bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P371: Healthy Clinics, Healthy Kids - Lifestyle Intervention on Cardiometabolic Disease Prevention in Pediatric Clinical Settings
Authors: Hollar Danielle , Heitz Caitlin , Lombardo Michelle 
Published: July 2021

Childhood obesity should be addressed in multiple sectors, including the health services/clinical setting. While many physicians believe it is their responsibility to help adult patients lose weight, the majority feels they are not equipped to manage weight problems of their patients. Healthy Clinics, Healthy Kids (HCHK) was designed to test the impact of addressing obesity, using a lifestyle approach, among pediatric patients and families in a variety of primary care clinical settings.
HCHK interventions took place over a 2-year period (2010-2012) in three states (MI, MS and NM). Lifestyle interventions (nutrition, healthy living, physical activity education/technical assistance), targeted children and caregivers in low-income clinical settings that care for children. The goal was to help clinical staff address obesity issues and concerns of patients and families.
Impact of interventions was assessed using pre and post surveys. 21 sites completed pre and post surveys (MI (9), MS (9), and NM (3)). Respondents included nurses (14), managers (2), physicians (2), coordinators (1), and a registered dietitian. Prevalence of obesity among children was higher than the national average (respondents reported that only 56% were “normal”, as compared to approximately 66% nationally). 32% indicated private insurance pays for some obesity care, and 42% indicated public insurance. 44% indicated they discuss weight with parents of “normal” weight children, and about 73% indicated they discuss this with parents of “overweight” children.
Statistically significantly (at the p<.05 level) more respondents indicated, at the end of the project than at the beginning, that they discuss “the impact of childhood obesity on their future risk for chronic diseases in adulthood” (70% versus 57%). Statistically significantly more indicated that they discuss this topic with parents at the end (76% versus 57%). There was an increase in discussing obesity with patients, topics including exercise and physical activity (+8.5%) and limiting sedentary behaviors (+5.0%). There was an increase in conversations with parents, topics including healthy food and beverage choices (+4.8%), physical activity (+9.4%), limiting sedentary behaviors (+4.7%), “creating a healthy home environment” (+19.1%), and “removing the TV from the bedroom” (+14.3%) Although at baseline it was not discussed much (22.2%), at follow-up, there was an increase in “encouraging breastfeeding for childhood obesity prevention, if pregnant” (38.1%). Regarding parents, although already a topic with high comfort level at baseline, statistically significantly more respondents indicated at the end of the project that they felt comfortable discussing exercise and physical activity (76.2% versus 90.5% respectively). Overall, HCHK showed that implementation of a nutrition and healthy living program for clinics is feasible and effective.
Abstract P419: Diet patterns in Argentinean adults
Authors: Elorriaga Natalia , Irazola Vilma E , Gutierrez Laura , Defagó Maria D , Poggio Rosana , Rubinstein Adolfo L 
Published: July 2021

Objectives:
to identify Diet Patterns (DP) in the adult population of Argentina, and explore associations with gender, age and educational level.

Methods:
We defined DP among 3,010 adults between 35 to 74 years old, participating in CESCAS I, a population-based cohort study carried out in two cities in Argentina, Marcos Paz and Bariloche. Data on food intake was obtained from a validated self-administered food frequency questionnaire. Principal component Analysis (PCA) was used to identify DP. A summary score for each pattern was then derived and used in multiple regression analysis to examine the relationship between DP and socio-demographic variables.

Results:
3 major eating patterns were identified. They explained 25% of the total variance.

Factor 1 (Traditional diet pattern) was characterized by a high intake of refined grains, red meat, whole- fat dairy products, vegetable oils and other fat spreads, and “mate”, a traditional South American drink. Factor 2 (Healthy diet pattern), was characterized by a high intake of vegetables, fruit, low-fat dairy products, whole grains, and legumes. Factor 3 (Processed-food diet pattern) consisted mainly of processed meat, snacks, pizza, and “empanadas”, a stuffed bread baked or fried.
After adjusting for energy intake, we found that DP were associated with age, gender, and educational level. Traditional DP score was lower at high educational level (p 0.001), Healthy DP score was higher among women (p 0.000), and high educational level (p 0.001) while men scored significantly higher in the Processed-food DP (p 0.002).

