bluuebunny/crossref_metadata_2025_split huggingface dataset:
The mitochondrial dysfunction, alongside the modifiable burden of traditional risk factors, drives the development of early-onset coronary artery disease
Authors: Campolo Jonica , Canale Paola , Gazzaniga Gianluca , Parolini Marina , Piccaluga Emanuela , Bossi Irene , Oreglia Jacopo , Borghini Andrea , Marinaro Irene , Andreassi Maria Grazia 
Published: February 2025

ObjectiveMitochondrial dysfunction is associated with increased risk of atherosclerosis by disrupting key cellular processes that contribute to premature vascular ageing. However, the specific role of mitochondrial dysfunction in early-onset coronary artery disease (EOCAD), which is increasing at a particularly alarming rate, remains largely unexplored. This study investigated the association of leukocyte mtDNA-CN and mtDNA4977 deletion with the risk of EOCAD.MethodsThe study included 118 patients (99 men, 51.0 ± 5.6 years) with angiographically EOCAD (≤60 years) and 150 healthy controls (94 men, 49.8 ± 5.8 years). Quantitative RT-PCR was used to quantify mtDNA-CN and mtDNA4977 deletion rate.ResultsThe EOCAD group had a higher prevalence of male gender (p &lt; 0.001), smoking (p = 0.001), hypertension (p &lt; 0.001), diabetes mellitus (p = 0.04) and obesity (p &lt; 0.001) than controls. EOCAD patients had lower mtDNA-CN (p &lt; 0.001) and higher mtDNA4977 deletion (p = 0.026). Low mtDNA-CN levels were significantly associated with male gender (p &lt; 0.001), smoking (p = 0.004), hypertension (p = 0.039), hypercholesterolemia (p &lt; 0.001), and obesity (p &lt; 0.001). Increased levels of the mtDNA4977 deletion were significantly higher in males (p = 0.026) and hypercholesterolemic patients (p &lt; 0.001). The ROC curve of mtDNA-CN and mtDNA4977 deletion in predicting EOCAD showed an AUC of 0.902 (95% CI 0.867–0.937, p &lt; 0.001) and 0.762 (95% CI 0.691–0.834, p &lt; 0.001), respectively. Logistic regression analysis adjusted for confounders showed that both mtDNA-CN and mtDNA4977 deletion were independent significant predictors of EOCAD (p &lt; 0.001 and p = 0.001, respectively).ConclusionsEOCAD is characterized by a high prevalence of modifiable risk factors and mitochondrial damage, underscoring the need for more efforts to reduce the burden of traditional risk factors and highlighting the potential for innovative mitochondrial-targeted therapies.
Clinical performance of subcutaneous vs. transvenous implantable defibrillator in patients with ischemic cardiomyopathy: data from Monaldi Rhythm Registry
Authors: Russo Vincenzo , Caturano Alfredo , Bianchi Valter , Rago Anna , Ammendola Ernesto , Papa Andrea Antonio , Della Cioppa Nadia , Guarino Annamaria , Masi Alessandro , D'Onofrio Antonio , Golino Paolo , Di Lorenzo Emilio , Nigro Gerardo 
Published: February 2025

IntroductionSubcutaneous ICD (S-ICD) is an alternative to a transvenous implantable cardioverter-defibrillator (TV-ICD) system in selected patients not in need of pacing or resynchronization. Currently, little is known about the effectiveness and safety of S-ICD in patients with ischemic cardiomyopathy (ICM). The aim of our study was to describe the clinical features and the drivers of S-ICD implantation among patients with ICM, as well as the clinical performance of S-ICD vs. TV-ICD among this subset of patients during a long-term follow-up.Materials and methodsAll ICM patients with both S-ICD and TV-ICD implanted and followed at Monaldi Hospital from January 1, 2015, to January 1, 2024, were evaluated; among them, only ICD recipients with no pacing indication were included. We collected clinical and anamnestic characteristics, as well as ICD inappropriate therapies, ICD-related complications and infections.ResultsA total of 243 ICM patients (mean age 63.0 ± 11.0, male 86.0%) implanted with TV-ICD (n: 129, 53.1%) and S-ICD (n: 114, 46.9%) followed at our center for a median follow-up of 66.9 [39.4–96.4] months were included in the study. Kaplan–Meier analysis revealed no significant difference in the risk of inappropriate ICD therapies (log-rank p = 0.137) or ICD-related complications (log-rank p = 0.055) between S-ICD and TV-ICD groups. TV-ICD patients showed a significantly higher risk of ICD-related infections compared to those in the S-ICD group (log-rank p = 0.048). At multivariate logistic regression analysis, the only independent predictors of S-ICD implantation were female sex [OR: 52.62; p &lt; 0.001] and primary prevention [OR: 17.60; p &lt; 0.001].ConclusionsAmong patients with ICM not in need of pacing or resynchronization (CRT), the decision to implant an S-ICD was primarily influenced by female gender and primary prevention indications. No significant differences in inappropriate ICD therapies and complications were found; in contrast, the S-ICD group showed a numerically reduced risk of ICD-related infections.
Shared diagnostic biomarkers and underlying mechanisms between endometriosis and recurrent implantation failure
Authors: Li Hui , Zhu Chenxu , Gu Yingjie , Wei Xiaojiao , Wang Xiaowen , Yang Xiaojun , Zhang Hong 
Published: February 2025

