bluuebunny/crossref_metadata_2025_split huggingface dataset:
The operational foundations of PT-symmetric and quasi-Hermitian quantum theory
Authors: Alase Abhijeet , Karuvade Salini , Scandolo Carlo Maria 
Published: May 2022

AbstractPT-symmetric quantum theory was originally proposed with the aim of extending standard quantum theory by relaxing the Hermiticity constraint on Hamiltonians. However, no such extension has been formulated that consistently describes states, transformations, measurements and composition, which is a requirement for any physical theory. We aim to answer the question of whether a consistent physical theory with PT-symmetric observables extends standard quantum theory. We answer this question within the framework of general probabilistic theories, which is the most general framework for physical theories. We construct the set of states of a system that result from imposing PT-symmetry on the set of observables, and show that the resulting theory allows only one trivial state. We next consider the constraint of quasi-Hermiticity on observables, which guarantees the unitarity of evolution under a Hamiltonian with unbroken PT-symmetry. We show that such a system is equivalent to a standard quantum system. Finally, we show that if all observables are quasi-Hermitian as well as PT-symmetric, then the system is equivalent to a real quantum system. Thus our results show that neither PT-symmetry nor quasi-Hermiticity constraints are sufficient to extend standard quantum theory consistently.
RCM approach to the CDE-tricyclic structure of nakiterpiosin
Authors: Matsuyuki Yoe , Fukaya Keisuke , Urabe Daisuke 
Published: May 2022

Abstract
A synthetic approach to the CDE-tricyclic structure of nakiterpiosin, a marine-derived antimitotic C-nor-D-homosteroid, is reported. The trans-disubstituted indanone was synthesized from a commercially available carboxylic acid in 9 steps, and the ring closing metathesis of the indanone constructed the trans-fused 5/6-membered ring system. The present approach enables the concise synthesis of the functionalized CDE-tricyclic structure, which will serve as a synthetic intermediate toward nakiterpiosin.
Evidence of Transmission and Circulation of Deltacron XD Recombinant Severe Acute Respiratory Syndrome Coronavirus 2 in Northwest France
Authors: Moisan Alice , Mastrovito Brice , De Oliveira Fabienne , Martel Mélanie , Hedin Hugues , Leoz Marie , Nesi Nicolas , Schaeffer Justine , Ar Gouilh Meriadeg , Plantier Jean-Christophe 
Published: May 2022

Abstract
In February 2022, samples collected in northwest France showed discordant molecular results. After virological and epidemiological investigations, 17 cases of Deltacron XD recombinant severe acute respiratory syndrome coronavirus 2 were confirmed by sequencing or suspected due to epidemiological links, showing evidence of an extended transmission event and circulation of this form, with low clinical severity.
Persistent methicillin-Resistant Staphylococcus aureus Bacteremia: Resetting the Clock for Optimal Management
Authors: Holland Thomas L , Bayer Arnold S , Fowler Vance G 
Published: May 2022

Abstract
A positive follow-up blood culture for methicillin-resistant Staphylococcus aureus (MRSA) while on seemingly appropriate therapy is a common and ominous development. However, the definition and management of persistent MRSA bacteremia is unstandardized. In this Opinion Paper, we identify the presence of bacteremia for &gt; 1 calendar day as a “worry point” that should trigger an intensive diagnostic evaluation to identify metastatic infection sites. Next, we define the duration of MRSA bacteremia that likely constitutes antibiotic failure and outline a potential management algorithm for such patients. Finally, we propose pragmatic clinical trial designs to test treatment strategies for persistent MRSA bacteremia.
Clinical utility of the SCAI classification in cardiogenic shock patients of any etiology treated by a multidisciplinary team
Authors: Lozano Jimenez S , Hernandez Perez FJ , Escudier Villa JM , Iranzo R , Oteo Dominguez JF , Torres Ramos M , Mitroi C , Rivas Lasarte M , Vieitez JM , Gomez Bueno M , Forteza A , Segovia Cubero J 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
The recently proposed classification of the Society of Cardiovascular Angiography and Interventions (SCAI) stratifies cardiogenic shock (CS) in 5 stages from least to greatest severity (1,2). The aim of this project is to apply the SCAI classification to a cohort of patients in CS and analyze the results among the different stages.

