bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of risk prediction models applied to longitudinal electronic health record data for the prediction of major cardiovascular events in the presence of data shifts
Authors: Li Yikuan , Salimi-Khorshidi Gholamreza , Rao Shishir , Canoy Dexter , Hassaine Abdelaali , Lukasiewicz Thomas , Rahimi Kazem , Mamouei Mohammad 
Published: October 2022

AbstractAimsDeep learning has dominated predictive modelling across different fields, but in medicine it has been met with mixed reception. In clinical practice, simple, statistical models and risk scores continue to inform cardiovascular disease risk predictions. This is due in part to the knowledge gap about how deep learning models perform in practice when they are subject to dynamic data shifts; a key criterion that common internal validation procedures do not address. We evaluated the performance of a novel deep learning model, BEHRT, under data shifts and compared it with several ML-based and established risk models.Methods and resultsUsing linked electronic health records of 1.1 million patients across England aged at least 35 years between 1985 and 2015, we replicated three established statistical models for predicting 5-year risk of incident heart failure, stroke, and coronary heart disease. The results were compared with a widely accepted machine learning model (random forests), and a novel deep learning model (BEHRT). In addition to internal validation, we investigated how data shifts affect model discrimination and calibration. To this end, we tested the models on cohorts from (i) distinct geographical regions; (ii) different periods. Using internal validation, the deep learning models substantially outperformed the best statistical models by 6%, 8%, and 11% in heart failure, stroke, and coronary heart disease, respectively, in terms of the area under the receiver operating characteristic curve.ConclusionThe performance of all models declined as a result of data shifts; despite this, the deep learning models maintained the best performance in all risk prediction tasks. Updating the model with the latest information can improve discrimination but if the prior distribution changes, the model may remain miscalibrated.
Long-term results of a stented bioprosthetic valve in the aortic position: structural valve deterioration and valve haemodynamic deterioration of bovine pericardial and porcine valves
Authors: Jung Yoo Jin , Choi Jae Woong , Kang Yoonjin , Kim Ji Seong , Sohn Suk Ho , Hwang Ho Young , Kim Kyung Hwan 
Published: October 2022

AbstractOBJECTIVESThis study compared the clinical outcomes of bovine and porcine bioprosthetic valves based on structural valve deterioration (SVD) and valve haemodynamic deterioration (VHD) in the aortic position.METHODSFrom January 1995 to December 2014, patients who underwent aortic valve replacement (AVR) using a bovine pericardial valve or porcine valve were enrolled. SVD and VHD were defined according to the mean transprosthetic gradient and the grade of aortic regurgitation on transthoracic echocardiography. The propensity score matching was used to adjust for differences in preoperative and operative characteristics.RESULTSA total of 520 patients were enrolled. Of these, 372 patients underwent AVR using a bovine pericardial valve and 148 patients underwent AVR using a porcine valve. Then, 135 pairs of patients were extracted after propensity score matching. The median follow-up duration was 8.2 years (interquartile range, 5.4–11.3). Among the matched patients, no significant differences occurred in overall survival (survival at 10 years: 64.7% vs 70.9%) or cardiac death (cumulative incidence at 10 years: 14.2% vs 13.1%) between the 2 groups. The cumulative incidence of moderate or greater SVD and VHD was significantly higher in the porcine valve group than in the bovine valve group (SVD at 10 years—porcine: 29.8% vs bovine: 13%; VHD at 10 years—porcine: 19.8% vs bovine: 3.8%, respectively). However, no significant differences were noted in the cumulative incidence of severe SVD and severe VHD between the 2 groups.CONCLUSIONSThe bovine pericardial valve should be considered in AVR because the cumulative incidences of moderate or greater SVD and VHD were significantly lower than those of the porcine valve.
Thoracoscopic trans-mitral myectomy for hypertrophic obstructive cardiomyopathy: a retrospective single-centre study
Authors: Wei Peijian , Ma Jiexu , Tan Tong , Zhu Wei , Yuan Haiyun , Zhuang Jian , Liu Jian , Guo Huiming 
Published: October 2022

Abstract

OBJECTIVES
Transaortic myectomy is a common procedure for patients with hypertrophic obstructive cardiomyopathy. Thoracoscopic trans-mitral myectomy has been described in a few small-sample studies and has been recommended as preferable. We herein report our clinical outcomes using the thoracoscopic trans-mitral approach with 76 patients.

