Predictors of Adherence to Stroke Prevention in the BALKAN-AF Study:A Machine-Learning Approach

Background  Compared with usual care, guideline-adherent stroke prevention strategy, based on the ABC (Atrial fibrillation Better Care) pathway, is associated with better outcomes. Given that stroke prevention is central to atrial fibrillation (AF) management, improved efforts to determining predictors of adherence with ‘A’ (avoid stroke) component of the ABC pathway are needed. Purpose  We tested the hypothesis that more sophisticated methodology using machine learning (ML) algorithms could do this. Methods  In this post-hoc analysis of the BALKAN-AF dataset, ML algorithms and logistic regression were tested. The feature selection process identified a subset of variables that were most relevant for creating the model. Adherence with the ‘A’ criterion of the ABC pathway was defined as the use of oral anticoagulants (OAC) in patients with AF with a CHA (2) DS (2) -VASc score of 0 (male) or 1 (female). Results  Among 2,712 enrolled patients, complete data on ‘A’-adherent management were available in 2,671 individuals (mean age 66.0 ± 12.8; 44.5% female). Based on ML algorithms, independent predictors of ‘A-criterion adherent management’ were paroxysmal AF, center in capital city, and first-diagnosed AF. Hypertrophic cardiomyopathy, chronic kidney disease with chronic dialysis, and sleep apnea were independently associated with a lower likelihood of ‘A’-criterion adherent management. ML evaluated predictors of adherence with the ‘A’ criterion of the ABC pathway derived an area under the receiver-operator curve of 0.710 (95%CI 0.67–0.75) for random forest with fine tuning. Conclusions  Machine learning identified paroxysmal AF, treatment center in the capital city, and first-diagnosed AF as predictors of adherence to the A pathway; and hypertrophic cardiomyopathy, chronic kidney disease with chronic dialysis, and sleep apnea as predictors of non adherence

GABA-Producing Natural Dairy Isolate From Artisanal Zlatar Cheese Attenuates Gut Inflammation and Strengthens Gut Epithelial Barrier in vitro

Probiotic bacteria are recognized for their health-promoting properties, including maintenance of gut epithelial integrity and host immune system homeostasis. Taking into account the beneficial health-promoting effects of GABA, the presence of the gadB gene, encoding glutamate decarboxylase that converts L-glutamate to GABA, was analyzed in Lactic Acid Bacteria (LAB) natural isolates from Zlatar cheese. The results revealed that 52% of tested Lactobacillus spp. and 8% of Lactococcus spp. isolates harbor the gadB gene. Qualitative and quantitative analysis of GABA production performed by thin-layer chromatography (TLC) and high-performance liquid chromatography (HPLC) revealed the highest GABA production by Lactobacillus brevis BGZLS10-17. Since high GABA-producing LAB natural isolates are the most valuable source of naturally produced GABA, the probiotic properties of BGZLS10-17 were characterized. This study demonstrated high adhesion of BGZLS10-17 strain to Caco-2 cells and the ability to decrease the adhesion of Escherichia coli ATCC25922 and Salmonella enterica C29039. Treatment of differentiated Caco-2 cells monolayer with BGZLS10-17 supernatant containing GABA alleviated inflammation (production of IL-8) caused by IL-1β and significantly stimulated the expression of tight junction proteins (zonulin, occludin, and claudin 4), as well as the expression of TGF-β cytokine leading to the conclusion that immunosuppression and strengthening the tight junctions can have significant role in the maintenance of intestinal epithelial barrier integrity. Taken together the results obtained in this study support the idea that using of GABA producing BGZLS10-17 probiotic strain could be a good strategy to modulate immunological response in various inflammatory diseases, and at the same time, it could be a good candidate for adjunct starter culture for production of GABA-enriched dairy foods and beverages offering new perspectives in designing the novel functional foods

Adherence to the 4S-AF Scheme in the Balkan region:insights from the BALKAN-AF survey

