bluuebunny/crossref_metadata_2025 huggingface dataset:
ПРОЦЕС СТАНОВЛЕННЯ ІДЕНТИЧНОСТІ ІНОЗЕМНИХ СТУДЕНТІВ-МЕДИКІВ У КОНТЕКСТІ УСПІШНОГО ВИВЧЕННЯ ДРУГОЇ МОВИ
Authors: Авраменко М. О. , Рагріна Ж. М. , Репетун А. К.
Published: December 2023

Актуальність обраної теми полягає у необхідності виокремити й описати фактори, що впливають на становлення позитивної ідентичності майбутніх іноземних фахівців-медиків. Проблема становлення ідентичності розглядається авторами через призму засвоєння іноземними здобувачами освіти мови як іноземної. У статті розглянуто взаємозв’язок та відмінності в процесах вивчення першої та другої мов індивідами. Автори висвітлили й проаналізували етапи (бар’єри), які необхідно подолати студентам – іноземним громадянам під час освоєння ними мови як іноземної. Доведено, що успіх у вивченні другої мови безпосередньо впливає на успішне становлення позитивної ідентичності іноземного студента. У статті охарактеризовано фактори, що впливають на успішність вивчення другої мови, що так само впливають на становлення позитивної ідентичності іноземців. Дослідники виділили 4 основні фактори, що впливають на ефективне засвоєння мови як іноземної: інтелект, ставлення, мотивацію і тривожність. Автори статті довели роль когнітивного компонента в процесі вивчення другої мови. Наголошено на залежності інтелекту та мотивації від виду завдань та поставлених цілей перед іноземними здобувачами вищої освіти. Розглянуто поняття мотивації та описано її роль у процесі вивчення іноземної мови в закладах вищої освіти. Охарактеризовано поняття мотиваційних орієнтацій, розглянуто типи орієнтацій. Проаналізовано мотиваційний процес, що ґрунтується на афективному ставленні особистості до іншомовної спільноти. Описано антагоністичні компоненти мотиваційного процесу. Виокремлено й описано фактор ставлення, що визначає успішність у засвоєнні мови як іноземної. Наголошено, що на становлення позитивної ідентичності іноземного студента впливає почуття самоідентифікації, описано етнолінгвістичну теорію. Описано фактор тривожності як один із корелятів успішного освоєння другої мови. Наголошено на ролі викладача в процесі становлення позитивної ідентичності майбутнього іноземного фахівця. Запропоновано ефективні педагогічні та психологічні методи, що сприятимуть становленню позитивної ідентичності іноземного студента.
ІНТЕРАКТИВНІ МЕТОДИ НАВЧАННЯ ЯК МЕТОДОЛОГІЧНА ОСНОВА ТРЕНУВАННЯ КОМУНІКАТИВНИХ НАВИЧОК СТУДЕНТІВ МЕДИЧНОГО ЗАКЛАДУ ВИЩОЇ ОСВІТИ
Authors: Бількевич Н. А. , Кавецька Н. А. , Чернець Т. Ю.
Published: December 2023

У зв’язку з глобалізацією освітніх процесів протягом останніх десятиліть та зміною парадигми освіти з орієнтацією на результати навчання (компетентності) постає питання пошуку нових підходів та вдосконалення освітніх методик із метою підвищення ефективності навчального процесу.
Мета статті – аналіз даних літератури щодо досвіду впровадження інтерактивних методів навчання для покращення процесу набуття комунікативної компетентності студентами вітчизняних медичних закладів вищої освіти.
Проаналізовано та узагальнено переваги інтерактивних методів навчання в тренінгу студентами комунікативних навичок у медичних закладах вищої освіти, методичні підходи до організації занять у такому форматі, роль викладача як фасилітатора. Доведено, що такий підхід значно ефективніший у плані трансформації теоретичних знань студентів у практичну площину та набуття ними комунікативної компетентності. Обґрунтовано необхідність рефлексії як необхідного компонента інтерактивного заняття, з метою трансформації набутих навичок у компетентності. Рефлексія дає змогу усвідомити, структурувати та узагальнити отриманий на занятті досвід і тому повинна бути організована після виконання кожного з етапів заняття.
Представлено та узагальнено інформацію щодо вітчизняного досвіду впровадження методів інтерактивного навчання в медичну освіту, щоб трансформувати набуті навички в компетентності. Згідно з проведеним аналізом, існує мало даних щодо застосування інтерактивних методів із метою тренінгу власне комунікативних навичок, більшою мірою такий підхід використовують для розвит­ку клінічного мислення студентів, вивчення мовних аспектів комунікації, підготовки до іспитів тощо. Наявні дані також вказують на необхідність більш детальної розробки методики проведення інтерактивного заняття з тренінгу комунікативних навичок.
Зроблено висновок про перспективність охарактеризованих навчальних підходів та необхідність ширшого впровадження інтерактивних методів у навчальний процес вітчизняних медичних закладів вищої освіти. Необхідна також розробка методичної бази для проведення таких занять.
Diagnóstico, planejamento e gestão
Authors:   Universidade de São Paulo. Escola de Engenharia de São Carlos, Benites Igor Matheus , Castro Ana Maria Rodrigues Costa de ,   Universidade de São Paulo. Escola de Engenharia de São Carlos, Andrade Júlia Fonseca Colombo ,   Universidade de São Paulo. Escola de Engenharia de São Carlos, Nunes Cleyse Kelly Barbosa ,   Universidade de São Paulo. Escola de Engenharia de São Carlos
Published: December 2023

Com o objetivo de celebrar o vigésimo aniversário do Núcleo de Estudo e Pesquisa em Resíduos Sólidos (NEPER) vinculado ao Programa de Pós-Graduação em Engenharia Hidráulica e Saneamento, da Escola de Engenharia de São Carlos, Universidade de São Paulo, em 2023 e promover a disseminação do conhecimento científico na área de resíduos sólidos, foi elaborada esta compilação de obras abrangendo todos os estudos realizados pelo grupo até 2022. O volume 1, intitulado "Diagnóstico, planejamento e gestão" reune estudos de caracterização e diagnóstico; planos; políticas; análise financeira; avaliação da gestão; eventos sustentáveis e integra as Contribuições cientificas em resíduos sólidos: compilação de estudos do NEPER.
Timeu: a Cosmologia de Platão
Authors:   Universidade de São Paulo. Instituto de Astronomia, Geofísica e Ciências Atmosféricas, Matsuura Oscar Toshiaki
Published: December 2023

