bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Related to Visual Outcomes after Lens Surgery in Isolated Microspherophakia
Authors: Zheng Jialei , Cheng Lina , Chen Zexu , Chen Tianhui , Jiang Yongxiang
Published: April 2022

Purpose. To evaluate the main factors influencing visual performance after lens subluxation surgery in subjects with isolated MSP. Design. Retrospective study. Methods. In this study, 38 eyes of subjects with isolated MSP (microspherophakia) were included and divided into two groups based on preoperative IOP (intraocular pressure), IOP <21 mmHg, or IOP ≧21 mmHg. Phacoemulsification and scleral-fixated modified capsular tension ring implantation were performed with or without goniosynechialysis according to the IOP. Some ocular biometric parameters, such as corneal curvature, corneal pachymetry, endothelial cell count (ECC), anterior chamber depth (ACD), and axial length, were evaluated. The best-corrected visual acuity (BCVA) and IOP of these subjects were measured before the surgery and during <1 month and 3- to 6-month postoperative follow-ups. Results. Compared with the high IOP group, the normal IOP group was significantly younger and had better preoperative BCVA, a higher ECC, deeper ACD, a lower postoperative IOP, and flatter total corneal refractive power K1. The multivariable analysis revealed that preoperative ACD (b = −0.113, t = −2.070,

P
=
0.047

) and preoperative BCVA (b = 0.153, t = 2.562,

P
=
0.015

) were significantly associated with postoperative BCVA at 3–6 months. A preoperative ACD of 1.86 mm was found to be the optimal cut-off point for 3- to 6-month postoperative BCVA of ≧20/63 (≤0.52 logMAR). Conclusions. In addition to the effect of normal IOP, better preoperative BCVA and deeper ACD also correlated with better visual outcomes after lens surgery. Preoperative ACD served as a warning for isolated MSP subjects, especially for the risk of irreversible loss of postoperative vision. This trial is registered with “ChiCTR2000039132.”
Single Neuron for Solving XOR like Nonlinear Problems
Authors: Mishra Ashutosh , Cha Jaekwang , Kim Shiho
Published: April 2022

XOR is a special nonlinear problem in artificial intelligence (AI) that resembles multiple real-world nonlinear data distributions. A multiplicative neuron model can solve these problems. However, the multiplicative model has the indigenous problem of backpropagation for densely distributed XOR problems and higher dimensional parity problems. To overcome this issue, we have proposed an enhanced translated multiplicative single neuron model. It can provide desired tessellation surface. We have considered an adaptable scaling factor associated with each input in our proposed model. It helps in achieving optimal scaling factor value for higher dimensional input. The efficacy of the proposed model has been tested by randomly increasing input dimensions for XOR-type data distribution. The proposed model has crisply classified even higher dimensional input in their respective class. Also, the computational complexity is the same as that of the previous multiplicative neuron model. It has shown more than an 80% reduction in absolute loss as compared to the previous neuron model in similar experimental conditions. Therefore, it can be considered as a generalized artificial model (single neuron) with the capability of solving XOR-like real problems.
Sharing Method of Online Teaching Resources of Spoken English Based on Deep Learning
Authors: Cai Wei , Peng Yan
Published: April 2022

In order to improve the sharing effect of online teaching resources of spoken English, this paper considers the sharing of resources among tasks in a mixed criticality system based on fixed task priority scheduling. Moreover, this paper extends the traditional PCP protocol and proposes a resource sharing protocol suitable for the AMC scheduling model in a verifiable hybrid criticality system. In addition, with the support of deep learning, this paper analyzes the worst blocking time and the worst response time of the task at each stage. Finally, this paper analyzes the sharing methods of online teaching resources of spoken English in combination with deep learning methods and constructs a corresponding intelligent teaching resource sharing system. The experimental research results show that the sharing method of online teaching resources of spoken English based on deep learning has a good resource sharing effect.
Anonymization of Quasi-Sensitive Attribute Sets in Aggregated Dataset
Authors: Li Yafan , Yuan Shuguang , Yuan Yulin , Chen Chi , Yu Jing
Published: April 2022

The widespread use of Internet of Things (IoT) and Data Fusion technologies make privacy protection an urgent problem to be solved. The aggregated datasets generated in these two scenarios face extra privacy disclosure. We define attribute sets with different sources in an aggregated dataset as quasi-sensitive attribute sets (QS sets). The QS set itself is not sensitive, but internal linking attacks may occur when two QS sets in an aggregated dataset are linked. In this paper, we propose a new privacy model, namely, the QS k-anonymity model. The QS k-anonymity model is effective in preventing internal linking attacks. We provide two algorithms for the QS k-anonymity model, the Greedy QS k-anonymity algorithm and the Efficient QS k-anonymity algorithm. We evaluate our algorithms on real datasets. The experimental results show that the Greedy QS k-anonymity algorithm has good data utility, the Efficient QS k-anonymity algorithm shows better efficiency, and both algorithms are well scalable.
Wearable Sensors with Internet of Things (IoT) and Vocabulary-Based Acoustic Signal Processing for Monitoring Children’s Health
Authors: Nagwanshi Kapil Kumar , Noonia Ajit , Tiwari Shivam , Doohan Nitika Vats , Kumawat Vijeta , Ahanger Tariq Ahamed , Amoatey Enoch Tetteh
Published: April 2022

