bluuebunny/crossref_metadata_2025 huggingface dataset:
Immune reconstitution is the trigger of herpes zoster with lymphopenia and high neutrophil-to-lymphocyte ratio in a retrospective cohort study
Authors: Yamamoto Takenobu , Aoyama Yumi
Published: May 2024

Background

Herpes zoster (HZ) rarely results in subsequent death, but predictive biomarkers for mortality necessitate further elucidation.

Objectives

To investigate immune dynamics prior to an HZ event, risk factors for HZ onset and immune status at initial HZ.

Methods

This retrospective study extracted from patient records the absolute neutrophil and lymphocyte counts (ANC and ALC, respectively) at the initial HZ date of appearance and up to 30 days before HZ. A follow-up survey was completed within 180 days of onset of illness.

Results

Patients with HZ showed a higher neutrophil-to-lymphocyte ratio (NLR) and lower ALC than patients in the control group at the initial date and had a poorer prognosis. In the pre-onset examination, the maximum and minimum ALC values were significantly lower in patients with HZ than in the control group, and the maximum ALC value in patients with HZ was lower than the minimum value in the control group. The lowest ALC was observed 7 days before the onset of HZ. An NLR of 4.53 or more and an ALC of 0.64 × 109 cells L–1 or less were predictive markers of HZ development within 30 days. Patients who died after HZ had a lower minimum ALC than those who survived longer.

Conclusions

HZ develops in a state of immune reconstitution in patients with immunocompromised conditions, as part of ‘unmasking’ the immune reconstitution inflammatory syndrome. Lymphopenia prior to HZ onset is one of the most crucial factors in its pathogenesis and vital prognosis. Limitations of the study were small population size, varying age distribution, retrospective nature, and potential overestimation of pre-onset data.
Exploring gender identity in paediatric dermatology
Authors: Bali Radhika , Pointon Molly , Laguda Bisola , Hussain Khawar
Published: May 2024

This ethical dilemma explores gender identity within the paediatric population. It also considers the fundamental principles of consent for minors, with nonmaleficence as an overarching framework to safeguard children.
Cannabis Use in Patients With Inflammatory Bowel Disease Following Legalization of Cannabis in Canada
Authors: Iablokov Vadim , Gregor Jamie , Chande Nilesh , Ponich Terry , Jairath Vipul , Khanna Reena , Asfaha Samuel
Published: May 2024

Background

Cannabis is used by patients with Crohn’s disease (CD) and ulcerative colitis (UC) as an alternative to, or in combination with, conventional therapies to treat symptoms such as abdominal pain, poor sleep, and reduced appetite. The clinical efficacy of cannabis for these disorders is controversial, with some studies showing harmful outcomes associated with its use. Previous studies suggest that cannabis is used by ~12% of patients with UC and ~16% of patients with CD in the USA despite legal prohibition.

Methods

We conducted a prospective cohort study of adult patients with inflammatory bowel diseases (IBD) followed in a Canadian tertiary care center. Patients completed an online 40-question survey that included demographics, IBD disease history, cannabis use, and the Short Inflammatory Bowel Disease Questionnaire (SIBDQ).

Results

Completed surveys were obtained from 254 participants (148 with CD, 90 with UC, and 16 with indeterminate colitis). Recent cannabis use was reported by 41% of CD and 31% of UC participants. Interestingly, only 46% of participants who used cannabis discussed their use with their physician. Participants who recently used cannabis reported more abdominal pain, poor appetite, and flatulence, and importantly this was associated with lower SIBDQ scores (recent use 37 vs non-recent use 40).

Conclusions

Cannabis use among patients with IBD has more than doubled since its legalization. Cannabis use is associated with worse abdominal symptoms and quality of life. Physicians should inquire about cannabis use and optimize symptom control with evidence-based therapies.
The Heidelberg registry of atrial fibrillation. a summary in the era of transition of oral anticoagulation regimes over an 11-year period
Authors: Salbach C , Yildirim M , Milles B , Hund H , Biener M , Mueller-Hennessen M , Frey N , Katus H , Giannitsis E
Published: May 2024

Funding Acknowledgements

Type of funding sources: Private company. Main funding source(s): The study was supported by a research grant from Daiichi Sankyo and Bayer diagnostics. The sponsor had no influence on the study concept, data collection, or interpretation.

Background

Management of patients with atrial fibrillation (AF) has improved in recent years. Particularly, the shift from vitamin-k containing (VKA) oral anticoagulation (OAC) regimes to factor Xa or thrombin inhibitor containing non-vitamin K regimes (NOAC) regimes has revolutionized stroke prevention in AF patients.

Purpose

This study aimed to illustrate the shift from VKA to NOAC regimes over an 11-year period in an emergency department (ED) setting.

Methods

The Heidelberg Registry of Atrial Fibrillation (HERA-FIB) is a retrospective, observational single-center study and collected data from patients with AF presenting to the ED of our hospital between 2009 and 2020. Inclusion criteria were (a) diagnosis of AF and (b) age >18 years. Exclusion criteria were (a) non-availability of at least one high sensitive troponin T value and (b) lost to follow-up for all-cause mortality. Repeated visits to the ED were also excluded. Clinical data was accessed retrospectively from available medical records. A sequential follow-up was performed for all-cause mortality, stroke, major bleeding and myocardial infarction. This study was conducted according to ethical principles stated in the Declaration of Helsinki (2008).

