bluuebunny/crossref_metadata_2025 huggingface dataset:
An association between early rescue left heart unloading during VA-ECMO treatment and prognosis of cardiogenic shock; the post-hoc study of the EARLY-UNLOAD trial
Authors: Lim Y , Park S , Kim M C , Jeong I S
Published: May 2024

Funding Acknowledgements

None.

Background/introduction

Recently published studies showed prophylactic left heart unloading does not improve mortality in cardiogenic shock (CS) treated with venoatrial extracorporeal membrane oxygenation (VA-ECMO). However, significant proportion of patients on VA-ECMO treatment for CS require early rescue left heart unloading.

Purpose

To compare characteristics and prognosis according to rescue-unloading timing in patients with CS treated with VA-ECMO.

Methods

This study is a post-hoc analysis of the EARLY-UNLOAD trial (NCT04775472), the trial evaluated an impact of an early prophylactic unloading strategy using left atrial cannulation (LAC) within 12 hours from the initiation of VA-ECMO treatment.

This analysis was performed per-protocol basis for patients without violation (N = 108). Patients were classified into four groups according to timing of left heart unloading: prophylactic (<12h, N = 53), early rescue (<30h, N = 16), late rescue (>30h, N= 10), and no unloading (N = 29). The primary endpoint was in-hospital mortality, and secondary endpoint was 30-day all-cause death. Logistic regression was used to search factors related to the primary endpoint.

Results

Among patients in the conservative strategy arm, rescue unloading was performed in 47% of patients, and 29% of patients received left heart unloading within 30 hours. Median time from ECMO pump on to rescue unloading was 23 hours. Compared to other groups, the early rescue group had the highest initial arterial lactate level (6.2 vs 11.4 vs 4.3 vs 6.3 mmol/L, prophylactic, early rescue, late rescue, and no unloading, respectively, P = 0.011) and SAPS2 score at baseline (52.7 vs 68.2 vs 50.6 vs 55.7, P = 0.017). Inotropes requirement on day 1 was also highest in the group (vasoactive-inotropic score, 12.4 vs 31.2 vs 7.5 vs 13.8, P = 0.014). The early rescue unloading group showed the highest in-hospital mortality (Figure 1, 87.5%, P = 0.004) and 30-day mortality (75%, P = 0.029). Survival analysis using Kaplan-Meier analysis and log-rank test showed significant difference of probability of all cause death at 30 days among these 4 groups (Figure 2, P by log-rank test = 0.049). In the logistic regression models for in-hospital mortality, rescue unloading within 30 hours was associated with increased odds ratio (OR) for in-hospital mortality (OR = 6.87, 95% confidence interval [CI] = 1.31-35.92.15, P = 0.022).

Conclusions

In this post-hoc analysis of the EARLY-UNLOAD trial, early-rescue unloading within 30 hours was associated with increased in-hospital mortality in patient treated with VA-ECMO for CS.
Prescription of lipid-lowering therapy, LDLc control, and risk of MACE in patients after ST-elevation myocardial infarction in Mexico
Authors: Hernandez Pastrana S , Villalobos Pedroza M , Robles Ledesma M , Najera Rojas N A , Juarez Tolen J , Ordonez Olvera J C , Diaz Herrera B A , Gonzalez Macedo E , Sierra Gonzalez De Cossio A , Garcia Espinosa J I , Arias Mendoza A , Araiza Garaygordobil D
Published: May 2024

Funding Acknowledgements

None.

Background/Introduction

Optimal control of low-density lipoprotein cholesterol (LDLc) has been demonstrated to reduce cardiovascular event rates after ST-elevation myocardial infarction (STEMI). However, real-world data shows that a low proportion of patients achieve LDLc targets. Furthermore, the association of LDLc levels and major cardiovascular adverse events (MACE) in post-STEMI patients is limited in developing countries.

Purpose

In this study, we aimed to assess the prescription patterns of lipid-lowering therapies, LDLc control, and their impact on the risk of MACE after STEMI in Mexico.

Methods

We conducted a prospective observational study of patients with STEMI. LDLc levels and prescriptions of lipid-lowering therapy were assessed during the first scheduled visit following STEMI hospital discharge. LDLc control was determined in accordance with the 2023 European Society of Cardiology Acute Coronary Syndrome Guidelines, which recommend achieving LDLc levels below 55 mg/dL for secondary prevention. Patients were categorized as controlled (if LDLc <55 mg/dL) and not controlled (if LDLc >55 mg/dL) and were followed for a median of 4.5 years to evaluate the rate of MACE, including cardiovascular death, cardiogenic shock, recurrent MI, and heart failure.

Results

We included 447 patients with a mean age of 57.87 (± 10.5 years), predominantly male (84.5%). Hypertension (43.8%), smoking (41.1%), type 2 diabetes mellitus (33.5%), obesity (26.6%), and dyslipidemia (21.4%) were highly prevalent. The median LDLc level in the total population was 65.4 mg/dL (IQR 49.2- 87.7). Among these, 34% (152) were considered controlled, while 66% (295) were not. Baseline clinical characteristics did not significantly differ among the groups. Prescription of high-intensity statins reached 94.7%, and ezetimibe and PCSK-9i were used in 1.8% and 0.4% of cases, respectively. We observed no statistically significant difference (Hazard ratio: 1.03, 95% confidence interval 0.74-1.73) in the rate of MACE based on LDLc control (Fig.1). The risk of MACE was also not different based on the use of high-intensity statins.

