bluuebunny/crossref_metadata_2025 huggingface dataset:
The association of non-alcoholic fatty liver disease and advanced hepatic fibrosis with cardiovascular mortality in Taiwanese adults: a longitudinal cohort study
Authors: Wei X , Yu T , Bo Y , Ho K , Lao X
Published: November 2023

Background

Non-alcoholic fatty liver disease (NAFLD) is prevalent in adults, and advanced hepatic fibrosis (AHF) occurs in the more progressive stage of NAFLD. Despite the known risk of cardiovascular diseases among NAFLD patients, the effect of NAFLD and AHF on cardiovascular mortality (CVM) in general populations remains understudied.

Purpose

This study aims to examine the association of NAFLD and AHF with CVM in a general population.

Methods

Participants were enrolled in the Taiwan MJ cohort and attended regular medical check-ups. We derived the death dates and causes up to 31 May 2019 from Taiwan Death Registry and linked them to participants by identity number. CVM included death from heart diseases, hypertension, or atherosclerosis defined by the International Classification of Diseases (ICD) codes (ICD 9: 390-414, 420-429, 440; ICD 10: I01-I02.0, I05-I25, I27, I30-I52, and I70). We excluded regular alcohol drinkers and participants with cardiovascular diseases, hepatitis, cirrhosis, or liver cancer at baseline. The fatty liver index (FLI) was calculated to identify participants with NAFLD, among whom the BARD score was estimated to determine AHF. Cox proportional hazards models with time-varying covariates were applied in the analysis. We also conducted a stratified analysis by sex and age subgroups.

Results

404,948 participants were recruited from 1997 to 2016 and followed until 31 May 2019, with a median follow-up duration of 15.1 (IQR: 10.1–19.5) years. There were 2,560 cardiovascular deaths, with an incidence of four deaths per 10,000 person-years. FLI was positively associated with CVM, with a hazard ratio (HR) of 1.301 (95%CI: 1.255–1.348) per standard deviation increase. We identified 41,807 participants with NAFLD (FLI≥60). NAFLD was related to a significantly higher risk of CVM [HR: 1.871 (95%CI: 1.688–2.073)]. Moreover, 17,274 participants with NAFLD developed AHF (BARD≥2). AHF elevated the risk of CVM among participants with NAFLD [HR: 1.388 (95%CI: 1.135–1.698)]. In stratified analysis, significant positive associations were observed in each sex or age subgroup. The CVM hazards of NAFLD were more pronounced in females (HR: 1.921) than in males (HR: 1.741) and higher in adults under 40 years of age at baseline (HR: 4.905) than in older adults (HR: 1.772). Similarly, AHF had a higher HR in females versus males (HR: 1.684 vs. 1.281) and a much higher HR in adults with a NAFLD onset age under 40 versus adults with older onset age (HR: 2.246 vs. 1.258).

Conclusions

NAFLD remarkably increases CVM in the general population across different sex and age groups. Among people with NAFLD, AHF aggravates the risk of CVM. These adverse effects are relatively prominent in females and adults under middle age.The forest plot of hazard ratios
Dietary fruits and vegetables and risk of cardiovascular diseases in elderly Chinese
Authors: Wang K , Chen Z L , Shen M Q , Chen P F , Xiao Y C , Fang Z F , Hu X Q , Tang J J , Liu Q M , Zhou S H
Published: November 2023

Background

Evidence regarding the potential effect of fruit and vegetable consumption on cardiovascular diseases (CVD) was limited and inconsistent among Asian people.

Purpose

We aimed to investigate the association between fruit and vegetable consumption and risk of CVD, including total CVD, hypertension, heart disease and stroke.

Methods

We followed 9,740 Chinese elderly population (≥65 years, mean baseline age: 88 years) from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) during a follow-up of 10 years (2008-2018). Dietary data were collected using a validated food frequency questionnaire. We examined the associations of fruit and vegetable consumption with risk of CVD using Cox proportional hazard models.

Results

During 37,366 person-years of follow-up, a total of 3,738 CVD cases were recorded. After adjusting for demographics, dietary, lifestyle, and economical social factors, higher intakes of total fruits and vegetables were associated with lower risk of CVD (comparing with extreme quintiles, hazard ratio (HR) and 95%CI: 0.84 (0.74, 0.95)). The inverse association was mainly driven by vegetable consumption (0.86 (0.77, 0.95)). Furthermore, the inverse association was stronger for risk of hypertension (0.84(0.72, 0.98)). These associations were consistent across age, sex, BMI, residence, exercise status, smoking, drinking and health status.

Conclusion

This study suggests that higher intakes of total fruits and vegetables are associated with lower risk of CVD among elderly Chinese people, supporting the current recommendations of increasing fruit and vegetable consumption as part of healthy diet for the prevention of CVD.
Lower cardiorespiratory fitness is associated with left atrial structural, functional and electrical remodelling in patients with symptomatic atrial fibrillation
Authors: Elliott A , Ariyaratnam J A , Mishima R S , Gallagher C , Kuklik P , Sanders P
Published: November 2023

Background

Preserved cardiorespiratory fitness (CRF) is associated with improved rhythm control in patients with symptomatic atrial fibrillation (AF). However, the pathophysiological features associated with low cardiorespiratory fitness are not well described.

Purpose

Evaluate the association between cardiorespiratory fitness and structural, functional and electroanatomical features of the left atrium (LA) amongst patients with symptomatic AF.

