Publications by authors named "James Moon"

Background: Aircraft noise is a growing concern for communities living near airports.

Objectives: This study aimed to explore the impact of aircraft noise on heart structure and function.

Methods: Nighttime aircraft noise levels (L) and weighted 24-hour day-evening-night aircraft noise levels (L) were provided by the UK Civil Aviation Authority for 2011.

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Background: Hypertrophic cardiomyopathy (HCM) is a leading cause of sudden cardiac death. Current diagnosis emphasizes the detection of left ventricular hypertrophy (LVH) using a fixed threshold of ≥15-mm maximum wall thickness (MWT). This study proposes a method that considers individual demographics to adjust LVH thresholds as an alternative to a 1-size-fits-all approach.

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The pathophysiology of myocardial injury following COVID-19 remains uncertain. COVID-HEART was a prospective, multicentre study utilising cardiovascular magnetic resonance (CMR) to characterise COVID-related myocardial injury. In this pre-specified analysis, the objectives were to examine (1) the frequency of myocardial ischaemia following COVID-19, and (2) the association between ischaemia and myocardial injury.

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Squamous cell carcinomas (SCC) are often preceded by potentially malignant precursor lesions, most of which remain benign. The terminal exhaustion phenotypes of effector T-cells and the accumulation of myeloid-derived suppressor cells (MDSC) have been thoroughly characterized in established SCC. However, it is unclear what precancerous lesions harbor a bona fide high risk for malignant transformation and how precancerous epithelial dysplasia drives the immune system to the point of no return.

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  • In aortic stenosis, the heart's left ventricle thickens, but after aortic valve replacement (AVR), it begins to reverse this hypertrophy, though the details of this process are not fully understood.
  • A study involving 39 patients assessed changes in the heart's structure and function before and about 8 weeks after AVR, revealing a significant reduction in left ventricular mass primarily due to a decrease in the cellular component.
  • After AVR, while the cellular area shrank more than the extracellular space, an increased extracellular volume fraction was linked to a decline in heart function, even though the method of surgery (surgical or transcatheter) didn't affect outcomes.
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  • Coronary computed tomography angiography (CCTA) was evaluated as an alternative to intravascular imaging techniques for assessing plaque pathology in patients with chronic coronary syndrome.
  • The study involved 70 patients and compared CCTA with near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) to analyze atheroma burden and composition, focusing on the accuracy of detecting lipid-rich plaques.
  • Results showed that CCTA had limitations in accurately measuring plaque dimensions and composition, leading to potential issues in planning for coronary interventions.
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  • The BYPASS-CTCA trial found that using computed tomography cardiac angiography (CTCA) prior to invasive coronary angiography (ICA) in patients with previous bypass surgery reduces procedure time and the risk of kidney injury, improving patient satisfaction.
  • In this study, 688 patients were divided into two groups: one receiving CTCA before ICA and the other receiving ICA alone, with follow-up averaging 3 years.
  • Results showed that although benefits like being angina-free and improved quality of life were seen at 3 months, long-term outcomes showed CTCA/ICA patients had lower imaging resource use and fewer major adverse cardiac events compared to those who only had ICA.
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Purpose Of Review: Rectal prolapse in the pediatric population presents a clinical challenge with wide variability in etiology, presentation, work-up and management. In this article, we reviewed the evidence supporting various medical and surgical treatment options as well as the recent trends amongst pediatric surgeons.

Recent Findings: Medical therapy is highly effective in most patients, with bowel management programs being particularly successful.

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  • Dilated cardiomyopathy (DCM) is a major cause of heart failure, and this study analyzes genetic factors by examining 14,256 DCM cases and 36,203 participants from the UK Biobank for related traits.
  • Researchers discovered 80 genomic risk loci and pinpointed 62 potential effector genes tied to DCM, including some linked to rare variants.
  • The study uses advanced transcriptomics to explore how cellular functions contribute to DCM, showing that polygenic scores can help predict the disease in the general population and emphasize the importance of genetic testing and development of precise treatments.
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Our group has developed an extra-uterine environment for newborn development (EXTEND) using an ovine model, that aims to mimic the womb to improve short and long-term health outcomes associated with prematurity. This study's objective was to determine the histologic and transcriptomic consequences of EXTEND on the brain. Histology and RNA-sequencing was conducted on brain tissue from three cohorts of lambs: control pre-term (106-107 days), control late pre-term (127 days), and EXTEND lambs who were born pre-term and supported on EXTEND until late pre-term age (125-128 days).

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Hantaan virus (HTNV) and Puumala virus (PUUV) are pathogenic zoonoses found in Asia and Europe, respectively. We conducted a randomized Phase 1 clinical trial of individual HTNV and PUUV DNA vaccines targeting the envelope glycoproteins (GnGc), as well as a combined HTNV/PUUV DNA vaccine delivered at varying doses using the PharmaJet Stratis® needle-free injection system (NCT02776761). Cohort 1 and 2 vaccines consisted of 2 mg/vaccination of HTNV or PUUV plasmid, respectively.

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Metformin is an antihyperglycemic used to treat type 2 diabetes mellitus (T2DM). Patients with T2DM are at increased risk of cardiovascular disease. We explored the association between metformin use and cardiovascular magnetic resonance (CMR) derived stress myocardial blood flow (MBF), myocardial perfusion reserve (MPR) and major adverse cardiovascular events (MACE; all cause death, MI, stroke, heart failure hospitalisation and coronary revascularisation) in patients with T2DM.

