bluuebunny/crossref_metadata_2025 huggingface dataset:
Video Abnormal Action Recognition Based on Multimodal Heterogeneous Transfer Learning
Authors: Huang Hong-Bo , Zheng Yao-Lin , Hu Zhi-Ying
Published: January 2024

Human abnormal action recognition is crucial for video understanding and intelligent surveillance. However, the scarcity of labeled data for abnormal human actions often hinders the development of high-performance models. Inspired by the multimodal approach, this paper proposes a novel approach that leverages text descriptions associated with abnormal human action videos. Our method exploits the correlation between the text domain and the video domain in the semantic feature space and introduces a multimodal heterogeneous transfer learning framework from the text domain to the video domain. The text of the videos is used for feature encoding and knowledge extraction, and knowledge transfer and sharing are realized in the feature space, which is used to assist in the training of the abnormal action recognition model. The proposed method reduces the reliance on labeled video data, improves the performance of the abnormal human action recognition algorithm, and outperforms the popular video-based models, particularly in scenarios with sparse data. Moreover, our framework contributes to the advancement of automatic video analysis and abnormal action recognition, providing insights for the application of multimodal methods in a broader context.
Elucidating the Visual Snow Spectrum: A Latent Class Analysis Study
Authors: Thompson Amy Claire , Goodbourn Patrick T. , Forte Jason D.
Published: January 2024

Objective. People with visual snow syndrome (VSS) experience a range of perceptual phenomena, in addition to visual snow (VS; flickering pinpricks of light throughout the visual field). We investigated the patterns of perceptual phenomena associated with VSS in a large sample of people without prior knowledge of VSS or its associated symptoms. Methods and Measures. Two thousand participants completed a screening questionnaire assessing the frequency and severity of perceptual phenomena associated with VSS. We used latent class analysis (LCA), a clustering technique which identifies qualitatively different subgroups within a given population, to investigate whether the presence (or absence) of VS impacted class structure. Results. Of 1,846 participants included for analysis, 41.92% experienced VS some of the time, including 4.49% who had VSS without prior knowledge. The mean number of perceptual phenomena experienced was 2.03. Optimal four‐class LCA solutions did not substantially differ whether VS was included in the model; instead, classes differed in the frequency and total number of symptoms experienced. Discussion. Our results suggest that the perceptual phenomena associated with VSS are likely to be common in the general population and do not necessarily indicate an underlying pathology. We also showed that visual snow itself does not explain the presence of other perceptual phenomena.
Novel Probabilistic Approach for Quantification of Cost-Overruns Risk and Determination of Primary Causes
Authors: Liu Tianyu , Zhang Shen , Wang Xingyu
Published: January 2024

Cost management is a crucial component of construction project management, which assumes an increasingly critical role in modern large-scale projects. Ideally, cost management is achieved through a comparison between the current cost and the predetermined cost schedule. However, in real-world projects, it is often difficult to consistently obtain accurate costs for each cost item throughout the project life cycle and to predict the probability of various risk occurrences. To address this challenge, we propose a novel building information modeling- (BIM-) based algorithm to quantify the risk of cost overruns and cost deviation; and identify the primary causes without a detailed cost breakdown. The role of BIM in our approach is to automatically extract precise quantitative information that we can use to calculate the probability density function of the current cost and the expected total cost and eventually combine reliability analysis to provide the risk probability. The numerical experiment demonstrates that this algorithm can estimate the probability of cost overruns and cost deviation, and identify the primary cause of deviation. Additionally, the sensitivity requirements for cost management can be adjusted by adjusting the parameters, indicating its potential to meet multiple requirements in the different projects. The proposed algorithm provides a method for detecting the current risk of cost overruns and cost deviation, as well as identifying the primary cause of deviation, which is of potential value in the practical applications.
Targeting the Epigenetic Reader ENL Inhibits Super-Enhancer–Driven Oncogenic Transcription and Synergizes with BET Inhibition to Suppress Tumor Progression
Authors: Chen Yongheng , Ying Ying , Ma Wenlong , Ma Hongchao , Shi Liang , Gao Xuefeng , Jia Min , Li Meiqi , Song Xiaoman , Kong Weixiao , Chen Wei , Zheng Xiangyi , Muluh Tobias Achu , Wang Xiaobin , Wang Maolin , Shu Xing-sheng
Published: January 2024