The brain is the most complex organ in the human body, and it is also the most complex organ in the whole biological system, making it the most complex organ on the planet. According to the findings of current studies, modern study that properly characterises the EEG data signal provides a clear classification accuracy of human activities which is distinct from previous research. Various brain wave patterns related to common activities such as sleeping, reading, and watching a movie may be found in the Electroencephalography (EEG) data that has been collected. As a consequence of these activities, we accumulate numerous sorts of emotion signals in our brains, including the Delta, Theta, and Alpha bands. These bands will provide different types of emotion signals in our brain as a result of these activities. As a consequence of the nonstationary nature of EEG recordings, time-frequency-domain techniques, on the other hand, are more likely to provide good findings. The ability to identify different neural rhythm scales using time-frequency representation has also been shown to be a legitimate EEG marker; this ability has also been demonstrated to be a powerful tool for investigating small-scale neural brain oscillations. This paper presents the first time that a frequency analysis of EEG dynamics has been undertaken. An augmenting decomposition consisting of the “Versatile Inspiring Wavelet Transform” and the “Adaptive Wavelet Transform” is used in conjunction with the EEG rhythms that were gathered to provide adequate temporal and spectral resolutions. Children’s wearable sensors are being used to collect data from a number of sources, including the Internet. The signal is conveyed over the Internet of Things (IoT). Specifically, the suggested approach is assessed on two EEG datasets, one of which was obtained in a noisy (i.e., nonshielded) environment and the other was recorded in a shielded environment. The results illustrate the resilience of the proposed training strategy. Therefore, our method contributes to the identification of specific brain activity in children who are taking part in the research as a result of their participation. On the basis of several parameters such as filtering response, accuracy, precision, recall, and F-measure, the MATLAB simulation software was used to evaluate the performance of the proposed system.
SV2G-ET: A Secure Vehicle-to-Grid Energy Trading Scheme Using Deep Reinforcement Learning
Authors: Kumari Aparna , Trivedi Mihir , Tanwar Sudeep , Sharma Gulshan , Sharma Ravi
Published: April 2022

In recent years, advancements in electric vehicle (EV) technology and rising petrol prices have increased the demand for EVs and also made them important for the Smart Grid (SG) economy. During the high energy demand, Vehicle to Grid (V2G) comprises a notable feature that returns the stored energy back to the grid. However, due to dynamic nature of energy prices and EVs availability, determining the best charging and discharging strategy is quite difficult. The existing approaches need a model to predict the uncertainty and optimize the scheduling problem. Further, other issues like security, scalability, and real-time data accessibility of EVs energy trading (ET) data at low cost also exist. Though many solutions exist, they are not adequate to handle the aforementioned issues. This paper proposes a Secure V2G-Energy Trading (SV2G-ET) scheme using deep Reinforcement Learning (RL) and Ethereum Blockchain Technology (EBT). The proposed SV2G-ET scheme employs a deep Q-network for EVs scheduling for charging/discharging. SV2G-ET scheme uses InterPlanetary File System (IPFS) and smart contract (SC) for secure access of EV’s ET data in real time. The experimental results prove the efficacy of the proposed SV2G-ET scheme that leads to improved scalability, saving the EVs charging cost, low ET data storage cost, and increased EV owner’s profit.
Atypical Eclampsia in a Pregnant Woman Infected by COVID-19
Authors: Odeh Maha Ahmad , Abuzneid Yousef S. , Badareen Omar , Masarweh Khaled
Published: April 2022

The coronavirus disease 2019, also called (COVID-19), is an infectious disease which is caused by a virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first report was in December 2019, and on March 12, 2020, the World Health Organization (WHO) declared this disease a pandemic. COVID-19 targets many major organs causing life-threatening systemic complications. It can cause lung damage and respiratory failure in addition to systemic inflammation and immune dysregulation. Hypercoagulable state and numerous neurological abnormalities also have been reported due to this condition. Going through the literature review, we found some cases of pregnant women with novel coronavirus infection, being mostly mild illnesses, and most of these cases were focused on maternal-fetal transmission and neonatal outcomes. In this case report, we present the case of a COVID-19 positive woman who came to our emergency department at 34 weeks of gestation with tonic-clonic seizures. This case was a challenge for us because we faced a new an unknown manifestation of both COVID and eclampsia.
Quantification of Neoantigen-Mediated Immunoediting in Cancer Evolution
Authors: Wu Tao , Wang Guangshuai , Wang Xuan , Wang Shixiang , Zhao Xiangyu , Wu Chenxu , Ning Wei , Tao Ziyu , Chen Fuxiang , Liu Xue-Song
Published: April 2022

Immunoediting includes three temporally distinct stages, termed elimination, equilibrium, and escape, and has been proposed to explain the interactions between cancer cells and the immune system during the evolution of cancer. However, the status of immunoediting in cancer remains unclear, and the existence of neoantigen depletion in untreated cancer has been debated. Here we developed a distribution pattern-based method for quantifying neoantigen-mediated negative selection in cancer evolution. The method can provide a robust and reliable quantification for immunoediting signal in individual patients with cancer. Moreover, this method demonstrated the prevalence of immunoediting in the immunotherapy-naive cancer genome. The elimination and escape stages of immunoediting can be quantified separately, where tumor types with strong immunoediting-elimination exhibit a weak immunoediting-escape signal, and vice versa. The quantified immunoediting-elimination signal was predictive of clinical response to cancer immunotherapy. Collectively, immunoediting quantification provides an evolutionary perspective for evaluating the antigenicity of neoantigens and reveals a potential biomarker for precision immunotherapy in cancer.