Conclusions

In this real-world study of patients post-STEMI, LDLc control was achieved in just one-third of the population. While the prescription of high-intensity statins was high, combination therapy was low. We did not observe a statistically significant association with an increased long-term risk of MACE; however, we noted a higher rate of events compared with other series.
Modulation of cytokine response in post-cardiac arrest syndrome through prehospital high-dose glucocorticoid treatment
Authors: Obling L , Beske R P , Meyer M A S , Grand J , Wiberg S , Bjerre M , Folke F , Eifer Moeller J , Kjaergaard J , Hassager C
Published: May 2024

Funding Acknowledgements

Type of funding sources: Foundation. Main funding source(s): Novo Nordisk Foundation

Research Foundation of Rigshospitalet.

Background

Post-cardiac arrest syndrome (PCAS) following out-of-hospital cardiac arrest (OHCA) is a life-threatening condition, characterized by a cascade of pathological events, including the development of a severe cytokine response. This inflammatory response may be associated with secondary brain injury and multi-organ dysfunction. In the randomized STEROHCA trial, high-dose glucocorticoid was administered immediately following resuscitation in the prehospital setting. The intervention exhibited a significant decrease in interleukin (IL) 6 levels, but its effect on other cytokines has yet to be assessed.

Purpose

We aimed to investigate the effects of high-dose glucocorticoid treatment in mitigating the cytokine response observed in PCAS after OHCA.

Methods

The modified intention-to-treat population of the double-blind, randomized STEROHCA trial consisted of 137 OHCA patients, who were randomized to a single prehospital injection of methylprednisolone 250 mg or placebo. Of these, this sub-study included 112 patients who were comatose and admitted to an ICU. Cytokine profiling was performed with a 17-plex assay, including pro- and anti-inflammatory cytokines, which were measured at 0, 24, 48, and 72h after admission. We applied mixed-model analyses to assess the effect of the intervention over time with log-transformed data. To maintain an exploratory approach, we chose not to correct for multiple testing.

Results

The intervention induced a reduction in the levels of several cytokines, with a significant treatment over time effect for IL-4, IL-8, IL-10, Monocyte Chemoattractant Protein-1 (MCP-1), Macrophage Inflammatory Protein-1 Beta (MIP-1β), and Tumor Necrosis Factor Alpha (TNF-α), all p<0.01. These cytokines, except for IL-10, exhibited lower values in the glucocorticoid group after 24h, Figure 1. Higher levels of IL-10 were observed in the glucocorticoid group at 0h. We found no differences in cytokine levels after 48-, and 72h between the two groups.

Conclusion

High-dose glucocorticoid treatment administered promptly after resuscitation from OHCA reduced several pro-inflammatory cytokines after 24h. TNF-α has previously been associated with poor outcomes following OHCA, whereas the exact role of the other cytokines following OHCA is unclear.Cytokines at 0-, 24-, 48-, and 72 hours
Hemodynamic effects of treatment with the ketone body 3-hydroxybutyrate in cardiogenic shock - a randomized, controlled, assessor-blinded porcine trial
Authors: Horsdal O , Nielsen R , Wethelund K , Helgestad O , Wiggers H , Gopalasingam N , Berg-Hansen K
Published: May 2024

Funding Acknowledgements

Type of funding sources: Foundation. Main funding source(s): Novo Nordisk Foundation Independent Research Fund DK.

Background

Cardiogenic shock (CS) is a life-threatening disease with limited evidence-based treatment options. Treatment with the ketone body 3-hydroxybutyrate (3-OHB) induces favorable hemodynamic effects in patients with heart failure and CS. It increases cardiac output (CO) and left ventricular (LV) ejection fraction (LVEF) while reducing cardiac filling pressures. Yet, whether treatment with 3-OHB demonstrates beneficial hemodynamic effects during acute ischemic LV stunning in CS must be fully elucidated. This study aimed to examine the acute hemodynamic effects and underlying cardiovascular mechanisms of 3-OHB infusion in the acute phase of LV stunning in a porcine model of ischemic CS.

Methods

Sixteen 60-kg-pigs were included in a randomised, controlled, assessor-blinded crossover study. CS was achieved by repeated, slow injections of microspheres into the left main coronary artery. CS was defined as ≥30% reduction in CO and/or mixed venous saturation (SVO2). Upon the onset of CS, following a one-hour no-touch period, the pigs received an infusion with 3-OHB and isoosmolar, isovolumic saline (control) for two hours each in random order. Infusion periods were separated by a one-hour washout period. CO (primary endpoint), SVO2, and pulmonary pressures were measured by right heart catheterization. A pressure-volume admittance catheter was placed in the LV to measure LVEF, contractility (the slope of end systolic pressure-volume relationship, denoded as Ees), afterload (arterial elastance, Ea, and end-systolic pressure, ESP), preload (end-diastolic volume, EDV), and work-related parameters.

Results

CS was successfully achieved in all randomized animals. CO decreased by 36% from 4.5±1.0 L/min to 2.9±0.5 L/min (p<0.001) and SVO2 decreased by 31% from 55.0±8.1% to 37.7±5.8% (p<0.001). During 3-OHB infusion, CO increased by 0.9 L/min (95% CI: 0.4 to 1.3 L/min) compared with the control infusion. In parallel, Ees increased by 0.22 mmHg/mL (95% CI: 0.08 to 0.37 mmHg/mL), LVEF improved by 7 percentage points (95%CI: 1 to 13 percentage points) and cardiac efficiency increased by 6 percentage points (95%CI: 1 to 11 percentage points). Systemic vascular resistance was decreased by 479 dyn*cm5 (95% CI: 736 to 221 dyn*cm5); Ea and ESP remained similar. Heart rate was increased during 3-OHB infusion by 21 bpm (95% CI: 11 to 32 bpm) while no significant change was observed in stroke volume (p=0.6).

