bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantum canonical correlation analysis algorithm
Authors: Song Chuan-Dong , Li Jian , Hou Yan-Yan , Liu Qing-Hui , Wang Zhuo
Published: August 2023

Canonical correlation analysis (CCA) is a fundamental technique used to analyze data correlation in various fields, including video and medical data analysis. In this paper, we propose a quantum canonical correlation analysis (QCCA) algorithm. First, we introduce a combined density matrix representation method that transforms CCA into generalized eigenvalue decomposition. Moreover, to address the challenge of performing generalized eigenvalue decomposition in high-dimensional scenarios, we propose a quantum method for extracting the canonical principal axes. In this method, two sets of variables are transformed into a reduced density matrix, so that the product of variable matrices can be accelerated by phase estimation and controlled rotation. Complexity analysis shows that the QCCA algorithm achieves exponential acceleration in variable dimensions n, p and variable size m compared to classical algorithms. The QCCA algorithm serves as a foundation for the subsequent development of quantum algorithms for classification, regression, and other machine learning tasks.
Percolation in random sequential adsorption of polydisperse mixtures of extended objects on a triangular lattice
Authors: Dujak D , Karač A , Jakšić Z M , Vrhovac S B , Budinski-Petković Lj
Published: August 2023

Percolation properties of an adsorbed polydisperse mixture of extended objects on a triangular lattice are studied by Monte Carlo simulations. The depositing objects of various shapes are formed by self-avoiding walks on the lattice. We study polydisperse mixtures in which the size

ℓ

of the shape making the mixture increases gradually with the number of components. This study examines the influence of the shape of the primary object defining a polydisperse mixture on its percolation and jamming properties. The dependence of the jamming density and percolation threshold on the number of components n making the mixture is analyzed. Determining the contribution of the individual components in the lattice covering allowed a better insight into the deposit structure of the n-component mixture at the percolation threshold. In addition, we studied mixtures of objects of various shapes but the same size.
Coexisting and cooperating light–matter interaction regimes in a polaritonic photovoltaic system
Authors: Caligiuri V , Siprova S , Patra A , Lio G E , Termine R , Cilurzo S , Golemme A , Luca A De
Published: August 2023

Common quantum frameworks of light–matter coupling demonstrate the interaction between an atom and a cavity occurring through a single feedback channel: an exciton relaxes by emitting a photon that is stored in the cavity for several roundtrips before being re-absorbed to create another exciton, and so on. However, the possibility for the excited system to relax through two different channels belonging to two different regimes has been, until now, neglected. Here, we investigate the case in which the strong coupling regime and the photovoltaic effect cooperate to enhance the wavelength-dependent photocurrent conversion efficiency (defined as the incident photons to converted electrons ratio, namely the external quantum efficiency—EQE) of a photovoltaic cell specifically engineered to behave as an optical cavity tuned to the excitonic transition of the embedded active material (CH3NH3PbI3 perovskite). We exploit the angular dispersion of such photovoltaic cell to show that when the cavity mode approaches the energy of the exciton, the strong coupling regime is achieved and the EQE is significantly enhanced with respect to a classic configuration serving as a benchmark. Our findings do not aim at demonstrating an immediate impact in enhancing the performance of photovoltaic systems but, rather, constitute a proof-of-principle experimental demonstration of how the photovoltaic effect can benefit from the generation of polaritons. Nonetheless, such a peculiar cooperating dual-light–matter interaction could be exploited in future polaritonic photovoltaic architectures.
Ultrasensitive photodetector based on 2D WS2/AgInGaS quantum dots heterojunction with interfacial charge transfer
Authors: Wang Xusheng , Yan Danni , Zhu Cheng , Feng Yiping , Guo Tingting , Jia Runmeng , Qu Kairui , Li Linyun , Zhao Tong , Xiong Yunhai , Farhan Ahmad , Lin Yuhai , Wu Linxiang , Dong Yuhui , Zhang Shengli , Chen Xiang , Song Xiufeng
Published: August 2023

Tungsten disulfide (WS2), as a typical member of transition metal chalcogenides (TMDs), has attracted extensive research interest in optoelectronics, especially photodetectors. However, the performance of photodetectors based on monolayer WS2 is restricted to weak light absorption. Here, AgInGaS quantum dots (AIGS-QDs) with a large absorption coefficient and high quantum efficiency are integrated onto WS2 atomic layers to achieve excellent photoelectric performance. Notably, the observed photoluminescence (PL) quenching and the reduction of the decay time of PL in the WS2/AIGS-QDs heterojunction confirm the interfacial charge transfer from AIGS-QDs to WS2 layer. The results show that type II energy band arrangement leads to the efficient separation of photoexcited carriers at the interface between WS2 and AIGS-QDs. This WS2/AIGS-QDs photodetector achieves an ultrahigh responsivity (R) of 3.3 × 103 A W−1, an external quantum efficiency (EQE) of 7.8 × 106% and a detectivity (D*) of 1.3 × 1013 Jones. Our work provides promising potential for future high-performance monolayer TMD-based photodetectors.
The role of digital governance on carbon emission performance: evidence from the cities in yangtze river delta, China
Authors: Wang Yunhui , Zhang Xuan , Lin Feiyang , Peng Meijuan
Published: August 2023

