bluuebunny/crossref_metadata_2025 huggingface dataset:
Conclusion
Authors: Bruno G Anthony
Published: January 2025

The untold history of the concept of facticity traces a line from Kant, through the rise and fall of German idealism and the emergence of neo-Kantianism, to the flourishing of phenomenology. Admittedly, this history is one chapter in philosophy’s ancient, abiding confrontation with brute facts. However, in light of the Copernican turn that opens that chapter, philosophy’s confrontation with bruteness takes the form of a specific question, namely, whether a science of the conditions of intelligibility can tolerate brute facts. This question is decisive for the kind of philosophy one chooses after Kant, for it concerns our resoluteness in the face of human finitude. The bruteness, radical contingency, or groundlessness of the conditions of intelligibility, of the freedom and character with which we pursue a science of intelligibility, of intelligible existence itself, and of our thrownness into intelligible existence all refer to our inescapably finite standpoint on intelligibility. We are radical contingency incarnate. How we choose to answer the post-Kantian question therefore inevitably exhibits whether and to what extent we own up to our finitude.
Introduction
Authors: Argomaniz Javier
Published: January 2025

The introduction to this volume contextualizes the topic and explains the importance of the Basque case for the literature on terrorism, political violence, and civil resistance. It identifies the key concepts that will drive the analysis. It explains how the study’s theoretical framework draws from scholarship on civil society peacebuilding, contentious politics, nonviolent resistance, and social movements. It describes the main empirical and conceptual contributions of this work and highlights that this is the first in-depth study of the impact of civil action on a terrorist campaign. It also introduces the main claims made in this work that will be later developed throughout the book. Finally, the chapter dissects the data that have informed the argument before concluding with a general outline of the book.
Daily hassle effects on daily cigarette and/or e-cigarette use: the moderating effect of daily uplifts
Authors: Lin Yitong , B O’Connor Daryl , Conner Mark
Published: January 2025

Background

Daily hassles, as minor stressful events, are common in life. However, they have received less attention in previous studies on relationships between stressful events and nicotine product use. Meanwhile, daily uplifts have also been investigated less in research on nicotine use.

Purpose

The current study was conducted to explore the relationships between daily measures of hassles, uplifts, and the use of nicotine products (ie, cigarettes, e-cigarettes).

Methods

This was a daily diary study. Participants completed 1 diary each day for up to 7 days. One hundred and eighty-one adults who currently use cigarettes or e-cigarettes solely or co-use both completed a total of 886 daily diary entries. Multilevel modeling was used to predict the daily use of the above nicotine products from daily hassles, daily uplifts, and their interactions.

Results

Daily hassles were positively associated with any daily nicotine use. There were no significant associations between daily hassles and daily cigarette use or between daily hassles and daily e-cigarette use. Daily uplifts were not directly associated with any behaviors, but daily hassles and daily uplifts showed a significant interaction in affecting any daily nicotine use, daily cigarette use, and daily e-cigarette use. In each use pattern, increasing levels of uplifts were associated with an attenuation of the relationship between hassles and the use of nicotine products.

Conclusions

It may be worthwhile to explore further the effects of daily hassles and daily uplifts on nicotine product use through ecological momentary assessments.
Effect of COVID-19 Pandemic Related Healthcare Disruption on Hypertension Control: A Retrospective Analysis of Older Adults with Multiple Chronic Conditions in New York City
Authors: Banco Darcy , Kanchi Rania , Divers Jasmin , Adhikari Samrachana , Titus Andrea , Davis Nichola , Uguru Jenny , Bakshi Parampreet , George Annie , Thorpe Lorna E , Dodson John
Published: January 2025

Background

Disruption of ambulatory healthcare in New York City (NYC) during the COVID-19 pandemic was common, but the impact on the cardiometabolic health of vulnerable patient groups is unknown. Therefore, we estimated the effect of total care disruption (TCD) on blood pressure (BP) control among older NYC residents with hypertension and at least one other chronic condition, and examined whether neighborhood poverty moderated this impact.

Methods

From the INSIGHT Clinical Research Network, we identified NYC residents ≥50 years of age with hypertension and at least one other chronic condition. TCD was defined as no ambulatory or telehealth visit during the pandemic. We contrasted the change in prevalence of controlled BP (BP <140/90) before and after the pandemic among those with and without TCD via an inverse probability weighted (IPW) difference-in-difference regression model.

Results

Among 212,673 eligible individuals, mean age was 69.5 years (SD: 10.2 years) and 15.1% experienced TCD. BP control declined from 52.4% to 45.9% among those with TCD and from 53.6% to 48.9% among those without TCD. After IPW adjustment, a larger decline in BP control was noted among those with TCD (adjusted difference-in-difference = 1.13 percentage points (95% CI 0.32-1.94, p-value=0.0058)). There was no consistent difference in the relationship between TCD and post-pandemic BP control across neighborhood poverty levels.

Conclusion

COVID-19-related TCD was associated with a modest decline in BP control among older adults with hypertension in NYC; this was not moderated by neighborhood poverty level.
Phylogenetic diversity sheds light on the evolution of the unique fern flora of Mount Kinabalu, Borneo
Authors: Qian Hong , Kessler Michael
Published: January 2025

Background and Aims

Mount Kinabalu is an isolated, geologically young mountain (Pliocene and early Pleistocene) in northern Borneo harbouring a highly diverse flora with a high level of endemism. It is one of the global centres of fern diversity, but how this diversity has evolved has not been studied to date. We assess patterns of evolutionary legacies in the fern flora of Mount Kinabalu, with an emphasis on testing the tropical niche conservatism hypothesis.

