bluuebunny/crossref_metadata_2025_split huggingface dataset:
Organization of pRF size along the AP axis of the hippocampus and adjacent medial temporal cortex is related to specialization for scenes versus faces
Authors: Leferink Charlotte A , DeKraker Jordan , Brunec Iva K , Köhler Stefan , Moscovitch Morris , Walther Dirk B 
Published: November 2023

Abstract
The hippocampus is largely recognized for its integral contributions to memory processing. By contrast, its role in perceptual processing remains less clear. Hippocampal properties vary along the anterior–posterior (AP) axis. Based on past research suggesting a gradient in the scale of features processed along the AP extent of the hippocampus, the representations have been proposed to vary as a function of granularity along this axis. One way to quantify such granularity is with population receptive field (pRF) size measured during visual processing, which has so far received little attention. In this study, we compare the pRF sizes within the hippocampus to its activation for images of scenes versus faces. We also measure these functional properties in surrounding medial temporal lobe (MTL) structures. Consistent with past research, we find pRFs to be larger in the anterior than in the posterior hippocampus. Critically, our analysis of surrounding MTL regions, the perirhinal cortex, entorhinal cortex, and parahippocampal cortex shows a similar correlation between scene sensitivity and larger pRF size. These findings provide conclusive evidence for a tight relationship between the pRF size and the sensitivity to image content in the hippocampus and adjacent medial temporal cortex.
Spatial simulation of autologous cell defection for cancer treatment
Authors: Choi Jibeom 
Published: November 2023

Abstract
Cancer cells are highly cooperative in a nepotistic way and evolutionarily dynamic. Present cancer treatments often overlook these aspects, inducing the selection of resistant cancer cells and the corresponding relapse. As an alternative method of cancer elimination, autologous cell defection (ACD) was suggested by which modified cancer cells parasitically reliant on other cancer cells are implemented to the cancer cluster. Specifically, modified cancer cells should not produce costly growth factors that promote the growth of other cancer cells while receiving the benefit of exposure to such growth factors. Analytical models and rudimentary experiments up to date provide the medical feasibility of this method. In this study, I built comprehensive spatial simulation models by embracing the effects of the multiple growth factors, the Warburg effect, mutations and immunity. The simulation results based on planar spatial structures indicate that implementation of the defective modified tumours may replace the existing cancer cluster and defective cells would later collapse by themselves. Furthermore, I built a mathematical model that compares the fitness of the cells adjacent to the hypertumour–cancer interface. I also calculated whether anticancer drugs that reduce the effects of the growth factors promote or demote the utility of ACD under diverse fitness functions. The computational examination implies that anticancer drugs may impede the therapeutic effect of ACD when there is a strong concavity in the fitness function. The analysis results could work as a general guidance for effective ACD that may expand the paradigm of cancer treatment.
Hemodynamics analysis and computational fluid dynamics simulations to identify potential location of rupture in abdominal aortic aneurysm
Authors: Al-Thani H , Yalcin H , Mutlu O , El-Menyar A 
Published: November 2023

Abstract

Background
Abdominal Aortic Aneurysm (AAA) rupture is the most severe consequence of aneurysmal disease, with an overall death rate of 80%. Early diagnosis and appropriate follow-up and management of AAA will significantly reduce the risk of rupture and mortality. Rupture risk assessment of AAA has a critical role for the early warning.

Purpose
To Predict of the course of an AAA and determine the rupture risk and location from a biomechanical point of view. AAA hemodynamics were investigated to clarify the relation between the hemodynamic parameters and the AAA rupture.

Methods
Computed tomography (CT) images of one healthy aorta and 23 patients’ aorta with aneurysms were analyzed. WSS-related hemodynamic parameters of time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), endothelial cell activation potential (ECAP), and relative residence time (RRT) are investigated in patient-specific AAA geometries by performing computational fluid dynamics (CFD) simulations (Figure 1). Patient-specific AAA geometries are identified using medical imaging techniques and realistic boundary conditions are determined using Doppler ultrasonography.

Results
AAA rupture locations predicted by CFD simulations were in good agreement with the actual rupture locations of retrospective data. The rupture locations had relatively low TAWSS, high OSI, high ECAP, and high RTT levels. High risk of rupture is expected in regions with a local minimum of TAWSS, and a local maximum of OSI, ECAP, and RRT.

