bluuebunny/crossref_metadata_2025_split huggingface dataset:
943 THE RIGHT VENTRICULAR-ARTERIAL COUPLING AS AN INDICATOR OF PROGNOSIS IN PATIENTS WITH FUNCTIONAL MITRAL REGURGITATION UNDERGOING TRANSCATHETER “EDGE-TO-EDGE“ VALVE REPAIR
Authors: Lucchino Alessandro , Polimeni Alberto , Mongiardo Annalisa , Spaccarotella Carmen , Messina Chiara , Vizzari Francesca , Velato Letizia , Di Costanzo Assunta , Durante Pierfrancesco , Estévez-loureiro Rodrigo , D´ascenzo Fabrizio , Indolfi Ciro 
Published: December 2022

Abstract

Aims
Patients affected by severe functional Mitral Regurgitation (MR) complaining symptoms despite optimal medical therapy should undergo intervention. When the surgery, the gold standard, is not indicated due to high surgical risk, the transcatheter edge-to-edge repair (TEER) should be considered, if feasible. In patients undergoing TEER, the clinical outcome is not always optimal and strongly correlates to the patient's clinical conditions, so a correct selection of the patients is essential. In this regard, some studies have evaluated the RV-PA coupling as an important predictor of outcome in patients with Heart Failure (HF). In clinical practice, RV-pulmonary artery (PA) coupling could be estimated in a non-invasive way through the relationship between TAPSE (systolic excursion of the annular plane of the tricuspid valve) /PAPs (systolic pressure of the pulmonary artery) ratio that gives information about the state of contractility and adaptability to the load of the RV. In this study, we sought to evaluate how the TAPSE /PAPs ratio at baseline may improve prognostic stratification in patients undergoing TEER with the MitraClip system.

Methods and Results
Data from 236 patients with symptomatic, moderate to severe functional MR, subjected to implantation of MitraClip between March 2012 and June 2021, were obtained from the University's MITRA-CTV, multicenter observational register comprising data from the Magna Graecia University of Catanzaro (Italy), the University of Turin (Italy) and the University of Vigo (Spain). The median follow-up was 686 days (IQR 393-1131 days), with a 1-year follow-up in 224 of 236 (95%) patients. We divided the population into two groups based on the median value of the ratio TAPSE / PAPs ≤ 0.35 and TAPSE / PAPs&gt; 0.35. The primary endpoint of this study includes Re-hospitalization for HF and Death from all causes at one-year follow-up. At Cox regression analysis, Hospital stay&gt; 10 days (HR 1.67, 95% CI [1.03-2.77], p = 0.039) and the TAPSE / PAPs ratio ≤ 0.35 (HR1.58, 95% CI [1, 01-2.48], p = 0.0488) independently increased the risk of the primary endpoint at long-term follow-up. At Kaplan Meier analysis, a TAPSE / PAPs ratio of ≤ 0.35 was related to an increased incidence of the primary endpoint of Rehospitalization for HF and Death (HR 1.54, 95% CI [ 1-2.41], p = 0.0464).

Conclusion
In our study, the right ventricular-arterial coupling, estimated through TAPSE/PAPs Ratio, was identified as a predictor of outcome in patients with severe functional MR undergoing TEER.
763 ACTIVATION OF SIRT1 ATTENUATES VASCULAR DYSFUNCTION AND THROMBOSIS IN MTHFR DEFICIENCY
Authors: Carrizzo Albino , Iside Concetta , Nebbioso Angela , Carafa Vincenzo , Damato Antonio , Ciccarelli Michele , Venturini Eleonora , Di Pietro Paola , Trimarco Bruno , Selleri Carmine , Altucci Lucia , Vecchione Carmine 
Published: December 2022

