bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterization and Investigation of Risk Factors for Late-Relapsing Hepatitis After Yellow Fever
Authors: Rezende Izabela Mauricio de , McClure Max A , Pereira Leonardo S , Fradico Jordana R B , Cenachi Adriana R C , Moura Alexandre S , Paladino Luísa L de A , Dutra Maria Rita T , Alves Pedro A , Xavier Marcelo A P , Said Rodrigo F do C , Ramalho Dario B , Gama Thaysa D P , Martins-Filho Olindo A , Monath Thomas P , Teixeira-Carvalho Andréa , Drumond Betânia P , LaBeaud Angelle D ,   for the Yellow Fever Collaborative Group, Castro Bragato Alexandre Maurício , Araújo Argus Leão , de Almeida Faria Flávio Augusto , Penido Indiara , Menezes Letícia , Rabelo Livia Frota , Pamplona Livia , da Cunha Melo Lívia Fulgêncio , Fonte Boa Lívia Soares Coelho , dos Santos Lívia Zignago Moreira , de Paula Ludmila , Marçal Marcelle Cardoso , Albuquerque Natalia Soares , Macedo Rodrigo , Araújo Tayrine 
Published: April 2023

Abstract

Background
Late-relapsing hepatitis after yellow fever (LHep-YF) during the convalescent phase of the disease has been described during recent yellow fever (YF) outbreaks in Brazil. LHep-YF is marked by a rebound in liver enzymes and nonspecific clinical manifestations around 46–60 days after YF symptom onset.

Methods
Here we have characterized the clinical course and risk factors for LHep-YF using data from a representative cohort of patients who survived YF in Brazil, 2017–2018. A total of 221 YF-positive patients were discharged from the infectious disease reference hospital in Minas Gerais and were followed up at 30, 45, and 60 days post–symptom onset.

Results
From 46 to 60 days post–symptom onset, 16% of YF patients (n = 36/221) exhibited a rebound of aminotransferases (aspartate aminotransferase or alanine aminotransferase &gt;500 IU/L), alkaline phosphatase, and total bilirubin levels. Other etiologies of liver inflammation such as infectious hepatitis, autoimmune hepatitis, and metabolic liver disease were ruled out. Jaundice, fatigue, headache, and low platelet levels were associated with LHep-YF. Demographic factors, clinical manifestations, laboratory tests, ultrasound findings, and viral load during the acute phase of YF were not associated with the occurrence of LHep-YF.

Conclusions
These findings provide new data on the clinical course of Late-relapsing hepatitis during the convalescent phase of YF and highlight the need for extended patient follow-up after acute YF.
Lifelong statins for long life in dialysis patients?
Authors: Ebert Thomas , Bárány Peter 
Published: April 2023

ABSTRACT
Dyslipidemia in chronic kidney disease (CKD) contributes to the increasing cardiovascular risk during progression of the disease. Statins reduces the risk of ischemic cardiovascular events in CKD patients not treated with dialysis and treatment is generally recommended in patients above 50 years old. In CKD patients on maintenance dialysis treatment, it is not recommended to initiate statins based on evidence from randomized clinical trials. In an article by Marx et al. in this issue of CKJ, a post hoc analysis of cardiovascular events in the 4D study of dialysis patients with diabetes mellitus shows different time trends for events in statin-treated patients compared with those in the placebo group. Although the numbers of cardiovascular events were not different, the risk increased over time in the placebo group whereas it stabilized after 1.5 years and remained constant in the atorvastatin group. In this Editorial we discuss this analysis in the context of current guidelines and clinical practice in dialysis patients.
Breast Cancer Mass Classification Using Machine Learning, Binary-Coded Genetic Algorithms and an Ensemble of Deep Transfer Learning
Authors: Tiryaki Volkan Müjdat , Tutkun Nedim 
Published: April 2023

