bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thrombolytic therapy for mechanical aortic valve thrombosis in pregnancy: case report
Authors: Nguyen Khoa , Prasad Pooja , Pare Emmanuelle , Chadderdon Scott , Khan Abigail 
Published: December 2022

Abstract

Background
Mechanical heart valves require long-term anticoagulation strategies to prevent valve thrombosis. Pregnant women with mechanical heart valves are especially susceptible to valve thrombosis, given their procoagulant state and the complexity of anticoagulation strategies during pregnancy. We describe a case of prosthetic valve thrombosis in a pregnant woman treated successfully with low-dose slow infusion of thrombolytic therapy.

Case Summary
A 23-year-old pregnant woman with a mechanical aortic valve on subcutaneous enoxaparin presented to the maternal cardiac clinic for a follow-up visit. Her physical exam was notable for a loud grade three crescendo decrescendo murmur and follow-up transthoracic echocardiography revealed peak and mean gradients of 87 and 58 mmHg, respectively. The Doppler velocity index (DVI) was 0.24 with an acceleration time of 130 ms. Fluoroscopy confirmed a stuck leaflet disk. Thrombolysis was performed using a low-dose ultra-slow infusion of thrombolytic therapy (1 mg/h of tissue-type plasminogen activator) with the restoration of normal valve function after 8 days. A repeat transthoracic echocardiography showed a decrease in the peak and mean gradients to 37 and 21 mmHg, respectively, with an improvement in the DVI to 0.53. Repeat fluoroscopy confirmed the opening of both leaflet disks.

Discussion
Treatment options for mechanical aortic valve thrombosis are either slow-infusion, low-dose thrombolytic therapy or emergency surgery. The hypercoagulable state of pregnancy makes adequate anticoagulation, proper monitoring, and medication adherence even more critical to prevent valve thrombosis. Physicians should educate pregnant patients on anticoagulation strategies and participate in shared decision-making.
Obesity-induced vena cava compression syndrome: a case report of a rare precipitant of a type 2 myocardial infarction in a patient with critical aortic stenosis
Authors: Sellers Alexander M , Alam Ferdous , Bennetts Jayme S , Lehman Sam J , Sinhal Ajay R 
Published: December 2022

Abstract

Background
Obesity is a global health problem of increasing prevalence with a broad range of multisystem complications. An under-recognized complication of severe obesity is the potential haemodynamic compromise that may arise due to pathological external compression of the inferior vena cava whilst lying in the supine position, a phenomenon known as obesity-induced vena cava compression syndrome.

Case summary
A 56-year-old independent woman presented to a rural Australian hospital for routine dressing care for bilateral lymphoedema on a background of class III morbid obesity (weight 197 kg, body mass index 68.55 kg/m3) and aortic stenosis. Whilst laid in the supine position with both legs elevated to aid lower limb venous return, the patient developed angina with associated troponin rise (15 to 75 to 332 ng/L) and inferolateral territory ischaemic changes on electrocardiogram. The pain then resolved shortly after restoring the patient to the upright position. A transthoracic echocardiogram showed critical bicuspid aortic stenosis. Computerized tomography coronary angiogram showed no significant coronary artery disease. Following multidisciplinary discussions, a transcatheter aortic valve insertion was performed via a transfemoral approach. Post-procedure, she went into atrial fibrillation, she was cardioverted into a sinus rhythm with new left bundle branch block. There were no complications otherwise, and the patient was discharged home following a brief period of convalescence.

Discussion
We describe a case of suspected obesity-induced vena cava compression syndrome precipitating a type 2 myocardial infarction in a pre-load dependent patient with critical bicuspid valve aortic stenosis. This case highlights a potential haemodynamic consequence of morbid obesity in the supine position.
Translational opportunities of single-cell biology in atherosclerosis
Authors: de Winther Menno P J , Bäck Magnus , Evans Paul , Gomez Delphine , Goncalves Isabel , Jørgensen Helle F , Koenen Rory R , Lutgens Esther , Norata Giuseppe Danilo , Osto Elena , Dib Lea , Simons Michael , Stellos Konstantinos , Ylä-Herttuala Seppo , Winkels Holger , Bochaton-Piallat Marie-Luce , Monaco Claudia 
Published: December 2022

