513 results on '"Siva K"'
Search Results
2. Prediction of permanent pacemaker implantation after transcatheter aortic valve replacement: The role of machine learning
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Pradyumna Agasthi, Hasan Ashraf, Sai Harika Pujari, Marlene Girardo, Andrew Tseng, Farouk Mookadam, Nithin Venepally, Matthew R Buras, Bishoy Abraham, Banveet K Khetarpal, Mohamed Allam, Siva K Mulpuru MD, Mackram F Eleid, Kevin L Greason, Nirat Beohar, John Sweeney, David Fortuin, David R Jr Holmes, and Reza Arsanjani more...
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Cardiology and Cardiovascular Medicine - Published
- 2023
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Catalog
3. Subcutaneous implantable cardioverter‐defibrillator noise following left ventricular assist device implantation
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Banveet Kaur Khetarpal, Awad Javaid, Justin Z. Lee, Fred Kusumoto, Siva K. Mulpuru, Dan Sorajja, Yong‐Mei Cha, and Komandoor Srivathsan
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Cardiology and Cardiovascular Medicine - Published
- 2023
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4. <scp>11‐Cl‐BBQ</scp> , a select modulator of <scp>AhR</scp> ‐regulated transcription, suppresses lung cancer cell growth via activation of p53 and <scp> p27 Kip1 </scp>
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Bach D. Nguyen, Brenna L. Stevens, Daniel J. Elson, Darren Finlay, John T. Gamble, Prasad R. Kopparapu, Robyn L. Tanguay, Andrew B. Buermeyer, Nancy I. Kerkvliet, and Siva K. Kolluri
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Cell Biology ,Molecular Biology ,Biochemistry - Published
- 2022
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5. Causes of Early Mortality After Transvenous Lead Removal
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Justin Z. Lee, Min-Choon Tan, Suganya Karikalan, Abhishek J. Deshmukh, Dan Sorajja, Arturo Valverde, Komandoor Srivathsan, Luis Scott, Fred M. Kusumoto, Paul A. Friedman, Samuel J. Asirvatham, Siva K. Mulpuru, and Yong-Mei Cha more...
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Hospitalization ,Heart Failure ,Risk Factors ,Minnesota ,Humans ,Retrospective Studies - Abstract
Recognition of the causes of early mortality (≤30 days) after transvenous lead removal (TLR) is an essential step for the development of quality improvement programs.This study sought to determine the causes of early mortality after TLR and to further understand the circumstances surrounding death after TLR.A retrospective analysis was performed of all patients undergoing TLR from January 1, 2001, to January 1, 2021, at the Mayo Clinic (Rochester, Minnesota; Phoenix, Arizona; and Jacksonville, Florida). Causes of death were identified through a detailed chart review of the electronic health record from within the Mayo Clinic system and outside records when available. The causes of death were further characterized based on whether it was related to the TLR procedure.A total of 2,319 patients were included in the study. The overall 30-day all-cause mortality rate was 3% (n = 69). Among all 30-day deaths, infection was the most common primary cause of death (42%). This was followed by decompensated heart failure (17%), procedure-related death (10%), sudden cardiac arrest (7%), and respiratory failure (6%). The 30-day mortality rate directly due to complications associated with the TLR procedure was 0.3%. One-third of deaths (33%) occurred after discharge from the index hospitalization; among these, 43% were readmitted before their death, 35% died at home or at a nursing facility, and 22% were discharged on comfort care and died in hospice. The main reasons for readmission before death were sepsis and decompensated heart failure.The majority (90%) of 30-day mortality after TLR was not due to complications associated with TLR procedures. The primary causes were infection and decompensated heart failure. This highlights the importance of increased emphasis on postprocedure management of infection and heart failure to reduce postoperative mortality, including after hospital discharge. more...
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- 2022
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6. Experimental investigation of flame height and air entrainment of n-heptane double open pool fires
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Siva K Bathina and Sudheer Siddapureddy
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Control and Systems Engineering ,Electrical and Electronic Engineering ,Instrumentation - Published
- 2022
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7. Adoption of Sustainable Agricultural Practices Among Smallholder Dairy Farmers in Malaysia: Contributing Factors and Smart Farming Prospects
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Thanuja Rathakrishnan, Chubashini Suntharalingamb, Lim Yi Shern, Loong Shih Keng, Lee Hai Yen, Tee Keng Kok, Sathis Sri Thanarajoo, and Siva K Balasundram
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Adoption of Sustainable Agricultural Practices (SAP) among smallholder dairy farmers in developing countries, especially within the Asia Pacific region remains low. This is probably attributable to the fact that psycho-social factors are not considered during the adoption process. The current study was carried out in order to increase the adoption of SAP in Malaysia, by investigating psycho-social factors among dairy farmers. It adopted the enhanced Theory of Planned Behaviour to investigate smallholder dairy farmers’ intention to uptake SAP in Malaysia. This study applied the Partial Least Squares Structural Equation Modelling (PLS-SEM) to model how psycho-social factors influence farmers’ SAP adoption decisions. A key finding of this study was that farmers who are equipped with the right attitude and belief have the ability to adopt SAP and are inclined to adopt SAP in their farms. Hence, it was proposed that a holistic approach is recommended towards formulating policies and drawing intervention strategies that focus on the farmers’ needs and abilities. This would motivate farmers to make choices that would lead to a change of behaviour towards adopting SAP. Additionally, the producer-led approach adopted in this study provided insights into smallholder dairy farmers’ beliefs and behaviour. more...
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- 2022
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8. Cardiac resynchronization therapy response in cardiac sarcoidosis
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Samuel A. Shabtaie, Ojasav Sehrawat, Justin Z. Lee, Yong‐Mei Cha, Siva K. Mulpuru, Narayan G. Kowlgi, Konstantinos C. Siontis, Andrew N. Rosenbaum, John P. Bois, Omar F. AbouEzzeddine, Peter A. Noseworthy, Samuel J. Asirvatham, Christopher V. DeSimone, and Abhishek J. Deshmukh more...
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Heart Failure ,Male ,Sarcoidosis ,Middle Aged ,Defibrillators, Implantable ,Cardiac Resynchronization Therapy ,Myocarditis ,Treatment Outcome ,Physiology (medical) ,Humans ,Female ,Cardiomyopathies ,Cardiology and Cardiovascular Medicine ,Aged ,Retrospective Studies - Abstract
Cardiac sarcoidosis (CS) is a nonischemic cardiomyopathy (NICM) characterized by infiltration of noncaseating granulomas involving the heart with highly variable clinical manifestations that can include conduction abnormalities and systolic heart failure. Cardiac resynchronization therapy (CRT) has shown significant promise in NICM, though little is known about its efficacy in patients with CS.To determine if CRT improved cardiac remodeling in patients with CS.We retrospectively reviewed all patients with a clinical or histological diagnosis of CS who underwent CRT implantation at the Mayo Clinic enterprise from 2000 to 2021. Baseline characteristics, imaging parameters, heart failure hospitalizations and need for advanced therapies, and major adverse cardiac events (MACE) were assessed.Our cohort was comprised of 55 patients with 61.8% male and a mean age of 58.7 ± 10.9 years. Eighteen (32.7%) patients had definite CS, 21 (38.2%) had probable CS, while 16 (29.1%) had presumed CS, and 26 (47.3%) with extracardiac sarcoidosis. The majority underwent CRT-D implantation (n = 52, 94.5%) and 3 (5.5%) underwent CRT-P implantation with 67.3% of implanted devices being upgrades from prior pacemakers or implantable cardioverter defibrillators. At 6 months postimplantation there was no significant improvement in ejection fraction (34.8 ± 10.9% vs. 37.7 ± 14.2%, p = .331) or left ventricular end-diastolic diameter (58.5 ± 10.2 vs. 57.5 ± 8.1 mm, p = .236), though mild improvement in left ventricular end systolic diameter (49.1 ± 9.9 vs. 45.7± 9.9 mm, p .0001). Within the first 6 months postimplantation, 5 (9.1%) patients sustained a heart failure hospitalization. At a mean follow-up of 4.1± 3.7 years, 14 (25.5%) patients experienced a heart failure hospitalization, 11 (20.0%) underwent cardiac transplantation, 1 (1.8%) underwent left ventricular assist device implantation and 7 (12.7%) patients died.Our findings suggest variable response to CRT in patients with CS with no overall improvement in ventricular function within 6 months and a substantial proportion of patients progressing to advanced heart failure therapies. more...