METHODS
This is a retrospective single-centre analysis of the safety and efficacy of thoracoscopic trans-mitral myectomy by comparing the clinical outcomes with that of transaortic myectomy.

RESULTS
Between April 2019 and October 2021, 132 patients underwent either a transaortic (n = 56) or a thoracoscopic trans-mitral myectomy (n = 76). Compared with those in the transaortic group, patients in the trans-mitral group were more likely to be weaned off the ventilator within 24 h after surgery (80.3% vs 60.7%, P &lt; 0.05) and to require a shorter duration of ventilation [29.01 (43.91) vs 51.12 (94.96) h, P = 0.08] and lower transfusion rate (26.3% vs 48.2%, P &lt; 0.05). The in-hospital mortality rate of the transaortic and trans-mitral groups was 3.6% (n = 2) and 1.3% (n = 1), respectively. No significant inter-group differences were observed regarding in-hospital mortality, the incidence of low cardiac output syndrome or permanent pacemaker implantations. In the trans-mitral group, the thickness of the interventricular septum was significantly reduced postoperatively, with resultant relief of the left ventricular outflow tract obstruction [89.37 (27.5) vs 10.51 (0.65) mmHg, P &lt; 0.01]. Transaortic myectomy also resulted in a significant reduction in left ventricular outflow tract gradient [90.41 (33.31) vs 11.35 (9.43) mmHg, P &lt; 0.01]. And the incidence of residual systolic anterior motion of the trans-mitral group and the transaortic group was 2.67% and 1.9%, respectively.

CONCLUSIONS
The thoracoscopic trans-mitral approach provides excellent exposure to the septum and anomalies of the mitral valve and papillary muscle. It relieves obstruction effectively, without increasing the incidence of major complications.
Antimicrobial resistance pattern, virulence determinants and molecular analysis of carbapenem-resistant Klebsiella pneumoniae isolated from clinical samples in Iran
Authors: Ghamari Mahsa , Beigverdi Reza , Jabalameli Fereshteh , Emaneini Mohammad 
Published: October 2022

Abstract
Carbapenem-resistant Klebsiella pneumoniae (CRKP) has emerged as an important global threat in recent years. The objective of the present study was to characterize the molecular characteristics, antibiotic resistance pattern and the distribution of virulence factors in CRKP isolated from different clinical specimens. A total of 60 clinical CRKP isolates were collected from clinical samples. Based on Clinical Laboratory Standards Institute guidelines, antimicrobial susceptibility testing was assessed by the disk diffusion method. Carbapenem and aminoglycoside resistance determinants in addition to virulence genes were inspected by PCR. Molecular characteristics of CRKP isolates were analyzed by random amplified polymorphic DNA (RAPD) PCR and enterobacterial repetitive intergenic consensus (ERIC) PCR. All isolates were resistant to imipenem, meropenem, cefoxitin, levofloxacin, cefotaxime, ceftazidime and ciprofloxacin. Resistance to tetracycline, gentamicin and kanamycin were detected in 53%, 75% and 72% of isolates, respectively. The most common carbapenem resistance genes were OXA-48 (28.5%) and NDM (22%). The most common aminoglycosides resistance genes were aac6´Ib (57%) and aac(3)-IVa (28%). The most prevalent virulence genes were mrkD (82%), entB (62%) and ybts (58%). ERIC and RAPD analyses revealed 55 and 53 different patterns of CRKP isolates, respectively. We conclude that CRKP infections have been associated with different genotypes and that the carbapenemase type (OXA-48) and AME gene (aac6´-Ib) were widely distributed in CRKP isolates in our hospital. Continued compliance with existing phenotypes and genotypes, and strict enforcement of infection control guidelines, are recommended approaches for the prevention and dissemination of these strains.
Adoption and scale-up of the cardiovascular Polypill: a realist institutional analysis
Authors: Abimbola Seye , Liu Hueiming 
Published: October 2022

