bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mycophenolate Mofetil Appears Effective for the Treatment of Patients With Refractory Crohn’s Disease
Authors: Rosenfeld Sam , Clark-Snustad Kindra , Kamp Kendra J , Jacobs Jeffrey , Barahimi Mitra , Harper Jason , Lee Scott David 
Published: December 2024

Abstract

Background
Medically refractory Crohn’s disease (CD) is associated with a high risk of complications. Mycophenolate mofetil (MMF), a small molecule immunosuppressant, has limited data in patients with CD, and objective endoscopic response to MMF has not been reported.

Aims
We evaluated the safety and clinical, endoscopic, and biochemical effectiveness of off-label MMF for refractory CD as monotherapy or in combination with a biologic in patients with CD.

Methods
We retrospectively assessed adverse events (AEs), clinical response (Harvey–Bradshaw index), endoscopic response (simple endoscopic score in Crohn’s disease), and physician global assessment at an academic medical center and county hospital.

Results
60 patients received MMF as monotherapy (n = 40) or in combination with a biologic (n = 20) between 2008 and 2021 at a dose ranging from 1000 to 4000 mg daily. Median age was 39 years and median disease duration was 12 years. All patients previously failed ≥ 1 advanced therapy (median = 4). The median MMF therapy duration was 27 weeks. 54% achieved clinical response and 19% achieved clinical remission after a mean of 19.5 weeks (SD 14.5). Endoscopic response occurred in 32%, endoscopic remission in 16%, and endoscopic healing in 4% after a mean of 46.6 weeks (SD 31.0). 48% of patients experienced AEs, most commonly mild infection, nausea/vomiting, and headache. One serious AE occurred, which was assessed as unrelated to MMF.

Conclusions
MMF resulted in clinical, endoscopic, and biochemical benefits in some patients with refractory CD, and was tolerated by most patients. Further randomized controlled trials are needed to define optimal dosing and long-term efficacy and safety.
Toward clearer recognition and easier usefulness: development of a cross-lingual atherosclerotic cerebrovascular disease ontology
Authors: Ma Hetong , Shen Liu , Wang Jiayang , Wang Shilong , Wang Min , Wang Meng , Li Zixiao , Li Jiao 
Published: December 2024

Abstract
Atherosclerotic cerebrovascular disease could result in a great number of deaths and disabilities. However, it did not acquire enough attention. Less information, statistics, or data on the disease has been revealed. Thus, no systematic concept datasets were released to help clinicians clarify the scope, assist research, and offer maximized value. This study aimed to develop a cross-lingual atherosclerotic cerebrovascular disease ontology; describe the workflow, schema, hierarchical structure, and the highlighted content; design a brand-new rehabilitation ontology; implement the ontology evaluation; and illustrate the application scenarios in real-world scenarios. We implemented nine steps based on the Ontology Development 101 methodologies combined with expert opinions. The ontology included collection and specification of clinical requirements, background investigation and knowledge acquisition, ontology selection and reuse, scope identification, schema definition, concept extraction, concept extension, ontology verification, and ontology evaluation. We evaluated the proposed ontology in the literature classification task. The current ontology included 10 top-level classes, respectively, clinical manifestation, comorbidity, complication, diagnosis, model of atherosclerotic cerebrovascular disease, pathogenesis, prevention, rehabilitation, risk factor, and treatment. There are 1715 concepts in the 11-level ontology, covering 4588 Chinese terms, 6617 English terms, and 972 definitions. The ontology could be applied in real-world scenarios such as information retrieval, new expression discovery, named entity recognition, and knowledge fusion, and the use case proved that it could offer satisfying support to related medical scenarios. The ontology was proven to be useful in text classification tasks, and the weight-F1 score could reach &gt;80% combined with the pretrained model. The proposed ontology provided a clear set of cross-lingual concepts and terms with an explicit hierarchical structure, helping scientific researchers to quickly retrieve relevant medical literature, assisting data scientists to efficiently identify relevant contents in electronic health records, and providing a clear domain framework for academic reference.
Database URL: https://bioportal.bioontology.org/ontologies/ACVD_ONTOLOGY
Ulcerative Colitis Severity Classification and Localized Extent (UC-SCALE): An Artificial Intelligence Scoring System for a Spatial Assessment of Disease Severity in Ulcerative Colitis
Authors: Gutierrez-Becker Benjamin , Fraessle Stefan , Yao Heming , Luscher Jerome , Girycki Rafal , Machura Bartosz , Czornik Janusz , Goslinsky Jaroslaw , Pitura Marek , Levitte Steven , Arús-Pous Josep , Fisher Emily , Bojic Daniela , Richmond David , Bigorgne Amelie E , Prunotto Marco 
Published: December 2024

