bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paraconduit hiatus hernia after esophageal cancer surgery: incidence, risk factors, and management
Authors: Ahmed Rakesh , Elliott Jessie A , Blaser Marcelle , Donohoe Claire L , Ravi Narayanasamy , Reynolds John V 
Published: October 2024

Summary
In parallel with improved operative and oncologic outcomes for esophageal cancer, paraconduit hiatus hernia (PHH) is an increasingly recognized entity, both in the early postoperative phase and in long-term follow-up. The aim of this study was to assess the incidence of and risk factors for PHH, and to describe management approaches in a tertiary referral center. All patients undergoing surgery with curative intent for esophageal cancer from 2008 to 2022 at a single center were included. Early PHH was defined as occurring within three months of index surgery, with all other cases defined as late PHH. Surveillance computed tomography scans were undertaken among all disease-free patients to 5 years postoperatively. Kaplan Meier and Cox proportional hazards regression models were used to determine independent risk factors for PHH. Overall, 897 patients were studied. Totally, 62 patients (6.9%) developed PHH during follow-up. The 5-year survival-adjusted incidence of PHH was 9.7%. PHH was an asymptomatic radiologic finding in 45.5% of early and 84.3% of late cases (P = 0.070). Surgical intervention was required in 16 cases (25.8%), more commonly following early (63.6%) as compared with late PHH (17.6%, P &lt; 0.01). Younger age (P &lt; 0.039), initial transhiatal operative approach (P &lt; 0.006) and extended resection of the crura (P &lt; 0.001) were independently associated with increased risk of PHH on multivariable analysis. PHH was identified in almost 1 in 10 patients using surveillance imaging in long-term follow-up, independently associated with the transhiatal surgical approach and resection of crura, which raises consideration of prevention strategies. Surgical intervention is often required for patients with PHH presenting early after surgery, but many patients presenting with late PHH may be managed expectantly.
Maternal mitochondrial DNA copy number and methylation as possible predictors of pregnancy outcomes in a Michigan pregnancy cohort
Authors: Cinzori Maria E , Nicol Megan , Dewald Alisa L , Goodrich Jaclyn M , Zhou Zheng , Gardiner Joseph C , Kerver Jean M , Dolinoy Dana C , Talge Nicole , Strakovsky Rita S 
Published: October 2024

Abstract
Little is understood about the roles of mitochondria in pregnancy-related adaptations. Therefore, we evaluated associations of maternal early-to-mid pregnancy mitochondrial DNA copy number (mtDNAcn) and mtDNA methylation with birth size and gestational length. Michigan women (n = 396) provided venous bloodspots at median 11 weeks gestation to quantify mtDNAcn marker NADH-ubiquinone oxidoreductase chain 1 (ND1) using real-time quantitative PCR and mtDNA methylation at several regions within four mitochondria-specific genes using pyrosequencing: MTTF (mitochondrially encoded tRNA phenylalanine), DLOOP (D-loop promoter region, heavy strand), CYTB (cytochrome b), and LDLR (D-loop promoter region, light strand). We abstracted gestational length and birthweight from birth certificates and calculated birthweight z-scores using published references. We used multivariable linear regression to evaluate associations of mtDNAcn and mtDNA methylation with birthweight and birthweight z-scores. Cox Proportional Hazards Models (PHMs) and quantile regression characterized associations of mitochondrial measures with gestational length. We also considered differences by fetal sex. Using linear regression and Cox PHMs, mtDNAcn was not associated with birth outcomes, whereas associations of mtDNA methylation with birth outcomes were inconsistent. However, using quantile regression, mtDNAcn was associated with shorter gestation in female newborns at the upper quantiles of gestational length, but with longer gestational length in males at the lower quantiles of gestational length. Maternal LDLR, DLOOP, and MTTF methylation was associated with longer gestational length in females at the upper quantiles and in males at lower gestational length quantiles. Maternal mtDNAcn and mtDNA methylation were associated with gestational length in babies born comparatively early or late, which could reflect adaptations in mitochondrial processes that regulate the length of gestation.
Challenges posed by climate hazards to cardiovascular health and cardiac intensive care: implications for mitigation and adaptation
Authors: Münzel Thomas , Khraishah Haitham , Schneider Alexandra , Lelieveld Jos , Daiber Andreas , Rajagopalan Sanjay 
Published: October 2024