AbstractThe advent of single-cell biology opens a new chapter for understanding human biological processes and for diagnosing, monitoring, and treating disease. This revolution now reaches the field of cardiovascular disease (CVD). New technologies to interrogate CVD samples at single-cell resolution are allowing the identification of novel cell communities that are important in shaping disease development and direct towards new therapeutic strategies. These approaches have begun to revolutionize atherosclerosis pathology and redraw our understanding of disease development. This review discusses the state-of-the-art of single-cell analysis of atherosclerotic plaques, with a particular focus on human lesions, and presents the current resolution of cellular subpopulations and their heterogeneity and plasticity in relation to clinically relevant features. Opportunities and pitfalls of current technologies as well as the clinical impact of single-cell technologies in CVD patient care are highlighted, advocating for multidisciplinary and international collaborative efforts to join the cellular dots of CVD.
Empagliflozin, irrespective of blood pressure, improves outcomes in heart failure with preserved ejection fraction: the EMPEROR-Preserved trial
Authors: Böhm Michael , Anker Stefan , Mahfoud Felix , Lauder Lucas , Filippatos Gerasimos , Ferreira João Pedro , Pocock Stuart J , Brueckmann Martina , Saloustros Ilias , Schüler Elke , Wanner Christoph , Zannad Faiez , Packer Milton , Butler Javed 
Published: December 2022

Abstract

Aims
Empagliflozin reduces the risk of cardiovascular death or heart failure (HF) hospitalization in patients with HF and preserved ejection fraction. This study aims to evaluate if systolic blood pressure (SBP) moderates these effects.

Methods and results
The association of SBP and the treatment effects of empagliflozin in EMPEROR-Preserved (empagliflozin outcome trial in patients with chronic heart failure with preserved ejection fraction) was evaluated. Randomized patients (n = 5988) were grouped according to SBP at baseline (&lt;110 mmHg, n = 455; 110–130 mmHg, n = 2415; &gt; 130 mmHg, n = 3118). The effect of empagliflozin on blood pressure, cardiovascular death or HF hospitalization (primary outcome), total HF hospitalizations, and rate of decline in estimated glomerular filtration rate was studied. Over a median of 26.2 months, the placebo-corrected decline was small and not significantly different across baseline SBP. On placebo, the risk of cardiovascular death or hospitalization for HF was 8.58 at &gt;130 mmHg, 8.26 at 110–130 mmHg, and 11.59 events per 100 patient-years at &lt;110 mmHg (P = 0.12 vs. &gt; 130 mmHg, P = 0.08 vs. 110–130 mmHg). There was no evidence for baseline SBP moderating the effect of empagliflozin on risk of HF events (primary endpoint interaction P = 0.69, recurrent HF hospitalizations interaction P = 0.55). When comparing empagliflozin with placebo, SBP did not meaningfully associate with adverse events such as hypotension, volume depletion, and acute renal failure.

Conclusion
In EMPEROR-Preserved, empagliflozin was effective and safe without SBP meaningfully moderating empagliflozin’s treatment effects. This analysis of EMPEROR-Preserved shows that empagliflozin can be used safely and effectively without blood pressure being a meaningful moderator of the drug benefit.

Clinical Trial Registration
URL: https://www.clinicaltrials.gov Unique identifier: NCT03057951
Lifetime risk of comorbidity in patients with simple congenital heart disease: a Danish nationwide study
Authors: El-Chouli Mohamad , Meddis Alessandra , Christensen Daniel M , Gerds Thomas A , Sehested Thomas , Malmborg Morten , Phelps Matthew , Bang Casper N , Ahlehoff Ole , Torp-Pedersen Christian , Sindet-Pedersen Caroline , Raunsø Jakob , Idorn Lars , Gislason Gunnar 
Published: December 2022

