bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness and feasibility of cardiovascular disease personalized prevention on high polygenic risk score subjects: a randomized controlled pilot study
Authors: Viigimaa Margus , Jürisson Mikk , Pisarev Heti , Kalda Ruth , Alavere Helene , Irs Alar , Saar Aet , Fischer Krista , Läll Kristi , Kruuv-Käo Krista , Mars Nina , Widen Elisabeth , Ripatti Samuli , Metspalu Andres 
Published: December 2022

Abstract

Aims
The aim of this study was to evaluate the effect of the intervention by proactively sharing a patient’s high polygenic risk score (PRS) for coronary artery disease (CAD). Outcomes included: (i) reduction in cardiovascular disease (CVD) risk factors over 12 months; (ii) difference in purchased prescriptions of lipid-lowering and anti-hypertensive drugs between intervention group and control group subjects; and (iii) opinion of the participating physicians and subjects on PRS usefulness.

Methods and results
This randomized controlled trial was conducted among middle-aged subjects with a top 20% CAD PRS in a family medicine setting. Participants were selected from 26 953 Estonian Biobank cohort participants. Subjects were informed and counselled about their PRS score and CAD risk using the visual tool at baseline (Visit I), counselling session (Visit II), and on the final Visit III at 12 months. The primary endpoint was not significantly different. However, the intervention group participants had a significantly higher probability of initiating statin treatment compared with the controls. Their levels of LDL-cholesterol (LDL-C) were significantly decreased compared with baseline on Visit III and significantly lower than in the control group. The vast majority of participating family physicians believe that finding out about genetic risks will affect the subject’s lifestyle and medication compliance.

Conclusion
Most of our outcome measures were in favour of this intervention. Participants achieved larger changes in cholesterol and blood pressure values. The vast majority (98.4%) of family physicians are interested in continuing to use genetic risk assessment in practice.
66 MYOCARDIAL EDEMA CONTRIBUTES TO INTERSTITIAL EXPANSION AND ASSOCIATES WITH MECHANICAL AND ELECTROCARDIOGRAPHIC CHANGES IN TAKOTSUBO SYNDROME: A CMR T1 AND T2 MAPPING STUDY
Authors: Arcari Luca , Camastra Giovanni , Ciolina Federica , Limite Luca Rosario , Danti Massimiliano , Ansalone Gerardo , Musumeci Beatrice , Sclafani Matteo , Sbarbati Stefano , Cacciotti Luca 
Published: December 2022

Abstract

Background
myocardial edema has a central role in takotsubo syndrome (TTS). Relationships between edema, mechanical and electrical abnormalities in TTS are still elusive.

Methods
n=32 hospitalized TTS patients and n=23 controls were analyzed. We performed cardiac magnetic resonance (CMR) with tissue mapping for the assessment of edema and interstitial expansion, global longitudinal (GLS) and circumferential strain (GCS) were evaluated by CMR feature-tracking. Twelve-lead ECGs were recorded at the time of CMR in TTS patients, aVR voltage, negative T-wave voltage and QTc length were calculated.

Results
mean age of the TTS cohort was 72±12-year-old, 94% women, undergoing CMR at a median of 4 days (interquartile range 2, 6) after hospital admission. Compared with controls, patients had increased LV mass (55±11 g/m2 vs 46±8 g/m2, p&lt;0.001), worse left ventricular ejection fraction (LVEF), GLS and GCS (all p&lt;0.001), higher septal native T1 (1116±73 msec vs 970±23 msec, p&lt;0.001), T2 (56±5 msec vs 46±2 msec, p&lt;0.001) and extra-cellular volume (ECV) fraction (32±5% vs 24±1%, p&lt;0.001). TTS patients had higher apicobasal gradient of T2 values (12±6 msec vs 2±6 msec, p&lt;0.001), basal LV wall displayed higher native T1, T2 and ECV (all p&lt;0.002) but similar circumferential strain against controls (-23±3% vs -24±4%, p=0.351). In the TTS cohort, septal T2 value showed significant correlations with native T1 (r=0.609, p&lt;0.001), ECV (r=0.689, p&lt;0.001), LVEF (r=-0.459, p=0.008) and aVR voltage (r=-0.437, p&lt;0.05). Negative T waves voltage and QTc length significantly correlated with apicobasal T2 mapping gradient (r=0.499, p=0.007 and r=0.372, p=0.047 respectively) but not with other tissue mapping measurements.

