bluuebunny/crossref_metadata_2025 huggingface dataset:
Deconfounding User Preference in Recommendation Systems through Implicit and Explicit Feedback
Authors: Liang Yuliang , Yang Enneng , Guo Guibing , Cai Wei , Jiang Linying , Wang Xingwei
Published: June 2024

Recommender systems are influenced by many confounding factors (i.e., confounders) which result in various biases (e.g., popularity biases) and inaccurate user preference. Existing approaches try to eliminate these biases by inference with causal graphs. However, they assume all confounding factors can be observed and no hidden confounders exist. We argue that many confounding factors (e.g., season) may not be observable from user–item interaction data, resulting inaccurate user preference. In this article, we propose a deconfounded recommender considering unobservable confounders. Specifically, we propose a new causal graph with explicit and implicit feedback, which can better model user preference. Then, we realize a deconfounded estimator by the front-door adjustment, which is able to eliminate the effect of unobserved confounders. Finally, we conduct a series of experiments on two real-world datasets, and the results show that our approach performs better than other counterparts in terms of recommendation accuracy.
Open Problems Column
Authors: Gasarch William
Published: June 2024

This Issue's Column!
This issue's Open Problem Column is by Josh Burdick. It is about an approach to lower bounds on circuits for variants on the CLIQUE problem.

Request for Columns!
I invite any reader who has knowledge of some area to contact me and arrange to write a column about open problems in that area. That area can be (1) broad or narrow or anywhere inbetween, and (2) really important or really unimportant or anywhere inbetween.
Comparison of Mammography and Mammography with Supplemental Whole-Breast US Tomography for Cancer Detection in Patients with Dense Breasts
Authors: Yamashita Mary W. , Larsen Linda H. , Perez Jeremiah , Edwards Alexandra V. , Papaioannou John , Jiang Yulei
Published: June 2024

In women with dense breasts, automated breast US tomography added to screening mammography led to increased breast cancer detection and increased specificity for Breast Imaging Reporting and Data System category 3 lesions compared with mammography alone.
Large Language Models for Automated Synoptic Reports and Resectability Categorization in Pancreatic Cancer
Authors: Bhayana Rajesh , Nanda Bipin , Dehkharghanian Taher , Deng Yangqing , Bhambra Nishaant , Elias Gavin , Datta Daksh , Kambadakone Avinash , Shwaartz Chaya G. , Moulton Carol-Anne , Henault David , Gallinger Steven , Krishna Satheesh
Published: June 2024

GPT-4 enabled near-perfect creation of pancreatic ductal adenocarcinoma synoptic reports from original reports and accurate resectability categorization using chain-of-thought prompting, which improved surgeon accuracy and efficiency in interpreting reports for resectability categorization.
An Equivalent Siding Mode Observer for Electric Vehicle Lithium Battery SOC Estimation
Authors: Nan Wenzhi , Pang Hui , Chen Kaiqiang , Wang Fengbin , Lin Guangyang
Published: June 2024

Accurate state of charge (SOC) estimation for lithium-ion batteries is essential to guarantee long-term stable operation of electric vehicles. In this study, an equivalent sliding mode observer (ESMO) is proposed to estimate the battery SOC. First, a sliding mode observer (SMO) was designed with Walcott-Zak structure to increase the sliding region. Next, a controlled equivalent function was used to replace sign function in the SMO, which can lessen chattering issue and increase system robustness. Furthermore, this study performs online parameter identification of a second-order resistance capacitor equivalent circuit model using the forgetting factor recursive least squares approach. Lastly, the experiments under dynamic current conditions were conducted to verify the proposed ESMO. The results show that the mean square error of the ESMO is decreased to 0.5%, which implies that the proposed ESMO can estimate the SOC with higher accuracy compared to the traditional SMO.
Preparation and Antifiltration Performance of Organic Zirconium Crosslinker for Guar Gum‐Fracturing Fluid
Authors: Chen Yirong , Wang Yufang , Wei Wei , He Jiahui
Published: June 2024

Aiming at the characteristics of low shear resistance and high filtration loss of guar gum‐fracturing fluid, a high‐efficiency organic zirconium crosslinker was prepared. In addition, the effects of different factors on the filtration coefficient and apparent viscosity of fracturing fluid were studied, and this study explores the micro mechanisms of various factors affecting the filtration coefficient from a molecular dynamics perspective. The results show that the antifiltration ability of guar gum‐fracturing fluid is inversely proportional to the fluid viscosity. The increase of crosslinker content and reservoir pressure is beneficial to improve the viscosity and antishear ability of guar gum‐fracturing fluid. When the crosslinker content is 0.25% and pressure is 30 MPa, the fracturing fluid parameters are 145 mPa·s and 2.1 × 10−2 m3 · min1/2, respectively, while the increase of reservoir temperature and the shear rate reduces the rheology and shear resistance of guar gum‐fracturing fluid, so that the viscosity and filtration coefficient of fracturing fluid at 180°C and 200 s-1 are 123 mPa·s and 2.3 × 10-2 m3·min1/2, respectively. This work not only paves a new avenue for synthesizing organic zirconium as a crosslinker but also provides an efficient measure to reduce the filtration of guar gum‐fracturing fluid on the oil and gas reservoirs.
Application of Intraoperative Radiotherapy in Early‐Stage Breast Cancer Patients in a Clinical Setting
Authors: Wang Ao , Quint Elchanan , Kukeev Ivan , Agassi Ravit , Belochitski Olga , Barski Gay , Vaynshtein Julie
Published: June 2024

Background: Intraoperative radiation therapy (IORT) has gained popularity in recent years as an alternative to external beam whole breast radiation therapy (WBRT) for early‐stage breast cancer. Here, we report 43‐month recurrence and survival outcomes in a multiethnic cohort treated with IORT in a clinical context.

