bluuebunny/crossref_metadata_2025_split huggingface dataset:
Kidney function–specific cut-off values of high-sensitivity cardiac troponin T for the diagnosis of acute myocardial infarction
Authors: Chen Ruixuan , Pang Mingzhen , Yu Hongxue , Luo Fan , Zhang Xiaodong , Su Licong , Li Yanqin , Zhou Shiyu , Xu Ruqi , Gao Qi , Gan Daojing , Xu Xin , Nie Sheng , Hou Fan Fan ,   for the CRDS study Investigators, Xu Hong , Liu Bicheng , Weng Jianping , Chen Chunbo , Liu Huafeng , Yang Qiongqiong , Li Hua , Li Guisen , Wan Qijun , Zha Yan , Hu Ying , Xu Gang , Shi Yongjun , Zhou Yilun , Tang Ying , Gong Mengchun , Wang Chen , Liu Dehui , Luo Pengli , Shen Jie , Bai Yihua 
Published: August 2024

ABSTRACT

Background
The diagnosis of acute myocardial infarction (AMI) using high-sensitivity cardiac troponin T (hs-cTnT) remains challenging in patients with kidney dysfunction.

Methods
In this large, multicenter cohort study, a total of 20 912 adults who underwent coronary angiography were included. Kidney function–specific cut-off values of hs-cTnT were determined to improve the specificity without sacrificing sensitivity, as compared with that using traditional cut-off value (14 ng/L) in the normal kidney function group. The diagnostic accuracy of the novel cut-off values was validated in an independent validation cohort.

Results
In the derivation cohort (n = 12 900), 3247 patients had an estimated glomerular filtration rate (eGFR) &lt;60 mL/min/1.73 m2. Even in the absence of AMI, 50.2% of participants with eGFR &lt;60 mL/min/1.73 m2 had a hs-cTnT concentration ≥14 ng/L. Using 14 ng/L as the threshold of hs-cTnT for diagnosing AMI led to a significantly reduced specificity and positive predictive value in patients with kidney dysfunction, as compared with that in patients with normal kidney function. The kidney function–specific cut-off values were determined as 14, 18 and 48 ng/L for patients with eGFR &gt;60, 60–30 and &lt;30 mL/min/1.73 m2, respectively. Using the novel cut-off values, the specificities for diagnosing AMI in participants with different levels of kidney dysfunction were remarkably improved (from 9.1%–52.7% to 52.8–63.0%), without compromising sensitivity (96.6%–97.9%). Similar improvement of diagnostic accuracy was observed in the validation cohort (n = 8012).

Conclusions
The kidney function–specific cut-off values of hs-cTnT may help clinicians to accurately diagnose AMI in patients with kidney dysfunction and avoid the potential overtreatment in practice.
The association between klotho and kidney and cardiovascular outcomes: a comprehensive systematic review and meta-analysis
Authors: Kanbay Mehmet , Brinza Crischentian , Ozbek Lasin , Guldan Mustafa , Sisman Uluman , Copur Sidar , Covic Andreea , Scripcariu Dragos-Viorel , Burlacu Alexandru , Covic Adrian 
Published: August 2024

ABSTRACT

Background
Chronic kidney disease (CKD) and end-stage renal disease (ESKD) are significant global health challenges associated with progressive kidney dysfunction and numerous complications, including cardiovascular disease and mortality. This study aims to explore the potential association between plasma klotho levels and various prognostic outcomes in CKD and ESKD, including all-cause mortality, cardiovascular events, metabolic syndrome development and adverse renal events necessitating renal replacement therapies.