Results

Within the inclusion period of HERA-FIB a total of 76,528 visits to CPU were screened over an 11-year time period. 24.4% were excluded for other diagnosis than AF, resulting in a total of 12,279 visits to ED within the inclusion period. Here, a total of 5.4% of the patients were excluded after re-adjustment of AF diagnosis, 1,5% for non-sufficient laboratory values and 10% for lost-to follow-up. The total study population of HERA-FIB included 10,222 patients with the diagnosis of AF. Within the inclusion period of HERA-FIB, a significant change form VKA containing to NOAC containing anticoagulation regimes could be detected among patients presenting to the ED. Additionally, the number of patients on OAC compared to the number of patients without any OAC regime increased over time. Within the inclusion period, a total of 69.7% received an OAC regime. Here 59.5% of the AF patients received a NOAC and 40.5% VKA at discharge. Hazard ratio for patients on VKA for all-cause mortality was 1.25 (95%CI: 1.11-1.41), p=0.0003.

Conclusions

HERA-FIB is one of the largest real-world retrospective single-center databases for patients with AF, reflecting the shift from NOAC to VKA containing anticoagulation regimes in AF patients presenting to an ED over an 11-year period.
Clinical impact of sarcopenia on long-term mortality in patients undergoing coronary bypass grafting
Authors: Lee S H , Jo J , Yang J H , Kim S M , Choi K H , Song Y B , Jeong D S , Lee J M , Park T K , Hahn J , Choi S , Cho Y H , Sung K , Kim W S , Gwon H
Published: May 2024

Funding Acknowledgements

None.

Aims

Sarcopenia is an aging-related condition characterized by loss of skeletal muscle mass and is an indicator of subclinical atherosclerosis. The relationship between sarcopenia and long-term clinical outcomes in patients with advanced coronary artery disease who have undergone coronary artery bypass grafting (CABG) is not fully understood. We evaluated the prognostic implications of sarcopenia in patients undergoing CABG.

Methods and Results

A total of 2,810 patients who underwent CABG was analyzed and classified according to presence of sarcopenia. The skeletal muscle index (SMI) was calculated as L3 muscle area (cm2)/height (m)2 on computed tomography. Sarcopenia was defined as SMI ≤45 cm2/m2 in men and ≤38 cm2/m2 in women. The primary outcome was all-cause mortality during follow-up. The median follow-up was 8.7 years, and 924 patients (32.9%) had sarcopenia. Patients with sarcopenia were older and more frequently women. SMI was significantly correlated with age (R=-0.34, P<0.001), weight (R=-0.56, P<0.001), and body mass index (R=-0.52, P<0.001). SMI was significantly associated with risk of death on a restricted cubic spline curve (HR=1.04 per-1 decrease, 95% CI 1.03-1.05, P<0.001). Patients with sarcopenia had a higher incidence of long-term mortality than those without sarcopenia (survival rate 41.4% vs. 62.8%; adjusted HR=1.18, 95% CI 1.03-1.36, P=0.02). Subgroup analysis showed that the prognostic implication of sarcopenia on long-term survival was more evident in men (adjusted HR=2.01, 95% CI 1.72-2.35) than women (adjusted HR=1.28, 95% CI 0.98-1.68) (interaction P=0.006).

Conclusions

Sarcopenia, defined by SMI on computed tomography, was associated with long-term mortality after CABG.
Do air pollutants levels during the previous 48 hours predict out-of-hospital cardiac arrest incidence compared to same-day pollutants levels?
Authors: Roca Guerrero C , Garcia-Garcia C , Baneras-Rius J , Sionis-Green A , Sanchez-Salado J C , Izquierdo-Ribas M , Moreno-Monterde E , Cubells-Pastor M , Lopez-Sobrino T , Ortiz-Perez J T , De Diego-Soler O , Andrea-Riba R
Published: May 2024

Funding Acknowledgements

None.

Introduction

Association between air pollutants (APs) levels and out-of-hospital cardiac arrest (OHCA) at the same day of the measurements have been previously described. Whether APs levels measured during the previous 48 hours may predict OHCA occurrence is not known.

Purpose

To analyse whether same-day APs levels compared to APs levels during the previous 48 hours are associated with OHCA incidence.

Methods

OHCA admissions on five Cardiac Intensive Care Units of our city were assessed during September-2020 to December-2021.

Free access data regarding particulate matter (PM10), carbon monoxide (CO), nitrogen dioxide (NO2) and ozone (O3) levels during the same period were also registered. APs measures occurred each hour daily at three different spots, delivering more than 31000 measurements.

APs levels during the previous 48 hours and during the index day were compared between OHCA-free days (OHCA-Fd) and OHCA-days.

Results

179 patients were included. Main demographic characteristics are shown on table 1. Daily OHCA incidence and APs mean levels/month are shown in Table 2.

As shown at table 3 same-day higher NO2 and lower O3 levels were found on OHCA-days compared to OHCA-fd: 41 ±10 vs. 36 ±9 µg/m3, p=0.016 for NO2 and 45 ±13 vs. 51 ±11 µg/m3, p= 0.003 for O3.

As shown on Table 2 same day mean O3 levels were also higher from April to September compared to the rest of the year (p<0.001). OHCA incidence was lower in this same period (p<0.001).

There wasn’t any association between OHCA incidence and APs (NO2, O3, PM10 and CO) measured at any moment during the event's prior 48 hours.

Conclusions

Same-day higher NO2 and lower O3 levels were associated to a higher OHCA incidence in our city. On the other hand, association between OHCA and NO2, O3, PM10 or CO measurements during the previous 48 hours was not found in our cohort.

