bluuebunny/crossref_metadata_2025 huggingface dataset:
Fabrication and Electrochemical Characterizations of Strip Ultramicroelectrode Array Prepared by Nanoskiving
Authors: Wang Jiqiang , Zhou Yekuan , Zhao Hainan , Yan Yongda , Fang Zhuo , Geng Yanquan
Published: November 2024

Strip ultramicroelectrodes (SUE) have been widely used in micro-nano manufacturing, trace element detection, and energy storage. Preparation of SUE is thus the basis for these applications. A method for the preparation of SUE and its array (SUEA) is proposed based on a nanoskiving technique. The effects of embedding materials and storage methods on electrode stability were investigated. The continuous and stable working time of 120 min and the storage time of 92 h were achieved. Furthermore, the effect of nanowire feature dimensions on the electrochemical properties of the SUE was analyzed. Parameters such as steady-state limiting current and reversible electron transfer were evaluated. Compared to SUE, the SUEA exhibits a ten-fold increase in steady-state limiting current. The findings in this study provide an approach to obtain high-performance SUE, which will promote the practical application of SUE in micro/nano electrochemical detection.
Construction of Mo-Doped CuO Incorporated on Carbon Black Modified Disposable Sensor for the Voltammetric Detection of Metol in Environmental Samples
Authors: Sivaji Saravana Pandi , Rex Shanlee Santhiyagu Sahayaraj , Chen Tse-Wei , Chen Shen-Ming , Elayappan Tamilalagan , Al-onazi Wedad A. , Ali M. Ajmal , S. Elshikh Mohamed , Ravikumar Mekatharseni
Published: November 2024

In this study, a molybdenum-doped copper oxide (Mo–CuO) composite was synthesized via a hydrothermal method and combined with carbon black (CB) to form Mo–CuO@CB. This composite was used to modify a screen-printed carbon electrode (SPCE) for the detection of Metol (MT), an industrial pollutant harmful to both human health and the environment. Structural and surface characterization was performed using high-resolution transmission electron microscopy, field-effect scanning electron microscopy, energy-dispersive spectroscopy, Raman spectroscopy, X-ray photoelectron spectroscopy, and X-ray diffraction. Electrochemical techniques, including differential pulse voltammetry and cyclic voltammetry, were used to assess the sensor’s performance. The Mo–CuO@CB@SPCE sensor exhibited a low detection limit of 2.7 nM, and limit of quantification is 82 nM, a broad linear range (5.0 × 10−9–170 mol L−1), and high sensitivity (4.148 μA μM−1 cm−2), benefiting from the catalytic activity of Mo–CuO and the large surface area of CB. With recovery rates ranging from 96% to 100.6% in pond, river, and tap water, the sensor effectively detects MT in environmental samples, ensuring reliable monitoring of this persistent pollutant.
Zn-Modified TiO2 Thin-Films for Real-Time Formaldehyde Sensing at Room Temperature
Authors: Rajkumar D. , Umamahesvari H.
Published: November 2024

This study explores the fabrication and application of zinc-modified titanium dioxide (Zn-TiO2) thin-films for real-time recognition of volatile organic compounds (VOCs), with a particular emphasis on formaldehyde (HCHO) sensing at room temperature. The Zn-TiO2 thin-films were produced using an economical spray-pyrolysis method. Structural, morphological, and optical characterizations confirmed the successful integration of zinc with varied Wt% (0, 2, 4, and 6) into the TiO2 lattice. The real-time monitoring capabilities of the sensors were assessed against a range of VOCs, highlighting its specificity for formaldehyde detection amidst diverse environmental constituents. The fabricated thin film sensors with zinc dopant were optimized to enhance the sensor’s performance. 4 Wt% Zn-TiO2 demonstrated excellent sensitivity to formaldehyde vapor at ambient conditions, showcasing a rapid and selective response. The underlying sensing mechanism was explored, emphasizing the role of zinc doping in tailoring the material’s surface properties and facilitating enhanced adsorption of formaldehyde molecules. The study underscores the potential of Zn-modified TiO2 thin films as a reliable and efficient platform for real-time VOC monitoring, with a specific focus on HCHO sensing at room-temperature. The sensor shows remarkable stability and repeatability, making it a promising candidate for continuous monitoring applications.
Early exposure to a cholinergic receptor blocking agent mitigates adult obesity and protects pancreatic islet function in male rats
Authors: Malta Ananda , Matiusso Camila Cristina Ianoni , de Lima Lucas da Silva , Ribeiro Tatiane Aparecida , Tófolo Laize Peron , Almeida Douglas Lopes , Moreira Veridiana Mota , Martins Isabela Peixoto , Pavanello Audrei , de Freitas Mathias Paulo Cezar
Published: November 2024

High insulin levels during early life may lead to the late development of obesity and diabetes. We investigated whether attenuation of insulin levels by using an antimuscarinic agent could prevent diet-induced obesity and diabetes. Rats’ early exposure to an antimuscarinic agent reduced insulin levels during the lactation period and promoted protection against obesity and metabolic dysfunctions. Independent of the programming mechanisms, insulin levels during early life may be a defining factor of health or diseases later in life.
Velocity coding in the central brain of bumblebees
Authors: Jaske Bianca , Tschirner Katja , Strube-Bloss Martin Fritz , Pfeiffer Keram
Published: November 2024

Using extracellular recordings, we show that neurons in the central brain and central complex of bumblebees show velocity coding properties.
Isolation and Genomic Characteristics of a Novel Pathogenicity Type I Feline Coronavirus in Mainland China
Authors: Wang Yuanhong , Wang Junna , Zhao You , Liu Yun , Zhang Miao , Deng Xiaoying , Zhu Jie , Li Guoxin , Liu Guangqing
Published: November 2024

