Publications by authors named "Koren O"

Background: Lifetime treatment of aortic valve disease is a matter of increasing debate. Although the risks of a second aortic valve intervention are recognized, little attention has been given to the challenges of a third.

Objectives: This study delves into the clinical characteristics, indications, and outcomes of patients undergoing 3 aortic valve interventions.

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  • The study examines the outcomes of mitral transcatheter edge-to-edge repair (TEER) performed during off-hours (before 7:30 am, after 5:30 pm, or on weekends/holidays) to see how they compare to procedures done during regular hours.
  • The analysis included 1,177 procedures, with 117 (9.9%) occurring off-hours; off-hours procedures were often urgent and involved higher-risk patients, yet technical success was high in both groups.
  • Although baseline MR severity and functional class improved for both groups, off-hours patients experienced higher rates of deaths and heart failure hospitalizations, with no procedural timing linked to outcomes in matched comparisons, suggesting experienced interventionalists can conduct these procedures safely regardless
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  • * Clinical studies show probiotics might help reduce side effects like diarrhea from Clostridioides difficile, yet there's no direct evidence connecting these outcomes to microbiota protection.
  • * The review discusses the complexities of studying microbiota restoration, including the challenges of defining a "normal" microbiota, varying measurement methods, and individual differences, while suggesting future research directions.
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There is growing interest in the potential exploitation of the gut microbiome as a diagnostic tool in medicine, but evidence supporting its clinical usefulness is scarce. An increasing number of commercial providers offer direct-to-consumer microbiome diagnostic tests without any consensus on their regulation or any proven value in clinical practice, which could result in considerable waste of individual and health-care resources and potential drawbacks in the clinical management of patients. We convened an international multidisciplinary expert panel to standardise best practices of microbiome testing for clinical implementation, including recommendations on general principles and minimum requirements for their provision, indications, pre-testing protocols, method of analyses, reporting of results, and potential clinical value.

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Background: Most infants with febrile urinary tract infection (UTI) do not have an underlying anatomical risk factor. Thus, other non-anatomical risk factors should be considered. Since the most common pathogens arise from the fecal microbiota, our aim was to investigate whether the gut microbiota composition differs between febrile infants younger than 2 months with or without UTI.

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Background: Prognostically meaningful tricuspid regurgitation (TR) is not well-defined in the mitral transcatheter edge-to-edge repair arena. We aimed to explore the prevalence, correlates, and consequences of TR grades and postprocedural trends in this setting.

Methods And Results: A single-center registry of isolated, first-time interventions was retrospectively assessed for pre-, intra-, and postprocedural aspects up to 1 year, of them the primary composite outcome of all-cause deaths or heart failure (HF) hospitalizations, all according to TR severity at baseline and at 1 month following mitral transcatheter edge-to-edge repair.

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  • Balloon-expandable valves (BEVs) and self-expanding valves (SEVs) are compared for their effects on patients with Sievers type 1 bicuspid aortic valve (BAV) stenosis undergoing transcatheter aortic valve replacement.
  • The analysis, based on a registry of 955 patients, found no significant difference in midterm major adverse events or technical success between BEVs and SEVs after adjusting for baseline differences.
  • However, BEVs had lower risks of new permanent pacemaker implantation and moderate or greater paravalvular regurgitation, but a higher risk of severe patient-prosthesis mismatch compared to SEVs.
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Background: Systemic alterations in the oral cavity can be reflected in skin disorders like psoriasis. However, data about oral health factors that are affected and controlled mainly by oral microbiota in atopic dermatitis (AD) are sparse. This study compared the oral status and oral microbiota of AD patients and healthy controls.

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Background: An enhanced classification of primary mitral regurgitation (PMR) based on extramitral cardiac involvement may refine patient selection and optimize the timing of transcatheter edge-to-edge repair (TEER).

Aims: This study aimed to assess the prognostic significance of a recently established classification system that characterizes the extent of extramitral cardiac damage in patients undergoing TEER for PMR.

Methods: Consecutive PMR patients who received MitraClip implantation were categorized according to the presence of extramitral cardiac damage, determined through preprocedural echocardiography.

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The microbiome has been linked to numerous neurological and psychiatric diseases, including schizophrenia. Nevertheless, correlating microbial perturbations to pathophysiological aspects of schizophrenia remains elusive, as study participants are typically medicated when sampled, complicating mechanistic investigation. Here we explored specific microbial and metabolic alterations in schizophrenia patients, while explicitly considering their medications.

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  • The study examines the characteristics and outcomes of patients with tapered raphe-type bicuspid aortic valve (BAV) when undergoing trans-catheter aortic valve replacement (TAVR), focusing on the safety and effectiveness of modern heart valves.
  • Researchers analyzed data from 897 patients, finding that those with tapered configurations showed similar success rates and safety between two sizing strategies: annular and supra-annular.
  • The results indicate that TAVR is a safe and effective procedure for these patients, regardless of the sizing method used, maintaining a high rate of clinical efficacy at mid-term follow-up.
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Background: Research on the role of transcatheter heart valve (THV) deformation and calcium distribution in patients with bicuspid aortic valves (BAVs) undergoing transcatheter aortic valve replacement (TAVR) remains limited.

