bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac Magnetic Resonance Feature-Tracking Identifies Preclinical Abnormalities in Hypertrophic Cardiomyopathy Sarcomere Gene Mutation Carriers
Authors: Negri Francesco , Sanna Giuseppe Damiano , Di Giovanna Giulia , Cittar Marco , Grilli Giulia , De Luca Antonio , Dal Ferro Matteo , Baracchini Nikita , Burelli Massimo , Paldino Alessia , Del Franco Annamaria , Pradella Silvia , Todiere Giancarlo , Olivotto Iacopo , Imazio Massimo , Sinagra Gianfranco , Merlo Marco 
Published: April 2024

BACKGROUND:
Assessing myocardial strain by cardiac magnetic resonance feature tracking (FT) has been found to be useful in patients with overt hypertrophic cardiomyopathy (HCM). Little is known, however, of its role in sarcomere gene mutation carriers without overt left ventricular hypertrophy (subclinical HCM).

METHODS:
Thirty-eight subclinical HCM subjects and 42 healthy volunteers were enrolled in this multicenter case-control study. They underwent a comprehensive cardiac magnetic resonance study. Two-dimensional global radial, circumferential, and longitudinal strain of the left ventricle (LV) were evaluated by FT analysis.

RESULTS:

The subclinical HCM sample was 41 (22–51) years old and 32% were men. FT analysis revealed a reduction in global radial strain (29±7.2 versus 47.9±7.4;
P
<0.0001), global circumferential strain (−17.3±2.6 -versus -20.8±7.4;
P
<0.0001) and global longitudinal strain (−16.9±2.4 versus −20.5±2.6;
P
<0.0001) in subclinical HCM compared with control subjects. The significant differences persisted when considering the 23 individuals free of all the structural and functional ECG and cardiac magnetic resonance abnormalities previously described. Receiver operating characteristic curve analyses showed that the differential diagnostic performances of FT in discriminating subclinical HCM from normal subjects were good to excellent (global radial strain with optimal cut-off value of 40.43%: AUC, 0.946 [95% CI, 0.93–1.00]; sensitivity 90.48%, specificity 94.44%; global circumferential strain with cut-off, −18.54%: AUC, 0.849 [95% CI, 0.76–0.94]; sensitivity, 88.10%; specificity, 72.22%; global longitudinal strain with cut-off, −19.06%: AUC, 0.843 [95% CI, 0.76–0.93]; sensitivity, 78.57%; specificity, 78.95%). Similar values were found for discriminating those subclinical HCM subjects without other phenotypic abnormalities from healthy volunteers (global radial strain with optimal cut-off 40.43%: AUC, 0.966 [95% CI, 0.92–1.00]; sensitivity, 90.48%; specificity, 95.45%; global circumferential strain with cut-off, −18.44%: AUC, 0.866 [95% CI, 0.76–0.96]; sensitivity, 92.86%; specificity, 77.27%; global longitudinal strain with cut-off, −17.32%: AUC, 0.838 [95% CI, 0.73–0.94]; sensitivity, 90.48%; specificity, 65.22%).

CONCLUSIONS:
Cardiac magnetic resonance FT-derived parameters are consistently lower in subclinical patients with HCM, and they could emerge as a good tool for discovering the disease during a preclinical phase.
Historical Redlining and Heart Failure Outcomes Following Hospitalization in the Southeastern United States
Authors: Fields Nicole D. , Tristan Urrutia Andrea , Morris Alanna A. , Kramer Michael R. , Lewis Tené T. , Patel Shivani A. 
Published: April 2024

Background
Historical redlining, a discriminatory lending practice, is an understudied component of the patient risk environment following hospital discharge. We investigated associations between redlining, patient race, and outcomes following heart failure hospitalization.