Rapid industrialization and ambitious socio-economic targets have presented significant challenges to China’s carbon neutrality process. However, digital transformation offers new opportunities for sustainable development. This research examines the influence of digital governance (Digov) on carbon emission performance (Cep) and explores its underlying mechanisms. The study utilizes data from cities in China’s Yangtze River Delta from 2011 to 2019. The results show that digital governance has significantly improved carbon emission performance, a conclusion that remains robust even after conducting a series of rigorous tests and addressing endogeneity concerns. The main impact mechanisms of digital governance on carbon emission performance include energy intensity reduction, energy consumption scale reduction, industrial structure adjustment, and energy consumption structure optimization.Furthermore, the results indicate that the variation in carbon emission reduction due to digital governance can be attributed to differences in city administrative level, city size, and government capacity. In particular, digital governance plays a pivotal role in facilitating the sustainable transformation of resource-based cities.From the perspective of digital governance, this study provides effective recommendations and valuable insights for achieving low-carbon targets and promoting sustainable development of cities.
New horizons in hearing conditions
Authors: Henshaw Helen , Calvert Sian , Heffernan Eithne , Broome Emma E , Burgon Clare , Dening Tom , Fackrell Kathryn
Published: August 2023

Hearing conditions such as hearing loss, tinnitus and hyperacusis are highly prevalent in the population and can severely impact communication and quality of life. Hearing is affected by multiple factors, including heredity, noise exposure, age, sex, ear disorders and lifestyle factors. Globally, hearing loss affects over 80% of adults aged 80 years and older, is often experienced in combination with other long-term health conditions and is a mid-life risk factor for dementia. To form a themed collection, we searched Age and Ageing for articles on hearing conditions published from 2000 onwards. This resulted in 22 articles included within the collection. They examined a range of important topics related to hearing healthcare and research, including noise-induced hearing loss, health service quality and safety, psychological and psychosocial consequences of hearing loss and co-morbidities of hearing loss. All articles reported on hearing loss; there were no published articles with a primary focus on other hearing conditions such as tinnitus or hyperacusis, on the health of older people from the Deaf community or on users of Cochlear implants, suggesting key gaps in knowledge and targets for future research. This New Horizons article highlights novel directions in research and practice and takes a forward look at how research into hearing conditions may develop in years to come. It highlights opportunities for the growth of patient-centred research and hearing healthcare supported by the better integration of health and care services as well as cross-speciality working to include common co-morbid health conditions.
Postoperative Mechanomodulation Decreases T-Junction Dehiscence After Reduction Mammaplasty: Early Scar Analysis From a Randomized Controlled Trial
Authors: Panton Jasmine , Vingan Nicole , Barillas Jennifer , Akgul Yucel , Lazzarini Ariane , Coroneos Christopher J , Amirlak Bardia , Kenkel Jeffrey , Culver Abby
Published: August 2023

Background

Soft tissue and cutaneous tension is an important contributor to complicated wound healing and poor scar cosmesis after surgery and its mitigation is a key consideration in aesthetic and reconstructive procedures.

Objectives

The study objective was to assess the efficacy of the force modulating tissue bridge (FMTB) (“Brijjit”, Brijjit Medical Inc., Atlanta, GA) in reducing mechanical tension on postoperative wounds.

Methods

A prospective, single-center, randomized, within-subject clinical trial was conducted to evaluate wound healing and nascent scar formation after 8 weeks of postoperative wound support with the FMTB. Patients received standard of care (SOC) subcuticular closure on the vertical incision of 1 breast and experimental closure with the FMTB on the contralateral incision after Wise-pattern reduction mammaplasty. Three-dimensional wound analysis and rates of T-junction dehiscence were evaluated by clinical assessment at 2, 4, 6, and 8 weeks postsurgery.

Results

Thirty-four patients (n = 68 breasts) completed 8 weeks of postoperative FMTB application. There was a reduced rate of T-junction wound dehiscence in FMTB breasts (n = 1) vs SOC breasts (n = 11) (P < .01). The mean vertical incision wound area during the intervention period was significantly decreased in the FMTB breast (1.5 cm2) vs the SOC breast (2.1 cm2) (P < .01) and was significantly lower at 2-, 4-, and 8-week follow-up (P < .01). Only the closure method was significantly associated with variations in Week 8 wound area (P < .01) after linear regression modeling.

Conclusions

FMTBs decrease nascent scar dimensions and reduce the occurrence of wound dehiscence. This study provides evidence that the use of continuous mechanomodulation significantly reduces postoperative wound complications after skin closure.

Level of Evidence: 2
MSDRP: a deep learning model based on multisource data for predicting drug response
Authors: Zhao Haochen , Zhang Xiaoyu , Zhao Qichang , Li Yaohang , Wang Jianxin
Published: August 2023

Motivation

Cancer heterogeneity drastically affects cancer therapeutic outcomes. Predicting drug response in vitro is expected to help formulate personalized therapy regimens. In recent years, several computational models based on machine learning and deep learning have been proposed to predict drug response in vitro. However, most of these methods capture drug features based on a single drug description (e.g. drug structure), without considering the relationships between drugs and biological entities (e.g. target, diseases, and side effects). Moreover, most of these methods collect features separately for drugs and cell lines but fail to consider the pairwise interactions between drugs and cell lines.