Methods

Consecutive patients with symptomatic paroxysmal or persistent AF undergoing AF ablation were recruited. CRF was assessed objectively by peak oxygen consumption (VO2peak) assessed during maximal cycle ergometry. Invasive assessment of LA remodelling involved direct assessment of resting LA pressures (LAP), LA stiffness during saline infusion and LA electrical function using high-density electroanatomical maps. Non-invasive assessment involved 2D transthoracic echocardiography at rest and during exercise. The association between VO2PEAK and atrial parameters were determined using multivariable linear regression models adjusted for age and sex.

Results

In total, 110 participants were recruited. Mean age was 63±11 and 74.5% of the cohort was male. In adjusted analyses, higher VO2PEAK was associated with lower mean LAP (p<0.001) and invasively assessed LA stiffness (p=0.005). On non-invasive testing, VO2PEAK was positively associated with left atrial emptying fraction (LAEF) (p=0.001) and reservoir strain (p<0.001) at rest. During exercise, VO2PEAK remained associated with LAEF (p<0.001) and LA reservoir strain (p=0.007). Higher VO2peak was positively associated with LA bipolar voltages (p=0.035) but not LA conduction velocities (p=0.131) or LA fractionation (p=0.452)

Conclusions

In patients with symptomatic AF, lower cardiorespiratory fitness is independently associated with extensive LA remodelling involving impaired LA haemodynamics, increased LA stiffness, LA mechanical dysfunction and LA electrical remodeling.
Influence of Lp(a) and systemic inflammation on all-cause mortality in a primary prevention population: data from our clinic database
Authors: Cho L , Brennan D , Costa-Scharplatz M , Itani T , Nissen S
Published: November 2023

Background

Epidemiological, pathophysiological, and genetic studies have established Lp(a) as a causal risk factor for development of cardiovascular (CVD) and valvular heart disease. However, there is controversy about how inflammation can modulate Lp(a) risk and major adverse cardiovascular events. We aim to investigate the influence of elevated Lp(a) and systemic inflammation on all-cause mortality in a primary prevention setting.

Method

We analyzed data obtained from the Preventive Cardiology Information System (PreCis), a database of clinical and laboratory information on 8,136 primary prevention patients seen at our clinic preventive cardiology clinic between 1st Jan 1999-12th Dec 2018. Primary prevention was defined as having no history of coronary artery disease (CAD), coronary and peripheral arterial revascularization, nor atherosclerosis. Lp(a) ≥50 mg/dL was considered as clinically elevated. The association between Lp(a) and the demographic and clinical variables of interest was examined using the student’s t-test or Chi-squared test. All-cause mortality was assessed using Kaplan-Meier estimates, and adjusted Cox proportional hazards models. All statistical analyses were conducted using SAS version 9.4.

Result

In the overall primary prevention population (n=8,136), the median age was 54 years, with 56.9% women and 84.8% being Caucasian. In this cohort, 21% had hypertension, and 5.5% had diabetes. The median Lp(a) was 21 mg/dL (interquartile interval 7-57 mg/dL). Lp(a) was ≥50 mg/dL in 29% of the population. Of those with elevated Lp(a) (n=2,368), 1,751 (73.9%) patients had hsCRP drawn. In this group, 782 patients (44.7%) had hsCRP <2 mg/L and 969 (55.3%) had hsCRP ≥2 mg/L. The all-cause mortality rate in individuals with elevated Lp(a) and hsCRP ≥2mg/L was 9.2% compared to 4.2% in those with elevated Lp(a) and hsCRP <2mg/L. In a multivariable Cox proportional hazard regression model adjusted for age and gender, in patients with elevated Lp(a), hsCRP ≥2 mg/L was significantly associated with all-cause mortality (HR 2.35, 95% CI (1.57-3.53), p>0.001) (Figure 1).

Conclusion

In a primary prevention population without established atherosclerosis, elevated Lp(a), increased systemic inflammation was associated with increased all-cause mortality. This finding supports the need for risk classification and targeted primary prevention management of higher risk patients with elevated Lp(a).
Predicting the death caused by cardiovascular and/or cerebrovascular disease within 7 years follow-up using machine learning models
Authors: Tsarapatsani K , Sakellarios A I , Tsakanikas V , Marz W , Trampisch H J , Rudolf H , Fotiadis D I
Published: November 2023

Background

Cardiovascular and cerebrovascular disorders, which are now the leading and second causes of death in the majority of the world's countries, affect human life and health. Moreover, the prediction of death caused by these is deemed necessary to prevent it and reduce its rate.

Purpose

We employ machine learning models for the prediction of cardiovascular and/or cerebrovascular death within 7 years follow-up using clinical and laboratory features.

Methods

We analyzed the dataset of German epidemiological trial on ankle brachial index (getABI) study, including 5,587 patients (mean age 71.14 years, 40.7 % male, 359 deceased patients and 5,228 alive patients). Recursive feature elimination with cross-validation selected 11 features from a set of 55 features: diabetes mellitus, ABI index before exercise, vitamin D, troponin I, triglycerides, potassium, LDL cholesterol, HDL cholesterol, the flow noise of the right and left carotid artery and the pulse status of the right popliteal artery. Additionally, the handling of missing values was achieved by SimpleImputer. Random Forest (RF), Adaptive Boosting (AdaBoost), LightGBM classifiers were applied to predict death and were trained and tested using 5-fold cross-validation. Moreover, GridSearchCV tuned the hyperparameters of the models.