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- 2022
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9. Clinical outcomes and predictors of complications in patients undergoing leadless pacemaker implantation
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Faris Haddadin, Monil Majmundar, Ahmad Jabri, Luke Pecha, Claire Scott, Marilyne Daher, Ashish Kumar, Ankur Kalra, Rand Fram, Farah Haddadin, Soufian Almahameed, Christopher V. DeSimone, Yong-Mei Cha, Siva K. Mulpuru, Kenneth A. Ellenbogen, Mohammad Saeed, Mihail G. Chelu, and Abhishek J. Deshmukh more...
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Adult ,Pacemaker, Artificial ,Treatment Outcome ,Physiology (medical) ,Humans ,Kidney Failure, Chronic ,Arrhythmias, Cardiac ,Equipment Design ,Cardiology and Cardiovascular Medicine ,Pericardial Effusion - Abstract
Leadless pacemakers have emerged as a viable alternative for traditional transvenous pacemakers to reduce the risk of device-related complications.The purpose of this study was to examine the real-world clinical outcomes and complications associated with the implantation of leadless pacemaker devices.Using the National Readmission Database (NRD), we examined patient demographics, and in-hospital and 30-day procedural outcomes after leadless pacemaker implantation from 2016-2018. Our cohort comprised adults (≥18 years) with an ICD-10 procedural code for leadless pacemaker implantation.Our cohort included a total of 7821 patients who underwent leadless pacemaker implantation. Overall immediate procedure-related complications, as defined broadly in this study, occurred in 7.5% of patients. Pericardial effusion without the need for pericardiocentesis occurred in 1.9% of patients, with pericardiocentesis performed in 1.0%. Vascular complications occurred in 2.3% of patients; 0.33% required repair, and device dislodgment occurred in 0.51%. The most significant predictor for procedural complications was end-stage renal disease (odds ratio [OR] 1.65; 95% confidence interval [CI] 1.17-2.32; P = .004), congestive heart failure (OR 1.28; 95% CI 1.01-1.62; P = .04), and coagulopathy (OR 1.77; 95% CI 1.34-2.34; P.001). All-cause readmission occurred in 17.9% of patients within 30 days from device implant, with 1.36% of readmissions being procedure related. At 30 days postimplant and after discharge, 0.25% of patients needed a new pacemaker, and 0.18% had pericardial complications.In our large real-life cohort, we found the rate of serious complications after leadless pacemaker implantation to be relatively low and comparable to prior studies in a high-risk population with multiple comorbid conditions. more...
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- 2022
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10. The cyclin‐dependent kinase inhibitor <scp> p27 Kip1 </scp> interacts with the aryl hydrocarbon receptor and negatively regulates its transcriptional activity
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Daniel J. Elson, Bach D. Nguyen, Rhand Wood, Yi Zhang, Veronica Puig‐Sanvicens, and Siva K. Kolluri
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Structural Biology ,Genetics ,Biophysics ,Cell Biology ,Molecular Biology ,Biochemistry - Published
- 2022
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11. Causes of Early Mortality After Catheter Ablation of Atrial Fibrillation
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Min Choon Tan, Pattara Rattanawong, Suganya Karikalan, Abhishek J. Deshmukh, Komandoor Srivathsan, Luis R. Scott, Christopher J. McLeod, Samuel J. Asirvatham, Peter A. Noseworthy, Siva K. Mulpuru, Yong-Mei Cha, Thomas M. Munger, and Justin Z. Lee more...
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Background: Recognition of the causes of early mortality after atrial fibrillation (AF) catheter ablation is essential for the improvement of patient safety. This study sought to determine the causes of early mortality (≤90 days) after AF ablation. Methods: We performed a retrospective analysis of AF ablation from January 1, 2013, to December 1, 2021 at the Mayo Clinic (Rochester, Phoenix, and Jacksonville). Causes of death were identified through a comprehensive chart review of the electronic health record from within the Mayo Clinic system and outside records when available. Results: A total of 6723 patients were included in the study. The 90-day all-cause mortality rate was 0.22% (n=15). Among all 90-day deaths, majority of the deaths (73.3%) did not have a direct relationship with the procedure. Sudden death was the most common cause of early death (20%), followed by peri-procedural stroke (13%), respiratory failure (13%), atrioesophageal fistula (13%), infection (7%), heart failure (7%), and traumatic brain injury (7%). The 90-day mortality rate directly due to AF ablation procedural complications was 0.06% (n=4). Conclusions: AF ablation procedure has a 90-day mortality of 0.22%, and the most common cause of early mortality was sudden death. The majority (73.3%) of early mortality was not directly associated with a procedural complication, and the mortality rate due to complications associated with the AF ablation procedure was low at 0.06%. Further studies are required to investigate causes and risk factors associated with sudden death in this patient population. more...
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- 2023
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12. Leaders or Followers? A Temporal Analysis of Tweets from IRA Trolls
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Balasubramanian, Siva K., Bilgic, Mustafa, Culotta, Aron, Hemphill, Libby, Nikolich, Anita, and Shapiro, Matthew A.
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Social and Information Networks (cs.SI) ,FOS: Computer and information sciences ,Computer Science - Social and Information Networks ,Information Retrieval (cs.IR) ,Computer Science - Information Retrieval - Abstract
The Internet Research Agency (IRA) influences online political conversations in the United States, exacerbating existing partisan divides and sowing discord. In this paper we investigate the IRA's communication strategies by analyzing trending terms on Twitter to identify cases in which the IRA leads or follows other users. Our analysis focuses on over 38M tweets posted between 2016 and 2017 from IRA users (n=3,613), journalists (n=976), members of Congress (n=526), and politically engaged users from the general public (n=71,128). We find that the IRA tends to lead on topics related to the 2016 election, race, and entertainment, suggesting that these are areas both of strategic importance as well having the highest potential impact. Furthermore, we identify topics where the IRA has been relatively ineffective, such as tweets on military, political scandals, and violent attacks. Despite many tweets on these topics, the IRA rarely leads the conversation and thus has little opportunity to influence it. We offer our proposed methodology as a way to track the strategic choices of future influence operations in real-time., Comment: ICWSM 2022 more...
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- 2022
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13. Early Sensing of Tomato Brown Rugose Fruit Virus in Tomato Plants via Electrical Measurements
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Siva K. Reddy, Gil Ben-Yashar, Yarden Mazal Jahn, Yahav Ben-Shimon, Aviv Dombrovsky, Avital Bechar, and Assaf Ya'akobovitz
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Electrical and Electronic Engineering ,Instrumentation - Published
- 2022
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14. Impact of timing of transvenous lead removal on outcomes in infected cardiac implantable electronic devices
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Justin Z. Lee, Monil Majmundar, Ashish Kumar, Samarthkumar Thakkar, Harsh P. Patel, Dan Sorajja, Arturo M. Valverde, Ankur Kalra, Yong-Mei Cha, Siva K. Mulpuru, Samuel J. Asirvatham, Christopher V. Desimone, and Abhishek J. Deshmukh more...
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Hospitalization ,Pacemaker, Artificial ,Prosthesis-Related Infections ,Physiology (medical) ,Humans ,Electronics ,Cardiology and Cardiovascular Medicine ,Device Removal ,Defibrillators, Implantable ,Retrospective Studies - Abstract
Cardiovascular implantable electronic device (CIED) infections are associated with increased mortality and morbidity.This study sought to evaluate the impact of early vs delayed transvenous lead removal (TLR) on in-hospital mortality and outcomes in patients with CIED infection.Using the nationally representative, all payer, Nationwide Readmissions Database, we evaluated patients undergoing TLR for CIED infection between January 1, 2016, and December 31, 2018. The timing of TLR was determined on the basis of hospitalization days after the initial admission for CIED infection. The impact of early (≤7 days) vs delayed (7 days) TLR on mortality and major adverse events was studied.Of the 12,999 patients who underwent TLR for CIED infection, 8834 (68%) underwent early TLR and 4165 (32%) underwent delayed TLR. Delayed TLR was associated with a significant increase in in-hospital mortality (8.3% vs 3.5%; adjusted odds ratio 1.70; 95% confidence interval 1.43-2.03; P.001). Subgroup analysis of patients with CIED infection and systemic infection showed that delayed TLR in patients with systemic infection was associated with a higher rate of in-hospital mortality compared with early TLR (10.4% vs 7.5%; adjusted odds ratio 1.24; 95% confidence interval 1.04-1.49; P.019). Delayed TLR was also associated with significantly higher adjusted odds of major adverse events and postprocedural length of stay.These data suggest that delayed TLR in patients with CIED infection is associated with increased in-hospital mortality and major adverse events, especially in patients with systemic infection. more...
