bluuebunny/crossref_metadata_2025_split huggingface dataset:
Motor cortex activation during visuomotor transformations: evoked potentials during overt and imagined movements
Authors: Syrov Nikolay , Yakovlev Lev , Kaplan Alexander , Lebedev Mikhail 
Published: November 2023

Abstract
Despite the prevalence of visuomotor transformations in our motor skills, their mechanisms remain incompletely understood, especially when imagery actions are considered such as mentally picking up a cup or pressing a button. Here, we used a stimulus–response task to directly compare the visuomotor transformation underlying overt and imagined button presses. Electroencephalographic activity was recorded while participants responded to highlights of the target button while ignoring the second, non-target button. Movement-related potentials (MRPs) and event-related desynchronization occurred for both overt movements and motor imagery (MI), with responses present even for non-target stimuli. Consistent with the activity accumulation model where visual stimuli are evaluated and transformed into the eventual motor response, the timing of MRPs matched the response time on individual trials. Activity-accumulation patterns were observed for MI, as well. Yet, unlike overt movements, MI-related MRPs were not lateralized, which appears to be a neural marker for the distinction between generating a mental image and transforming it into an overt action. Top-down response strategies governing this hemispheric specificity should be accounted for in future research on MI, including basic studies and medical practice.
Bone mineral density after exercise training in patients with chronic kidney disease stages 3 to 5: a sub-study of RENEXC—a randomized controlled trial
Authors: Petrauskiene Vaida , Hellberg Matthias , Svensson Philippa , Zhou Yunan , Clyne Naomi 
Published: November 2023

Abstract

Background
We evaluated the effects of 12 months of exercise training on bone mineral density (BMD) in patients with chronic kidney disease (CKD) stages 3–5 not on kidney replacement therapy (KRT).

Methods
A total of 151 patients were randomized to 12 months of either balance or strength training, both together with endurance training. Some 112 patients completed and 107 (69 men, 38 women) were analysed, with a mean age 66 ± 13.5 years and 31% having diabetes. The exercise training was self-administered, prescribed and monitored by a physiotherapist. Total body, hip and lumbar BMD, T score and Z score were measured at baseline and after 12 months using dual energy X-ray absorptiometry.

Results
Both groups showed increased physical performance. The prevalence of osteoporosis and osteopenia was unchanged. The strength group (SG) decreased total body BMD (P &lt; .001), the balance group (BG) increased total body T score (P &lt; .05) and total body Z score (P &lt; .005). Total body ΔT score was negative in the SG and unchanged in the BG (P &lt; .005). Total body ΔZ score was negative in the SG and positive in the BG (P &lt; .001). The proportion of progressors measured by ΔT (P &lt; .05) and ΔZ scores (P &lt; .05) was significantly lower in the BG compared with the SG. In multivariate logistic regression analysis, belonging to the BG was the only factor with a lower risk of deterioration of total body BMD, T and Z scores.

Conclusions
Twelve months of balance training together with endurance training seemed to be superior to strength training in maintaining and improving BMD in patients with CKD not on KRT.
TWAIL and Alternative Visions: ‘Talking About a Revolution’: Afterword to the Foreword by Antony Anghie
Authors: Kapur Ratna 
Published: November 2023

Abstract
This Afterward is in response to an invitation by EJIL to engage with Tony Anghie’s Foreword in the same journal entitled ‘Rethinking International Law: A TWAIL Retrospective’. I join in conversation with Anghie to further expand and amplify the redemptive potential of TWAIL, through a focus on human rights. I tease out and amplify a robust account of what constitutes an ‘alternative vision’ found in TWAIL as an epistemological inquiry that reflects a yearning to break free of the Eurocentric discourses that continue to structure human rights and the human subject. It also draws attention to the transformative and revolutionary vision of the project available in the aftermath of the critiques of traditional international law.
Overlapping methodologies? Rhetoric, English Studies, and the social world
Authors: Finlayson Alan 
Published: November 2023

Abstract
This article reflects on the overlaps of English studies with studies of Political Rhetoric. It outlines current UK-based research agendas in ‘Rhetorical Political Analysis’. It proposes a shared agenda focused on speech and argument as social action, and informed by the idea of ‘Rhetorical Citizenship’, the right to participate fully in disputation.
The impact of Covid-19 on mortality and clinical characteristics in hospitalized patients with peripheral artery disease in the year 2020
Authors: Piepenburg S , Maslarska M , Kaier K , Von Zur Muehlen C , Westermann D , Hehrlein C 
Published: November 2023

Abstract

Background
The Covid-19 pandemic developed its full destructive capacity and caused over 6.6 million confirmed deaths worldwide in the year 2020. This retrospective study aimed to examine the effects of Covid-19 on the mortality and clinical characteristics of peripheral artery disease (PAD) patients because these chronically ill patients are at risk for arterial embolic vascular complications and a fatal outcome.

