bluuebunny/crossref_metadata_2025_split huggingface dataset:
Innate immune memory in cardiometabolic disease
Authors: Bahrar Harsh , Bekkering Siroon , Stienstra Rinke , Netea Mihai G , Riksen Niels P 
Published: February 2023

Abstract
Low-grade systemic inflammation is a key pathophysiological component of atherosclerotic cardiovascular disease (CVD), and long-term activation of myeloid cells is thought to be crucial for these effects. Obesity and associated metabolic complications including hyperglycaemia and dyslipoproteinaemia can induce long-lasting inflammatory reprogramming of the innate immune cells and their bone marrow progenitors, which in turn contributes to atherosclerosis. In this review, we discuss the mechanisms through which innate immune cells undergo long-term changes in their functional, epigenetic, and metabolic characteristics upon even short-term exposure to endogenous ligands, a process also termed ‘trained immunity’. Inappropriate induction of trained immunity leads to the development of long-lasting hyperinflammatory and proatherogenic changes in monocytes and macrophages, an important factor in the development of atherosclerosis and CVDs. Knowledge of the specific immune cells and the distinct intracellular molecular pathways involved in the induction of trained immunity will reveal novel pharmacological targets that could be used to prevent or treat CVDs in the future.
Kinematic parameters related to functional capacity, fatigue, and breathlessness during the 6-min walk test in older adults with heart failure with preserved ejection fraction
Authors: Fuentes-Abolafio Iván José , Trinidad-Fernández Manuel , Ricci Michele , Roldán-Jiménez Cristina , Gómez-Huelgas Ricardo , Arjona-Caballero José María , Escriche-Escuder Adrián , Bernal-López María Rosa , Pérez-Belmonte Luis Miguel , Cuesta-Vargas Antonio Ignacio 
Published: February 2023

Abstract

Aims
This paper aims to assess kinematic parameters related to functional capacity, fatigue, and breathlessness during the 6-min walk test (6MWT) in patients with heart failure with preserved ejection fraction (HFpEF).

Methods and results
A cross-sectional study was conducted in which adults 70 years or older with HFpEF were voluntarily recruited between April 2019 and March 2020. An inertial sensor was placed at the L3–L4 level and another on the sternum to assess kinematic parameters. The 6MWT was divided into two 3-min phases. Leg fatigue and breathlessness, assessed by the Borg scale, the heart rate (HR), and the oxygen saturation (SpO2), were measured at the beginning and the end of the 6MWT. The difference in kinematic parameters between the 6MWT two 3-min phases was also calculated. Bivariate Pearson correlations and subsequent multivariate linear regression analysis were performed. Seventy older adults with HFpEF (mean = 80.74 years old) were included. Kinematic parameters explained 81.00% of the functional capacity, 45.50% of the leg fatigue and 66.10% of the breathlessness variance. Moreover, kinematic parameters could explain 30.90% of the SpO2 variance at the end of the 6MWT. Kinematic parameters also explained 33.10% of the SpO2 difference between the beginning and end of 6MWT. Kinematic parameters explained neither the HR variance at the end of 6MWT nor the HR difference between the beginning and end.

Conclusion
Gait kinematics from L3-L4 and sternum explain a part of the variance in subjective outcomes, assessed by the Borg scale, and objective outcomes such as functional capacity and SpO2. The kinematic assessment allows clinicians to quantify fatigue and breathlessness through objective parameters related to the patient’s functional capacity.

Registration
ClinicalTrials.gov NCT03909919.
Coherent mapping of atrial tachycardias in patients with congenital heart disease
Authors: Klehs Sophia , Paech Christian , Bertagnolli Livio , Markel Franziska , Dähnert Ingo , Gebauer Roman 
Published: February 2023

