bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuronal nets and logistic regression analysis provide improved prediction of infective endocarditis compared to the modified Duke Score: a post-hoc analysis of the prospective PRO-ENDOCARDITIS study
Authors: Vogel L , Dykun I , Totzeck M , Rassaf T , Mahabadi A 
Published: December 2022

Abstract

Introduction
The modified Duke score is the currently recommended diagnostic algorithm in suspected infective endocarditis (IE). The categorization in major and minor criteria enables an easy clinical application, but may not optimally utilize individual patient's information. In contrast, detailed statistical evaluation of multiple characteristics using artificial intelligence and logistic regression report improved prediction of various cardiovascular diseases over conventional clinical strategies. We tested the hypothesis that neuronal nets and logistic regression analysis would provide improved prediction of IE as compared to the modified Duke score.

Methods
This post-hoc evaluation of the prospective observational PRO-ENDOCARDITIS study was conducted at the West German Heart and Vascular center between December 2017 and May 2019 and includes 261 patients. Duke criteria and clinical characteristics were prospectively collected. Transesophageal echocardiography (TEE) imaging was evaluated by a blinded cardiologist at a central core-lab. IE as primary endpoint was adjudicated by an independent clinical endpoint committee. The database was divided into a training (70%) and validation cohort (30%). We compared the value of the Duke score, neuronal nets and logistic regression analysis for prediction of the primary endpoint.

Results
The mean age was 60.1±16.1 years, 37.2% were female. In 47 cases, IE was present. The modified Duke score achieved an AUC of 0.863 in the training cohort and 0.913 within the validation cohort. The logistic regression and the neural net exceeded the predictive value in both cohorts (training cohort: 0.992 and 0.986; validation cohort: 0.964, 0.957; for logistic regression and neuronal nets, respectively, Figure 1). Without the use of TEE, the remaining Duke criteria only poorly predicted IE (training cohort: 0.771, 0.951 and 0.938; validation cohort: 0.835, 0.862 and 0.780, for the Duke score, logistic regression and neuronal nets, respectively).

Discussion
Logistic regression analysis and neuronal nets provide improved prediction of IE as compared to the clinically established modified Duke score. Further studies on larger databases are needed to confirm our results and provide algorithms for clinical routine.

Funding Acknowledgement
Type of funding sources: None.
Development of an app-based bedside clinical decision-making tool for mechanical cardiocirculatory support in patients with cardiogenic shock: the MCS-Aid app
Authors: Giustino G , Serrao G W , Melarcode-Krishnamoorty P , Vengrenyuk A , Kyaw H , Gidwani U , Sharma S K , Kini A 
Published: December 2022

Abstract

Background
Patients presenting with cardiogenic shock remain at high risk of morbidity and mortality. Several mechanical cardiocirculatory support (MCS) devices have been developed and their use is rapidly increase in clinical practice. However, there is significant heterogeneity in patient selection, timing of implantation, and post-implantation management across centers and operators.

Purpose
We sought to develop and smartphone app-based clinical decision-making tool to help bedside selection and post-implantation management of MCS devices in patients presenting with cardiogenic shock or cardiac arrest.

Methods
The MCS-Aid app will consistent of 3 major sections: (i) initial device selection based on clinical presentation (patients with cardiogenic shock or cardiac arrest post-ROSC); (ii) guide for escalation or addition of MCS based on the individual hemodynamic scenario; (iii) guide for weaning after implantation of MCS device. The app will have an interactive interface that will allow the user to select the most appropriate next step in management based on the clinical information being entered. A calculator to derive key hemodynamic parameters (e.g. cardiac power output or pulmonary artery pulsatility index) will be incorporated in the App to inform clinical decision-making when appropriate. An example of an algorithm that will be part of the MCS-Aid app is illustrated in the figure.

Conclusions
The MCS-Aid app is an user-friendly bedside clinical decision tool that could help fellows-in-training, early-career interventionalist and interventional cardiologist to select the appropriate MCS device according to the individual clinical and hemodynamic scenario.

Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Abiomed
Implementation of a clinical trial recruitment support system based on fast healthcare interoperability resources (FHIR) in a cardiology department
Authors: Scherer C , Endres S , Orban M , Kaeaeb S , Massberg S , Winter A , Loebe M 
Published: December 2022

Abstract

Background
Clinical Trial Recruitment Support Systems can booster patient inclusion of clinical trials by automatically analyzing eligibility criteria based on electronic health records. However, missing interoperability has hindered introduction of those systems on a broader scale.

