bluuebunny/crossref_metadata_2025 huggingface dataset:
A Supply Chain Model Based on Data-Driven Demand Uncertainty under the Influence of Carbon Tax Policy
Authors: Chen Lei , Zhao Jie , Zhao Jiaying , Li Feng , Yang Yun
Published: June 2022

The era of digital economy has spawned new factors of production represented by big data. Data-driven sustainable growth and innovative development is the main line of enterprise digital transformation. In view of the uncertainty of supply chain demand, the optimization of supply chain management under the influence of carbon tax policy is studied from the low-carbon perspective. By introducing the fuzzy theory and a membership function to describe the need for uncertainty, a supply chain optimization model considering the influence of carbon emissions is constructed. Carbon tax policy is regarded as the constraint condition of external production. In the case of fuzzy cost changes, the optimization decision of enterprise supply chain management under carbon tax policy is explored. A trapezoidal fuzzy number is used to determine model fuzziness, and the trapezoidal fuzzy number combined with a genetic algorithm is used to solve the model. Furthermore, taking a certain enterprise as an example, the validity of the model is verified by the mathematical programming model method, considering the data driven and taking the data as the means of production.
Analysis of Noise Pollution during Dussehra Festival in Bhubaneswar Smart City in India: A Study Using Machine Intelligence Models
Authors: Bhoi Sourav Kumar , Mallick Chittaranjan , Mohanty Chitta Ranjan , Nayak Ranjan Soumya
Published: June 2022

Controlling noise pollution in smart cities is a big challenge nowadays due to rise in urbanization and industrialization. As population mass grows, the celebration of yearly festivals such as Dussehra in Bhubaneswar city is also getting popular. However, since this sound pollution is creating a risk to human health, regular monitoring is strictly needed. In this work, the noise pollution level of Bhubaneswar smart city during Dussehra 2020 is predicted using different supervised machine learning (ML) prediction models. The input parameters considered for this work are area or zones of Bhubaneswar city, time at which sound level recorded, equivalent continuous sound level (Leq in dBA), and noise level (high/low compared to the standard value). The data collected for training phase and testing phase by using different ML models is taken from State Pollution Control Board, Odisha, India, for the years 2015–2020. The supervised ML models taken in this work are Decision Tree (DT), Neural Network (NN), k-Nearest Neighbor (k-NN), Naïve Bayes (NB), Support Vector Machine (SVM), and Random Forest (RF). The predictions of the models are evaluated using Orange 3.26 data analytics tool. From the results, it was found that DT and RF show a higher classification accuracy, 92.5%, than that of other ML models. Moreover, it is observed that the probability of prediction of noise pollution level for the testing dataset for DT is higher for high noise level and for RF is higher for low noise level than other prediction models.
An Enhanced Coupling Adaptive Sliding Mode Control Method for Casting Cranes Based on Radial Spring Damping
Authors: Wang Tianlei , Tan Nanlin , Zhang Xianwen , Liu Renju , Qiu Jiongzhi , Zhou Jing , Hao Xiaoxi
Published: June 2022

During the transference of a ladle by the casting crane, the antiswing control of the ladle is particularly difficult due to liquid sloshing, so we designed a model based on a radial spring damper. During the ladle swings, the centrifugal force causes the spring damper to move radially, thereby generating a Coriolis force that inhibits the sloshing of the liquid. In addition, a sloshing analysis of the liquid in the ladle is carried out, and a double-pendulum casting crane model based on viscous damping and radial spring damper is established. On the basis of this model, the Enhanced Coupled Adaptive Sliding Mode Control (ECASMC) method is proposed. By introducing an enhanced coupling variable and constructing a new coupling deviation signal, we enhance the relationship among state quantities. Then, a new type of sliding surface is designed based on the enhanced coupling deviation signal, and adaptive technology is used to adjust the sliding mode parameters, which enhances the system's robustness for system parameter variations and external disturbances. Using LaSalle's invariance principle and Lyapunov theorem, we prove that the casting crane system is asymptotically stable near the desired equilibrium point. The simulation results verify the effectiveness and superior control performance of the proposed method even in the presence of uncertainties.
Heavyweight Statistical Alignment to Guide Neural Translation
Authors: Nguyen Thien , Nguyen Trang
Published: June 2022

Transformer neural models with multihead attentions outperform all existing translation models. Nevertheless, some features of traditional statistical models, such as prior alignment between source and target words, prove useful in training the state-of-the-art Transformer models. It has been reported that lightweight prior alignment can effectively guide a head in the multihead cross-attention sublayer responsible for the alignment of Transformer models. In this work, we make a step further by applying heavyweight prior alignments to guide all heads. Specifically, we use the weight of 0.5 for the alignment cost added to the token cost in formulating the overall cost of training a Transformer model, where the alignment cost is defined as the deviation of the attention probability from the prior alignments. Moreover, we increase the role of prior alignment, computing the attention probability by averaging all heads of the multihead attention sublayer within the penultimate layer of Transformer model. Experimental results on an English-Vietnamese translation task show that our proposed approach helps train superior Transformer-based translation models. Our Transformer model (25.71) outperforms the baseline model (21.34) by the large 4.37 BLEU. Case studies by native speakers on some translation results validate the machine judgment. The results so far encourage the use of heavyweight prior alignments to improve Transformer-based translation models. This work contributes to the literature on the machine translation, especially, for unpopular language pairs. Since the proposal in this work is language-independent, it can be applied to different language pairs, including Slavic languages.
Improving Recognition of Overlapping Activities with Less Interclass Variations in Smart Homes through Clustering-Based Classification
Authors: Sarwar Muhammad Usman , Gillani Labiba Fahad , Almadhor Ahmad , Shakya Manoj , Tariq Usman
Published: June 2022