Abstract
The diagnosis of breast cancer (BC) as early as possible is crucial for increasing the survival rate. Mammography enables finding the breast tissue changes years before they could develop into cancer symptoms. In this study, machine learning methods for BC mass pathology classification have been investigated using the radiologists’ mass annotations on the screen-film mammograms of the Breast Cancer Digital Repository (BCDR). The performances of precomputed features in the BCDR and discrete wavelet transform followed by Radon transform have been investigated by using four sequential feature selections and three genetic algorithms. Feature fusion from craniocaudal and mediolateral oblique views was shown to increase the performance of the classifier. Mass classification has been implemented by deep transfer learning (DTL) using the weights of ResNet50, NASNetLarge and Xception networks. An ensemble of DTL (EDTL) was shown to have higher classification performance than the DTL models. The proposed EDTL has area under the receiver operating curve (AUC) scores of 0.8843 and 0.9089 for mass classification on the region of interest (ROI) and ROI union datasets, respectively. The proposed EDTL has the highest BC mass classification AUC score on the BCDR to date and may be useful for other datasets.
Differences in Healthcare Utilization in Women with and without Inflammatory Bowel Diseases During Preconception, Pregnancy and Postpartum: A Population-Based Cohort Study
Authors: Tandon Parul , Huang Vivian W , Feig Denice S , Saskin Refik , Maxwell Cynthia , Gao Yiding , Fell Deshayne B , Seow Cynthia H , Snelgrove John W , Nguyen Geoffrey C 
Published: April 2023

Abstract

Background and Aims
Compared to those without inflammatory bowel disease [IBD], women with IBD may have increased healthcare utilization during pregnancy and postpartum, though this remains to be confirmed. We aimed to characterize this healthcare use between these groups.

Methods
Administrative databases were accessed to identify women [aged 18–55 years] with and without IBD who had a live, singleton pregnancy between 2003 and 2018. Differences in emergency department [ED] visits, hospitalizations and prenatal care during 12 months preconception, pregnancy and 12 months postpartum were characterized. Multivariable negative binomial regression was performed to report incidence rate ratios [IRRs] with 95% confidence intervals [95% CIs]. Covariates included maternal age at conception, location of residence, socioeconomic status and maternal comorbidity.

Results
In total, 6163 women with IBD [9158 pregnancies] and 1091 013 women without IBD [1729 411 pregnancies] were included. Women with IBD were more likely to visit the ED [IRR 1.13, 95% CI 1.08–1.18] and be hospitalized [IRR 1.11, 95% CI 1.01–1.21] during pregnancy, and visit the ED [IRR 1.21, 95% CI 1.15–1.27] and be hospitalized [IRR 1.18, 95% CI 1.05–1.32] during postpartum. On unadjusted analysis, women with IBD were more likely to be hospitalized for venous thromboembolic events. There was no difference in healthcare use in preconception. Finally, women with IBD also had a greater number of prenatal visits during pregnancy and were more likely to receive a first-trimester prenatal visit.

Conclusion
Women with IBD have increased healthcare utilization during pregnancy and postpartum. Efforts should be made to increase ambulatory care access during this period, which in turn may reduce this health-services utilization.
Management of Inflammatory Bowel Disease Using E-health Technologies: A Systematic Review and Meta-Analysis
Authors: Kuriakose Kuzhiyanjal Anish J , Nigam Gaurav B , Antoniou George A , Farraye Francis A , Cross Raymond K , Limdi Jimmy K 
Published: April 2023

Abstract

Background and Aims
Technological advances have provided innovative, adaptive, and responsive models of care for inflammatory bowel diseases [IBD]. We conducted a systematic review to compare e-health interventions with standard care in management of IBD.

Methods
We searched electronic databases for randomised, controlled trials [RCT] comparing e-health interventions with standard care for patients with IBD. Effect measures were standardised mean difference [SMD], odds ratio [OR], or rate ratio [RR], calculated using the inverse variance or Mantel–Haenszel statistical method and random-effects models. Version 2 of the Cochrane tool was used to assess the risk of bias. The certainty of evidence was appraised with the GRADE framework

Results
Fourteen RCTs [n = 3111; 1754 e-health and 1357 controls] were identified. The difference in disease activity scores (SMD 0.09, 95% confidence interval [CI]: -0.09-0.28) and clinical remission (odds ratio [OR] 1.12, 95% CI: 0.78-1.61) between e-health interventions and standard care were not statistically significant. Higher quality of life [QoL] [SMD 0.20, 95% CI: 0.05-0.35) and IBD knowledge [SMD 0.23, 95% CI: 0.10-0.36] scores were noted in the e-health group, and self-efficacy levels [SMD -0.09, 95% CI: -0.22-0.05] were comparable. E-health patients had fewer office [RR 0.85, 95% CI: 0.78-0.93] and emergency [RR 0.70, 95% CI: 0.51- 0.95] visits, with no statistically significant difference in endoscopic procedures, total health care encounters, corticosteroid use, and IBD related hospitalisation or surgery. The trials were judged to be at high risk of bias or to have some concerns for disease remission. The certainty of evidence was moderate or low.