Feline coronavirus (FCoV) is an enveloped, positive‐sense RNA virus, which is widespread among feline populations, and can cause a fatal serious disease called feline infectious peritonitis (FIP). According to the differences of antigen and genetic composition, FCoV consists of two genotypes, FCoV I and FCoV II. In this study, we have isolated and identified a FCoV I strain named HL2019. Based on the complete genome of HL2019, phylogenetic analysis showed that HL2019 strain formed in the cluster FCoV I which is more closed to human coronavirus 229E (HCoV 229E) and HCoV NL63, while the FCoV I stains is distantly related to FCoV II strains. Analyzing with RDP4 and Simplot software showed that the virus HL2019 is recombinant by the FCoV I China/ZJU1709 and FCoV I Netherlands/UU16 strains. Furthermore, the pathogenicity of HL2019 was evaluated in 9–12‐month‐old cats. Two of three challenged cats developed serious clinical signs and died at 28‐day postchallenge (dpc). Real‐time polymerase chain reaction (PCR) analysis showed that HL2019 has broad tissue tropism, especially in the duodenum with viral load up to 104 copies/mg. In summary, our data show that we have successfully isolated a strain of FCoV I named HL2019 that is highly pathogenic to cats.
Real‐Time Gait Intention Recognition for Active Control of Unilateral Knee Exoskeleton
Authors: Zhang Ziwei , Cai Xuefeng , Zhang Minbo , Chen Wuxiong , Chen Yijie , Wang Pu
Published: November 2024

Real‐time gait estimation is important for the synchrony control of robotic exoskeleton to provide walking assistance. However, for stroke patients with hemiplegic paralysis, the gait pattern is very complex. Accurate and timely gait intention recognition is therefore difficult. To achieve human–robot synchrony control for an unilateral knee exoskeleton, a gait intention recognizer coupling the adaptive frequency oscillator (AFO) and back propagation neural networks (BPNN) is proposed in this paper. The BPNN is trained with gait data of healthy subjects and stroke patients to improve the accuracy of recognized gait pattern, which is then imported into flexible interaction module to provide appropriate assistance. To evaluate the performance of gait intention recognition, three stroke patients were recruited to conduct level ground walking tests. The kinematic and biomechanical data were captured in each test and processed for the evaluation. Experimental results demonstrate the effectiveness of gait intention recognition and movement assistance.
Abstract B021: tRNA fragments extracted from patient plasma extra cellular vesicles display potential as biomarkers for high-grade glioma
Authors: Phinney Thomson R , Alwadei Ali , Wajnberg Gabriel Gabriel , Han Jae , Chacko Simi , Attwood Kathleen , Roy Jeremy , Weeks Adriennne
Published: November 2024

Transfer RNA (tRNA) are non-coding RNAs that bring amino acids to ribosomes during translation. Recent studies have shown that cleaved fragments derived from tRNA (tRFs) serve regulatory roles in epigenetics, signaling, transcription, and translation. tRFs can be released from cells and can be found in extracellular vesicles to perform some aspects of paracrine signaling. Utilizing high throughput small RNA sequencing, we have identified over 750 uniquely or multi-mapped (6.9% of total sRNA mapped reads) tRFs in extracellular vesicles of high-grade glioma (IDH-WT) patient plasma. By performing differential expression analysis, we identified 6 upregulated tRFs and 36 downregulated tRFs between high-grade glioma plasma EVs and non-cancer controls (n = 14, FDR<0.05). Differentially expressed tRFs (all 42) were further analyzed using bioinformatic techniques (RNAhybrid and IntaRNA) to predict potential gene targets. By performing gene ontology analysis (ShinyGO) we found that 70 of 75 genes related to glioma formation were identified as potential gene targets, indicating a possible role of tRFs in the regulation and formation of gliomas. A number of differentially expressed tRFs were predicted to target cancer-related genes including Metastasis Associated Lung Adenocarcinoma Transcript 1 (MALAT-1). This analysis demonstrates that tRFs may serve as important biomarkers and regulators with therapeutic potential in the future

Citation Format: Thomson R Phinney, Ali Alwadei, Gabriel Gabriel Wajnberg, Jae Han, Simi Chacko, Kathleen Attwood, Jeremy Roy, Adriennne Weeks. tRNA fragments extracted from patient plasma extra cellular vesicles display potential as biomarkers for high-grade glioma [abstract]. In: Proceedings of the AACR Special Conference: Liquid Biopsy: From Discovery to Clinical Implementation; 2024 Nov 13-16; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(21_Suppl):Abstract nr B021.
Abstract B026: Glioblastoma multiforme disseminates outside the central nervous system
Authors: Stejskal Pavel , Srovnal Josef , Rehulkova Alona , Kalita Ondrej , Slachta Marek , Hajduch Marian
Published: November 2024

Introduction: The liquid biopsy (LB) concept has gained significant attention in the last decade and has the potential to revolutionize cancer care. However, more validation in clinical trials is required on the value of LB in medical settings. Here, we focus on glioblastoma multiforme (GBM), a highly invasive and fatal subtype of the central nervous system malignant tumors. Circulating tumor cells (CTCs) are primary tumor cells released into the peripheral blood and migrating to distant organs. CTC presence is related to tumor spread and recurrence. In GBM, factors like short patient survival, the blood-brain barrier (BBB), and lack of lymphatic drainage in brain tissue make systemic dissemination rare but possible. Thus, noninvasive CTC detection can hold potential for diagnostic, predictive, and prognostic applications. Material and Methods: For cell stability preservation before sample processing, the peripheral blood samples from curatively resected GBM patients were collected preoperatively in Cell-Free DNA BCT® tubes (Streck, Inc.). CTCs were identified using CytoTrack CT11TM (2/C), a semi-automated immunofluorescence microscopy using glial fibrillary acidic protein, vimentin, and CD45 immunostaining, and DAPI counterstaining. The preliminary Kaplan-Maier survival analysis based on CTC positivity was performed in 39 patients with a follow-up longer than two years. Results: We analyzed the CTC presence in 100 GBM patient peripheral blood samples. The CTCs or cancer cell clusters were found in 35% of GBM patients. The Kaplan-Maier survival analysis did not show a correlation between CTC presence and survival. This phenomenon may be associated with the generally short survival of these patients, which is expected to increase with advances in oncology and palliative care and/or a possible suppression of tumor cell growth outside the CNS. Conclusions: We have observed the CTCs in the peripheral blood of GBM patients. The patient enrollment and clinical data recording are still ongoing.