The systems of sensing technology along with machine learning techniques provide a robust solution in a smart home due to which health monitoring, elderly care, and independent living take advantage. This study addresses the overlapping problem in activities performed by the smart home resident and improves the recognition performance of overlapping activities. The overlapping problem occurs due to less interclass variations (i.e., similar sensors used in more than one activity and the same location of performed activities). The proposed approach overlapping activity recognition using cluster-based classification (OAR-CbC) that makes a generic model for this problem is to use a soft partitioning technique to separate the homogeneous activities from nonhomogeneous activities on a coarse-grained level. Then, the activities within each cluster are balanced and the classifier is trained to correctly recognize the activities within each cluster independently on a fine-grained level. We examine four partitioning and classification techniques with the same hierarchy for a fair comparison. The OAR-CbC evaluates on smart home datasets Aruba and Milan using threefold and leave-one-day-out cross-validation. We used evaluation metrics: precision, recall, F score, accuracy, and confusion matrices to ensure the model’s reliability. The OAR-CbC shows promising results on both datasets, notably boosting the recognition rate of all overlapping activities more than the state-of-the-art studies.
Comparative Snake Venom Analysis for Facilitating Wildlife Forensics: A Pilot Study
Authors: Bhargava Saurabh , Kumari Kiran , Sarin Rajendra Kumar , Singh Rajvinder
Published: June 2022

Confirm and authentic identification of species is required for the implementation of wildlife laws in cases of illegal trafficking of snake venoms. Illegally trafficked snake venom might be misidentified with other drugs of abuse, and sometimes, the species of venom-yielding snake cannot be verified. Snake venoms from medically important snake species, Naja naja and Daboia russelii, were procured from Irula Snake Catcher’s Society, Tamil Nadu, India. Comparative analyses of both venoms were carried out using SDS-PAGE, LC-MS/MS, ICP-MS, and mtDNA analysis. The protein concentration of Naja naja and Daboia russelii venoms was 76.1% and 83.9%, respectively. SDS analysis showed a distinct banding pattern of both venoms. LC-MS/MS results showed proteins and toxins from 12 to 14 protein families in Naja naja and Daboia russelii venoms. Elemental analysis using ICP-MS showed a different profile of some elements in both venoms. mtDNA analysis of venoms using universal primers against Cyt b gene showed homology with sequence of Naja naja and Daboia russelii genes. The study proposed a template of various conventional and advanced molecular and instrumental techniques with their pros and cons. The template can be used by forensic science laboratories for detection, screening, and confirmatory analysis of suspected venoms of snakes. Clubbing of various techniques can be used to confirm the identification of species of snake from which the alleged venom was milked. The results can be helpful in framing charge-sheets against accused of illegal venom trafficking and can also be used to verify the purity and quality of commercially available snake venoms.
Quantitative Analysis of Broken Rotor Bars in Cage Motor Based on Energy Characteristics of Vibration Signals
Authors: Shi Jie , Shen Haifeng , Ding Zhenkai
Published: June 2022

The rotor, as the power output device of a cage motor, is subject to a type of invisible fault, BRB, during long-term use. The conventional motor vibration signal fault monitoring system only analyzes the rotor qualitatively for the fault of BRBs and cannot evaluate the fault degree of BRBs quantitatively. Moreover, the vibration signal used for monitoring has nonstationary and nonlinear characteristics. It is necessary to manually determine the time window and basis function when extracting the characteristics of the time-frequency domain. To address these problems, this paper proposes a method for quantitative analysis of BRBs based on CEEMD decomposition and weight transformation for feature extraction and then uses the AdaBoost to construct a classifier. The method applies CEEMD for adaptive decomposition while extracting IMFs’ energy as the initial feature values, uses OOB for contribution evaluation of features to construct weight vectors, and performs a spatial transformation on the original feature values to expand the differences between the feature vectors. To verify the effectiveness and superiority of the method, vibration signals were collected from motors in four BRB states to produce rotor fault data sets in this paper. The experiment results show that the feature extraction method based on CEEMD decomposition and weight transformation can better extract the feature vectors from the vibration signals, and the constructed classifier can accurately perform quantitative analysis of BRB fault.
DOA Estimation Method for Ultra-Wide-Band Insect Radar Based on Variable Conical Conformal Array: Adjustable MUSIC Algorithm
Authors: Mei Jia-Lei , Zhou Pei-Cong , Xiong Xin-Nong , Liu Ren-Xin , Zhang Qing-Yue , Yin Zi-Cong
Published: June 2022

Insect radar is an important tool for studying the ecological behaviors of insects. Due to the harsh environment, radar is susceptible to interference from ground echoes, which makes it difficult to monitor insects in low altitude. To study the flying insects at low altitude in radar entomology, the research of ultra-wideband (UWB) insect radar based on log-periodic antenna array was proposed. This method uses a conical conformal array to receive signals and an improved multiple signal classification (MUSIC) algorithm to process the signals. This array is capable of monitoring insects of different sizes in the ultra-wideband range, adjusting the angle of the cone tip to change the position and polarization information, and obtaining information on various insects flying at low altitude. The problem of two-dimensional angle of arrival estimation of insect cone conformal array was analyzed by computer simulation, which are low-altitude flying targets with different cone apex angles. In addition, a modified multiple signal classification algorithm was implemented to make the radar search and catch multiple targets faster and more accurate. The algorithm greatly reduces computational complexity while maintaining the accuracy of estimation. There is a linear relationship between the time calculation and the accuracy with the modified algorithm, compared with the relationship between exponential growth and the generalized MUSIC algorithm. Finally, the experimental simulation has proved the superiority of the proposed algorithm.
BCL10 Mutations Define Distinct Dependencies Guiding Precision Therapy for DLBCL
Authors: Xia Min , David Liron , Teater Matt , Gutierrez Johana , Wang Xiang , Meydan Cem , Lytle Andrew , Slack Graham W. , Scott David W. , Morin Ryan D. , Onder Ozlem , Elenitoba-Johnson Kojo S.J. , Zamponi Nahuel , Cerchietti Leandro , Lu Tianbao , Philippar Ulrike , Fontan Lorena , Wu Hao , Melnick Ari M.
Published: June 2022

