bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contact pathway in surgical and transcatheter aortic valve replacement
Authors: de la Morena-Barrio María Eugenia , Corral Javier , López-García Cecilia , Jiménez-Díaz Víctor Alonso , Miñano Antonia , Juan-Salvadores Pablo , Esteve-Pastor María Asunción , Baz-Alonso José Antonio , Rubio Ana María , Sarabia-Tirado Francisco , García-Navarro Miguel , García-Lara Juan , Marín Francisco , Vicente Vicente , Pinar Eduardo , Cánovas Sergio José , de la Morena Gonzalo 
Published: July 2022

BackgroundAortic valve replacement is the gold standard treatment for severe symptomatic aortic stenosis, but thrombosis of bioprosthetic valves (PVT) remains a concern.ObjectiveTo analyze the factors involved in the contact pathway during aortic valve replacement and to assess their impact on the development of thromboembolic complications.MethodsThe study was conducted in 232 consecutive patients who underwent: transcatheter aortic valve replacement (TAVR, N = 155), and surgical valve replacement (SAVR, N = 77) (MUVITAVI project). Demographic and clinical data, outcomes including a combined end point (CEP) of thrombotic events, and imaging controls were recruited. Samples were collected 24 h before and 48 h after valve replacement. FXII, FXI and (pre)kallikrein were evaluated by Western Blot and specific ELISA with nanobodies.ResultsThe CEP of thrombotic events was reached by 19 patients: 13 patients presented systemic embolic events and 6 patients subclinical PVT. Valve replacement did not cause FXII activation or generation of kallikrein. There was a significant reduction of FXI levels associated with the procedure, which was statistically more pronounced in SAVR than in TAVR. Cases with reductions of FXI below 80% of basal values had a lower incidence of embolic events during the procedure than patients in whom FXI increased above 150%: 2.7 vs. 16.7%; p: 0.04.ConclusionTAVR or SAVR did not significantly activate the contact pathway. A significant reduction of FXI, was observed, particularly in SAVR, associated with lower incidence of thrombotic events. These results encourage evaluating the usefulness and safety of FXI-directed antithrombotic treatments in these patients.
Identifying novel subgroups in heart failure patients with unsupervised machine learning: A scoping review
Authors: Sun Jin , Guo Hua , Wang Wenjun , Wang Xiao , Ding Junyu , He Kunlun , Guan Xizhou 
Published: July 2022

BackgroundHeart failure is currently divided into three main forms, HFrEF, HFpEF, and HFmrEF, but its etiology is diverse and highly heterogeneous. Many studies reported a variety of novel subgroups in heart failure patients, with unsupervised machine learning methods. The aim of this scoping review is to provide insights into how these techniques can diagnose and manage HF faster and better, thus providing direction for future research and facilitating its routine use in clinical practice.MethodsThe review was performed following PRISMA-SCR guideline. We searched the PubMed database for eligible publications. Studies were included if they defined new subgroups in HF patients using clustering analysis methods, and excluded if they are (1) Reviews, commentary, or editorials, (2) Studies not about defining new sub-types, or (3) Studies not using unsupervised algorithms. All study screening and data extraction were conducted independently by two investigators and narrative integration of data extracted from included studies was performed.ResultsOf the 498 studies identified, 47 were included in the analysis. Most studies (61.7%) were published in 2020 and later. The largest number of studies (46.8%) coming from the United States, and most of the studies were authored and included in the same country. The most commonly used machine learning method was hierarchical cluster analysis (46.8%), the most commonly used cluster variable type was comorbidity (61.7%), and the least used cluster variable type was genomics (12.8%). Most of the studies used data sets of less than 500 patients (48.9%), and the sample size had negative correlation with the number of clustering variables. The majority of studies (85.1%) assessed the association between cluster grouping and at least one outcomes, with death and hospitalization being the most commonly used outcome measures.ConclusionThis scoping review provides an overview of recent studies proposing novel HF subgroups based on clustering analysis. Differences were found in study design, study population, clustering methods and variables, and outcomes of interests, and we provided insights into how these studies were conducted and identify the knowledge gaps to guide future research.
Holter-determined arrhythmias in young elite athletes with suspected risk: Insights from a 20-year experience
Authors: Boraita Araceli , Heras María-Eugenia , Valenzuela Pedro L. , Diaz-Gonzalez Leonel , Morales-Acuna Francisco , Alcocer-Ayuga María , Bartolomé-Mateos Sonia , Santos-Lozano Alejandro , Lucia Alejandro 
Published: July 2022