Methods

We used several metrics of phylogenetic structure, including phylogenetic diversity (PD), mean nearest taxon distance (MNTD), mean pairwise distance (MPD), and their respective standardized effect sizes (PDses, MNTDses and MPDses), which represent different depths of evolutionary history, to investigate patterns of evolutionary legacies in the fern flora of Mount Kinabalu.

Key Results

We found that there was a decrease of PDses with elevation, reflecting a tropical origin of ferns and a gradual evolutionary adaptation to colder environments by fewer successive lineages. However, when separating the evolutionary old non-polypod lineages from the modern polypod radiation, we found a decrease of MNTD with elevation for the former, reflecting an ongoing upslope evolutionary trend, whereas for the modern polypod radiation, the inverse was true. Within the polypods, terrestrial and epiphytic species also showed different patterns, with the former showing a hump-shaped pattern for all phylogenetic diversity metrics, whereas the latter showed a more or less linear decline. Again, this suggests different evolutionary histories for ferns inhabiting the forest floor and canopy, due to the influence of the different habitat conditions. Finally, we found that mean annual temperature had a much stronger effect on phylogenetic diversity metrics than annual precipitation.

Conclusions

We found that the current fern assemblages on Mount Kinabalu show a strong evolutionary legacy that mirrors that of other mountains, suggesting a global consistency in phylogenetic diversity patterns of ferns along elevational transects, presumably due to a combination of dispersal between mountains and evolutionary convergence.
Reproduction is driven by seasonal environmental variation in an equatorial mammal, the banded mongoose (Mungos mungo)
Authors: Khera Monil , Arbuckle Kevin , Mwanguhya Francis , Cant Michael A , Nichols Hazel J
Published: January 2025

Reproduction is an energetically costly activity and so is often timed to occur when conditions are most favorable. However, human-induced changes in long-term, seasonal, and short-term climatic conditions have imposed negative consequences for reproduction across a range of mammals. Whilst the effect of climate change on reproduction in temperate species is well known, its effect on equatorial species is comparatively understudied. We used long-term ecological data (~20 yr) to investigate the impact of changes in rainfall and temperature on reproduction in an equatorial mammal, the banded mongoose (Mungos mungo). After controlling for the effects of group-size, we found that more females were pregnant and gave birth following periods of high seasonal rainfall, pregnancies increased at higher seasonal temperatures, and births increased with long-term rainfall. This is likely beneficial as high rainfall is positively associated with pup growth and survival. Females cannot, however, carry and raise pups over the course of a single wet season, so females face a trade-off in reproductive timing between maximizing resource availability during gestation or the early life of pups, but not both. Since the duration of the wet seasons is predicted to increase with climate change, the optimum conditions for banded mongoose reproduction may be extended. However, the potential benefits of extended wet seasons may be counteracted by the negative impacts of high temperatures on pup growth and survival. Our results highlight the importance of seasonality in reproduction of tropical mammals and the complex impacts of anthropogenic climate change on recruitment in equatorial species.
Niacin ameliorates Charcot-Marie-Tooth 4B1 neuropathy without interfering with nerve regeneration
Authors: Cipriani Silvia , Porrello Emanuela , Cerea Matteo , Gazzaniga Andrea , Di Guardo Roberta , Heslegrave Amanda , Valenzano Serena , Del Carro Ubaldo , Duong Phu , Svaren John , Previtali Stefano Carlo , Bolino Alessandra
Published: January 2025

Charcot-Marie-Tooth (CMT) neuropathies represent a broad and very heterogeneous group of disorders for which no therapies are yet available. Due to the huge genetic heterogeneity, therapeutical approaches that can benefit several forms independently of the unique pathogenetic mechanism have been sought. Niacin, nicotinic acid, is a vitamin used for many decades as anti-dyslipidaemic and anti-cholesterol drug product under the commercial name of Niaspan®, the extended-release formulation of niacin. Of note, niacin can have other effects depending on the dose, formulation and physiology and it has been used to reduce inflammation, to promote angiogenesis and to protect neurons, muscle and axons by boosting nicotinamide adenine dinucleotide (NAD+) levels. Niacin also activates TNF-alpha convertase enzyme (TACE) secretase, which negatively regulates Neuregulin type I-mediated signalling in the peripheral nervous system and myelination. We previously postulated that niacin-mediated TACE activation can be effective in reducing aberrant excessive myelin associated with different CMT forms. Here, we explored efficacy of this strategy by performing a long-term preclinical trial and we provided evidence that a novel niacin-based long-lasting formulation ameliorates neurophysiology and reduces fibre degeneration in a model of Charcot-Marie-Tooth type 4B1 (CMT4B1) neuropathy, characterized by aberrant myelin. We also sought to determine whether this strategy might interfere with nerve regeneration, which is dependent on Neuregulin type I signalling. Surprisingly, we found that the Mtmr2 knockout mice, a model of CMT4B1, have a defect in nerve regeneration and that niacin-based treatment is not detrimental to nerve regeneration.
Predicting individual long-term prognosis of spatial neglect based on acute stroke patient data
Authors: Röhrig Lisa , Wiesen Daniel , Li Dongyun , Rorden Christopher , Karnath Hans-Otto
Published: January 2025