Methods
A literature search was conducted through 3 June 2024 using the electronic databases Cochrane Library, Ovid MEDLINE, CINAHL, Web of Science, SCOPUS and PubMed. This systematic review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results
Fourteen studies were included. For all-cause mortality, comparing CKD patients with low versus high klotho levels showed a significant association {odds ratio [OR] 1.81 [95% confidence interval (CI) 1.34–2.44], P = .0001}, with substantial heterogeneity (I2 = 69%). Excluding one study reduced heterogeneity (I2 = 43%) while maintaining significance [OR 1.97 (95% CI 1.45–2.66), P &lt; .0001]. Cardiovascular mortality was higher in patients with low klotho levels [OR 2.11 (95% CI 1.61–2.76), P &lt; .00001], with low heterogeneity (I2 = 25%). Excluding one study eliminated heterogeneity (I2 = 0%) while maintaining significance [OR 2.39 (95% CI 1.83–3.12), P &lt; .00001]. Composite cardiovascular events did not differ significantly between low and high klotho groups [OR 1.51 (95% CI 0.82–2.77), P = .18], but with high heterogeneity (I2 = 72%). Patients with low klotho levels had a higher risk of adverse renal events [OR 2.36 (95% CI 1.37–4.08), P = .002], with moderate heterogeneity (I2 = 61%). Sensitivity analysis reduced heterogeneity (I2 = 0%) while maintaining significance [OR 3.08 (95% CI 1.96–4.85), P &lt; .00001]. Specifically, for ESKD or kidney replacement therapy risk, low klotho levels were associated with an increased risk [OR 2.30 (95% CI 1.26–4.21), P = .007]. Similarly, CKD progression risk was higher in patients with lower klotho levels [OR 2.48 (95% CI 1.45–4.23), P = .0009].

Conclusion
Lower serum klotho levels serve as a significant predictor of adverse outcomes, including increased risks of all-cause mortality, cardiovascular mortality and progression to end-stage kidney disease among CKD patients.
Dynamic assessment of left ventricular coupling and myocardial reserve in patients with cardiogenic shock
Authors: Kanelidis Anthony J , Randazzo Michael J , Kalantari Sara , Smith Bryan , Nguyen Ann , Chung Ben B , Swat Stanley , Sarswat Nitasha , Salerno Christopher , Jeevanandam Valluvan , Kim Gene , Belkin Mark N , Grinstein Jonathan 
Published: August 2024

Abstract

Aims
Pulmonary artery catheter haemodynamics are associated with improved survival in cardiogenic shock (CS). We investigated the utility of aortic pulsatility index (API) and cardiac power output (CPO) as surrogates for left ventricular (LV) coupling and myocardial reserve, respectively, in patients with CS undergoing dynamic assessment after a milrinone bolus.

Methods and results
Patients with SCAI Stage C CS underwent a milrinone drug study (50 mcg/kg bolus infused over 10 min) to assess inotropic response. Haemodynamic measurements were obtained at baseline and following the bolus. Aortic pulsatility index and CPO were used to risk-stratify patients with the incidence of LV assist device (LVAD), orthotopic heart transplantation (OHT), or death at 1 year as the primary composite endpoint. Two hundred and twenty-four patients in SCAI Stage C CS underwent haemodynamics prior to milrinone bolus, and 117 patients had low baseline API &lt; 1.45. Of the 117 patients, 88 had a final API &lt; 2.2 after milrinone load, consistent with LV decoupling, in which 73% met the composite endpoint. The remaining 29 patients had a final API ≥ 2.2 consistent with LV recoupling, and only 55% met the composite endpoint (P = 0.046). Of the 117 patients, 40 patients had low myocardial reserve (final CPO &lt; 0.77 W), in which 78% met the composite endpoint. Of the 77 patients who demonstrated myocardial reserve (final CPO ≥ 0.77 W), only 64% met the composite endpoint (P = 0.039).