Purpose
Our aim was to develop a recruitment support system based on FHIR R4 and evaluate its usage and features in a cardiology department.

Methods/Implementation
Clinical conditions, anamnesis, examinations, allergies, medication, laboratory data and echocardiography results were imported as FHIR resources. Trial study nurses and physicians were enabled to add new and edit trial information and input inclusion and exclusion criteria using a web-browser user interface in the hospital intranet. All information were recorded on the server side as the FHIR resources “ResearchStudy” and “Group”. Eligibility criteria linked by the logical operation “OR” were represented by using multiple FHIR Group resources for enrollment. On the client side, eligibility criteria were transformed to a tree-like structure (see Figure 1). Upon user demand, all hospitalized and ambulatory patients in the cardiology department were instantly screened for trial eligibility using the FHIR eligibility criteria on the existing patients' FHIR resources. Furthermore, study personal was able to manually edit trial status (i.e. ineligible, on-study, ...) of patients, which was implemented using the FHIR resource “ResearchSubject”.

Results
This implementation of a CTRSS based on FHIR R4 was evaluated in clinical practice: Beginning from 1st April 2021 the application was used as an additional patient screening tool for the four trials CLOSURE-AF, FAIR-HF2, SPRIRIT-HF and TORCH-PLUS of the German Centre for Cardiovascular Research. As the COVID-19 pandemic is prohibiting any proper comparison of patient inclusion rates, efficacy of the recruitment support system was tested by comparing the numbers of patients identified by the recruitment support system and enrolled in a trial to the actual number of enrolled patients irrespective of the screening method from 1st April 2021 to 23rd November 2021. The system was able to identify 52 of 55 patients included in those four clinical trials.

Conclusion
Use of FHIR for defining eligibility criteria of clinical trials may facilitate interoperability and allow automatic screening for eligible patients at multiple sites of different healthcare providers in the future. Upcoming changes in FHIR should allow easier description of “OR”-linked eligibility criteria.

Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Deutsche Forschungsgemeinschaft
Insights into diurnal variations of advanced hemodynamic parameters in ambulatory individuals enabled by a photoplethysmography-based wearable monitor
Authors: Nachman D , Kolben Y , Carmon E , Hazan E , Goldstein N , Eisenkraft A , Fons M , Amir O , Asleh R , Gepner Y 
Published: December 2022

Abstract

Background
Recent technological developments enable non-invasive monitoring of advanced hemodynamic parameters, allowing big data-driven insights on diurnal changes for the first time. This study aimed to describe the trends of multiple advanced cardiovascular parameters among ambulatory individuals using a medical grade wearable monitor.

Methods
Common and advanced cardio-respiratory parameters were monitored for 24 hours in ambulatory volunteers using a photoplethysmography-based wearable monitor. The multi vital ambulatory monitoring (MVAM) included stroke volume (SV), cardiac index (CI), systemic vascular resistance (SVR), blood oxygen saturation (SpO2), respiratory rate (RR), systolic (SBP) and diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse pressure (PP), and heart rate (HR). Diurnal variations were evaluated among all participants, and analyses were stratified based on sex, age, and body-mass index (BMI).

Results
A total of 256 participants were included in the analysis. All measured parameters showed significant (p&lt;0.001) diurnal changes. Nighttime values were lower excluding RR and SVR, reaching the nadir at 5 am, and then increasing to a maximum at 10 am, plateauing, and then gradually declining from 7 to 8 pm. CI demonstrated a reduction of 0.6 L/min/m2 (20%), while SVR demonstrated the opposite trend and was higher during the night increasing by up to 212 dynes/sec/cm5 (16%). Females demonstrated higher HR and CI with lower SVR during daytime and nighttime. Obese participants (BMI &gt;30 kg/m2) had a higher SBP and DBP, and lower SV and CI. SVR was higher among the elderly.

Conclusions
Diurnal changes using MVAM corresponding with awake-sleep hours were noticed in the monitored parameters and differed between sex, age, and BMI groups. This suggests that wearable monitoring platforms could shed more light on hemodynamic changes in subgroups, and might help with future efforts to provide tailored personalized medicine and pre-symptomatic diagnosis and prevention.