Conclusions
CMR T1 and T2 mapping demonstrated increased myocardial water content conditioning interstitial expansion in acute TTS. Myocardial edema was detected even outside areas of abnormal wall motion, its burden and distribution associated with mechanical and electrocardiographic changes, making it a potential prognostic marker and therapeutic target in TTS.
839 DAPAGLIFOZIN AND INTIMA-MEDIA TICKNESS IN TYPE II DIABETIC PATIENTS
Authors: Lamaida Norman , Cerciello Antonio 
Published: December 2022

Abstract

Background
Carotid Doppler ultrasonography (USG) is widely used to measure haemodynamic parameters, such as Intima–Media Thickness (IMT) and blood flow velocities (i.e. Peak–Systolic Velocity [PSV], End–Diastolic Velocity [EDV], and Resistive Index [RI]). Dapaglifozin (SGLT2i) have been shown to reduce the risk of cardiovascular disease in type 2 diabetes (T2DM) patients. SGLT2i is a sodium–glucose co–transporter 2 inhibitor that reduces renal glucose reabsorption, thus increasing urinary glucose excretion. This leads to sustained systolic and diastolic blood pressure reduction, through natriuresis. We hypothesized that this agent would also reduce arterial stiffness. AIM: The purpose of this study was to evaluate cardiovascular disease risk indirectly through USG of carotid artery vascular markers in T2DM patients using dapagliflozin.

Methods and Results
40 patients presenting to our clinic between march 2019 and march 2021 and diagnosed with T2DM were included in the study. These were divided into two groups : 1) a dapagliflozin group of 20 patients and 2) 20 patients non–dapagliflozin control group. Velocity parameters were: peak–systolic velocity (PSV), end–diastolic velocity (EDV), pulsatility index (PI), resistive index (RI). Examination was performed on distal portion of CCA, and we took the mean of both CCA. The mean duration of follow–up was 2.0 years. Mean ages were 55 ± 10 years in the dapagliflozin group and 50 ± 10 in the control group. Common carotid artery, PSV, and EDV parameters were higher while RI was lower (p &lt; 0.01), in the dapagliflozin group than in the control group. Vascular resistance was lower in the group using dapagliflozin for diabetes management. In addition In the dapagliflozin group, the IMT decreased after dapagliflozin therapy (P &lt; 0.01).

Conclusions
haemodynamic parameters were better performing in the group using dapagliflozin for diabetes management. Finally SGLT2i can decrease the IMT in patients with T2DM, which is closely related to cardiovascular benefit in patients with T2DM.
3 SAFETY OF NOVEL ORAL ANTICOAGULANTS COMPARED TO VITAMIN K ANTAGONISTS IN THE TREATMENT OF VENOUS THROMBOEMBOLISM: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Ridolfi Lorenzo , Masini Gabriele , Castiglione Vincenzo , Gentile Francesco , Favilli Marco , Mazzola Matteo , Lepone Attilio , Scalera Silvia Teresa , Italiano Andrea , Negro Francesco , Guarini Giacinta , Ricci Fabrizio , Renda Giulia , De Caterina Raffaele , Morrone Doralisa 
Published: December 2022

Abstract

Background
Individual randomized controlled trials (RCTs) enrolling patients with venous thromboembolism (VTE) have demonstrated that novel oral anticoagulants (NOACs) are comparable to vitamin K antagonists (VKAs) in reducing the risk of recurrent VTE but hold a safer bleeding profile. Nonetheless, pooled data from RCTs on the safety of NOACs versus VKAs in patients with VTE are still scarce.

