bluuebunny/crossref_metadata_2025 huggingface dataset:
Maximal resolving sets in a graph
Authors: Swaminathan V. , Sundareswaran R.
Published: February 2024

Let G be a connected graph. A subset [Formula: see text] of [Formula: see text] is called a resolving set of G if the code of any vertex [Formula: see text] with respect to S is different from the code of any other vertex where code of u with respect to S denoted by [Formula: see text] is defined as [Formula: see text]. Resolving set was earlier studied in the name of locating set by Slater and Harary and Melter too studied this concept. The minimum cardinality of a resolving set is called the metric dimension (locating number). A vertex [Formula: see text] in a connected graph G is said to resolve two vertices [Formula: see text] if [Formula: see text] Clearly, x resolves [Formula: see text] A subset S of [Formula: see text] is a resolving set of G if for any two distinct vertices [Formula: see text] there exists a vertex [Formula: see text] such that x resolves [Formula: see text] Motivated by this equivalent definition, a study of resolving chain and maximal resolving set is initiated in this paper. Also, study of total resolving sets is initiated.
PCA, arithmetic, and murmurations
Authors: Oliver Thomas
Published: February 2024

We outline how murmurations were first observed in the context of data scientific exploration. Specifically, we highlight the relationship between murmurations and PCA. Subsequently, we apply PCA to datasets of real quadratic fields, and speculate on an emergent perspective on arithmetic suggested by these experiments.
Average multiplicities
Authors: Rohrlich David E.
Published: February 2024

This note summarizes my talk at the ICERM workshop on Murmurations and Arithmetic, 6 June 2023 to 8 June 2023. The talk was based on the paper [14], to which the reader is referred for details and proofs. The two addenda at the end appeared neither in the talk nor in [14] but are complementary to both. It is a pleasure to thank ICERM and the organizers of the workshop for inviting me to participate in a meeting that was both enjoyable and productive.
Characteristic polynomials of some min and max matrices
Authors: Xie Wei
Published: February 2024

In this paper, we investigate Min matrices [Formula: see text] and Max matrices [Formula: see text] whose entries are [Formula: see text] and [Formula: see text], respectively, where [Formula: see text] and [Formula: see text]. By utilizing combinatorial identities, we derive the characteristic polynomials of M and U. Additionally, relationship between generalized Fibonacci numbers and the characteristic polynomials of these matrices is established. Finally, some examples are given to illustrate our results.
Refractive Laser Beam Measuring Diffusion Coefficient of Concentrated Battery Electrolytes
Authors: Betts Katherine , Heenkenda K. Y. , Jacome Bryan , Kim Sohyo , Tovar Michael , Feng Zhange
Published: February 2024

A thorough understanding of electrolyte transport properties is crucial in the development of alternative battery technology. As a key parameter, the diffusion coefficient offers important insights into the behavior of electrolytes, especially for fast charge of high-energy batteries. Existing methods of measurement are often limited by redox species or offer questionable accuracy due to side reactions and/or disruption of the diffusion profile. This work provides a novel optical method for measuring diffusion coefficients of liquid-phase concentrated battery electrolytes without electrochemical reactions. The method relies on the deflection of a refractive laser beam passing through an electrolyte of a minor concentration gradient in a triangular diffusion column. The diffusion coefficient, D, for a range of zinc sulfate electrolytes was successfully extracted by correlating the position of the laser beam to its concentration. Several other physicochemical properties of the same electrolytes are studied to correlate to the concentration-dependent diffusion coefficients, including viscosity, conductivity, and microstructure analysis based on vibrational spectroscopy (Infrared and Raman). Also included is the future application of the triangular column for in situ electrochemical measurements.
Nanoscale Metal/Metal Multilayers Electrodeposited from Ethaline
Authors: Sousa N. G. , Salgueira J. F. S. , da Silva L. T. V. , do Nascimento R. F. , de Lima-Neto P. , Correia A. N. , Mubshrah A. , Schwarzacher W.
Published: February 2024

Nanoscale metal/metal multilayer films electrodeposited from a single electrolyte under either potentiostatic or galvanostatic control have been widely studied. When the electrolyte contains two metal species it is possible to alternate between depositing the more noble component and an alloy of both simply by switching either the deposition potential or current density. Most work in this field has used aqueous electrolytes, but in some situations working with alternative solvents could offer advantages. Here we present results for Ni-Cu/Cu multilayers electrodeposited from an ethaline (1:2 choline chloride: ethylene glycol) electrolyte containing 1.2 M NiCl2 and 0.06 M CuCl2. The deposition potential was alternated between −0.45 V vs Ag/AgCl to deposit Cu and −1.2 V at which a Ni-rich Ni-Cu alloy was expected. Specular films consisting of multiple repeats with nominal thicknesses down to 5 nm Ni-Cu/ 1 nm Cu were obtained, and their multilayer structure was confirmed by X-ray diffraction. Average composition measurements for series of multilayers in which the thickness of one of the components was maintained constant provide further insight to the multilayer deposition process.
Evaluating peripheral neuromuscular function with brief movement-evoked pain
Authors: Ogalo Emmanuel , Linde Lukas D. , Ro Hannah , Ortiz Oscar , Kramer John L. K. , Berger Michael J.
Published: February 2024

We provide neurophysiological evidence to indicate that peak force and rate of force development are reduced by movement-evoked pain despite a lack of change in EMG and early rapid force development in the first dorsal interosseous muscle. Additional evidence suggests that these findings may coexist with a reorganization in motoneuronal activation strategy.
Revisiting Cancer Diagnosis in Scotland: Further Insights from the Second Scottish National Cancer Diagnosis Audit
Authors: Maxwell Susanne , Kynn Mary , Weller David , Anderson Lesley , Murchie Peter
Published: February 2024