Abstract
Beyond well-assessed risk factors, cardiovascular events could be also associated with the presence of epigenetic and genetic alterations, such as the methylenetetrahydrofolate-reductase (MTHFR) C677T polymorphism. This gene variant is related to increased circulating levels of homocysteine (Hcy) and cardiovascular risk. However, heterozygous carriers have an augmented risk of cardiovascular accidents independently from normal Hcy levels, suggesting the presence of additional deregulated processes in MTHFR C677T carriers. Here we hypothesize that targeting Sirtuin 1 (SIRT1) could be an alternative mechanism to control the cardiovascular risk associated to MTHFR deficiency condition.
Flow Mediated Dilatation (FMD) and light transmission aggregometry assay were performed in subjects carrying MTHFR C677T allele after administration of resveratrol, the most powerful natural clinical usable compound that owns SIRT1 activating properties. MTHFR C677T carriers with normal Hcy levels revealed endothelial dysfunction and enhanced platelet aggregation associated with SIRT1 downregulation. SIRT1 activity stimulation by resveratrol intake was able to override these abnormalities without affecting Hcy levels.
Impaired endothelial function, bleeding time, and wire-induced thrombus formation were rescued in a heterozygous Mthfr-deficient (Mthfr+/-) mouse model after resveratrol treatment. Using a cell-based high-throughput multiplexed screening (HTS) assay, a novel selective synthetic SIRT1 activator, namely ISIDE11, was identified. Ex vivo and in vivo treatment of Mthfr+/- mice with ISIDE11 rescues endothelial vasorelaxation and reduces wire-induced thrombus formation, effects that were abolished by SIRT1 inhibitor. Moreover, platelets from MTHFR C677T allele carriers treated with ISIDE11 showed normalization of their typical hyper-reactivity.
These results candidate SIRT1 activation as a new therapeutic strategy to contain cardio and cerebrovascular events in MTHFR carriers.
719 CIRCULATING SORTILIN LEVELS ARE INCREASED IN PATIENTS RECEIVING LONG-TERM WARFARIN AND ITS INHIBITION ATTENUATES WARFARIN-INDUCED VASCULAR CALCIFICATION
Authors: Di Pietro Paola , Abate Angela Carmelita , Rusciano Maria Rosaria , Visco Valeria , Izzo Carmine , Iacoviello Licia , Toni Anna Laura , Ciccarelli Michele , Carrizzo Albino , Vecchione Carmine 
Published: December 2022

Abstract
Long-term use of the vitamin K antagonist (VKA) warfarin, has been shown to accelerate vascular and valvular calcification both in rodents and in humans. Increasing evidence suggests that vascular endothelium contributes to calcification via endothelial-mesenchymal transition (EndMT). However, additional research is warranted to elucidate the signaling mechanisms involved. In the last decade, a prominent role for sortilin has been demonstrated in cardiovascular calcification. Moreover, we recently demonstrated that the increase of sortilin in the endothelium promotes endothelial dysfunction, a known initiator of EndMT.
Thus, we aim to investigate a potential contribution of sortilin in vascular calcification induced by warfarin. For this purpose, human endothelial cells and aortic rings from wild type C57BL/6J mice were cultured in promineralization medium in the presence of therapeutic levels of warfarin. Plasma sortilin and calcium levels were measured in 19 patients under VKA therapy who were stratified into short-term (3-12 months) or long-term group (24-45 months) based on VKA treatment duration.
Increased protein expression of sortilin was found both in the endothelial and in the medial smooth muscle layers of aortic rings. Sortilin immunostaining was found to co-localize with α-SMA in the endothelium of warfarin-treated aortic rings, a hallmark of EndMT. Interestingly, pharmacological inhibition of sortilin with AF38469 reduced calcification and prevented loss of expression of the endothelial marker von Willebrand Factor (vWF) induced by warfarin treatment in human endothelial cells and mouse aortas.
Finally, along with elevated plasma calcium levels, patients receiving long-term VKA showed increased circulating sortilin levels when compared to short term VKA-treated patients.
Our data provide evidence for a potential role for endothelial-derived sortilin in regulating vascular calcification promoted by warfarin, and suggest that targeting circulating sortilin may be beneficial for the prevention of warfarin-associated cardiovascular calcification.
734 APHASIC AORTITIS - A CASE REPORT
Authors: Berghi Razvan , Gonano Nicola , Del Mestre Eva , Pagura Linda , Tomietto Paola , Franzese Ilaria , Mazzaro Enzo , Merlo Marco , Sinagra Gianfranco 
Published: December 2022

