Miracle-dz/UniFAR-FTUs huggingface dataset:
Pleomorphic Ventricular Tachycardia in Dilated Cardiomyopathy Predicts Ventricular Tachycardia Recurrence After Ablation Independent From Cardiac Function: Comparison With Patients With Ischemic Heart Disease

Background: In dilated cardiomyopathy (DCM), outcome after catheter ablation of ventricular tachycardia (VT) is modest, compared with ischemic heart disease (IHD). Pleomorphic VT (PL-VT) has been associated with fibrotic remodeling and end-stage heart failure in IHD. The prognostic role of PL-VT in DCM is unknown. Methods: Consecutive IHD (2009–2016) or DCM (2008–2018) patients undergoing ablation for monomorphic VT were included. PL-VT was defined as ≥1 spontaneous change of the 12-lead VT-morphology during the same induced VT episode. Patients were followed for VT recurrence and mortality. Results: A total of 247 patients (86% men; 63±13 years; IHD n=152; DCM n=95) underwent ablation for monomorphic VT. PL-VT was observed in 22 and 29 patients with IHD and DCM, respectively (14% versus 31%, P=0.003). In IHD, PL-VT was associated with lower LVEF (28±9% versus 34±12%, P=0.02) and only observed in those with LVEF<40%. In contrast, in DCM, PL-VT was not related to LVEF and induced in 27% of patients with LVEF>40%. During a median follow-up of 30 months, 79 (32%) patients died (IHD 48; DCM 31; P=0.88) and 120 (49%) had VT recurrence (IHD 59; DCM 61; P<0.001). PL-VT was associated with mortality in IHD but not in DCM. In IHD, VT recurrence was independently associated with LVEF, number of induced VTs, and procedural noncomplete success. Of note, in DCM, PL-VT (HR, 2.62 [95% CI, 1.47–4.69]), pathogenic mutation (HR, 2.13 [95% CI, 1.16–3.91]), and anteroseptal VT substrate (HR, 1.75 [95% CI, 1.00–3.07]) independently predicted VT recurrence. Conclusions: In IHD, PL-VT was associated with low LVEF and mortality. In DCM, PL-VT was not associated with mortality but a predictor of VT recurrence independent from LVEF. PL-VT in DCM may indicate a specific arrhythmic substrate difficult to control by current ablation techniques.
‘A drive to make change’ - exploring the views and experiences of medical students engaging in advocacy: a qualitative study in a UK medical school

ABSTRACT Background Advocacy is a recognised competency for medical graduates. Many medical students engage in advocacy, but research on this topic is limited. This study aimed to explore the views and experiences of medical student advocates. Methods Qualitative study using semi-structured interviews. Nine medical students from advocacy organisations were recruited by purposive sampling. Thematic analysis was used to generate codes and develop themes. Results There were five themes: triggers and enablers; barriers and disablers; knowledge, skills, and attributes; advocacy in the role of health professionals, and career aspirations; and teaching and assessment of advocacy. Triggers and enablers included internal drivers (e.g. experiencing injustice), and external drivers (e.g. role models). Obstacles included lack of institutional support, personal challenges, and discomfort around professionalism in advocacy. Student enhanced their knowledge of social issues and improved communication skills. Advocacy activities strongly influenced students’ future plans. Most agreed that advocacy is an important topic in medical education, suggesting teaching it early in medical school via small-group tutorials and role-modelling. For assessment, a reflective approach was preferred over written exams. Conclusion Medical students’ engagement in advocacy has complex facilitators and barriers, and the relationship between advocacy and professionalism requires clarity. Benefits of advocacy include fostering empathy and other transferable skills required of future doctors. Advocacy teaching was welcomed by students, with suggested approaches proposed. The optimal learning and assessment strategy remains uncertain, and further research is needed.
The abundance of sulfur in extragalactic H II regions

A long-slit CCD survey of forbidden S III 9069, 9532 A radiation in 13 extragalactic H II regions is presented, and the data are used to study the variation of S/O as a function of O/H. The data are consistent with the idea that S/O remains constant as O/H varies. There is no evidence that S/O is larger at low O/H. Photoionization models confirm that observations of O(+)/O(2+) and S(+)/S(2+) can be used to estimate the effective temperature of the ionizing stars in an H II region. This provides a potentially powerful new tool for studying the ionizing stars of H II regions in external galaxies. However, the models fail to reproduce the S(+)/S(2+) ratio in nebulae with large O(2+) fractions for reasonable values of T(eff). Simple chemical evolution models are calculated to compare observations with expectations from stellar neucleosynthesis calculations. 84 refs.
Automated stellar abundance analysis