Objective. To characterise cancer diagnosis in Scottish primary care in 2018/19 and draw comparisons with diagnostic activity in 2014. Methods. A national audit of cancer diagnosis undertaken in Scottish general practices. Participating GPs collected diagnostic pathway data on patients diagnosed with cancer in 2018/19 from medical records. These data were supplemented by linkage to the Scottish Cancer Registry and previous audit data from 2014. Analyses explored and compared patient demographics, presentation, diagnostic routes, and intervals. Results. Seventy-three practices submitted data on 2,014 cases in 2014 and 90 practices submitted data on 2,318 cases in 2018/2019. Individual demographics and types of cancer were similar. There was a higher proportion of USC (urgent suspected cancer) referrals in 2019 than 2014 (42.9% vs 38.1%, p=0.008) but a similar proportion of emergency presentations (19.2% vs 20.4%). Primary care (median 4 (IQR 0–22) vs 5 (0–23)) and diagnostic intervals (27 (10–59) vs 30 (13–68)) were similar in both periods. Significantly fewer (24.5% vs 28.3, p=0.015) had a diagnostic interval >60 days in 2019 than 2014. Harder to diagnose cancers were more likely to present as emergencies and be subject to prolonged delays in both cohorts. Conclusions. The 2014 and 2018/19 cohorts were broadly similar. There is limited evidence that USC use had increased between 2014 and 2018/19. Harder to diagnose cancers are still most likely to present as emergencies and be subject to delays. Overall, it seems there were small improvements in cancer diagnosis prepandemic and a further audit could examine evidence for a postpandemic recovery.
Seroprevalence and Potential Risk Factors of Toxocariasis among General Population in Southwest Iran: Implications on the One Health Approach
Authors: Foroutan Masoud , Vafae Eslahi Aida , Soltani Shahrzad , Kamyari Naser , Moradi-Joo Ehsan , Magnaval Jean-Francois , Badri Milad
Published: February 2024

Toxocariasis is one of the most common zoonotic diseases distributed worldwide. This study aimed to estimate the seroprevalence of anti‐Toxocara immunoglobulin G (IgG) antibodies and the associated risk factors among general populations living in urban and rural areas of Abadan and Khorramshahr cities in Khuzestan Province, Southwest Iran. This cross‐sectional study was conducted between March and September 2022. There were 363 participants (190 females and 173 males) aged from <20 to ≥60 years old. Anti‐Toxocara IgG antibodies in serum samples were measured using a commercially available enzyme‐linked immunosorbent assay (ELISA). A structured questionnaire was employed to collect information regarding sociodemographic status and probable risk factors associated with toxocariasis. It was found that the seroprevalence rate in males (15.0%, 95% CI = 10.47–21.11) was higher than in females (10.5%, 95% CI = 6.92–15.70). Moreover, we observed that the seroprevalence was higher in participants at younger ages compared to other age ranges (COR = 2.55, 95% CI = 0.92–7.12, p  = 0.073). The findings of the univariate analysis revealed that residency in rural areas (p  < 0.001), using unpurified water (p  < 0.001), contact with dog (p  = 0.002), contact with soil (p  < 0.001), consumption of improperly washed vegetables (p  < 0.001), and history of drinking untreated water (p  < 0.001) were risk factors associated with toxocariasis. Further comprehensive studies with a focus on humans and animals should be designed in different areas of the Province. The data represented by the current study are useful to health policymakers to consider precise surveillance and effective prevention measures to control this zoonotic infection among general populations.
A Novel Method for 3D Object Detection in Open-Pit Mine Based on Hybrid Solid-State LiDAR Point Cloud
Authors: Li Cheng , Yao Gang , Long Teng , Yuan Xiwen , Li Peijie
Published: February 2024

In recent years, the mining industry has encountered challenges, such as a shortage of human resources, an ongoing emphasis on safety enhancements, and increased ecological preservation requirements. Autonomous mining trucks have emerged as a novel solution to effectively address these issues within open-pit mining operations. To meet the demanding conditions of open-pit mines, characterized by intense vibrations and extreme temperature variations, hybrid solid-state LiDAR has emerged as the primary choice for perception sensors. Recognizing the distinct data structure and distribution disparities between point clouds obtained through nonrepetitive scanning methods of hybrid solid-state LiDAR and traditional mechanical LiDAR, this paper proposed an innovative LiDAR 3D object detection model, PointPillars-HSL (PointPillars-Hybrid Solid-state LiDAR). This approach harmonizes the unique characteristics of open-pit mining environments and hybrid solid-state LiDAR point clouds. It optimizes the model’s preprocessing methodology, augments the dimensionality of pillar features, fine-tunes the loss function, and employs transfer learning techniques to reduce the reliance on specific datasets. The result is the effective deployment of a 3D object detection algorithm customized for hybrid solid-state LiDAR within the specific operational framework of open-pit mining. This achievement has yielded a noteworthy overall vehicle recognition rate of 89.72%.
The Effect of Leisure Intervention on Occupational Performance and Occupational Balance in Individuals with Substance Use Disorder: A Pilot Study
Authors: Farhadian Majid , Akbarfahimi Malahat , Hassani Abharian Peyman , Khalafbeigi Mitra , Yazdani Farzaneh
Published: February 2024