Results

In this paper, we propose a deep learning framework, named MSDRP for drug response prediction. MSDRP uses an interaction module to capture interactions between drugs and cell lines, and integrates multiple associations/interactions between drugs and biological entities through similarity network fusion algorithms, outperforming some state-of-the-art models in all performance measures for all experiments. The experimental results of de novo test and independent test demonstrate the excellent performance of our model for new drugs. Furthermore, several case studies illustrate the rationality for using feature vectors derived from drug similarity matrices from multisource data to represent drugs and the interpretability of our model.

Availability and implementation

The codes of MSDRP are available at https://github.com/xyzhang-10/MSDRP.
Use of systemic and biological therapy in patients with moderate-to-severe psoriasis
Authors: Liljendahl Mie S , Loft Nikolai , Nguyen Tri-Long , Skov Lone , Egeberg Alexander
Published: August 2023

Background

Patients with moderate-to-severe psoriasis are candidates for systemic treatment, but it is unknown how many receive such therapy at a national level in Denmark.

Objectives

We aimed to determine the prevalence of conventional systemic therapy use in patients with moderate-to-severe psoriasis and, further, to investigate the time to discontinuation of conventional systemic therapy and initiation of biological therapy among biologic-naïve patients.

Methods

This registry-based study identified a cohort of patients with psoriasis in Denmark. We estimated the prevalence of moderate-to-severe psoriasis at a national level using registry data. Inverse probability weighting was used to mitigate potential selection bias in the prevalence estimate of moderate-to-severe psoriasis. Analyses were then performed on the weighted cohort.

Results

Of patients with psoriasis in Denmark, 10.9% were estimated to have moderate-to-severe psoriasis, of whom 62.3% received either conventional systemic or biological therapy, meaning 37.7% who were considered candidates for systemic therapy did not receive any systemic treatment. The study demonstrated that, comparing previous time periods with more recent years: (i) time on conventional systemic therapy for patients with moderate-to-severe psoriasis has become shorter, with a median (interquartile range) of 3.0 years (0.6–10.0) in 1985–1994 vs. 0.6 years (0.3–2.0) in 2014–2018; (ii) more patients initiated biologics as second-line therapy, with 69.5% in 2010–2013 vs. 71.2% in 2014–2018; and (iii) the median time from initiation of systemic therapy to initiation of biological therapy decreased from 13.3 years (11.5–16.8) in 2010–2013 to 1.9 years (1.7–2.4) in 2014–2018.

Conclusions

This study found that nearly 37.7% of Danish patients with moderate-to-severe psoriasis do not receive systemic treatment even though they would qualify for this. Furthermore, for patients treated with conventional systemics, drug survival decreased during the observation period.
Pigmented demodicosis: a rare cause of facial hyperpigmentation
Authors: Dash Siddhartha , Panda Dinesh Ranjan , Mohanty Jayashree , Bisoyi Diptiranjani , Nayak Nupoor , Mishra Debashis
Published: August 2023

Demodex-induced facial hyperpigmentation or pigmented demodicosis is the term given to a type of hyperpigmentation on the face with specific clinicopathological and dermoscopic findings that responds to antidemodectic treatment. We report the case of a patient with facial hyperpigmentation caused by Demodex.
Quantification of Urine and Plasma Porphyrin Precursors Using LC–MS in Acute Hepatic Porphyrias: Improvement in Routine Diagnosis and in the Monitoring of Kidney Failure Patients
Authors: Poli Antoine , Manceau Hana , Nguyen Anvi Laetitia , Moulouel Boualem , Dessendier Nathalie , Talbi Neila , Puy Hervé , Junot Christophe , Gouya Laurent , Schmitt Caroline , Lefebvre Thibaud
Published: August 2023

Background

The quantification of delta-aminolevulinic acid (ALA) and porphobilinogen (PBG) in urine are the first-line tests for diagnosis and monitoring of acute hepatic porphyrias (AHP). Ion-exchange chromatography (IEC), which is time- and staff-consuming and limited to urine, is still the preferred method in many specialized laboratories, despite the development of mass spectrometry-based methods.

Methods

We describe a new LC-MS method that allows for rapid and simple quantification of ALA and PBG in urine and plasma with an affordable instrument that was used to analyze 2260 urine samples and 309 blood samples collected in 2 years of routine activity. The results were compared to those obtained with IEC, and urine reference ranges and concentrations in asymptomatic carriers were determined. Plasma concentrations were measured in healthy subjects and subgroups of symptomatic and asymptomatic AHP carriers.

Results

In urine, the clinical decision limits were not impacted by the change of method despite discrepancies in low absolute concentrations, leading to lower normal values. Two-thirds of asymptomatic AHP carriers (with the exception of coproporphyria carriers) showed an increased urine PBG concentration. Urine and plasma levels showed a good correlation except in patients with kidney disease in whom the urine/plasma ratio was relatively low.

