bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postmenopausal giant ovarian tumor: a rare case report and literature review
Authors: Fu Lingyang , Ren Fang , Ma Xiaoxin , Xu Xiaoxuan , Wang Tifang , Li Meijun , Guo Zhiqiang 
Published: July 2022

Abstract

Objective
A giant ovarian tumor weighing 62 kg and containing 51 L cyst fluid is rare among postmenopausal women, and an early diagnosis contributes to a good prognosis.

Methods
We report a case of a 62-kg giant ovarian tumor, the largest ovarian tumor ever reported in China. A 64-year-old woman with a giant pelvic abdominal mass underwent surgery. Because of the occurrence of serious perioperative and postoperative complications, we then conducted a literature review to investigate possible risk factors for severe complications.

Results
During the operation, 51 L of intratumoral fluid was drained, and a giant ovarian tumor of approximately 62 kg was removed. The pathological examination showed that the tumor was a mucinous borderline one. The patient had perioperative hypotension and postoperative respiratory failure. After a comprehensive literature review, we found that the occurrence of serious complications may not be related to tumor volume and weight but age and the amount of fluid in the tumor.

Conclusions
The high incidence of severe complications should be carefully considered when huge ovarian tumors or tumors containing a large amount of tumor fluid in postmenopausal women are removed.
Impact of the CBT-Meno protocol on menopause-specific beliefs, dysfunctional attitudes, and coping behaviors
Authors: Donegan Eleanor , Frey Benicio N. , McCabe Randi E. , Streiner David L. , Fedorkow Donna M. , Furtado Melissa , Green Sheryl M. 
Published: July 2022

Abstract

Objective
A recent clinical trial demonstrated that a group cognitive-behavioral therapy protocol for menopause (CBT-Meno; Green et al. Menopause 2019;26(9):972-980) was effective in reducing menopausal symptoms, including vasomotor and depressive symptoms. The current analyses evaluated the effectiveness of CBT-Meno in improving menopause-specific beliefs, dysfunctional attitudes associated with depression, and menopause-specific behaviors.

Methods
In a subset of participants from the larger trial, women assigned to CBT-Meno or waitlist and who had completed symptom, cognitive, and behavioral measures at least at baseline were included. Assessments were conducted at baseline, 12 weeks after baseline, and 3 months after treatment. Measures included the Hot Flash Related Daily Interference Scale, the vasomotor subscale of the Greene Climacteric Scale, the Beck Depression Inventory II, the Hot Flush Beliefs Scale, the Dysfunctional Attitudes Scale, and the Hot Flush Behavior Scale (HFBehS).

Results
As reported in the main study outcomes (Green et al. Menopause 2019;26(9):972-980), CBT-Meno participants reported greater improvements than waitlist in terms of vasomotor symptom interference and depressive symptoms (Hot Flash Related Daily Interference Scale, Beck Depression Inventory II; partial eta-squared [η
2
p] = 0.15-0.18), although not in vasomotor severity (Greene Climacteric Scale [vasomotor subscale]; η
2
p = 0.05). CBT-Meno participants reported greater improvements than waitlist in menopause-specific beliefs (Hot Flush Beliefs Scale; η
2
p = 0.08-0.12), dysfunctional attitudes (Dysfunctional Attitudes Scale; η
2
p = 0.09), and menopause-specific behaviors (HFBehS; η
2
p = 0.08-0.12). Within-group analyses showed improvements in CBT-Meno on all variables (d = 0.38-1.26) except in cooling strategies (d = 0.18). Gains in CBT-Meno were maintained from posttreatment to 3-month follow-up, although a decrease in positive coping behaviors was observed (HFBehS—positive behavior subscale; d = 0.99).

Conclusions
The CBT-Meno protocol is effective in improving menopause-related symptoms and a broader range of outcomes, including problematic beliefs about menopause, dysfunctional attitudes related to depression, and menopause-specific behaviors.
New concepts in heart failure with preserved ejection fraction and hypertension
Authors: Joury Abdulaziz , Gupta Tripti , Krim Selim R. 
Published: July 2022

Purpose of review
Hypertension (HTN) remains the most common and strongest contributing factor to the development of heart failure with preserved ejection fraction (HFpEF). In this review, we aim to summarize the pathophysiological processes linking HTN to HFpEF and highlight novel concepts in medical and device-based management of HFpEF and HTN.