AbstractAimsIn a continuously ageing population of patients with congenital heart disease (CHD), understanding the long-term risk of morbidity is crucial. The aim of this study was to compare the lifetime risks of developing comorbidities in patients with simple CHD and matched controls.Methods and resultsUsing the Danish nationwide registers spanning from 1977 to 2018, simple CHD cases were defined as isolated atrial septal defect (ASD), ventricular septal defect (VSD), pulmonary stenosis, or patent ductus arteriosus in patients surviving until at least 5 years of age. There were 10 controls identified per case. Reported were absolute lifetime risks and lifetime risk differences (between patients with simple CHD and controls) of incident comorbidities stratified by groups and specific cardiovascular comorbidities. Of the included 17 157 individuals with simple CHD, the largest subgroups were ASD (37.7%) and VSD (33.9%), and 52% were females. The median follow-up time for patients with CHD was 21.2 years (interquartile range: 9.4–39.0) and for controls, 19.8 years (9.0–37.0). The lifetime risks for the investigated comorbidities were higher and appeared overall at younger ages for simple CHD compared with controls, except for neoplasms and chronic kidney disease. The lifetime risk difference among the comorbidity groups was highest for neurological disease (male: 15.2%, female: 11.3%), pulmonary disease (male: 9.1%, female: 11.7%), and among the specific comorbidities for stroke (male: 18.9%, female: 11.4%). The overall risk of stroke in patients with simple CHD was mainly driven by ASD (male: 28.9%, female: 17.5%), while the risks of myocardial infarction and heart failure were driven by VSD. The associated lifetime risks of stroke, myocardial infarction, and heart failure in both sexes were smaller in invasively treated patients compared with untreated patients with simple CHD.ConclusionPatients with simple CHD had increased lifetime risks of all comorbidities compared with matched controls, except for neoplasms and chronic kidney disease. These findings highlight the need for increased attention towards early management of comorbidity risk factors.
Association between social jetlag and sugar-sweetened beverages (SSBs) in adolescents in Western Canada
Authors: Zhang Kexin , Guhn Martin , Conklin Annalijn I 
Published: December 2022

AbstractBackgroundSleep debt is linked to poor health behaviours, and adolescents may be especially vulnerable to deficit from the mismatch of their late chronotype with socially determined sleep timing. We aimed to investigate the potential association between social jetlag and sugar-sweetened beverages (SSBs) consumption among adolescents.MethodsCross-sectional data from 1031 adolescents (13–18 years) who participated in the population-based British Columbia Adolescent Substance Use Survey in 2012. Regression analysis using interaction terms estimated the associations between social jetlag (using self-reported weekday/weekends sleep times) and odds of SSB intake in girls and boys.ResultsOn average, adolescents reported 1.59 (SD 0.73) hours of social jetlag, but girls had significantly more social jetlag (1.64) than boys (1.52). Most adolescents (84%) reported consuming SSBs, and significantly more boys (87%) than girls (81%); median SSB intake in boys was 1–2 times per week and in girls less than once per week. Significant differences in girls consuming any SSB were seen across levels of social jetlag. The odds of any SSB intake were significantly higher in adolescents with social jetlag between 1 and 2 h [odds ratio (OR): 1.6 (1.14–2.38)] and over 2 h [OR 1.87 (1.11–3.14)], compared with 1 h or less; associations were stronger and only significant in girls.ConclusionsThis study is the first to show social jetlag is a common sleep deficit that is associated with SSB intake in adolescents, particularly among teen girls.
Job satisfaction criteria to improve general practitioner recruitment: a Delphi consensus
Authors: Le Floch Bernard , Bastiaens Hilde , Le Reste Jean-Yves , Nabbe Patrice , Le Floch Perrine , Cam Mael , Montier Tristan , Peremans Lieve 
Published: December 2022

Abstract

Background
The clinical general practitioner (GP) workforce is decreasing. Many studies have analysed the negative aspects of the profession but, few examine the positive aspects and job satisfaction. A European collaborative group including 8 participating countries recently conducted a qualitative study to analyse the positive factors and found 31 job satisfaction factors.

Objectives
To determine which of these 31 factors are important and applicable to future policies to improve family medicine attractiveness, recruitment, and retention in France.