Results

LightGBM was the most accurate model, achieving 87.56 % mean balanced accuracy and 90.63 % mean value of the area under (AUC) the Receiver Operating Characteristic Curve (ROC). The mean ROC-AUC value of the RF, and AdaBoost were equal to 87.25 % and 89.52 %, respectively. Τhe mean ROC-AUC value, its standard deviation and the mean balanced accuracy of the models are presented in Figure 1. Moreover, Figure 2 indicates the ROC-AUC values for each k-fold and the mean value of them which achieved by the best classifier, the LightGBM.

Conclusion

Machine learning models achieved accurate prediction of cardiovascular and cerebrovascular death in 5,587 patients within 7 years follow-up utilizing basic medical data.
Genetic risk score and epicardial adipose tissue: the new tools with impact on cardiovascular risk assessment
Authors: Temtem M , Mendonca M I , Sousa J A , Serrao M , Santos M , Sa D , Sousa F , Henriques E , Rodrigues M , Freitas S , Borges S , Guerra G , Drumond A , Sousa A C , Palma Dos Reis R
Published: November 2023

Background

Cardiovascular disease (CVD) remains the leading cause of death worldwide. One of its main contributors is coronary artery disease (CAD), a complex multifactorial disease influenced by hereditary and environmental factors. A better cardiovascular risk assessment is a real challenge in our daily clinical practice. Evidence points to high Epicardial Adipose Tissue (EAT) volume as an essential player in the pathophysiology of CAD. On the other hand, genetic predisposition to CAD remains crucial to improve cardiovascular risk assessment and treatment. It is unknown whether the association between these two risk markers improved the ability to predict CV events.

Objective

Evaluate whether a high EAT volume added to a Genetic Risk Score (GRS) improves the predictive ability to discriminate CV events in an asymptomatic population without known CVD.

Methods

A prospective cohort was performed with 1024 participants (mean age 51.6±8.2 years, 75.6% male) selected from controls of the GENEMACOR Study. The GRS was created from 33 genetic variants associated with CAD by GWAS, choosing those with a hazard ratio (HR) higher than 1. EAT volume was measured with a quantitative semi-automated procedure using a postprocessing workstation-TeraRecon Aquarius Workstation (version 4.4.7, TeraRecon, Inc., San Mateo, CA, USA). We evaluated the discriminative ability of the GRS model without (model 1) and with EAT volume (model 2) using the Harrel C statistics. Categorical free Net Reclassification Improvement (cfNRI) and Integrated Discrimination Index (IDI) reclassified patients.

Results

Cox regression analysis showed that GRS and EAT remained in the equation with an HR of 1.140 (p=0.002) and HR of 1.221 (p=0.002), respectively. C-statistic demonstrated that the predictive value for MACE was 0.588 (95%CI 0.445-0.731) for GRS and increased to 0.689 (95%CI 0.577-0.801) when EAT volume was added to GRS, showing a better discrimination capacity for MACE. The difference between the two C indexes was significant (p=0.003). CfNRI reclassified 58.9% of the population (p=0.001), and IDI improved the discrimination when EAT was included in the GRS model (IDI=0.012; p=0.015).

Conclusion

Our results displayed that the GRS associated with a high EAT volume increased the discriminative ability to predict MACE occurrence. Improving the identification of high-risk patients at a subclinical stage could avoid atherosclerosis progression and events occurrence through more rigorous and earlier preventive and even therapeutic measures.
Plasma levels of amyloid beta 1-40 are associated with ultrasonographic morphological characteristics related with carotid plaque vulnerability in individuals without cardiovascular disease
Authors: Delialis D I M I T R , Angelidakis L , Georgiopoulos G , Aivalioti E , Mavraganis G , Tual-Chalot S , Sopova K , Bampatsias D , Maneta E , Dimopouou A M , Patras R , Konstantaki C , Papaioannou M , Stellos K , Stamatelopoulos K
Published: November 2023

Background

Amyloid-beta (1-40) (Αb40), a proinflammatory and pro-atherosclerotic peptide, is associated with concurrent subclinical atherosclerotic cardiovascular disease (ASCVD) and with major adverse cardiac events in both primary and secondary prevention settings conferring additive and reclassification value over traditional risk factors and risk scores. This evidence supports the hypothesis that Ab40 could be a biomarker of ASCVD. However, mechanistic data on the association of Αb40 with in vivo morphological characteristics of atherosclerosis related with plaque vulnerability are not available.

Purpose

To examine the association of Ab40 levels with characteristics of the carotid artery wall in the general population.

Methods

In the settings of the Athens Vascular registry, subjects without clinically overt ASCVD were consecutively recruited (n=301). Subclinical carotid atherosclerosis was assessed by ultrasonography and the images were subsequently analyzed using a dedicated software (AMS v3.03). The sum and maximal area of atherosclerotic plaques (PLQ) and the minimum echogenicity using grey scale median (GSM) of intima-media thickness (IMT, IMT_GSM) and atherosclerotic plaques (PLQ_GSM) were used as the main endpoints of the analysis. Αb40 was measured in plasma samples.