Conclusions:
Local DP has been identified in our population. This study will provide useful information to set priority targets for nutrition interventions, and promote healthy policies based on local food habits.
Abstract 11697: Hyperhomocysteinemia Induces CD40
+
Monocyte and Inflammatory Monocyte in Chronic Kidney Disease Subjects via DNA Hypomethylation-Related Mechanism
Authors: Yang Jiyeon , Kolli Abhigna C , Choi Eric T , Yang Xiao-Feng , Wang Hong 
Published: July 2021

Hyperhomocysteinenia (HHcy) is associated with chronic kidney disease (CKD) which has increased cardiovascular disease (CVD) mortality and mobility. Elevated inflammatory monocyte (inf. MC) is a cellular hallmark of chronic inflammation which contributes to the burden CVD. We previously reported that HHcy induces inf. MC differentiation in mice and DNA hypomethylation in vascular cells. We assesses whether HHcy causes MC differentiation in CKD and the underlying mechanism.
Degree of CKD was determined by plasma creatinine from patients with peripheral vascular disease (VD). Estimated glomerular filtration rate was calculated with modification in age, race and gender. (VD, n=13; VD with CKD, n=13; Healthy donor without evidence of VD and CKD, n=13). Blood cells were assessed for phenotypic characterization by flow cytometry.
We found that plasma Hcy levels are elevated in VD and CKD. CD14++CD16+ inf. MC are increased in VD subjects and mild HHcy(>15μM). Plasma Hcy levels are positively correlated with inf. MC, CD40, TNF receptor family 5. We identify that CKD patient serum and Hcy (50μM) treatment increased CD40 in purified human blood MC by RT-PCR. Hcy metabolites, S-adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH), are increased in CKD subjects. SAM/SAH ratio, an indicator of methylation status, is reduced and is negatively correlated with Hcy, inf. MC, and CD40+ inf. MC. Hcy induced MC-origin inflammatory cytokines IL-6 mRNA in MC isolated from healthy donor by RT-PCR, and potentiated inflammatory cytokine IL-6, TNFα, and IFN[[Unable to Display Character: &#612;]]-induced CD40 expression in cultured PBMCs. Hcy suppressed CD40 transcription and reduced DNA methyltransferase 1 protein levels in cultured human MC. We identified four DNA hypomethylation CpG dinucleotides at p65 and PU.1 transcription factor consensus sequences on CD40 promoter in white blood cells isolated from CKD patients by Bisulfite pyrosequencing. Finally, CD40L levels are positively correlated with plasma Hcy and inf. MC. CD40 ligation by CD40L treatment (0.4μg/l) in peripheral blood mononuclear cells (PBMC) induced inf. MC differentiation.
We conclude that HHcy potentiates IFN[[Unable to Display Character: &#612;]]-mediated CD40 expression via CD40 DNA hypomethylation in CKD and promotes CD40-CD40L mediated inf. MC differentiation.
Abstract 11989: Cardiac 12-Lipoxygenase-Induced Oxidative Stress Promotes the Development of Diabetic Cardiomyopathy
Authors: Kayama Yosuke , Suzuki Hirofumi , Sakamoto Masaya , Shimizu Ippei , Nagoshi Tomohisa , Minamino Tohru , Yoshimura Michihiro 
Published: July 2021

Diabetes mellitus affects cardiac structure and function, and it has been suggested that diabetes leads to cardiomyopathy. Arachidonic acid (AA) metabolism was thought to be a potential mediator of cardiac fibrosis and heart failure associated with oxidative stress. 12-lipoxygenase (12-LOX) is a key lipid peroxidizing enzyme of the AA cascade that plays an important role in the development of atherogenesis and neurodegenerative disease. However, the role of 12-LOX in diabetic cardiomyopathy has not been examined.
To determine whether 12-LOX is a key molecule in the development of diabetic cardiomyopathy, we created streptozotocin (STZ)-induced diabetic mice (WT-STZ) and compared to control mice. Cardiac expression of 12-LOX pathway was up-regulated after induction of diabetes. Histological analysis revealed that expression of 12-LOX was specifically up-regulated in cardiomyocytes but not vascular cells and fibroblast cells. Cardiac fibrosis was increased after induction of diabetes. We next created STZ-induced diabetic mice using 12-LOX KO mice (KO-STZ) and compared them to WT-STZ. Cardiac dysfunction and fibrosis in WT-STZ were significantly inhibited in KO-STZ.
We next examined the relationship between 12-LOX and cardiac oxidative stress in the diabetic heart. Cardiac expression of 4-hydroxy-2-nonenal (4-HNE) and nicotinamide adenine dinucleotide phosphate oxidase 4 (NOX4) were up-regulated in the diabetic heart. This increase was inhibited by disruption of 12-LOX.
To further investigate the subcellular mechanism of the increase reactive oxygen species (ROS) in the diabetic heart, intracellular ROS levels in cardiomyocytes were estimated under high glucose condition (HG) and normal glucose condition (LG) by fluorimetry and using MitoTracker® Red in vitro. Cardiomyocytes under HG showed the enhancement of fluorescence intensity of DCF-DA and loss of mitochondrial membrane potential. Treatment with 12-LOX inhibitor (CDC) improved the enhancement of DCF-DA and mitochondrial membrane potential under HG condition.
These in vivo and in vitro results suggest that 12-LOX pathway is important in the process of production of ROS and oxidative stress in diabetic heart and promotes the development of diabetic cardiomyopathy.
Abstract 13037: Tenascin-c Modulates Inflammatory Response and Aggravate Ventricular Remodeling After Myocardial Infarction in Mice Model
Authors: Kimura Taizo , Sato Akira , Tajiri Kazuko , Zeng Wang , Sakai Satoshi , Yoshida Toshimichi , Hiroe Michiaki , Yoshida Kyoko I , Aonuma Kazutaka 
Published: July 2021