Methods
Retrospective study of CS patients attended by our multidisciplinary team between September 2014-December 2020. The patients were assigned to one of the 5 stages by two independent cardiologists. SCAI subgroups were interpreted considering the recent consensus statement; based on clinical, laboratory, and hemodynamic parameters. In-hospital mortality was the main outcome analyzed.

Results
163 patients were included. Mean age was 55 years (44-62), 76% were male. 9 patients (6%) were assigned to SCAI class C, 55 (34%) D and 99 (61%) in E. There was an almost perfect concordance between the two independent cardiologists when performing the classification (kappa =0.93, p &lt;0.001).
In-hospital mortality was 11%, 31%, and 59% in stages C, D, and E respectively (p &lt;0.001) Figure 1. The SCAI classification had an area under the ROC curve of 0.65 to predict hospital mortality. In the multivariate analysis, SCAI stage E and initial lactate levels were independent predictors of in-hospital mortality.

Conclusion
The SCAI classification is easy to apply in clinical practice and provides a firm prediction of the prognosis of patients in CS. Each SCAI class was significantly associated with the primary endpoint. Its widespread use would allow the optimization of communication between professionals, as well as serve as the basis for the design of future research projects.
Long-term prognostic impact of new-onset atrial fibrillation in patients with preserved and mildly reduced ejection fraction following myocardial infarction
Authors: Savic L , Mrdovic I , Asanin M , Krljanac G , Lasica R , Rajic D , Kastel B 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background/aim
It is well known that atrial fibrillation (AF) significantly increases risk of short- and long-term mortality in patients with ST-elevation myocardial infarction (STEMI), especially in those with reduced left ventricular ejection fraction (EF), but its prognostic impact in patients with STEMI and preserved or mildly reduced EF is not well defined. The aim of this study was to analyse the prognostic impact of new-onset AF on long-term mortality in patients with preserved and mildly reduced EF after STEMI.

Method
we included 1874 consecutive STEMI patients treated with primary percutaneous coronary intervention (pPCI). New-onset AF was defined as electrocardiographic or monitoring evidence of a AF lasting at least 30 seconds in patients with no medical history of previous AF. Echocardiographic examination was performed before discharge, EF was calculated using bi-plane method. Preserved EF was defined as ≥50% and midly reduced EF was defined as EF 41-49%. Patients with cardiogenic shock at admission and patients with previous AF of any form (paroxysmal, persistent or permanent) were excluded. The follow-up period was 6 years.

Results
Among all analysed patients 491 (26.6%) patients were women and 1375 (73.4%) were men. The median age of all analysed patients was 58 (IQR 46, 69) years and median EF was 52% (IQR 45%, 57%). New-onset AF was registered in 78 (4.2%) patients. Among them 27 (34.6%) patients had AF at admission and 51 (65.4%) patients develop AF later at a median time 4 (IQR 1, 25) hours. Median duration of AF was 17 (IQR 6, 25) hours. All of the analyzed patients with new-onset AF were converted into sinus rhythm with medication (amiodarone) or they converted spontaneously upon myocardial revascularization. As compared with patients without AF, those with AF were older and presented more often with Killip class II and III; they had lower systolic blood pressure and creatinine clearance at admission; they had more often 3-vessel coronary artery disease (at initial angiogram), preprocedural flow TIMI=0 and postprocedural flow TIMI&lt;3. EF values were similar among patients with and without AF 50% (IQR 44%, 55%) and 51% (IQR 45%, 55%) respectively, p=0.93. Six-year mortality was significantly higher in patients with new-onset AF as compared with patients without AF (14.1% vs 2.6%, respectively, p&lt;0.001) as shown in Figure 1. In Cox regression model new-onset AF was an independent predictor of 6-year mortality–HR 4.53 (95% CI 2.29-8.94), p&lt;0.001. Other independent predictors for 6-year mortality were older age, Killip class II and III at admission and baseline creatinine clearance &lt;60ml/min/m2.

Conclusion
New-onset AF was a strong indepedent predictor for 6-year mortality in analyzed patients with preserved and mildly reduced EF after STEMI.
A new marker of risk for ischemic events
Authors: Ferraz LM , Faustino A , Carvalho P , Carvalho D , Pacheco A , Viana J , Neves A 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Although dobutamine stress echocardiography (SE) has a high specificity, there is still a subset of patients (P) with false positive tests (FP) and their prognosis remains unclear.