Method
The Delphi consensus method was chosen. Two Delphi rounds were conducted in March–April 2017 and retained satisfaction factors with at least 70% of scores ≥7. The Nominal Group Technique (NGT) was used to rank these retained factors. Participants assigned 5 points to the factor they considered most important, 3 points to the second, and 1 point to the third. Factors receiving at least 5% (10 points) of the total points (198 points) were included in the final list. The expert panel included GPs and non-GPs.

Results
Twenty-nine experts began the procedure and 22 completed it. Thirty factors were retained after the 2 Delphi rounds. The NGT resulted in 8 factors: (i) Engage in family medicine to take care of the patients; (ii) Care coordination, patient advocacy; (iii) Flexibility in work; (iv) Trying to be a person-centred doctor; (v) Involvement in healthcare organization; (vi) Benefiting from a well-managed practice; (vii) Being a teacher, a trainer; (viii) Efficient professional collaboration.

Conclusion
These 8 job satisfaction factors are important to consider and apply to future policy development.
Bacterial diversity across four drinking water distribution systems in Croatia: impacts of water management practices and disinfection by-products
Authors: Štiglić Jurica , Ujević Bošnjak Magdalena , Héry Marina , Kurajica Livia , Kinsela Andrew S , Casiot Corinne , Capak Krunoslav 
Published: December 2022

Abstract
Several factors may impact bacterial diversity in drinking water distribution systems (DWDSs) including the origin of the raw water, the water treatment technologies, and the disinfection practices applied. 16S rRNA metabarcoding was used for the in-depth characterization of bacterial communities in the four studied Croatian DWDSs (A, B, C, D) two of which had residual disinfectant (A, B) and two were without (C, D), while only B utilized the conventional water treatment technology. Significantly higher diversity and species richness were evidenced in non-disinfected DWDSs (P&lt;0.05) compared to disinfected DWDSs. The phylum Proteobacteria was the most abundant in all the DWDSs, being proportionately higher in non-disinfected systems (P&lt;0.05). The most abundant genera in DWDS-A Mycobacterium and Sphingomonas both positively correlated, whereas Lactobacillus negatively correlated with the concentration of disinfection by-products (DBPs) as a sum of haloacetic acids (HAAs). Conversely, the genus Ralstonia positively correlated with the individual DBP dichloroacetic acid. These results indicate that genera Sphingomonas, Mycobacterium, Lactobacillus, and Ralstonia could have an effect on promoting the formation of DBPs, in a similar manner to how negatively correlated taxa may influence their degradation.
Janthinobacterium kumbetense sp. nov., a violacein-producing bacterium isolated from spring water in Turkey, and investigation of antimicrobial activity of violacein
Authors: INAN BEKTAS Kadriye , Nalcaoglu Aleyna , Kati Hatice , Ceylan Esma , Nalcacioglu Remziye , Belduz Ali Osman , Canakci Sabriye 
Published: December 2022

Abstract
Strain GKT was isolated from the Kumbet plateu of Giresun in Turkey. Phylogenetic analysis based on 16S rRNA gene sequences indicated that strain GKT belonged to genus Janthinobacterium and 16S rRNA gene sequence similarities with all type strains of the genus Janthinobacterium were 98.89%–99.78%. The calculated pairwise average nucleotide identity (ANI) values between strain GKT and all type strains of Janthinobacterium species were in the range of 79.8%–93.2%. In addition, digital DNA–DNA hybridization (dDDH) values were in the range of 23.0%–51.7%. Major fatty acids are C10:03OH, C12:0, C16:1ω7c, C16:0, and C18:1ω7c, and polar lipids included phosphatidylethanolamine, phosphatidylglycerol, also one unidentified phospholipid and one unidentified aminophospholipid. The respiratory quinone of strain GKT was determinated to be Q-8. The genome sizes of strain GKT was 6 197 538 bp with 63.16% G + C ratio. Strain GKT is Gram-stain-negative, aerobic, rod-shaped, and motile. A violet pigment was produced by strain GKT. The crude violacein pigments were separated into two diferent bands on a TLC sheet. Then violacein and deoxyviolacein were purifed by vacuum liquid column chromatography and identifed by NMR spectroscopy. The antimicrobial activities of purifed violacein and deoxyviolacein were screened for seven microorganisms. Based on the results of the morphological, biochemical, physiological, phylogenetic, and genomic characteristics, we propose classifying the strain GKT as representative of a novel species of the genus Janthinobacterium, for which the name Janthinobacterium kumbetense sp. nov. is proposed (GKT = LMG 32662T = DSM 114233T).
Writing and Selfhood in the Pedagogy of Célestin Freinet
Authors: Mason Richard 
Published: December 2022

