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Angelo Oliva,1,2 Davide Cao,1,3 Alessandro Spirito,1 Johny Nicolas,1 Brunna Pileggi,1,4 Karim Kamaleldin,1 Birgit Vogel,1 Roxana Mehran1 1The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; 2Cardio Center, Humanitas Research Hospital IRCCS Rozzano, Milan, Italy; 3Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy; 4Department of Cardiopneumonology, Heart Institute of the University of Sao Paulo, Sao Paulo, BrazilCorrespondence: Roxana Mehran, Tel +1-212-659-9649, Email roxana.mehran@mountsinai.orgAbstract: Antiplatelet therapy is the cornerstone of antithrombotic prevention in patients with established atherosclerosis, since it has been proven to reduce coronary, cerebrovascular, and peripheral thrombotic events. However, the protective effect of antiplatelet agents is counterbalanced by an increase of bleeding events that impacts on patients’ mortality and morbidity. Over the last years, great efforts have been made toward personalized antithrombotic strategies according to the individual bleeding and ischemic risk profile, aiming to maximizing the net clinical benefit. The development of risk scores, consensus definitions, and the new promising artificial intelligence tools, as well as the assessment of platelet responsiveness using platelet function and genetic testing, are now part of an integrated approach to tailored antithrombotic management. Moreover, novel strategies are available including dual antiplatelet therapy intensity and length modulation in patients undergoing myocardial revascularization, the use of P2Y12 inhibitor monotherapy for long-term secondary prevention, the implementation of parenteral antiplatelet agents in high-ischemic risk clinical settings, and combination of antiplatelet agents with low-dose factor Xa inhibitors (dual pathway inhibition) in patients suffering from polyvascular disease. This review summarizes the currently available evidence and provides an overview of the principal risk-stratification tools and antiplatelet strategies to inform treatment decisions in patients with cardiovascular disease.Keywords: antiplatelet therapy, cardiovascular disease, P2Y12 inhibitor, aspirin

Jaya Chandrasekhar,1 Amrita Gill,1,2 Roxana Mehran1 1Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, NY, 2Saint Louis University, St Louis, MO, USA Abstract: Acute myocardial infarction (AMI) is the leading cause of death in women worldwide. Every year, in the USA alone, more than 30,000 young women

BACKGROUND: Patients with severe aortic stenosis and a small aortic annulus are at risk for impaired valvular hemodynamic performance and associated adverse cardiovascular clinical outcomes after transcatheter aortic-valve replacement (TAVR). METHODS: We randomly assigned patients with symptomatic severe aortic stenosis and an aortic-valve annulus area of 430 mm2 or less in a 1:1 ratio to undergo TAVR with either a self-expanding supraannular valve or a balloon-expandable valve. The coprimary end points, each assessed through 12 months, were a composite of death, disabling stroke, or rehospitalization for heart failure (tested for noninferiority) and a composite end point measuring bioprosthetic-valve dysfunction (tested for superiority). RESULTS: A total of 716 patients were treated at 83 sites in 13 countries (mean age, 80 years; 87% women; mean Society of Thoracic Surgeons Predicted Risk of Mortality, 3.3%). The Kaplan-Meier estimate of the percentage of patients who died, had a disabling stroke, or were rehospitalized for heart failure through 12 months was 9.4% with the self-expanding valve and 10.6% with the balloon-expandable valve (difference, -1.2 percentage points; 90% confidence interval [CI], -4.9 to 2.5; P<0.001 for noninferiority). The Kaplan-Meier estimate of the percentage of patients with bioprosthetic-valve dysfunction through 12 months was 9.4% with the self-expanding valve and 41.6% with the balloon-expandable valve (difference, -32.2 percentage points; 95% CI, -38.7 to -25.6; P<0.001 for superiority). The aortic-valve mean gradient at 12 months was 7.7 mm Hg with the self-expanding valve and 15.7 mm Hg with the balloon-expandable valve, and the corresponding values for additional secondary end points through 12 months were as follows: mean effective orifice area, 1.99 cm2 and 1.50 cm2; percentage of patients with hemodynamic structural valve dysfunction, 3.5% and 32.8%; and percentage of women with bioprosthetic-valve dysfunction, 10.2% and 43.3% (all P<0.001). Moderate or severe prosthesis-patient mismatch at 30 days was found in 11.2% of the patients in the self-expanding valve group and 35.3% of those in the balloon-expandable valve group (P<0.001). Major safety end points appeared to be similar in the two groups. CONCLUSIONS: Among patients with severe aortic stenosis and a small aortic annulus who underwent TAVR, a self-expanding supraannular valve was noninferior to a balloon-expandable valve with respect to clinical outcomes and was superior with respect to bioprosthetic-valve dysfunction through 12 months. (Funded by Medtronic; SMART ClinicalTrials.gov number, NCT04722250.). [ABSTRACT FROM AUTHOR]

