bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 363: Dantrolene Decreases Susceptibility to Refibrillations by Restoring Vf Dependent Cardiac Calcium Handling Dysfunction
Authors: Zamiri Nima , Kusha Marjan , Massé Stephane , Azam Mohammad Ali , Lai Patrick , Meyer Chris , Dorian Paul , Nanthakumar Kumaraswamy 
Published: April 2024

Background:
Ventricular refibrillation frequently occurs after successful defibrillation of Ventricular Fibrillation (VF) and negatively affects outcomes. Diastolic elevation in cytosolic calcium and dysfunction in calcium handling is proposed to underlie post-shock arrhythmias. Ryanodine Receptor 2 (RyR2) is the major calcium handling protein in cardiomyocytes. its dysfunction causes diastolic calcium leak from sarcoplasmic reticulum and calcium transient amplitude alternans (Ca-Alt), which can lead to arrhythmias. We hypothesized Dantrolene protects against refibrillations by restoring cardiac calcium handling and stabilizing RyR2 after VF.

Methods and Results:
Hearts from 14 healthy New-Zealand rabbits were excised and perfused using Langendorff method; VF(+ISO) was induced by burst pacing and left untreated for 4 min. Hearts received either Dantrolene (20μM) or saline during VF. Upon defibrillation, 4 more VF episodes were attempted. Sustainability (VF≥60 sec) and inducibility of refibrillations (VF≥10 sec) was evaluated. Calcium mapping using RhoD-2 was performed to assess Ca-Alt and diastolic Spontaneous Calcium Elevation (SCaE). Ca-Alt was defined as ≥10% variability in Calcium transient amplitudes. SCaE amplitude was measured during diastolic pause after termination of pacing.

In total, 83.33% of attempts to induce refibrillation in controls were successful compared to 41.18% in Dantrolene-treated hearts. (P=0.007)
Dantrolene (20μM) significantly decreased SCaE amplitude post VF. (Table 1) Ca-Alt emerged at shorter PCL in Dantrolene-treated hearts with 10% decrease from 195±9.5ms at baseline to 173±6.7ms post-VF compared to 11% increase in controls from 215±20ms to 235±8ms. (P=0.05)

Conclusion:
Dantrolene ameliorated arrhythmogenic diastolic SCaE caused by VF and increased calcium alternans threshold and may be the basis for the decreased susceptibility of treated hearts to refibrillations.
Building Successful International Cardiovascular Nursing Research in Heart Failure Care
Authors: Jaarsma Tiny 
Published: April 2024

International collaboration is vital to address the causes and deal with the impacts of many of the global challenges that society faces. One example of this is an international approach to fighting cardiovascular disease and its consequences for patients and their families. Selective national initiatives might not always be an optimal use of recourses, but instead international collaboration in cardiovascular caring research can help us in seeking excellence, build capacity and improve political influence, all needed to ultimately improve patient care. However, several countries worldwide have different health care systems, medical and nursing education programs and professional roles, and responsibilities, posing a major challenge to optimal collaboration and implementation of research findings.
An example of successful international teamwork is illustrated by research in the area of self-care in heart failure patients with collaboration in the area of empirical research, theory development and instrument development. Several intervention studies on improving self-care are conducted in different parts of the world, strengthening the evidence base of nursing interventions to improve outcomes of heart failure patients. Current international professional guidelines for the management of heart failure patients include advices on self-care. However, to transcend above post hoc pooling of data or adding a new data collecting site in another country, other structural forms of collaboration should be considered. Capacity building, including joint proposal writing, funding and joint policy statements need to be extended globally if it is to optimize reach and impact.
Abstract 15686: Coagulation-Independent Effects of Factor Xa on Protease-Activated Receptor 2 (PAR-2) in Pulmonary Hypertension
Authors: Joseph Christine , Berghausen Eva M , Behringer Arnica , Vantler Marius , Rosenkranz Stephan , Baldus Stephan 
Published: April 2024