Conclusion

We described an LC-MS based method for the routine diagnosis and monitoring of AHP that allows for the detection of more asymptomatic carriers than the historical method. Blood analysis appears to be particularly relevant for patients with kidney disease, where urine measurement underestimates the increase in ALA and PBG levels.
Oxidative physiology of two small and highly migratory Arctic seabirds: Arctic terns (Sterna paradisaea) and long-tailed jaegers (Stercorarius longicaudus)
Authors: Fowler Melinda A , Wong Joanna B , Harrison Autumn-Lynn
Published: August 2023

Arctic ecosystems are changing rapidly. The tundra supports nesting migratory seabirds that spend most of their year over the ocean. Migrations are demanding, but it is unclear how physiological capability may equip organisms to respond to their changing environments. For two migratory seabird species nesting in Alaska, USA, the Arctic tern (n = 10) and the long-tailed jaeger (n = 8), we compared oxidative physiology and aerobic capacity measured during incubation and we recorded individual movement paths using electronic tracking tags. Within species, we hypothesized that individuals with longer-distance migrations would show higher oxidative stress and display better aerobic capacity than shorter-distance migrants. We examined blood parameters relative to subsequent fall migration in jaegers and relative to previous spring migration in terns. We present the first measurements of oxidative stress in these species and the first migratory movements of long-tailed jaegers in the Pacific Ocean. Arctic terns displayed positive correlation of oxidative variables, or better integration than jaegers. Relative to physiological sampling, pre-breeding northward migration data were available for terns and post-breeding southward data were available for jaegers. Terns reached a farther maximum distance from the colony than jaegers (16 199 ± 275 km versus 10 947 ± 950 km) and rate of travel northward (447 ± 41.8 km/day) was positively correlated with hematocrit, but we found no other relationships. In jaegers, there were no relationships between individuals’ physiology and southward rate of travel (193 ± 52.3 km/day) or migratory distance. While it is not clear whether the much longer migrations of the terns is related to their better integration, or to another factor, our results spark hypotheses that could be evaluated through a controlled phylogenetic study. Species with better integration may be less susceptible to environmental factors that increase oxidative stress, including thermal challenges or changes in prey distribution as the Arctic climate changes rapidly.
Single accessory pathway with multiple insertions? First-in-human 3D visualization using dipole charge density mapping: a case report
Authors: Minciuna Ioan-Alexandru , Gagyi Rita B , Wijchers Sip , Szili-Torok Tamas
Published: August 2023

Background

Accessory pathways (APs) with multiple atrial insertions are often unrecognized and associated with initial catheter ablation (CA) failure. Recently, a novel dipole charge density mapping (DCDM) system was developed that allows mapping of complex arrhythmias based on a single beat. We aim to present the first-in-human report of 3D visualization of a single AP with two atrial insertion sites using high-resolution DCDM.

Case summary

A 43-year-old man with recurrent symptomatic atrioventricular re-entrant tachycardia and previously failed CA attempts underwent repeated CA using DCDM. Dipole charge density mapping identified two quasi-simultaneous early atrial activation sites at the left lateral and left anterolateral atrial aspects of the mitral annulus, suggesting the presence of a single AP with dual atrial insertion sites. Successful radiofrequency CA was performed at the mid-body of the AP.

Discussion

The true prevalence of APs with multiple atrial insertion sites may be higher than currently reported. This is the first-in-human report of 3D visualization of a single AP with two atrial insertion sites using high-resolution DCDM. Dipole charge density mapping allows the accurate localization of APs with multiple insertion sites based on a single beat.
Computed tomographic–based three-dimensional printing of giant coronary artery fistulas to guide surgical strategy: a case series
Authors: Ørbæk Andersen Mads , Smerup Morten H , Munk Kim , Mortensen Ulrik Markus , Nørgaard Bjarne Linde , Helvind Morten , Andersen Henrik Ørbæk , Linde Jesper James
Published: August 2023

Background

Coronary artery fistulas (CAFs) are abnormal communications between the coronary arteries and the heart chambers, arteries, or veins, potentially leading to significant shunting, myocardial ischaemia and heart failure. Computed tomographic (CT) angiography or conventional invasive angiography is the reference standard for the diagnosis of coronary fistulas. The fistula anatomy can become very complex, which makes surgical or interventional planning challenging.

Case summary

We report two cases of hugely dilated and tortuous coronary circumflex artery fistulas draining into the coronary sinus. Both patients were followed up for more than 10 years because of very complex coronary fistula anatomy and mild symptoms. From two-dimensional (2D) sliced CT images alone it, was uncertain whether surgery was feasible. However, since both patients had symptom progression (Patient 1 developed heart failure, and Patient 2 had recurrent pericardial effusions), three-dimensional (3D) heart models were printed for better understanding of the complex fistula anatomy and improved surgical planning. Both patients had successful surgery and symptomatic relief at follow-up.