Conclusion

Treatment with 3-OHB improved CO, LVEF, and cardiac efficiency in CS. The increase was mediated through increased ventricular contractility and decreased peripheral resistance accompanied by increased heart rate.CO, Ees and cardiac efficiencyEndpoint parameters during 3-OHB
Gender-related impact of vitamin D status on severity of coronary artery disease
Authors: Aleksova A , Fluca A L , Janjusevic J , Barbati G , D'errico S , Sinagra G
Published: May 2024

Funding Acknowledgements

None.

Background

Vitamin D has cardioprotective properties. A status of hypovitaminosis D, defined as vitamin D ≤ 20 ng/ml, was found to have a comparable effect to diabetes mellitus (DM) in terms of adverse outcomes in patients with acute myocardial infarction (AMI). To date, it is known that hypovitaminosis D is more frequent in women than men but there is still a paucity of data on how gender differences in vitamin D levels are associated with the extent of coronary heart disease (CAD).

Purpose

To evaluate the relationship between vitamin D status on CAD incidence and severity in patients with AMI.

Methods

Blood samples were obtained from 1484 patients with AMI on hospital admission. Levels of vitamin D ≤ 10 ng/ml were considered as severe hypovitaminosis D. CAD was defined as the presence of at least one coronary vessel stenosis greater than 50%, while severe CAD was defined as left main disease and/or three-vessel disease. The endpoint was all-cause mortality.

Results

The cohort's mean age was 66.25 (11.47) years, the majority were male (71.8%) and 24.3% of patients had DM. Overall, 86.2% of patients had CAD and 32.9% severe CAD. The median vitamin D concentration was 17.25 [10.3 - 24.7] ng/ml, and 23.6% of patients had severe hypovitaminosis D.

In female patients, hypovitaminosis D was significantly more common in whom with severe CAD (74.1% vs 58.1%, p=0.002), but not in men (61.3% vs 57.1%, p=0.193). On the other hand, severe hypovitaminosis D was significantly more frequent in patients with severe CAD in both genders (male and female respectively 26.6% vs 17.9%, p=0.005; 40.5% vs 26.4%, p=0.001).

In female patients, severe CAD was predicted by hypovitaminosis D (OR: 1.85 [1.14 – 3.03], p=0.013) along with DM and older age after correction for confounders as GFR<60 mL/min/1.73 m2, higher cholesterol levels and body mass index. However, hypovitaminosis D was not an independent predictor of severe CAD in men. Moreover, a composite of hypovitaminosis D and DM was identified as a predictor of severe CAD when compared to patients with neither hypovitaminosis D nor DM (OR: 3.56 [1.8 – 7.03], p=0.021) only in female patients.

Conclusions

The identification of an association between hypovitaminosis D and severe CAD in women but not in men is a novelty in this field. Furthermore, we found that the presence of both hypovitaminosis D and DM has a greater contribution to severe CAD in female patients with AMI.
Validation of utstein-based score to predict return of spontaneous circulation (UB-ROSC) in patients with out-of-hospital cardiac arrest
Authors: Caputo M , Fasolino A , Baldi E , Burkart R , Wilmes A , Cresta R , Benvenuti C , Primi R , Currao A , Bendotti S , Compagnoni S , Gentile F R , Savastano S , Klersy C , Auricchio A
Published: May 2024

Funding Acknowledgements

None.

Background and aims

The Utstein Based-ROSC (UB-ROSC) score has been developed to predict ROSC in OHCA victims. Aim of the study was to validate the UB-ROSC score using two Utstein-based OHCA registries: the SWiss REgistry of Cardiac Arrest (SWISSRECA) and the Lombardia Cardiac Arrest Registry (Lombardia CARe), northern Italy.

Methods

Consecutive patients with OHCA of any etiology occurring between January 1st, 2019 and December 31st 2021 were included in a prospectively designed validation study. UB-ROSC score was computed for each patient and categorized in one of 3 subgroups:low, medium or high likelihood of ROSC according to the UB-ROSC cut-offs (≤-19; -18 to 12; ≥13). To assess the performance of the UB-ROSC score in this new cohort, we assessed both discrimination and calibration. The score was plotted against the survival to hospital admission.

Results

A total of 12,577 patients were included in the study. A sustained ROSC was obtained in 2,719 patients (22%). The UB-ROSC model resulted well calibrated and showed a good discrimination (AUC 0.71, 95% CI 0.70-0.72). In the low likelihood subgroup of UB-ROSC, only 9% of patients achieved ROSC, whereas the proportion raised to 36% for a score between -18 and 12 (OR 5.0, 95% CI 2.9-8.6, P<0.001) and to 85% for a score ≥ 13 (OR 49.4, 95%CI 14.3-170.6, P <0.001).

Conclusions

UB-ROSC score represents a reliable tool to predict ROSC probability in OHCA patients. Its application may help the medical decision-making process, providing a realistic stratification of the probability for ROSC.
Temporal and regional trends of case-fatality in patients hospitalized with acute respiratory distress syndrome in Germany
Authors: Sagoschen I , Keller K , Farmakis I , Lurz P , Hobohm L
Published: May 2024

Funding Acknowledgements

None.