Reducing production of NO2 (i.e., reducing fossil-fuel consumption) may reduce OHCA risk during that same day.
Echocardiographic image monitoring during Impella use: our experience
Authors: Legarra P , Garcia Ugaldebere J , Jimenez O , Lanaspa A , Ugarriza J , Segur M , Borderias T , Sanchez G , Villabona C , Martinez J , Munarriz A
Published: May 2024

Funding Acknowledgements

None.

Introduction

Impella CP is a type of percutaneous left ventricular (LV) mechanical circulatory support located inside LV and placed through the aortic valve. There is little information about the incidence of valvular complications related to its use or other complications assessable by echocardiography.

Purpose

To determine the existence of complications assessable by echocardiography in patients treated with Impella CP in our centre.

Methods

Retrospective analysis of patients treated with Impella CP in 2020 and 2021 in our centre. Baseline clinical characteristics were studied and pre- and post-procedure echocardiograms of these patients were reviewed.

Results

A total of 32 echocardiograms were analysed in 16 patients with a mean age of 70 years. Clinical and echocardiographic features are described in table 1. After device removal, the presence or degree of aortic regurgitation did not change in the patients, including 2 patients who had moderate aortic regurgitation pre-implantation. However, on echocardiograms after device removal, intraventricular thrombus was detected in 2 patients, who also had severe LV systolic dysfunction and who had the longest duration in days of implantation (6 and 7 days). The mean number of days of implantation was 1.68 days.

Conclusion

Echocardiography is a useful tool for the management and detection of complications during the time of support with Impella CP, such as valve dysfunction and the presence of intraventricular thrombus. In our centre, the use of Impella is not related to the onset or worsening of aortic valve pathology.
Exploring biomarkers as predictors of left ventricular recovery in a national registry of takotsubo syndrome patients (RETAKO)
Authors: Rivas Garcia A , Lopez Flores L , Marin Andreu P , Lopez Flores C , Andres M , Perez Castellanos A , Uribarri A , Nunez Gil I J , Garcia Rubira J C , Almendro Delia M
Published: May 2024

Funding Acknowledgements

None.

Introduction

Tako-Tsubo Syndrome (TTS) is characterized by transient dysfunction of the left ventricle (LV) of uncertain etiology, although considered a benign entity, TTS has a mortality rate and complications similar to STEMI patients (1). Late LV recovery (>10 days) has been associated with a worse prognosis. Currently, there is no data on biomarkers that can predict the disease's progression.

Purpose

We aim to correlate different biomarkers with LV recovery in TTS patients.

Method

We used data from the National Multicenter Registry on Tako-Tsubo Syndrome (RETAKO). Information on biomarkers, including NT-proBNP, C-reactive protein (CRP), leukocytes, and platelets, was collected both upon admission and at peak values. Early recovery was considered when it occurred within the first 10 days after the index event. A non-parametric correlation analysis was conducted to assess the predictive capacity of different biomarkers on LV recovery.

Results

Out of a total of 1,463 patients, 373 (25.5%) experienced late LV recovery. The average age was around 73 years, with the majority of the sample being women (86%). Significant differences were observed between the groups in NT-proBNP, CRP, and peak values of leukocytes and platelets, with higher levels in the late recovery group. In the linear correlation analysis, a significant association was found between late recovery and higher levels of NT-proBNP, peak leukocytes and platelets, however it was not statistically significant for the levels of CRP.

Conclusions

In a large national cohort of TTS patients, higher levels of NT-proBNP, peak of leukocytes and platelets during the hospital stay were significantly associated with late LV recovery. This recovery appears to depend on the degree of LV dysfunction and the inflammatory response.Biomarkers table 1
The role of cardiac rehabilitation in patients following acute coronary syndrome
Authors: Paula S , Figueiredo M , Coelho M , Santos M , Almeida S , Almeida L
Published: May 2024

Funding Acknowledgements

None.

Introduction

The benefits of cardiac rehabilitation in patients with acute coronary syndrome (ACS) are well established. Although there are limited centres with cardiac rehabilitation and patients, especially from peripheral hospitals, wait a long time to enter the programme and many of them don’t even enter these programmes.

Purpose

Characterize the patient population that go to cardiac rehabilitation and evaluate short- and long-term outcomes.

Methods

Multicenter retrospective study, patients with the diagnosis of ACS and data collected from 1/01/2015 to 31/12/2021. Patients were divided into 2 groups (G). G1 – Patients with cardiac rehabilitation programmed and/or planned; G2 – Patients not referenced for cardiac rehabilitation. We further analyse patients according to MACE events, group A without MACE; group B with MACE.

Results

11992 patients were enrolled, only 3162 (26.4%) patients were referenced for cardiac rehabilitation. G1 was younger 63.5 ± 12.4 (p<0.001), had more males 76.7% (p<0.001) and more smokers 38.0% vs 25.3% (p<0.001), but less patients with arterial hypertension (AH) 65.1% vs 70.9% (p<0.001), diabetes mellitus (DM) 29.5% vs 32.8% (p<0.001), dyslipidemia 57.0% vs 61.2% (p<0.001), previous heart failure 4.8% vs 7.9% (p<0.001) and chronic kidney disease (CKD) 3.8% vs 7.3% (p<0.001). G1 had although more patients with symptoms of angina 29.2% vs 23.3% (p<0.001) and previous MI 20.5% vs 17.6% (p<0.001). Regarding MACE events G1 had better outcomes 1.3% vs 6.1% (p<0.001). Considering MACE events, group B was older 74±12 years (p<0.001), male gender was predominant (62.5%) and had more patients with AH 76.9% vs 68.8% (p<0.001), DM 45.1% vs 31.1% (p<0.001), CKD 14.6% vs 5.6% (p<0.001) and pacemaker (PM) or ICD devices 3.8% vs 1.7% (p<0.001).