AbstractEfforts to promote the adoption and scale-up of health system innovations must contend with the existing institutional context. But there are no commonly used frameworks to ensure that the insights of actors involved in such institutional efforts connect to one another. To test and modify a potential framework—the ‘four-by-four’ framework—we interviewed researcher-entrepreneurs involved in the unfolding story of the cardiovascular Polypill. The framework has four types/levels of institutions that affect adoption and scale-up: (1) informal institutions (L1, e.g. social norms), (2) formal institutions (L2, e.g. government policies and regulation), (3) organizational structures (L3, e.g. organizational boards and mission) and (4) everyday exchange (L4, e.g. service delivery), vis-à-vis four potential entrepreneurial strategies in response: (1) abide by existing institutions, (2) evade them, (3) alter them and/or (4) exit entrepreneurial action. Using this framework, we conducted a realist-informed analysis to understand how context (i.e. institutions) and mechanism (i.e. entrepreneurial strategies) influence each other to shape outcomes (i.e. adoption and scale-up). We found that researcher-entrepreneurs began with efforts to abide with existing institutions but encountered institutional obstacles at each level. Efforts to abide were followed by seeking to evade and/or alter unfavourable institutions, with greater success evading and/or altering lower (L3 and L4) than upper (L1 and L2) institutions. Exit considerations followed the failure of the evade or alter strategy. Shifts between strategies were propelled by ‘learning’. The ‘four-by-four’ framework can be used as a scaffold to generate narratives of adoption or scale-up efforts, a sensitizing tool to prospectively map out contingencies and a matrix to synthesize narratives and experiences across multiple innovations or settings. Used in these ways, the ‘four-by-four’ framework can help to optimize the transferability and cumulation of insights on how to promote the adoption and scale-up of health system innovations.
An RSV Live-Attenuated Vaccine Candidate Lacking G Protein Mucin Domains Is Attenuated, Immunogenic, and Effective in Preventing RSV in BALB/c Mice
Authors: Roe Molly K , Perez Maria A , Hsiao Hui-Mien , Lapp Stacey A , Sun He-Ying , Jadhao Samadhan , Young Audrey R , Batista Yara S , Reed Ryan C , Taz Azmain , Piantadosi Anne , Chen Xuemin , Liang Bo , Koval Michael , Snider Timothy A , Moore Martin L , Anderson Evan J , Anderson Larry J , Stobart Christopher C , Rostad Christina A 
Published: October 2022

Abstract

Background
Respiratory syncytial virus (RSV) is a leading viral respiratory pathogen in infants. The objective of this study was to generate RSV live-attenuated vaccine (LAV) candidates by removing the G-protein mucin domains to attenuate viral replication while retaining immunogenicity through deshielding of surface epitopes.

Methods
Two LAV candidates were generated from recombinant RSV A2-line19F by deletion of the G-protein mucin domains (A2-line19F-G155) or deletion of the G-protein mucin and transmembrane domains (A2-line19F-G155S). Vaccine attenuation was measured in BALB/c mouse lungs by fluorescent focus unit (FFU) assays and real-time polymerase chain reaction (RT-PCR). Immunogenicity was determined by measuring serum binding and neutralizing antibodies in mice following prime/boost on days 28 and 59. Efficacy was determined by measuring RSV lung viral loads on day 4 postchallenge.

Results
Both LAVs were undetectable in mouse lungs by FFU assay and elicited similar neutralizing antibody titers compared to A2-line19F on days 28 and 59. Following RSV challenge, vaccinated mice showed no detectable RSV in the lungs by FFU assay and a significant reduction in RSV RNA in the lungs by RT-PCR of 560-fold for A2-line19F-G155 and 604-fold for A2-line19F-G155S compared to RSV-challenged, unvaccinated mice.

Conclusions
Removal of the G-protein mucin domains produced RSV LAV candidates that were highly attenuated with retained immunogenicity.
Outcomes among patients admitted for non-ST-segment myocardial infarction in the pre-pandemic and pandemic COVID-19 era: Israel Nationwide study
Authors: Asher Elad , Fardman Alexander , Shmueli Hezzy , Orvin Katia , Oren Daniel , Kofman Natalia , Mohsen Jameel , Moady Gassan , Taha Louay , Rubinshtein Ronen , Azriel Osherov , Efraim Roi , Saleem Dabbah , Taieb Philippe , Ben-assa Eyal , Cohen Tal , Klempfner Robert , Orlev Amir , Beigel Roy , Segev Amit , Matetzky Shlomi 
Published: October 2022