BackgroundThe 4S-AF scheme includes stroke risk, symptoms, severity of burden, and substrate severity domain.AimWe aimed to assess the adherence to the 4S-AF scheme in patients classified according to stroke risk in post hoc analysis of the BALKAN-AF dataset.MethodsA 14-week prospective enrolment of consecutive patients with electrocardiographically documented atrial fibrillation (AF) was performed in seven Balkan countries from 2014 to 2015.ResultsLow stroke risk (CHA2DS2-VASc score, 0 in males or 1 in females) was present in 162 (6.0%) patients. 2 099 (77.4%) patients had CHA2DS2-VASc score ≥3 in females or ≥2 in males (high stroke risk), and 613 (22.6%) had CHA2DS2-VASc score ConclusionsOAC overuse was observed in patients with low stroke risk, whilst OAC underuse was evident in those with high risk of stroke. The percentage of highly symptomatic patients with high risk of stroke who were offered a rhythm control strategy was low

Antithrombotic therapy in patients with atrial fibrillation and acute coronary syndrome and / or undergoing percutaneous coronary intervention

The use of triple antithrombotic therapy (TAT) consisting of an oral anticoagulant (OAC), aspirin, and a P2Y12 inhibitor in patients with atrial fibrillation (AF) and acute coronary syndrome (ACS) and / or undergoing percutaneous coronary intervention (PCI) is associated with a high risk of bleeding. Recently, several randomized clinical trials tested the hypothesis as to whether dual antithrombotic therapy (DAT) regimens (consisting of an OAC and a single antiplatelet drug) may be safer in terms of bleeding events as compared with TAT. They also investigated the role of non–vitamin K antagonist oral anticoagulants (NOACs) as a part of DAT and TAT. The purpose of this review is to provide an overview of available evidence regarding the safety and efficacy of DAT compared with TAT regimens, international guidelines recommendations, knowledge gaps, and unmet needs in the management of patients with AF and ACS and / or undergoing PCI

Influence of Pr3+ and CO32- Ions Coupled Substitution on Structural, Optical and Antibacterial Properties of Fluorapatite Nanopowders Obtained by Precipitation

Coupled substitution of fluorapatite (FAP) crystal lattice plays an important role in the engineering of optically active nanomaterials. Uniform fluorapatite nanopowders doped with praseodymium (Pr3+) and carbonate (CO32-) ions have been successfully synthesized by precipitation method under room temperature (25 degrees C). The structural, morphological, chemical and optical properties of monophase material were characterized by X-ray diffraction (XRD), Fourier Transform Infrared and Far Infrared Spectroscopy (FTIR and FIR, respectively), Scanning Electron Microscopy with Energy Dispersive Spectroscopy (SEM/EDS), Transmission Electron Microscopy (TEM) and Photoluminescence Spectroscopy (PL). Coupled substitution of FAP crystal lattice with Pr3+ and CO32- reduces the crystallite size with a constant c/a ratio of 1.72. FTIR study showed that synthesized nanopowders were AB-type CO32- substitution, and FIR study revealed new Pr-O vibrations. TEM analysis was found that synthesized nanopowders were composed of irregular spheres in the nanometer range. The fluorescence of FAP nanoparticles was in the violet-blue region of the visible part of the spectrum. When Pr3+ was doped in a lattice, the violet-blue emission becomes sharper due to reabsorption. MCR-ALS analyses of fluorescence spectra indicated the shift of the maximum to the blue color with the increase in the concentration of Pr3+ ions. Additionally, luminescent nanopowders demonstrated significant antibacterial activity against Escherichia coli. As the obtained nanoparticles showed a good absorption of ultraviolet A light and reabsorption of blue-green luminescence, they are suitable for further development of optically active nanomaterials for light filtering. Optically active PrCFAP nanopowders with antibacterial properties may be promising additives for the development of multifunctional cosmetic and health care products

AV in DH: State of the Field

This presentation was created in the Fall semester of 2017 while the author served as an intern in the Office of Digital Research and Scholarship at Florida State University, where he researched the ways in which audio-visual media was being utilized in digital humanities projects. Offering a kind of "state of the field," this presentation summarizes the key issues associated with this kind of work while providing an overview of several projects, platforms, and tools used in digital humanities projects dealing with audio-visual materials and collections