Epigenetic alterations at cis-regulatory elements (CRE) fine-tune transcriptional output. Epigenetic readers interact with CREs and can cooperate with other chromatin regulators to drive oncogene transcription. Here, we found that the YEATS domain-containing histone acetylation reader ENL (eleven–nineteen leukemia) acts as a key regulator of super-enhancers (SE), which are highly active distal CREs, across cancer types. ENL occupied the majority of SEs with substantially higher preference over typical enhancers, and the enrichment of ENL at SEs depended on its ability to bind acetylated histones. Rapid depletion of ENL by auxin-inducible degron tagging severely repressed the transcription of SE-controlled oncogenes, such as MYC, by inducing the decommissioning of their SEs, and restoring ENL protein expression largely reversed these effects. Additionally, ENL was indispensable for the rapid activation of SE-regulated immediate early genes in response to growth factor stimulation. Furthermore, ENL interacted with the histone chaperone FACT complex and was required for the deposition of FACT over CREs, which mediates nucleosome reorganization required for transcription initiation and elongation. Proper control of transcription by ENL and ENL-associated FACT was regulated by the histone reader BRD4. ENL was overexpressed in colorectal cancer and functionally contributed to colorectal cancer growth and metastasis. ENL degradation or inhibition synergized with BET inhibitors that target BRD4 in restraining colorectal cancer progression. These findings establish the essential role of epigenetic reader ENL in governing SE-driven oncogenic transcription and uncover the potential of ENL intervention to increase sensitivity to BET inhibition.

Significance:

ENL plays a key role in decoding epigenetic marks at highly active oncogenic super-enhancers and can be targeted in combination with BET inhibition as a promising synergistic strategy for optimizing cancer treatment.
Accumulation of Carbamylation-Derived Products in Aneurysmal Aorta
Authors: Doué Manon , Marques Guillaume , Okwieka Anaïs , Gorisse Laëtitia , Piétrement Christine , Gillery Philippe , Jaisson Stéphane
Published: January 2024

Introduction: Carbamylation is a nonenzymatic post-translational modification of proteins characterized by the binding of isocyanic acid to amino groups of proteins, which leads to the alteration of their properties. An increase in serum carbamylation-derived products, including homocitrulline (HCit), has been shown to be associated with the development of cardiovascular diseases. Methods: HCit was quantified by LC-MS/MS within extracts of aneurysmal and control human aortas. A mouse model of aortic aneurysm (ApoE−/− mice perfused with angiotensin II and fed with sodium cyanate) was used to evaluate the role of carbamylation in aneurysm development. Results: HCit quantification showed a greater heterogeneity of values in aneurysmal aortas in comparison with control ones. At the maximum diameter of dilation, HCit values were significantly higher (+94%, p < 0.05) compared with less dilated areas. No differences were observed according to aneurysm size or when comparing ruptured and unruptured aneurysms. No significant effect of carbamylation on aneurysm development was observed using the animal model. Conclusions: These results evidenced the accumulation of HCit within aneurysmal aortas but do not allow concluding about the exact participation of protein carbamylation in the development of human abdominal aortic aneurysms.
Follicular Psoriasis: A Case Report and Review of Literature
Authors: Gaurav Vishal , Anand Gouri R.P. , Grover Chander
Published: January 2024