Background and Purpose. Leisure, as an occupation, played a crucial role in promoting individuals’ health and well‐being. However, the specific impact of leisure as an intervention for individuals with substance use disorder remains unclear. This pilot study was aimed at investigating the effect of a leisure intervention on occupational performance and occupational balance in individuals with substance use disorder. Methods. The sample for this quasiexperimental pretest–posttest with a two‐month follow‐up design comprised nine individuals aged between 18 and 55 years, selected using a convenience sampling method. The intervention consisted of a 2‐month group leisure participation program, conducted twice a week, followed by a 2‐month follow‐up period. Primary outcome measures included occupational performance and occupational balance, and secondary outcome measures were leisure participation, quality of life, and drug craving. Outcome measures were assessed three times: preintervention, postintervention, and after the follow‐up period. The outcome measures included the Canadian Occupational Performance Measure (COPM), Occupational Balance Questionnaire‐11 (OBQ11), Nottingham Leisure Questionnaire (NLQ), 36‐Item Short‐Form Health Survey (SF‐36), and Desire to Drug Questionnaire (DDQ). Data analysis was performed using the Friedman test and Wilcoxon signed‐rank test as a post hoc procedure, with a significance level set at 5%. Results. The findings showed significant improvements in participants’ occupational performance in postintervention and follow‐up assessments (p < 0.01, r = 0.59) and better occupational balance from pre‐ to postintervention (p < 0.01, r = 0.59) and after the follow‐up period (p < 0.01, r = 0.60). Furthermore, significant enhancements were observed in leisure participation, quality of life, and a reduction in drug craving. Conclusion. The findings indicate that leisure intervention positively impacted both occupational performance and occupational balance, suggesting its potential as a beneficial therapeutic approach for individuals with substance use disorder. Additional research is warranted to delve deeper into and validate the effectiveness of leisure intervention within this specific population.
Do Different Tooth Bleaching–Remineralizing Regimens Affect the Bleaching Effectiveness and Enamel Microhardness In Vitro?
Authors: Mohammadipour Hamideh Sadat , Shokrollahi Parnian , Gholami Sima , Bagheri Hosein , Namdar Fatemeh , Sekandari Salehe
Published: February 2024

Objective. Tooth bleaching may negatively affect the enamel surface properties, such as reduction in hardness values, and remineralizing agents can reverse these effects. This study evaluated the effect of remineralizing agents before, during, and after the bleaching process on enamel’s whitening effectiveness and microhardness. Methods and Materials. The initial color of 104 bovine incisors after immersion in tea solution was recorded, and then, the teeth were randomly divided into eight groups (n = 13). Group 1 (NC) was considered the control with no treatment, and Group 2 (B) was bleached with 40% hydrogen peroxide gel. The 3% fluorohydroxyapatite (FHA) and 2% sodium fluoride (NaF) were applied before (FHA/B, NaF/B), during (FHA + B, NaF + B) and after (B/FHA, B/NaF) the bleaching process in other groups. The final color and microhardness in three depths of 20–30, 50–60, and 100–120 µm were measured. Data were analyzed using Shapiro–Wilk, one‐way ANOVA, Tukey, Games Howell, repeated measurement, and LSD tests. Results. The FHA + B presented the lowest ΔE, significantly lower than other groups, except B/FHA. The ΔE in B/FHA was significantly lower than B/NaF. The bleaching significantly reduced the enamel hardness in three depths. The highest microhardness values were reported for B/NaF and NaF + B, which have no noticeable difference with NC, while FHA/B showed the lowest hardness in three depths, which was significantly lower than NC. Conclusion. The application of NaF before, during, and after the bleaching improved the microhardness of bleached enamel as the unbleached one with no adverse effect on whitening effectiveness.
Effects of DPP4 Inhibitors as Neuroprotective Drug on Cognitive Impairment in Patients with Type 2 Diabetes Mellitus: A Meta-Analysis and Systematic Review
Authors: Yuan Yuting , Zhang Yue , Lei Min , Guo Xiying , Yang Xiaosong , Ouyang Changhan , Liu Chao , Chen Qingjie
Published: February 2024

Purpose. Type 2 diabetes mellitus is considered as one of the risk factors for cognitive impairment. DPP4 inhibitors are effective drugs for the treatment of type 2 diabetes mellitus. However, the relationship between DPP4 inhibitors and cognitive dysfunction remains unclear. Therefore, we used a meta-analysis to determine the association between DPP4 inhibitors and cognitive impairment in type 2 diabetes mellitus. Methods. We systematically searched PubMed, CNKI, and the Cochrane Library at the time of establishment, 2022, and then made inclusion criteria and screened strategies to identify studies with more precise correlations. Results. We included 10 studies with 5,583 participants. The data showed that DPP4 inhibitors significantly reduced the incidence rate of cognitive impairment in type 2 diabetes mellitus (SMD: 0.99; 95% CI [0.59, 1.38]). Furthermore, there was a linear correlation found between cognitive impairment in type 2 diabetes mellitus and fasting blood glucose, 2-hour postprandial blood glucose, and glycosylated hemoglobin. DPP4 inhibitors decreased fasting blood glucose (FPG) (SMD: 0.52; 95% CI [−0.68, −0.37]), blood glucose (2hPPG) at 2 hours after the meal (SMD: 0.82; 95% CI, [−1.2, −0.43]), and HbA1c (SMD: 0.34; 95% CI [−0.48, −0.21]). All data were statistically significant (P<0.0001). Furthermore, we conducted subgroup analyses of the following measures at various treatment durations and ages: cognitive scores, fasting blood glucose, glycosylated hemoglobin, and two-hour postprandial blood glucose. Conclusion. DPP4 inhibitors significantly improved type 2 diabetic mellitus individuals’ cognitive impairment and reduced fasting blood glucose, 2-hour postprandial blood glucose, and glycosylated hemoglobin. Subgroup analysis showed that people aged 60 to 70 years had better treatment effects at 0–180 days. This trial is registered with CRD42023399473.
FIGURE 2 from Natural History of Germline BRCA1 Mutated and BRCA Wild-type Triple-negative Breast Cancer
Authors: Gardi Nilesh , Chaubal Rohan , Parab Pallavi , Pachakar Sunil , Kulkarni Suyash , Shet Tanuja , Joshi Shalaka , Kembhavi Yogesh , Chandrani Pratik , Quist Jelmar , Kowtal Pradnya , Grigoriadis Anita , Sarin Rajiv , Govindarajan Raman , Gupta Sudeep
Published: February 2024

