bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of a multisensor implantable defibrillator algorithm for HF monitoring in presence of comorbidities
Authors: Santobuono V E , Tavoletta V , Manzo M , Calo' L , Bertini M , Santini L , Savarese G , Dello Russo A , Viscusi M , Lavalle C , Amellone C , Calvanese R , Valsecchi S , Favale S 
Published: December 2022

Abstract

Background
Cardiovascular and non-cardiovascular comorbidities are common in heart failure (HF) patients and impact disease severity and prognosis. Select modern implantable defibrillators (ICDs) are equipped with multisensor algorithms for HF monitoring. The HeartLogic index combines multiple ICD-based sensor data (heart rate, heart sounds, thoracic impedance, respiration, activity), and the associated alert has proved to be a sensitive and timely predictor of impending HF decompensation in cardiac resynchronization therapy (CRT-D) patients The algorithm was developed using data from CRT-D patients; the performance in non-CRT ICD patients and the impact of selected comorbidities on performance requires further study.

Methods
The HeartLogic feature was activated in 568 ICD patients (410 with CRT) from 26 centers. The median follow-up was 25 months [25th–75th percentile: 15–35].

Results
During follow-up, 97 hospitalizations were reported (53 cardiovascular) and 55 patients died. We recorded 1200 HeartLogic alerts (0.71 alerts/patient-year) in 370 patients. Overall, the time IN the alert state was 13% of the total observation period. The rate of cardiovascular hospitalizations or death was 0.48/patient-year (95% CI: 0.37–0.60) with the HeartLogic IN alert state and 0.04/patient-year (95% CI: 0.03–0.05) OUT of alert state, with an incidence rate ratio of 13.35 (95% CI: 8.83–20.51, p&lt;0.001). Among patient characteristics, atrial fibrillation (AF) at implantation (HR: 1.62, 95% CI: 1.27–2.07, p&lt;0.001) and chronic kidney disease (CKD) (HR: 1.53, 95% CI: 1.21–1.93, p&lt;0.001) independently predicted alerts. HeartLogic alerts were not associated with CRT vs. non-CRT device implantation (HR: 1.03, 95% CI: 0.82–1.30, p=0.775). The comparisons of the clinical event rates in the IN alert state with those in the OUT of alert state yielded incidence rate ratios ranging from 9.72 to 14.54 (all p&lt;0.001) in all groups of patients stratified by: CRT/non-CRT, AF/non-AF, CKD/non-CKD. Indeed, after multivariate correction for CKD and AF at implantation, the time IN the HeartLogic alert state &gt;13% was associated with the occurrence of the combined endpoint of cardiovascular hospitalization or death (HR: 2.54, 95% CI: 1.61–4.01, p&lt;0.001).

Conclusions
The burden of HeartLogic alerts appears similar between CRT and non-CRT patients, while patients with AF and CKD seem more exposed to alerts. Nonetheless, the ability of the HeartLogic algorithm to identify patients during periods of significantly increased risk of clinical events is confirmed regardless of the type of device, the presence of AF, or CKD.

Funding Acknowledgement
Type of funding sources: None.
Use of a device-based remote management heart failure care pathway is associated with reduced hospitalization and improved patient outcomes: TriageHF Plus real-world evaluation
Authors: Ahmed F Z , Sammut-Powell C , Martin G P , Callan P , Cunnington C , Kale M , Gerritse B , Lanctin D , Soken N , Campbell N G , Taylor J K 
Published: December 2022

Abstract

Background
Heart failure (HF) is a leading cause of hospital admission. However, prompt identification of worsening HF using implantable device data and proactive intervention may reduce hospitalizations.
The validated TriageHF algorithm in enabled ICD/CRT devices uses sensor data to risk stratify patients for HF hospitalization in the next 30 days. TriageHF Plus is a novel device-based HF care pathway (DHFP) that uses “high” risk status as the trigger for remote intervention (see Figure 1 for pathway overview). Outcomes after DHFP implementation in a clinical setting have not been examined.

Purpose
To evaluate the impact of TriageHF Plus clinical pathway on hospitalisation rates.

