bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spontaneous coronary artery dissection: an unpredictable event
Authors: Smirnova Alexandra , Aliberti Flaminia , Cavaliere Claudia , Gatti Ilaria , Vilardo Viviana , Giorgianni Carmelina , Cassani Chiara , Repetto Alessandra , Narula Nupoor , Giuliani Lorenzo , Urtis Mario , Ozaki Yukio , Prati Francesco , Arbustini Eloisa , Ferrari Michela 
Published: April 2023

Abstract
Spontaneous coronary artery dissection (SCAD) is an under-recognized cause of acute coronary syndrome that predominantly affects women in adulthood and is the leading cause of acute myocardial infarction in pregnancy. The most common clinical presentation is ST-segment elevation myocardial infarction (STEMI) or non-STEMI, followed by cardiogenic shock (∼2%), sudden cardiac death (0.8% in autopsy series), cardiac arrest, ventricular arrhythmias (∼5%), and Takotsubo syndrome. The prevalence of SCAD in the general population is largely uncertain due to underdiagnosis. Oral contraceptives, post-menopausal therapy, and infertility treatments are recognized associated factors. The pathological substrates (fibromuscular dysplasia) and triggers (especially emotional stress) are commonly present in affected women. The few cases with a precise genetic aetiology occur in the context of syndromic and non-syndromic connective tissue diseases. The only true certainty in SCAD is the overwhelming prevalence in women. The first event as well as the recurrence (up to 30%, which varies depending on the definition) is largely unpredictable. The treatment strategy is highly individualized and requires extensive additional study in order to optimize outcomes and prevent major adverse cardiovascular events in affected individuals. We have known about SCAD for nearly a century, but we still do not know how best to prevent, diagnose, and treat it, making SCAD a highly important and unmet clinical need.
Long-term follow-up after invasive or conservative management of stable coronary disease: the ISCHEMIA-EXTEND study
Authors: Bolognese Leonardo , Reccia Matteo Rocco , Sabini Alessandra 
Published: April 2023

Abstract
The ISCHEMIA trial found no statistical difference in the primary endpoint between initial invasive and conservative management of patients with chronic coronary disease and moderate-to-severe ischaemia on stress testing. However, an invasive strategy increased peri-procedural myocardial infarction (MI) but decreased spontaneous MI with continued separation of curves over time. Thus, in order to assess the long-term effect of invasive management strategy on mortality, the ISCHEMIA-EXTEND observational study was planned including surviving participants from the initial phase of the ISCHEMIA trial with a projected median follow-up of nearly 10 years. Recently, an interim report of 7-year all-cause, cardiovascular (CV), and non-CV mortality rates has been published showing no difference in all-cause mortality between the two strategies, but with a lower risk of CV mortality and higher risk of non-CV mortality with an initial invasive strategy over a median follow-up of 5.7 years. The trade-offs in CV and non-CV mortality observed in ISCHEMIA-EXTEND raise many important questions regarding the heterogeneity of treatment effect, the drivers of mortality, and the relative importance and reliability of CV vs. all-cause mortality. Overall, findings from ISCHEMIA and ISCHEMIA-EXTEND trials might help physicians in shared decision-making as to whether to add invasive management to guideline-directed medical management in selected patients with chronic coronary artery disease and moderate or severe ischaemia.
Impact of the exposome on cardiovascular disease
Authors: Bonanni Alice , Basile Mattia , Montone Rocco Antonio , Crea Filippo 
Published: April 2023

Abstract
Air pollution, noise pollution, and light pollution have emerged as important but often overlooked risk factors for cardiovascular disease. In this review, we examine the emerging concept of the exposome, highlighting the close relationship between environmental exposure (e.g. PM2.5, traffic noise, and night light) and cardiovascular disease, finally addressing the possible mitigation strategies that should be implemented to reduce the impact of air, noise, and light pollution on cardiovascular morbidity and mortality.
The new in anticoagulation: factor XI inhibitors
Authors: Muscente Francesca , De Caterina Raffaele 
Published: April 2023

