bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early‐Life Risk Factors and Clinical Features of Food Allergy Among Thai Children
Authors: Thongsukkaeo Samkhwan , Suksawat Yiwa 
Published: October 2024

Background: Food allergy affects 1%–10% of children under five worldwide, with genetic and early‐life factors playing a primary role. Reported factors include a family history of allergic diseases, personal atopic dermatitis, cesarean section, dietary restrictions during pregnancy and lactation, and the timing of introducing solid foods. This study was aimed at identifying various factors associated with food allergy and evaluate each food allergy’s clinical features.Methods: We conducted a case–control study with a participant ratio of 1:2 between cases and controls. Data were gathered from both groups of participants, and questionnaires included living area, sex, and natal history (birth details, maternal diet during pregnancy and breastfeeding, feeding history during infancy, family history of atopic diseases, and household smoking).Results: All 72 cases with food allergy and 145 controls were included in the study. Term birth comprised a protective factor for developing food allergy (adjusted odds ratio [aOR] 0.213, p value 0.022). In contrast, personal atopic dermatitis (aOR 20.097, p value 0.001) and a family history of allergic disease constituted risks (aOR 3.183, p value 0.002). Food allergy was unrelated to cesarean section, low birth weight, dietary restrictions during lactation and pregnancy, exclusive breastfeeding, or the early introduction of complementary foods. The three most common food allergens were egg white (40.2%), wheat (34.7%), and cow’s milk (30.5%), respectively.Conclusions: In this study, risk factors associated with food allergy comprised a personal history of atopic dermatitis and a family allergic disease, which may be used as predictive factors for developing food allergy among Thai children.
The Efficacy and Safety of Low‐Intensity Pulsed Ultrasound Therapy for the Treatment of Peyronie’s Disease (A Report of 106 Cases): A Retrospective Study
Authors: Yu Lei , Pan Yu , Wang Hongqiang , Guo Xiaojing , Fu Ling , Wang Peitao , Gao Yaowu , Jing Shaoping , Li Shenqian , Zhang Kaishu , Li Qiang , Wang Hanshu , Jing Tao 
Published: October 2024

Objective: To evaluate the efficacy and safety of low‑intensity pulsed ultrasound (LIPUS) for the treatment of Peyronie’s disease (PD).Methods: To analyze the treatment effect of 106 PD patients, 56 patients treated with LIPUS as therapy group and 50 patients with oral L‐carnitine and vitamin E as control group. 56 patients were treated with LIPUS three times per week for four consecutive weeks (12 times totally). Penile erectile pain, erectile function, the size of penile plaques, and penile curvature were assessed for all of these 106 PD patients before treatment and at 4‐ and 24‐week follow‐ups to evaluate the treatment effect. Erectile pain was assessed by visual analog scale (VAS), while erectile function using the International Index of Erectile Function scale (IIEF‐5), and penile plaque size was measured by ultrasound. After alprostadil was injected into the penile body to induce a full erection, the penis was measured with a protractor at the maximum bending degree.Results: After 4‐weeks follow‐up, the VAS scores of the LIPUS group were significantly lower than the baseline (P < 0.01), while no significant differences were found in the control group (P > 0.05). After 24‐weeks follow‐up, the VAS scores of the control group reduced significantly but also were significantly higher than the LIPUS group (P < 0.01). The IIEF‐5 scores of the LIPUS group were significantly higher than the baseline (P < 0.01). While the IIEF‐5 scores of the control group showed no significant differences both after 4‐ and 24‐weeks follow‐up (P > 0.05). The penile plaque size showed no significant differences after 4‐ and 24‐weeks follow‐up both in the LIPUS group and the control group (P > 0.05). The penile curvature degrees showed a significant reduction after 4‐weeks follow‐up in LIPUS group (P < 0.01). While the penile curvature degrees of the control group showed no significant differences both after 4‐ and 24‐weeks follow‐up (P > 0.05). No complications, such as penile pain, hematoma, or skin ecchymosis, were observed during the entire process of LIPUS treatment, nor did they appear during follow‐up.Conclusions: In patients with acute PD, LIPUS could relieve erectile pain and improve erectile dysfunction. Moreover, it appears not to reduce plaque size and not to have a clinically significant effect on penile curvature. Furthermore, LIPUS also shows a good safety profile during the management of PD and should be recommended for the clinical management of PD.
Vascular Complications and Bleeding After Transfemoral TAVR With Surgical Versus Percutaneous Approach: A Contemporary Prospective Study
Authors: Dardaillon Annick Astié , Akodad Mariama , Huet Fabien , Meunier Pierre Alain , Gandet Thomas , Macia Jean-Christophe , Schmutz Laurent , Targosz Frederic , Roubille François , Steinecker Matthieu , Lattuca Benoit , Robert Pierre , Berdeu Jean-Michel , Cayla Guillaume , Leclercq Florence 
Published: October 2024