AbstractAimsCoherent mapping (CM) uses a new algorithm to identify critical conduction isthmuses of atrial tachycardias (ATs). We analysed our experience of ablation of AT in patients with congenital heart disease (CHD) with this new technology.Methods and resultsAll patients with CHD who had CM of AT using the high-density mapping PENTARAY™ catheter and three-dimensional electroanatomic mapping system Carto3 between June 2019 and June 2021 were included retrospectively (n = 27). As a control group, 27 patients with CHD and mapping of AT without CM between March 2016 and June 2019 were included. In total, 54 ablation procedures were performed in 42 patients [median age 35 (interquartile range, IQR 30–48) years] and 64 ATs were induced and mapped (thereof 50 AT intraatrial re-entrant tachycardia and 14 AT ectopic AT). The median procedure duration was 180 (120–214) min and median fluoroscopy time was 10 (5.2–14) min. Acute success was 100% (27/27) in the Coherence group and 74% (20/27) in the non-Coherence group (P = 0.01). During follow-up [median 26 (12–45) months], AT recurred in 28/54 patients, thereof 15 patients needed a re-ablation procedure. Log-rank test showed no difference in recurrence rate between the two groups (P = 0.29). Three minor complications occurred (5.5%).ConclusionMapping of AT in patients with CHD using the PENTARAY™ mapping catheter and the CM algorithm led to excellent acute success. All ATs were possible to map and no complications related to the PENTARAY™ mapping catheter were observed. Thus, the use of the CM algorithm represents a promising tool in patients with CHD and complex AT.
Mapping-guided atrial lead placement determines optimal conduction across Bachmann’s bundle: a rationale for patient-tailored pacing therapy
Authors: van Schie Mathijs S , Ramdat Misier Nawin L , Knops Paul , Heida Annejet , Taverne Yannick J H J , de Groot Natasja M S 
Published: February 2023

AbstractAimsConventional right atrial appendage (RAA) pacing is associated with increased atrial activation time resulting in higher incidences of atrial tachyarrhythmia. Optimal pacing sites ideally shorten inter-atrial conduction delay, thereby decreasing atrial excitation time. We therefore examined the impact of programmed electrical stimulation (PES) from the right atrium (RA) and left atrium (LA) on the electrophysiological properties of Bachmann’s bundle (BB).Methods and resultsHigh-resolution epicardial mapping of BB was performed during sinus rhythm (SR) and PES in 34 patients undergoing cardiac surgery. Programmed electrical stimulation was performed from the RAA, junction of the RA with inferior caval vein (LRA), and left atrial appendage (LAA). Pacing from either the RAA or LAA resulted in, respectively, right- and left-sided conduction across BB. However, during LRA pacing in most patients (n = 15), activation started in the centre of BB. The total activation time (TAT) of BB during RAA pacing [63 (55–78) ms] was similar to that of SR [61 (52–68) ms, P = 0.464], while it decreased during LRA [45 (39–62) ms, P = 0.003] and increased during LAA pacing [67 (61–75) ms, P = 0.009]. Reduction of both conduction disorders and TAT was most often achieved during LRA pacing (N = 13), especially in patients who already had a higher amount of conduction disorders during SR [9.8 (7.3–12.3) vs. 4.5 (3.5–6.6)%, P &lt; 0.001].ConclusionPacing from the LRA results in a remarkable decrease of TAT compared with pacing from the LAA or RAA. As the most optimal pacing site varies between patients, individualized positioning of the atrial pacing lead guided by mapping of BB may be one of the new frontiers for atrial pacing.
Candrive—Development of a Risk Stratification Tool for Older Drivers
Authors: Marshall Shawn , Bédard Michel , Vrkljan Brenda , Tuokko Holly , Porter Michelle M , Naglie Gary , Rapoport Mark J , Mazer Barbara , Gélinas Isabelle , Gagnon Sylvain , Charlton Judith L , Koppel Sjaan , MacLeay Lynn , Myers Anita , Mallick Ranjeeta , Ramsay Tim , Stiell Ian , Wells George , Man-Son-Hing Malcolm 
Published: February 2023

Abstract

Background
Assessing an older adult’s fitness-to-drive is an important part of clinical decision making. However, most existing risk prediction tools only have a dichotomous design, which does not account for subtle differences in risk status for patients with complex medical conditions or changes over time. Our objective was to develop an older driver risk stratification tool (RST) to screen for medical fitness-to-drive in older adults.

Methods
Participants were active drivers aged 70 and older from 7 sites across 4 Canadian provinces. They underwent in-person assessments every 4 months with an annual comprehensive assessment. Participant vehicles were instrumented to provide vehicle and passive Global Positioning System (GPS) data. The primary outcome measure was police-reported, expert-validated, at-fault collision adjusted per annual kilometers driven. Predictor variables included physical, cognitive, and health assessment measures.

