bluuebunny/crossref_metadata_2025_split huggingface dataset:
P480 SUBMITRAL LEFT VENTRICULAR ANEURYSM AND STROKE IN A YOUNG CAUCASIAN WOMAN
Authors: Ferrari V , Mazzanti C 
Published: May 2023

Abstract
Submitral aneurysms are infrequent and they are generally described in populations from Subsaharian Africa. The aetiology is still unclear: it has been proposed that they could be caused by congenital alterations of ventricular wall, infectious events, chest trauma, cardiac surgery or Myocardial Infarction. Submitral aneurysms can induce arrhythmias, stroke, heart failure secondary to mitral insufficiency, and can facilitate infections. We report the case of a 39–year–old Caucasian woman who was hospitalized in our Institution after relapsing fever episodes, presenting with altered state of consciousness. The ECG showed sinus rhythm and normal morphology. When she was hospitalized, laboratory test findings included normocytic anaemia (Hb 9,8 g/dl), thrombocytopenia (94x103 platelets), neutrophilia (81% neutrophils), ESR 32 mm/h, CRP 8,84, low electolyte level, procalcitonin 11,54 ng/ml. Blood culture was positive for Candida Albicans. A transthoracic echocardiogram showed normal left ventricle dimensions and wall thickness, without abnormalities of global or segmental wall motion, thickening of mitral valve leaflets, which appeared slightly hyperechogen. It was found an aneurysmatic area in correspondence of subvalvular apparatus of mitral valve, between mitral annulus and posterior papillary muscle. Mitral annulus was shifted toward the atrial roof. These findings were confirmed by a thransesophageal echocardiogram. The aneurysm measured 33x22 mm in correspondence to the atrio–ventricular junction. A cardiac MRI confirmed these morphologic alterations without evidence of infarction areas, supposing the presence of an infectious lesion. A brain MRI showed multiple and diffuse areas of altered signal referred to stroke. The patient was referred to the Heart Surgery of our Institution. Intraoperatively, a large aneurysm arose from submitral area; moreover, the posterior leaflet of the mitral valve was characterized by some fissures. The aneurysm was excluded by a direct suturing and the mitral valve was replaced with a biological valve. In our patient, mitral annulus dislocation was evident, supporting the hypothesis of a congenital malformation that can have promoted a mycotic infection and the formation of thrombi responsible for the cerebral disease. In patients with cardiac arrhythmias or embolic events, without other motivating factors, it’s necessary to pay attention and to make a differential diagnosis with these types of aneurysms.
P481 PREDICTIVE FACTORS OF CLINICAL OUTCOME IN PATIENTS WITH AORTIC STENOSIS: DATA FROM THE VENETO REGISTER
Authors: Pagliani L , Buso R , Nicolosi E , Di Naro A , Denas G , Antonini–canterin F , Simmini S , Rattazzi M 
Published: May 2023

Abstract

Background
Aortic valve stenosis represents the most relevant valve disease in the Western world, with a mortality rate exceeding 50%. Calcific aortic valve stenosis was once considered a passive process of the valve deposition of calcium salts, but is now considered a cell–mediated disease. The aim of the present study is to search for predictors of mortality, cardiovascular events and valve replacement in patients with aortic stenosis. Materials and

Methods
A subgroup of 140 patients affected by moderate–severe aortic valve stenosis from the Cardiology departments of the Treviso Hospital and the High Specialization Hospital of Motta di Livenza included in the Veneto Register. For each patient, information relating to deaths, cardiovascular events and valve staging was therefore collected over time.

Results
The deceased were 36% of which 22.9% without having replaced the valve. The mean follow–up was 24.99±21.72 months. In the follow–up, the deceased were characterized by an older age, a greater frequency of ischemic heart disease, atrial fibrillation and chronic kidney disease (CKD), a worse eGFR, a higher phosphate level. Among the Cox regression biohumoral data, serum phosphate was significantly associated with mortality in the univariate survey, and eGFR values were also always independently significantly associated with mortality. Kaplan Meyer curves also showed significant differences in the risk of CV events over time between groups with eGFR values greater than equal and less than 60 mL/min.