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- 2022
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15. Magnetic Resonance Imaging in Patients With Temporary Screw-In Pacemakers
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Ikram U. Haq, Kiaran P. McGee, Jeremy D. Collins, Nora E. Olson, Siva K. Mulpuru, Yong-Mei Cha, Paul A. Friedman, and Ammar M. Killu
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- 2023
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16. One-year outcomes of catheter ablation for atrial fibrillation in young patients
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Andrew S. Tseng, Harsh P. Patel, Ashish Kumar, Chinmay Jani, Kirtenkumar Patel, Rahul Jaswaney, Samarthkumar Thakkar, Narayan G. Kowlgi, Sourbha S. Dani, Shilpkumar Arora, Siva K. Mulpuru, Malini Madhavan, Ammar M. Killu, Yongmei Cha, Christopher V. DeSimone, and Abhishek Deshmukh more...
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Cardiology and Cardiovascular Medicine - Abstract
Background Atrial fibrillation (AF) is relatively less frequent in younger patients (age Methods We included all hospitalized patients between 18 and 50 years with a diagnosis of AF from the Nationwide Readmission Database 2016–2017 from the Healthcare Cost and Utilization Project. Demographic and comorbidity data were collected and analyzed. Outcomes assessed included one-year AF readmission rates, all-cause readmission, ischemic stroke, and all-cause mortality. Subgroup analyses were performed for all demographic and comorbidity variables. Results Overall, 52,598 patients (medium age 44, interquartile range 38–48, female 25.7%) were included in the study, including 2,146 (4.0%) who underwent catheter ablation for AF. Patients who underwent catheter ablation had a significantly lower rate of readmission for AF or any cause at one year (adjusted hazard ratios (HR) of 0.52 [95% confidence interval (CI): 0.43–0.63] and HR of 0.81 [95% CI: 0.72–0.89], respectively). There was no difference in 1-year readmission for stroke or all-cause mortality between the two groups. Subgroup analyses showed a consistent reduction in the risk of AF readmission among major demographic and comorbidity subgroups. Conclusion Catheter ablation in young patients with AF was associated with a reduction in 1-year AF related and all-cause readmissions. These data merit further prospective investigation for validation, through dedicated registries and multicenter collaborations to include young AF from diverse population. more...
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- 2023
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17. PO-05-019 WHEN RIGHT IS WRONG: INCIDENCE AND OUTCOMES OF RIGHT BUNDLE BRANCH BLOCK FOLLOWING TRANSCATHETER AORTIC VALVE REPLACEMENT
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Nicholas Y. Tan, Demilade Adedinsewo, Abdallah El Sabbagh, Ahmed Sayed Ahmed, Andrea C. Morales-Lara, Malini Madhavan, Yong-Mei Cha, Siva K. Mulpuru, Mackram F. Eleid, and Ammar M. Killu
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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18. PO-05-009 SAFETY OF MAGNETIC RESONANCE IMAGING IN PATIENTS WITH SURGICALLY IMPLANTED PERMANENT EPICARDIAL LEADS
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YUEDONG MA, Robert E. Jr. Watson, Nora E. Olson, Ulrika M. Birgersdotter-Green, Kavisha Patel, Siva K. Mulpuru, Malini Madhavan, Abhishek J. Deshmukh, Ammar M. Killu, Paul A. Friedman, and Yong-Mei Cha more...
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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19. PO-05-046 TRENDS IN NON-INFECTIOUS CARDIOVASCULAR IMPLANTABLE ELECTRONIC DEVICE COMPLICATIONS OVER THIRTY YEARS: INSIGHTS FROM THE ROCHESTER EPIDEMIOLOGY PROJECT DEVICE REGISTRY
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Gurukripa N. Kowlgi, Vaibhav Vaidya, Mingyan Dai, Rahul Mishra, David Hodge, Abhishek J. Deshmukh, Siva K. Mulpuru, and Yong-Mei Cha
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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20. PO-04-192 RISK FACTORS AND OUTCOMES OF ELECTRICAL STORM AFTER LEFT VENTRICULAR ASSIST DEVICE IMPLANTATION
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Suganya Arunachalam Karikalan, Hicham Z. El Masry, Ammar M. Killu, Abhishek J. Deshmukh, Christopher J. McLeod, Dan Sorajja, Luis R. Scott, Siva K. Mulpuru, Yong-Mei Cha, and Justin Z. Lee
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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21. Post hoc assessment of the relationship among coronary stenosis, electrocardiography, and ventricular function in patients with heart disease
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Kimberly Padawer, Christopher Bitetzakis, Igor Sunjic, Jared Tur, Srinivas M. Tipparaju, Aarti Patel, Nidhi Patel, Wesley Hamlin, Siva K. Kumar, and Edin Sadic
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Male ,Risk ,medicine.medical_specialty ,Post hoc ,Heart disease ,Physiology ,Coronary Artery Disease ,Coronary artery disease ,Electrocardiography ,chemistry.chemical_compound ,Text mining ,Physiology (medical) ,Internal medicine ,Natriuretic Peptide, Brain ,Humans ,Ventricular Function ,Medicine ,In patient ,cardiovascular diseases ,Aged ,Retrospective Studies ,Pharmacology ,Creatinine ,medicine.diagnostic_test ,Ventricular function ,business.industry ,Age Factors ,Coronary Stenosis ,Stroke Volume ,General Medicine ,Middle Aged ,medicine.disease ,chemistry ,Echocardiography ,cardiovascular system ,Cardiology ,Female ,business ,Biomarkers ,Glomerular Filtration Rate - Abstract
Cardiovascular diseases including cardiac arrhythmias lead to fatal events in patients with coronary artery disease; however, clinical associations from echocardiography, electrocardiography (ECG), and biomarkers remain unknown. We sought to identify the factors that may be related to elevated QRS intervals in patients with risk for coronary artery disease. In this study, we performed analysis of clinical data from 503 patients divided into two groups, i.e., patients with either 50% coronary artery stenosis. We further examined patients with elevated ECG parameters such as QRS > 100 ms and QTc > 440 ms. Patients with >50% coronary artery stenosis exhibited significant increases in age, triglycerides, and troponin levels. Further, ECG parameters demonstrated increased QRS and QTc durations, while echocardiographic parameters highlighted a decrease in ejection fraction (EF) and fractional shortening (FS). Patients with QTc > 440 ms exhibited increased brain natriuretic peptide and creatinine levels with a decrease in estimated glomerular filtration rate clearance rates. Patients with QRS > 100 ms had greater left ventricular (LV) mass and LV internal diameter in systole and diastole. Multimodal logistic regression showed significant relation between QTc, age, and creatinine. These findings suggest that patients with significant coronary stenosis may have lower EF and FS with prolonged QRS intervals, demonstrating greater risk for arrhythmic events. more...
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- 2021
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22. Catheter ablation of ventricular tachycardia in patients with postinfarction left ventricular aneurysm
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Konstantinos C. Siontis, Thomas M. Munger, Mustapha Amin, Suraj Kapa, Samuel J. Asirvatham, Abhishek Deshmukh, Ammar M. Killu, Medhat Farwati, Paul A. Friedman, Emilie Hilaire, Yong-Mei Cha, Malini Madhavan, and Siva K. Mulpuru more...
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Male ,medicine.medical_specialty ,Adolescent ,Heart Ventricles ,medicine.medical_treatment ,Myocardial Infarction ,Infarction ,Catheter ablation ,Ventricular tachycardia ,Aneurysm ,Recurrence ,Physiology (medical) ,Internal medicine ,Humans ,Medicine ,cardiovascular diseases ,Myocardial infarction ,Heart Aneurysm ,Aged ,Ejection fraction ,business.industry ,Middle Aged ,medicine.disease ,Treatment Outcome ,Left Ventricular Aneurysm ,Pericardiocentesis ,Catheter Ablation ,Tachycardia, Ventricular ,cardiovascular system ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background While ventricular tachycardia (VT) in the setting of postmyocardial infarction left ventricular aneurysms (LVA) is not uncommonly encountered, there is a scarcity of data regarding the safety, efficacy, and outcomes of ablation of VT in this subset of patients. Methods Our study included consecutive patients aged 18 years or older with postmyocardial infarction LVA who presented to Mayo Clinic for catheter ablation of VT between 2002 and 2018. Results Of 34 patients, the mean age was 70.4 ± 9.1 years; 91% were male. Mean LVEF was 29 ± 9.7% and left ventricular end-diastolic dimension was 64.9 ± 6.6 mm. The site of the LVA was apical in 21 patients (62%). Fifteen patients (44%) presented with electrical storm or incessant VT. Nine patients (26%) had a history of intracardiac thrombus. All except for one patient had at least one VT originating from the aneurysm. The mean number of VTs was 2.9 ± 1.7. All patients underwent ablation at the site of the aneurysm. Ablation outside the aneurysm was performed in 13 patients (38%). Low-voltage fractionated potentials and/or late potentials at the aneurysmal site were present in all cases. Complete elimination of all VTs was achieved in 18 (53%), while the elimination of the clinical VT with continued inducibility of nonclinical VTs was achieved in a further 11 patients (32%). Two patients developed cardiac tamponade requiring pericardiocentesis. During a mean follow-up period of 2.3 ± 2.4 years, 11 patients (32%) experienced VT recurrence. Freedom from all-cause mortality at 1-year follow-up was 94%. Conclusion Radiofrequency catheter ablation targeting the aneurysmal site is a feasible and reasonably effective management strategy for clinical VTs in patients with postinfarction LVA. more...