É apresentado um resumo do diálogo “Timeu” de Platão de forma contextualizada e preservando sua estrutura geral. Aproveita-se a oportunidade dessa apresentação para se discutir, sucintamente, os desdobramentos das ideias cosmológicas seminais desse diálogo no âmbito da História e da Filosofia da Ciência, até chegar à Cosmologia contemporânea.
Paisagens Cósmicas: da Terra ao Big Bang
Authors:   Universidade de São Paulo. Instituto de Astronomia, Geofísica e Ciências Atmosféricas, Cypriano Elysandra Figueredo , Damineli Neto Augusto ,   Universidade de São Paulo. Instituto de Astronomia, Geofísica e Ciências Atmosféricas
Published: December 2023

Material adaptado da exposição “Paisagens Cósmicas” que fez parte das comemorações do Ano Internacional da Astronomia - 2009. Curadoria científica e texto final: Profa. Dra. Elysandra Figueredo Cypriano e Prof. Dr. Augusto Damineli. Edição impressa (formato A6) distribuída gratuitamente pelo IAG
Erasmo Xavier e as novas leituras sobre os modernismos
Authors: Cerchiaro Marina Mazze
Published: December 2023

O livro apresenta a trajetória e a obra do caricaturista, ilustrador e cenógrafo Erasmo Xavier por meio de documentos de arquivo pessoal, depoimentos e artigos de jornais e revistas. É uma edição revista e ampliada da primeira versão publicada em 1989.  Dos vários fragmentos apresentados, emergem narrativas multifacetadas potentes e contraditórias sobre o artista e a obra que contribuem para as recentes revisões do modernismo brasileiro.
Abstract 104: Photoplethysmogram Signal Characteristics as a Non-Invasive Surrogate of Diastolic Blood Pressure During Cardiopulmonary Resuscitation
Authors: Bender Dieter , Sutoris Grace , Hershey Marc , Graham Kathryn , Nadkarni Vinay M , Berg Robert A , Morgan Ryan W , Sutton Robert M , Nataraj C.
Published: December 2023

Background:
During cardiopulmonary resuscitation (CPR), diastolic blood pressure (DBP) is a key driver of coronary perfusion pressure and thereby, blood flow during CPR. Although resuscitation guidelines advise measuring DBP as an indicator of CPR quality, the need for an invasive arterial catheter to measure DBP limits scope of patients for whom a BP-directed CPR strategy can be implemented.

Aims and Hypothesis:
We aimed to study the photoplethysmogram (PPG) signal acquired from pulse oximetry monitoring as a non-invasive indicator of CPR quality. We hypothesized that a machine learning algorithm using dynamic PPG features would accurately classify CPR segments according to whether they met established pediatric DBP thresholds associated with improved outcomes (≥25mmHg in infants and ≥30 mmHg in older children).

Methods/Approach:
This was an NHLBI-funded ancillary study of the ICU-RESUScitation clinical trial (NCT02837497). This initial pilot study included 12 children who received CPR for an IHCA and had both arterial BP and pulse oximetry monitoring in place. Physiologic data were summarized into five-second epochs and DBP for each epoch was dichotomized by whether it met age-based DBP thresholds. Time-domain features (
k
=25) were systematically engineered from the PPG signal, and a Support Vector Machine (SVM) model with a Gaussian kernel was trained to classify the CPR quality samples.

Results:
The analysis yielded
n=
268 five-second CPR epochs, of which 147 (55.9%) met DBP thresholds. In the testing set of 134 previously unseen samples (50% of
n
,

n
low

=59,

n
high

=75), the SVM model achieved a classification accuracy of 91% with 100% precision and specificity, 79.7% sensitivity, and a negative predictive value of 86.2% only influenced by false negatives. Throughout development, six features describing the dicrotic notch characteristics reflected in the PPG waveform were empirically observed as significant CPR quality indicators.

Conclusion:
In this multicenter pilot investigation, the PPG waveform derived from pulse oximetry readings showed promise as a non-invasive surrogate of invasively measured DBP during pediatric CPR. This has the potential to greatly broaden the population for whom physiologic monitoring during CPR is possible.
Abstract 108: Mitochondria-Targeted S-Nitrosothiol MitoSNO Improves Neurological Recovery and Survival After Asphyxial Cardiac Arrest in Rats
Authors: Endo Yusuke , Becker Lance B , Takegawa Ryosuke , Aoki Tomoaki , Nakamura Eriko , Murphy Michael P. , Hayashida Kei
Published: December 2023

Introduction:
Mitochondria-targeted S-nitrosothiol MitoSNO offers protection against ischemia-reperfusion injury by attenuating the reverse electron transport of mitochondrial complex I during reperfusion. This study aimed to assess whether administration of MitoSNO after ROSC improves neurological and survival outcomes following cardiac arrest (CA).

Methods:
Adult male rats were subjected to 10 minute of asphyxial CA followed by mechanical ventilation and manual CPR. After successful CPR, animals were assigned to one of two experimental groups: receiving respiration buffer as a vehicle or MitoSNO (100 ng per dose). Based on our preliminary study, two doses of each drug were intravenously injected via femoral vein: immediately after ROSC and at 60 minutes post-ROSC. The survival time and neurological function score (NFS) were recorded for up to 72 h. Surgery, CPR, drug injections, echocardiography, and immunohistochemistry were performed in a blind manner.