Conclusions
The results of the study suggest that the pathology appears to be linked to senescence processes and shares a common basis with atherosclerotic pathology, but also appears to be influenced in its evolution by further determinants such as CKD and blood phosphorus values. These considerations prompt us to reflect on the need for studies aimed at understanding the pathogenetic mechanisms of the proven relationship between cardiovascular MACE and phosphorus values, and that between worse renal function and cardiovascular mortality/morbidity. On the other hand, it seems urgent to be able to propose in the near future an internationally shared prognostic score that considers these predictive variables and can help us to better stratify the clinical evolution of aortic stenosis and influencing the surgical timing.
P484 IMPACT OF VISCERAL FAT ON MORTALITY IN PATIENTS TREATED BY TAVI
Authors: Somaschini A , Casirati A , Olivotti L , Cornara S , Giachello V , Astuti M , Ghione M , Botta M , Buscemi M , Caccialanza R , Bellone P , Cordone S 
Published: May 2023

Abstract

Introduction
Sarcopenia, evaluated by body composition analysis through CT scan at the third lumbar vertebra level (L3–CT), is a promising prognostic stratification parameter in patients undergoing Transcatheter Aortic Valve Implantation (TAVI). Conversely, only a few data are available on the impact of visceral fat, a metabolic active tissue associated with unfavorable cardiovascular outcome. AIMS. We investigated the correlation between baseline visceral fat and 30–days mortality in patients undergoing TAVI.

Methods
We prospectively collected anamnestic and clinical data of 81 patients (42.5% males) who underwent TAVI in 2010–2020. Trough retrospective analysis of 55 available CT–L3 images (Fig 1), we measured visceral adipose tissue index (VATi), expressed as cm2/m2. The sample was classified according to the median VATi value (&gt;50percentile VS &lt;50p). The two groups were compared by Mann–Whitney test for continuous variables (expressed as median value 25p–75p) and cross tables with Chi–square test for categorical variables (expressed as %).

Results
VATi median value was 57.4 cm2/m2. Patients with VATi&gt;50p were younger (83.3 [76.5–87] vs. 86 [83–88] years, p=0.020) and showed more often pre–operative NYHA class &gt;2 (78% vs. 40%, p=0.021) as compared with patients with VATi&lt;50p. No differences were found in the incidence of atrial fibrillation, diabetes, COPD, advanced CKD, previous stroke / MI / surgical or percutaneous revascularization. STS mortality score and Euroscore II did not differ significantly. Thirty–days and 1–year mortality were respectively 3.6% and 12.7%. As showed in Fig 2, VATi&gt;50p group presented a higher 1–year mortality (21.4% vs. 3.7%, HR=7.01, p=0.05), whereas no differences were found in 30–days mortality (3.6% vs. 3.7%, p=0.745).

Conclusions
Visceral fat is associated with a higher 1–year all cause mortality in patients treated by TAVI. Further studies on wider populations are needed to confirm this finding. Adding the evaluation of visceral fat to the clinical practice could help to optimize pre–operative mid–term mortality risk stratification in this setting.
P487 THE NEW PCSK9–INHIBITOR INCLISIRAN: AN EXCEPTIONAL REDUCTION IN LDL CHOLESTEROL FROM THE FIRST PATIENTS OF THE NIGUARDA HOSPITAL
Authors: Merlo A , Maloberti A , Ossola P , Caccia A , Busti A , Garofani I , Fabbri S , Senni M , Giannattasio C 
Published: May 2023

Abstract

Background
Dyslipidemia is one of the most prominent risk factors in coronary artery disease. With the new strict target of Low Density Lipoprotein (LDL) cholesterol in secondary prevention in some patients oral medication may not be sufficient. Inclisiran is a small interfiring RNA that inhibits the hepatic PCSK–9 synthesis inducing a reduction in low–density lipoprotein levels up to 50%. Conveniently, it only requires one administration every six months. Case description: a 53–year–old man, with no previous cardiologic history, presented to our emergency department reporting acute chest pain and left arm paresthesia developed after an emotional stress. Electrocardiogram was normal with a slightly and stable increased of high sensitivity troponin T levels (18 ng/l). The patient had the following cardiovascular risk factors: type 2 diabetes mellitus, dyslipidemia, obstructive sleep apnea syndrome, obesity (body mass index 30), sedentary lifestyle. Taking into consideration his clinical presentation and his cardiovascular risk, a coronary computer tomography was performed showing severe stenosis in Left Anterior Descending (LAD) and right coronary arteries. The subsequent coronary angiography confirms the severe stenosis in the proxymal LAD and the mild stenosis (30%) in the right coronary artery. The LAD was treated with a drug eluting stent. At the time of the event the patient was already on therapy with rosuvastatina/ezetimibe 10/10 mg that we increased to a dosage of 20/10 mg. At the first medical examination after the hospitalization, his blood tests showed uncontrolled LDL cholesterol (70 mg/dl). We therefore decided to try lowering his cholesterol levels with addition of inclisiran. After 3 months of inclisiran therapy, his blood test showed a surprisingly decrease in cholesterol levels (total cholesterol 78 mg/dl and LDL 11 mg/dl) reaching the desirable target.