Conclusions
Examining the spatial distribution of the hemodynamic parameters was a powerful approach for rupture risk assessment of AAA. Predicting the rupture location using a single hemodynamic parameter is not feasible, and the accuracy of AAA rupture risk assessment can be improved by using multiple WSS-related parameters by identifying the common intersection regions of low TAWSS, high OSI, high ECAP, and high RRT.Figure 1
Risks and benefits of antiplatelet therapy in patients with abdominal aortic aneurysm without symptomatic atherosclerotic disease: a nationwide cohort study
Authors: Nicolajsen C , Soegaard M , Eldrup N , Larsen T B , Goldhaber S Z , Behrendt C A , Nielsen P B 
Published: November 2023

Abstract

Background
Patients with abdominal aortic aneurysm (AAA) suffer a high risk of ischemic events associated with concomitant atherosclerotic cardiovascular disease, and current clinical practice guidelines recommend antiplatelet therapies to mitigate this risk. However, in patients with AAA and no symptomatic atherosclerosis, the benefit of antiplatelet is sparsely investigated.

Purpose
To assess the effectiveness of antiplatelets vs no antiplatelets on the risk of ischemic events (composite of myocardial infarction and ischemic stroke) and bleeding in individuals with AAA who had no concomitant atherosclerotic vascular disease.

Methods
We designed a target trial to compare outcomes among treatment initiators and non-initiators and emulated the trial contingent on patient eligibility at time of inclusion, utilizing Danish nationwide observational data from January 2010 through August 2021. Confounding was handled by means of inverse probability treatment weighting based on the propensity score. The emulated sequential trial results for all possible trial months were pooled by means of pooled logistic regression models to estimate the intention-to-treat average treatment effects, and the 5-year associated treatment differences were expressed as hazard ratio (HR) with 95% confidence intervals (CI) and estimated event-free survival.

Results
A total of 6,344 patients provided 131,047 trial participants: 3,363 of these were new initiators of antiplatelet therapy, while 127,684 were non-initiators. During a median follow-up of 24 months, 173 and 369 ischemic events occurred among initiators and non-initiators, respectively. The corresponding HR of 0.91 (CI 95% 0.73 to 1.17) and an estimated absolute event-free survival difference of -0.6% (Figure 1). For bleeding, the HR was 1.26 (CI 0.97 to 1.58) and the event-free survival difference was 1.0%.

Conclusion
This target trial emulation, using nationwide observational data on all patients with AAA and no record of symptomatic atherosclerotic disease, did not find evidence of antiplatelets to lower the risk of ischemic events, but also no evidence of substantial higher bleeding risk. The observed differences between the treatment groups were minimal, suggesting limited clinically relevance of this treatment.ischemia- and bleeding free survival
Cerebral Embolic Protection Device protects against stroke during Transcatheter Aortic Valve Replacement (TAVR): An Updated Meta-Analysis
Authors: Basit J , Fatima M , Zaheer Z , Ebad Ur Rehman M , Ahmed N , Lee Q , Saeed S , Leung C , Maqbool S , Malik J , Tse G 
Published: November 2023

Abstract

Background
Cerebral Embolic Protection Device (CEPD) is used to capture emboli during Transcatheter Aortic Valve Replacement (TAVR). Previous meta-analyses have yielded conflicting results regarding efficacy and safety of CEPD in TAVR. With recently published pivotal trial and multiple Cohort studies reporting new data, there is a need of re-calibration of available statistical evidence.

Aims
The aim of our study was to explore the effects of using CEPD on TAVR outcomes.

Methods
A systematic literature search was conducted across Pubmed, Cochrane, Embase, and clinicaltrials.gov from inception till February 2023. Dichotomous outcomes were pooled using Odds Ratio (OR) while continuous outcomes were pooled using Standardized Mean Difference (SMD). Revman 5.4 was used to pool the data using random effects model With Mantel-Haenszel method. Subgroup analysis for study type (RCT vs NRS) was conducted. Sensitivity analysis using leave one out method and multiple exit method was conducted to find out, if unadjusted cohort studies had an impact on the pooled outcomes.