Significance:

Quantification of neoantigen-mediated negative selection in cancer progression reveals distinct features of cancer immunoediting and can serve as a potential biomarker to predict immunotherapy response.
Long-term Safety of Treatment with Autologous Mesenchymal Stem Cells in Patients with Radiation-Induced Xerostomia: Primary Results of the MESRIX Phase I/II Randomized Trial
Authors: Lynggaard Charlotte Duch , Grønhøj Christian , Jensen Siri B. , Christensen Robin , Specht Lena , Andersen Elo , Andersen Tobias T. , Ciochon Urszula M. , Rathje Gulla S. , Hansen Adam E. , Stampe Helene , Fischer-Nielsen Anne , von Buchwald Christian
Published: April 2022

Purpose:

Mesenchymal stem/stromal cell therapy may reduce radiation-induced xerostomia. We investigated the long-term safety of autologous adipose tissue-derived mesenchymal stem/stromal cell (ASC) injections into the submandibular glands.

Experimental Design:

An investigator-initiated, randomized, single-center, placebo-controlled trial. Previous patients with oropharyngeal squamous cell carcinoma with radiation-induced xerostomia were randomly (1:1) allocated to receive a 2.8 million ASCs/cm3 injection or placebo in both submandibular glands and followed for a minimum of 2 years. The primary endpoint was number of serious adverse events (SAE). Secondary endpoints included whole saliva flow rates and xerostomia-related symptoms. Data analysis was based on the intention-to-treat population using repeated measures mixed-effects linear models.

Results:

Thirty-three patients were randomized; 30 patients were treated (ASC group, n = 15; placebo group, n = 15). Long-term safety data were collected from all 30 patients. During follow-up, 6 of 15 (40%) of the ASC-treated patients versus 5 of 15 (33%) of the placebo patients experienced an SAE; no SAEs appeared to be treatment related. Unstimulated whole saliva flow rate increased to 0.20 and 0.16 mL/minute in the ASC and placebo group, respectively, yielding a 0.05 mL/minute (95% confidence interval: 0.00–0.10; P = 0.051) difference between groups. Patient-reported xerostomia symptoms diminished according to a decreased xerostomia questionnaire summary score of 35.0 and 45.1, respectively [−10.1 (−18.1 to −2.2); P = 0.013]. Three of the visual analog scale xerostomia measures indicated clinical benefit following use of ASC.

Conclusions:

Our data show that ASC therapy is safe with a clinically relevant effect on xerostomia-related symptoms. Confirmation in larger randomized controlled trials is warranted.
Bifurcated Silicone Stents for the Management of Anastomotic Complications in Lung Transplanted Patients: Ten Years’ Experience
Authors: Guinde Julien , Bismuth Jeremy , Laroumagne Sophie , Coiffard Benjamin , Astoul Philippe , Thomas Pascal Alexandre , Reynaud-Gaubert Martine , Dutau Hervé
Published: April 2022

Background: In lung transplantation (LT), the actual surgical practice is to cut the donor bronchus as short as possible in order to reduce anastomotic complications (AC). Consequently, the anastomosis is very close to the secondary carina. If AC occur, regular straight stents may be unsatisfactory and on-site modified bifurcated stents may represent an alternative. Objectives: This retrospective study sought to assess the short- and long-term outcomes of patients treated with customized bifurcated stent (CBS) for the management of AC following LT. Methods: Data from patients with AC following LT requiring CBS placement between June 2010 and June 2020 were analyzed. Results: Four hundred patients underwent lung transplant. AC requiring airway stenting occurred in 32 patients (8%), and CBS were inserted in 15 patients (3.5%). Indications were stenosis (n = 12; 80%) and bronchial dehiscence (n = 3; 20%). CBS were successfully deployed in 14 patients and failed in 1 patient. No migration was recorded during the follow-up. The median number of complication was 1 per patient (0–5). CBS could be removed in 11 patients (78.6%), and 3 died with their stents in place. AC recurrence or complications requiring new stenting occurred in 4/11 patients (36.3%), with a median time of 7 days (0–29). Seven patients (63.7%) had no AC recurrence, with a median follow-up of 925 days (118–3,249). Conclusions: The actual surgical anastomotic technique in LT provides new endoscopic challenges. CBS seem ideally positioned to address these difficulties safely and effectively but are associated with stent related complications requiring further endoscopic management.
Dioecismo y Ciudad Ideal. Acerca de la República de Platón, VII 540e4-541a1
Authors: Lévystone David Xavier
Published: April 2022

The radical mean suggested by Socrates in order to carry out the program of the Republic - the relegation to the fields of all inhabitants over the age of 10 - has perplexed modern commentators who have seen in it an ironical remark, a reductio ad absurdum presented in order to establish the very impossibility of Kallipolis or, on the contrary, a sign of the totalitarian and criminal character of the Platonic city. But it is far from evident, in view of political or military events prior and contemporary with the redaction of the Republic, that this solution could offend the moral conscience of fourth-century Greeks. This practice even seems to be the logical consequence of a certain oligarchic or aristocratic ideology, common by the end of the 5th c. and at the beginning of the 4th c., which associated, on the one hand, rural organization with the ‘best regime’ and, on the other, urban centralisation with democracy. The actual practices of the Lacedaemonian city, which maintained its primitive organization in komai, and even tried to impose it to other cities, could also serve as a model for the opponents of Athenian democracy. All of Plato's political models, from the Republic to the Laws, present cities whose essential, if not exclusive, productive activity is agriculture. The displacement of the population to the countryside seems, from this perspective, a rather serious proposal of the philosopher. *
 