Funding Acknowledgement
Type of funding sources: None.
Appendicular Lean Mass, Grip Strength, and the Incidence of Dementia Among Older Adults in the Health ABC Study
Authors: Andrews James S , Gold Laura S , Reed May J , Hough Catherine L , Garcia Jose M , McClelland Robyn L , Fitzpatrick Annette L , Covinsky Ken E , Crane Paul K , Yaffe Kristine , Cawthon Peggy M 
Published: December 2022

Abstract

Background
Identification of novel risk factors for dementia in older adults could facilitate development of methods to identify patients most at risk and improve their cognitive outcomes. We aimed to determine whether lower appendicular lean mass (ALM), assessed by dual-energy x-ray absorptiometry (DXA), and lower grip strength are associated with a greater likelihood of incident dementia among older adults in the Health Aging and Body Composition Study (Health ABC).

Methods
Health ABC data from 1997 to 2008 were analyzed (n = 2 704). Baseline ALM to body mass index (BMI) ratio (ALMBMI) was assessed by DXA. Baseline grip strength was assessed by hand-held dynamometry. Incident dementia diagnosis was defined as either (i) dementia-related hospitalization plus a Modified Mini-Mental State Examination (3MS) score of ≤ 90; or (ii) record of prescription for anti-dementia medication; or (iii) decline of at least 1.5 SDs on the 3MS score compared to baseline. Cox proportional hazard models estimated associations of ALMBMI and grip strength with incident dementia over follow-up with and without adjusting for covariates, stratified by sex.

Results
Among older men, each standard deviation decrement in ALMBMI (adjusted hazard ratio [aHR]: 1.33; 95% confidence interval [CI]: 1.07, 1.65) or grip strength (aHR 1.22; 95% CI: 1.06, 1.41) was associated with increased likelihood of incident dementia.

Conclusions
Lower ALMBMI and grip strength may be important risk factors for the development of dementia among older men. How these factors may belong to a causal pathway of dementia must be elucidated in future work.
Introducing HL7 FHIR Genomics Operations: a developer-friendly approach to genomics-EHR integration
Authors: Dolin Robert H , Heale Bret S E , Alterovitz Gil , Gupta Rohan , Aronson Justin , Boxwala Aziz , Gothi Shaileshbhai R , Haines David , Hermann Arthur , Hongsermeier Tonya , Husami Ammar , Jones James , Naeymi-Rad Frank , Rapchak Barbara , Ravishankar Chandan , Shalaby James , Terry May , Xie Ning , Zhang Powell , Chamala Srikar 
Published: December 2022

AbstractObjectiveEnabling clinicians to formulate individualized clinical management strategies from the sea of molecular data remains a fundamentally important but daunting task. Here, we describe efforts towards a new paradigm in genomics-electronic health record (HER) integration, using a standardized suite of FHIR Genomics Operations that encapsulates the complexity of molecular data so that precision medicine solution developers can focus on building applications.Materials and MethodsFHIR Genomics Operations essentially “wrap” a genomics data repository, presenting a uniform interface to applications. More importantly, operations encapsulate the complexity of data within a repository and normalize redundant data representations—particularly relevant in genomics, where a tremendous amount of raw data exists in often-complex non-FHIR formats.ResultsFifteen FHIR Genomics Operations have been developed, designed to support a wide range of clinical scenarios, such as variant discovery; clinical trial matching; hereditary condition and pharmacogenomic screening; and variant reanalysis. Operations are being matured through the HL7 balloting process, connectathons, pilots, and the HL7 FHIR Accelerator program.DiscussionNext-generation sequencing can identify thousands to millions of variants, whose clinical significance can change over time as our knowledge evolves. To manage such a large volume of dynamic and complex data, new models of genomics-EHR integration are needed. Qualitative observations to date suggest that freeing application developers from the need to understand the nuances of genomic data, and instead base applications on standardized APIs can not only accelerate integration but also dramatically expand the applications of Omic data in driving precision care at scale for all.
Effects of genotype, sex, and feed restriction on the biochemical composition of chicken preen gland secretions and their implications for commercial poultry production
Authors: Gvoždíková Javůrková Veronika , Doležal Petr , Fraňková Adéla , Horák Monika , Chodová Darina , Langrová Iva , Tůmová Eva 
Published: December 2022

