bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case report on intravascular lithotripsy to facilitate retrograde wire passage from the subintimal to the luminal space in a calcified chronic total occlusion
Authors: Werner Gerald S , Yaginuma Kenji 
Published: November 2023

Abstract

Background
Severe calcifications are a major reason for failures in chronic total coronary occlusions, as they can obstruct the wire passage both in the antegrade and retrograde technique.

Case summary
The proximal occlusion of the left anterior descending artery in a 75-year-old man presented with a completely concentric calcified ring all along the segment proximal to the occlusion. The antegrade wire could not pass the calcified occlusion, and in a retrograde approach via the right posterior descending artery the retrograde wire was not able to enter the lumen from a subintimal position outside of the calcified ring. Intravascular lithoplasty in the proximal segment led to a crack in this ring to enable the same retrograde wire now to pass into the true lumen with then successful conclusion of the case. Intravascular ultrasound demonstrated the modification of the calcified ring and the passage of the wire with only a very short subintimal pathway.

Discussion
Intravascular lithoplasty is a new option to modify severely calcified vessel segments to facilitate the reverse controlled antegrade and retrograde tracking approach. In the present case, this helped to avoid a long subintimal pathway and preserved the vessel anatomy.
Repeated thrombus occlusion in superficial femoral artery at the gap between two stents: a case report
Authors: Matsumoto Yuki , Shimada Ryutaro , Morioka Hidemi , Morino Yoshihiro 
Published: November 2023

Abstract

Background
In recent years, endovascular treatment has emerged as a preferred option for treating long lesions in the superficial femoral artery (SFA), including those classified as Trans-Atlantic Inter-Society Consensus IIC and D. This approach may involve the use of multiple stents to ensure adequate coverage of the entire lesion, as maintaining primary patency is a key consideration in the treatment strategy.

Case summary
An 82-year-old woman underwent endovascular treatment with two stents for a chronic total occlusion lesion in the left SFA. Six months later, she was admitted to our hospital with acute limb ischaemia (ALI). Angiography revealed significant thrombus within the stents and a gap between the stents, while intravascular ultrasounds showed neointimal hyperplasia at the gap. Initially, the patient was treated with a cutting balloon for the gap, but experienced another episode of ALI the following day. Subsequently, a stent was placed to cover the gap, resulting in the resolution of ALI without further recurrence.

Discussion
Superficial femoral arteries expose the stent to high stresses due to the unique external forces. When multiple stents are implanted, there must be sufficient overlap. If a stent gap occurs, stent deployment is unavoidable due to the neointimal hyperplasia as well as the coronary stent gap. Further research and clinical expertise are needed to optimize stent placement strategies and minimize stent-related complications in SFA lesions.
Case series: cardiac sarcoma
Authors: Killian Michael , Barry Timothy , Larsen Carolyn , Alsidawi Said 
Published: November 2023

Abstract

Background
Cardiac masses encompass a wide differential including primary and secondary malignancies and can present with a variety of symptoms, many of which are non-specific. Early identification and classification are important, particularly for cardiac malignancies such as sarcomas as these are aggressive tumours with exceptionally poor prognoses when metastases are present at diagnosis.

Case summary
We report two cases of patients who presented with dyspnoea and were diagnosed with cardiac sarcomas; the former a primary sarcoma (undifferentiated pleomorphic subtype) and the latter a secondary sarcoma (round cell myxoid liposarcoma) that serve as comparisons for presentation and management of different types of this disease. Computed Tomography (CT) and echocardiography imaging findings are demonstrated showing the typical location and morphology of each subtype.

Discussion
Cardiac sarcomas are the most common primary cardiac malignancy, of which undifferentiated pleomorphic sarcoma is a common subtype. Undifferentiated pleomorphic sarcomas are aggressive, have a tendency to arise in the left atrium, and can appear similar to benign cardiac masses. Round cell myxoid liposarcomas by contrast are rare causes of secondary cardiac malignancies, metastasizing to the heart from soft tissues. Both diagnoses carry poor prognoses and although rare, are important to recognize as timely intervention with surgery, radiotherapy, and consideration of chemotherapy is key to maximizing survival.
Vertebral osteomyelitis secondary to infective endocarditis detected by repeated magnetic resonance imaging: a case report
Authors: Hashimoto Masaki , Ueda Kazutaka , Nakao Tomoko , Tanaka Takahiro , Komuro Issei 
Published: November 2023

Abstract

Background
Patients with infective endocarditis (IE) experience various symptoms, a major one being back pain, which is occasionally caused by concomitant vertebral osteomyelitis (VO). Magnetic resonance imaging (MRI) is generally used to detect VO; however, the sensitivity of detection using MRI is very low in the early stages of VO.