Aims

Significant progress has been made in understanding the pathophysiology of acute respiratory distress syndrome (ARDS). However, ARDS it is still a life-threatening medical condition with a high mortality rate. Little is known about temporal trends and regional variations in Germany.

Methods

We analyzed data on the characteristics, comorbidities and in-hospital outcomes for all hospitalized patients with ARDS in Germany between 2005 and 2019. Diagnoses were coded according to the International Classification of Diseases and Related Health Problems, 10th Revision with German Modification (ICD-10-GM), and diagnostic, surgical or interventional procedures according to the German Procedure Classification (OPS, surgery and procedures codes. The computed study analyses were performed on our behalf by the Research Data Center of the Federal Statistical Office and the Statistical Offices of the federal states in Wiesbaden, Germany.

Results

Overall, 8,369,723 inpatients aged ≥18 years were included in this analysis; among these, 155,872 (1.9%) were codes with the diagnosis of ARDS. The annual number of ARDS cases increased from 7,286 in 2005 to 13,722 in 2019 in parallel with a significant decrease of in-hospital mortality. Overall, 74,751 (48.0%) patients with ARDS died during the in-hospital stay and in-hospital case-fatality grew exponentially with age. Independent predictors of in-hospital fatality with an OR >2 were age ≥70 years, necessity of ECMO, severe liver disease, acute renal failure, dialysis, shock and cardio-pulmonary resuscitation. Most patients with ARDS were treated in hospitals in urban areas (n=56,582) with a high case-fatality rate (49.7%), but also with concomitant high proportion rate of mechanical ventilation (23.7%) compared to hospitals in suburban or rural areas.

Conclusion

The number of patients with ARDS increased markedly in Germany between 2005 and 2019, in parallel with a decrease of in-hospital fatality. Our findings may suggest that general management of ARDS have improved over time and might draw more attention to predictors for in-hospital fatality in patients hospitalized with ARDS. The need for mechanical ventilation and a poor outcome was more likely in urban areas – this might be accentuated by patient transfer to specialized high care centers usually located in urban settings.
Predictive value of procalcitonin for early atrial fibrillation recurrence post-cardioversion at the emergency department
Authors: Diakantonis A , Bistola V , Verras C , Boultadakis A , Bezati S , Parissis J , Polyzogopoulou E
Published: May 2024

Funding Acknowledgements

None.

Background

Cardioversion of acute atrial fibrillation (AF) in the emergency department (ED) has been shown to be a safe and effective treatment strategy that allows direct discharge from the ED thereby reducing avoidable hospitalizations. However, early AF recurrence may present a limitation, thereby necessitating the identification of predictors of AF recurrence post-ED cardioversion.

Methods

117 patients with acute AF (first detected or recurrent paroxysmal) of <48 hours duration, managed by pharmacological (PC) or electrical cardioversion (EC) at the ED were prospectively enrolled upon ED presentation. Clinical, echocardiography, routine laboratory and NT-proBNP and procalcitonin assessments were performed upon presentation. We investigated the utility of inflammatory biomarker procalcitonin as predictor of acute success of cardioversion and early AF recurrence up to 30 days post-cardioversion.

Results

Study group consisted of 50% males, of mean(±SD) age 67±12years, 41% with first episode and 59% with paroxysmal AF, left ventricular ejection fraction (LVEF) 54±7% and left atrial diameter (LAD) 39±5mm. Median (IQR) creatinine, NTproBNP, hsTroponinT and procalcitonin were: 0.9(0.8-1.1)mg/dl, 517(137-1454)pg/ml, 11.8(6.7-19)pg/ml and 0.03(0.02-0.05)pg/ml, respectively. Of the total group, 59% had paroxysmal and 41% first-episode AF, whereas 70% received EC and 30% PC. Acute cardioversion success was achieved in 81%, while sinus rhythm was maintained in 84% at 8 days and in 86% in 30 days post-cardioversion. In univariate regression analysis, lower procalcitonin levels were associated with higher acute cardioversion success [HR, 95%CI: 0.208(0.050-0.863), p=0.031] as well as lower risk of AF recurrence at 8 days [HR, 95%CI: 0.142(0.028-0.730), p=0.019] and 30 days post-cardioversion [HR, 95%CI: 0.190(0.044-0.818), p=0.026]. Predictive value of procalcitonin was maintained after adjustment for LAD in multivariate regression (all p<0.05).

Conclusions

In acute AF managed by cardioversion in the ED, procalcitonin, a marker of inflammatory stimulation, may predict acute non-response as well as early AF recurrence up to 30 days post-cardioversion.
Anatomy of a premodern state
Authors: Costa Leonor Freire , Henriques António , Palma Nuno
Published: May 2024

We provide a blueprint for constructing measures of state capacity in premodern states, offering several advantages over the current state of the art. We argue that assessing changing state capacity requires considering the composition of revenues, expenditure patterns, and local-level budgets. As an application, we examine the case of Portugal (1367–1844). Our findings demonstrate that throughout most of this extended period, Portugal maintained comparatively high fiscal and legal capacities. This challenges claims that Portugal’s economic decline from the second half of the eighteenth century was due to low state capacity.
Lactate metabolism promotes in vivo fitness during Acinetobacter baumannii infection
Authors: Morris Faye C , Jiang Yan , Fu Ying , Kostoulias Xenia , Murray Gerald L , Yu Yusong , Peleg Anton Y
Published: May 2024