Recent findings
Despite the global increase in the prevalence of HFpEF, there has been limited benefit in current medication and device-based therapy for this complex syndrome. The hallmark of HFpEF is an elevated left intra-atrial and ventricular pressure and exertional dyspnea. Traditional medications used for treating HTN in patients with reduced left ventricular ejection fraction have unclear benefits in patients with HFpEF. Careful analysis of emerging medications such as angiotensin receptor–neprilysin inhibitor and sodium–glucose co-transporter-2 inhibitors showed benefit in reducing not only blood pressure but also hospitalizations in patients with HFpEF. Current data on device-based therapy aims to reduce left intra-atrial pressure, ventricular pressure and stimulate baroreceptors to lower blood pressure; however, needs further investigation.

Summary
The nexus of HTN and HFpEF remains strong and complex. Although traditional medications for treating HFrEF did not affect long-term outcomes, novel therapies with angiotensin receptor neprilysin-inhibitor and sodium-glucose co-transporter-2 inhibitor offer promising results. Many device-based interventions in the HFpEF population are being developed with the aim to reduce left intra-atrial and ventricular pressure; however, their role in HFpEF hypertensive patients needs to be further investigated.
The potential of CRISPR-Cas9 prime editing for cardiovascular disease research and therapy
Authors: Bharucha Nike , Arias Ariel , Karakikes Ioannis 
Published: July 2022

Purpose of review
The ability to edit any genomic sequence has led to a better understanding of gene function and holds promise for the development of therapies for genetic diseases. This review describes prime editing - the latest CRISPR-Cas9 genome editing technology. Prime editing enables precise and accurate genome editing in terminally differentiated, postmitotic cells like cardiomyocytes, paving the way for therapeutic applications for genetic cardiomyopathies.

Recent findings
Prime editing has been used to precisely insert up to 40 bases, create deletions up to 80 base pairs, and can perform all 12 possible transition and transversion base mutations with lower indels and off-target effects than other genome editing methods. The development of several software tools has simplified the experimental design and led to increased efficiency of the process. Improvements in methods for in-vivo delivery of the prime editing components should enable this technology to be used to edit the genome in patients.

Summary
Prime editing has the potential to revolutionize the future of biomedical research and transform cardiovascular medicine. Improved understanding of the prime editing process and developments in agent design, efficacy and delivery will benefit scientists and patients and could be an effective way to cure cardiovascular diseases.
Influence of the cardio-ankle vascular index on chronic-phase left ventricular dysfunction after ST-segment elevation myocardial infarction
Authors: Kirigaya Jin , Iwahashi Noriaki , Abe Takeru , Gohbara Masaomi , Hanajima Yohei , Horii Mutsuo , Minamimoto Yugo , Okada Kozo , Matsuzawa Yasushi , Hibi Kiyoshi , Kosuge Masami , Ebina Toshiaki , Tamura Kouichi , Kimura Kazuo 
Published: July 2022

Objective:
This study aimed to investigate the possible influence of arterial stiffness assessed by the cardio-ankle vascular index (CAVI) on chronic-phase left ventricular dysfunction in patients with ST-segment elevation myocardial infarction (STEMI).

Methods:
A total of 208 consecutive patients with first STEMI (age, 64 ± 11 years; 86% men) who underwent reperfusion therapy within 12 h of onset were enrolled. We analysed arterial stiffness by measuring CAVI in a stable phase after admission and performed two-dimensional echocardiography at baseline and 7 months’ follow-up. Subsequently, we assessed left ventricular global longitudinal strain (LV-GLS) to evaluate left ventricular function. A total of 158 (75.9%) patients underwent baseline cardiac magnetic resonance (CMR). We estimated left ventricular infarct size by measuring peak levels of creatine kinase-myocardial band (CK-MB), and CMR-late gadolinium enhancement (LGE).

Results:
On the basis of the median CAVI value, the patients were allocated into high CAVI (CAVI ≥ 8.575) and low CAVI (CAVI < 8.575) groups. The groups showed no statistically significant differences in LV-GLS at baseline (-13.5% ± 3.1 vs. -13.9% ± 2.7%, P = 0.324). However, LV-GLS was significantly worse in the high CAVI group than in the low-CAVI group at 7 months (-14.0% ± 2.9 vs. -15.6% ± 3.0%, P < 0.001). Stratified by CAVI and peak CK-MB or LGE, the four groups showed significant differences in LV-GLS at 7 months after STEMI (both P < 0.001). Multivariate linear regression analysis with the forced inclusion model showed that CAVI was an independent predictor of LV-GLS at 7 months (P = 0.015).

