bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modulation of macrophages by biophysical cues in health and beyond
Authors: Wilson Heather M 
Published: August 2023

Summary
Macrophages play a key role in tissue development and homeostasis, innate immune defence against microbes or tumours, and restoring homeostasis through tissue regeneration following infection or injury. The ability to adopt such diverse functions is due to their heterogeneous nature, which is driven largely by their developmental origin and their response to signals they encounter from the microenvironment. The most well-characterized signals driving macrophage phenotype and function are biochemical and metabolic. However, the way macrophages sense and respond to their extracellular biophysical environment is becoming increasingly recognized in the field of mechano-immunology. These biophysical cues can be signals from tissue components, such as the composition and charge of extracellular matrix or topography, elasticity, and stiffness of the tissue surrounding cells; and mechanical forces such as shear stress or stretch. Macrophages are important in determining whether a disease resolves or becomes chronic. Ageing and diseases such as cancer or fibrotic disorders are associated with significant changes in the tissue biophysical environment, and this provides signals that integrate with those from biochemical and metabolic stimuli to ultimately dictate the overall function of macrophages. This review provides a brief overview of macrophage polarization, followed by a selection of commonly recognized physiological and applied biophysical stimuli impacting macrophage activity, and the potential signalling mechanisms driving downstream responses. The effects of biophysical cues on macrophages’ function in homeostasis and disease and the associated clinical implications are also highlighted.
Comparing clinical outcomes of peroral endoscopic myotomy for achalasia between Eastern and Western countries: a systematic review and meta-analysis
Authors: Zhang Han , Pu Xinxin , Huang Shu , Xia Huifang , Zou Kang , Zeng Xinyi , Jiang Jiao , Ren Wensen , Peng Yan , Lü Muhan , Tang Xiaowei 
Published: August 2023

Abstract
Peroral endoscopic myotomy (POEM) has revolutionized the therapeutic strategy for achalasia with promising results. We conducted this meta-analysis to compare clinical outcomes between Eastern and Western countries. A comprehensive literature search was conducted in PubMed, EMBASE, Web of Science and Cochrane Library databases to query for studies that assessed the efficacy of POEM for achalasia. All articles published from inception to December 31, 2021 were included. The primary outcome was the pooled clinical success rate. The secondary outcomes included the pooled technical success rate, incidence of adverse events, procedure time and hospital stay. Eighteen Eastern studies involving 5962 patients and 11 Western studies involving 1651 patients were included. The pooled clinical success rate and technical success rate for POEM was equal in the Eastern studies compared to Western studies. The pooled incidence of procedure adverse events for POEM was a little lower in the Eastern studies compared to Western studies (6.6% vs. 8.7%). Similarly, the incidence of reflux-related adverse events was lower in Eastern studies than that in Western studies. The pooled procedure time of POEM was shorter in Eastern studies compared to Western studies (61 minutes vs. 80 minutes), while the length of hospital stay was longer in Eastern studies compared to Western studies (5.8 days vs. 2.4 days). Overall, Eastern countries have the similar POEM outcomes compared to Western countries. However, Eastern countries still need to do more to reduce the length of hospital stay.
The effect of aging on short- and long-term results after esophagectomy: an international multicenter retrospective analysis
Authors: Mengardo Valentina , Weindelmayer Jacopo , Ceccherini Giovanni , Wilkinson Michelle , de Manzoni Giovanni , Allum William , Giacopuzzi Simone 
Published: August 2023