BackgroundEndometriosis (EMs) is a common condition that causes dysmenorrhea, chronic pelvic pain, and infertility, affecting millions of women worldwide. Despite the use of assisted reproductive technology, EMs patients often experience lower embryo implantation rates and recurrent implantation failure (RIF) due to impaired uterine endometrial receptivity. This study aims to identify shared diagnostic genes and underlying mechanisms between EMs and RIF using integrated transcriptomic analysis and machine learning with Gene Expression Omnibus (GEO) datasets.MethodsWe analyzed GSE11691, GSE7305, GSE111974, and GSE103465 as training datasets for EMs and RIF, and GSE25628 and GSE92324 as validation datasets. Differentially expressed genes (DEGs) and Weighted Gene Co-Expression Network Analysis (WGCNA) identified key genes specific to and shared by EMs and RIF. Machine learning algorithms were used to determine the shared diagnostic gene, whose performance was validated in both training and validation datasets. Single-gene Gene Set Enrichment Analysis (GSEA) revealed shared biological processes in EMs and RIF, while CIBERSORT analysis highlighted similarities and differences in immune infiltration between the two conditions. Finally, endometrial samples from healthy controls, EMs, and RIF patients were collected, and qRT-PCR was performed to validate the diagnostic gene.ResultsWe identified 48 shared key genes between EMs and RIF. The diagnostic gene EHF was selected through machine learning algorithms, and its diagnostic performance was validated in both training and validation datasets. ROC curve analysis demonstrated excellent diagnostic accuracy of EHF for both diseases. Gene Set Enrichment Analysis (GSEA) revealed that both conditions shared biological processes, including dysregulated extracellular matrix remodeling and abnormal immune infiltration. Furthermore, we validated the expression of EHF in endometrial samples from healthy controls, EMs, and RIF patients. Additionally, we characterized the immune microenvironment in EMs and RIF, highlighting changes in immune cell components associated with EHF.DiscussionThe diagnostic gene EHF identified in this study may serve as a key link between EMs and RIF. The shared pathological processes in both conditions involve alterations in the extracellular matrix and subsequent changes in the immune microenvironment. These findings provide novel insights into potential therapeutic strategies for improving infertility treatment in patients with EMs.
Measles vaccination in lung transplant candidates
Authors: Kostinov Мikhail P. , Polishchuk Valentina B. , Ryzhov Аleksey А. , Zhuravlev Pavel I. , Karchevskaya Natalia A. , Tarabrin Evgeniy A. , Solovieva Irina L. , Cherdantsev Alexander P. , Khrapunova Izabella A. , Foshina Elena P. 
Published: February 2025