Factor Xa (FXa) is a key molecule in the coagulation cascade. Besides, FXa exerts direct effects on cells via protease-activated receptor 2 (PAR-2), inducing proliferation and migration.
Pulmonary hypertension (PH) is a fatal disease, defined by increased pulmonary vascular resistance, causing pulmonary arterial pressure elevation and finally right heart failure. Aberrant proliferation and migration of smooth muscle cells (SMCs) are crucial for underlying vascular remodeling processes in the pulmonary vasculature.
We hypothesize that FXa contributes to vascular remodeling in PH via PAR-2 in pulmonary arterial SMCs (PASMCs).
In vitro proliferation was assayed via BrdU incorporation, migration via modified Boyden chamber, respectively.
Human PASMCs (hPASMCs), as well as murine PASMCs (mPASMCs) from WT and PAR-2-/- mice were used. FXa (0.1-1.5U/ml) and the following inhibitors were applied: Vorapaxar (PAR-1), U0126 (ERK), and SKI-178 (sphingonsine-kinase-1).
Adult male WT and PAR-2-/- mice were exposed to normoxia vs. hypoxia to develop PH. After 21 days, right ventricular systolic pressure (RVSP) was measured. Right heart hypertrophy was determined by ratio of right ventricle to left ventricle plus septum (RV/(LV+S)).
FXa mediated hPASMC proliferation (2.78±0.60 fold vs. ctrl, n>4) via ERK and sphingosine-kinase-1. Whereas, vorapaxar did not affect FXa-mediated proliferation in hPASMCs (n=3). FXa-induced proliferation was significantly impaired in PAR-2-/- vs. WT PASMCs (1.41±0.11 vs. 1.79±0.05, n=6).
FXa induced chemotaxis of hPASMCs (1.46±0.13 fold vs. ctrl, n=6). PAR-2-/- PASMCs displayed impaired basal migratory responses (1.45±0.46 cells) and decreased chemotaxis towards FXa vs. WT cells (1.37±0.81 vs. 9.958± 0.29 cells, n=3).
PAR-2 deficiency protected from hypoxia-induced elevation of RVSP compared to WT mice (30.86±1.315 mm/Hg vs. 40.38±1.257 mm/Hg; n≥7). However, RV/(LV+S) was not decreased in PAR-2-/- vs. WT animals (0.392±0.026 vs. 0.413±0.0142; n≥7).
Conclusively, PAR-2 plays an important role in experimental PH in mice. Additionally, we elucidated that F-Xa exerts direct mitogenic and chemotactic effects in PASMCs via PAR-2 activation, indicating a direct link between F-Xa and PAR-2 in pulmonary hypertension.
Abstract 16819: Circulating Growth Factors and Cardiac Remodeling in the Community: The Framingham Heart Study
Authors: Castro-Diehl Cecilia , Song Rebecca J , Xanthakis Vanessa , Sawyer Douglas B , Cheng Susan , Vasan Ramachandran S 
Published: April 2024

Cardiac and vascular growth factors may influence myocardial and vascular remodeling through their pro- and anti-angiogenic effects. We hypothesized that higher circulating concentrations of growth factors will be associated with cardiac remodeling patterns consistent with their known biological effects.
We related circulating concentrations of vascular endothelial growth factor (VEGF), VEGF-1, angiopoietin 2 (Ang2), Hepatocyte GF (HGF), insulin-like GF (IGF)-1, IGF binding protein (IGFBP)-3, growth differentiation factor-15 (GDF-15), to echocardiographic (echo) indices of cardiac remodeling in 3151 Framingham Study participants (mean age 40 years, 55% women). We evaluated the following echo measures (dependent variables): left ventricular (LV) mass index (LVMi), LV ejection fraction (LVEF), global longitudinal strain (GLS), left atrial ejection fraction (LAEF), and aortic root diameter (AoR) using generalized linear models to account for relatedness. We also related circulating NTProBNP and Troponin (TnI) to echo measures (as positive controls). In multivariable-adjusted analyses blood GDF-15 levels were associated with higher values of LVMi. TnI concentrations were negatively associated with LVEF. IGF-1 and Ang2 concentrations were positively and negatively associated with GLS, respectively. Lower IGFBP-3 concentrations and higher NT-ProBNP concentrations were associated with lower LAEF. Higher VEGF-1, Ang2 and NT-Pro-BNP levels were associated with smaller AoR (Figure).
In our large community-based cross-sectional study, we observed patterns of associations between several circulating vascular growth factors and cardiac remodeling indices that are consistent with the known biological effects of these pro- and anti-angiogenic factors on the myocardium and conduit arteries. Additional findings are warranted to replicate our findings and assess their prognostic significance
Abstract 14124: Long-term Cardiovascular Mortality Disparities By Race In The Us Adult Population
Authors: Banerjee Srikanta , Harvey David , Banerjee Karen , Schwab Michael 
Published: April 2024

