bluuebunny/crossref_metadata_2025_split huggingface dataset:
Type 2 Myocardial Infarction in a Sub‐Saharan Africa Population: Challenging the Current Concepts—Data From REACTIV
Authors: Yao Hermann , Touré Camille , Ekou Arnaud , Sepih Elvis , Cottin Yves , Zeller Marianne , Putot Alain , N'Guetta Roland 
Published: July 2024

Background
From a large observational acute coronary syndrome registry in Côte d'Ivoire, we aimed to assess incidence, clinical presentation, management, and in‐hospital outcomes for type 2 myocardial infarction (T2MI) compared with type 1 MI.

Methods and Results

We conducted a cross‐sectional monocentric study using data from REACTIV (Registre des Infarctus de Côte d'Ivoire) at the Abidjan Heart Institute. All patients hospitalized with MI between 2018 and 2022 who underwent coronary angiography were included. For each patient, sociodemographic data, cardiovascular risk factors and history, and clinical and paraclinical presentation were collected at admission. In‐hospital outcomes, including major adverse cardiovascular events and mortality, were reported. Among 541 consecutive patients hospitalized with MI, 441 met the definition of type 1 MI or T2MI. T2MI accounted for 14.1% of cases. Patients with T2MI showed a trend toward slightly younger age (54 versus 58 years,
P
=0.09). Patients with T2MI seemed to have less severe coronary artery disease, with less frequent multivessel disease (
P
<0.001). Main triggering factors for T2MI were coronary embolism (24.2%), severe hypertension with or without left ventricular hypertrophy (22.6%), and tachyarrhythmia (16.1%).

In‐hospital event rates were low in both MI types. Although the difference was nonsignificant, death rates for patients with type 1 MI tended to be higher than for patients with T2MI, as well as occurrence of major adverse cardiovascular events.

Conclusions
Our study revealed disparities in clinical characteristics, angiographic features, cause, and in‐hospital outcomes in T2MI in our population compared with Western populations. These results suggest the heterogeneity of T2MI and the potential causative and demographic variability depending on geographical area.
Depression and Implantable Cardioverter‐Defibrillator Implantation in Black Patients at Risk for Sudden Cardiac Death
Authors: Boursiquot Brian C. , Young Rebecca , Alhanti Brooke , Sullivan Lonnie T. , Maul Andrew J. , Khedagi Apurva , Sears Samuel F. , Jackson Larry R. , Thomas Kevin L. 
Published: July 2024

Background
Black patients meeting indications for implantable cardioverter‐defibrillators (ICDs) have lower rates of implantation compared with White patients. There is little understanding of how mental health impacts the decision‐making process among Black patients considering ICDs. Our objective was to assess the association between depressive symptoms and ICD implantation among Black patients with heart failure.

Methods and Results
This is a secondary analysis of the VIVID (Videos to Address Racial Disparities in ICD Therapy via Innovative Designs) randomized trial, which enrolled self‐identified Black individuals with chronic systolic heart failure. Depressive symptoms were assessed by the Patient Health Questionnaire‐2 and the Mental Component Summary of the 12‐Item Short‐Form Health Survey. Decisional conflict was measured by an adapted Decisional Conflict Scale (DCS). ANCOVA was used to assess differences in Decisional Conflict Scale scores. Multivariable logistic regression was used to examine the association between depressive symptoms and ICD implantation. Among 306 participants, 60 (19.6%) reported depressed mood, and 142 (46.4%) reported anhedonia. Participants with the lowest Mental Component Summary of the 12‐Item Short‐Form Health Survey scores (poorer mental health and higher likelihood of depression) had greater decisional conflict regarding ICD implantation compared with those with the highest Mental Component Summary of the 12‐Item Short‐Form Health Survey scores (adjusted mean difference in Decisional Conflict Scale score, 3.2 [95% CI, 0.5–5.9]). By 90‐day follow‐up, 202 (66.0%) participants underwent ICD implantation. There was no association between either the Patient Health Questionnaire‐2 score or the Mental Component Summary of the 12‐Item Short‐Form Health Survey score and ICD implantation.