Abstract
Global warming, driven by increased greenhouse gas emissions, has led to unprecedented extreme weather events, contributing to higher morbidity and mortality rates from a variety of health conditions, including cardiovascular disease (CVD). The disruption of multiple planetary boundaries has increased the probability of connected, cascading, and catastrophic disasters with magnified health impacts on vulnerable populations. While the impact of climate change can be manifold, non-optimal air temperatures (NOTs) pose significant health risks from cardiovascular events. Vulnerable populations, especially those with pre-existing CVD, face increased risks of acute cardiovascular events during NOT. Factors such as age, socio-economic status, minority populations, and environmental conditions (especially air pollution) amplify these risks. With rising global surface temperatures, the frequency and intensity of heatwaves and cold spells are expected to increase, emphasizing the need to address their health impacts. The World Health Organization recommends implementing heat–health action plans, which include early warning systems, public education on recognizing heat-related symptoms, and guidelines for adjusting medications during heatwaves. Additionally, intensive care units must be prepared to handle increased patient loads and the specific challenges posed by extreme heat. Comprehensive and proactive adaptation and mitigation strategies with health as a primary consideration and measures to enhance resilience are essential to protect vulnerable populations and reduce the health burden associated with NOTs. The current educational review will explore the impact on cardiovascular events, future health projections, pathophysiology, drug interactions, and intensive care challenges and recommend actions for effective patient care.
Prognostic and therapeutic implications of a low aortic valve calcium score in patients with low-gradient aortic stenosis
Authors: Juhász D , Vecsey-Nagy M , Jermendy Á L , Szilveszter B , Simon J , Vattay B , Boussoussou M , Dávid D , Maurovich-Horvát P , Merkely B , Apor A , Molnár L , Dósa E , Rakovics M , Johnson J , Manouras A , Nagy A I 
Published: October 2024

Abstract

Aims
Low-gradient (LG) aortic stenosis (AS) poses a diagnostic challenge. Aortic valve calcium score (AVCS) assessment has emerged as a complementary diagnostic method when echocardiography provides discordant results. However, the diagnostic and prognostic values of AVCS in LGAS have not been thoroughly studied. Our aims in this study were to investigate the prognostic importance of AVCS in LGAS and to assess whether symptomatic patients with LGAS and low AVCS may benefit from aortic valve intervention (AVI).

Methods and results
A total of 327 symptomatic patients (78.5 ± 7.3 years, 51% women) with severe AS defined by the aortic valve area who underwent computed tomography for transcatheter aortic valve intervention (TAVI) planning were enrolled. AVCS was measured. AVCS &lt; 2000AU in men and &lt; 1200 AU in women was considered a low AVCS. A total of 243 patients had high gradient (HG) and 84 had LGAS. A low AVCS was present in 25 (10%) patients with HG and 34 (40%) with LGAS. Over a median follow-up period of 4.9 years, 194 deaths occurred. In multivariate analysis, AVCS was a significant independent predictor of all-cause mortality among patients with HGAS [adjusted hazard ratio (aHR): 2.317; CI: 1.104–4.861; P = 0.026] but not among those with LGAS (aHR: 0.848; CI: 0.434–1.658; P = 0.630). After propensity score matching between patients who underwent AVI and those who were medically treated, AVI (94% TAVI) was a significant and independent predictor of survival among LGAS patients with a low AVCS even after adjustment for clinical variables (aHR: 0.102, CI: 0.028–0.369; P &lt; 0.001).

Conclusion
The prevalence of a low AVCS is much higher in patients with LGAS than in those with HGAS. In patients with symptomatic severe LGAS, a low AVCS does not entail a better prognosis. AVI is equally beneficial in LGAS patients with a high or low AVCS, similarly to those with HGAS.
The Creation of State Anniversaries: James VI and I and the Politics of Thanksgiving
Authors: Williamson Philip , Mears Natalie 
Published: October 2024

