bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiovascular Health Among Young Men and Women in Puerto Rico as Assessed by the Life's Essential 8 Metrics
Authors: Pérez Cynthia M. , López‐Cepero Andrea , Almodóvar‐Rivera Israel , Kiefe Catarina I. , Tucker Katherine L. , Person Sharina D. , Mattei Josiemer , Rodríguez‐Orengo José , Rosal Milagros C. 
Published: October 2024

Background
Cardiovascular health (CVH) in young adulthood is associated with CVD in later life, yet CVH in young adults in the United States falls below ideal levels, with noticeable sex differences. Research on CVH in young adults in Puerto Rico is scarce. This study examined CVH and sex differences in CVH in a large cohort of young adults in Puerto Rico.

Methods and Results

Data from 2162 Puerto Rican young adults aged 18 to 29 residing in PR were obtained from the PR‐OUTLOOK (Puerto Rico Young Adults' Stress, Contextual, Behavioral, and Cardiometabolic Risk) study (2020–2023). Participants were recruited through various media and community outreach. CVH scores, graded on a 0 (worst) to 100 (best) scale, were derived from survey responses, physical exams, and laboratory assays. Linear regression with the margins postestimation command was used to determine adjusted means (95% CIs) for CVH scores by sex, controlling for age, marital status, education, childhood material deprivation, subjective social status, health insurance, and depressive symptoms. CVH was less than ideal (score<80) in 72.6% of the cohort (70.5% of women, 75.9% of men,
P
<0.05). Men had a significantly lower adjusted mean overall CVH score than women (70.7 versus 73.0) and lower adjusted mean scores for nicotine exposure (78.3 versus 86.7), non‐high‐density lipoprotein cholesterol (80.6 versus 86.4), and blood pressure (79.5 versus 92.2). Women had a significantly lower adjusted mean physical activity score compared with men (50.4 versus 59.5).

Conclusions
Less‐than‐ideal CVH is notable among young adults, with men having worse CVH than women. These identified sex differences warrant further investigation and the design of interventions to enhance and preserve CVH.
Development and Validation of Prognostic Models for Bleeding and Ischemia in Elderly Patients With Comorbid Acute Coronary Syndrome and Atrial Fibrillation
Authors: Zhang Honghong , Zheng Li , Yang Zengao , Zhao Haijing , Zhu Yue , Ma Yuhan , Wu Zhengfeng , Qiu Weize , Zhou Zhirui , Liu Yuqi , Chen Yundai 
Published: October 2024

Background
Acute coronary syndrome and atrial fibrillation are common cardiovascular diseases in elderly individuals. Patients with comorbidities face increased risks of bleeding and ischemia; however, there is a lack of prognostic models for quantifying these risks in this special population.

Methods and Results

In this retrospective cohort study, 1851 patients (≥65 years old) with acute coronary syndrome and atrial fibrillation from 2 hospitals in China were included in the development cohort (1252 individuals) and 2 external validation cohorts (284 and 315 individuals). During 1‐year follow‐up, 96 Bleeding Academic Research Consortium type 3 or 5 bleeding events and 245 thromboembolic events were observed. In the development cohort, the concordance indexes for bleeding at 3, 6, and 12 mo ranged from 0.737 to 0.845 and for ischemia ranged from 0.723 to 0.777. The calibration curve and decision curve analysis indicated adequate calibration and clinical practicability. The concordance indexes varied from 0.679 to 0.809 in the validation cohorts. Subgroup analyses focusing on anticoagulant drugs and antithrombotic therapy were conducted, revealing similar discrimination and calibration. Kaplan–Meier curves demonstrated significant differences (log‐rank
P
<0.001). Additionally, the models outperformed conventional models in concordance indexes, integrated discrimination improvement, and net reclassification improvement.

Conclusions
Our study provides 2 robust prognostic models with easily available clinical factors for predicting bleeding and ischemia in elderly patients with acute coronary syndrome and atrial fibrillation. Furthermore, we provide online calculators to facilitate individualized risk evaluation and clinical decision‐making.