Methods
A prospective, multi-center evaluation comparing monthly hospitalization rates for patients enrolled in a DHFP with a concurrent standard of care (SoC) cohort and characterizing staffing resources necessary to implement the DHFP. The DHFP cohort received telephonic assessment and guideline-directed clinical care upon transition to high-risk status. Propensity scores (PS) were applied to DHFP and SoC cohorts to allow unbiased comparison. A negative binomial model was fitted to the monthly number of all-cause hospitalizations with treatment group (DHFP vs. SoC) as a covariate, using PS as weights.

Results
Between 09/11/2019 and 06/24/2021, 758 patients were included in the study (443 DHFP, 315 SoC). Proportion CRT 76%/ 89% and LVEF &lt;50% 78%/ 66% for DHFP/ SoC, respectively.
196 high risk transmissions prompted telephone assessment, with successful contact in 182; of which, 79 (43%) identified an explanatory acute medical issue. A secondary intervention was undertaken in 44/79 (56%). High risk transmissions took on average 19 minutes per clinical assessment (initial telephone triage and 30 day follow up). The rate of hospitalizations was 58% lower in the DHFP group, compared with SoC, after PS adjustment (IRR 0.42, 95% CI: 0.23, 0.76, p=0.004), see Figure 2. Sensitivity analyses showed Covid-19 had little effect on results.

Conclusions
This is the first prospective, real-world evaluation of a device-based HF care pathway to report a reduction in hospitalizations and does so with minimal staffing time. Integrated into existing HF services, device-based remote monitoring of HF patients can improve outcomes.

Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Medtronic
Effects of the COVID-19 pandemic on offering and acceptance in a cardiac rehabilitation programme: introduction of a remote CR programme
Authors: Sestayo Fernandez M , Alonso Vazquez M , Gonzalez Maestro A , Gonzalez Salvado V , Gonzalez Juanatey J R , Pena Gil C 
Published: December 2022

Abstract

Background
The impact of the COVID-19 pandemic on multimodal cardiac rehabilitation (CR) programmes has forced a continuous readjustment of clinical practice. Our regional healthcare system was faced with providing quality remote CR to ischaemic heart disease (IHD) patients in a scattered, mostly rural population, for which three new CR modalities replaced the previous in-person CR program: 1) telephone follow-up programme, 2) TELEA online platform for patient follow-up and 3) TELEA online follow-up & online training sessions.

Purpose
To study the impact of the COVID-19 pandemic on CR offering and acceptance and the reasons for patient refusal, and to assess the outcome of new remote CR modalities in this setting.

Methods
Single center, observational retrospective study from all consecutive patients with IHD eligible for CR from 2015 to 2021. A descriptive analysis of patient baseline characteristics, CR modality, offering and acceptance rates, and reasons for refusal per year was performed. Additionally, a comparative analysis of “pre-COVID period” (Jan 2015–Feb 2020) vs. “COVID period” (Mar 2020–Dec 2021) was performed to assess the impact of the pandemic on patient recruitment and the usefulness of remote CR modalities to enhance participation.

Results
N=2626 patients (20% women, 69.7±45.8 years) were offered CR from 2015 to 2021. CR offering decreased from the pre-COVID (78.6%) to the COVID period (52.6%), while participation increased (67.9% and 79.7%, respectively) Figure 1. Reasons for CR refusal significantly changed with an odds ratio (OR) of 5.63 and confidence interval (CI) 95% (3.2–9.9). In the pre-COVID period main reasons for CR refusal was “transportation difficulties” (47%); while during the COVID-19 period, the main reason shifted to “lack of interest” (78.2%) (Table 1).

Conclusions
Offering CR decreased during the COVID pandemic possibly due to stricter inclusion criteria. However, the implementation of new remote CR modalities allowed not only to maintain similar levels of acceptance but also to improve it despite the unfavourable setting, and helped to amend transportation difficulties as the leading reason for refusal. Remote CR may be a useful tool, combined with in-person programs, to enhance participation in CR.

