Enhancing Clinical Decision Making by Predicting Readmission Risk in Patients With Heart Failure Using Machine Learning: Predictive Model Development Study.

Background: Patients with heart failure frequently face the possibility of rehospitalization following an initial hospital stay, placing a significant burden on both patients and health care systems. Accurate predictive tools are crucial for guiding clinical decision-making and optimizing patient care. However, the effectiveness of existing models tailored specifically to the Chinese population is still limited.

The Role of Clinician-Developed Applications in Promoting Adherence to Evidence-Based Guidelines: Pilot Study.

Background: Computerized clinical decision support systems (CDSS) are increasingly being used in clinical practice to improve health care delivery. Mobile apps are a type of CDSS that are currently being increasingly used, particularly in lifestyle interventions and disease prevention. However, the use of such apps in acute patient care, diagnosis, and management has not been studied to a great extent.

Correlation between the 5-tier fetal heart rate pattern classification at delivery and Apgar scores.

Aim: In Japan, the fetal heart rate pattern on cardiotocography is usually categorized into five levels for intrapartum management; however, studies on the 5-tier cardiotocography classification are limited. This study aimed to determine the correlation between 5-tier cardiotocography levels at delivery, neonatal Apgar scores and perinatal prognosis using a perinatal registry database.

Methods: This retrospective study used the 2018 Perinatal Registry Database of the Japan Society of Obstetrics and Gynecology.

hURAT1 Transgenic Mouse Model for Evaluating Targeted Urate-Lowering Agents.

Background: Urate transporter 1 (URAT1) is a well-known therapeutic target for reducing urate levels in the treatment of hyperuricemia and gout. However, current pharmacological studies have failed to evaluate the efficacy of URAT1 inhibitors in non-primate animal models. We established a human URAT1 (hURAT1) transgenic knock-in (KI) mouse model to assess uricosuric agents' effectiveness and characterize URAT1-caused pathogenesis.

Transient suppression of high-prevalence Kell blood group antigens and concomitant development of a Kell-related antibody that appears to recognize a high-prevalence Kell antigen not previously defined.

A previously healthy 32-year-old male patient was admitted to hospital with malaise, dyspnea, anemia, thrombocytopenia, and leukopenia. Anemia and thrombocytopenia worsened during the third week. Considering the possible need for transfusion, routine ABO and D typing and an antibody detection test were performed.

Cardiovascular and Metabolic Adverse Events of Endocrine Therapies in Women with Breast Cancer: A Disproportionality Analysis of Reports in the FDA Adverse Event Reporting System.

Introduction: Emerging evidence suggests potential cardiovascular toxicities from oral endocrine therapies (ETs); however, results are conflicting. This study comprehensively examined adverse reactions of ETs and investigated cardiovascular and metabolic safety signals within the FDA Adverse Event Reporting System (FAERS).

Methods: Reports in the FAERS through December 2023 were analyzed for documented reactions to tamoxifen, letrozole, anastrozole, and exemestane in female breast cancer patients.

Obesity-induced activation of NADPH oxidase 2 prolongs cardiac repolarization via inhibiting K+ currents.

Obesity is associated with abnormal repolarization manifested by QT interval prolongation, and oxidative stress is an important link between obesity and arrhythmias. However, the underlying electrophysiological and molecular mechanisms remain unclear. The aim of this study is to evaluate the role of obesity in potassium current in ventricular myocytes and the potential mechanism of NADPH oxidase 2 (Nox2).

Comparison of age-related decline in C57BL/6J and CB6F1J male mice.

Variability in physical resilience to aging prompts a comprehensive examination of underlying mechanisms across organs and individuals. We conducted a detailed exploration of behavioral and physiological differences between male C57BL/6J and male CB6F1J mice across various age groups (4, 12, 20, 24 months). In behavioral assays, C57BL/6J mice displayed superior performance in rotarod tasks but higher anxiety while CB6F1J mice exhibited a decline in short-term memory with age.