Results
The initial search revealed 870 articles. After primary and secondary screening, data was included from 17 studies (6 RCTs, 11 cohorts, n= 180187). Use of CEPD was associated with 50% reduced odds of stroke (OR=0.50, 95% CI=0.03-0.75, p=&lt;0.01, I2=32%). There was no significant difference in 30 days mortality between the two groups (OR=0.76, 95% CI=0.44-1.31, p=0.33, I2=18%). On Diffusion Weighted Magnetic Resonance Imaging (DW-MRI), the two groups did not have any significant differences in volume per lesion (SMD=-0.07,CI=-0.28-0.14, p=0.52,I2=71%), Total volume of lesions (SMD=-0.08, p=0.73, CI=-0.53,0.17, I2=84%) and Number of lesions per patient (SMD=-0.15, p=0.45, CI=-0.23,0.10, I2=84%). On subgroup analysis, RCTs were found to have high heterogeneity while NRS had zero heterogeneity. The pooled analysis revealed no significant association with either of the group regarding Acute Kidney Injury (OR=0.84, p=0.43,I2=0%), risk of pacemaker implantation (OR=1.17,p=0.35,I2=0%), major bleed (OR=0.97,p=0.94,I2=62%), Worsening National Institute of Health Stroke Scale (NIHSS) (OR=0.46,p=0.36,I2=76%), and Vascular complications VC (OR=0.85,p=0.35,I2=0%). The results remained insignificant for subgroup analysis for study type and sensitivity analysis using leave one out and exit multiple methods for unadjusted cohort studies.

Conclusion
The use of CEPD during TAVR was found to be associated with reduced risk of stroke, however, there was no significant association with mortality, DW-MRI findings, AKI, major bleed, minor bleed, risk of pacemaker implantation, worsening NIHSS score and vascular complications. Further, large scale prospective trials are needed to provide definitive evidenceFig 1:Plots for mortality and strokeFig 2:Plots for VC and AKI
Prevalence and prognostic effects of comorbid coronary artery disease detected in patients undergoing carotid endarterectomy
Authors: Nakajima H , Momose T , Misawa T 
Published: November 2023

Abstract

Introduction
Coronary artery disease (CAD) shares common risk factors with carotid artery stenosis and is a known perioperative risk factor for carotid endarterectomy (CEA). It is feasible to perform CEA with continuation of antiplatelet drugs, including dual antiplatelet therapy. Differing opinions exist with respect to detection of CAD prior to CEA. To support the discussions, we aimed to assess recent prevalence and prognostic effects of comorbid CAD in patients undergoing CEA without known CAD.

Methods
This single-center prospective cohort study included patients scheduled for elective CEA between 2013 and 2021. Of these, 108 patients without a medical history of CAD (mean age 76.6±7.3 years, 73.1% men) underwent coronary computed tomography angiography (CCTA). Coronary angiography (CAG) and subsequent fractional flow reserve (FFR) estimation were performed where necessary. CAD was defined as total or subtotal occlusion observed on CCTA, ≥75% stenosis on CAG, or lesions with FFR ≤ 0.80 in the major coronary arteries. Optimal medical therapy and/or coronary revascularization was added according to the presence, severity, and extent of CAD. The primary endpoint was MACE (the composite of all-cause mortality, myocardial infarction, or stroke) after CEA.

Results
The prevalence of comorbid CAD was 19.4% (21 of 108 patients). During a mean follow-up of 4.0 years, the incidence of MACE and stroke was significantly higher in patients with CAD (adjusted HR: 3.10, 95% CI: 1.43–6.71, p=0.0042 and HR: 2.76, 95% CI 1.08–7.31, p=0.041, respectively). Other than patient age, only CAD was a significant predictor of MACE.