Independent predictors of MACE achieved through logistic regression analysis are gender p<0.001, OR 0.325, CI (95%) 0.158-0.672; CKD p= 0.042, OR 4.027, CI 1.019-15.911; time from symptoms to 1st contact ≥ 120min p=0.032, OR 2.088, CI 1.067-4.087; usage of inotropic medications p<0.001, OR 6.383, CI 2.995-13.602; left ventricular ejection fraction <30% vs ≥30% p=0.002, OR 4.172, CI 1.722-10.108; need of invasive mechanical ventilation p<0.001, OR 6.593, CI 2.812-15.457 and need of temporary PM p<0.001, OR 12.372, CI 4.025-38.031.

Conclusion

In these study population, patients with less cardiovascular (CV) risk factors and comorbidities were more often assigned to cardiac rehabilitation programmes. Not unpredictable patients with more comorbidities suffered more from MACE events. Survival analysis also showed that CV mortality and re-admission at 1 year were higher in patients not assigned for cardiac rehabilitation.
Incremented Amyloid-beta values predict mortality during long-term follow-up in patients with acute myocardial infarction, both STEMI and NSTEMI
Authors: Aleksova A , Fluca A L , Janjusevic M , Barbati G , D'errico S , Sinagra G
Published: May 2024

Funding Acknowledgements

None.

Background

Both the amyloid-β (Aβ) isoforms, namely Aβ1-40 and Aβ1-42 are implicated in the pathogenesis of Alzheimer’s disease through different mechanisms. While Aβ42 easily forms oligomers in brain, Aβ1-40 is more abundant in circulation where it exerts a pro-inflammatory role. Recently, Aβ1-40 has raised interest in the cardiovascular field for its contribution to atherosclerosis, more specifically through plaque formation and destabilization. However, to date, the prognostic role of Aβ1-40 in patients with acute myocardial infarction (AMI) is limited to NSTEMI.

Purpose

Since there is a need for better risk stratification of AMI patients, we analyzed the impact of plasma Aβ1-40 on long-term mortality in a cohort of real-world patients with AMI, including STEMI and NSTEMI. Further, we sought to identify predictors for elevated Aβ1-40 levels.

Methods

Blood samples were obtained from patients hospitalized for AMI and Aβ1-40 levels were evaluated with Human Aβ40 ELISA Kit. The endpoint was all-cause mortality.

Results

Our population included 1119 consecutive patients, with a mean age of 67 years, 72% male, 2/3 of them had a first ischemic event and 68.4% had STEMI diagnosis. The median plasma Aβ1-40 concentration on admission was 86.9 [54.5-128.9] pg/ml and there was no difference in Aβ1-40 levels between NSTEMI and STEMI (93.6 [61.2-130.9] Vs. 85.3 [52.9-128.7] pg/ml, respectively, p=0.1). At logistic regression multivariate analysis, higher Aβ1-40 levels were predicted by older age, worse left ventricular systolic function, HbA1C > 39 mmol/mol and GFR<60ml/min/m 2 (Fig.1a). From the final multivariable model, a nomogram for prediction of high levels of Aβ1-40 was computed (Fig.1b). One hundred ninety-three patients (17.2%) died, during the median follow-up of 57 [30 - 80] months. Patients who died had significantly higher levels of Aβ1-40 compared to alive patients (113.1 [67.9 – 159.5] Vs. 83.9 [52.5 – 122.6] pg/ml, p<0.01). Higher plasma Aβ1-40 values were associated with increased mortality risk, in both STEMI and NSTEMI (p<0.01) (Fig.2a). Further, at Cox multivariate analysis including the whole population, Aβ1-40 levels were predictive of mortality (HR 1.03, p=0.02), together with older age, higher Il-1β, GFR<60ml/min/m 2 and worse left ventricular systolic function (Fig.2b). The predictive value of our final model was superior to GRACE score for up to 60 months (AUC 0.830 (0.793 – 0.868) Vs 0.797 (0.756 – 0.837), respectively, p=0.03, Fig.2c), after which they were comparable.

Conclusions

Elevated levels of Aβ1-40 values are independent predictors of long-term mortality in a real-world cohort including both STEMI and NSTEMI patients.
Clinical characteristics and outcome of non-acute myocardial syndrome cardiogenic shock in comparison to its ischaemic aetiology
Authors: Sokolski M , Krupka D , Chelmonski A , Mazur K , Barteczko B , Kupiec A , Bochenek M , Biegus J , Zymlinski R , Gozdzik W , Przybylski R , Kuliczkowski W
Published: May 2024

Funding Acknowledgements

None.

Background

The mortality in cardiogenic shock (CS) remains high but the report mostly concerns CS in the course of acute myocardial syndrome (ACS). There is limited data about non- ischaemic CS.

Purpose

The aim of this study was to analyse the clinical characteristics, treatments and outcomes in patients with non-ACS CS in comparison to ischemic aetiology CS.

Methods

80 patients with an average age of 62 ± 13 years (81 % male) with CS admitted in 2021 and 2022 to tertiary hospital were divided into 2 subgroups: non-acute myocardial infarction cardiogenic shock (non-ACS-CS) consisted of 16 individuals (20%) and CS in the course of ACS (ACS-CS) consisted of 64 (80%) individuals. The main cause of CS in non-ACS group was worsening of previously diagnosed heart failure 11 (14%).