One of the most pressing questions after a stroke is whether an individual patient will recover in the long term. Previous studies demonstrated that spatial neglect—a common cognitive deficit after right hemispheric stroke—is a strong predictor for poor performance on a wide range of everyday tasks and for resistance to rehabilitation. The possibility of predicting long-term prognosis of spatial neglect is therefore of great relevance. The aim of the present study was to test the prognostic value of different imaging and non-imaging features from right hemispheric stroke patients: individual demographics (age, sex), initial neglect severity and acute lesion information (size, location). Patients’ behaviour was tested twice in the acute and the chronic phases of stroke and prediction models were built using machine learning-based algorithms with repeated nested cross-validation and feature selection. Model performances indicate that demographic information seemed less beneficial. The best variable combination comprised individual neglect severity in the acute phase of stroke, together with lesion location and size. The latter were based on individual lesion overlaps with a previously proposed chronic neglect region of interest that covers anterior parts of the superior and middle temporal gyri and the basal ganglia. These variables achieved a remarkably high level of accuracy by explaining 66% of the total variance of neglect patients, making them promising features in the prediction of individual outcome prognosis. An online tool is provided with which our algorithm can be used for individual outcome predictions (https://niivue.github.io/niivue-neglect/).
Janus kinase inhibitors in the management of acute severe ulcerative colitis: a comprehensive review
Authors: Gisbert Javier P , Chaparro María
Published: January 2025

Background

One-third of patients with acute severe ulcerative colitis (ASUC) are steroid-refractory. Cyclosporine and infliximab are currently the mainstays of salvage therapy. Janus kinase inhibitors (JAKi) could play a role in the treatment of ASUC.

Aim

To review the evidence on JAKi in the management of ASUC.

Methods

We performed a bibliographic search to identify studies focusing on the treatment of ASUC with JAKi.

Results

Potential advantages of JAKi for the management of ASUC include their oral administration, rapid onset of action, short half-life, lack of immunogenicity, and effectiveness in patients with prior biologic exposure. Thirty studies (including 373 patients) have evaluated the efficacy of tofacitinib in ASUC, with a response rate (avoidance of colectomy) ranging between 43% and 100%, with a weighted mean of 82%. Experience with upadacitinib is more limited (only 10 studies and 74 patients are available) but also encouraging: mean colectomy-free rate ranging between 67% and 100%, with a weighted mean of 79%. However, experience with filgotinib in ASUC is currently nonexistent. Regarding safety, the available data does not reveal any new safety concerns when JAKi are used in ASUC, although follow-up periods are still short.

Conclusion

JAKi seems to be a promising treatment option for ASUC, with both tofacitinib and upadacitinib achieving colectomy-free rates of approximately 80%. Further studies are essential to define whether JAKi can replace cyclosporine/infliximab as second-line therapy for the medical management of ASUC, or whether they can even be used as initial treatment in place of intravenous corticosteroids.
‘Tuberculosis pericarditis’: a case report in a high-income country
Authors: Gonçalves Carolina Miguel , Cabral Margarida , Martins Rita , Silva Maria João , Martins Hélia
Published: January 2025

Background

The incidence of tuberculous (TB) infection varies greatly geographically. In endemic countries, it is one of the major aetiologies of pericardial diseases, whereas it is an uncommon cause in industrialized countries. The mortality rate of TB pericarditis complications is up to 40%, emphasizing the importance of early diagnosis and management.

Case summary

An 82-year-old woman presented with fever, dry cough, and constitutional symptoms for 2 weeks. The electrocardiogram showed low-voltage complexes, chest X-ray showed unspecific changes, and blood work revealed mild anaemia and a slight elevation of inflammatory parameters. A diagnosis of pulmonary infection was assumed, and the patient was discharged with antibiotics. One month later, she presented with worsening exertion fatigue and an increase in cardiothoracic index was noted on the chest X-ray. Further imaging studies by computed tomography and echocardiography revealed a severe pericardial effusion (PE) with echocardiographic signs of hemodynamic instability. The patient underwent a pericardiocentesis. Polymerase chain reaction study for Mycobacterium tuberculosis in the pericardial fluid was positive. Pulmonary involvement was confirmed by videobronchoscopy with bronchoalveolar lavage. The patient received tetraconjugate management and corticosteroids with an adequate clinical response. The follow-up echocardiographic assessment showed mild PE with no constrictive physiology.

Discussion

This is a case of definitive TB pericarditis that emphasizes the potential increase in TB cases in non-endemic countries and the need for a high clinical suspicion ensure early diagnosis and treatment, reducing complications and mortality of this disease.
Geometric Insights into Evolutionary Rescue Dynamics in a Two-Deme Model
Authors: Mohammadi Azadeh , Campos Paulo R A
Published: January 2025

