Academic literature on the topic '(New York, N.Y. : 163 Bowery)'

Magnitudes and patterns in the deposition of chlorophyll (Chl), organic carbon, particulate phosphorus (PP), and suspended solids are documented for seven New York reservoirs based on analyses of metalimnetic and near-bottom sediment trap collections. Inorganic material dominated the trap collections and caused a decoupling of the downward fluxes of Chl and PP because of major contributions of inorganic components to P deposition. These contributions were manifested in the stoichiometry of trap collections, the much higher estimates of settling velocity (SV) for PP compared with Chl, and differences in patterns of Chl and PP deposition within individual reservoirs and among these systems. Most of the deposited phosphorus in these reservoirs (71–98%) was associated with nonphytoplankton particles. In contrast to the other constituents, the estimates of SV for Chl were lower and more uniform; nearly 50% of the individual estimates (n = 188) were between 0.15 and 0.25 m·day–1. Longitudinal gradients in sediment deposition occurred as a result of gradients in both overlying water concentrations and settling characteristics of the particles. Seasonal and vertical patterns in trap collections and budget calculations indicate that resuspension contributed to deposition, to varying extents, in all of the reservoir basins.

Accurate antimicrobial susceptibility testing is vital for patient care and surveillance of emerging antimicrobial resistance. The National Committee for Clinical Laboratory Standards (NCCLS) outlines generally agreed upon guidelines for reliable and reproducible results. In January 1997 we surveyed 320 laboratories participating in the New York State Clinical Evaluation Program for General Bacteriology proficiency testing. Our survey addressed compliance with NCCLS susceptibility testing guidelines for bacterial species designated a problem (Staphylococcus aureus and Enterococcusspecies) or fastidious (Streptococcus pneumoniae,Haemophilus influenzae, and Neisseria gonorrhoeae) organism. Specifically, we assessed compliance with guidelines for inoculum preparation, medium choice, number of disks per plate, and incubation conditions for disk diffusion tests. We also included length of incubation for S. aureus andEnterococcus species. We found overall compliance with the five characteristics listed above in 80 of 153 responding laboratories (50.6%) for S. aureus and 72 of 151 (47.7%) laboratories for Enterococcus species. The most common problem was an incubation time shortened to less than 24 h. Overall compliance with the first four characteristics was reported by 92 of 221 (41.6%) laboratories for S. pneumoniae, 49 of 163 (30.1%) laboratories for H. influenzae, and 11 of 77 (14.3%) laboratories for N. gonorrhoeae. Laboratories varied from NCCLS guidelines by placing an excess number of disks per plate. Laboratories also reported using alternative media forEnterococcus species, N. gonorrhoeae, andH. influenzae. This study demonstrates a need for education among clinical laboratories to increase compliance with NCCLS guidelines.

Objectives Cause-of-death information, reported by frontline clinicians after a patient’s death, is an irreplaceable source of public health data. However, systematic bias in cause-of-death reporting can lead to over- or underestimation of deaths attributable to different causes. New York City consistently reports higher rates of deaths attributable to pneumonia and influenza than many other US cities and the country. We investigated systematic erroneous reporting as a possible explanation for this phenomenon. Methods We reviewed all deaths from 2 New York City hospitals during 2013-2014 in which pneumonia or influenza was reported as the underlying cause of death (n = 188), and we examined the association between erroneous reporting and multiple extrinsic factors that may influence cause-of-death reporting (patient demographic characteristics and medical comorbidities, time and hospital location of death, type of medical provider reporting the death, and availability of certain diagnostic information). Results Pneumonia was erroneously reported as the underlying cause of death in 163 (86.7%) reports. We identified heart disease and dementia as the more likely underlying cause of death in 21% and 17% of erroneously reported deaths attributable to pneumonia, respectively. We found no significant association between erroneous reporting and the multiple extrinsic factors examined. Conclusions Our results underscore how erroneous reporting of 1 condition can lead to underreporting of other causes of death. Misapplication or misunderstanding of procedures by medical providers, rather than extrinsic factors influencing the reporting process, are key drivers of erroneous cause-of-death reporting.