Conclusions
Depressed mood and anhedonia were prevalent among ambulatory Black patients with chronic systolic heart failure considering ICD implantation. The presence of depressive symptoms did not impact the likelihood of ICD implantation in this population.
Addition of Social Determinants of Health to Coronary Heart Disease Risk Prediction: The Multi‐Ethnic Study of Atherosclerosis
Authors: Murphy Brittany Saldivar , Nam Yunbi , McClelland Robyn L. , Acquah Isaac , Cainzos‐Achirica Miguel , Nasir Khurram , Post Wendy S. , Aldrich Melinda C. , DeFilippis Andrew P. 
Published: July 2024

Background
Social determinants of health (SDoH) are associated with cardiovascular risk factors and outcomes; however, they are absent from risk prediction models. We aimed to assess if the addition of SDoH improves the predictive ability of the MESA (Multi‐Ethnic Study of Atherosclerosis) Risk Score.

Methods and Results

This was a community‐based prospective population cohort study that enrolled 6286 men and women, ages 45–84 years, who were free of clinical coronary heart disease (CHD) at baseline. Data from 10‐year follow‐up were examined for CHD events, defined as myocardial infarction, fatal CHD, resuscitated cardiac arrest, and revascularization in cases of anginal symptoms. Participants included 53% women with average age of 62 years. When adjusting for traditional cardiovascular risk factors, SDoH, and coronary artery calcium, economic strain, specifically low family income, was associated with a greater risk of CHD events (hazard ratio [HR], 1.42 [95% CI, 1.17–1.71],
P
value<0.001). Area under the curve of risk prediction with SDoH was 0.822, compared with 0.816 without SDoH. The calibration slope was 0.860 with SDoH and 0.878 in the original model.

Conclusions
Significant associations were found between economic/financial SDoH and CHD risk factors and outcomes. Incorporation of SDoH into the MESA Risk Score did not improve predictive ability of the model. Our findings do not support the incorporation of SDoH into current risk prediction algorithms.
Intensive Versus Moderate Statin‐Based Therapies in Patients With Mild Ischemic Stroke: A Prospective Multicenter Cohort Study
Authors: Fan Hai‐mei , Wang Yong‐le , Zhang Kai‐li , Liu Ting‐ting , Li Xin‐yi , Li Ya‐nan , Li Ya‐li , Li Juan , Ren Jing , Liu Yu‐ting , Wang Jun‐hui , Xue Li‐xi , Du Wen‐xian , Niu Wen‐hua , Yan Yu‐ping , Gao Xiao‐lei , Liu Qing‐ping , Li Gai‐mei , Wu Xue‐mei , Niu Xiao‐yuan 
Published: July 2024

Background
Statins are widely used for treating patients with ischemic stroke at risk of secondary cerebrovascular events. It is unknown whether Asian populations benefit from more intensive statin‐based therapy for stroke recurrence. Therefore, in the present study we evaluated the effectiveness and safety of high‐dose and moderate‐dose statins for patients who had experienced mild ischemic stroke during the acute period.

Methods and Results

This multicenter prospective study included patients with mild ischemic stroke who presented within 72 hours of symptom onset. The outcomes of patients in the high‐intensity and moderate‐intensity statin treatment groups were compared, with the main efficacy outcome being stroke recurrence and the primary safety end point being intracranial hemorrhage. The propensity score matching method was employed to control for imbalances in baseline variables. Subgroup analyses were conducted to evaluate group differences. In total, the data of 2950 patients were analyzed at 3 months, and the data of 2764 patients were analyzed at 12 months due to loss to follow‐up. According to the multivariable Cox analyses adjusted for potential confounders, stroke recurrence occurred similarly in the high‐intensity statin and moderate‐intensity statin groups (3 months: adjusted hazard ratio [HR], 1.12 [95% CI, 0.85–1.49];
P
=0.424; 12 months: adjusted HR, 1.08 [95% CI, 0.86–1.34];
P
=0.519). High‐intensity statin therapy was associated with an increased risk of intracranial hemorrhage (3 months: adjusted HR, 1.81 [95% CI, 1.00–3.25];
P
=0.048; 12 months: adjusted HR, 1.86 [95% CI, 1.10–3.16];
P
=0.021). The results from the propensity score‐matched analyses were consistent with those from the Cox proportional hazards analysis.

Conclusions
Compared with moderate‐intensity statin therapy, high‐dose statin therapy may not decrease the risk of mild, noncardiogenic ischemic stroke recurrence but may increase the risk of intracranial hemorrhage.