Citation Format: Pavel Stejskal, Josef Srovnal, Alona Rehulkova, Ondrej Kalita, Marek Slachta, Marian Hajduch. Glioblastoma multiforme disseminates outside the central nervous system [abstract]. In: Proceedings of the AACR Special Conference: Liquid Biopsy: From Discovery to Clinical Implementation; 2024 Nov 13-16; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(21_Suppl):Abstract nr B026.
A Comprehensive Target Panel Allows to Extend the Genetic Spectrum of Neuroendocrine Tumors
Authors: Tsoy Uliana A. , Sokolnikova Polina S. , Kravchuk Ekaterina N. , Ryazanov Pavel A. , Kozyreva Alexandra A. , Fomicheva Yulia V. , Aramisova Liana S. , Karonova Tatiana L. , Kostareva Anna A. , Grineva Elena
Published: November 2024

Introduction: Neuroendocrine tumors (NETs) frequently have a genetic basis, and the range of genes implicated in NET development continues to expand. Application of targeted gene panels (TGPs) in next-generation sequencing is a central strategy for elucidating novel variants associated with NET development. Methods: In this study, we conducted comprehensive molecular genetic analyses using TGP on a cohort of 93 patients diagnosed with various NETs subtypes, mainly accompanied by various endocrine syndromes: insulinoma (n = 26), pheochromocytoma and paraganglioma (PPGL) (n = 38), parathyroid adenoma (n = 18, including three with insulinoma), and NETs of other locations (n = 14). The TGP encompassed genes linked to diverse NETs and other hereditary endocrine disorders, with subsequent variant classification according to the American College of Medical Genetics and Genomics guidelines. Results: Among the identified variants, 20 were found in genes previously linked to specific tumor types, and 10 were found in genes with a limited likelihood and unclear molecular mecanisms of association with observed NETs. Remarkably, 13 variants were discovered in genes not previously associated with the NETs observed in our patients. These genes, such as ABCC8, KCNJ11, KLF11, HABP2, and APC, were implicated in insulinoma; ZNRF3, GNAS, and KCNJ5 were linked with PPGL; parathyroid adenomas were related to variants in SDHB and TP53; while NETs of other locations displayed variants in APC and ABCC8. Conclusion: Our study demonstrates that utilizing broad TGP in examining patients with various functioning NETs facilitates the identification of new germinal variants in genes that may contribute to the diseases. The verification of revealed findings requires research in vaster sample.
Screening for Mitochondrial tRNA Variants in 200 Patients with Systemic Lupus Erythematosus
Authors: Xuan Dan , Qiang Fuyong , Xu Hui , Wang Li , Xia Yonghui
Published: November 2024

Introduction: Systemic lupus erythematosus (SLE) is a common autoimmune disease with unknown etiology. Recently, a growing number of evidence suggested that mitochondrial dysfunctions played active roles in the pathogenesis of SLE, but its detailed mechanism remains largely undetermined. The aim of this study was to analyze the frequencies of mitochondrial tRNA (mt-tRNA) variants in Chinese individuals with SLE. Methods: We carried out a mutational screening of mt-tRNA variants in a cohort of 200 patients with SLE and 200 control subjects by PCR-Sanger sequencing. The potential pathogenicity of mt-tRNA variants was evaluated by phylogenetic conservation and haplogroup analyses. In addition, trans-mitochondrial cybrid cell lines were established, and mitochondrial functions including ATP, reactive oxygen species (ROS), mitochondrial DNA (mtDNA) copy number, mitochondrial membrane potential (MMP), superoxide dismutase (SOD), and mt-RNA transcription were analyzed in cybrids with and without these putative pathogenic mt-tRNA variants. Results: We identified five possible pathogenic variants: tRNAVal G1606A, tRNALeu(UUR) A3243G, tRNAIle A4295G, tRNAGly T9997C, and tRNAThr A15924G that only found in SLE patients but were absent in controls. Interestingly, these variants were located at extremely conserved nucleotides of the corresponding tRNAs and may alter tRNAs’ structure and function. Furthermore, cells carrying these tRNA variants had much lower levels of ATP, mtDNA copy number, MMP, and SOD than controls; by contrast, the levels of ROS increased significantly (p < 0.05 for all). Furthermore, a significant reduction in mt-ND1, ND2, ND3, ND5, and A6 mRNA expression was observed in cells with these mt-tRNA variants, while compared with controls. Thus, failures in tRNA metabolism caused by these variants would impair mitochondrial translation and subsequently lead to mitochondrial dysfunction that was involved in the progression and pathogenesis of SLE. Conclusions: Our study suggested that mt-tRNA variants were important causes for SLE, and screening for mt-tRNA pathogenic variants was recommended for early detection and prevention for this disorder.
Demographics and Immunotherapy Efficacy for Advanced Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis of Phase III Clinical Trials
Authors: Shao Yu-Yun , Akhmetzhanov Andrei R.
Published: November 2024