Purpose
To identify the clinical and echocardiographic predictors of FP on SE and to evaluate the prognostic impact of FP on SE.

Methods
Retrospective study of 355 consecutive adult P who underwent SE for ischemia assessment over a one-year period: 134 (37,7%) women, 70,3 ± 0,57 years, body surface area (ASC) 1,85±0,01 cm2. Demographics, risk factors, clinical and laboratorial parameters and SE variables were evaluated. A FP result was defined as a positive SE for ischemia in the absence of ≥50% coronary artery (CA) lesion in a major artery of the corresponding coronary territory on subsequent angiography. P were divided into 2 groups regarding the presence (FP+) or the absence (FP0: 15,5% true positives, 79,7% true negatives, 0,3% false negatives ) of a FP result on SE and a comparative analysis was performed in order to characterize the groups and identify potencial predictors of FP results. P were followed for 2 years to assess acute myocardial infarction (AMI), hospitalization for acute heart failure (HF) and mortality (M).

Results
The FP rate was 4,5% (16P). Comparing to F0, P in group FP+ were younger (65,1±2,4 vs 70,5±0,6 years; p=0,045), baseline wall motion abnormalities were more frequent (75,0% vs 41,6%; p=0,009), had higher mean blood pressure values at rest (99,3±5,4 vs 82,0±1,3 mmHg; p=0,004) and at peak stage (140,3±5,6 vs 102,8±2,3 mmHg; p&lt;0,001) and more often hypertensive response (37,5% vs 7,1%; p&lt;0,001). There were no significant differences regarding previous CA disease, medication or complete left bundle branch block. By multivariate analysis, only mean blood pressure values at rest (OR 0,01; 95%CI 0,005-0,02; p=0,003) and at peak stage (OR 0,02; 95%CI 0,000-0,004; p=0,003) were independente predictors of FP. During follow-up was observed: AMI (FP+: 12,5% vs FP0: 1,8%, p=0,046), HF (FP+: 6,3% vs FP0: 11,5%, p=0,44) and M (FP+: 6,3% vs FP0: 6,2%, p=0,65). After adjustment for age, sex and comorbidities, there were no diferences between the groups regarding HF (p=0,45) and M (p=0,77), but the group FP+ mantained a higher rate of AMI (OR 0,21; 95%CI 0,065-0,354; p=0,005).

Conclusion
A FP result on SE is associated with higher mean blood pressure values during the test and with higher rates of AMI during follow-up. This result on SE should therefore be faced as a risk marker for ischemic events and can identify P that may benefit from aggressive risk factor control and careful clinical follow-up.
New-onset atrial fibrillation predicts poor prognosis in critically ill COVID-19 patients
Authors: Lopes V , Baptista J P , Moreira N , Goncalves L 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background/Introduction
The association between new-onset atrial fibrillation (AF) and prognosis in critically ill non-COVID-19 patients and non-critically ill patients has been studied, but few studies reflect the reality of COVID-19 patients admitted to a general intensive care unit (ICU).

Purpose
This study sought to investigate the relationship between new-onset AF in COVID-19 patients admitted to an ICU and prognosis.

Methods
We retrospectively analyzed patients consecutively admitted to an ICU with COVID-19, with a median follow-up of 10 months. Two groups were identified, with new-onset AF and without new-onset AF. Groups were compared, with special interest regarding ICU mortality, duration of mechanical ventilation, in-hospital diagnosis of heart failure, NT-proBNP value in the first 48 hours after admission, and length of hospitalization. Mortality rate and re-hospitalization during follow-up were compared.

Results
From a total of 219 patients, AF was identified in 17.8% (n=39) of patients, of whom 69.2% (n=27) presented new-onset AF.
Patients with new-onset AF were older (66.4 ±9.0 vs 61.5 ±12.2, p &lt;0.001), with no differences regarding sex distribution. During hospitalization, patients with new-onset AF presented more often with new-onset heart failure (33.3% vs 6.3%, p &lt;0.001), had a longer duration of mechanical ventilation (19.5 ±11 vs 9 ±12 days, p &lt;0.001), longer ICU length of stay (20 ±12 vs 12 ±10 days, p&lt;0.001), higher ICU mortality rate (55.6% vs 29.3%, p=0.006), and higher global mortality (55.6% vs 33.0%, p=0.022). Re-hospitalization rates were similar among groups (7.4% vs 6.3%, p=0.686). NT-proBNP in the first 48 hours was not statistically different among groups, although clinically new-onset AF patients presented higher values [median 1372 (IQR 3664) vs 246 (IQR 893), p=0.455). Main results are presented in Table 1.
In multivariate logistic regression, after adjustment for age and APACHE II score, new-onset AF was identified as an independent predictor of ICU mortality (OR=2.475, 95% CI 1.05-5.84, p=0.039).