* Agradezco a Héctor Zagal y a María-Elena García-Peláez por sus observaciones y sugerencias al texto en español.
Abstract 12178: Photon Counting Computed Tomography for Aortic Valve Calcium Scoring in Contrast- Enhanced Datasets of the Heart
Authors: Harmel Eva K , Braun Franziska , Rippel Katharina , Scheurig-Münkler Christian , Kroencke Thomas , Girdauskas Evaldas , von Scheidt Wolfgang , Schwarz Florian
Published: April 2022

Introduction:
The prognostic value of aortic valve calcium in patients prior to TAVR is well established. Its reliable quantification requires a non-contrast CT of the heart (‘true non contrast’, TNC) which in this cohort is not regularly performed at all centers. Photon Counting Detector CT (PCD-CT) permits the routine derivation of ‘virtual non-contrast’ (VNC) series from CT Angiography (CTA) acquisitions due to its intrinsic spectral sensitivity. These might render separate non-contrast acquisitions unnecessary. The aim of our study was to evaluate the feasibility of aortic valve calcium quantification on VNC series derived from CTA scans.

Methods:
All patients underwent TAVR planning CT on a novel PCD-CT (NAEOTOM Alpha, Siemens Healthineers, Erlangen, Germany) comprising a non-contrast CT of the heart, followed by a CTA of the heart, aorta and iliac arteries. VNC series were derived from CTA acquisitions and two readers independently quantified aortic valve calcium scores and volumes on VNC- and TNC-series.

Results:
Here, we report initial results of the first 5 of 100 patients. In comparison with those derived from TNC series, calcium scores and volumes derived from VNC series were consistently lower (mean 713 vs. 1110 and 563 vs. 894 mm
3
) but correlation was excellent for both calcium score and volume (r’s: 0.945 and 0.938, respectively, both p’s=0.01).

Conclusions:
Our initial patient experience with TAVR planning CT on a novel PCD-CT shows excellent correlation of aortic valve calcium scores and volumes derived from VNC series, as compared with those derived from TNC series. These will most likely be interchangeable, thus rendering non-contrast acquisitions redundant for TAVR planning.

Figure 1
Corresponding series of a TAVR patient with high-grade aortic stenosis demonstrating severe aortic valve calcifications on (A) true non-contrast CT (TNT-Score: 3772), (B) CTA for annulus measurement and (C) VNC-reconstructions derived from CTA (VNC-Score: 3099).
Abstract 12234: Is Maintenance of a Subcutaneous Implantable Cardioverter-Defibrillator a Feasible Option in Hypertrophic Cardiomyopathy Patients With Left Bundle Branch Block After Septal Myectomy?
Authors: Narayanan Chockalingam , Shrestha Srijan , Gionfriddo William , Weinstock Jonathan , Homoud Munther , Maron Barry , Maron Martin S , Rowin Ethan J , Garlitski Ann , Madias Christopher
Published: April 2022

Introduction:
Subcutaneous implantable cardioverter-defibrillators (SICD) are effective for sudden death (SCD) prevention in patients (pts) with hypertrophic cardiomyopathy (HCM). Pre-implant ECG screening to evaluate R and T wave sensing is done to decrease the risk of inappropriate shocks (IAS). Pts who undergo septal myectomy are at high risk of developing left bundle branch block (LBBB) that could potentially result in SICD T wave oversensing (TWOS).

Objective:
We describe 6 cases of pts with SICD and septal myectomy to understand the risks and benefits of maintaining SICD therapy in this cohort.

Methods:
We performed a retrospective cohort study of all pts with HCM who underwent SICD implantation and septal myectomy from 2013 to 2021.

Results:
Six pts with HCM underwent both SICD implantation and myectomy. Post myectomy ECGs for all pts show LBBB with QRS between 137 to 166 ms. Four of these pts were implanted prior to myectomy. The average time to myectomy after SICD was 1.3 years. Three out of the four pts have had no IAS or TWOS since myectomy. One patient experienced TWOS with 2 IAS 4 months after myectomy. The sensing vector was changed from primary to alternate with no further TWOS for the last 6 years. The remaining two pts underwent SICD implantation after myectomy, both of whom screened “OK” using the manual screening tool prior to implant. Neither patient has experienced IAS. One patient displayed episodes of TWOS and underwent vector change with no TWOS for the last 5 years. At the time of recent SICD generator replacement, he was screened using the automated programmer software and failed screening in all 3 vectors (Figure 1).

Conclusions:
This series demonstrates that maintenance of SICD is a viable option for SCD prevention in young pts who develop LBBB after septal myectomy. With close monitoring and vector adjustment, IAS and TWOS can be avoided. Further larger studies are necessary to assess the long-term risk of TWOS and IAS in this unique population.
Abstract 12300: Impact of Catheter Contact Angle on Local Impedance Drop and Lesion Size Using the INTELLANAV STABLEPOINT Ablation Catheter: Insight From a Porcine Experimental Study
Authors: Matsuura Gen , Fukaya Hidehira , Ogawa Emiyu , Kawakami Sota , Yutaro Mitani , Murayama Yusuke , Saito Daiki , Sato Tetsuro , Nakamura Hironori , Ishizue Naruya , Oikawa Jun , Kishihara Jun , Niwano Shinichi , Ako Junya
Published: April 2022

Background:
Local impedance (LI) at a distal tip of the ablation catheter can indirectly measure tissue temperature during radiofrequency catheter ablation (RFCA). LI decreases by RFCA, and a degree of LI drop is correlated with lesion size. However, data on the effects of catheter contact angle on LI parameters were scarce. This study aimed to evaluate the influence of catheter contact angle on LI change and lesion size in a porcine experimental model.