Understanding evolutionary rescue mechanisms in fragmented populations is crucial in the context of rapidly changing environments. This study employs analytical derivations and simulations within a two-deme metapopulation model using Fisher’s geometric model (FGM) framework. We explore the impacts of abrupt environmental changes on two subpopulations that lead to distinct phe- notypic optima. We determine the probability density of distances between these optima through analytical derivations. This enables us to calculate the inter- section volume of the rescue domains of two subpopulations in the phenotypic space. This approach also allows us to assess the fixation probability of muta- tions that concurrently rescue both subpopulations and identify the domain of one-step rescue mutations. Our findings reveal that the likelihood of joint evolu- tionary rescue diminishes with increasing dimensionality of the phenotypic space, posing significant challenges for species with complex trait configurations. The study underscores the importance of genetic variation due to de novo mutations, local adaptation, and migration rates. These insights enhance our understanding of the factors that govern the adaptive potential of fragmented populations in response to severe environmental disturbances.
Infinite Prandtl number, mixed-heated convection in a spherical domain: velocity and heat flux scaling trends
Authors: Garrido-Tomasini Julian , Lenardic Adrian , Moore William , Weller Matthew
Published: January 2025

Numerical simulations of infinite Prandtl number convection in Cartesian domains have shown that a combination of internal and basal heating allows for behaviour not observed in either end-member cases of pure basal or pure internal heating. In particular, these mixed heating systems exhibit a decrease in the upper boundary layer velocity as internal heating increases. This leads to an inverse relationship between surface heat flow and boundary layer velocity. The inverse relationship has been attributed to boundary layer interactions, leading to deviations from classic boundary layer theory. Herein, we extend that work by presenting results from numerical experiments for mixed-heated convection in an isoviscous fluid in a fully 3-D spherical domain. We show that an increase in internal heating causes a decrease in surface velocity, consistent with previous Cartesian results. We confirm that boundary layer interactions decrease with increased internal heating, which correlates with decreasing surface velocities. A scaling theory, previously applied to Cartesian geometry, is modified for spherical geometries and tested against the results of the numerical solutions. The modified scalings lead to good fits for temperature and heat flux trends. The scalings predict that velocities can decrease with increased internal heating from low to moderate internal heating rates and become constant at higher heating rates, consistent with numerical results. The quantitative match between velocity scalings and numerical results is not as good as observed for heat flow and temperature trends. We attribute this to surface velocities being more strongly affected by observed changes in convective wavelengths and planform transitions from sheet-like to plume-like downwellings as the rate of internal heating and/or basal heating increases.
The chromatin remodeler Brg1 is essential for cochlear sensory epithelium differentiation and patterning
Authors: Song Yuning , Dou Zhilin , Liu Wenwen , Zhang Aizhen , Gao Xiaotong , Shi Hongbiao , Zhang Zhixiong , Gao Jiangang , Jin Yecheng
Published: January 2025

Human genome analyses have revealed that abnormal BAF (BRG1/BRM-associated factor) complex is highly associated with hearing loss. However, the underlying pathogenesis remains largely unknown. Disrupted structure and function of the organ of Corti is the most prevalent cause of sensorineural hearing loss in mammals. Here, we investigated the role of Brg1-based BAF complex during the differentiation and development of the auditory sensory epithelium, a crucial period for the formation of the organ of Corti. Our findings indicate that deletion of Brg1 leads to premature hair cell (HC) differentiation by inactivating Sonic hedgehog (Shh) signaling. Despite the formation of HCs, subsequent differentiation of inner hair cells (IHCs) and outer hair cells (OHCs) was impaired. Additionally, we observed that the mosaic-like arrangement of HCs and supporting cells (SCs) was disrupted resulting in abnormal sensory epithelium patterning. Furthermore, we found the planar cell polarity of the Brg1-deficient cochlea was abnormal. Our study demonstrates the pivotal role of Brg1 in the differentiation and patterning of the organ of Corti.
Influenza 5xM2e mRNA lipid nanoparticle vaccine confers broad immunity and significantly enhances the efficacy of inactivated split vaccination when coadministered
Authors: Grovenstein Phillip , Bhatnagar Noopur , Kim Ki-Hye , Pal Surya Sekhar , Le Chau Thuy Tien , Raha Jannatul Ruhan , Liu Rong , Shin Chong Hyun , Park Bo Ryoung , Du Lanying , Subbiah Jeeva , Wang Bao-Zhong , Kang Sang-Moo
Published: January 2025

Current influenza vaccines are not effective in conferring protection against antigenic variants and pandemics. To improve cross-protection of influenza vaccination, we developed a 5xM2e messenger RNA (mRNA) vaccine encoding the tandem repeat conserved ectodomain (M2e) of ion channel protein M2 derived from human, swine, and avian influenza A viruses. The lipid nanoparticle (LNP)–encapsulated 5xM2e mRNA vaccine was immunogenic, eliciting high levels of M2e-specific IgG antibodies, IFN-γ+ T cells, T follicular helper cells, germinal center phenotypic B cells, and plasma cells. The mice with 5xM2e mRNA vaccination were broadly protected against lethal infection regardless of hemagglutinin (H1, H3, H5) subtypes by preventing severe weight loss. Injection of 5xM2e mRNA LNP vaccine induced acute innate responses recruiting monocytes, macrophages, and diverse subsets of dendritic cells. A single dose of combined 5xM2e mRNA LNP and split vaccines resulted in significantly enhanced and sustainable IgG antibody responses to viral antigens and protection against homologous and heterologous viruses. This study provides a new strategy of combined mRNA and seasonal vaccination, significantly enhancing vaccine protective efficacy.
Assessing impact of a community-based screening campaign to address social determinants of cervical cancer
Authors: Po Justine , Bookstein Arthur , Lee Woori , Barahona Rosa , Baezconde-Garbanati Lourdes
Published: January 2025

Background

Screening represents a cornerstone of cervical cancer control strategy. However, disparities in social determinants of health (SoDoH) have perpetuated gaps in screening among racial/ethnic minorities. SoDoH including cultural stigma and lack of insurance have contributed to decreased screening among Hispanic women. To increase cancer screening in this population, community-academic partnerships and culturally-tailored media have emerged as promising strategies.

