Impact of percutaneous mitral valve repair using the MitraClip™ system on ventricular arrhythmias and ICD therapies

Transcatheter edge-to-edge repair (TEER) using the MitraClip™ device has been established as a suitable alternative to mitral valve surgery in patients with severe mitral regurgitation (MR) and high or prohibitive surgical risk. Only limited information regarding the impact of TEER on ventricular arrhythmias (VA) has been reported. The aim of the present study was to assess the impact of TEER using the MitraClip(TM) device on the burden of VA and ICD (Implantable Cardioverter Defibrillator) therapies. Among 600 MitraClip(TM) implantations performed in our clinic between September 2009 and October 2018, we identified 86 patients with successful TEER and an active implantable cardiac device (pacemaker, ICD, CRT-P/D (Cardiac Resynchronization Therapy-Pacemaker/Defibrillator)) eligible for retrospective VA analyses. These patients presented with mainly functional MR (81.4%) and severely reduced left ventricular ejection fraction (mean LVEF 22.1% ± 10.3%). The observation period comprised 456 ± 313 days before and 424 ± 287 days after TEER. The burden of ventricular arrhythmias (sustained ventricular tachycardia (sVT) and ventricular fibrillation (VF)) was significantly reduced after TEER (0.85 ± 3.47 vs. 0.43 ± 2.03 events per patient per month, p = 0.01). Furthermore, the rate of ICD therapies (anti-tachycardia pacing (ATP) and ICD shock) decreased significantly after MitraClip(TM) implantation (1.0 ± 3.87 vs. 0.32 ± 1.41, p = 0.014). However, reduction of VA burden did not result in improved two-year survival in this patient cohort with severely reduced LVEF. Mitral valve TEER using the MitraClip™ device was associated with a significant reduction of ventricular arrhythmias and ICD therapies

Statins attenuate but do not eliminate the reverse epidemiology of total serum cholesterol in patients with non-ischemic chronic heart failure

© 2017 Elsevier B.V. Background In patients with chronic heart failure (CHF) increasing levels of total serum cholesterol are associated with improved survival – while statin usage is not. The impact of statin treatment on the “reverse epidemiology” of cholesterol is unclear. Methods 2992 consecutive patients with non-ischemic CHF due to left ventricular systolic dysfunction from the Norwegian CHF Registry and the CHF Registries of the Universities of Hull, UK, and Heidelberg, Germany, were studied. 1736 patients were individually double-matched on both cholesterol levels and the individual propensity scores for statin treatment. All-cause mortality was analyzed as a function of baseline cholesterol and statin use in both the general and the matched sample. Results 1209 patients (40.4%) received a statin. During a follow-up of 13,740 patient-years, 360 statin users (29.8%) and 573 (32.1%) statin non-users died. When grouped according to total cholesterol levels as low (≤ 3.6 mmol/L), moderate (3.7–4.9 mmol/L), high (4.8–6.2 mmol/L), and very high ( >  6.2 mmol/L), we found improved survival with very high as compared with low cholesterol levels. This association was present in statin users and non-users in both the general and matched sample (p  <  0.05 for each group comparison). The negative association of total cholesterol and mortality persisted when cholesterol was treated as a continuous variable (HR 0.83, 95%CI 0.77–0.90, p  <  0.001 for matched patients), but it was less pronounced in statin users than in non-users (F-test p  <  0.001). Conclusions Statins attenuate but do not eliminate the reverse epidemiological association between increasing total serum cholesterol and improved survival in patients with non-ischemic CHF

Hantavirus Prevalence in the IX Region of Chile

An epidemiologic and seroprevalence survey was conducted (n=830) to assess proportion of persons exposed to hantavirus in IX Region Chile, which accounts for 25% of reported cases of hantavirus cardiopulmonary syndrome. This region has three geographic areas with different disease incidences and a high proportion of aboriginals. Serum samples were tested for immunoglobulin (Ig) G antibodies by enzyme-linked immunosorbent assay against Sin Nombre virus N antigen by strip immunoblot assay against Sin Nombre, Puumala, Río Mamoré, and Seoul N antigens. Samples from six patients were positive for IgG antibodies reactive with Andes virus; all patients lived in the Andes Mountains. Foresting was also associated with seropositivity; but not sex, age, race, rodent exposure, or farming activities. Exposure to hantavirus varies in different communities of IX Region. Absence of history of pneumonia or hospital admission in persons with specific IgG antibodies suggests that infection is clinically inapparent