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- 2021
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23. Novel Regularization for Learning the Fuzzy Choquet Integral With Limited Training Data
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Muhammad Aminul Islam, Timothy C. Havens, Derek T. Anderson, Anthony J. Pinar, and Siva K. Kakula
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business.industry ,Computer science ,Applied Mathematics ,Parameterized complexity ,Regularization (mathematics) ,Fuzzy logic ,Data visualization ,Computational Theory and Mathematics ,Choquet integral ,Artificial Intelligence ,Control and Systems Engineering ,sort ,Quadratic programming ,business ,Frequency modulation ,Algorithm - Abstract
Fuzzy integrals (FIs) are powerful aggregation operators that fuse information from multiple sources. The aggregation is parameterized using a fuzzy measure (FM), which encodes the worths of all subsets of sources. Since the FI is defined with respect to an FM, much consideration must be given to defining the FM. However, in practice this is a difficult task—the number of values in an FM scales as $2^n$ , where $n$ is the number of input sources, thus manually specifying an FM quickly becomes tedious. In this article, we review an automatic, data-supported method of learning the FM by minimizing a sum-of-squared error objective function in the context of decision-level fusion of classifiers using the Choquet FI. While this solves the specification problem, we illuminate an issue encountered with many real-world data sets; i.e., if the training data do not contain a significant number of all possible sort orders, many of the FM values are not supported by the data. We propose various regularization strategies to alleviate this issue by pushing the learned FM toward a predefined structure; these regularizers allow the user to encode knowledge of the underlying FM to the learning problem. Furthermore, we propose another regularization strategy that constrains the learned FM's structure to be a linear order statistic. Finally, we perform several experiments using synthetic and real-world data sets and show that our proposed extensions can improve the learned FM behavior and classification accuracy. A previously proposed visualization technique is employed to simultaneously quantitatively illustrate the FM as well as the FI. more...
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- 2021
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24. Causes of Early Mortality After Ventricular Tachycardia Ablation in Patients With Reduced Ejection Fraction
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Justin Z. Lee, Min-Choon Tan, Suganya Karikalan, Abhishek J. Deshmukh, Komandoor Srivathsan, Win K. Shen, Hicham El-Masry, Luis Scott, Samuel J. Asirvatham, Yong-Mei Cha, Christopher J. McLeod, and Siva K. Mulpuru more...
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Recognition of the causes of early mortality after ventricular tachycardia (VT) ablation in patients with reduced left ventricular ejection fraction (LVEF) is an essential step toward improving postprocedural outcomes.This study sought to determine the causes of early mortality (≤30 days) after VT ablation in patients with reduced LVEF and to understand further the circumstances surrounding death after the procedure.We performed a retrospective analysis of all patients undergoing VT ablation in patients with reduced LVEF from January 1, 2013, to November 10, 2021, at the Mayo Clinic (Rochester, Phoenix, and Jacksonville). Causes of death were identified through a detailed chart review of the electronic health record within the Mayo Clinic system and outside records.A total of 503 patients (mean age 63 ± 13 years, 11.2% women) with ejection fraction 50% were included in the study. The 30-day all-cause mortality rate was 5.0% (n = 25), and the mortality rate due to a procedural complication was 0.4%. Among all 30-day deaths, recurrent VT was the most common primary cause of death (44.0%). This was followed by decompensated heart failure (28.0%), procedure-related death (8.0%), cerebrovascular accident (4.0%), and infection (4.0%). Most patients (91.0%) who died from VT had VT recurrence within 3 days of the ablation. The average PAINESD score among early mortality was 20 ± 4, and 92.0% of these patients (n = 23) had a score15. Significant predictors of early mortality included nonischemic cardiomyopathy, lower LVEF, electrical storm, and ventricular fibrillation.The overall early mortality (≤30 days) rate after catheter ablation of VT in patients with reduced LVEF was 5.0%, but the death rate directly due to a procedural complication was only 0.4%. The most common cause of death was recurrent VT, followed by heart failure. Further research into ablation strategies is vital to improving the safety, efficacy, and durability of VT ablation. more...
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- 2022
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25. Priming movie product placements: New insights from a Cross-National case study
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Giacomo Gistri and Siva K. Balasubramanian
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Marketing ,Communication ,Product placement ,Advertising ,Product (category theory) ,Psychology ,Priming (psychology) ,Cognitive psychology ,Cross national - Abstract
The paucity of research on priming product placements and insights from practitioners (Study 1) motivated our investigation into how and when priming works in movie placements. Study 2 explores the... more...
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- 2021
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26. Author response for '<scp>11‐Cl‐BBQ</scp> , a Select Modulator of <scp>AhR</scp> ‐regulated Transcription, Suppresses Lung Cancer Cell Growth via activation of p53 and <scp> p27 Kip1 </scp>'
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null Bach D. Nguyen, null Brenna L. Stevens, null Daniel J. Elson, null Darren Finlay, null John Gamble, null Prasad Kopparapu, null Robyn L. Tanguay, null Andrew B. Buermeyer, null Nancy I. Kerkvliet, and null Siva K. Kolluri more...
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- 2022
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27. 11-Cl-BBQ, a Select Modulator of AhR-regulated Transcription, Suppresses Lung Cancer Cell Growth via activation of p53 and p27
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Bach D, Nguyen, Brenna L, Stevens, Daniel J, Elson, Darren, Finlay, John, Gamble, Prasad, Kopparapu, Robyn L, Tanguay, Andrew B, Buermeyer, Nancy I, Kerkvliet, and Siva K, Kolluri
- Abstract
Aryl hydrocarbon receptor (AhR) is a ligand-activated transcription factor and functions as a tumor suppressor in different cancer models. In this study, we report detailed characterization of 11-chloro-7H-benzimidazo[2,1-a]benzo[de]iso-quinolin-7-one (11-Cl-BBQ) as a Select Modulator of AhR-regulated Transcription (SMAhRT) with anti-cancer actions. Treatment of lung cancer cells with 11-Cl-BBQ induced potent and sustained AhR-dependent anti-proliferative effects by promoting G1-phase cell cycle arrest. Investigation of 11-Cl-BBQ-induced transcription in H460 cells with or without the AhR expression by RNA-seq revealed activation of p53 signaling. In addition, 11-Cl-BBQ suppressed multiple pathways involved in DNA replication and increased expression of cyclin-dependent kinase inhibitors, including p27 more...
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- 2022
28. Identification of genomic regions associated with the plasticity of carbon 13 ratio in soybean
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Siva K. Chamarthi, Avjinder S. Kaler, Hussein Abdel‐Haleem, Felix B. Fritschi, Jason D. Gillman, Jeffery D. Ray, James R. Smith, and Larry C. Purcell
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Genetics ,Plant Science ,Agronomy and Crop Science - Abstract
Improving water use efficiency (WUE) for soybean [Glycine max (L.) Merr.] through selection for high carbon isotope (C13) ratio may increase drought tolerance, but increased WUE may limit growth in productive environments. An ideal genotype would be plastic for C13 ratio; that is, be able to alter C13 ratio in response to the environment. Our objective was to identify genomic regions associated with C13 ratio plasticity, C13 ratio stability, and overall C13 ratio in two panels of diverse Maturity Group IV soybean accessions. A second objective was to identify accessions that differed in their C13 ratio plasticity. Panel 1 (205 accessions) was evaluated in seven irrigated and four drought environments, and Panel 2 (373 accessions) was evaluated in four environments. Plasticity was quantified as the slope from regressing C13 ratio of individual genotypes against an environmental index calculated based on the mean within and across environments. The regression intercept was considered a measure of C13 ratio over all environments, and the root mean square error was considered a measure of stability. Combined over both panels, genome-wide association mapping (GWAM) identified 19 single nucleotide polymorphisms (SNPs) for plasticity, 39 SNPs for C13 ratio, and 16 SNPs for stability. Among these SNPs, 71 candidate genes had annotations associated with transpiration or water conservation and transport, root development, root hair elongation, and stomatal complex morphogenesis. The genomic regions associated with plasticity and stability identified in the current study will be a useful resource for implementing genomic selection for improving drought tolerance in soybean. more...