Results

Subjects with Ab40 levels in the highest tertile had higher prevalence of male sex, presence of carotid plaque atherosclerosis, higher sum and maximal PLQ are and lower GFR HDL-C levels and lower PLQ_GSM (p<0.05 for all). Ab40 in the highest vs. lower tertile was associated with higher sum and maximal plaque area (b-coefficient= 22.9 95% CI: 0.72, 45.1, p=0.43 and b-coefficient= 10.5 95% CI: 1.77, 19.3, p=0.019, for sum and maximal plaque area, respectively) after adjustment for traditional cardiovascular risk factors and GFR (core model). Moreover, Ab40 in the highest tertile was associated with decreased GSM of both IMT and PLQ in the carotid arteries (b-coefficient= -6.0 95% CI: -9.6, -2.36, p=0.001, for IMT and b-coefficient= -8.66 95% CI: -16.5, -0.79, p=0.31, for PLQ) after adjustment for the core model.

Conclusion

In individuals without clinically overt ASCVD, higher levels of Ab40 are associated with the larger atherosclerotic burden and with ultrasonographic characteristics related to higher plaque vulnerability. These findings suggest a mechanistic background for the established association of Ab40 with major adverse cardiovascular events.
Impact of a multimorbidity-focused national general practice chronic disease programme on cardiovascular risks factors
Authors: Reilly O O , Gallagher J , Mcconnaghy D , Kelly S , Mckeogh S , Crowley G , Healy P , Mcdonald K , Brien S O
Published: November 2023

Introduction

Multimorbidity occurs in adults of all ages, but the number and complexity of comorbid conditions commonly increases with advancing age. Therefore cardiovascular disease (CVD) in older adults typically occurs in a context of multimorbidity. Current clinical practice and research mainly target single disease-specific care that does not embrace the complexities imposed by concurrent conditions. A national chronic disease programme focused on multimorbid patients was developed, with funding based on process rather than outcome measures. The conditions included were chronic coronary syndromes, heart failure, atrial fibrillation, transient ischaemic attacks, stroke, diabetes, COPD and asthma. This report focuses on the initial results of this programme.

Methods

The programme commenced in March 2020 and analysis occurred based on patients returned by January 2022. The programme involved general practice teams providing a maximum of two visits to eligible patients every 12 months. The visit structure was supported by adaptation of the electronic health record returns depending on the conditions involved. The programme was introduced on a phased basis so that only those over 65 years were included in this analysis. Among all programme participants who had three visits, data on risk factors such as smoking, alcohol, physical activity, weight, blood pressure (BP), and lipid control were collected. HbA1c was also collected in those with diabetes.

Results

186,210 people were enrolled in the programme by January 2022. 13% of patients who were current smokers ceased smoking between first and third programme visits. In those who had inadequate physical activity levels at their first visit, almost 30% had achieved adequate physical activity levels by their third visit. Of those who had increased, high risk or harmful alcohol consumption patterns at visit one, 8.3% had become non-drinkers and 58.7% had normal drinking patterns by visit three. There was a population drop of a mean of 1mmHg in BP during the programme. Of those with elevated BP at visit one, 43.4% had a BP <140/90 mmHg at visit three. The mean LDL cholesterol of the cohort was 2.2 mmol/L. In those with diabetes and ischaemic heart disease, 49% had an LDL cholesterol <1.8mmol/l. By visit three, 23% of those with an LDL cholesterol initially above target subsequently had an LDL level <1.8 mmol/L. The mean HbA1c in people with diabetes was 53.5 mmol/mol. 40% of those with a HbA1c >64mmol/mol reduced this level between first and third visits. 81% of patients had received influenza vaccination. 75% of patients had received a pneumococcal vaccine.

Conclusion

Despite the COVID 19 pandemic a general practice based multimorbidity focused chronic disease management programme had significant impact on cardiovascular risk factors.
Potential lifetime benefit of applying two-step ESC prevention strategy
Authors: Van Trier T , Snaterse M , Hageman S H J , Ter Hoeve N , Sunamura M , Deckers J , Martens F M A C , Visseren F L J , Dorresteijn J A N , Scholte Op Reimer W J M , Peters R J G , Jorstad H T
Published: November 2023

Background

The 2021 ESC Prevention guideline recommends a two-step strategy for risk management in patients with atherosclerotic cardiovascular disease (ASCVD). We estimated the potential lifetime benefit of complete implementation of this approach, compared to current practice.

Methods

In a pooled cohort (N=1,937) of coronary patients >45 years, lifetime risk for recurrent events and gained event-free years with STEP 1 and STEP 2 were estimated using the SMART-REACH model. For all patients, STEP 1 included non-smoking, the use of antiplatelet therapy and specific targets for low-density lipoprotein cholesterol (LDL-C<1.8 mmol/L) and systolic blood pressure (SBP<140 mmHg), with use of diabetic medication if indicated. In patients with residual lifetime risk >30%, STEP 2 included stricter targets (LDL-C<1.4 mmol/L and SBP<130 mmHg) and intensified treatments (colchicine and dual antiplatelet therapy).

Results

With current treatment following a coronary event, 196 (10%) of patients (20% women, mean age 64) met targets of STEP 1 and 46 (2%) of STEP 2, indicating a lifetime risk of 52% [interquartile range (IQR) 45-59]. Implementing STEP 1 would lower lifetime risk to 37% [IQR 28-45] (Fig 1) and result in a gain of 3.2 [IQR 1.4-5.9] years without events (Fig 2). Intensified STEP 2 treatment was indicated in 70% (median residual risk 41% [36-48]), resulting in lifetime risk in all patients of 26% [21-31] and 5.5 [3.8-8.1] event-free years.