Activated B cell–like diffuse large B-cell lymphomas (ABC-DLBCL) have unfavorable outcomes and chronic activation of CARD11–BCL10–MALT1 (CBM) signal amplification complexes that form due to polymerization of BCL10 subunits, which is affected by recurrent somatic mutations in ABC-DLBCLs. Herein, we show that BCL10 mutants fall into at least two functionally distinct classes: missense mutations of the BCL10 CARD domain and truncation of its C-terminal tail. Truncating mutations abrogated a motif through which MALT1 inhibits BCL10 polymerization, trapping MALT1 in its activated filament-bound state. CARD missense mutations enhanced BCL10 filament formation, forming glutamine network structures that stabilize BCL10 filaments. Mutant forms of BCL10 were less dependent on upstream CARD11 activation and thus manifested resistance to BTK inhibitors, whereas BCL10 truncating but not CARD mutants were hypersensitive to MALT1 inhibitors. Therefore, BCL10 mutations are potential biomarkers for BTK inhibitor resistance in ABC-DLBCL, and further precision can be achieved by selecting therapy based on specific biochemical effects of distinct mutation classes.

Significance:

ABC-DLBCLs feature frequent mutations of signaling mediators that converge on the CBM complex. We use structure–function approaches to reveal that BCL10 mutations fall into two distinct biochemical classes. Both classes confer resistance to BTK inhibitors, whereas BCL10 truncations confer hyperresponsiveness to MALT1 inhibitors, providing a road map for precision therapies in ABC-DLBCLs.
Renal Megalin mRNA Downregulation Is Associated with CKD Progression in IgA Nephropathy
Authors: Wen Lu , Wang Xiaoyang , Ji Fengping , Wen Jianguo , Zhao Zhanzheng
Published: June 2022

Introduction: Megalin plays an important role in proximal tubule uptake of filtered proteins. Downregulation and dysfunction of megalin were previously demonstrated in IgA nephropathy (IgAN); however, its relationship to IgAN progression remains unclear. Methods: We measured renal megalin mRNA and miR-148b, previously identified as a regulator of megalin, in a retrospective cohort of 417 IgAN patients at the time of biopsy, and evaluated their associations with chronic kidney disease (CKD) progression event, defined as end-stage renal disease or ≥40% decline in estimated glomerular filtration rate, using Cox proportional hazard models. Risk classification statistics were calculated for CKD progression. Results: During a median follow-up of 43 months, 121 (29.0%) patients reached the CKD progression event. Patients in the highest tertile of renal megalin mRNA had a lower risk for CKD progression than in the lowest tertile (hazard ratio (HR): 0.407, 95% confidence interval (CI) 0.231–0.719; p = 0.002). Log megalin mRNA was independent and negatively associated with CKD progression in IgAN (HR: 0.529, 95% CI 0.377–0.742; p < 0.001). The addition of renal megalin mRNA to a model with traditional risk factors improved risk prediction of disease progression (C statistic from 0.76 to 0.80; integrated discrimination index: 0.04 [95% CI: 0.02–0.07]). Moreover, patients in the highest tertile of renal miR-148b had a 2.3-fold higher risk for CKD progression compared with those in the lowest tertile. Conclusions: Lower renal megalin mRNA levels were associated with a greater risk of CKD progression in IgAN independent of clinical and pathological characteristics, suggesting that renal megalin could be an important prognostic factor for IgAN.
Subclinical AKI and Clinical Outcomes in Elderly Patients Undergoing Cardiac Surgery: Diagnostic Utility of NGAL versus Standard Creatinine Increase Criteria
Authors: Marcello Matteo , Virzì Grazia Maria , Muciño-Bermejo María-Jimena , Milan Manani Sabrina , Giavarina Davide , Salvador Loris , Ronco Claudio , Zanella Monica
Published: June 2022

Background: Acute kidney injury (AKI) is a common and serious postoperative complication in patients undergoing cardiac surgery and its incidence is particularly high among elderly patients. Cardiac surgery-associated AKI (CSA-AKI) represents the second most common cause of AKI in the intensive care unit but its true incidence could be underestimated, especially in elderly population. The current biomarkers of AKI are unreliable and delayed during acute changes in kidney function. In the setting of subclinical AKI (SAKI), biomarkers of tubular damage, such as NGAL, seem to be an early indicator of kidney damage. The aim of this study was to investigate NGAL utility in the SAKI diagnosis in the first 48 h after cardiac surgery and its helpfulness in predicting adverse clinical outcomes in comparison to current criteria for AKI. Methods: This is an observational study of 72 patients admitted to San Bortolo’s cardiac surgery department for elective cardiosurgical procedure enrolled over a 5-months period. All patients underwent peripheral venous sample 48 h after cardiac surgery to assess plasmatic creatinine (48Cr) and NGAL (48pNGAL) in addition to exams already foreseen by clinical practice. For each patient we studied renal, respiratory and cardiovascular outcome during hospitalization as well as 30 days and 6 months mortality. Creatinine Increase AKI (CrIAKI) was defined by 48CrI ≥0.3 mg/dL and SAKI was defined by 48pNGAL ≥100 pg/dL. We also assessed Respiratory (ArespO) as well as Cardiovascular (ACvO) outcome. Results: Thirty days mortality was 8.3% (6 patients) and 6 months mortality was 12.5% (9 patients). A total of 27 patients (37.5%) presented AKI according to KDIGO (4) and 4 (5.5%) needed renal replacement therapy (RRT). SAKI was significantly associated with 30 days mortality (p = 0.0238), 6 months mortality (p = 0.002), Adverse renal outcome (ARenO) (p = 0.004) and need for RRT (p = 0.005). CrIAKI was significantly associated with 30 days mortality (p = 0.009) and ARenO (p = 0.0001), but not with 6 months mortality nor need for RRT.
Violencia de género en Colombia: epidemia silenciosa en medio del covid-19
Authors:   Universidad del Valle Colombia, Palomino Angarita Diala María
Published: June 2022