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- 2022
29. Use of Flecainide in Stable Coronary Artery Disease: An Analysis of Its Safety in Both Nonobstructive and Obstructive Coronary Artery Disease
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Nway L. Ko Ko, Sai Harika Pujari, Vatsal Ladia, Pradyumna Agasthi, Hasan Ashraf, Luis R. Scott, Dan Sorajja, Fergus O’Herlihy, Tadhg Prendiville, and Siva K. Mulpuru
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medicine.medical_specialty ,Stress testing ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Coronary artery disease ,03 medical and health sciences ,Myocardial perfusion imaging ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Pharmacology (medical) ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,Flecainide ,Retrospective Studies ,Proarrhythmia ,medicine.diagnostic_test ,business.industry ,General Medicine ,medicine.disease ,medicine.anatomical_structure ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Perfusion ,medicine.drug ,Artery - Abstract
Flecainide is a class IC antiarrhythmic drug that is contraindicated in patients who have a history of myocardial infarction, but its effect on mortality and risk of proarrhythmia in patients with stable obstructive and nonobstructive epicardial coronary artery disease (CAD) has not been assessed. We sought to compare the safety of flecainide administration in patients who had angiographic evidence of either no or minimal CAD versus nonobstructive CAD, and those who underwent nuclear stress testing with perfusion defects versus those without perfusion defects. We conducted a retrospective chart review of 348 patients who were treated with flecainide for at least 1 year duration and underwent evaluation for CAD with coronary angiography or myocardial perfusion imaging (MPI) stress testing within 3 months of initiating flecainide. We compared overall mortality and proarrhythmia between varying levels of CAD and perfusion defects. There was a similar 10-year survival between those with no or minimal CAD, nonobstructive CAD, and obstructive CAD (p = 0.6). Additionally, there was no difference in arrhythmia burden, including sustained ventricular tachycardias or frequent premature ventricular contractions (> 5% daily burden; p = 0.25). There was also no increase in mortality among those who had reversible perfusion defects >0% compared with those without, among subjects who underwent MPI (p = 0.14). On subgroup analysis, there was no increased risk in all-cause mortality with any specific coronary artery involvement, or with obstructive multivessel CAD (p = 0.89). Flecainide use is not associated with an increase in either all-cause mortality or ventricular arrhythmias in low-risk patients with stable nonobstructive CAD. more...
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- 2021
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30. Long-Term Clinical Outcomes of Underdosed Direct Oral Anticoagulants in Patients with Atrial Fibrillation and Atrial Flutter
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Pradyumna Agasthi, Nirat Beohar, David R. Holmes, Mohamed Allam, Pattara Rattanawong, Sai Harika Pujari, Komandoor Srivathsan, Dan Sorajja, Win Kuang Shen, William K. Freeman, Ramila A. Mehta, Hicham El Masry, Farouk Mookadam, Eric H. Yang, Hasan Ashraf, Xiaoxi Yao, Anusha Shanbhag, Reza Arsanjani, Siva K. Mulpuru, and Peter A. Noseworthy more...
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Adult ,Male ,medicine.medical_specialty ,Time Factors ,Statistics, Nonparametric ,Body Mass Index ,Time ,chemistry.chemical_compound ,Edoxaban ,Internal medicine ,Atrial Fibrillation ,medicine ,Humans ,Myocardial infarction ,Stroke ,Aged ,Retrospective Studies ,Analysis of Variance ,Rivaroxaban ,business.industry ,Atrial fibrillation ,General Medicine ,Middle Aged ,medicine.disease ,Thrombosis ,Atrial Flutter ,chemistry ,Cardiology ,Female ,Apixaban ,business ,Atrial flutter ,Factor Xa Inhibitors ,Follow-Up Studies ,medicine.drug - Abstract
Background Although direct oral anticoagulants (DOACs) have been shown to be effective at reducing the risk of stroke in patients with atrial fibrillation/flutter (AF), they are sometimes underdosed off-label to mitigate their associated higher bleeding risk. We sought to evaluate frequency and clinical outcomes of inappropriate underdosing of DOACS in patients with AF. Methods We conducted a study of subjects with AF who had a clinical indication for stroke prophylaxis (with a congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke or transient ischemic attack, vascular disease, age 65 to 47 years, sex category [CHA2DS2-VASc] of 2 or greater) and were prescribed 1 of the 4 clinically approved DOACs (apixaban, rivaroxaban, dabigatran, or edoxaban). We compared all-cause mortality, composite of stroke and systemic embolism, composite of myocardial infarction (MI), acute coronary syndromes (ACS), and coronary revascularization, and major bleeding between patients appropriately dosed and inappropriately underdosed. Results A total of 8125 patients met inclusion criteria, with a mean follow up of 2.2 ± 2 years. Of those, 1724 patients (21.2%) were inappropriately dosed. After adjusting for baseline variables, there was no difference in all-cause mortality, risk of stroke or systemic embolism, International Society on Thrombosis and Haemostasis (ISTH) major bleeding, or composite of myocardial infarction, acute coronary syndromes, or coronary revascularization between patients appropriately dosed and inappropriately underdosed. In subgroup analysis, only apixaban demonstrated an increased incidence all-cause mortality (hazard ratio [HR] 1.24, 95% confidence interval [CI] 1.03-1.49) with inappropriate underdosing. There was no difference in the remaining clinical outcomes noted on subgroup analysis. Conclusion Underdosing of DOACs did not minimize risk of bleeding, systemic embolization or all-cause mortality in patients with AF. Inappropriate underdosing with apixaban in particular was associated with increased all-cause mortality. more...
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- 2021
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31. Graphene foam resonators: Fabrication and characterization
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Siva K. Reddy, Assaf Ya'akobovitz, and Yahav Ben-Shimon
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Fabrication ,Materials science ,business.industry ,Graphene ,Graphene foam ,Resonance ,02 engineering and technology ,Dissipation ,010402 general chemistry ,021001 nanoscience & nanotechnology ,Condensed Matter Physics ,01 natural sciences ,Atomic and Molecular Physics, and Optics ,0104 chemical sciences ,law.invention ,Characterization (materials science) ,Resonator ,law ,Electrical network ,Optoelectronics ,General Materials Science ,Electrical and Electronic Engineering ,0210 nano-technology ,business - Abstract
Three-dimensional graphene foams (GFs) benefit from a large surface area and unique physical properties. We present here the first-ever miniaturized GF-based resonators. We developed a simple yet reliable fabrication process, in which GFs are synthesized and assembled on a cavity to form suspended GF devices. We electrostatically excited these devices and analyzed their resonance and ring-down responses. We observed significant energy dissipation, as the quality factor of the devices was in the order of several tens. Additionally, we investigated the influence of temperature on the operation of the devices and found that high temperatures mechanically soften the resonators but also considerably enhance energy dissipation. Finally, our devices demonstrated a mode-coupling of a resonance mode and a mode having twice its frequency. Thus, this work paves the way toward the development of novel GF resonators that could be integrated into future devices, such as GF-based nano-electromechanical sensors, electrical circuits, and oscillators. more...
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- 2021
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32. Implanting and Extracting Cardiac Devices
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Samuel J. Asirvatham, Malini Madhavan, Siva K. Mulpuru, Matthew J. Swale, Paul A. Friedman, and David L. Hayes
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medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Cardiology ,business ,Coronary sinus ,Lead extraction - Published
- 2021
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33. Inappropriate Dosing of Direct Oral Anticoagulants in Patients with Atrial Fibrillation
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Siva K. Mulpuru, Samuel J. Asirvatham, Konstantinos C. Siontis, Alan Sugrue, Ramila A. Mehta, Medhat Farwati, Malini Madhavan, Abhishek Deshmukh, Bernard J. Gersh, Azza Ahmed, David Sanborn, Haarini Sridhar, and Mustapha Amin more...