BackgroundThe incidence of measles is now increasing. Measles is especially dangerous for high-risk individuals, including lung transplant candidates with severe progressive bronchopulmonary disorders.ObjectiveThe objective of this study was to investigate how vaccine-induced immunity is developed in lung transplant candidates seronegative for measles. In order to study vaccine-induced measles immunity, the study subjects were divided in two groups. The main group consisted of 22 patients (11 males and 11 females) with severe bronchopulmonary disorders, aged 19 to 58. The control group was made up of healthcare providers who were matched with respect to age and gender to the patients in the main group. All study subjects were given a single dose of measles vaccine. Levels of anti-measles IgG antibodies (Ab) were measured by enzyme-linked immunosorbent assay (ELISA) using the VectoMeasles-IgG kit (Russia).ResultsOne month after vaccination, both study groups showed a statistically significant increase in anti-measles IgG Ab compared to baseline levels. In the main group, vaccine-induced Ab levels were significantly lower than in the control group (0.41 [0.098; 1.75] IU/mL vs. 1.94 [0.96; 3.3] IU/mL; р&lt;0.0001). The rates of seroconversion were 73% and 100% in the main and control groups, respectively. The majority of non-responders (83%) in the main group had restrictive pulmonary disease. One year after vaccination, anti-measles Ab were detected in 36% (5/14) of the patients in the main group.ConclusionAdministration of a single dose of measles vaccine to seronegative lung transplant candidates with severe progressive bronchopulmonary disorders was safe and resulted in protective levels of antibodies in 73% of patients. One year after vaccination, anti-measles Ab were detected in 36% of the patients, which suggested that a single dose failed to induce a robust immune response in this patient population.
Cytokine profiles and CD4 counts in HIV-positive individuals with cysticercosis: implications for sex-specific immune responses in co-endemic regions of Tanzania
Authors: Lema Yakobo Leonard , Prodjinotho Ulrich Fabien , Makasi Charles , Nanyaro Mary-Winnie A. , Kilale Andrew Martin , Godfrey Mfinanga Sayoki , Schmidt Veronika , Carabin Hélène , Winkler Andrea Sylvia , Lyamuya Eligius F. , Ngowi Bernard James , Prazeres da Costa Clarissa 
Published: February 2025

IntroductionThe interplay between HIV and Taenia solium cysticercosis in co-endemic regions remains poorly understood, particularly regarding the immune responses but is relevant for an effective treatment strategy. This study aimed to investigate the relationship between peripheral cytokine profiles, CD4+ T-cell counts, and cysticercosis infection status in HIV-positive individuals in Tanzania’s southern highlands.MethodsWe conducted a cross-sectional study involving 110 HIV-positive individuals. Cysticercosis was diagnosed using antibody and antigen tests, with neurocysticercosis confirmed by CT imaging. CD4 counts and serum cytokine levels (pro- and anti-inflammatory) were analyzed using multivariate regression and MANOVA, including sex-stratified analyses.ResultsAmong participants, 20.9% tested positive for cysticercosis antibodies, 43.6% for antigens and 20.2% presented with brain cysts, with 10.6% showing active neurocysticercosis. Cysticercosis-positive individuals showed positive correlations between CD4 counts and pro-inflammatory cytokines (e.g., TNF-α, IL-1β), contrasting with negative correlations in cysticercosis-negative individuals. Sex-stratified analysis showed stronger regulatory cytokine responses in males compared to females, particularly involving higher levels of IL-10 and IL-4 indicating sex-specific immune modulation in co-infected individuals. However, overall cytokine profiles were not significantly influenced by CD4 categories or cysticercosis status.ConclusionThese results contribute to our understanding of immunological interactions in HIV-cysticercosis co-infection and underscore the need for further research with larger sample sizes to elucidate the clinical implications of these findings. Such studies could inform the development of more effective, sex-personalized treatment strategies for HIV patients in cysticercosis-endemic regions.
Systemic inflammation is an important risk factor and predictor of graft loss and mortality one year after kidney transplantation
Authors: Heldal Torbjørn F. , Åsberg Anders , Ueland Thor , Reisæter Anna V. , Pischke Søren E. , Mollnes Tom E. , Aukrust Pål , Reinholt Finn P. , Hartmann Anders , Heldal Kristian , Jenssen Trond G. 
Published: February 2025