Registration

URL:
www.chictr.org.cn/
. Unique Identifier: ChiCTR1900025214.
The Eastern Mediterranean Boundary Current: Seasonality, Stability, and Spiral Formation
Authors: Verma Vicky , Barkan Roy , Solodoch Aviv , Gildor Hezi , Toledo Yaron 
Published: July 2024

Abstract
Seasonal variability and the effect of bottom interaction on the dynamics of the along-slope boundary current flowing around the Levantine Basin are investigated using nested high-resolution simulations of the eastern Mediterranean Sea. The numerical solutions show a persistent boundary current year-round that is ≈60 km wide and ≈200 m deep. An enstrophy balance diagnostic reveals significant bottom-drag influence on the boundary current, leading to anticyclonic vorticity generation in thin regions along the coast, which in turn become unstable and roll into surface-intensified anticyclonic spirals characterized by O(1) Rossby numbers. An eddy kinetic energy generation analysis suggests that a mix of baroclinic and barotropic instabilities is likely responsible for the spiral formation. The boundary current and spirals play a crucial role in the cross-shore transport of materials. In winter, the anticyclonic spirals frequently interact and exchange material with the energetic offshore submesoscale flow field. In summer, when the offshore flow structures are relatively less energetic, the spirals remain confined to the boundary current region as they are advected by the boundary current and undergo an upscale kinetic energy (KE) cascade that is manifested in spiral merging and growth up to 100 km in diameter. In both seasons, a coarse-graining analysis demonstrates that the cross-scale KE fluxes are spatially localized in coherent structures. The upscale KE fluxes typically occur within the spirals, while the downscale KE fluxes are confined to fronts and filaments at spiral peripheries.
Exploring the complex associations among risks of malnutrition, sarcopenia, and frailty in community-dwelling older adults
Authors: Celik Halil Ibrahim , Koc Ferda , Siyasal Kübra , Ay Büsra , Ilter Nazlı Bengu , Celik Ozge Mengi 
Published: July 2024

Abstract
Background
Malnutrition, sarcopenia, and frailty are age-related conditions that are associated with multiple health-related negative outcomes. However, the complex associations between them remain to be elucidated. The aims of the study were to explore: (1) whether the risk of sarcopenia has a mediator effect on the association between risks of malnutrition and frailty; and (2) whether physical activity (PA) level modulates this mediator effect in community-dwelling older adults.

Methods
This cross-sectional study involved 593 older adults (62.73% female; mean age = 71.35 ± 5.86 years). The Mini Nutritional Assessment-Short Form (MNA-SF), the SARC-F Questionnaire, and the FRAIL Questionnaire were used to assess the risks of malnutrition, sarcopenia, and frailty, respectively. The International Physical Activity Questionnaire Short Form (IPAQ-SF) was employed to assess PA level. Using the Hayes PROCESS macro (Models 4 and 7), mediation and moderated mediation analyses were performed.

Results
The mediation analysis demonstrated that the MNA-SF had a significant effect on the SARC-F (B=-0.325; p < 0.001) and the SARC-F, in turn, had a significant effect on the FRAIL (B = 0.341; p < 0.001). The total (B=-0.171; p < 0.001), direct (B=-0.061; p = 0.001), and indirect (B=-0.111; bootstrap CI did not include zero, which indicates a significant effect) effects of MNA-SF on FRAIL were significant, showing that 65% of the association between the MNA-SF and FRAIL was explained by the SARC-F acting as a mediator. The moderated mediation analysis demonstrated that the association between MNA and SARC-F was moderated by the PA level (B = 0.253; p = 0.016). The SARC-F mediated and relatively enhanced the association between MNA-SF and FRAIL only in older adults with a moderate PA level (B=-0.120; CI: -0.154 to -0.085).

Conclusions
The SARC-F partially mediates the association between the MNA-SF and the FRAIL, indicating that malnutrition affects frailty through an indirect path via sarcopenia. Furthermore, the PA level moderates this mediator effect, with sarcopenia serving as a mediator in older adults with moderate a PA level but not in those with a low PA level. These findings reveal that it may be beneficial to consider PA level in combination with malnutrition and sarcopenia in the management and prevention of frailty in community-dwelling older adults.
Anticandidal applications of selenium nanoparticles biosynthesized with Limosilactobacillus fermentum (OR553490)
Authors: Mohamed Esraa Ali , El‑Zahed Mohamed Marzouk 
Published: July 2024

