wentian 
Published: October 2018

Background: Although antipsychotic monotherapy is recommended as the main treatment for schizophrenia, antipsychotic polypharmacy is not rare in practice. However, longitudinal data on antipsychotic polypharmacy in schizophrenia treatment are limited. Methods: This longitudinal database study described antipsychotic polypharmacy in the treatment of schizophrenia in real-world settings in China and Japan. We retrieved information about antipsychotic treatment for schizophrenia from January 2010 to December 2014 from two hospital Electronic Medical Records databases in China and one claims database, Japan Medical Data Centre in Japan. Eligible patients had a diagnosis of schizophrenia (International Classification of Diseases, Tenth Revision F20.x) and at least one prescription for first or second generation antipsychotics. Antipsychotic polypharmacy was defined as having more than one antipsychotic medication overlapping for ⩾60 days. The Japan Medical Data Centre study cohort was further stratified by employees (insurance beneficiaries) and their dependents. Results: The study cohorts comprised 11,961 patients from China and 25,034 (10,661 employee sub-cohort and 14,373 dependent sub-cohort) from 14 days Japan Medical Data Centre in Japan. Most patients were prescribed monotherapy (87.3% in China and 80.1% in Japan), of which oral second-generation antipsychotics were the majority (78.9% in China and 65.8% in Japan). The prevalence rate of antipsychotic polypharmacy was 12.7% in China and 19.9% in Japan (13.7% in employees vs 24.5% in dependents). The most common combinations were two oral antipsychotics. Combinations of more than two drugs were uncommon in China (0.3%) but were prescribed for 5.3% of patients in Japan. Among patients treated with monotherapy, 12.6/100 person-years (11.8%) in China and 9.6/100 person-years (11.0%) in Japan switched to antipsychotic polypharmacy during follow-up. Younger patients were more likely to switch to antipsychotic polypharmacy than older patents in all study cohorts. Conclusion: The observed rates of antipsychotic polypharmacy ranged from 12.7% in China to 19.9% in Japan. Switching from monotherapy to antipsychotic polypharmacy was most likely to occur in younger patients with schizophrenia.
Reach and Adoption of a Randomized Weight Loss Maintenance Trial in Rural African Americans of Faith: The WORD (Wholeness, Oneness, Righteousness, Deliverance)
Authors: Yeary Karen H. Kim , Moore Page C. , Gauss C. Heath , Cornell Carol , Prewitt T. Elaine , Shakya Samjhana , Turner Jerome , Scarbrough Catherine , Porter Gwenndolyn , Estabrooks Paul A. 
Published: October 2018

Purpose: There is minimal information regarding the Reach and Adoption of evidence-based weight loss maintenance interventions for African Americans of faith. Design: The WORD (Wholeness, Oneness, Righteousness, Deliverance) was an 18-month, cluster randomized trial designed to reduce and maintain weight loss in African American adults of faith. Participants received the Diabetes Prevention Program adapted core weight loss program for 6 months, and churches were subsequently randomized to 12-month maintenance treatment or control. All participants underwent body weight and associated behavioral and psychosocial assessments at baseline, 6, 12, and 18 months. The current article focuses on assessing Reach and Adoption at baseline and 6 months using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Setting: Lower Mississippi Delta. Participants: Thirty churches, 61 WORD Leaders (WLs), and 426 participants. Intervention: Group delivered by trained community members (WLs). Measures: Body mass index and percentage weight lost from baseline to 6-month follow-up were measured. Reach was assessed at participant, WL, and church levels through calculating participation rates and sociodemographics of each level. Adoption was assessed at church and WL levels. Analysis: Descriptive statistics summarized baseline characteristics of each level. Continuous and categorical end point comparisons were made. Results: Participants’ participation rate was 0.84 (n = 437 agreed to participate, n = 519 eligible invited to participate); they were predominantly female, employed, and had a mean age of 49.8. Dropouts by 6 months were younger, had differential marital status, and religious attendance compared with retained participants. Church participation rate was 0.63 (n = 30 enrolled, n = 48 eligible approached) and the majority reported ≤100 active members. The WL participation rate was 0.61 (n = 61 implemented intervention, n = 100 eligible approached); they were primarily female and aged 53.9 (mean). Conclusion: Recruitment, engagement, and delivery strategies employed by the WORD show promise of sustained engagement and adoption in other faith-based behavioral weight management programs for African Americans.