Graphical representation of clonal evolution observed in sequentially collected samples over time in 3 patients with TNBC. Timepoints are depicted on the X-axis and Cellular Prevalence (Clonal Prevalence) is shown on the Y-axis. Different colors in each patient represent various clones and their changing dynamics over time. Clonal phylogeny for each patient is shown on the left side of main figure. A, Patient_02. B, Patient_04. C, Patient_07.
Data from Natural History of Germline BRCA1 Mutated and BRCA Wild-type Triple-negative Breast Cancer
Authors: Gardi Nilesh , Chaubal Rohan , Parab Pallavi , Pachakar Sunil , Kulkarni Suyash , Shet Tanuja , Joshi Shalaka , Kembhavi Yogesh , Chandrani Pratik , Quist Jelmar , Kowtal Pradnya , Grigoriadis Anita , Sarin Rajiv , Govindarajan Raman , Gupta Sudeep
Published: February 2024

Abstract
We report a deep next-generation sequencing analysis of 13 sequentially obtained tumor samples, eight sequentially obtained circulating tumor DNA (ctDNA) samples and three germline DNA samples over the life history of 3 patients with triple-negative breast cancer (TNBC), 2 of whom had germline pathogenic BRCA1 mutation, to unravel tumor evolution. Tumor tissue from all timepoints and germline DNA was subjected to whole-exome sequencing (WES), custom amplicon deep sequencing (30,000X) of a WES-derived somatic mutation panel, and SNP arrays for copy-number variation (CNV), while whole transcriptome sequencing (RNA-seq) was performed only on somatic tumor.

There was enrichment of homologous recombination deficiency signature in all tumors and widespread CNV, which remained largely stable over time. Somatic tumor mutation numbers varied between patients and within each patient (range: 70–216, one outlier). There was minimal mutational overlap between patients with TP53 being the sole commonly mutated gene, but there was substantial overlap in sequential samples in each patient. Each patient's tumor contained a founding (“stem”) clone at diagnosis, which persisted over time, from which all other clones (“subclone”) were derived (“branching evolution”), which contained mutations in well-characterized cancer-related genes like PDGFRB, ARID2, TP53 (Patient_02), TP53, BRAF, BRIP1, CSF3R (Patient_04), and TP53, APC, EZH2 (Patient_07). Including stem and subclones, tumors from all patients were polyclonal at diagnosis and during disease progression. ctDNA recapitulated most tissue-derived stem clonal and subclonal mutations while detecting some additional subclonal mutations. RNA-seq revealed a stable basal-like pattern, with most highly expressed variants belonging to stem clone.
Significance:
In germline BRCA1 mutated and BRCA wild-type patients, TNBC shows a branching evolutionary pattern of mutations with a single founding clone, are polyclonal throughout their disease course, and have widespread copy-number aberrations. This evolutionary pattern may be associated with treatment resistance or sensitivity and could be therapeutically exploited.
Occurrence of Fatal Tubulopathy in an Old, Fit Patient Receiving Nivolumab and Ipilimumab for Metastatic Melanoma: A Case Report
Authors: Georgery Marine , Ram Aurélie , Van Meerhaeghe Tess , Drowart Annie , Clause Anne-Lorraine , Dal Lago Lissandra , Rouvière Héloïse
Published: February 2024

Introduction: The use of immune checkpoint inhibitors has revolutionized cancer treatment, and their application to older people is considered safe by the scientific community. However, immune-related adverse events (irAEs) remain common, and their management poses significant challenges, especially in this population. Case Presentation: We report the case of a fit 82-year-old woman who developed immune-mediated colitis and Fanconi syndrome during treatment with ipilimumab and nivolumab for metastatic melanoma. Treatment consisted of discontinuation of immunotherapy, use of systemic corticosteroids, and second-line immunosuppressants. Despite well-managed treatment, the patient did not recover and died from a gastrointestinal infection. Conclusion: Although studies have shown identical efficacy and safety in younger patients compared to older patients, the consequences of irAEs can potentially be more serious in the older population. The fatal outcome despite well-managed treatment highlights the need to identify predictive factors of immunotherapy-related adverse events in the older population.
Examining a Healthy Lifestyle as a Moderator of the Relationship between Psychological Distress and Cognitive Decline among Older Adults in the NuAge Study
Authors: D'Amico Danielle , Alter Udi , Laurin Danielle , Ferland Guylaine , Fiocco Alexandra J.
Published: February 2024