AbstractCandida albicans is one of the most dangerous pathogenic fungi in the world, according to the classification of the World Health Organization, due to the continued development of its resistance to currently available anticandidal agents. To overcome this problem, the current work provided a simple, one-step, cost-effective, and safe technique for the biosynthesis of new functionalized anticandidal selenium nanoparticles (Se NPs) against C. albicans ATCC10231 using the cell-free supernatant of Limosilactobacillus fermentum (OR553490) strain. The bacterial strain was isolated from yogurt samples available in supermarkets, in Damietta, Egypt. The mixing ratio of 1:9 v/v% between cell-free bacterial metabolites and sodium selenite (5 mM) for 72 h at 37 °C were the optimum conditions for Se NPs biosynthesis. Ultraviolet–visible spectroscopy (UV–Vis), Fourier transform infrared spectroscopy (FT-IR), transmission electron microscopy (TEM), X-ray diffraction (XRD), Zeta analyses, and elemental analysis system (EDS) were used to evaluate the optimized Se NPs. The Se NPs absorption peak appeared at 254 nm. Physicochemical analysis of Se NPs revealed the crystalline-shaped and well-dispersed formation of NPs with an average particle size of 17–30 nm. Se NPs have − 11.8 mV, as seen by the zeta potential graph. FT-IR spectrum displayed bands of symmetric and asymmetric amines at 3279.36 cm−1 and 2928.38 cm−1, aromatic and aliphatic (C–N) at 1393.32 cm−1 and 1237.11.37 cm−1 confirming the presence of proteins as stabilizing and capping agents. Se NPs acted as a superior inhibitor of C. albicans with an inhibition zone of 26 ± 0.03 mm and MIC value of 15 µg/mL compared to one of the traditional anticandidal agent, miconazole, which revealed 18 ± 0.14 mm and 75 µg/mL. The cytotoxicity test shows that Se NPs have a low toxic effect on the normal keratinocyte (IC50 ≈ 41.5 μg/mL). The results indicate that this green synthesis of Se NPs may have a promising potential to provide a new strategy for drug therapy.
Evolution content in school textbooks: data from eight European countries
Authors: Panayides Andreas , Sá-Pinto Xana , Mavrikaki Evangelia , Aanen Duur K. , Aboim Sara , Cavadas Bento , Dvorakova Radka Marta , Eens Marcel , Filova Eliska , Gregorčič Tanja , Kapsala Nausica , Nieuwenhuis Mathijs , Ometto Lino , Papadopoulou Penelope , Pinxten Rianne , Realdon Giulia , Ribeiro Nuno , Coelho da Silva José Luis , Sousa Bruno , Torkar Gregor , Korfiatis Konstantinos 
Published: July 2024

Abstract
Background
Evolution is a unifying theme in biology and its understanding is essential to address sustainability problems. However, many people across the world do not understand evolution. Textbooks are among the most widely used educational resources and the way they depict evolution may greatly impact students’ scientific literacy in evolution. In this paper we investigate which evolution concepts are addressed in European science textbooks, from the 1st to the 9th grade. A content analysis using the ‘Framework for the Assessment of school Curricula on the presence of Evolutionary concepts”, was performed on textbooks from eight European countries: Belgium, Cyprus, Czech Republic, Greece, Italy, Netherlands, Portugal and Slovenia. At least two experienced coders per country independently analysed the texts, images and activities, discussed the results and reached a final consensus.

Results
Our results show that textbooks lack or rarely address concepts considered important for evolution understanding, notably the processes driving evolution and their daily life implications, limiting opportunities for education for sustainability.

Conclusions
We recommend that science textbooks emphasize evolution and its processes since the first school years. This recommendation is particularly relevant for the analysed textbooks from Cyprus and Belgium, that cover less than 45% of the concepts important to evolution literacy.
Host defense alteration in Caenorhabditis elegans after evolution under ionizing radiation
Authors: Quevarec Loïc , Morran Levi T. , Dufourcq-Sekatcheff Elizabeth , Armant Olivier , Adam-Guillermin Christelle , Bonzom Jean-Marc , Réale Denis 
Published: July 2024