Discussion

The delay in surgery, until clinical deterioration, may partly be a consequence of a general reluctance in performing complex surgery in patients with CAFs. As of now, CT-based 3D printing has primarily been used in isolated cases. However, 3D printing is evolving rapidly and supplementing 2D sliced CT images with a physical 3D heart model may improve the anatomical understanding and pre-surgical planning that could lead to better surgical outcome.
Spontaneous coronary artery dissection with leucoencephalopathy associated with thrombospondin Type 1 domain containing 1 gene mutation: a case report
Authors: Ranasinghe Gotabhaya , Sovis Rasika , Shellvacumar Sajeev , Dissanayake Vajira H W
Published: August 2023

Background

Spontaneous coronary artery dissection (SCAD) is increasingly diagnosed as one of the infrequent causes of acute coronary syndrome. Almost no cause was identified in half of the cases. Here, we report a rare case of spontaneous coronary artery dissection with leucoencephalopathy (SCADLE) associated with a mutation of the thrombospondin Type 1 domain containing 1 (THSD1) gene.

Case summary

A 36-year-old lady who presented with ischaemic type chest pain for 4 h duration and found to have anterior ST elevation myocardial infarction. She was thrombolysed with tenecteplase and had good resolution. Her coronary angiogram revealed a spontaneous dissection in the left anterior descending artery (LAD) with TIMI 3 flow. Intra-vascular ultrasound study confirmed the LAD spiral dissection and intramural haematoma. She has had recurrent transient ischaemic attacks 5 years and 7 years ago, and there was a significant family history of young stroke. Her magnetic resonance imaging (MRI) brain showed peri-ventricular white matter hyper-intensities and lacunar infarcts suggestive of leucoencephalopathy. An association with cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL) and SCAD was suspected, and exome gene sequencing followed by genetic analysis was performed. It identified a variant c.67°C > G (p. Arg224Gly) in the THSD1 gene with normal NOTCH gene.

Discussion

Thrombospondin Type 1 domain containing 1 gene encodes proteins involving in the extra-cellular matrix (ECM). This THSD1 mutation is inherited as an autosomal dominant fashion and associated with arterial dissections (rare), fibromuscular dysplasia, intra-cranial aneurysm, and subarachnoid haemorrhages. Therefore, SCADLE could be a result of arteriopathy secondary to dysfunction of ECM proteins in cerebral and coronary vasculature resulting in neurological manifestations and MRI features like in CADASIL and SCAD.
Atlas of gut microbe-derived products from aromatic amino acids and risk of cardiovascular morbidity and mortality
Authors: Nemet Ina , Li Xinmin S , Haghikia Arash , Li Lin , Wilcox Jennifer , Romano Kymberleigh A , Buffa Jennifer A , Witkowski Marco , Demuth Ilja , König Maximilian , Steinhagen-Thiessen Elisabeth , Bäckhed Fredrik , Fischbach Michael A , Tang W H Wilson , Landmesser Ulf , Hazen Stanley L
Published: August 2023

Aims

Precision microbiome modulation as a novel treatment strategy is a rapidly evolving and sought goal. The aim of this study is to determine relationships among systemic gut microbial metabolite levels and incident cardiovascular disease risks to identify gut microbial pathways as possible targets for personalized therapeutic interventions.

Methods and results

Stable isotope dilution mass spectrometry methods to quantitatively measure aromatic amino acids and their metabolites were used to examine sequential subjects undergoing elective diagnostic cardiac evaluation in two independent cohorts with longitudinal outcome data [US (n = 4000) and EU (n = 833) cohorts]. It was also used in plasma from humans and mice before vs. after a cocktail of poorly absorbed antibiotics to suppress gut microbiota. Multiple aromatic amino acid-derived metabolites that originate, at least in part, from gut bacteria are associated with incident (3-year) major adverse cardiovascular event (MACE) risks (myocardial infarction, stroke, or death) and all-cause mortality independent of traditional risk factors. Key gut microbiota-derived metabolites associated with incident MACE and poorer survival risks include: (i) phenylacetyl glutamine and phenylacetyl glycine (from phenylalanine); (ii) p-cresol (from tyrosine) yielding p-cresol sulfate and p-cresol glucuronide; (iii) 4-OH-phenyllactic acid (from tyrosine) yielding 4-OH-benzoic acid and 4-OH-hippuric acid; (iv) indole (from tryptophan) yielding indole glucuronide and indoxyl sulfate; (v) indole-3-pyruvic acid (from tryptophan) yielding indole-3-lactic acid and indole-3-acetyl-glutamine, and (vi) 5-OH-indole-3-acetic acid (from tryptophan).

Conclusion

Key gut microbiota-generated metabolites derived from aromatic amino acids independently associated with incident adverse cardiovascular outcomes are identified, and thus will help focus future studies on gut-microbial metabolic outputs relevant to host cardiovascular health.
Placing patient-reported outcomes at the centre of cardiovascular clinical practice: implications for quality of care and management
Authors: Moons Philip , Norekvål Tone M , Arbelo Elena , Borregaard Britt , Casadei Barbara , Cosyns Bernard , Cowie Martin R , Fitzsimons Donna , Fraser Alan G , Jaarsma Tiny , Kirchhof Paulus , Mauri Josepa , Mindham Richard , Sanders Julie , Schiele Francois , Torbica Aleksandra , Zwisler Ann Dorthe
Published: August 2023