Registration

URL:
www.chictr.org.cn/
. Unique Identifier: ChiCTR2200067185.
Loss of NAT10 Reduces the Translation of
Kmt5a
mRNA Through ac4C Modification in Cardiomyocytes and Induces Heart Failure
Authors: Xu Ting , Du Tailai , Zhuang Xiaodong , He Xin , Yan Youchen , Wu Jialing , Zhou Huimin , Li Yan , Liao Xinxue , He Jiangui , Liu Chen , Dong Yugang , Ou Jingsong , Lin Shuibin , Chen Demeng , Huang Zhan‐Peng 
Published: October 2024

Background
In the past decade, the biological functions of various RNA modifications in mammals have been uncovered. N4‐acetylcytidine (ac4C), a highly conserved RNA modification, has been implicated in human diseases. Despite this, the involvement of RNA ac4C modification in cardiac physiology and pathology remains incompletely understood. NAT10 (N‐acetyltransferase 10) stands as the sole acetyltransferase known to catalyze RNA ac4C modification. This study aims to explore the role of NAT10 and ac4C modification in cardiac physiology and pathology.

Methods and Results

Cardiac‐specific knockout of NAT10, leading to reduced RNA ac4C modification, during both neonatal and adult stages resulted in severe heart failure. NAT10 deficiency induced cardiomyocyte apoptosis, a crucial step in heart failure pathogenesis, supported by in vitro data. Activation of the
p53
signaling pathway was closely associated with enhanced apoptosis in NAT10‐deficient cardiomyocytes. As ac4C modification on mRNA influences translational efficiency, we employed ribosome footprints coupled with RNA sequencing to explore genome‐wide translational efficiency changes caused by NAT10 deficiency. We identified and validated that the translational efficiency of
Kmt5a
was suppressed in NAT10 knockout hearts due to reduced ac4C modification on its mRNA. This finding was consistent with the observation that
Kmt5a
protein levels were reduced in heart failure despite unchanged mRNA expression. Knockdown of
Kmt5a
in cardiomyocytes recapitulated the phenotype of NAT10 deficiency, including increased cardiomyocyte apoptosis and activated
p53
signaling. Finally, overexpression of
Kmt5a
rescued cardiomyocyte apoptosis and
p53
activation induced by NAT10 inhibition.

Conclusions

Our study highlights the significance of NAT10 in cardiomyocyte physiology, demonstrating that NAT10 loss is sufficient to induce cardiomyocyte apoptosis and heart failure. NAT10 regulates the translational efficiency of
Kmt5a
, a key mediator, through mRNA ac4C modification during heart failure.
Intraindividual Discordance Between Remnant Cholesterol and Low‐Density Lipoprotein Cholesterol Associated With Incident Stroke: Results From 2 National Cohorts
Authors: Cui Cancan , Li Pingan , Qi Yitian , Song Jiayin , Han Tianjiao , Shang Xinyun , Balmer Lois , Sheng Chen , Zha Yining , Xu Zhonghang , Wang Xu , Wu Zhiyuan 
Published: October 2024

Background
The atherogenic effect of remnant cholesterol is being increasingly acknowledged. This study aimed to explore the association of discordance between remnant cholesterol and low‐density lipoprotein cholesterol with stroke onset using 2 Chinese national cohorts.

Methods and Results
We studied 11 139 participants from CHARLS (China Health and Retirement Longitudinal Study) and 5993 participants from CHNS (China Health and Nutrition Survey) aged 45 years or older. The discordance between remnant cholesterol and low‐density lipoprotein cholesterol was defined using the difference in percentile units (>15 units). There were 988 (8.9%) and 128 (2.1%) stroke events reported during follow‐up in the 2 cohorts. Elevated remnant cholesterol was significantly associated with a higher risk of total stroke in 2 cohorts. After adjusting for remnant cholesterol level, the discordantly high remnant cholesterol group was significantly associated with an increased stroke risk (CHARLS: subdistribution hazard ratio [sHR], 1.31 [95 CI, 1.10–1.55]; CHNS: sHR, 1.84 [95 CI, 1.15–3.08]) compared with the discordantly low group. Consistent results were shown even among those with optimal low‐density lipoprotein cholesterol level.

Conclusions
The discordance between remnant cholesterol and low‐density lipoprotein cholesterol, representing the intraindividual discrepancy, is significantly associated with stroke onset among Chinese adults.
Outcomes of Watchful Waiting Strategy and Predictors of Postoperative Prognosis in Asymptomatic or Equivocally Symptomatic Chronic Severe Aortic Regurgitation With Preserved Left Ventricular Function
Authors: Suzuki Sho , Amano Masashi , Nakagawa Shoko , Irie Yuki , Moriuchi Kenji , Okada Atsushi , Kitai Takeshi , Amaki Makoto , Kanzaki Hideaki , Nishimura Kunihiro , Fukushima Satsuki , Kusano Kengo , Fujita Tomoyuki , Noguchi Teruo , Izumi Chisato 
Published: October 2024

Background
The optimal surgical timing for asymptomatic or equivocally symptomatic chronic severe aortic regurgitation with preserved left ventricular ejection fraction remains controversial.