Abstract
The optimal treatment for esophageal cancer in elderly patients is still debated and data on postoperative results are limited. This retrospective international study aims to clarify the impact of age on clinical and oncological outcomes after esophagectomy. All patients that underwent esophagectomy for cancer between 2007 and 2016 at two European high-volume Centers have been included in the study. Patients were divided into three groups according to their age: young-age group (YAG) (18–69), middle-age group (70–74) and old-age group (&gt;74). Primary outcome was 5-year overall survival (OS), while secondary outcomes considered were 5-year disease free survival and disease related survival, 90-day morbidity and mortality, readmission rate and radicality. A total of 575 patients were included. No differences emerged in terms of morbidity and length of stay, while mortality increased with aging from 2% in YAG to 4.8% in old-aged (P = 0.003). Old-age patients had less neoadjuvant treatment (P &lt; 0.001), a less aggressive mediastinal lymphadenectomy and presented a more advanced pathological stage. As expected, OS decreased significantly for older patients compared with the other two age groups (P = 0.044) but, on the other hand, disease free and disease related survival were comparable between the groups. Age itself should not be considered a contraindication to esophagectomy. Although in patients older than 75 years postoperative mortality is significantly increased, esophagectomy could be still an option in selected patients, favoring the use of minimally invasive techniques and enhanced recovery protocols.
Late gadolinium enhancement distribution patterns in non-ischaemic dilated cardiomyopathy: genotype–phenotype correlation
Authors: de Frutos Fernando , Ochoa Juan Pablo , Fernández Ana Isabel , Gallego-Delgado María , Navarro-Peñalver Marina , Casas Guillem , Basurte María Teresa , Larrañaga-Moreira José María , Mogollón María Victoria , Robles-Mezcua Ainhoa , García-Granja Pablo Elpidio , Climent Vicente , Palomino-Doza Julián , García-Álvarez Ana , Brion María , Brugada Ramón , Jiménez-Jáimez Juan , Bayes-Genis Antoni , Ripoll-Vera Tomas , Peña-Peña María Luisa , Rodríguez-Palomares José F , Gonzalez-Carrillo Josefa , Villacorta Eduardo , Espinosa Maria Angeles , Garcia-Pavia Pablo , Mirelis Jesus G 
Published: August 2023

Abstract

Aims
Late gadolinium enhancement (LGE) is frequently found in patients with dilated cardiomyopathy (DCM); there is little information about its frequency and distribution pattern according to the underlying genetic substrate. We sought to describe LGE patterns according to genotypes and to analyse the risk of major ventricular arrhythmias (MVA) according to patterns.

Methods and results
Cardiac magnetic resonance findings and LGE distribution according to genetics were performed in a cohort of 600 DCM patients followed at 20 Spanish centres. After exclusion of individuals with multiple causative gene variants or with variants in infrequent DCM-causing genes, 577 patients (34% females, mean age 53.5 years, left ventricular ejection fraction 36.9 ± 13.9%) conformed to the final cohort. A causative genetic variant was identified in 219 (38%) patients, and 147 (25.5%) had LGE. Significant differences were found comparing LGE patterns between genes (P &lt; 0.001). LGE was absent or rare in patients with variants in TNNT2, RBM20, and MYH7 (0, 5, and 20%, respectively). Patients with variants in DMD, DSP, and FLNC showed a predominance of LGE subepicardial patterns (50, 41, and 18%, respectively), whereas patients with variants in TTN, BAG3, LMNA, and MYBPC3 showed unspecific LGE patterns. The genetic yield differed according to LGE patterns. Patients with subepicardial, lineal midwall, transmural, and right ventricular insertion points or with combinations of LGE patterns showed an increased risk of MVA compared with patients without LGE.

Conclusion
LGE patterns in DCM have a specific distribution according to the affected gene. Certain LGE patterns are associated with an increased risk of MVA and with an increased yield of genetic testing.
Gene-echocardiography: refining genotype–phenotype correlations in hypertrophic cardiomyopathy
Authors: Zhou Nianwei , Weng Haobo , Zhao Weipeng , Tang Lu , Ge Zhendan , Tian Fangyan , Meng Fangmin , Pan Cuizhen , Shu Xianhong 
Published: August 2023

Abstract

Aims
This study aims to clarify the association between hypertrophic patterns and genetic variants in hypertrophic cardiomyopathy (HCM) patients, contributing to the advancement of personalized management strategies for HCM.