Purpose
We aimed to compare the effect of NOACs versus VKA on the risk of fatal bleeding, major bleeding, clinically relevant non-major bleeding (CRNMB) and any bleeding in patients with VTE through a meta-analysis of RCTs.

Methods
We performed a systematic review of the literature, from January 1970 to December 2021, using PubMed database with four independent reviewers (L.R.; G.M.; V.C.; F.G.). Discrepancies were solved by consensus with a senior researcher (D.M.). Phase 3 randomized controlled trials comparing NOACs versus VKAs, either as an acute treatment or as an extended therapy, in patients with pulmonary embolism or deep vein thrombosis were selected. We performed a meta-analysis using a random-effects model with the Mantel–Haenszel method for each safety endpoint. Study outcomes were expressed as odd ratios (OR) with 95% confidence interval (CI) and illustrated in a Forest plot diagram. A two-sided p-value &lt;0.05 was considered statistically significant. Heterogeneity was tested using the I2-statistic.

Results
Seven trials were included (n=29,879 patients), either investigating the direct thrombin inhibitor dabigatran (RE-COVER, RE-COVER II and RESONATE trials) or the factor Xa inhibitors rivaroxaban (EINSTEIN-DVT and EINSTEIN-PE studies), apixaban (AMPLIFY study) and edoxaban (Hokusai-VTE study). Compared to VKAs, treatment with NOACs was associated with lower risk of fatal bleeding (OR 0.35; 95% CI 0.16-0.81), major bleeding (OR 0.60; 95% CI 0.45-0.80), and any bleeding (OR 0.62; 95% CI 0.54-0.72) - fig. 1. There was no significant difference between the two groups concerning the risk of CRNMB.

Conclusions
In patients with VTE, treatment with NOACs was associated with fewer bleeding complications compared with VKAs.
Lipomatous metaplasia prolongs repolarization and increases repolarization dispersion within post-infarct ventricular tachycardia circuit cites
Authors: Xu Lingyu , Zahid Sohail , Khoshknab Mirmilad , Moss Juwann , Berger Ronald D , Chrispin Jonathan , Callans David , Marchlinski Francis E , Zimmerman Stefan L , Han Yuchi , Desjardins Benoit , Trayanova Natalia , Nazarian Saman 
Published: December 2022

AbstractAimsPost-infarct myocardium contains viable corridors traversing scar or lipomatous metaplasia (LM). Ventricular tachycardia (VT) circuitry has been separately reported to associate with corridors that traverse LM and with repolarization heterogeneity. We examined the association of corridor activation recovery interval (ARI) and ARI dispersion with surrounding tissue type.Methods and resultsThe cohort included 33 post-infarct patients from the prospective Intra-Myocardial Fat Deposition and Ventricular Tachycardia in Cardiomyopathy (INFINITY) study. We co-registered scar and corridors from late gadolinium enhanced magnetic resonance, and LM from computed tomography with intracardiac electrogram locations. Activation recovery interval was calculated during sinus or ventricular pacing, as the time interval from the minimum derivative within the QRS to the maximum derivative within the T-wave on unipolar electrograms. Regional ARI dispersion was defined as the standard deviation (SD) of ARI per AHA segment (ARISD). Lipomatous metaplasia exhibited higher ARI than scar [325 (interquartile range 270–392) vs. 313 (255–374), P &lt; 0.001]. Corridors critical to VT re-entry were more likely to traverse through or near LM and displayed prolonged ARI compared with non-critical corridors [355 (319–397) vs. 302 (279–333) ms, P &lt; 0.001]. ARISD was more closely associated with LM than with scar (likelihood ratio χ2 50 vs. 12, and 4.2-unit vs. 0.9-unit increase in 0.01*Log(ARISD) per 1 cm2 increase per AHA segment). Additionally, LM and scar exhibited interaction (P &lt; 0.001) in their association with ARISD.ConclusionLipomatous metaplasia is closely associated with prolonged local action potential duration of corridors and ARI dispersion, which may facilitate the propensity of VT circuit re-entry.
Mixed origin of juvenile Atlantic cod (Gadus morhua) along the Swedish west coast
Authors: Henriksson Simon , Pereyra Ricardo T , Sodeland Marte , Ortega-Martinez Olga , Knutsen Halvor , Wennhage Håkan , André Carl 
Published: December 2022