Abstract

Background and Aims
Validated scoring methods such as the Mayo Clinic Endoscopic Subscore (MCES) evaluate ulcerative colitis (UC) severity at the worst colon segment, without considering disease extent. We present the Ulcerative Colitis Severity Classification and Localized Extent (UC-SCALE) algorithm, which provides a comprehensive and automated evaluation of endoscopic severity and disease extent in UC.

Methods
Ulcerative Colitis Severity Classification and Localized Extent consists of 3 main elements: (1) a quality filter selecting readable images (frames) from colonoscopy videos, (2) a scoring system assigning an MCES to each readable frame, and (3) a camera localization algorithm assigning each frame to a location within the colon. Ulcerative Colitis Severity Classification and Localized Extent was trained and tested using 4326 sigmoidoscopy videos from phase III Etrolizumab clinical trials.

Results
The high agreement between UC-SCALE and central reading at the level of the colon section (𝜅 = 0.80), and the agreement between central and local reading (𝜅 = 0.84), suggested a similar inter-rater agreement between UC-SCALE and experienced readers. Furthermore, UC-SCALE correlated with disease activity markers such calprotectin, C-reactive protein and patient-reported outcomes, Physician Global Assessment and Geboes Histologic scores (rs 0.40-0.55, ps &lt; 0.0001). Finally, the value of using UC-SCALE was demonstrated by assessing individual endoscopic severity between baseline and induction.

Conclusions
Our fully automated scoring system enables accurate, objective, and localized assessment of endoscopic severity in UC patients. In addition, we provide a topological representation of the score as a marker of disease severity that correlates highly with clinical metrics. Ulcerative Colitis Severity Classification and Localized Extent reproduces central reading and holds promise to enhance disease severity evaluation in both clinical trials and everyday practice.
Global longitudinal strain is a predictor of mortality in patients with cardiogenic shock
Authors: Berg-Hansen Kristoffer , Ito Saki , Oh Jae , Yang Jeong Hoon , Wiggers Henrik , Jentzer Jacob C 
Published: December 2024

Abstract

Aims
Cardiogenic shock (CS) is a critical manifestation of severe cardiac dysfunction, necessitating precise evaluation of left ventricular (LV) function by transthoracic echocardiography. The prognostic value of global longitudinal strain (GLS) has not been examined in patients with CS. Therefore, we aimed to assess the prognostic significance of GLS in patients with CS.

Methods and results
This was a retrospective study of patients with CS from 2007 to 2018 who had a transthoracic echocardiography performed within 24 h of admission. GLS was measured, and conventional parameters were obtained. LV dysfunction was categorized by GLS: &gt; 9.7% (Quartile 1), 7.0% &lt; GLS ≤ 9.7% (Quartile 2), 5.0% &lt; GLS ≤ 7.0% (Quartile 3), and ≤5.0% (Quartile 4). Outcomes included in-hospital and 1-year all-cause mortality. Among 623 patients with CS with the median LVEF of 31% [inter-quartile range (IQR): 24–41%] and the median GLS of 7.0% (IQR: 5.0–9.7%), in-hospital mortality was 29%. Mortality increased across GLS quartiles: Quartile 1: 17%; Quartile 2: 22%; Quartile 3: 35%; and Quartile 4: 42%. GLS remained the only independent echocardiographic predictor of in-hospital mortality after adjusting for clinical covariates (adjusted odds ratio: 1.23 per 1% decrease, 95% confidence interval: 1.04–1.46, P = 0.015). GLS independently predicted 1-year all-cause mortality (P &lt; 0.001). The prognostic value of GLS was superior in cases with acute coronary syndrome. A classification and regression tree analysis identified GLS as the most important echocardiographic variable for predicting in-hospital mortality.