Introduction: Immune checkpoint inhibitors (ICIs) are fundamental in treating advanced hepatocellular carcinoma (HCC). Considering previous reports implied varied responses among patient subgroups, such as patients with different hepatitis etiologies, we planned this meta-analysis to identify specific populations that might derive greater survival benefits from ICIs as a first-line treatment. Methods: We conducted a comprehensive search in PubMed and the Cochrane Library for phase III clinical trials comparing ICIs and multikinase inhibitors (MKIs) as first-line therapies for advanced HCC. We extracted and synthesized hazard ratios (HRs) for overall survival across different patient subgroups mainly using the random-effect model. Results: Our analysis included nine phase III trials involving ICIs, either alone or in combination with other treatments, compared with MKIs. The synthesized HRs for patients with hepatitis B virus, hepatitis C virus, and nonviral etiologies were 0.74, 0.77, and 0.86, respectively, showing no significant differences (p = 0.13). Such finding remained when we only analyzed clinical trials with positive results. HRs consistently favored ICIs across various demographics such as age, sex, geographic region, performance status, alpha-fetoprotein levels, and disease stage or extent. Notably, patients with extrahepatic spread showed a trend toward better outcomes (HR 0.73) compared to those without (HR 0.85, p = 0.07). Conclusion: The efficacy of ICIs as a first-line treatment for advanced HCC was consistent across diverse patient subgroups, regardless of hepatitis etiology or other demographic factors. These findings do not support using these characteristics to determine the use of ICI therapy in advanced HCC.
Tendência temporal dos casos confirmados de COVID-19 em crianças, adolescentes e adultos de São Carlos - SP entre 2020 e 2021: um estudo de série temporal
Authors: Carvalho Carlos Henrique Araújo de , Valete Cristina Ortiz , Ferreira Esther Angelica Luiz , Sartoreli Ana Luiza Carvalho , Mestre Crislaine Aparecida Antônio
Published: November 2024

Introduction: COVID-19 behavior in childhood was different from that of adults and the evaluation of these cases and their trend over time was poorly explored. Also, lethality in the disease in the pediatric population was observed, highlighting the importance of studies in this population. Objective: To analyze the temporal trend in COVID-19-confirmed cases in children and adolescents and compare it to adults in São Carlos. Methods: A time-series study was conducted between February 2020 and March 2021 in São Carlos, SP, Brazil, comparing children and adolescents to adults, both with a positive reverse transcription polymerase chain reaction (RT-PCR) test, in the Epidemiology Surveillance database. Time was split at the 38th epidemiological week (periods 1 and 2). The data were analyzed using a Prais–Winsten generalized linear regression model, considering a p-value < 0.05. The e-SUS database was investigated in the same period, to evaluate clinical cases in children and adolescents’ characteristics. Results: Three thousand and sixteen RT-PCR tests were performed on children and adolescents, and 791 (26.0%) were positive. There was a rising trend of cases, and the comparison between the periods revealed a 2.5-fold increase for children and adolescents and a 3.0-fold increase for adults. Conclusion: There was a rising trend in cases that was comparable between children, adolescents, and adults. This result helps the knowledge about the transmission in children, adolescents, and adults, at the local level. This way, it contributes to the construction of preventive interventions that are necessary and related to public policies.
A passagem do tudo ao nada: Roberto Schwarz entre colapsos temporais e desafios de geração
Authors: Graziani Vitor Morais
Published: November 2024

At 2012, when happened the publication of the book Martinha versus Lucrécia, from the literary critic Roberto Schwarz, a review of Milton Ohata about the material came for us an interesting expresion to summarize Schwarz's work: "estatic future". From this notion, the present article wants to investigate a certain fenomenology of time at Roberto Schwarz's work, having as capital point for the anylisis the period before and after 1964's coup d'etat, moment that can institute the estatic future. Looking for the moviments of Roberto's dialetic thinking around the years, we want to apoint the changes and obstacles of dialetic critics to the brazilian experience, from the national-developmentalista pact at today. So, if 1964 ends an historical moment by a colpase (a colapse that does not end at 1964), another time begins, and new answers are expected from the dialetic critic.
Update on Diagnosis and Management of Kawasaki Disease: A Scientific Statement From the American Heart Association
Authors: Jone Pei-Ni , Tremoulet Adriana , Choueiter Nadine , Dominguez Samuel R. , Harahsheh Ashraf S. , Mitani Yoshihide , Zimmerman Meghan , Lin Ming-Tai , Friedman Kevin G. ,   on behalf of the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Lifelong Congenital Heart Disease and Heart Health in the Young; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Radiology and Intervention; and Council on Clinical Cardiology
Published: November 2024

Kawasaki disease (KD), an acute self-limited febrile illness that primarily affects children <5 years old, is the leading cause of acquired heart disease in developed countries, with the potential of leading to coronary artery dilation and coronary artery aneurysms in 25% of untreated patients. This update summarizes relevant clinical data published since the 2017 American Heart Association scientific statement on KD related to diagnosis, cardiac imaging in acute KD treatment, and long-term management. Criteria defining North American patients at high risk for developing coronary artery aneurysms who may benefit from more intensive initial treatment have been published. Advances in cardiovascular imaging have improved the ability to identify coronary artery stenosis in patients with KD, yet knowledge gaps remain regarding optimal frequency of serial imaging and the best imaging modality to identify those at risk for inducible myocardial ischemia. Recent data have advanced the understanding of safety and dosing for several anti-inflammatory therapies in KD. New anticoagulation medication, myocardial infarction management, transition of health care for patients with KD, and future directions in research are discussed.
Abstract 4113164: Central Arterial Stiffness in Young Adults with Perinatal HIV Exposure
Authors: Urbina Elaine , Yu Wendy , Williams Paige , Sawyer George , Van Dyke Russell , Colan Steven , Lipshultz Steven
Published: November 2024

Intro:
Young adults with perinatally acquired HIV (YPHIV) have higher morbidity and mortality than uninfected persons. Antiretroviral therapy (ART) has extended life expectancy making adult CV disease a concern. Perinatal exposure to HIV increases inflammation which is associated with increased arterial stiffness which predicts CV disease.