La emergencia sanitaria por covid-19 en Colombia no solo afectó la salud física de toda la población; también incrementó las violencias en contra de las mujeres y las personas LGTBI, convirtiéndose así en una epidemia silenciosa. Con las medidas de cuarentena obligatoria se elevó el número de denuncias de violencia de género, aumentó el desempleo de las mujeres y muchas, que son trabajadoras domésticas, durante el confinamiento no recibieron remuneración alguna. Entre otros hechos sociales y familiares, el abordaje de esta problemática social parte, entonces, desde la crianza, los hogares, los determinantes sociales, la divulgación e incluso de acciones que prioricen a aquellas mujeres que desconocen sus derechos, así como la diversidad de violencias de a las cuales son sometidas; por tanto, con la participación social - ciudadana se busca que confluyan redes de construcción sobre nuevas posturas para contrarrestar la violencia de género, la de-construcción de representaciones sociales e imaginarios conforme al rol del género y la re-construcción de alternativas, apuestas y nuevas propuestas que lleven a cambios significativos sobre el trato hacia la mujer en los diversos contextos y desde todas las aristas posibles.
Os animais do novo mundo figurados na “Arca de Noé sobre o Monte Ararat” de Simon de Myle (1570): um estudo das fontes iconográficas
Authors: Teixeira Dante Martins
Published: June 2022

Ativo no terceiro quartel do século XVI, Simon de Myle constitui um verdadeiro enigma, pois sua vida e carreira permanecem totalmente desconhecidas até os dias de hoje. A “Arca de Noé sobre o Monte Ararat” é seu único quadro assinado e datado ("Simone de Myle inventor et fecit 1570"), figurando o desembarque dos animais após o dilúvio. Levando em conta mesmo as representações demasiado precárias, essa composição inclui nada menos de 228 monstros, voláteis e quadrúpedes, isso sem considerar as carcaças e as espécies aquáticas deixadas para trás com o recuo das águas. Entre as fontes iconográficas utilizadas destacam-se vários tomos da “Historia Animalium” de Conrad Gesner, além da “Warachtighe Fabulen der Dieren” de Marcus Gheeraerts. Ao contrário de outras pinturas quinhentistas acerca do mesmo tema, essa “Arca de Noé” retrata um número inesperado de animais do Novo Mundo, elenco composto por dois mamíferos, pelo menos três aves e dois “seres prodígiosos”. Nesse particular, o quadro de Simon de Myle inadvertidamente evoca as dúvidas sobre a verossimilhança da passagem bíblica relativa à Arca de Noé, reflexo da descoberta de um número cada vez maior de espécies zoológicas em terras distantes. Colocada já em 1502 por Amerigo Vespucci, essa questão atravessaria os séculos XVI e XVII, levando autores como Joseph de Acosta (1590) e Athanasius Kircher (1675) a buscar uma improvável conciliação entre a realidade factual observada no outro lado do oceano e a verdade revelada contida no livro do Gênesis.
Herpetofauna of the Serra do Tombador Nature Reserve, State of Goiás, Central Brazil
Authors: Guerra Vinicius , Ramalho Werther Pereira , Machado Iberê Farina , Brandão Reuber Albuquerque
Published: June 2022

Data on species occurrence and richness are important to support conservation actions for strategic areas. To increase knowledge about the herpetofauna of the Cerrado biome, we present a list of amphibians and reptiles' species from the Private Reserve of Natural Heritage Serra do Tombador (RNST). The fieldwork was performed in November 2016 and the samplings were carried out through pitfall traps, active search, occasional encounters, and third-party records. We also consider the species recorded in the RNST Management Plan. We recorded 34 amphibians and 55 reptiles, and expanded the known distribution of some species. The observed and estimated amphibian species curves showed a tendency to stabilize, with the observed richness representing 89% of the number of species expected. On the other hand, observed and estimated reptile species curves did not show a stabilization trend. Even considering the smallest sample period in this study, the richness of amphibian and reptile species was similar or greater to those found in protected areas in the Cerrado, close to the RNST. The presence of species with restricted endemism, recently described, and data deficient highlights the importance of the RNST for the conservation of the Cerrado herpetofauna.
A estética da produção: o senso de comunidade entre os Cubeo e os Piaroa
Authors: Overing Joanna
Published: June 2022

Este artigo procura recuperar a concepção de "senso de comunidade" de Vico - que incorpora o julgamento estético à lei moralidade - para compreender o que é "o social" para os índios da floresta tropical sul-americana. O trabalho mostra que a falta de estruturas de hierarquias ou de instituições de coerção não significa falta de organização social, mas, ao contrário, representa um credo político com intenção moral e estética.
Os domínios cósmicos: um dos aspectos da construção da categoria humana Kayapó-Xikrin
Authors: Giannini Isabelle Vidal
Published: June 2022