Information retrieval and text mining technologies for chemistry

Efficient access to chemical information contained in scientific literature, patents, technical reports, or the web is a pressing need shared by researchers and patent attorneys from different chemical disciplines. Retrieval of important chemical information in most cases starts with finding relevant documents for a particular chemical compound or family. Targeted retrieval of chemical documents is closely connected to the automatic recognition of chemical entities in the text, which commonly involves the extraction of the entire list of chemicals mentioned in a document, including any associated information. In this Review, we provide a comprehensive and in-depth description of fundamental concepts, technical implementations, and current technologies for meeting these information demands. A strong focus is placed on community challenges addressing systems performance, more particularly CHEMDNER and CHEMDNER patents tasks of BioCreative IV and V, respectively. Considering the growing interest in the construction of automatically annotated chemical knowledge bases that integrate chemical information and biological data, cheminformatics approaches for mapping the extracted chemical names into chemical structures and their subsequent annotation together with text mining applications for linking chemistry with biological information are also presented. Finally, future trends and current challenges are highlighted as a roadmap proposal for research in this emerging field.A.V. and M.K. acknowledge funding from the European Community’s Horizon 2020 Program (project reference: 654021 - OpenMinted). M.K. additionally acknowledges the Encomienda MINETAD-CNIO as part of the Plan for the Advancement of Language Technology. O.R. and J.O. thank the Foundation for Applied Medical Research (FIMA), University of Navarra (Pamplona, Spain). This work was partially funded by Consellería de Cultura, Educación e Ordenación Universitaria (Xunta de Galicia), and FEDER (European Union), and the Portuguese Foundation for Science and Technology (FCT) under the scope of the strategic funding of UID/BIO/04469/2013 unit and COMPETE 2020 (POCI-01-0145-FEDER-006684). We thank Iñigo Garciá -Yoldi for useful feedback and discussions during the preparation of the manuscript.info:eu-repo/semantics/publishedVersio

Participatory action research as a means of achieving ecological wisdom within climate change resiliency planning

The impacts of recent extreme weather events as well as the evidence of our changing climate has sparked a new sense of urgency in resiliency planning in the Northeast U.S. Vulnerability to climate change impacts is not limited to the built environment, but rather extends to the sociotechnical systems that include the perceptions, values, preferences and patterns of behavior of various groups of human stakeholders. To more fully incorporate the human dimension into resiliency planning we must elicit and apply the ecological wisdom (EW) of local residents and stakeholders. The complexity of EW has yet to be fully described; this paper does not develop a new definition, but rather, expands the definition of EW to include local knowledge of urban dwellers that can be tapped to more effectively inform resiliency planning. We present a recent example that demonstrates how participatory action research (PAR) methods can be used to gather EW that would not ordinarily be obtained by more traditional vulnerability assessment methods. Our case study is based upon the Alewife Disaster Preparedness and Community Resiliency Planning Initiative of the City of Cambridge, Massachusetts. Despite the limited scope of this PAR project, a surprising number of useful observations and recommendations were obtained, which could serve to enhance the ongoing resiliency planning of the City of Cambridge. Local stakeholders also suggested a number of what W.F. Whyte described as “social inventions” for strengthening the quality of disaster preparedness and community resiliency within the Alewife community. We highlight the need to give more attention to the human dimension of resiliency planning by better understanding how a variety of local stakeholders’ experience climate-related disasters, perceive the effectiveness of alternative disaster preparedness and community resiliency strategies, and determine their willingness to contribute to ongoing resiliency planning taking place within their community