Conclusion

A two-step (residual) risk reduction strategy in ASCVD patients has the potential to lower lifetime risk of recurrent events and to approximately add three event-free years per step to their lifetime.Decrease in lifetime risk per stepGain of event-free years per step
The determinant role of high-density lipoprotein cholesterol on the recovery of left ventricle ejection fraction after acute coronary syndromes
Authors: Cordero A , Escribano D , Flores E , Quintanilla M A , Martinez Rey-Ranal E , Munoz-Villalba M P , Selva A , Galan F , Munoz-Garcia N , Padro T , Vilahur G , Lopez-Ayala J M , Badimon L
Published: November 2023

Background

Higher levels of high-density lipoprotein cholesterol (HDLc) have been associated to lower atherosclerosis-associated cardiovascular disease. Patients admitted for acute coronary syndromes (ACS) usually have low levels of HDLc.

Methods

Between 2015 and 2020 a total of 1,794 patients were admitted from an ACS; 75 (4.23%) died within the hospitalization, 619 (36.0%) were discharged having a LVEF <0.50 from whom 562 (90.79%) had an echocardiogram available within the first 12 months after discharge. We evaluated the evolution of LVEF and assessed the percentage of patients with postdischarge LVEF >0.35 or >0.50. Multivariate analyses were performed by competing risk regression considering all-cause mortality as a competing event and adjusted by risk factors, age, medical treatment at discharge and revascularization; results are presented as sub-hazard ratio (sHR).

Results

Mean (standard deviation) age was 65.61 (12.16), 21.% were males, 28.6% had DM and 51% were discharged after an ST-elevation myocardial infarction (STEMI). During the ACS, LVEF was 43.19 (11.12) and 33.92% had LVEF ≤0.35. Mean HDLc was 40.73 (13.94) mg/dL and no differences were observed in patients with LVEF 0.35 or <0.20.

Median time to postdischarge echocardiogram was 200 days (IQ range 90-295). Postdischarge LVEF was 48.61 (12.83), 54.8% had LVEF >0.50 and 14.41% had LVEF ≤0.35. Eleven patients died before having a postdischarge echocardiogram.

Patients with postdischarge LVEF <0.50 had the same age and sex but had more frequently STEMI (56.13 vs. 47.71%; p=0.048), Killip class >I (47.43% vs. 25.82%; p<0.01), lower LVEF at the ACS (37.24 (0.58) vs. 48.17 (0.58); p<0.01) and specially LVEF<0.35 (45.68% vs. 20.19%; p<0.01). Patients who had postdischarge LVEF <0.50 had lower HDLc (38.19 (0.79) vs 41.11 (0.70) mg/dL; p<0.01) and lower LDLc (85.64 (37.64) vs. 97.45 (35.95) mg/dL; p<0.001) and glomerular filtration rate (73.47(24.57) vs. 78.54 (20.60) ml/min/1.72m2; p<0.001); no differences were observed in triglycerides, hemoglobin or C-reactive protein. The competing risk regression identified an independent predictive value of HDLc for LVEF improvement (figure). HDLc >40 mg/dL in the ACS was independently associated to higher probability of postdischarge LVEF >0.50 (sHR: 1.28 95% CI 1.07-1.53; p<0.001).

Conclusions

HDLc levels, measured during an ACS hospitalization, predict LVEF recovery in patients discharged with LVEF <0.50.
European and US guideline-based statin eligibility, genetically predicted coronary artery disease, and the risk of major coronary events
Authors: Park H , Kim D H , You S C , Jang E S , Yu H T , Kim T H , Kim D M , Sung J H , Pak H N , Lee M H , Yang P S , Joung B Y
Published: November 2023

Objectives

To investigate whether polygenic risk score for coronary artery disease (CAD-PRS) can guide the initiation of lipid-lowering treatment as well as deferral beyond the statin eligibility criteria.

Methods

311,799 individuals aged 40 to 73 years and free of atherosclerotic cardiovascular disease (ASCVD), diabetes, chronic kidney disease, and lipid-lowering treatment at baseline were included from the UK Biobank. Participants were categorized by statin eligibility using the European and US guidelines on statin use.

Results

For a median (IQR) follow-up of 11.9 (11.2-12.6) years, 8,196 individuals experienced major coronary events. CAD-PRS added to European-SCORE2 and US-PCE models identified 18% and 12% of individuals with class II indication for statin use whose risk of major coronary events were same or higher than the average risk of those with class I indication and 16% and 12% of individuals with class I indication whose major coronary event risks were same or lower than the average risk of those with class II indication. For ASCVD events, CAD-PRS added to European-SCORE2 and US-PCE models resulted in a net reclassification improvement of 13.6% (95% CI 11.8 to 15.5) and 14.7% (95% CI 13.1 to 16.3) among class I indicated, 10.8% (95% CI 9.6 to 12.0) and 15.3% (95% CI 13.2 to 17.5) among class II indicated, and 0.9% (95% CI 0.6 to 1.3) and 3.6% (95% CI 3.0 to 4.2) among class III indicated individuals.

Conclusions

CAD-PRS may guide statin initiation as well as deferral among individuals with class I and class II indication for statin use as defined by the European and US guidelines. However, the CAD-PRS had little clinical utility among individuals who were not eligible for statins.
Distinguishing left ventricular hypertrophy from hypertrophic cardiomyopathy in adolescents: a longitudinal observation study
Authors: Forså Marianne I , Smedsrud Marit K , Haugaa Kristina H , Bjerring Anders W , Früh Andreas , Sarvari Sebastian I , Landgraff Hege W , Hallén Jostein , Edvardsen Thor
Published: November 2023

Aims

Echocardiographic characteristics to distinguish physiological left ventricular (LV) hypertrophy from pathology are warranted in early adolescent athletes. This study aimed to explore the phenotype, progression, and potential grey zone of LV hypertrophy during adolescence in athletes and hypertrophic cardiomyopathy (HCM) genotype–positive patients.