Methods

This study assessed the impact of a culturally-tailored cervical cancer screening campaign implemented through academic-community-government partnership. Intercept surveys, conducted from 2015-2018 in eastern neighborhoods of Los Angeles, assessed campaign recall, interpretation and screening intention among Hispanic women aged 21-65 after exposure to the campaign. Screening intention was evaluated using Chi-square tests and logistic regression by participant characteristics, with thematic analysis for campaign interpretation.

Results

Out of 673 participants, 26.1% were uninsured and 85.9% primarily spoke Spanish at home. Campaign recall was 25.1%, with 64.5% interpreting the campaign’s message as cervical cancer screening or health checkups. The campaign’s most-liked aspect was emphasis on family (cited by 37.1% of participants). Post-campaign, 89.5% of participants overall were likely or extremely likely to schedule a Pap test, including 83.5% of women who had not had a Pap test in the last three years.

Conclusions

Our findings underscore several important strategies to reduce cervical cancer disparities: 1) associating positive cultural values with screening to decrease stigma, 2) combining culturally-tailored outreach with interventions that target other known screening barriers, 3) facilitating long-term community relationships and 4) leveraging academic-community-government partnerships.
Primary leiomyoma in the hepatorenal space: a case report
Authors: Huang Haoyang , Xu Dingwei , Huang Jie
Published: January 2025

Leiomyomas can occur in various organs and tissues throughout the body, but reports of their occurrence in the hepatorenal space are rare. The video presents a comprehensive breakdown of the diagnostic procedures and surgical resection procedures. Emphasizing the key strategies for easy misdiagnosis. For leiomyomas occurring in rare sites, the compression on surrounding organs often leads to blurred boundaries in imaging, making it difficult to determine their origin and resulting in misdiagnosis. For rare tumors located at the junction areas, in order to achieve better treatment outcomes, abdominal exploration and intraoperative multidisciplinary consultations should be carried out under sufficient preoperative preparations.
Lipid transfer protein VAS inhibits the hypersensitive response via reactive oxygen species signaling in Nicotiana benthamiana
Authors: Koyama Rina , Suzuki Akira , Ohnishi Kouhei , Hikichi Yasufumi , Kiba Akinori
Published: January 2025

Lipid transfer proteins (LTPs) are small cysteine-rich soluble proteins that affect flower and seed development, cuticular wax deposition, and biotic and abiotic stress responses. We isolated an LTP-encoding gene homologous to LTPVAS in Nicotiana benthamiana and designated it LTP-VASCULAR TISSUE SIZE (NbLTPVAS). This gene was expressed in seeds, leaves, roots, and stems. Additionally, NbLTPVAS expression was induced by hypersensitive response (HR)-inducing agents. Cell death was accelerated and the phytopathogenic bacterial population decreased significantly in NbLTPVAS-silenced plants infected with the incompatible Ralstonia solanacearum strain 8107. The expression of HR marker gene hin1 in NbLTPVAS-silenced plants was markedly induced by R. solanacearum 8107, indicative of the acceleration of HR. HR cell death in NbLTPVAS-silenced plants was also promoted by the Agrobacterium-mediated expression of HR-inducing proteins including INF1, AvrA, and PopP1. Excessive production of reactive oxygen species (ROS) was detected in NbLTPVAS-silenced plants. The expression of NbrbohB (encoding a ROS-generating enzyme) also increased in NbLTPVAS-silenced plants, but the expression of the antioxidant enzyme-encoding genes NbSOD and NbAPX decreased. The silencing of both NbLTPVAS and NbrbohB adversely affected HR induction. Moreover, NbLTPVAS was secreted into the intercellular washing fluid. The transient expression of the full-length NbLTPVAS induced the expression of antioxidant genes, attenuated ROS production, and suppressed the induction of HR cell death. This is the first functional analysis of LTPVAS in plant–microbe interactions. Our study provides novel insights into the role of NbLTPVAS as a negative regulator of HR via ROS homeostasis in N. benthamiana.
Positron Emission Tomography
Authors: Chareonthaitawee Panithaya , Bois John P.
Published: January 2025

Positron emission tomography is a valuable imaging modality for management of known or suspected coronary artery disease and has recently become a powerful diagnostic tool for patients with suspected cardiac sarcoidosis. Similar costs and lower patient radiation exposure with cardiac positron emission tomography imaging compared with conventional nuclear imaging have added to the growth of cardiac positron emission tomography imaging. In addition, with increased use of cardiac positron emission tomography imaging, evidence for its clinical usefulness is rapidly expanding and demonstrating high diagnostic accuracy and incremental prognostic value.
Electrocardiographic Diagnoses: Criteria and Definitions of Abnormalities
Authors: Hammill Stephen C.
Published: January 2025