Methods:
Lesions were created on porcine myocardial left ventricles by the LI and Contact force(CF)-sensing ablation catheter (INTELLANAV STABLEPOINT™). Radiofrequency ablation was performed with a power of 30 watts and a duration of 30 seconds. CF (0, 5, 10, 20, and 30g) and catheter contact angle (30°, 45°, and 90°) were changed in each set (total 120 lesions, n=8 each). LI rise by catheter contact, LI drop by RF application, and lesion size (lesion width, surface width, and lesion depth) were evaluated.

Results:
The values of LI rise increased as CF increased. Regarding the difference of catheter angles, LI rise with 90° was lower than those with 30°. The LI drop also increased as CF increased in all contact angles. The LI drop with 90° was lower than those with 30° in CF 5, 10, 20, and 30 g, respectively. Maximum lesion width and surface width were smaller in 90° than those in 30°, whereas there were no differences in maximum lesion depth except for CF 5g. The approximate curves were well fitted with a quadratic equation in all angles on LI drop vs. maximum lesion width, and lesion depth.

Conclusion:
Under the same CF, the values of LI drop and lesion width in 90° were significantly lower than those in 30° despite lesion depths were not different among the three angles. LI drop correlates with lesion width and lesion depth at any angle, which may be a good predictor of lesion size.
Abstract 12305: Cardiomyocyte Alignment Control Promotes the Electrical Integration and Improve the Contractile Function of Human Cardiac Tissue
Authors: Takada Takuma , Sasaki Daisuke , Matsuura Katsuhisa , Miura Koichiro , Sakamoto Satoru , Goto Hiroshi , Homma Jun , Shimizu Tatsuya , Hagiwara Nobuhisa
Published: April 2022

Introduction:
Alignment, as seen in the native myocardium, is crucial for maintaining the functional cardiac tissue. However, it remains unclear how cardiomyocyte alignment control influences cardiac function and the underlying mechanisms. The aims of our study were to fabricate aligned human cardiac tissue using a micro-processed fibrin gel and elucidated the effect of alignment control on contractile properties.

Methods:
We fabricated aligned human cardiac tissue through cultivating human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) on a micro-processed fibrin gel with inverted V-shaped ridges (MFG). The orientation index was calculated based on the Fourier analysis using Phalloidin staining images. The cardiac tissue function was evaluated with a contractile force measurement system.

Results:
The orientation index of hiPSC-CMs on MFG was significantly higher than that on the control fibrin gel (1.5±0.1 vs. 1.2±0.1, p<0.001, n=4) and that was close to the orientation index of an adult rat heart tissue (1.6±0.1), suggesting hiPSC-CMs on MFG were aligned more uniformly than the control. The contractile force, maximum contractile velocity, and relaxation velocity were significantly increased in aligned cardiac tissue compared with non-aligned cardiac tissue [contractile force (75bpm): 0.9±0.5 mN vs. 0.5±0.3 mN, p=0.02, n=11]. Motion capture analysis revealed cardiomyocytes in the aligned cardiac tissues showed more unidirectional contraction than the non-aligned cardiac tissues. Furthermore, the timing of contraction at five designated points in the tissues was significantly closed in the aligned tissue, suggesting cardiomyocyte alignment control might improve the systolic and relaxation function of cardiac tissue by promoting synchronous cardiomyocyte contraction.

Conclusion:
Cardiomyocyte alignment control promoted the electrical integration of cardiomyocytes and contributed to generate the strong contractile force. Understanding the molecular mechanisms of alignment control-mediated synchronous contraction of cardiomyocytes might provide us the new insights on electrophysiological properties of heart tissue.
Abstract 12310: Metabolic Gain Index is Associated With Adverse Clinical Outcomes Independently of Peak VO
2
in Patients With Heart Failure With Reduced Ejection Fraction Undergoing Cardiopulmonary Exercise Stress Testing
Authors: Chaikijurajai Thanat , Engelman Timothy , Finet J. Emanuel , Tang Wai Hong W
Published: April 2022

Introduction:
Cardiopulmonary exercise stress test (CPET) is an essential prognostic tool in patients with heart failure with reduced ejection fraction (HFrEF) for advanced therapy evaluation. We studied the predictive utility of the metabolic gain index (MGI), which reflects the relative gain of the CPET-estimated stroke volume by the relative change in the product of VO
2
and heart rate (HR) from resting to peak exercise. This novel MGI aims to reflect cardiac reserve function, and, overall prognosis in HFrEF patients.

Hypothesis:
The MGI is an independent predictor of adverse outcomes in patients with HFrEF.

Methods:
We reviewed electronic medical records of 843 HFrEF patients (LVEF ≤40%) undergoing CPET from 12/2012 to 9/2020. The MGI was calculated using the formula, [(Peak VO
2
x Peak HR)-(Resting VO
2
x Resting HR)]/(Resting VO
2
x Resting HR). Patients with hypotensive or bradycardia response during exercise were excluded. Primary outcome was the composite of all-cause mortality, LVAD implantation, and heart transplantation. Multivariable Cox proportional hazard models and log rank test were used. For subgroup analysis, patients were stratified by the RER, age, sex, BMI, and beta-blocker use.

