bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protective role of protein Klotho biomarker in acute heart failure
Authors: Plonka J , Olejnik A , Klus A , Gawrylak- Dryja E , Wezyk-Wylegala N , Rzepiela L , Dabrowska K , Bil-Lula I , Gierlotka M 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): This work was supported by a grant from the Institute of Medical Sciences, Univeristy of Opole, Poland

Background
Klotho is an antiaging protein with pleiotropic actions that exerts organ protection. There is evidence that Klotho protein acts as a human aging-suppression molecule and correlates with life span, coronary artery disease, atherosclerosis, and osteoporosis. In laboratory models of damage, an increased expression of Klotho protein in human cardiac myocytes and release of Klotho protein into the extracellular space suggests a potential compensatory and cardioprotective effect. The aim of the present study was to assess changes of Klotho protein levels during an episode of acute heart failure (AHF) as well as its long-term prognostic utility in population of AHF patients compared to other biomarkers.

Methods
We analysed 112 consecutive patients admitted to ICCU between June 2019 and January 2021 due to hight-risk AHF. Blood samples were collected on admission, at discharge as well as at the 30-day. Patients were then followed-up for all-cause mortality and rehospitalizations due to heart failure.

Results
Patients (N=112; median age 68 years, 75% men, median left ventricular ejection fraction 30% [IQR 20-38%]) had median admission levels of Klotho protein = 670 pg/ml [501-851], FGF-23 = 1278 pg/ml [283-4429], NT-proBNP = 5361 ng/l [3019-13182], and GDF-15 = 4582 pg/ml [3028-9081]. Klotho protein decreased by 19% from admission to discharge and then increased by 13% from discharge to 30-day (P&lt;0.001). During median 478 days follow-up 40 patients (36%) died or were hospitalised due to heart failure - they were older, more often with new onset AHF, of ischaemic aetiology and diabetics. Patients with lower levels of Klotho protein (in the 1st as well as in the 2nd quartile) had higher mortality (Figure). ROC analyses showed Klotho had comparable predictive value of unfavourable prognosis as other biomarkers (GDF-15, NT-proBNP).

Conclusion
The levels of Klotho protein in patients with AHF are higher compared to healthy population and they show dynamics dependent on the clinical state what indicates the utility of Klotho as a typical biomarker. Lower values of Klotho protein in AHF patients are associated with higher mortality which may suggests protective effect of higher Klotho levels.
Dual marker rule-out of non-AMI acute cardiovascular conditions in chest pain patients
Authors: Pedersen CK , Stengaard C , Boetker MT , Dodt KK , Soendergaard HM , Terkelsen CJ 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Danish Heart foundation
Independent Research Fund Denmark

Background
A dual marker strategy combining prehospital copeptin and in-hospital hs-cTnT has shown promising results in early rule out of AMI. This combination may also allow for rule out of other life-threatening conditions in patients presenting with chest pain. Copeptin is a nonspecific marker of endogenous stress and elevated levels would be expected in life-threatening conditions causing haemodynamic instability. Elevated troponin levels due to secondary acute myocardial injury is often seen in life-threatening conditions (e.g. pulmonary embolism and aortic dissection).

Purpose
To evaluate if an accelerated DMS combining prehospital copeptin and 1st in-hospital hs-cTnT can rule out other life threatening conditions than AMI in patients with symptoms suggestive of AMI.

Methods
The diagnostic performance of the accelerated DMS regarding serious cardiovascular conditions other than AMI was compared in patients with suspected AMI from a randomized, controlled, multicentre trial. Serious cardiovascular conditions included pulmonary embolism, pneumothorax, ventricular tachycardia, and aortic dissection. Diagnoses were retrieved from the Danish National Registry of Patients. Serious conditions were ruled out if copeptin was below 9.8 pmol/L (95th percentile) and troponin T was below 14 ng/L (99th percentile).

Results
In 3,426 with both prehospital copeptin and 1st in-hospital troponin T available, 39 patients received a diagnosis of one of the predefined serious cardiovascular condition during index admission. The accelerated DMS performed with a sensitivity of 82%, a specificity of 48% and a NPV of 99.5%.