Conclusion
Inclisiran is a valid therapeutic strategy for reaching the desiderable cholesterol target in patient at high cardiovascular risk. In our first patients inclisiran, added to statin and ezetimibe therapy, successfully lowered LDL to the desirable target. Surprinsigly, it lowered LDL up to 85%, much more than expected. Further studies will be needed to identify which patients may be super responders to Inclisiran.
P491 YOUNG AND MIDDLE–AGED PATIENTS PRESENTING WITH ACUTE CORONARY SYNDROME: THE ROLE OF LIPOPROTEIN(A)
Authors: Meringolo F , Panattoni G , Proietti G , Jacomelli I , Lanzillo C , Calò L 
Published: May 2023

Abstract

Background
Lipoprotein(a) [Lp(a)] is a liver–derived lipoprotein with genetically determined concentrations. High level of lipoprotein(a) is a common risk factor for cardiovascular disease and stroke. Higher plasma Lp(a) concentrations are associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD), through mechanisms associated with increased atherogenesis, inflammation, and thrombosis.

Methods
The study enrolled patients ≤ 55 years of age referred to Cardiology Department of Policlinico Casilino with acute coronary syndrome (ACS). In order to identify patients with high cardiovascular risk, we measured, according to current guidelines, Lp(a) value.

Results
A total of 73 patients (84% males, mean age 47±7 years old) were enrolled from July 2020 to March 2022. Mean Lp(a) level was 50.9± 46.7 mg/dL. High Lp(a) &gt; 50 mg/dL was documented in 31.5 % of patients, while the interim grey zone of elevated Lp (a) (30–50 mg/dL) in 27.4%.

Conclusion
In our experience, elevated levels of Lp(a) was documented in more than half of patients, presenting with ACS at a relatively young age. This support recent guidelines recommendation to measure Lp (a) at least once in adults, preferably in the first lipid profile, to identify patients with high cardiovascular risk of recurrence. This result focus on the potential use in clinical practice of efficacious Lp(a)–lowering drugs.
Immune Modulation of HIV-1 Reservoir Size in Early-Treated Neonates
Authors: Hartana Ciputra Adijaya , Broncano Pilar Garcia , Maswabi Kenneth , Ajibola Gbolahan , Moyo Sikhulile , Mohammed Terence , Maphorisa Comfort , Makhema Joseph , Powis Kathleen M , Lockman Shahin , Burbelo Peter D , Gao Ce , Yu Xu G , Kuritzkes Daniel R , Shapiro Roger , Lichterfeld Mathias 
Published: May 2023

Abstract
Immune mechanisms that modulate human immunodeficiency virus-1 (HIV-1) reservoir size in neonates are poorly understood. Using samples from neonates who initiated antiretroviral therapy shortly after birth, we demonstrate that interleukin-8–secreting CD4 T cells, which are selectively expanded in early infancy, are more resistant to HIV-1 infection and inversely correlated with the frequency of intact proviruses at birth. Moreover, newborns with HIV-1 infection displayed a distinct B-cell profile at birth, with reduction of memory B cells and expansion of plasmablasts and transitional B cells; however, B-cell immune perturbations were unrelated to HIV-1 reservoir size and normalized after initiation of antiretroviral therapy.
Clinical Trials Registration. NCT02369406.
Extracellular vesicles in systemic juvenile idiopathic arthritis
Authors: Maller Justine , Morgan Terry , Morita Mayu , McCarthy Frank , Jung Yunshin , Svensson Katrin J , Elias Joshua E , Macaubas Claudia , Mellins Elizabeth 
Published: May 2023