Results:
MitoSNO significantly improved NFS and survival rate (
Fig A
). Echocardiography revealed that MitoSNO improved left ventricular ejection fraction 2 h post-ROSC compared to the vehicle. In another set of experiments, relative cerebral blood flow (rCBF) compared to baseline was invasively monitored at 2 h post-CA using a laser speckle imaging. The imaging showed CA caused a reduction in rCBF 2 h post-CA in the vehicle group, which was markedly improved by MitoSNO (
Fig B
). Western blotting assay showed, in brain 2 h post-CA, MitoSNO significantly mitigated protein levels of 3-NT, a marker for nitrogen free radical-modified proteins, and cleaved Caspase-3, an indicator of programmed cell death. Immunohistochemistry revealed that MitoSNO suppressed neuronal degeneration in vulnerable brain regions of surviving animals.

Conclusions:
Our study demonstrated that MitoSNO inhibited the production of oxidative stress in the brain and improved neurological and survival outcomes following CA in rats.
Abstract 110: Brain Injury Biomarkers Are Associated With Poor Neurological Outcomes Within 24 Hours After Refractory VT/VF Cardiac Arrest Requiring Extracorporeal Cardiopulmonary Resuscitation
Authors: Rojas-Salvador Nelly Carolina C , Bartos Jason
Published: December 2023

Background:
Extracorporeal cardiopulmonary resuscitation (ECPR) is an emerging method that improve survival after refractory VF/VT cardiac arrest. Neuron-specific enolase (NSE) and S-100B are used to predict neurological outcome; however, it is unclear the reliability and earliest time point during ECPR.

Methods:
Single-center, retrospective cohort study included OHCA patients who underwent ECPR at the University of Minnesota between December 2015 and January 2023. NSE and S100B levels were obtained at admission, at 12 and 24h after ROSC in a total of 361 unconscious patients. The primary outcome was poor neurological outcome (defined as CPC 3-5) at hospital discharge. We evaluated the optimal cut-off levels for NSE and S100B by maximizing the Youden index and ROC analyses for poor clinical results. Finally, NSE and S100B at 12h and 24h were added to a multivariable logistic model (age, sex, bystander and witnessed).

Results:
Of 361 patients, 170 survived to hospital admission. Of these 85% (145/170) survived neurologically favorable. Mean (SD) NSE (ng/mL) values were significantly higher in the CPC 3-5 group at every time point, 52.3 (53) vs 21.1 (12) on admission; 92.8 (92) vs 20 (10) after 12h; 107.1(94.4) vs 21.5 (12.9) after 24h; p<0.01 at all time points. Again, mean (SD) S100B (ng/L) values were significantly higher in the CPC 3-5 group at every time point 3912 (990) vs 986 (920) on admission; 3975 (4972) vs 272.2 (209) after 12h; 4454 (7300) vs 192 (239) after 24h; p<0.01 at all time points. At 24h, NSE and S100B significantly predicted poor neurological outcome with AUC 0.92; 95%CI:0.87-0.95 (optimal NSE cut-off value of 47) and 0.91; 95%CI: 0.87-0.95 (optimal cut-off S100B value of 354), respectively. High concentrations of both biomarkers at 24h (NSE: odds ratio [OR] 2.4 per 1 ng/mL, p<0.001; S100B: odds ratio [OR] 1.1 per 1 ng/L, p<0.05) were independent for poor outcome in a multivariate analysis. Additionally, the combination of both markers (AUC, 0.94; 95%CI: 0.91-0.97) showed significantly higher predictive performance than when using them individually.

Conclusions:
By using serial measurements, high NSE and S100B levels may help early predict progression to poor neurological outcome in OHCA survivors requiring ECPR in the first 24h after ROSC.
Abstract 111: Combination Therapy of Hydrogen Inhalation and Hypothermic Temperature Control Improves Neurological Outcomes After Out-of-Hospital Cardiac Arrest
Authors: Tamura Tomoyoshi , Narumiya Hiromichi , Suzuki Masaru ,   HYBRID II Study Group
Published: December 2023

Background:
In a randomized trial, we demonstrated that hydrogen (H
2
) inhalation improves outcomes after cardiac arrest (CA). All patients underwent target temperature management (TTM), but the selection of a target temperature between 32 and 36 °C varied per institutional protocol.

Hypothesis:
The combination of hypothermic TTM and H
2
improves neurological outcomes after CA.

Aims:
This study aimed to investigate the interaction of H
2
and hypothermic TTM on neurological outcomes after CA.

Methods:
This post-hoc analysis of a randomized controlled trial (HYBRID II Trial; jRCTs031180352) included comatose patients after cardiogenic out-of-hospital CA (OHCA). They received either 2% H
2
mixed oxygen (H
2
group) or oxygen alone (control group) for 18 hours under hypothermic TTM (<35°C) or normothermic TTM (35-36°C). A target temperature was reached quickly, maintained for 24 hours, and rewarmed over 48 hours. A good neurological outcome was defined as a Cerebral Performance Category (CPC) of 1 or 2 at 90 days. The neurological outcomes were compared between the H
2
and control groups under hypothermic or normothermic TTM.

Results:
The analysis included 72 patients with outcome data (39 and 33 patients in the H
2
and control group, respectively). Hypothermic TTM was implemented in 25 (64%) and 24 (73%) patients in the H
2
and control group, respectively (P=0.46). Under hypothermic TTM, 17 (68%) and 9 (38%) patients achieved CPC 1 or 2 in the H
2
and control group, respectively (relative risk 1.81 [95%CI: 1.05-3.66]). In contrast, under normothermic TTM, CPC of 1 or 2 was achieved in 5 (36%) and 4 (44%) patients (P>0.99) in the H
2
and control group, respectively. A multivariable logistic regression analysis indicated that the interaction between H
2
and hypothermic TTM was independently associated with CPC 1 or 2 at 90 days (adjusted odds ratio 3.71 [95%CI: 1.14-12.1]) after adjusting for confounding factors including age, sex, witness status, bystander CPR implementation, shockable rhythm, CA duration, and time from the return of spontaneous circulation to gas inhalation.

