bluuebunny/crossref_metadata_2025_split huggingface dataset:
Type A aortic dissection is more aggressive in women
Authors: Gasser Simone , Stastny Lukas , Kofler Markus , Krapf Christoph , Bonaros Nikolaos , Grimm Michael , Dumfarth Julia 
Published: January 2022

Abstract

OBJECTIVES
The aim of this study was to evaluate gender differences in the pre- and postoperative course in patients with acute aortic dissection type A.

METHODS
Of all patients undergoing surgery from 2000 to 2020, data on symptoms at presentation, operative strategy and postoperative course were analyzed. Long-term follow-up was obtained through visits at our outpatient clinic or via telephone interviews.

RESULTS
Out of 394 patients, 32% (n = 126) were female. Women suffered from aortic dissection type A at an older age (women 67.5 years vs men 57 years; P &gt; 0.001) and experienced a more aggressive preoperative course leading to critical presentation or even lethal rupture [women 7.9% (n = 10) vs men 2.2% (n = 6); P = 0.008]. Chest pain as initial symptom was more common in men [women 59.5% (n = 75) vs men 73.5% (n = 197); P = 0.005]. Perfusion of the right carotid was impaired more often [women 22.5% (n = 27) vs men 13.7% (n = 36); P = 0.031] and preoperative rate of neurological dysfunction was higher in women [women 23% (n = 29) vs men 14.2% (n = 38); P = 0.028]. Time from symptom onset to surgery did not differ between gender. Surgical repair was less extensive and faster in women. Female patients were more likely to suffer from postoperative neurological injury [women 23.8% (n = 30) vs men 10.2% (n = 40); P = 0.023]. We detected impaired 30-day and long-term survival in women.

CONCLUSIONS
Women represent an older and sicker patient collective. Preoperative course of aortic dissection type A is more aggressive and complicated in women. While time from onset of symptoms to surgery did not differ between gender, neurological outcome and survival were impaired in women.
Long-term durability of a reimplantation valve-sparing aortic root replacement can be expected in both Marfan syndrome and Loeys-Dietz syndrome
Authors: Seike Yoshimasa , Yokawa Koki , Koizumi Shigeki , Masada Kenta , Inoue Yosuke , Morisaki Hiroko , Morisaki Takayuki , Sasaki Hiroaki , Matsuda Hitoshi 
Published: January 2022

Abstract

OBJECTIVES
The goal of this study was to evaluate the surgical outcomes of a valve-sparing root replacement using the reimplantation technique for annuloaortic ectasia in patients with Marfan syndrome (MFS) and in those with Loeys-Dietz syndrome (LDS).

METHODS
We reviewed 103 patients with MSF with mutations in the fibrillin-1 gene and 28 patients with LDS with mutations in the transforming growth factor-beta receptor and 2, SMAD3 and transforming growth factor beta-2 from 1988 to 2020.

RESULTS
Forty-four (42.7%) patients with MFS [26 men, 31 (7.6) years] and 10 (35.7%) patients with Loeys-Dietz syndrome (LDS) [7 men, 22 (standard deviation: 8.6) years] who had no aortic dissection and underwent valve-sparing root replacement were included. The preoperative sinus diameter [46 (45–50.5) mm in those with MFS vs 48 (47–50) mm in those with LDS, p = 0.420] and the percentage of aortic insufficiency &gt; grade 2+ [31.8% (10/44) in patients with MFS vs 10.0% (1/10) in those with LDS, p = 0.667] revealed no significant differences between the 2 groups. The cumulative incidences of aortic insufficiency greater than grade 1 (p = 0.588) and aortic valve reoperation (p = 0.310) were comparable between the 2 groups. Patients with LDS had a higher tendency towards aortic dissection after the initial operation (p = 0.061) and a significantly higher cumulative incidence of aortic reoperation (p = 0.003) versus those with MFS.

CONCLUSIONS
Patients with MFS and those with LDS showed similar cumulative incidences of recurrent aortic valve insufficiency and aortic valve reoperation. Those with LDS revealed a higher cumulative incidence of aortic reoperation and a greater tendency towards aortic dissection after the initial operation compared with those with MFS.
Frozen elephant trunk in acute aortic type a dissection: risk analysis of concomitant root replacement
Authors: Beckmann Erik , Martens Andreas , Kaufeld Tim , Natanov Ruslan , Krueger Heike , Rudolph Linda , Haverich Axel , Shrestha Malakh 
Published: January 2022

Abstract

OBJECTIVES
To analyse whether full root replacement increases perioperative risks in patients who undergo frozen elephant trunk for acute aortic dissection.

