bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term incidence of cardiac device complications with intrathoracic versus extrathoracic venous access: results from the PLACE (Planning Lead Access for Cardiac Electrostimulation) study
Authors: Ghiglieno C , Dell’ Era G , Palmisano P , Floris R , Pimpini L , Coluccia G , Delogu G , Colombo C , Marconetto C , De Zan G , D’amico A , Mazzoleni F , Patti G 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Optimal venous access is crucial in successful cardiac device implantation. Most commonly used accesses are subclavian or axillary vein puncture and cephalic vein cutdown. The extrathoracic access has the advantage of reducing the risk of pneumothorax and lead disfunction; thus, this approach is recommended as the first choice approach.

Purpose
The aim of our retrospective registry was to evaluate the incidence of long-term device complications (pneumothorax, lead rupture or displacement, hematoma, infection or bleeding) with different venous approaches in four high-volume centers in Italy.

Methods
We collected data from implantation and device complications during follow up using available electronic records from each center.

Results
We included 4443 patients, mean age 73±11 years. Median follow up was 118 months (IC range 59-198 months). The incidence of any complication was 7.7 %, without difference between intrathoracic and extrathoracic access (7.8% vs 7.7% respectively, p=0.70). However, lead rupture was more frequent in the intrathoracic group (5.3% vs 1.4%, p=0.04).

Conclusion
In experienced, high-volume centers, the use of intrathoracic vein puncture in the case of unsuitable extrathoracic access may represent a safe alternative of venous access in patients undergoing cardiac device implantation, although associated with a higher occurrence of lead rupture.
Cardiac surgery in cardiac implantable electronic device patients and risk of device infections: a nationwide nested case-control study
Authors: Frausing MARIA , Nielsen JC , Johansen JB , Jorgensen OD , Kristensen J , Olsen T , Gerdes C , Kronborg MB 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Karen Elise Jensen’s Foundation

Background
Cardiac surgery in patients with cardiac implantable electronic devices (CIEDs) has been associated with a higher risk of infective endocarditis, but how it influences risk of CIED-specific infections is not known.

Purpose
To examine risk of systemic CIED infections after cardiac surgery in patients with CIEDs.

Methods
Based on data obtained from Danish administrative registries and the Danish Pacemaker and ICD Register, we conducted a case-control study nested within a nationwide cohort of patients who underwent a de novo CIED implantation in Denmark between 1998-2017. Patients entered the study at six months after implantation. We defined cases as incident systemic CIED infections resulting in device system extraction. Controls were sampled 1:100 on age, sex and follow-up time using risk set sampling. Exposure was defined as coronary artery bypass graft (CABG)-, or cardiac heart valve replacement- or repair surgery.

Results
From a study cohort comprising 67,621 patients, we identified 170 cases and 16,966 controls. In the minimally adjusted model, the incidence rate ratio (IRR) for systemic CIED infection was 6.4 (95% confidence interval (CI) 3.9-17.1) with cardiac surgery, and after confounder adjustment, 7.0 (95% CI 4.1-11.9). IRRs were higher when exposure was restricted to heart valve replacement surgery (adjusted IRR (aIRR) 9.7, 95% CI 5.2-17.8), and when limiting our exposure time window to one year (aIRR 12.7, 95% CI 5.8-27.8).

Conclusion
Cardiac surgery in patients with de novo CIEDs was associated with a high risk of systemic CIED infections. Highest risk was observed after heart valve replacement surgery, and within the first year of surgery.
Smartwatch-based detection of atrial arrhythmia using a deep neural network in a tertiary care hospital
Authors: Fiorina L , Lefebvre B , Gardella C , Henry C , Coquard C , Younsi S , Ait Said M , Salerno F , Horvilleur J , Lacotte J , Mannenti V 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background/Introduction
Smartwatch electrocardiograms (SW ECG) have been identified as a promising noninvasive solution to assess heart rhythm abnormalities, especially atrial arrhythmias (AA) which includes atrial fibrillation, atrial flutter and supraventricular tachycardia. This study evaluates the performance of the detection of AA with a smartwatch and compares the accuracy of two algorithms, the latest version of the original companion application (Apple ECG 2.0 App) and a novel deep neural network (DNN), in a population typical of an electrophysiology department.