Abstract
Religious anniversaries ordered by the state—by the monarch, royal council or parliament—were observed in England and Ireland from the seventeenth to the nineteenth centuries. These have been studied chiefly as occasions for special sermons and popular festivities, the expression of English or Irish Protestant national identity, or the pursuit of party controversies. But examination of both the original establishment of state anniversaries by James VI and I, with three appointed during the short period from 1600 to 1605, and the principal documents published for these occasions, the orders and the forms of prayer, brings different perspectives. The anniversaries were British in scope. The first was originally ordered in Scotland, where James developed a politics of thanksgiving that he subsequently re-applied in England and Wales, with anniversaries which were later duplicated in Ireland. The king’s immediate purposes were to assist the management of political and ecclesiastical difficulties, and to advance a closer union of his Scottish and English kingdoms. His long-term aim was to increase the authority and the godly claims of the Stuart dynasty. This promotion of a divine-right British monarchy remained central to the special English and Irish church services which were conducted each year during the following centuries. In so far as the anniversaries came to be concerned with national identities or party causes, these were in tension with the texts and meanings of their religious services.
Finite element analysis and computational fluid dynamics to elucidate the mechanism of distal stent graft-induced new entry after frozen elephant trunk technique
Authors: Morodomi Shinri , Okamura Homare , Ujihara Yoshihiro , Sugita Shukei , Nakamura Masanori 
Published: October 2024

Abstract

OBJECTIVES
Distal stent graft-induced new entry (dSINE), a new intimal tear at the distal edge of the frozen elephant trunk (FET), is a complication of FET. Preventive measures for dSINE have not yet been established. This study aimed to clarify the mechanisms underlying the development of dSINE by simulating the mechanical environment at the distal edge of the FET.

METHODS
The stress field in the aortic wall after FET deployment was calculated using finite element analysis. Blood flow in the intraluminal space of the aorta and FET models was simulated using computational fluid dynamics. The simulations were conducted with various oversizing rates of FET ranging from 0 to 30% under the condition of FET with elastic recoil.

RESULTS
The elastic recoil of the FET, which caused its distal edge to push against the greater curvature of the aorta, induced a concentration of circumferential stress and increased wall shear stress (WSS) at the aorta. Elastic recoil also created a discontinuous notch on the lesser curvature of the aorta, causing flow stagnation. An increase in the oversizing rate of the FET widened the large circumferential stress area on the greater curvature and increases the maximum stress. Conversely, a decrease in the oversizing rate of the FET increased the WSS and widened the area with high WSS.

CONCLUSIONS
Circumferential stress concentration due to an oversized FET and high WSS due to an undersized FET can cause a dSINE. The selection of smaller-sized FET alone might not prevent dSINE.
The Elderly Bias of the Spanish Welfare State (1958–2012)
Authors: Souto Guadalupe , Herranz-Loncán Alfonso , Espuelas Sergio , Abio Gemma , Patxot Ció 
Published: October 2024

Abstract
The Spanish welfare state is strongly biased toward sustaining the elderly’s welfare, rather than children’s. We study the evolution of that bias since 1958 through National Transfer Accounts (NTA). NTA disentangle how people produce, consume, and save along their life cycle, and how resources move among generations through different mechanisms (families, markets, and governments). We extend the available NTA (2000–2012) to the past and show that Spanish social policies were biased toward the elderly since their early stages. The gradual increase in social expenditure and the aging of Spanish society have turned such bias into a serious challenge for the economy.
The inflammatory and oxidative phenotype of gestational diabetes is epigenetically transmitted to the offspring: role of methyltransferase MLL1-induced H3K4me3
Authors: Di Pietrantonio Nadia , Sánchez-Ceinos Julia , Shumliakivska Mariana , Rakow Alexander , Mandatori Domitilla , Di Tomo Pamela , Formoso Gloria , Bonfini Tiziana , Baldassarre Maria Pompea Antonia , Sennström Maria , Almahmeed Wael , Pandolfi Assunta , Cosentino Francesco 
Published: October 2024

Abstract

Background and Aims
Hyperglycaemia during gestational diabetes (GD) predisposes women and their offspring to later cardiometabolic disease. The hyperglycaemia-mediated epigenetic changes remain to be elucidated. Methyltransferase MLL1-induced trimethylation of histone 3 at lysine 4 (H3K4me3) activates inflammatory and oxidative phenotype. This epigenetic mark in GD women and its transmission to the offspring were investigated.