METHODS
Between March 2013 and December 2019, 115 patients underwent emergency frozen elephant trunk for acute dissection. Patients without root replacement were assigned to group A, while patients with concomitant full root replacement to group B.

RESULTS
Mean age was 50.8 (12.5) years and 85 (73.9%) patients were male. Preoperative malperfusion was present in 49 (42.6%) patients. In group B, 27 (41.5%) patients received composite root replacement and 38 (33.0%) aortic valve-sparing David procedure. Cardiopulmonary-bypass and cross-clamp times were 252.5 (208.5–293.0) and 96.0 (40.5–148.0) min in group A, and 310.0 (274.0–346.5) and 121.0 (89.0–182.0) in group B (P &lt; 0.001). Continuous myocardial perfusion was used in 40 (80.0%) patients of group A and 59 (90.8%) of group B (P = 0.098). Disabling stroke was present in 10 (20.0%) patients in group A and 12 (18.5%) in group B (P = 0.835). Thirty-day mortality was 12.0% (n = 6) in group A and 9.2% (n = 6) in group B (P = 0.630). The 1- and 5-year survival rates were 80% and 62% in group A, and 81% and 79% in group B. Logistic regression analysis identified age (odds ratio = 1.117, 95% confidence interval = 1.004–1.242, P = 0.041), cardiopulmonary-bypass time (odds ratio = 1.012, 95% confidence interval = 1.001–1.022, P = 0.029) and abdominal malperfusion (odds ratio = 17.394, 95% confidence interval = 2.030–149.013, P = 0.009) to be associated with 30-day mortality.

CONCLUSIONS
Full root replacement does not increase the perioperative risk in patients who undergo frozen elephant trunk for acute dissection. Careful patient selection is important for such complex procedures. Continuous myocardial perfusion can help reducing the risk for intraoperative complications during such complex operations.
Heart transplantation from an extended criteria donation after circulatory death donor
Authors: Vokshi Ismail , Large Stephen , Berman Marius , Tsui Steven 
Published: January 2022

Abstract
Transplantation of donation after circulatory death (DCD) donor hearts is gaining acceptance. However, DCD heart selection has been understandably cautious. We report a case of reconditioning a DCD heart using thoraco-abdominal normothermic regional perfusion in a 46-year-old donor who suffered irreversible brain injury following emergency type-A aortic dissection repair. The DCD heart was procured with cold preservation and directly transplanted into a 63-year-old male who was bridged to transplant with extracorporeal life support. The recipient required a brief period of mechanical circulatory support post-transplant but made a good recovery. To our knowledge, this is the first report of successful heart transplantation from such an extended criteria DCD donor.
Biological substrate modification suppresses ventricular arrhythmias in a porcine model of chronic ischaemic cardiomyopathy
Authors: Dawkins James F. , Ehdaie Ashkan , Rogers Russell , Soetkamp Daniel , Valle Jackelyn , Holm Kevin , Sanchez Lizbeth , Tremmel Ileana , Nawaz Asma , Shehata Michael , Wang Xunzhang , Prakosa Adityo , Yu Joseph , Van Eyk Jennifer E , Trayanova Natalia , Marbán Eduardo , Cingolani Eugenio 
Published: January 2022

Abstract

Aims
Cardiomyopathy patients are prone to ventricular arrhythmias (VA) and sudden cardiac death. Current therapies to prevent VA include radiofrequency ablation to destroy slowly conducting pathways of viable myocardium which support re-entry. Here, we tested the reverse concept, namely that boosting local tissue viability in zones of slow conduction might eliminate slow conduction and suppress VA in ischaemic cardiomyopathy.

Methods and results
Exosomes are extracellular vesicles laden with bioactive cargo. Exosomes secreted by cardiosphere-derived cells (CDCEXO) reduce scar and improve heart function after intramyocardial delivery. In a VA-prone porcine model of ischaemic cardiomyopathy, we injected CDCEXO or vehicle into zones of delayed conduction defined by electroanatomic mapping. Up to 1-month post-injection, CDCEXO, but not the vehicle, decreased myocardial scar, suppressed slowly conducting electrical pathways, and inhibited VA induction by programmed electrical stimulation. In silico reconstruction of electrical activity based on magnetic resonance images accurately reproduced the suppression of VA inducibility by CDCEXO. Strong anti-fibrotic effects of CDCEXO, evident histologically and by proteomic analysis from pig hearts, were confirmed in a co-culture assay of cardiomyocytes and fibroblasts.