Funding Acknowledgement
Type of funding sources: None.
Employment Decline During the Great Recession: the Role of Firm Size Distribution
Authors: Xu Wenjian 
Published: December 2022

Abstract
Over 8,000,000 jobs were lost in the Great Recession, creating widespread economic hardship. This paper documents a novel and robust empirical regularity that highly concentrated local labour markets experienced larger employment declines during the Great Recession. Through setting up a model with heterogeneous firms facing idiosyncratic productivity shocks, I show that firm size distribution summarised by the Herfindahl-Hirschman index plays a crucial role in the reallocation of workers, and it magnifies negative idiosyncratic shocks and attenuates positive ones. I undertake a series of empirical tests to rule out alternative explanations, and show that large employment losses in concentrated labour markets are not driven by highly concentrated industry locations being hit harder during the Great Recession, having smaller labour markets or higher firm leverage ratios. The effect of concentration level is larger in sectors with higher labour supply elasticity, or a higher variance of productivity shocks, and rises during the Great Recession compared to other periods, consistent with my model’s predictions.
Eliminating the ecological hazards of Heterosigma akashiwo bloom by a microbial algicide: removal of nitrite contamination, redirection of carbon flow and restoration of metabolic generalists
Authors: Cai Guanjing , Yu Xiaoqi , Cai Runlin , Wang Hui 
Published: December 2022

Abstract
Harmful algal blooms (HABs) attracted much attention due to their extensive ecological hazards and the increasing influences on global biogeochemical cycles with the intensification of human impact and global warming. Lysing algal cells with species-specific microbial algicide seemed to be promising to eliminate HABs, but the potential ecotoxicity was rarely studied. In this study, microcosms simulating Heterosigma akashiwo blooms were established to reveal the influences of a microbial algicide from Streptomyces sp. U3 on the biological, physicochemical parameters and bacterial community. The results showed that H. akashiwo bloom accumulated nitrite to a lethal dose, produced bio-labile DOM with widespread influences and enriched pathogenic Coxiella to a high abundance. Lysing H. akashiwo cells by microbial algicide induced a bacterial bloom, eliminated nitrite contamination, enhanced the recalcitrance of DOM, and restored bacterial population from a Gammaproteobacteria-dominant community during bloom back to an Alphaproteobacteria-dominant community similar to the non-bloom seawater. Succession of bacterial genera further suggested that the variation from algal exudates to lysates promoted the restoration of metabolic generalists, which redirected the carbon flow to a less ecologically impactive path. This study revealed the benefits of using microbial algicide to remediate the ecological hazards of HABs, which provided references for future application.
A Least-Cost Dynamic Optimization Approach for Obtaining a Desired Balanced Uneven-Aged Structure
Authors: Lamsal Basanta , Wagner John E , Germain René 
Published: December 2022

AbstractThere has been increasing interest among foresters and landowners in modifying existing even-aged forest structures to multi-aged or uneven-aged structures. Maintaining a continuous forest structure often provides a wider array of forest values over the long term. The conversion process is challenging in regions of the Northeast United States characterized by forests composed of dense diseased beech thickets and low-vigor deformed overstory trees. Abundance of noncommercial beech may result in negative cash flows during the conversion process to achieve a desired balanced uneven-aged structure. The Forest Vegetation Simulator was used to model growth and yield. Given the possibility of negative cash flows, a least-cost dynamic program with a penalty function was used to determine least-cost time paths for two management scenarios, one characterized by the successful removal of beech and the other simulating the continued presence of beech. Incorporating a penalty function allowed creating a continuum of least-cost paths from a zero penalty with the greatest weight given to net revenue goals to the largest penalty with the greatest weight given to ecological goals. Sensitivity analyses revealed least-cost paths were more stable given changes in prices and wages when greater emphasis was placed on the ecological goals associated with the target structure.
Effects of 1-methylcyclopropene treatment on the quality of red ‘Fuji’ apples fruit during short-term storage
Authors: Peng Zhenzhen , Fu Daqi 
Published: December 2022