AbstractBackgroundSince the beginning of the coronavirus disease 2019 (COVID-19) pandemic in 2019, several countries have reported a substantial drop in the number of patients admitted with non-ST-segment myocardial infarction (NSTEMI).ObjectiveWe aimed to evaluate the changes in admissions, in-hospital management and outcomes of patients with NSTEMI in the COVID-19 era in a nationwide survey.MethodA prospective, multicenter, observational, nationwide study involving 13 medical centers across Israel aimed to evaluate consecutive patients with NSTEMI admitted to intensive cardiac care units over an 8-week period during the COVID-19 outbreak and to compare them with NSTEMI patients admitted at the same period 2 years earlier (control period).ResultsThere were 624 (43%) NSTEMI patients, of whom 349 (56%) were hospitalized during the COVID-19 era and 275 (44%) during the control period. There were no significant differences in age, gender and other baseline characteristics between the two study periods. During the COVID-19 era, more patients arrived at the hospital via an emergency medical system compared with the control period (P = 0.05). Time from symptom onset to hospital admission was longer in the COVID-19 era as compared with the control period [11.5 h (interquartile range, IQR, 2.5–46.7) vs. 2.9 h (IQR 1.7–6.8), respectively, P &lt; 0.001]. Nevertheless, the time from hospital admission to reperfusion was similar in both groups. The rate of coronary angiography was also similar in both groups. The in-hospital mortality rate was similar in both the COVID-19 era and the control period groups (2.3% vs. 4.7%, respectively, P = 0.149) as was the 30-day mortality rate (3.7% vs. 5.1%, respectively, P = 0.238).ConclusionIn contrast to previous reports, admission rates of NSTEMI were similar in this nationwide survey during the COVID-19 era. With longer time from symptoms to admission, but with the same time from hospital admission to reperfusion therapy and with similar in-hospital and 30-day mortality rates. Even in times of crisis, adherence of medical systems to clinical practice guidelines ensures the preservation of good clinical outcomes.
Digital Histological Study of Neocortical Grey and White Matter Tau Burden Across Tauopathies
Authors: Coughlin David G , Hiniker Annie , Peterson Claire , Kim Yongya , Arezoumandan Sanaz , Giannini Lucia , Pizzo Donald , Weintraub Daniel , Siderowf Andrew , Litvan Irene , Rissman Robert A , Galasko Douglas , Hansen Lawrence , Trojanowski John Q , Lee Edward , Grossman Murray , Irwin David 
Published: October 2022

Abstract
3R/4R-tau species are found in Alzheimer disease (AD) and ∼50% of Lewy body dementias at autopsy (LBD+tau); 4R-tau accumulations are found in progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). Digital image analysis techniques can elucidate patterns of tau pathology more precisely than traditional methods but repeatability across centers is unclear. We calculated regional percentage areas occupied by tau pathological inclusions from the middle frontal cortex (MFC), superior temporal cortex (STC), and angular gyrus (ANG) from cases from the University of Pennsylvania and the University of California San Diego with AD, LBD+tau, PSP, or CBD (n = 150) using QuPath. In both cohorts, AD and LBD+tau had the highest grey and white matter tau burden in the STC (p ≤ 0.04). White matter tau burden was relatively higher in 4R-tauopathies than 3R/4R-tauopathies (p &lt; 0.003). Grey and white matter tau were correlated in all diseases (R2=0.43–0.79, p &lt; 0.04) with the greatest increase of white matter per unit grey matter tau observed in PSP (p &lt; 0.02 both cohorts). Grey matter tau negatively correlated with MMSE in AD and LBD+tau (r = −4.4 to −5.4, p ≤ 0.02). These data demonstrate the feasibility of cross-institutional digital histology studies that generate finely grained measurements of pathology which can be used to support biomarker development and models of disease progression.
Reversible down-regulation of photosystems I and II leads to fast photosynthesis recovery after long-term drought in Jatropha curcas
Authors: Sapeta Helena , Yokono Makio , Takabayashi Atsushi , Ueno Yoshifumi , Cordeiro André M , Hara Toshihiko , Tanaka Ayumi , Akimoto Seiji , Oliveira M Margarida , Tanaka Ryouichi 
Published: October 2022