Method: Two hundred and eleven patients with low‐risk features were treated with IORT for early‐stage breast cancer from 2014 to 2021. Selection criteria were based on Group Europeen de Curietherapie‐European Society for Therapeutic Radiology and Oncology (GEC‐ESTRO) guidelines: preferably unifocal intraductal carcinoma (IDC), aged > 50, tumor size ≤ 2.0 cm, and without lymph node involvement. All patients received 20 Gy of radiation dose during the lumpectomy. Information on patient and tumor characteristics was collected.

Results: The mean age of this cohort was 67.5 years; 95.2% of patients are Jewish, and the rest are Bedouins (4.7%). Most tumors were intraductal carcinoma (97.2%) and stage 1 (94.8%). The mean follow‐up time was 43.4 months. Bedouins had larger tumor sizes (mean 1.21 vs. 1.13 cm) and were younger at diagnosis than Jewish patients (mean 65.4 vs. 67.6 years), although the differences are not significant. The overall recurrence rate was 1.4%. One case of local recurrence (0.5%) and two cases of metastasis (0.9%) were observed during the study period. One patient died from metastasis.

Conclusion: Our findings suggest that IORT in selected low‐risk patients can achieve an excellent prognosis with low rates of recurrence and metastasis.
Quantification of Rhodojaponin II and Rhodojaponin III in Rat Plasma by Ultra‐Performance Liquid Chromatography‐Tandem Mass Spectrometry
Authors: Sun Cheng , Wang Wanhang , Bao Xi , Chen Dizhong , Mei Shenshen , Ma Jianshe , Jiang Xiajuan
Published: June 2024

An ultra‐performance liquid chromatography‐tandem mass spectrometry (UPLC‐MS/MS) method was developed to determine the concentrations of Rhodojaponin II and Rhodojaponin III in rat plasma, and their pharmacokinetic profiles were investigated. A UPLC HSS T3 (2.1 mm × 50 mm, 1.8 μm) chromatographic column was employed at a temperature of 40°C. The mobile phase consisted of acetonitrile‐0.1% formic acid in water, and a gradient elution method with an elution time of 6 min and flow rate of 0.4 mL/min was utilized for analysis purposes. Methodological investigations were conducted accordingly. The plasma concentrations of Rhodojaponin II and Rhodojaponin III exhibited excellent linearity within the range of 2 ng/mL–1250 ng/mL. Moreover, both intraday and interday precision were below 15%, while accuracy ranged from 88% to 115%. Additionally, matrix effect fell within the range of 90%–110%, and recoveries ranged from 78% to 87%. These results comply with relevant regulations for drug analysis in biological samples. Therefore, this method is deemed suitable for quantifying Rhodojaponin II and Rhodojaponin III levels in rats.
Supplementary Tables from Monitoring Circulating Tumor DNA During Surgical Treatment in Patients with Gastrointestinal Stromal Tumors
Authors: Johansson Gustav , Berndsen Marta , Lindskog Stefan , Österlund Tobias , Fagman Henrik , Muth Andreas , Ståhlberg Anders
Published: June 2024

Supplementary Table S1 shows detailed sample characteristics. Supplementary Table S2 shows sequences of synthetic spike-in DNA. Supplementary Table S3 shows assay sequences. Supplementary Table S4 shows details related to surgical treatment. Supplementary Table S5 shows resistance events of tyrosine kinase inhibitors in the COSMIC database. Supplementary Table S6 shows patient characteristics. Supplementary Table S7 shows concordance between imaging and ctDNA.
Figure 2 from Monitoring Circulating Tumor DNA During Surgical Treatment in Patients with Gastrointestinal Stromal Tumors
Authors: Johansson Gustav , Berndsen Marta , Lindskog Stefan , Österlund Tobias , Fagman Henrik , Muth Andreas , Ståhlberg Anders
Published: June 2024

ctDNA characteristics in 32 patients diagnosed with GISTs. A, Detailed overview of tumor-specific ctDNA and clinical parameters. ctDNA status in relation to surgery is shown for each patient. Days at the bottom relates to surgical treatment. Red and black samples indicate samples being ctDNA positive and negative, respectively. Gray samples are negative samples, but with less than 50 cfDNA molecules detected. Patients with metastatic disease are shown as bold patient identification (ID). Information about Ki-67, tumor size, TKI treatment, and last known disease status is shown. NED, no evidence of disease; AWD, alive with disease; DBD, dead by disease. B, Tumor cell proliferation rates versus presence of ctDNA. Patients with at least one ctDNA-positive sample were considered positive. Data are shown in log10 scale. n = 32; *, P ≤ 0.05; Student t test on log-transformed values. C, Tumor size versus presence of ctDNA. Patients with at least one ctDNA-positive samples were considered positive. n = 32; **, P ≤ 0.01, Student t test. D, Total ctDNA levels versus presence of ctDNA in each sample. Data are shown in log10 scale. Values out of range (OOR) was in statistical calculation replaced with the value 0.39, which is the lowest detected value divided by two, n = 161. n.s., not significant, Student t test on log-transformed values. E, Type of tumor-specific mutation detected as ctDNA. Frequency of single-nucleotide variations (SNP) and indel. n = 32; **, P ≤ 0.01; Fisher exact test.
Figure 1 from Monitoring Circulating Tumor DNA During Surgical Treatment in Patients with Gastrointestinal Stromal Tumors
Authors: Johansson Gustav , Berndsen Marta , Lindskog Stefan , Österlund Tobias , Fagman Henrik , Muth Andreas , Ståhlberg Anders
Published: June 2024