Conclusion(s)
Accelerated DMS did not perform with acceptable sensitivity for the rule out of other life-threatening conditions in patients with suspected AMI.
Clinical value of troponin profiles in early post coronary artery bypass grafting acute care in advanced chronic kidney disease patients: An insight into perioperative patient characteristics
Authors: Gobolos L , Manla Y , Khan N , Bhatnagar G , Aljabery Y , Sanger S , Alsindi F , Hamour I , Attallah N , Hogan M 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background and Aims
Diagnosis of type V myocardial infarction (MI) in patients with advanced chronic kidney disease (CKD) undergoing coronary revascularisation surgery (CAB) presents a clinical challenge. We describe postoperative serum troponin (cTn) trends after CAB in CKD stages IV-V, and assess associations with gender, preoperative dialysis, clinical presentation and CAB method.

Methods
We analysed 51 patients with CKD stage IV-V who underwent CAB at a single centre between 2016-2021. Data on patient characteristics, CAB surgery, and cTn (T) levels were collected retrospectively, and independently for our Society of Thoracic Surgeons database. Patient characteristics were compared between patients undergoing on-pump vs off-pump CAB using appropriate testing methods. The differences in cTn trends between males vs females, acute coronary syndrome (ACS) vs stable angina, patients undergoing preoperative dialysis vs not, and on-pump vs off-pump CAB at different time points were assessed using repeated measurements, and a p value&lt;0.05 was considered to be statistically significant.

Results
Among 51 patients with stage IV (47%) and V (53%) CKD, off-pump CAB was conducted in 41% (21) of the patients, while the rest underwent on-pump CAB. Patients in the off-pump group were older (62.2 vs 56.6 years, p=0.03), and there were no other statistically significant differences in patient characteristics between groups (Table). Over time, cTn levels increased from 0.34 [0.08-0.9] ng/mL at 24h preoperatively to achieve a peak of 0.75 [0.44-1.7] ng/mL at 18h postoperatively. When comparing cTn trends according to gender, preoperative dialysis, clinical presentation and CAB method, cTn levels were higher in males, patients presenting with ACS, patients who did not undergo preoperative dialysis, and in the on-pump CAB group (Figure). However, in this small sample size study, between-group differences in cTn trends did not achieve statistical significance (p=0.26, p=0.18, p=0.5, and p=0.28, respectively).

Conclusion
Serum troponin levels peaked consistently by 18h postoperatively in advanced CKD patients undergoing CAB. In addition, males, ACS, on-pump CAB, and non-preoperatively dialysed patients had higher levels of cTn. Further large scale studies are required to definitively evaluate the diagnostic utility and cTn cut-off in this high-risk population.
Vascular biomechanics and molecular disease activity in the thoracic aorta: a novel imaging method
Authors: Minderhoud Savine C S , Fletcher Alexander J , MacNaught Gillian , Cadet Sebastien , Korteland Suze-Anne , Kardys Isabella , Rizopoulos Dimitris , Slomka Piotr , Newby David E , Roos-Hesselink Jolien W , Walker Niki L , Semple Scott , Hirsch Alexander , Dweck Marc R , Wentzel Jolanda J 
Published: May 2022

Abstract

Aims
The influence haemodynamics have on vessel wall pathobiology in aortic disease is incomplete. This aim of this study was to develop a repeatable method for assessing the relationship between aortic wall shear stress (WSS) and disease activity by fusing 4D flow cardiovascular magnetic resonance (CMR) with hybrid positron emission tomography (PET).

Methods and results
As part of an ongoing clinical trial, patients with bicuspid aortic valve (BAV) were prospectively imaged with both 18F-sodium fluoride (18F-NaF) PET, a marker of calcification activity, and 4D flow CMR. We developed novel software allowing accurate 3D co-registration and high-resolution comparison of aortic peak systolic WSS and 18F-NaF PET uptake (maximum tissue-to-background ratio). Intra-observer repeatability of both measurements was determined using Bland–Altman plots and intra-class correlation coefficients (ICCs). The relationship between localized WSS and 18F-NaF uptake was analysed using linear mixed-effect models. Twenty-three patients with BAV (median age 50 [44–55] years, 22% female) were included. Intra-observer repeatability for WSS (ICC = 0.92) and 18F-NaF (ICC = 0.91) measurements obtained within 1.4 ± 0.6 cm2 regions of interest was excellent. On multivariable analysis, 18F-NaF PET uptake was independently and negatively associated with WSS as well as diastolic blood pressure (both P &lt; 0.05), adjusted for age.