Conclusion
Biological substrate modification by exosome injection may be worth developing as a non-destructive alternative to conventional ablation for the prevention of recurrent ventricular tachyarrhythmias.
A qualitative study on men’s experiences of health after treatment for ischaemic heart disease
Authors: Elbrønd Pia Gammelgaard , Larsen Malene , Missel Malene , Bay Laila Twistmann , Petersson Nadja Buch , Oliffe John L , Borregaard Britt 
Published: January 2022

Abstract

Aims
Globally, ischaemic heart disease (IHD) is one of the leading causes of mortality among men, and the health management of men is pivotal to prevention and recovery. Many men delay help-seeking and lack knowledge of disease symptomologies. Thus, the aim was to explore how men experience and manage their health while suffering from ischaemic heart disease and having received treatment with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI).

Methods and results
The study applied a qualitative approach designed within a phenomenological–hermeneutical methodology. Interviews were conducted between April and November 2019 with a criterion sample of 21 male patients within 1–2 weeks post-discharge. The analysis was guided by Paul Ricoeur’s theory of text interpretation. After analysing the interviews, the following themes were identified: A functioning body as health, illuminating how a functioning body leads to a feeling of independence; misinterpreting signs of illness showing how symptoms are interpreted as signs of ageing rather than disease; and navigating life with ischaemic heart disease focusing on how men retain or maintain health after the threat to life.

Conclusion
The findings of this study provide insight into men’s health and their health management: illuminating how a functioning body can give men a sense of freedom and control, making it difficult to interpret signs of illness, and thus, failing to seek help and feel motivated to make changes when facing a serious health threat. These perspectives should be considered when planning future care and communication with male patients.
Changes in fish skin microbiota along gradients of eutrophication in human-altered rivers
Authors: Côte Jessica , Jacquin Lisa , Veyssière Charlotte , Manzi Sophie , Etienne Roselyne , Perrault Annie , Cambon Marine C , Jean Séverine , White Joël 
Published: January 2022

ABSTRACT
The skin microbiota plays a major role in health of organisms but it is still unclear how such bacterial assemblages respond to changes in environmental conditions and anthropogenic perturbations. In this study, we investigated the effects of the eutrophication of freshwater ecosystems on the skin microbiota of fish. We sampled wild gudgeon Gobio occitaniae from 17 river sites along an eutrophication gradient and compared their skin microbiota diversity and composition, using a 16s rRNA gene metabarcoding approach. Results showed a tendency for higher taxonomic and phylogenetic diversity in highly eutrophic sites linked to the presence of suspended organic matters. We also highlighted significant links between eutrophication and skin microbiota taxonomic composition and beta-diversity. In contrast, skin microbiota characteristics did not correlate with host factors such as age or sex, although microbiota beta-diversity did vary significantly according to host parasite load. To conclude, our study highlights the importance of environmental factors, especially eutrophication, on the diversity and composition of skin mucus bacterial communities. Because changes in the skin microbiota may induce potential deleterious consequences on host health and population persistence, our results confirm the importance of accounting for host-microbiota interactions when examining the consequences of anthropogenic activities on aquatic fauna.
Diagnostic performance of elastography on liver fibrosis in antiviral treatment-naive chronic hepatitis B patients: a meta-analysis
Authors: Mingkai Li , Sizhe Wan , Xiaoying Wu , Ying Lin , Wu Bin 
Published: January 2022

Abstract

Background
This study aimed to assess the performance of transient elastography (TE), two-dimensional shear wave elastography (2D-SWE), and magnetic resonance elastography (MRE) for staging significant fibrosis and cirrhosis in untreated chronic hepatitis B (CHB) patients.

Methods
Pubmed, Embase, Web of Science, and Cochrane Library were searched for terms involving CHB, TE, 2D-SWE, and MRE. Other etiologies of chronic liver disease, previous treatment in patients, or articles not published in SCI journals were excluded. Hierarchical non-linear models were used to evaluate the diagnostic accuracy of TE, 2D-SWE, and MRE. Heterogeneity was explored via analysis of threshold effect and meta-regression.