Conclusion(s)
The present study shows that new-onset AF in critically ill patients is not a trivial phenomenon and is closely related to the risk of death and worse in-hospital outcomes.
Patient characteristics and periprocedural outcomes of percutaneous coronary intervention of the left main coronary artery
Authors: Costa D , Barbosa B , Tapia K , Matsudo M , Dadlicandro A , Acosta MF , Sero B , Sardan O , Rossini A , Notrica M , Muzzio M , Coronel R 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Left main (LM) disease is found in 5 to 6% of all coronary angiograms. Revascularization has a class IA recommendation, but the choice of the revascularization method whether by coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) is currently under debate. The selection depends on patient’s characteristics (age, sex, comorbidities, frailty), as well as anatomical considerations.
We aim to describe the patients with LM disease that were treated with PCI and report their short-term outcomes in a tertiary center.

Methods
Single-center retrospective study including all patients who underwent LM PCI from 2013 to 2019. The basal characteristics were retrieved from the electronic medical records. Acute kidney injury was defined as an absolute increase in serum creatinine of ≥ 0.3 mg/dL or ≥ 1.5-fold from baseline. Type IVa myocardial infarction was assessed by the Third Universal Definition.

Results
A total of 110 procedures were performed during the study period (table 1). Most of the patients were male, with a median age of 61 years. A considerable number of patients showed a reduced ejection fraction (41.2%). The left main lesions were most frequently distal and associated with left anterior descending artery disease. Radial access was used in a minority of cases (33.6%), although most were IVUS-guided (93.6%). Complete revascularization was achieved in 55.5%. The number of procedures over time is depicted in figure 1.
There was only 1 death (0.9%) during index hospitalization. There was a high incidence of type IVa myocardial infarction (19.1%) and acute kidney injury (10%), and a low incidence of TIMI major bleeding (1.8%).

Conclusion
Current practice shows an increase of left main PCI over time, particularly from 2016, after the EXCEL trial results were published. This can be due to improved technical aspects such as IVUS guidance, which was used in most patients. Noticeable, almost half of the patients had a reduced ejection fraction.
Although there was a very low short-term mortality associated with the procedure (1%), as well as a low bleeding risk (4.8%), there was a high incidence of type IVa myocardial infarction (20.2%). Only 55.5% archived a complete revascularization. Despite promising immediate results in clinical practice, long term follow up will be essential to determine the future role of left main PCI.
Clinical outcomes and predictors of acute cerebrovascular strokes after coronary artery bypass graft surgery
Authors: Laimoud M , Maghirang M , Alanazi M , Al-Mutlaq S , Althibait S , Alanazi B , Alhalees Z 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Coronary artery bypass graft (CABG) surgery still carries a significant risk acute cerebrovascular stroke despite advances in anesthetic, surgical and medical managements.

Objective
To study the risk factors and get the predictors of acute stroke after CABG and study the clinical outcomes during hospitalization and follow up.

Methods
This retrospective study included 410 patients who underwent CABG at our tertiary care hospital from January 2016 to August 2020. The patients were divided into two groups according to the occurrence of acute cerebrovascular stroke.