Methods and Results
We followed a hospital‐based cohort of Black and White patients using electronic medical records for acute heart failure hospitalizations between 2010 and 2018 (n=6800). Patient residential census tracts were geocoded according to the 1930s Home Owners' Loan Corporation map grades (A/B: best/still desirable, C: declining, D: redlined). We used Poisson regression to analyze associations between Home Owners' Loan Corporation grade and 30‐day outcomes (readmissions, mortality, and their composite). One‐third of patients resided in historically redlined tracts (n=2034). In race‐stratified analyses, there was a positive association between historically declining neighborhoods and composite readmissions and mortality for Black patients (risk ratio [RR], 1.24 [95% CI, 1.003–1.54]) and an inverse association between redlined neighborhoods and 30‐day readmissions among White patients (RR, 0.58 [95% CI, 0.39–0.86]). Examining racial disparities across Home Owners' Loan Corporation grades, Black patients had higher 30‐day readmissions (RR, 1.86 [95% CI, 1.31–2.65]) and composite readmissions and mortality (RR, 1.32 [95% CI, 1.04–1.65]) only in historically redlined neighborhoods.

Conclusions
Historical redlining had potentially mixed impacts on outcomes by race, such that residing in less desirable neighborhoods was associated with an elevated risk of an adverse outcome following heart failure hospitalization in Black patients and a reduced risk in White patients. Moreover, racial disparities in patient outcomes were present only in historically redlined neighborhoods. Additional research is needed to explore observed heterogeneity in outcomes.
γ‐Glutamyl Transferase and Long‐Term Survival in the SYNTAXES Trial: Is It Just the Liver?
Authors: Ninomiya Kai , Serruys Patrick W. , Garg Scot , Kageyama Shigetaka , Kotoku Nozomi , Masuda Shinichiro , Revaiah Pruthvi C. , O'leary Neil , Kappetein Arie Pieter , Mack Michael J. , Holmes David R. , Davierwala Piroze M. , Mohr Friedrich W. , Thuijs Daniel J. F. M. , Onuma Yoshinobu ,   for the SYNTAX Extended Survival (SYNTAXES) Investigators
Published: April 2024

Background
Recently, machine learning algorithms have identified preprocedural γ‐glutamyl transferase (GGT) as a significant predictor of long‐term mortality after coronary revascularization in the SYNTAX (Synergy Between PCI [Percutaneous Coronary Intervention] With Taxus and Cardiac Surgery) trial. The aim of the present study is to investigate the impact of preprocedural GGT on 10‐year all‐cause mortality in patients with complex coronary artery disease after revascularization.

Methods and Results
The SYNTAX trial was a randomized trial comparing PCI with coronary artery bypass grafting in 1800 patients with complex coronary artery disease. The present report is a post hoc subanalysis of the SYNTAXES (Synergy Between PCI With Taxus and Cardiac Surgery Extended Survival) trial, an investigator‐driven extended 10‐year follow‐up of the SYNTAX trial. The association between preprocedural GGT and 10‐year all‐cause mortality was investigated. The mean values of GGT for men and women were 43.5 (SD, 48.5) and 36.4 (SD, 46.1) U/L, respectively. In multivariable Cox regression models adjusted by traditional risk factors, GGT was an independent predictor for all‐cause death at 10‐year follow‐up, and each SD increase in log‐GGT was associated with a 1.24‐fold risk of all cause death at 10‐year follow‐up (95% CI, 1.10–1.40). According to previously reported sex‐related GGT thresholds, patients with higher GGT level had a 1.74‐fold risk of all‐cause death at 10‐year follow‐up (95% CI, 1.32–2.29) compared with patients with lower GGT level.

Conclusions
Preprocedural GGT is an independent predictor of 10‐year mortality after coronary revascularization in patients with complex coronary artery disease. In patients with elevated GGT, strong secondary prevention may be required after revascularization and must be studied prospectively.