Methods and results
From a German nationwide registry of 2020 all patients hospitalized with PAD (n=173.075) were compared in four different groups. The first group had no additional diabetes mellitus type 2 or Covid-19 (n=110.531), the second diabetes mellitus but no Covid-19 (n=59.991), the third diabetes mellitus and Covid-19 (n=1497) and the fourth no diabetes mellitus but Covid-19 (n=1056). Mortality rates in all PAD patients without Covid-19 were low and ranging between 1.1-3.6%, depending on PAD classification. However, PAD patients with Covid-19 had significantly higher mortality rates of 11.1-12.6%. Clinical characteristics and the Charlson- comorbidity index surprisingly revealed that PAD patients with Covid-19 but without diabetes mellitus presented more complications such as higher rates of stroke (1.4%), cardiogenic shock (3.3%), chronic kidney failure with GFR &lt; 15 ml/min (10.5%) and prolonged ventilation time &gt;48 hours (4.4%).

Conclusion
Covid-19 massively increased death rates in PAD patients in the year 2020. Neither disease severity of different stages of PAD nor additional diabetes mellitus had an effect on in-hospital mortality. One explanation of this finding might be that the risk for arterial embolism increases after a Covid-19 infection and thus leads to higher mortality rates in PAD patients, who are in danger for vascular/embolic complications. Our study reveals the importance of preventing the spread of Covid-19 disease, especially in the case of patients with atherosclerotic diseases.
Haptoglobin 1 gene polymorphism protects against postoperative cardiovascular events
Authors: Mohsen Y , Shami A , Edsfeldt A , Sun J , Goncalves I 
Published: November 2023

Abstract

Background
Haptoglobin (Hp) is a plasma glycoprotein with antioxidant properties that plays a role in maintaining the integrity of the bloodstream and in clearing plasma lipids. The human haptoglobin gene is polymorphic, with two prevalent alleles (Hp1 and Hp2) resulting in three distinct phenotypes. The Hp subtypes have been linked to the risk of symptomatic carotid stenosis and major ischemic cardiovascular events, with some studies suggesting a protective role of the Hp1 allele. However, observed discrepancies in the relationship between Hp genotype and cardiovascular events suggest the presence of additional underlying mechanisms or differences among Hp1 allele subtypes. This study aims to examine the role of Hp1 alleles (Hp1F and Hp1S) in atherosclerosis and determine their association with cardiovascular events in our cohort of carotid endarterectomy patients.

Methods
The study included a total of 691 patients who underwent a carotid endarterectomy. All patients underwent genotyping for Haptoglobin. A total of 668 carotid plaques were collected, and 45 of these plaques were randomly selected for histopathological analysis and underwent staining for lipids using (Oil Red O), hemorrhage (glycophorin A), macrophages (CD68 [cluster of differentiation 68]), smooth muscle cells (alpha-actin) and collagen (Movat pentachrome).
Participants were subsequently followed-up for postoperative cardiovascular events using data from clinical registers. The median follow-up for cardiovascular events was 48 months. All included patients gave written informed consent. The study was approved by the local ethical review board and followed the declaration of Helsinki.

Results
There were no significant differences in the baseline clinical characteristics between Hp1S carriers (36.6%) and non-carriers (63.4%). Postoperative cardiovascular and mortality events were found to be significantly associated with Hp1S subtype, with carriers exhibiting a decreased risk (HR=0.372, 95%CI 0.180-0.769, p=0.008). The histological examination of the plaques revealed that Hp1S carriers had a significantly greater percentage of plaque area stained positive alpha-actin (p=0.033). However, there were no significant differences observed in other histological markers.