Conclusions:
H
2
in combination with hypothermic TTM improved neurologicaloutcomes after cardiogenic OHCA. However, the favorable effects of inhaled H
2
were not observed under normothermic TTM.
Abstract 11373: Suppression of Plasma Angiotensin II by GLP-1 in Humans is Independent of Changes in Plasma Angiotensinogen
Authors: Jensen Boye L , Asmar Ali
Published: December 2023

Introduction:
In humans, the natriuretic effect of GLP-1 depends on GLP-1 receptor interaction, is independent of changes in renal blood flow, renin, ANP, and aldosterone but is accompanied by suppression of angiotensin II (ANGII). The mechanism by which GLP-1 reduces ANGII independently of changes in renin is not clarified.

Hypothesis:
It was hypothesized that GLP-1 suppresses renin substrate, angiotensinogen, in plasma.

Methods:
To test this proposal, we measured arterial angiotensinogen concentration in biobanked plasma samples from healthy males during a 3-hour GLP-1 infusion that induced natriuresis (1). Samples were from a study with fixed sodium intake where eight healthy men were examined twice in random order during a 3-hour infusion of either GLP-1(1.5 pmol kg
-1
min
-1
) or vehicle together with an intravenous infusion of 0.9% NaCl (750 mL/hour). Arterial plasma angiotensinogen was measured in plasma by dilution (1:200) and addition of excess exogenous human renin (Inst. Of Biological Standards UK). After prolonged incubation, ANGI was quantified by radioimmunoassay. Intraassay variation was 9-12%.

Results:
Arterial plasma angiotensinogen and renin levels decreased similarly and modestly (~15 and ~30%, respectively) after NaCl infusion during both studies whereas ANGII levels decreased significantly (~25%) only during GLP-1 infusion.

Conclusions:
Suppression of plasma angiotensinogen is less likely to account for GLP-1-mediated ANGII suppression in healthy young males. In perspective, GLP-1 could enhance pathways of ANGII degradation rather than inhibit its formation.

1. Asmar A et al. Extracellular fluid volume expansion uncovers a natriuretic action of GLP-1: a functional GLP-1-renal axis in man.
J Clin Endocrinol Metab.
2019 Jul 1;104(7):2509-2519.
Abstract 11443: Metabolic Profile Signature of Obesity in Heart Failure With Preserved Ejection Fraction
Authors: Liu Chang , Udeshi Eisha , Jones Dean , Quyyumi Arshed A , Morris Alanna A
Published: December 2023

Introduction:
Heart failure (HF) affects an estimated 6.2 million people in the US, with at least 50% of patients having HF with preserved ejection fraction (HFpEF). Obesity is a risk factor for HFpEF, however the association of obesity with metabolic signatures in HFpEF remains unclear. We aimed to identify unique metabolic profile of obesity among patients with HFpEF.

Methods:
A total of 41 participants from the Metabolomics, Oxidative Stress and Vascular Function (MOV) in HF study formed the discovery cohort, and 40 participants from the Atlanta Cardiomyopathy Consortium (TACC) study formed the validation cohort. All patients had HFpEF with left ventricular ejection fraction ≥ 50%. Untargeted high-resolution plasma metabolomic profiling identified 1,986 metabolic features. Partial least squares-discriminant analysis (PLS-DA) was performed separately in two cohorts to find the differently expressed metabolic features among obese (body mass index [BMI] ≥ 30 kg/m
2
) vs. non-obese (BMI < 30 kg/m
2
) patients with HFpEF. Variable Importance in Projection (VIP) score > 1 was used for feature selection. Annotation was performed by matching to an in-house library of previously confirmed metabolites. All features with VIP > 1 were used to explore pathway enrichment using Mummichog.

Results:
The MOV and TACC cohorts included 68.3% and 42.5% obese patients, respectively. The PLS-DA identified 23 metabolic features with confirmed annotations associated with obesity in the MOV, and 9 metabolic pathways were represented. Ten metabolites were validated in TACC, including 2,6-dihydroxypyridine, l-proline, taurine, l-methionine, guanine, 4-coumarate/phenylpyruvate, pyridoxamine, 1-methyl-6,7-dihydroxy-1,2,3,4-tetrahydroisoquinoline, ll-2,6-diaminoheptanedioate, and linoleate. One metabolic pathway, di-unsaturated fatty acid beta-oxidation, was validated.

Conclusions:
In two cohorts of HFpEF patients, by comparing the metabolic profiles of obese vs. non-obese patients, we identified alterations in amino acids, fatty acids, alkaloids, and vitamins. Moreover, pathway analysis confirmed alterations in the metabolic pathway of beta-oxidation of unsaturated fatty acids such as linoleate are also associated with obesity.
Abstract 11516: Micra vs Transvenous Pacemaker: A Comparative Systematic Review and Meta-Analysis
Authors: Haseeb Shahan , Ansari Umair A , Masoud Ahmed T. , Chhetri Chandra , Usman Shaheryar , Zulqarnain Muhammad , Goyal Rajat
Published: December 2023

Background:
Leadless pacemakers (LP) represent an emerging modality for treating bradyarrhythmias. We performed a meta-analysis and systematic review comparing safety and efficacy outcomes of Micra LP and transvenous pacemakers (TVP).

Methods:
A literature search was performed. The primary efficacy endpoints were successful implantation rate and acceptable capture threshold of <2V at 1 year. Primary safety outcomes were vascular injury, tamponade, device or lead dislodgement, pneumothorax, and major complications (needing intervention, prolonged hospital stay, readmission or death). A double-arm analysis was performed comparing LP and TVP. Data was pooled as mean differences (MD) or risk ratio (RR) including the 95% CI.

Results:
A total of 60 studies were included. There was no significant difference between the LP and TVP groups in terms of the rate of successful implantation (RR=1.02, P=0.95) and acceptable capture threshold (RR=0.90, P=0.11). LP was associated with a significantly lower incidence of major complications (RR = 0.54, [0.44, 0.67], P < 0.001) and dislodgment (RR= 0.31, [0.21, 0.46], P < 0.001). TVP had a significantly lower incidence of vascular injury (RR= 2.62, P=0.001) and a lower incidence of cardiac tamponade (RR= 2.29, P=0.001). There was no statistically significant difference regarding the incidence of infection (RR=0.76, P=0.6) and pneumothorax (RR= 0.58, P = 0.37).