Introduction: Psoriasis is an autoimmune papulosquamous disorder characterized by erythematous plaques. There are various subtypes, of which follicular psoriasis (FP) is an underreported entity, presenting as scaly follicular papules. Only a few cases have been reported, with limited dermoscopy findings having been described. This report aims to review the literature and emphasize the role of dermoscopy in the diagnosis of this rare variant. Case Report: A 31-year-old diabetic and obese male presented with symmetrical, itchy, scaly follicular lesions on his axillae, elbows, and knees for 6 months. Clinical differentials included follicular pityriasis rosea, pityriasis versicolor, or eczema. Dermoscopy revealed white scales and erythematous areas with multiple red dots present around hair follicles. Histopathology showed distended follicular infundibula with parakeratotic scales and psoriasiform changes, leading to a diagnosis of FP. Treatment with topical mometasone furoate and oral levocetirizine led to complete resolution within a month. Discussion: FP is a relatively uncommon subtype of psoriasis, manifesting differently in adults and juveniles. Although its exact cause remains unknown, hair follicle immune cells and/or keratin 17 (K17) may be involved. Dermoscopy can help distinguish it by revealing typical features including perifollicular white scales and vascular structures. Further epidemiological studies and long-term follow-up are needed for a comprehensive understanding of FP.
The Trajectory of Successful Aging: Insights from Metagenome and Cytokine Profiling
Authors: Chulenbayeva Laura , Ganzhula Yuliya , Kozhakhmetov Samat , Jarmukhanov Zharkyn , Nurgaziyev Madiyar , Nurgozhina Ayaulym , Muhanbetzhanov Nurislam , Sergazy Shynggys , Zhetkenev Sanzhar , Borykbay Zhanar , Tkachev Viktor , Urazova Saltanat , Vinogradova Elizaveta , Kushugulova Almagul
Published: January 2024

Introduction: The longevity is influenced by genetic, environmental, and lifestyle factors. The specific changes that occur in the gut microbiome during the aging process, and their relationship to longevity and immune function, have not yet been fully understood. The ongoing research of other microbiome based on longevity cohort in Kazakhstan provides preliminary information on longevity-related aging, where cytokine expression is associated with specific microbial communities and microbial functions. Methods: Metagenomic shotgun sequencing study of 40 long-lived individuals aged 90 years and over was carried out, who were conditionally healthy and active, able to serve themselves, without a history of serious infection and cancer, who had not taken any antimicrobials, including probiotics. Blood serum was analyzed for clinical and laboratory characteristics. The cytokine and chemokine profile in serum and stool samples was assessed using multiplex analysis. Results: We found a significant increase in the expression of pro-inflammatory cytokines IL-1a, IL-6, 12p70, IP-10, IFNα2, IL-15, TNFa, as well as chemokines MIP-1a/CCL3 and MIP-1b/CCL4, chemokine motif ligands MCP-3/CCL7 and MDC/CCL22(1c). Nonagenerians and centenarians demonstrated a greater diversity of core microbiota genera and showed an elevated prevalence of the genera Bacteroides, Clostridium, Escherichia, and Alistipes. Conversely, there was a decrease in the abundance of the genera Ruminococcus, Fusicatenibacter, Dorea, as well as the species Fusicatenibacter saccharivorans. Furthermore, functional analysis revealed that the microbiome in long-lived group has a high capacity for lipid metabolism, amino acid degradation, and potential signs of chronic inflammatory status. Conclusion: Long-lived individuals exhibit an immune system imbalance and observed changes in the composition of the gut microbiota at the genus level between to the two age-groups. Age-related changes in the gut microbiome, metabolic functions of the microbial community, and chronic inflammation all contribute to immunosenescence. In turn, the inflammatory state and microbial composition of the gut is related to nutritional status.
The Role of Multiparametric MRI (mpMRI) in the Prediction of Adverse Prostate Cancer Pathology in Radical Prostatectomy Specimen
Authors: Riedel Andreas , Michael Marlene , Grünberg Jenny , Mehralivand Sherif , Böehm Katharina , Hachtel Jakob , Platzek Ivan , Sommer Ulrich , Baunacke Martin , Thomas Christian , Borkowetz Angelika
Published: January 2024