Results

Patients from non-ACS group were younger 52±16 vs. 65±11 years old, p=0.005. There were no differences in baseline heart rate 90 [72;100] vs. 95 [80;107] beats per minute and mean artery pressure 89 [73;97] vs. 80 [70;97] mmHg for non-ACS-CS vs. ACS-CS, respectively all p>0.05. Patients from non-ACS-CS group had lower baseline troponin level 0.29 [0.04;0.96] vs. 7.05 [0.69;57.4] ng/mL, p=0.003, white blood cell count 11 [9;13] vs. 15 [10;19] × 109/L; p=0.035, procalcitonin 0.06 [0.05;0.28] vs. 0.69 [0.10;2,48] ng/mL, p=0.001 and higher pH 7.4 [7.3;7.5] vs. 7.2 [7.0;7.4], p=0.012 in blood gas analysis when compared with ACS-CS. There were no significant differences in the severity of the shock according to Society for Cardiovascular Angiography and Interventions (SCAI) SHOCK classification among the groups: from C: 1 (6%) vs. 6 (10%), D: 11 (69%) vs. 27 (42%), E: 4 (25%) vs. 31 (48%), respectively for non-ACS vs. ACS-shock. The non-ACS-CS was more often treated with V-A ECMO 10 (63%) vs. 20 (32%) in ACS-CS, p=0.024. The overall number of in-hospital deaths was 57 (71%). The non-ACS-CS group had significantly lower in-hospital mortality 8 (50%) compared to the ACS-CS patients 49 (77%), p=0.034.

Conclusion

Patients experiencing non-ACS-CS were younger, have lower levels of inflammatory markers and a higher pH in blood gas analysis at admission. Despite more favourable biomarker profile non-ACS-CS group was treated more aggressively and had significantly lower in-hospital mortality rates when compared with patients facing ACS-CS, which indicates the need to look at CS differently depending on its aetiology.
Aortic valve laceration following rotational atherectomy: a case report
Authors: Othman Farrah , Yong Gerald , Whelan Alan , Ihdayhid Abdul Rahman
Published: May 2024

Background

Iatrogenic aortic valve injury during cardiovascular catheterization interventions is extremely rare. Severe aortic regurgitation that ensues can be catastrophic and the management is typically with surgical valve replacement or repair. Percutaneous management of native pure aortic regurgitation is difficult due to anatomical challenges and the limitations of current transcatheter heart valve technology to anchor in the absence of leaflet or annular calcification.

Case Summary

An 82-year-old female underwent rotational atherectomy (RA) for a severely calcified stenosis of the left anterior descending artery. The patient was discharged well following placement of two drug eluting stents. She represented to hospital 7 days later with acute pulmonary oedema. Bedside transthoracic echocardiography demonstrated new, severe AR with preserved left ventricular size and function. Review of the prior percutaneous coronary intervention revealed significant trauma to the aortic valve during RA, with contrast seen refluxing into the LV during diastole, evolving throughout the procedure. Given the patient was not an operative candidate, an oversized transcatheter aortic valve was successfully implanted. In the post-operative setting, the patient suffered a stroke. Extensive hypoattenuated leaflet thickening (HALT) and thrombus was seen on dedicated 4D CT imaging. She made full neurological recovery and valve function returned to normal following a period of anticoagulation.

Conclusion

Although iatrogenic aortic valve laceration is rare, this case highlights several important learning points including the importance of good guide catheter support during RA; the feasibility of Transcatheter Aortic Valve Replacement for pure native AR; and the detection and management of HALT.
Standardized ketogenic dietary preparation for metabolic PET imaging in suspected and known cardiac sarcoidosis
Authors: Hutt Erika , Goldar Ghazaleh , Jaber Wael A , Cremer Paul C
Published: May 2024

Aims

A major limitation of cardiac positron emission tomography (PET) with F18-fluorodeoxyglucose (F18-FDG) for the evaluation of cardiac sarcoidosis (CS) is associated with physiologic myocardial glucose uptake. The optimal dietary protocol to suppress physiologic myocardial F18-FDG uptake is not well-established. We aimed to evaluate the diagnostic performance of a novel dietary preparation using a ketone-based infant formula.

Methods and results

Between 2018 and 2021, consecutive studies using a ketogenic dietary preparation were identified (n = 198). The rate of non-diagnostic studies due to failure to suppress myocardial glucose was 7.1% (n = 14) with a similar incidence in diabetics (n = 6, 8.1%). Among studies reported to have no inflammation (n = 137), 130 studies (66%) had mean myocardial standardized uptake value (SUV) less than or equal to mean blood pool SUV.

Conclusion

Patient preparation with a ketone-based infant formula resulted in low rate of inappropriate myocardial glucose suppression in patients undergoing F18-FDG cardiac PET to evaluate CS.
Medical treatment of heart failure with renin–angiotensin–aldosterone system inhibitors and beta-blockers in aortic stenosis: association with long-term outcome after aortic valve replacement
Authors: Hopfgarten Johan , James Stefan , Lindhagen Lars , Baron Tomasz , Ståhle Elisabeth , Christersson Christina
Published: May 2024

Aims

There is a lack of robust data on the optimal medical treatment of heart failure in patients with severe aortic stenosis, with no randomized controlled trials guiding treatment. The study aimed to study the association between exposure to renin–angiotensin–aldosterone system (RAS) inhibitors or beta-blockers and outcome after aortic valve replacement in patients with aortic stenosis and heart failure.