Experimental overview and primary tumor mutations. A, Consort diagram of the eligible patient cohort and study enrollment. The cohort consisted of all patients treated at the Deparment of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden, between November 2016 and March 2019. Forty-three of the 91 initially included patients were excluded. Of the excluded patients, nine patients revealed other diagnoses than GIST by pathology analysis, five patients displayed neither KIT nor PDGFRA mutations (wild-type) in tumor biopsy, three patients had no mutation analysis performed on the tumor material and 26 patients were enrolled after surgery and hence excluded. Thirty-two of 48 patients that were included before surgery were finally analyzed for the presence of ctDNA. Of the 16 additionally excluded patients, five patients were excluded, because sampling was not possible during surgery, samples from two patients were used in workflow optimization and nine patients were excluded as their tumor-specific mutations were not targeted by the developed assays. B, Five SiMSen-Seq assays were used to assess each patient, including one tumor-specific assay targeting the mutation identified in the tumor biopsy combined with four resistance assays. Blood samples were collected during routine visit before and after surgery. At surgery, samples were collected at start of surgery, during mobilization of the tumor and at closure. Extracted cfDNA was analyzed by SiMSen-Seq. Several quality controls were used to monitor the experimental performance. C, Assay overview and detected mutations in tumor biopsy. The length and exon position of each assay are shown. All types of mutations and their position are indicated for all 32 patients. SNV, single-nucleotide variant; indel, insertion or deletion mutation.
FIgure S2 from Characterization of KRAS Mutation Subtypes in Non–small Cell Lung Cancer
Authors: Judd Julia , Abdel Karim Nagla , Khan Hina , Naqash Abdul Rafeh , Baca Yasmine , Xiu Joanne , VanderWalde Ari M. , Mamdani Hirva , Raez Luis E. , Nagasaka Misako , Pai Sachin Gopalkrishna , Socinski Mark A. , Nieva Jorge J. , Kim Chul , Wozniak Antoinette J. , Ikpeazu Chukwuemeka , de Lima Lopes Gilberto , Spira Alexander I. , Korn W. Michael , Kim Edward S. , Liu Stephen V. , Borghaei Hossein
Published: June 2024

Supplemental Figure 2 . Differences in co-mutations and immune markers between patients with KRAS mutated (KRAS MT) NSCLC with or without an ATM mutation (ATM MT; A) and between patients with KRAS mutated (KRAS MT) NSCLC with or without a U2AF1 co-mutation (U2AF1 MT; B). (A) Frequency of the 10 most common co-occurring mutations as well as TMB high in patients with tumors harboring KRAS mutations with or without an ATM mutation. (B) Fequency of the 10 most common co-occurring mutation in patients with tumors harboring both KRAS mutations with or without U2AF1 mutations.
Lactate Induces Tumor Progression via LAR Motif-Dependent Yin-Yang 1 Degradation
Authors: Du Shujuan , Chen Xiaoting , Han Xiao , Wang Yuyan , Yu Dan , Li Ying , Zhu Caixia , Tong Yin , Gao Shujun , Wang Junwen , Wei Fang , Cai Qiliang
Published: June 2024

The metabolic reprogramming of aerobic glycolysis contributes to tumorigenesis. High plasma lactate is a critical regulator in the development of many human malignancies; however, the underlying molecular mechanisms of cancer progression in response to lactate (LA) remain elusive. Here, we show that the reduction of Yin-Yang 1 (YY1) expression correlated with high LA commonly occurs in various cancer cell types, including B-lymphoma and cervical cancer. Mechanistically, LA induces YY1 nuclear export and degradation via HSP70-mediated autophagy adjacent to mitochondria in a histidine (His)-rich LA-responsive (LAR) motif-dependent manner. The mutation of the LAR motif blocks LA-mediated YY1 cytoplasmic accumulation and in turn enhances cell apoptosis. Furthermore, low expression of YY1 promotes colony formation, invasion, angiogenesis, and growth of cancer cells in response to LA in vitro and in vivo using a murine xenograft model. Taken together, our findings reveal a key LAR element and may serve as therapeutic target for intervening cancer progression.

Implications: We have shown that lactate can induce YY1 degradation via its His-rich LAR motif and low expression of YY1 promotes cancer cell progression in response to lactate, leading to better prediction of YY1 targeting therapy.
Figure S8 from HDAC6 Inhibition Releases HR23B to Activate Proteasomes, Expand the Tumor Immunopeptidome and Amplify T-cell Antimyeloma Activity
Authors: Rana Priyanka S. , Ignatz-Hoover James J. , Kim Byung-Gyu , Malek Ehsan , Federov Yuriy , Adams Drew , Chan Timothy , Driscoll James J.
Published: June 2024

Fig. S8. Effect of top pharmacologics from the HTS that inhibited proteasome ChT-like activity in E.G7-Ova and EL4 cells. Cells (50,000/well) were incubated with each pharmacologic for 72 hrs. Proteasome ChT-like activity was determined after 24 hrs incubation. E.G7-Ova and EL4 cells. Cells (50,000/well) were incubated with each pharmacologic for 72 h. Proteasome ChT-like activity was determined after 24 h incubation.
Figure S3 from HDAC6 Inhibition Releases HR23B to Activate Proteasomes, Expand the Tumor Immunopeptidome and Amplify T-cell Antimyeloma Activity
Authors: Rana Priyanka S. , Ignatz-Hoover James J. , Kim Byung-Gyu , Malek Ehsan , Federov Yuriy , Adams Drew , Chan Timothy , Driscoll James J.
Published: June 2024

Fig. S3. Chemical structure of top pharmacologics identified in the HTS that increased proteasome ChT-like activity.
Figure S14 from HDAC6 Inhibition Releases HR23B to Activate Proteasomes, Expand the Tumor Immunopeptidome and Amplify T-cell Antimyeloma Activity
Authors: Rana Priyanka S. , Ignatz-Hoover James J. , Kim Byung-Gyu , Malek Ehsan , Federov Yuriy , Adams Drew , Chan Timothy , Driscoll James J.
Published: June 2024