Results
The study included 410 patients with a median age of 60(55-68) years with a male predominance (82.2%). Thirty-one (7.5%) patients developed strokes after CABG. The stroke group had significantly higher initial sequential organ failure assessment (SOFA) score [ 3(2-4) vs. 2(1-3), p=0.002], SOFA after 48 hours [5(1-7) vs. 1(0-2), p&lt;0.001], higher peak blood lactate level [12.5(7.6-14.7) vs. 5.1(3.7-8.5),p&lt;0.001], longer ICU stay [11(6-42) vs. 4(3-5), p&lt;0.001], more ventilator days [10(2-32) vs. 1(1-2), p&lt;0.001], more tracheostomies (38.7 vs. 0, p&lt;0.001) ,longer post ICU ward stay [11(2-57) vs. 5(3-7), p=0.015] and greater hospital mortality (25.8 vs. 0.8, p&lt;0.001) compared to the non-stroke group respectively. Both groups showed insignificant mortality during a follow up period of 41.5(26.5-54.5) months. Multivariate regression revealed that early hospital stroke was independently predicted with carotid artery disease (OR:8.22, 95%CI:2.92-23.1, p&lt;0.001), CPB time (OR:5.64, 95%CI:1.97-16.11, p&lt;0.001), initial SOFA score (OR:1.643, 95%CI:1.194-2.26, p=0.002), prior stroke (OR:4.412, 95%CI:1.286-15.14, p=0.018), postoperative new AF (OR: 3.014, 95%CI:1.158-7.84, p=0.024) and CKD (OR:1.28,95%CI:1.05-3.75, p=0.017). Late cerebrovascular stroke was independently predicted with CAD (OR:9.38, 95%CI:3.72-23.66, p&lt;0.001), postoperative AF (OR: 2.35,95%CI:1.0125-5.41, p=0.016), prior stroke (OR:3.725,95%CI:1.179-11.768, p=0.025), CABG plus valve surgery (0R:7.44, 95%CI:2.75-20.145, p&lt;0.001), HBA1c (OR:1.431, 95%CI:1.071-1.914, p=0.016) and CKD (OR:2.33, 95%CI:1.056-5.165, p=0.036).

Conclusion
Acute cerebrovascular stroke is a serious complication after CABG and associated with increased mortality, longer hospital stays with multiple morbidities and resources consumption. Appropriate assessment and management of carotid artery disease, and post-operative atrial fibrillation should be routinely implemented to reduce the risk of early and late strokes in patients undergoing CABG.
What is the clinical benefit of left main coronary artery treatment by percutaneous coronary intervention?
Authors: Costa H , Fernandes R , Mota T , Santo ME , Palmeiro H , Bispo J , Carvalho D , Guedes J , Mimoso J , Vinhas H , Jesus I 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
The treatment of choice of left main coronary artery (LMCA) disease has been subject to intense debate and investigation in the last decade. More recent studies showed benefit of percutaneous coronary intervention (PCI) in patients with less complex coronary anatomy. Although it is not the standard treatment, the use of this technique has been increasing.

Objectives
Characterize the patient population undergoing LMCA PCI and analyze its clinical benefit. Also, try to identify patient profiles according to the composite outcome (angor, heart failure symptoms (HF), myocardial infarction (MI) or death) in short and medium term (30 days (D) and 180D).

Methods
Observational and retrospective study of patients submitted to LMCA PCI, between 1 January 2019 and 31 December 2020. A descriptive analysis was carried out. Chi-Square test was used for categorical variables and the T-Student test for numerical variables, with a significance level of 95%. CHIAD algorithm was applied to identify patient profiles – composite outcome was the dependent variable (fixed 15 parent nodes and 5 children nodes). For statistical analysis, SPSS 24.0 was used.

Results
N120 patients, mean age of 70,4 years (standard deviation of 10.8), 76% were male. 81.7% had multivessel disease, with LMCA-anterior descendig artery injury being the most frequent (31.7%). The average LVEF was 49%. The complication rate was 15.8%, most vessel dissections. The most serious complications (cardio-respiratory arrest and cardiogenic shock) occurred in 0.8% of cases. The composite outcome occurred in 25,2% (30D) and 13,3% (180D), regardless of past medical history and number/type of vessels affected. The presence of angor was 9.9% (30D) and 1.3% (180D); HF symptoms in 13.5% (30D) and 4.8% (180D); MI in 2.7% (30D) and 1.2% (180D) and mortality in 2.7% (30D) and 2.4% (180D). In a logic of dependence and profiles, patients with LVEF [45-55%] (95.6%-p=0.003) who treated the lesions in first intention (AdHoc) (100%-p=0.009) presented fewer occurrences at 30D. Patients with occurrences at 30D (65.2%-p=0.001) or without PV of LVEF (66.7%-p = 0.016) and dyslipidemia (53.8%-p = 0.027) were those with most occurrences at 180D.

Conclusion
This analysis highlights the experience of the angiography laboratory. The majority of patients experienced evident clinical improvement and recovered in shortand medium term. The rate of serious events was low. The analysis suggests that the greatest benefit were found in the profile of patients with LVEF [45-55%] with an AdHoc approach.