Abstract The advent of Milky Way high-resolution spectroscopic surveys has brought our attention to the importance of precise chemical abundance measurements to disentangle the stellar population puzzle of the Galaxy. Moreover, automated stellar parameters are the bedrock of Galactic spectroscopic surveys science. They allow a rapid and homogeneous processing of extensive data sets, necessary for an efficient scientific return. In this review, I discuss the different parametrization techniques, focusing on the automated determination of individual element abundances. Each of them has its optimal application conditions that mainly depend on the computation time constraints, the spectral resolution, the wavelength domain, the data signal-to-noise ratio and parameter degeneracy problems. The main algorithms in the literature are also reviewed.
A Randomized Controlled Trial of Fibrin Glue to Prevent Bleeding After Gastric Endoscopic Submucosal Dissection

INTRODUCTION: This study evaluated the efficacy of fibrin glue for preventing postendoscopic submucosal dissection (ESD) bleeding in high-risk patients for bleeding (expected iatrogenic ulcer size ≥40 mm or receiving antithrombotic therapy). METHODS: A multicenter, open-label, randomized controlled trial was performed at 4 tertiary medical centers in South Korea between July 1, 2020, and June 22, 2022. Patients with gastric neoplasm and a high risk of post-ESD bleeding were enrolled and allocated at 1:1 to a control group (standard ESD) or a fibrin glue group (fibrin glue applied to iatrogenic ulcers after standard ESD). The primary outcome was overall bleeding events within 4 weeks. The secondary outcomes were acute bleeding (within 48 hours post-ESD) and delayed bleeding (48 hours to 4 weeks post-ESD). RESULTS: In total, 254 patients were randomized, and 247 patients were included in the modified intention-to-treat population (125 patients in the fibrin glue group and 122 patients in the control group). Overall bleeding events occurred in 12.0% (15/125) of the fibrin glue group and 13.1% (16/122) of the control group (P = 0.791). Acute bleeding events were significantly less common in the fibrin glue group than in the control group (1/125 vs 7/122, P = 0.034). Delayed bleeding events occurred in 11.2% (14/125) in the fibrin glue group and 7.3% (9/122) in the control group (P = 0.301). DISCUSSION: This trial failed to show a preventive effect of fibrin glue on overall post-ESD bleeding in high-risk patients. However, the secondary outcomes suggest a potential sealing effect of fibrin glue during the acute period.
Normality of Posterior Distribution Under Misspecification and Nonsmoothness, and Bayes Factor for Davies' Problem

We examine the large sample properties of Bayes procedures in a general framework, where data may be dependent and models may be misspecified and nonsmooth. The posterior distribution of parameters is shown to be asymptotically normal, centered at the quasi maximum likelihood estimator, under mild conditions. In this framework, the Bayes factor for the test problem of Davies (1997, 1987), where a parameter is unidentified under the null hypothesis, is analyzed. The probability that the Bayes factor leads to a correct conclusion about the hypotheses in Davies’ problem is shown to approach to one.
CONDITIONAL MARKOV PROCESSES

Relationships are given between the probabilities of conditional Markov chains for neighboring tests. The conditional probabilities at the end of the observation interval (the final probabilities) are satisfied by equations of the first kind corresponding to an increase in the observation interval. The equations of the second kind for the conditional probabilities within the observation interval are written in terms of these final probabilities.The following special cases are considered. Gaussian noise with independent values which becomes a delta-correlational process when the moments of time are compacted, and a continuous Markov process.The related problem of the time reversal of ordinary (a priori) Markov processes is treated as a side issue.
Development and Validation of a Genomic Profile for the Omission of Local Adjuvant Radiation in Breast Cancer