Purpose
Determine if a novel DNN can improve the detection of AA on SW ECG in a tertiary care hospital.

Methods
101 patients from the electrophysiology department of one tertiary center were included in this ongoing study. Three simultaneous ECGs were collected for each patient: one 12-lead ECG (Mindray BeneHeart R12) and two SW ECGs (Apple Watch) taken from the left wrist (SWw ECG) and the lower left abdomen (SWa ECG). 12-lead ECGs were adjudicated by a blinded expert electrophysiologist as 52 AA and 49 not AA and considered as gold standard. The SW ECGs were processed by the ECG 2.0 App and the DNN in parallel. The proportions of inconclusive diagnoses returned and the performances were assessed and compared.

Results
Overall, the ECG 2.0 App yielded inconclusive diagnoses for 19% (19/101) of all SWw ECGs while the DNN reduced that number to 0% (0/101). A similar result holds for SWa ECGs (Figure 1). Regarding the detection of AA from SWw ECGs, the ECG 2.0 App had a sensitivity of 81% (95% CI, 67%-90%), a specificity of 97% (95% CI, 87%-100%) and an accuracy of 89% (95% CI, 80%-94%) while the DNN had a sensitivity of 92% (95% CI, 82%-97%), a specificity of 90% (95% CI, 78%-96%) and an accuracy of 91% (95% CI, 84%-95%). For SWa ECGs (Figure 2), the sensitivity of the DNN was found significantly higher compared to the ECG 2.0 App: 96% (95% CI, 89%-98%) vs 76% (95% CI, 61%-87%). Conclusion(s): A novel DNN algorithm decreased the number of inconclusive diagnostics in the detection of AA from SW ECG from around 20% to 0%, which could help limit the overreading time spent by the physicians. Excluding inconclusive diagnostics, we observed no significant difference in performance between the two algorithms except for the sensitivity for SW ECG taken from the abdomen where the DNN outperforms the ECG 2.0 App. Routine application of this SW ECG analysis in tertiary care hospitals offers significant promise in arrhythmia diagnosis.
FIND-AF: a widely applicable artificial intelligence algorithm to target systematic screening for atrial fibrillation in older individuals through primary care electronic health records
Authors: Wu J , Nadarajah R , Raveendra K , Cowan JC , Gale CP 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): British Heart Foundation

Background
Systematic screening for atrial fibrillation (AF) in people ≥75 years of age can improve detection rates, anticoagulant prescription and clinical outcomes but is inefficient.(1) A large proportion of European populations are registered in primary care with a routinely-collected electronic health record (EHR).(2) An algorithm embedded in this system to identify people at higher risk of incident AF could facilitate targeted AF screening.

Purpose
To develop and internally validate a widely-applicable artificial intelligence (AI) algorithm for predicting incident AF in people ≥75 years of age using primary care EHRs.

Methods
We identified people who were ≥75 years of age (1998 – 2018), in the nationwide Clinical Practice Research Datalink (CPRD)-GOLD primary care EHR dataset and followed them until a diagnosis of AF, or withdrawal from CPRD, or 6 months. Each subject had 81 features including age, sex, ethnicity and comorbidities. Algorithms developed with random forest (RF) and multivariable logistic regression (MLR), were compared by area under receiver operating curve (AUROC) and the proportion of patient EHRs to which the algorithms could be applied

Results
440,000 patients were studied, with 3922 occurrences of AF. The RF algorithm achieved an AUROC of 0.77 after 10 fold cross-validation, 12% better than the MLR algorithm (0.68). Notably the RF algorithm could be applied to all EHRs. At 75% sensitivity, the RF algorithm would reduce the potential number needed to screen for one new case of AF to 11, an improvement of over 6-fold compared to using age alone.