Conclusion:
CAVI early after STEMI onset was significantly associated with chronic-phase LV-GLS. In addition, combining CAVI with CK-MB or LGE improves its predictive ability for evaluation of chronic-phase LV-GLS. Thus, the arterial stiffness assessment by CAVI was an important factor related to chronic-phase left ventricular dysfunction after the first STEMI.
Antihypertensive treatment effect on exercise blood pressure and exercise capacity in older adults
Authors: Jones Siana , Schultz Martin G. , Park Chloe , Tillin Therese , Chaturvedi Nishi , Hughes Alun D. 
Published: July 2022

Background:
An exaggerated blood pressure (BP) response to exercise and low exercise capacity are risk factors for cardiovascular disease (CVD). The effect of pharmacological antihypertensive treatment on exercise BP in older adults is largely unknown. This study investigates these effects accounting for differences in exercise capacity.

Methods:
Participants enrolled in the Southall and Brent Revisited (SABRE) study undertook a 6-min stepper test with expired gas analysis and BP measured throughout exercise. Participants were stratified by antihypertensive treatment status and resting BP control. Exercise systolic and diastolic BP (exSBP and exDBP) were compared between groups using potential outcome means [95% confidence intervals (CIs)] adjusted for exercise capacity. Exercise capacity was also compared by group.

Results:
In total, 659 participants were included (mean age ± SD: 73 ± 6.6 years, 57% male). 31% of normotensive and 23% of hypertensive older adults with controlled resting BP had an exaggerated exercise BP. ExSBP was similar between normotensive and treated/controlled individuals [mean (95%CI): 180 (176 184) mmHg vs. 177 (173 181) mmHg, respectively] but was higher in treated/uncontrolled and untreated/uncontrolled individuals [mean (95% CI): 194 (190 197) mmHg, P < 0.001 and 199 (194 204) mmHg, P < 0.001, respectively]; these differences persisted after adjustment for exercise capacity and other confounders. Exercise capacity was lower in treated vs. normotensive individuals [mean (95% CI) normotensive: 16.7 (16.0,17.4) ml/kg/min]; treated/controlled: 15.5 (14.8,16.1) ml/kg/min, P = 0.009; treated/uncontrolled: [15.1 (14.5,15.7) ml/kg per min, P = 0.001] but was not reduced in untreated/uncontrolled individuals [mean (95% CI): 17.0 (16.1,17.8) ml/kg per min, P = 0.621].

Conclusion:
Irrespective of resting BP control and despite performing less exercise, antihypertensive treatment does not fully mitigate an exaggerated BP response to exercise suggesting residual CVD risk in older adults.
Complement factors D and C3 cross-sectionally associate with arterial stiffness, but not independently of metabolic risk factors: The Maastricht Study
Authors: Jin Shunxin , Reesink Koen D. , Kroon Abraham A. , de Galan Bastiaan , van der Kallen Carla J.H. , Wesselius Anke , Schalkwijk Casper G. , Stehouwer Coen D.A. , van Greevenbroek Marleen M.J. 
Published: July 2022

Background:
Arterial stiffness predicts cardiovascular outcomes. The complement system, particularly the alternative complement pathway, has been implicated in cardiovascular diseases. We herein investigated the associations of factor D, the rate-limiting protease of the alternative pathway, and C3, the central complement component, with arterial stiffness.

Methods:
In 3019 population-based participants (51.9% men, 60.1 ± 8.2 years, 27.7% type 2 diabetes [T2D], oversampled]), we measured carotid-femoral pulse wave velocity (cfPWV), carotid distensibility coefficient (DC) and carotid Young's elastic modulus (YEM), and plasma concentrations of factors D and C3. We conducted multiple linear regression to investigate the association of factors D and C3 (main independent variables, standardized) with cfPWV (primary outcome) and DC and YEM (secondary outcomes), adjusted for potential confounders.

Results:
Per SD higher factors D and C3, cfPWV was 0.41 m/s [95% confidence interval: 0.34; 0.49] and 0.33 m/s [0.25; 0.41] greater, respectively. These associations were substantially attenuated when adjusted for age, sex, education, mean arterial pressure, and heart rate (0.08 m/s [0.02; 0.15] and 0.11 m/s [0.05; 0.18], respectively), and were not significant when additionally adjusted for T2D, waist circumference and additional cardiovascular risk factors (0.06 m/s [−0.01; 0.13] and 0.01 m/s [−0.06; 0.09], respectively). Results were comparable for carotid YEM and DC. In persons with T2D, but not in those without, the association between factors D and cfPWV was significant in the fully adjusted model (0.14 m/s, [0.01; 0.27], P = 0.038, P
interaction < 0.05).