Este artigo analisa a concepção de Mundo Xikrin, em particular procura entender as relações que unem a categoria dos homens às diferentes categorias do cosmo. Para tanto, serão estudados os rituais de iniciação. principalmente do xamanismo. Será analisado especialmente o papel que as aves desempenham na cosmologia Xikrin.
Identidades passadas, presentes e emergentes: requisitos para etnografias sobre a modernidade no final do século XX ao nível mundial
Authors: Marcus George
Published: June 2022

Este trabalho analisa os dilemas que a etnografia precisa enfrentar para compreender a modernidade. A etnografia contemporânea se vê obrigada a abandonar uma perspectiva de análise, que parte unicamente da experiência vivenciada em nível local, e procurar atendimento de um ponto de vista global. Esse deslocamento coloca sob o foco da reflexão antropológica o modo como as identidades coletivas e individuais são negociadas nos lugares onde o antropólogo faz suas pesquisas de campo.
Myocardial Iron Deficiency and Mitochondrial Dysfunction in Advanced Heart Failure in Humans
Authors: Zhang Hao , Jamieson K. Lockhart , Grenier Justin , Nikhanj Anish , Tang Zeyu , Wang Faqi , Wang Shaohua , Seidman Jonathan G. , Seidman Christine E. , Thompson Richard , Seubert John M. , Oudit Gavin Y.
Published: June 2022

Background

Myocardial iron deficiency (MID) in heart failure (HF) remains largely unexplored. We aim to establish defining criterion for MID, evaluate its pathophysiological role, and evaluate the applicability of monitoring it non‐invasively in human explanted hearts.

Methods and Results

Biventricular tissue iron levels were measured in both failing (n=138) and non‐failing control (NFC, n=46) explanted human hearts. Clinical phenotyping was complemented with comprehensive assessment of myocardial remodeling and mitochondrial functional profiles, including metabolic and oxidative stress. Myocardial iron status was further investigated by cardiac magnetic resonance imaging. Myocardial iron content in the left ventricle was lower in HF versus NFC (121.4 [88.1–150.3] versus 137.4 [109.2–165.9] μg/g dry weight), which was absent in the right ventricle. With a priori cutoff of 86.1 μg/g d.w. in left ventricle, we identified 23% of HF patients with MID (HF‐MID) associated with higher NYHA class and worsened left ventricle function. Respiratory chain and Krebs cycle enzymatic activities were suppressed and strongly correlated with depleted iron stores in HF‐MID hearts. Defenses against oxidative stress were severely impaired in association with worsened adverse remodeling in iron‐deficient hearts. Mechanistically, iron uptake pathways were impeded in HF‐MID including decreased translocation to the sarcolemma, while transmembrane fraction of ferroportin positively correlated with MID. Cardiac magnetic resonance with T2* effectively captured myocardial iron levels in failing hearts.

Conclusions

MID is highly prevalent in advanced human HF and exacerbates pathological remodeling in HF driven primarily by dysfunctional mitochondria and increased oxidative stress in the left ventricle. Cardiac magnetic resonance demonstrates clinical potential to non‐invasively monitor MID.
Amiodarone Use and All‐Cause Mortality in Patients With a Continuous‐Flow Left Ventricular Assist Device
Authors: Gopinathannair Rakesh , Pothineni Naga Venkata K. , Trivedi Jaimin R. , Roukoz Henri , Cowger Jennifer , Ahmed Mustafa M. , Bhan Adarsh , K. Ravichandran Ashwin , Bhat Geetha , Al Ahmad Amin , Natale Andrea , Di Biase Luigi , Slaughter Mark S. , Lakkireddy Dhanunjaya
Published: June 2022

Background

Atrial and ventricular arrhythmias are commonly encountered in patients with advanced heart failure, with amiodarone being the most commonly used antiarrhythmic drug in continuous‐flow left ventricular assist device (CF‐LVAD) recipients. The purpose of this study was to assess the impact of amiodarone use on long‐term all‐cause mortality in ptients with a CF‐LVAD.

Methods and Results

A retrospective multicenter study of CF‐LVAD was conducted at 5 centers including all CF‐LVAD implants from 2007 to 2015. Patients were stratified based on pre–CF‐LVAD implant amiodarone use. Additional use of amiodarone after CF‐LVAD implantation was also evaluated. Primary outcome was all‐cause mortality during long‐term follow‐up. Kaplan‐Meier curves were used to assess survival outcomes. Multivariable Cox regression was used to identify predictors of outcomes. Propensity matching was done to address baseline differences. A total of 480 patients with a CF‐LVAD (aged 58±13 years, 81% men) were included. Of these, 170 (35.4%) were on chronic amiodarone therapy at the time of CF‐LVAD implant, and 310 (64.6%) were not on amiodarone. Rate of all‐cause mortality over the follow‐up period was 32.9% in the amiodarone group compared with 29.6% in those not on amiodarone (
P
=0.008). Similar results were noted in the propensity‐matched group (log‐rank,
P
=0.04). On multivariable Cox regression analysis, amiodarone use at baseline was independently associated with all‐cause mortality (hazard ratio, 1.68 [95% CI, 1.1–2.5];
P
=0.01).