AbstractObjectivesThe aim of this study is to determine the mechanism through which 1-methylcyclopropene (1-MCP) affects the quality of red ‘Fuji’ apples, which were stored for a short duration.Materials and MethodsRed ‘Fuji’ apples were treated with 1-MCP (1.0 μl/L), stored at 25 °C for 0, 12, 24, 48, 72, and 96 h, and ethylene production was measured. An integrated metabolomic and transcriptomic analysis was performed on apples stored for 24 h.ResultsThe release of ethylene was significantly delayed from red ‘Fuji’ apples subjected to 1-MCP treatment. By performing an integrated transcriptome and metabolome analyses, we identified 117 differentially expressed genes (DEGs) and 44 differentially accumulated metabolites (DAMs). By performing functional enrichment analysis, we found that DEGs were involved in the following pathways: carbon metabolism (LPD2, gpmA, LTA2, ACC, PSAT1, MdCAS2), phytohormone signal transduction (EBF1), amino acid metabolism (MdACS-1), fatty acid metabolism (LOX1.5, KCS4, KAS1), energy metabolism (Lhcb1, Lhcb6, PsbY, GPDHC1, PUMP5), metabolic pathways (TRE1, HEXO1) and cell wall metabolism (CSLG2). Thus, these DEGs were involved in the ripening of fruits, and they controlled the quality of fruits at the post-harvest stage. The metabolites were enriched with DAMs. These were found to be individually involved in the metabolic pathway, secondary metabolite biosynthesis, phenylpropanoid biosynthesis, flavonoids, and flavonol synthesis.ConclusionsThe results indicate that 1-MCP inhibits the biosynthesis of ethylene and suppresses energy metabolism. Moreover, it also downregulates metabolic pathways and the enzymatic genes related to fruit quality. Therefore, 1-MCP delays the ripening of fruits at the post-harvest stage. This study helps us understand how 1-MCP treatment affects the ripening and quality of fruits.
Variation in mutational (co)variances
Authors: Mallard François , Noble Luke , Baer Charles F , Teotónio Henrique 
Published: December 2022

Abstract
Because of pleiotropy, mutations affect the expression and inheritance of multiple traits and, together with selection, are expected to shape standing genetic covariances between traits and eventual phenotypic divergence between populations. It is therefore important to find if the M matrix, describing mutational variances of each trait and covariances between traits, varies between genotypes. We here estimate the M matrix for six locomotion behavior traits in lines of two genotypes of the nematode Caenorhabditis elegans that accumulated mutations in a nearly neutral manner for 250 generations. We find significant mutational variance along at least one phenotypic dimension of the M matrices, but neither their size nor their orientation had detectable differences between genotypes. The number of generations of mutation accumulation, or the number of MA lines measured, was likely insufficient to sample enough mutations and detect potentially small differences between the two M matrices. We then tested if the M matrices were similar to one G matrix describing the standing genetic (co)variances of a population derived by the hybridization of several genotypes, including the two measured for M, and domesticated to a lab-defined environment for 140 generations. We found that the M and G were different because the genetic covariances caused by mutational pleiotropy in the two genotypes are smaller than those caused by linkage disequilibrium in the lab population. We further show that M matrices differed in their alignment with the lab population G matrix. If generalized to other founder genotypes of the lab population, these observations indicate that selection does not shape the evolution of the M matrix for locomotion behavior in the short-term of a few tens to hundreds of generations and suggests that the hybridization of C. elegans genotypes allows selection on new phenotypic dimensions of locomotion behavior.
Behavioural plasticity in the use of a neritic foraging area by loggerhead sea turtles: insights from 37 years of capture–mark–recapture in the Adriatic Sea (Mediterranean Sea)
Authors: Baldi Giulia , Furii Giovanni , Del Vecchio Massimo , Salvemini Pasquale , Vallini Carola , Angelini Valeria , Pari Sauro , Lombardi Moraes Kamyla , Profico Chiara , Olivieri Vincenzo , Margaritoulis Dimitris , Rees Alan F , Çurri Anxhela , Hochscheid Sandra , Freggi Daniela , Lazar Bojan , Luschi Paolo , Casale Paolo 
Published: December 2022