Abstract Introduction/Objective The majority of tracking methods have employed whole genome sequencing, which can be very expensive and time consuming. An alternative method has been to use genotyping of specific mutations to identify variants. However, tracking SARS-CoV-2 variants by targeted methods has been a moving target. Most methods only multiplex four targets per reaction, but we have multiplexed 8 targets in a single tube using fragment analysis. Methods/Case Report Fluorescently labeled primers targeted a combination of insertion/ deletion mutations and single nucleotide mutations. The PCR amplified products, amplicons, were separated by capillary electrophoresis. Primers were designed to detect changes in size indicative of insertion or deletion mutations including: ORF1A:Del3675_3677, S:Del69_70, S:Del144, S:Del157_158, S:Del242_244, ORF8:Del119_120, and ORF8:ins28269-28273. Allele-specific primers were designed to detect both the wild-type and mutated versions of S:N501Y, S:E484K, and S:L452R. Residual nasopharyngeal and nasal specimens testing positive for SARS-CoV-2 by RT-PCR or isothermal amplification (IDnow) methods were selected from May 1- June 24, 2021. Variant analysis was performed by multiplex targeted PCR and whole genome sequencing in parallel on the same specimens to determine positive percent agreement. Results (if a Case Study enter NA) Variant analysis was performed on 250 specimens detecting each of the major variants of concern Alpha (B.1.1.7, U.K. origin, n= 108), Beta (B.1.351, South Africa origin, n=3), Gamma (P.1, Brazil origin, n=12), Delta (B.1.617.2, Indian origin, n=17), and Iota (B.1.526, New York, n=5). Some specimens with low viral load were detected by only PCR (n=18), only WGS (n=41), or neither (n=20). Overall positive percent agreement was 95% (163/171). Conclusion This adjustable method robustly and accurately identifies COVID-19 VOCs utilizing a platform amenable to multiple targets (20-40 targets ranging from 100-500b.p. across four fluorescent channels) using equipment commonly found in routine molecular pathology laboratories. Future directions include adjusting targets to detect new variants.

Background and objectivesKidney biopsy is the current gold standard to diagnose membranous nephropathy. Approximately 70%–80% of patients with primary membranous nephropathy have circulating anti-phospholipase A2 receptor antibodies. We previously demonstrated that in proteinuric patients with preserved eGFR and absence of associated conditions (e.g., autoimmunity, malignancy, infection, drugs, and paraproteinemia), a positive anti-phospholipase A2 receptor antibody test by ELISA and immunofluorescence assay confirms the diagnosis of membranous nephropathy noninvasively. These data have not been externally validated.Design, setting, participants, & measurementsThe clinical and pathologic characteristics of patients with a positive anti-phospholipase A2 receptor antibody test at the Mayo Clinic, the University Hospital Vall D’Hebron (Barcelona), and the Columbia University Medical Center (New York) were retrospectively reviewed. Biopsy findings and presence or absence of a potential associated condition were assessed.ResultsFrom a total of 276 patients with positive anti-phospholipase A2 receptor serology, previously reported patients (n=33), kidney transplant recipients (n=9), pediatric patients (n=2), and patients without kidney biopsy (n=69) were excluded. Among the 163 remaining patients, associated conditions were identified in 47 patients, and 15 patients had diabetes mellitus. All 101 patients of the final cohort had a primary diagnosis of membranous nephropathy on kidney biopsy. In the 79 patients with eGFR≥60 ml/min per 1.73 m2, none of the biopsy findings altered diagnosis or management. Among the 22 patients with decreased eGFR, additional findings included superimposed acute interstitial nephritis (n=1).ConclusionsIn patients with preserved eGFR and absence of associated conditions or diabetes, a positive anti-phospholipase A2 receptor test by either ELISA >20 RU/ml or a positive immunofluorescence assay confirms the diagnosis of membranous nephropathy, precluding the requirement for a kidney biopsy.