Results
A total of 928 older drivers were recruited for this study beginning in 2009. The average age at enrollment was 76.2 (standard deviation [SD] = 4.8) with 62.1% male participants. The mean duration for participation was 4.9 (SD = 1.6) years. The derived Candrive RST included 4 predictors. Out of 4 483 person-years of driving, 74.8% fell within the lowest risk category. Only 2.9% of person-years were in the highest risk category where the relative risk for at-fault collisions was 5.26 (95% confidence interval = 2.81–9.84) compared to the lowest risk group.

Conclusions
For older drivers whose medical conditions create uncertainty regarding their fitness-to-drive, the Candrive RST may assist primary health care providers when initiating a conversation about driving and to guide further evaluation.
The potential role of nondigestible Raffinose family oligosaccharides as prebiotics
Authors: Kanwal Freeha , Ren Dingxin , Kanwal Wajiha , Ding Mengying , Su Junqing , Shang Xiaoya 
Published: February 2023

AbstractBased on factual scientific health claims, prebiotics have gained significant importance in ever-growing food and pharmaceutical industries. The diverse nature of distinct prebiotics influences the host differently in distinguishable patterns. Functional oligosaccharides are either plant-derived or commercially prepared. Raffinose, stachyose, and verbascose are the 3 types of raffinose family oligosaccharides (RFOs) that have been extensively used as medicine, cosmetic, and food additives. These dietary fiber fractions avert the adhesion and colonization by enteric pathogens and add nutrition metabolites for a healthy immune system. Enrichment of RFOs in healthy foods should be promoted as these oligosaccharides augment gut microecology by enhancing the health conferring microbes i.e. bifidobacteria and lactobacilli. RFOs influence the host’s multiorgan systems due to their physiological and physicochemical properties. For example, the fermented microbial products of such carbohydrates affect neurological processes, including memory, mood, and behavior in humans. Raffinose-type sugar uptake is thought to be a ubiquitous property of bifidobacteria. This review paper summarizes the source of RFOs and their metabolizing entities, highlighting bifidobacterial carbohydrate utilization and health benefits.
Exploring experiences with stressors and coping resources among Dutch socioeconomic groups during the COVID-19 pandemic
Authors: van der Kamp Dani , Torensma Marieke , Vader Sarah , Pijpker Roald , den Broeder Lea , Fransen Mirjam P , Wagemakers Annemarie 
Published: February 2023

SummaryThe COVID-19 crisis impacts populations globally. This impact seems to differ for groups with low- and high-socioeconomic status (SES). We conducted a qualitative study in the Netherlands using a salutogenic perspective to examine experiences with stressors and coping resources during the pandemic among both SES groups to gain insight on how to promote the health and well-being of these groups. We conducted 10 focus group discussions and 20 interviews to explore the experiences, including resources and stressors, of respondents from low- (N = 37) and high-SES (N = 38) groups (25–55 years, Dutch speaking). We analyzed the findings at individual, community, and national levels. The results show that coping depends on government-imposed measures and the way individuals handle these measures; restriction to the home context with positive and negative consequences for work and leisure; psychological negative consequences and resourcefulness; and social effects related to unity (e.g. social cohesion or support) and division (including polarization). Respondents with lower SES expressed more problems with COVID-19 measures and experienced more social impact in their neighborhood than those with higher SES. Where low-SES groups especially mentioned the effects of staying at home on family life, high-SES groups mentioned effects on work life. At last, psychological consequences seem to differ somewhat across SES groups. Recommendations include consistent government-imposed measures and government communication, support for home schooling children, and strengthening the social fabric of neighborhoods.
Evidence of bluefin tuna (Thunnus thynnus) spawning in the Slope Sea region of the Northwest Atlantic from electronic tags
Authors: Aalto Emilius A , Dedman Simon , Stokesbury Michael J W , Schallert Robert J , Castleton Michael , Block Barbara A 
Published: February 2023