Fig. S14. Effect of HDAC6 inhibitors at the indicated concentrations and times on a. proteasome activity and b. cell viability. Panel c. shows the effect of non-specific HDAC inhibitors on proteasome activity and cell viability. In panels a, b, and c, MM cells (50,000/well) were incubated with each pharmacologic at 1 uM for 72 h. Cell viability was determined using the XTT assay. d. Effect of HAT activators on proteasome activity and cell viability. MM cells (50,000/well) were incubated with each pharmacologic at 1 uM for 72 h. Cell viability was determined using the XTT assay.
FIGURE 6 from HDAC6 Inhibition Releases HR23B to Activate Proteasomes, Expand the Tumor Immunopeptidome and Amplify T-cell Antimyeloma Activity
Authors: Rana Priyanka S. , Ignatz-Hoover James J. , Kim Byung-Gyu , Malek Ehsan , Federov Yuriy , Adams Drew , Chan Timothy , Driscoll James J.
Published: June 2024

Effect of HDAC6 inhibitors on the antimyeloma effect of autologous T cells. A, Effect of HDAC6 inhibitors on the viability of myeloma patient CD138+ cells. Cells were treated with the pharmocologics at 1 µmol/L for 18 hours and cell viability measured using the XTT assay. Assays were performed in triplicate. B, Effect of HDAC6 inhibitors on ChT-like proteasome activity in CD138+ myeloma patient cells. Cells were treated with tubastatin-A, ACY-738, and ACY-1215 for 18 hours. Posttreatment cells were then incubated for 21 hours with LLVY-R110. Cleavage of LLVY-R110 was determined as above. C, Effect of HDAC6 inhibitors on pan MHC-I (HLA-ABC) presentation on CD138+ cells. Cells were treated with tubastatin-A, ACY-738 and ACY-1215 for 18 hours at 1 µmol/L, PBS washed, and stained with a mouse anti-human HLA-ABC (BD Pharmingen, 55555) and CD138 antibody per manufacturer's guidelines. Cells that stained positively with an anti-human HLA-ABC were analyzed on Attune Nxt and quantified using Flow Jo version 10.9.0. Error bars represent the median absolute deviation percentile (MADP) of the average. D, Effect of HDAC6 inhibitors on autologous T cell–mediated myeloma cytotoxicity. CD138+ cells were treated with tubastatin-A, ACY-738, and ACY-1215 for 18 hours and cocultured with T cells for 18 hours. After treatment, cells were then PBS washed and stained with CD138, FITC annexin-V in buffer containing propidium iodide for 20 minutes at room temperature. Cells were then analyzed on an Attune NxT and quantified using Flow Jo version 10.9.0. Error bars represent the MADP of the average. A P-value ≤ 0.05 is flagged with one star (*) and a P-value ≤ 0.001 is flagged with three stars (***).
FIGURE 3 from HDAC6 Inhibition Releases HR23B to Activate Proteasomes, Expand the Tumor Immunopeptidome and Amplify T-cell Antimyeloma Activity
Authors: Rana Priyanka S. , Ignatz-Hoover James J. , Kim Byung-Gyu , Malek Ehsan , Federov Yuriy , Adams Drew , Chan Timothy , Driscoll James J.
Published: June 2024

Effect of HDAC6 inhibitors on the murine MHC class I immunopeptidome. A, Number of peptides eluted from murine MHC class I molecule at each indicated peptide lengths (range = 6 to 15 amino acids). B, Effect of HDAC6 inhibitor treatment on SIINFEKL presentation. C, Number of peptides and their fold increase after treatment of E.G7-Ova cells with each HDAC6 inhibitor. D, The terminal amino acids of the top 50 peptides upregulated by tubastatin-A or ACY-738 treatment were analyzed. Shown is the relative percent for each terminal amino acid for the top 50 peptides upregulated
by treatment with each HDAC6 inhibitor. E, Shown are gene accession numbers for the top 20 peptides most upregulated following treatment with either tubastatin-A or ACY-738. Red asterisks indicate genes and peptides that were upregulated following treatment with both of the HDAC6 inhibitors.
Data from HDAC6 Inhibition Releases HR23B to Activate Proteasomes, Expand the Tumor Immunopeptidome and Amplify T-cell Antimyeloma Activity
Authors: Rana Priyanka S. , Ignatz-Hoover James J. , Kim Byung-Gyu , Malek Ehsan , Federov Yuriy , Adams Drew , Chan Timothy , Driscoll James J.
Published: June 2024

Abstract
Proteasomes degrade intracellular proteins to generate antigenic peptides that are recognized by the adaptive immune system and promote anticancer immunity. However, tumors subvert the antigen presentation machinery to escape immunosurveillance. We hypothesized that proteasome activation could concomitantly increase antigen abundance and diversity in multiple myeloma cells. High-throughput screens revealed that histone deacetylase 6 (HDAC6) inhibitors activated proteasomes to unmask neoantigens and amplify the tumor-specific antigenic landscape. Treatment of patient CD138+ cells with HDAC6 inhibitors significantly promoted the antimyeloma activity of autologous CD8+ T cells. Pharmacologic blockade and genetic ablation of the HDAC6 ubiquitin-binding domain released HR23B, which shuttles ubiquitinylated cargo to proteasomes, while silencing HDAC6 or HR23B in multiple myeloma cells abolished the effect of HDAC6 inhibitors on proteasomes, antigen presentation, and T-cell cytotoxicity. Taken together, our results demonstrate the paradigm-shifting translational impact of proteasome activators to expand the myeloma immunopeptidome and have revealed novel, actionable antigenic targets for T cell–directed immunotherapy.
Significance:
The elimination of therapy-resistant tumor cells remains a major challenge in the treatment of multiple myeloma. Our study identifies and functionally validates agents that amplify MHC class I–presented antigens and pave the way for the development of proteasome activators as immune adjuvants to enhance immunotherapeutic responses in patients with multiple myeloma.
Assessment of Cirrhotic Patients by the EncephalApp Fails to Predict Low-Grade Hepatic Encephalopathy
Authors: Neye Rebecca Maria , Kircheis Gerald , Stratmann Daria , Hilger Norbert , Lüth Stefan
Published: June 2024