Abstract Objectives Data from the 2020 Needs Satisfaction Survey revealed that 82% of registered dietitian nutritionists identified as white and 93% as female. On Dec 7, 2020 the New York Times published the article, “Is American Dietetics a White-Bread World? These Dietitians Think So.” The article presented information about diversity among dietetics professionals and the perspectives of numerous dietetics professionals and organizations. The objective of this study was to describe public comments on this article in order to assess public perspectives on diversity among dietetics professionals. Methods The online article was open for comments Dec 7, 2020 to Dec 9, 2020. All published comments and the number of recommends (i.e., endorsements) on each comment were recorded. Three coders (AH, JR, AK) coded all comments using a directed qualitative coding scheme developed by AH: Supportive of diversity; Dismissive of diversity; Recommendation for increasing diversity; Critique of article; or Off-topic. Codes were not mutually exclusive. Inter-rater reliability (Fleiss’ kappa, κ) ranged from moderate to good (κ’s = 0.42–0.74). Descriptive statistics were calculated. Results A total of 286 comments (163 original posts, 123 replies) were recorded. More comments were rated as supportive (39%, n = 112) than dismissive (19%, n = 55). Few comments (7%, n = 19) included a recommendation for increasing diversity. A sizeable minority of comments (11%, n = 32) were critical of the article (e.g., tone, information presented). Over half of comments included off-topic remarks (65%, n = 185). Recommends ranged from 0 to 278 (median = 10), with the top 5% of comments receiving ≥66 recommends. Among the top 5% of recommended comments (n = 14), 86% were supportive, 29% were dismissive, 29% were critical, 14% included a recommendation, and 29% included an off-topic remark. The most recommended comment (278 recommends) was supportive and included a recommendation for increasing diversity, specifically addressing the unpaid internship requirement. Conclusions Results generally indicated public support for diversity among dietetics professionals. However, the high frequency of off-topic remarks and presence of dismissive and critical comments highlight a need for expanded public education about the dietetics profession and importance of diversity, equity, and inclusion. Funding Sources None.

MacWhinney, Bates, and colleagues developed the Competition Model in the 1980s as an alternate to Chomskyan models that encapsulate syntax as a special-purpose module. The Competition Model adopted the functional perspective that language serves communicative goals and functions. In contrast to the premise that knowledge of language is innate, the Competition model asserts that language is learned and processed through general cognitive mechanisms that identify and weight phonological, morphological, syntactic, and semantic cues in the language experiences of the learner. These weighted cues guide the language user in the comprehension and production of language forms. The present article provides background on the Competition Model, describes machine simulations of linguistic competition, and extends the principles of the Competition Model to new machine models and applications through deep learning networks. References Bates, E. & MacWhinney, B. (1982). A functionalist approach to grammar. In E. Wanner & L. Gleitman (Eds.), Language acquisition: the state of the art. New York: Cambridge University Press. Bates, E., & MacWhinney, B. (1989). Functionalism and the competition model. In: The Crosslinguistic Study of Sentence Processing, (pp 3-76). B. MacWhinney and E. Bates (Eds.), New York: Cambridge University Press. Devescovi, A., D’Amico, S., Smith, S., Mimica, I., & Bates, E. (1998). The development of sentence comprehension in Italian and Serbo-Croatian: Local versus distributed cues. In: Syntax and Semantics: Vol. 31. Sentence Pocessing: A Cross-Linguistic Perspective, (pp. 345-377). D. Hillert (Ed.), San Diego: Academic Press. Hauser, M. D., Chomsky, N., & Fitch, W. T. (2002). The faculty of language: What it is, who has it, and how did it evolve? Science, 298, 1569-1579. Just, M. A., & Carpenter, P. A. (1980). A theory of reading: From eye fixations to comprehension. Psychological Review, 87, 329-354. Langacker, R. (1989). Foundations of cognitive grammar. Vol. 2: Applications. Stanford: Stanford University Press. Li, P., & MacWhinney, B. (2013). Competition model. In: The Encyclopedia of Applied Linguistics. C. A. Chapelle (Ed.), Malden, MA: Wiley. MacWhinney, B. (1987). The competition model. In: Mechanisms of Language Acquisition, (pp.249-308). B. MacWhinney (Ed.).Hillsdale, NJ: Lawrence Erlbaum. MacWhinney, B. (2001). The competition model: The input, the context, and the brain. In: Cognition and Second Language Instruction, (pp. 69–90). P. Robinson (Ed.), New York: Cambridge University Press. MacWhinney, B. (2008). A Unified Model. In: Handbook of Cognitive Linguistics and Second Language Acquisition, (pp. 341-371). P. Robinson & N. Ellis (Eds.). Mahwah, NJ: Lawrence Erlbaum Associates. MacWhinney B. (2012). The logic of the Unified Model. In: The Routledge Handbook of Second Language Acquisition, (pp. 211–227). S. Gass and A. Mackey (Eds.). New York: Routledge. MacWhinney, B. (2015). Multidimensional SLA. In: Usage-Based Perspectives on Second Language Learning, (pp. 22-45). S. Eskilde and T. Cadierno (Eds.). New York: Oxford University Press. MacWhinney, B., Bates, E. & Kliegl, R. (1984). Cue validity and sentence interpretation in English, German, and Italian. Journal of Verbal Learning and Verbal Behavior, 23, 127-150. MacWhinney, B., Leinbach, J., Taraban, R., & McDonald, J. (1989). Language learning: Cues or rules? Journal of Memory and Language, 28, 255-277. McClelland, J. L., & Rumelhart, D. E. (1986). Parallel Distributed Processing. Explorations in the Microstructure of Cognition. Volume 2: Psychological and Biological Models. Cambridge, MA: MIT Press. Presson, N. & MacWhinney, B. (2011). The Competition Model and language disorders. In: Handbook of Psycholinguistic and Cognitive Processes, (pp. 31-48). J. Guendozi, F. Loncke, and M. Williams (Eds.). New York: Psychology Press. Sokolov, J. L. (1988). Cue validity in Hebrew sentence comprehension. Journal of Child Language, 15, 129-156. Taraban, R. (2004). Drawing learners’ attention to syntactic context aids gender-like category induction. Journal of Memory and Language, 51(2), 202-216. Taraban, R. (2017). Hate, white supremacy, PTSD, and metacognition. In: Improve With Metacognition [online]. L. Scharff, A. Richmond, & J. Draeger (Eds.). Retrieved from: www.improvewithmetacognition.com. Taraban, R., & Kempe, V. (1999). Gender processing in native and non-native Russian speakers. Applied Psycholinguistics, 20, 119-148. Taraban, R., McDonald, J., & MacWhinney, B. (1989). Category learning in a connectionist model: Learning to decline the German definite article. In R. Corrigan, F. Eckman, & M. Noonan (Eds.), Linguistic categorization (pp. 163-193). Philadelphia: Benjamins. Taraban, R., & Roark, B. (1996). Competition in learning language-based categories. Applied Psycholinguistics, 17, 125-148.

Concurrently with the rapid development in digital society, the demand for communication skills was clear in childhood. Early childhood education needs to pay attention to children's speech skills development. This study aims to determine the effect of cognitive style and attachment on the ability to speak in early childhood speech development. The method used is a 2 x 2 factorial comparison design which is divided into two groups namely independent and dependent fields involving 138 samples. Re- search findings about differences in the ability to speak early childhood who have independent field cognitive style and children who have field dependent cognitive style in groups of children with high attachment obtained (A2B1), obtained Q count = 9.39 and Q table (0.05; 4: 10) = 4 , 33. 