Abstract
Cryptic population structure in exploited fishes poses a major challenge for fisheries management. In Atlantic cod, sympatric ecotypes are well-known, for instance off the coast of northern Norway. Recently, two sympatric cod ecotypes have also been documented in the Skagerrak and Kattegat, where adult cod has declined dramatically. One ecotype has an apparent offshore origin and displays a more migratory lifestyle than the other, which is generally resident at the coast throughout its life. To investigate their relative abundances along the Swedish west coast, juvenile cod were collected at high spatial resolution along the coast and genetically assigned to ecotypes. The results reveal large proportions of the coastal ecotype in the southern Kattegat, Öresund, and inshore Swedish Skagerrak, whereas the offshore ecotype dominates in offshore areas. A regression model comparison suggests that differences in bottom depth, rather than distance from the open sea, explain the heterogeneous spatial distribution of the two ecotypes. In addition, the two ecotypes display genetic differences suggesting adaptation to different environments. The results underline that successful fisheries management requires identification and consideration of locally adapted sympatric ecotypes.
Recognizing the Diverse Faces of Later Life: Old Age as a Category of Intersectional Analysis in Medical Ethics
Authors: Weßel Merle , Schweda Mark 
Published: December 2022

AbstractPublic and academic medical ethics debates surrounding justice and age discrimination often proceed from a problematic understanding of old age that ignores the diversity of older people. This article introduces the feminist perspective of intersectionality to medical ethical debates on aging and old age in order to analyze the structural discrimination of older people in medicine and health care. While current intersectional approaches in this field focus on race, gender, and sexuality, we thus set out to introduce aging and old age as an additional category that is becoming more relevant in the context of longer life expectancies and increasing population aging. We analyze three exemplary cases on the individual, institutional, and public health level, and argue that considering the intersections of old age with other social categories helps to accommodate the diverse identities of older people and detect inequality and structural discrimination.
Neuropathologic findings in a young woman 4 years following declaration of brain death: case analysis and literature review
Authors: Folkerth Rebecca D , Crary John F , Shewmon D Alan 
Published: December 2022

Abstract
Brain death (death by neurologic criteria) is declared in 2% of all in-hospital deaths in the United States. Published neuropathology studies of individuals maintained on cardiorespiratory support are generally decades old, and notably include only 3 cases with long intervals between brain and “somatic” death (68 days, 101 days, 20 years). Here, we share our observations in a young woman supported for nearly 4½ years following declaration of brain death after oropharyngeal surgery. While limited by tissue availability and condition, we found evidence of at least partial perfusion of the superficial cerebral and cerebellar cortices by external carotid and vertebral arteries (via meningeal and posterior pharyngeal branches), characterized by focal cellular reaction and organization. Dural venous sinuses had thrombosis and recanalization, as well as iron deposition. In nonperfused brain areas, tissue “mummification,” akin to that seen in certain postmortem conditions, including macerated stillbirths and saponification (adipocere formation), was identified, and are reviewed herein. Unfortunately, correlation with years-earlier clinical and radiographic observations was not possible. Nevertheless, we feel that our careful neuropathologic inspection of this case expands the understanding of the spectrum of human brain tissue alterations possible in a very rarely seen set of conditions.
X-shooter survey of young intermediate-mass stars – I. Stellar characterization and disc evolution
Authors: Iglesias Daniela P , Panić Olja , van den Ancker Mario , Petr-Gotzens Monika G , Siess Lionel , Vioque Miguel , Pascucci Ilaria , Oudmaijer René , Miley James 
Published: December 2022