Methods and Results

Two hundred ten consecutive patients (median age 65 years) with asymptomatic or equivocally symptomatic chronic severe aortic regurgitation and left ventricular ejection fraction ≥50% were registered. First, the treatment plans (aortic valve replacement or watchful waiting) after initial diagnosis were investigated. Then, 2 studies were set: Study A (n=144) investigated the prognosis of patients who were managed under the watchful waiting strategy after initial diagnosis; Study B (n=99) investigated the postoperative prognosis in patients who underwent aortic valve replacement at initial diagnosis or after watchful waiting. The primary outcomes were all‐cause death in Study A and postoperative cardiovascular events in Study B. In Study A, 3 died of noncardiovascular causes during a median follow‐up of 3.2 years. In Kaplan–Meier analysis, the survival curve was similar to that of an age‐sex‐matched general population in Japan. In Study B, 9 experienced the primary outcome during a median follow‐up of 5.0 years. In Cox regression analysis, preoperative left ventricular end‐systolic diameter enlargement (hazard ratio, 1.11;
P
=0.048) and left ventricular end‐systolic diameter >45 mm (hazard ratio, 12.75;
P
=0.02) were significantly associated with poor postoperative prognosis. In Kaplan–Meier analysis, left ventricular end‐systolic diameter >45 mm predicted a higher risk of the primary outcome (
P
<0.01).

Conclusions
Watchful waiting was achieved safely in asymptomatic or equivocally symptomatic chronic severe aortic regurgitation with preserved left ventricular ejection fraction. Preoperative left ventricular end‐systolic diameter >45 mm predicted a poor postoperative outcome and may be an optimal cut‐off value for surgical indication.
Efficacy and Safety of Intravenous Tenecteplase Versus Alteplase in Treating Acute Ischemic Stroke With Diabetes and Admission Hyperglycemia
Authors: Liu Huihui , Jin Aoming , Pan Yuesong , Meng Xia , Li Hao , Li Zixiao , Wang Yongjun , Li Shuya 
Published: October 2024

Background
The aim of this study was to investigate the efficacy and safety of tenecteplase versus alteplase in patients with acute ischemic stroke, considering their diabetes history and admission hyperglycemia status.

Methods and Results

This was a post hoc analysis of the TRACE‐2 (Tenecteplase Reperfusion Therapy in Acute Ischemic Cerebrovascular Events‐2) randomized clinical trial that enrolled patients in China between June 2021 and May 2022. Eligible patients with acute ischemic stroke for standard intravenous thrombolysis, but ineligible for endovascular thrombectomy, were randomly assigned (1:1) to tenecteplase or alteplase within 4.5 hours of symptom onset. Admission hyperglycemia was defined as plasma glucose >7.8 mmol/L. The primary efficacy and safety outcome were excellent functional outcome at 90 days (modified Rankin Scale score of 0–1) and symptomatic intracranial hemorrhage within 36 hours, respectively. The Cochran–Mantel–Haenszel
χ
2
test was used for the outcomes. Of the 1382 patients included, 369 (26.7%) had a history of diabetes, and 482 (34.9%) experienced admission hyperglycemia. The primary efficacy outcome, comparing tenecteplase to alteplase, was achieved in 93 (56.7%) versus 97 (48.3%) among patients with a history of diabetes (
P
=0.11) and 335 (64.6%) versus 300 (62.2%) among those without diabetes (
P
=0.45), respectively. The primary efficacy outcome for tenecteplase versus alteplase was comparable among patients with and without admission hyperglycemia (57.5% versus 53.9%,
P
= 0.44; 65.4% versus 60.4%,
P
=0.12, respectively). No significant difference in the risk of symptomatic intracranial hemorrhage within 36 hours was observed between tenecteplase and alteplase, regardless of diabetes history or admission hyperglycemia.

Conclusions
This study demonstrated that intravenous tenecteplase exhibits similar clinical outcomes compared with alteplase, irrespective of the patient's glucose metabolism status.