Introduction: Prostate cancer (PCa) risk stratification is essential in guiding therapeutic decision. Multiparametric magnetic resonance tomography (mpMRI) holds promise in the prediction of adverse pathologies (AP) after prostatectomy (RP). This study aims to identify clinical and imaging markers in the prediction of adverse pathology. Methods: Patients with PCa, diagnosed by targeted biopsy after mpMRI and undergoing RP, were included. The predictive accuracy of mpMRI for extraprostatic extension (ECE), seminal vesicle infiltration (SVI), and lymph node positivity was calculated from the final histopathology. Results: 846 patients were involved. Independent risk parameters include imaging findings such as ECE (OR 3.12), SVI (OR 2.55), and PI-RADS scoring (4: OR 2.01 and 5: OR 4.34). mpMRI parameters such as ECE, SVI, and lymph node metastases showed a high prognostic accuracy (73.28% vs. 95.35% vs. 93.38%) with moderate sensitivity compared to the final histopathology. The ROC analysis of our combined scoring system (D’Amico classification, PSA density, and MRI risk factors) improves the prediction of adverse pathology (AUC: 0.73 vs. 0.69). Conclusion: Our study supports the use of mpMRI for comprehensive pretreatment risk assessment in PCa. Due to the high accuracy of factors like ECE, SVI, and PI-RADS scoring, utilizing mpMRI data enabled accurate prediction of unfavorable pathology after RP.
Ontology learning from object-relational mapping metadata and relational database
Authors: Sutejo Agus , Gernowo Rahmat , Andreas Purwoadi Michael
Published: January 2024

Ontologies play an important role in representing the semantics of data sources. Building an ontology as a representation of domain knowledge from available data sources is not a simple process, particularly when dealing with relational data, which remains prevalent in existing knowledge systems. In this study, we create an ontology from a relational database using object-relational mapping (ORM) metadata as additional rules for mapping. Our method comprises two main phases: ontology schema construction using ORM metadata and the generation of ontology instances from the relational database. During the initial phase, we analyzed the ORM metadata to map it to an resource description framework schema (RDF(S))-OWL representation of the ontology. In the subsequent phase, we applied mapping rules to convert the relational database (RDB) data into ontological instances, which are then represented as RDF triples. Using ORM metadata, we enhance the accuracy of the resulting ontology, particularly in terms of extracting concepts and hierarchical relationships. This study contributes to the field of ontology learning by showcasing a novel approach that leverages ORM metadata to create ontologies from relational databases.
Numerical modelling of the impact of coronavirus disease 2019 on fertility and population growth rate in Malaysia
Authors: Abdulhabib Alzaeemi Shehab , Sathasivam Saratha , Gaik Tay Kim , Hafieza Adzhar Nur , Hannani Shamsudin Nur , Ain Izzati Ramli Nur
Published: January 2024

Over the past four years, the world has grappled with an unprecedented global pandemic caused by COVID-19, resulting in a significant surge in reported cases and fatalities across numerous countries. This health crisis has had far-reaching demographic repercussions, with a notable decline in global birth rates, plummeting by 1.12% in 2020 compared to the preceding year. This trend is exemplified in Malaysia, where the number of births dwindled from 123,751 in September 2019 to 116,434 during the corresponding period in 2020. The reluctance to have children stems from the heightened vulnerability to the virus, compounded by financial constraints due to widespread unemployment, further dampening population growth. This study is dedicated to comprehending the impact of COVID-19 on Malaysia's population growth rates and forecasting its trajectory for the subsequent five years following the outbreak. Researchers scrutinized the data using numerical methods and population modeling and employed the Euler method, aided by MATLAB software, to compare their findings against authentic population figures. Their analysis disclosed that the COVID-19 pandemic affected Malaysia's population growth rates, although it did not directly impact mortality rates, as recovery rates exceeded mortality rates. In essence, the pandemic has primarily influenced birth rates, contributing to a noteworthy demographic shift in the country.
Substations power quality improvement by flexible alternating current transmission system devices
Authors: G Chremk Chremk Faissl , Medhaffar Hanene
Published: January 2024