Abstract
A 66yo man, without previous cardiological history, 3-month history of asthenia and left leg claudication, presence of tibial painless nodular lesions, was admitted at our emergency department in the clinical context of an acute aortic syndrome with chest and interscapular pain, fluctuating systemic BP (215/90 ←→ 90/60 mmHg) ​​and 60 mmHg pressure gradient between the arms. EKG documented diffuse negative T waves. Echocardiography revealed normal biventricular morphology and function and normal valve system. TC angiography documented a dilated aortic root (46mm), diffuse thickening of the aortic walls from the valvular plane (8mm), with involvement of the coronary and epiaortic arteries (50% stenosis of left subclavian artery), extended up to the aortic bifurcation to affect the common iliac arteries. Blood chemistry showed high C-reactive protein levels (29 mg/L; n.v. &lt;5 mg/L) and low troponin levels. In the suspicion of an aortic wall hematoma, the patient was rushed to the OR with evidence of a lardaceous-looking aorta and free from wall hematomas. Surgery was stopped. Histological sample of left inguinal artery showed diffuse wall sclerosis and rare intramural lymphocyte infiltration. PET-CT showed an increased metabolism of the aortic walls. On the second postoperative day, the patient developed fluctuating aphasia aggravated by orthostatic position and arterial hypotension. In the suspicion of TIA, CT angiography was performed and showed no acute brain lesions, but a critical stenosis of the right carotid bifurcation, a right vertebral artery occlusion and a left internal carotid subocclusion. DAPT (clopidogrel + aspirin) was initiated. Blood chemistry showed normal WBC count, elevated C-reactive protein (133 mg/L; n.v. &lt; 5 mg/L) and erythrocyte sedimentation rate (90 mm/h; n.v. &lt; 35 mm/h). Blood and urine cultures, bacterial serology (syphilis, tubercolosis), viral serology (HBV, HCV, HIV) and autoantibodies tested (ANA, ENA, ANCA, MPO, PR3) resulted negative. In the context of a great vessel arteritis, IV methylprednisolone was introduced with clinical and biochemical response (C-reactive Protein 10 mg/L). MRI on day 10 demonstrated the presence of two cerebral subacute ischemic lesions with hemorrhagic infarction. Aspirin was discontinued. In suspicion of Takayasu arteritis, methotrexate was initiated with clinical benefit. Takayasu arteritis has an incidence of 2.6/1 million, female:male 8:1 and the age of onset is usually between 15 and 30 years. The cause is unknown. It can manifest as an acute aortic syndrome. It is important to be aware of this disease and to consider it in clinically ambiguous cases like this one.
676 A PITFALL IN ECHOGRAPHIC DIAGNOSIS OF ABDOMINAL AORTIC ANEURYSM: WHEN PARA-AORTIC LYMPH NODES REQUIRE ATTENTION
Authors: Natale Francesco , Loffredo Francesco , Molinari Riccardo , Covino Simona , Alfieri Roberta , Altobelli Ippolita , Pezzullo Enrica , Cimmino Giovanni 
Published: December 2022

Abstract

Image focus
A 65-year-old women was scheduled for coronary angiography during the pre-surgery evaluation because of an abdominal aortic aneurysm (AAA) detected at ultrasound (Figure). The patient referred worsening dyspnoea and asthenia in the last few months, associated with atypical chest pain. Because of these symptoms and taking into account that AAA patients are at very high cardiovascular risk, exclusion of coronary artery disease seemed appropriate. At admission, patient showed enlarged lymph nodes at cervical and inguinal region. In the suspicion of a malignant cancer, a contrast enhanced computed tomography was scheduled, showing an increase in para-aortic, inguinal, cervical and axillary lymph nodes size in absence of the AAA (Figure). After blood tests and an haematologic consultation, a final diagnosis of chronic myeloid leukaemia was made.
The Echo-colour Doppler is the first line imaging test for the diagnosis of AAA. However, in some cases it might be not sufficient. Para-aortic lymphadenopathy should be considered as a possible pitfall in the differential diagnosis of abdominal aortic aneurysm.
Association of genetically predicted lipid traits and lipid-modifying targets with heart failure
Authors: Xiao Jun , Ji Jianguang , Zhang Naiqi , Yang Xi , Chen Keyuan , Chen Liangwan , Huang Wuqing 
Published: December 2022