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Male ,medicine.medical_specialty ,Pyridones ,Embolism ,Hemorrhage ,Comorbidity ,030204 cardiovascular system & hematology ,Article ,Dabigatran ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Rivaroxaban ,Risk Factors ,Internal medicine ,Atrial Fibrillation ,medicine ,Humans ,Medication Errors ,Drug Dosage Calculations ,030212 general & internal medicine ,Dosing ,Stroke ,Aged ,Ischemic Stroke ,Aged, 80 and over ,business.industry ,Age Factors ,Atrial fibrillation ,Middle Aged ,medicine.disease ,Ischemic Attack, Transient ,Cohort ,Cardiology ,Pyrazoles ,Female ,Apixaban ,Cardiology and Cardiovascular Medicine ,business ,Factor Xa Inhibitors ,medicine.drug - Abstract
Direct Oral Anticoagulants (DOACs) require dose adjustment based on specific patient characteristics, making them prone to incorrect dosing. The current study aimed to evaluate the prevalence of inappropriate DOAC dosing, its predictors, and corresponding outcomes in a single-center cohort of atrial fibrillation (AF) patients. We reviewed all patients with AF treated at Mayo Clinic with a DOAC (Apixaban, Rivaroxaban, or Dabigatran) between 2010 and 2017. Outcomes examined were ischemic stroke /transient ischemic attack (TIA)/embolism and bleeding. 8,576 patients (mean age 69.5 ± 11.9 years, 35.1 % female, CHA2DS2-VASc 3.0±1.8) received a DOAC (38.6% apixaban, 35.8% rivaroxaban, 25.6% dabigatran). DOAC dosing was inappropriate in 1,273 (14.8%) with 1071 (12.4%) receiving an inappropriately low dose, and 202(2.4%) an inappropriately high dose. Patients prescribed inappropriate doses were older (72.4 ± 11.7 vs 69.0 ± 11.8, p more...
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- 2021
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34. PO-04-193 RIGHT ATRIUM TO LEFT VENTRICLE ACCESS FOR VENTRICULAR TACHYCARDIA ABLATION IN PATIENTS WITH DOUBLE MECHANICAL VALVES: FEASIBILITY, SAFETY AND OUTCOMES IN A MULTICENTER REGISTRY
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Konstantinos C. Siontis, George S. Waits, Timothy R. Maher, Siva K. Mulpuru, Matthew M. Zipse, Muhammet Celik, tayyar gökdeniz, Arvindh N. Kanagasundram, Wendy S. Tzou, Andre D'Avila, Jeffrey R. Winterfield, Francis Marchlinski, William G. Stevenson, and Pasquale Santangeli more...
- Subjects
Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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35. PO-02-026 LONG-TERM MORTALITY IN PATIENTS WITH ISCHEMIC VERSUS NONISCHEMIC CARDIOMYOPATHY FOLLOWING CARDIAC RESYNCHRONIZATION THERAPY
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Anshul Gupta, Suganya Arunachalam Karikalan, Gurukripa N. Kowlgi, Christopher V. DeSimone, Freddy Del Carpio Munoz, Yong-Mei Cha, Justin Z. Lee, Malini Madhavan, Siva K. Mulpuru, Samuel J. Asirvatham, and Abhishek J. Deshmukh more...
- Subjects
Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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36. PO-04-191 RISK FACTORS AND OUTCOMES OF EARLY VENTRICULAR ARRHYTHMIAS AFTER LEFT VENTRICULAR ASSIST DEVICE IMPLANTATION
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Suganya Arunachalam Karikalan, Hicham Z. El Masry, Ammar M. Killu, Abhishek J. Deshmukh, Christopher J. McLeod, Dan Sorajja, Luis R. Scott, Siva K. Mulpuru, Yong-Mei Cha, and Justin Z. Lee
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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37. Paroxysmal supine hypoxaemia with hyperthyroidism and atrial fibrillation: a case report of a diagnostic challenge
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Liang Yen Liu, Yogesh N V Reddy, Alexander S Niven, Tiffany Y Hu, Kathryn F Larson, Siva K Mulpuru, and Michael W Cullen
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Cardiology and Cardiovascular Medicine - Abstract
Background A patent foramen ovale (PFO) is a persistent embryonic defect in the interatrial septum. Platypnoea-orthodeoxia syndrome is characterized by positional hypoxaemia that is most commonly due to right-to-left shunting through a PFO. Dynamic right-to-left shunting through a PFO can also exacerbate positional hypoxaemia without platypnea-orthodeoxia syndrome. Case summary A 78-year-old woman with hyperthyroidism and paroxysmal atrial fibrillation (AF) presented with positional hypoxaemia exacerbated by supine positioning. Diagnostic testing revealed intermittent right-to-left shunting through a PFO triggered by worsening atrial functional tricuspid regurgitation and elevated right atrial pressures. Diuresis, rate control, and thyroidectomy initially led to resolution of positional hypoxaemia, but recurrent AF episodes triggered right-to-left shunting with recurrent desaturation. Left atrial and cavo-tricuspid isthmus ablation led to restoration of normal sinus rhythm and resolution of positional hypoxaemia without PFO closure. Discussion The clinical presentation of intermittent intracardiac right-to-left shunting can mimic decompensated heart failure with pulmonary oedema. Persistent hypoxaemia out of proportion to the degree of pulmonary oedema and minimally responsive to supplemental O2 should raise suspicion for right-to-left shunt aetiology. Positional arterial blood gases can facilitate the diagnostic evaluation of refractory hypoxaemia in cases of suspected shunting. Diagnostic imaging for PFO detection includes both transthoracic and transesophageal echocardiography with Valsalva manoeuver and agitated saline injection. Closure of a PFO for management of arterial deoxygenation syndromes should not be performed before treating other causes of arterial deoxygenation and optimizing factors that may exacerbate shunting across the PFO. more...
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- 2022
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38. Loss of the aryl hydrocarbon receptor increases tumorigenesis in p53-deficient mice
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Jessica L. Phillips, Christiane V. Löhr, Bach D. Nguyen, Andrew B. Buermeyer, and Siva K. Kolluri
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Pharmacology ,Mice, Knockout ,Mice ,Cell Transformation, Neoplastic ,Receptors, Aryl Hydrocarbon ,Carcinogenesis ,Basic Helix-Loop-Helix Transcription Factors ,Animals ,Tumor Suppressor Protein p53 ,Toxicology ,Ligands - Abstract
The aryl hydrocarbon receptor (AhR) is a ligand-activated transcription factor that regulates cell fate via activation of a diverse set of genes. There are conflicting reports describing the role of AhR in cancer. AhR-knockout mice do not develop tumors spontaneously, yet the AhR can act as a tumor suppressor in certain contexts. Loss of tumor suppression by p53 is common in human cancer. To investigate AhR function in the absence of p53, we generated mice lacking both AhR and p53. Mice deficient for AhR and p53 had shortened lifespan, increased tumorigenesis, and an altered tumor spectrum relative to control mice lacking only p53. In addition, knockout of both AhR and p53 resulted in reduced embryonic survival and neonatal fitness. We also examined the consequences of loss of AhR in p53-heterozygous mice and observed a significantly reduced lifespan and enhanced tumor burden. These findings reveal an important role for the AhR as a tumor suppressor in the absence of p53 signaling and support the development of anti-cancer therapeutics that would promote the tumor suppressive actions of the AhR. more...
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- 2022
39. The cyclin-dependent kinase inhibitor p27
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Daniel J, Elson, Bach D, Nguyen, Rhand, Wood, Yi, Zhang, Veronica, Puig-Sanvicens, and Siva K, Kolluri
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Gene Expression Regulation ,Receptors, Aryl Hydrocarbon ,Cell Cycle Proteins ,Cyclin-Dependent Kinase Inhibitor p27 ,Cyclin-Dependent Kinases - Abstract
p27
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- 2022
40. Sodium glucose co-transport 2 inhibitors for gout treatment
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Manoj Kumar Reddy, Somagutta, Enkhmaa, Luvsannyam, Molly, Jain, Gaurav Venkat, Cuddapah, Sandeep, Pelluru, Nafisa, Mustafa, Duaa S, Nasereldin, Siva K, Pendyala, Nagendrababu, Jarapala, and Bhavani, Padamati more...