Introduction: The objective of this study was to examine whether a healthy lifestyle composite score of social engagement, physical activity, and Mediterranean diet adherence moderates the association between psychological distress and global cognitive decline among cognitively healthy older adults (67+ years of age at baseline). Methods: A total of 1,272 cognitively intact older adults (Mage = 74.1 ± 4.1 years, 51.9% female) in the Quebec Longitudinal Study on Nutrition and Successful Aging (NuAge) completed a series of self-reported questionnaires to measure psychological distress and lifestyle behaviors, and the Modified Mini-Mental Examination (3MS) to assess cognitive performance at baseline and annually over 3 years. Results: Controlling for sociodemographic and health-related characteristics, greater psychological distress was associated with steeper cognitive decline over time among males (B = −0.07, 95% CI: [−0.12, −0.02]), but not females (B = 0.008, 95% CI: [0.03, 0.04]). Although a healthy lifestyle composite score did not statistically significantly moderate the distress-cognition relationship (B = −0.005, 95% CI: [−0.02, 0.01]), there was an association between higher psychological distress and greater cognitive decline at low levels of social engagement (B = −0.05, 95% CI: [−0.09, −0.006]), but not at high levels of social engagement (B = 0.02, 95% CI: [−0.03, 0.07]). Conclusion: This study suggests that the potentially harmful impact of stress on cognitive function may be malleable through specific healthy lifestyle behaviors and emphasizes the importance of taking a sex-based approach to cognitive aging research.
Eosinophils are an endogenous source of IL-4 during filarial infections and contribute to the development of an optimal T helper 2 response
Authors: Guth Cécile , Schumacher Pia Philippa , Vijayakumar Archena , Borgmann Hannah , Balles Helene , Koschel Marianne , Risch Frederic , Lenz Benjamin , Hoerauf Achim , Hübner Marc P. , Ajendra Jesuthas
Published: February 2024

Interleukin-4 (IL-4) is a central regulator of type 2 immunity, crucial for the defense against multicellular parasites like helminths. This study focuses on its roles and cellular sources during Litomosoides sigmodontis infection, a model for human filarial infections. Our research uncovers eosinophils as a major source of IL-4, especially during the early phase of filarial infection. Using dblGATA mice lacking eosinophil and subsequently eosinophil-derived IL-4, we reveal their profound impact on the Th2 response. Lack of eosinophils impact Th2 polarization and resulted in impaired type 2 cytokine production. Surprisingly, eosinophil deficiency had no impact on macrophage polarization and proliferation as well as on antibody production. These findings shed new light on IL-4 dynamics and eosinophil effector functions in filarial infections.
The Global Hidradenitis Suppurativa Atlas Methodology: Combining Global Proportions in a Pooled Analysis
Authors: Bouazzi Dorra , Andersen Rune K. , Vinding Gabrielle R. , Medianfar Cecilia E. , Nielsen Sabrina M. , Saunte Ditte M.L. , Chandran Nisha S. , van der Zee Hessel H. , Zouboulis Christos C. , Benhadou Farida , Villumsen Bente , Alavi Afsaneh , Ibekwe Perpetua U. , Hamzavi Iltefat H. , Ingram John R. , Naik Haley B. , Garg Amit , Boer Jurr , Christensen Robin , Jemec Gregor B.E.
Published: February 2024

Introduction: Data concerning the global burden of hidradenitis suppurativa (HS) are limited. Reported prevalence estimates vary between 0.0003% and 4.1%, and data from various geographical regions are still to be collected. Previously reported prevalences have been limited by the methodological approach and source of data. This has resulted in great heterogeneity as prevalence data from physician-diagnosed cases poorly match those of self-reported apparent HS disease. Methods: The Global Hidradenitis Suppurativa Atlas (GHiSA) introduces an innovative approach to determine the global prevalence of HS. This approach involves using a previously validated questionnaire to screen apparently healthy adults accompanying a patient to a non-dermatological outpatient clinic visit in a hospital or a private/family medicine clinic. The screening questionnaire (i.e., the index test) is combined with a subsequent physician-based in-person validation (i.e., the reference standard) of the participants who screen positive. Approximately ten percent of the screen-negative participants are also clinically assessed to verify the diagnostic precision of the test. The local prevalence (pi) will be estimated from each country that submits the number of patients who are HS positive according to the index test and clinical examination (n), and the corresponding total number of observations (N). Conclusion: The GHiSA Global Prevalence studies are currently running simultaneously in 58 countries across six continents (Africa, Europe, Australia, North America, South America, and Asia). The goal of the combined global proportion is the generation of a single summary (i.e., proportional meta-analysis), which will be done after a logit transformation and synthesized using a random-effects model. The novel standardization of the Global Prevalence Studies conducted through GHiSA enables direct international comparisons, which were previously not possible due to substantial heterogeneity in past HS prevalence studies.
Anticoagulation Intensity during Appendage Occlusion: Lessons from Silent Cerebral Embolism
Authors: Wang Kexin , Xu Mingjia , Wang Zhe , Wang Zidun , Li Mingfang , Liu Hailei , Chen Hongwu , Ju Weizhu , Chen Minglong
Published: February 2024

Introduction: Endovascular left atrial appendage occlusion (LAAO) is associated with a high incidence of peri-procedure silent cerebral embolism (SCE), while the recommended activated clotting time (ACT) level by the expert consensus is lower than that in atrial fibrillation (AF) ablation. The aim of our study was to investigate whether raising the targeted ACT level during LAAO to the same level as AF ablation could decrease the incidence of SCE. Methods: It was a prospective observational cohort study. Consecutive AF patients receiving LAAO between January 2021 and December 2022 were included and categorized into two groups based on the time of enrollment. Patients enrolled in 2021 (group 250) maintained a target ACT level of ≥250 s during LAAO procedure, while patients enrolled in 2022 (group 300) maintained the peri-procedure ACT ≥300 s. All patients underwent cerebral magnetic resonance imaging before and after the procedure. Results: A total of 81 patients were included (38 in the group 250 and 43 in the group 300). After inverse probability of treatment weighting (IPTW), patients in the group 250 showed a significantly lower incidence of SCE than group 300 (IPTW p = 0.038). Only a stable high ACT pattern could decrease the risk of SCE. No significant differences were found between other ACT change patterns on the SCE incidence. Conclusion: Raising the peri-procedure ACT level to a stable 300 s could decrease the risk of the SCE without increasing the major bleeding events.
Body Mass Index and All-Cause Mortality in Elderly Patients with Percutaneous Coronary Intervention: A Meta-Analysis
Authors: Wang Yunhui , Li Junwu , Zhang Yulian , Chen Shiyu , Zheng Fang , Deng Wei
Published: February 2024