Conclusion
GLS independently predicted short- and long-term mortality in patients with CS, surpassing conventional echocardiographic parameters in prognostic value, supporting its potential role in risk stratification in this population.
Predictors of coronary atherosclerosis in middle-aged and older athletes: the MARC-2 study
Authors: Berge Kristian , Janssen Sylvan L J E , Velthuis Birgitta K , Myhre Peder Langeland , Mosterd Arend , Omland Torbjørn , Eijsvogels Thijs M H , Aengevaeren Vincent L 
Published: December 2024

Abstract

Aims
Exercise improves cardiovascular health, but high-volume high-intensity exercise is associated with increased coronary artery calcification (CAC). We aimed to identify predictors of CAC in athletes.

Methods and results
We assessed the association of traditional and non-traditional cardiovascular risk factors with CAC using linear and logistic regression. A total of 289 male athletes from the MARC-2 study were included, with a median age of 60 (Q1–3 56–66) years, lifelong weekly training load of 26 (17–35) metabolic equivalent of task hours, body mass index of 24.5 (22.9–26.6) kg/m2, systolic blood pressure of 139 ± 18 mmHg, and reported 0.0 (0.0–8.0) smoking pack years. Thirty-one per cent had a CAC score &gt; 100 and 13% &gt; 400. Among traditional cardiovascular risk factors, higher age, systolic blood pressure, smoking pack years, and family history of coronary artery disease independently predicted greater CAC scores, while body mass index, low-density lipoprotein cholesterol, and diabetes mellitus did not. Among non-traditional risk factors, higher training loads, serum phosphate, and lower adjusted energy intake and fat percentage of energy intake independently predicted greater CAC scores. The full model with all traditional and non-traditional risk factors had higher accuracy in predicting CAC &gt; 100 [receiver operating characteristic area under the curve 0.76, 95% confidence interval (0.70–0.82)] and CAC &gt; 400 [0.85 (0.77–0.92)] than traditional cardiovascular risk factors alone [0.72 (0.65–0.78), P = 0.012, and 0.81 (0.74–0.90), P = 0.038, respectively].

Conclusion
Non-traditional risk factors, including training load, dietary patterns, and serum phosphate, were independently associated with CAC in aging male athletes. Prediction accuracy for CAC increased when including these variables in a prediction model with traditional risk factors.
A shot through the heart: a case report on retained bullet causing cardiac tamponade
Authors: Shah Rakesh , Dacey Thomas , Sebastian Joseph , Zehr Kenton , Cardozo Shaun 
Published: December 2024

Abstract

Background
As a rare complication of penetrating chest trauma, one can occasionally find foreign bodies inside the pericardium. Even rarer is finding an intact bullet inside the pericardial cavity following the gunshot injury.

Case summary
A 17-year-old male presented to the emergency department as a Level 1 trauma for multiple gunshot wounds. Upon arrival, the patient was tachycardic but normotensive. Physical exam was notable for several penetrating wounds to the chest and right clavicle. The initial chest X-ray demonstrated a metallic foreign body consistent with a bullet overlying the cardiac silhouette. Approximately 24 h into the hospital course, ST-segment elevation was noted on telemetry. An electrocardiogram demonstrated sinus tachycardia with diffuse ST-segment elevation in all leads, consistent with acute pericarditis. Over the following several hours, the patient gradually developed tamponade physiology, prompting a more emergent median sternotomy.

Discussion
Although penetrating cardiac injury carries a high mortality rate, management of these patients and complications that may arise during their hospital course are rarely explained. The diagnosis of projectile chest trauma starts with history and physical examination. The primary diagnostic modalities are the X-ray, computed tomography scan of the chest, electrocardiogram, and echocardiogram. Management of a patient with cardiac gunshot depends largely on haemodynamic status. As in our case, a patient with haemodynamic instability is managed with emergency exploration and removal of the foreign body.
A case report of familial catecholaminergic polymorphic ventricular tachycardia with a novel mutation in the ryanodine receptor 2
Authors: Shoji Yoshikuni , Hayashida Satoshi , Masuda Hikaru , Tachibana Eizo , Okumura Yasuo 
Published: December 2024

Abstract

Background
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is suspected by clinical characteristics involving fatal arrhythmic events in childhood and adolescence. On the other hand, genetic testing is also important because the mutation site in the specific genes of CPVT is related to the risk of ventricular arrhythmias and gene penetrance.