4). Differences in the ability to speak early childhood who have an independent field cognitive style and children who have a field dependent cognitive style in groups of children with low attachment obtained (A2B2), ob- tained Q count = 4.39 and Q table (0.05; 4: 10) = 4 , 33. It show that early children who have independent field cognitive style have higher speech skills scores than early children who have field dependent cog- nitive style while early children who are independent field cognitive style with low attachment have lower speech skills scores than early childhood the field dependent cognitive style with low attachment. Keywords: Cognitive style and Attachment, Early Childhood, Speech Skills Reference Aulya Purnama, R., & Wahyuni, S. (2018). Kelekatan (Attachment) pada Ibu dan Ayah Dengan Kompetensi Sosial pada Remaja. Jurnal Psikologi, 13(1), 30. https://doi.org/10.24014/jp.v13i1.2762 Berk, L. E. (2007). Child Development Boston. Pearson (seventh Ed). 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Advances in Life Course Research, 35(February), 126–134. https://doi.org/10.1016/j.alcr.2018.02.001 Holmes, J. (2014). John Bowlby and Attachment Theory (2nd Editio). https://doi.org/https://doi.org/10.4324/9781315879772 Kerlinger, F. N. (1990). Asas-asas Penelitian Behavioral (3th ed.). Yogyakarta: Gajah Mada University Press. Larasati, N. I., & Desiningrum, dinie R. (2017). Hubungan Antara Kelekatan Aman Dengan Ibu Dan Regulasi Emosi Siswa Kelas X Sma Negeri 3 Salatiga. Empati, 6(3), 127–133. Lwin, M., Khoo, A., Lyen, K., & Sim, C. (2002). How to Multiply Your Child’s Intelligence: A Practical Guide for Parents of Seven-Year-Olds and Below. Singapore: Pearson Education Asia Pte., Ltd. Machado, J. M. (2012). Early Childhood Experiences in Language Arts: Early Literacy (10 edition). Belmont, USA: Wadsworth Publishing. Madyawati, L. (2016). Strategi Pengembangan Bahasa Pada Anak. Jakarta: Kencana. Mahabbati, A. (2013). Layanan Pendidikan untuk Anak Berkebutuhan Khusus dan Pendidikan Inklusif. Retrieved from http://staffnew.uny.ac.id/upload/132318126/pengabdian/ppmlayanan-pendidikan-untuk- anak-berkebutuhan-khusus. McLeod, S., Harrison, L. J., & Wang, C. (2019). A longitudinal population study of literacy and numeracy outcomes for children identified with speech, language, and communication needs in early childhood. Early Childhood Research Quarterly, 47, 507–517. https://doi.org/10.1016/j.ecresq.2018.07.004 Nasution, S. (2011). Berbagai Pendekatan Dalam Proses Belajar Dan Mengajar. Jakarta: Bumi Aksara. Nussipzhanova, B., Berdibayeva, S., Garber, A., Tuyakova, U., Mursaliyeva, A., & Baizhumanova, B. (2017). Cognitive development of pre-school children with language and speech disorders. The European Journal of Social and Behavioural Sciences, 21(1), 2570– 2583. https://doi.org/10.15405/ejsbs.227 Ormrod, J. E. (2009). Psikologi Pendidikan Membantu Siswa Tumbuh dan Berkembang (6th editio). 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Background:Axial spondyloarthritis (axSpA) is an inflammatory disease characterised by chronic back pain, and it comprises radiographic axSpA and non-radiographic axSpA (nr-axSpA).1 Secukinumab (SEC) 150 mg, with (LD) or without loading (NL), dose significantly improved the signs and symptoms of patients with nr-axSpA in the PREVENT (NCT02696031) study through Week 52.2Objectives:To report the long-term clinical efficacy and safety of secukinumab from the PREVENT study through 2 years.Methods:A detailed study design, key primary and secondary endpoints have been reported previously.2 In total, 555 patients fulfilling ASAS criteria for axSpA plus abnormal C-reactive protein (CRP) and/or MRI, without evidence of radiographic changes in sacroiliac (SI) joints according to modified New York Criteria for AS were randomised (1:1:1) to receive SEC 150 mg with LD, NL, or placebo (PBO) at baseline. LD patients received SEC 150 mg at Weeks 1, 2, 3, and 4, and then every 4 weeks (q4wk) starting at Week 4. NL patients received SEC 150 mg at baseline and PBO at weeks 1, 2, and 3, and then 150 