Patient-reported outcomes (PROs) provide important insights into patients’ own perspectives about their health and medical condition, and there is evidence that their use can lead to improvements in the quality of care and to better-informed clinical decisions. Their application in cardiovascular populations has grown over the past decades. This statement describes what PROs are, and it provides an inventory of disease-specific and domain-specific PROs that have been developed for cardiovascular populations. International standards and quality indices have been published, which can guide the selection of PROs for clinical practice and in clinical trials and research; patients as well as experts in psychometrics should be involved in choosing which are most appropriate. Collaborations are needed to define criteria for using PROs to guide regulatory decisions, and the utility of PROs for comparing and monitoring the quality of care and for allocating resources should be evaluated. New sources for recording PROs include wearable digital health devices, medical registries, and electronic health record. Advice is given for the optimal use of PROs in shared clinical decision-making in cardiovascular medicine, and concerning future directions for their wider application.
Mineralocorticoid receptor antagonists with sodium–glucose co-transporter-2 inhibitors in heart failure: a meta-analysis
Authors: Banerjee Mainak , Maisnam Indira , Pal Rimesh , Mukhopadhyay Satinath
Published: August 2023

Background and Aims

To investigate the cardiovascular effects of sodium–glucose co-transporter-2 inhibitors (SGLT2i) with concomitant mineralocorticoid receptor antagonist (MRA) use in heart failure (HF) regardless of ejection fraction (EF) and explore the risk of MRA-associated adverse events in individuals randomized to SGLT2i vs. placebo.

Methods

PubMed/MEDLINE, Web of Science, Embase, and clinical trial registries were searched for randomized controlled trials/post-hoc analyses evaluating SGLT2i in HF with or without MRA use (PROSPERO: CRD42023397129). The main outcomes were composite of first hospitalization or urgent visit for HF/cardiovascular death (HHF/CVD), HHF, and CVD. Others were all-cause mortality, composite renal and safety outcomes. Hazard ratios (HR)/risk ratios were extracted. Fixed-effects meta-analyses and subgroup analyses were performed.

Results

Five eligible studies were included, pooling data from 21 947 people with HF (type 2 diabetes mellitus, n = 10 805). Compared to placebo, randomization to SGLT2i showed a similar reduction in HHF/CVD and HHF in people who were or were not using MRAs [HHF/CVD: hazard ratio (HR) 0.75; 95% confidence interval (CI) 0.68–0.81 vs. HR 0.79; 95% CI 0.72–0.86; P-interaction = .43; HHF: HR 0.74; 95% CI 0.67–0.83 vs. HR 0.71; 95% CI 0.63–0.80; P-interaction = .53], with a suggestion of greater relative reduction in CVD in chronic HF people randomized to SGLT2i and using MRAs irrespective of EF (HR 0.81; 95% CI 0.72–0.91 vs. HR 0.98; 95% CI 0.86–1.13; P-interaction = .034). SGLT2i reduced all-cause mortality (P-interaction = .27) and adverse renal endpoints regardless of MRA use (P-interaction = .73) despite a higher risk of volume depletion with concomitant MRAs (P-interaction = .082). SGLT2i attenuated the risk of mild hyperkalaemia (P-interaction < .001) and severe hyperkalaemia (P-interaction = .051) associated with MRA use.

Conclusions

MRAs did not influence SGLT2i effects on the composite of HHF/CVD, HHF or all-cause mortality; however, findings hinted at a more pronounced relative reduction in CVD in chronic HF patients regardless of EF who were randomized to SGLT2i and receiving an MRA compared to those randomized to SGLT2i and not receiving MRAs. SGLT2i attenuated the risk of MRA-associated treatment-emergent hyperkalaemia. These findings warrant further validation in well-designed randomized controlled trials.
Leishmania LPG interacts with LRR5/LRR6 of macrophage TLR4 for parasite invasion and impairs the macrophage functions
Authors: Mazumder Sayani , Sinha Archana , Ghosh Sanhita , Sharma Gurumayum Chourajit , Prusty Biswa Mohan , Manna Debasis , Pal Durba , Pal Chiranjib , Dasgupta Suman
Published: August 2023

Visceral leishmaniasis (VL) is a severe form of leishmaniasis, primarily affecting the poor in developing countries. Although several studies have highlighted the importance of toll-like receptors (TLRs) in the pathophysiology of leishmaniasis, the role of specific TLRs and their binding partners involved in Leishmania donovani uptake are still elusive. To investigate the mechanism of L. donovani entry inside the macrophages, we found that the parasite lipophosphoglycan (LPG) interacted with the macrophage TLR4, leading to parasite uptake without any significant alteration of macrophage cell viability. Increased parasite numbers within macrophages markedly inhibited lipopolysachharide-induced pro-inflammatory cytokines gene expression. Silencing of macrophage-TLR4, or inhibition of parasite-LPG, significantly stemmed parasite infection in macrophages. Interestingly, we observed a significant enhancement of macrophage migration, and generation of reactive oxygen species (ROS) in the parasite-infected TLR4-silenced macrophages, whereas parasite infection in TLR4-overexpressed macrophages exhibited a notable reduction of macrophage migration and ROS generation. Moreover, mutations in the leucine-rich repeats (LRRs), particularly LRR5 and LRR6, significantly prevented TLR4 interaction with LPG, thus inhibiting cellular parasite entry. All these results suggest that parasite LPG recognition by the LRR5 and LRR6 of macrophage-TLR4 facilitated parasite entry, and impaired macrophage functions. Therefore, targeting LRR5/LRR6 interactions with LPG could provide a novel option to prevent VL.
Early Divergence and Gene Exchange Highways in the Evolutionary History of Mesoaciditogales
Authors: Farrell Anne A , Nesbø Camilla L , Zhaxybayeva Olga
Published: August 2023