Registration

URL:
https://clinicaltrials.gov
; Unique identifier: NCT04797013.
Cardiopulmonary Fitness and Personalized Exercise Prescription in Patients With Hypertrophic Cardiomyopathy
Authors: Cavigli Luna , Ragazzoni Gian Luca , Vannuccini Francesca , Targetti Mattia , Mandoli Giulia Elena , Senesi Giada , Pastore Maria Concetta , Focardi Marta , Cameli Matteo , Valente Serafina , Bonifazi Marco , Olivotto Iacopo , D'Ascenzi Flavio 
Published: October 2024

Background
Patients with hypertrophic cardiomyopathy (HCM) are generally restricted regarding participation in competitive sports based on the potential risk of sudden cardiac death and malignant arrhythmias. As a result, they are often inactive and experience the negative consequences of a sedentary lifestyle. Hence, the need arises to strike the right balance between these 2 extremes through personalized exercise prescription. The aims of this study were (1) to assess the characteristics of patients with HCM practicing regular aerobic physical activity compared with sedentary patients; (2) to perform a personalized moderate‐intensity exercise prescription and evaluate its effects.

Methods and Results

Patients with HCM were evaluated through clinical assessment, ECG, ambulatory ECG monitoring, echocardiography, and cardiopulmonary testing. A personalized moderate‐intensity exercise prescription was performed, and the same investigations were repeated. Physically active patients with HCM demonstrated better cardiopulmonary functional capacity than sedentary patients (oxygen consumption
peak
/kg 32.9±7.4 versus 25.2±7.4 mL/min per kg
P
≤0.0001, ventilation/carbon dioxide production slope 26.7±4.3 versus 29.9±5.2
P
=0.004), with similar prevalence of ventricular arrhythmias (
P
=0.43). Sedentary subjects showed a borderline higher prevalence of obesity (
P
=0.07) than physically active subjects. Moderate‐intensity exercise prescription led to improved cardiopulmonary fitness without occurrence of adverse events.

Conclusions
Patients with HCM practicing regular aerobic exercise have a better functional capacity in the absence of relevant events than sedentary patients. Conversely, a sedentary lifestyle led to a deterioration of cardiopulmonary functional capacity and fitness. The tailored moderate‐intensity personalized exercise prescription appears to be a feasible approach in carefully selected patients with HCM to counterbalance the negative effects of sedentary behavior without significant major events.
Oxygen Extraction Fraction Mapping on Admission Magnetic Resonance Imaging May Predict Recovery of Hyperacute Ischemic Brain Lesions After Successful Thrombectomy: A Retrospective Observational Study
Authors: Bani-Sadr Alexandre , Hermier Marc , de Bourguignon Charles , Mechtouff Laura , Eker Omer F. , Cappucci Matteo , Tommasino Emanuele , Martin Anna , Cho Tae-Hee , Derex Laurent , Nighoghossian Nobert , Berthezene Yves 
Published: October 2024

BACKGROUND:
In acute stroke, diffusion-weighted imaging (DWI) is used to assess the ischemic core. Dynamic-susceptibility contrast perfusion magnetic resonance imaging allows an estimation of the oxygen extraction fraction (OEF), but the outcome of DWI lesions with increased OEF postrecanalization is unclear. This study investigated the impact of OEF on the fate of DWI lesions in patients achieving recanalization after thrombectomy.

METHODS:
This was a retrospective analysis of the HIBISCUS-STROKE cohort (Cohort of Patients to Identify Biological and Imaging Markers of Cardiovascular Outcomes in Stroke; NCT: 03149705), a single-center observational study that prospectively enrolled patients who underwent magnetic resonance imaging triage for thrombectomy and a day-6 T2-fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging. Automated postprocessing of admission dynamic-susceptibility contrast perfusion magnetic resonance imaging generated OEF maps. At visual analysis, the OEF status within DWI lesions was assessed in comparison to the contralateral side and correlated with volume changes (difference of ischemic lesion between admission DWI and registered day-6 T2-FLAIR). At voxel-based analysis, recovered DWI regions (lesions present on the admission DWI but absent on the registered day-6 T2-FLAIR) and nonrecovered regions were segmented to extract semiquantitative OEF values.

RESULTS:

Of the participants enrolled from 2016 to 2022, 134 of 321 (41.7%) were included (median age, 71.0 years; 58.2% male; median baseline National Institutes of Health Scale score, 15.0). At visual analysis, 46 of 134 (34.3%) patients had increased OEF within DWI lesions. These patients were more likely to show a reduction in ischemic lesion volumes compared with those without increased OEF (median change, −4.0 versus 4.8 mL;
P
<0.0001). Multivariable analysis indicated that increased OEF within DWI lesions was associated with a reduction in ischemic lesion volumes from admission DWI to day-6 T2-FLAIR (odds ratio, 0.68 [95% CI, 0.49–0.87];
P
=0.008). At voxel-based analysis, recovered DWI regions had increased OEF, while nonrecovered regions had decreased OEF (median, 126.9% versus −27.0%;
P
<0.0001).