Results
Twenty-eight articles with a total of 4,540 untreated CHB patients were included. The summary areas under the receiver-operating characteristic curves (AUROCs) using TE, 2D-SWE, and MRE for predicting significant fibrosis (SF) were 0.84, 0.89, and 0.99, respectively. The AUROC values of TE, 2D-SWE, and MRE for staging cirrhosis were 0.9, 0.94, and 0.99, respectively. Based on the meta-analysis of studies with head-to-head comparison, 2D-SWE is superior to TE (0.92 vs 0.85, P &lt; 0.01) in staging significant fibrosis.

Conclusion
TE, 2D-SWE, and MRE express acceptable diagnostic accuracies in staging significant fibrosis and cirrhosis in untreated CHB patients. 2D-SWE outperforms TE in detecting significant fibrosis in treatment-naive people with hepatitis B virus.
MOET: a web-based gene set enrichment tool at the Rat Genome Database for multiontology and multispecies analyses
Authors: Vedi Mahima , Nalabolu Harika S , Lin Chien-Wei , Hoffman Matthew J , Smith Jennifer R , Brodie Kent , De Pons Jeffrey L , Demos Wendy M , Gibson Adam C , Hayman G Thomas , Hill Morgan L , Kaldunski Mary L , Lamers Logan , Laulederkind Stanley J F , Thorat Ketaki , Thota Jyothi , Tutaj Monika , Tutaj Marek A , Wang Shur-Jen , Zacher Stacy , Dwinell Melinda R , Kwitek Anne E 
Published: January 2022

Abstract
Biological interpretation of a large amount of gene or protein data is complex. Ontology analysis tools are imperative in finding functional similarities through overrepresentation or enrichment of terms associated with the input gene or protein lists. However, most tools are limited by their ability to do ontology-specific and species-limited analyses. Furthermore, some enrichment tools are not updated frequently with recent information from databases, thus giving users inaccurate, outdated or uninformative data. Here, we present MOET or the Multi-Ontology Enrichment Tool (v.1 released in April 2019 and v.2 released in May 2021), an ontology analysis tool leveraging data that the Rat Genome Database (RGD) integrated from in-house expert curation and external databases including the National Center for Biotechnology Information (NCBI), Mouse Genome Informatics (MGI), The Kyoto Encyclopedia of Genes and Genomes (KEGG), The Gene Ontology Resource, UniProt-GOA, and others. Given a gene or protein list, MOET analysis identifies significantly overrepresented ontology terms using a hypergeometric test and provides nominal and Bonferroni corrected P-values and odds ratios for the overrepresented terms. The results are shown as a downloadable list of terms with and without Bonferroni correction, and a graph of the P-values and number of annotated genes for each term in the list. MOET can be accessed freely from https://rgd.mcw.edu/rgdweb/enrichment/start.html.
Associations of Visual Function With Cognitive Performance in Community-Based Older Adults: The Eye Determinants of Cognition Study
Authors: Arsiwala Lubaina T , Guo Xinxing , Ramulu Pradeep Y , Sharrett A Richey , Mihailovic Aleksandra , Swenor Bonnielin K , Mosley Thomas , Dong YaNan , Abraham Alison G 
Published: January 2022

Abstract

Background
Given the detrimental impacts of visual and cognitive impairment separately, in older adults, understanding their coexistence could inform strategies against age-related cognitive changes.

Methods
Participants from Washington County (White) and Jackson (Black) sites of the Atherosclerosis Risk in Communities Study were recruited who differed on racial, regional, urbanicity, and community-based factors. Presenting distance visual acuity (DVA; representing vision loss due to disease or lack of eye-care), corrected DVA (representing optimal correction for refractive loss of vision), and contrast sensitivity were measured. Factor scores for global cognition, memory, executive function, and language domains were calculated for 3 visits. We quantified the associations of vision measures with change in cognitive scores, stratified by community/race, using generalized estimating equations.

Results
In 982 participants, mean (standard deviation [SD]) baseline age was 74 (4) years, with 37% males and 45% Jackson/Black participants. As hypothesized, after accounting for potential confounders, in the better-eye, worse presenting DVA was associated with greater 10-year decline rate in global cognition, memory, and executive function in Washington County/White participants (eg, global cognition: −0.08 SD [95% confidence interval: −0.12, −0.04]). Worse corrected DVA was associated with greater 10-year decline rate in executive function in Washington County/White participants (−0.10 SD [−0.15, −0.04]). Better contrast sensitivity was associated with lower 10-year decline rate in global cognition and executive function in Washington County/White participants (eg, global cognition: 0.10 SD [0.06,0.14]). None of these associations were confirmed in Jackson/Black participants.