Enhanced heart sound classification using Mel frequency cepstral coefficients and comparative analysis of single vs. ensemble classifier strategies.

This paper seeks to enhance the performance of Mel Frequency Cepstral Coefficients (MFCCs) for detecting abnormal heart sounds. Heart sounds are first pre-processed to remove noise and then segmented into S1, systole, S2, and diastole intervals, with thirteen MFCCs estimated from each segment, yielding 52 MFCCs per beat. Finally, MFCCs are used for heart sound classification.

The Evaluation of Right Ventricular Synchrony by Two-Dimensional Speckle Tracking Echocardiography in Connective Tissue Disease-Associated Pulmonary Arterial Hypertension.

Objectives: Numerous studies have demonstrated impaired right ventricular (RV) synchronicity in pulmonary arterial hypertension (PAH). However, few studies have focused on connective tissue disease (CTD)-associated PAH. This study evaluates RV dyssynchrony and its prognostic value in CTD-associated PAH.

Unmasking the Epicardial Adipose Tissue-Left Atrial Strain Nexus in HFpEF: A Potential Echocardiographic Signature of Cardiac Adaptation.

Purpose: This study aims to investigate the relationship between epicardial adipose tissue (EAT) and left atrial function in patients with preserved ejection fraction heart failure (HFpEF).

Methods: We conducted a cross-sectional study involving 113 patients diagnosed with HFpEF and 48 control subjects without heart failure. Echocardiography was performed to assess EAT thickness and left atrial function was quantified using Autostrain left atrium (LA), including left atrial strain during reservoir phase (LASr), left atrial strain during conduit phase (LAScd), and left atrial strain during contraction phase (LASct).

Prognostic Value of Advanced Echocardiography in Patients with Ischemic Heart Disease: A Comprehensive Review.

Cardiovascular (CV) diseases caused 20.5 million deaths in 2021, making up nearly one-third of global mortality. This highlights the need for practical prognostic markers to better classify patients and guide treatment, especially in ischemic heart disease (IHD), which represents one of the leading causes of CV mortality.

Barriers and facilitators for cardiopulmonary resuscitation discussions with people with heart failure.

Background: Care planning with people with advanced heart failure enables appropriate care, and prevents futile interventions, such as cardio-pulmonary resuscitation (CPR).

Aim: To explore what motivates clinicians to conduct, and people with heart failure and their carers, to engage in well-conducted CPR discussions.

Methods: In-depth remote interviews with i) people with heart failure and self-reported daily symptoms (≥ 3 months), ii) informal carers and, iii) clinicians recruited through social media and professional groups, team contacts and snowballing.

Mechanical Circulatory Support for Right Ventricular Primary Graft Dysfunction After Heart Transplant: A Review.

Primary graft dysfunction (PGD) is the most common cause of early mortality following heart transplantation. Although PGD can affect both ventricles, isolated right ventricular dysfunction (RV-PGD) is observed in nearly half of PGD patients. RV-PGD requires specific medical management to support the preload, afterload, and function of the failing RV; however, the use of mechanical circulatory support of the RV (RV-MCS) might be required when optimal medical therapy is insufficient in preventing forward failure and retrograde venous congestion.

SGLT2 expression in human vasculature and heart correlates with low-grade inflammation and causes eNOS-NO/ROS imbalance.

Aims: Sodium-glucose co-transporter 2 inhibitors (SGLT2i) show a cardioprotective effect in heart failure and myocardial infarction, pathologies often associated with low-grade inflammation. This cross-sectional study aims to investigate whether low-grade inflammation regulates SGLT2 expression and function in human vasculature, heart, and endothelial cells (ECs).

Methods And Results: Human internal thoracic artery (ITA), left ventricle (LV) specimens, and cultured porcine coronary artery ECs were used.

Differential microvascular endothelial cell responses in the retina in diabetes compared to the heart and kidneys, a spatial transcriptomic analysis.