Conclusion:
The strong association of plasma factors D and C3 with arterial stiffness in this population-based cohort was not independent of T2D and other metabolic risk factors. Our data suggest that a possible causal pathway starting from alternative complement activation may via hypertension and T2D contribute to greater arterial stiffness.
Gonioscopy and Angle-Based Glaucoma Surgical Training on Human Eyes in the Wet Lab
Authors: Pujari Amar , Rakheja Vaishali , Dada Tanuj , Verma Saurabh , Gupta Shikha , Agarwal Tushar , Sharma Namrata , Titiyal Jeewan S. 
Published: July 2022

Précis:
Human corneoscleral rims provide a low cost model and resource to enhance angle based glaucoma surgical training skills.

Purpose:
To understand the feasibility, utility, and efficacy of a low-cost model for performing anterior chamber angle gonioscopy and micro-surgery on human corneoscleral tissues in wet lab on resident skill enhancement.

Methods:
Post-keratoplasty residual corneoscleral rims and/or the expired donor corneoscleral buttons were included for the purpose of this study. Initially, inverted rims were used to demonstrate the basic angle anatomy on a slit lamp bio-microscope. Central hazy cornea was then replaced with an artificial cornea and an artificial anterior chamber to simulate indirect gonioscopy, direct gonioscopy, goniotomy, and other angle-based surgeries. Direct gonioscopy and goniotomy exercises (as a means to simulate intraoperative gonioscopy and other angle-based surgeries respectively) were evaluated quantitatively, and the rest qualitatively.

Results:
A total of 65 residents were included in the exercise. The mean age was 26.69±1.74 years. Amongst these, 55 ophthalmology residents performed the basic examination, that is, slit lamp mounted angle anatomy examination (n=55) and artificial chamber mounted indirect gonioscopic examination through artificial cornea (n=55). In the second exercise, 10 glaucoma fellows performed the direct gonioscopic and the goniotomy exercises on artificial chamber. The fellows demonstrated a statistically significant improvement in interpretation and surgical skill enhancement concurrent with reduction in time taken with increasing number of attempts (P<0.05). In the third simulation exercise, micro-stent placement within the Schlemm’s canal, subconjunctival space, and the suprachoroidal space was re-produced successfully on multiple occasions.

Conclusions:
The residual human corneoscleral rims proved to be an important resource for teaching both the basic examination skills and those required for transitioning to advanced intraoperative gonioscopy and goniotomy skills. These low cost, easy to adapt models can be incorporated within the curriculum for improved glaucoma training of both the residents and the glaucoma fellows.
Relationship Between Optical Coherence Tomography and Anterior Chamber Depth After Pupillary Dilation in Primary Angle Closure Suspects
Authors: Kao Brandon Wei-Hsiang , Yonamine Sean , Zhao Mengya , Oatts Julius , Yu Yinxi , Ying Gui-Shuang , Xu Xun , Han Ying 
Published: July 2022

Précis:
Anterior chamber depth (ACD) change after pupillary dilation is correlated with lens vault (LV) and anterior chamber width (ACW), as observed by swept-source optical coherence tomography (SS-OCT) at both horizontal and vertical scans in patients with primary angle closure suspect and cataract.

Purpose:
The purpose of this study is to evaluate the association between ACD and other anterior chamber parameters after pharmacological dilation in patients with primary angle closure suspect and cataract.

Patients and Methods:
SS-OCT was performed for 78 patients at baseline and 1 hour after pharmacological dilation. Measurements were taken at 8 evenly spaced axes at 250, 500, and 750 μm from the scleral spur. Pearson correlation coefficient (ρ) was used to evaluate the relationship between averaged ACD change and other SS-OCT parameters. Multivariable regression analyses were performed to determine the parameters that predict ACD change.

Results:
Across all 14 dimension and angle parameters, 12 parameters at the 270-degree axis and 10 parameters at the 0-degree axis yielded significant correlations with ACD change (ρ=0.24–0.55, P<0.05). Angle parameters were most significantly correlated to ACD change 750 µm from the scleral spur. The prediction model for ACD change after pharmacological dilation at 0 degree included decreased LV, wider ACW, and increased trabecular iris space area (all P≤0.001). The prediction model for ACD change at 270 degrees included: decreased LV, wider ACW, larger change in anterior chamber volume, larger baseline anterior chamber volume, and smaller baseline angle opening distance (all P≤0.03).