Conclusions
Hp1S was associated with lower risk of postoperative cardiovascular events in our cohort of carotid endarterectomy patients. Patients with this genotype had plaques with more smooth muscle cells, so possibly more stable. This suggests that Hp1 subtypes could be of interest in risk stratification of this patient population, deserving further studies.
Impact of atrial fibrillation on mortality of patients undergoing bifurcation PCI
Authors: Mileva N , Vassilev D , Panayotov P , Rigatelli G , Gil R 
Published: November 2023

Abstract

Background
Patients with coronary bifurcation lesions represent a group with a greater risk of mortality when referred for e percutaneous coronary intervention (PCI).

Aim
We aimed to compare the clinical outcomes in patients with or without present atrial fibrillation (AF) undergoing bifurcation PCI.

Methods
Investigator-initiated prospective study of patients with stable coronary artery disease, with a significant angiographic bifurcation lesion defined as diameter stenosis ≥50% who were referred for a PCI. All patients were followed up by telephone contact and/or clinical visit at 30 days and then monthly for vital status. Cardiovascular (CV) death was defined as death with clearly determined cardiac origin or death from an unknown reason. Log-rank test was used to assess the difference in mortality between the two groups. Propensity-matching was performed to account for differences in age, sex, hypertension, dyslipidemia, diabetes, smoking, cancer, renal failure, LV ejection fraction, and SYNTAX score between the two groups. The primary endpoint was the incidence of all-cause and cardiovascular death.

Results
A total of 358 patients were included – 179 in each group. The mean age was 71.1 ± 9.6, 31% (112) were females, 32% (119) were smokers, 98% (353) -hypertensive, 92% (329) with dyslipidemia, 44% (156) -diabetics, 28% (99) had previous MI, mean EF was 51.9 ±10.8 %. After 1:1 propensity-score matching, baseline characteristics between the two groups were similar. Intervention vessel was LAD in 69% (n=247), LCx – 17% (62), RCA – 10% (37) of the patients. For a median follow-up time of 56.5 [39-110] months, total mortality was 40%, whereas CV death occurred in 30.5% (n=109) of the patients. Both all-cause and CV death were significantly higher in patients with AF - 64 (35.8%) versus 79 (44.1%); p=0.040, and - 47 (26.3%) versus 62 (34.6%); p=0.031, respectively. Furthermore, atrial fibrillation was revealed as an independent predictor of cardiovascular death in Cox-regression analysis, together with the following factors: AF – HR 1.704, 95%CI [1.156-2.510], p=0.007, age – HR 1.057, 95%CI [1.032-1.082], p&lt;0.01; diabetes HR 1.556, 95%CI [1.059-2.2287], p=0.024; COPD HR 2.037 95%CI [1.328-3.123], p=0.001; EF –HR 0.968, 95% CI [0.950-0.987], p=0.001.

Conclusion
The presence of atrial fibrillation in patients with coronary bifurcation lesions referred for PCI is associated with higher all-cause and cardiovascular mortality.
Impact of intracoronary imaging-guided percutaneous coronary intervention on procedural outcomes among complex patient groups
Authors: Mohamed M , Kinnaird T , Wijeysundera H C , Johnson T W , Zaman S , Moledina S , Mamas M 
Published: November 2023

Abstract

Background
Intracoronary imaging (ICI) has been previously shown to improve survival and clinical outcomes after percutaneous coronary intervention (PCI). However, whether this prognostic benefit is sustained across different indications/patient groups remains unclear.

Methods
All PCI procedures performed in England and Wales between 1st April 2014 and 31st March 2020 were retrospectively analysed. The association between ICI use and in-hospital MACCE (major adverse cardiovascular and cerebrovascular outcomes; composite of all-cause mortality, stroke and reinfarction) and mortality was examined using multivariable logistic regression analysis for each imaging-recommended indication (stent thrombosis (ST), in-stent restenosis, stent length&gt;60mm, acute coronary syndrome (ACS) indications, chronic total occlusion, left main stem (LMS) intervention, renal failure and bioresorbable vascular scaffolds (BVS)).