Introduction: The “obesity paradox” in elderly patients suffering from percutaneous coronary intervention (PCI) remains a source of controversy. The present meta-analysis focused on exploring the real existence of “obesity paradox” in these patients. Methods: As of November 2022, PubMed, Cochrane, and Embase databases were comprehensively searched to identify articles reporting all-cause mortality according to diverse body mass index (BMI) categories after PCI among the old cases developing coronary artery disease (CAD). Summary estimates of relative risks (RRs) were assigned to four BMI groups, including underweight, normal weight, overweight, and obesity groups. Results: There were altogether nine articles involving 25,798 cases selected for further analysis. Relative to normal weight group, overweight and obesity groups had decreased all-cause mortality (RR: 0.86, 95% CI: 0.77–0.95 for overweight group; RR: 0.57, 95% CI: 0.40–0.80 for obesity group), while underweight group had elevated all-cause mortality (RR: 1.52, 95% CI: 1.01–2.29). Conclusion: Our study revealed an “obesity paradox” relation of BMI with all-cause mortality in elderly cases receiving PCI. In comparison with normal weight group, overweight and obesity groups had decreased all-cause mortality, while underweight group had increased all-cause mortality.
A Randomized Comparison of Radial Artery Intimal Hyperplasia Following Distal Versus Proximal Transradial Access for Coronary Angiography: PRESERVE RADIAL
Authors: Tehrani Behnam N. , Sherwood Matthew W. , Damluji Abdulla A. , Epps Kelly C. , Bakhshi Hooman , Cilia Lindsey , Dassanayake Isuru , Eltebaney Moemen , Gattani Raghav , Howard Edward , Kepplinger David , Ofosu‐Somuah Araba , Batchelor Wayne B.
Published: February 2024

Background

Distal transradial access (dTRA) is an alternative to conventional forearm transradial access (fTRA) for coronary angiography (CAG). Differences in healing of the radial artery (RA) in the forearm have not been evaluated between these 2 access strategies. We sought to compare the mean difference in forearm RA intimal‐medial thickening (IMT) in patients randomized to dTRA versus fTRA.

Methods and Results

In this single‐center randomized clinical trial, 64 patients undergoing nonemergent CAG were randomized (1:1) to dTRA versus fTRA. Ultra–high‐resolution (55‐MHz) vascular ultrasound of the forearm and distal RA was performed pre‐CAG and at 90 days. The primary end point was the mean change in forearm RA IMT. Secondary end points included procedural characteristics, vascular injury, RA occlusion, and ipsilateral hand pain and function.

Baseline demographics and clinical characteristics, mean forearm RA IMT, and procedural specifics were similar between the dTRA and fTRA cohorts. There was no difference in mean change in forearm RA IMT between the 2 cohorts (0.07 versus 0.07 mm;
P
=0.37). No RA occlusions or signs of major vascular injury were observed at 90 days. Ipsilateral hand pain and function (Borg pain scale score: 12 versus 11;
P
=0.24; Disabilities of the Arm, Shoulders, and Hand scale score: 6 versus 8;
P
=0.46) were comparable.

Conclusions

Following CAG, dTRA was associated with no differences in mean change of forearm RA IMT, hand pain, and function versus fTRA for CAG. Further investigation is warranted to elucidate mechanisms and predictors of RA healing and identify effective strategies to preserving RA integrity for repeated procedures.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT04801901.
Does Atrial Septal Anatomy Still Matter in the Etiological Evaluation of Ischemic Stroke Beyond the Age of 60?
Authors: Dusonchet Antoine , Varenne Olivier , Puscas Tania , Saadi Malika , Hagege Albert , Calvet David , Mas Jean‐Louis , Turc Guillaume
Published: February 2024

Background

Patent foramen ovale (PFO) is causally associated with stroke in some patients younger than 60 years, especially when it is large or associated with an atrial septal aneurysm (ASA). After 60 years of age, this association is less well understood. We assessed the relationships between detailed atrial septal anatomy and the cryptogenic nature of stroke in this population.

Methods and Results

We reviewed all patients aged 60 to 80 years admitted to our stroke center for ischemic stroke who underwent contrast echocardiography between 2016 and 2021. The atherosclerosis, small‐vessel disease, cardiac pathology, other causes, and dissection (ASCOD) classification was used to reevaluate the etiological workup. Associations between cryptogenic stroke and (1) PFO presence or (2) categories of PFO anatomy (nonlarge PFO without ASA, nonlarge PFO with ASA, large PFO without ASA, and large PFO with ASA) were assessed using logistic regression. Among 533 patients (median National Institutes of Health Stroke Scale score=1), PFO was present in 152 (prevalence, 28.5% [95% CI, 24.9–32.5]). Compared with noncryptogenic stroke, cryptogenic stroke (n=218) was associated with PFO presence (44.5% versus 17.5%;
P
<0.0001). Among patients with a PFO, septal anatomy categories were associated with cryptogenic stroke (
P
=0.02), with a strong association for patients with both large PFO and ASA (38.1% versus 14.5%,
P
=0.002).