Conclusions
CAD is commonly detected in patients undergoing CEA, and it predicts future MACE and stroke event.
Imaging signs of vulnerability, neurological events and cognitive impairment in asymptomatic carotid artery stenosis: results from the Carotid Artery Multi-modality imaging Prognostic (CAMP) study
Authors: Gargani L , Masini G , Baldini M , Napoli V , Orlandi G , Lucchi G , Totaro P , D'amelio C , Galeotti G G , Ghicopulos I , Nilsson I , Goncalves I , Palombo C , Cosottini M , De Caterina R 
Published: November 2023

Abstract

Background
Carotid artery plaques with imaging signs of vulnerability, such as ulceration, intraplaque haemorrhage (IPH) or a lipid-rich necrotic core (LRNC), are associated with a high risk of ischemic stroke, and are reported to be considered for invasive treatment if % diameter stenoses ≥60. Little is known about their fate in patients with &lt;60% stenoses.

Purpose
To evaluate the prevalence of ulceration, IPH and LRNC and their characteristics in patients with asymptomatic, non-significant (&lt;60%) carotid artery stenoses.

Methods
One hundred and twenty-one patients with asymptomatic, unilateral, mild/moderate (40-60%) carotid artery stenoses at Doppler ultrasound (DUS), were prospectively evaluated with computed tomography angiography (CTA), magnetic resonance angiography (MRA) and brain magnetic resonance imaging (MRI). IPH and LRNC were defined at MRA, while ulceration was defined at CTA. Verbal and memory skills were tested by the Fifteen Reye’s Words and other standardized tests.

Results
At least one sign of vulnerability (IPH, LRNC or ulceration) was detected in 51.6% patients. Signs of vulnerability were more frequent in patients with ≥50% stenoses compared with those with &lt;50% at DUS (62.5% vs 27.6%, p=0.002). No difference in the prevalence of cardiovascular risk factors was present in those with and without signs of vulnerability (Table). An ulceration at CTA was significantly associated with presence of IPH or LRNC even after adjustment for the degree of stenosis (OR 4.2, 95% CI 1.3-13.2; OR 4.0, 95% CI 1.4-11.2). Subclinical embolic brain infarctions were found in 10% of patients. A higher prevalence of LRNC was found in patients with brain infarctions (50% vs 17%, p&lt;0.05). Patients with either IPH or LRNC performed worse at standardized tests of cognitive impairment (score 1.6±1.1 vs 2.2±1.4, p&lt;0.05).

Conclusions
Imaging signs of vulnerability are highly prevalent in patients with asymptomatic intermediate carotid artery stenosis, and can be detected in more than one fourth of patients with a non-significant plaque in terms of degree of stenosis. Plaque ulceration at CTA is independently associated with LRNC and IPH at MRA, independent of the degree of stenosis. Plaques with LRNC are associated with subclinical embolic brain infarcts and a worse cognitive performance.TableFigure
Combined predictive value of pre-procedural protein-energy wasting and inflammation status for amputation and/or mortality after lower extremity revascularization in patients on hemodialysis
Authors: Takahashi H , Kumada Y , Ito R , Oshima Y , Murohara T , Izawa H , Ozaki Y , Ishii H 
Published: November 2023

Abstract

Background
Although lower extremity revascularization has been commonly performed in chronic hemodialysis (HD) patients with peripheral artery disease (PAD), poorer prognosis after revascularization still remains major problems. Recently, protein-energy wasting (PEW) or malnutrition have been considered to be strongly associated with chronic inflammation and advanced atherosclerosis in HD patients. We investigated the association of geriatric nutritional risk index (GNRI) as a surrogate marker of the PEW, C-reactive protein (CRP) and their joint role with prediction of amputation and/or mortality after lower extremity revascularization in HD patients.

Method
We enrolled a total of 800 HD patients (age 67±10 years, diabetes 63.3% and critical limb ischemia 52.9%) who successfully underwent lower extremity revascularization [535 with endovascular therapy (EVT) and 265 with bypass surgery]. Patients were divided into tertiles according to pre-procedural GNRI levels; tertile 1 (T1): &lt;88.1, T2: 88.1-96.7and T3: &gt;96.7, and CRP levels; T1: &lt;2.0mg/l, T2: 2.0-12.6mg/l and T3: &gt;12.6mg/l, respectively. Primary outcome was amputation-free survival (AFS). They were followed up for up to 8 years.