Introduction: An early detection of low-grade hepatic encephalopathy (HE) is of high importance. The aim of the study was to compare a neuropsychological with a psychophysical test on the basis of the psychometric hepatic encephalopathy score (PHES) regarding effectiveness in diagnosing minimal HE (MHE). Methods: In our prospective controlled observational study, we examined a total of 103 patients with liver cirrhosis for HE. The PHES, CFF, and EncephalApp were performed in all patients. Graduation was based on the result of the PHES. Patients without evidence for HE 1&2 according to the mental state (West-Haven criteria) with a PHES <−4 value points and no clinical symptoms were defined as having MHE. Patients were considered as HE0 when in the PHES none of the psychometric subtest results was abnormal or with a PHES ≥−4 value points. Patients with clinical symptoms were considered HE 1&2 patients. Different cut-off values were determined, and their specificity and sensitivity were calculated. Results: Ninety-six of the involved patients had liver cirrhosis and 25 acted as a healthy control group. The ROC analysis for the classification resulted in an AUC of 0.806, with the highest Youden index for the cut-off time >224 s, for which the sensitivity was 82% and the specificity 75%. Cases of withdrawals were seen in 10.74% of all tested patients. Conclusion: The EncephalApp distinguishes well between HE0 and MHE but has its limitations in grading higher forms of HE. Diagnosis using only the EncephalApp is not sufficient.
Abdominal Hypoperfusion and Acute Kidney Injury in the Critically Ill Patient with Liver Cirrhosis: A Prospective Cohort Study
Authors: Pereira Rui , Lopes Diogo , Machado Sara Brandão , Val-Flores Luís , Caeiro Fernando , Perdigoto Rui , Marcelino Paulo Alexandre , Saliba Faouzi
Published: June 2024

Background: Reduced abdominal perfusion pressure (APP) is an underdiagnosed potential pathophysiological mechanism for acute kidney injury (AKI) in the patient with liver cirrhosis and ascites. This study aimed to analyze the prevalence of abdominal hypoperfusion (AhP) (APP <60 mm Hg) and the impact of APP on AKI in critically ill patients with liver cirrhosis. Methods: This was a post hoc analysis from a prospective cohort study set in a general ICU at a tertiary university hospital. Patients were recruited between October 2016 and December 2021. Acute renal failure (ARF) was defined by stage 3 AKI according to the International Club of Ascites. Results: Fifty-eight patients where included, with a mean age of 57 (±8.4) years, 79% were male, and 93% had acute-on-chronic liver failure at admission. The prevalence of AhP reached 75%, and 29% of cases had persisting AhP during the first week of ICU stay. Patients with baseline AhP had a higher 28-day mortality compared to those without AhP (respectively, 76% vs. 49%, p = 0.03). Acute renal failure developed in 48% of patients. Higher serum urea (aOR: 1.01, 95% CI: 1.00–1.02, p = 0.04) and white blood cell count (aOR: 1.1, 95% CI: 1.01–1.2, p = 0.02) at ICU admission, as well as low persisting APP (aOR: 0.9, 95% CI: 0.86–0.98, p = 0.02) were independent risk factors for ARF. Conclusion: Critically ill patients with liver cirrhosis presented a high prevalence of ARF, independently associated with higher baseline serum urea and WBC, and lower persisting APP. A structured clinical approach to optimize APP may reduce renal dysfunction in high-risk patients with cirrhosis.
Darcy Ribeiro latino-americanista
Authors: Cione Vinicius Melleu
Published: June 2024

Este artículo pretende discutir el modo como el profesor Darcy Ribeiro trató a América Latina en el curso de su obra sociológica, enfatizando las modificaciones operadas entre tres libros de su pentalogía de estudios sobre la antropología de la civilización – El proceso civilizatorio, Las Américas y la civilización y El dilema de América Latina – en comparación con textos publicados entre las décadas de 1970 y 1980, organizados en América Latina: la patria grande. La idea es examinar críticamente la metodología empleada por el autor en cada uno de los libros analisados, además de presentar puntos de continuidad o desplazamientos interpretativos entre las tres primeras obras y la última. Finalmente, se hará un repaso de sus aportes teóricos, problematizando algunos conceptos y destacando la perspicacia de otros.
Desmontagem e esquecimento: os metais remanescentes da estrada de ferro de Bragança - PA (1883-1965)
Authors: Rosa Larisse de Fátima Farias da , Palácios Flávia Olegário
Published: June 2024

The railroads in Brazil were of paramount importance for the agricultural economy expanded by several places in the country in the middle of the 19th and 20th centuries, among these, the Amazon region. In this context, there was the Estrada de Ferro de Bragança (EFB), being the first railway implanted in the Brazilian Amazon, built in mid-1883-1908. After decades of activity, the road that connected Belém (capital of PA) to Bragança (Northeast of PA, concentration of agricultural production colonies) was deactivated in 1965. The closure of EFB activities triggered a series of transformations in its railway collection, among the items were metal parts used in the composition of the railroad in a structural way and ornamental integrated goods. The dismantling of such metallic items touches on the discussion of their origin: industrial, serial and mobile. With this, the present research aimed to contribute with the systematization of information regarding the discussion of the abundant use of metallic items in the composition of the EFB, the destination of such pieces after the deactivation of the railway, and also in terms of theoretical reflections on the architecture as a document. The methodology was developed through the use of historical sources (official documents and periodicals), with a temporal cut of the period of the assembly of the railroad 1883-1908 and the consequences of the disassembly (decades 1960-1990), the theoretical reflection was based on works of Restoration Theory as The Objective Restoration by Antoni González Moreno-Navarro (1999) and Contemporary Theory of Restoration by Salvador Muñoz Viñas (2010).
Os réditos do tráfico de escravos com a Costa da Mina: os contratos do direito de 3$500 réis da capitania da Bahia, 1724-1764
Authors: Salles Hyllo Nader de Araújo
Published: June 2024