Conclusions

PFO presence remains strongly associated with cryptogenic stroke between 60 and 80 years of age. Large PFO, ASA, and their association were strongly associated with cryptogenic stroke in this age group. Our results support performing contrast echocardiography even after 60 years of age, although the optimal secondary prevention therapy in this population remains to be determined in randomized trials.
Plasma Markers of Alzheimer's Disease Pathology, Neuronal Injury, and Astrocytic Activation and MRI Load of Vascular Pathology and Neurodegeneration: The SMART‐MR Study
Authors: Twait Emma L. , Gerritsen Lotte , Moonen Justine E. F. , Verberk Inge M. W. , Teunissen Charlotte E. , Visser Pieter Jelle , van der Flier Wiesje M. , Geerlings Mirjam I. ,   UCC SMART Study Group, the NCDC Consortium
Published: February 2024

Background

Two of the main causes for dementia are Alzheimer's disease (AD) and vascular pathology, with most patients showing mixed pathology. Plasma biomarkers for Alzheimer's disease‐related pathology have recently emerged, including Aβ (amyloid‐beta), p‐tau (phosphorylated tau), NfL (neurofilament light), and GFAP (glial fibrillary acidic protein). There is a current gap in the literature regarding whether there is an association between these plasma biomarkers with vascular pathology and neurodegeneration.

Methods and Results

Cross‐sectional data from 594 individuals (mean [SD] age: 64 [8] years; 17% female) were included from the SMART‐MR (Second Manifestations of Arterial Disease‐Magnetic Resonance) study, a prospective cohort study of individuals with a history of arterial disease. Plasma markers were assessed using single molecular array assays (Quanterix). Magnetic resonance imaging markers included white matter hyperintensity volume, presence of infarcts (yes/no), total brain volume, and hippocampal volume assessed on 1.5T magnetic resonance imaging. Linear regressions were performed for each standardized plasma marker with white matter hyperintensity volume, total brain volume, and hippocampal volume as separate outcomes, correcting for age, sex, education, and intracranial volume. Logistic regressions were performed for the presence of lacunar and cortical infarcts. Higher p‐tau181 was associated with larger white matter hyperintensity volume (
b
per SD increase=0.16 [95% CI, 0.06–0.26],
P
=0.015). Higher NfL (
b
=−5.63, [95% CI, −8.95 to −2.31],
P
=0.015) was associated with lower total brain volume and the presence of infarcts (odds ratio [OR], 1.42 [95% CI, 1.13–1.78],
P
=0.039). Higher GFAP levels were associated with cortical infarcts (OR, 1.45 [95% CI, 1.09–1.92],
P
=0.010).

Conclusions

Plasma biomarkers that have been associated with tau pathology, axonal injury, and astrocytic activation are related to magnetic resonance imagingmarkers of vascular pathology and neurodegeneration in patients with manifest arterial disease.
Circulating microRNA Biomarkers of Thiazide Response in Hypertension
Authors: Chekka Lakshmi Manasa S. , Tantawy Marwa , Langaee Taimour , Wang Danxin , Renne Rolf , Chapman Arlene B. , Gums John G. , Boerwinkle Eric , Cooper‐DeHoff Rhonda M. , Johnson Julie A.
Published: February 2024

Background

Thiazide diuretics are the second most frequently prescribed class of antihypertensives, but up to 50% of patients with hypertension have minimal antihypertensive response to thiazides. We explored circulating microRNAs (miRNAs) in search of predictive biomarkers of thiazide response.

Methods and Results

We profiled 754 miRNAs in baseline plasma samples of 36 hypertensive European American adults treated with hydrochlorothiazide, categorized into responders (n=18) and nonresponders (n=18) on the basis of diastolic blood pressure response to hydrochlorothiazide. miRNAs with ≥2.5‐fold differential expression between responders and nonresponders were considered for validation in 3 cohorts (n=50 each): hydrochlorothiazide‐treated European Americans, chlorthalidone‐treated European Americans, and hydrochlorothiazide‐treated Black individuals. Different blood pressure phenotypes including categorical (responder versus nonresponder) and continuous diastolic blood pressure and systolic blood pressure were tested for association with the candidate miRNA expression using multivariate regression analyses adjusting for age, sex, and baseline blood pressure. After quality control, 74 miRNAs were available for screening, 19 of which were considered for validation. In the validation cohort, miR‐193b‐3p and 30d‐5p showed significant associations with continuous SBP or diastolic blood pressure response or both, to hydrochlorothiazide in European Americans at Benjamini‐Hochberg adjusted
P
<0.05. In the combined analysis of validation cohorts, let‐7g (odds ratio, 0.6 [95% CI, 0.4–0.8]), miR‐142‐3p (odds ratio, 1.1 [95% CI, 1.0, 1.2]), and miR‐423‐5p (odds ratio, 0.7 [95% CI, 0.5–0.9]) associated with categorical diastolic blood pressure response at Benjamini‐Hochberg adjusted
P
<0.05. Predicted target genes of the 5 miRNAs were mapped to key hypertension pathways: lysine degradation, fatty acid biosynthesis, and metabolism.

Conclusions

The above identified circulating miRNAs may have a potential for clinical use as biomarkers for thiazide diuretic selection in hypertension.

Registration

URL:
ClinicalTrials.gov
. Unique identifiers:
NCT00246519
,
NCT01203852
,
NCT00005520
.
Patient Outcomes by Ventricular Systolic and Diastolic Function
Authors: Levene Jacqueline , Voigt Andrew , Thoma Floyd , Mulukutla Suresh , Bhonsale Aditya , Kancharla Krishna , Shalaby Alaa , Estes N.A. Mark , Jain Sandeep , Saba Samir
Published: February 2024

Background

Left ventricular dysfunction is characterized by systolic and diastolic parameters, leading to heart failure (HF) with reduced or preserved ejection fraction (EF), respectively. The goal of this study is to examine the impact of left ventricular systolic and diastolic dysfunction (DD) on patient outcomes.