Conclusions
This study showed a novel AI algorithm that can be widely applied in nationwide European primary care EHRs to target screening for AF in a population that derives clinical benefit.
The in-ear region as a novel anatomical site for ecg signal detection: validation study on patients affected by atrial tachyarrhythmias
Authors: De Lucia R , Zucchelli G , Della Volpe S , Fiorentini F , Parollo M , Giannotti Santoro M , Barletta V , Canu A , Mazzocchetti L , Bongiorni MG 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Purpose
Early detection of cardiac arrhythmias is a major opportunity for mobile health, as portable devices nowadays available can detect multiple-lead electrocardiogram (ECG). The study aims to validate the in-ear region as a new anatomical site for ECG signal detection in patients (pts) affected by atrial tachyarrhythmias.

Methods
We performed the ECG using KardiaMobile 6L device on 20 patients affected by tachyarrhythmias and admitted to our hospital for electrical cardioversion. All the digital ECGs were detected in a modified modality or using the left in-ear region instead of the right hand. All the recorded ECGs were analyzed by the device and the results checked by two cardiologists.

Results
We successfully collected all 20 modified digital ECGs performed on the group of 20 pts (age 68.4 ± 9.2 years; male 60%; 14pts in atrial fibrillation (AF); 6pts in atrial flutter (AFl); medium HR 94±28.4bpm; 65% affected by hypertension; 5% affected by diabetes mellitus; 95% in NOACs).
In case of AF, the KardiaMobile 6L diagnosis of the ECG detected by this modified modality was correct in 100% of cases. In the 6 pts affected by AFl the KardiaMobile 6L diagnosis was "normal" in 3 cases and "not classified" in the other 3. For that reason, in these 6 pts, we performed a new digital ECG using the KardiaMobile 6L in the standard modality, and the diagnosis for each patients was the same.

Conclusion
The in-ear region could be a reliable novel anatomical site for ECG signal detection in patients affected by atrial fibrillation. Further studies are needed to overcome the misdiagnosis of digital ECG in case of patients affected by atrial flutter. These data support the development of new portable ECG devices using the left in ear region and so leaving at least one hand free.
Magnetic field interactions of smartwatches and portable electronic devices with cardiovascular implantable electronic devices
Authors: Badertscher P , Vergne C , Fery C , Spies F , Schlageter V , Mannhart D , Quirin T , Kuehne M , Sticherling C , Pascal J , Knecht S 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Magnetic interference of portable electronic devices (PEDs), such as state-of-the-art mobile phones, with cardiovascular implantable electronic devices (CIEDs) has been reported.

Purpose
The aim of the study was to quantify the magnetic fields of latest generation Smartwatches and other PEDs and to evaluate and predict their risk of CIED interactions.

Method
High resolution magnetic field characterization of five smartwatches able to record an ECG Apple Watch, Series 6 and 7, Fitbit Sense, Samsung Galaxy Watch 3, and Withings Move ECG Watch was performed using a magnetic field camera consisting of 1024 calibrated three axis Hall sensors. Maximal distance of 1 mT (10 Gauss) field strength and 1 mT volume was calculated. Ex vivo measurements of the minimal safety distance (MSD) at which no mode switch can be observed between six representative CIEDs and the PEDs was performed. Results were compared to other PEDs, such as digital pens, headsets and their cases, and a Smartphone.

Result
Maximal 1 mT distances ranged between 10 mm and 19 mm, and 1 mT volumes between 6 cm3 and 19 cm3. The smartwatches and PEDs with measured 1 mT distance 15 mm (B: Microsoft surface pen, C: Airpods Pro case) showed device interaction up to &gt; 15 mm (Figure). Linear regression analysis showed an inverse linear relationship of the MSD with 1 mT distance (B coefficient: 0.459; 95% CI: 0.246-0.672; p&lt;0.001) but not with the volume (p=0.842)

Conclusions
Standardized measurements of the 1 mT field distance and volume is feasible and has the potential to assess the risk of CIED interaction. Smartwatches seem to be safe in contrast to other PEDs such as the Microsoft surface pen or Airpods Pro case with high 1mT volumes and maximal distances with regards to CIED interaction.
The impact of atrial fibrillation and atrial tachycardias on the hemodynamic status of patients with pulmonary hypertension
Authors: Dusik M , Fingrova Z , Marek J , Dytrych V , Jansa P , Havranek S 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Supported by Ministry of Health, Czech Republic – conceptual development of research organization (General University Hospital in Prague – VFN, 00064165)