Case summary
We present a case of a 15-year-old male with a familial history of CPVT and a history of syncope at the age of 5. He experienced a cardiac arrest prompting out-of-hospital cardiopulmonary resuscitation, and his circulatory dynamics recovered. Multiple premature ventricular contractions inducted by a treadmill exercise test disappeared after a dosage of verapamil, flecainide, and nadolol, and a subcutaneous implantable cardioverter defibrillator was implanted. The novel pathogenic mutation with an insertion of histidine near the C-terminus of the RYR2 protein was identified by genetic testing in this case and his mother.

Discussion
The RYR2 mutation in this case has not been previously reported and may be an intractable phenotype of CPVT associated with a strong familial history and fatal cardiac events even under adequate medical therapy.
Congenital absence of the left atrial appendage: a positive coincidence for the electrophysiologist? A case report
Authors: Batista Lage João Gabriel , Rangel Rafael Augusto Lethier , de Oliveira Júnior Nilson Araújo , Tavares Pinheiro Martha Valeria , de Souza Olga Ferreira 
Published: December 2024

Abstract

Background
The congenital absence of the left atrial appendage (LAA) is an extremely rare anatomical anomaly, with only 23 cases documented in medical literature. The LAA plays a critical role in thrombus formation, particularly in patients with atrial fibrillation (AF), thus impacting stroke prevention strategies and the management of anticoagulation.

Case summary
We report a 48-year-old male with a 2-year history of hypertension and prior episodes of tachycardic palpitations, who presented with AF and chest pain. During catheter ablation for AF, a transoesophageal echocardiogram revealed the absence of the LAA, initially suspected to be a thrombus. The procedure was suspended until a computed tomography confirmed the congenital absence of the LAA. The patient successfully underwent pulmonary vein isolation with radiofrequency and, after a shared decision-making process, discontinued anticoagulation. He remains asymptomatic without AF recurrence.

Discussion
The congenital absence of the LAA raises important considerations for managing stroke risk in AF patients, as standard thromboembolic risk scores do not account for such anatomical variations. Despite the LAA being the most common site for thrombus formation, stroke risk in AF results from multiple factors beyond a single site of thrombus formation. Left atrial appendage occlusion is a viable alternative for stroke prevention in patients contraindicated for anticoagulation. Recent guidelines recommend individualized risk assessment using scores such as CHA2DS2-VA, even in atypical cases, ensuring that management strategies are tailored to each patient’s risk profile.
Ex vivo imaging of subacute myocardial infarction with ultra-short echo time 3D quantitative T1- and T1ρ-mapping magnetic resonance imaging in mice
Authors: Räty Iida , Aarnio Antti , Nissi Mikko J , Kettunen Sanna , Ruotsalainen Anna-Kaisa , Laidinen Svetlana , Ylä-Herttuala Seppo , Ylä-Herttuala Elias 
Published: December 2024

Abstract

Aims
The aim of this study was to develop an ultra-short echo time 3D magnetic resonance imaging (MRI) method for imaging subacute myocardial infarction (MI) quantitatively and in an accelerated way. Here, we present novel 3D T1- and T1ρ-weighted Multi-Band SWeep Imaging with Fourier Transform and Compressed Sensing (MB-SWIFT-CS) imaging of subacute MI in mice hearts ex vivo.

Methods and results
Relaxation time–weighted and under-sampled 3D MB-SWIFT-CS MRI were tested with manganese chloride (MnCl2) phantom and mice MI model. MI was induced in C57BL mice, and the hearts were collected 7 days after MI and then fixated. The hearts were imaged with T1 and adiabatic T1ρ relaxation time–weighted 3D MB-SWIFT-CS MRI, and the contrast-weighted image series were estimated with a locally low-rank regularized subspace constrained reconstruction. The quantitative parameter maps, T1 and T1ρ, were then obtained by performing non-linear least squares signal fitting on the image estimates. For comparison, the hearts were also imaged using 2D fast spin echo-based T2 and T1ρ mapping methods. The relaxation rates varied linearly with the MnCl2 concentration, and the T1 and T1ρ relaxation time values were elevated in the damaged areas. The ischaemic areas could be observed visually in the 3D T1, 3D T1ρ, and 2D MRI maps. The scar tissue formation in the anterior wall of the left ventricle and inflammation in the septum were confirmed by histology, which is in line with the results of MRI.