Results
Of 555,398 PCI procedures, 10.8% (n=59,752) were performed under ICI guidance. ICI use doubled between 2014 (7.8%) and 2020 (17.5%). ICI use was highest for BVS (44.7%) and LMS PCI (41.2%) cases and lowest in ACS (9%). Overall, the odds ratios (OR) of in-hospital MACCE and mortality were only reduced with ICI-guided PCI in cases with an imaging-recommended indication (OR 0.75 95% confidence interval (CI) 0.69-0.81 and OR 0.69 95%CI 0.63-0.76, respectively). Only specific imaging-recommended indications were associated with reduced MACCE and mortality, including LMS PCI (OR 0.45 95%CI 0.39-0.52 and 0.41 95%CI 0.35-0.48, respectively), ACS (OR 0.76 95%CI 0.70-0.82 and 0.70 95%CI 0.63-0.77), stent length&gt;60mm (OR 0.75 95%CI 0.59-0.94 and 0.72 95%CI 0.54-0.95). ST was only associated with lower mortality (OR: 0.69 95%CI 0.52-0.91) while renal failure was associated with reduced MACCE (OR 0.77 95%CI 0.60-0.99) but not mortality. (Figure 1)

Conclusion
The utilisation of ICI has more than doubled over a seven-year period at a national level but remains low, with less than 1-in-5 procedures performed under ICI guidance. In-hospital survival was better with ICI-guided than angiography-guided PCI, albeit only for specific indications.Figure 1
The integration of angio-IMR, QFR and FFR for the detection of ischemia
Authors: Jukema R , Raijmakers P , Driessen R , Van Diemen P , Knuuti J , Maaniitty T , Twisk J , Kooistra R , Timmer J , Reiber J , Van Der Hoef T , Knaapen P , Danad I 
Published: November 2023

Abstract

Background
Fractional flow reserve (FFR) and quantitative flow ratio (QFR) are important tools to assess coronary-specific ischemia, but ischemia may be obscured in the presence of coronary microvascular dysfunction (CMD). Wire free angiography based index of microcirculatory resistance (angio-IMR) might aid in identifying ischemic territories with normal FFR or QFR.

Purpose
First we sought to validate angio-IMR against invasive resistance indices and [15O]H2O positron emission tomography (PET) derived resistance. Secondly, we investigated whether angio-IMR can help identifying ischemic vessels with normal FFR/QFR.

Methods
In this PACIFIC 1 and 2 sub study symptomatic patients underwent [15O]H2O PET and invasive coronary angiography with routine three vessel FFR. Invasive hyperemic microvascular resistance (HMR) and IMR were measured in a sub set of patients. A FFR/QFR ≤0.80 and hyperemic myocardial blood flow (hMBF) ≤2.3 ml/min/g were considered ischemic. Microvascular resistance on PET was defined as the ratio of mean distal coronary pressure to MBF. Angio-IMR, QFR and PET analyses were performed by core labs blinded to invasive angiography results.

Results
Among 259 patients (mean age 61 ± 9 years, 188 (73%) male) 494 vessels were included. Invasive IMR and or HMR were measured in 95 vessels. Angio-IMR did not correlate with invasive HMR/IMR for the right coronary artery (RCA) but correlated weakly with invasive HMR (r=0.39, p=0.03) and moderately (r=0.48, p&lt;0.01) with invasive IMR for the left coronary artery (LCA). The RCA was excluded for further analysis. A very weak correlation between angio-IMR and PET resistance was observed (r=0.17, p&lt;0.01). Territories with ischemia and a normal FFR showed a higher angio-IMR than ischemic territories with reduced FFR (31.3 ± 13.8 vs 22.2 ± 10.3, p&lt;0.01). The same was observed after stratification by QFR/PET results (34.3 ± 15.5 vs 23.9 ± 9.9, p&lt;0.01). Results remained consistent after stratification for diameter stenosis percentage.

Conclusions
A weak to moderate correlation was found between angio-IMR and invasive resistance indices for the LCA. In territories with an ischemic perfusion angio-IMR was higher in those with a normal FFR/QFR compared to patients with a reduced FFR/QFR. Integration of FFR/QFR and angio-IMR might lead to superior vessel-specific ischemia detection.
Treatment of coronary artery disease with sirolimus- versus paclitaxel-coated balloons
Authors: Cuculi F , Madanchi M , Cioffi G M , Majcen I , Gnan E , Gjergjizi V , Zhi Y , Seiler T , Attinger-Toller A , Bossard M 
Published: November 2023

Abstract

Background
Percutaneous coronary interventions (PCI) with paclitaxel-coated balloons (PCB) represent an established treatment for in-stent restenosis (ISR) and small coronary arteries. Lately sirolimus-coated balloons (SCB) have been introduced. Yet, studies comparing SCBs to PCBs are lacking.

Purpose
We sought to assess clinical outcomes at 12 months of an all-comer population presenting with acute or chronic coronary artery disease (CAD) treated with either a novel SCB or an established PCB.