Methods and results

The study included all patients with heart failure undergoing aortic valve replacement for aortic stenosis in Sweden between 2008 and 2016 (n = 4668 patients). Exposure to treatment was assessed by a continuous tracking of drug dispensations, and outcome events were all-cause mortality and hospitalization for heart failure collected from national patient registries. After adjustment for age, sex, atrial fibrillation, hypertension, diabetes mellitus, and prior myocardial infarction, Cox regression analysis showed that RAS inhibition was associated with a lower risk of all-cause mortality in patients with reduced left ventricular ejection fraction (LV-EF) [hazard ratio (HR) 0.58, 95% confidence interval (CI) 0.51–0.65] and preserved LV-EF (HR 0.69, 95% CI 0.56–0.85). Beta-blockade was associated with a lower risk of all-cause mortality in patients with reduced LV-EF (HR 0.81, 95% CI 0.71–0.92), but not in preserved LV-EF (HR 0.87, 95% CI 0.69–1.10). There was no association between RAS inhibition or beta-blockade and the risk of hospitalization for heart failure.

Conclusion

The RAS inhibition was associated with a lower all-cause mortality after valve replacement in patients with both reduced and preserved LV-EF. Beta-blockade was associated with lower all-cause mortality only in patients with reduced LV-EF.
UV damage induces production of mitochondrial DNA fragments with specific length profiles
Authors: Waneka Gus , Stewart Joseph , Anderson John R , Li Wentao , Wilusz Jeffrey , Argueso Juan Lucas , Sloan Daniel B
Published: May 2024

UV light is a potent mutagen that induces bulky DNA damage in the form of cyclobutane pyrimidine dimers (CPDs). Photodamage and other bulky lesions occurring in nuclear genomes can be repaired through nucleotide excision repair (NER), where incisions on both sides of a damaged site precede the removal of a single-stranded oligonucleotide containing the damage. Mitochondrial genomes (mtDNAs) are also susceptible to damage from UV light, but current evidence suggests that the only way to eliminate bulky mtDNA damage is through mtDNA degradation. Damage-containing oligonucleotides excised during NER can be captured with antidamage antibodies and sequenced (XR-seq) to produce high-resolution maps of active repair locations following UV exposure. We analyzed previously published datasets from Arabidopsis thaliana, Saccharomyces cerevisiae, and Drosophila melanogaster to identify reads originating from the mtDNA (and plastid genome in A. thaliana). In A. thaliana and S. cerevisiae, the mtDNA-mapping reads have unique length distributions compared to the nuclear-mapping reads. The dominant fragment size was 26 nt in S. cerevisiae and 28 nt in A. thaliana with distinct secondary peaks occurring in regular intervals. These reads also show a nonrandom distribution of di-pyrimidines (the substrate for CPD formation) with TT enrichment at positions 7–8 of the reads. Therefore, UV damage to mtDNA appears to result in production of DNA fragments of characteristic lengths and positions relative to the damaged location. The mechanisms producing these fragments are unclear, but we hypothesize that they result from a previously uncharacterized DNA degradation pathway or repair mechanism in mitochondria.
The Untapped Potential of Comparative Biology in Aging Research: Insights From the Extraordinary-Long-Lived Naked Mole-Rat
Authors: Buffenstein Rochelle , Amoroso Vince G
Published: May 2024

The search for solutions to the vagaries of aging has, historically, been akin to searching at night in the bright light under street lamps by utilizing the few preexisting and well-established animal model systems. Throughout my career as a comparative biologist, I have ventured into the darkness across 4 continents and studied over 150 different animal species, many of which have evolved remarkable adaptations to survive on the harsh and rugged fitness landscape that exists outside of the laboratory setting. In this Fellows Forum, I will discuss the main focus of my research for the last 25 years and dig deeply into the biology of the preternaturally long-lived naked mole-rat that makes it an ideal model system for the characterization of successful strategies to combat aging.
A new multipolar order: combined development, state forms and new business classes
Authors: Wijaya Trissia , Jayasuriya Kanishka
Published: May 2024

What are the key social forces and interests that underpin an emerging multipolar world? Existing research oscillates between the retreat of the liberal international order and the rise of the rest, which remains trapped in a form of geopolitical fetishism. These explanations tell us little about the kinds of forces that are driving a more fragmented and disordered global order. In this article, we suggest going beyond this by fleshing out the underlying social class relations that this new emerging order is based on. At the core of it is the emergence of a new business class—fraction of capital—that in turn sustains what we call competing regulatory geographies. The latter are internalized within state institutions and policies and have reconsolidated a combination of state and market-led industrial policy. Empirically, we also show how these dynamics unfold in key non-core states. In highlighting this particularly potent dynamic of the contemporary global order, this article calls for policy-makers to better recognize the internal contestation within states that shapes and is shaped by combined capitalist development.
Time-dependent Changes in Shrimp Armor and Escape Kinematics under Ocean Acidification and Warming
Authors: Taylor Jennifer R A , Astbury Mia , Childers Elizabeth C , Contractor Kanisha , Lin Xinyu , Mencarelli Jenna , Prohroff Elisa J , Tapia Kendra
Published: May 2024