Objectives: The aim of this study was to evaluate the impact of THV deformation on clinical outcomes in individuals with BAVs undergoing TAVR and the influence of calcium on these outcomes.

Methods: In total, 229 consecutive patients with BAVs who underwent TAVR with balloon-expandable valves and had computed tomography (CT) performed 30 days post-TAVR were analyzed.

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Understanding when host-microbiome interactions are first established is crucial for comprehending normal development and identifying disease prevention strategies. Furthermore, bacterially derived metabolites play critical roles in shaping the intestinal immune system. Recent studies have demonstrated that memory T cells infiltrate human intestinal tissue early in the second trimester, suggesting that intestinal immune education begins in utero.

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Here, we explored the vast potential of microbiome-based interventions in preventing and managing non-communicable diseases including obesity, diabetes, allergies, celiac disease, inflammatory bowel diseases, malnutrition, and cardiovascular diseases across different life stages. We discuss the intricate relationship between microbiome and non-communicable diseases, emphasizing on the "window of opportunity" for microbe-host interactions during the first years after birth. Specific biotics and also live biotherapeutics including fecal microbiota transplantation emerge as pivotal tools for precision medicine, acknowledging the "one size doesn't' fit all" aspect.

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Detecting life has driven research and exploration for centuries, but recent attempts to compile and generate a framework that summarizes life features, aimed to develop strategies for life detection missions beyond planet Earth, have disregarded a key life feature: behavior. Yet, some behaviors such as biomineralization or motility have occasionally been proposed as biosignatures to detect life. Here, we capitalize on a specific taxis' motility behavior, magnetotaxis, to experimentally provide insights in support of behavior as an unambiguous, sensitive biosignature, and magnetic forces as a prescreening option.

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Recent research has unveiled conflicting evidence regarding the link between aggression and the gut microbiome. Here, we compared behavior profiles of control, germ-free (GF), and antibiotic-treated mice, as well as re-colonized GF mice to understand the impact of the gut microbiome on aggression using the resident-intruder paradigm. Our findings revealed a link between gut microbiome depletion and higher aggression, accompanied by notable changes in urine metabolite profiles and brain gene expression.

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The role of hormones in gut-brain crosstalk is largely elusive, but recent research supports specific changes in hormone levels correlated with the gut microbiota. An interesting but unstudied area in microbial endocrinology is the interplay between the microbiota and sex hormones. The aim of this study is to investigate the effect of testosterone and sex on the mouse gut microbiome.

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Objective: Identifying biomarkers that can distinguish trauma-exposed youth at risk for developing posttraumatic pathology from resilient individuals is essential for targeted interventions. As trauma can alter the microbiome with lasting effects on the host, our longitudinal, multimeasure, cross-species study aimed to identify the microbial signature of posttraumatic stress disorder (PTSD).

Method: We followed children exposed to war-related trauma and matched controls from early childhood ( = 2.

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While the number of infectious zoonotic disease outbreaks has been rising, their impact on civil war and social conflict is poorly understood. This study addresses this fundamental limitation using a geolocated monthly dataset on 22 zoonotic diseases in Africa. Zoonotic disease is a key driver of new epidemics, making such pathogens a useful test case.

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  • Haemodynamic monitoring with implantable pressure sensors lowers heart failure hospitalizations and empowers patients to manage their treatment, potentially enhancing adherence and reducing healthcare provider workloads.
  • The VECTOR-HF I and IIa studies evaluate a patient self-management approach for heart failure, showing no serious complications and high adherence (91.4%) over a year, with significant reductions in hospitalizations and improvements in physical function and quality of life.
  • Interim results indicate that patient self-management using left atrial pressure monitoring is safe, feasible, and may lead to better outcomes for heart failure patients.
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Residual significant mitral regurgitation (MR) can increase the risk of adverse events after transcatheter aortic valve replacement (TAVR). The clinical benefits of staged transcatheter edge-to-edge repair (TEER) after TAVR remain underexplored. This study aimed to investigate the clinical outcomes of staged TEER for residual significant MR after TAVR.

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Executive Summary: Microbes are all pervasive in their distribution and influence on the functioning and well-being of humans, life in general and the planet. Microbially-based technologies contribute hugely to the supply of important goods and services we depend upon, such as the provision of food, medicines and clean water. They also offer mechanisms and strategies to mitigate and solve a wide range of problems and crises facing humanity at all levels, including those encapsulated in the sustainable development goals (SDGs) formulated by the United Nations.

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  • Transcatheter aortic valve replacement (TAVR) for patients with bicuspid aortic valve (BAV) stenosis can lead to complications like paravalvular regurgitation (PVR), which is the leakage of blood around the valve.
  • A study involving 946 patients aimed to understand how often PVR occurs after TAVR, what factors predict it, and its impact on patient outcomes, finding that 44.7% experienced some level of PVR.
  • Moderate or severe PVR was linked to higher risks of major adverse events (MAEs) like death or hospitalization, highlighting the importance of careful monitoring and management in these patients.
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Typhimurium is a zoonotic pathogen that poses a major threat to public health. This generalist serotype can be found in many hosts and the environment where varying selection pressures may result in the accumulation of antimicrobial resistance determinants. However, the transmission of this serotype between food-producing hosts, specifically between poultry layer flocks and nearby dairy herds, was never demonstrated.

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