Results
During follow-up period (median: 43 months), 56 (7.0%) patients needed major amputation and 183 (22.9%) patients died. Kaplan-Meier analysis shows that the AFS rates for 8 years were 47.0%, 56.9% and 69.5% in T1, T2 and T3 of GNRI, and were 65.8%, 58.7% and 33.2% in T1, T2 and T3 of CRP, respectively (p&lt;0.0001 in both). After adjustment for male, age, previous coronary artery disease, procedure (EVT vs. bypass surgery), below-knee artery disease and ulcer/gangrene as covariates with p&lt;0.05 by univariate analysis, declined GNRI [hazard ratio (HR) 2.18, 95% confidence interval (CI) 1.57-3.07, p&lt;0.0001 for T1 vs. T3] and elevated CRP (HR 1.78, 95%CI 1.24-2.59, p=0.0016 for T3 vs. T1) were identified as independent predictors of amputation and/or mortality. In the combined setting of both variables, the risk of amputation and/or mortality was 3.77-fold higher (95%CI 1.97-7.69, p&lt;0.0001) in the group with T1 of GNRI and T3 of CRP than in that with T3 of GNRI and T1 of CRP (Figure). Addition of GNRI and CRP in a predicting model with established risk factors improved C-statistics (0.661 to 0.716, p=0.0021) greater than that of each alone.

Conclusion
Among HD patients undergoing lower extremity revascularization for PAD, those with pre-procedural declined GNRI and elevated CRP frequently experienced amputation and/or mortality, furthermore, combination of both variables could more accurately stratify the risk of amputation and/or mortality.
Inflammatory activity of vulnerable plaques in asymptomatic, non-hemodynamically significant carotid artery stenoses: preliminary results of the carotid artery multi-modality imaging prognostic study
Authors: Masini G , Gargani L , Baldini M , Aghakhanyan G , Volterrani D , Erba P A , Marciano A , Napoli V , Cosottini M , Lucchi G , D'angelo G , Morizzo C , Orlandi G , Palombo C , De Caterina R 
Published: November 2023

Abstract

Background
[18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) is a valid technique to quantify carotid plaque inflammation and can improve identification of patients at high risk for stroke. There are few data on the inflammatory plaque activity in asymptomatic patients and of its association with other characteristics of plaque vulnerability.

Purpose
To assess the inflammatory carotid plaque activity and its correlations with patient characteristics and features of plaque vulnerability detected by other imaging techniques in a population of patients with asymptomatic mild/moderate degree of stenosis.

Methods
Seventy-five asymptomatic patients with 40-60% unilateral carotid stenosis at Doppler ultrasound (DUS) were prospectively evaluated with [18F]FDG-PET, computed tomography angiography (CTA), and magnetic resonance angiography (MRA). Regions of interests were drawn using fused PET/CT slices on the most diseased segment (MDS), defined as the single hottest slice of [18F]FDG uptake. Background blood pool activity was obtained from regions of interests placed in the lumen of the jugular vein. The target-to-background ratio (TBR) was calculated by dividing maximum standardized uptake value (SUVmax) of the MDS to SUVmax of ipsilateral blood pool activity. Plaque vulnerability was defined as the presence of an echolucent plaque at DUS, plaque ulceration at CTA, intraplaque hemorrhage, and lipid-rich necrotic core at MRA.

Results
Patients with a TBR ≥median (1.75), compared with those below the median, were significantly more frequently male and on statin therapy, had higher prevalence of ulcerated plaque at CTA (61% vs 35%, p=0.03) and intraplaque hemorrhage at MRA (33% vs 10%, p=0.03), while the prevalence of a lipid-rich necrotic core at MRA was not significantly different (p=0.16). TBR and SUVmax of the MDS were similar in those with or without a ≥50% stenosis, and peak velocities indices at DUS were not significantly correlated with TBR or SUVmax. Log(TBR) was significantly higher in ulcerated, rather than non-ulcerated, plaque (0.27 vs 0.21, p=0.03) and numerically higher in plaques with an intraplaque hemorrhage (0.22 vs 0.30, p=0.06). Log(TBR) and Log(SUVmax) were similar in plaques with and without a lipid-rich necrotic core (p=0.86 for both).

Conclusions
Higher TBR or SUVmax, indicating a high inflammatory activity, are associated with an ulcerated plaque and the presence of intraplaque hemorrhage but not with either the degree of stenosis or the presence of a lipid-rich necrotic core.