Abstract

This article explores the relationship between writing and selfhood in the thought and practice of the French pedagogue Célestin Freinet. After setting out the centrality of writing practices to Freinetian pedagogy, the article analyses writing’s conceptual parameters within this context, stressing in particular Freinet’s desire to make the classroom permeable to the outside world, and the vitalist orientation of his approach. Freinet’s educational politics and his iconoclastic attitude towards the orthodoxies of the
école républicaine
led him to refuse the educational and cultural privilege traditionally accorded to writing. In keeping with broader tendencies within the international New Education movement, Freinet prioritized instead a more inclusive notion of expression. This article explores in particular Freinet’s conception of the passage from lived experience to written expression, as well as his promotion of collective expressive practices over individualized models of creativity and authorship. More broadly, the article invites consideration of what examples drawn from the domain of education might have to offer transdisciplinary reflections on the relationship between writing and selfhood.
Daytime Napping and Cognitive Health in Older Adults: A Systematic Review
Authors: Li Junxin , McPhillips Miranda V , Deng Zhongyue , Fan Fangfang , Spira Adam 
Published: December 2022

Abstract

Background
Daytime napping may improve cognitive function in older adults. However, the association can be complicated by specific features of napping and the older adult’s health. This systematic review aims to synthesize the current literature on napping and cognition in older adults and provide recommendations for future research and daytime sleep practice in older adults.

Methods
Systematic searches for relative research published between January 1995 and October 2022 were conducted at PubMed, MEDLINE, PsycINFO, and Google Scholar using keywords individually and in multiple combinations. Manual searches were performed to identify additional studies. All included studies were critically appraised by 2 authors.

Results
Thirty-five studies, including 23 observational and 12 intervention studies, were reviewed. Findings from observational studies suggest a possible inverted U-shaped association between napping duration and cognitive function: short and moderate duration of naps benefited cognitive health in older adults compared with both non-napping and long or extended napping. Findings from intervention studies suggest one session of afternoon napping might improve psychomotor function and working memory, although with some inconsistency. The effect of multiple nap sessions on cognition was inconclusive due to a limited number of studies.

Conclusion
More rigorous research studies are needed to investigate what causes different patterns of daytime napping, the associations between these distinct patterns and cognitive function, and to determine whether interventions targeting napping patterns can improve cognition in older adults. In addition, future research needs to comprehensively assess daytime napping using a combination of measures such as sleep diary and actigraphy.
The Intersectional Impact of Race/Ethnicity and Sex on Access to Technology Among Older Adults
Authors: Suntai Zainab , Beltran Susanny J 
Published: December 2022

Abstract

Background and Objectives
Research on technological access and usage has revealed a digital divide based on several sociodemographic factors, including race/ethnicity, sex, income, and education. While several studies have examined these factors separately, few studies have considered how multiple vulnerable identities may combine to influence access to technology. Using the theory of intersectionality, this study assesses the combined impact of race/ethnicity and sex on access to a working cellphone and a working laptop/computer among U.S. older adults.

Research Design and Methods
Data were derived from the 2018 National Health and Aging Trends Study. Chi-square tests were used to test group differences, and four multivariable logistic regression models were used to examine the association between the intersection of race/ethnicity and sex, and access to a working cellphone and a working laptop/computer.

Results
After accounting for other explanatory variables, White female participants, Black male participants, Black female participants, Hispanic male participants, and Hispanic female participants were all less likely to have a working cellphone or a working laptop/computer compared to White male participants.

Discussion and Implications
The results of this study point to a significant disparity in access to technology based on intersectional identities, with Black and Hispanic female participants having the least access to technology. Interventions aiming to improve access to technology should target these two groups, with a focus on reducing the cost of purchasing technological equipment and the provision of training programs that improve technological skills.