Results:
In our study cohort (mean age 56.2±12.2 years, 73% men, 85% with beta-blockers, mean LVEF 24.8±8.0 %, 16% with BMI ≥35 kg/m
2
, and 75% with RER >1.05), there were 279 (33.1%) patients developed adverse events during median follow up time of 897 days. Lower MGI was independently associated with increased risk of the adverse outcomes with adjustment for age, sex, comorbidities, LVEF, and peak VO
2
(quartile 1 vs 4, hazard ratio 1.83, 95% CI 1.03-3.25,
p
=0.040,
Figure 1A
), especially in patients with RER > 1.05, BMI < 35 kg/m
2
, and without beta-blocker use (
Figure 1B
).

Conclusions:
Lower MGI is associated with poor prognosis independently of peak VO
2
. The prognostic value of MGI needs to be further corroborated in other multicenter HFrEF cohorts.
Abstract 12504: The Gender-Based Outcome in the Patients Undergoing Percutaneous Left Atrial Appendage Occlusion With the Watchman Device: A Longitudinal Nationwide Inpatient Sample Analysis
Authors: Patel Neel , Amgai Birendra , Sandipan Chakraborty , Hajra Adrija , Patel Zeel , Binit Aryal , Khalid mazin , Paul Prodip Kumar , Aronow Wilbert S
Published: April 2022

Introduction:
Compared to men, women have an increased risk of having a stroke, cardiovascular disease, and death. It requires continuous anticoagulation use based on CHA
2
DS
2
-VASc scores for stroke prevention. The Watchman device is indicated for patients with non-valvular AF at high risk of stroke who have contraindications to long-term anticoagulation use. We sought to determine the periprocedural outcome difference based on gender in the patients undergoing watchman device implantation.

Methods:
National Inpatient Sample databases from 2016 to 2018 were utilized using Stata 16.0. NIS databases are the ICD-10-CM code-based largest publicly available all-payer inpatient database. Patients with atrial fibrillation who underwent the watchman procedure were identified; later divided and compared based on gender. Multivariate logistic regression, linear regression, and student t-t-tests were used for analysis. Data were further analyzed after greedy propensity matching for accuracy.

Results:
Out of 33,825 patients who had the procedure, 14,105 (41.8%) were female, and 19,690 (58.2%) were male. The mean age for women and men were 76.5±7.5 and 75.6±8.1 respectively. Co-morbidities such as DM, CAD, CKD, PVD, and history of CABG were more in men, whereas anemia and pulmonary hypertension were more in women. Mortalities in women were 30 whereas it was 26 in men. There was no difference in mortality on multivariate logistic regression analysis. Complications such as pericardial drain and major bleeding requiring blood transfusion were higher in women. There was no difference in pericardial complications, ischemic stroke, hemorrhagic stroke, and AKI. The overall mean LOS and cost per hospitalization were higher in women.

Conclusions:
Patients undergoing watchman procedure showed no difference in periprocedural mortality between men and women; however, women had high events of pericardial drainage and major bleeding requiring blood transfusion.
Abstract 12544: A miRNA Cassette for Reprogramming Vascular Smooth Muscle Cells Into Endothelial Cells
Authors: McCoy Michael G , Pérez Cremades Daniel , Belkin Nathan , Peng Wenhui , Zhang Bofang , Wara Akm , Cheng Henry , Zhuang Rulin , Feinberg Mark W
Published: April 2022

Introduction:
Vascular smooth muscle cells (SMCs) and endothelial cells (ECs) exhibit unique miRNA profiles, which regulate their overall function. However, whether differentially expressed miRNAs can be used for transcriptional reprogramming of SMCs into ECs is unknown. MiRNA profiling of SMCs and ECs revealed differential regulation of miR-143-3p, miR-145-3p, miR-146a-5p, and miR-181b-5p as a set of candidates for transdifferentiation.

Methods:
Human coronary SMCs were transfected with miR-143-3p and miR-145-3p inhibitors alongside miR-146a-5p and miR-181b-5p mimics and selectively expanded. Induced endothelial cells (iECs) were then assessed for their transcriptional, protein expression, and functional similarities to ECs (Fig. 1).

Results:
Principal component and gene set enrichment analyses determined that iECs are transcriptionally clustered closer to ECs than SMCs in whole transcriptome profiling and selected EC and SMC gene sets. Top pathways included ‘blood vessel morphogenesis’, ‘regulation of angiogenesis’ and ‘Notch, VEGF, integrin signaling’. Transcriptome data was validated via PCR and Western blot analyses as iECs exhibited robust upregulation in EC markers CD31, VE-Cadherin, and VEGFR2 and downregulation of SMC markers MHY11, Vimentin, and αSMA. The similarity of iECs to ECs was functional as iECs demonstrated oxLDL and Ac-LDL uptake, tube formation in Matrigel™ assays, eNOS phosphorylation in response to VEGF, and iEC migratory and cell growth properties were similar to human umbilical vein ECs in the presence of VEGF. A hindlimb ischemia model validated iEC similarity to ECs as injected iECs restored blood flow and significantly reduced limb necrosis similar to ECs.

Conclusion:
A miRNA cassette consisting of miR-143-3p and miR-145-3p inhibitors and miR-146a-5p and miR-181b-5p mimics transformed SMCs into endothelial-like cells and show promise as a potential novel regenerative strategy for endothelial cells.
Abstract 12545: Autologous Induced Mesenchymal Stem Cells-derived Exosomes Exhibit Enhanced Protection Of Cardiomyocytes From Injuries
Authors: Gurusamy Narasimman , SIGAMANI VINOTH , RAJASINGH SHEEJA , Johnson Rajasingh
Published: April 2022

Introduction:
Mesenchymal stem cells (MSC)-derived exosomes containing small non-coding RNAs (sncRNAs) showed protection of the myocardium from injury, infection, and disease. Recently, we have generated a safe and non-viral method of generating induced pluripotent stem cell (iPSC)-derived MSCs (iMSCs) with high replicative, autologous, cardioprotecive potentials, originally derived from human urinary epithelial cells.