Cardiovascular disease remains the leading cause of mortality and disproportionately affects vulnerable populations. Among disparities in overall mortality, Black Americans experience higher mortality rates than White Americans. However, it is unknown, if the same disparities persist after long-term follow-up. In this study, we assessed the hypothesis that Non-Hispanic Black Americans experience higher 10-year cardiovascular disease (CVD) mortality follow-up than Non-Hispanic White Americans.
We analyzed data on adults (≥ 20 years) from the 1999-2010 National Health and Nutrition Examination Survey, with mortality data obtained through 2015. The causes of death for adults (N=4037) were defined using the International Classification of Disease coding (ICD-10). Complex Samples Cox regression was used to assess if diabetes status modified the relationship between race and CVD-mortality.
Out of the respondents (N=4037), 17.7% of Non-Hispanic Blacks individuals died from CVD versus 16.4% among Non-Hispanic White counterparts. During the 11-year follow-up, the hazard ratio (HR) for CVD-mortality among Non-Hispanic Black Adults, with adjustment for age and gender only, was 1.36; 95% confidence interval [CI: 1.11, 1.67]. Over the age of 20, there is higher CVD-mortality in Non-Hispanic Black men (HR, 1.15; 95% CI, 0.91–2.05, p > .05) and women (HR, 2.50; 95% CI, 1.56–3.99, p < .01) than in their White counterparts even after controlling for medical (obesity, CVD, diabetes) and demographic (education, age, food insecurity level, and poverty level) variables.
In conclusion, Black Americans experience higher probability of death from cardiovascular disease in 10-year follow-up than other races. Due to the chronicity of CVD, disparities are compounded over a long period of time. The observed ethnic disparities in treatment and control, with the relative deficits observed in Black Americans, are potentially due to ethnic differences in healthcare-seeking behaviors and access to care. Policy considerations should address how to improve equitable screening and prevention, as it pertains to race.
Managing Clopidogrel Resistance in Neurointervention: Surveying Current Approaches
Authors: Kim Hyun Woo , Bach Ivo , Gutierrez Juan Carlos Martinez , Dmytriw Adam A. , D'Amato Salvatore , Zeineddine Hussein A. , Yoo Albert J. , Sheth Sunil A. 
Published: April 2024

Background
Because of the variability in patient responses to clopidogrel and to reduce the risk of thromboembolic complications, adjusting the antiplatelet regimen based on platelet function testing has become a widespread practice in neurointervention. We aimed to explore current patterns related to this practice.

Methods

We conducted a survey targeting neurointerventionalists, comprising multiple‐choice questions and opportunities for free‐text responses when necessary. The survey was distributed via a professional society distribution list (the
Society of Vascular and Interventional Neurology
) and 2 consortium emailing lists (WovenEndoBridge and Neurointerventional Research Consortia). The data obtained from the responses were analyzed using descriptive statistics.

Results
A total of 133 neurointerventionalists, representing 79 institutions within 27 countries, responded to the survey. A total of 62% of respondents tested for clopidogrel resistance before any neurovascular stent placements. A total of 80% used VerifyNow point‐of‐care P2Y12 assay; other assays included multiplate analyzer, platelet function analyzer, and CYP2C19 genotype assay. Respondents reported 25 different therapeutic thresholds, with the P2Y12 reaction unit range between 60 and 180 most commonly used (16.4%). A total of 61% reported they would switch to ticagrelor in the case of persistent resistance. On the other hand, when patients are supratherapeutic, 48% did not make any changes, whereas 42% reduced clopidogrel dose. Finally, 93% opined that a well‐established protocol for management of clopidogrel resistance was needed.