Conclusion
The use of API and CPO in a dynamic assessment after provocative testing led to improved risk stratification in patients with SCAI Stage C CS for clinical outcomes including LVAD, OHT, or death at 1 year.
Decellularized aortic homografts versus mechanical composite grafts for aortic root replacement
Authors: Andreeva Alexandra , Werner Paul , Coti Iuliana , Kocher Alfred , Laufer Guenther , Ehrlich Marek , Zimpfer Daniel , Andreas Martin 
Published: August 2024

Abstract

OBJECTIVES
Mechanical composite valve grafts (MCVGs) are the first-line therapy for aortic root replacement in young adults. Decellularized aortic homografts (DAH) present a promising novel alternative due to their lower thrombogenicity. We aimed to compare both treatment options regarding survival and valve-related adverse events.

METHODS
This study was designed as a single-centre retrospective cohort study including patients who underwent root replacement with MCVG or DAH between 2000 and 2022. Urgent or emergent procedures were excluded.

RESULTS
The study cohort included 289 patients (MCVG n = 216, DAH n = 73) with a mean age of 48.5 ± 12 years (MCVG 49 ± 12 years vs DAH 47 ± 11 years; P = 0.23) and a median EuroScore II of 1.7% (1.2, 2.6). The 30-day mortality was 1% (n = 3). Cumulative survival at 3 years was 99% for DAH and 94% for MCVG, respectively (P = 0.15). Mean follow-up was 98.9 ± 72.7 months. Bleeding events (n = 14, 6.5%) and thromboembolism (n = 14, 6.5%) were only observed in the MCVG group (P = 0.19 and 0.09, respectively). Four cases (5%) of moderate structural valve deterioration occurred, all in the DAH group (P ≤ 0.001). The cumulative incidence of a composite end point of valve-related adverse events was significantly higher in the MCVG group (P = 0.0295).

CONCLUSIONS
Aortic root replacement with MCVGs and decellularized aortic homografts showed low mortality in an elective setting. Patients in the homograft cohort demonstrated significantly higher freedom from valve-related adverse events. DAH present a promising treatment option for young patients requiring root replacement; however, data on long-term durability are needed.
Surgical prognosis of lung invasive mucinous and non-mucinous adenocarcinoma: propensity score matched analysis
Authors: Lee Jun Oh , Lee Geun Dong , Choi Sehoon , Kim Hyeong Ryul , Kim Yong-Hee , Kim Dong Kwan , Park Seung-Il , Yun Jae Kwang 
Published: August 2024

Abstract

OBJECTIVES
Invasive mucinous adenocarcinoma exhibits distinct prognostic outcomes compared to non-mucinous adenocarcinoma (ADC). This study investigated and compared the clinical outcomes and prognostic factors of invasive mucinous and non-mucinous ADC patients.

METHODS
This retrospective study included patients who underwent curative surgery for ADC between 2011 and 2021. Patient characteristics were balanced using propensity score matching. Cumulative incidence was analysed to evaluate cancer recurrence incidence, and the Kaplan–Meier method was used to calculate overall survival (OS) for each group.

RESULTS
A total of 6101 patients were included. After matching, the non-mucinous group and mucinous groups comprised 798 and 408 patients, respectively. The patients in the mucinous group had a lower recurrence incidence than those in the non-mucinous group (P = 0.014). The recurrence incidence in the mucinous group was between those of grades 1 (P = 0.011) and 2 (P = 0.012) and the OS rates were comparable to those of grades 2 (P = 0.6) and 3 (P = 0.2). Multivariable analysis revealed that the maximal standardized uptake value [hazard ratio (HR): 1.13, P = 0.11] and progressed pathological stages (pStage II, HR: 3.9, P = 0.028; pStage III, HR: 8.33, P = 0.038) served as adverse prognostic factors for the mucinous group.

CONCLUSIONS
Patients with mucinous ADC demonstrated lower recurrence incidence and similar OS rates compared to those with non-mucinous ADC. The recurrence incidence of mucinous ADC was between those of International Association for the Study of Lung Cancer grades 1 and 2, with the OS rates comparable to those of grades 2 and 3.