Conclusions

Amiodarone use was associated with significantly increased rates of all‐cause mortality in CF‐LVAD recipients. Earlier interventions for arrhythmias to avoid long‐term amiodarone exposure may improve long‐term outcomes in CF‐LVAD recipients and needs further study.
Neutrophil‐to‐Lymphocyte Ratios in Patients Undergoing Aortic Valve Replacement: The PARTNER Trials and Registries
Authors: Shahim Bahira , Redfors Björn , Lindman Brian R. , Chen Shmuel , Dahlen Torsten , Nazif Tamim , Kapadia Samir , Gertz Zachary M. , Crowley Aaron C. , Li Ditian , Thourani Vinod H. , Kodali Susheel K. , Zajarias Alan , Babaliaros Vasilis C. , Guyton Robert A. , Elmariah Sammy , Herrmann Howard C. , Cohen David J. , Mack Michael J. , Smith Craig R. , Leon Martin B. , George Isaac
Published: June 2022

Background

The neutrophil‐to‐lymphocyte ratio (NLR) as a marker of systemic inflammation has been associated with worse prognosis in several chronic disease states, including heart failure. However, few data exist on the prognostic impact of elevated baseline NLR or change in NLR levels during follow‐up in patients undergoing transcatheter or surgical aortic valve replacement (TAVR or SAVR) for aortic stenosis.

Methods and Results

NLR was available in 5881 patients with severe aortic stenosis receiving TAVR or SAVR in PARTNER (Placement of Aortic Transcatheter Valves) I, II, and S3 trials/registries (median [Q1, Q3] NLR, 3.30 [2.40, 4.90]); mean NLR, 4.10; range, 0.5–24.9) and was evaluated as continuous variable and categorical tertiles (low: NLR ≤2.70, n=1963; intermediate: NLR 2.70–4.20, n=1958; high: NLR ≥4.20, n=1960). No patients had known baseline infection. High baseline NLR was associated with increased risk of death or rehospitalization at 3 years (58.4% versus 41.0%; adjusted hazard ratio [aHR], 1.39; 95% CI, 1.18–1.63;
P
<0.0001) compared with those with low NLR, irrespective of treatment modality. In both patients treated with TAVR and patients treated with SAVR, NLR decreased between baseline and 2 years. A 1‐unit observed decrease in NLR between baseline and 1 year was associated with lower risk of death or rehospitalization between 1 year and 3 years (aHR, 0.86; 95% CI, 0.82–0.89;
P
<0.0001).

Conclusions

Elevated baseline NLR was independently associated with increased subsequent mortality and rehospitalization after TAVR or SAVR. The observed decrease in NLR after TAVR or SAVR was associated with improved outcomes.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT00530894, NCT0134313, NCT02184442, NCT03225001, NCT0322141.
Potential Impact of 2017 American College of Cardiology/American Heart Association Hypertension Guideline on Contemporary Practice: A Cross‐Sectional Analysis From NCDR PINNACLE Registry
Authors: Hussain Aliza , Virani Salim S. , Zheng Luke , Gluckman Ty J. , Borden William B. , Masoudi Frederick A. , Maddox Thomas M.
Published: June 2022

Background

Clinical implications of change in the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline on the diagnosis and management of hypertension, compared with recommendations by 2014 expert panel and Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7), are not known.

Methods and Results

Using data from the NCDR (National Cardiovascular Data Registry) PINNACLE (Practice Innovation and Clinical Excellence) Registry (January 2013‐Decemver 2016), we compared the proportion and clinical characteristics of patients seen in cardiology practices diagnosed with hypertension, recommended antihypertensive treatment, and achieving blood pressure (BP) goals per each guideline document. In addition, we evaluated the proportion of patients at the level of practices meeting BP targets defined by each guideline. Of 6 042 630 patients evaluated, 5 027 961 (83.2%) were diagnosed with hypertension per the 2017 ACC/AHA guideline, compared with 4 521 272 (74.8%) per the 2014 panel and 4 545 976 (75.2%) per JNC7. The largest increase in hypertension prevalence was seen in younger ages, women, and those with lower cardiovascular risk. Antihypertensive medication was recommended to 70.6% of patients per the ACC/AHA guideline compared with 61.8% and 65.9% per the 2014 panel and JNC7, respectively. Among those on antihypertensive agents, 41.2% achieved BP targets per the ACC/AHA guideline, compared with 79.4% per the 2014 panel and 64.3% per JNC7. Lower proportions of women, non‐White (Black and "other") races, and those at higher cardiovascular risk achieved BP goals. Median practice‐level proportion of patients meeting BP targets per the 2014 panel but not the ACC/AHA guideline was 37.8% (interquartile range, 34.8%–40.7%) and per JNC7 but not the ACC/AHA guideline was 22.9% (interquartile range, 19.8%–25.9%).

Conclusions

Following publication of the 2017 guideline, significantly more people, particularly younger people and those with lower cardiovascular risk, will be diagnosed with hypertension and need antihypertensive treatment compared with previous recommendations. Significant practice‐level variation in BP control also exists. Efforts are needed to improve guideline‐concordant hypertension management in an effort to improve outcomes.
Lipoprotein(a) and Subclinical Vascular and Valvular Calcification on Cardiac Computed Tomography: The Atherosclerosis Risk in Communities Study
Authors: Obisesan Olufunmilayo H. , Kou Minghao , Wang Frances M. , Boakye Ellen , Honda Yasuyuki , Uddin S. M. Iftekhar , Dzaye Omar , Osei Albert D. , Orimoloye Olusola A. , Howard‐Claudio Candace M. , Coresh Josef , Blumenthal Roger S. , Hoogeveen Ron C. , Budoff Matthew J. , Matsushita Kunihiro , Ballantyne Christie M. , Blaha Michael J.
Published: June 2022

Background

Lipoprotein(a) (Lp(a)) is a potent causal risk factor for cardiovascular events and mortality. However, its relationship with subclinical atherosclerosis, as defined by arterial calcification, remains unclear. This study uses the ARIC (Atherosclerosis Risk in Communities Study) to evaluate the relationship between Lp(a) in middle age and measures of vascular and valvular calcification in older age.