AbstractAtlantic bluefin tuna (ABT) are large, wide-ranging pelagic predators, which typically migrate between foraging regions in the North Atlantic and two principal spawning regions, the Gulf of Mexico and the Mediterranean Sea. A new spawning area has been described in the Slope Sea (SS) region off New England; however, the relationship between ABT that spawn in the SS and ABT using the principal spawning regions remains poorly understood. We used electronic tags to examine the location, temperature, and diving behaviour of ABT in the SS, and identified 24 individuals that were present during the spawning season (June–August) with tag data showing temperatures and behaviour consistent with spawning ABT. In general, the SS spawners had similar spatial ranges to Mediterranean-spawning ABT; however, some individuals displayed distinct behaviours that were identified first in the Gulf of Mexico spawners. Using monthly spatial distributions, we estimated that the SS spawners have high exposure to fishing pressure relative to other ABT and may represent a disproportionate share of the West Atlantic catch. This analysis provides the first description of the behaviour of ABT frequenting this spawning ground, creating a foundation for integrating this region into multi-stock management and, potentially, conserving an important source of genetic diversity.
Hollow-fibre system model of tuberculosis reproducibility and performance specifications for best practice in drug and combination therapy development
Authors: Gumbo Tawanda , Srivastava Shashikant , Deshpande Devyani , Pasipanodya Jotam G , Berg Alexander , Romero Klaus , Hermann David , Hanna Debra 
Published: February 2023

AbstractBackgroundThe hollow-fibre system model of tuberculosis (HFS-TB) has been endorsed by regulators; however, application of HFS-TB requires a thorough understanding of intra- and inter-team variability, statistical power and quality controls.MethodsThree teams evaluated regimens matching those in the Rapid Evaluation of Moxifloxacin in Tuberculosis (REMoxTB) study, plus two high-dose rifampicin/pyrazinamide/moxifloxacin regimens, administered daily for up to 28 or 56 days against Mycobacterium tuberculosis (Mtb) under log-phase growth, intracellular growth or semidormant growth under acidic conditions. Target inoculum and pharmacokinetic parameters were pre-specified, and the accuracy and bias at achieving these calculated using percent coefficient of variation (%CV) at each sampling point and two-way analysis of variance (ANOVA).ResultsA total of 10 530 individual drug concentrations, and 1026 individual cfu counts were measured. The accuracy in achieving intended inoculum was &gt;98%, and &gt;88% for pharmacokinetic exposures. The 95% CI for the bias crossed zero in all cases. ANOVA revealed that the team effect accounted for &lt;1% of variation in log10 cfu/mL at each timepoint. The %CV in kill slopes for each regimen and different Mtb metabolic populations was 5.10% (95% CI: 3.36%–6.85%). All REMoxTB arms exhibited nearly identical kill slopes whereas high dose regimens were 33% faster. Sample size analysis revealed that at least three replicate HFS-TB units are needed to identify &gt;20% difference in slope, with a power of &gt;99%.ConclusionsHFS-TB is a highly tractable tool for choosing combination regimens with little variability between teams, and between replicates.
The role of gut microbiota and metabolites in regulating the immune response in drug-induced enteritis
Authors: Chen Yuxuan , Wang Zhaojun , Chen Xinli , Chao Guanqun , Zhang Shuo 
Published: February 2023

AbstractDrug-induced enteritis is an inflammatory disease changing in the morphology and function of the intestine as a result of medicine damage. With the increase in drug abuse in recent years, the incidence of drug-associated enteritis accordingly rises and becomes an important disease affecting the health and life quality of patients. Hence, elucidating the pathogenesis of drug-induced enteritis and finding cost-effective diagnostic and therapeutic tools have become current research focuses. The gut microbiota and metabolites regulate the immune response, playing a key role in the maintenance of homeostasis in the intestine. Numerous studies have found that many medicines can induce intestinal flora disorders, which are closely related to the development of drug-induced enteritis. Therefore, this paper analyses the role of gut microbiota and metabolites in regulating the immune response, and provides basic research direction and clinical reference strategies for drug-induced enteritis, taking into account the existing applications and perspectives.
Digital healthcare equity in primary care: implementing an integrated digital health navigator
Authors: Rodriguez Jorge Alberto , Charles Jean-Pierre , Bates David W , Lyles Courtney , Southworth Bonnie , Samal Lipika 
Published: February 2023