This investigation is dedicated to understanding the structure and dynamics of the collection of the tax of 3$500 réis, which was levied on slaves from Costa da Mina, and was applied to the payroll of the islands of São Tomé and Príncipe, when this tax was submitted to the contract system. The sources that support this research are the renderings of the Salvador customs accounts of the income from the tax on slaves coming from Costa da Mina, keeping by the Arquivo Histórico Ultramarino and made available in the Projeto Resgate Barão do Rio Branco. By analyzing them following the methods of quantitative and serial history, it was possible to reconstruct the current account of that tax; the volume of slaves landing in Salvador; the morbidity rate in the career from São Tomé and Príncipe to Salvador.
Sex Differences in Outcomes of an Intensive Risk Factor Modification Program in Patients With Atrial Fibrillation
Authors: Noubiap Jean Jacques , Pathak Rajeev K. , Thomas Gijo , Elliot Adrian D. , Sanders Prashanthan , Middeldorp Melissa E.
Published: June 2024

BACKGROUND:

The outcomes of atrial fibrillation (AF) seem to be variable between males and females. We therefore aimed to determine sex differences in weight loss, cardiorespiratory fitness gain, and recurrence and progression of AF following risk factor management.

METHODS:

Of 1415 consecutive patients referred for electrophysiology management of AF, 825 had a body mass index of ≥27 kg/m
2
; after exclusions, 355 (males, 234; females, 121) were offered risk factor management and participation in a tailored exercise program.

RESULTS:

Females were older than males (65.5±10.4 versus 62.5±10.6 years;
P
=0.013) with a higher body mass index (34.1±5.4 versus 32.6±4.1 kg/m
2
;
P
=0.003) and more commonly paroxysmal AF (67.8% versus 48.3%;
P
<0.001). There was no sex difference in clinic attendance (58.7% versus 60%;
P
=0.82), weight loss (
P
=0.86), fitness gain (
P
=0.44), or improvement in AF symptoms (
P
=0.35). Weight loss (≥10% compared with <10%) was associated with lower total AF recurrence in males (hazard ratio, 0.41 [95% CI, 0.23–0.73]) and females (hazard ratio, 0.41 [95% CI, 0.20–0.83]). Fitness gain (≥2 metabolic equivalents compared with <2 metabolic equivalents) was associated with lower total AF recurrence in females (hazard ratio, 0.13 [95% CI, 0.05–0.30]) but not in males (hazard ratio, 0.63 [95% CI, 0.38–1.04];
P
=0.002). There was a trend toward more reversal from persistent to paroxysmal AF in males compared with females (21.8% versus 14.0%;
P
=0.079).

CONCLUSIONS:

Males and females with AF demonstrate a similar degree of weight loss and fitness gain through structured risk factor management. However, fitness had a much greater benefit for total arrhythmia recurrence in females compared with males, whereas there was a trend toward more AF reversal in males.

REGISTRATION:

URL:
https://anzctr.org.au
; Unique identifier: ACTRN12614001123639.
Nonpharmacological Approaches to Managing Heart Failure With Preserved Ejection Fraction
Authors: Tang Feiyang , Han Haofu , Fu Sheng , Liu Qiming , Zhou Shenghua , Huang Jiapeng , Xiao Yichao
Published: June 2024

Heart failure with preserved ejection fraction (HFpEF) is a common subtype of heart failure marked by impaired left ventricular diastolic function and decreased myocardial compliance. Given the limited availability of evidence-based pharmacological treatments for HFpEF, there is a growing interest in nonpharmacological interventions as viable therapeutic alternatives. This review aims to explore the pathophysiology of HFpEF and present recent advancements in nonpharmacological management approaches, encompassing noninvasive therapies, invasive procedures and targeted treatments for comorbidities. An extensive literature review was undertaken to identify and synthesize emerging nonpharmacological treatment options for HFpEF, assessing their potential to enhance patient outcomes. Nonpharmacological strategies, such as vagus nerve stimulation, percutaneous pulmonary artery denervation, renal denervation, transcatheter insertion of atrial shunts and pericardial resection, demonstrate promising potential for alleviating HFpEF symptoms and improving patient prognosis. Moreover, addressing comorbidities, such as hypertension and diabetes, may offer additional therapeutic benefits. These cutting-edge techniques, in conjunction with well-established exercise therapies, pave the way for future research and clinical applications in the field. Nonpharmacological interventions hold promise for advancing HFpEF patient care and fostering a deeper understanding of these treatment approaches, which will facilitate new clinical applications and contribute to the development of more targeted therapies.
Myocardial Blood Flow by Magnetic Resonance in Patients With Suspected Coronary Stenosis: Comparison to PET and Invasive Physiology
Authors: Rasmussen Laust Dupont , Murphy Theodore , Milidonis Xenios , Eftekhari Ashkan , Karim Salma Raghad , Westra Jelmer , Dahl Jonathan Nørtoft , Isaksen Christin , Brix Lau , Ejlersen June Anita , Nyegaard Mette , Johansen Jane Kirk , Søndergaard Hanne Maare , Mortensen Jesper , Gormsen Lars Christian , Christiansen Evald Høj , Chiribiri Amedeo , Petersen Steffen E. , Bøttcher Morten , Winther Simon
Published: June 2024

BACKGROUND:

Despite recent guideline recommendations, quantitative perfusion (QP) estimates of myocardial blood flow from cardiac magnetic resonance (CMR) have only been sparsely validated. Furthermore, the additional diagnostic value of utilizing QP in addition to the traditional visual expert interpretation of stress-perfusion CMR remains unknown. The aim was to investigate the correlation between myocardial blood flow measurements estimated by CMR, positron emission tomography, and invasive coronary thermodilution. The second aim is to investigate the diagnostic performance of CMR-QP to identify obstructive coronary artery disease (CAD).