Methods and results
A comprehensive evaluation of genetic mutations was conducted in 392 HCM-affected families using Whole Exome Sequencing. Concurrently, relevant echocardiographic data from these individuals were collected. Our study revealed an increased susceptibility to enhanced septal and interventricular septal thickness in HCM patients harbouring gene mutations compared with those without. Mid-septal hypertrophy was found to be associated predominantly with myosin binding protein C3 (MYBPC3) variants, while a higher septum-to-posterior wall ratio correlated with myosin heavy chain 7 (MYH7) variants. Mutations in MYH7, MYBPC3, and other sarcomeric or myofilament genes (troponin I3 [TNNI3], tropomyosin 1 [TPM1], and troponin T2 [TNNT2]) showed a relationship with increased hypertrophy in the anterior wall, interventricular septum, and lateral wall of the left ventricle. In contrast, alpha kinase 3 (ALPK3)-associated hypertrophy chiefly presented in the apical region, while hypertrophy related to titin (TTN) and obscurin (OBSCN) mutations exhibited a uniform distribution across the myocardium. Hypertrophic patterns varied with the type and category of gene mutations, offering valuable diagnostic insights.

Conclusion
Our findings underscore a strong link between hypertrophic patterns and genetic variants in HCM, providing a foundation for more accurate genetic testing and personalized management of HCM patients. The novel concept of ‘gene-echocardiography’ may enhance the precision and efficiency of genetic counselling and testing in HCM.
Bioinformatic platforms for clinical stratification of natural history of atherosclerotic cardiovascular diseases
Authors: Benincasa Giuditta , Suades Rosa , Padró Teresa , Badimon Lina , Napoli Claudio 
Published: August 2023

Abstract
Although bioinformatic methods gained a lot of attention in the latest years, their use in real-world studies for primary and secondary prevention of atherosclerotic cardiovascular diseases (ASCVD) is still lacking. Bioinformatic resources have been applied to thousands of individuals from the Framingham Heart Study as well as health care-associated biobanks such as the UK Biobank, the Million Veteran Program, and the CARDIoGRAMplusC4D Consortium and randomized controlled trials (i.e. ODYSSEY, FOURIER, ASPREE, and PREDIMED). These studies contributed to the development of polygenic risk scores (PRS), which emerged as novel potent genetic-oriented tools, able to calculate the individual risk of ASCVD and to predict the individual response to therapies such as statins and proprotein convertase subtilisin/kexin type 9 inhibitor. ASCVD are the first cause of death around the world including coronary heart disease (CHD), peripheral artery disease, and stroke. To achieve the goal of precision medicine and personalized therapy, advanced bioinformatic platforms are set to link clinically useful indices to heterogeneous molecular data, mainly epigenomics, transcriptomics, metabolomics, and proteomics. The DIANA study found that differential methylation of ABCA1, TCF7, PDGFA, and PRKCZ significantly discriminated patients with acute coronary syndrome from healthy subjects and their expression levels positively associated with CK-MB serum concentrations. The ARIC Study revealed several plasma proteins, acting or not in lipid metabolism, with a potential role in determining the different pleiotropic effects of statins in each subject. The implementation of molecular high-throughput studies and bioinformatic techniques into traditional cardiovascular risk prediction scores is emerging as a more accurate practice to stratify patients earlier in life and to favour timely and tailored risk reduction strategies. Of note, radiogenomics aims to combine imaging features extracted for instance by coronary computed tomography angiography and molecular biomarkers to create CHD diagnostic algorithms useful to characterize atherosclerotic lesions and myocardial abnormalities. The current view is that such platforms could be of clinical value for prevention, risk stratification, and treatment of ASCVD.
Decreased liver-to-spleen ratio in low-dose computed tomography as a biomarker of fatty liver disease reflects risk for myocardial ischaemia
Authors: Hokkanen A , Hämäläinen H , Laitinen T M , Laitinen T P 
Published: August 2023

Abstract

Aims
A strong association between fatty liver disease (FLD) and coronary artery disease is consistently reported. Our aim was to evaluate whether FLD diagnosed using low-dose non-contrast computed tomography (LDCT), as a by-product of myocardial perfusion imaging (MPI), is associated with myocardial ischaemia or left ventricular function parameters.