Abstract
Haemostasis and thrombosis are closely linked, so that any anticoagulant strategy available today that reduces the thrombotic risk inevitably increases the bleeding risk. However, epidemiological and experimental evidence suggests that inhibiting the contact pathway—the first phase of the intrinsic coagulation pathway—and especially factor XI (FXI) achieves the objective of preventing thrombosis with minimal interference on the haemostatic process. Several pharmacological strategies that act by inhibiting FXI are being studied in clinical trials. Specifically, Phase 2 clinical trials in patients undergoing major orthopaedic surgery, end-stage renal disease, atrial fibrillation (AF), and acute coronary syndrome have shown promising results, allowing clinical research to advance into Phase 3 clinical trials. FXI inhibitors will not necessarily replace currently available direct oral anticoagulants: this would appear too ambitious as of today. However, it is possible to hypothesize that FXI inhibitors are a useful addition to our therapeutic armamentarium in contexts where current anticoagulants have failed or have not been adequately tested, as well as in categories of patients who are at a high risk of bleeding even with current direct oral anticoagulants.
The metaverse in medicine
Authors: Massetti Massimo , Chiariello Giovanni Alfonso 
Published: April 2023

Abstract
The metaverse is an alternative digital world, accessed by means of dedicated audiovisual devices. In this parallel world, various forms of artificial intelligence meet, including individuals in the form of digital copies of real people (avatars), able to interact socially. Metaverse in medicine may be used in many different ways. The possibility to perform surgery at a distance of thousands of miles separating the patient from the surgeon, who could have also the possibility to visualize in real-time patient’s clinical data, including diagnostic images, obviously is very appealing. It would be also possible to perform medical treatments and to adopt pharmacological protocols on human avatars clinically similar to the patients, thus observing treatment effects in advance and significantly reducing the clinical trials duration. Metaverse may reveal an exceptional educational tool, offering the possibility of interactive digital lessons, allowing to dissect and to study an anatomical apparatus in detail, to navigate within it, not only to study, but also to see the evolution of the pathological process, and to simulate in advance surgical or medical procedures on virtual patients. However, while artificial intelligence is now an established reality in the clinical practice, the metaverse is still in its initial stages, and to figure out its potential usefulness and reliability, further developments are expected.
Acute coronary syndromes: hospital management of dyslipidaemia with proprotein convertase subtilisin/kexin 9 inhibitors: time to act
Authors: Musumeci Giuseppe , Annibali Gianmarco , Delnevo Fabrizio 
Published: April 2023

Abstract
Atherosclerotic cardiovascular disease (ASCVD) in its countless clinical presentations is, in industrialized countries, the most frequent cause of death and, in recent years, a leading role in the prevention of ASCVD has been attributed to the treatment of dyslipidaemias. If statins and ezetimibe remain the cornerstone of pharmacological treatment, an increasingly relevant role is attributed to the inhibitors of the proprotein convertase subtilisin/kexin 9 (PCSK9i), as a result of the excellent results obtained in their respective trials, not only on the reduction of low-density lipoprotein (LDL) or LDL cholesterol (LDL-C) but also on plaque stabilization and regression. The addition of PCSK9 inhibitors leads to a further reduction in LDL levels and a consequent improvement in prognosis and it is recommended in ‘fast-track’ administration (intrahospital/discharge) in patients with acute coronary syndromes (ACSs) or multiple cardiovascular events already on statin therapy and LDL &gt;70 mg/dL and in statin-naïve ACS patients and LDL &gt;140 mg/dL. By applying guidelines and fast-track, ∼25% of patients with ACS should receive PCSK9i at discharge but unfortunately patients are currently undertreated.
Takotsubo syndrome: more frequent in women, more dangerous in men
Authors: Natale Enrico , Mistrulli Raffaella 
Published: April 2023

Abstract
Takotsubo syndrome (TTS) is an acute myocardial disease characterized by reversible left ventricular dysfunction, in the absence of obstructive coronary artery disease, caused by adrenergic overactivity and associated with non-negligible morbidity and mortality. Takotsubo syndrome, by far more frequent in women, who account for 9 out of 10 cases, is generally triggered by intense psychoemotional stress. In men, TTS has different, though not yet fully defined, characteristics and clinical course. In fact, men have a higher prevalence of a physical trigger and comorbidities, such as bronchopulmonary or cerebral pathologies, diabetes mellitus, and malignant neoplasms. The hospital course is burdened by a higher rate of cardiogenic shock and mortality. The long-term prognosis is also less favourable in men. Takotsubo syndrome in men characterizes a higher-risk phenotype, which requires close monitoring during hospitalization and careful surveillance during follow-up.
Dilemmas in cardiology: when to recanalize a chronic total occlusion
Authors: Stazi Filippo 
Published: April 2023