PURPOSE Adjuvant radiotherapy (RT) is used for women with early-stage invasive breast cancer treated with breast-conserving surgery. However, some women with low risk of recurrence may safely be spared RT. This study aimed to identify these women using a molecular-based approach. METHODS We analyzed two randomized trials of women with node-negative invasive breast cancer to ± RT following breast-conserving surgery: SweBCG91-RT (stage I-II, no adjuvant systemic therapy) and Princess Margaret (age 50 years or older, T1-T2, adjuvant tamoxifen). Transcriptome-wide profiling was performed (Affymetrix Human Exon 1.0 ST microarray). Patients with estrogen receptor–positive/human epidermal growth factor receptor 2–negative tumors and with gene expression data were included. The SweBCG91-RT cohort was divided into training (N = 243) and validation (N = 354) cohorts. A 16-gene signature named Profile for the Omission of Local Adjuvant Radiation (POLAR) was trained to predict locoregional recurrence (LRR) using elastic net regression. POLAR was then validated in the SweBCG91-RT validation cohort and the Princess Margaret cohort (N = 132). RESULTS Patients categorized as POLAR low-risk without RT had a 10-year LRR of 6% (95% CI, 2 to 16) and 7% (0 to 27) in SweBCG91-RT and Princess Margaret cohorts, respectively. There was no significant benefit from RT in POLAR low-risk patients (hazard ratio [HR], 1.1 [0.39 to 3.4], P = .81, and HR, 1.5 [0.14 to 16], P = .74, respectively). Patients categorized as POLAR high-risk had a significant decreased risk of LRR with RT (HR, 0.43 [0.24 to 0.78], P = .0055, and HR, 0.25 [0.07 to 0.92], P = .038, respectively). An exploratory analysis testing for interaction between RT and POLAR in the combined validation cohort was performed (P = .066). CONCLUSION The novel POLAR genomic signature on the basis of LRR biology may identify patients with a low risk of LRR despite not receiving RT, and thus may be candidates for RT omission.
Spitzer Observations of NGC 2362: Primordial Disks at 5 Myr

We present results from a mid-infrared imaging survey of the ∼5 Myr old cluster NGC 2362 carried out with the Infrared Array Camera (IRAC) on board the Spitzer Space Telescope. The archival mid-infrared data were merged with extant Hα emission data, optical and near-infrared photometry, and moderate-resolution optical spectroscopy to identify the remnant disk-bearing population of the cluster and to estimate the fraction of stars that still retain primordial circumstellar disks. The principal sample of 232 suspected cluster members with masses ranging from ∼10 to 0.3 M⊙ (B2-M5 spectral types) was drawn from known Hα emission stars, X-ray-detected stars from a single 100 ks archival Chandra observation, and established lithium-rich stars. A second sample of 153 stars over a similar mass range whose membership status was based on optical photometry alone was also examined. Measured fluxes in the optical and infrared passbands were fitted with synthetic, low-resolution spectra created using the NextGen atmospheric models, permitting the detection of infrared excesses relative to predicted stellar photospheric fluxes. Using the measured slope of the stellar spectral energy distribution through the four IRAC channels to characterize disk emission for the 195 out of 232 activity/lithium-selected stars and the 105 out of 153 photometric membership candidates having complete IRAC photometry, we derive an upper limit for the primordial, optically thick disk fraction of NGC 2362 of ∼7% ± 2%, with another ∼12% ± 3% of suspected members exhibiting infrared excesses indicative of weak or optically thin disk emission. The presence of circumstellar disks among candidate members of NGC 2362 is strongly mass-dependent, such that no stars more massive than ∼1.2 M⊙ exhibit significant infrared excess shortward of 8 μm. An upper limit for the fraction of stars hosting primordial, optically thick disks peaks near 10.7% ± 4% for stars with masses between 1.05 and 0.6 M⊙, but the Spitzer IRAC survey is sensitivity-limited below ∼0.3 M⊙. From Hα emission-line strengths, an upper limit for the accretion fraction of the cluster is estimated at ∼5%, with most suspected accretors associated with primordial, optically thick disks identified with Spitzer. The presence of primordial disk-bearing stars in NGC 2362, some of which are suspected of still experiencing gaseous accretion, may imply that even within dense cluster environments, sufficient numbers of inner disks survive to ages consistent with core accretion models of giant planet formation to account for the observed frequency of exoplanets within 5 AU of all FGKM-type stars.
Direct Approach in Inverse Problems for Dynamic Systems