Conclusion
Fused assessment of WSS and 18F-NaF PET uptake is feasible and repeatable, demonstrating a clear association between these two factors. This high spatial resolution approach has major potential to advance our understanding of the relationship between vascular haemodynamics and disease activity.
A clinician’s guide to understanding and critically appraising machine learning studies: a checklist for Ruling Out Bias Using Standard Tools in Machine Learning (ROBUST-ML)
Authors: Al-Zaiti Salah S , Alghwiri Alaa A , Hu Xiao , Clermont Gilles , Peace Aaron , Macfarlane Peter , Bond Raymond 
Published: May 2022

Abstract
Developing functional machine learning (ML)-based models to address unmet clinical needs requires unique considerations for optimal clinical utility. Recent debates about the rigours, transparency, explainability, and reproducibility of ML models, terms which are defined in this article, have raised concerns about their clinical utility and suitability for integration in current evidence-based practice paradigms. This featured article focuses on increasing the literacy of ML among clinicians by providing them with the knowledge and tools needed to understand and critically appraise clinical studies focused on ML. A checklist is provided for evaluating the rigour and reproducibility of the four ML building blocks: data curation, feature engineering, model development, and clinical deployment. Checklists like this are important for quality assurance and to ensure that ML studies are rigourously and confidently reviewed by clinicians and are guided by domain knowledge of the setting in which the findings will be applied. Bridging the gap between clinicians, healthcare scientists, and ML engineers can address many shortcomings and pitfalls of ML-based solutions and their potential deployment at the bedside.
Machine learning cardiac-MRI features predict mortality in newly diagnosed pulmonary arterial hypertension
Authors: Alabed Samer , Uthoff Johanna , Zhou Shuo , Garg Pankaj , Dwivedi Krit , Alandejani Faisal , Gosling Rebecca , Schobs Lawrence , Brook Martin , Shahin Yousef , Capener Dave , Johns Christopher S , Wild Jim M , Rothman Alexander M K , van der Geest Rob J , Condliffe Robin , Kiely David G , Lu Haiping , Swift Andrew J 
Published: May 2022

Abstract

Aims
Pulmonary arterial hypertension (PAH) is a rare but serious disease associated with high mortality if left untreated. This study aims to assess the prognostic cardiac magnetic resonance (CMR) features in PAH using machine learning.

Methods and results
Seven hundred and twenty-three consecutive treatment-naive PAH patients were identified from the ASPIRE registry; 516 were included in the training, and 207 in the validation cohort. A multilinear principal component analysis (MPCA)-based machine learning approach was used to extract mortality and survival features throughout the cardiac cycle. The features were overlaid on the original imaging using thresholding and clustering of high- and low-risk of mortality prediction values. The 1-year mortality rate in the validation cohort was 10%. Univariable Cox regression analysis of the combined short-axis and four-chamber MPCA-based predictions was statistically significant (hazard ratios: 2.1, 95% CI: 1.3, 3.4, c-index = 0.70, P = 0.002). The MPCA features improved the 1-year mortality prediction of REVEAL from c-index = 0.71 to 0.76 (P ≤ 0.001). Abnormalities in the end-systolic interventricular septum and end-diastolic left ventricle indicated the highest risk of mortality.

Conclusion
The MPCA-based machine learning is an explainable time-resolved approach that allows visualization of prognostic cardiac features throughout the cardiac cycle at the population level, making this approach transparent and clinically interpretable. In addition, the added prognostic value over the REVEAL risk score and CMR volumetric measurements allows for a more accurate prediction of 1-year mortality risk in PAH.
Late outcome of extracardiac Fontan patients: 32 years of follow-up
Authors: Giannico Salvatore , Trezzi Matteo , Cantarutti Nicoletta , Cafiero Giulia , Ravà Lucilla , Adorisio Rachele , Brancaccio Gianluca , Albanese Sonia , Drago Fabrizio , Carotti Adriano , Amodeo Antonio , Galletti Lorenzo 
Published: May 2022

Abstract

OBJECTIVES
We sought to evaluate the long-term survival and risk factors for morbidity and mortality in our cohort of patients after extracardiac (EC) Fontan.

METHODS
We collected and analysed follow-up data until September 2020 for all patients who underwent EC Fontan operation at our institution from November 1988 to November 2015.