The increase in load demand has a negative impact on power system quality, reliability, and stability. Transporting reactive power from the generating side to the distribution side reduces the transmission line’s capacity to deliver active power to loads. In conventional power systems, during faults or sudden loads, the load flow changes and causes extra voltage drop. Reactive power compensation at the load side can improve voltage quality at distribution busbars, but the conventional compensation method doesn’t offer the required flexibility. With the development of the power electronics industry, flexible alternating current transmission system (FACTS) devices have been introduced. There are many categories for FACTS controllers, including series, shunt, and hybrid, which can exhibit dynamic operating characteristics. In this paper, two types of FACTS devices (STATCOM and fixed capacitor-thyristor-controlled reactors (FCTCR)) have been used to improve voltage profile in a part of Iraq’s high voltage power system during unusual operating conditions, such as sudden loads and the absence generation. Load flow calculations were conducted to determine the critical bus, and then the performance of the FACTS devices was investigated during heavy loading when the devices were connected separately to the critical bus. The voltage drop in the bus was 1.58%, which reduced to 0.78% with STATCOM and 0.96% with FCTCR.
Design and development of arduino-based automation home system using the internet of things
Authors: Adeola Ajagbe Sunday , Adeoye Adeaga Oyetunde , Omotayo Alabi Oluwaseyi , Bashir Ikotun Adewale , A. Akintunde Musa , O. Adigun Matthew
Published: January 2024

The home automation system described in this paper is low-cost, dependable, and versatile. It uses an Arduino microcontroller and Bluetooth internet protocol (IP) connectivity to allow authorized users to remotely access and control devices. The suggested system employs the internet of things (IoT), which is server-independent, to manage human-desired appliances ranging from industrial machinery to consumer products. In this project, we have taken a Bluetooth module that is programmed through an Arduino Nano to control various devices auto-switching of mechanical devices and monitoring of water level within a range of 130 m using an Android application. This is done to show the effectiveness and viability of this system. Each bulb was switched on/off remotely using a mobile phone successfully. The operation of the water pump attached to the source bucket were controlled from the phone while in manual mode and controlled by an ultrasonic sensor while in automatic mode. It enables remote control of a number of devices, including lights and pumps, and decision-making based on sensor feedback.
Enhanced low voltage ride-through control of multilevel flying capacitor inverter based wind generation
Authors: El Khlifi Younes , El Magri Abdelmounime , Mansouri Adil , Lajouad Rachid
Published: January 2024

This paper introduces a cost-effective control method to enhance the low voltage ride-through (LVRT) capability and smooth the output power of a three-phase multilevel flying capacitor inverter (FCI) in wind turbine-based permanent magnet synchronous generator (PMSG). The proposed approach utilizes the energy storage capability of flying capacitors to mitigate wind power fluctuations and address short-duration outages and deep voltage sags. Additionally, a nonlinear controller based Lyapunov theory is developed to regulate capacitor voltages, improve power factors, and balance DC-link voltage. Numerical simulations are conducted in MATLAB/SimPower systems environment to validate the effectiveness of this comprehensive control strategy across different grid operation scenarios.
Por uma gênese do cinema ensaio latino-americano
Authors: Caixeta Ana Paula de Aquino , Teixeira Laís de Lorenço
Published: January 2024

Um verificado trânsito reflexivo fez reverberar tendências do cinema francês em países latino-americanos por volta dos anos 60-70, como foi o caso do cinema de autor. Apesar disso, nota-se uma incômoda ausência de obras latino-americanas em teorias que se propõem a delinear a gênese do cinema ensaio neste mesmo período. Assim, nos questionamos se manifestos e obras como as de Glauber Rocha, Fernando Solanas e Octavio Getino e Arthur Omar podem conformar inflexões ensaísticas na América Latina. Partimos da hipótese de que suas propostas tensionam instâncias como subjetividade, experiência pública e pensamento, reivindicando uma liberdade formal e estética que compartilha ideias e características recorrentes no domínio ensaístico.
O cinema de Carmelo Bene através das lentes de seu fotógrafo
Authors: Wahrhaftig Alexandre
Published: January 2024