PurposeWe assessed the occurrence of rhythm alterations in elite athletes with suspected risk using Holter monitoring, and the association of Holter-determined rhythm alterations with echocardiographic findings.MethodsA large cohort of Spanish elite athletes (N = 6,579, 34% female) underwent in-depth cardiological examination (including echocardiographic evaluation, and resting and exercise electrocardiogram [ECG]) between 01/02/1998 and 12/31/2018. Holter monitoring was performed in those reporting cardiovascular symptoms, with suspicion of cardiac structural abnormalities potentially associated with dangerous arrhythmias, or with resting/exercise ECG features prompting a closer examination. We assessed the occurrence of cardiac rhythm alterations, as well as the association between echocardiography-determined conditions and rhythm alterations.ResultsMost athletes (N = 5925) did not show any sign/symptom related to arrhythmia (including normal resting and exercise/post-exercise ECG results) whereas 9.9% (N = 654; 28% female; median age, 24 years [interquartile range 19–28]; competition experience [mean ± SD] 10±6 years) met the criteria to undergo Holter monitoring. Among the latter, sinus bradycardia was the most common finding (present in 96% of cases), yet with a relatively low proportion of severe (&lt;30 bpm) bradycardia (12% of endurance athletes during night-time). Premature atrial and ventricular beats were also common (61.9 and 39.4%, respectively) but sinus pauses ≥3 s, high-grade atrioventricular blocks, and atrial fibrillation/flutter were rare (&lt;1%). Polymorphic premature ventricular contractions (PVC, 1.4%) and idioventricular rhythm (0.005%) were also rare. PVC couplets were relatively prevalent (10.7%), but complex ventricular arrhythmias were not frequent (PVC triplets: 1.8%; sustained ventricular tachycardia: 0.0%; and nonsustained ventricular tachycardia: 1.5%). On the other hand, no associations were found between arrhythmias (including their different morphologies) and major cardiac structural alterations (including mitral prolapse). However, an association was found between mild mitral regurgitation and supraventricular (odds ratio 2.61; 95% confidence interval 1.08–6.32) and ventricular (2.80; 1.15–6.78; p = 0.02) arrhythmias, as well as between mild or moderate mitral regurgitation and ventricular arrhythmias (2.49; 1.03–6.01).ConclusionsIrrespective of the sports discipline, “dangerous” ventricular arrhythmias are overall infrequent even among young elite athletes who require Holter monitoring due to the presence of symptoms or abnormal echocardiographic/ECG findings, and do not seem to be associated with underlying serious cardiac structural pathologies.
Pathology-related changes in cardiac energy metabolites, inflammatory response and reperfusion injury following cardioplegic arrest in patients undergoing open-heart surgery
Authors: Skeffington Katie L. , Moscarelli Marco , Abdul-Ghani Safa , Fiorentino Francesca , Emanueli Costanza , Reeves Barnaby C. , Punjabi Prakash P. , Angelini Gianni D. , Suleiman M-Saadeh 
Published: July 2022

IntroductionChanges in cardiac metabolites in adult patients undergoing open-heart surgery using ischemic cardioplegic arrest have largely been reported for non-ventricular tissue or diseased left ventricular tissue, with few studies attempting to assess such changes in both ventricular chambers. It is also unknown whether such changes are altered in different pathologies or linked to the degree of reperfusion injury and inflammatory response. The aim of the present work was to address these issues by monitoring myocardial metabolites in both ventricles and to establish whether these changes are linked to reperfusion injury and inflammatory/stress response in patients undergoing surgery using cold blood cardioplegia for either coronary artery bypass graft (CABG, n = 25) or aortic valve replacement (AVR, n = 16).MethodsVentricular biopsies from both left (LV) and right (RV) ventricles were collected before ischemic cardioplegic arrest and 20 min after reperfusion. The biopsies were processed for measuring selected metabolites (adenine nucleotides, purines, and amino acids) using HPLC. Blood markers of cardiac injury (Troponin I, cTnI), inflammation (IL- 6, IL-8, Il-10, and TNFα, measured using Multiplex) and oxidative stress (Myeloperoxidase, MPO) were measured pre- and up to 72 hours post-operatively.ResultsThe CABG group had a significantly shorter ischemic cardioplegic arrest time (38.6 ± 2.3 min) compared to AVR group (63.0 ± 4.9 min, p = 2 x 10−6). Cardiac injury (cTnI release) was similar for both CABG and AVR groups. The inflammatory markers IL-6 and Il-8 were significantly higher in CABG patients compared to AVR patients. Metabolic markers of cardiac ischemic stress were relatively and significantly more altered in the LV of CABG patients. Comparing diabetic and non-diabetic CABG patients shows that only the RV of diabetic patients sustained major ischemic stress during reperfusion and that diabetic patients had a significantly higher inflammatory response.DiscussionCABG patients sustain relatively more ischemic stress, systemic inflammatory response and similar injury and oxidative stress compared to AVR patients despite having significantly shorter cross-clamp time. The higher inflammatory response in CABG patients appears to be at least partly driven by a higher incidence of diabetes amongst CABG patients. In addition to pathology, the use of cold blood cardioplegic arrest may underlie these differences.
Effects of the Chinese herbal medicine Hong Huang decoction, on myocardial injury in breast cancer patients who underwent anthracycline-based chemotherapy
Authors: Cao Sihan , Xue Jingxian , Chen Lu , Hao Yun , Lu Meijuan , Feng Ming , Wang Huanhuan , Zhou Jun , Yao Chang 
Published: July 2022

