bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coronary Microvascular Dysfunction in Patients With Heart Failure: Characterization of Patterns in HFrEF Versus HFpEF
Authors: Paolisso Pasquale , Gallinoro Emanuele , Belmonte Marta , Bertolone Dario Tino , Bermpeis Konstantinos , De Colle Cristina , Shumkova Monika , Leone Attilio , Caglioni Serena , Esposito Giuseppe , Fabbricatore Davide , Moya Ana , Delrue Leen , Penicka Martin , De Bruyne Bernard , Barbato Emanuele , Bartunek Jozef , Vanderheyden Marc 
Published: December 2023

BACKGROUND:
Coronary microvascular dysfunction (CMD) is involved in heart failure (HF) onset and progression, independently of HF phenotype and obstructive coronary artery disease. Invasive assessment of CMD might provide insights into phenotyping and prognosis of patients with HF. We aimed to assess absolute coronary flow, absolute microvascular resistance, myocardial perfusion, coronary flow reserve, and microvascular resistance reserve in patients with HF with preserved ejection fraction and HF with reduced ejection fraction (HFrEF).

METHODS:
Single-center, prospective study of 56 consecutive patients with de novo HF with nonobstructive coronary artery disease divided into HF with preserved ejection fraction (n=21) and HFrEF (n=35). CMD was invasively assessed by continuous intracoronary thermodilution and defined as coronary flow reserve <2.5. Left ventricular and left anterior descending artery–related myocardial mass was quantified by echocardiography and coronary computed tomography angiography. Myocardial perfusion (mL/min per g) was calculated as the ratio between absolute coronary flow and left anterior descending artery–related mass.

RESULTS:

Patients with HFrEF showed a higher left ventricular and left anterior descending artery–related myocardial mass compared with HF with preserved ejection fraction (
P
<0.010). Overall, 52% of the study population had CMD, with a similar prevalence between the 2 groups. In HFrEF, CMD was characterized by lower absolute microvascular resistance and higher absolute coronary flow at rest (functional CMD;
P
=0.002). CMD was an independent predictor of a lower rate of left ventricular reverse remodeling at follow-up. In patients with HF with preserved ejection fraction, CMD was mainly due to higher absolute microvascular resistance and lower absolute coronary flow during hyperemia (structural CMD;
P
≤0.030).

CONCLUSIONS:
Continuous intracoronary thermodilution allows the definition and characterization of patterns with distinct CMD in patients with HF and could identify patients with HFrEF with a higher rate of left ventricular reverse remodeling at follow-up.
Unraveling Potential Sex‐Specific Effects of Cardiovascular Medications on Longevity Using Mendelian Randomization
Authors: Kwok Man Ki , Schooling C. Mary 
Published: December 2023

Background
Establishing the sex‐specific efficacy of cardiovascular medications is pivotal to evidence‐based clinical practice, potentially closing the gender gap in longevity. Trials large enough to establish sex differences are unavailable. This study evaluated sex‐specific effects of commonly prescribed cardiovascular medications on lifespan.

Methods and Results

In a two‐sample Mendelian randomization study, established genetic variants mimicking effects of lipid‐lowering drugs, antihypertensives, and diabetes drugs were applied to genetic associations with lifespan proxied by UK Biobank maternal (n=412 937) and paternal (n=415 311) attained age. Estimates were obtained using inverse variance weighting, with sensitivity analyses where possible. For lipid‐lowering drugs, genetically mimicked PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors were associated with longer lifespan, particularly in men (2.39 years per SD low‐density lipoprotein cholesterol reduction [95% CI, 0.42–4.36],
P
for interaction=0.14). Genetically mimicked treatments targeting
APOC3
,
LPL
, or possibly
LDLR
were associated with longer lifespan in both sexes. For antihypertensives, genetically mimicked β‐blockers and calcium channel blockers were associated with longer lifespan, particularly in men (
P
for interaction=0.17 for β‐blockers and 0.31 for calcium channel blockers). For diabetes drugs, genetically mimicked metformin was associated with longer lifespan in both sexes. No associations were found for genetically mimicked statins, ezetimibe, or angiotensin‐converting enzyme inhibitors.