Acinetobacter baumannii is one of the most prevalent causes of nosocomial infections worldwide. However, a paucity of information exists regarding the connection between metabolic capacity and in vivo bacterial fitness. Elevated lactate is a key marker of severe sepsis. We have previously shown that the putative A. baumannii lactate permease gene, lldP, is upregulated during in vivo infection. Here, we confirm that lldP expression is upregulated in three A. baumannii strains during a mammalian systemic infection. Utilising a transposon mutant disrupted for lldP in the contemporary clinical strain AB5075-UW, and a complemented strain, we confirmed its role in the in vitro utilisation of l-(+)-lactate. Furthermore, disruption of the lactate metabolism pathway resulted in reduced bacterial fitness during an in vivo systemic murine competition assay. The disruption of lldP had no impact on the susceptibility of this strain to complement mediated killing by healthy human serum. However, growth in biologically relevant concentrations of lactate observed during severe sepsis, led to bacterial tolerance to killing by healthy human blood, a phenotype that was abolished in the lldP mutant. This study highlights the importance of the lactate metabolism pathway for survival and growth of A. baumannii during infection.
Associations and Mediating Pathways Between Childhood Adversity and Risk of Dementia: A Cohort Study in the UK Biobank
Authors: Hu Wei , Zhang Wei-Bo , Liu Bao-Peng , Jia Cun-Xian
Published: May 2024

Background

While childhood adversity (CA) is known to be associated with multiple adverse outcomes, its link with dementia is an area with limited exploration and inconsistent agreement. The study aimed to examine the longitudinal associations of CA with incident all-cause dementia and to quantify the potential mediating pathways.

Methods

Data from the UK Biobank. CA, encompassing neglect and abuse, was evaluated retrospectively by an online mental health questionnaire. Physical performance, psychological factors, lifestyles, and biological indicators assessed at baseline were considered potential mediators. Incident all-cause dementia was defined by International Classification of Diseases, Tenth Revision codes obtained through self-reported medical conditions, primary care, hospital admission, and death registrations. Cox proportional hazard models were applied to estimate the longitudinal associations. Mediation analyses were conducted on potential mediators to examine their contribution.

Results

This cohort study comprised 150 152 nondemented individuals (mean [SD] age, 55.9 [7.7] years) at baseline (2006–2010). Compared to individuals who did not experience CA, those exposed to any CA exhibited a 30.0% higher risk of dementia (hazard ratio = 1.300, 95% confidence interval [CI]: 1.129–1.496). Each additional CA was associated with a 15.5% (95% CI: 8.8%–22.5%, pfor trend < .001) increased dementia risks. Depression, smoking, and low grip strength explained 8.7%, 2.4%, and 0.9% of the associations, respectively. Biomarkers involving inflammation, erythrocytes, liver, and kidney function mediated the associations by 0.6%–1.4%.

Conclusions

The study revealed the detrimental effects of CA on dementia and identified some potential mediators, namely depression, smoking, low grip strength, and several targeted biomarkers. In addition to calling more attention to CA, the findings underscore the importance of interventions targeting modifiable mediators in preventing dementia.
Educational Attainment Moderates Task-State Control Network Connectivity Relations to Response Conflict Among Healthy Older Adults
Authors: Pipoly Marco , Lee Hyun Kyu , Hazeltine Eliot , Voss Michelle W
Published: May 2024

Objectives

Older adult executive function varies widely due to brain and cognitive aging. Variance in older adult executive function is linked to increased response conflict from cognitive and brain aging. Cognitive reserve (CR) is a theoretical protective mechanism that lessens brain aging’s impact on cognition and is associated with greater educational attainment. Recent work in rest-state functional magnetic resonance imaging (fMRI) suggests CR proxies moderate the relationship between functional connectivity (FC) and cognitive performance. Brain network FC in “control networks,” including the salience (SN), dorsal attention and frontoparietal networks, are associated with cognitive processes in older adults. CR is hypothesized to maintain cognitive processing in part through changes in how brain networks respond to cognitive demands. However, it is unclear how CR proxies like educational attainment are related to control network FC during performance when cognitive demands are increased relative to rest. Because CR is expressed more in those with higher education, we hypothesized stronger control network FC would relate to better performance, where this relationship would be strongest among the most educated.

Methods

We collected flanker task data during fMRI to assess the impact of a CR proxy (i.e., educational attainment) on response conflict among older adult subjects (n = 42, age = 65–80).

Results

Linear mixed-effects models showed more educated older adults with greater SN-FC had a smaller flanker effect (i.e., less influence of distractors; p < .001) during task performance.

Discussion

For the first time, we show that educational attainment moderates the relationship between task-state SN-FC and executive function among older adults.
The electric vehicle sector in Brazil, India, and South Africa: Are there green windows of opportunity?
Authors: Lema Rasmus , Wuttke Tobias , Konda Primoz
Published: May 2024

The shift to electric mobility is driving disruptive transformations in the automotive sector worldwide. It poses significant but different opportunities and challenges to incumbents and latecomers at both the firm and country levels. China’s green industrial policy has facilitated its rapid catching up and even leapfrogging in some domains of electromobility. This article asks whether the exploitation of this window of opportunity can be replicated in other latecomer countries. Accordingly, it provides a comparative analysis of the automotive green window of opportunity in Brazil, India, and South Africa, three emerging economies with long established but structurally different automotive industries. To do so, it examines domestic preconditions, policy and enterprise responses, and preliminary industrial development outcomes. Although all the three countries face constraints in replicating China’s relative success, the article shows how green opportunities and threats are unequally divided between the three countries.
Humoral Correlates of Protection Against Influenza A/H3N2 Virus Infection
Authors: Hoy Gregory , Stadlbauer Daniel , Balmaseda Angel , Kuan Guillermina , López Roger , Carreno Quiroz Juan Manuel , Ojeda Sergio , Sánchez Nery , Yellin Temima , Plazaola Miguel , Frutos Aaron , Krammer Florian , Gordon Aubree
Published: May 2024