This chapter is a diagnostic guide for all physicians who evaluate electrocardiograms and should be of specific value to persons taking professional examinations in cardiology and internal medicine. The criteria for each electrocardiographic diagnosis are those used in clinical practice at Mayo Clinic. Because of this, the criteria may differ in minor ways from those used on examinations, and, thus, it is important to check the specific diagnoses available on the answer sheet. These criteria are not endorsed by any professional examination body or organization.
Indications for Invasive and Noninvasive Electrophysiologic Testing
Authors: Mulpuru Siva K.
Published: January 2025

Cardiac EP testing encompasses invasive and noninvasive strategies to assess cardiac electrical function for diagnostic or therapeutic purposes.
Ventricular Tachycardia
Authors: DeSimone Christopher V. , Munger Thomas M.
Published: January 2025

The prevalence of ventricular tachycardia is greatly influenced by the presence of coronary artery disease and structural heart disease, especially that complicated by myocardial infarction. Ventricular tachycardia occurs in 1% to 2% of patients in the year after myocardial infarction; this is because scar formation serves as a substrate for reentrant ventricular tachycardia. Infarct- or scar-related ventricular tachycardia (also referred to as ischemic ventricular tachycardia) represents the largest subgroup of patients with ventricular tachycardia who require some form of therapeutic intervention. In addition to ischemic ventricular tachycardia, some types of ventricular tachycardia are not related to coronary artery disease; these are known as nonischemic ventricular tachycardia. These may be found in the context of dilated cardiomyopathy, arrhythmogenic right ventricular dysplasia, hypertrophic cardiomyopathy, left ventricular noncompaction cardiomyopathy, infiltrative diseases of the heart, and congenital heart disease. Additionally, idiopathic ventricular tachycardia can be seen in patients with structurally normal hearts; these patients may or may not have associated syndromes of abnormal repolarization.
Arrhythmias in Congenital Heart Disease
Authors: McLeod Christopher J. , Brady Peter A.
Published: January 2025

The number of persons with congenital heart disease who survive into adulthood has increased substantially in the past few decades. In this population, arrhythmias are a major cause of late morbidity and death and may herald worsening underlying hemodynamic changes and associated worse outcomes. In addition, the risk of sudden cardiac death is high, especially in patients with certain repaired malformations. Device therapy (pacing and defibrillation) is often complicated and may require thoracotomy for epicardial lead placement. Risk markers for arrhythmias in patients with congenital heart disease include the presence of residual hemodynamic defects, surgical repair later in life, and older age.
Cardiac Resynchronization Therapy
Authors: Kowlgi Guru G. , Killu Ammar M.
Published: January 2025

Cardiac resynchronization therapy is a cardiac pacing modality used in patients with left ventricular systolic dysfunction and ventricular electromechanical delay (dyssynchrony). Disrupted electromechanical coupling is a frequent accompaniment of progressive left ventricular systolic failure, manifesting as delays in atrioventricular nodal conduction and the His-Purkinje system in one-third of patients. Left bundle-branch block makes up a substantial proportion of infra-Hisian conduction disease. Intraventricular conduction delay results in adverse ventricular remodeling, with left ventricular dilatation, functional mitral regurgitation, and increased cardiometabolic demands. By virtue of reversing dyssynchrony, cardiac resynchronization therapy has spawned a revolution in the field of heart failure therapy, offering a survival benefit in some patients whose only previous option was heart transplant. The key points of cardiac resynchronization therapy are summarized in this chapter.
Implantable Cardioverter-Defibrillator  Troubleshooting
Authors: Siontis Konstantinos , Killu Ammar M.
Published: January 2025

This chapter reviews common problems seen on implantable cardioverter-defibrillator interrogation which are likely to be encountered in clinical practice. Implantable cardioverter-defibrillators are now commonplace, and the ability to understand basic implantable cardioverter-defibrillator interrogation and troubleshooting is an essential requirement in most general cardiology practices. Like a pacemaker, it is dependent on the ability to appropriately sense cardiac signals and deliver energy appropriately. The implantable cardioverter-defibrillator has a greater complexity of analysis than a pacemaker, and its energy delivery can be in the form of either pacing (bradycardia or tachycardia pacing) or defibrillation (shock).
Autonomic Function Testing
Authors: Parikh Pragnesh , Venkatachalam K. L.
Published: January 2025

Syncope is defined as a transient loss of consciousness due to a temporary limitation in cerebral blood flow. The causes include 1) low systemic BP (arrhythmias, valvular disease, medications, reflex causes); 2) reduced cerebral blood flow (cerebral vasospasm, hyperventilation); and 3) Miscellaneous causes of cerebral dysfunction (metabolic, endocrine, and electrolyte abnormalities). Most cardiology referrals for autonomic function testing are for near-syncope, syncope, or palpitations. The focus of this chapter will be limited to autonomic function assessment as related to cardiology, specifically the evaluation of a patient referred for syncope.
Valvular Regurgitation
Authors: El Sabbagh Abdallah , Nishimura Rick A.
Published: January 2025

The mitral valve is a complicated structure that requires the correct functioning of the valve leaflets, valve commissures, mitral annulus, papillary muscles, chordae tendineae, and left ventricle for competence. Mitral regurgitation results from failure of 1 or more of the components of normal competence of the mitral valve. The presentation and management of mitral regurgitation depend on the underlying cause, duration, severity, symptoms (including objective exercise tolerance), and left ventricular size and systolic function. Aortic regurgitation may result from intrinsic structural abnormalities of the aortic valve or the ascending aorta or both.
Rheumatic Heart Disease
Authors: Lane Colleen E. , Moore Andrew G. , Anavekar Nandan S.
Published: January 2025