Introduction
Atrial fibrillation and atrial tachycardias (AF/AT) have been reported as a common condition in patients with pulmonary hypertension (PH). The presence of arrhythmia in patients with PH leads to increased morbidity and mortality. The significance and possibilities of AF/AT treatment in patients with PH is still being discussed. The aim of this study is to evaluate the effect of acute heart rhythm change on hemodynamical parameters in PH patients with AF/AT being treated by catheter ablation.

Methods
We performed an analysis of hemodynamic parameters and their changes in relation to the present heart rhythm. The study group consisted of 11 PH patients with AF/AT (6 males, median age (IQR) 72 (53;76) years) and was compared with a control group of 9 patients with AF/AT without PH or other structural heart disease (5 males, 56 (49;62) years). The data was acquired during the catheter ablation procedure using a Swan-Ganz catheter.

Results
PH patients had higher mean pressures (median; IQR; mmHg) in the right ventricle (31 (24;32) vs. 23 (18;25), p&lt;0.05) and in the pulmonary artery (36 (30;37) vs. 22 (19;25), p&lt;0.05) compared to the control group. Other parameters were comparable. There was a significant decrease of the left atrial pressure in the presence of arrhythmia in the PH group compared to the left atrial pressure change in the control group (p&lt;0.05). The changes of the remaining hemodynamic parameters did not differ significantly between the groups. There was no significant difference in cardiac output in sinus rhythm and AF/AT in both groups. The detailed results are presented in the table below.

Conclusion
The left atrial pressure in PH patients changes significantly according to the actual heart rhythm. The acute impact of AF/AT on the other hemodynamical parameters, including cardiac output, has not been proven.
Genomics of Diversification of Pseudomonas aeruginosa in Cystic Fibrosis Lung-like Conditions
Authors: Schick Alana , Shewaramani Sonal , Kassen Rees 
Published: May 2022

Abstract
Pseudomonas aeruginosa is among the most problematic opportunistic pathogens for adults with cystic fibrosis (CF), causing repeated and resilient infections in the lung and surrounding airways. Evidence suggests that long-term infections are associated with diversification into specialized types but the underlying cause of that diversification and the effect it has on the persistence of infections remains poorly understood. Here, we use evolve-and-resequence experiments to investigate the genetic changes accompanying rapid, de novo phenotypic diversification in lab environments designed to mimic two aspects of human lung ecology: spatial structure and complex nutritional content. After ∼220 generations of evolution, we find extensive genetic variation present in all environments, including those that most closely resemble the CF lung. We use the abundance and frequency of nonsynonymous and synonymous mutations to estimate the ratio of mutations that are selectively neutral (hitchhikers) to those that are under positive selection (drivers). A significantly lower proportion of driver mutations in spatially structured populations suggests that reduced dispersal generates subpopulations with reduced effective population size, decreasing the supply of beneficial mutations and causing more divergent evolutionary trajectories. In addition, we find mutations in a handful of genes typically associated with chronic infection in the CF lung, including one gene associated with antibiotic resistance. This demonstrates that many of the genetic changes considered to be hallmarks of CF lung adaptation can arise as a result of adaptation to a novel environment and do not necessarily require antimicrobial treatment, immune system suppression, or competition from other microbial species to occur.
Black hole spin measurements based on a thin disc model with finite thickness – I. An example study of MCG−06-30-15
Authors: Jiang Jiachen , Abdikamalov Askar B , Bambi Cosimo , Reynolds Christopher S 
Published: May 2022