Background

Influenza virus remains a threat to human health, but gaps remain in our knowledge of the humoral correlates of protection against influenza virus A/H3N2, limiting our ability to generate effective, broadly protective vaccines. The role of antibodies against the hemagglutinin (HA) stalk, a highly conserved but immunologically subdominant region, has not been established for influenza virus A/H3N2.

Methods

Household transmission studies were conducted in Managua, Nicaragua, across 3 influenza seasons. Household contacts were tested for influenza virus infection using reverse-transcription polymerase chain reaction. We compared preexisting antibody levels against full-length HA, HA stalk, and neuraminidase (NA) measured by enzyme-linked immunosorbent assay, along with hemagglutination inhibition assay titers, between infected and uninfected participants.

Results

A total of 899 individuals participated in household activation, with 329 infections occurring. A 4-fold increase in initial HA stalk titers was independently associated with an 18% decrease in the risk of infection (adjusted odds ratio [aOR], 0.82 [95% confidence interval {CI}, .68–.98]; P = .04). In adults, anti-HA stalk antibodies were independently associated with protection (aOR, 0.72 [95% CI, .54–.95]; P = .02). However, in 0- to 14-year-olds, anti-NA antibodies (aOR, 0.67 [95% CI, .53–.85]; P < .01) were associated with protection against infection, but anti-HA stalk antibodies were not.

Conclusions

The HA stalk is an independent correlate of protection against A/H3N2 infection, though this association is age dependent. Our results support the continued exploration of the HA stalk as a target for broadly protective influenza vaccines but suggest that the relative benefits may depend on age and influenza virus exposure history.
Declining Antibody Affinity Over Time After Human Vaccination With a Plasmodium falciparum Merozoite Vaccine Candidate
Authors: Persson Kristina E M , Horton Jessica L , Kurtovic Liriye , McCarthy James S , Anders Robin F , Beeson James G
Published: May 2024

Maintaining high-affinity antibodies after vaccination may be important for long-lasting immunity to malaria, but data on induction and kinetics of affinity is lacking. In a phase 1 malaria vaccine trial, antibody affinity increased following a second vaccination but declined substantially over 12 months, suggesting poor maintenance of high-affinity antibodies.

Clinical Trials Registration

Australian New Zealand Clinical Trials Registry ACTRN12607000552482.
Tibetan Buddhism in the Age of Waste
Authors: Brox Trine
Published: May 2024

Taking examples from lived Tibetan Buddhism, this article explores the role of religion in the generation, sorting, and handling of waste that is produced or ends up in the religious field. Rather than assuming that waste is the negative and worthless endpoint of consumption, it introduces the concepts of “waste imaginaries” and “waste trajectories” to examine the importance of religion in the relationship between how and why things come to be defined and sorted as waste and the ways in which they are then handled and treated. By examining how Tibetan Buddhists talk about and act around different kinds of waste, both sacred and banal, the article unfolds the moral politics of waste, showing how waste trajectories are negotiated through changing and sometimes conflicting waste imaginaries.
An Evaluation of Burn Fellowship Program Websites’ Presence and Content
Authors: Mayorga-Young Danielle , LaGuardia Jonnby , Zaronias Callista , Park Won , Bell Derek
Published: May 2024

Fellowship program websites pertaining to various subspecialties have been evaluated according to the amount and type of content they communicate to prospective applicants. This study aimed to evaluate what information specifically burn fellowship programs communicate through their websites and to what extent, if at all. In total, 10 of the 30 unique burn fellowship programs, American Burn Association (ABA)-verified or otherwise, identified through the ABA website did not have official websites which could be readily located at the time of data collection. Thus, 20 burn fellowship program websites were included in the analysis. Burn fellowship program websites were assessed according to 23 criteria relating to recruitment, education, and social life. On average, each website contained an average of 8.5 ± 2.6 criteria (range, 2-13), with all of them listing a program contact email/phone, and 95% containing a program description. Only 35% of programs listed the faculty, and a single program advertised alumni job placement. Neither the total number of fellows, the total number of clinical faculty, nor the Accreditation Council for Graduate Medical Education accreditation status were significantly associated with the amount or type of content. Geographic region was associated with a significant difference in the amount of education-related content. Fellowship program websites are important to prospective applicants when comparing programs and deciding where to apply. These results show where burn fellowship programs can increase the amount of publicly available information that applicants tend to find helpful in order to hopefully both diversify and tailor their applicant pool to those whose goals align with the programs’.
Osteomodulin deficiency in mice causes a specific reduction of transversal cortical bone size
Authors: Zhao Wenbo , von Kroge Simon , Jadzic Jelena , Milovanovic Petar , Sihota Praveer , Luther Julia , Brylka Laura , von Brackel Felix N , Bockamp Ernesto , Busse Björn , Amling Michael , Schinke Thorsten , Yorgan Timur A
Published: May 2024