Methods and results
We analysed 742 patients who had undergone MPI using single photon emission computed tomography (SPECT) and LDCT. A liver-to-spleen ratio (in Hounsfield units) of &lt;1 was defined as FLD. Myocardial ischaemia was defined as a summed difference score (SDS) ≥3. Left ventricular size and systolic function were assessed from the electrocardiogram-gated SPECT. FLD patients were younger (63 vs. 68 years) and had a higher body mass index (34.6 vs. 29.0 kg/m2) and a higher SDS (2.65 vs. 1.63), P &lt; 0.001 for all. Independently of several possible confounding factors including traditional risk factors, patients with FLD had a 1.70-fold risk of ischaemia (95% confidence interval 1.11–2.58, P = 0.014). Left ventricular end-diastolic volume (109 vs. 109 mL) and ejection fraction (61 vs. 61%) were comparable in those with and without FLD (non-significant for both).

Conclusions
With the help of LDCT, it is possible to identify FLD, which is associated with an increased risk of myocardial ischaemia. Therefore, evaluation of FLD from LDCT is recommended along with MPI.
First report of the wattle rust pathogen, Uromycladium acaciae (Raveneliaceae, Pucciniales) in Ethiopia
Authors: Pham Nam Q , Wingfield Michael J , Marincowitz Seonju , Tanga Agena A , Tiki Kumela R , Kassie Weldesenbet B , Hurley Brett P , Germishuizen Ilaria , Lawson Simon A , Healey Madaline A , Wondafrash Mesfin 
Published: August 2023

Abstract
Australian Acacia species are among the most important trees planted for wood and pulp production in several African countries, including Ethiopia. In 2020, symptoms of a serious shoot and leaf rust disease were observed on black wattle (Acacia mearnsii De Wild.) trees across the three main wattle growing regions of Ethiopia. The aim of this study was to describe the disease and identify its causal agent based on morphological characteristics as well as DNA sequence data for the ITS and LSU regions of ribosomal DNA. Here we report for the first time, the presence of the wattle rust pathogen, Uromycladium acaciae, in Ethiopia.
National assessment of emergency staff level of practice in the management of forensic evidence
Authors: Albishri Saad B , Albednah Fahed A , Alenazi Nawaf S , Alsubaie Nahaa E , Elserafy Osama S 
Published: August 2023

Abstract

The emergency room is the most likely location where victims of violent crime would be encountered by the healthcare system, as the emergency staff is the first to evaluate the victim or culprit, exposing them to a range of forensic evidence. Forensic evidence can help exclude, identify, and prosecute a suspect and is classified as informational or physical evidence. Emergency staff must be proficient and knowledgeable in gathering, preserving, and documenting forensic evidence in their practice. To our knowledge, this is the first study that assesses the emergency staff’s level of practice in managing forensic evidence. The aims of this study are to assess the level of practice of emergency staff in managing forensic evidence and observe an association between emergency experience and the level of practice in managing forensic evidence, study a connection between forensic education/training and the level of practice in the management of forensic evidence. This observational cross-sectional analytical study in Saudi Arabia was conducted from January 2022 to December 2022. Participants completed a self-administered online survey. Measuring the level of practice was implemented through a researcher-designed questionnaire based on a paper that provided guidelines for forensic evidence collection in the emergency department. Most emergency healthcare workers had a good level of practice in managing forensic evidence (64.7%). Those with excellent practice scored the lowest in documentation, whereas participants in the poor practice category scored the lowest in the trace evidence and clothes domains. Emergency workers who encountered less number of forensic cases per month, i.e. less than two or three to five cases, were found to be more likely to have poor management of forensic evidence. Emergency personnel with no prior education or training are more likely to engage in poor practice in forensic evidence collection. Furthermore, those who had acquired forensic education/training had higher percentages of excellent forensic practice (56.52%) compared to poor practice (7.14%). Those who claimed that their institution had issued guidelines were more likely to have excellent practice (75.36%), whilst those who did not receive guidelines were more likely to have poor forensic evidence management (85.71%). More research is required involving local hospitals and utilizing consistently validated methods in evaluating forensic evidence collection.