ABSTRACT
We present a re-analysis of the XMM–Newton and NuSTAR observing campaigns for the well-studied, X-ray-bright AGN MCG−06-30-15. In particular, we consider a disc model with finite thickness. By fitting the disc reflection spectra in the data, we obtain a black hole spin of 0.87–0.99 (90 per cent confidence range) after taking the thickness of the disc into consideration. Spectral models with a grid of mass accretion rate from 0 to $30{{\,\rm per\,cent}}\,\dot{M}_{\rm Edd}$ are calculated for MCG−06-30-15. This result is obtained by considering a free disc reflection fraction parameter frefl and is consistent with previous measurements based on razor-thin disc models. Besides, an isotropic, point-like geometry, i.e. the ‘lamppost’ geometry, is assumed for the corona in our model. We find that such a geometry overestimates frefl in the data. Therefore, thin disc models with consistent ‘lamppost’ values of frefl provide a worse fit than ones with a free frefl parameter. We discuss possible reasons for the discrepancy between the observed and theoretical values of frefl at the end of the paper. Modifications for the over-simplified lamppost model might be needed when the thickness of the thin disc is considered in future work.
A puzzle solved after two decades: SN 2002gh among the brightest of superluminous supernovae
Authors: Cartier Régis , Hamuy Mario , Contreras Carlos , Anderson Joseph P , Phillips Mark M , Morrell Nidia , Stritzinger Maximilian D , Hueichapan Emilio D , Clocchiatti Alejandro , Roth Miguel , Thomas-Osip Joanna , González Luis E 
Published: May 2022

ABSTRACT
We present optical photometry and spectroscopy of the superluminous SN 2002gh from maximum light to +204 d, obtained as part of the Carnegie Type II Supernova (CATS) project. SN 2002gh is among the most luminous discovered supernovae ever, yet it remained unnoticed for nearly two decades. Using Dark Energy Camera archival images we identify the potential supernova (SN) host galaxy as a faint dwarf galaxy, presumably having low metallicity, and in an apparent merging process with other nearby dwarf galaxies. We show that SN 2002gh is among the brightest hydrogen-poor SLSNe with MV = −22.40 ± 0.02, with an estimated peak bolometric luminosity of 2.6 ± 0.1 × 1044 erg s−1. We discount the decay of radioactive nickel as the main SN power mechanism, and assuming that the SN is powered by the spin-down of a magnetar we obtain two alternative solutions. The first case, is characterized by significant magnetar power leakage, and Mej between 0.6 and 3.2 M⊙, Pspin = 3.2 ms, and B = 5 × 1013 G. The second case does not require power leakage, resulting in a huge ejecta mass of about 30 M⊙, a fast spin period of Pspin ∼ 1 ms, and B ∼ 1.6 × 1014 G. We estimate a zero-age main-sequence mass between 14 and 25 M⊙ for the first case and of about 135 M⊙ for the second case. The latter case would place the SN progenitor among the most massive stars observed to explode as an SN.
The impact of 17O + α reaction rate uncertainties on the s-process in rotating massive stars
Authors: Frost-Schenk J , Adsley P , Laird A M , Longland R , Angus C , Barton C , Choplin A , Diget C Aa , Hirschi R , Marshall C , Portillo Chaves F , Setoodehnia K 
Published: May 2022

ABSTRACT
Massive stars are crucial to galactic chemical evolution for elements heavier than iron. Their contribution at early times in the evolution of the Universe, however, is unclear due to poorly constrained nuclear reaction rates. The competing 17O(α, γ)21Ne and 17O(α, n)20Ne reactions strongly impact weak s-process yields from rotating massive stars at low metallicities. Abundant 16O absorbs neutrons, removing flux from the s-process, and producing 17O. The 17O(α, n)20Ne reaction releases neutrons, allowing continued s-process nucleosynthesis, if the 17O(α, γ)21Ne reaction is sufficiently weak. While published rates are available, they are based on limited indirect experimental data for the relevant temperatures and, more importantly, no uncertainties are provided. The available nuclear physics has been evaluated, and combined with data from a new study of astrophysically relevant 21Ne states using the 20Ne(d, p)21Ne reaction. Constraints are placed on the ratio of the (α, n)/(α, γ) reaction rates with uncertainties on the rates provided for the first time. The new rates favour the (α, n) reaction and suggest that the weak s-process in rotating low-metallicity stars is likely to continue up to barium and, within the computed uncertainties, even to lead.