A direct and effective approach is presented for the inverse problem of dynamic structural systems, which is related to structural optimization, system identification, and damage detection. The structural modifications are sought for the characteristic changes assigned from the design goals or modal measurements. A finite element method is used for the system analysis and inverse problem. Mathematical programming techniques are applied for the minimization of the deviation of the finite element model from the desired inverse system, along with an objective function of least structural change. The modal method is based on the perturbation equations of a set of selected degrees of freedom and the energy equation associated with the frequency change. The mode shape change is expressed as the sum of the baseline mode shape and complementary vector, which plays a very important role in the search for the inverse solution. The linear perturbation equation is employed to get an initial approximation, which can be improved through iterations with the nonlinear perturbation equation. The proposed method does not involve the system reduction. Therefore, it is believed to be superior to conventional methods, which suffer from the residual error due to transformation of the eigenproblem.
Association Between Baseline Uric Acid and the Risk of Acute Pancreatitis

Objectives The aim of the study is explore the association between serum uric acid (UA) and acute pancreatitis (AP) risk in a Chinese population. Methods We included 124,316 participants who enrolled in the Kailuan cohort from 2006 to 2009. We fitted Cox models to estimate the correlation between UA and AP. Result During an average follow-up of 11.97 years (standard deviation, 2.16 years), 396 AP developed. The incidence rates from quartile 1 to quartile 4 of AP were 20.76, 18.78, 30.58, and 36.79 per 100,000 person-years, respectively. Multivariate analysis showed a significantly increased risk in quartile 3 (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.05–1.91) and quartile 4 (HR, 1.61; 95% CI, 1.19–2.17) compared with quartile 1. The association may be modified by alcohol use (P for interaction = 0.017). The quartile 4 group with excessive alcohol consumption showed an enormously increased risk of AP (HR, 9.09; 95% CI, 1.18–70.21) than those without (HR, 1.46; 95% CI, 1.07–2.00). Conclusions Elevated serum UA is an independent risk factor for AP. Surveillance of serum UA, especially among heavy drinkers, may be helpful for AP prevention.
Diamond photoconducting detectors as high power z‐pinch diagnostics (invited)

Diamond photoconducting detectors (PCDs) are one of the primary x‐ray diagnostics for z‐pinch experiments at Sandia National Laboratories’ Saturn facility. Diamond PCDs represent a significant advance in the state of the art for electrical x‐ray detectors because of their stability of response, overall flatness of response, and ease of use. We have observed no aging effects in detectors used for years. Five PCDs on Saturn experiments where 1–3 TW of keV x‐ray power is emitted in 5–20‐ns pulses by z‐pinch x‐ray sources are routinely fielded. Typical PCDs used at Sandia have dimensions of 1 mm width ×3 mm long ×0.5 mm thick. The techniques used in the assembly, fielding, and calibration of diamond PCDs will be described.Diamond photoconducting detectors (PCDs) are one of the primary x‐ray diagnostics for z‐pinch experiments at Sandia National Laboratories’ Saturn facility. Diamond PCDs represent a significant advance in the state of the art for electrical x‐ray detectors because of their stability of response, overall flatness of response, and ease of use. We have observed no aging effects in detectors used for years. Five PCDs on Saturn experiments where 1–3 TW of keV x‐ray power is emitted in 5–20‐ns pulses by z‐pinch x‐ray sources are routinely fielded. Typical PCDs used at Sandia have dimensions of 1 mm width ×3 mm long ×0.5 mm thick. The techniques used in the assembly, fielding, and calibration of diamond PCDs will be described.
Assessing the prognostic utility of hematologic response for overall survival in patients with newly diagnosed AL amyloidosis: results of a meta-analysis