Abstract Boehmite nanoparticles and NaY nanozeolite were synthesized by co-precipitation and hydrothermal methods, respectively, and characterized by XRD, FT-IR, TG-DTA, BET, and SEM techniques. XRD and BET analyses demonstrated the formation of boehmite nanoparticles with a surface area of 350 m2/g and high crystallinity NaY nanozeolite with a surface area of 957 m2/g. In order to evaluate the effect of the content of the mesoporous boehmite nanoparticles on the catalytic performance of the Residue Fluid Catalytic Cracking (RFCC) catalyst, alumina active matrix-based and silica inactive matrix-based catalysts were prepared. Results actually demonstrated that the acidity of the zeolite composition improved with the addition of boehmite nanoparticles. On the other hand, in equal zeolite content, the alumina active matrix-based catalyst possessed higher acidity (NC30B20, 3.44 mmol NH3/g catalyst) than the silica inactive matrix-based catalyst (NC30B0, 2.31 mmol NH3/g catalyst). Microactivity tests (MAT) demonstrated that, with equal zeolite content, active matrix-based catalysts exhibited higher catalytic performance than inactive matrix-based catalyst. Furthermore, the active matrix-based catalyst (NC30B20) with a surface area of 370 m2/g showed the optimum catalytic performance in the RFCC process. The synthesized NC30B20 catalyst with 20 wt% mesoporous boehmite nanoparticles as an active matrix and 30 wt% zeolite nanoparticles balanced with silica had the highest gasoline yield (42 wt%) and gasoline selectivity (65.1 wt%). The catalytic performance test results showed that in equal MAT conversion (almost 64 wt%), the synthesized NC30B20 catalyst had higher catalytic performance than the commercial catalyst.

Abstract Background Despite all the advances in our knowledge regarding obesity, our understanding of its etiology is still far from complete. This study aimed to evaluate the association of serum irisin levels with physical activity and some of the metabolic syndrome-related biomarkers among obese people with low-calorie intake and non-obese people with high-calorie intake. Methods Obese and non-obese healthy individuals with respectively low and high-calorie intakes were recruited. Irisin and other biomarkers were measured using standard biochemical methods. Participants’ physical activity was evaluated by administering the International Physical Activity Questionnaire (IPAQ). To analyze the body composition of the participants, a standard body composition device (ioi 353) was applied. Logistic regression was used to calculate the odds ratio (OR) and to examine the effect of confounders such as age, sex, genetics, and activity. Results Data from the seventy-seven participants were included in the final analysis. The mean age of the participants in the obese and non-obese groups was 38.33 ± 14.88 and 30.24 ± 13.37 years, respectively. Participants in the obese group had lower physical activity compared to the non-obese group (3395.38 ± 2801 MET-min/week vs. 6015.18 ± 3178 MET-min/week; p

Background: Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT) are known to mitigate impulsivity in patients with borderline personality disorder (BPD). Aims and Objectives: This study aims to evaluate their impact on impulsivity in individuals without BPD. Materials and Methods: A non-randomized trial using a convenience sampling method, was conducted with 65 patients exhibiting impulsive behaviors who visited the Amir Kabir Medical Center in Arak between January 20 and March 20, 2023. After excluding those who did not meet the inclusion criteria, 48 participants remained. These participants were divided into three groups: two experimental groups receiving either DBT or CBT, and a control group with no intervention. Both experimental groups underwent 14 sessions of 45 minutes each. Pretest and posttest evaluations were conducted using the Barratt Impulsiveness Scale (BIS), and the data were analyzed using multivariate analysis of covariance. Results: The findings revealed a significant reduction in impulsive behaviors in both experimental groups compared to their pretest scores, with a statistically significant difference between the experimental and control groups. Conclusion: This study demonstrates that the techniques employed can serve as an effective behavioral treatment package for impulsive behaviors in non-BPD patients.