Conclusions

PCSK9 inhibitors, β‐blockers, and calcium channel blockers may prolong lifespan in the general population, particularly men. Treatments targeting
APOC3
,
LPL
, or
LDLR
and metformin may be relevant to both sexes. Whether other null findings are attributable to lack of efficacy requires investigation. Further investigation of repurposing should be conducted.
Prognostic Value of Nighttime Double Product in Nondialysis Chronic Kidney Disease With Hypertension
Authors: Jiang Xinying , Li Xuehong , Peng Hui , Li Man , Wang Cheng 
Published: December 2023

Background
Both nighttime systolic blood pressure and pulse rate are associated with adverse outcomes in patients with chronic kidney disease (CKD). However, nighttime double product (DP), which is the product of nighttime systolic blood pressure and pulse rate, has not yet been investigated in this context. The present study aimed to explore the prognostic value of nighttime DP for adverse outcomes in patients with CKD and hypertension.

Methods and Results
This retrospective cohort study included a total of 1434 patients with nondialysis CKD complicated by hypertension. The patients were enrolled in Zhuhai and Guangzhou, China, with a median follow‐up of 23.8 months. Patient enrollment for the high or low nighttime DP group was performed on the basis of the cutoff value determined by time‐dependent receiver operator characteristic curve analysis. The primary end point was a composite of major cardiovascular and cerebrovascular events, and the secondary end point was all‐cause death and composite renal end point. The 24‐hour circadian DP rhythm was established via multiple‐component cosinor analysis. Cox regression was used to explore the association between nighttime DP and adverse outcomes. The DP of nondialysis patients with CKD and hypertension showed a diurnal rhythm, which varied with renal function. After adjustment, high nighttime DP was associated with a higher risk for major cardiovascular and cerebrovascular events (hazard ratio [HR], 5.823 [95% CI, 2.382–14.233]), all‐cause death (HR, 4.978 [95% CI, 2.205–11.240]), and composite renal event (HR, 1.661 [95% CI, 1.128–2.447]), compared with low nighttime DP. These associations were independent of nighttime systolic blood pressure and PR.

Conclusions
The present cohort study demonstrated that DP had diurnal fluctuations and nighttime DP was an important prognostic factor in nondialysis patients with CKD and hypertension, outperforming traditional risk factors, including systolic blood pressure and pulse rate.
Uncertainty in the Past and Future Changes of Tropical Pacific SST Zonal Gradient: Internal Variability versus Model Spread
Authors: Wang Zheng , Dong Lu , Song Fengfei , Zhou Tianjun , Chen Xiaolong 
Published: December 2023

Abstract
The zonal sea surface temperature (SST) gradient across the tropical Pacific is a pacemaker of the variable rates of global warming. In both historical simulations and future projections, the current state-of-the-art climate models show evident spread in the changes of zonal SST gradient, but the reasons remain unknown. Here, we quantify the contributions of internal variability and model spread to the uncertainty of zonal SST gradient changes by analyzing 342 realizations from CMIP5 and CMIP6 models and several sets of large-ensemble simulations. We found that the internal variability dominates the total uncertainty at multidecadal time scales (∼31-yr trends). Although the ratio of internal uncertainty to the total uncertainty declines along with higher emission of greenhouse gases under global warming, it is still over 80% at the multidecadal time scales in the future. The Pacific decadal oscillation is identified as the key internal mode responsible for the multidecadal uncertainty. For the future projections at centurial time scales, the uncertainty of zonal SST gradient changes is mainly from the intermodel spread in response to external forcing, accounting for about 70% of the uncertainty based on the difference between 2070–99 and 1970–99. The model spread in the cloud–shortwave radiation–SST feedback over the tropical Pacific is important in the uncertainty of zonal SST gradient changes. In particular, the intensity of negative convective cloud feedback in the western Pacific dominates the spread in CMIP5 models, while the intensity of stratocumulus cloud feedback over the southeastern Pacific is the primary process influencing the uncertainty in CMIP6 models.
Percutaneous coronary intervention versus coronary artery by-pass grafting in premature coronary artery disease: What is the evidence? -A narrative review
Authors: Goulden Christopher J 
Published: December 2023