Skeletal growth, modeling, and remodeling are regulated by various molecules, one of them being the recently identified osteoanabolic factor WNT1. We have previously reported that WNT1 transcriptionally activates the expression of Omd, encoding Osteomodulin (OMD), in a murine mesenchymal cell line, which potentially explained the skeletal fragility of mice with mutational WNT1 inactivation, since OMD has been shown to regulate type I collagen fibril formation in vitro. In this study we confirmed the strong induction of Omd expression in a genome-wide expression analysis of transfected cells, and we obtained further evidence for Omd being a direct target gene of WNT1. To assess the in vivo relevance of this regulation, we crossed Omd-deficient mice with a mouse line harboring an inducible, osteoblast-specific Wnt1 transgene. After induction of Wnt1 expression for 1 or 3 weeks, the osteoanabolic potency of WNT1 was not impaired despite the Omd deficiency. Since current knowledge regarding the in vivo physiological function of OMD is limited, we next focused on skeletal phenotyping of wild-type and Omd-deficient littermates, in the absence of a Wnt1 transgene. Here we did not observe an impact of Omd deficiency on trabecular bone parameters by histomorphometry and μCT either. Importantly, however, male and female Omd-deficient mice at the ages of 12 and 24 weeks displayed a slender bone phenotype with significantly smaller long bones in the transversal dimension, while the longitudinal bone growth remained unaffected. Although mechanical testing revealed no significant changes explained by impaired bone material properties, atomic force microscopy of the femoral bone surface of Omd-deficient mice revealed moderate changes at the nanostructural level, indicating altered regulation of collagen fibril formation and aggregation. Taken together, our data demonstrate that, although OMD is dispensable for the osteoanabolic effect of WNT1, its deficiency in mice specifically modulates transversal cortical bone morphology.
Whole snake genomes from eighteen families of snakes (Serpentes: Caenophidia) and their applications to systematics
Authors: Roberts Jackson R , Bernstein Justin M , Austin Christopher C , Hains Taylor , Mata Joshua , Kieras Michael , Pirro Stacy , Ruane Sara
Published: May 2024

We present genome assemblies for 18 snake species representing 18 families (Serpentes: Caenophidia): Acrochordus granulatus, Aparallactus werneri, Boaedon fuliginosus, Calamaria suluensis, Cerberus rynchops, Grayia smithii, Imantodes cenchoa, Mimophis mahfalensis, Oxyrhabdium leporinum, Pareas carinatus, Psammodynastes pulverulentus, Pseudoxenodon macrops, Pseudoxyrhopus heterurus, Sibynophis collaris, Stegonotus admiraltiensis, Toxicocalamus goodenoughensis, Trimeresurus albolabris, and Tropidonophis doriae. From these new genome assemblies, we extracted thousands of loci commonly used in systematic and phylogenomic studies on snakes, including target-capture datasets composed of ultraconserved elements (UCEs) and anchored hybrid enriched loci (AHEs), as well as traditional Sanger loci. Phylogenies inferred from the two target-capture loci datasets were identical with each other and strongly congruent with previously published snake phylogenies. To show the additional utility of these non-model genomes for investigative evolutionary research, we mined the genome assemblies of two New Guinea island endemics in our dataset (S. admiraltiensis and T. doriae) for the ATP1a3 gene, a thoroughly researched indicator of resistance to toad toxin ingestion by squamates. We find that both these snakes possess the genotype for toad toxin resistance despite their endemism to New Guinea, a region absent of any toads until the human-mediated introduction of Cane Toads in the 1930s. These species possess identical substitutions that suggest the same bufotoxin resistance as their Australian congenerics (Stegonotus australis and Tropidonophis mairii) which forage on invasive Cane Toads. Herein, we show the utility of short-read high-coverage genomes, as well as improving the deficit of available squamate genomes with associated voucher specimens.
Archives, Transitional Justice and the Spectre of Politics
Authors: Lühe Ulrike
Published: May 2024

This review essay considers The Prisons Memory Archive. A Case Study in Filmed Memory of Conflict edited by Jolene Mairs Dyer, Conor McCafferty and Cahal McLaughlin (2022) and Archives and Human Rights edited by Jens Boel, Perrine Canavaggio and Antonio González Quintana (2021). Both books are discussed in terms of their key themes, approaches and contributions before discussing their specific contributions to understanding the interaction of transitional, domestic and international politics and archival practice.
Combining statistical dialog management and intent recognition for enhanced response selection
Authors: Griol David , Callejas Zoraida
Published: May 2024

Conversational interfaces are becoming ubiquitous in an increasing number of application domains as Artificial Intelligence, Natural Language Processing and Machine Learning methods associated with the recognition, understanding and generation of natural language advance by leaps and bounds. However, designing the dialog model of these systems is still a very demanding task requiring a great deal of effort given the number of information sources to be considered related to the analysis of user utterances, interaction context, information repositories, etc. In this paper, we present a general framework for increasing the quality of the system responses by combining a statistical dialog management technique and a deep learning-based intention recognizer that allow replacing the system responses initially selected by the statistical dialog model with other presumably better candidates. This approach is portable to different task-oriented domains, a diversity of methodologies for dialog management and intention estimation techniques. We have evaluated our two-step proposal using two conversational systems, assessed several intention recognition methodologies and used the developed modules to dynamically select the system responses. The results of the evaluation show that the proposed framework achieves satisfactory results by making it possible to reduce the number of non-coherent dialog responses by replacing them by more coherent alternatives.
The application of artificial neural networks to forecast financial time series
Authors: González-Cortés D , Onieva E , Pastor I , Wu J
Published: May 2024