Methods and results

In this longitudinal observation study, we compared seventy-six 12-year-old athletes with 55 age-matched and sex-matched HCM genotype–positive patients. Echocardiographic parameters were evaluated by using paediatric reference values (Z-scores). Hypertrophic cardiomyopathy genotype–positive patients were included if they had no or mild LV hypertrophy [maximum wall thickness <13 mm, Z-score <6 for interventricular septum diameter (ZIVSd), or posterior wall thickness]. We collected clinical data, including data on cardiac events. The mean follow-up-time was 3.2 ± 0.8 years. At baseline, LV hypertrophy was found in 28% of athletes and 21% of HCM genotype–positive patients (P = 0.42). Septum thickness values were similar (ZIVSd 1.4 ± 0.9 vs. 1.0 ± 1.3, P = 0.08) and increased only in HCM genotype–positive patients {ZIVSd progression rate −0.17 [standard error (SE) 0.05], P = 0.002 vs. 0.30 [SE 0.10], P = 0.001}. Left ventricular volume Z-scores (ZLVEDV) were greater in athletes [ZLVEDV 1.0 ± 0.6 vs. −0.1 ± 0.8, P < 0.001; ZLVEDV progression rate −0.05 (SE 0.04), P = 0.21 vs. −0.06 (SE 0.04), P = 0.12]. Cardiac arrest occurred in two HCM genotype–positive patients (ages 13 and 14), with ZIVSd 8.2–11.5.

Conclusion

Left ventricular hypertrophy was found in a similar proportion in early adolescence but progressed only in HCM genotype–positive patients. A potential grey zone of LV hypertrophy ranged from a septum thickness Z-score of 2.0 to 3.3. Left ventricular volumes remained larger in athletes. Evaluating the progression of wall thickness and volume may help clinicians distinguish physiological LV hypertrophy from early HCM.
The main genetic locus associated with the evolution of gamecocks is centered on ISPD
Authors: Bendesky Andres , Brew Joseph , Francis Kerel X , Tello Corbetto Enrique F , González Ariza Antonio , Nogales Baena Sergio , Shimmura Tsuyoshi
Published: November 2023

Chickens were domesticated >4,000 years ago, probably first for fighting them and only later as a source of food. Fighting chickens, commonly known as gamecocks, continue to be bred throughout the world, but the genetic relationships among geographically diverse gamecocks and with nongame chickens are not known. Here, we sequenced the genomes of 44 geographically diverse gamecocks and 62 nongame chickens representing a variety of breeds. We combined these sequences with published genomes to generate the most diverse chicken genomes dataset yet assembled, with 307 samples. We found that gamecocks do not form a homogeneous group, yet they share genetic similarities that distinguish them from nongame chickens. Such similarities are likely the result of a common origin before their local diversification into, or mixing with nongame chickens. Particularly noteworthy is a variant in an intron of the isoprenoid synthase domain containing gene (ISPD), an extreme outlier present at a frequency of 89% in gamecocks but only 4% in nongame chickens. The ISPD locus has the strongest signal of selection in gamecocks, suggesting it is important for fighting performance. Because ISPD variants that are highly prevalent in gamecocks are still segregating in nongame chickens, selective breeding may help reduce its frequency in farm conditions in which aggression is not a desired trait. Altogether, our work provides genomic resources for agricultural genetics, uncovers a common origin for gamecocks from around the world and what distinguishes them genetically from chickens bred for purposes other than fighting, and points to ISPD as the most important locus related to fighting performance.
Meal kit subscription services and opportunities to improve family vegetable consumption
Authors: Fraser Kylie , Love Penelope , Laws Rachel , Campbell Karen J , Spence Alison
Published: November 2023

Popular commercial meal kit subscription services (MKSSs) may support families to overcome barriers to cooking and eating at home, and facilitate improved vegetable consumption. The global meal kit market has expanded rapidly creating a gap in our understanding of the health-promoting potential of MKSSs. This paper describes the contemporary MKSS market in Australia and provides a vegetable-specific content analysis of a sample of recipes. A 1-week subscription was purchased for all Australian-based MKSSs (n = 9) and websites were systematically reviewed to document key characteristics and recipe features. Vegetable content of all available recipes within a 1-week period were analysed. Our findings highlight the rapid expansion and evolution of MKSS market offerings over the past decade and their potential to support family vegetable consumption. Across all analysed recipes (n = 179), MKSSs provided a median of 2.5 vegetable serves per person (range 0.7–7.5 serves) and a median of 3 different types of vegetables from 2 vegetable subgroups (i.e. dark green, red and orange, starchy, legumes and all other vegetables). This suggests that MKSSs may support family vegetable consumption if families select recipes with a greater number and variety of vegetables. However, an opportunity remains for MKSSs to improve both vegetable quantity and variety to positively influence population health. Further research is required to describe how families use meal kits promoting a greater understanding of their potential to improve family nutrition.
ASAS-NANP symposium: Mathematical Modeling in Animal Nutrition: The power of identifiability analysis for dynamic modeling in animal science:a practitioner approach
Authors: Muñoz-Tamayo Rafael , Tedeschi Luis O
Published: November 2023