Tenascin-C (TN-C), an extracellular matrix glycoprotein, transiently appeared in myocardial tissue after acute myocardial infarction (AMI). We have previously reported that AMI patients with higher serum TN-C levels had worse long-term prognosis, suggesting TN-C may play important roles during the development of ventricular remodeling. However, the biological function of TN-C in ventricular remodeling is not fully understood. In this study, using TN-C knock-out(KO) mice, we investigated the effects of TN-C on LV remodeling and the biological function of TN-C during the acute phase of inflammatory responses after myocardial infarction.
The 8 to 10 weeks old male wild type (WT) and TN-C knock-out (KO) mice were divided into 4 groups of WT+Sham, KO+Sham, WT+MI and KO+MI. Mice 12 weeks post-MI, the survival rate of both WT+MI (48.3%,14 of 29 mice) and KO+MI (55.6%,15 of 27 mice) groups had no significant difference. However, TN-C KO group had the better cardiac function than WT had (LVEF, 19.02±6.31% vs 10.63±4.43%; p<0.001). Interstitial fibrosis at border area was significantly increased in the WT +MI group to compare with that of KO+MI, whereas the extent of fibrosis in the remote area revealed no significant difference between the two groups. By RT-PCR analysis, WT+MI group showed significantly higher expression of atrial natriuretic peptide at the border including infarcted areas than that of KO+MI at chronic MI phase. At acute phase, fluorescence activated cell sorting analysis showed that ratio of CD45+, CD11b+, Ly6c high pro-inflammatory monocyte were significantly decreased, whereas CD45+, F4/80+, CD206+, anti-inflammatory M2 macrophage were significantly increased in KO+MI compared with WT+MI group 7 days after MI. RT-PCR analysis showed that the expression of IL-10, an anti-inflammatory cytokine, was significantly higher in KO+MI than WT+MI.
These findings suggest, TN-C aggravates the deterioration of LV function due to MI partly by modulating inflammation at acute phase.
Abstract 13624: Perceived Health and Physical Activity among Patients treated with Ablation for Atrial Fibrillation or Atrial Flutter compared with a Healthy General Population - Results from a Nationwide Survey
Authors: Risom Signe S , Berg Selina K , Christensen Anne V , Zwisler Ann-Dorthe , Svendsen Jesper H , Thygesen Lau C 
Published: July 2021

Introduction:
Patients with atrial fibrillation (AF) or atrial flutter (AFL) report poor perceived health and avoidance behavior when suffering the arrhythmia. It is important to investigate if this perception and behavior changes after treatment with ablation, so that normality is regained.

Objective:
To describe patients’ perceived health and physical activity 6-12 months after ablation for AF or AFL and compare with an age- and sex- matched healthy general population.

Methods:
The nationwide cross-sectional survey was mailed to participants >18 years old who had been hospitalized for ablation for AF or AFL from January to June 2011.

The patients were identified in the Danish National Patient Register (n=714). The mailed questionnaire included Short Form 36 (SF-36) and a question about physical activity and was sent in Dec 2011 to eligible patients (n=627). The nationally representative Danish Health Interview Survey 2005 was used to sample an age- and sex-matched reference population.
Differences in perceived health (SF-36) were tested with t-test and chi2-test was used to determine the differences in physical activity levels.

Results:
The questionnaire was answered by 462 patients (74%). We found in all domains on SF-36 significantly lower scores for patients treated for AF and AFL compared with the reference group (p=0.0001) (see Table 1). Physical activity levels were also significantly lower for the patients treated for AF and AFL (p<0.0001).