CLINICAL REGISTRATION NUMBER
None.
No effect of surgery on kidney and cardiovascular risk factors in mild primary hyperparathyroidism: secondary analyses from a 10-year randomized controlled trial
Authors: Heck Ansgar , Pretorius Mikkel , Lundstam Karolina , Godang Kristin , Hellström Mikael , Ueland Thor , Bollerslev Jens 
Published: August 2024

Abstract

Objective
Renal function and the skeleton are classic target organs in primary hyperparathyroidism (PHPT), affected by the chronic course of the disease. Most patients diagnosed today exhibit mild PHPT, characterized by slight hypercalcemia and no or unspecific symptoms. Concerns have been raised that PHPT could promote deteriorating kidney function and increase cardiovascular risk directly. To examine the effect of parathyroidectomy (PTX) on mild PHPT on renal function and markers for bone turnover, cardiovascular disease (CVD), and vascular inflammation.

Design
Prospective randomized controlled trial. ClinicalTrials.gov: NCT00522028.

Setting
Eight Scandinavian referral centers.

Participants
From 1998 to 2005, 191 patients with mild PHPT were included in Sweden, Norway, and Denmark. Of these 150 were included in the present analyses.

Intervention
Seventy patients were randomized to PTX and 80 to observation without intervention (OBS).

Measures
e-GFR was calculated based on creatinine and cystatin C. Markers of CVD and systemic inflammation: osteoprotegerin, vascular cell adhesion molecule 1, soluble CD40 ligand, interleukin-1 receptor antagonist, von Willebrand factor. Bone turnover markers: C-terminal telopeptide of type 1 collagen (CTX-1) and serum Procollagen type 1 N-terminal propeptide.

Results
No differences in the development of renal function or vascular and systemic inflammation were detected. CTX-1 was lower in PTX after 10 years.

Limitations
Secondary analyses of a randomized controlled trial.

Conclusion
PTX does not appear to affect renal function or markers of CVD and vascular inflammation in mild PHPT in a ten-year perspective.
When the Sun, the Moon and the Stars Align: Litigating LGBTQIA+ Rights and the Death Penalty in East Africa and the Caribbean
Authors: Caserta Salvatore , Madsen Mikael Rask 
Published: August 2024

Abstract
This article analyses LGBTQIA+ rights and death penalty litigation in the Caribbean and East Africa before and after the establishment of new regional international courts. LGBTQIA+ rights and the death penalty are both difficult and contested issues where global movements and litigation strategies easily clash with local sentiments. For litigation to have an impact in such issue areas, the article finds that three elements must align. First, there is a need for new institutional opportunities such as new judicial venues or laws. Second, there is a need for coordinated legal strategies that can utilize the available legal venues. Third, there is a need for a societal momentum for the cause, or at least the absence of strong political contestation against the cause. In our study, the establishment of new regional courts provided institutional opportunities that could be seized by transnational litigation networks. And as international courts operate at a distance from local politics, they have created a more neutral international legal opportunity structure. In the two regions and across the two issue areas studied, these three elements were most clearly aligned regarding death penalty litigation in the Caribbean and the least aligned regarding LGBTQIA+ litigation in East Africa.
Smoking timing, genetic susceptibility, and the risk of incident atrial fibrillation: a large prospective cohort study
Authors: Zhou Jian , Hu Ying , Tang Rui , Kou Minghao , Wang Xuan , Ma Hao , Li Xiang , Heianza Yoriko , Qi Lu 
Published: August 2024

Abstract

Aims
Although smoking is a well-known risk factor for atrial fibrillation (AF), the association of smoking timing with AF risk remains unclear. This study aimed to prospectively investigate the association of smoking timing with the risk of incident AF and test the modification effect of genetic susceptibility.