Em I miei film con Carmelo Bene / My films with Carmelo Bene / Mes films avec Carmelo Bene (2020), encontramos um depoimento memorialístico do diretor de fotografia Mario Masini dos tempos em que trabalhou com o multiartista italiano Carmelo Bene entre as décadas de 1960 e 1970. O livro mescla anedotas de bastidores de filmagem, que nos aproximam do ambiente de trabalho em que estavam imersos Bene e sua trupe, com comentários mais técnicos em torno dos desafios propriamente fotográficos para a realização de um cinema de uma visualidade inventiva e complexa. Organizado em ordem cronológica, o depoimento de Masini cobre desde o primeiro encontro com Bene até seus últimos projetos juntos.
Mares e Aquários: águas do deslugar no cinema de Karim Aïnouz
Authors: Souza Lucas Soares de , Fischer Sandra
Published: January 2024

O trabalho explora, a partir da análise comparativa de Praia do Futuro (Brasil/Alemanha, 2014) e A Vida Invisível (Brasil, 2019), ambos do cineasta Karim Aïnouz, os efeitos de sentidos simbólicos provocados pelos elementos espaciais que circundam as personagens. Buscamos identificar a forma como figuras da natureza, as cores e as escolhas de objetos cênicos refletem a condição psicológica e existencial das personagens, em diálogo com seus arcos dramáticos. Identificamos também a presença do deslugar (FISCHER, 2014), como elemento medular na construção estética e narrativa dos filmes abordados.
Print media in digital age: creativity as e-learning tool
Authors: Curcio Gustavo Orlando Fudaba , Barata Fernanda Sarmento , Dayé Claudia
Published: January 2024

The Covid-19 pandemic has transformed the relationship between teachers and students. Consolidated and proven effective pedagogical strategies were adapted in a short time. This article describes the once-unlikely experience of teaching printing techniques to undergraduate graphic designers remotely. The experiment was conducted by two professors with consistent expertise in editorial printed design, Dr. Gustavo Curcio and Dr. Fernanda Sarmento, and assisted by Claudia Dayé. A class of fifty-five students, organised into small groups of four to five students, performed a series of practical exercises monitored by the university's Modular Object-Oriented Dynamic Learning Environment (moodle). This paper describes the successful articulation of students' practice, technique and creative stimulation.
Novas narrativas de Comunicação Não Violenta e Educação para a Paz nas famílias: o papel humanizador e restaurativo das Oficinas de Parentalidade no judiciário brasileiro
Authors: Andreucci Ana Claudia Pompeu Torezan , Nassar Paulo
Published: January 2024

O presente artigo objetiva analisar a utilização dos pressupostos do direito à Comunicação Não-Violenta, bem como da Educação para a Paz nas famílias, a partir da prática restaurativa brasileira denominada de Oficinas de Parentalidade propostas pelos Tribunais de Justiça dos estados em parceria com o Conselho Nacional de Justiça, com vistas a garantir em processos judiciais de ruptura conjugal e familiar a minimização dos traumas advindos para todos os envolvidos, em especial, crianças e adolescentes. As Oficinas Parentais partem do incentivo à mediação e conciliação dos conflitos, buscando harmonizar e humanizar os processos judiciais de separação e divórcio quando houver filhos a partir do dever parental, da ética do afeto, da Educação para a Paz e da Comunicação Não-Violenta, e em especial, fortalecendo-se os direitos à Comunicação e à voz de crianças e adolescentes.
Classification Algorithm to Distinguish Between Type 1 and Type 2 Myocardial Infarction in Administrative Claims Data
Authors: Wasfy Jason H. , Price Mary , Normand Sharon-Lise T. , Januzzi James L. , McCarthy Cian P. , Hsu John
Published: January 2024

BACKGROUND:

Type 2 myocardial infarction (T2MI) and type 1 myocardial infarction (T1MI) differ with respect to demographics, comorbidities, treatments, and clinical outcomes. Reliable quality and outcomes assessment depends on the ability to distinguish between T1MI and T2MI in administrative claims data. As such, we aimed to develop a classification algorithm to distinguish between T1MI and T2MI that could be applied to claims data.