Abstract The PERSIAN eye cohort study is a population-based study that evaluates the overall prevalence of cataracts and their subtypes (nuclear sclerosis, cortical, and PSC) in Iran. In this study, from January 2015 to September 2021, 16,016 participants over 35 years of age from four provinces who were selected by random cluster sampling were examined. Demographic information, education, socioeconomic status, and place of residence were collected through interviews. The cataract status of the study participants was examined by two experienced ophthalmologists using slit lamp photography. The average age of the study participants was 49.52 ± 9.31 and 8891 (55.5%) were female. The overall prevalence of each type of cataract, nuclear sclerosis, cortical, and PSC was 18.90%, 12.65%, 9.20%, and 3.08%, respectively. The results indicated that the prevalence of any type of cataract (adjusted OR = 0.85, 95% CI: 0.78–0.92, p

Abstract Tuberculosis represents a significant menace to health, leading to millions of cases and fatalities each year. Traditional diagnostic methods, while effective, have limitations, necessitating improved tools. Aptamers possessing remarkable specificity single-stranded DNA or RNA molecules promising in TB diagnosis due to their adaptability and precise biomarker detection capabilities. In this study, we aimed to evaluate the research on aptamer applications in TB diagnosis, evaluating the efficacy, limitations, and future prospects. The present systematic review study followed PRISMA guidelines, including peer-reviewed studies on aptamer efficacy in TB diagnosis. Eligibility criteria covered experimental and human studies on TB diagnosis, prognosis, progression, and treatment response. Of 1165 identified studies, 35 met inclusion criteria. Aptamers were utilized for MTB and mycobacterial antigen detection, showcasing notable sensitivity and specificity. Targeted antigens included ESAT-6, HspX, MPT 64, and IFN-γ. Various aptamer-based assays, such as electrochemical, fluorescent, and immunosensors, demonstrated effectiveness. Multiplex assays, particularly for IFN-γ, showed enhanced diagnostic accuracy. Aptamer-based assays exhibited discrimination between active TB and other conditions, showcasing their diagnostic value. Aptamers, especially in conjunction with nanomaterials, show promise in developing advanced TB biosensors with superior detection capabilities. Cost-effective devices with heightened sensitivity for clinical and screening use are crucial for TB control, emphasizing the need for ongoing research in this field.

Abstract A series of M/NiCo-Ferrite (M: Pt, Pd, Ru, and Rh) nanoparticles were successfully synthesized, through a facile sol–gel auto-combustion followed by impregnation-reduction approach, as a catalyst for hydrogen generation from hydrolysis of NaBH4. All synthesized samples were characterized by XRD, N2 adsorption–desorption method, ICP-OES, FE-SEM, and EDX analysis. Compared to the other samples, it was observed that the Rh/NiCo-Ferrite sample exhibited higher particle distribution and surface area. To evaluate the hydrogen generation rate, the hydrolysis was carried out at a temperature of 35 °C, with an aqueous solution containing 5 wt.% NaBH4 and 3 wt.% NaOH. The experimental findings indicate that the Rh/NiCo-Ferrite sample exhibited a superior rate of hydrogen generation, with an average value of 11,667 mL/min.gcat, compared to the other samples studied. Enhanced catalytic properties may be responsible for its high activity. In addition, the activation energy of hydrolysis of sodium borohydride over the Rh/NiCo-Ferrite sample was 54.5 kJ/mol which is lower than the activation energy of many Ferrite-based catalysts. Moreover, the re-usability test of the Rh/NiCo-Ferrite sample denoted a decline in the catalytic activity after 4 recycling experiments due to the alterations in morphology and the reduction in the quantity of active phase.