Hypothesis:
We hypothesize that exosomes from iMSC possess a superior cardioprotective, and regenerative characteristics compared to the exosomes from adult umbilical cord MSCs (hereafter referred as MSCs) for the treatment of ischemic cardiomyopathy (ICM).

Methods & Results:
Exosomes isolated from serum-free conditioned media obtained from iMSCs and MSCs were characterized using Zetasizer, which showed that exosomes from iMSCs had smaller particle size than the MSCs (Fig. A). Exosomal tetraspanin proteins (CD9, CD63 and CD81) were identified by Western blotting. Cardioprotective properties of exosomes were evaluated using functional iPSC-derived cardiomyocytes (iCMCs), which were treated with 50 μg of exosomes 1 hr before subjecting them to either 24 hrs of Ang II treatment (10 μM) or 6 hrs of 1% hypoxia and 24 hrs of reoxygenation. The exosomes from iMSCs elicited a superior cardioprotective characteristic studied through qRT-PCR expression of survival genes and measurement of mitochondrial membrane potentials (JC1 dye), intracellular reactive oxygen species (CM-H2DCFDA), and in situ cell death by apoptosis (Fig. B) when compared to the exosomes from MSCs. Furthermore, the expressions of injury-associated sncRNAs such as SNORD32a, SNORD33, and SNORD35a were identified in both exosomes.

Conclusions:
In comparison with the exosomes of available MSCs, exosomes from iMSCs showed an enhanced protection of cardiomyocytes from injuries and can be a valuable cell-free source for the treatment of ICM.
Abstract 12807: Effects of Ischemic Pain Inducing Walking Exercise vs. Pain Free Walking Exercise on Walking Velocity and Functional Performance in Peripheral Artery Disease. Results From the Lite Randomized Clinical Trial
Authors: Hammond Michael , Xu Shujun , Tian Lu , Zhao Lihui , Zhang Dongxue , McDermott Mary M
Published: April 2022

Introduction:
The LITE randomized trial recently demonstrated that home-based pain free walking exercise did not improve 6-minute walk distance, compared to home-based ischemic pain inducing walking exercise, and compared to an attention control group, among people with lower extremity peripheral artery disease (PAD). This study examined effects of home-based pain free walking exercise and home-based ischemic pain inducing walking exercise on walking velocity, and the short physical performance battery (SPPB).

Methods:
305 participants with PAD were randomized to home-based pain free walking exercise, home-based ischemic pain inducing walking exercise, or an attention control group in a multi-centered randomized trial, over 12 months. Participants in the pain free walking exercise group walked at a pace that did not cause ischemic leg symptoms. Participants in the ischemic pain inducing walking exercise group walked at a pace that caused ischemic leg symptoms. The attention control group received health education talks. Usual-paced 4-meter walking velocity (4MWV), fast-paced 4MWV, and SPPB (total score range: 0-12; 12=best) were measured at baseline and 12-month follow-up.

Results:
Of the 305 PAD participants randomized, 246 (mean age: 69 ± 9 years; 48% women; 60% black) with baseline or 12-month data on either usual-paced 4MWV, fast-paced 4MWV, or SPPB were included. The effects of the exercise interventions on each functional measure are shown in the table.

Conclusion:
These data suggest that ischemic pain inducing walking exercise improves walking speed and functional performance, while walking exercise at a comfortable pace may worsen walking velocity in PAD.
Abstract 12815: Changes in Circulating microRNA-375 Levels in Response to Lifestyle Interventions and Improvements in Visceral Adiposity and Hepatic Fat Content: The CENTRAL Trial
Authors: Heianza Yoriko , Krohn Knut , Xue Qiaochu , Yaskolka Meir Anat , Ziesche Stefanie , Schwarzfuchs Dan , Ceglarek Uta , Bluher Matthias , Keller Maria , Kovacs Peter , Shai Iris , Qi Lu
Published: April 2022

Introduction:
MicroRNA (miRNAs) are short non-coding RNAs that regulate gene expression at the translational level. Circulating exosomal miRNAs have emerged as novel biomarkers of obesity, insulin resistance, and related metabolic abnormalities. miR-375 has been identified as a regulator of insulin secretion, and miR-375 may also be involved in regulating visceral adiposity and ectopic fat accumulation in the liver.

Hypothesis:
We aimed to investigate whether changes in circulating miR-375 induced by lifestyle interventions were related to improved visceral adiposity and hepatic fat depot among individuals with abdominal obesity.

Methods:
This study included adults with abdominal obesity from an 18-month diet and physical activity intervention study (the CENTRAL trial) and with available data on circulating miR-375-3p at baseline (n=222) and 18 months (n=152). Magnetic resonance imaging (MRI) was performed to assess body fat distribution and ectopic fat depots. Outcome measurements included 18-month changes in abdominal (total [TAT], visceral [VAT], deep subcutaneous [DSAT], superficial subcutaneous [SSAT]) adipose tissue area and intrahepatic fat content.