Abstract
Systemic juvenile idiopathic arthritis is a chronic pediatric inflammatory disease of unknown etiology, characterized by fever, rash, hepatosplenomegaly, serositis, and arthritis. We hypothesized that intercellular communication, mediated by extracellular vesicles, contributes to systemic juvenile idiopathic arthritis pathogenesis and that the number and cellular sources of extracellular vesicles would differ between inactive and active states of systemic juvenile idiopathic arthritis and healthy controls. We evaluated plasma from healthy pediatric controls and patients with systemic juvenile idiopathic arthritis with active systemic flare or inactive disease. We isolated extracellular vesicles by size exclusion chromatography and determined total extracellular vesicle abundance and size distribution using microfluidic resistive pulse sensing. Cell-specific extracellular vesicle subpopulations were measured by nanoscale flow cytometry. Isolated extracellular vesicles were validated using a variety of ways, including nanotracking and cryo-electron microscopy. Extracellular vesicle protein content was analyzed in pooled samples using mass spectrometry. Total extracellular vesicle concentration did not significantly differ between controls and patients with systemic juvenile idiopathic arthritis. Extracellular vesicles with diameters &lt;200 nm were the most abundant, including the majority of cell-specific extracellular vesicle subpopulations. Patients with systemic juvenile idiopathic arthritis had significantly higher levels of extracellular vesicles from activated platelets, intermediate monocytes, and chronically activated endothelial cells, with the latter significantly more elevated in active systemic juvenile idiopathic arthritis relative to inactive disease and controls. Protein analysis of isolated extracellular vesicles from active patients showed a proinflammatory profile, uniquely expressing heat shock protein 47, a stress-inducible protein. Our findings indicate that multiple cell types contribute to altered extracellular vesicle profiles in systemic juvenile idiopathic arthritis. The extracellular vesicle differences between systemic juvenile idiopathic arthritis disease states and healthy controls implicate extracellular vesicle–mediated cellular crosstalk as a potential driver of systemic juvenile idiopathic arthritis disease activity.
XTE J1906+090: a persistent low-luminosity Be X-ray binary
Authors: Sguera V , Sidoli L , Bird A J , La Palombara N 
Published: May 2023

ABSTRACT
We present new results from INTEGRAL and Swift observations of the hitherto poorly studied and unidentified X-ray source XTE J1906+090. A bright hard X-ray outburst (luminosity of ∼1036 erg s−1 above 20 keV) has been discovered with INTEGRAL observations in 2010, this being the fourth outburst ever detected from the source. Such events are sporadic, the source duty cycle is in the range (0.8–1.6) per cent as inferred from extensive INTEGRAL and Swift monitoring in a similar hard X-ray band. Using five archival unpublished Swift/X-Ray Telescope (XRT) observations, we found that XTE J1906+090 has been consistently detected at a persistent low X-ray luminosity value of ∼1034 erg s−1, with limited variability (a factor as high as 4). Based on our findings, we propose that XTE J1906+090 belongs to the small and rare group of persistent low-luminosity Be X-ray binaries.
Characterizing abundance–age relations of GALAH stars using oxygen-enhanced stellar models
Authors: Sun Tiancheng , Chen Xunzhou , Bi Shaolan , Ge Zhishuai , Xiang Maosheng , Wu Yaqian 
Published: May 2023

ABSTRACT
Main-sequence turn-off (MSTO) stars and subgiant stars are good tracers of Galactic populations. We present a study of 41 034 MSTO and subgiant stars from the GALAH survey. Using a grid of stellar models that accounts for the variation of O abundances, we determine their ages with a median age uncertainty of ∼9.4 per cent. Our analysis reveals that the ages of high-O stars based on O-enhanced models are smaller than those determined with α-enhanced models, resulting in a mean fractional age difference of −5.3 per cent at [O/α] = 0.2 and −11.0 per cent at [O/α] = 0.4. This age difference significantly impacts the age distribution of thick disc and halo stars, leading to a steeper downward trend in the [Fe/H]–age plane from 8 to 14 Gyr, indicating a shorter formation time-scale and a faster chemical-enhanced history for these populations. We confirm the V-shape of the normalized age-metallicity distribution p(τ∣[Fe/H]) of thin disc stars, which is presumably a consequence of the second gas infall. Additionally, we find that the halo stars in our sample can be divided into two sequences, a metal-rich sequence (Splash stars) and a metal-poor sequence (accreted stars), with the Splash stars predominantly older than 9 Gyr and the accreted halo stars older than 10 Gyr. Finally, we observe two distinct sequences in the relations between various chemical abundances and ages for disc stars, namely a young sequence with ages &lt; ∼8 Gyr and an old sequence with ages &gt; ∼8 Gyr.
Extending the theory of propagating fluctuations: the first fully relativistic treatment and analytical Fourier–Green’s functions
Authors: Mummery Andrew 
Published: May 2023