Registration

URL:
https://clinicaltrials.gov/study/NCT03417050
.
Validation of TRI‐SCORE for Outcome Prediction After Isolated Tricuspid Valve Surgery in Asian Patients
Authors: Kim Dae‐Young , Kim Jihoon , Cho Iksung , Kim Eun Kyoung , Hong Geu‐Ru , Ha Jong‐Won , Park Sung‐Ji , Shim Chi Young 
Published: April 2024

Background
TRI‐SCORE was recently developed in Europe as a risk model for predicting in‐hospital death after isolated tricuspid valve surgery. We aimed to validate TRI‐SCORE in an Asian population and investigate its value for predicting long‐term outcomes.

Methods and Results

The TRI‐SCORE was calculated for 202 patients (65±11 years, 61% women, 81% functional tricuspid regurgitation) who underwent isolated tricuspid valve surgery for severe tricuspid regurgitation at 2 Korean centers and was based on 8 parameters: age, New York Heart Association class, right‐sided heart failure signs, furosemide daily dose, glomerular filtration rate, bilirubin, left ventricular ejection fraction, and moderate/severe right ventricular dysfunction. The primary outcome was all‐cause death during follow‐up; the secondary outcome was in‐hospital death. During a median follow‐up duration of 50 (interquartile range, 21–82) months after isolated tricuspid valve surgery, 23 (11.4%) patients experienced the primary outcome, and 7 (3.5%) patients experienced the secondary outcome. Observed all‐cause death and in‐hospital death increased by up to 50% in those with higher scores. Patients with the primary outcome had a higher TRI‐SCORE (4.5±2.4 versus 2.9±2.1;
P
=0.001) than those without. The TRI‐SCORE showed a significant association with the primary outcome (concordance index, 0.77, cutoff value, 4) and in‐hospital death (area under the curve, 0.84; cutoff value, 3). Using the Kaplan–Meier analysis, patients with a high TRI‐SCORE exhibited a poor outcome for all‐cause death at follow‐up (log‐rank
P
<0.001) and in‐hospital death (log‐rank
P
=0.004).

Conclusions
TRI‐SCORE was validated in an Asian population and helped predict long‐term outcomes after isolated tricuspid valve surgery.
Disulfiram Reduces Atherosclerosis and Enhances Efferocytosis, Autophagy, and Atheroprotective Gut Microbiota in Hyperlipidemic Mice
Authors: Traughber C. Alicia , Timinski Kara , Prince Ashutosh , Bhandari Nilam , Neupane Kalash , Khan Mariam R. , Opoku Esther , Opoku Emmanuel , Brubaker Gregory , Shin Junchul , Hong Junyoung , Kanuri Babunageswararao , Ertugral Elif G. , Nagareddy Prabhakara R. , Kothapalli Chandrasekhar R. , Cherepanova Olga , Smith Jonathan D. , Gulshan Kailash 
Published: April 2024

Background
Pyroptosis executor GsdmD (gasdermin D) promotes atherosclerosis in mice and humans. Disulfiram was recently shown to potently inhibit GsdmD, but the in vivo efficacy and mechanism of disulfiram's antiatherosclerotic activity is yet to be explored.