Results:
At baseline, higher levels of miR-375 were related to lower degrees of BMI (
p
=0.0006), waist circumference (
p
=0.0008), as well as abdominal adipose tissue area (TAT [
p
=0.0024], VAT [
p
=0.059], DSAT [
p
=0.011], and SSAT [
p
=0.0027]). There was a significant increase in circulating miR-375 levels after the 18-month lifestyle interventions (

P
by paired t-test

< 0.0001). When we analyzed effects (β) of per 1 SD increase in miR-375 changes on the outcomes after adjusting for covariates including baseline levels of miR-375 and BMI, we found that greater increase in miR-375 was associated with larger reductions of VAT (β -8.09 [3.09] cm
2
,
p
=0.01), as well as DSAT (β -7.87 [2.21] cm
2
,
p
=0.001) and intrahepatic fat content (β -1.38% [0.5%],
p
=0.006) at 18 months.

Conclusions:
Circulating miR-375 levels significantly increased after the long-term lifestyle interventions, and greater increases in miR-375 were related to significant improvements in visceral adiposity and liver fat content that are closely related to insulin resistance in adults with abdominal obesity.
Abstract 12825: Immediate versus Staged Complete Revascularization in Acute ST-segment Elevation Myocardial Infarction Patients With Multi-Vessel Disease Undergoing Primary Percutaneous Coronary Intervention: Prospective, Randomized, Multicenter Trial of Complete versus Culprit Lesion Revascularization in Acute ST-segment Elevation Myocardial Infarction Patients With Multivessel Disease Undergoing Primary Percutaneous Coronary Intervention With Everolimus Eluting Stent (cocua Trial)
Authors: Park Soohyung , Choi Byoung Geol , Choi Se Yeon , Byun Jae Kyeong , Cha Jinah , Lee Kyuho , Back Seungmin , Lee Jieun , Kang Dong O , Kim Ji Bak , Choi Jah , Roh Seung-young , Na Jin O , Choi Cheol Ung , Kim Eung Ju , Park Chang Gyu , Seo Hong-Seog , Rha Seung Woon W
Published: April 2022

Background:
In the present study, we aimed to compare the 12-month clinical outcomes of immediate versus staged complete revascularization in acute ST-segment elevation myocardial infarction (STEMI) patients with multivessel disease undergoing primary percutaneous coronary intervention (PCI) with everolimus-eluting stents (EES).

Method:
A total of 248 patients were enrolled in a prospective, randomized, open-label, multicenter registry. Immediate complete revascularization was defined as simultaneous PCI of the culprit and non-culprit lesions during the index procedure (Immediate group). Staged complete revascularization was defined as PCI of non-culprit lesion as a separate staged procedure after the culprit lesion PCI (mean 4.4 days, interquartile range; 1 to 11.4, Staged group). The study end points were major adverse cardiovascular events (MACE; the composite of total death, recurrent myocardial infarction, and revascularization), and individual hard endpoints including cardiac death, stent thrombosis and stroke at 12 months clinical follow up.

Results:
Although the incidence of MACE was not significantly different between the two groups (11.6% vs. 7.5%, p = 0.313), the incidence of total death was higher in the immediate group than the staged group (9.7% vs. 2.8%, P=0.040). Despite the incidence of target lesion and vessel revascularization were similar, there was a trend toward higher incidence of TLR- MACE in the immediate group than the staged group (9.7% vs. 3.7%, p =0.086). There was no significant difference in the risk of in-hospital complications including transfusion, bleeding, acute renal failure or acute heart failure between the groups.

Conclusion:
For STEMI patients with multi-vessel disease undergoing primary PCI with drug-eluting stents, routine immediate complete revascularization should not be justified possibly due to higher event risks.
Abstract 12836: Predictors of Recurrent Pericardial Effusion in Cancer Patients Requiring Pericardiocentesis
Authors: AHMED TALHA , Safdar Ayesha , Song Juhee , Banchs Jose , Kim Peter , Palaskas Nicolas L , Iliescu Cezar
Published: April 2022

Introduction:
Pericardial effusion (PE) is a common manifestation of various malignancies and tends to recur in a subset of patients requiring recurrent PC.

Hypothesis:
We sought to evaluate the factors determining the recurrence of PE in certain subsets of patients.

Methods:
All data pertaining to PC for large PE in a cancer patient population performed and enrolled over a decade 2010-2020 in a Cancer Center Pericardiocentesis Registry were analyzed. Patient characteristics were summarized using descriptive statistics (Mean (SD) for continuous variables and frequency (%) for categorical variables. Time to first recurrent PC was defined as time interval from index PC to first recurrent PC. Fine-Gray models were used to identify risk factors associated with incidence of recurrent PC while Cox regression models were used to identify risk factors associated with risk of death.

Results:
Data set included 418 subjects with index PC and 65 (16%) had recurrent PC while 353 (84%; 286 died without recurrent PC and 67 were alive without recurrent PC) did not have recurrent PC. Descriptive statistics for the entire group are described in table 1. Younger age, elevated creatinine, non-colon cancer, established advanced-stage cancer, presence of cardiac metastasis, and non-colon cancer (P=<0.05) were associated with increased incidence of recurrence of pericardiocentesis. The risk of death was higher in patients with older age, malignant effusion by cytology, no use of anti-inflammatory agents, and primary lung cancer (p=<0.05). The cumulative incidence of recurrent pericardiocentesis at 12 months was 15 % and did not differ much at 60 (16 %).

Conclusions:
Patients with advanced-stage cancer are more likely to present with recurrent pericardial effusion and tamponade. Pericardiocentesis appears to have a palliative role in this population with increased disease and treatment-related mortality.