AbstractAimsTo assess the association of genetically predicted lipid traits and lipid-modification via licensed or investigational targets with heart failure (HF).Methods and resultsTwo-sample Mendelian randomization (MR) study was conducted using summary-level genome-wide association studies (GWASs) from UK Biobank and HERMES Consortium. Genetic variants obtained from UK Biobank GWAS data were selected as instrumental variables to predict the level of lipid traits [LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), triglyceride (TG), apolipoprotein B (ApoB), and apolipoprotein AI (ApoAI)] and lipid-modifying effect of eight drug targets [HMGCR, PCSK9, NPC1L1, PPARA, lipoprotein lipase (LPL), ANGPTL3, APOC3, and cholesteryl ester transfer protein (CETP)]. In this study, we observed that genetically predicted LDL-C, TG, HDL-C or ApoB were significantly related to HF, which were mainly mediated by coronary heart disease (CHD). Drug target MR analyses identified PCSK9, CETP, and LPL as potential targets to prevent HF. The genetic proxy of LDL-C and ApoB increase modified by PCSK9 showed similar evidence in increasing risk of HF (PLDL-C = 1.27*10−4; PApoB = 1.94*10−4); CETP played a role in HF risk via modifying all investigational lipid traits with the strongest evidence though ApoB (P = 5.87*10−6); LPL exerted effects on HF via modifying most lipid traits with the strongest evidence observed via modifying TG (P = 3.73*10−12).ConclusionThis two-sample MR study provided genetic evidence of the associations between lipid traits and HF risk, which were mostly mediated by CHD. Besides, drug target MR studies indicated that PCSK9 inhibition, CETP inhibition, and LPL activation were effective in HF reduction.
Prevalence and concordance of oral and genital HPV by sexual orientation among US men
Authors: Sonawane Kalyani , Shyu Shiang Shiuan , Damgacioglu Haluk , Li Ruosha , Nyitray Alan G , Deshmukh Ashish A 
Published: December 2022

Abstract
The objective of our study was to describe oral and genital human papillomavirus (HPV) infection prevalence and concordance by sexual orientation among US men using a nationally representative sample. We conducted a retrospective cross-sectional analysis of the 2013-2016 National Health and Nutrition Examination Survey. The survey conducts a physical examination and collects oral rinse and genital swab specimens; demographic and health behaviors are self-reported. We used descriptive statistics and multivariate regression models to estimate HPV infection prevalence and the likelihood of HPV infection, respectively. All analyses were adjusted for National Health and Nutrition Examination Survey design and weights, and statistical significance was tested at a 2-sided P value of less than .05. Men who have sex with men had a statistically significantly higher prevalence of oral HPV (high-risk, 9-valent, 4-valent, and HPV 16 and 18), genital HPV (9-valent, 4-valent, and HPV 16 and 18), and concordant oral and genital HPV (high-risk and 9-valent) infections compared with heterosexual men. Improved HPV prevention among men is needed.
Integrating Geriatric Assessment Measures into National Cancer Institute Clinical Trials
Authors: Magnuson Allison , Van der Walde Noam , McKoy June M , Wildes Tanya M , Wong Melisa L , Le-Rademacher Jennifer , Little Richard F , Klepin Heidi D 
Published: December 2022

AbstractTo improve the care of older adults with cancer, the traditional approach to clinical trial design needs to be reconsidered. Older adults are underrepresented in clinical trials with limited or no information on geriatric-specific factors, such as cognition or comorbidities. To address this knowledge gap and increase relevance of therapeutic clinical trial results to the real-life population, integration of aspects relevant to older adults is needed in oncology clinical trials. Geriatric assessment (GA) is a multidimensional tool comprising validated measures assessing specific health domains that are more frequently affected in older adults, including aspects related to physical function, comorbidity, medication use (polypharmacy), cognitive and psychological status, social support, and nutritional status. There are several mechanisms for incorporating either the full GA or specific GA measures into oncology therapeutic clinical trials to contribute to the overarching goal of the trial. Mechanisms include utilizing GA measures to better characterize the trial population, define trial eligibility, allocate treatment receipt within the context of the trial, develop predictive models for treatment outcomes, guide supportive care strategies, personalize care delivery, and assess longitudinal changes in GA domains. The objective of this manuscript is to review how GA measures can contribute to the overall goal of a clinical trial, to provide a framework to guide the selection and integration of GA measures into clinical trial design, and ultimately enable accrual of older adults to clinical trials by facilitating the design of trials tailored to older adults treated in clinical practice.
Workers’ Responses to Paternalism in British Factory-Based Events (1840–1860)
Authors: Moine Fabienne 
Published: December 2022