Methods and Results

We used human/mouse macrophages, endothelial cells, and smooth muscle cells and a hyperlipidemic mouse model of atherosclerosis to determine disulfiram antiatherosclerotic efficacy and mechanism. The effects of disulfiram on several atheroprotective pathways such as autophagy, efferocytosis, phagocytosis, and gut microbiota were determined. Atomic force microscopy was used to determine the effects of disulfiram on the biophysical properties of the plasma membrane of macrophages. Disulfiram‐fed hyperlipidemic apolipoprotein E
−/−
mice showed significantly reduced interleukin‐1β release upon in vivo Nlrp3 (NLR family pyrin domain containing 3) inflammasome activation. Disulfiram‐fed mice showed smaller atherosclerotic lesions (~27% and 29% reduction in males and females, respectively) and necrotic core areas (~50% and 46% reduction in males and females, respectively). Disulfiram induced autophagy in macrophages, smooth muscle cells, endothelial cells, hepatocytes/liver, and atherosclerotic plaques. Disulfiram modulated other atheroprotective pathways (eg, efferocytosis, phagocytosis) and gut microbiota. Disulfiram‐treated macrophages showed enhanced phagocytosis/efferocytosis, with the mechanism being a marked increase in cell‐surface expression of efferocytic receptor MerTK. Atomic force microscopy analysis revealed altered biophysical properties of disulfiram‐treated macrophages, showing increased order‐state of plasma membrane and increased adhesion strength. Furthermore, 16sRNA sequencing of disulfiram‐fed hyperlipidemic mice showed highly significant enrichment in atheroprotective gut microbiota
Akkermansia
and a reduction in atherogenic
Romboutsia
species.

Conclusions
Taken together, our data show that disulfiram can simultaneously modulate several atheroprotective pathways in a GsdmD‐dependent as well as GsdmD‐independent manner.
Current Trends in Hypertension Identification and Management: Insights from the National Health and Nutrition Examination Survey (NHANES) Following the 2017 ACC/AHA High Blood Pressure Guidelines
Authors: Heaton Joseph , Alshami Abbas , Imburgio Steven , Mararenko Anton , Schoenfeld Matthew , Sealove Brett , Asif Arif , Almendral Jesus 
Published: April 2024

Background
Hypertension is a global health issue associated with increased cardiovascular morbidity and mortality. This study aimed to investigate contemporary hypertension identification and management trends following the 2017 American College of Cardiology/American Heart Association guidelines.

Methods and Results
Data from the National Health and Nutrition Examination Survey conducted from 2017 to 2020 were analyzed. Participants between 20 and 79 years of age were included. Participants were stratified into different treatment groups based on indication and guideline adherence. Descriptive statistics were used to compare medication use, diagnosis rates, and blood pressure control. A total of 265 402 026 people met the inclusion criteria, of which 19.0% (n=50 349 209) were undergoing guideline antihypertensive management. In the guideline antihypertensive management group, a single antihypertensive class was used to treat 45.7% of participants, and 55.2% had uncontrolled blood pressure. Participants not undergoing guideline antihypertensive management qualified for primary prevention in 11.5% (n=24 741 999) of cases and for secondary prevention in 2.4% (n=5 070 044) of cases; of these, 66.3% (n=19 774 007) did not know they may have hypertension and were not on antihypertensive medication.

Conclusions
Adherence to guidelines for antihypertensive management is suboptimal. Over half of patients undergoing guideline treatment had uncontrolled blood pressure. One‐third of qualifying participants may not be receiving treatment. Education and medical management were missing for 2 in 3 qualifying participants. Addressing these deficiencies is crucial for improving blood pressure control and reducing cardiovascular event outcomes.
Broad brain networks support curiosity-motivated incidental learning
of naturalistic dynamic stimuli with and without monetary
incentives
Authors: Meliss Stefanie , Tsuchiyagaito Aki , Byrne Phoenix , van Reekum Carien , Murayama Kou 
Published: April 2024