Case summary
A 60-year-old man visited our hospital with complaints of fever and persistent back pain over the past 7 days. A holosystolic heart murmur was auscultated, and an echocardiography revealed a vegetation on the posterior mitral leaflet. Blood cultures were positive for Streptococcus sanguinis. He was diagnosed with IE and treated with antimicrobials. A lumbar spine MRI on Day 1 showed no clear signs of vertebral infection, but the back pain continued and gradually worsened. Magnetic resonance imaging retest on Day 8 showed high signal intensity within the lumbar vertebral bodies and the disk on T2-weighted sequences, indicating VO. Intravenous antimicrobial therapy was extended, followed by oral antimicrobials, and a corset was put on to protect the lumbar spine to prevent bone degradation.

Discussion
For persistent back pain in IE patients, repeat MRIs at regular intervals of time can detect possible vertebral infection even if signs of vertebral infection were absent on the initial MRI.
Risk of hyperkalaemia in patients with type 2 diabetes mellitus prescribed with SGLT2 versus DPP-4 inhibitors
Authors: Wu Mei-zhen , Teng Tiew-Hwa Katherine , Tsang Christopher Tze-Wei , Chan Yap-Hang , Lee Chi-Ho , Ren Qing-wen , Huang Jia-Yi , Cheang Iok-fai , Tse Yi-Kei , Li Xin-li , Xu Xin , Tse Hung-Fat , Lam Carolyn S P , Yiu Kai-Hang 
Published: November 2023

Abstract

Aims
To investigate the risk of hyperkalaemia in new users of sodium–glucose cotransporter 2 (SGLT2) inhibitors vs. dipeptidyl peptidase-4 (DPP-4) inhibitors among patients with type 2 diabetes mellitus (T2DM).

Methods and results
Patients with T2DM who commenced treatment with an SGLT2 or a DPP-4 inhibitor between 2015 and 2019 were collected. A multivariable Cox proportional hazards analysis was applied to compare the risk of central laboratory-determined severe hyperkalaemia, hyperkalaemia, hypokalaemia (serum potassium ≥6.0, ≥5.5, and &lt;3.5 mmol/L, respectively), and initiation of a potassium binder in patients newly prescribed an SGLT2 or a DPP-4 inhibitor. A total of 28 599 patients (mean age 60 ± 11 years, 60.9% male) were included after 1:2 propensity score matching, of whom 10 586 were new users of SGLT2 inhibitors and 18 013 of DPP-4 inhibitors. During a 2-year follow-up, severe hyperkalaemia developed in 122 SGLT2 inhibitor users and 325 DPP-4 inhibitor users. Use of SGLT2 inhibitors was associated with a 29% reduction in incident severe hyperkalaemia [hazard ratio (HR) 0.71, 95% confidence interval (CI) 0.58–0.88] compared with DPP-4 inhibitors. Risk of hyperkalaemia (HR 0.81, 95% CI 0.71–0.92) and prescription of a potassium binder (HR 0.74, 95% CI 0.67–0.82) were likewise decreased with SGLT2 inhibitors compared with DPP-4 inhibitors. Occurrence of incident hypokalaemia was nonetheless similar between those prescribed an SGLT2 inhibitor and those prescribed a DPP-4 inhibitor (HR 0.90, 95% CI 0.81–1.01).

Conclusion
Our study provides real-world evidence that compared with DPP-4 inhibitors, SGLT2 inhibitors were associated with lower risk of hyperkalaemia and did not increase the incidence of hypokalaemia in patients with T2DM.
4-Hydroxynonenal impairs miRNA maturation in heart failure via Dicer post-translational modification
Authors: Kiyuna Ligia A , Candido Darlan S , Bechara Luiz R G , Jesus Itamar C G , Ramalho Lisley S , Krum Barbara , Albuquerque Ruda P , Campos Juliane C , Bozi Luiz H M , Zambelli Vanessa O , Alves Ariane N , Campolo Nicolás , Mastrogiovanni Mauricio , Bartesaghi Silvina , Leyva Alejandro , Durán Rosario , Radi Rafael , Arantes Guilherme M , Cunha-Neto Edécio , Mori Marcelo A , Chen Che-Hong , Yang Wenjin , Mochly-Rosen Daria , MacRae Ian J , Ferreira Ludmila R P , Ferreira Julio C B 
Published: November 2023

Abstract

Background and Aims
Developing novel therapies to battle the global public health burden of heart failure remains challenging. This study investigates the underlying mechanisms and potential treatment for 4-hydroxynonenal (4-HNE) deleterious effects in heart failure.