Abstract
Opportunities to celebrate the success of the firm, its leaders and, by extension, its employees, were numerous in the mid-Victorian period: banquets, dinners and outings, annual gatherings, pleasure trips and excursions, processions around the mills, or ceremonies directly related with the employer’s family. The purpose of this paper is to analyse some of these large communal events organized in textile mills in order to better understand the practices and meanings of paternalism on the side of the workers. The first part of this study of paternalism ‘from below’ explores the feudal structure of paternalism and the complex role played by deference in the large communal events organized in textile factories. The second part, about the large social events organized by captains of industry turned philanthropists, Titus Salt and Samuel Courtauld, examines the display of power in ‘the theatre of paternalism’ and raises the question of a possible circumvention of the paternalistic model on the part of workers. The last part is about the specificities of laudatory poems praising captains of industry and thanking them for the outings and celebrations they organized for their employees. It analyses how this specific poetical subgenre offers a space for renegotiation of paternalism and social boundaries.
86. Antibiotic-resistant gram-negative bacterial infections among persons with or without a prior positive test for SARS-CoV-2 in 10 U.S. sites, 2020
Authors: Bulens Sandra N , Grass Julian E , Duffy Nadezhda , Tola Jigsa , Jacob Jesse T , Smith Gillian , Vaeth Elisabeth , Dumyati Ghinwa , Looi Hsioa Che , Phipps Erin C , Flores Kristina , Wilson Christopher , Muleta Daniel , Czaja Christopher A , Driscoll Jennifer , Lynfield Ruth , O'Malley Sean M , Maloney Meghan , Stabach Nicole , Nadle Joelle , Pierce Rebecca , Hertzel Heather , Guh Alice 
Published: December 2022

Abstract

Background
The Centers for Disease Control and Prevention’s Emerging Infections Program (EIP) conducts active laboratory- and population-based surveillance for carbapenem-resistant Enterobacterales (CRE), extended spectrum beta-lactamase-producing Enterobacterales (ESBL-E), and carbapenem-resistant Acinetobacter baumannii (CRAB) in 10 U.S. sites. To describe the impact of the COVID-19 pandemic on the epidemiology of these antibiotic-resistant gram-negative bacteria (AR-GNB), we assessed characteristics of AR-GNB patients with and without a prior SARS-CoV-2 positive (SC2+) viral test.

Methods
In 2020 among EIP catchment-area residents, an incident CRAB or CRE case was defined as the first isolation of A. baumannii complex, Escherichia coli, Enterobacter cloacae complex, Klebsiella aerogenes, K. oxytoca, K. pneumonia, or K. variicola in a 30-day period resistant to ≥1 carbapenem (excluding ertapenem for CRAB) from a normally sterile site or urine. An incident ESBL-E case was defined as the first isolation of E. coli, K. pneumonia, or K. oxytoca in a 30-day period resistant to any third-generation cephalosporin and non-resistant to all carbapenems from a normally sterile site or urine. Patient charts were reviewed.

Results
Of 3904 AR-GNB cases with data available, 163 (4%) had a prior SC2+ test (85 ESBL-E, 70 CRE, and 8 CRAB). Median time from the most recent SC2+ test to AR-GNB culture date was 20 days (IQR 1–48 days). AR-GNB cases with a SC2+ test versus those without were more likely to be Black, non-Hispanic than another race/ethnicity (31% vs 15%; P&lt; 0.0001), aged ≥65 years (62% vs 52%; P=0.0139), and to have prior healthcare exposures (63% vs 49%; P=0.0003) and indwelling devices (51% vs 28%; P&lt; 0.0001). They were also more likely to have bacteremia (24% vs 11%; P&lt; 0.0001), pneumonia (6% vs 1%; P&lt; 0.0001) and be hospitalized around the time of their AR-GNB culture (67% vs 36%; P&lt; 0.0001); median time from SC2+ test to hospital admission was 0.5 day (IQR 0–29.5 days).

Conclusion
AR-GNB infections preceded by a SC2+ test were rare but more severe and associated with more healthcare risk factors. This underscores the need for continued infection prevention and control practices and monitoring of these infections during the COVID-19 pandemic.

Disclosures
Ghinwa Dumyati, MD, Pfizer: Grant/Research Support.