Rheumatic heart disease is a long-term sequela of acute rheumatic fever. Myocardial inflammation (carditis) leads to left ventricular remodeling and cardiac valve damage, resulting in progressive valve disease and congestive heart failure. Although both acute rheumatic fever and rheumatic heart disease are rare in North America and Europe, it remains endemic in many low-economy countries, where it is an important public health problem.
Peripheral Vascular Disease
Authors: Spittell Peter C. , Pollak Amy W.
Published: January 2025

Lower extremity peripheral arterial disease affects 8 to 12 million Americans and can range in clinical presentation from impaired walking ability to intermittent claudication or critical limb ischemia. Pseudoclaudication is caused by lumbar spinal stenosis and can be confused with intermittent claudication. Peripheral arterial occlusive disease has a substantial mortality rate because of its association with systemic atherosclerosis. The symptoms of acute arterial occlusion are sudden in onset (<5 hours) and include the “5 Ps”: pain, pallor, paresthesia (numbness), poikilothermy (coldness), and absent pulses. Abdominal aortic aneurysm is a frequent comorbid condition. Other predisposing factors for aneurysmal disease include hypertension, familial tendency, connective tissue disease, trauma, infection, and inflammatory disease. Heparin-induced thrombocytopenia affects between 5% and 10% of patients who receive heparin therapy, but the incidence of arterial or venous thrombosis is less than 1% or 2%.
Venous and Lymphatic Disorders
Authors: Shields Raymond C.
Published: January 2025

Venous and lymphatic diseases frequently coexist with cardiac or arterial disease, and an understanding of these diseases is an important part of a cardiovascular practice. Venous thromboembolism is the third most common cardiovascular disease, after acute coronary syndromes and stroke. Independent acquired risk factors for venous thromboembolism include immobility, neurologic disease with leg paresis, recent surgery, hospitalization for acute medical illness, trauma/fracture, cancer, advanced age, history of superficial thrombophlebitis, central venous catheter or transvenous pacemaker, pregnancy, and estrogen use.
Vasculitis
Authors: Anand Vidhu , Bois John P.
Published: January 2025

By definition, vasculitis is inflammation of a vessel. Vasculitis is a diverse group of diseases that are as difficult to classify as they are to diagnose and treat. Large, medium, and small arteries, capillaries, and venules may be involved. The presenting symptoms vary by the organ system or systems affected. Both primary and secondary causes of vasculitis exist, and several conditions can mimic vasculitis. This chapter discusses types of vasculitis grouped by vessel size, with cardiovascular pathology emphasized whenever appropriate.
Marfan Syndrome and Other Genetic Aortopathies
Authors: Bowen Juan M. , Connolly Heidi M. , Ammash Naser M.
Published: January 2025

Marfan syndrome is recognized as the most common of the genetic aortopathies, with a prevalence of approximately 1 in 5,000 persons. The cause is a sequence variation in the FBN1 gene, which encodes for fibrillin-1, a component of elastic microfibrils. The diagnosis of Marfan syndrome is made by applying accepted diagnostic criteria in the evaluation of a patient. Surgical intervention together with medical treatment has led to marked improvement in survival, with newer therapies having the potential to further improve the natural history of the disease. This chapter will primarily address Marfan syndrome because it is the most common and best-studied genetic aortopathy but will also include pertinent information about related disorders.
Cardiovascular Risk Assessment
Authors: Kullo Iftikhar J.
Published: January 2025

Cardiovascular risk assessment is the first step in individualizing therapy for primary prevention of atherosclerotic cardiovascular disease events. Risk factors for such events, identified in population-based studies, have been included in multivariable risk scores for coronary heart disease, stroke, peripheral arterial disease, heart failure, and composite cardiovascular disease end points. Most of these risk calculators estimate a patient’s probability of having a cardiovascular event within a 5- to 10-year period. Commonly used cardiovascular risk scores include the Framingham coronary heart disease Risk Score and its derivative, the Adult Treatment Panel III risk assessment profile, and the European Systematic COronary Risk Evaluation algorithm for cardiovascular disease death. The American College of Cardiology/American Heart Association guidelines include pooled cohort equations for assessment of cardiovascular risk in the clinical setting
Reperfusion Strategies for Cardiovascular Disease
Authors: Widmer Robert J. , Anavekar Nandan S. , Pollak Peter M. , Murphy Joseph G.
Published: January 2025

This chapter covers the initial recognition, risk stratification, and medical stabilization of patients with acute coronary syndrome, followed by treatment options and optimal approach to reperfusion for patients with ST-segment elevation myocardial infarction and non- ST-segment elevation myocardial infarction, including percutaneous coronary intervention and thrombolytic therapy.
Pericardial Disease
Authors: Melduni Rowlens M.
Published: January 2025

The pericardium is a fibromembranous inelastic sac less than 2 mm in thickness that comprises 2 distinct layers. The outer inelastic fibrous layer (fibrous pericardium) anchors the heart in the mediastinum with attachments anterior to the manubrium and xiphoid process, posterior to the vertebral column, and inferior to the diaphragm. The inner serous double layer (serous pericardium) is divided into the visceral pericardium (epicardium) and the parietal pericardium.
Pulmonary Hypertension
Authors: Murphy Joseph G. , Kane Garvan C.
Published: January 2025