- Abstract
Hyperuricemia remains the most prevalent cause of gout. Gout patients present with joint inflammation and uric acid crystals deposition manifesting as tophi. The association of gout with increased risk of insulin resistance, diabetes, metabolic disorders, increased cardiometabolic risk, and kidney disease is well established. These factors influence the treatment plan, and current treatment options have limited cardiovascular risk reduction. So the need for novel treatments with a broad range of coverage for the complications is warranted. Sodium-glucose co-transporter 2 inhibitors are novel drugs approved for treating type-2 diabetes. They prevent glucose reabsorption and lower serum uric acid levels. Recently few studies have studied their association with reducing the risk of gout. They may help address the gout related complications through their recorded benefit with weight loss, improved insulin resistance, and cardiovascular benefits in recent studies. . SGLT2-Is may be useful to reduce the risk of gout in individuals with type 2 diabetes. Limited literature is available on the safety and efficacy of these novel antidiabetic drugs in patients with gout. This review is aimed to summarize the current knowledge on the role and effectiveness of novel antidiabetic medication as an early therapeutic option in gout patients. more...
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- 2022
41. Leveraging a High-Throughput Screening Method to Identify Mechanisms of Individual Susceptibility Differences in a Genetically Diverse Zebrafish Model
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Dylan J. Wallis, Jane La Du, Preethi Thunga, Daniel Elson, Lisa Truong, Siva K. Kolluri, Robyn L. Tanguay, and David M. Reif
- Abstract
Understanding the mechanisms behind chemical susceptibility differences is key to protecting sensitive populations. However, elucidating gene-environment interactions (GxE) presents a daunting challenge. While mammalian models have proven useful, problems with scalability to an enormous chemical exposome and clinical translation faced by all models remain; therefore, alternatives are needed. Zebrafish (Danio rerio) have emerged as an excellent model for investigating GxE. This study used a combined bioinformatic and experimental approach to probe the mechanisms underlying chemical susceptibility differences in a genetically diverse zebrafish population. Starting from high-throughput screening (HTS) data, a genome-wide association study (GWAS) using embryonic fish exposed to 0.6 μM Abamectin revealed significantly different effects between individuals. A hypervariable region with two distinct alleles–one with G at the SNP locus (GG) and one with a T and the 16 bp deletion (TT)–associated with differential susceptibility was found. Sensitive fish had significantly lower sox7 expression. Due to their location and the observed expression differences, we hypothesized that these sequences differentially regulate sox7. A luciferase reporter gene assay was used to test if these sequences, alone, could lead to expression differences. The TT allele showed significantly lower expression than the GG allele in MCF-7 cells. To better understand the mechanism behind these expression differences, predicted transcription factor binding differences between individuals were compared in silico, and several putative binding differences were identified. EMSA was used to test for binding differences in whole embryo protein lysate to investigate these TF binding predictions. We confirmed that the GG sequence is bound to protein in zebrafish. Through a competition EMSA using an untagged oligo titration, we confirmed that the GG oligo had a higher binding affinity than the TT oligo, explaining the observed expression differences. This study identified differential susceptibility to chemical exposure in a genetically diverse population, then identified a plausible mechanism behind those differences from a genetic to molecular level. Thus, an HTS-compatible zebrafish model is valuable and adaptable in identifying GxE mechanisms behind susceptibility differences to chemical exposure. more...
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- 2022
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42. Antibody Drug Conjugates
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Siva K Prasad and Stalin Bala
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0301 basic medicine ,Drug ,Antibody-drug conjugate ,biology ,business.industry ,medicine.drug_class ,media_common.quotation_subject ,Monoclonal antibody ,body regions ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Cell killing ,Oncology ,Biochemistry ,030220 oncology & carcinogenesis ,Pediatrics, Perinatology and Child Health ,biology.protein ,Medicine ,Cytotoxic T cell ,Antibody ,business ,Linker ,media_common ,Conjugate - Abstract
Antibody drug conjugates (ADCs) are chemically engineered drugs consisting of monoclonal antibody (mAb) and cytotoxic compound attached chemically by a linker. Upon attachment to a specific target antigen, ADC enters into the cell and payload is released, which finally leads to cell killing. Payloads are broadly divided into tubulin-disrupting agents and DNA-damaging agents. Most of the current ADCs utilize humanized mAbs, and fully human mAbs are under investigation. ADC development process is accelerated by better designing and bio-engineering methods. more...
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- 2020
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43. Heat dissipation in graphene foams
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Yaniv Cohen, Siva K. Reddy, and Assaf Ya'akobovitz
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Convection ,Materials science ,Infrared ,Orders of magnitude (temperature) ,Graphene ,Graphene foam ,02 engineering and technology ,010402 general chemistry ,021001 nanoscience & nanotechnology ,Condensed Matter Physics ,01 natural sciences ,Atomic and Molecular Physics, and Optics ,0104 chemical sciences ,law.invention ,symbols.namesake ,law ,Heat transfer ,Thermal ,symbols ,General Materials Science ,Electrical and Electronic Engineering ,Composite material ,0210 nano-technology ,Raman spectroscopy - Abstract
Graphene foam (GF)—a three-dimensional network of hollow graphene branches—is a highly attractive material for diverse applications. However, to date, the heat dissipation characteristics of GFs have not been characterized. To fill this gap, we synthesized GF devices, subjected them to high temperatures, and investigated their thermal behavior by using infrared microthermography. We find that while the convective area of GF devices is comparable to that of bulk materials (such as metals), the coefficient of convection of these devices is several orders of magnitude higher than that of metals. In addition, the GF devices showed a reproducible thermal behavior, which we attribute to negligible temperature-induced morphological changes (as confirmed by Raman analysis). Taken together, our findings suggest GF as a promising candidate material for advanced cooling applications where efficient heat dissipation is needed, e.g., in electrical circuits. more...
- Published
- 2020
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44. Ventricular asystole in the presence of a biventricular device
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Siva K. Mulpuru, James W. Lloyd, Christopher V. DeSimone, Samuel J. Asirvatham, and Roshan Karki
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Pacemaker, Artificial ,medicine.medical_specialty ,Heart Ventricles ,Event (relativity) ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Physiology (medical) ,Internal medicine ,Ventricular asystole ,Humans ,Lead Dislodgement ,Medicine ,cardiovascular diseases ,030212 general & internal medicine ,Asystole ,Cardiac device ,Heart Failure ,business.industry ,Cardiac Pacing, Artificial ,Ventricular pacing ,medicine.disease ,Heart Arrest ,Treatment Outcome ,cardiovascular system ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
In pacemaker-dependent patients with a newly implanted cardiac device, acute lead dislodgement constitutes one of the most common causes of loss of capture and ventricular asystole. In a biventricular system, it would be expected that such a potentially catastrophic event would be prevented with back-up right ventricular pacing unless both leads dislodge. more...
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- 2020
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45. Fibroplasty (venoplasty) to facilitate transvenous lead placement: A single‐center experience
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Yong Mei Cha, Tracy L. Webster, Omar Yasin, Paul A. Friedman, Danesh Kella, Deepak Padmanabhan, Siva K. Mulpuru, and Ameesh Isath
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Pacemaker, Artificial ,medicine.medical_specialty ,030204 cardiovascular system & hematology ,Balloon ,Single Center ,03 medical and health sciences ,0302 clinical medicine ,Physiology (medical) ,medicine ,Humans ,Fluoroscopy ,Vascular Diseases ,030212 general & internal medicine ,Lead (electronics) ,Device Removal ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Medical record ,Incidence (epidemiology) ,Retrospective cohort study ,Defibrillators, Implantable ,Surgery ,Treatment Outcome ,Cardiology and Cardiovascular Medicine ,Complication ,business - Abstract
Introduction Venous stenosis is a well-recognized complication of transvenous leads (TVLs) that is encountered during lead revisions or device upgrades. We here report the outcomes of TVL placement facilitated by fibroplasty or tunneling (TUN) procedure. Methods We conducted a single-center retrospective cohort study of all patients undergoing TVL implantation requiring fibroplasty or TUN from 2005 to 2017. Medical records and procedure reports were reviewed for relevant data. Outcomes for fibroplasty and TUN to facilitate TVL placement were compared. Results Sixty patients had fibroplasty and thirty-five patients had a TUN procedure. There was no difference in procedure success rates between the two groups (97% fibroplasty vs. 100% TUN; p = .98). The fluoroscopy time was longer (fibroplasty = 39.7 ± 21.5 min vs. TUN = 29.2 ± 21.3 min; p = .01) and the total procedural time was shorter in the fibroplasty group (fibroplasty = 247 ± 77.8 min vs. TUN = 287 ± 77.1 min; p = .01). TUN was associated with a significantly higher incidence of acute complications (fibroplasty = 0 vs. TUN = 8; p = .002) most requiring invasive intervention and/or transfusion with blood products. Long-term complications requiring additional device-related procedures were comparable between the two groups (fibroplasty = 6 vs. TUN = 6; logrank p = .21). Conclusions For patients with venous stenosis requiring additional TVL, balloon fibroplasty is associated with similar rates of success and a significantly decreased incidence of acute complications when compared with subcutaneous TUN. more...