Conclusion
MI with early fibrosis, increased inflammatory activity, and interstitial oedema were determined simultaneously with T1 and T1ρ relaxation time constants within the myocardium by using the 3D MB-SWIFT-CS method, allowing quantitative isotropic 3D assessment of the entire myocardium.
Acute cardiovascular effects of electronic cigarettes: a systematic review and meta-analysis
Authors: Cheraghi Mahdis , Amiri Mehrnaz , Omidi Fatemeh , Shahidi Bonjar Amir Hashem , Bakhshi Hooman , Vaezi Atefeh , Nasiri Mohammad Javad , Mirsaeidi Mehdi 
Published: December 2024

Abstract
Electronic cigarette (EC) is widely advertised as a safe alternative to traditional cigarette (TC). We aimed to investigate the cardiovascular effect of EC with/without nicotine compared with TC. We systematically searched PubMed/MEDLINE, EMBASE, and Cochrane CENTRAL for randomized controlled trials that compared the effect of different smoking modalities on cardiovascular function up to 1 October 2024. Analysis used the weighted mean difference (WMD) with a 95% confidence interval (CI) via Comprehensive Meta-Analysis software, version 3.0. The study evaluated key cardiovascular parameters, including pulse wave velocity (PWV), augmentation index at 75 beats/min (AIx75), flow-mediated dilation (FMD), heart rate (HR), systolic blood pressure, and diastolic blood pressure. We analysed 9 trials involving 370 participants. Acute exposure to EC with nicotine (ECN) compared with nicotine-free EC (EC0) increased PWV (WMD = 0.26; 95% CI: 0.14–0.38, P &lt; 0.001), AIx75 (WMD = 4.29; 95% CI: 2.07–6.51, P &lt; 0.001), and HR (WMD = 5.06; 95% CI: 2.13–7.98, P = 0.001), significantly. In contrast, comparison between ECN and TC revealed no significant differences in FMD (WMD = 0.80; 95% CI: −0.09–1.70, P = 0.08). Our meta-analysis suggests that ECN acutely increases arterial stiffness more than EC0 does. Additionally, we found that the acute effect of ECN on endothelial dysfunction is not different from TC. Therefore, our study suggests that vaping cannot be considered as a safe substitute for TC. Further investigation is needed to explore the long-term cardiovascular effects of vaping and its modalities.
A new clinical index scale for measuring secondary alveolar bone grafting success based on canine eruption
Authors: Rivers Clare M , Grant Jaime , McIntyre Grant , Devlin Mark F D , Russell Craig J H , Gillgrass Toby 
Published: December 2024

Abstract

Objectives
To develop a reproducible, reliable clinical index of alveolar bone grafting (ABG) outcome based on the eruption position of the cleft canine tooth and determine the association between eruption position and radiographic outcome at 6 months post-grafting.

Methods
Children with complete, non-syndromic, unilateral/bilateral cleft lip and palate in the West of Scotland were identified. Post-ABG radiographic outcome (Kindelan index) and canine eruption position in children with a cleft of the alveolus who had undergone ABG were documented. A Kindelan score was assigned to the 6-month post-bone-graft radiograph. Following canine tooth eruption, four-point clinical index scale (CIS) scores were assigned to maxillary occlusal images taken prior to commencement of definitive orthodontics; 1—canine eruption in alveolar crest, 2—canine eruption buccal to alveolar crest, 3—canine eruption palatal to alveolar crest, and 4—canine impaction. Intra and inter-rater reliability was assessed using Cohen and Fleiss kappa’s, respectively. Duration of orthodontics treatment, number of orthodontic clinic visits, and clinical management of the cleft site space were noted.

Results
Eighty-three patients representing 98 bone graft sites were identified. CIS scoring intra- and inter-rater reliability was 0.69–0.99 and 0.63–0.75, respectively. CIS score was associated with reduced visits (P = .015), months in orthodontics (P = .009), and likelihood of space closure (P = .006).

Limitations
This is a retrospective study with small numbers but is comparative to other similar studies in the literature.

Conclusions
The CIS presented appears to be a reliable index of ABG outcome. It also demonstrates an association with the burden of orthodontic care post-cleft alveolar bone graft.