ABSTRACT Objectives: Amyloid light-chain (AL) amyloidosis is a rare disease characterized by amyloid fibril deposits made up of toxic light chains causing progressive organ dysfunction and death. Recent studies suggest that hematologic response may be an important prognostic indicator of overall survival (OS) in AL amyloidosis. The aim of this study was to evaluate the trial-level association between hematologic complete response (CR) or very good partial response or better (≥ VGPR) and OS in newly diagnosed patients. Methods: Studies were identified via systematic literature review. Pooled effect estimates were generated by a random-effects model. Results: Nine observational studies reporting hematologic CR or ≥VGPR and OS hazard ratios (HRs) were included in the meta-analysis. Achieving hematologic CR was associated with improved OS (HR, 0.21; 95% confidence interval [CI] 0.13–0.34). Achieving ≥ VGPR was also associated with improved OS (HR 0.21; 95% CI 0.17–0.26). Results of a sensitivity analysis excluding one outlier study revealed no heterogeneity and a better overall HR estimate. Potential limitations of this meta-analysis include the small number of eligible studies (consistent with the rarity of the disease) and inconsistencies in reporting of results. Conclusions: Overall, our findings support the use of deep hematologic response (CR or ≥VGPR) as a clinical trial endpoint in newly diagnosed AL amyloidosis. This study provides evidence that early hematologic response is a strong patient-level surrogate for long-term OS in patients with AL amyloidosis receiving frontline therapy. Structured data collection of depth of response in future trials will further strengthen these observations.
ISAnalytics enables longitudinal and high-throughput clonal tracking studies in hematopoietic stem cell gene therapy applications

Abstract Longitudinal clonal tracking studies based on high-throughput sequencing technologies supported safety and long-term efficacy and unraveled hematopoietic reconstitution in many gene therapy applications with unprecedented resolution. However, monitoring patients over a decade-long follow-up entails a constant increase of large data volume with the emergence of critical computational challenges, unfortunately not addressed by currently available tools. Here we present ISAnalytics, a new R package for comprehensive and high-throughput clonal tracking studies using vector integration sites as markers of cellular identity. Once identified the clones externally from ISAnalytics and imported in the package, a wide range of implemented functionalities are available to users for assessing the safety and long-term efficacy of the treatment, here described in a clinical trial use case for Hurler disease, and for supporting hematopoietic stem cell biology in vivo with longitudinal analysis of clones over time, proliferation and differentiation. ISAnalytics is conceived to be metadata-driven, enabling users to focus on biological questions and hypotheses rather than on computational aspects. ISAnalytics can be fully integrated within laboratory workflows and standard procedures. Moreover, ISAnalytics is designed with efficient and scalable data structures, benchmarked with previous methods, and grants reproducibility and full analytical control through interactive web-reports and a module with Shiny interface. The implemented functionalities are flexible for all viral vector-based clonal tracking applications as well as genetic barcoding or cancer immunotherapies.
Water dissociation at the water–rutile TiO2(110) interface from ab initio-based deep neural network simulations

Significance The character—molecular vs. dissociated—of adsorbed water on TiO2 surfaces plays a critical role in many applications, e.g., photocatalysis and surface functionalization, and has been studied for decades. However, there is still limited information on water dissociation at theTiO2–liquid water interface, the system most relevant to applications. Ab initio simulations have provided valuable insights, but their time scales are insufficient to characterize the amount of dissociation at aqueous interfaces. We here overcome this limitation using deep neural network potentials that accurately reproduce the ab initio results for water interacting with the prototypical TiO2(110) surface. The average dissociation fraction,22 ± 6%, predicted by these simulations is a key information for understanding TiO2’s photocatalytic activity.
Comparison between Navier–Stokes and Direct Monte–Carlo Simulations of the Circumnuclear Coma: I. Homogeneous, Spherical Source

Abstract The structure of the near-nucleus H 2 O atmosphere formed by sublimation under solar heating of a hypothetical large dusty ice sphere is computed (1) by the direct simulation Monte–Carlo method (DSMC) and (2) by solving Navier–Stokes equations (NSE) combined with a locally plane-parallel solution of the collisional Boltzmann equation for the nonequilibrium near-surface Knudsen layer. For Hale–Bopp-like comets, perfect agreement is obtained between the two methods on the day and night sides. This excellent agreement is maintained on the near-nucleus dayside for less productive comets, even down to production rates as low as those expected for Comet P/Wirtanen near 3 AU. It provides a direct validation of the gasdynamic simulations performed in support of the ESA Rosetta mission lander descent optimization studies (Crifo et al. 2001) and also confirms the similarity between the dayside coma and underexpanded axially symmetric free jets pointed out in Crifo (1986). On the nightside, moderate to high discrepancies appear between the two solutions as the production rate decreases, revealing the limits of the NSE method. The limits of the present study are delineated, and directions for future investigations are indicated.