mg q4wk. 90% patients were anti-tumour necrosis factor (anti-TNF) naïve, 57% had elevated CRP and 73% had evidence of SI joint inflammation on MRI. All images were assessed centrally before inclusion. All patients continued to receive open-label SEC 150 mg treatment after Week 52. Efficacy assessments through Week 104 included ASAS40 in anti-TNF-naïve patients, ASAS40, BASDAI change from baseline, BASDAI50, ASAS partial remission, and ASDAS-CRP inactive disease in the overall population. The safety analyses included all patients who received ≥1 dose of study treatment for the entire treatment period up to Week 104. Data are presented as observed.Results:Overall, 438 patients completed 104 weeks of study: 78.9% (146/185; LD), 77.7% (143/184; NL) and 80.1% (149/186; PBO). Efficacy results at Week 52 were sustained through Week 104 and are reported in the Table 1. The safety profile was consistent with the previous reports with no deaths reported during the entire treatment period up to Week 104.2Conclusion:Secukinumab 150 mg demonstrated sustained improvement in the signs and symptoms of patients with nr-axSpA through 2 years. Secukinumab was well tolerated with no new or unexpected safety signals.References:[1]Strand V, et al. J Clin Rheumatol. 2017; 23(7):383–91.[2]Deodhar A, et al. Arthritis Rheumatol. 2020. Online ahead of print.Figure 1.ASAS40 response was maintained through Week 104 in the overall populationTable 1.Summary of clinical efficacy (Observed data)EndpointsWeekSEC 150 mg LD(N=185)SEC 150 mg NL(N=184)PBO-SEC 150 mg(N=186)*ASAS40 in anti-TNF-naïve patients, n/M (%)52a90/137 (65.7)95/145 (65.5)85/151 (56.3)10478/123 (63.4)83/123 (67.5)83/134 (61.9)BASDAI change from baseline, mean±SD52a−3.7±2.8−3.7±2.6−3.3±2.4104−4.1±2.6−3.9±2.6−3.7±2.5BASDAI50, n/M (%)52a90/153 (58.8)92/163 (56.4)90/161 (55.9)10488/137 (64.2)84/136 (61.8)87/142 (61.3)ASAS partial remission,n/M (%)52a46/152 (30.3)56/163 (34.4)46/161 (28.6)10451/137 (37.2)50/135 (37.0)50/142 (35.2)ASDAS CRP inactive disease, n/M (%)52a49/152 (32.2)58/163 (35.6)48/160 (30.0)10450/132 (37.9)53/133 (39.8)53/142 (37.3)*For anti-TNF-naïve patients, N=164, LD; 166, NL; 171, PBO-SEC.a total number of evaluable patients including open-label SEC and standard of care (SOC; 2 patients in LD, 1 patient in NL continued on SOC). After Week 52, only patients who continued to receive open-label SEC are presented.ASAS, Assessment of SpondyloArthritis International Society; ASDAS, Ankylosing Spondylitis Disease Activity Score; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; M, number of patients with evaluation; N, total randomised patients; n, number of patients who are responders; SD, standard deviationDisclosure of Interests:Denis Poddubnyy Speakers bureau: AbbVie, BMS, Eli Lilly, MSD, Novartis, Pfizer, UCB, Consultant of: AbbVie, Biocad, BMS, Eli Lilly, Gilead, MSD, Novartis, Pfizer, Samsung Bioepis, UCB, Grant/research support from: AbbVie, MSD, Novartis, Pfizer, Atul Deodhar Speakers bureau: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myer Squibb (BMS), Eli Lilly, GSK, Janssen, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, GSK, Janssen, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Eli Lilly, GSK, Novartis, Pfizer, and UCB, Xenofon Baraliakos Speakers bureau: AbbVie, BMS, Celgene, Chugai, MSD, Novartis, Pfizer, and UCB, Consultant of: AbbVie, BMS, Celgene, Chugai, Galapagos, Gilead, MSD, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie and Novartis, Ricardo Blanco Speakers bureau: AbbVie, Pfizer, Roche, Bristol-Myers, Janssen, UCB pharma and MSD and Eli Lilly, Consultant of: AbbVie, Pfizer, Roche, Bristol-Myers, Janssen, UCB pharma and MSD, Grant/research support from: AbbVie, MSD, and Roche, Eva Dokoupilova Grant/research support from: AbbVie, Affibody AB, Eli Lilly, Galapagos, Gilead, GSK, Hexal AG, MSD, Novartis, Pfizer, R-Pharm, Sanofi-Aventis, and UCB, Stephen Hall Speakers bureau: Novartis, Merck, Janssen, Pfizer, Eli Lilly, and UCB, Consultant of: Novartis, Merck, Janssen, Pfizer, Eli