ObjectiveTo assess the effects of Hong Huang Decoction (HHD), a Chinese herbal medicine, on myocardial injury in breast cancer patients who underwent anthracycline (ANT)-based chemotherapy.MethodsA total of 51 patients with breast cancer who underwent an ANT-based chemotherapy program and met the inclusion/exclusion criteria were allocated to the treatment or placebo groups using a random number generation process. Patients in the treatment group received liquid HHD twice a day. Treatment was given from 1 day prior to chemotherapy up to the end of chemotherapy (after 6 months). Participants in the placebo group received a placebo over the same schedule. Left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), diagnostic markers of acute myocardial infarction [e.g., lactate dehydrogenase (LDH), creatine kinase-MB (CK-MB), and B-type natriuretic peptide (BNP)], nitric oxide (NO), superoxide dismutase (SOD), as well as pro-inflammatory cytokines [e.g., tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and human C-reactive protein (CRP)], and anti-inflammatory cytokine interleukin-10 (IL-10), were outcome measures assessed before chemotherapy, 3 and 6 months after chemotherapy.ResultsCompared to the placebo group, the GLS value was significantly higher in the treatment group (19.95 ± 1.16 vs. 19.06 ± 1.64, P ≤ 0.001). Significant differences were also noted for levels of SOD (689.71 ± 203.60 vs. 807.88 ± 182.10, P &lt; 0.05), IL-6 (58.04 ± 22.06 vs. 194.20 ± 40.14, P ≤ 0.001), IL-10 (237.90 ± 94.98 vs. 68.81 ± 32.92, P ≤ 0.001), NO (75.05 ± 26.39 vs. 55.83 ± 19.37, P ≤ 0.005), and TNF-α (301.80 ± 134.20 vs. 680.30 ± 199.60, P ≤ 0.001) in the patients before chemotherapy compared to 6 months after initiating chemotherapy.ConclusionHHD regulated the levels of IL-6, IL-10, SOD, NO, and TNF-α. The results demonstrated that GLS is a better indicator of early myocardial injury compared to LVEF, and HHD could modulate oxidative stress to protect against ANT cardio toxicity.Clinical trial registrationChinese Clinical Trial Registry, identifier ChiCTR1900022394. Date of registration: 2019-04-09.
Oral anticoagulant decreases stroke recurrence in patients with atrial fibrillation detected after stroke
Authors: Hsu Jin-Yi , Liu Peter Pin-Sung , Sposato Luciano A. , Huang Huei-Kai , Liu An-Bang , Lai Edward Chia-Cheng , Lin Swu-Jane , Hsieh Cheng-Yang , Loh Ching-Hui 
Published: July 2022