Endothelial cells and high glucose-induced endothelial dysfunction are the common origin of chronic diabetic complications such as retinopathy, nephropathy, and cardiomyopathy. Yet their common origins, the vascular manifestations of such complications are different. We examined the basal heterogeneity between microvascular endothelial cells(MECs) from the retina, kidneys, and heart, as well as their differential responses to hyperglycemia in diabetes.

Tsg101 mimicry of canonical E2 enzymes underlies its role in ubiquitin signaling.

Tsg101 is a highly conserved protein best known as an early-functioning component of cellular ESCRT machinery participating in recognition, sorting, and trafficking of cellular cargo to various intracellular destinations. It shares sequence and structural homology to canonical ubiquitin-conjugating (E2) enzymes and is linked to diverse events regulated by Ub signaling. How it might fulfill these roles is unclear.

Memory control deficits in the sleep-deprived human brain.

Sleep disturbances are associated with intrusive memories, but the neurocognitive mechanisms underpinning this relationship are poorly understood. Here, we show that sleep deprivation disrupts prefrontal inhibition of memory retrieval, and that the overnight restoration of this inhibitory mechanism is associated with time spent in rapid eye movement (REM) sleep. The functional impairments arising from sleep deprivation are linked to a behavioral deficit in the ability to downregulate unwanted memories, and coincide with a deterioration of deliberate patterns of self-generated thought.

An animal model recapitulates human hepatic diseases associated with mutations.

Heterozygotic mutations are responsible for various congenital diseases in the heart, pancreas, liver, and other organs in humans. However, there is lack of an animal that can comprehensively model these diseases since GATA6 is essential for early embryogenesis. Here, we report the establishment of a knockout zebrafish which recapitulates most of the symptoms in patients with mutations, including cardiac outflow tract defects, pancreatic hypoplasia/agenesis, gallbladder agenesis, and various liver diseases.

Neurological Nurses' Perspectives on Communication of Stroke Recurrence Risks: A Mixed-Method Study.

Aim: To gain a comprehensive understanding of the practices, attitudes, and thoughts of neurological nurses regarding communication about the risk of stroke recurrence.

Design: This is a mixed-method study with a sequential explanatory design.

Methods: An electronic survey was conducted amongst 280 neurological nurses from 30 hospitals to explore their clinical practice and attitudes towards stroke recurrence risk communication (RC).

Effects of Graphene Quantum Dots on Renal Fibrosis Through Alleviating Oxidative Stress and Restoring Mitochondrial Membrane Potential.

Podocyte injury and proteinuria in glomerular disease are critical indicators of acute kidney injury progression to chronic kidney disease. Renal mitochondrial dysfunction, mediated by intracellular calcium levels and oxidative stress, is a major contributor to podocyte complications. Despite various strategies targeting mitochondria to improve kidney function, effective treatments remain lacking.

Delineation of the Genetic Architecture and Clinical Polymorphism of 3q29 Duplication Syndrome: A Review of the Literature and a Report of Two Novel Patients With Single-Gene BDH1 Duplications.

Background: Chromosome 3q29 duplication syndrome is a rare chromosomal disorder with a frequency of 1:5000 in patients with a neurodevelopmental phenotype. The syndrome is characterized by phenotypic polymorphism and reduced penetrance.

Methods: Patients were investigated by performing a cytogenetic analysis of GTG-banded metaphases, aCGH with the SurePrint G3 Human CGH Microarray 8×60K, qPCR, FISH, and WES.

Ultrasound-Guided Axillary Vein Puncture Versus Landmark-Guided Approach for Cardiac Implantable Electronic Device Placement.

Introduction: Ultrasound (US)-guided axillary vein puncture is a safe and effective approach for cardiac implantable electronic device (CIED) implantation, and it is highly recommended by the current consensus document. However, only reports on small populations are available in the current literature regarding the comparison of this technique with other traditional approaches (subclavian vein blind puncture and cephalic vein surgical cutdown).

Purpose: We aimed to assess the effectiveness and safety of US- guided axillary vein puncture using a microintroducer kit for CIED implantation as compared to the aforementioned traditional approaches.