Coronary artery disease (CAD) remains one of the leading causes of death globally. In the United States of America, in 2016, 19% of all patients under the age of 65 died of cardiovascular disease despite improvements in primary prevention. The premature clinical onset of symptoms in the young population (<60 years) is much more aggressive than in the older population, and the overall long-term prognosis is poor. CAD appears to have a rapidly progressive form in those under the age of 60 due to genetic predisposition, smoking, and substance abuse, however, the ideal management strategy is still yet to be established. The two primary methods of establishing coronary revascularization are percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG). Despite the increasing prevalence of CAD in the young population, they are consistently underrepresented in major randomized clinical trials of each revascularization strategy. Both CABG and PCI are known to have similar survival rates, but PCI is associated with higher repeat revascularization rate. Many argue this may be due to the progressive nature of CAD combined with the vessel patency time required in a patient under 60 with potentially another 20-30 years of life. There is little in literature regarding the outcomes of these various revascularization strategies in populations under 60 years with CAD. This review summarises the current evidence for each revascularisation strategy in patients under the age of 60 and suggests future avenues of research for this unique age group.
RoboCraft: Learning to see, simulate, and shape elasto-plastic objects in 3D with graph networks
Authors: Shi Haochen , Xu Huazhe , Huang Zhiao , Li Yunzhu , Wu Jiajun 
Published: December 2023

Modeling and manipulating elasto-plastic objects are essential capabilities for robots to perform complex industrial and household interaction tasks (e.g., stuffing dumplings, rolling sushi, and making pottery). However, due to the high degrees of freedom of elasto-plastic objects, significant challenges exist in virtually every aspect of the robotic manipulation pipeline, for example, representing the states, modeling the dynamics, and synthesizing the control signals. We propose to tackle these challenges by employing a particle-based representation for elasto-plastic objects in a model-based planning framework. Our system, RoboCraft, only assumes access to raw RGBD visual observations. It transforms the sensory data into particles and learns a particle-based dynamics model using graph neural networks (GNNs) to capture the structure of the underlying system. The learned model can then be coupled with model predictive control (MPC) algorithms to plan the robot’s behavior. We show through experiments that with just 10 min of real-world robot interaction data, our robot can learn a dynamics model that can be used to synthesize control signals to deform elasto-plastic objects into various complex target shapes, including shapes that the robot has never encountered before. We perform systematic evaluations in both simulation and the real world to demonstrate the robot’s manipulation capabilities.
Barriers to the uptake of oral pre-exposure prophylaxis among young key populations in Nigeria
Authors: Olakunde Babayemi O , Ujam Chukwugozie , Ndukwe Chinwedu D. , Falola-Anoemuah Yinka , Olaifa Yewande , Oladele Tolulope T. , Yahaya Hidayat B , Ogundipe Alex 
Published: December 2023

Background Young key populations (YKP) contribute to the burden of HIV in Nigeria and are a priority population for oral pre-exposure prophylaxis (PrEP). However, their uptake of PrEP remains low. We assessed the main barriers to PrEP uptake and the variation among YKP (15–24 years) in Nigeria. Methods This study was a secondary data analysis of the 2020 Integrated Biological & Behavioural Surveillance Survey conducted among key populations (KP), including female sex workers (FSW), men who have sex with men (MSM), people who inject drugs (PWID), and transgender people (TG), in 12 states in Nigeria. A closed-ended question asking the main reason for not taking PrEP among KP who had never taken PrEP was included in the surveillance questionnaire. We collapsed the responses into six barrier themes. Using multinomial logistic regression analysis, we examined the association between the barriers (dependent variable) and KP group (independent variable), controlling for age, educational attainment, religion, marital status, employment status, and geopolitical zone. Results A total of 1776 YKP were included in this study. The most cited barriers by KP group were: lack of access (28.3%) and fear of side effects (28.3%) by FSW; lack of interest (37.1%) by MSM; low risk perception (65.5%) by PWID; and lack of access (34.4%) by TG. The odds of reporting fear of side effects, lack of access, lack of interest, and nonspecific/others reasons were significantly different by KP group. Conclusions The barriers limiting the uptake of PrEP among YKP vary by KP group. Our results highlight the need for KP-specific interventions to improve the uptake of PrEP among YKP in Nigeria.
Management and health-related quality of life among patients with prostate cancer in a Kenyan tertiary health facility
Authors: Karaihira Wairimu , Karimi Peter N , Weru Irene W 
Published: December 2023