Aims:
We compared arterial stiffness between YPHIV and young adults perinatally HIV exposed but uninfected (YPHEU), and evaluated the association of type and duration of ART regimens, HIV disease severity, and cardiac structure and function with arterial stiffness.

Methods:
In a substudy of the Pediatric HIV/AIDS Cohort Study, 150 participants (95 YPHIV, 55 YPHEU, mean 23.4 yrs, 60% female, 72% Black, 24% Hispanic) had echocardiography and pulse wave velocity (PWV) measured. We compared PWV between YPHIV and YPHEU, adjusting for covariates. Among YPHIV, we fit linear regression models to evaluate the association of current (within 1 year of PWV) and historical measures of HIV disease severity with PWV. We computed correlations between PWV and measures of left ventricular (LV) structure and function, overall and by HIV status.

Results:
Mean PWV and hemodynamic parameters did not differ between YPHIV and YPHEU (YPHIV 5.63 vs YPHEU 5.39 m/s; p=0.5). HIV control was good (82% with viral load <400 copies/ml), 91% used combination ART: integrase strand inhibitors (INSTIs; median duration 4.6 years), protease inhibitors (PIs 15.1 years), or non-nucleoside reverse transcriptase inhibitors (NNRTIs 5.2 years). Most participants had normal PWV compared to healthy controls but all values above 11.8 m/sec (
Figure
, level associated with CV events in adults) were only in YPHIV. Only weak correlations were observed between PWV and echocardiographic measures (<0.20) in both YPHEU and YPHIV. Among YPHIV, HIV severity measures were not associated with PWV using either current or historical measures. Mean PWV was 1.68 (-0.36, 3.72) m/s higher among YPHIV with current PI use than those on INSTIs, and 1.58 (-0.94, 4.11) m/s higher than those on NNRTIs, although these differences were not significant.

Conclusions:
PWV was within normal ranges in most YPHIV and YPHEU although 5% YPHIV had elevated PWV. PWV may be higher with PI use due to cardiometabolic side effects. Successful HIV treatment and control of traditional CV risk factors may prevent premature vascular aging and subsequent cardiac compromise in YPHIV.
Abstract 4117406: The Safety and Efficacy of Surgical Cardiac Sympathetic Denervation for Ventricular Arrhythmias: An Updated Systematic Review&Meta-Analysis
Authors: Hanna Daniel , Karimianpour Reza , Mamprejew Nicole , Fiechter Christopher , Sierra Juan , Verghese Dhiran , Navas Elsy , Sharma Dinesh
Published: November 2024

Objectives:
This meta-analysis sought to explore the long-term arrhythmic outcomes of cardiac sympathetic denervation (CS) by measuring event rates of recurrent ventricular arrhythmias (VA) and implantable cardiac defibrillator shocks (ICD) post CSD.

Background:
The role of sympathetic nervous system in the beginning and continuation of ventricular arrhythmias (VAs) is well known. CS has been associated with improved arrhythmic outcomes in patients with refractory ventricular arrhythmias. However, whether CSD lowers shock event rates after the procedure is still uncertain and therefore, we performed a systematic review and meta-analysis to evaluate this.

Methods&Materials:
A comprehensive literature search was performed at Medline and Embase until March 2023. Our primary outcome was event rate of ICD shocks at 30 days, 90 days, and 1 year following CS. All analysis was conducted using Comprehensive Meta-Analysis software.

Results:
The initial search found 1,324 articles. After all articles were examined, a total of 29 studies fit our criteria. ICD shocks 1 year post CSD had a pooled event rate of 66.5% with a 95% confidence interval (CI) of 57.7% to 74.3% and the I-squared (I2) statistics. ICD shocks at 6 months had an event rate at 61.7% with a 95% confidence interval of 53.3% to 69.4% with I2 at 46. VA in one year post CSD had a pooled event rate of 62.5 with a 95% with a CI of 53.3% to 69.1% and I2 at 22%. At 6 months the event rate was 64.2 with a 95% CI of 56.3% to 71.4% with I2 at 33% Mortality from cardiac arrhythmia and classified 0-30 days (short term), 21-364 days (medium term), and >365 days (long term). The pooled event rate for short term morality was 6.8% with a 95% CI of 4.2%-11.0% with I2 at 0%, medium term was 5.2% with a 95% CI of 2.9% to 8.9% with I2 at 0%, and long term was 5.0% with a 95% CI of 2.7% to 9.2% and I2 at 0%.

Conclusion:
CSD may be an alternative form of therapy that reduces shock event rates and recurrent VA in patients that are refractory to ablation and medical therapy. However larger prospective studies are needed to further evaluate the usefulness and safety of CSD.
Abstract 4118762: Large-scale multinational trends in the use of cardioprotective antihyperglycemic agents as first-line therapy in patients with type 2 diabetes and cardiovascular disease: a LEGEND-T2DM study
Authors: Thangaraj Phyllis , Aminorroaya Arya , Dhingra Lovedeep , Pedroso Camargos Aline , Zhou Jin , Blacketer Clair , Bu Fan , Chai Yi , Chattopadhyay Shounak , Dorr David , Duarte-Salles Talita , Lau Wallis , Liu Yuntian , Lu Yuan , Man Kenneth , Minty Evan , Richter Lauren , Ross Joseph , Shah Nigam , Ryan Patrick , Schuemie Martijn , Hripcsak George , Krumholz Harlan , Suchard Marc , Khera Rohan
Published: November 2024

Background:
US guidelines for type 2 diabetes (T2DM) recommend metformin as first-line anti-hyperglycemic therapy (AHT), but prioritizing the use of AHTs that reduce cardiovascular disease (CVD) risk – GLP1-RAs and SGLT2is – is increasingly suggested for people with CVD. We examine the multinational use patterns of GLP1-RAs, SGLT2is, DPP4is, and sulfonylureas (SUs) as first-line therapies for patients with CVD.