Methods
Biochemical, functional, and histochemical measurements were applied to identify 4-HNE adducts in rat and human failing hearts. In vitro studies were performed to validate 4-HNE targets.

Results
4-HNE, a reactive aldehyde by-product of mitochondrial dysfunction in heart failure, covalently inhibits Dicer, an RNase III endonuclease essential for microRNA (miRNA) biogenesis. 4-HNE inhibition of Dicer impairs miRNA processing. Mechanistically, 4-HNE binds to recombinant human Dicer through an intermolecular interaction that disrupts both activity and stability of Dicer in a concentration- and time-dependent manner. Dithiothreitol neutralization of 4-HNE or replacing 4-HNE-targeted residues in Dicer prevents 4-HNE inhibition of Dicer in vitro. Interestingly, end-stage human failing hearts from three different heart failure aetiologies display defective 4-HNE clearance, decreased Dicer activity, and miRNA biogenesis impairment. Notably, boosting 4-HNE clearance through pharmacological re-activation of mitochondrial aldehyde dehydrogenase 2 (ALDH2) using Alda-1 or its improved orally bioavailable derivative AD-9308 restores Dicer activity. ALDH2 is a major enzyme responsible for 4-HNE removal. Importantly, this response is accompanied by improved miRNA maturation and cardiac function/remodelling in a pre-clinical model of heart failure.

Conclusions
4-HNE inhibition of Dicer directly impairs miRNA biogenesis in heart failure. Strikingly, decreasing cardiac 4-HNE levels through pharmacological ALDH2 activation is sufficient to re-establish Dicer activity and miRNA biogenesis; thereby representing potential treatment for patients with heart failure.
Cardiovascular hospitalizations and mortality among adults aged 25–64 years in the USA
Authors: Henry Chantal M , Oseran Andrew S , Zheng ZhaoNian , Dong Huaying , Wadhera Rishi K 
Published: November 2023

Abstract

Background and Aims
Declines in cardiovascular mortality have stagnated in the USA since 2011. There is growing concern that these patterns reflect worsening cardiovascular health in younger adults. However, little is known about how the burden of acute cardiovascular hospitalizations and mortality has changed in this population. Changes in cardiovascular hospitalizations and mortality among adults aged 25–64 years were evaluated, overall and by community-level income.

Methods
Using the National Inpatient Sample, age-standardized annual hospitalization and in-hospital mortality rates for acute myocardial infarction (AMI), heart failure, and ischaemic stroke were determined among adults aged 25–64 years. Quasi-Poisson and quasi-binominal regression models were fitted to compare outcomes between individuals residing in low- and higher-income communities.

Results
Between 2008 and 2019, age-standardized hospitalization rates for AMI increased among younger adults from 155.0 (95% confidence interval: 154.6, 155.4) per 100 000 to 160.7 (160.3, 161.1) per 100 000 (absolute change +5.7 [5.0, 6.3], P &lt; .001). Heart failure hospitalizations also increased (165.3 [164.8, 165.7] to 225.3 [224.8, 225.8], absolute change +60.0 (59.3, 60.6), P &lt; .001), as ischaemic stroke hospitalizations (76.3 [76.1, 76.7] to 108.1 [107.8, 108.5], absolute change +31.7 (31.2, 32.2), P &lt; .001). Across all conditions, hospitalizations rates were significantly higher among younger adults residing in low-income compared with higher-income communities, and disparities did not narrow between groups. In-hospital mortality decreased for all conditions over the study period.

Conclusions
There was an alarming increase in cardiovascular hospitalizations among younger adults in the USA from 2008 to 2019, and disparities between those residing in low- and higher-income communities did not narrow.
Identification of Brugada syndrome based on P-wave features: an artificial intelligence-based approach
Authors: Zanchi Beatrice , Faraci Francesca Dalia , Gharaviri Ali , Bergonti Marco , Monga Tomas , Auricchio Angelo , Conte Giulio 
Published: November 2023

Abstract

Aims
Brugada syndrome (BrS) is an inherited disease associated with an increased risk of ventricular arrhythmias. Recent studies have reported the presence of an altered atrial phenotype characterized by abnormal P-wave parameters. The aim of this study was to identify BrS based exclusively on P-wave features through an artificial intelligence (AI)-based model.