Conclusions
Neurointerventional practice patterns around clopidogrel resistance remain heterogeneous. Our results underscore the need for evidence‐based guidance on the management of clopidogrel resistance in neurointervention.
Social Perception in the Infant Brain and Its Link to Social Behavior
Authors: Grossmann Tobias 
Published: April 2024

Abstract
The current longitudinal study (n = 98) utilized a developmental cognitive neuroscience approach to examine whether and how variability in social perception is linked to social behavior in early human development. Cortical responses to processing dynamic faces were investigated using functional near-infrared spectroscopy at 7 months. Individual differences in sociability were measured using the Early Childhood Behavior Questionnaire at 18 months. Confirming previous work with infants and adults, functional near-infrared spectroscopy results show that viewing changing faces recruited superior temporal cortices in 7-month-old infants, adding to the view that this brain system is specialized in social perception from early in ontogeny. Our longitudinal results show that greater engagement of the right superior temporal cortex at 7 months predicts higher levels of sociability at 18 months. This suggests that early variability in social perception is linked to later differences in overtly displayed social behavior, providing novel longitudinal evidence for a social brain–behavior association.
Induction treatment for lupus nephritis at a high-complexity hospital in Chile
Authors: Ramirez Paulina , Giglio Andres , Verdugo Jorge , Gutierrez Francisco 
Published: April 2024

Introduction Systemic lupus erythematosus (SLE) causes kidney compromise in up to 40% of patients, contributing significantly to morbidity. Lupus nephritis (LN), an early onset manifestation in most patients, is histologically classified into six types, with types III, IV, and V requiring treatment with induction therapies, usually glucocorticoids with mycophenolate mofetil (MMF) or intravenous cyclophosphamide (IVC). However, up to 60% of patients fail to achieve complete remission, and 27%–66% have subsequent flares. There is scarce literature on the superiority of IVC or MMF in the Latin population. Methodology A retrospective cohort study of 72 LN patients at a high-complexity hospital in Chile between 2016 and 2021 was conducted. Demographics, urine studies, creatinine levels, complement levels, antibody profiles, biopsy results, and response to treatment were analysed. Results The median age of the cohort was 29 years, with women representing 90% of patients. At diagnosis, 87.5% of the patients presented with proteinuria, 55% had haematuria, and 49% had acute kidney injury. The most common LN type was type IV. For induction therapy, half of the patients were treated with IVC, and the other half with MMF. The response to treatment did not differ significantly between the two. Discussion This is one of the few studies to focus on the Latin American population, specifically Chile. These results are consistent with the current understanding of LN treatment. Despite its limitations, this study provides valuable insights into the treatment effectiveness of IVC and MMF in this population. Conclusion This study did not find significant differences in the clinical response to IVC or MMF at 6 months. Future prospective studies are required to determine the optimal induction therapy for LN, especially in Latin populations.
Knowledge, Attitude, and Practices Toward Kangaroo Mother Care Among Mothers in a Tertiary Neonatal Care Unit
Authors: Pradhan Monalisa , Kar Shrutiprajna , Sahoo Tanushree , Som Tapas , Mohanty Pankaj Kumar , Devi Usha 
Published: April 2024

Aim: To study the knowledge, attitude, and practices of Kangaroo Mother Care (KMC) among eligible postnatal mothers in the postnatal ward (PNW) and neonatal intensive care unit (NICU) of a tertiary neonatal unit in Eastern India. Methods: A cross-sectional survey was conducted among 100 mothers of low-birth-weight babies in our PNW and NICU. As part of the unit protocol, all mothers of eligible babies were counseled about KMC at first contact verbally as well as by using an informative video on KMC. Data was collected using a structured questionnaire after the routine counseling of the mothers on their first visit after delivery. The analysis of the data was done using appropriate statistics. Results: More than three-fourths (83.2%) of mothers had good knowledge of KMC. A good attitude toward using KMC was found in 91.6% of the mothers. Almost all the mothers (98%) knew the correct KMC position, and 12% of mothers had a previous preterm baby and had given KMC. Many mothers felt the small size of the baby, pain after cesarean section, and central or peripheral intravenous lines in the baby were barriers to KMC. Conclusion: The knowledge regarding KMC among mothers whose babies were admitted into the PNW/NICU was good. Though the attitude toward KMC was good, mothers felt there were multiple barriers to initiating KMC.
Sexual Knowledge, Sexual Attitudes, and the Need for Sex Education Among Adolescent Defectors From North Korea
Authors: Lee In-Sook , Jeon Jung-Hee , Kim Kyoung Ja 
Published: April 2024