Constructing dynamic mathematical models of biological systems requires estimating unknown parameters from available experimental data, usually using a statistical fitting procedure. This procedure is usually called parameter identification, parameter estimation, model fitting, or model calibration. In animal science, parameter identification is often performed without analytic considerations on the possibility of determining unique values of the model parameters. These analytical studies are related to the mathematical property of structural identifiability, which refers to the theoretical ability to recover unique values of the model parameters from the measures defined in an experimental setup and use the model structure as the sole basis. The structural identifiability analysis is a powerful tool for model construction because it informs whether the parameter identification problem is well-posed (i.e., the problem has a unique solution). Structural identifiability analysis is helpful to determine which actions (e.g., model reparameterization, choice of new data measurements, and change of the model structure) are needed to render the model parameters identifiable (when possible). The mathematical technicalities associated with structural identifiability analysis are very sophisticated. However, the development of dedicated, freely available software tools enables the application of identifiability analysis without needing to be an expert in mathematics and computer programming. We refer to such a non-expert user as a practitioner for hands-on purposes. However, a practitioner should be familiar with the model construction and software implementation process. In this paper, we propose to adopt a practitioner approach that takes advantage of available software tools to integrate identifiability analysis in the modeling practice in the animal science field. The application of structural identifiability implies switching our regard of the parameter identification problem as a downstream process (after data collection) to an upstream process (before data collection) where experiment design is applied to guarantee identifiability. This upstream approach will substantially improve the workflow of model construction toward robust and valuable models in animal science. Illustrative examples with different levels of complexity support our work. The source codes of the examples were provided for learning purposes and to promote open science practices.
Left-sided cholecystitis in a patient with situs inversus totalis, complicated by portal venous malformations
Authors: Suvarna Rishabh , Gupta Ankit , Amtul Nasira
Published: November 2023

Situs inversus totalis (SIT) is a rare autosomal recessive anomaly in which the thoracoabdominal viscerae are laterally transposed, introducing unique challenges in surgical scenarios. Only a few reports have demonstrated the treatment of cholecystitis in situs inversus, much less so in the context of portal vascular anomalies. We present the case of a 41-year-old female presenting to the emergency department with right upper quadrant pain, and subsequently found to have left-sided cholecystitis complicated by SIT with portal venous malformations on magnetic resonance cholangiopancreatography and abdominal computed tomography. Initially, she was referred for open cholecystectomy however due to the lack of symptoms and the presence of a tortuous recanalized portal vein presenting multiple thrombotic complications, an expectant approach was adopted. Thus, imaging remains the gold-standard to diagnose SIT and consideration of all congenital risk factors to cholecystectomy is crucial to avoid post-operative complications.
Markers of Natural Killer Cell Exhaustion in HIV/HCV Coinfection and Their Dynamics After HCV Clearance Mediated by Direct-Acting Antivirals
Authors: Osegueda Ariel , Polo Maria Laura , Baquero Lucia , Urioste Alejandra , Ghiglione Yanina , Paz Silvia , Poblete Gabriela , Gonzalez Polo Virginia , Turk Gabriela , Quiroga Maria Florencia , Laufer Natalia
Published: November 2023

Background

Liver fibrosis is a leading cause of morbimortality in people with HIV/hepatitis C virus (HCV). Natural killer (NK) cells are linked with amelioration of liver fibrosis; however, NK cells from individuals coinfected with HIV/HCV with cirrhosis display impaired functionality and high PD-1 expression. Here, we aimed to study PD-1, TIGIT, and Tim3 as potential exhaustion markers in NK cells from persons coinfected with HIV/HCV with mild and advanced liver fibrosis. We also evaluated the role of PD-1 expression on NK cells after HCV clearance by direct-acting antivirals (DAAs).

Methods

Peripheral blood mononuclear cells were isolated from individuals coinfected with HIV/HCV (N = 54; METAVIR F0/F1, n = 27; F4, evaluated by transient elastography, n = 27). In 26 participants, samples were collected before, at the end of, and 12 months after successful DAA treatment. The frequency, immunophenotype (PD-1, TIGIT, and Tim3 expression), and degranulation capacity (CD107a assay) of NK cells were determined by flow cytometry.

Results

Unlike PD-1, Tim3 and TIGIT were comparably expressed between persons with mild and advanced fibrosis. Degranulation capacity was diminished in NK/TIGIT+ cells in both fibrosis stages, while NK/PD-1+ cells showed a lower CD107a expression in cirrhotic cases. Twelve months after DAA treatment, those with advanced fibrosis showed an improved NK cell frequency and reduced NK/PD-1+ cell frequency but no changes in CD107a expression. In individuals with mild fibrosis, neither PD-1 nor NK cell frequency was modified, although the percentage of NK/CD107a+ cells was improved at 12 months posttreatment.