Abstract
Curiosity—the intrinsic desire to know—is a concept central to the human mind and knowledge acquisition. Experimental studies on information-seeking have found that curiosity facilitates memory encoding and exhibits similar rewarding properties as extrinsic rewards/incentives, by eliciting a dopaminergic response in the reward network. However, it is not clear whether these findings hold with more naturalistic dynamic stimuli and how the joint effect of curiosity and extrinsic incentive manifests in learning and neural activation patterns. Herein, we presented participants with videos of magic tricks across two behavioural (N1 = 77, N2 = 78) and one fMRI study (N = 50) and asked them to rate subjective feelings of curiosity, while also performing a judgement task that was incentivised for the half of participants. Incidental memory for the magic trick was tested a week later. The integrated results showed that both curiosity and availability of extrinsic incentives enhanced encoding but did not interact with each other. However, curiosity influenced only high-confidence recognition memory, whereas extrinsic incentives affected memory regardless of confidence, suggesting the involvement of different encoding mechanisms. Analysis of the fMRI data using the intersubject synchronisation framework showed that, while the effects of curiosity on memory were located in the hippocampus and dopaminergic brain areas, neither the effects of curiosity nor incentives themselves were found in the often-implicated reward network. Instead, they were associated with cortical areas involved in processing uncertainly and attention. These results challenge a traditional focus on reward networks in curiosity and highlight the involvement of broader brain networks.
Causes and Timing of Unplanned ICU Admissions Among Trauma Patients at a Level 1 Trauma Center
Authors: Jensen Stephanie , Gallagher Robert , Sing Ronald , Torres Fajardo Rafael 
Published: April 2024

Background Unexpected ICU admissions are a key quality metric in trauma care. The purpose of this study is to identify the most common causes of unplanned ICU admissions among trauma patients at an ACS-verified level 1 trauma center. Methods A retrospective review was conducted of all trauma patients with unplanned admission to the ICU at a level 1 trauma center between 2019 and 2021. Unplanned ICU admissions were categorized into (1) “bounce-backs,” patients previously admitted to the ICU and (2) “upgrades,” patients who had not previously been cared for in the ICU. Results Of 300 unexpected ICU transfers, bounce-backs accounted for 69% and upgrades 31%. The most common injuries were traumatic brain injuries (40%) and rib fractures (41.3%). In-hospital mortality rate was 10% and did not significantly differ between bounce-backs and upgrades (12 vs 5%, P = .92). Respiratory distress was the most common cause of transfer (41.1%), followed by neurologic (29.6%) and cardiovascular decline (21.2%). Patients were on average 928 mL fluid positive 72 hours prior to transfer (t > 0, P < .0001), and 295 mL fluid positive in the 24 hours prior to transfer (t > 0, P .0003). Patients transferred for respiratory distress were no more fluid over-balanced than those transferred for other reasons. Conclusion We found a large percent of unplanned transfers occurring within 48 hours of admission or transfer out of the ICU suggesting under-triage as a leading cause of bounce-backs and upgrades. Respiratory distress was the leading cause of transfer. These findings highlight opportunities for targeted interventions.
Deconstructing the Operative Times of Robotic Pancreaticoduodenectomy
Authors: Ross Sharona , Sucandy Iswanto , Vasanthakumar Padma , Espeut Abigail , Christodoulou Maria , Pattilachan Tara M. , Rosemurgy Alexander 
Published: April 2024

Introduction Despite numerous benefits offered, robotic procedures take longer than “open” procedures. With the intent to reduce operative duration, we examined the degree each operative step contributes to operative duration in robotic pancreaticoduodenectomy. Materials and Methods With IRB approval, we prospectively followed 88 patients to determine the duration of robotic pancreaticoduodenectomy, and the duration of 12 key steps. Each operative step was regressed against the operation date, from most distant to most recent operation date. Data are presented as median (mean ± SD) for illustrative purposes. Results Patients were 73 (71 ± 10.2) years old; 53% were men. Total time patient spent in the operating room was 471 (488 ± 93.3) minutes. Total operative time was 399 (421 ± 90.7) minutes. Total console time was 293 (297 ± 68.0) minutes. The 3 longest portions of the operation were (1) mobilization of the specimen and specimen extraction; (2) construction of the duodenojejunostomy; and (3) closure. Conclusion A third of the operative time is spent off the console. Over half of the steps required more than 20 minutes each to complete. Since robotic operations are associated with shorter LOS and without increased complication rates relative to “open” operations, salutary benefit can be gained by decreasing operative times of robotic procedures. Operative duration is an important metric that needs to be addressed. We need to target the most time-consuming steps, and break them into smaller pieces, to reach optimal efficiency and provide the benefits of decreased operative duration to the patients, hospitals, and providers.
Opportunity for a Community Health Fair Model of Bleeding Control Training
Authors: DePolo Nicole , Dellen Matthew , Hughes Elizabeth , Ike Andre , Lum Sharon , Mukherjee Kaushik , Turay David , Burruss Sigrid 
Published: April 2024