Conclusion:
LP and TVP have equivalent implant success and long-term efficacy. LP had lower rates of major complications and dislodgement. TVP had lower rates of vascular injury and tamponade. Infection and pneumothorax rates were the same in both groups.
Abstract 11536: Cardiac Magnetic Resonance Imaging Paralleled Recurrent Pericarditis Clinical Response to Rilonacept Treatment Over 18 Months: A RHAPSODY Subgroup Analysis
Authors: Cremer Paul C , Brucato Antonio , Insalaco Antonella , Lin David , Luis Sushil A , Kwon Deborah H , Jellis Christine L , Clair JoAnn , Curtis Allison , Wang Sheldon , Klein Allan L , Imazio Massimo , Paolini John F ,   for the RHAPSODY Investigators
Published: December 2023

Introduction:
Rilonacept treatment in RHAPSODY resolved active pericarditis recurrences, and long-term treatment led to sustained risk reduction. Prior analysis linked greater baseline Late Gadolinium Enhancement (LGE), with more rapid recurrence upon rilonacept suspension after 12 weeks of treatment. Serial cardiac magnetic resonance (CMR) imaging (T2-STIR, LGE) enabled longitudinal assessment for tracking clinical improvement, guiding decision-making, and predicting patient outcomes after treatment cessation.

Methods:
At the long-term extension (LTE) 18-month decision milestone (18MDM), investigators chose, based on clinical status, to continue rilonacept, suspend rilonacept/observe, or discontinue the LTE. An imaging core lab blinded to clinical data measured pericardial thickness and graded pericardial edema (T2-STIR) and LGE at baseline and 18MDM. Pericarditis recurrence was assessed clinically following rilonacept suspension.

Results:
Baseline and 18MDM CMRs were available for 13 patients. Reductions in pericardial thickness, T2-STIR, and LGE from baseline to 18MDM while on treatment are provided in
Figure
. CMRs were obtained in 7/8 patients suspending rilonacept at 18MDM: LGE was none/trace, and T2-STIR was negative; yet, 5/7 (71%) had pericarditis recurrence within 1-4 months of rilonacept suspension despite prophylactic colchicine (n=2).

Conclusions:
Continued clinical improvement during prolonged rilonacept treatment corresponded with improvement on CMR, including reduced pericardial thickness, resolution of pericardial edema on T2-STIR, and resolution of LGE. Negative/trace LGE at 18MDM while on treatment did not predict absence of pericarditis recurrence upon subsequent rilonacept suspension in this size-limited subgroup. Larger prospective studies examining CMR parameters in guiding RP treatment duration decisions and informing associated clinical outcomes are warranted.
Abstract 11577: Malnutrition Stratified by Marasmus and Kwashiorkor in Patients With Heart Failure
Authors: Sato Yu , Yoshihisa Akiomi , Sugawara Yukiko , Misaka Tomofumi , Sato Takamasa , Oikawa Masayoshi , Kobayashi Atsushi , Yamaki Takayoshi , Nakazato Kazuhiko , Takeishi Yasuchika
Published: December 2023

Introduction:
Malnutrition is characterized by marasmus and kwashiorkor in children. However, the clinical significance of these aspects has been unclear in adult patients with heart failure (HF).

Methods and Results:
We divided a total of 1,888 patients with HF (median age 70.0, interquartile range 59.0-78.0) into four groups according to the presence/absence of marasmus type malnutrition (body mass index < 18.5 kg/m
2
) and kwashiorkor type malnutrition (serum albumin < 3.4 g/dL): Group C (patients without malnutrition, n = 1,302, 69.0%), Group M (those with only marasmus, n = 117, 6.2%), Group K (those with only kwashiorkor, n = 390, 20.7%) and Group MK (those with both marasmus and kwashiorkor, n = 79, 4.2%). Group M showed lowest systolic blood pressure (Groups C, M, K, and MK; 122.0, 111.0, 125.0 and 122.0 mmHg, respectively, P < 0.001). Groups K and MK showed higher levels of B-type natriuretic peptide (171.2, 375.4, 532.6 and 598.9 pg/mL, P < 0.001). Mean right atrial pressure was lowest in Group M and highest in Group K (6.0, 5.0, 8.0 and 6.0 mmHg, P < 0.001). Kaplan-Meir analysis demonstrated that Group MK had the lowest event-free rate of all-cause death compared to Group C, while Groups M and K had intermediate prognosis (
Figure
). In the multivariable Cox proportional hazard analysis, Groups M, K, MK were associated with all-cause death compared to Group C as a reference (adjusted hazard ratio 1.820, 1.623 and 2.248, respectively).

Conclusions:
Marasmus type malnutrition indicated wasting, kwashiorkor type malnutrition was characterized by congestion, and both types of malnutrition were independently associated with all-cause death in patients with HF.
Abstract 11583: Association Between Baseline and Trajectories of Preserved Ratio Impaired Spirometry (PRISm) and Mortality in Chinese Adults: Results From the Prospective Urban Rural Epidemiology (PURE) Study
Authors: Li Mengya , Li Yang , Li Wei , Lap Ah Tse
Published: December 2023

Introduction:
Longitudinal studies on preserved ratio impaired spirometry (PRISm) are scarce, especially in Chinese population.

Objectives:
To investigate the prevalence of PRISm in the general Chinese population, and to compare all-cause and cardiovascular diseases (CVD) mortality in PRISm subjects with normal spirometry.

Methods:
This study was based on PURE-China study with 40,279 individuals aged 35-70 years from 115 urban and rural communities in 12 provinces of China at baseline during 2005-2009. Participants were classified into PRISm, airflow obstruction (AO), and normal groups according to spirometry. Cox frailty proportional hazards model were performed to evaluate all-cause and CVD mortality in association with the baseline and trajectories of spirometry.