The placement of a nonhyperthermophilic order Mesoaciditogales as the earliest branching clade within the Thermotogota phylum challenges the prevailing hypothesis that the last common ancestor of Thermotogota was a hyperthermophile. Yet, given the long branch leading to the only two Mesoaciditogales described to date, the phylogenetic position of the order may be due to the long branch attraction artifact. By testing various models and applying data recoding in phylogenetic reconstructions, we observed that early branching of Mesoaciditogales within Thermotogota is strongly supported by the conserved marker genes assumed to be vertically inherited. However, based on the taxonomic content of 1,181 gene families and a phylogenetic analysis of 721 gene family trees, we also found that a substantial number of Mesoaciditogales genes are more closely related to species from the order Petrotogales. These genes contribute to coenzyme transport and metabolism, fatty acid biosynthesis, genes known to respond to heat and cold stressors, and include many genes of unknown functions. The Petrotogales comprise moderately thermophilic and mesophilic species with similar temperature tolerances to that of Mesoaciditogales. Our findings hint at extensive horizontal gene transfer (HGT) between, or parallel independent gene gains by, the two ecologically similar lineages and suggest that the exchanged genes may be important for adaptation to comparable temperature niches.
Feeling Lonely, Engaging Online During the Outbreak of COVID-19: A Longitudinal Study of Chinese Older Adults
Authors: Xu Yi , Zhou Dong
Published: August 2023

Background and Objectives

There is growing concern that the coronavirus disease 2019 (COVID-19) pandemic and associated social distancing policies may exacerbate mental health problems in older adults. Most studies primarily have focused on developed countries, whereas the mental consequences of the pandemic in developing countries are less well known. This study evaluates the influences of the global pandemic in relation to loneliness and family contact among older Chinese adults and examines the roles of internet adoption in alleviating the emotional experience of loneliness.

Research Design and Methods

We run individual fixed effects regression models using the 2018 and 2020 waves of the Chinese Family Panel Studies survey with 4,944 respondents aged 60 and above to capture the average within-person changes before and after the first outbreak of COVID-19 in China. We further examine the mediating effects of internet adoption on loneliness using structural equation modeling (SEM). Simultaneous SEM tested the effects of internet literacy and social network site use, and heterogeneous effects analyses were also conducted across subgroups.

Results

Fixed effects estimates indicated increased loneliness and decreased family contact during the pandemic. Moreover, more older adults were found to use the internet in 2020. The fixed-effect estimations and structural equation models consistently found that older adults’ use of the internet contributed to more social contacts and virtual meetings with their children, which have alleviated the emotional experience of loneliness.

Discussion and Implications

Digital inclusion of older adults to adopt the internet can be beneficial to improve mental well-being and alleviate loneliness during times of pandemic crisis. The targeted acceleration of digitalization to reduce the digital divide needs to be considered.
Extensive Colitis and Smoking Are Associated With Postoperative Complications Within 30 Days of Ileal Pouch–Anal Anastomosis
Authors: Barnes Edward L , Esckilsen Scott , Ashburn Jean , Barto Amy , Bloomfeld Richard , Cairns Ashley , Mehta Kurren , Patel Pooja , Dziwis Jennifer , Dunn Michael S , Rahbar Reza , Sadiq Timothy S , Hanson John S , Herfarth Hans H
Published: August 2023

Background

Our understanding of outcomes after proctocolectomy with ileal pouch–anal anastomosis (IPAA) for ulcerative colitis (UC) is largely based on analyses of selected populations. We created a state-level registry to evaluate the epidemiology of IPAA surgery and pouch-related outcomes across the major healthcare systems performing these surgeries in our state.

Methods

We created a retrospective cohort of all patients undergoing restorative proctocolectomy with IPAA for UC at 1 of 4 centers between January 1, 2018, and December 31, 2020. The primary outcomes of this study were the rate of complications and all-cause readmissions within the first 30 days of the final stage of IPAA surgery.

Results

During the study period, 177 patients underwent IPAA surgery with 66 (37%) experiencing a complication within 30 days. After adjusting for the number of stages in IPAA surgery, patients with extensive UC (odds ratio, 3.61; 95% confidence interval, 1.39-9.33) and current or former smokers (odds ratio, 2.98; 95% confidence interval, 1.38-6.45) were more likely to experience a complication. Among all patients, 57 (32%) required readmission within 30 days. The most common reasons for readmission were ileus/small bowel obstruction (22%), peripouch abscess (19%), and dehydration (16%).