Methods:
In 10 US and 6 non-US databases between 2016 and 2021 mapped to a common data model [A], we measured yearly initiation of GLP1-RAs, SGLT2is, DPP4is, and SUs as first-line AHTs in patients with T2DM with and without CVD [B]. We also compared the initiation of the drug classes as second-line after metformin. We calculated the annual rate of change in proportional initiation of each drug class as first-line AHT and assessed differences in trends as group x time interactions in linear mixed models.

Results:
Across all data sources, 3.3 million patients with T2DM used GLP1-RAs, SGLT2is, DPP4is, or SUs as first-line AHTs, and 3.9m initiated these drug classes as second-line AHT after metformin. Within the first-line cohort, 1.4m (41%) had established CVD compared with 1.2m (31%) in the second-line cohort. For GLP1-RAs and SGLT2is, the annual rate of their relative use as first-line agents increased among patients with T2DM with CVD (GLP1RAs: ranging 1.3-5.4% in US [C] and 0.3-0.8% in non-US [D], SGLT2is: 2.1-12.9% in US [E] and 8.1-10.6% in non-US databases [F]). There was a larger relative increase in the use of SGLT2i and a smaller increase in GLP1RA use in CVD vs non-CVD cohorts (P
interaction
<.001). While there was a larger increase in GLP1RAs uptake in the US cohorts, SGLT2i use increased more in non-US cohorts ([C-F], P
interaction
<.001 for all, except .01 for SGLT2i). Of note, across cohorts, the uptake of GLP1RA and SGLT2i as first-line was higher than second-line use among those with CVD (P
interaction
<.001). In contrast, DPP4i and SU use as first-line was lower than GLP1RA and SGLT2is and decreased over time (P<.001).

Conclusions:
In a large-scale multinational, federated cohort of patients with T2DM, the use of cardioprotective agents increased as first-line AHT, with variation in SGLT2i and GLP1RAs uptake across study cohorts.
Abstract 4119116: Percutaneous Aspiration of Mitral Valve Endocarditis using the AngioVac Device
Authors: Cao Jenny Jia Ling , Rihal Charanjit , Motiei Arashk , Kietselaer Bastiaan
Published: November 2024

Case Description:
A 68-year-old man with end-stage renal disease on dialysis, peripheral vascular disease with metatarsal amputations, atrial fibrillation and type 1 diabetes was admitted for foot osteomyelitis secondary to MSSA bacteremia.

Transesophageal echocardiogram revealed mobile mitral valve vegetations up to 1.8cm on the atrial aspect of the posterior mitral valve leaflet which prolapsed through the mitral valve during diastole. Ejection fraction was 60% and there was trivial-mild mitral regurgitation without valvular destruction or peri-annular extension into the mitral annulus. MRI brain showed bilateral cerebral and cerebellar hemispheric infarcts, consistent with acute embolic stroke.

He was at high risk for both recurrent embolism and operative mortality (STS risk score 51%) due to his comorbidities and risk of hemorrhagic conversion of stroke. After shared decision making, percutaneous aspiration of the mitral vegetation was performed with AngioVac (Fig). Cerebral embolism protection devices were deployed prior to AngioVac evacuation of the mass.

There was no residual mitral regurgitation and only a small vegetation strand remained (Fig). Surgical pathology confirmed MSSA endocarditis. Blood cultures remained negative, and the patient did not suffer from recurrent embolic events. The patient underwent revision metatarsal amputation and was discharged with a 6-week course of IV cefazolin.

Discussion:
Infective endocarditis with high embolic risk is life-threatening and challenging to treat in patients with high surgical risk. We illustrate a case of percutaneous vegetation aspiration using the AngioVac device in our patient who suffered from embolic strokes due to MSSA mitral valve endocarditis. Meta-analyses have shown clinically successful debulking in 90% of cases, with 82% of patients able to clear bacteremia with AngioVac. Although most commonly used in right-sided lesions, percutaneous debulking of left-sided endocarditis with AngioVac and cerebral protection can be considered as a treatment strategy in select patients with prohibitive surgical risk.
Abstract 4119267: Diagnosing An Uncommon Presentation of Cardiac Sarcoidosis with Isolated Bi-Atrial Involvement: A Case Report
Authors: Nelson Favour , Rajkarnikar Ruja , Carry Brendan
Published: November 2024

Background:
Sarcoidosis, a systemic granulomatous inflammatory disorder can involve various organs, including the heart but isolated bi-atrial cardiac involvement is rare. Advanced cardiac imaging especially in atypical presentations, can aid in early diagnosis.

Case:
A 59 year-old man with history of biopsy-proven pulmonary sarcoidosis presented with non exertional chest pain for 2 months. EKG, cardiac enzymes, and Initial echocardiogram(TTE) was unremarkable. Stress echocardiogram ruled out myocardial ischemia. CT scan noted mediastinal lymphadenopathy consistent with known sarcidosis. In absence of other explainable etiolgies for chest pain, Cardiac MRI was done and showed preserved biventricular function, subepicardial enhancement in the basal inferior, inferolateral, and anterolateral walls. The enhancement raised suspicion for CS. However, symptoms resolved spontaneously, cardiac workup paused and he was monitored conservatively with serial Echocardiogram(TTE) until onset of dyspnea 3 years later. Repeat TTE and EKG then noted newly enlarged left atrium and atrial tachycardia. Further testing with Cardiac positron emission tomographic imaging with F-18 fluorodeoxyglucose (FDG-PET CT) showed abnormal myocardial uptake in both atrial posterior walls but no ventricular involvement, indicative of isolated bi-atrial inflammation in CS. He was treated with prednisone and methotrexate. Successful symptom and inflammation resolution on FDG-PET CT occurred in 3 months