Methods and Results

Lp(a) was measured at ARIC visit 4 (1996–1998), and coronary artery calcium (CAC), together with extracoronary calcification (including aortic valve calcium, aortic valve ring calcium, mitral valve calcification, and thoracic aortic calcification), was measured at visit 7 (2018–2019). Lp(a) was defined as elevated if >50 mg/dL and CAC/extracoronary calcification were defined as elevated if >100. Logistic and linear regression models were used to evaluate the association between Lp(a) and CAC/extracoronary calcification, with further stratification by race. The mean age of participants at visit 4 was 59.2 (SD 4.3) years, with 62.2% women. In multivariable adjusted analyses, elevated Lp(a) was associated with higher odds of elevated aortic valve calcium (adjusted odds ratio [aOR], 1.82; 95% CI, 1.34–2.47), CAC (aOR, 1.40; 95% CI, 1.08–1.81), aortic valve ring calcium (aOR, 1.36; 95% CI, 1.07–1.73), mitral valve calcification (aOR, 1.37; 95% CI, 1.06–1.78), and thoracic aortic calcification (aOR, 1.36; 95% CI, 1.05–1.77). Similar results were obtained when Lp(a) and CAC/extracoronary calcification were examined on continuous logarithmic scales. There was no significant difference in the association between Lp(a) and each measure of calcification by race or sex.

Conclusions

Elevated Lp(a) at middle age is significantly associated with vascular and valvular calcification in older age, represented by elevated CAC, aortic valve calcium, aortic valve ring calcium, mitral valve calcification, thoracic aortic calcification. Our findings encourage assessing Lp(a) levels in individuals with increased cardiovascular disease risk, with subsequent comprehensive vascular and valvular assessment where elevated.
Prognostic Implications of Prestent Pullback Pressure Gradient and Poststent Quantitative Flow Ratio in Patients Undergoing Percutaneous Coronary Intervention
Authors: Dai Neng , Yuan Sheng , Dou Kefei , Zhang Rui , Hu Nan , He Jining , Guan Changdong , Zou Tongqiang , Qiao Zheng , Duan Shaofeng , Xie Lihua , Yu Yongfu , Zhang Yingmei , Xu Bo , Ge Junbo
Published: June 2022

Background

Coronary diffuse disease associates with poor outcomes, but little is known about its role after percutaneous coronary intervention (PCI). We aimed to investigate the prognostic implication of pre‐PCI focal or diffuse disease patterns combined with post‐PCI quantitative flow ratio (QFR).

Methods and Results

Pre‐PCI QFR derived pullback pressure gradient (PPG) (QFR‐PPG) was measured to assess physiological disease patterns for 1685 included vessels; the vessels were classified according to dichotomous pre‐PCI QFR‐PPG and post‐PCI QFR. Vessel‐oriented composite outcome, a composite of vessel‐related ischemia‐driven revascularization, vessel‐related myocardial infarction, or cardiac death at 2 years was compared among these groups. Vessels with low pre‐PCI PPG (3.9% versus 2.0%, hazard ratio [HR], 1.93; 95% CI, 1.08–3.44;
P
=0.02) or low post‐PCI QFR (9.8% versus 2.7%, HR, 3.78; 95% CI, 1.61–8.87;
P
=0.001) demonstrated higher vessel‐oriented composite outcome risk after stent implantation. Of note, despite high post‐PCI QFR achieved, vessels with low pre‐PCI QFR‐PPG presented higher risk of vessel‐oriented composite outcome than those with high pre‐PCI QFR‐PPG (3.7% versus 1.8%, HR, 2.03; 95% CI, 1.09–3.76;
P
=0.03) and pre‐PCI QFR‐PPG demonstrated direct prognostic effect not mediated by post‐PCI QFR. Integration of groups classified by pre‐PCI QFR‐PPG and post‐PCI QFR showed significantly higher discriminant and reclassification abilities than clinical factors (C‐index 0.77 versus 0.72,
P
=0.03; integrated discrimination improvement 0.93%,
P
=0.04; net reclassification index 0.33,
P
=0.02).

Conclusions

Prognostic value of pre‐PCI focal or diffuse disease patterns assessed by QFR‐PPG index was retained even after successful PCI, which is mostly explained by its direct effect that was not mediated by post‐PCI QFR. Integration of both pre‐PCI and post‐PCI physiological information can provide better risk stratification in vessels with stent implantation.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT05104580.
Workers’ Activity Profiles Associated With Predicted 10‐Year Cardiovascular Disease Risk
Authors: Biswas Aviroop , Chen Cynthia , Prince Stephanie A. , Smith Peter M. , Mustard Cameron A.
Published: June 2022

Background

There is a need to explore common activity patterns undertaken by workers and the association between these activity profiles and cardiovascular disease (CVD). This study explored the number and type of distinct profiles of activity patterns among workers and the association between these profiles and predicted 10‐year risk for a first atherosclerotic CVD event.

Methods and Results

Distinct activity patterns from a cross‐section of workers’ accelerometer data were sampled from Canadian Health Measures Survey participants (5 cycles, 2007–2017) and identified using hierarchical cluster analysis techniques. Covariates included accelerometer wear time, work factors, sociodemographic factors, clinical markers, and lifestyle variables. Associations between activity profiles and high atherosclerotic CVD risk >10% were estimated using robust Poisson regression models. Six distinct activity profiles were identified from 8909 workers. Compared with the “lowest activity” profile, individuals in the “highest activity” and “moderate evening activity” profiles were at 42% lower risk (relative risk [RR], 0.58; 95% CI, 0.47, 0.70) and 33% lower risk (RR, 0.67; 95% CI, 0.44, 0.87) of predicted 10‐year atherosclerotic CVD risk of >10%, respectively. “Moderate activity” and “fluctuations of moderate activity” profiles were also associated with lower risk estimates, whereas the “high daytime activity” profile was not statistically different to the reference profile.