Conclusion
E-health technologies may have a role in value-based care in IBD.
Ganglionated plexi ablation in the right atrium for the treatment of cardioinhibitory syncope
Authors: Rebecchi Marco , De Ruvo Ermenegildo , Borrelli Alessio , Sette Antonella , Sgueglia Marianna , Grieco Domenico , Canestrelli Stefano , Politano Alessandro , Panattoni Germana , Licciardello Claudio , Latorre Maria , Panuccio Marco , Mattatelli Antonella , Calò Leonardo 
Published: April 2023

Abstract
Neurocardiogenic syncope, also called vasovagal syncope, represents one of the clinical manifestations of neurally mediated syncopal syndrome. Generally, the prognosis of the cardioinhibitory form of neurocardiogenic syncope is good, but quality of life is seriously compromised in patients who experience severe forms. Drug therapy has not achieved good clinical results and very heterogeneous data come from studies regarding permanent cardiac pacing. In this scenario, the ganglionated plexi ablation has been proposed as an effective and safe method in patients with cardioinhibitory neurocardiogenic syncope, especially in young patients in order to avoid or prolong, as much as possible, the timing of definitive cardiac pacing. Certainly, making this procedure less extensive and limiting the ablation in the right atrium (avoiding the potential complications of a left atrial approach) and at level of anatomical regions of the most important ganglionated plexy, considered ‘gateway’ of the sino-atrial and atrio-ventricular node function (through the recognition of specific endocardial potentials), could be very advantageous in this clinical scenario. Finally, randomized, multicentre, clinical trials on a large population are needed to better understand which is the best ablation treatment (right-only or bi-atrial) and provide evidence for syncope guidelines.
Cardiovascular prevention: sometimes dreams can come true
Authors: Ferrari Roberto , Cimaglia Paolo , Cantone Anna , Serenelli Matteo , Guardigli Gabriele 
Published: April 2023

Abstract
Cardiovascular disease (CVD) is a chronic condition driven by the complex interaction of different risk factors including genetics, lifestyle, environment, etc. which, differently from other pathologies, can be prevented. Treatment of CVD has been inconceivably successful but now it seems that it has reached a plateau suggesting that prevention is the way forward. However, the COVID-19 pandemic has spotted all the limits of the actual health system regarding territorial and, particularly, of preventive medicine. To this end, recently, the SCORE2 risk prediction algorithms, a contemporary model to estimate 10 years risk of CVD in Europe and the new guidelines on prevention have been released. The present review article describes a dream: how prevention of CVD should be addressed in the future. New concepts and paradigms like early genetically personalized and imaging driven risk factors, cardiac risk cartography, measurements of the exposome, estimation of costs of a delayed outcome vs. healthy lifespan, are all addressed. We highlight the importance of technologies and the concept of being engaged in a ‘healthy’ and not just ‘sick’ system as it is today. The concept of ‘clearing house’ with a ‘care health team’ instead of a ‘heart team’ is described. Finally, we articulate the four points necessary for the dream to come true.
Stabilization of vulnerable plaque in the ACS patient: evidence from HUYGENS studies
Authors: Zanda Greca , Varbella Ferdinando 
Published: April 2023

Abstract
The introduction of PCSK9 inhibitors in addition to statin therapy allowed better control of LDL-C plasma levels with a subsequent reduction of cardiovascular events. Human atherosclerosis has been previously considered an irreversible condition; studies firstly based on angiography imaging and secondly with intra-coronary imaging—mainly IVUS based—have demonstrated that lipid-lowering therapy based on statins can stabilize and even reduce atherosclerotic burden of coronary circulation. While plaque stabilization and/or reduction with PCSK9 inhibitors have already been demonstrated in the GLAGOV study, the HUYGENS study showed a positive effect not only on atherosclerotic burden but also on plaque phenotype, with an increased FCT, decrease in maximum lipid arch, and reduction of macrophages infiltration. Further studies need to assess the clinical impact of the reduction of plaques displaying high-risk features with PCSK9 inhibitors.
Autopsy and sudden death
Authors: Thiene Gaetano 
Published: April 2023