Discussion:
CS is rare and seen clinically in about 5% and diagnosed postmortem in 25% of sarcoidosis cases. Symptoms vary widely, with potential for severe heart complications. Left ventricle and interventricular septum are commonly involved, but isolated bi-atrial involvement is rare. Early diagnosis aided by Cardiac MRI and FDG-PET CT is crucial. Prednisone is mainstay of treatment, often combined with methotrexate. Cases of concurrent atrial CS involvement and bi-atrial fibrosis with Left ventricular hyperenhancement are documented, but this is the first known report of isolated bi-atrial hyperenhancement on FDG-PET CT for CS. This case highlights the need for symptom correlation with clinical and imaging follow-up, especially in atypical presentations.
Abstract 4119658: Catheter Ablation for Ventricular Arrhythmias in Transthyretin Cardiac Amyloidosis: A Single Center Experience
Authors: Al-Shakarchi Nader James , Haq Ikram , Tan Nicholas , Grogan Martha , Dispenzieri Angela , Sugrue Alan , Abou-Ezzeddine Omar , Killu Ammar
Published: November 2024

Background:
Transthyretin cardiac amyloidosis (ATTR-CA) carries an elevated risk of developing ventricular arrhythmias (VA) but there remains limited evidence supporting the role of catheter ablation in this population.

Purpose:
To assess the safety and efficacy of catheter ablation for VA in ATTR-CA.

Methods:
An electronic database was used to identify all patients suspected of having ATTR-CA who underwent catheter ablation for VA at our institution between January 2010 and December 2023. Patients who did not meet the diagnosis of ATTR-CA and had a negative workup who underwent catheter ablation for ventricular tachycardia (VT) or premature ventricular contractions (PVCs) were used to form a control group matched for age, sex and left ventricular ejection fraction at a ratio of 2:1.

Results:
20 controls and 10 cases of ATTR-CA were identified. Examining the two groups at baseline (Table 1), the mean age at index ablation was 67.7±7.0 and 68.6±8.1 years (p=0.359), mean follow-up time was 4.1±3.1 and 4.2±2.6 years (p=0.494), and the proportion of males was 100% and 90% respectively. The ATTR-CA group had a significantly higher proportion of chronic kidney disease (90% vs. 50%, p=0.032) and prior stroke or thrombotic events compared to the control group (50% vs. 10%, p=0.026) with similar CHA
2
DS
2
VASc scores (4.2±1.6 vs. 3.8±1.3, p=0.233). Both groups had comparable left ventricular ejection fraction (41.4%±14% vs. 46.9%±15.2%, p=0.173), VT/PVCs at presentation (40%/60% vs. 25%/75%, p=0.77), use of antiarrhythmics (70% vs. 60%, p=0.592), and high proportion of atrial fibrillation/flutter (70% vs. 90%, p=0.168). Procedural (261.2±101.2 vs. 265.7±125.6 mins, p=0.449) and total energy delivery time (1442.9±1509.1 vs. 1744.6±956.2 secs, p=0.296) was not significantly different in the two groups. Both groups had a significant decrease in PVC burden postablation with a reduction from 26.8% to 3.8% (p=0.024) and from 27.1% to 13.6% (p=0.028) in the ATTR-CA and control group respectively. A downward trend was seen in antitachycardia pacing events for VT postablation in the ATTR-CA (14.7±9.8 vs. 5.3±6.7, p =0.184) and control (193±387.6 vs. 0.67±1.2. p=0.139) groups. No major complications occurred after ablation (Table 2). Mean time to recurrence post-index ablation was similar between both groups (1620.4±483.8 vs. 1498.8±291.4 days, p=0.987, Figure 1).

Conclusions:
Catheter ablation appears to be safe and effective for VT and PVCs in patients with ATTR-CA.
Abstract 4119992: 12-lead electrocardiograms predict adverse cardiovascular outcomes of emergency department patients
Authors: Haimovich Julian , Kolossvary Marton , Alam Ridwan , Padros I Valls Raimon , Lu Michael , Aguirre Aaron
Published: November 2024

Introduction:
Chest pain is a common cause for presentation to the emergency department (ED). Identifying patients at increased risk of adverse cardiovascular outcomes may help guide testing.

Aims:
We sought to determine if deep learning enabled 12-lead electrocardiogram (ECG) analysis may improve prediction of adverse cardiovascular outcomes of ED patients presenting with chest pain compared to conventional approaches.

Methods:
A pretrained convolutional neural network was applied to derive numerical representations of the index ECG waveforms from patients presenting to the Brigham and Women’s Hospital (BWH) ED with chest pain. We trained a neural network model (‘CP-AI’) to predict 30-day major adverse cardiovascular events (MACE) defined as myocardial infarction (MI), pulmonary embolism (PE), aortic dissection (AD), or mortality using age, sex, cardiac biomarkers (troponin and d-dimer), and the numerical ECG representations as inputs (
Figure 1
). In a holdout sample of Massachusetts General Hospital (MGH) ED patients, we compared the performance of the CP-AI model to alternative models fit on (1) demographics (‘Age and Sex’) (2) demographics + cardiac biomarkers (‘Biomarker Model’), and (3) demographics + numerical ECG representations (‘ECG Model’).