Abstract
Preen gland secretions spread on the feathers contain various chemical compounds dominated by fatty acids (FAs) and volatile organic compounds (VOCs). These chemicals may significantly affect plumage condition, microbial and ectoparasitic load on feathers, and chemical communication of birds. However, how chemical composition of preen secretions varies in commercially produced chickens with respect to their genotype, sex, and feeding regime remain largely unknown, as well as the welfare implications for farmed poultry. We found that while polyunsaturated fatty acids in chicken preen secretions differed significantly with genotype (P &lt;&lt; 0.001), saturated fatty acids and monounsaturated fatty acids varied with genotype-dependent preen gland volume (P &lt; 0.01). Chickens of meat-type fast-growing Ross 308 genotype had reduced preen gland volume and lower proportions of all FA categories in their preen secretions compared with dual-purpose slow-growing ISA Dual chickens. A total of 34 FAs and 77 VOCs with tens of unique FAs were detected in preen secretions of both genotypes. While differences in the relative proportion of 6 of the 10 most dominant VOCs in chicken preen gland secretions were related to genotype (P &lt; 0.001), only 1 of the 10 most dominant VOCs showed a sex effect (P &lt; 0.01), and only 2 of the 10 most dominant VOCs showed a genotype-dependent effect of feed restriction (P &lt; 0.05). Feed restriction had no effect on the relative proportion of any of the FAs in chicken preen gland secretions. Moreover, we found that meat-type Ross 308 preen secretions were dominated by VOCs, which are proven attractants for poultry red mite and may also increase infestation with other ectoparasites and negatively influence overall odor-mediated intraspecific communication and welfare. This study shows that no feeding management, but long-term genetic selection in commercial breeding may be the main cause of the differences in the biochemistry and function of chicken preen secretions. This might have negative consequences for chemosignaling, antiparasitic, and antimicrobial potential of preen secretions and can lead to increased susceptibility to ectoparasites, plumage care disorders, and can affect the overall condition, welfare, and productivity of commercially bred chickens. Selection-induced preen gland impairments must therefore be considered and compensated by proper management of the chicken farm and increased care about animal well-being.
C/EBPα promotes triacylglycerol synthesis via regulating PPARG promoter activity in goat mammary epithelial cells
Authors: Tian Huibin , Luo Jun , Guo Peng , Li Chun , Zhang Xueying 
Published: December 2022

Abstract
CCAAT/enhancer binding protein α (C/EBPα) is the key transcription factor involved in lipid metabolism, however, the role of C/EBPα in milk fat synthesis of dairy goats remains unknown. The objective of the present research was to clarify the function of C/EBPα in goat mammary epithelial cells (GMECs) and its impact on peroxisome proliferator-activated receptor gamma (PPARG) promoter activity. In this study, C/EBPα overexpression increased its mRNA and protein levels by 42-fold and 6-fold, respectively. In contrast, transfecting siRNA targeting C/EBPα decreased its mRNA level to 20% and protein abundance to 80% of the basal level. The contents of lipid droplets, triacylglycerol (TAG), and cholesterol were increased (P &lt; 0.05) in C/EBPα-overexpressing GMECs, and knockdown of C/EBPα led to the opposite results. Overexpression of C/EBPα significantly increased the expression levels of genes involved in TAG synthesis (AGPAT6, DGAT2, P &lt; 0.01), lipid droplet formation (PLIN2, P &lt; 0.01), and fatty acid synthesis (FADS2, P &lt; 0.05; ELOVL6, P &lt; 0.01). Knockdown of C/EBPα decreased (P &lt; 0.05) the expression levels of AGPAT6, DGAT1, DGAT2, PLIN2, FADS2, and ELOVL6. C/EBPα upregulated the expression level of PPARG (P &lt; 0.05), and four C/EBPα binding regions were identified in the PPARG promoter at −1,112 to −1,102 bp, −734 to −724 bp, −248 to −238 bp, and −119 to −109 bp. Knockdown of C/EBPα reduced (P &lt; 0.05) the PPARG promoter activity when the C/EBPα binding regions were mutated at −1,112 to −1,102 bp, −734 to −724 bp, and −248 to −238 bp locations of the promoter. However, the promoter activity did not change when the mutation was located at −119 bp. In conclusion, our results suggest that C/EBPα can promote TAG synthesis in GMECs through its effects on mRNA abundance of genes related to lipid metabolism and regulation of the PPARG promoter activity via C/EBPα binding regions.
Glassy-Winged Sharpshooters Cease Feeding and Avoid Plants Treated With Sub-Lethal Doses of the Neonicotinoid Insecticide Imidacloprid
Authors: Sisterson Mark S , Uchima Sean Y , Wallis Christopher M , Krugner Rodrigo 
Published: December 2022