Methods and results
Continuous 5 min 12-lead ECG recordings were obtained in sinus rhythm from (i) patients with spontaneous or ajmaline-induced BrS and no history of AF and (ii) subjects with suspected BrS and negative ajmaline challenge. The recorded ECG signals were processed and divided into epochs of 15 s each. Within these epochs, P-waves were first identified and then averaged. From the averaged P-waves, a total of 67 different features considered relevant to the classification task were extracted. These features were then used to train nine different AI-based supervised classifiers. A total of 2228 averaged P-wave observations, resulting from the analysis of 33 420 P-waves, were obtained from 123 patients (79 BrS+ and 44 BrS−). Averaged P-waves were divided using a patient-wise split, allocating 80% for training and 20% for testing, ensuring data integrity and reducing biases in AI-based model training. The BrS+ patients presented with longer P-wave duration (136 ms vs. 124 ms, P &lt; 0.001) and higher terminal force in lead V1 (2.5 au vs. 1.7 au, P &lt; 0.01) compared with BrS− subjects. Among classifiers, AdaBoost model had the highest values of performance for all the considered metrics, reaching an accuracy of over 81% (sensitivity 86%, specificity 73%).

Conclusion
An AI machine-learning model is able to identify patients with BrS based only on P-wave characteristics. These findings confirm the presence of an atrial hallmark and open new horizons for AI-guided BrS diagnosis.
Optimizing the balance between heterologous acetate- and CO2-reduction pathways in anaerobic cultures of Saccharomyces cerevisiae strains engineered for low-glycerol production
Authors: van Aalst Aafke C A , Geraats Ellen H , Jansen Mickel L A , Mans Robert , Pronk Jack T 
Published: November 2023

Abstract
In anaerobic Saccharomyces cerevisiae cultures, NADH (reduced form of nicotinamide adenine dinucleotide)-cofactor balancing by glycerol formation constrains ethanol yields. Introduction of an acetate-to-ethanol reduction pathway based on heterologous acetylating acetaldehyde dehydrogenase (A-ALD) can replace glycerol formation as ‘redox-sink’ and improve ethanol yields in acetate-containing media. Acetate concentrations in feedstock for first-generation bioethanol production are, however, insufficient to completely replace glycerol formation. An alternative glycerol-reduction strategy bypasses the oxidative reaction in glycolysis by introducing phosphoribulokinase (PRK) and ribulose-1,5-bisphosphate carboxylase/oxygenase (RuBisCO). For optimal performance in industrial settings, yeast strains should ideally first fully convert acetate and, subsequently, continue low-glycerol fermentation via the PRK-RuBisCO pathway. However, anaerobic batch cultures of a strain carrying both pathways showed inferior acetate reduction relative to a strain expressing only the A-ALD pathway. Complete A-ALD-mediated acetate reduction by a dual-pathway strain, grown anaerobically on 50 g L−1 glucose and 5 mmol L−1 acetate, was achieved upon reducing PRK abundance by a C-terminal extension of its amino acid sequence. Yields of glycerol and ethanol on glucose were 55% lower and 6% higher, respectively, than those of a nonengineered reference strain. The negative impact of the PRK-RuBisCO pathway on acetate reduction was attributed to sensitivity of the reversible A-ALD reaction to intracellular acetaldehyde concentrations.
Crossover shortage in potato is caused byStMSH4mutant alleles and leads to either highly uniform unreduced pollen or sterility
Authors: Clot Corentin R , Klein Dennis , Koopman Joey , Schuit Cees , Engelen Christel J M , Hutten Ronald C B , Brouwer Matthijs , Visser Richard G F , Jurani Martina , van Eck Herman J 
Published: November 2023