Abstract
The decision whether or not to recanalize a chronic total occlusion (CTO) of a coronary artery is truly a dilemma for the cardiologist. The procedure is in fact complex, with a non-negligible rate of complications and with a probability of success lower than that of non-obstructive lesions. The analysis of the data available in the literature, with the significant discrepancy between the results of the randomized studies and the observational studies, does not currently allow conclusive statements on the role of the percutaneous coronary interventions in CTO. It is therefore essential to incorporate clinical, anatomical and procedural elements into the decision-making algorithm. While awaiting new randomized clinical trials of greater dimensions and better methodology, a careful selection of patients is certainly essential, limiting the procedure to those who are symptomatic or who have a high ischaemic burden and excluding those who have no evidence of vitality, without which it is not legitimate to expect any benefit from the intervention. Finally, the presence of the collateral circulation does not in itself appear to be an element that should have a significant decision-making role.
Dietary intake and cardiovascular outcomes in patients with chronic vascular disease: insights from the COMPASS trial cohort
Authors: Wan Darryl , Dehghan Mahshid , de Souza Russell J , Ramasundarahettige Chinthanie , Eikelboom John W , Bosch Jackie , Maggioni Aldo P , Bhatt Deepak L , Yusuf Salim , Anand Sonia S 
Published: April 2023

Abstract

Aims
Patients with coronary artery disease (CAD) and patients with peripheral artery disease (PAD) are at risk for major adverse cardiovascular events (MACE) and major adverse limb events (MALE). There are limited data regarding dietary patterns and the risk of recurrent MACE and MALE in CAD and PAD patients. We aimed to identify dietary patterns associated with MACE and MALE in patients with CAD and/or PAD.

Methods and results
We analysed data collected from patients enrolled into the Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) trial, in which diet was assessed by a short food frequency questionnaire (FFQ) at baseline. Two dietary pattern scores, the modified Alternate Healthy Eating Index (mAHEI) and Mediterranean Diet Score (mMDS), were calculated. We tested the association between mAHEI and mMDS and the incidence of MACE and/or MALE. The mean mAHEI score was 23.0 ± 7.7 (out of 70) overall and was similar comparing CAD and PAD patients. The incidence of MACE or MALE was 6.3% in the lowest diet quality quartile (as assessed by mAHEI) compared with 4.2% in the highest quartile over 30 months. In the fully adjusted model, the hazard ratio of a low diet quality (Quartile 1) compared with the highest (Quartile 4) for MACE or MALE was 1.27 (95% CI: 1.08–1.49; P = 0.004, Q1 vs. Q4). This excess hazard was primarily driven by higher MACE in both the CAD and PAD cohorts.

Conclusions
Poor diet quality as assessed by the mAHEI is independently associated with a higher risk of recurrent MACE and MALE in patients with chronic CAD and/or PAD.
The role of recognition error in the stability of green-beard genes
Authors: Choi Jibeom , Lee Seoeun , Kim Hyun , Park Junpyo 
Published: April 2023

Abstract
The empirical examples of the green-beard genes, once a conundrum of evolutionary biology, are accumulating, while theoretical analyses of this topic are occasional compared to those concerning (narrow-sense) kin selection. In particular, the recognition error of the green-beard effect that the cooperator fails to accurately recognize the other cooperators or defectors is readily found in numerous green-beard genes. To our knowledge, however, no model up to date has taken that effect into account. In this article, we investigated the effect of recognition error on the fitness of the green-beard gene. By employing theories of evolutionary games, our mathematical model predicts that the fitness of the green-beard gene is frequency dependent (frequency of the green-beard gene), which was corroborated by experiments performed with yeast FLO1. The experiment also shows that the cells with the green-beard gene (FLO1) are sturdier under severe stress. We conclude that the low recognition error among the cooperators, the higher reward of cooperation, and the higher cost of defection confer an advantage to the green-beard gene under certain conditions, confirmed by numerical simulation as well. Interestingly, we expect that the recognition error to the defectors may promote the cooperator fitness if the cooperator frequency is low and mutual defection is detrimental. Our ternary approach of mathematical analysis, experiments, and simulation lays the groundwork of the standard model for the green-beard gene that can be generalized to other species.
A novel intelligent chromo capsule endoscope for the diagnosis of neoplastic lesions in the gastrointestinal tract
Authors: Shi Huiying , Pang Suya , Ming Fanhua , Yangdai Tianyi , Tian Shuxin , Lin Rong 
Published: April 2023