Conclusion

In this first state-level examination of the epidemiology of IPAA for UC, we demonstrated that the complication rate after IPAA for UC was 37%, with one-third of patients being readmitted within 30 days. Extensive disease at the time of colectomy appears to be an indicator of more severe disease and may portend a worse prognosis after IPAA.
Impact of Cannabis Use on Immune Cell Populations and the Viral Reservoir in People With HIV on Suppressive Antiretroviral Therapy
Authors: Falcinelli Shane D , Cooper-Volkheimer Alicia D , Semenova Lesia , Wu Ethan , Richardson Alexander , Ashokkumar Manickam , Margolis David M , Archin Nancie M , Rudin Cynthia D , Murdoch David , Browne Edward P
Published: August 2023

Background

Human immunodeficiency virus (HIV) infection remains incurable due to the persistence of a viral reservoir despite antiretroviral therapy (ART). Cannabis (CB) use is prevalent amongst people with HIV (PWH), but the impact of CB on the latent HIV reservoir has not been investigated.

Methods

Peripheral blood cells from a cohort of PWH who use CB and a matched cohort of PWH who do not use CB on ART were evaluated for expression of maturation/activation markers, HIV-specific T-cell responses, and intact proviral DNA.

Results

CB use was associated with increased abundance of naive T cells, reduced effector T cells, and reduced expression of activation markers. CB use was also associated with reduced levels of exhausted and senescent T cells compared to nonusing controls. HIV-specific T-cell responses were unaffected by CB use. CB use was not associated with intact or total HIV DNA frequency in CD4 T cells.

Conclusions

This analysis is consistent with the hypothesis that CB use reduces activation, exhaustion, and senescence in the T cells of PWH, and does not impair HIV-specific CD8 T-cell responses. Longitudinal and interventional studies with evaluation of CB exposure are needed to fully evaluate the impact of CB use on the HIV reservoir.
A scoping review of clinical handover mnemonic devices
Authors: Yung Amos H W , Pak Chi Shing , Watson Bernadette
Published: August 2023

Since the Institute of Medicine (IOM) published To Err is Human: Building a Safer Health System in 1999, clinical handovers (or handoffs) and their relationship with the communication of patient safety have raised concerns from the public, regulatory bodies, and medical practitioners. Protocols, guidelines, forms, and mnemonic devices have been created to ensure safer clinical handovers. An initial literature search did not find a framework to describe the clinical processes and functions of each mnemonic device and its elements. The absence of a systematic framework could hinder the study across and the reusability of the established clinical handover mnemonic devices. This study aims to develop a universal framework to describe the clinical processes and functions essential for patient safety during handover. We queried PubMed.gov and obtained 98 articles related to clinical handovers. We examined the citing sources of the mnemonics mentioned in these articles. A total of 42 handover mnemonics with 238 elements were identified. Our review noted that there was no taxonomy to describe the clinical functions and process associated with the clinical handover mnemonic devices. We used grounded theory to address this gap and built a new taxonomy from the 42 mnemonics. A researcher read all mnemonics, developed a taxonomy for tagging clinical handover mnemonics, and categorized all mnemonic elements into correct processes and functions. After that, the second researcher, a medical practitioner, examined the taxonomy and made suggested corrections for the labelled functions of all mnemonic elements. Both researchers agreed on the taxonomy and the labelled processes and functions of different mnemonic elements. The taxonomy contains three processes and twenty functions in clinical handovers. Clinical processes like ‘medical condition’, ‘medical history’, ‘medical evaluation’, ‘care plan’, ‘outstanding care/tasks/results’, and ‘patient information’, as an administrative process, were widely adopted in clinical handover mnemonics. Moreover, mnemonic elements on communication manner and information validation had been identified in the list of clinical handover mnemonics. Although we recognize challenges because of both the vast number of clinical handover scenarios and the task of placing them under a few predefined groups, our findings suggest that such a taxonomy, as developed for this study, could assist medical practitioners to devise a clinical handover mnemonic to best fit their workplace.
Smart Multivariate Spectrophotometric Determination of Two Co-Administered Autoimmune Drugs; Sulfasalazine and Pentoxifylline; in Bulk and Spiked Human Plasma
Authors: Magdy Maimana A , Farid Nehal F , Anwar Basma H , Abdelhamid Nessreen S
Published: August 2023

Background

Sulfasalazine and pentoxifylline are co-prescribed together to treat psoriasis and pemphigus vulgaris. Sulfasalazine is an anti-inflammatory, immunosuppressant, and antibiotic drug, while pentoxifylline is a vasodilator and immunosuppressant. The spectra of the two drugs and plasma suffer from severe overlap.

Objective

This work aims to simultaneously determine sulfasalazine and pentoxifylline in their binary mixture and spiked human plasma by the assessment of their UV spectral data.

Methods

Two model updated chemometric methods were established using principal component regression and partial least-squares regression models. The two models were validated in accordance with the U.S. Food and Drug Administration guidelines for bioanalysis and were applied for the determination of both drugs in synthetic mixtures or spiked human plasma.

Results

Accuracy and precision were within the accepted limits. In addition, three different assessment methods were used to evaluate the environmental greenness of the proposed models.

Conclusion

The two updated models are simple, rapid, sensitive, and precise, and could be easily applied in QC laboratories for determination of sulfasalazine and pentoxifylline, without any preliminary separation steps or interference from plasma matrix.

Highlights

Two updated chemometric models called principlal component regression and partial least-squares regression were established for determination of sulfasalazine and pentoxifylline in spiked human plasma using UV spectrophotometric data.