Background: Percutaneous (PC) access has become the first‐line strategy for transfemoral (TF) transcatheter aortic valve replacement (TAVR), but surgical cutdown (SC) may be required in selected and usually challenging cases. We aimed to compare the efficacy and safety of SC versus echo‐guided PC approach in TF TAVR.Methods: Between November 2019 and December 2020, all patients undergoing TF TAVR were included in a prospective study. The choice of PC or SC strategy was left at operators’ discretion, according to predictable access site difficulties. The primary endpoint included all vascular complications (VCs) and all bleeding at 1‐month follow‐up according to Valve Academic Research Consortium‐2 criteria.Results: Among 225 patients, 166 (73.8%) and 59 (26.2%) underwent PC or SC approach, respectively. Median age was 82 years, EuroSCORE 2 was higher (p = 0.02), and peripheral arterial disease (p < 0.001) was more common in the SC group. Femoral access was successful in 100% in the SC group vs 97.6% in the PC group (p = 0.2). The primary endpoint was reached in 32 patients (14.2%), 5 (8.4%) in the SC group and 27 (16.2%) in the PC group (p = 0.1) with low incidence of major VC in both groups (1.7% vs 3% in the SC and PC groups respectively, p = 0.6).Conclusion: Despite a higher risk profile of patients in the SC group, SC and PC approaches appear safe and effective in TF TAVR, with a high success rate. SC may be considered when vascular access is anticipated as complex, but this strategy might be confirmed in a randomized study.Trial Registration: ClinicalTrials.gov identifier: NCT03865043
Structural Neuroimaging and Molecular Signatures of Drug‐Naive Depression With Melancholic Features
Authors: Yuan Lijin , Chu Zhaosong , Chen Xianyu , He Mengxin , Lu Yi , Xu Xiufeng , Shen Zonglin 
Published: October 2024

Objectives: Melancholic depression (MD) is a common subtype of major depressive disorder (MDD). It is difficult to treat because its neurobiological basis is poorly understood. Therefore, to investigate whether MD patients have any structural changes in gray matter (GM) and the molecular foundation of these changes, we combined voxel‐based morphometry (VBM) analysis with neurotransmitter system‐derived mapping from public data.Methods: 137 drug‐naive MDD patients and 75 healthy controls (HCs) were recruited for structural magnetic resonance imaging. The imaging results were analyzed using VBM analysis. MDD patients were then divided into MD and nonmelancholic depression (NMD) subgroups according to their scores on the Montgomery–Asberg Depression Rating Scale (MADRS) and the Hamilton Depression Rating Scale. Next, we analyzed the spatial correlation between the changes in the gray matter volume (GMV) maps and the neurotransmitter receptor/transporter protein density maps provided by the JuSpace toolbox.Results: Compared to HCs, patients with MD had significant GMV reduction in the bilateral hippocampus, bilateral thalamus, right amygdala, and right posterior cingulate cortex (PCC)/precuneus. Compared to patients with NMD, MD patients had significant GMV reduction in the bilateral PCC/precuneus and lateral occipital cortex. Moreover, compared to HCs, changes in GMV introduced by MD were spatially associated with the serotonin transporter, cannabinoid receptor, and μ‐opioid receptor. Compared to NMD patients, changes in GMV introduced by MD were spatially associated with the vesicular acetylcholine transporter.Conclusion: The present study discovered abnormal GMV alterations in patients with subtypes of depression. We also found a series of neurotransmitter receptors that may be associated with the alterations. The findings of the current study may provide a more comprehensive understanding of the molecular mechanisms underlying the structural abnormalities in subtypes of depression and potentially offer new insights into developing new therapeutic strategies.
Abstract MP36: Excessive ATP Promotes Hypertension Via Stimulating T cells
Authors: Liu Yunmeng 
Published: October 2024