Synopsis

Pandalid shrimp use morphological and behavioral defenses against their numerous fish and invertebrate predators. Their rapid tail-flip escape and rigid exoskeleton armor may be sensitive to changes in ocean temperature and carbon chemistry in ways that alter their efficacy and impact mortality. Here we tested the hypothesis that ocean warming and acidification conditions affect the antipredator defenses of Pandalus gurneyi. To test this hypothesis, we exposed shrimp to a combination of pH (8.0, 7.7, 7.5) and temperature (13°C, 17°C) treatments and assessed their tail-flip escape and exoskeleton armor after short-term (2 weeks) and medium-term (3 months) exposure. Results revealed complex effects on escape kinematics, with changes in different variables explained by either pH, temperature, and/or their interaction; decreased pH, for instance, primarily explains reduced acceleration while cold temperature explains increased flexion duration. Carapace mineral content (Ca and Mg) was unaffected, but warmer temperatures primarily drove enhanced mechanical properties (increased hardness and stiffness). No effects were observed in the stiffness and strength of the rostrum. Furthermore, most of the observed effects were temporary, as they occurred after short-term exposure (2 weeks), but disappeared after longer exposure (3 months). This demonstrates that P. gurneyi defenses are affected by short-term exposure to temperature and pH variations; however, they can acclimate to these conditions over time. Nonetheless, changes in the tail-flip escape kinematics may be disadvantageous when trying to flee predators and the enhanced exoskeleton armor could make them more resistant to predation during short periods of environmental change.
Lung volume reduction surgery is safe and feasible after initial endobronchial valve treatment for emphysema patients
Authors: Van Dijk Marlies , Van De Wauwer Caroline , Koster T David , Klooster Karin , Slebos Dirk-Jan
Published: May 2024

OBJECTIVES

Bronchoscopic lung volume reduction with endobronchial valves is a guideline treatment leading to improved pulmonary function, exercise tolerance and quality of life, in patients with advanced emphysema, severe hyperinflation and no collateral ventilation. After valve treatment, loss of the initial lung volume reduction effect can occur, as well as local valve-induced complications such as persistent haemoptysis. In these cases, a surgical lobectomy can be considered to achieve similar efficacy outcomes. We evaluated the safety and feasibility of a video-assisted thoracoscopic surgery lobectomy after valve treatment.

METHODS

This single-centre retrospective study included patients who underwent an elective lobectomy after previous valve treatment. Data were evaluated for safety and efficacy for the additional surgical procedure.

RESULTS

Twenty-one patients [73% female, median age 67 (7) years, forced expiratory volume in 1 s 29 (7) %pred, and residual volume 223 (58) %pred] were included. There was no 90-day mortality and there were no postoperative intensive care admissions. Pulmonary infections (14%) and prolonged air leak (14%) were the most common complications. In patients who underwent surgery due to loss or lack of effect of valve treatment, a lobectomy led to a significant improvement in pulmonary function; median forced expiratory volume in 1 s +75 (193) ml (P < 0.013), forced vital capacity +450 (572) ml (P = 0.001), residual volume –665 (715) ml (P = 0.005). In patients who underwent a lobectomy because of complications of valve treatment, all complications were resolved after surgery.

CONCLUSIONS

We demonstrate that an elective lobectomy after an initial valve treatment is safe and feasible and restores the lung volume reduction effect.
CRONOSOJA: a daily time-step hierarchical model predicting soybean development across maturity groups in the Southern Cone
Authors: Severini Alan D , Álvarez-Prado Santiago , Otegui María E , Kavanová Monika , Vega Claudia R C , Zuil Sebastián , Ceretta Sergio , Acreche Martín , Amarilla Fidencia , Cicchino Mariano , Fernández-Long María E , Crespo Aníbal , Serrago Román , Miralles Daniel J
Published: May 2024

Abstract. Accurate prediction of phenology is the most critical aspect for the development of models aimed at estimating seed yield, particularly in species that exhibit variable sensitivity to environmental factors throughout the cycle and among genotypes. With this purpose, we evaluated the phenology of 34 soybean varieties in field experiments located in Argentina, Uruguay and Paraguay. Experiments covered a broad range of maturity group (MG)s (2.2–6.8), sowing dates (SDs) (from spring to summer) and latitude range (24.9–35.6 °S), thus ensuring a wide range of thermo-photoperiodic conditions during the growing season. Based on the observed data, daily time-step models were developed and tested, first for each genotype, and then across MGs. We identified base temperatures specific for different developmental phases and an extra parameter for calculating the photoperiod effect after the R1 stage (flowering). Also, an optimum photoperiod length for each MG was found. Model selection showed that the determinants of phenology across MGs were mainly affecting the duration of vegetative and early reproductive phases. Even so, early phases of development were better predicted than later ones, particularly in locations with cool growing seasons, where the model tended to overestimate their duration. In summary, we have constructed a soybean phenology model that simulates phenology accurately across various geographic locations and sowing dates. The model’s process-based approach has resulted in root mean square errors ranging from 5.8 to 9.5 days for different developmental stages. The final model was made available at http://cronosoja.agro.uba.ar.
The parasitic louse genusMyrsidea(Amblycera: Menoponidae): a comprehensive review and world checklist
Authors: Kolencik Stanislav , Sychra Oldrich , Johnson Kevin P , Weckstein Jason D , Sallam Mohamed F , Allen Julie M
Published: May 2024