Results:
The prevalence of PRISm at baseline was 29.3%. During a median of 11.9 years follow-up, 2214 participants died, 773 of whom died from CVD. After adjustment of the confounders, participants with baseline PRISm had higher risks of all-cause mortality (HR=1.42, 95%CI: 1.29-1.58), CVD mortality (HR=1.35, 95%CI: 1.14-1.60). Trajectories analysis showed that subjects with PRISm at baseline but transitioned to normal during the follow-up demonstrated a substantially lower risk of all-cause mortality and CVD mortality than those with persistent PRISm, while such risk levels were close to people maintaining normal spirometry.

Conclusions:
PRISm is likely a risk factor to increase all-cause mortality and CVD mortality, comparing with normal spirometry in Chinese general population. Early detection and control of PRISm may be an effective approach for mitigating long-term disease burden.

Keywords:
preserved ratio impaired spirometry (PRISm), trajectories, mortality, cardiovascular disease, cohort
Abstract 11597: A Rare Cause of an NSTEMI: Left Main Coronary Artery Compression in a Patient With Pulmonary Hypertension
Authors: Secrest Kayla M , Ketcham Scott W , Thomas Michael P
Published: December 2023

Background:
Pulmonary hypertension has varying effects on cardiac function. Though uncommon, a dilated pulmonary artery can cause decreased coronary perfusion through extrinsic compression of the left main coronary artery (LMCA). While the most common presentation of LMCA compression is angina, acute coronary syndrome is rare.

Case Summary:
An 81-year-old female with a history of group 3 pulmonary hypertension presenting with neck and shoulder pain was found to have elevated cardiac biomarkers and EKG findings remarkable for isolated ST elevation in aVR with diffuse ST depressions in all other leads, consistent with a non-ST elevation myocardial infarction. Coronary angiography revealed left main coronary artery compression that was successfully intervened on with placement of a single drug eluding stent. Right heart catheterization was remarkable for evidence of severe pulmonary hypertension with a mean pulmonary artery pressure of 60 mmHg.

Discussion:
Given the patient’s past medical history, presenting symptoms, coronary and right heart catheterization findings the etiology of her acute coronary syndrome presentation was thought to be driven by left main coronary artery compression from pulmonary artery dilation. Pulmonary artery dilation in individuals with a history of pulmonary hypertension is common, with several modalities available to evaluate for this anatomic compensatory measure. Management for left main coronary artery compression in this patient population is percutaneous coronary intervention. Future studies to determine if routine screening for coronary compression in patients with pulmonary hypertension is needed.
Abstract 11627: Association of Cardiac Power Output Index With PET Glucose Metabolism and Prognosis in Pulmonary Arterial Hypertension Patients. Two-year Follow-Up
Authors: Kazimierczyk Remigiusz , Malek Lukasz , Nekolla Stephan , Szumowski Piotr , Blaszczak Piotr , Sobkowicz Bozena , Mysliwiec Janusz , Kaminski Karol
Published: December 2023

Introduction:
In pulmonary arterial hypertension (PAH) there is still a need for new prognostic markers to precisely identify the patients before clinical deterioration. We investigated cardiac power index (CPi) as a tool to assess right ventricular (RV) function and overall prognosis.

Hypothesis:
Hemodynamic changes occurring in PAH assessed with CPi are related with cardiac metabolism alterations in PET imaging what affects prognosis.

Methods:
Twenty-eight stable (WHO class II or III) patients (49.9±15.9 yo) had hybrid PET/MRI scans and heart catheterization performed during baseline and after 24-months. SUV RV/LV ratio was used to estimate cardiac 18-fluorodeoxyglucose uptake. Clinical endpoints (CEP - death or clinical deterioration) were assessed between visits. CPi was defined as the cardiac index х mean pulmonary artery pressure x 2.22 х 10-3.

Results:
Baseline CPi was 0.28±0.09 W/m2 and it correlated significantly with PET-derived SUV RV/LV ratio (r=0.55, p=0.002), confirming relationship between RV hemodynamics and cardiac metabolism. After 24 months of PAH specific therapy, we observed significant improvement in follow-up CPi - 0.23±0.04 W/m2 (p=0.04). Interestingly, baseline CPi predicted follow-up SUV RV/LV ratio. During 2-year observation, 16 patients (57%) had experienced CEP (including 4 deaths). Patients with CEP had higher baseline CPi than stable patients (0.32±0.09 vs 0.21±0.05, p=0.0006), as well as increased SUV RV/LV. CPi cut-off value to predict worse prognosis was 0.24 W/m2 (log-rank test, p=0.003, Figure) and CPi was also a significant predictor of CEP in multivariate analysis (R2 = 0.69; p=0.001).

Conclusions:
Indexed cardiac power output parameter is related with RV metabolism alterations in PAH and may help to identify stable patients at higher risk of death or clinical deterioration.
Abstract 11676: Use of Natriuretic Peptides and Echocardiography for Diagnosing Heart Failure
Authors: Talha Khawaja M , Januzzi James L , Meng Tong , Greene Stephen J , Vaduganathan Muthiah , Krnjeta Janicijevic Tijana , John Ani , Bayes-Genis Antoni , Butler Javed
Published: December 2023

Introduction:
International guidelines have recommended the use of echocardiography and natriuretic peptides (NP) in the diagnostic evaluation of heart failure (HF) for more than 10 years. However, real-world utilization of these tests in the US is not known.

Objective:
To assess contemporary trends in echocardiography and NP testing for diagnosing HF in the US.

Methods:
The TriNetX data was queried to ascertain the total number of first HF diagnoses in adults aged
>
18 in the US from 2016-2019. A random cohort was selected with the following exclusions applied: history of infiltrative or congenital causes of HF, need for heart transplant/ventricular assist device, no healthcare utilization 1 year before diagnosis, fewer than 2 recorded HF diagnoses, and without a valid visit type recorded. NP testing and echocardiography any time before through one year following index diagnosis were assessed. Temporal trend significance was evaluated using Cochran-Armitage trend tests.