Abstract
Insecticides are a primary means for suppressing populations of insects that transmit plant pathogens. Application of insecticides for limiting the spread of insect-transmitted plant pathogens is often most effective when applied on an area-wide scale. The glassy-winged sharpshooter is a vector of the bacterial pathogen Xylella fastidiosa, which causes numerous plant diseases including Pierce’s disease of grapevine. The glassy-winged sharpshooter has been the subject of an area-wide suppression program in California for nearly two decades. Overreliance on a limited number of active ingredients including the neonicotinoid imidacloprid has resulted in increased levels of resistance to commonly applied products. In California, glassy-winged sharpshooters move between citrus, an important overwintering host, and vineyards. Accordingly, imidacloprid is routinely applied via the irrigation system in vineyards and citrus orchards. For soil applied applications, it may take days to weeks for concentrations in plants to increase to lethal doses. Further, as the dose of imidacloprid required to kill sharpshooters increases due to resistance, so too does the period that sharpshooters are exposed to sub-lethal doses. Response of glassy-winged sharpshooter to cowpea plants treated with sub-lethal doses of imidacloprid was evaluated by conducting no-choice and choice tests. In no-choice feeding assays, glassy-winged sharpshooters caged on plants treated with sub-lethal doses of imidacloprid ceased feeding and produced little excreta. Further, sub-lethal exposure to a range of doses over a 4-d period did not affect viability over a 9-wk post-exposure holding period on untreated plants. In choice-tests, glassy-winged sharpshooters avoided treated plants and were observed predominately on untreated plants. Results suggest that application of imidacloprid to vineyards and citrus orchards may push glassy-winged sharpshooters out of treated habitats rather than kill them.
Morphology and genetics of grasshopper mice revisited in a paleontological framework: reinstatement of Onychomyini (Rodentia, Cricetidae)
Authors: Kelly Thomas S , Martin Robert A , Ronez Christophe , Cañón Carola , Pardiñas Ulyses F J 
Published: December 2022

AbstractGrasshopper mice of the genus Onychomys, represented by three living species in North America, have a long and controversial taxonomic history. Usually allocated to either the cricetine or neotomine cricetids, they also have been considered to represent a distinct tribe. Since the discovery and description of the extinct grasshopper mouse relative Acrolophomys rhodopetros from the late Miocene of the upper Dove Spring Formation of California, dated at 9.3–8.8 Ma, it has become apparent that the grasshopper mouse clade has a long, distinct evolutionary history. Using a combination of morphological (including paleontological material) and molecular data, we reassessed the phylogenetic position of grasshopper mice. A morphological phylogenetic analysis was done on fossil and modern specimens of all recognized neotomine tribes, including craniodental, phallic, and soft tissue characters. A DNA-based matrix was constructed including 72 species representing all known living genera of Neotominae and 13 outgroup taxa belonging mostly to cricetid subfamilies. DNA sampling covered the mitochondrial protein-coding gene cytochrome-b (Cytb), and seven nuclear loci. The morphological analysis yielded a single most parsimonious tree of 42 steps, placing Ochrotomys (Ochrotomyini), Baiomys (Baiomyini), Reithrodontomys (Reithrodontomyini), and an Onychomys–Acrolophomys clade as successive sister clades to a Peromyscus clade, respectively. The molecular phylogenetic analyses recovered seven major clades: (1) a clade including Habromys, Megadontomys, Neotomodon, Osgoodomys, Podomys, and a paraphyletic Peromyscus clade, sister to (2) a second clade containing extant Onychomys species, (3) a Reithrodontomys clade, (4) an Isthmomys clade, (5) a clade including Baiomys and Scotinomys, (6) an Ochrotomys clade, and (7) a well-­supported clade containing Hodomys, Neotoma, and Xenomys. A Bayesian combined morphological and molecular analysis recovered the same major phylogenetic associations as the molecular analyses. The sum of molecular markers and morphological traits expressed by Acrolophomys and Onychomys leads to a phylogenetic position supporting their recognition as a distinct tribe.