RESULTS
Out of 406 patients treated with EC Fontan at a mean age of 5.4 ± 4.5 years, 372 (91.6%) were discharged home; 15% were lost to follow-up. The median follow-up was 14.6 years (interquartile range 8.7–20.3). Two hundred patients (54%) had a good long-term outcome, with an event-free long-term survival, but late adverse events of any kind needing interventional or surgical reoperations were reported in 128 patients (34%). Forty-four patients (12%) developed late Fontan failure. Thirty-seven survivors (10%) had late arrhythmias, with the need for pacemaker implantation. Obstruction of the cavopulmonary pathway occurred in 49 patients (13%), but just 8 patients needed conduit surgical replacement. At 32 years, the survival probability was 84%. The risk of orthotopic heart transplant, considering death as a competing event (showed as cumulative incidence), was 12.5%. A preoperative diagnosis of hypoplastic left heart syndrome was an independent risk factor for the need for heart transplant.

CONCLUSIONS
The EC Fontan shows satisfactory long-term survival and low incidence of adverse events and late failure. Conduit replacement is rare, and its longevity may not represent a substantial issue in these patients. However, as with other technical variants, the need for reoperations during long-term follow-up is a significant challenge.
Anatomical reconstruction of proximal coronary artery stenosis in children
Authors: Krokovay A , Prêtre R , Kretschmar O , Knirsch W , Valsangiacomo Buechel E , Dave H 
Published: May 2022

Abstract

OBJECTIVES
Timing and method of surgical reconstruction for non-sclerotic proximal coronary artery stenosis, occurring de novo or post-coronary artery transfer, are evolving. We have pursued a technique of anatomical reconstruction of ostial and short segment proximal coronary artery stenosis and atresia in children, using patch plasty or interposition vein graft. Here, we discuss the medium- to long-term outcomes.

METHODS
Nine consecutive children undergoing 10 left main coronary artery reconstructions using autologous great saphenous vein patch (n = 4), autologous pericardium (n = 4), xenopericardium (n = 1) or great saphenous vein interposition graft (n = 1) were retrospectively analysed. Complementary wedge resection of the stenotic coronary ostium was performed in chronic cases.

RESULTS
The aetiology of coronary artery stenosis was post-arterial switch operation (n = 6), Takayasu’s arteritis (n = 1), idiopathic left main coronary artery atresia (n = 1) and anomalous origin of the left coronary artery from the pulmonary artery (n = 1). The median age and weight at operation were 0.15 (range 0.01–13.1) years and 4.4 (range 3–13.1) kg, respectively. Survival was 100% at the medi follow-up of 12.6 (range 1–19.2) years. All patients showed normal left ventricular ejection fraction on transthoracic echocardiogram. In 1 patient, kinking of the proximal left circumflex artery resulted in non-significant obstruction. In all other cases, follow-up catheter angiography revealed unobstructed coronary arteries. Cardiac magnetic resonance tomography showed no significant perfusion deficit in any child.

CONCLUSIONS
Anatomical reconstruction of the proximal left coronary artery using autologous saphenous vein may allow optimal restoration of physiological coronary blood flow, keeping the option of future coronary bypass operation open.
Preferential associations of soil fungal taxa under mixed compositions of eastern American tree species
Authors: Kutos Steve , Barnes Elle M , Bhutada Arnav , Lewis J D 
Published: May 2022

Abstract
Soil fungi are vital to forest ecosystem function, in part through their role mediating tree responses to environmental factors, as well as directly through effects on resource cycling. While the distribution of soil fungi can vary with abiotic factors, plant species identity is also known to affect community composition. However, the particular influence that a plant will have on its soil microbiota remains difficult to predict. Here, we paired amplicon sequencing and enzymatic assays to assess soil fungal composition and function under three tree species, Quercus rubra, Betula nigra, and Acer rubrum, planted individually and in all combinations in a greenhouse. We observed that fungal communities differed between each of the individual planted trees, suggesting at least some fungal taxa may associate preferentially with these tree species. Additionally, fungal community composition under mixed-tree plantings broadly differed from the individual planted trees, suggesting mixing of these distinct soil fungal communities. The data also suggest that there were larger enzymatic activities in the individual plantings as compared to all mixed-tree plantings which may be due to variations in fungal community composition. This study provides further evidence of the importance of tree identity on soil microbiota and functional changes to forest soils.
Stability study of fortified low-fat spreads with preservatives
Authors: Kharb Suman , Thompkinson Dilip Kumar , Kumari Harshita 
Published: May 2022