Lilly, and UCB, Grant/research support from: AbbVie, UCB, Janssen, and Merck, Alan Kivitz Shareholder of: Pfizer, Sanofi, Novartis, Amgen, GlaxoSmithKline, Gilead Sciences, Inc., Speakers bureau: Celgene, GlaxoSmithKline, Eli Lilly, Merck, Novartis, Pfizer, Sanofi, Genzyme, Flexion, AbbVie, UCB, Consultant of: AbbVie, Boehringer Ingelheim, Flexion, Janssen, Pfizer, Sanofi, Regeneron, SUN Pharma Advanced Research, Gilead Sciences, Inc., Marleen G.H. van de Sande Speakers bureau: Novartis, MSD, Consultant of: Abbvie, Novartis, Eli Lily, Grant/research support from: Novartis, Eli Lilly, Janssen, UCB, Anna Stefanska Shareholder of: Novartis, Employee of: Novartis, Patricia Pertel Shareholder of: Novartis, Employee of: Novartis, Hanno Richards Shareholder of: Novartis, Employee of: Novartis, Juergen Braun Speakers bureau: Abbvie (Abbott), Amgen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, EBEWE Pharma, Medac, MSD (Schering-Plough), Mundipharma, Novartis, Pfizer (Wyeth), Roche, Sanofi-Aventis and UCB pharma, Eli Lilly, Consultant of: Abbvie (Abbott), Amgen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, EBEWE Pharma, Medac, MSD (Schering-Plough), Mundipharma, Novartis, Pfizer (Wyeth), Roche, Sanofi-Aventis and UCB, Eli Lilly, Grant/research support from: Abbvie (Abbott), Amgen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, Medac, MSD (Schering-Plough), Mundipharma, Novartis, Pfizer (Wyeth), Roche, Sanofi-Aventis and UCB, Eli Lilly

Background To study the effect of tricuspid valve repair/replacement on outcomes of patients with reduced systolic right ventricular function. Methods Between January 2012 and July 2016, 191 patients with isolated tricuspid valve regurgitation and/or in combination with other valve diseases were enrolled into this retrospective study. We compared early postoperative outcomes (i.e., 30 days after surgery) between patients' cohort with a preoperative reduced (i.e., at least moderately) versus normal (or mildly reduced) right ventricular function as defined by means of preoperative echocardiography. Results A total of 82 (43%) patients had preoperatively reduced right ventricle function with tricuspid annular plane systolic excursion (TAPSE) of 13.3 ± 3.3 versus 20.2 ± 4.9 mm (p < 0.001). Ring annuloplasty was the most common surgical technique (i.e., 91% in both groups). Time of procedure (317 ± 123 vs. 262 ± 88 minutes, p < 0.01) and time on cardiopulmonary bypass (163 ± 77 vs. 143 ± 57 minutes, p = 0.036) were significantly longer in patients with impaired right ventricular function. Postoperative lactate (3.5 ± 3 vs. 2 ± 1 mmol/L, p = 0.001) and dose of catecholamines (epinephrine, 0.07 ± 0.15 vs. 0.013 ± 0.02 µg/kg/min, p = 0.001; norepinephrine, 0.18 ± 0.23 vs. 0.07 ± 0.09 µg/kg/min, p = 0.007) were also higher in this group. Postoperative rate of low cardiac output syndrome (10 vs. 27%, p = 0.005) and early mortality (n = 2 vs. n = 9, p = 0.018) were significantly increased in patients with reduced right ventricular function. Previous cardiac operation (p = 0.045), preoperative higher number of acute decompensations of heart failure (p < 0.001), reduced right ventricular function (p = 0.018), postoperative low cardiac output syndrome (p < 0.001), and renal replacement therapy (p < 0.001) were identified as risk factors for early mortality. Echocardiography at discharge revealed tricuspid valve regurgitation grade of 0.9 ± 0.7 versus 0.7 ± 0.6 (p = 0.052) and TAPSE of 12 ± 3 versus 15 ± 5 mm (p = 0.026) in patients with reduced right ventricular function. The New York Heart Association (NYHA) class improved to 1.7 ± 0.7 versus 1.3 ± 1 (p < 0.001) in this group of patients. Conclusion Tricuspid valve repair/replacement effectively eliminated severe tricuspid regurgitation and improved clinical signs of heart failure. Although mortality and morbidity were increased in the group with reduced right ventricular function, even these patients benefitted from improved functional status and right ventricular systolic function early postoperatively.