METHODS:

Using data for beneficiaries in a Medicare accountable care organization contract in a large health care system in New England, we examined the distribution of MI diagnosis codes between 2018 to 2021 and the patterns of care and coding for beneficiaries with a hospital discharge diagnosis
International Classification of Diseases
,
Tenth Revision
code for T2MI, compared with those for T1MI. We then assessed the probability that each hospitalization was for a T2MI versus T1MI and examined care occurring in 2017 before the introduction of the T2MI code.

RESULTS:

After application of inclusion and exclusion criteria, 7759 hospitalizations for myocardial infarction remained (46.5% T1MI and 53.5% T2MI; mean age, 79±10.3 years; 47% female). In the classification algorithm, female gender (odds ratio, 1.26 [95% CI, 1.11–1.44]), Black race relative to White race (odds ratio, 2.48 [95% CI, 1.76–3.48]), and diagnoses of COVID-19 (odds ratio, 1.74 [95% CI, 1.11–2.71]) or hypertensive emergency (odds ratio, 1.46 [95% CI, 1.00–2.14]) were associated with higher odds of the hospitalization being for T2MI versus T1MI. When applied to the testing sample, the C-statistic of the full model was 0.83. Comparison of classified T2MI and observed T2MI suggest the possibility of substantial misclassification both before and after the T2MI code.

CONCLUSIONS:

A simple classification algorithm appears to be able to differentiate between hospitalizations for T1MI and T2MI before and after the T2MI code was introduced. This could facilitate more accurate longitudinal assessments of acute myocardial infarction quality and outcomes.
High‐Intensity Interval Training Is Associated With Improved 10‐Year Survival by Mediating Left Ventricular Remodeling in Patients With Heart Failure With Reduced and Mid‐Range Ejection Fraction
Authors: Hsu Chih‐Chin , Fu Tieh‐Cheng , Wang Chao‐Hung , Huang Ting‐Shuo , Cherng Wen‐Jin , Wang Jong‐Shyan
Published: January 2024

Background

This study aimed to assess the left ventricular (LV) remodeling response and long‐term survival after high‐intensity interval training (HIIT) in patients with various heart failure (HF) phenotypes during a 10‐year longitudinal follow‐up.

Methods and Results

Among 214 patients with HF receiving guideline‐directed medical therapy, those who underwent an additional 36 sessions of aerobic exercise at alternating intensities of 80% and 40% peak oxygen consumption (

V
̇

$$ \dot{\mathrm{V}} $$

O
2peak
) were considered HIIT participants (n=96). Patients who did not undergo HIIT were considered participants receiving guideline‐directed medical therapy (n=118). Participants with LV ejection fraction (EF) <40%, ≥40% and <50%, and ≥50% were considered to have HF with reduced EF, HF with mid‐range EF, and HF with preserved EF, respectively.

V
̇

$$ \dot{\mathrm{V}} $$

O
2peak
, serial LV geometry, and time to death were recorded. In all included participants, 10‐year survival was better (
P
=0.015) for participants who underwent HIIT (80.3%) than for participants receiving guideline‐directed medical therapy (68.6%). An increased

V
̇

$$ \dot{\mathrm{V}} $$

O
2peak
, decreased minute ventilation carbon dioxide production slope, and reduced LV end‐diastolic diameter were protective factors against all‐cause mortality. Regarding 138 patients with HF with reduced EF (
P
=0.044) and 36 patients with HF with mid‐range EF (
P
=0.036), 10‐year survival was better for participants who underwent HIIT than for participants on guideline‐directed medical therapy. Causal mediation analysis showed a significant mediation path for LV end‐diastolic diameter on the association between HIIT and 10‐year mortality in all included patients with HF (
P
<0.001) and those with LV ejection fraction <50% (
P
=0.006). HIIT also had a significant direct association with 10‐year mortality in patients with HF with LV ejection fraction <50% (
P
=0.027) but not in those with LV ejection fraction ