bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of Donor Heart Acceptance for Transplant and Its Clinical Implications: Results From The Donor Heart Study
Authors: Wayda Brian , Weng Yingjie , Zhang Shiqi , Luikart Helen , Pearson Thomas , Nieto Javier , Nicely Bruce , Geraghty P.J. , Belcher John , Nguyen John , Neidlinger Nikole , Groat Tahnee , Malinoski Darren , Zaroff Jonathan G. , Khush Kiran K. 
Published: September 2024

BACKGROUND:
Despite a shortage of potential donors for heart transplant in the United States, most potential donor hearts are discarded. We evaluated predictors of donor heart acceptance in the United States and applied machine learning methods to improve prediction.

METHODS:
We included a nationwide (2005–2020) cohort of potential heart donors in the United States (n=73 948) from the Scientific Registry of Transplant Recipients and a more recent (2015–2020) rigorously phenotyped cohort of potential donors from DHS (Donor Heart Study; n=4130). We identified predictors of acceptance for heart transplant in both cohorts using multivariate logistic regression, incorporating time-interaction terms to characterize their varying effects over time. We fit models predicting acceptance for transplant in a 50% training subset of DHS using logistic regression, least absolute shrinkage and selection operator, and random forest algorithms and compared their performance in the remaining 50% (test) of the subset.

RESULTS:

Predictors of donor heart acceptance were similar in the nationwide and DHS cohorts. Among these, older age (
P
value for time interaction, 0.0001) has become increasingly predictive of discard over time while other factors, including those related to drug use, infection, and mild cardiac diagnostic abnormalities, have become less influential (
P
value for time interaction, <0.05 for all). A random forest model (area under the curve, 0.908; accuracy, 0.831) outperformed other prediction algorithms in the test subset and was used as the basis of a novel web-based prediction tool.

CONCLUSIONS:
Predictors of donor heart acceptance for transplantation have changed significantly over the last 2 decades, likely reflecting evolving evidence regarding their impact on posttransplant outcomes. Real-time prediction of donor heart acceptance, using our web-based tool, may improve efficiency during donor management and heart allocation.
NT-proBNP and Cardiac Troponin I, but Not Cardiac Troponin T, Are Associated With 7-Year Changes in Cardiac Structure and Function in Older Adults: The ARIC Study
Authors: Myhre Peder L. , Claggett Brian , Ballantyne Christie M. , Hoogeveen Ron C. , Selvin Elizabeth , Matsushita Kunihiro , Kitzman Dalane , Konety Suma , Mosley Thomas , Shah Amil M. 
Published: September 2024

BACKGROUND:
Higher circulating concentrations of NT-proBNP (N-terminal pro-B-type natriuretic peptide) and high-sensitivity cardiac troponin T (hs-cTnT) and I (hs-cTnI) are associated with left ventricular remodeling and with incident heart failure. The associations of these cardiac biomarkers with changes in cardiac structure and function over time are uncharacterized.

METHODS:
Among 2006 participants in the ARIC prospective cohort study (Atherosclerosis Risk in Communities) who were free of overt cardiovascular disease and underwent echocardiography at study visits 5 (2011– 2013) and 7 (2018–2019), we assessed the associations of NT-proBNP, hs-cTnT, and hs-cTnI concentrations at visit 5 with changes in left ventricular structure and function between visits 5 and 7 (≈7-year change) using multivariable linear regression with the biomarkers modeled as restricted cubic splines. Models were adjusted for age, sex, race, body mass index, smoking, diabetes, hypertension, and renal function at visit 5; blood pressure and heart rate at both visits; and the baseline value of the echocardiographic parameter of interest.

RESULTS:

Mean±SD age was 74±4 years at visit 5; 61% were women; and 23% were Black adults. Median (25th–75th percentile) concentrations at visit 5 of NT-proBNP, hs-cTnT, and hs-cTnI were 87 ng/L (50–157 ng/L), 9 ng/L (6–12 ng/L), and 2.6 ng/L (1.9–3.9 ng/L). In adjusted models, elevated baseline concentrations of NT-proBNP and hs-cTnI were significantly associated with 7-year decline in left ventricular systolic function (ejection fraction, longitudinal and circumferential strain) and worsening diastolic indices. In contrast, elevated baseline concentrations of hs-cTnT were not significantly associated with 7-year changes in cardiac structure, systolic function, or diastolic function (all
P
>0.05).

CONCLUSIONS:
Higher concentrations of NT-proBNP and hs-cTnI, but not hs-cTnT, were associated with greater declines in left ventricular function over ≈7 years in late life independently of traditional cardiovascular risk factors.
Circulating Autoantibodies Targeting TREK-1 in Patients With Short-Coupled Ventricular Fibrillation
Authors: Li Jin , Janin Alexandre , Patoughi Mona , Gaudreault Nathalie , Kis Lenke , Moha Ou Maati Hamid , Bossé Yohan , Steinberg Christian 
Published: September 2024

BACKGROUND:
Short-coupled ventricular fibrillation (SCVF) is increasingly being recognized as a distinct primary electrical disorder and cause of otherwise unexplained cardiac arrest. However, the pathophysiology of SCVF remains largely elusive. Despite extensive genetic screening, there is no convincing evidence of a robust monogenic disease gene, thus raising the speculations for alternative pathogeneses. The role of autoimmune mechanisms in SCVF has not been investigated so far. The objective of this study was to screen for circulating autoantibodies in patients with SCVF and assess their role in arrhythmogenesis.

METHODS:
This is a prospective, single-center, case-control study enrolling cardiac arrest survivors diagnosed with SCVF or idiopathic ventricular fibrillation (IVF) between 2019 and 2023 at the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval Inherited Arrhythmia Clinic in Canada. Plasma samples were screened for autoantibodies targeting cardiac ion channels using peptide microarray technology. Identified target autoantibodies were then purified from pooled plasma samples for subsequent cellular electrophysiological studies.

RESULTS:

Fourteen patients with SCVF (n=4 [29% of patients] female patients; median age, 45 years [interquartile range: 36, 59]; n=14 [100% of patients] non-Hispanic White) and 19 patients with idiopathic ventricular fibrillation (n=8 [42%] female patients; median age, 49 years [38, 57]; n=19 [100%] non-Hispanic White) were enrolled in the study and compared with 38 (n=20 [53%] female subjects; median age, 45 years [29, 66]; n=36 [95%] non-Hispanic White) sex-, age- and ethnicity-matched healthy controls. During the study period, 11 (79%) SCVF probands experienced ventricular fibrillation recurrence after a median of 4.3 months (interquartile range, 0.3–20.7). Autoantibodies targeting cardiac TREK-1 (TWIK [tandem of pore-domains in a weakly inward rectifying potassium channel]–related potassium channel 1 were identified in 7 (50%) patients with SCVF (
P
=0.049). Patch clamp experiments demonstrated channel-activating properties of anti–TREK-1 autoantibodies that are antagonized by quinidine in both HEK293 cells and human induced pluripotent stem cell–derived cardiomyocytes.

CONCLUSIONS:
Patients with SCVF harbor circulating autoantibodies against the cardiac TREK-1 channel. Anti–TREK-1 autoantibodies not only present the first reported biomarker for SCVF, but our functional studies also suggest a direct implication in the arrhythmogenesis of SCVF.
An Evaluation of the First Clinical Posting in Psychiatry of the Competency-Based Medical Education (CBME) Curriculum for Undergraduate Medical Students in India
Authors: Perugu Shalini , Sreedaran Priya , Chari Uttara , Sethuraman Bhuvaneshwari , Salazar Luke Joshua 
Published: September 2024

Background: The new competency-based medical education (CBME) curriculum presents an opportunity to address the many deficiencies in undergraduate (UG) psychiatry education in India. There are no published reports of such evaluations of psychiatry teaching programs based on the new CBME curriculum. Methods: We performed a cross-sectional evaluation of the first clinical posting in psychiatry of the new CBME curriculum using the following metrics: clinical skills, knowledge, attitudes towards psychiatry, self-efficacy in performing the specific learning objectives (SLOs), and satisfaction with specific teaching–learning and assessment methods implemented. Results: The mean knowledge score after the posting was significantly higher compared to the mean knowledge score at baseline (7.79 vs 5.45, p<0.001). The mean clinical skills score after the posting was 13.77 (0–20 range). Improvement was noted in the mean scores on all three sub-scales of the attitudes toward psychiatry scale. However, the improvement in scores was statistically significant only on the ‘Stigma of Psychiatry’ sub-scale. The mean scores on the items of the self-efficacy scale were between 63.41 and 77.73 (0–100 range). The mean scores on all items of the satisfaction scale were between 4 (somewhat satisfied) and 5 (very satisfied). Conclusion: We have described an evaluation of the first clinical posting in psychiatry of the new CBME curriculum. The posting was effective in imparting knowledge and clinical skills and potentially bringing about favorable changes in the attitudes toward psychiatry among UG medical students. The students also perceived confidence in performing the SLOs and were satisfied with the teaching-learning methods and assessment methods implemented.
Clinical effects of CYP2D6 phenoconversion in patients with psychosis
Authors: De Brabander Emma Y , Breddels Esmee , van Amelsvoort Therese , van Westrhenen Roos ,   GROUP Investigators
Published: September 2024

Background: Pharmacogenetics is considered a promising avenue for improving treatment outcomes, yet evidence arguing for the use of pharmacogenetics in the treatment of psychotic disorders is mixed and clinical usefulness is under debate. Many patients with psychosis use multiple medications, which can alter the metabolic capacity of CYP enzymes, a process called phenoconversion. In clinical studies, treatment outcomes of drugs for psychosis management may have been influenced by phenoconversion. Aim: Here we evaluate the impact and predictive value of CYP2D6 phenoconversion in patients with psychotic disorders under pharmacological treatment. Method: Phenoconversion-corrected phenotype was determined by accounting for inhibitor strength. Phenoconversion-corrected and genotype-predicted phenotypes were compared in association with side effects, subjective well-being and symptom severity. Results: Phenoconversion led to a large increase in poor metabolizers (PMs; 17–82, 16% of sample), due to concomitant use of the serotonin reuptake inhibitors fluoxetine and paroxetine. Neither CYP2D6-predicted nor phenoconversion-corrected phenotype was robustly associated with outcome measures. Risperidone, however, was most affected by the CYP2D6 genotype. Conclusion: Polypharmacy and phenoconversion were prevalent and accounted for a significant increase in PMs. CYP2D6 may play a limited role in side effects, symptoms and well-being measures. However, due to the high frequency of occurrence, phenoconversion should be considered in future clinical trials.
Abnormal brain regional activity in acute thyrotoxic myopathy assessed by resting-state functional MRI
Authors: Kuang Yaqi , Liang Xinghuan , Ye Wei , Fu Shien , Qin Yingfen , Ma Yan , Luo Zuojie 
Published: September 2024

Background The neurophysiological mechanisms underlying manifestations of bulbar paralysis in acute thyrotoxic myopathy (ATM) and the afflicted brain areas are unclear. Purpose We used resting-state functional magnetic resonance imaging (rs-fMRI) to evaluate the regional brain activities in patients with ATM. Material and Methods In total, 16 patients with ATM, 16 patients with hyperthyroidism without ATM, and 16 healthy controls underwent functional MRI scans. By calculating the fractional amplitude of low-frequency fluctuation (fALFF), regional homogeneity (ReHo), and functional connectivity (FC), we assessed variations in resting-state cerebral activity. The correlation between the resting-state functional indexes and clinical assessments was also explored. Results Compared to the hyperthyroid patients, patients with ATM had stronger ReHo in the left precentral gyrus, reduced ReHo in the left orbitofrontal gyrus (OFG), and decreased FC in the left precentral gyri, left superior frontal gyrus (SFG), and left middle frontal gyrus (MFG). Patients with ATM showed reduced fALFF and ReHo in the right SFG and decreased ReHo in the bilateral supplementary motor area (SMA). A significantly decreased FC in the left SFG and left MFG, right precentral gyrus, and the orbital part of the right interior frontal gyrus was observed in patients with ATM compared to healthy controls. Additionally, fALFF and ReHo values were positively correlated with serum thyroid-related hormones and antibodies. Conclusion The findings of rs-fMRI demonstrate that particular brain regions’ functional activity was aberrant in individuals with ATM, especially in SFG area. This finding may help with better understanding of underlying pathophysiology of patients with ATM.
Observational, retrospective real-world evidence study demonstrates safety, performance and usefulness of antimicrobial central venous catheters
Authors: Philbeck Thomas E. , Bardin Amy , McDonald John G. 
Published: September 2024

Objective To collect real-world data to demonstrate the safety and performance of Arrowg+ard Blue® /Arrowg+ard Blue Plus® (AGB/AGB+) central venous catheters (CVCs). Methods This observational, retrospective study involved patients who required AGB/AGB+ CVCs at designated general hospitals in USA (22), UK (19) and Germany (2). Data were extracted from electronic medical records. There were no specific inclusion/exclusion criteria. Primary endpoint was successful treatment without an adverse event (AE). Secondary endpoint was rate of AEs. Results In total, 384 cases were included from 43 centres and most patients (74%) were >35 years of age. A success rate of 99%, and an overall AE rate of 0.8% were observed. Moreover, the overall infection rate was lower than typically reported for standard catheters. In addition, power injection of contrast media was successful in all 51 cases. Conclusions This study indicates the AGB/AGB+ CVCs perform as intended with a high success rate and few AEs. Further large-scale, controlled studies are required to confirm our findings.
Leriche Memorial Lecture at 24th World Congress ‘Takayasu's Arteritis in Asia’
Authors: Mishima Yoshio 
Published: September 2024

An uncommon type of chronic and progressive arteritis characterized by peculiar ocular findings, an absent radial pulse and hypersensitivity of the carotid body and sinus was first described in 1908 by Takayasu, a Japanese ophthalmologist. This disorder was defined as a clinical entity by Shimizu in 1948. Takayasu's arteritis was initially thought to be confined to the Orient. Subsequent reports however indicated that this condition affected all races and has a worldwide distribution. It is also referred to as pulseless disease, aortitis syndrome, and non-specific aortoarteritis. The current widespread interest in this disease has mainly been in the Japanese literature. Takayasu's arteritis predominates in women in the second and third decade. Recently, the classical pulseless disease has declined and symptoms resulting from hypertension and aortic regurgitation are recognised as the most important factors in prognosis.
Development of Oral Heparin Therapy for Prophylaxis and Treatment of Deep Venous Thrombosis
Authors: Money Samuel R. , York John W. 
Published: September 2024

Objective: To review the current research and published literature regarding the development of oral heparin therapy for the prophylaxis and treatment of deep venous thrombosis. Background: Currently, the accepted practice of prophylaxis and/or treatment of acute deep venous thrombosis (DVT) is intravenous or subcutaneous (SQ) heparin followed by oral warfarin or SC low molecular weight heparin (LMWH) therapy followed by warfarin. Both of which are less than ideal. More recently, advances have been made towards an effective oral heparin preparation that would resolve many of the drawbacks to the current therapies. Methods: A review of the current and relevant English literature identified via a search of the Medline database from January 1990 to present. Results: Initial oral heparin therapy for DVT was unsuccessful due to presumed inadequate intestinal absorption as a result of heparin's molecular and structural characteristics. The development of oral heparin therapy, based on combining heparin with the carrier molecule Sodium N-(8[2-hydroxybenzoyl]amino) caprylate (SNAC) to enhance its intestinal absorption and bioavailability for the prophylaxis and treatment of DVT has been demonstrated to be effective in animal models. More recent efforts have been aimed at human trials. Conclusion: Recent advances in prophylaxis and treatment of DVT have stimulated great interest among researchers to develop an effective, convenient, and well tolerated oral therapy. An effective oral heparin therapy may represent an ideal method of prophylaxis and treatment of DVT.
Different Behavior of Sequential versus Single Left Internal Mammary Artery to Left Anterior Descending Area Grafts
Authors: Hartman J. M. , Kelder J.C. , Ackerstaff R.G.A. , Bal E.T. , Vermeulen F.E.E. , Bogers A.J.J.C. 
Published: September 2024

To study echo Doppler characteristics of sequential versus single left internal mammary artery (LIMA) to left anterior descending (LAD) area grafts transthoracic echo Doppler at the LIMA origin and angiography were performed pre- and postoperatively. In 17 patients single LIMA to LAD (group I) and in 45 patients sequential LIMA to LAD area (group II) bypass grafting was performed. All patients show an early postoperative shift towards diastolic coronary Doppler velocity spectra. Only group II shows a further significant late increase in diastolic, velocity time integral and some systolic echo Doppler parameters at rest. Diastolic peak and diastolic as well as total mean and velocity time integral maximal values are significantly higher in group II in late postoperative hyperemic response. Preoperative and late control angiography showed no significant differences in overall grading of native LAD stenosis between both groups. The large coronary reserve in LIMA sequential grafts may contribute to an improved long-term patency.
Outcome of Transaxillary Rib Resection for Thoracic Outlet Syndrome — a 10 Year Experience
Authors: Fulford P. E. , Baguneid M. S. , Ibrahim M. R. , Schady W. , Walker M. G. 
Published: September 2024

Background: This study assessed the outcome of transaxillary first and/or cervical rib resection in a unit, which has a policy of combined assessment by a neurologist and vascular surgeon. Methods: 61 patients underwent 83 transaxillary rib resections for thoracic outlet syndrome. A retrospective casenote review of these patients was undertaken. All patients completed a telephone questionnaire regarding long-term outcome. Results: Post-operative outpatient assessment at a median of 6 months recorded 91.5% improved, of whom 61.5% were symptom-free. 61% were available for the telephone questionnaire at a median follow-up of 4 yr. 74% reported an improvement, with complete resolution in 58%. Six described temporary improvement following surgery. Conclusion: Transaxillary rib resection is a safe and effective procedure, allowing almost two thirds of patients a return to normal activity. Combined assessment by vascular and neurological teams may help in patient selection for surgery, as well as the accurate long-term assessment of outcome.
Combined Carotid and Coronary Artery Surgery: What Have We Learned after 15 Years?
Authors: Perić M. , Huskić R. , Nežić D. , Gradinac S. , Popović Z. , Popović A. D. , Bojić M. 
Published: September 2024

Optimal surgical strategy in patients with concomitant coronary and carotid artery disease is debatable. We have analysed 15-years of experience (January 1981-August 1996) with 195 consecutive patients in whom we have used two different surgical approaches. Group A consisted of 48 patients who underwent a single-stage surgical procedure, and group B (147 patents) underwent a two-stage procedure, either as carotid endarterectomy followed by coronary artery bypass surgery (group B1, 97 patients), or as coronary artery bypass surgery followed by carotid endarterectomy (group B2, 50 patients). Overall, there were 40 (20.5%) patients with left main coronary artery disease, 49 (25.1%) with poor left ventricular function, 128 (65.6%) with previous myocardial infarction, 134 (68.7%) were in New York Health Authority (NYHA) functional class III or IV, and bilateral carotid involvement was present in 57 patients (29.2%). Unstable angina was more frequent in groups A and B2 ( P < 0.0001), NYHA class III-IV was more frequent in group A ( versus B1, P = 0.001 and versus B2, P = 0.02), low ejection fraction (EF) was more frequent in groups A and B2 ( P < 0.0001 for both), bilateral carotid stenosis in groups A and B1 ( P = 0.02 and P = 0.0001, respectively) and ulcerated plaque in group B1 ( versus A, P = 0.0001). These differences dictated the surgical strategy, which resulted in different protocols for clinical and operative management. Results: Early mortality for the entire group was 4.6% (9/195–6.2% in group A, 6.2% in group B1 and 0% in group B2, respectively P > 0.05). Serious morbidity occurred in 7.3% of patients (14/195–8.3% in group A. 7.2% in group B1 and 6% in group B, respectively P > 0.05). Univariate analysis revealed only bilateral carotid stenosis as a predictor of outcome ( P = 0.04). Follow-up was completed for 156 patients (80.0%) and averaged 84.1 ± 13.3 months (range 1–180 months). Kaplan–Meier survival estimate for the entire group was 81% and event-free survival was 76% at 5 years. Actuarial and event-free survivals were similar for all groups. Early and late outcome in these patients were influenced more by their preoperative clinical status than by the surgical strategy itself. It is therefore concluded that surgical approach should be individualized for the majority of patients.