BackgroundAn inflammatory environment following kidney transplantation is associated with increased risk of graft loss and mortality, however, evaluation of systemic inflammation is not implemented in structured risk assessment in kidney transplant recipients. Long-term results after transplantation are not satisfactory, and thus tools addressing these issues are needed. In this study, we tested the associations and predictive abilities of a predefined systemic inflammation score one year after transplantation on death-censored graft loss and mortality.MethodsWe included 805 patients who underwent kidney transplantation between 2013 and 2017 at the Oslo University Hospital, Rikshospitalet. The inflammation score included five specifically selected biomarkers known to reflect various inflammatory pathways and to be associated with adverse outcomes following transplantation. The score was assessed in relation to outcomes in models with established risk factors. Discriminatory analyses were performed using Harrell´s C-statistic, and model assessment were evaluated using internal validation, calibration, and likelihood ratio tests.ResultsThe median follow-up time was 6.4 years. There were 168 deaths (20.9%) and 42 graft losses (5.2%). The inflammation score one year after transplantation was significantly associated with graft loss (P&lt;0.001) and mortality (P&lt;0.001). The diagnostic performance of the model for graft loss revealed a c-statistic of 0.77 both with and without histological data. The diagnostic performance for mortality displayed a c-statistic of 0.79. In all tested scenarios, the model fit significantly improved after including the inflammation score.ConclusionsThese results suggest a strong association between systemic inflammation one year after transplantation and both graft loss and mortality. Predictive models including the inflammation score and established risk factors were particularly informative when considering mortality. Evaluation of systemic inflammation using this score could be an important tool for risk-assessment after transplantation.
Aberrant lipid profiles and lymphocyte counts in systemic sclerosis population, reassessing predictive value for concurrent cardiovascular diseases
Authors: Guo Ronghong , Gao Jinfang , Yang Yanli , Xu Ke 
Published: February 2025

ObjectiveTo investigate alterations in blood lipid profiles and T cell subsets among systemic sclerosis (SSc) patients, and to assess their potential utility in predicting cardiovascular disease (CVD) risk.Methods105 SSc patients and 80 age- and sex-matched healthy controls (HCs) were enrolled. Flow cytometry was employed to quantify T cell subsets. Multivariate logistic regression analysis investigated the association between blood lipid profile, T cell subsets, SSc occurrence, and CVD risk. Additionally, a prediction model was developed to assess the potential predictive value of CVD risk.ResultsIn the SSc patients, low-density lipoprotein cholesterol (LDL-C) (OR = 3.212, 95%CI = 1.132-9.113, p= 0.028), ESR (OR = 1.218, 95%CI = 1.086-1.367, p= 0.001), CRP (OR = 2.156, 95% CI = 1.393-3.338, p = 0.001), T helper (Th)cells (OR = 1.004, 95% CI = 1.001-1.008, p = 0.034) were positively correlated with the risk of SSc. Further studies found that absolute increases in Th cells in SSc patients were positively associated with the risk of CVD (OR=1.002, 95%CI=1.001-1.005, p =0.011) and were independent predictors of CVD risk in SSc. When Th cells exceeded 866.53 cells/μL, the risk of CVD in SSc patients was greatly increased (p&lt;0.001).ConclusionAltered lipid profiles and dysregulated Th cell expression in SSc patients, with a significant elevation of Th cells specifically noted in SSc-CVD patients, suggesting that Th cells may serve as a potential predictive biomarker for CVD in SSc patients, thereby aiding in early diagnosis. The underlying mechanism of this association requires further investigation.
Artificial intelligence in healthcare education: evaluating the accuracy of ChatGPT, Copilot, and Google Gemini in cardiovascular pharmacology
Authors: Salman Ibrahim M. , Ameer Omar Z. , Khanfar Mohammad A. , Hsieh Yee-Hsee 
Published: February 2025

BackgroundArtificial intelligence (AI) is revolutionizing medical education; however, its limitations remain underexplored. This study evaluated the accuracy of three generative AI tools—ChatGPT-4, Copilot, and Google Gemini—in answering multiple-choice questions (MCQ) and short-answer questions (SAQ) related to cardiovascular pharmacology, a key subject in healthcare education.MethodsUsing free versions of each AI tool, we administered 45 MCQs and 30 SAQs across three difficulty levels: easy, intermediate, and advanced. AI-generated answers were reviewed by three pharmacology experts. The accuracy of MCQ responses was recorded as correct or incorrect, while SAQ responses were rated on a 1–5 scale based on relevance, completeness, and correctness.ResultsChatGPT, Copilot, and Gemini demonstrated high accuracy scores in easy and intermediate MCQs (87–100%). While all AI models showed a decline in performance on the advanced MCQ section, only Copilot (53% accuracy) and Gemini (20% accuracy) had significantly lower scores compared to their performance on easy-intermediate levels. SAQ evaluations revealed high accuracy scores for ChatGPT (overall 4.7 ± 0.3) and Copilot (overall 4.5 ± 0.4) across all difficulty levels, with no significant differences between the two tools. In contrast, Gemini’s SAQ performance was markedly lower across all levels (overall 3.3 ± 1.0).ConclusionChatGPT-4 demonstrates the highest accuracy in addressing both MCQ and SAQ cardiovascular pharmacology questions, regardless of difficulty level. Copilot ranks second after ChatGPT, while Google Gemini shows significant limitations in handling complex MCQs and providing accurate responses to SAQ-type questions in this field. These findings can guide the ongoing refinement of AI tools for specialized medical education.
Impact of preoperative frailty on new disability or death after cardiac surgery in elderly patients: a prospective cohort study
Authors: Ma Wenwen , Shui Weikang , Peng Qian , Zhu Chaoyang , Zhao Wenjing , Fan Guanglei , Zhu Shanshan 
Published: February 2025