Conclusions:
We found that patients treated for AF or AFL’s perceived health and physical activity levels were significantly impaired compared with a healthy general population. This is vital information for the health professional seeing the patients for follow-up after the ablation and rehabilitation should be considered.
Abstract 14803: Use of Real-Time Transesophageal Echocardiography to Improve Safety of Lead Extraction
Authors: Oestreich Brett , Ahlgren Bryan , Tompkins Christine , Varosy Paul , Seres Tamas , Aleong Ryan 
Published: July 2021

Background:
Transvenous lead extraction (TLE) carries a small but measurable risk of serious adverse events. Few studies have examined the potential benefit of continuous monitoring with transesophageal echocardiography (TEE) during this procedure.

Objective:
Evaluate the utility of TEE during TLE involving both conventional and laser lead removal.

Methods:
TEE was performed in 100 consecutive patients undergoing TLE. All patients underwent TLE in the operating room with general anesthesia and continuous TEE monitoring.

TLE was attempted for 193 leads in 100 patients. Eighty patients required laser lead extraction (80%). Indications for extraction were device endocarditis (28), lead fracture (28), recalled lead (21), pocket infection (17), and other (6).

Results:
Sixty-seven patients were male and the average age was 56.96 +- 17.01 years. The average length since lead implant was 78±55.19 (1.4-274.43) months. Complete success occurred in 181 leads (94%), partial success in 4 leads (2%), and failure in 8 leads (4%). Major complications included right ventricle laceration (1) and right atrium/superior vena cava laceration (2) which resulted in detection and localization within 1-2 minutes and prompt surgical repair. Premature termination and unnecessary surgery were prevented in 4 patients with hypotension but no intracardiac abnormalities seen on TEE (Figure 1). There was one upper gastrointestinal bleed from the TEE probe (1). In-hospital mortality was 0%.

Conclusion:
In total the clinical management was changed in 7 patients (7%) based on real-time TEE monitoring helping to decrease the TLE related mortality and premature termination of the procedure.

Figure 1
Monitoring with real time TEE prevented premature termination of cases with severe hypotension showing RV obstruction due to invagination of the free wall.
RA: right atrium; RV: right ventricle.
Abstract 15578: The Combination of an Ostium Secundlum Type Atrial Septal Defect with a Pulmonary Arterial Thromboembolism Caused an Enlarged Pulmonary Artery, Pulmonary Hypertension and Recurrent Paradoxical Cerebral Embolism due to Deep Vein Thrombosis
Authors: Funabashi Nobusada , Takaoka Hiroyuki , Ozawa Koya , Tanabe Nobuhiro , Tatsumi Koichiro , Kobayashi Yoshio 
Published: July 2021

A 65 year old female was referred to our hospital with dyspnea on effort. When she was 42 years old, she was diagnosed by transthoracic echocardiology (TTE) with an ostium secundlum type atrial septal defect (ASD) with a pre-existing right to left shunt through the ASD. When she was 60 years old, she was diagnosed with a brain abscess due to a paradoxical cerebral embolism and admitted to our brain surgery ward a total of three times. The diagnosis was confirmed and treatment with Clopidogrel sulfate was started. Six months ago, she felt dyspnea on effort and gradually worsened. She was referred to our department for further examination. Chest X ray revealed cardiac enlargement with a cardiothoracic ratio of 61%. Serum d dimer and brain natriuretic peptide were elevated to 3.3μg/ml and 492pg/mL, respectively. TTE showed an enlarged PA, right atria (RA) and right ventricle (RV) with a thickened RV wall. A bidirectional shunt through a large ASD could also be observed. PA systolic pressure was estimated, by the pressure gradient from tricuspid valve regurgitation, at 94mmHg. CT revealed an enlarged, calcified PA with a mural thrombus, enlarged and thickened RV wall and a right to left shunt through the ASD. The LV was compressed by the RV, suggesting RV pressure load. Because a mural thrombus was observed in the PA, CT acquisitions of the lower extremities were added 3 minutes after contrast injection. An enlarged popliteal vein with a deep venous thrombus (DVT) was observed. Tadalafil was prescribed for pulmonary hypertension to improve oxygen concentration. Heparin followed by warfarin was administered for the DVT and mural thrombus in the PA.
At follow up, CT showed no change to the mural thrombus in the PA, therefore home oxygen therapy was started.
From experience of this case, and in subjects with Eisenmenger ASD, if severe PA dilation and PA hypertension and paradoxical cerebral embolism are detected, one should also suspect PA thromboembolism due to DVT.
Abstract 16013: Direct Nkx2-5 Transcriptional Repression of Isl1 Controls Cardiomyocyte Subtype Identity
Authors: Goedel Alexander , Dorn Tatjana , Lam Jason T , Herrmann Franziska , Haas Jessica , Bundschu Karin , Dobreva Gergana , Schiemann Matthias , Dirschinger Ralf , Kühl Susanne J , Sinnecker Daniel , Moretti Alessandra , Kühl Michael , Laugwitz Karl-Ludwig 
Published: July 2021