METHODS:

Prospectively enrolled symptomatic patients with >50% diameter stenosis on computed tomography angiography underwent dual-bolus CMR and positron emission tomography with rest and adenosine-stress myocardial blood flow measurements. Subsequently, an invasive coronary angiography (ICA) with fractional flow reserve and thermodilution-based coronary flow reserve was performed. Obstructive CAD was defined as both anatomically severe (>70% diameter stenosis on quantitative coronary angiography) or hemodynamically obstructive (ICA with fractional flow reserve ≤0.80).

RESULTS:

About 359 patients completed all investigations. Myocardial blood flow and reserve measurements correlated weakly between estimates from CMR-QP, positron emission tomography, and ICA-coronary flow reserve (r<0.40 for all comparisons). In the diagnosis of anatomically severe CAD, the interpretation of CMR-QP by an expert reader improved the sensitivity in comparison to visual analysis alone (82% versus 88% [
P
=0.03]) without compromising specificity (77% versus 74% [
P
=0.28]). In the diagnosis of hemodynamically obstructive CAD, the accuracy was only moderate for a visual expert read and remained unchanged when additional CMR-QP measurements were interpreted.

CONCLUSIONS:

CMR-QP correlates weakly to myocardial blood flow measurements by other modalities but improves diagnosis of anatomically severe CAD.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03481712.
Ultrasound-Guided Transfemoral Access for Coronary Procedures: A Pooled Learning Curve Analysis From the FAUST and UNIVERSAL Trials
Authors: d’Entremont Marc-André , Seto Arnold H. , Alrashidi Sulaiman , Alansari Omar , Brochu Bradley , Lemaire-Paquette Samuel , Heenan Laura , Skuriat Elizabeth , Tyrwhitt Jessica , Raco Michael , Tsang Michael B. , Valettas Nicholas , Velianou James , Sheth Tej , Sibbald Matthew , Mehta Shamir R. , Pinilla-Echeverri Natalia , Schwalm Jon-David , Natarajan Madhu K. , Abu-Fadel Mazen , Kelly Andrew , Akl Elie , Tawadros Sarah , Faidi Walaa , Bauer John , Moxham Rachel , Nkurunziza James , Dutra Gustavo , Winter Jose , Couture Étienne L. , Jolly Sanjit S.
Published: June 2024

BACKGROUND:

The learning curve for new operators performing ultrasound-guided transfemoral access (TFA) remains uncertain.

METHODS:

We performed a pooled analysis of the FAUST (Femoral Arterial Access With Ultrasound Trial) and UNIVERSAL (Routine Ultrasound Guidance for Vascular Access for Cardiac Procedures) trials, both multicenter randomized controlled trials of 1:1 ultrasound-guided versus non–ultrasound-guided TFA for coronary procedures. Outcomes included the composite of major bleeding or vascular complications and successful common femoral artery cannulation. Participants were stratified by the operators’ accrued case volume. We used adjusted repeated-measurement logistic regression, with random intercepts for operator clustering, for comparison against the non–ultrasound-guided TFA group and to model the learning curve.

RESULTS:

The FAUST and UNIVERSAL trials randomized a total of 1624 patients, of which 810 were randomized to non–ultrasound-guided TFA and 814 to ultrasound-guided TFA (cases 1–10, 391; 11–20, 183; and >20, 240). Participants who had operators who performed >20 ultrasound-guided TFAs had a decreased risk for the primary end point (5/240 [2.1%] versus 64/810 [7.9%]; adjusted odds ratio, 0.26 [95% CI, 0.09–0.61]) compared with non–ultrasound-guided TFA. Operators who performed >20 ultrasound-guided procedures had increased odds of successfully cannulating the common femoral artery (224/246 [91.1%] versus 327/382 [85.6%]; adjusted odds ratio, 1.76 [95% CI, 1.08–2.89]) compared with non–ultrasound-guided TFA. The learning curve plots demonstrated growing competence with increasing accrued cases.

CONCLUSIONS:

New operators should perform at least 20 ultrasound-guided TFA to decrease access site complications and increase proper cannulation compared with non–ultrasound-guided TFA. Additional accrued cases may lead to increased proficiency. Training programs should consider these findings in the transradial era.
Text Messages to Promote Physical Activity in Patients With Cardiovascular Disease: A Micro-Randomized Trial of a Just-In-Time Adaptive Intervention
Authors: Golbus Jessica R. , Shi Jieru , Gupta Kashvi , Stevens Rachel , Jeganathan V.Swetha E. , Luff Evan , Boyden Thomas , Mukherjee Bhramar , Kohnstamm Sarah , Taralunga Vlad , Kheterpal Vik , Kheterpal Sachin , Resnicow Kenneth , Murphy Susan , Dempsey Walter , Klasnja Predrag , Nallamothu Brahmajee K.
Published: June 2024

BACKGROUND:

Text messages may enhance physical activity levels in patients with cardiovascular disease, including those enrolled in cardiac rehabilitation. However, the independent and long-term effects of text messages remain uncertain.

METHODS:

The VALENTINE study (Virtual Application-supported Environment to Increase Exercise) was a micro-randomized trial that delivered text messages through a smartwatch (Apple Watch or Fitbit Versa) to participants initiating cardiac rehabilitation. Participants were randomized 4× per day over 6-months to receive no text message or a message encouraging low-level physical activity. Text messages were tailored on contextual factors (eg, weather). Our primary outcome was step count 60 minutes following a text message, and we used a centered and weighted least squares mean method to estimate causal effects. Given potential measurement differences between devices determined a priori, data were assessed separately for Apple Watch and Fitbit Versa users over 3 time periods corresponding to the initiation (0–30 days), maintenance (31–120 days), and completion (121–182 days) of cardiac rehabilitation.