Methods and results
A total of 305 627 participants with detailed information for time from waking to the first cigarette were enrolled from UK Biobank database. The Cox proportional hazard model was employed to assess the relationship between smoking timing and AF risk. The weighted genetic risk score for AF was calculated. Over a median 12.2-year follow-up, 13 410 AF cases were documented. Compared with non-smokers, time from waking to the first cigarette showed gradient inverse associations with the risk of incident AF (P-trend &lt;0.001). The adjusted hazard ratio related to smoking timing was 1.13 [95% confidence interval (CI): 0.96–1.34] for &gt;120 min, 1.20 (95% CI: 1.01–1.42) for 61–120 min, 1.34 (95% CI: 1.19–1.51) for 30–60 min, 1.43 (95% CI: 1.26–1.63) for 5–15 min, and 1.49 (95% CI: 1.24–1.63) for &lt;5 min, respectively. Additionally, we found that the increased risk of AF related to shorter time from waking to the first cigarette was strengthened by the genetic susceptibility to AF.

Conclusion
Our findings suggest gradient inverse association between time from waking to the first cigarette and risk of incident AF, and the association is strengthened by the genetic susceptibility to AF.
Ecological speciation in sympatric palms: 5. Evidence for pleiotropic speciation genes using gene knockout and high-throughput phenotyping
Authors: Coathup Matthew J , Mouhu Katriina , Himanen Kristiina , Turnbull Colin G N , Savolainen Vincent 
Published: August 2024

Abstract
Theoretical models predict that sympatric, ecological speciation may be facilitated more readily when so-called ‘magic traits’ are present, linking traits under divergent selection with assortative mating. Such traits might be encoded by pleiotropic genes, that is, genes that affect multiple, apparently unrelated, phenotypes. However, few convincing examples of sympatric speciation exist, and empirical evidence for the role of magic traits in driving such speciation is rare. One of the strongest cases of sympatric speciation is the Howea palms of Lord Howe Island, Australia, comprising the sister species Howea belmoreana and Howea forsteriana, which have diverged due to soil substrate preferences and flowering time displacement. Here we investigate the role that pleiotropy may have played in the speciation process by carrying out high-throughput phenotyping experiments using 1830 Arabidopsis thaliana plants with knockouts of candidate Howea ‘speciation genes’. We identify several genes that show signatures of adaptive divergence between the Howea species and demonstrate pleiotropic roles in soil stress tolerance and flowering time, consistent with the Howea speciation scenario—notably, Howea orthologues of the A. thaliana loci At2-MMP, DCL1, RCD1, SAL1, and SIZ1. Empirical evidence is provided, therefore, for a range of pleiotropic genes with the potential to have driven sympatric speciation by generating magic traits which link divergent selection to non-random mating.
Impaired Neurocirculatory Control in Chronic Kidney Disease: New Evidence for Blunted Sympathetic Baroreflex and Reduced Sympathetic Transduction
Authors: Sabino-Carvalho Jeann L , Mekonnen Elsa , Zanuzzi Matias , Li Sabrina , Cui Xiangqin , Park Jeanie 
Published: August 2024