Results:
The BWH derivation sample included 18,811 individuals (51% female, mean age 65 ± 16 years). The MGH validation sample included 14,476 individuals (45% female, mean age 65 ± 15 years). The CP-AI model significantly outperformed the comparison models for prediction of 30-day MACE with an area under the receiver operating characteristic curve (AUROC) of 0.82 [95% CI 0.81-0.83] (
Figure 1
). CP-AI also significantly outperformed the comparison models for classification of the 30-day MACE components including MI (AUROC 0.91 [95% CI 0.90-0.92]), PE (AUROC 0.74 [95% CI 0.72-0.76]), and mortality (AUROC 0.86 [95% CI 0.85-0.87]), but not aortic dissection (0.71 [95% CI 0.68-0.75]).

Conclusions:
The integration of deep learning ECG analysis with conventional assessment improved prediction of adverse cardiovascular of ED patients presenting with chest pain.
Abstract 4120743: MEK inhibition for recurring pulmonary valve stenosis in RASopathy patients
Authors: Chaput Dominic , Delrue Marie-Ange , Andelfinger Gregor
Published: November 2024

Backgound:
The RASopathies are developmental syndromes resulting from variants in the RAS/mitogen-activated protein (MAPK) cascade. The vast majority of RASopathy-causing variants lead to a gain of function in RAS-MAPK signaling. This has motivated compassionate use of MEK inhibition (MEKi) for rare, but potentially lethal complications such as hypertrophic cardiomyopathy and lymphatic disease. However, the most recurrent cardiac complication in RASopathies is pulmonary valve stenosis (PVS). PVS may require balloon valvuloplasty (BV) and can recur over time.

Research question:
Can MEKi be successfully used for recurrent PVS in RASopathy-patients?

Aim:
To report compassionate use of MEKi (trametinib) in recurring RASopathy-associated PVS.

Method:
Retrospective, single-center study at CHU Sainte Justine, Montreal, from 2021 to 2024.

Results:
After informed parental consent for off-label compassionate use of trametinib, four patients with recurrence of severe PVS after balloon valvuloplasty (>= 80 mmHg) had a total of 5 treatment episodes. Three patients were female, and one patient was male. The following genotypes were represented: Case 1, RIT1 A77V; case 2, PTPN11 N308D; case 3, RIT1 F82V, del22q11dist; case 4, PTPN11 Q110G, dup Xp22.13 (VUS), dup 16p11.2. Initial BV was carried out between three weeks and 10 months of age. Recurrence of PVS was noted between 4 days and 6 months after BV. Peak gradients at recurrence measured 72 -96 mmHg, and decreased to 40 – 64 mmHg (Dp -10 to -40 mmHg) at one to three months after treatment. Treatment had to be stopped in three cases for cutaneous side effects, with a rapid second recurrence in one case, which again responded to MEKi. PVS residual gradients at latest follow-up ranged from 30 – 69 mmHg. In all four patients, repeat catheter intervention or surgery could be avoided. In three out of four RASopathy patients with severe recurrent PVS after initial BV, we observe mild or moderate residual PVS. The patient with residual severe PS also carries a del22q11.2dist, which renders her haploinsufficient for LZTR1, a potential disease/treatment modifier within the RAS-MAPK cascade.

Conclusion:
Our results potentially expand the indications for MEKi in selected cases of RASopathy-associated recurrence of PVS and suggest an alternative to surgery or repeat catheterization. However, this case series is limited by the lack of an adequate contemporaneous, genotyped control cohort and its retrospective nature.
Abstract 4120924: Effect Of Colchicine On Myocardial Infarction: Updated Systematic Review And Meta-analysis Of Randomized Controlled Trials
Authors: Younas Ayesha , Khan Tehreem , Raja Hafsa Arshad Azam , Shaukat Muhammad Talha , Munir Aqsa , Gamarra Norma , Jaiswal Vikash
Published: November 2024

Background:
Colchicine, in multiple ways, has beneficial as well as adverse effects on patients with myocardial infarction.

Objective:
Our current study aims to study the efficacy as well as harmful effects of colchicine on patients with myocardial infarction.

Methods:
A comprehensive search was conducted on PubMed, the Cochrane Library, Scopus, Google Scholar, and Clinical trials till May 2024, and Randomized controlled trials were searched investigating the effect of Colchicine on patients with Myocardial Infarction. The quality of trials was assessed with the Cochrane risk of bias tool. Our primary Outcomes include adverse cardiovascular events while secondary outcomes include All-cause Mortality, adverse gastrointestinal effects, levels of hs-CRP, incidence of stroke, cardiac arrest, and hospitalization urgency. Risk ratios and mean differences were pooled under the Random-effect Model.

Results:
Statistical analysis shows that colchicine did not impact all-cause Mortality (RR =1.00, 95% CI=0.72-1.39, P=0.98, I2=0%), cardiac arrest (RR=0.81, 95% CI=0.33-1.95, P=0.63, I2=0), incidence of stroke(RR=0.45, 95% CI= 0.17-1.19, P=0.11, I2=36%) recurrent myocardial infarction (RR=0.78, 95%CI=0.57-1.06, P=0.11, I2=11%) and levels of hs-CRP (MD= -0.87, 95% CI=-1.80-0.06, P=0.07, I2=67%). However, colchicine shows statistically significant reduction in cardiovascular events(RR=0.75, 95%CI=0.60-0.94 , P=0.01, I2= 48%) , hospitalization urgency(RR=0.46, 95% CI=0.31-0.68, P=0.0001, I2=0%) and statistically significant increase adverse gastrointestinal events (RR=1.86, CI=1.14-3.02, P=0.01, I2=79%).

Conclusion:
Hence, we conclude that colchicine reduces adverse cardiovascular events, hospitalization urgency and increases adverse gastrointestinal events especially diarrhea in patients with myocardial infarction. However, colchicine did not reduce all-cause deaths, cardiac arrest, stroke incidence, the incidence of recurrent myocardial infarction, and hs-CRP; we still believe that the effect of colchicine on myocardial infarction needs further investigation and encourages the researcher to conduct more trials, especially with long-term follow-up.