Methods and Results

Two cohorts were used in this analysis: Cohort A included 136 455 patients with EF ≥50%, stratified by the presence and grade of DD. Cohort B included 16 850 patients with EF <50%, stratified by EF quartiles. Patients were followed to the end points of all‐cause death and cardiovascular, HF, or cardiac arrest hospitalizations. Over a median follow‐up of 3.42 years, 23 946 (16%) patients died and 31 113 (20%), 13 305 (9%), and 1269 (1%) were hospitalized for cardiovascular, HF, or cardiac arrest causes, respectively. With adjustment for comorbidities, the risk of all‐cause mortality and of cardiovascular and HF hospitalizations increased steadily with increasing grade of DD in patients with normal EF, and even more so in patients with worsening EF. The risk of hospitalization for cardiac arrest in patients with grade III DD, however, was comparable to that of patients with EF <25% (hazard ratio, 1.00 [95% CI, 0.98–1.01]) and worse than that of patients in better EF quartiles.

Conclusions

Although systolic dysfunction is associated with a greater risk of overall death and HF hospitalizations than DD, the risk of cardiac arrest in patients with grade II and III DD is comparable to that of patients with moderate and severe systolic dysfunction, respectively. Future studies are needed to examine treatment strategies than can improve these outcomes.
Practical application of the patient data-based quality control method: the potassium example
Authors: Zhang Yan , Wang Hua-Li , Xie Ye-Hong , He Da-Hai , Zhou Chao-Qiong , Kong Li-Rui
Published: February 2024

Introduction: Internal quality control (IQC) is a core pillar of laboratory quality control strategies. Internal quality control commercial materials lack the same characteristics as patient samples and IQC contributes to the costs of laboratory testing. Patient data-based quality control (PDB-QC) may be a valuable supplement to IQC; the smaller the biological variation, the stronger the ability to detect errors. Using the potassium concentration in serum as an example study compared error detection effectiveness between PDB-QC and IQC. Materials and methods: Serum potassium concentrations were measured by using an indirect ion-selective electrode method. For the training database, 23,772 patient-generated data and 366 IQC data from April 2022 to September 2022 were used; 15,351 patient-generated data and 246 IQC data from October 2022 to January 2023 were used as the testing database. For both PDB-QC and IQC, average values and standard deviations were calculated, and z-score charts were plotted for comparison purposes. Results: Five systematic and three random errors were detected using IQC. Nine systematic errors but no random errors were detected in PDB-QC. The PDB-QC showed systematic error warnings earlier than the IQC. Conclusions: The daily average value of patient-generated data was superior to IQC in terms of the efficiency and timeliness of detecting systematic errors but inferior to IQC in detecting random errors.
Pain as the Essence of Torture: Exploring the Characteristics and Requirements of the Element of “Pain or Suffering” in the Crime Against Humanity of Torture
Authors: Luciano Simone Antonio
Published: February 2024

Pain is the very essence of torture. This article explores the element of “pain or suffering” in the crime against humanity of torture and contributes to the existing literature by identifying the characteristics and requirements of such element within international criminal law. In particular, it examines, discusses and compares the case law of the International Criminal Tribunals in order to determine the specific characteristics that pain must possess for the mistreatment to qualify as torture as well as the required level of severity of pain and the subjective and objective criteria used for the assessment of such severity. At the same time, it also explores the case law of the echr on torture and compares the approach of this Court towards this crime with the approach of the International Criminal Tribunals to determine the extent of the echr’s contribution to the definition of torture in international criminal law.
Enforcing Sustainability
Authors: Giupponi Belen Olmos
Published: February 2024

After the Lisbon Treaty, the European Union (EU) has prioritized sustainable development as a key aspect of its external trade and investment policy. This emphasis on sustainability has been reinforced through treaty- making and has received support from the Court of Justice of the European Union (cjeu). However, there are notable variations and nuances in the understanding and implementation of sustainability in the EU’s treaties. Moreover, these treaties introduce innovative dispute resolution mechanisms, such as arbitration and alternative dispute resolution methods, which can significantly impact international dispute settlement practices. Opinion 2/ 15 on the EU- Singapore Free Trade Agreement marked a crucial moment in clarifying the scope and nature of sustainable development chapters within the EU’s trade and investment policy. Different agreements concluded after the Lisbon Treaty reflect diverse approaches to sustainability. In the context of environmental protection, these agreements encompass a range of provisions, from generic to more specific clauses addressing particular aspects. This article critically analyzes the effectiveness and scope of “green conditionality” within the Sustainable Development Chapters of EU-established Trade and Investment Agreements. It examines the incorporation of environmental provisions in these agreements, evaluates their role in promoting sustainable development objectives, and explores the implications of dispute settlement and international arbitration mechanisms. This analysis aims to provide a cutting- edge perspective on the topic.
Westmoreland v Canada
Authors: Botero Daniel Quintero
Published: February 2024

This case- note focuses on the award issued in Westmoreland Mining Holding LLC V Government of Canada on 31 January 2022. The decision sets a relevant precedent against the transferability of treaty claims. The tribunal held that it lacked jurisdiction ratione temporis to decide a claim brought by the assignee of a treaty claim, considering that the claimant was not the investor that owned or controlled the investment at the time of the alleged breach. This case-note summarises the award and offers an analysis on the transferability of treaty claims, proposing that the ratione temporis requirement should not defeat the jurisdiction of tribunals facing claims brought by assignees.