AbstractBackgroundChromoendoscopy has not been fully integrated into capsule endoscopy. This study aimded to develop and validate a novel intelligent chromo capsule endoscope (ICCE).MethodsThe ICCE has two modes: a white-light imaging (WLI) mode and an intelligent chromo imaging (ICI) mode. The performance of the ICCE in observing colors, animal tissues, and early gastrointestinal (GI) neoplastic lesions in humans was evaluated. Images captured by the ICCE were analysed using variance of Laplacian (VoL) values or image contrast evaluation.ResultsFor color observation, conventional narrow-band imaging endoscopes and the ICI mode of the ICCE have similar spectral distributions. Compared with the WLI mode, the ICI mode had significantly higher VoL values for animal tissues (2.154 ± 1.044 vs 3.800 ± 1.491, P = 0.003), gastric precancerous lesions and early gastric cancers (2.242 ± 0.162 vs 6.642 ± 0.919, P &lt; 0.001), and colon tumors (3.896 ± 1.430 vs 11.882 ± 7.663, P &lt; 0.001), and significantly higher contrast for differentiating tumor and non-tumor areas (0.069 ± 0.046 vs 0.144 ± 0.076, P = 0.005). More importantly, the sensitivity, specificity, and accuracy of the ICI mode for early GI tumors were 95.83%, 91.67%, and 94.64%, respectively, which were significantly higher than the values of the WLI mode (78.33% [P &lt; 0.001], 77.08% [P = 0.01], and 77.98% [P &lt; 0.001], respectively).ConclusionsWe successfully integrated ICI into the capsule endoscope. The ICCE is an innovative and useful tool for differential diagnosis based on contrast-enhanced images and thus has great potential as a superior diagnostic tool for early GI tumor detection.
Palaeosecular variation in Northern Patagonia recorded by 0–5 Ma Caviahue–Copahue lava flows
Authors: Moncinhatto Thiago R , de Oliveira Wellington P , Haag Mauricio B , Hartmann Gelvam A , Savian Jairo F , Poletti Wilbor , Brandt Daniele , Sommer Carlos A , Caselli Alberto T , Trindade Ricardo I F 
Published: April 2023

SUMMARY
Palaeosecular variation (PSV) determinations and studies of the geometry of the Earth’s main magnetic field provide important information about the field evolution, and to constrain numerical geodynamo models. Palaeomagnetic directional data from lava flows over the last few million years is of particular interest because the regional and global tectonic effects are minimal. However, the distribution of this type of palaeomagnetic data is uneven where the Southern Hemisphere is the destitute side. Therefore, the better knowledge of the geomagnetic field behaviour depends on the increased availability of high-quality data, especially in the Southern Hemisphere. A PSV and the time-averaged field (TAF) study was then performed in 0–5 Ma lava flows from the Caviahue–Copahue Volcanic Complex located in Northern Patagonia, Argentina (37°0′S, 71°10′W). The magnetic mineralogy of lava flows was investigated through thermomagnetic susceptibility curves, isothermal remanent magnetization (IRM) acquisition curves, hysteresis loops and first-order reversal curves (FORCs). Samples are essentially comprised of titanomagnetite with different Ti contents and magnetic domain structures typical of vortex state particles. A total of 50 volcanic sites were sampled, which provided 42 reliable palaeomagnetic site-mean directions after alternating field and thermal demagnetization. From these 42 sites, 36 are of normal and 6 are of reversed polarity. The mean direction from normal (reversed) sites is D = 356.2°, I = −50.1°, α95 = 4.0° and N = 36 (D = 176.5°, I = 59.5°, α95 = 14.1° and N = 6). Using only site-level data with the precision parameter k ≥ 100, we obtain 26 palaeomagnetic sites for PSV and TAF investigations in the study region. The filtered data set has a mean direction (D = 354.4°, I = −53.2° and α95 = 5.1°) close to the expected direction for a geocentric axial dipole (GAD) field (IGAD = −57.3°). The palaeopole (Plat = 84.4°, Plon = 229.1° and A95 = 5.7°) coincides with the Earth’s spin axis within the 95 per cent confidence interval. Virtual geomagnetic pole scatter ($S_{B} = {15.8^{18.9}_{11.8}}^{\circ }$) and the inclination anomaly ($\Delta I = 4.1_{-1.0}^{{9.2}^{\circ }}$) are both consistent at the 95 per cent confidence level with recent PSV and TAF models, respectively. Our results support the presence of small non-dipole field contributions (&lt;3 per cent) superimposed on the GAD term, as reported by South American studies at mid southern latitudes.
Propagation of a vector wavelet through von Kármán-type random elastic media: Monte Carlo simulation by using the spectrum division method
Authors: Sato Haruo , Emoto Kentaro 
Published: April 2023