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- 2020
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46. Twitter Presence and Experience Improve Corporate Social Responsibility Outcomes
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Yiwei Fang, Zihao Yang, and Siva K. Balasubramanian
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Economics and Econometrics ,business.industry ,Qualitative interviews ,05 social sciences ,06 humanities and the arts ,Public relations ,0603 philosophy, ethics and religion ,General Business, Management and Accounting ,Transparency (behavior) ,Arts and Humanities (miscellaneous) ,ComputingMethodologies_SYMBOLICANDALGEBRAICMANIPULATION ,0502 economics and business ,Accountability ,Corporate social responsibility ,Social media ,060301 applied ethics ,Business and International Management ,Business ethics ,business ,Law ,050203 business & management ,Quality of Life Research - Abstract
We investigate the role of social-media-triggered public pressure on corporate social responsibility (CSR) that includes expectations of transparency and accountability on the firm’s part, and participative/evaluative inputs on the public’s part. Using the date when SP it is also shown that CSR outcomes do not motivate corporations to establish a social media presence on Twitter. Finally, firms with more experience (number of years) on Twitter, and those with more followers, tweets or Twitter accounts are associated with improved CSR outcomes. We draw on two theories and qualitative interviews with senior CSR executives to explain why social media influences CSR firm behaviors. more...
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- 2020
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47. Basics of cardiac pacing: components of pacing, defibrillation, and resynchronization therapy systems
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Justin Z. Lee, Vaibhav R. Vaidya, and Siva K. Mulpuru
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medicine.medical_specialty ,Cardiac pacing ,business.industry ,Defibrillation ,medicine.medical_treatment ,Internal medicine ,Cardiac resynchronization therapy ,medicine ,Cardiology ,business ,Cardiac stimulation - Published
- 2020
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48. Clinical Outcomes of Various Management Strategies for Symptomatic Bradycardia
- Author
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Victor A. Abrich, Gregory W. Barsness, Rachel J. Le, Paul A. Friedman, Eric H. Yang, Siva K. Mulpuru, Bradley R. Lewis, Yong Mei Cha, and Ryan J. Lennon
- Subjects
Male ,Bradycardia ,Pacemaker, Artificial ,030213 general clinical medicine ,Time Factors ,Heart block ,Transcutaneous pacing ,Sinus bradycardia ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Heart rate ,medicine ,Humans ,Hospital Mortality ,Adverse effect ,Aged ,Original Research ,Aged, 80 and over ,Community and Home Care ,business.industry ,General Medicine ,Emergency department ,Middle Aged ,medicine.disease ,Transvenous pacing ,Anesthesia ,Female ,medicine.symptom ,business - Abstract
OBJECTIVE: To determine clinical outcomes of various management strategies for reversible and irreversible causes of symptomatic bradycardia in the inpatient setting. DESIGN: Retrospective observational study. SETTING: Emergency room and inpatient. PARTICIPANTS: Patients presenting to the emergency department with symptomatic bradycardia. METHODS: We retrospectively reviewed electronic health records of 518 patients from two Mayo Clinic campuses (Rochester and Phoenix) who presented to the emergency department with symptomatic bradycardia (heart rate ≤50 beats/minute) from January 1, 2010 through December 31, 2015. Sinus bradycardia was excluded. The following management strategies were compared: observation, non-invasive management (medications with/without transcutaneous pacing), early permanent pacemaker (PPM) implantation (≤2 days), and delayed PPM implantation (≥3 days). Study endpoints included length of stay and adverse events related to bradycardia (syncope, central line–associated bloodstream infections, cardiac arrest, and in-hospital mortality). Patients who received a PPM were further stratified by weekend hospital admission. RESULTS: Heart block occurred in 200 (38.6%) patients, and atrial arrhythmias with slow ventricular response occurred in 239 (46.1%) patients. Reversible causes of bradycardia included medication toxicity in 22 (4.2%) patients and hyperkalemia in 44 (8.5%) patients. Adverse events were similar in patients who underwent early compared to delayed PPM implantation (6.6% vs 12.5%, P=.20), whereas adverse events were higher in patients who received temporary transvenous pacing (19.1% vs 3.4%, P more...
- Published
- 2020
- Full Text
- View/download PDF
49. An artificial intelligence-enabled ECG algorithm for comprehensive ECG interpretation: Can it pass the 'Turing test'?
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Siva K. Mulpuru, Peter A. Noseworthy, Paul A. Friedman, Abhishek Deshmukh, Zachi I. Attia, Wei-Yin Ko, Rickey E. Carter, and Anthony H. Kashou
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Artificial intelligence ,Computer program ,Adult patients ,ECG ,Computer science ,business.industry ,Interpretation (philosophy) ,Convolutional neural network ,ECG interpretation ,Electrocardiogram ,Electrocardiography ,symbols.namesake ,RC666-701 ,Medical technology ,Turing test ,symbols ,Diseases of the circulatory (Cardiovascular) system ,General Earth and Planetary Sciences ,R855-855.5 ,business ,Algorithm ,General Environmental Science - Abstract
Objective To develop an artificial intelligence (AI)–enabled electrocardiogram (ECG) algorithm capable of comprehensive, human-like ECG interpretation and compare its diagnostic performance against conventional ECG interpretation methods. Methods We developed a novel AI-enabled ECG (AI-ECG) algorithm capable of complete 12-lead ECG interpretation. It was trained on nearly 2.5 million standard 12-lead ECGs from over 720,000 adult patients obtained at the Mayo Clinic ECG laboratory between 2007 and 2017. We then compared the need for human over-reading edits of the reports generated by the Marquette 12SL automated computer program, AI-ECG algorithm, and final clinical interpretations on 500 randomly selected ECGs from 500 patients. In a blinded fashion, 3 cardiac electrophysiologists adjudicated each interpretation as (1) ideal (ie, no changes needed), (2) acceptable (ie, minor edits needed), or (3) unacceptable (ie, major edits needed). Results Cardiologists determined that on average 202 (13.5%), 123 (8.2%), and 90 (6.0%) of the interpretations required major edits from the computer program, AI-ECG algorithm, and final clinical interpretations, respectively. They considered 958 (63.9%), 1058 (70.5%), and 1118 (74.5%) interpretations as ideal from the computer program, AI-ECG algorithm, and final clinical interpretations, respectively. They considered 340 (22.7%), 319 (21.3%), and 292 (19.5%) interpretations as acceptable from the computer program, AI-ECG algorithm, and final clinical interpretations, respectively. Conclusion An AI-ECG algorithm outperforms an existing standard automated computer program and better approximates expert over-read for comprehensive 12-lead ECG interpretation. more...
- Published
- 2022
50. Novel Antidiabetic Medications in Polycystic Ovary Syndrome
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Manoj Reddy, Somagutta, Molly, Jain, Utkarsha, Uday, Siva K, Pendyala, Ashwini, Mahadevaiah, Greta, Mahmutaj, Nagendrababu, Jarapala, Mohamed A, Gad, Pathan Mayur, Srinivas, Nayana, Sasidharan, and Nafisa, Mustafa more...
- Abstract
Polycystic ovary syndrome is a very common endocrine disorder prevalent in premenopausal women. Patients with polycystic ovary syndrome present with abnormal menstruation, ovulation disorders, and hyperandrogenemia. They are often accompanied by insulin resistance, metabolic disorders, and other cardiovascular abnormalities. Also, they have comorbidities, such as dyslipidemia, obesity, diabetes type 2, non-alcoholic fatty liver disease, which all influence the treatment plan. Metformin has been defined as a treatment option in patients with polycystic ovary syndrome. However, the clinical responses to metformin are limited. Thus, the need for novel treatments with a broad range of coverage for the complications is warranted. Sodium-glucose co-transporter 2 inhibitors, glucagon-like peptide-1 receptor agonists, incretin analogs are novel drugs approved for treating type-2 diabetes. Because of their recorded benefit with weight loss, improved insulin resistance, and cardiovascular benefits in recent studies, they may help polycystic ovary syndrome women address the polycystic ovary syndrome-related risk of metabolic, reproductive, and psychological consequences. Limited literature is available on the safety and efficacy of these novel antidiabetic drugs in patients with polycystic ovary syndrome. Thus, this review is investigating the role and effectiveness of novel antidiabetic medication as an early therapeutic option in polycystic ovary syndrome. more...
- Published
- 2022
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