ABSTRACT
The aperiodic variability ubiquitously observed from accreting black hole X-ray binary systems is generally analysed within the framework of the so-called ‘theory of propagating fluctuations’. In this paper we derive the Fourier transforms of the Green’s function solutions of the thin disc equations. These solutions suffice to describe all possible solutions through standard convolution techniques. Solutions are found for both Newtonian discs and general relativistic solutions with a vanishing ISCO stress. We use this new relativistic theory to highlight the Kerr black hole spin dependence of a number of observable variability properties of black hole discs. The phase lags, coherence, and power density spectra of Kerr discs are shown to be strong functions of black hole spin. Observations of the aperiodic variability of black hole accretion sources may now, at least in principle, offer a new avenue to directly constrain black hole spins.
Writing the Approach and Methods Section
Authors: Robinson Marin S. , Stoller Fredricka L 
Published: May 2023

Abstract
This chapter illustrates the process of writing the Approach and Methods section of the research proposal, in which authors tell readers how they will conduct the proposed work. It is typically the longest section of the proposal. Unlike the experimental section of a journal article, where authors describe work completed in the past, here they describe what they propose to do in the future (if funded). Reviewers, after reading this section, should be convinced that the work is plausible and that the investigator has the background and expertise necessary to carry out the proposed work. The chapter then distinguishes between prior accomplishments and preliminary findings. It also looks at how to describe the proposed methods, develop project aims, identify obstacles, and suggest possible contingency plans.
Language Tips
Authors: Robinson Marin S. , Stoller Fredricka L 
Published: May 2023

Abstract
This chapter provides details about many of the language features and chemistry writing conventions highlighted throughout the book. Each Language Tip includes helpful hints for communicating effectively in writing. Tips for writing concisely, one of the hallmarks of writing in chemistry, are presented. Writing in chemistry requires that authors use vocabulary that is more formal and academic than they would use in speaking, thus word choice is addressed. Unlike chemistry-specific writing conventions, however, English grammar rules apply across the disciplines. The chapter covers parallelism, plural and singular scientific words, split infinitives, and subject–verb agreement. Correct punctuation also contributes substantially to writing clarity. The chapter also considers word usage, looking at 12 word pairs that are commonly confused by writers.
The Overlap Between Patent and Design Protection
Authors: Musker David 
Published: May 2023

Abstract
This chapter looks into the overlap between patent and design protection and its respective laws. It starts with the patent of the Circular Beach Towel and its subsequent grounds that invalidate the design. Intellectual property practitioners are accustomed to multiple coexisting patents or copyrights in the same work, but the objection to overlap often refers to stretch, election, post expiry right to use, mismatched defences, circumventing, and undermining. The chapter explains how avoiding the overlap leads to creating gaps, so utility models were originally a gap-fill between patents and designs. It also elaborates on how the Paris Convention provides cross-priority claims between a utility model and a design.
The Relationship Between Trademark Rights and Unfair Competition Law
Authors: Nordemann Axel , Aaron-Stelluto Tara 
Published: May 2023

Abstract
This chapter expounds on the relationship between trademark rights and unfair competition law. Laws against unfair competition ensure the proper execution of the competition between market participants and the observation of the rules of fairness. Moreover, the federal law of trademarks and unfair competition primarily exists for the benefit of consumers while also offering market players advantages like nationwide protection and the ability to bring cases in federal court. The chapter looks into scenarios wherein trademark infringements and unfair competitive practices coincide, while simultaneously referencing German law, American laws, and European laws. It also cites that national laws and jurisdiction are influenced by the Court of Justice of the European Union (CJEU) jurisdiction.
Dreyfus Time
Authors: Wood Michael 
Published: May 2023

Abstract
The Dreyfus Affair in many ways defined history for Proust, and we could say that both the Affair and his writing are symptoms of the problematic late days of the nineteenth century. This chapter explores Proust’s portraits of this period and concentrates especially on what happens when too many parties and people have special interests and when prejudice becomes a major form of social education. Proust learns to see politics as a kind of epistemology, a matter of how we know what we think we know. The perspective may seem familiar to many of us, living as we do in a world of fake facts, a world where real facts, although not non-existent, can seem desperately scarce.