Abstract
Jatropha curcas is a drought-tolerant plant that maintains its photosynthetic pigments under prolonged drought, and quickly regains its photosynthetic capacity when water is available. It has been reported that drought stress leads to increased thermal dissipation in PSII, but that of PSI has been barely investigated, perhaps due to technical limitations in measuring the PSI absolute quantum yield. In this study, we combined biochemical analysis and spectroscopic measurements using an integrating sphere, and verified that the quantum yields of both photosystems are temporarily down-regulated under drought. We found that the decrease in the quantum yield of PSII was accompanied by a decrease in the core complexes of PSII while light-harvesting complexes are maintained under drought. In addition, in drought-treated plants, we observed a decrease in the absolute quantum yield of PSI as compared with the well-watered control, while the amount of PSI did not change, indicating that non-photochemical quenching occurs in PSI. The down-regulation of both photosystems was quickly lifted in a few days upon re-watering. Our results indicate, that in J. curcas under drought, the down-regulation of both PSII and PSI quantum yield protects the photosynthetic machinery from uncontrolled photodamage.
Star formation quenching in the infall region around galaxy clusters
Authors: Salerno Juan Manuel , Muriel Hernán , Coenda Valeria , Cora Sofía A , Pereyra Luis , Ruiz Andrés N , Vega-Martínez Cristian A 
Published: October 2022

ABSTRACT
We analyse the connection between the star formation quenching of galaxies and their location in the outskirts of clusters in the redshift range z = [0, 2] by estimating the fraction of red galaxies. More specifically, we focus on galaxies that infall isotropically from those that are infalling alongside filaments. We use a sample of galaxies obtained from the semi-analytical model of galaxy formation sag applied to the MultiDark simulation, mdpl2. In agreement with observational results, we find that the infall regions show levels of star formation that are intermediate between those of galaxies in clusters and in the field. Moreover, we show that, in the redshift range [0–0.85], the quenching of the star formation is stronger in the filamentary region than in the isotropic infall region. We also study the fraction of red galaxies as a function of the normalized distance to the cluster centre and find that, for radii R/R200 &gt; 3, the fraction of red galaxies in the filamentary region is considerably larger than in the isotropic infall region. From the analysis of properties of the main progenitors of galaxies identified at z = 0, we find that they have different evolutionary behaviours depending on the stellar mass and environment. Our results confirm the observational findings that suggest that the infall regions of clusters play an important role in the pre-processing of galaxies along most of the evolutionary history of galaxies.
A compact symmetric ejection from the low mass AGN in the LINER galaxy NGC 4293
Authors: Yang Xiaolong , Wang Ruiling , Guo Quan 
Published: October 2022

ABSTRACT
We conducted a Very Long Baseline Array (VLBA) observation of the low mass active galactic nucleus (AGN) in galaxy NGC 4293 (z = 0.003). The object is associated with a low-ionization nuclear emission-line region (LINER). Its black hole mass is estimated as ∼105 or ${\sim}10^7 \, \mathrm{M}_\odot$. The VLBA 1.5 GHz image shows an inverse symmetric structure with two discrete radio blobs separated by an angular distance of ∼120 mas, corresponding to ∼7 parsec. Furthermore, its integrated radio spectrum has a turnover at the frequency of ∼0.44 GHz. Based on the compactness and spectrum, the nuclear radio source in NGC 4293 belongs to a sample of (megahertz) peaked spectrum (PS/MPS) radio sources with compact symmetric morphologies. NGC 4293 has 1.4 GHz radio power of only ${\sim}10^{20}\, \mathrm{W\, Hz^{-1}}$ with the VLBA observation, which is consistent with local AGNs but lower than the current PS samples. One of the two blobs has a steep radio spectrum α = −0.62 ± 0.08 (Sν ∝ ν+α), while the other one has an inverted spectrum α = 0.32 ± 0.10. The VLBA 1.5 GHz luminosity ratio of the two blobs is 3.23 and both blobs show lateral-flowing structures where the hotspots reside at the edge of each radio lobe. This can be explained as jet interactions with dense circumnuclear medium. We estimate the black hole mass of NGC 4293 through the Fundamental Plane of black hole activity, which constrains the black hole mass to be ${\lesssim}10^6\, \mathrm{M}_\odot$. It supports that the object is a low-mass AGN and a potential candidate for accreting and ejecting IMBHs.