Methods
We analyzed consecutive patients from the ongoing prospective SIROOP registry (NCT:04988685). Outcomes of interest included, target lesion failure (TLF), target lesion revascularization (TLR), target vessel myocardial infarction (TV-MI) and cardiac-death (cv-death). All angiograms and outcomes were independently adjudicated.

Results
A total of 359 patients were included in this analysis, 220 (61%) and 139 (39%) patients were treated with SCBs and PCBs, respectively. Diabetes was present in 108 (30%) of patients and 145 (40%) patients presented with an acute coronary syndrome. The mean Syntax score of the overall population was 17.8±11, 95 (26%) of the lesions were ISR, 30 (8.4%) chronic total occlusions (CTOs) and 211 (59%) had moderate to severe calcifications. All lesions were treated with a DCB-only approach in both groups. Mean DCB diameter was 2.8±0.56 mm and the maximal mean dilatation pressure was 8.1±4.7 atm. We encountered no relevant coronary artery perforations or acute vessel closures. Further baseline and procedural characteristics can be found in Figure 1.
At 1-year follow-up, there was no statistically significant difference in the TLF rate between patients treated with SCBs versus PCBs (14 (7.4%) versus 12 (10%), respectively, (p=0.5)), with TLR being the leading cause for TLF (13 (6.8%) in the SCB and 10 (8.8%) in the PCB group, p=0.7). Figure 2 depicts the Kaplan-Meier curve of TLF over time. The leading TLF cause appeared to be lesion recoil/ collapse in both groups. Comparing ISR lesions treated with SCBs versus PCBs, there was also no significant difference with regards to the TLF rate (3 (9.1%) versus 4 (8.2%), respectively, p=1.00).

Conclusions
To our best knowledge, this is one of the first studies comparing SCBs to PCBs for treatment of CAD. At 1-year follow-up, there was no significant difference in outcomes between the two groups. Moreover, there was a numerically lower number of adverse events among patients treated with SCBs. These findings warrant further investigation in a dedicated randomized trial.Baseline and procedural characteristicsKaplan-Meier curve of TLF
Comparison of clinical outcomes with short-term and long-term DAPT after PCI using second-generation drug-eluting stents in high bleeding risk patient : a systematic review and meta-analysis
Authors: Intan R , Suryawan I G R , Ratri A K , Lusida T T E , Jonatan M , Nugraha R A 
Published: November 2023

Abstract

Background
Now that second-generation drug-eluting stents (DES) are available in almost every hospital in the world, it is unknown whether reducing the duration of double antiplatelet therapy (DAPT) following percutaneous coronary intervention in high-bleeding-risk (HBR) populations is beneficial and safe.

Purpose
This systematic review and meta-analysis aims to determine the safety, efficacy, and advantages of shortening the duration of DAPT (&lt;6 months) in HBR patients with second-generation DES implantation.

Methods
We searched Ebsco, PubMed, Web of Science, Scopus, and Google scholar databases from inception to December 2022 for papers comparing short-term DAPT (6 months) followed by aspirin or P2Y 12 inhibitor monotherapy with long-term DAPT (6 months) in HBR patients after PCI with second generation DES. The primary objectives are major bleeding, definite or probable stent thrombosis (ST), and myocardial infarction (MI), while the secondary endpoint is mortality from any cause. Random-effect models were used to assess the relative risk and 95% confidence interval.

Results
This study included 9,789 HBR patients from three observational studies and one randomized controlled trial (Figure 1). Short DAPT for HBR patients undergoing PCI with second generation DES had a tendency of lower incidence of major bleeding in comparison with standard (6 months) DAPT, even though statistically non-significant (2.33% vs. 3.36%, RR 0.66 [95% CI 0.39 – 1.10], p = 0.11). Short-term DAPT was also found to be comparable and non-inferior to standard DAPT with in term of stent thrombosis (0.251% vs. 0.252%, RR 1.00 [95% CI 0.46-2.17], p = 0.99), Myocardial Infarction (2.08% vs. 1.85%, RR 1.09 [95% CI 0.82-1.44], p = 0.57), and All cause of death (3.01% vs. 2.56%, RR 1.17 [95% CI 0.93-1.49], p = 0.18) (Figure 2).

Conclusions
Among HBR patients implanted with second-generation DES, short DAPT was associated with slightly lower but comparable risk of major bleeding and non-inferior to reduce stent thrombosis, myocardial infarction, and all cause of death compared to standard DAPT.