ABSTRACT
Intermediate-mass stars (IMSs) represent the link between low-mass and high-mass stars, and cover a key mass range for giant planet formation. In this paper, we present a spectroscopic survey of 241 young IMS candidates with IR-excess, the most complete unbiased sample to date within 300 pc. We combined VLT/X-Shooter spectra with BVR photometric observations and Gaia DR3 distances to estimate fundamental stellar parameters such as Teff, mass, radius, age, and luminosity. We further selected those stars within the intermediate-mass range 1.5 ≤ M⋆/M⊙ ≤ 3.5, and discarded old contaminants. We used 2MASS and WISE photometry to study the IR-excesses of the sample, finding 92 previously unidentified stars with IR-excess. We classified this sample into ‘protoplanetary’, ‘hybrid candidates’, and ‘debris’ discs based on their observed fractional excess at 12 $\mu$m, finding a new population of 17 hybrid disc candidates. We studied inner disc dispersal time-scales for $\lambda &lt; 10 \,\mu$m and found very different trends for IMSs and low-mass stars (LMSs). IMSs show excesses dropping fast during the first 6 Myr independently of the wavelength, while LMSs show consistently lower fractions of excess at the shortest wavelengths, and increasingly higher fractions for longer wavelengths with slower dispersal rates. In conclusion, this study demonstrates empirically that IMSs dissipate their inner discs very differently than LMSs, providing a possible explanation for the lack of short period planets around IMSs.
New stellar velocity substructures from Gaia DR3 proper motions
Authors: Mikkola Daniel , McMillan Paul J , Hobbs David 
Published: December 2022

ABSTRACT
Local stellar motions are expected, and have been shown, to include signatures of the Galaxy’s past dynamical evolution. These are typically divided into the disc, which shows the dynamical effects of spiral arms and the bar, and the stellar halo, with structures thought to be debris from past mergers. We use Gaia Data Release 3 to select large samples of these populations without limiting them to sources with radial velocities. We apply a penalized maximum likelihood method to these samples to determine the full 3D velocity distribution in Cartesian (U, V, and W) or spherical (vr, vϕ, and vθ) coordinates. We find that the disc population is dominated by four moving groups and also detect a new moving group at (U, V) = (−10, −15) km s−1 which we call MMH-0. For the stellar halo, we isolate the accreted component with cuts in transverse velocity and the colour–magnitude diagram. In this component, we find several known structures believed to be caused by past mergers, particularly one around (vr, vϕ, vθ) = (−150, −300, and −100) km s−1 appears more prominent than previously claimed. Furthermore, we also identify two new structures near (vr, vϕ, and vθ) = (225, 25, and 325) km s−1 and (0, 150, and −125) km s−1, which we refer to as MMH-1 and MMH-2, respectively. These results give new insights into local stellar motions and shows the potential of using samples that are not limited to stars with measured line-of-sight velocities, which is key to providing large samples of stars, necessary for future studies.
Detailed analysis of the variable star population in the globular cluster NGC 7006
Authors: Arellano Ferro A , Rojas Galindo F C , Bustos Fierro I H , Muneer S , Yepez M A , Giridhar Sunetra 
Published: December 2022