Abstract
Assessing sea turtle movements and connectivity among different areas is pivotal to understanding their biology and implementing efficient conservation actions. In the Adriatic Sea, one of the most important sea turtle foraging areas in the Mediterranean, a total of 311 capture–mark–recapture (CMR) records (mostly bycatch) from 294 loggerhead turtles (Caretta caretta) in the period 1984–2021 were analysed. A general fidelity pattern to Adriatic subareas was indicated by a significantly shorter CMR distance than the potential dispersal distance and by the significantly higher proportion of re-encounters in the same area of release than expected. No seasonal pattern was detected between subareas, and shorter re-encounter distances were observed in turtles released and re-encountered in the same season, suggesting different winter and summer residential areas. Results suggest that turtles frequenting the Adriatic can go anywhere in the Mediterranean basin and may exhibit a wandering behaviour regardless of their size. A substantial connectivity with nesting sites in Greece was observed, confirming with empirical evidence that this is the most important breeding area for turtles foraging in the Adriatic Sea. This study highlights the value of cooperation among different groups and shows a main behavioural pattern of fidelity to neritic foraging grounds.
Comparison of Quantitative Values of Headspace Gas Chromatography--Mass Spectrometry and a Formate Quantification Kit in Blood Formate Quantification
Authors: Yoshida Haruhi , Harada Kazuo , Sakamoto Yukari , Yoshimura Jumpei , Shimazu Takeshi , Matsumoto Hiroshi 
Published: December 2022

AbstractMethanol poisoning is caused by the toxicity of formate, a by-product of methanol metabolism. Measurement of blood formate concentrations is required for emergency treatment and investigation of the cause of death. In this study, we measured concentrations of formate in the plasma of a patient with methanol poisoning using headspace gas chromatography--mass spectrometry (HS-GC--MS) and a formate assay kit. Results showed a discrepancy as the quantitative values of the kit were higher than those of HS-GC--MS. Metabolic profiling of low-molecular-weight organic compounds in patient plasma samples showed that the concentrations of lactate were correlated with the values obtained using the kit. We observed a progression when lactate and lactate dehydrogenase were added to the kit reaction simultaneously, even in the absence of formate. Moreover, disulfiram, an aldehyde dehydrogenase inhibitor, suppressed the values of patient plasma samples in the formate assay kit, implying that formate production from remaining methanol in patient plasma samples via formaldehyde occurred during the kit reaction. The reactions of the kit with lactate and methanol were undesirable for accurate measurement of formate concentration in the sample. However, considering that elevated concentrations of lactate and remaining methanol both cause acidosis and are dangerous to the body, cross-reactions with lactate and methanol in the formate assay kit may be acceptable for rapid diagnosis in facilities where HS-GC--MS and other physical and chemical equipment are unavailable.
A Retrospective Analysis of Sternal Lesions Detected on Breast MRI in Patients Without History of Cancer
Authors: Jen Aaron , Kochkodan-Self Jeanne , Mandell Jacob C 
Published: December 2022

Abstract

Objective
To determine the imaging characteristics and stability over time of sternal lesions identified on breast MRI in patients without history of cancer.

Methods
An IRB-approved retrospective analysis of all breast MRIs performed at our institution from September 1, 2017 to December 1, 2021 that included one of several key words related to the sternum. Studies with history of non-dermatologic malignancy including breast cancer, absence of a true sternal lesion, or presence of symptoms during the examination were excluded. Imaging was reviewed for size, distribution, signal characteristics, and presence of contrast enhancement, perilesional edema, periosteal edema, or intralesional fat. Available comparison imaging, clinical history, and follow-up recommendations were reviewed. Descriptive statistics were used to summarize lesion data.

Results
Of 60 lesions included from 60 patients, 40 lesions with more than two years of comparison imaging were either stable or decreased in size and none demonstrated change in signal characteristics. The majority of these presumed benign lesions demonstrated hypointense signal on T1-weighted sequences (21/40, 52.5%), hyperintense signal on fluid-sensitive sequences (33/40, 82.5%), contrast enhancement (32/40, 80.0%), and absence of clear intralesional fat (29/40, 72.5%). One patient who did not have comparison imaging was diagnosed with malignancy (multiple myeloma) eight months following their MRI. This lesion demonstrated uniquely diffuse and heterogeneous enhancement but did not undergo biopsy.

Conclusion
Sternal lesions in women without history of non-dermatologic malignancy have a very low likelihood of malignancy. Common imaging characteristics of the presumed benign lesions can inform imaging recommendations when incidental sternal lesions are discovered.