Findings:
A total of 124,126 patients were included in the study. Mean age was 68
+
13 years, 53% were male, and 71% were White. Overall, 61,023 (49%) diagnoses were made in the outpatient and 63,103 (51%) in the inpatient setting with a significantly increasing trend toward inpatient diagnoses (p<0.001;
Figure 1A
). Of all incident HF diagnoses, 67,991 (55%) patients underwent NP testing, 70,612 (57%) patients underwent echocardiography, and 31,206 (25%) patients did not undergo either diagnostic test. There were increasing trends in the proportion of patients diagnosed in inpatient vs outpatient among those who underwent NP testing, echocardiography, and either diagnostic test (p<0.001;
Figure 1B-D
).

Conclusions:
We found low rates of echocardiography and NP testing in those with HF, with more such testing performed in patients diagnosed inpatient. We also found increasing rates of inpatient HF diagnoses, indicating lost opportunities for earlier treatment initiation and worse outcomes.
Abstract 11711: Factors Predicting Acute Ischemic Stroke Following Surgical Repair of Acute Type A Aortic Dissection (ATAAD) in Adults
Authors: Pekyi-Boateng Prince K , Prempeh Isaac , Blankson George , Bonsu Rex , Agbinko-Djobalar Babbel , Agyeman Badu Nana , Dhillon Balkiranjit Kaur , Memon Rahat A , Wuni Nadia I , Blewusi George , Boateng Derick , Frimpong Smith , lohana petras , Asempa Joshua , Gbekor Stephen K , AYIREBI-ACQUAH EWURADJOA , Abimbilla Hamilton , Buckner Richmond , Adjei-Sefah Kwame , Pekyi-Boateng Patrick D , Sakthivel Hemamalini , Ramphul Kamleshun , Duodu Fiifi
Published: December 2023

Introduction:
Acute type A Aortic dissection (ATAAD) may require urgent surgical repair, and a major complication is acute ischemic stroke (AIS) post-surgery.

Aim:
To explore characteristics associated with AIS in ATAAD patients post-surgical repair (PSR).

Hypothesis:
We assessed the hypothesis that multiple factors influence events of AIS in ATAAD patients PSR.

Method:
Multivariate regression analysis for factors influencing AIS in adults with a principal diagnosis of ATAAD and undergoing surgical repair was performed via the 2016-2020 National Inpatient Sample.

Results:
Among the 20335 ATAAD cases with surgical repair, 14.7%(2985 cases) reported an event of AIS. Individuals ≥60 years (vs. ages 18-39 years, aOR 1.323, p=0.007) and presence of hypertension (aOR 1.228, P<.001), acute kidney injury (AKI) (aOR 1.353, P<.001), Charlson Comorbidity Index (CCI) ≥3 (aOR 15.129, p<.001), and Private insurances (vs. Medicare, aOR 1.454, p<.001) or Medicaid (vs. Medicare, aOR 1.673, p<.001) showed higher odds of developing AIS. On the contrary, smoking (aOR 0.613, p<.001), obesity (aOR 0.882, p=0.027), cirrhosis (aOR 0.309, p<.001), dyslipidemia (aOR 0.732, p<.001), diabetes (DM) (aOR 0.508, p<.001), peripheral vascular disease (PVD) (aOR 0.615, p<.001), Chronic Kidney Disease (CKD) (aOR 0.446, p<.001), prior MI (aOR 0.461, p<.001) and prior stroke (aOR 0.788, p=0.04) and Black race (aOR 0.736, p<.001) indicated lower odds. No significant difference was seen in age 40-59 (aOR 1.06, p=0.545), drug abuse (aOR 1.093, p=0.451), alcohol abuse (aOR 0.925, p=0.476), Females (vs. Males, aOR 0.973, p=0.579), and Hispanics (vs. Whites, aOR 1.102, p=0.285).

Conclusion:
In conclusion, a 14.7% rate of AIS in ATAAD PSR was observed. Ages ≥60, hypertension, AKI, CCI ≥3, and Private and Medicaid insurance holders appeared prone to AIS following such events, while smoking, obesity, cirrhosis, dyslipidemia, DM, PVD, CKD, prior MI, prior stroke, and Blacks had reduced odds.
Abstract 11720: Logistic and Economic Burden of Non-Obstructive Hypertrophic Cardiomyopathy - Results From Medical and Pharmacy Claims Data
Authors: Amonkar Sanika , Chen Meiling , Papademetriou Eros , Potluri Ravi , Rotter David , Butzner Michael , Abraham Theodore
Published: December 2023

Introduction:
Data are limited on the complication burden of non-obstructive hypertrophic cardiomyopathy (nHCM).

Hypothesis:
Symptoms and complications increase the logistic and economic burden of nHCM.

Aim:
To assess pre vs post complication resource use and charges (per person per year [PPPY], in USD) for patients with nHCM.

Methods:
We used Symphony medical and pharmacy claims data from 2016-2021 to identify (by ICD-10 code) 18,011 adult patients in the United States with symptomatic (SYMP) or asymptomatic (ASYMP) nHCM. SYMP was defined as fatigue, chest pain, syncope, dyspnea, heart failure (HF), or palpitations within 3 months of index date; and complications as atrial fibrillation (AF)/flutter, ventricular fibrillation/tachycardia (VF/VT), supraventricular tachycardia, stress cardiomyopathy, HF, or heart transplant.

Results:
In SYMP vs ASYMP nHCM (n=9600 vs 8411), mean age was 63±14 vs 62±16 years (
p
<0.001), 49% vs 45% were female (
p
<0.001), and incidence of complications was 0.96 vs 0.39 per 1000 patient years (
p
<0.001; HR 0.44, 95% CI 0.40-0.48). For both groups, the most frequent complications were HF, AF and VT. In SYMP nHCM, complications increased inpatient (IP) admissions (
p
<0.001
)
and all-cause charges ($59,070 to $73,630 PPPY;
p
=0.006), without altering outpatient (OP) visits (
p
=0.438) (Fig.). In ASYMP nHCM, complications increased IP admissions, OP visits (both
p
<0.001), and all-cause charges ($22,711 to $66,053 PPPY;
p
<0.001) (Fig.). For patients with SYMP vs ASYMP nHCM, incremental post complication charges were $14,560 vs $43,343 PPPY,
p
=0.007.