Conclusions

Workers accumulating physical activity throughout the day and during recreational hours were found to have optimal CVD risk profiles. Workers accumulating physical activity only during daytime work hours were not associated with reduced CVD risk. Findings can inform alternative strategies to conferring the cardiovascular benefits of physical activity among workers. Large prospective studies are needed to confirm these findings.
Clinician Responses to a Clinical Decision Support Advisory for High Risk of Torsades de Pointes
Authors: Gallo Tyler , Heise C. William , Woosley Raymond L. , Tisdale James E. , Tan Malinda S. , Gephart Sheila M. , Antonescu Corneliu C. , Malone Daniel C.
Published: June 2022

Background

Torsade de pointes (TdP) is a potentially fatal cardiac arrhythmia that is often drug induced. Clinical decision support (CDS) may help minimize TdP risk by guiding decision making in patients at risk. CDS has been shown to decrease prescribing of high‐risk medications in patients at risk of TdP, but alerts are often ignored. Other risk‐management options can potentially be incorporated in TdP risk CDS. Our goal was to evaluate actions clinicians take in response to a CDS advisory that uses a modified Tisdale QT risk score and presents management options that are easily selected (eg, single click).

Methods and Results

We implemented an inpatient TdP risk advisory systemwide across a large health care system comprising 30 hospitals. This CDS was programmed to appear when prescribers attempted ordering medications with a known risk of TdP in a patient with a QT risk score ≥12. The CDS displayed patient‐specific information and offered relevant management options including canceling offending medications and ordering electrolyte replacement protocols or ECGs. We retrospectively studied the actions clinicians took within the advisory and separated by drug class. During an 8‐month period, 7794 TdP risk advisories were issued. Antibiotics were the most frequent trigger of the advisory (n=2578, 33.1%). At least 1 action was taken within the advisory window for 2700 (34.6%) of the advisories. The most frequent action taken was ordering an ECG (n=1584, 20.3%). Incoming medication orders were canceled in 793 (10.2%) of the advisories. The frequency of each action taken varied by drug class (
P
<0.05 for all actions).

Conclusions

A modified Tisdale QT risk score–based CDS that offered relevant single‐click management options yielded a high action/response rate. Actions taken by clinicians varied depending on the class of the medication that evoked the TdP risk advisory, but the most frequent was ordering an ECG.
Sex, size and eco-geographic factors affect the feeding ecology of the Iberian adder, Vipera seoanei
Authors: Espasandín Ismael , Galán Pedro , Martínez-Freiría Fernando
Published: June 2022

Numerous dietary studies have shown that European vipers (genus Vipera) present low feeding frequency and a specialist diet, which is characterised by a marked ontogenetic shift. However, how eco-geographic factors shape species’ feeding ecology remains scarcely addressed. We investigated the feeding ecology of the Iberian adder, Vipera seoanei, examining 402 specimens distributed across its distributional range and addressing how biological, temporal and eco-geographic factors relate to the species feeding activity and dietary consumption. Our results indicated a low feeding frequency in the species, higher in juveniles than in adults. Adult females showed higher rates of prey consumption than adult males, which match to the distinct reproductive demands of both sexes, although no differences between reproductive and non-reproductive females were found. V. seoanei preyed on a varied taxa spectrum, but showed a rather specialist diet based on small mammals. Amphibians and reptiles were also an important part of its diet, particularly in the juveniles. Body size was found as the single biological trait related to the consumption of major prey groups, supporting the occurrence of an ontogenetic shift in the diet. Two habitat and two climatic factors correlated to the consumption of major prey groups, reflecting the ecological requirements of prey across the viper’s range. Overall, this study extends the existing knowledge on the feeding ecology of European vipers, signalling how energy intake and allometric constraints shape the feeding activity and dietary consumption of the species across the geography, leading to distinct feeding strategies in juveniles and adults.
A Chapter in the Debate on Chordate Phylogeny
Authors: Ottaviani Alessandro
Published: June 2022

In this essay we propose the edition of some unpublished papers of Francesco Todaro (1839–1918), at that time professor of human anatomy at the University of Rome; these papers collect the results of the research Todaro was carrying out on a sense organ in the Salps, which constitute an interesting chapter in the history of comparative embryology and morphology, in the framework of the debate on the phylogenetic relationships of chordates.
Mysteria, the Beauty of Silence: a Program of Contemplation to Cultivate the Awareness of Beauty in Art Museums
Authors: Melo Amelia , Echarri Fernando
Published: June 2022

This article analyzes the design, development, and evaluation of a program on the contemplation of beauty through art aimed at museums: Mysteria, the Beauty of Silence. It investigates if this program is an efficient way to cultivate the awareness of beauty and to favor its transformative power via the art that is contained within museums. The program had a gradual development and included the design of specific art-contemplation techniques. These techniques are eclectically based on the influence of Zen practices, Advaita Vedanta, Yoga, Mindfulness and the guidelines given by Mark Rothko to enable meaningful experiences. The program was developed in the Can Framis Museum of Barcelona (Spain). Twenty-four participants between the ages of 31 and 65 years each contributed over a period with a duration of nine weeks. The usage of a mixed methodology, both quantitative and qualitative, allowed demonstration of the existence of marked changes in the participants in terms of their significant experience with immaterial beauty.