Physiologically, normal pulmonary circulation is radically different from systemic circulation. It is characterized by a low blood pressure with a mean pulmonary arterial pressure between 12 and 16 mm Hg (pulmonary arterial systolic, 18-25 mm Hg). There is low resistance to blood flow through compliant, thin-walled pulmonary vessels which optimizes gas exchange at the level of the alveolar/capillary membrane, which varies from 0.2 µm to 2 µm in thickness, less than the thickness of a red blood cell in its thinnest dimension.
Adult Congenital Heart Disease
Authors: Ammash Naser M. , Warnes Carole A.
Published: January 2025

It is estimated that 95% of all current newborns with congenital heart disease will reach adulthood; the growing population of adults with congenital heart disease (increasing by 5% per year) means there are now more adults than children living with congenital heart disease. Patients are divided into 2 broad categories: natural selection and unnatural selection. This chapter discusses the most common types of congenital heart disease, associated hemodynamic disturbances, and complications before and after repair.
Cardiac Tumors
Authors: Murphy Joseph G.
Published: January 2025

Primary tumors of the heart are exceedingly rare and account for less than 5% of all cardiac tumors; the other 95% are metastatic tumors. Cardiac tumors may be present anywhere in the heart and may be attached to any cardiac surface. The most common primary cardiac tumors in adults are myxomas, usualy developing in the left atrium, followed by fibroelastomas and lipoma. The most common malignant cardiac tumor in adults is angiosarcoma. A malignant lymphoma may occasionally develop in the adult heart. In children, the most common benign cardiac tumor is rhabdomyoma, and the most common malignant tumor is rhabdomyosarcoma.
Sleep Apnea and Cardiac Disease
Authors: Konecny Tomas , Somers Virend , Kara Tomas
Published: January 2025

In patients with sleep apnea, also called sleep-disordered breathing, sleep can be a period of hemodynamic, respiratory, and electrochemical turmoil that contributes to the initiation, progression, and worsening of all forms of cardiovascular disease.
COVID-19 and the Cardiovascular System
Authors: Ezzeddine Fatima M. , Murphy Joseph G. , Anavekar Nandan S.
Published: January 2025

Cardiovascular complications are common in hospitalized patients with COVID-19 infection. One characteristic is the wide range of cardiovascular findings that can occur with COVID-19 infection, ranging from an asymptomatic increase in cardiac biomarkers and an abnormal electrocardiogram to fulminant heart failure, myocarditis, pulmonary embolism, cardiogenic shock, and sudden death. Preexisting cardiovascular disease, including coronary artery disease and systemic hypertension, increase the risk of clinical COVID-19 disease and its severity.
Reflex and Humoral Control  of the Circulation
Authors: Clavell Alfredo L. , Burnett John C.
Published: January 2025

Optimal regulation of the circulation depends on the integration of cardiovascular reflexes with local and circulating humoral factors that regulate myocardial contractility, vascular tone, and intravascular volume (intravascular volume is regulated primarily through renal sodium excretion). Under physiologic conditions, cardiovascular reflexes affect short-term cardiovascular control, whereas humoral mechanisms function more as long-term modulators of cardiovascular homeostasis.
Hypertrophic Cardiomyopathy
Authors: Tsay Julie L. , Ommen Steve R.
Published: January 2025

The clinical definition of hypertrophic cardiomyopathy is left ventricular hypertrophy (wall thickness >15 mm) without a secondary explanation such as hypertension or valvular disease. The size and volume of the left ventricle are usually normal or small. Most cases are familial with autosomal dominant inheritance. Histologically, loose connective tissue is surrounded by myocyte hypertrophy and disarray. Arrhythmias and systolic left ventricular outflow tract gradients are common, and premature sudden death occurs in approximately 1% of hypertrophic cardiomyopathy patients annually.
Coronary Artery Physiology, Endothelial Dysfunction, and Intracoronary Imaging
Authors: Murphy Joseph G. , Prasad Abhiram
Published: January 2025

The function of the coronary arteries is to provide oxygen and nutrients to the myocardium. In the resting state, myocardial oxygen extraction is near the maximum and coronary sinus oxygen saturation is typically 30% or less. Because myocardial oxygen extraction is already near the maximum, myocardial V.o2 can increase only by an increase in coronary blood flow, and changes in myocardial V.o2 closely parallel changes in coronary blood flow. Important determinants of myocardial V.o2 are heart rate, inotropic state, and intramyocardial wall stress. Myocardial V.o2 can be approximated clinically by the product of systolic blood pressure and heart rate. The rate-pressure product is frequently used during exercise testing as an estimate of cardiac workload.
Preparing for Cardiology Examinations
Authors: Murphy Joseph G. , Lloyd Margaret A.
Published: January 2025

The cardiovascular disease board examination is a computer-based examination that lasts 1.5 days for initial certification and 1 day for recertification. One full day is common to both examinations and consists of multiple-choice questions administered in four 2-hour sessions. Examination questions are written to reproduce clinical scenarios a practicing cardiologist may encounter. The majority of questions are based on real-life patient clinical scenarios in typical practice settings. The majority of examination questions are high-level questions that require integration of information from several sources (eg, clinical history, examinations, investigations), as in real cardiology practice.