BackgroundAtrial fibrillation detected after stroke (AFDAS) has a lower risk of ischemic stroke recurrence than known atrial fibrillation (KAF). While the benefit of oral anticoagulants (OAC) for preventing ischemic stroke recurrence in KAF is well established, their role in patients with AFDAS is more controversial. This study aimed to evaluate the association between OAC use and the risk of recurrent ischemic stroke in patients with AFDAS in a real-world setting.MethodsThis nationwide retrospective cohort study was conducted using the Taiwan National Health Insurance Research Database. Patients hospitalized with a first-ever ischemic stroke and AFDAS confirmed within 30 days after hospitalization were assigned to OAC and non-OAC cohorts. Inverse probability of treatment weighting was applied to balance the baseline characteristics of the cohorts. The primary outcome was ischemic stroke recurrence. Secondary outcomes were intracranial hemorrhage (ICH), death, and the composite outcome of “ischemic stroke recurrence, ICH, or death.” Multivariate Cox proportional hazard models were used to estimate adjusted hazard ratios (aHR) and 95% confidence intervals (CI).ResultsA total of 4,508 hospitalized patients with stroke and AFDAS were identified. Based on OAC use, 2,856 and 1,652 patients were assigned to the OAC and non-OAC groups, respectively. During the follow-up period (median duration, 2.76 years), the OAC cohort exhibited a lower risk of ischemic stroke recurrence (aHR, 0.84; 95% CI, 0.70–0.99), death (aHR, 0.65; 95% CI, 0.58–0.73), and composite outcome (aHR, 0.70; 95% CI, 0.63–0.78) than did the non-OAC cohort. The risk of ICH (aHR, 0.96; 95% CI, 0.62–1.50) was not significantly different between the two cohorts.ConclusionOAC use in patients with AFDAS was associated with reduced risk of ischemic stroke recurrence, without an increased risk of ICH. This supports current guidelines recommending OACs for secondary stroke prevention in patients with AF, regardless of the time of diagnosis.
Automated analysis of limited echocardiograms: Feasibility and relationship to outcomes in COVID-19
Authors: Pellikka Patricia A. , Strom Jordan B. , Pajares-Hurtado Gabriel M. , Keane Martin G. , Khazan Benjamin , Qamruddin Salima , Tutor Austin , Gul Fahad , Peterson Eric , Thamman Ritu , Watson Shivani , Mandale Deepa , Scott Christopher G. , Naqvi Tasneem , Woodward Gary M. , Hawkes William 
Published: July 2022

BackgroundAs automated echocardiographic analysis is increasingly utilized, continued evaluation within hospital settings is important to further understand its potential value. The importance of cardiac involvement in patients hospitalized with COVID-19 provides an opportunity to evaluate the feasibility and clinical relevance of automated analysis applied to limited echocardiograms.MethodsIn this multisite US cohort, the feasibility of automated AI analysis was evaluated on 558 limited echocardiograms in patients hospitalized with COVID-19. Reliability of automated assessment of left ventricular (LV) volumes, ejection fraction (EF), and LV longitudinal strain (LS) was assessed against clinically obtained measures and echocardiographic findings. Automated measures were evaluated against patient outcomes using ROC analysis, survival modeling, and logistic regression for the outcomes of 30-day mortality and in-hospital sequelae.ResultsFeasibility of automated analysis for both LVEF and LS was 87.5% (488/558 patients). AI analysis was performed with biplane method in 300 (61.5%) and single plane apical 4- or 2-chamber analysis in 136 (27.9%) and 52 (10.7%) studies, respectively. Clinical LVEF was assessed using visual estimation in 192 (39.3%), biplane in 163 (33.4%), and single plane or linear methods in 104 (21.2%) of the 488 studies; 29 (5.9%) studies did not have clinically reported LVEF. LV LS was clinically reported in 80 (16.4%). Consistency between automated and clinical values demonstrated Pearson's R, root mean square error (RMSE) and intraclass correlation coefficient (ICC) of 0.61, 11.3% and 0.72, respectively, for LVEF; 0.73, 3.9% and 0.74, respectively for LS; 0.76, 24.4ml and 0.87, respectively, for end-diastolic volume; and 0.82, 12.8 ml, and 0.91, respectively, for end-systolic volume. Abnormal automated measures of LVEF and LS were associated with LV wall motion abnormalities, left atrial enlargement, and right ventricular dysfunction. Automated analysis was associated with outcomes, including survival.ConclusionAutomated analysis was highly feasible on limited echocardiograms using abbreviated protocols, consistent with equivalent clinically obtained metrics, and associated with echocardiographic abnormalities and patient outcomes.
Effect of switching from cigarette smoking to the use of the tobacco heating system on periodontitis treatment outcome: Periodontal parameter results from a multicenter Japanese study
Authors: Pouly Sandrine , Ng Wee Teck , Blanc Nicolas , Hession Paul , Zanetti Filippo , Battey James N. D. , de La Bourdonnaye Guillaume , Heremans Annie , Haziza Christelle 
Published: July 2022