RESULTS:

One hundred eight participants were included with 70 552 randomizations over 6 months; mean age was 59.5 (SD, 10.7) years with 36 (32.4%) female and 68 (63.0%) Apple Watch participants. For Apple Watch participants, text messages led to a trend in increased step count by 10% in the 60-minutes following a message during days 1 to 30 (95% CI, −1% to +20%), with no effect from days 31 to 120 (+1% [95% CI, −4% to +5%]), and a significant 6% increase during days 121 to 182 (95% CI, +0% to +11%). For Fitbit users, text messages significantly increased step count by 17% (95% CI, +7% to +28%) in the 60-minutes following a message in the first 30 days of the study with no effect subsequently.

CONCLUSIONS:

In patients undergoing cardiac rehabilitation, contextually tailored text messages may increase physical activity, but this effect varies over time and by device.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT04587882.
Impact of Social Determinants of Health on Hypertension Outcomes: A Systematic Review
Authors: Metlock Faith E. , Hinneh Thomas , Benjasirisan Chitchanok , Alharthi Abeer , Ogungbe Oluwabunmi , Turkson-Ocran Ruth-Alma N. , Himmelfarb Cheryl R. , Commodore-Mensah Yvonne
Published: June 2024

Despite ample evidence linking social determinants of health (SDoH) and hypertension outcomes, efforts to address SDoH in the context of hypertension prevention and self-management are not commensurate with the burden and impact of hypertension. To provide valuable insights into the development of targeted and effective strategies for preventing and managing hypertension, this systematic review, guided by the Healthy People 2030 SDoH framework, aims to summarize the inclusion, measurement, and evaluation of SDoH in studies examining hypertension outcomes, with a focus on characterizing SDoH constructs and summarizing the current evidence of their influence on hypertension outcomes. Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a comprehensive search of electronic databases identified 10 608 unique records, from which 57 articles meeting inclusion criteria were analyzed. The studies, conducted nationally or regionally across the United States, revealed that higher educational attainment, health insurance coverage, income, and favorable neighborhood characteristics were associated with lower hypertension prevalence and better hypertension control among US adults. The findings underscore the importance of addressing SDoH such as education, health care access, economic stability, neighborhood environments, and social context to reduce hypertension disparities. Multilevel collaboration and community-engaged practices are necessary to tackle these disparities effectively.
Rethinking Instrumental Interface Design: The MetaBow
Authors: Alonso Trillo Roberto , Nelson Peter A. C. , Michailidis Tychonas
Published: June 2024

Although extensive research has been conducted over the past two decades on the development and implementation of sensors using inertial movement units for violin bows, most of these new interfaces share a common drawback—bulky and user-unfriendly design. Despite the advancements in sensor data processing for composition, performance, and pedagogy, interface design remains a critical bottleneck for the real-world implementation of these sensor-embedded devices. Our study introduces MetaBow, a low-cost, nonintrusive frog design for violin bows that can accommodate either a standard sensor kit or a custom-designed board. This interface eliminates the need for additional physical training and maintains the integrity of traditional violin performance mechanisms. We thus view MetaBow as heralding a new era in digital music interface design for the violin family with the potential for seamless human–computer and human–machine collaboration in music practice and performance.
Automatic segmentation of the spinal cord nerve rootlets
Authors: Valošek Jan , Mathieu Theo , Schlienger Raphaëlle , Kowalczyk Olivia S. , Cohen-Adad Julien
Published: June 2024

Precise identification of spinal nerve rootlets is relevant to delineate spinal levels for the study of functional activity in the spinal cord. The goal of this study was to develop an automatic method for the semantic segmentation of spinal nerve rootlets from T2-weighted magnetic resonance imaging (MRI) scans. Images from two open-access 3T MRI datasets were used to train a 3D multi-class convolutional neural network using an active learning approach to segment C2-C8 dorsal nerve rootlets. Each output class corresponds to a spinal level. The method was tested on 3T T2-weighted images from three datasets unseen during training to assess inter-site, inter-session, and inter-resolution variability. The test Dice score was 0.67 ± 0.16 (mean ± standard deviation across testing images and rootlets levels), suggesting a good performance. The method also demonstrated low inter-vendor and inter-site variability (coefficient of variation ≤ 1.41%), as well as low inter-session variability (coefficient of variation ≤ 1.30%), indicating stable predictions across different MRI vendors, sites, and sessions. The proposed methodology is open-source and readily available in the Spinal Cord Toolbox (SCT) v6.2 and higher.
On Recoding Ordered Treatments as Binary Indicators
Authors: Rose Evan K. , Shem-Tov Yotam
Published: June 2024

Researchers using instrumental variables to investigate ordered treatments often recode treatment into an indicator for any exposure. We investigate this estimand under the assumption that the instruments shift compliers from no treatment to some but not from some treatment to more. We show that when there are extensive margin compliers only (EMCO) this estimand captures a weighted average of treatment effects that can be partially unbundled into each complier group's potential outcome means. We also establish an equivalence between EMCO and a two-factor selection model and apply our results to study treatment heterogeneity in the Oregon Health Insurance Experiment.
Rooted in Society?
Authors: Makulilo Alexander , Mehler Andreas , Haji Mohamed
Published: June 2024

In 2010, Zanzibar, a sub-state within the United Republic of Tanzania, became a unique case of power sharing in Africa. The country conducted a referendum before establishing a government of national unity and entrenched it in Zanzibar’s Constitution of 1984. The aim was to make the power-sharing system durable and rooted in society to achieve peace and development. Nevertheless, a political system must be accepted, practised and routinised to be rooted in society. Usually, peace settlements involve elites, who negotiate, sign and occasionally benefit from the pact—and Zanzibar is not an exception. What is missing in peace negotiations is the broad-based participation of the citizens. Based on a survey and expert interviews, this article examines how power sharing in Zanzibar has nevertheless become rooted in society over time.