Methods
Peripheral blood mononuclear cells (PBMC) were collected from GD and control (C) women and also from adolescents born to women of both groups. Endothelial human umbilical vein endothelial cells (HUVEC) and cord blood mononuclear cells (CBMC) were from umbilical cords. The NF-κBp65 and NOX4 expressions were investigated by reverse transcription quantitative polymerase chain reaction and immunofluorescence (IF). MLL1 and H3K4me3 were investigated by immunoblotting and IF. H3K4me3 on NF-κBp65 and NOX4 promoters was studied by chromatin immunoprecipitation. Superoxide anion generation was measured by electron spin resonance spectroscopy. Plasma cytokines were measured by enzyme-linked immunosorbent assay. To investigate the role of MLL1, HUVEC were exposed to inhibitor MM102 or siRNA transfection.

Results
PBMC, CBMC, and HUVEC showed an increase of NF-κBp65, IL-6, ICAM-1, MCP-1, and VCAM-1 mRNAs. These findings were associated with H3K4me3 enrichment in the promoter of NF-κBp65. Elevated H3K4me3 and cytokine levels were observed in GD adolescents. MLL1 drives H3K4me3 not only on NF-kB p65, but also on NOX4 promoter. Inhibition of MLL1 blunted NF-κBp65 and NOX4 by modulating inflammatory and oxidative phenotype.

Conclusions
Such proof-of-concept study shows persistence of MLL1-dependent H3K4me3 in offspring born to GD women, suggesting an epigenetic-driven transmission of maternal phenotype. These findings may pave the way for pharmacological reprogramming of adverse histone modifications to mitigate abnormal phenotypes underlying early ASCVD.
Common misconceptions of speciation
Authors: Walker Jonah M , van der Heijden Eva S M , Maulana Arif , Rueda-M Nicol , Näsvall Karin , Salazar Patricio A , Meyer Marco , Meier Joana I 
Published: October 2024

Abstract
Speciation is a complex process that can unfold in many different ways. Speciation researchers sometimes simplify core principles in their writing in a way that implies misconceptions about the speciation process. While we think that these misconceptions are usually inadvertently implied (and not actively believed) by the researchers, they nonetheless risk warping how external readers understand speciation. Here we highlight six misconceptions of speciation that are especially widespread. First, species are implied to be clearly and consistently defined entities in nature, whereas in reality species boundaries are often fuzzy and semipermeable. Second, speciation is often implied to be ‘good’, which is two-fold problematic because it implies both that evolution has a goal and that speciation universally increases the chances of lineage persistence. Third, species-poor clades with species-rich sister clades are considered ‘primitive’ or ‘basal’, falsely implying a ladder of progress. Fourth, the evolution of species is assumed to be strictly tree-like, but genomic findings show widespread hybridization more consistent with network-like evolution. Fifth, a lack of association between a trait and elevated speciation rates in macroevolutionary studies is often interpreted as evidence against its relevance in speciation—even if microevolutionary case studies show that it is relevant. Sixth, obvious trait differences between species are sometimes too readily assumed to be (i) barriers to reproduction, (ii) a stepping-stone to inevitable speciation, or (iii) reflective of the species’ whole divergence history. In conclusion, we call for caution, particularly when communicating science, because miscommunication of these ideas provides fertile ground for misconceptions to spread.
Phylogenomic and anatomical evidence for the Late Cretaceous diversification of African characiform fishes, including a new family, under the influence of the Trans-Saharan Seaway
Authors: Melo Bruno F , Stiassny Melanie L J 
Published: October 2024