Abstract Background In developing nations, myocardial infarction (MI) remains a significant contributor to deaths from sudden cardiac arrest, with diet playing a key role in its incidence through oxidative stress mechanisms. Although the connection between the Dietary Antioxidant Index (DAI) and cardiovascular diseases has been demonstrated in some studies, the relationship between DAI and MI has not been extensively explored. Therefore, this research aims to investigate this association. Methods We conducted a nested case-control study involving 156 MI cases and 312 healthy controls, utilizing data from the Fasa Adults Cohort Study (FACS), a population-based study of individuals aged 35–70 residing in Fasa, Iran, with 11,097 participants included at baseline. The DAI was determined by normalizing the intake values of six dietary vitamins and minerals, adjusting by subtracting the global mean, and then dividing by the global standard deviation. MI diagnosis was established by an experienced cardiologist using electronic medical records. Conditional logistic regression was employed to examine the association between DAI and MI. Results There were no significant differences between the case and control groups in terms of age (P = 0.96), gender distribution (P = 0.98), and education level (P = 0.38). In a multiple conditional logistic regression analysis, after adjusting for key variables—including body mass index (BMI), smoking status, education level, and serum levels of triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), fasting blood sugar (FBS), saturated fatty acids (SFA), and polyunsaturated fatty acids (PUFA)—an inverse association was found between DAI and the risk of myocardial infarction (MI) [adjusted Odds Ratio (Adj OR) = 0.88, 95% Confidence Interval (CI): 0.85–0.92; P

Background: Rheumatoid arthritis (RA) is known as an inflammatory illness. Evidence shows that Vitamin D modulates immunologic function and inflammation by affecting various immunological cells. We decided to run a systematic review and meta-analysis to investigate the relationship between vitamin D supplementation and the outcomes of adult patients suffering from RA. Methods: We searched electronic databases, using specific search terms in PubMed, Scopus, and ISI Web of Science, until May 2024. Clinical studies involving patients with RA were included if they compared the effects of vitamin D supplementation to either a placebo or standard care. The results from the selected studies were presented as weighted mean differences (WMD) along with a 95 % confidence interval (CI). Results: Inclusion criteria have been met by 11 studies and presented as part of this analysis. The results indicate a major influence of vitamin D supplementation on the Disease Activity Score 28 (DAS-28) (WMD: −0.83, 95 % CI: −1.38 to −0.28, p-value

BackgroundNonalcoholic Fatty Liver Disease (NAFLD) is a prevalent condition strongly associated with poor dietary habits and obesity. The Lifelines Diet Score (LLDS), a measure of adherence to a health-promoting diet, may reduce the risk of NAFLD. This study investigates the association between LLDS and NAFLD risk, as well as its relationship with novel anthropometric indices in adults.MethodsThis case–control study included 180 NAFLD patients and 250 controls aged 20–65 years from Valiasr Hospital, Zanjan, Iran. Dietary intake was assessed using a validated 147-item food frequency questionnaire, and LLDS was calculated by scoring food groups according to dietary guidelines. Anthropometric measurements included Body Mass Index (BMI), Waist Circumference (WC), A Body Shape Index (ABSI), Body Roundness Index (BRI), and Visceral Adiposity Index (VAI). Logistic regression models estimated the odds ratios (ORs) for NAFLD across LLDS quartiles.ResultsParticipants in the highest LLDS quartile had significantly reduced odds of NAFLD compared to those in the lowest quartile (OR = 0.49; 95% CI: 0.30–0.65; p

IntroductionHypertension (HTN) is a prevalent condition associated with numerous cardiovascular and non-cardiac complications. Lifestyle interventions, including dietary adjustments, offer promising avenues for hypertension management. However, the precise relationship between dietary antioxidants and hypertension risk necessitates further investigation. This study aimed to elucidate the association between the Dietary Antioxidant Index (DAI) and hypertension risk using a nested case–control design.MethodA matched nested case–control study was conducted within the Fasa Adult Cohort Study (FACS), comprising 975 participants aged 35–70 years. Cases (n = 325) were hypertensive patients, while controls (n = 650) were individuals without hypertension, matched for sex and age. Dietary intake was assessed using a validated food frequency questionnaire, and DAI was computed based on standardized intake of antioxidants. Conditional logistic regression models were employed to evaluate the association between DAI and hypertension risk, adjusting for confounding variables.ResultsA significant inverse correlation was observed between DAI and hypertension risk across all models (OR = 0.89; 95% CI = 0.86–0.93, p