Conclusions

Although DAA improved exhaustion and frequency of NK cells in cirrhotic cases, functionality was reverted only in mild liver fibrosis, remarking the importance of an early DAA treatment.
Is electrostrain >1% in oxygen deficient Na0.5Bi0.5TiO3 a composition effect?
Authors: Tina Getaw Abebe , Muleta Gudeta Jafo , Adhikary Gobinda Das , Ranjan Rajeev
Published: November 2023

For over two decades Na0.5Bi0.5TiO3 (NBT) -based lead-free piezoelectrics have attracted attention due to its ability to exhibit large electric-field driven strain. Compared to the popular Pb(Zr, Ti)O3 (PZT)-based piezoelectrics, which exhibit electrostrain of about 0.3%, the derivatives of NBT-based lead-free piezoelectrics at the ergodic—non ergodic relaxor crossover exhibit larger electric-field driven strain ∼0.45%. In recent years, there has been a concerted effort to increase the maximum electrostrain in lead-free piezoceramics. Recent reports suggest that oxygen deficient NBT- based piezoceramics can exhibit electrostrain ∼1%. In this paper we explore this phenomenon and show that the ultra high electric field driven strain measured is primarily a consequence of reducing the thickness of the disc dimension below 500 microns and not an exclusive effect of the composition.
Green bonds and carbon emissions
Authors: Flammer Caroline
Published: November 2023

This paper examines the relationship between green bonds (that is, bonds whose proceeds are committed to financing green projects) and carbon emissions at the aggregate level. Using data for US states, I find that the issuance of $1,000 of green bonds per capita is associated with a subsequent decrease in state-level emissions by 0.9–1.4 per cent. I obtain similar magnitudes using cross-country data. These results are stronger for green bonds that are certified by independent third parties, suggesting that certification is an important governance mechanism in the green bond market.
Factors that predict the safe recovery of missing and abducted children
Authors: Reifel Kerri L , Sundberg-Alley Madison , McCaulley Karen L , Hayne Anita S
Published: November 2023

Over 2,000 children were reported as ‘critically missing’ to a federal law enforcement agency’s crisis watch unit between the years of 2014 and 2020. The present study examines characteristics from these cases to determine what factors may exist to help predict their safe recovery. Most children in the sample (89%) were recovered alive. Several factors that serve as predictors for a safe recovery were revealed, including being a multiple-victim incident; being reported last seen at school; the victim/offender relationship; and initial incident classification of abduction, as opposed to missing. A significant interaction between age and presence of Autism Spectrum Disorder (ASD) suggests that young victims with ASD are less likely to be recovered alive. Operational considerations for law enforcement are provided.
Novel Magnesium-Copper Hybrid Nanomaterials for Management of Bacterial Spot of Tomato
Authors: Choudhary Manoj , Liao Ying-Yu , Huang Ziyang , Pereira Jorge , Santra Swadeshmukul , Da Silva Susannah , Parajuli Apekshya , Freeman Joshua H. , Jones Jeffrey B. , Paret Mathews L.
Published: November 2023

Bacterial spot of tomato (BST), predominantly caused by Xanthomonas perforans (Xp) in Florida, is one of the most devastating diseases in hot, humid environments. Bacterial resistance to copper-based bactericides and antibiotics makes disease management extremely challenging. This necessitates alternative new solutions to manage the disease. In this study, we used two novel hybrid copper and magnesium nanomaterials, noted as magnesium double-coated (Mg-Db) and magnesium-copper (Mg-Cu), to manage BST. In in vitro experiments, no viable cells were recovered following 4 h of exposure to 500 μg/ml of both Mg-Db and Mg-Cu, while 100 and 200 μg/ml required 24 h of exposure for complete inhibition. In a viability assay using the live/dead cell straining method and epifluorescence microscopy, copper-tolerant Xp cells were killed within 4 h by both Mg-Cu and Mg-Db nanomaterials at 500 μg/ml but not by copper hydroxide (Kocide 3000). In the greenhouse, Mg-Db and Mg-Cu at 100 to 500 μg/ml significantly reduced BST severity compared with micron-sized commercial copper bactericide Kocide 3000 and the growers’ standard (copper hydroxide + mancozeb) (P < 0.05). In field studies, Mg-Db and Mg-Cu nanomaterials significantly reduced disease severity in two out four field trials. Mg-Db at 500 μg/ml reduced BST severity by 34% compared with the nontreated control without affecting yield in fall, 2020. The use of hybrid nanomaterials at the highest concentrations (500 μg/ml) evaluated in the field experiments can reduce copper use by 90% compared with the growers’ standard. In addition, there was no phytotoxicity observed with the use of hybrid nanomaterials in the field. These results suggest the potential of novel magnesium-copper-based hybrid nanomaterials to manage copper-tolerant bacterial pathogens.
Distribution and Frequency of Little Cherry Virus 2 Genotypes in Both Production and Ornamental Fruit Trees in the Pacific Northwest
Authors: Shires Madalyn K. , Molnar Cody , Wright Alice A. , Bishop Garrett , Harper Scott J.
Published: November 2023

Little cherry virus 2 (LChV2) is the causal agent of little cherry disease, a recurring problem affecting cherry production the U.S. Pacific Northwest. Previous research has shown that there are two genotypes (LC5 and Rube-74) of LChV2 present in Washington. Here, we used data and samples from 2017 to 2022 to determine the incidence of each genotype in the Pacific Northwest, their distribution in cultivated versus ornamental host systems, and evidence of coinfection of both genotypes in individual plants. We found that there was no geographic pattern in Washington, as both genotypes are distributed throughout the state, whereas in Oregon, LChV2 positives were concentrated on one region. In both states, the LC5 genotype was the most common and widespread of the two genotypes, suggesting that the Rube-74-like isolates found were more recently introduced but are being actively transmitted. There were no host-specific patterns found, as both genotypes were found in cultivated and ornamental cultivars. Coinfection of a single plant by both genotypes was common in both states, with no evidence of superinfection-exclusion, although, interestingly, LChV2 titer and frequency decreased in the presence of ‘ Candidatus Phytoplasma pruni’. Cumulatively, these data will help us better understand the epidemiology of this pathogen in the Pacific Northwest.