Introduction Advances made in the screening, diagnosis and management of prostate cancer have improved the survival rates of the patients. However, many of these treatments including surgery, radiotherapy, and pharmacotherapy, have an impact on the subsequent health-related quality of life (HRQoL) of these patients. Since it is an important prognostic factor of survival, failure to evaluate the HRQoL and its predictors in these patients typically results in long-term deficits in their overall well-being, that is, their physical, social, emotional, and mental health. The objective of this study was to evaluate the management and HRQoL among patients with prostate cancer at Kenyatta National Hospital. Methods This was a descriptive cross-sectional study. The sample size of 62 patients who met the eligibility criteria was selected through simple random sampling on the respective clinic days of the cancer treatment centre and urology clinic. Data was collected through a pre-tested structured questionnaire and HRQoL tools which are EORTC-QLQ-C30 and EORTC-QLQ-PR25 and analysed using STATA version 13 software. Descriptive analysis was used to summarise the continuous and categorical variables. Spearman's rho (rs) correlation was used to determine the predictors of HRQoL based on the strength and significance of association at 0.05 level of significance. Results The mean age of the participants was 70.5 (±7.35) years. The majority (52, 83.9%) of the patients had a prostate specific antigen (PSA) above 20 ng/ml. Twenty-one (33.9%) were graded as Gleason group 5 and 41 (66.1%) had stage IV disease at diagnosis. Fifty (80.9%) participants were on hormonal therapy, with most of them being on combined androgen blockade. The overall HRQoL was 65.1. Fatigue, one of the major complaints among these patients, was negatively associated with physical functioning (p = 0.0005), role functioning (p = 0.0026), social functioning (p = 0.0001), financial difficulties (p = 0.0077) and quality of life (p = 0.0050). Conclusion Fatigue was the most common predictor of poor HRQoL in several scales of measurement. For those on management, frequent assessment of HRQoL should be carried out and interventions instituted immediately.
Job preferences of Chinese primary health care workers: A discrete choice experiment
Authors: Lin Yingxi , Xie Jinfeng , Wu Dan , Wang Yingyu , Cai Yiyuan , Zhao Qing , Zhang Lanping , Li Jiaqi , He Wenjun , Xu Dong (Roman) 
Published: December 2023

Objective Primary health workers (PHWs) are a critical pillar of health systems but primary health care centers often struggle to attract and retain talented staff. To better understand why this is, we investigated the job preference of PHWs in a Chinese urban setting. Methods In a discrete choice experiment, PHWs from 15 primary health care centers in Guangzhou, China, made trade-offs between several hypothetical job scenario combinations of salary, type of health institution, bianzhi (permanent post), work years required for promotion, career development and training opportunities, educational opportunities for children, and community respect. Based on the estimate of the mixed logit model, willingness to pay and policy simulations were applied to estimate the utility of each attribute. Results Data were collected from 446 PHWs. The PHWs were willing to forgo Chinese Renminbi 2806.1 (US$ 438.5) per month to obtain better education opportunities for their children, making it the most important non-monetary factor. Their preferences were also influenced relatively more by salary, bianzhi, and community respect, than with the other attributes we tested for, work years required for promotion, career development and training opportunities, and type of health institution. Conclusion Salary is a robust predictive factor, while three non-monetary factors (opportunities for children’s education, bianzhi, and community respect) are essential in retaining health workers in primary care.
A retrospective study of endogenous endophthalmitis-related pyogenic liver abscess: An increasing complication in North Vietnam
Authors: Nguyen Long Cong , Pham Thuy Thi-Ngoc , Luu Diep Thi-Minh , Nguyen Tinh Nghe , Nguyen Ngoc Minh , Pham Hung Ngoc , Doan Ha Thi-Ngoc , Nguyen Son Truong , Nguyen Hieu Van 
Published: December 2023