During heart development the second heart field (SHF) provides progenitor cells for most cardiomyocytes and expresses the LIM-homeodomain transcription factor Islet-1 (Isl1) and the homeobox protein Nkx2-5.
Here, we show that a direct repression of Isl1 transcription by Nkx2-5 is necessary for proper specification and maturation of ventricular and atrial chamber-specific myocardial lineages. Overexpression of Nkx2-5 in mouse embryonic stem cells (ESCs) delayed specification of cardiac progenitors and inhibited expression of Isl1 and its downstream targets in the Isl1+ precursor population. These effects were partially rescued by Isl1 overexpression. Embryos deficient for Nkx2-5 in the Isl1+ lineage failed to downregulate Isl1 protein in cardiomyocytes of the heart tube (Figure 1A). We demonstrated that Nkx2-5 directly binds to an Isl1 gene enhancer and represses the transcriptional activity of Isl1. Furthermore, we showed that overexpression of Isl1 does not prevent cardiac differentiation of ESCs and in Xenopus laevis embryos. Instead, Isl1 overexpression in ESCs leads to enhanced specification of cardiac progenitors, earlier cardiac differentiation, and increased number of cardiomyocytes (Figure 1B). Functional and molecular analysis of Isl1-overexpressing cardiomyocytes revealed higher beating frequencies in both ESC-derived contracting areas and Xenopus Isl1-gain-of-function hearts (Figure 1C), which was associated with upregulation of nodal-specific genes and downregulation of transcripts of working myocardium.
Our findings provide an Isl1/Nkx2-5-mediated mechanism that coordinately regulates the specification of cardiac progenitors towards the different myocardial lineages and ensures proper acquisition of myocyte subtype-identity (Figure 1D).
Abstract 17153: Increased Atherosclerotic Plaque Instability in Advanced Atherosclerosis with Aging: the Role of Calpain 2 in SOD2-deficient ApoE-/- Mice
Authors: Vendrov Aleksandr E , Madamanchi Nageswara R , Stevenson Mark D , Runge Marschall S 
Published: July 2021

The prevalence of atherosclerosis and incidence of cardiovascular events increase with advancing age. Increased generation and/or decreased scavenging of reactive oxygen species (ROS) in the vascular wall are major determinants of vascular disease progression. We previously showed that SOD2 deficiency in aging increases vascular oxidative stress and reduces aortic compliance, while young ApoE-/-/SOD2+/- mice show increased mitochondrial DNA damage and accelerated atherogenesis. Here we investigated the effects of aging and SOD2 deficiency on atherosclerosis and vascular wall morphology in ApoE-/- mice.
Compared with the control ApoE-/-, aged ApoE-/-/SOD2+/- mice had increased total vascular wall (P < 0.001) and mitochondrial ROS levels (P < 0.05) and 70% higher atherosclerotic lesion area (P < 0.001). Pulse wave velocity (P < 0.001) and aortic wall collagen content (P < 0.05) were significantly increased, while atherosclerotic plaque fibrous cap thickness (P < 0.01) and vascular smooth muscle cell (VSMC)-positive area (P < 0.01) were decreased in aged ApoE-/-/SOD2+/- mice. Immunofluorescence analysis of atherosclerotic lesions revealed higher levels of calpain 2, a cysteine protease implicated in apoptosis and cleaved caspase-3 localized in smooth muscle-positive areas of the plaque in aged ApoE-/-/SOD2+/- mice. VSMC isolated from aged SOD2+/- had higher levels of mitochondrial oxidative stress and dysfunction compared with VSMC from wild-type mice, as determined by increased superoxide generation and mitochondrial protein carbonylation and lower complex I and III activity. The calpain 2 protein levels were significantly higher in the SOD2+/- VSMCs compared with the wild-type cells and its expression and activity increased after TNF-α treatment, causing apoptosis. TNF-α increased MMP2 activity in SOD2+/- VSMC in Calpain 2-dependent manner.
In conclusion, enhanced mitochondrial oxidative stress in aging increases aortic stiffening, atherosclerotic burden and plaque instability in advanced atherosclerosis, in part, via the activation of calpain 2 and MMP2. Targeting mitochondrial oxidative stress and calpain 2 activity may be a viable strategy to prevent aging-associated atherosclerosis complications.