Conclusions:
In this study, patients with SYMP vs ASYMP nHCM were older, predominantly female, and had higher rates of complications. Irrespective of symptoms, complications were associated with increased IP admissions and charges. Our data highlight the value of complication prevention, especially for patients with ASYMP nHCM, for whom complications may steeply increase charges.
Abstract 11760: Prevalence of Atherosclerosis, Heart Failure, and Chronic Kidney Disease Among Patients With Type 2 Diabetes and Management With Diabetes Pharmacotherapy
Authors: Mohl Jeff , Rattelman Cori R , Bidassie Balmatee , Robar Carey , Rajpura Jigar R
Published: December 2023

Introduction:
Individuals with type 2 diabetes (T2D) are at increased risk for cardiovascular disease (CVD), the leading cause of mortality in these patients, and chronic kidney disease (CKD). Recent clinical guidelines recommend the use of diabetes pharmacotherapy with cardiovascular or renal benefits in patients with T2D and CVD or CKD.

Aims:
The aims of this study were to 1) assess the prevalence of established CVD, including atherosclerotic cardiovascular disease (ASCVD) and heart failure (HF), and CKD, and 2) determine the proportion of patients prescribed CVD/CKD-protective diabetes pharmacotherapy (SGLT-2i and GLP1-RA) among individuals with T2D receiving primary care in the US.

Data:
Data for this retrospective, cross-sectional study were obtained from Optum Labs Data Warehouse, which contains de-identified administrative claims and electronic health record data representing a diversity of age, race, and ethnicity across the US. Eligible individuals were aged ≥18 years, had established T2D and were required to have ≥1 outpatient visit with a primary care provider in 2019.

Results:
This study included 843,119 individuals with T2D receiving care in 2019. Among these patients, the prevalence of CVD was 44.1%, with 41.5% having evidence of ASCVD and 14.4% having evidence of HF, and the prevalence of CKD was 34.6%. The prevalence of these comorbidities increased with age. For individuals who had T2D and ASCVD, HF, or CKD, 14.0%, 11.7% and 15.1%, respectively, were prescribed SGLT-2i or GLP1-RA, relative to 16.8% of patients with T2D without these comorbidities. Additionally, compared with younger patients, comorbid patients older than 65 years were prescribed these therapies at much lower rates.

Conclusions:
Among patients with T2D and established CVD, 9 of 10 patients had ASCVD: a 3-fold higher prevalence than HF. Less than 17% of individuals with T2D were prescribed a guideline-recommended glucose-lowering treatment with cardiovascular and renal benefits. The data from this study suggest that patients with T2D and CVD/CKD were prescribed less SGLT-2i or GLP1-RA compared to patients with T2D without these comorbidities. This trend was concerning among older patients, who had both higher rates of these comorbidities and lower prescribing trends.
Abstract 11776: Sex Differences in Coronary Artery Disease Characteristics Among Patients With Type 2 Myocardial Infarction: Results From the Prospective DEFINE-Type 2 MI Study
Authors: Lin Claire , McCarthy Cian P , Mohebi Reza , Liu Yuxi , Blankstein Ron , Rogers Campbell , Hedgire Sandeep , Murphy Sean , Miksenas Hannah , Amponsah Daniel , Rambarat Paula , Raghavan Avanthi , Levin Allison , Wasfy Jason H , Ghoshhajra Brian , Januzzi James L
Published: December 2023

Background:
Type 2 Myocardial Infarction (T2MI) is a result of coronary supply and demand imbalance and is associated with a poor prognosis. It is crucial to identify potential sex-based differences in the prevalence and nature of coronary artery disease (CAD) within this specific population. Retrospective analyses are limited by selection bias, unequal proportions of male and female subjects, and lack of angiographic definition.

Hypothesis:
In patients with T2MI, women and men will have unique characteristics.

Aim:
To evaluate sex-based differences in presentation, prevalence/characteristics of CAD and clinical management of T2MI.

Methods:
In a single-center prospective study, patients with strictly adjudicated T2MI underwent coronary computed tomography angiography and Fractional Flow Reserve (FFR
CT
) and quantitative plaque assessment was performed.

Results:
Of 50 study participants enrolled, 50% were women. Women with T2MI were older than men with T2MI (72.2 ± 10.1 vs. 64 ± 11.3 years; p = 0.009) but otherwise had similar baseline characteristics. A broad and similar mix of T2MI precipitants were present among both sexes. Ischemic ST depression was more common in women (64% vs. 32%; p = 0.05) while men were more likely to have T wave inversion (68% vs. 36%; p = 0.05). Women and men had comparable CAC scores (median [Q1, Q3] 152 [45, 762] vs. 234 [56, 422]; p = 0.07). Prevalence of any CAD (100% vs. 84%; p = 0.12), obstructive CAD (28% vs. 24%; p = 1.0), and hemodynamically significant focal stenosis with FFR
CT
< 0.80 (64% vs. 56%; p = 0.08) were similar between men and women. While total plaque volumes were similar between men and women, women had significantly lower levels of low-attenuation plaque (median [Q1, Q3]: 3 [1,7] vs. 9 [3, 14]; p = 0.03). Men and women did not significantly differ in percentile of plaque burden. Both sexes showed comparable increases in the utilization of aspirin (OR = 0.67; p = 0.53), beta blockers (OR = 0.76; p = 0.71), and statins (OR = 0.22; p = 0.08) by discharge.

Conclusions:
This prospective study of using FFRCT in T2MI identifies similarities and differences in clinical presentation and CAD characteristics of T2MI in both men and women. These findings may be helpful in improving the identification and management of T2MI.