The amount of information that is produced on a daily basis in the financial markets is vast and complex; consequently, the development of systems that simplify decision-making is an essential endeavor. In this article, several intelligent systems are proposed and tested to predict the closing price of the IBEX 35 index using more than ten years of historical data and five distinct architectures for neural networks. A multi-layer perceptron was the first step, followed by a simple recurrent neural network, a gated recurrent unit network and two long-short-term memory (LSTM) networks. The results of the analyses performed on these models have demonstrated a powerful capacity for prediction. Additionally, the findings of this research point to the fact that the application of intelligent systems can simplify the decision-making process in financial markets, which is a substantial advantage. Furthermore, by comparing the predicted outcome errors between the models, the LSTM presents the lowest error with a higher computational time in the training phase. The LSTM was able to accurately forecast the closing price of the day as well as the price for the following one and two days in advance. In conclusion, the empirical results demonstrated that these models could accurately predict financial data for trading purposes and that the application of intelligent systems, such as the LSTM network, represents a promising advancement in financial technology.
A Multicountry Model of the Term Structures of Interest Rates with a GVAR
Authors: Candelon Bertrand , Moura Rubens
Published: May 2024

Extant multicountry affine term structure models (ATSMs) handle global financial interdependence at the cost of increasing model dimensionality. To address this challenge, we propose a novel no-arbitrage ATSM with risk factor dynamics following a global vector-autoregressive (GVAR). Compared to referenced benchmarks, the GVAR − ATSM offers a more parsimonious representation, enables a faster estimation process, produces more precise model estimates, yields more plausible term premia dynamics, and improves bond yield out-of-sample forecasting. Furthermore, our empirical findings reveal the significant impact of China’s economic stances on Latin American yield curve dynamics, underscoring its importance as a global economic player.
Bayesian inference of atomic column positions in scanning transmission electron microscopy images
Authors: Nomura Yuki , Anada Satoshi , Kobayashi Shunsuke
Published: May 2024

Atomic-resolution scanning transmission electron microscopy combined with two-dimensional Gaussian fitting enables the accurate and precise identification of atomic column positions within a few picometers. The measurement performance significantly depends on the signal-to-noise ratio of the atomic columns. In areas with low signal-to-noise ratios, such as near surfaces, the measurement performance was lower than that of the bulk. However, previous studies evaluated the accuracy and precision only in bulk areas, underscoring the need for a method that quantitatively evaluates the accuracy and precision of each atomic column position with various signal-to-noise ratios. This study introduced Bayesian inference to assess the accuracy and precision of determining individual atomic column positions under various signals. We applied this method to simulated and experimental images and demonstrated its effectiveness in identifying statistically significant displacements, particularly near surfaces with signal degradation. The use of vector maps and kernel density estimate plots obtained from Bayesian inference provided a probabilistic understanding of the atom displacement. Therefore, this study highlighted the potential benefits of Bayesian inference in high-resolution imaging to reveal material properties.
Relationships between functional traits and survival mediated by tree size in subtropical forests
Authors: Wang Zhen-Yu , Huang Zhi-Qun
Published: May 2024

An important challenge in ecology is to link functional traits to plant survival for generalizable predictions of plant demographical dynamics. However, whether root and leaf traits are consistently associated with tree survival remains uncertain because of the limited representation of root traits. Moreover, the relationships between plant traits and survival are rarely linear and are likely to vary with tree size. We analyzed demographic data from 17 901 trees of 32 subtropical tree species under 3-year-old monocultures to test whether root and leaf traits have consistent relationships with tree survival and how the relationships between traits and tree survival vary with tree diameter. We discovered that leaf and root traits have inconsistent effects on tree survival. Specifically, while specific leaf area (SLA; an acquisition strategy) showed a marginally significant negative impact on survival, root diameter (RD; a conservative trait within the one-dimensional root economic spectrum) also demonstrated a significant negative effect on survival. Furthermore, we found size-dependent relationships between traits and tree survival. The effect of SLA, leaf phosphorus concentration and specific root length, on survival shifted from negative to positive with increasing tree size. However, species with high leaf thickness and RD were positively linked to survival only for small trees. The results highlight that to accurately predict the relationships between traits and tree survival, it is essential to consider both above- and belowground traits, as well as the size-dependent relationships between traits and tree survival.
A Case of Non-Seminomatous Germ Cell Tumor Complicated by Tumor Thrombus in an Active Duty Soldier
Authors: Grossmann Matthew , Kou Chung-Ting J , Vergonet Breanne , Soderstrom Matthew , Rendo Matthew J , Lee Lauren E
Published: May 2024

Testicular malignancies commonly affect adolescent and young adult males. Although they tend to respond well to cisplatin-based chemotherapy with excellent overall survival, complications such as inferior vena cava tumor thrombus are rare and can be associated with high morbidity and mortality. We present a case of tumor thrombus in a 21-year-old active duty male with a newly diagnosed stage IIIB non-seminomatous germ cell tumor presenting with extensive left lower extremity swelling. Ultrasound with Doppler was notable for significant thrombus of the left common femoral, femoral, and popliteal vein. Computed tomography imaging revealed extensive thrombus of the inferior vena cava, left iliac veins, and left gonadal vein with sparing of the left renal vein. Endovascular thrombectomy was performed with pathologic analysis confirming the presence of malignant cells consistent with tumor thrombus. The patient continued subsequent non-seminomatous germ cell tumor treatment without complications.