While CD8+ T cells (CD8Ts) have recently emerged as key players in hypertension, the precise mechanisms underlying their involvement remain incompletely understood. We reported previously that CD8T-activation is critical in initiating their direct interaction with renal tubules. Here, we discovered that CD8T activation in hypertension occurs in an antigen-independent manner. In this study, we delve into the contribution of the P2X7 receptor to CD8T activation and its subsequent promotion of hypertension.
To investigate whether CD8T activation in hypertension necessitates T cell receptor (TCR) stimulation, we employed Rag2/OT1 mice, which exclusively harbor transgenic OT1 CD8Ts, recognizing only ovalbumin peptides but no other antigens. These mice, without any exposure to ovalbumin, were induced hypertension through the DOCA + salt (DOCA) model. Blood pressure was monitored using biotelemetry, and CD8T activation was confirmed using flow cytometry. In our in-vitro studies, CD8Ts were obtained from WT or P2X7-KO mice and stimulated with ATP. The endpoints include calcium influx and cytokine production as indicators of activation. Moreover, we measured the activation profiles of CD8Ts obtained from WT or P2X7-KO mice subjected to sham or DOCA treatment using RT-PCR and flow cytometry. Additionally, we conducted an adoptive transfer experiment, transferring naive WT CD8Ts to P2X7-KO mice undergoing DOCA treatment.
We found that CD8Ts from Rag2/OT1 mice become activated in response to the DOCA pressor, leading to increased IFNγ production and contributing to salt-sensitive hypertension, even in the absence of TCR-mediated antigen stimulation. Furthermore, ATP elicited calcium influx in CD8Ts via P2X7, thereby upregulated IFNγ production. In addition, CD8Ts pre-treated with ATP exhibited a higher ability to stimulate sodium retention in co-cultured renal tubule epithelial cells compared to those co-cultured with naive CD8Ts. Notably, DOCA-treated P2X7 KO CD8Ts were unable to induce an increase in blood pressure in our adoptive transfer model. However, transferring sham WT CD8Ts to DOCA-treated P2X7 KO mice successfully restored hypertension to WT levels.
Our findings reveal a novel mechanism by which ATP/P2X7 signaling leads to activation of CD8Ts as the culprit to the pathogenesis of hypertension. As such, the CD8T P2X7 receptor presents itself as a promising target for improving blood pressure management.
Abstract P202: Excess of anything is detrimental - unraveling role of multiple accessory renal arteries in Pickering syndrome.
Authors: Harris Liliia , Zahid Zaid , Bains Nimrat 
Published: October 2024

Flash pulmonary edema (FPE) appears to be more common in patients with bilateral renal artery stenosis (RAS) as compared to those with unilateral disease. The combination of bilateral RAS and recurrent FEP has been named the Pickering syndrome. Here, we present a case of Pickering syndrome caused by unilateral RAS in combination with multiple accessory renal arteries (ARA). To our knowledge, this case marks the inaugural report within the literature.
A 68-year-old woman presented to ER with her third episode of FPE in two months, accompanied by hypertensive emergency, BP 232/127 mmHg.
Initial evaluation, including laboratory tests and RA ultrasound, showed no abnormalities. However, a CTA of the abdomen revealed a single heavily calcified L main RA with severe atherosclerosis extending into the lumen of the aorta and the proximal L main RA. Three RAs supply R kidney with questionable stenosis of superior, smaller R RA. Atherosclerotic plaque is present at the origin of the inferior R RA, but no definitive significant stenosis is detected.
Unilateral RAS and multiple ARAs were suspected to cause HTN and FPE. An aortogram with possible RA stenting was recommended by vascular surgery. It confirmed > 75% stenosis in the L RA, prompting stent deployment. However, no significant stenosis was observed in R ARAs.
Post-procedure BP control was achieved with a single agent.
FPE is a life-threatening syndrome. Cardiac systolic or diastolic dysfunctions usually accompany it. Recurrent FPE due to bilateral RAS was described by Pickering et al. in 1988. Although its exact mechanism is not completely understood, it is believed to result from excessive fluid volume due to decreased sodium excretion. A similar mechanism was proposed in RAS in a single functional kidney.
Could the presence of an ARA mimic the pathophysiology of RAS?
It has been theorized that an ARA may lead to HTN due to reduced blood flow to the kidney, caused by its longer and narrower caliber, which increases resistance and may lead to stenosis. The Poiseuille equation, rearranged to R=8μL/ΔPπR4 (where R=resistance, μ=viscosity, L=vessel's length, P=pressure, R=vessel's radius), suggests that both the radius and the length of ARAs may play a role in our patient's condition. In summary, ARAs are a common anatomical variation, and depending on their specific characteristics, they may contribute to resistant HTN and FPE through renin-dependent hyperaldosteronism.
Abstract P215: The reninness score: integrative analysis of multi-omic data to define renin cell identity.
Authors: xue bingjie , Medrano Silvia , Smith Jason , Martini Alexandre , Sequeira Maria Luisa , Sheffield Nathan , Gomez Ariel 
Published: October 2024

Renin cell
(RC)
descendants regain the endocrine renin phenotype to overcome homeostatic threats, a process known as recruitment. The determinants that control the identity, fate, and recruitment of RCs are not well understood.
We aim to 1) define the chromatin pattern that determines RC identity; and 2) develop a computational tool to score samples by similarity to that pattern.

We compared open chromatin regions (ATAC-seq) between non-renin-expressing (n = 184) and renin-expressing samples (n = 19) from three different sources and stimulation states: 1) primary RCs in basal state (WT); 2) primary RCs chronically stimulated to produce renin (Recruited); and 3) constitutively renin-expressing tumoral cells. Differential analyses between the three types of RCs and the non-RCs revealed 1,525 unique open chromatin regions shared in at least two RC groups, including regions associated with RC-specific genes:
Ren1
and
Akr1b7.
Increased accessibility regions in RC groups are cell type specific and enriched in renin-related GO terms (
e.g.,
cAMP and Notch signaling pathway). The bZip family (
e.g.
, Atf3, p < 10
-2147
) was the most enriched motifs in tumoral cells, and MEF2 family (
e.g.
, MEF2a, p < 10
-91
) in primary cells. We did not find a unique set of TFs specific to the Recruited group, indicating that renin recruitment may not be regulated by a recruitment-specific factor family, but could instead be driven by post-translational modification, differential co-factors, or epigenetic modifications.

Next, we used a machine-learning approach to calculate a "reninness" score by training a genomic region model with renin and non-renin bulkATAC-seq data. We identified a cluster of regions (n = 112,992) around the trained renin label, which included 89% (21,820 of 24,612) of the regions with increased accessibility from the differential analyses. We calculated the reninness score based on the distance between the trained label and the predicted bulkATA sample embeddings using the trained model. Homogeneous WT RCs had the highest score, followed by renin-expressing tumoral and primary cells. Non-RCs had the lowest scores. We also adapted bulkATAC region-embedding models to pseudo-bulk ATAC- and scATAC-seq data. The observed reninness scores show that the model can also capture differences in renin recruitment potential.
In conclusion, we identified the chromatin configurations defining the identity and recruitment of RCs and developed a computational score to quantify it.
Abstract P316: Beyond the Cuff: Revolutionizing Hypertension Care through Human-Centered Design and Tech-Driven Solutions in an Urban Community Health Center
Authors: Khan Aisha , McAuliff Kathleen , Govindarajan Geetha 
Published: October 2024