Introduction: Adolescent North Korean defectors are vulnerable due to harmful environments during defection, limited access to sex education in North Korea, and exposure to different sexual norms in South Korea. The purpose of this study was to investigate the sexual knowledge, attitudes, and sex education needs of North Korean refugee adolescents. Methods: A cross-sectional, descriptive survey was administered to 102 North Korean refugee adolescents. Results: The correct answer rate for questions on genital anatomy, physiology, masturbation, and contraception was less than 20%. The participants exhibited conservative attitudes toward female contraception, masturbation, and having friends of the opposite sex. A significant positive correlation was found between knowledge and the need for sex education. Discussion: These results highlight the importance of tailored sex education in providing accurate information, improving sexual knowledge, fostering positive attitudes, and enabling healthy behaviors among adolescent North Korean defectors.
The Relationship of Coronary Thrombus Burden and Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Score in Patients With ST-Segment Elevation Myocardial Infarction
Authors: Coşkun Gökhan , Ozde Cem , Kayapinar Osman , Aktore Gulsah , Ekşi Ensar , Afşin Hamdi , Sayın Ahmet Egemen 
Published: April 2024

Background The anticoagulation and risk factors in atrial fibrillation (ATRIA) score is associated with adverse cardiovascular events. However, its relationship with coronary thrombus burden is unclear. Therefore, we aimed to investigate the relationship between the ATRIA score and thrombus burden in patients with ST-segment elevation myocardial infarction (STEMI) who underwent percutaneous coronary intervention (PCI). Materials and Methods The study was designed as a prospective cross-sectional observational study. Our study included 319 patients who were prospectively admitted with STEMI between January 2021 and April 2022. Patients were divided into 2 groups with low thrombus burden (LTB) (grade <3) and high thrombus burden (HTB) (grade ≥3). ATRIA score was calculated and recorded for all patients. ATRIA scores of both groups were compared. Results In our study, 58.9% ( n  =  188) of patients in the LTB group and 41% ( n  =  131) of patients in the HTB group. The ATRIA risk score ( p < .001) was significantly higher in the HTB group. In multivariate logistic regression analysis, ATRIA score, glomerular filtration rate, hypertensıon, abciximab usage, and no-reflow were found to be independent predictors of HTB in STEMI patients undergoing primary PCI. In receiver operating characteristic analysis, ATRIA score >4 had a sensitivity of 66.2% and specificity of 95.2%, and ATRIA score >8 sensitivity of 98% and specificity of 100% predicted HTB. Conclusion In this study, we found that thrombus burden may be associated with ATRIA risk score in patients presenting with STEMI.
Immune-related adverse effects: Recognition and initiation of appropriate treatment in cancer patients on immunotherapy
Authors: Mohr Riley , Howard Anna , Townsend Melanie 
Published: April 2024

Purpose Delayed or improper identification of immune-related adverse events (IRAEs) during cancer treatment can impact time to receive proper treatment. This study describes rates of IRAE recognition and appropriate treatment in adult patients with cancer at a community teaching hospital. Methods This single-center, retrospective, cohort study evaluated rates of proper IRAE treatment in conjunction with National Comprehensive Cancer Network (NCCN) guidelines. Secondary outcomes included time from presentation to IRAE diagnosis and hospital readmissions/repeat emergency department (ED) visits following initial admission for IRAE. Retrospective chart review assessed IRAE presentation including common terminology criteria for adverse event (CTCAE) grading and treatment choices. Results Fifteen subjects included in this study contributed to 21 encounters with noted IRAE. Over half (52.4%) of the encounters received proper IRAE treatment (e.g. correct drug, dose, route, frequency, or therapy duration). Nearly 22% of total actionable components were improper, occurring more often in patients with colitis, pneumonitis, and hepatitis. Median time to IRAE diagnosis was approximately 3.5 days, with the longest being 24 days. There were eight all-cause rehospitalizations one year after initial IRAE presentation, with four directly IRAE-related. Most (75%) IRAE-related rehospitalizations occurred with colitis. Seven ED return visits were also noted. Conclusion Many IRAEs were misdiagnosed and/or received improper treatment resulting in increased rehospitalization/return ED visit rates. The importance of medical oncology involvement (e.g. medical oncology consult at time of admission and/or notification of primary oncologist) in IRAE management in the hospital or ED was also stressed. Organizations may benefit from systematic improvements and staff education to improve patient outcomes and prevent readmissions.