Conclusions:
LV and ACW, as measured in both vertical and horizontal scans, were found to be determinants of the ACD change after pharmacological pupillary dilation. Examination of these parameters may help identify patients at higher risk of developing angle-closure disease.
Mechanistic insights on the effect of crocin, an active ingredient of saffron, on atherosclerosis in apolipoprotein E knockout mice
Authors: Makaritsis Konstantinos P. , Kotidis Charalampos , Papacharalampous Konstantina , Kouvaras Evangelos , Poulakida Eirini , Tarantilis Petros , Asprodini Eftichia , Ntaios George , Koukoulis George Κ. , Dalekos George Ν. , Ioannou Maria 
Published: July 2022

Background
We investigated the effect of crocin treatment on atherosclerosis and serum lipids in apolipoprotein E knockout (ApoE−/−) mice, focusing on the expression of endothelial nitric oxide synthase (eNOS) and hypoxia-induced factor-1 alpha (HIF-1α).

Methods
Sixty-two animals were divided into two groups and randomly allocated to crocin (100 mg/kg/day) in drinking water or no crocin. All mice were maintained on standard chow diet containing 5% fat. Crocin was initiated at the 16th week of age and continued for 16 additional weeks. At 32 weeks of age, after blood sampling for plasma lipid determination and euthanasia, proximal aorta was removed and 3 μm sections were used to measure the atherosclerotic area and determine the expression of eNOS and HIF-1α by immunohistochemistry.

Results
Each group consisted of 31 animals (17 males and 14 females in each group). Crocin significantly reduced the atherosclerotic area (mm2 ± SEM) in treated mice compared to controls, both in males (0.0798 ± 0.017 vs. 0.1918 ± 0.028, P < 0.002, respectively) and females (0.0986 ± 0.023 vs. 0.1765 ± 0.025, P < 0.03, respectively). eNOS expression was significantly increased in crocin-treated mice compared to controls, both in males (2.77 ± 0.24 vs. 1.50 ± 0.34, P=0.004, respectively) and females (3.41 ± 0.37 vs. 1.16 ± 0.44, P=0.003, respectively). HIF-1α expression was significantly decreased in crocin-treated mice compared to controls, both in males (21.25 ± 2.14 vs. 156.5 ± 6.67, P < 0.001, respectively) and females (35.3 ± 7.20 vs. 113.3 ± 9.0, P < 0.01, respectively). No difference was noticed in total, low- and high-density lipoprotein cholesterol between treated and control mice.

Conclusion
Crocin reduces atherosclerosis possibly by modulation of eNOS and HIF-1α expression in ApoE−/− mice without affecting plasma cholesterol.
Does the use of polymer-free drug eluting stents improve clinical outcomes of patients undergoing percutaneous coronary interventions?
Authors: Loewenstein Itamar , Hochstadt Aviram , Merdler Ilan , Chorin Ehud , Wenkert Atalia , Moshkovits Yonatan , Erez Jonathan , Toledano Ella , Arbel Yaron , Halkin Amir , Ben-Shoshan Jeremy , Finkelstein Ariel , Banai Shmuel , Konigstein Maayan 
Published: July 2022

Background
Implantation of drug eluting stents (DES) is the mainstay treatment for patients requiring percutaneous coronary intervention (PCI). The polymer coating of DES has been associated with inflammatory response, increased arterial injury and long-term in-stent restenosis and thrombosis. Polymer-free stents (PFS) were designed to overcome limitations of polymer-coated stents (PCS). Our aim was to compare clinical outcomes of patients undergoing PCI with PFS versus contemporary PCS.

Methods
This is a prospective, open-label registry study enrolling consecutive all-comers patients admitted to a single center and undergoing PCI using contemporary DES. Clinical outcomes were compared between patients treated with PFS and PCS. The primary endpoint was target lesion revascularization (TLR) at 12 months. Subgroup analyses were conducted for diabetic and nondiabetic patients.

Results
Overall, 1664 patients were included: 928 (55.8%) of which were treated with PFS and 736 (44.2%) with PCS for 2046 and 1462 lesions, respectively. At 12 months, TLR rates were not significantly different between the groups (1.7% vs. 2.3% for PFS and PCS, respectively, P = 0.48). The use of PFS did not improve clinical outcomes among diabetic patients in comparison with PCS. Target vessel revascularization and major adverse cardiac events rates were also similar between groups, regardless of diabetes status.

Conclusion
Newer generation DES offer excellent results in diabetic and nondiabetic patients without significant differences in outcomes between PCS and PFS.