ABSTRACT
A 5-yr CCD photometric VI time series of NGC 7006 is employed to perform a detailed analysis of the known population of variable stars. In the process, we have corrected inconsistent classifications, sky coordinates and found 10 new cluster member variables. An independent reddening estimate with a value E(B−V) = 0.08 ± 0.05 is made. Using Fourier decompositions of RR Lyrae light curves and well-established calibrations, the cluster mean metallicity and distance [Fe/H]ZW = −1.53 ± 0.15 and 41.2 ± 1.4 kpc are estimated based on an extended sample of cluster member RRab stars. Using the Gaia DR3 data, we performed an extensive membership analysis that leads to a clean colour–magnitude diagram, and hence to the identification of variables that are likely field stars, and to considerations on the variable distribution in the horizontal branch (HB). A double-mode RR Lyrae and three CW stars are discussed. The origin of CW stars from precursors in the blue tail of the HB with very thin (∼0.06 ± 0.01 M⊙) envelopes is argued. Our models indicate that the main-sequence predecessor of RR Lyrae stars had a mass of 0.82–0.85 M⊙ and lost about 25–35 per cent of its mass during the red giant branch events before settling in the HB some 12–13.5 Gyr later.
869. Oral Encochleated Amphotericin B for Cryptococcal Meningitis: a Phase II Randomized Trial
Authors: Atukunda Mucunguzi , Kagimu Enock , Rutakingirwa Morris K , Tugume Lillian , Nsangi Laura , Musubire Abdu , Gakuru Jane , Mugabi Timothy , Akampurira Andrew , Ssebambulidde Kenneth , Kasibante John , Ellis Jayne , Mpoza Edward , Williams Darlisha A , Fieberg Ann M , Skipper Caleb , Abassi Mahsa , Hullsiek Kathy Huppler , Meya David , Boulware David R 
Published: December 2022

Abstract

Background
Intravenous (IV) amphotericin B is the gold standard treatment of severe mycoses. A new orally absorbed, less-toxic formulation of amphotericin has been developed (Matinas Biopharma). We evaluated the efficacy of this novel anti-fungal agent amongst adults with cryptococcal meningitis.

Methods
We conducted a phase II randomized clinical trial testing oral encochleated amphotericin B (cAMB) versus IV amphotericin B for first episode cryptococcal meningitis in Kampala, Uganda from December 2020 to August 2021. Participants were HIV-positive, CSF cryptococcal antigen (CrAg) positive, and had the capacity to consent and take oral medications (GCS=15). Participants in the experimental arm received two loading doses of either IV deoxycholate amphotericin B 1.0 mg/kg/day or liposomal amphotericin 3 mg/kg/day, followed by 1.8g oral cAMB daily in 6 divided doses through 2 weeks with flucytosine (5FC) at 100mg/kg/day, and thereafter cAMB at 1.2g daily in 4 divided doses through 6 weeks. Participants in the control arm received 7 days of IV amphotericin B (deoxycholate or liposomal) with 5FC, then 7 days of fluconazole 1200mg/day. After 14 days, all participants received fluconazole 800mg/day through 10 weeks and thereafter a maintenance dose of 200mg/day.

Results
We randomized 40 participants to oral cAMB + 5FC and 30 control participants to IV amphotericin + 5FC. With cAMB the 30-day survival was 97.5% (39/40) and 18-week survival was 90% (36/40) compared with 87% (26/30) 18-week survival in IV amphotericin controls.
The CSF Early Fungicidal Activity (EFA) was lower with oral cAMB (mean EFA = 0.42 log10Cryptococcus CFU/mL/day; 95%CI, 0.29 to 0.54) versus IV amphotericin (mean EFA = 0.52 log10 CFU/mL/day; 95%CI, 0.39 to 0.66). Among those CSF culture positive at baseline, CSF sterility was achieved by 2 weeks in 65% (24/37) of cAMB participants and 68% (17/25) of controls.
Grade &gt;=3 laboratory adverse events were more common with IV amphotericin. Grade 3–4 anaemia occurred in 10% (n=4) with cAMB versus 37% (n=11) with IV amphotericin. Grade 3 hypokalaemia (&lt; 3mEq/L) occurred in 5% (n=2) with cAMB versus 27% (n=8) with IV amphotericin.

Conclusion
Novel oral cAMB appears to be a safe agent with promising efficacy for HIV-related cryptococcal meningitis.

Disclosures
All Authors: No reported disclosures.