CONCLUSIONS:
Increased OEF within hyperacute DWI lesions was associated with ischemic lesion recovery between admission DWI and day-6 T2-FLAIR in patients achieving recanalization after thrombectomy.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03149705.
Survival and Evolutionary Adaptation of Populations Under Disruptive Habitat Change: A Study With Darwinian Cellular Automata
Authors: Derets Hanna , Nehaniv Chrystopher L. 
Published: October 2024

Abstract
The evolution of living beings with continuous and consistent progress toward adaptation and ways to model evolution along principles as close as possible to Darwin’s are important areas of focus in Artificial Life. Though genetic algorithms and evolutionary strategies are good methods for modeling selection, crossover, and mutation, biological systems are undeniably spatially distributed processes in which living organisms interact with locally available individuals rather than with the entire population at once. This work presents a model for the survival of organisms during a change in the environment to a less favorable one, putting them at risk of extinction, such as many organisms experience today under climate change or local habitat loss or fragmentation. Local spatial structure of resources and environmental quality also impacts the capacity of an evolving population to adapt. The problem is considered on a probabilistic cellular automaton with update rules based on the principles of genetic algorithms. To carry out simulations according to the described model, the Darwinian cellular automata are introduced, and the software has been designed with the code available open source. An experimental evaluation of the behavioral characteristics of the model was carried out, completed by a critical evaluation of the results obtained, parametrically describing conditions and thresholds under which extinction or survival of the population may occur.
Al-Balāghah’s Legacy in Modern Secular Journalism
Authors: Fontana Chiara 
Published: October 2024

Abstract
Contemporary studies have already explored al-Risālah magazine’s (1933–1953) dynamic role in championing a far-reaching secular-grounded educational mission— which was made more urgent by the encounter with Western innovations. Still, little attention has been paid to the journal’s strong linkages with Arabic classical heritage. This article argues that al-Risālah’s writings employed concepts and terminology related to al-balāghah, or eloquence, that were by turns accurate, controversial, and innovative. These uses enriched the spectrum of al-balāghah’s applicability also to the discussion of current preoccupations with other fields like psychology. While accounting for thought-provoking works like Tāhā Ḥusayn’s al-Bayān al-ʿarabī min al-Jāḥiẓ ilā ʿAbd al-Qāhir [The Arabic Bayān, from al-Jāḥiẓ to ʿAbd al-Qāhir, 1933,] Amīn al-Khūlī’s al-Balāghah wa-ʿilm al-nafs [al-Balāghah and Psychology, 1939,] and al-Zayyāt’s Difāʿun ʿan al-balāghah [In Defense of al-Balāghah, 1945] as pioneering studies towards the new conceptualizations of the discipline up to the mid-half of the twentieth-century, this study purports to trace the presence of al-balāghah in al-Risālah’s articles in both quantitative and qualitative terms through the employment of DH tools for data mining. By mapping the ontological shifts that occurred in traditional languages and concepts’ employment as both contrastive and continuous, the present inquiries showcase modern Arab culture’s dialectics of secularism and literary revisionism as self-sufficient, culturally embedded and integrated, and not as byproducts of contact with the West.
Le style pragmatique et commatique de Porphyre à Simplicius
Authors: Cutino Miriam 
Published: October 2024

Abstract
In this study, we aim to analyze the notions of “pragmatic” and “commatic” we encounter in what we highlight to be a process of canonization of style appropriate to each content and theological level since Porphyry. This research is divided into three parts: primarily, we investigate the sense in which the Neoplatonists use the adjective “commatic”, which includes on the one hand (1) defining what the Neoplatonists mean by “unity of meaning”, and on the other hand distinguishing between a “woven” and continuous style and a “disjointed” and broken style, collecting the stylistic criticisms made by the Neoplatonists of the ancient texts; then (2) we seek to establish the areas of application of the “commatic” style in Neoplatonic discourse, distinguishing on the one hand inspired and ethical discourse, and on the other hand clear and sharp dialectical discourse, bordering on that which eludes philosophical demonstration, namely, the ἀσάφεια; finally (3), we aim to study the “pragmatic” style associated with each theological content in order to highlight its corresponding style and vocabulary.
The present research stems from the need to show how behind the lexical and structural choices of the Neoplatonic writings there is a precise theory of style, produced by a process of aesthetic canonization that emerges clearly as early as Porphyry’s rhetorical fragments and from Neoplatonic exegetical activity on rhetorical works, as well as from an innumerable amount of references to a rhetorical tradition on the period and its parts, the commata and côla, which the Neoplatonists, as this study aims to show, master and apply on their own structuring and formalization of theological content.