Abstract
Geological evidence supports the occurrence of an epicontinental Trans-Saharan Seaway bisecting the African continent during the Late Cretaceous to early Palaeogene. The seaway formed a wide saltwater channel connecting the Neotethys with the South Atlantic, yet no previous study has investigated its impact on freshwater fish diversification. Phylogenomic data and time-calibrated trees indicate a Late Cretaceous signature for the appearance of three modern lineages of characiform fishes. Phylogenetic analyses using ultraconserved elements of 83 characiforms reveal that Alestidae, Hepsetus, and Lepidarchidae fam. nov. originated during the Santonian–Campanian of the Late Cretaceous (84–77.5 Mya). Lepidarchidae consists of two monotypic taxa not previously recognized as sister species: the Niger tetra Arnoldichthys endemic to the lower Niger and Ogun rivers of Nigeria, and the dwarf jellybean tetra Lepidarchus from coastal rivers of Ghana, Côte d’Ivoire, Liberia, Sierra Leone, and Guinea. Microcomputed tomography scans of 117 characiforms provide three novel morphological characters supporting Hepsetus and Lepidarchidae, four characters for the monophyly of Lepidarchidae, and five for a restricted Alestidae. The Santonian–Campanian divergence indicates allopatric speciation processes influenced by the Trans-Saharan Seaway, partitioning the African ichthyofauna in a west–east orientation. The timing for African characiform cladogenesis aligns with the Cenomanian fossil record and is ~16–23 Myr younger than the earliest characiform-like fossils from Late Cretaceous outcrops of Morocco and Sudan. This study highlights the magnitude of Cretaceous transgression events shaping the freshwater biota and gaps in our understanding of the evolutionary history and palaeobiogeography of ray-finned fishes across the African continent.
Representing the Needs of Rural Caregivers of People Living With Alzheimer’s Disease and Related Dementias Through User Personas
Authors: Jolliff Anna , Hill Jordan R , Zuraw Matthew , Elliott Christian , Werner Nicole E 
Published: October 2024

Abstract

Background and Objectives
Rural caregivers of people living with Alzheimer’s disease and related dementias (ADRD) face unique caregiving challenges. Current interventions do not address many of the systemic barriers experienced by rural ADRD caregivers, including barriers related to geography, healthcare services access, and financial insecurity. The objective of this study was to gain a deeper understanding of rural ADRD caregivers’ needs, strengths, and strategies in obtaining caregiving support, and to represent these attributes in the form of personas that can be used to design interventions for rural ADRD caregivers.

Research Design and Methods
In this qualitative user-centered design study, we conducted semistructured interviews with self-identified caregivers of people living with ADRD in rural areas. Interview data was copied to a virtual whiteboard, and affinity diagramming was used to confirm a priori attributes and yield inductive attributes relevant to rural ADRD caregivers. Attributes were assigned to personas, which were then validated through team-based discussion, consultation with a study advisory board, and review by rural caregivers and community partners.

Results
Analyses of N = 19 interviews yielded 7 inductive attributes relevant to rural ADRD caregivers of persons living with ADRD and 5 distinct personas: Capable Christine, Connected Connie, Isolated Irene, Learning Larry, and Discerning Dan. Personas differed on inductive attributes including financial security, subjective rurality, attitudes, connectedness, and information behavior, including preferences for traditional versus technology-based information seeking.

Discussion and Implications
The personas identified in the present study can be used as tools to represent and efficiently communicate the intersection and interaction of attributes relevant to designing interventions and technologies to meet the support needs of rural ADRD caregivers.
Fostering collective action for adolescent well-being: citizen science in a Colombian semi-rural area
Authors: Guerra Ana María , De La Vega-Taboada Eduardo , Sarmiento Olga L , Banchoff Ann , King Abby C , Stephens Dionne , Revollo Luis D , Revollo Ana P , Montes Felipe 
Published: October 2024

Abstract
We present findings from the Our Voice in Barú project, examining adolescent engagement in citizen science to address environmental and social factors affecting well-being in a semi-rural Afro-descendant community in Latin America. The project aimed to identify barriers and enablers of well-being, informing adolescent-led actions for sustainable environmental changes relevant to adolescent health. Utilizing the Our Voice citizen science method, which involved technology-enabled walks, participatory cartography workshops and community meetings, we engaged adolescents and other community members. Complex systems framework was employed to analyze results and assess the promotion of collective action and local change. Local enablers of well-being included availability of quality sports and recreational venues as safe spaces, educational settings and cultural aspects, fostering safety, community pride, and personal growth. Conversely, barriers included environmental contamination, deteriorated sports venues and drug addiction, indicating the community’s limited access to services and exposure to harmful substances. Adolescent citizen scientists, in partnership with the research team and relevant community decision-makers, successfully achieved changes aimed at identified barriers, including infrastructural enhancements like the repair of pumps to remove stagnant water, improvements in the quality and safety of recreational venues, and the implementation of community-led initiatives to address substance abuse and promote healthier behaviors. The Our Voice in Barú project empowered adolescents to advocate for change and promoted collective action to tackle barriers identified as significant to their well-being.