BackgroundDisability may be a potential adverse outcome of exposure to stressors in frail patients, and assessment of frailty may provide additional information for preoperative decision-making, but there is a lack of research on the impact of preoperative frailty on death or new disability after cardiac surgery. The main objective of this study was to evaluate the effect of preoperative frailty on short-term death or new disability after cardiac surgery in elderly individuals.Patients and methodsThis prospective cohort study included 351 patients aged ≥60 years who were scheduled to undergo elective open heart surgery at the Affiliated Hospital of Xuzhou Medical University from March 2023 to March 2024. Patients were examined prospectively using the Comprehensive Assessment of Frailty (CAF) score, which separated patients into frail and non-frail groups. The primary outcome was 90-day disability or death. Multivariate logistic regression models were used to estimate the association between frailty and 90-day new disability or death.ResultsAn assessment of frailty was performed on 351 patients, and 325 patients were included in the final analysis. The prevalence of frailty was found to be 23.08%. New disability or death occurred within 90 days after surgery in 41 (12.6%) of our patients. In multivariate analysis, frailty [OR, 3.31; 95% CI, 1.43–7.62] was independently associated with 90-day new disability or death. Empirical ROC analysis showed that CAF (AUC = 0.762) predicted 90-day new disability or death postoperatively more reliably than the traditional risk assessment tools ASA + age (AUC = 0.656) and EuroSCORE II (AUC = 0.643).ConclusionThe study demonstrates that preoperative frailty, bypass time, diabetes, BMI and EuroSCORE II are independent risk factors for 90-day new disability or death after cardiac surgery in elderly patients. Notably, frailty was a more effective predictor of 90-day new disability or death than the traditional risk predictors EuroSCORE II and ASA + age.
Systematic review and meta-analysis of the effectiveness of moxibustion therapy for primary dysmenorrhea
Authors: Song ShiWei , Chen Hao 
Published: February 2025

BackgroundPrimary dysmenorrhea is a common gynecological disease. Compared with traditional Chinese medicine treatment, moxibustion has advantages as a main treatment method. Therefore, we conducted a systematic review and meta-analysis to evaluate the efficacy of simple moxibustion therapy for primary dysmenorrhea.MethodsRandomized controlled trials were searched from PubMed, Web of Science, Embase, The Cochrane Library, China National Knowledge Infrastructure, Wan-fang database and VIP database. In the literature included in these databases, clinical reporters evaluated the efficacy of moxibustion as the treatment for primary dysmenorrhea. All included literature was assessed for risk bias by using Risk of Bias assessment tool 2.0, and meta-analysis was conducted using Rev. Man 5.4.ResultsThe findings demonstrated that the moxibustion group exhibited a statistically significant response in comparison to the control group. The improvement observed in the Cox Menstrual Symptom Scale and the visual analogue scale score between the two groups exhibited heterogeneity, with a statistically significant difference noted. In terms of Traditional Chinese Medicine symptom scores, the experimental group demonstrated superiority over the control group. Furthermore, the progesterone levels in the moxibustion treatment were found to be higher than in the control group, while the estrogen levels in the experimental group were lower than in the control group, with a statistically significant difference observed (p &lt; 0.05). Conversely, the levels of β-EP and PGE2 in the observation group were higher than those in the control group.ConclusionMoxibustion therapy shows significantly better efficacy in treating primary dysmenorrhea. However, a large sample, multi-center, high-quality RCT is still needed to evaluate its safety and efficacy.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, Identifier CRD42024580466.