Abstract
Our story dates back in the late 70s, when a series of juvenile sudden death (SD) occurred in the Veneto region, north east of Italy. A successful application for a prospective study on young people dying suddenly (&lt;35-year-old, sudden infant death syndrome excluded) was submitted to the regional health authorities, thus implementing a network of collaboration with local anatomic and forensic pathologists, to collect all such events and to gather demographic data. The project is still in progress, and since then, we studied hundreds of consecutive juvenile SD cases, allowing to identify the culprit diseases in the various organs and cardiac structures (aorta, coronary arteries, myocardium, valves, and conduction system). The long-standing Veneto region experience clearly shows that autopsy still plays a pivotal role in the study and prevention of SD and should be carried out regularly. With time, the investigation of SD moved from the classic post-mortem study to molecular autopsy, especially in cases of SD with structurally normal heart. Sudden death prevention in the young has to be faced by an interdisciplinary team, including pathologists, cardiologists, sport physicians, and geneticists, the clinicopathologic correlation method still being the polar star. The game in the fight against SD is still played in the anatomical theatre, the place where ‘death enjoys to save lives’.
Scarring/arrhythmogenic cardiomyopathy
Authors: Corrado Domenico , Zorzi Alessandro , Cipriani Alberto , Bauce Barbara , Bariani Riccardo , Brunetti Giulia , Graziano Francesca , De Lazzari Manuel , Mattesi Giulia , Migliore Federico , Pilichou Kalliopi , Rigato Ilaria , Rizzo Stefania , Thiene Gaetano , Perazzolo Marra Martina , Basso Cristina 
Published: April 2023

Abstract
The designation of ‘arrhythmogenic cardiomyopathy’ reflects the evolving concept of a heart muscle disease affecting not only the right ventricle (ARVC) but also the left ventricle (LV), with phenotypic variants characterized by a biventricular (BIV) or predominant LV involvement (ALVC). Herein, we use the term ‘scarring/arrhythmogenic cardiomyopathy (S/ACM)’ to emphasize that the disease phenotype is distinctively characterized by loss of ventricular myocardium due to myocyte death with subsequent fibrous or fibro-fatty scar tissue replacement. The myocardial scarring predisposes to potentially lethal ventricular arrhythmias and underlies the impairment of systolic ventricular function. S/ACM is an ‘umbrella term’ which includes a variety of conditions, either genetic or acquired (mostly post-inflammatory), sharing the typical ‘scarring’ phenotypic features of the disease. Differential diagnoses include ‘non-scarring’ heart diseases leading to either RV dilatation from left-to-right shunt or LV dilatation/dysfunction from a dilated cardiomyopathy. The development of 2020 upgraded criteria (‘Padua criteria’) for diagnosis of S/ACM reflected the evolving clinical experience with the expanding spectrum of S/ACM phenotypes and the advances in cardiac magnetic resonance (CMR) imaging. The Padua criteria aimed to improve the diagnosis of S/ACM by incorporation of CMR myocardial tissue characterization findings. Risk stratification of S/ACM patients is mostly based on arrhythmic burden and ventricular dysfunction severity, although other ECG or imaging parameters may have a role. Medical therapy is crucial for treatment of ventricular arrhythmias and heart failure. Implantable cardioverter defibrillator (ICD) is the only proven life-saving treatment, despite its significant morbidity because of device-related complications and inappropriate shocks. Selection of patients who can benefit the most from ICD therapy is one of the most challenging issues in clinical practice.
How the new technologies and tools will change the electrophysiology of the future
Authors: Tondo Claudio 
Published: April 2023

Abstract
Novel technologies and therapies are evolving rapidly in the field of electrophysiology and cardiac ablation, particularly with the aim of improving the management of atrial fibrillation (AF) where pharmacologic treatment fails. High-power short-duration radiofrequency (RF) ablation, in association with the optimized cooling process of the electrode–tissue interface, is one of the most promising approaches for treating durable lesions and pulmonary vein isolation (PVI). Cryo energy, laser, and RF current are examples of novel tools used by competitive balloon catheter platforms and these tools are specifically created to properly promote an effective PVI. Specific mention deserves to be made on the linear array ablation with ultra-low temperature cryoablation that appears promising for durable lesions. It is needless to remind here about the novel evolving energy source in the form of pulsed electrical field (PFA), which results in an irreversible electroporation of myocardial tissue, sparing the surrounding tissue, and thus, apparently with a significant reduction of potential untoward effects. Furthermore, intensive research is in place to specifically investigate the activation pattern of AF so as to devise a patient-(‘tailored’) target ablation, although with inhomogeneous results. Overall, it seems that technologies and therapies are evolving so rapidly than ever with the hope of achieving better long-term clinical results and an improved quality of life for our patients.
The PACMAN-AMI trial: a revolution in the treatment of acute coronary syndromes
Authors: De Luca Leonardo , Halasz Geza 
Published: April 2023