Key points
Access challenges for patients with limited English proficiency: a secret-shopper study of in-person and telehealth behavioral health services in California safety-net clinics
Authors: Uscher-Pines Lori , Kapinos Kandice , Rodriguez Claudia , Pérez-Dávila Samantha , Raja Pushpa , Rodriguez Jorge A , Rabinowitz Maya , Youdelman Mara , Sousa Jessica L 
Published: August 2023

AbstractThe recent growth of telehealth may be impacting access to care for patients, including those with limited English proficiency (LEP). Using a secret-shopper design, simulated patients contacted 386 safety-net clinics in California in both Spanish and English from February–March 2023. Callers stated that they were new patients seeking medication for depression, and they documented time to an appointment and available visit modalities (telehealth and in-person). Multinomial logistic regression models examined associations between clinic characteristics and available modalities. English-speaking callers were more likely to speak with a live scheduler and to obtain appointment information from a scheduler who could engage with them in their preferred language. Among Spanish-speaking callers who reached a live scheduler, 22% reached someone who did not engage (eg, were hung up on) and, as a result, could not obtain appointment information. The mean estimated time to a prescribing visit was 36 days and did not differ by language. Sixty-four percent of clinics offered both telehealth and in-person visits, 14% only offered in-person visits, and 22% only offered telehealth visits. More attention and resources are needed to support patients with LEP at the point of scheduling and to ensure choice of visit modality for all patient populations.
Cultural challenges to competition law enforcement in Latin America
Authors: Peña Julián 
Published: August 2023

Abstract
The internationalization of competition law in recent decades has been very successful. A very large number of jurisdictions have now adopted competition laws and apply them in marked similarity. And yet, at times, these laws, despite the similarity in wording and theory, lead to substantial differences when enforced. Differences in the meaning attributed to various concepts, to the goals of competition laws and to the methods of implementation, may result in inconsistency in the enforcement. The Latin American experience reveals a certain level of mutation process from the model laws through the flexibilization in their competition law enforcement, influenced by their own social values and beliefs, as well as their economic, political, institutional, and legal cultures. These cultural challenges need to be solved internally in each jurisdiction to allow competition law enforcement to further develop. Those jurisdictions where competition law enforcement has evolved the most are those that have adapted their competition laws to their cultural realities, while at the same time learning from the international experience. An interdisciplinary debate, at the local and regional levels, has showed to be an essential tool to help find possible solutions to the different challenges Latin American enforcers face.
Parental effects on offspring sex ratio in the Numbat (Myrmecobius fasciatus): does captivity influence paternal sex allocation?
Authors: Firman Renée C , Ellis Connor M , Thorn Sian , Mawson Peter R 
Published: August 2023

Abstract
Sex allocation theories predict that under different ecological conditions the production of sons and daughters will affect parental fitness differently. Skewed offspring sex ratios often occur under captive conditions where individuals are exposed to nutritional and social conditions that differ from nature. Here, we analyzed 29 years of offspring sex ratio data from a captive population of an endangered marsupial, the Numbat (Myrmecobius fasciatus). We partitioned variation in offspring sex ratio based on parental origin (captive- vs. wild-bred), parental weight, maternal age, and maternal reproductive history. Our analyses revealed no effect of parental weight or maternal origin on offspring sex ratio—however, there was a significant effect of paternal origin. Data visualization indicated that captive-bred males tended to produce male-biased litters. We discuss the result in relation to recent studies that have shown that male mammals have the capacity to be arbiters of sex allocation and highlight candidate mechanisms, but consider it with caution due to the small sample size from which the result was derived. We performed a population viability analysis (PVA) to explore the potential impact of a sex ratio skew on the sustainability of the captive Numbat population under hypothetical scenarios. Our PVA revealed that supplementation with wild individuals is critical to the persistence of the captive Numbat population and that a biased sex ratio will lead to extinction of the captive colony under certain conditions. Overall, our study demonstrates that covert sex ratio skews can persist undetected in captive populations, which have the potential to become impactful and compromise population sustainability under changed management processes.