Abstract
Background
Adaptation to a stressor can lead to costs on other traits. These costs play an unavoidable role on fitness and influence the evolutionary trajectory of a population. Host defense seems highly subject to these costs, possibly because its maintenance is energetically costly but essential to the survival. When assessing the ecological risk related to pollution, it is therefore relevant to consider these costs to evaluate the evolutionary consequences of stressors on populations. However, to the best of our knowledge, the effects of evolution in irradiate environment on host defense have never been studied. Using an experimental evolution approach, we analyzed fitness across 20 transfers (about 20 generations) in Caenorhabditis elegans populations exposed to 0, 1.4, and 50.0 mGy.h− 1 of 137Cs gamma radiation. Then, populations from transfer 17 were placed in the same environmental conditions without irradiation (i.e., common garden) for about 10 generations before being exposed to the bacterial parasite Serratia marcescens and their survival was estimated to study host defense. Finally, we studied the presence of an evolutionary trade-off between fitness of irradiated populations and host defense.

Results
We found a lower fitness in both irradiated treatments compared to the control ones, but fitness increased over time in the 50.0 mGy.h− 1, suggesting a local adaptation of the populations. Then, the survival rate of C. elegans to S. marcescens was lower for common garden populations that had previously evolved under both irradiation treatments, indicating that evolution in gamma-irradiated environment had a cost on host defense of C. elegans. Furthermore, we showed a trade-off between standardized fitness at the end of the multigenerational experiment and survival of C. elegans to S. marcescens in the control treatment, but a positive correlation between the two traits for the two irradiated treatments. These results indicate that among irradiated populations, those most sensitive to ionizing radiation are also the most susceptible to the pathogen. On the other hand, other irradiated populations appear to have evolved cross-resistance to both stress factors.

Conclusions
Our study shows that adaptation to an environmental stressor can be associated with an evolutionary cost when a new stressor appears, even several generations after the end of the first stressor. Among irradiated populations, we observed an evolution of resistance to ionizing radiation, which also appeared to provide an advantage against the pathogen. On the other hand, some of the irradiated populations seemed to accumulate sensitivities to stressors. This work provides a new argument to show the importance of considering evolutionary changes in ecotoxicology and for ecological risk assessment.
Improving the non-structural preparedness of the selected hospital based on the FOCUS-PDCA1 model: action research
Authors: Basiri Alireza , Farajzadeh Mohsen Abbasi , Belal Mohammad , Heidaranlu Esmail 
Published: July 2024

AbstractIntroductionWith the intensification of the country’s development process, the expansion of cities and population, and the inclusion of Iran in the accident-prone category, reducing the vulnerability of non-structures has received more attention from the organizations involved. In addition to damage to communities and infrastructure, accidents can affect hospitals and their non-organizational components. Hospitals, as the front line of providing medical services after accidents, must maintain their stability, ensure the safety of their patients and employees, and continue to operate without interruption as in normal conditions. Therefore, it is necessary to evaluate the non-structural safety and their preparedness to ensure they can perform acceptable in critical conditions.MethodsThis applied research was conducted in 2023 (September to December) using the participatory action research method in all selected hospital departments. The level of non-structural preparedness of the hospital was checked using the valid “Hospital Safety Index” questionnaire and the non-structural weaknesses of the hospital were identified. Then, in action research using the FOCUS-PDCA model, a program was implemented to improve the non-structural preparedness of different departments of hospitals in the face of accidents and disasters. The non-structural readiness level of the hospital was compared before and after the implementation of the change.ResultsBased on the evaluation conducted in the present study, the lowest level of safety was observed in the water supply system, office furniture and appliances, and fuel storage. The waste management systems, the fire protection system, and the long-distance communication systems were at a desirable performance level. Although in the evaluation before the change, the overall score of the hospital was 71.01%, and it had a desirable performance level in non-structural factors, in all the involved parts of the hospital, the sensitive, critical, and practical parts in the operation of the hospital had an average and sometimes low safety level. According to the obtained safety score, the safety level of the selected hospital before the change was 7 out of 10 (level seven of safety evaluation = medium). After the change and corrective measures, the non-structural safety assessment score was 76.93, and the hospital’s safety level was raised by one step to 8 out of 10 (8th level of safety assessment = relatively favorable).ConclusionThe present study showed that the application of Total Quality Management (TQM), primarily its application tool FOCUS-PDCA, is efficient and helpful in improving the non-structural preparedness of hospitals. Using action research in the health field in accidents and disasters can open blind knots in different dimensions of preparedness (structural, non-structural, and functional).