Abstract
After an acute coronary syndrome (ACS), the risk of major adverse cardiovascular events (MACE) persists despite the reperfusion of the culprit lesion. The addition of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) to standard lipid-lowering therapies has been demonstrated to effectively reduce the levels of low-density lipoprotein cholesterol (LDL-C), with a consistent decrease of MACE in large, randomized clinical trials enrolling patients at high risk of cardiovascular events. There is a strong rationale for an immediate and aggressive LDL-C lowering with the use of PCSK9i in ACS patients. The PACMAN-AMI trial tested this hypothesis demonstrating that in ACS patients, the addition of subcutaneous biweekly alirocumab, compared with placebo, to high-intensity statin therapy resulted in significantly greater coronary plaque regression in non-infarct-related arteries after 52 weeks, as assessed by novel intra-coronary imaging modalities. These findings might provide the mechanistic rationale in favour of early initiation of very intensive LDL-C-lowering therapy in the acute setting of ACS, potentially modifying the actual common pattern of treatment.
Dynamic Analysis of Early Stage Pine Wilt Disease in Pinus massoniana Using Ground-level Hyperspectral Imaging
Authors: Pan Jie , Xie Tianyi , You Cheng , Xia Xiuli 
Published: April 2023

Abstract
Pine wilt disease (PWD) is caused by the pine wilt nematode and is a tremendous threat to coniferous forests. Remote sensing, particularly hyperspectral remote sensing, has been utilized to identify PWD. However, most studies have focused on distinguishing the spectra between infected and healthy pine trees and ignored further visualization of spectral symptoms, which could greatly improve the pre-visual diagnosis of PWD. This research used the false color feature maps (FCFMs) synthesized using the normalized difference vegetation index (NDVI) and the ratio vegetation index (RVI) calculated from selected feature bands to analyze the changes in the spectral and image dimensions of the hyperspectral data. Our main findings were (1) the confirmed feature bands were 440, 550, 672, 752, 810, and 958 nm; and (2) NDVI (810, 440), NDVI (810, 672), NDVI (550, 672), RVI (810, 550), RVI (810, 672), and RVI (550, 672) were suitable to synthesize the FCFMs. As PWD developed, the color of the infected needles changed from blue and white to red on the NDVI-based feature maps and from blue to red on the RVI-based feature maps. Importantly, the color changes were captured by the FCFMs when the symptoms were not visible on the true color images, indicating the ability to identify PWD during the early infection stage.
Joint Associations of Device-Measured Sleep Duration and Efficiency With All-Cause and Cause-Specific Mortality: A Prospective Cohort Study of 90 398 UK Biobank Participants
Authors: Liang Yannis Yan , Ai Sizhi , Xue Huachen , Chen Yilin , Zhou Jiajin , Shu Xinyue , Weng Foqian , Zhou Mingqing , Ma Huan , Zhang Jihui , Geng Qingshan , Wing Yun-Kwok 
Published: April 2023

Abstract

Background
Both sleep duration and efficiency are essential for health outcomes. However, few studies have considered the effects of both sleep duration and efficiency on predicting the risks of mortality. This study investigated the independent and joint associations of accelerometer-measured sleep duration and efficiency with all-cause and cause-specific mortality.

Methods
The UK Biobank is a cohort study of over 500 000 individuals recruited between 2006 and 2010. This study included participants wearing wrist accelerometers for 7 consecutive days between February 2013 and December 2015. Mortality was ascertained by the national death registries.

Results
Of the 90 398 participants (age, 62.4 [7.8] years, 43.5% male) who were included, 2 685 deaths were reported within a median follow-up duration of 6.4 years. Both accelerometer-measured short (adjusted hazard ratios, 1.27; 95% confidence interval [CI]: 1.11–1.45) and long sleep duration (adjusted hazard ratios, 1.16; 95% CI: 1.06–1.28) were positively associated with the risks of all-cause mortality. Lower sleep efficiency was associated with an increased risk of all-cause and cause-specific mortality. Significant interaction existed between accelerometer-measured sleep duration and efficiency for the risk of all-cause mortality (Pinteraction = .001), participants with long sleep duration and lower sleep efficiency had a double mortality risk compared with those with higher sleep efficiency and normal sleep duration (adjusted hazard ratios = 2.11; 95% CI: 1.44–3.09).

Conclusions
Accelerometer-measured short/long sleep duration and lower sleep efficiency were associated with increased risks of mortality. Sleep efficiency modified the effects of long sleep duration on survival.