Introduction: Endogenous endophthalmitis-related Klebsiella pyogenic liver abscess is a rare complication of metastatic infection. In most cases, visual acuity results are often impaired, even blind, and even with aggressive treatment with topical antibiotics, the final results are unsatisfactory. The objective of this study is to retrospectively based on medical records to describe clinical features, risk factors, and visual outcomes of patients with endogenous endophthalmitis-related pyogenic liver abscesses. Methods: We reported a case series of 12 endogenous endophthalmitis-related pyogenic liver abscess patients from March 2021 to 2023. All cases of endogenous endophthalmitis were diagnosed at admission or during the hospital stay. Results: From the medical records of 588 pyogenic liver abscess patients, we found 12 cases of endogenous endophthalmitis with 2.0%. The result showed a mean age of 61.5 ± 12.0 (41–78), diabetes mellitus (7 of 12), right lobe (7 of 12), single abscess (9 of 12), and the mean largest abscess diameter of 5.8 ± 1.7 cm (3.3–9). All patients had ocular symptoms such as eye pain (9 of 12), pus discharge (3 of 12), hypopyon (1 of 12), swollen eyelids (2 of 12), and corneal edema (2 of 12), pyogenic liver abscess before endogenous endophthalmitis (10 of 12), the median interval between endogenous endophthalmitis and pyogenic liver abscess 6.1 ± 1.9 days, ocular symptoms before diagnosis endogenous endophthalmitis 4.4 ± 2.3 days. All affected eyes were injected intravitreously with ceftazidime, amikacin, and vancomycin. Two patients underwent evisceration. Conclusions: Endogenous endophthalmitis has permanent morbidity, reducing visual acuity, poor quality of life, and lacks the warning signs, so it is essential for early detection of symptoms and referral to ophthalmologists.
Factors Affecting Achieving Learning Outcomes in Basic Years in Medical School at King Abdul Aziz University, Jeddah, Saudi Arabia
Authors: Amoudi Aliaa Amr , AlShawwa Lana Adey 
Published: December 2023

OBJECTIVE This study was conducted as part of a curricular reform process in Faculty of Medicine (FOM), King Abdul Aziz University Jeddah Saudi Arabia. It explored the perspective of FOM stakeholders on the challenges and factors in the teaching and learning domains that are affecting achieving learning outcomes. METHODS Faculty teaching in the second and third year, students in third and fourth year, and administrative personnel were included. An electronic survey was created. Chi-Squared test for independence was used to test the association between the correspondent group and different statements. Kruskal-Wallis ANOVA was used to examine the differences in medians among the questions utilizing ranks to evaluate different questions, followed by post hoc pairwise comparison with Bonferroni-corrected alpha. RESULTS A strong association was seen between the correspondent level and perspective on time allocated for modules and vertical integration of the curriculum. Among the most highly ranked challenges for using various teaching strategies were the loaded curricula content and the limitation of time, with an overall median rank of 8. Student readiness and motivation were also significant factors, however, students considered motivation less of a challenge. CONCLUSION Continuous assessment of factors affecting teaching and learning will bridge gaps in curriculum.
Design of A Novel Wheel-Legged Robot with Rim Shape Changeable Wheels
Authors: Fu Ze , Xu Hao , Li Yinghui , Guo Weizhong 
Published: December 2023

AbstractThe wheel-legged hybrid structure has been utilized by ground mobile platforms in recent years to achieve good mobility on both flat surfaces and rough terrain. However, most of the wheel-legged robots only have one-directional obstacle-crossing ability. During the motion, most of the wheel-legged robots’ centroid fluctuates violently, which damages the stability of the load. What’s more, many designs of the obstacle-crossing part and transformation-driving part of this structure are highly coupled, which limits its optimal performance in both aspects. This paper presents a novel wheel-legged robot with a rim-shaped changeable wheel, which has a bi-directional and smooth obstacle-crossing ability. Based on the kinematic model, the geometric parameters of the wheel structure and the design variables of the driving four-bar mechanism are optimized separately. The kinetostatics model of the mobile platform when climbing stairs is established to determine the body length and angular velocity of the driving wheels. A prototype is made according to the optimal parameters. Experiments show that the prototype installed with the novel transformable wheels can overcome steps with a height of 1.52 times of its wheel radius with less fluctuation of its centroid and performs good locomotion capabilities in different environments.