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Aims: Cardiac amyloidosis (CA) is characterized by deposition of amyloid fibrils within the extracellular space, causing disarray of the myocardial structure and capillary architecture. This study aims to characterize the prevalence of microvascular obstruction (MVO) in patients with CA and to assess the association between MVO and prognosis.

Methods And Results: The study population comprised 800 patients, of which 400 had light-chain CA (AL-CA) and 400 had transthyretin CA (ATTR-CA).

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  • A phase 2 clinical trial tested the cyclin-dependent kinase inhibitor SCH 727965 in patients with metastatic melanoma to assess its safety and effectiveness, focusing on overall survival and progression-free survival rates.* -
  • Among 72 enrolled patients, there were no observed responses to the treatment out of 67 evaluable cases, with stable disease in only 21%, median progression-free survival at 1.4 months, and median overall survival at 8.2 months.* -
  • Despite some patients achieving a 1-year overall survival rate of 38%, the study concluded that SCH 727965 showed minimal benefit and significant toxic effects, suggesting it should not be further pursued as a single-agent therapy.*
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  • The study examined the effects of myocardial injury in hospitalized COVID-19 survivors who had elevated troponin levels, using cardiac imaging and tracking health-related quality of life over 12 months.* -
  • Conducted in 25 UK centers, the research involved 342 participants, finding that while some cardiovascular events occurred, overall major adverse outcomes were low after 12 months.* -
  • Results showed slight improvements in heart function and quality of life after 6 months, with no evidence of ongoing myocardial inflammation or progression of heart injury.*
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  • - The study analyzed how calcific (Ca) burden affects the accuracy of coronary computed tomography angiography (CTA) in assessing plaque burden and composition, using near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) as a comparison standard.
  • - Involving 64 patients and 186 vessels, results indicated that while Ca did not significantly alter correlations between NIRS-IVUS and CTA at the segment and lesion levels, it did affect their agreement at the cross-sectional level, specifically regarding lipid and Ca components.
  • - Ultimately, the presence of Ca burden influenced measurements and predictions of plaque volume and composition between NIRS-IVUS and CTA, highlighting the importance of considering coronary calcification in clinical evaluations.
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  • Cardiac amyloid infiltration significantly impacts survival in systemic light-chain (AL) amyloidosis, with guidelines suggesting early therapy changes for patients not responding well, regardless of cardiac amyloid severity.
  • The study aimed to compare serum biomarkers, echocardiography, and cardiovascular magnetic resonance (CMR) with extracellular volume (ECV) mapping in understanding cardiac amyloid and its prognostic value.
  • Findings revealed that ECV is a strong independent predictor of mortality, showing different relationships between the depth of hematological response and survival based on specific ECV thresholds over 1- and 6-month periods.
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The identification and characterization of antigen-specific T cells during health and disease remains a key to improving our understanding of immune pathophysiology. The technical challenges of tracking antigen-specific T cell populations within the endogenous T cell repertoire have been greatly advanced by the development of peptide:MHC tetramer reagents. These fluorescently labeled soluble multimers of MHC class I or class II molecules complexed to antigenic peptide epitopes bind directly to T cells with corresponding T cell receptor (TCR) specificity and can, therefore, identify antigen-specific T cell populations in their native state without a requirement for a functional response induced by ex vivo stimulation.

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Background: Coronary artery calcium score (CACS) is an established marker of coronary artery disease (CAD) and has been extensively used to stratify risk in asymptomatic individuals. However, the value of CACS in predicting plaque morphology in patients with advanced CAD is less established. The present analysis aims to assess the association between CACS and plaque characteristics detected by near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) imaging in patients with obstructive CAD.

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  • Bariatric surgery may improve coronary microvascular function and metabolic health in patients with obesity, reducing risks of heart dysfunction and heart failure.
  • A study showed significant decreases in obesity-related metabolic markers and an increase in myocardial blood flow and perfusion reserve 6 months after surgery.
  • Improvements in blood flow were linked to reductions in fasting insulin levels, but those with pre-existing type 2 diabetes saw less improvement.
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Background: Patients with refractory, symptomatic left ventricular (LV) mid-cavity obstructive (LVMCO) hypertrophic cardiomyopathy have few therapeutic options. Right ventricular pacing is associated with modest hemodynamic and symptomatic improvement, and LV pacing pilot data suggest therapeutic potential. We hypothesized that site-specific pacing would reduce LVMCO gradients and improve symptoms.

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  • The study investigates mitral annulus disjunction (MAD) using cardiac MRI in a group of 222 patients with an average age of 49.2 years, primarily male (56.8%).
  • MAD is identified by a separation of 2 mm or more between the left ventricular myocardium and the mitral annulus, and the study analyzes late gadolinium enhancement (LGE) patterns and ventricular arrhythmias (VA).
  • Results show that although non-sustained ventricular arrhythmias were more common in patients with greater MAD extent, no strong relationship between LGE and MAD severity was found, with no observed sustained VAs during the follow-up period of approximately 4 years.
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Despite the potential of oral immunotherapy against food allergy, adverse reactions and loss of desensitization hinder its clinical uptake. Dysbiosis of the gut microbiota is implicated in the increasing prevalence of food allergy, which will need to be regulated to enable for an effective oral immunotherapy against food allergy. Here we report an inulin gel formulated with an allergen that normalizes the dysregulated ileal microbiota and metabolites in allergic mice, establishes allergen-specific oral tolerance and achieves robust oral immunotherapy efficacy with sustained unresponsiveness in food allergy models.

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