Conclusions
Our study supports a functional link between some vision measures and cognition in older adults, but in only 1 of the 2 communities studied.
The informal economy as a provider of assistive technology: lessons from Indonesia and Sierra Leone
Authors: Walker Julian H , Tebbutt Emma 
Published: January 2022

Summary
Promoting the use of assistive technology (AT) is crucial for the health and well-being of users, but there is a huge global problem of unmet need for AT. In this context informal (unregulated) providers of AT play a significant role of meeting AT user need, particularly in less-resourced settings. This study draws on research into formal and informal AT provision in low-income urban communities in Indonesia and Sierra Leone to explore the potential of informal providers in addressing unmet need. Specifically, it looks at the different performance of formal and informal providers regarding the availability and the adequacy of AT that they provide. The study concludes by proposing further research into the scope for coproduction of AT between formal and informal providers.
Being small at the right moment: Path dependence after a shift in the technological regime
Authors: Hepp Jasper 
Published: January 2022

Abstract
This paper explores the impact of technological change on industry concentration and the underlying firm dynamics. Within the agent-based model EURACE@Unibi, it is shown that an exogenous acceleration in technological change in the capital goods sector leads to a diverging firm population in the downstream consumption goods sector in terms of productivities and skills and in turn also to a higher market concentration. A novel ex-post analysis at the micro level shows that the later dominant firms were relatively small at the beginning but benefited from a virtuous cycle between their capital choice and the skill level within their workforce that is initiated by a fortunate outcome on the labor market.
Seaweed ecosystems may not mitigate CO2 emissions
Authors: Gallagher John Barry , Shelamoff Victor , Layton Cayne 
Published: January 2022

AbstractGlobal seaweed carbon sequestration estimates are currently taken as the fraction of the net primary production (NPP) exported to the deep ocean. However, this perspective does not account for CO2 from the consumption of external subsidies. Here, we clarify: (i) the role of export relative to seaweed net ecosystem production (NEP) for a closed system and one more likely open to subsidies; (ii) the importance of subsidies by compiling published estimates of NEP from seaweed-dominated ecosystems; and (iii) discuss their impact on the global seaweed net carbon balance and other sequestration constraints as a mitigation service. Examples of seaweed NEP (n = 18) were sparse and variable. Nevertheless, the average NEP (−4.0 mmol C m–2 d–1 SE ± 12.2) suggested that seaweed ecosystems are a C source, becoming increasingly heterotrophic as their export is consumed. Critically, mitigation of greenhouse gas emissions was mixed relative to their replacement or baseline states, and where CO2 is supplied independently of organic metabolism and atmospheric exchange, we caution a sole reliance on NEP or NPP. This will ensure a more accurate seaweed mitigation assessment, one that does exceed their capacity and is effective within a compliance and carbon trading scheme.
Shifting seasonal timing of peak abundance of two invading ctenophore populations in the Black Sea during the period 1991–2017
Authors: Vereshchaka A L , Shatravin A V , Lunina A A 
Published: January 2022

Abstract
Factors affecting zooplankton dynamics, especially in shelf-sea ecosystems such as the Black Sea influenced by eutrophication, overfishing, climate variability, and biological invaders, merit special attention for successful development and management. We used coherence functions (phase angle) to analyze time series (918 samples collected every 10 days) of the two invading ctenophores Mnemiopsis leidyi and Beroe ovata and mesoplankton (seven species) in 1991–2017. We observed a constant behavior of focal mesoplankton taxa (no shift of phase angle along the time axis) against such environmental benchmarks as surface temperature and surface chlorophyll concentration. Conversely, development of the ctenophore populations progressively accelerated (phase angle decreased) against both mesoplankton and environmental benchmarks. Mnemiopsis was leading this racing and followed by Beroe: (i) in 1991–1998 (before the Beroe invasion) peaks of Mnemiopsis were lagging by ∼1½ months temperature peaks; (ii) in 1998–2002 (Beroe appeared) Mnemiopsis peaks were shifting earlier in time and (iii) in 2002–2008 they became leading Beroe peaks by ∼1½ months; (iv) in 2009–2013, Beroe peaks were also shifting earlier in time, and (v) in 2013–2017, Beroe has shifted by ∼1½ months and became nearly in-phase with Mnemiopsis. Our results provide a deeper insight into adaptive strategies of invading ctenophores and enable prognoses of ctenophore blooms.