Background Traumatic hemorrhage is a prevalent cause of death nationally, with >50% of civilian deaths estimated to be preventable with more timely intervention. This study investigated the efficacy of training large and diverse audiences in bleeding control methods including tourniquets in community health fair settings. Methods A booth was utilized for bleeding control training at community health fairs via direct demonstrations of pressure, wound packing, and commercial and improvised tourniquet application followed by hands-on practice. Participants self-rated their perceived abilities while instructors rated the participant competency. Results 117 community members participated during two fairs, though not every person completed every portion of the training. Average age was 33 (range 6-82) and the majority were female (65.0%). There was no difference in self-perceived skill compared to trainer grading of participant’s ability to identify life-threatening bleeding (112 (97.4%) vs 106 (97.2%); P = 1), apply pressure (113 (98.3%) vs 106 (97.2%); P = .68), and pack a wound (102 (88.7%) vs 92 (84.4%); P = .43). No difference in difficulty was noted in placing commercial vs improvised tourniquets (16 (43%) vs 14 (45%); P = .87). However, participants were overconfident in their ability to place tourniquets compared to trainer grading, respectively (112 (98.2%) vs 100 (91.7%; P = .03)). Discussion Community fair classes provide opportunities to train large and diverse audiences in bleeding control techniques. However, participants overestimated their ability to appropriately apply tourniquets. Further investigation is needed into best educational approaches to optimize the impact of bleeding control kits that have been distributed in multiple states.
Intimate Partner Violence and Human Trafficking Screening and Services in Primary Care Across Underserved Communities in the United States—Initial Examination of Trends, 2020-2021
Authors: Lin Sue C. , Chang Kimberly S.G. , Marjavi Anna , Chon Katherine Y. , Dichter Melissa E. , DuBois Palardy Jessica 
Published: April 2024

Objectives: The Health Resources and Services Administration (HRSA) began collecting data on intimate partner violence (IPV) and human trafficking (HT) in the 2020 Uniform Data System (UDS). We examined patients affected by IPV and HT served by HRSA-funded health centers in medically underserved US communities during the COVID-19 pandemic. Methods: We established a baseline and measured trends in patient care by analyzing data from the 2020 (N = 28 590 897) and 2021 (N = 30 193 278) UDS. We conducted longitudinal ordinal logistic regression analyses to assess the association of care trends and organization–level and patient characteristics using proportional odds ratios (PORs) and 95% CIs. Results: The number of clinical visits for patients affected by IPV and HT decreased by 29.4% and 88.3%, respectively, from 2020 to 2021. Health centers serving a higher (vs lower) percentage of pediatric patients were more likely to continuously serve patients affected by IPV (POR = 2.58; 95% CI, 1.01-6.61) and HT (POR = 6.14; 95% CI, 2.06-18.29). Health centers serving (vs not serving) patients affected by IPV were associated with a higher percentage of patients who had limited English proficiency (POR = 1.77; 95% CI, 1.02-3.05) and Medicaid beneficiaries (POR = 2.88; 95% CI, 1.48-5.62), whereas health centers serving (vs not serving) patients affected by HT were associated with a higher percentage of female patients of reproductive age (POR = 15.89; 95% CI, 1.61-157.38) and urban settings (POR = 1.74; 95% CI, 1.26-2.37). Conclusions: The number of clinical visits for patients affected by IPV and HT during the COVID-19 pandemic declined. Delayed care will pose challenges for future health care needs of these populations.