Community Health Centers serve populations burdened with cardiovascular disease due to social determinants of health, necessitating innovative solutions in resource-limited environments. Wi-Fi/Bluetooth-enabled home blood pressure monitors have emerged as clinical tools for diagnosing, monitoring, and managing hypertension. The real time data enables timely interventions by care teams of patients being monitored. A multifaceted approach beyond clinic settings, supported by digital tools, can help reduce healthcare costs by preventing avoidable emergency room visits.
We posited that implementing a self-monitored blood pressure (SMBP) program, supplemented by holistic, human-centered patient coaching and feedback, in a community health center setting would enhance patient engagement, medication adherence, and hypertension control.
We designed and piloted a small SMBP program using Bluetooth-enabled blood pressure devices, targeting adult patients with documented uncontrolled blood pressure seen in our health centers in a 6- month window. This was further augmented by a holistic, human-centered individual and group-level coaching session. Patients enrolled in the SMBP program received comprehensive education on hypertension, including medication management and lifestyle changes, as well as data-driven feedback on their blood pressure profiles during virtual group and individual outreach sessions. The program's goals were to increase patient engagement in their care, adherence to interventions, leading to better blood pressure control.
Results were significant: 22 of 32 participants graduated, achieving improved blood pressure control with medication and lifestyle changes. Average reductions of 17 mmHg in systolic and 6 mmHg in diastolic blood pressure were noted after being in the program for an average of three months. Among the graduates, 50% required medication intensification, and 60% adopted lifestyle changes, indicating the program's effectiveness.
Our pilot affirmed the efficacy of utilizing digital solutions and integrated strategies to improve hypertension control and empower patients to make timely changes with data feedback. The key findings from our pilot led to the expansion of the SMBP program to serve a larger cohort of patients in our clinic. This underscores the critical role of patient engagement, technology integration, and an integrated approach to care in improving hypertension management, particularly in underserved communities.
Abstract P324: Masked Hypertension Mimicking Migraine: A Case Report with Diagnostic Odyssey
Authors: Chitrala Sruthi , Mantripragada Nishanth , Suvvari Tarun Kumar , Tummala Nayanika , Menda Jaideep , Akthar Ahmed Aasim 
Published: October 2024

Introduction:
Masked hypertension (MH) involves normal office blood pressure but elevated readings outside clinical settings, increasing cardiovascular and neurological risks. About 10-30% of the population may have MH, often undiagnosed. This case highlights the importance of considering MH.

Case Presentation:
A 42-year-old woman had recurrent headaches for six months: bilateral, pulsating pain in the temples, with dizziness and occasional vomiting, lasting 2-4 hours, worsening after work. Diagnosed with migraines and treated with sumatriptan without relief. Medical history included a caesarean section; otherwise, she was healthy.

Physical exam showed normal vital signs, including blood pressure at 130/80 mmHg. Neurological and ophthalmological evaluations were normal. Lab investigations were unremarkable. The patient had a normal BMI of 21.3. Further workup, including ECG, MRI, CT scan, and neck radiography, all normal.
Ambulatory blood pressure monitoring (ABPM) revealed elevated blood pressure during evening hours (post work), starting around 4 pm and rising until 8-9 pm. Thereafter, blood pressure normalized to 110-130 mmHg systolic and 70-80 mmHg diastolic.
To rule out nephrogenic hypertension, an ultrasound of the kidneys, renal function tests, urinalysis, and plasma metanephrine tests were negative. Following the exclusion of other causes, a diagnosis of MH was established. The patient started on Telmisartan 20 mg daily, with lifestyle modifications. Follow-up ABPM showed normalized blood pressure, and the patient reported no further headaches.

Discussion:
MH affects many but often remains undiagnosed due to normal clinic readings. Ambulatory or home blood pressure monitoring is essential for diagnosis. Timely diagnosis of MH is crucial, given its association with heightened risks of stroke and cardiovascular disease. Studies have revealed significantly elevated left ventricular mass index, maximal intima-media thickness, and urinary albumin levels. Consequences include left ventricular hypertrophy, carotid atherosclerosis, and albuminuria.

Conclusion:
Early recognition and management of MH are vital for preventing complications. Diagnosis can be achieved by home blood pressure monitoring (HBPM) or 24-hour ambulatory blood pressure. This case stresses considering MH in patients with normal office readings but persistent symptoms, advocating for regular monitoring and patient education for optimal health outcomes.