Abstract
Chronic kidney disease (CKD) is characterized by over-activation of the sympathetic nervous system (SNS) that increases cardiovascular risk. Whether sympathetic baroreflex sensitivity (sBRS) is impaired or intact in CKD remains under-studied and controversial. Furthermore, the downstream effect of SNS activation on blood pressure transduction has not been previously examined in CKD. We tested the hypothesis that sBRS is attenuated, while sympathetic transduction is augmented in CKD. In 18 sedentary patients with CKD stages III-IV (eGFR: 40±14 mL/min) and 13 age-matched controls (eGFR: 95±10 mL/min), beat-to-beat blood pressure (BP; finger photoplethysmography), heart rate (electrocardiography) and muscle sympathetic nerve activity (MSNA; microneurography) were recorded at rest for 10-min. Weighted linear regression analysis between MSNA burst incidence and diastolic BP was used to determine the spontaneous sBRS. Sympathetic-BP transduction was quantified using signal averaging, whereby the BP response to each MSNA burst was tracked over 15 cardiac cycles and averaged to derive the peak change in BP. Compared with controls, CKD patients had an attenuated sBRS [CKD: −1.34 ± 0.59 versus CON: −2.91 ± 1.09 bursts (100 heartbeats)−1 mmHg−1; P = 0.001]. |sBRS| was significantly associated with eGFR (r = 0.69, P &lt; 0.001). CKD patients had attenuated sympathetic-BP transduction compared to controls (0.75 ± 0.7 vs. 1.60 ± 0.8 mmHg; P = 0.010). Resting MSNA was negatively associated with sympathetic transduction (r = −0.57, P = 0.002). CKD patients exhibit impaired sBRS that may contribute to SNS overactivation and cardiovascular risk in this patient population. In addition, CKD patients had an attenuated sympathetic transduction that may counteract the vascular effects of SNS overactivation.
Expression levels of core spliceosomal proteins modulate the MBNL-mediated spliceopathy in DM1
Authors: Louis Jiss M , Frias Jesus A , Schroader Jacob H , Jones Lindsey A , Davey Emily E , Lennon Claudia D , Chacko Jacob , Cleary John D , Berglund J Andrew , Reddy Kaalak 
Published: August 2024

Abstract
Myotonic dystrophy type 1 (DM1) is a heterogeneous multisystemic disease caused by a CTG repeat expansion in DMPK. Transcription of the expanded allele produces toxic CUG repeat RNA that sequesters the MBNL family of alternative splicing (AS) regulators into ribonuclear foci, leading to pathogenic mis-splicing. To identify genetic modifiers of toxic CUG RNA levels and the spliceopathy, we performed a genome-scale siRNA screen using an established HeLa DM1 repeat-selective screening platform. We unexpectedly identified core spliceosomal proteins as a new class of modifiers that rescue the spliceopathy in DM1. Modest knockdown of one of our top hits, SNRPD2, in DM1 fibroblasts and myoblasts, significantly reduces DMPK expression and partially rescues MBNL-regulated AS dysfunction. While the focus on the DM1 spliceopathy has centered around the MBNL proteins, our work reveals an unappreciated role for MBNL:spliceosomal protein stoichiometry in modulating the spliceopathy, revealing new biological and therapeutic avenues for DM1.
Food-Based Interventions as Therapy for Inflammatory Bowel Disease: Important Steps in Diet Trial Design and Reporting of Outcomes
Authors: Day Alice S , Ballard Tessa M , Yao Chu K , Gibson Peter R , Bryant Robert V 
Published: August 2024

Abstract
Diet therapy for inflammatory bowel disease (IBD) is an international research priority but guidance for IBD-specific diet trial design is lacking. This review critically evaluates key elements of prospective IBD food-based intervention trials and identifies gaps. Electronic databases were searched for interventional IBD diet studies. Prospective primary studies/trials were included if used food-based dietary strategies. Forty studies/trials evaluating 29 food-based strategies as therapy for IBD were identified. Considerable heterogeneity in diets, trial design, and methodology exists. Thirty-one trials (78%) intended the diet to modulate inflammation but 14/31 (46%) did not have a primary endpoint measuring an objective change in inflammatory activity and 20/31 (65%) controlled for medication stability prior to application of diet at baseline. Higher-quality IBD diet trials used symptom-based assessment tools coupled with an objective evaluation of inflammatory activity. Dietary advice trials are the most common. One-third of trials developed and administered diet education without a dietitian. Evaluation and reporting on adherence to diet therapy occurred in &lt;60% of trials. Failure to include or report on key elements of trial design reduced the interpretability and validity of the results. This is a considerable limitation to advancing scientific knowledge in this area. Diet therapy trials should adhere to similar rigorous quality standards used to develop other IBD therapies. Therefore, a set of practical recommendations was generated to provide the authors’ perspective to help inform the future design of high-quality IBD diet trials.