Myrsidea Waterston, 1915 (Phthiraptera: Menoponidae) is the most diverse genus of avian chewing lice. Myrsidea has a global distribution, is thought to be highly host-specific, and parasitizes mostly passerine birds. However, the rate of taxonomic studies describing new species is relatively low, and it is thought that much of the diversity of Myrsidea is yet to be discovered. This low rate of taxonomic description for this genus, and many others, may be related to the time-consuming nature of morphological species description and a lack of expertise in louse taxonomy. Furthermore, most of the taxonomic revisions and reviews have focused on specific host families, and no comprehensive review of the morphology and molecular work of Myrsidea has been completed in the last 20 years. Here, we review the taxonomy and systematics of Myrsidea to (i) describe this chewing louse genus and its biological importance; (ii) describe current problems with its taxonomy; (iii) simplify and summarize morphological descriptions; (iv) summarize molecular data; and (v) provide a comprehensive checklist of the Myrsidea species, with all publications and localities of occurrence included. Together, we hope that this information will provide researchers with a single source of information on the genus Myrsidea, making it easier for work to proceed on its taxonomy, systematics, ecology, and evolution. Importantly, our work highlights important gaps in our knowledge of Myrsidea, providing guideposts on where future work on Myrsidea is needed.
Needle bacterial community structure across the species range of limber pine
Authors: Carper Dana L , Lawrence Travis J , Quiroz Dianne , Kueppers Lara M , Frank A Carolin
Published: May 2024

Bacteria on and inside leaves can influence forest tree health and resilience. The distribution and limits of a tree species’ range can be influenced by various factors, with biological interactions among the most significant. We investigated the processes shaping the bacterial needle community across the species distribution of limber pine, a widespread Western conifer inhabiting a range of extreme habitats. We tested four hypotheses: (i) Needle community structure varies across sites, with site-specific factors more important to microbial assembly than host species selection; (ii) dispersal limitation structures foliar communities across the range of limber pine; (iii) the relative significance of dispersal and selection differs across sites in the tree species range; and (iv) needle age structures bacterial communities. We characterized needle communities from the needle surface and tissue of limber pine and co-occurring conifers across 16 sites in the limber pine distribution. Our findings confirmed that site characteristics shape the assembly of bacterial communities across the host species range and showed that these patterns are not driven by dispersal limitation. Furthermore, the strength of selection by the host varied by site, possibly due to differences in available microbes. Our study, by focusing on trees in their natural setting, reveals real needle bacterial dynamics in forests, which is key to understanding the balance between stochastic and deterministic processes in shaping forest tree-microbe interactions. Such understanding will be necessary to predict or manipulate these interactions to support forest ecosystem productivity or assist plant migration and adaptation in the face of global change.
Mixed waste contamination selects for a mobile genetic element population enriched in multiple heavy metal resistance genes
Authors: Goff Jennifer L , Lui Lauren M , Nielsen Torben N , Poole Farris L , Smith Heidi J , Walker Kathleen F , Hazen Terry C , Fields Matthew W , Arkin Adam P , Adams Michael W W
Published: May 2024

Mobile genetic elements (MGEs) like plasmids, viruses, and transposable elements can provide fitness benefits to their hosts for survival in the presence of environmental stressors. Heavy metal resistance genes (HMRGs) are frequently observed on MGEs, suggesting that MGEs may be an important driver of adaptive evolution in environments contaminated with heavy metals. Here, we report the meta-mobilome of the heavy metal-contaminated regions of the Oak Ridge Reservation subsurface. This meta-mobilome was compared with one derived from samples collected from unimpacted regions of the Oak Ridge Reservation subsurface. We assembled 1615 unique circularized DNA elements that we propose to be MGEs. The circular elements from the highly contaminated subsurface were enriched in HMRG clusters relative to those from the nearby unimpacted regions. Additionally, we found that these HMRGs were associated with Gamma and Betaproteobacteria hosts in the contaminated subsurface and potentially facilitate the persistence and dominance of these taxa in this region. Finally, the HMRGs were associated with conjugative elements, suggesting their potential for future lateral transfer. We demonstrate how our understanding of MGE ecology, evolution, and function can be enhanced through the genomic context provided by completed MGE assemblies.
Swarm and UNOISE outperform DADA2 and Deblur for denoising high-diversity marine seafloor samples
Authors: Nilsen Tonje , Snipen Lars-Gustav , Angell Inga Leena , Keeley Nigel Brian , Majaneva Sanna , Pettersen Ragnhild , Rudi Knut
Published: May 2024

The performance of sequence variant resolution analytic tools for metabarcoding has not yet been adequately benchmarked for high-diversity environmental samples. We therefore evaluated the sequence variant tools DADA2, Deblur, Swarm, and UNOISE, using high-diversity seafloor samples, resulting in comparisons of 1800 sequence variant tables. The evaluation was based on 30 sediment grab samples, for which 3 replica samples were collected. Each replica sample was extracted using 5 common DNA extraction kits, resulting in 450 DNA extracts which were 16S rRNA gene sequenced (V3–V4), using Illumina. Assessments included variation across replica samples, extraction kits, and denoising methods, in addition to applying prior knowledge about alpha diversity correlations toward the cosmopolitan marine archaeon Nitrosopumilus with high diversity and the sulfide oxidizing Sulfurovum with low diversity. DADA2 displayed the highest variance between replicates (Manhattan distance 1.14), while Swarm showed the lowest variance (Manhattan distance 0.93). For the analysis based on prior biological knowledge, UNOISE displayed the highest alpha diversity (Simpson’s D) correlation toward Nitrosopumilus (Spearman rho = 0.85), while DADA2 showed the lowest (Spearman rho = 0.10). Deblur completely eliminated Nitrosopumilus from the dataset. For Sulfurovum, on the other hand, all the methods showed comparable results. In conclusion, our evaluations show that Swarm and UNOISE performed better than DADA2 and Deblur for high-diversity seafloor samples.