SUMMARYFor the study of the random velocity fluctuation of the solid Earth medium, it is useful to measure the collapse of a seismic wavelet with increasing travel distance and the excitation of coda waves. Radiative transfer theory (RTT) is a powerful tool for synthesizing the propagation of a seismic wavelet in random media statistically characterized by the power spectral density function (PSDF) of the fractional velocity fluctuation. The Born scattering coefficient is a key building block of RTT. As the centre wavenumber of a wavelet increases, the phase shift across the correlation length increases and the Born approximation leads to an extremely large forward scattering exceeding the applicable range of the perturbation method. In such a case, the Eikonal approximation is able to explain the envelope broadening with increasing travel distance; however, it can not explain the coda excitation. To overcome the difficulty, we have proposed a hybrid Monte Carlo (MC) simulation for scalar waves. In the case of von Kármán-type random media, when the centre wavenumber is higher than the corner wavenumber, taking the centre wavenumber as a reference, we divide the PSDF into two spectral components. Applying the Born and Eikonal approximations to the high- and low-wavenumber spectral components, we statistically evaluate the wide-angle scattering and the narrow-angle ray bending, respectively. The proposed MC simulation serially using two kinds of scattering processes successfully synthesizes the time trace of the wave energy density from the onset to the late coda. The travel-distance fluctuation derived from the one-way propagation of the Eikonal approximation is also important. This paper extends this method for the propagation of a vector wavelet in random elastic media. We suppose that random fractional fluctuations of the P- and S-wave velocities and the mass density are linearly proportional to each other, which maintains the linear polarization of an Swave throughout the scattering process. Using the hybrid MC simulation with the spectrum division, we synthesize three-component energy density time traces for the anisotropic radiation from a moment tensor source, from which we derive three-component root mean square (RMS) velocity amplitude time traces at different azimuths. In parallel, we synthesize the propagation of a vector wavelet in many realized random elastic media by the finite-difference simulation, then we calculate three-component RMS velocity amplitude time traces. Using them as a benchmark, we confirm the validity of the proposed MC simulation for specific cases.
Novel inhibitory effect of galectin-3 on the respiratory burst induced by Staphylococcus aureus in human neutrophils
Authors: Venkatakrishnan Vignesh , Elmwall Jonas , Lahiri Trisha , Sundqvist Martina , Bergqvist Linda , Leffler Hakon , Nilsson Ulf J , Welin Amanda , Bylund Johan , Karlsson-Bengtsson Anna 
Published: April 2023

Abstract
Among the responders to microbial invasion, neutrophils represent the earliest and perhaps the most important immune cells that contribute to host defense with the primary role to kill invading microbes using a plethora of stored anti-microbial molecules. One such process is the production of reactive oxygen species (ROS) by the neutrophil enzyme complex NADPH-oxidase, which can be assembled and active either extracellularly or intracellularly in phagosomes (during phagocytosis) and/or granules (in the absence of phagocytosis). One soluble factor modulating the interplay between immune cells and microbes is galectin-3 (gal-3), a carbohydrate-binding protein that regulates a wide variety of neutrophil functions. Gal-3 has been shown to potentiate neutrophil interaction with bacteria, including Staphylococcus aureus, and is also a potent activator of the neutrophil respiratory burst, inducing large amounts of granule-localized ROS in primed cells. Herein, the role of gal-3 in regulating S. aureus phagocytosis and S. aureus-induced intracellular ROS was analyzed by imaging flow cytometry and luminol-based chemiluminescence, respectively. Although gal-3 did not interfere with S. aureus phagocytosis per se, it potently inhibited phagocytosis-induced intracellular ROS production. Using the gal-3 inhibitor GB0139 (TD139) and carbohydrate recognition domain of gal-3 (gal-3C), we found that the gal-3-induced inhibitory effect on ROS production was dependent on the carbohydrate recognition domain of the lectin. In summary, this is the first report of an inhibitory role of gal-3 in regulating phagocytosis-induced ROS production.