Abstract
Physicochemical variations in products are known to occur depending on storage conditions. This study examined the effects of storage time on the physicochemical, sensory, rheological, and microbiological properties of fortified low-fat spreads. Fortified spreads containing potassium sorbate (PS; 0.05% and 0.1%) or MicroGard 100 (MG; 0.5% and 1%) as preservatives and a control spread (CS) were packed in presterilized airtight polyethylene jars and their shelf lives were investigated by storage at (5±1) °C for 91 d. Based on the physicochemical properties, the addition of preservatives inhibited the formation of free fatty acids and thiobarbituric acid and influenced the pH and acidity. The emulsion stability of the preserved samples was greater than that of the CS after 14 d. As storage progressed, the sensory and rheological properties of the CS deteriorated continuously, whereas significantly smaller changes were observed for the samples containing 0.1% PS and 1% MG. The surface growth of yeasts and molds was the main cause of spoilage, particularly in the CS. For all the samples, the standard plate counts and the yeast and mold counts increased during storage. In contrast, the coliform counts were zero, indicating that the samples were manufactured and stored under hygienic conditions. The samples containing lower levels of preservatives (0.05% PS and 0.5% MG) were acceptable for 70 d and 77 d as compared to 49 d for the CS. Notably, the addition of 0.1% PS and 1% MG extended the shelf life to 91 d.
Contamination of microgreens by Salmonella enterica and Escherichia coli is influenced by selection breeding in chicory (Cichorium intybus L.)
Authors: Lenzi Anna , Baldi Ada , Lombardelli Letizia , Truschi Stefania , Marvasi Massimiliano , Bruschi Piero 
Published: May 2022

Abstract
The aim of this study was to assess whether selection breeding in chicory (Cichorium intybus L.) led changes in the susceptibility to Salmonella enterica and Escherichia coli contamination and whether the anatomical traits of the leaves are involved in the possible changes. Five chicory genotypes subjected to different intensities of selection were compared at the microgreen stage. Bacterial retention was evaluated after leaf incubation for 1.5 h on the surface of the bacterial suspension, followed by rinsing, grinding, plating on selective media, and colony forming unit (CFU) counting. The density of stomata and trichomes, total stomatal length and width, stomatal pit width, surface roughness and sharpness were evaluated. The intensively selected genotype (Witloof) was significantly more prone to contamination (2.9±0.3 lg CFU/cm2) as the average of the two bacterial types than the wild accession (Wild; 2.3±0.4 lg CFU/cm2) and the moderately selected genotypes (two leaf chicories, Catalogna type, and root chicory ‘Magdeburg’; on average, 1.9±0.3 lg CFU/cm2). Witloof microgreens also showed larger stomata (on average +34% for stoma width and +44% for pit width), which could justify, at least in part, the higher susceptibility to enterobacterial contamination. In fact, when contamination was performed in the dark (closed stomata), the bacterial retention in Witloof was significantly reduced in comparison with the opened stomata (–44%) and in Wild (–26%). Differences in retention between Witloof and Wild were still observed after UV treatment. The hierarchical clustering performed by grouping the leaf anatomical features was consistent with the chicory genetic groups. Our results suggest that the domestication process can affect the safety of produce and that the micromorphological traits of the leaves may be involved.
Dietary vitamin B12 regulates chemosensory receptor gene expression via the MEF2 transcription factor in Caenorhabditis elegans
Authors: McDonagh Aja , Crew Jeannette , van der Linden Alexander M 
Published: May 2022

Abstract
Dynamic changes in chemoreceptor gene expression levels in sensory neurons are one strategy that an animal can use to modify their responses to dietary changes. However, the mechanisms underlying diet-dependent modulation of chemosensory gene expression are unclear. Here, we show that the expression of the srh-234 chemoreceptor gene localized in a single ADL sensory neuron type of Caenorhabditis elegans is downregulated when animals are fed a Comamonas aquatica bacterial diet, but not on an Escherichia coli diet. Remarkably, this diet-modulated effect on srh-234 expression is dependent on the micronutrient vitamin B12 endogenously produced by Comamonas aq. bacteria. Excess propionate and genetic perturbations in the canonical and shunt propionate breakdown pathways are able to override the repressive effects of vitamin B12 on srh-234 expression. The vitamin B12-mediated regulation of srh-234 expression levels in ADL requires the MEF-2 MADS domain transcription factor, providing a potential mechanism by which dietary vitamin B12 may transcriptionally tune individual chemoreceptor genes in a single sensory neuron type, which in turn may change animal responses to biologically relevant chemicals in their diet.