AbstractThe balanced segregation of homologous chromosomes during meiosis is essential for fertility and is mediated by crossovers (COs). A strong reduction of CO number leads to the unpairing of homologous chromosomes after the withdrawal of the synaptonemal complex. This results in the random segregation of univalents during meiosis I and ultimately to the production of unbalanced and sterile gametes. However, if CO shortage is combined with another meiotic alteration that restitutes the first meiotic division, then uniform and balanced unreduced male gametes, essentially composed of nonrecombinant homologs, are produced. This mitosis-like division is of interest to breeders because it transmits most of the parental heterozygosity to the gametes. In potato, CO shortage, a recessive trait previously referred to as desynapsis, was tentatively mapped to chromosome 8. In this article, we have fine-mapped the position of the CO shortage locus and identified StMSH4, an essential component of the class I CO pathway, as the most likely candidate gene. A 7 base-pair insertion in the second exon of StMSH4 was found to be associated with CO shortage in our mapping population. We also identified a second allele with a 3,820 base-pair insertion and confirmed that both alleles cannot complement each other. Such nonfunctional alleles appear to be common in potato cultivars. More than half of the varieties we tested are carriers of mutational load at the StMSH4 locus. With this new information, breeders can choose to remove alleles associated with CO shortage from their germplasm to improve fertility or to use them to produce highly uniform unreduced male gametes in alternative breeding schemes.
Physically motivated moment-tensor decomposition for mining-induced seismicity
Authors: Rigby Alex 
Published: November 2023

SUMMARY
Compared to existing schemes, the decomposition of moment tensors for mining-induced seismic events into closing-crack and double-couple components has the advantage that each can be interpreted in terms of a physical source process (excavation convergence and slip/shear, respectively). Obviously, not every moment tensor permits such a decomposition, and we translate existing bounds on those that do to the Hudson source-type plot. For moment tensors falling within these bounds, it has previously been noted that there will be a infinite set of possible decompositions in general. We derive an implicit equation defining this set and suggest physically motivated criteria that can be used to select a single decomposition from it. Furthermore, for moment tensors falling outside the source-type bounds, we present a simple geometric scheme for determining the closest moment tensor within them (which can then be decomposed). To demonstrate the methods developed in this paper, we apply them to two catalogues of mining-induced seismicity.
“More than just checking the box”: community-based organizations on their role in Medicaid redesigns
Authors: Tsering Dolma , Stauffer Claire M , Gittzus Jordan A , Byhoff Elena , Taylor Lauren A 
Published: November 2023

Abstract
New York and Massachusetts 1115 Medicaid demonstration waivers aimed to prioritize social determinants of health and engage community-based organizations to improve health outcomes. This is an evaluation of community-based organizations' public comments regarding their participation in social services delivery within the 1115 waivers. Both states solicited public comments on waiver implementation to date and potential improvements. The research team extracted all publicly available comments (n = 359) made by direct service providers between November 2016 and April 2019. The sample was then limited to only comments that discussed social service provision and health care–social service partnerships (n = 58). Findings are presented in 2 stages: (1) concerns regarding delivery system reform incentive payments funding levels, timing, and flow and (2) perspectives on how states and Medicaid administrators could improve health care–community organization relationships. Resource-dependent, community-based organizations protested insufficient funding. Additional comments identified specific design, structure, and implementation aspects of the 1115 waiver that could improve partnerships. Despite 1115 waivers prioritizing social service integration, community-based organizations still feel underfunded and disenfranchised. Aligning with health care standards requires significant time and effort. Given resource constraints, the state must facilitate these investments. Community organizations’ feedback can also offer guidance on waiver strategies in other states.
Network of GRAS transcription factors in plant development, fruit ripening and stress responses
Authors: Neves Catarina , Ribeiro Beatriz , Amaro Rute , Expósito Jesús , Grimplet Jérôme , Fortes Ana Margarida 
Published: November 2023

Abstract
The plant-specific family of GRAS transcription factors has been wide implicated in the regulation of transcriptional reprogramming associated with a diversity of biological functions ranging from plant development processes to stress responses. Functional analyses of GRAS transcription factors supported by in silico structural and comparative analyses are emerging and clarifying the regulatory networks associated with their biological roles. In this review, a detailed analysis of GRAS proteins' structure and biochemical features as revealed by recent discoveries indicated how these characteristics may impact subcellular location, molecular mechanisms, and function. Nomenclature issues associated with GRAS classification into different subfamilies in diverse plant species even in the presence of robust genomic resources are discussed, in particular how it affects assumptions of biological function. Insights into the mechanisms driving evolution of this gene family and how genetic and epigenetic regulation of GRAS contributes to subfunctionalization are provided. Finally, this review debates challenges and future perspectives on the application of this complex but promising gene family for crop improvement to cope with challenges of environmental transition.