ObjectivesWe conducted a 6-month randomized clinical study to evaluate the impact of exposure to the aerosol of the Tobacco Heating System (THS), a smoke-free alternative to cigarettes, on changes in periodontal parameters after scaling and root planing (SRP) for periodontitis in subjects who were either continuing to smoke cigarettes or had switched to THS.Material and methodsSmokers with generalized periodontitis were randomized to continue smoking cigarettes or switch to THS use. They underwent SRP for up to 8 weeks, with dental assessments conducted at baseline and at 3 and 6 months after the first treatment.ResultsAfter SRP treatment, all groups showed improvements in the mean full-mouth probing depth (PD), full-mouth clinical attachment level (CAL), gingival inflammation score, plaque control record (PCR), and bleeding on probing (BoP). There were no statistically significant intergroup differences. However, as compared to smokers, THS users showed a trend toward more favorable outcomes in BoP, PCR, and PD improvement at sites with higher initial PD (≥7 mm).ConclusionsOur results indicate that SRP improves the course of periodontitis similarly in cigarette smokers and THS users. The beneficial effects of this treatment might mask the favorable changes that may occur upon modifying one of the several periodontitis risk factors, such as cigarette smoking.Clinical trial registrationClinicalTrials.gov, identifer: NCT03364751.
Lithium Isotope Geochemistry in the Barton Peninsula, King George Island, Antarctica
Authors: Ryu Jong-Sik , Lim Hyoun Soo , Choi Hye-Bin , Kim Ji-Hoon , Kim Ok-Sun , Vigier Nathalie 
Published: July 2022

Lithium (Li) has two stable isotopes, 6Li and 7Li, whose large relative mass difference is responsible for significant isotopic fractionation during physico-chemical processes, allowing Li isotopes to be a good tracer of continental chemical weathering. Although physical erosion is dominant in the Polar regions due to glaciers, increasing global surface temperature may enhance chemical weathering, with possible consequences on carbon biogeochemical cycle and nutriment flux to the ocean. Here, we examined elemental and Li isotope geochemistry of meltwaters, suspended sediments, soils, and bedrocks in the Barton Peninsula, King George Island, Antarctica. Li concentrations range from 8.7 nM to 23.3 μM in waters, from 0.01 to 1.43 ppm in suspended sediments, from 9.56 to 36.9 ppm in soils, and from 0.42 to 28.3 ppm in bedrocks. δ7Li values are also variable, ranging from +16.4 to +41.1‰ in waters, from −0.4 to +13.4‰ in suspended sediments, from −2.5 to +6.9‰ in soils, and from −1.8 to +11.7‰ in bedrocks. Elemental and Li isotope geochemistry reveals that secondary phase formation during chemical weathering mainly control dissolved δ7Li values, rather than a mixing with sea salt inputs from atmosphere or ice melting. Likewise, δ7Li values of suspended sediments and soils lower than those of bedrocks indicate modern chemical weathering with mineral neoformation. This study suggests that increasing global surface temperature enhances modern chemical weathering in Antarctica, continuing to lower δ7Li values in meltwater with intense water-rock interactions.
Establishment of Wind Gust Estimation Equation in Bohai Sea
Authors: Hu Haichuan , Huang Bin , Dai Kan , Qu Hongyu 
Published: July 2022

Wind gusts over the ocean can have a great influence on maritime transport and production operations. However, owing to the scarcity of marine observation data and the complex causes of wind gusts, the estimation and forecasting of gusts at sea are even more difficult. In this study, a gust estimation equation applicable to the Bohai Sea is established based on observation and reanalysis data, with representative observation stations on the coast and offshore in the Bohai Sea. During the process, partial correlation analysis and a significance test of correlation coefficient differences were used to further clarify the influence of average wind speed and vertical wind shear at different heights on wind gusts. The final gust estimation equation includes a mean wind speed term, a turbulence term, and a convection term, which are statistically significant contributors; in addition, there are clear physical meanings. Comparing two gust factor methods in this study, the average errors and fitting errors of the least squares gust estimation equation are the smallest. For wind gusts between 10 and 26 m/s, the fitting error in the gust estimation equation is 7.68–12.25% and 21.10–30.08% lower than those of the two gust factor methods in this study. The gust estimation equation better reflects the difference of wind gusts typical under different average wind speeds and vertical wind shear conditions, so a better prediction for wind gusts can be achieved.