Abstract
The 21st Century Cures Act and the rise of telemedicine led to renewed focus on patient portals. However, portal use disparities persist and are in part driven by limited digital literacy. To address digital disparities in primary care, we implemented an integrated digital health navigator program supporting portal use among patients with type II diabetes. During our pilot, we were able to enroll 121 (30.9%) patients onto the portal. Of newly enrolled or trained patients, 75 (62.0%) were Black, 13 (10.7%) were White, 23 (19.0%) were Hispanic/Latinx, 4 (3.3%) were Asian, 3 (2.5%) were of another race or ethnicity, and 3 (2.5%) had missing data. Our overall portal enrollment for clinic patients with type II diabetes increased for Hispanic/Latinx patients from 30% to 42% and Black patients from 49% to 61%. We used the Consolidated Framework for Implementation Research to understand key implementation components. Using our approach, other clinics can implement an integrated digital health navigator to support patient portal use.
Clinical utility gains from incorporating comorbidity and geographic location information into risk estimation equations for atherosclerotic cardiovascular disease
Authors: Xu Yizhe , Foryciarz Agata , Steinberg Ethan , Shah Nigam H 
Published: February 2023

Abstract

Objective
There are over 363 customized risk models of the American College of Cardiology and the American Heart Association (ACC/AHA) pooled cohort equations (PCE) in the literature, but their gains in clinical utility are rarely evaluated. We build new risk models for patients with specific comorbidities and geographic locations and evaluate whether performance improvements translate to gains in clinical utility.

Materials and Methods
We retrain a baseline PCE using the ACC/AHA PCE variables and revise it to incorporate subject-level information of geographic location and 2 comorbidity conditions. We apply fixed effects, random effects, and extreme gradient boosting (XGB) models to handle the correlation and heterogeneity induced by locations. Models are trained using 2 464 522 claims records from Optum©’s Clinformatics® Data Mart and validated in the hold-out set (N = 1 056 224). We evaluate models’ performance overall and across subgroups defined by the presence or absence of chronic kidney disease (CKD) or rheumatoid arthritis (RA) and geographic locations. We evaluate models’ expected utility using net benefit and models’ statistical properties using several discrimination and calibration metrics.

Results
The revised fixed effects and XGB models yielded improved discrimination, compared to baseline PCE, overall and in all comorbidity subgroups. XGB improved calibration for the subgroups with CKD or RA. However, the gains in net benefit are negligible, especially under low exchange rates.

Conclusions
Common approaches to revising risk calculators incorporating extra information or applying flexible models may enhance statistical performance; however, such improvement does not necessarily translate to higher clinical utility. Thus, we recommend future works to quantify the consequences of using risk calculators to guide clinical decisions.
Understanding Neural Factors in Burn-related Pruritus and Neuropathic Pain
Authors: Gunawardena Dulan A , Stanley Edward , Issler-Fisher Andrea C 
Published: February 2023

AbstractPost-burn pruritus and neuropathic pain significantly affect the quality of life of affected individuals in several domains including psychosocial well-being, sleep and general impairment in activities of daily living. Whilst neural mediators involved in itch in the non-burns setting have been well investigated, there remains a lacuna of literature examining the pathophysiological and histological changes unique to burn-related pruritus and neuropathic pain. The aim of our study was to conduct a scoping review into the neural factors that contribute to burn-related pruritus and neuropathic pain. A scoping review was conducted to provide an overview of the available evidence. The PubMed, EMBASE and Medline databases were searched for publications. Data regarding neural mediators implicated, population demographics, total body surface area (TBSA) affected and sex was extracted. In total, 11 studies were included in this review with a total of 881 patients. The most frequently investigated neurotransmitter was the Substance P (SP) neuropeptide which appeared in 36% of studies (n = 4), followed by calcitonin gene-related peptide (CGRP) in 27% of studies (n = 3). Post-burn pruritus and neuropathic pain are symptomatic experiences that are predicated upon a heterogeneous group of underlying mechanisms. What is clear from the literature, however, is that itch and pain may occur secondary to the influence of both neuropeptides, such as SP, and other neural mediators including Transient receptor protein channels. Of the articles included for review, they were characterized by small sample sizes and large differences in statistical methodology and reporting.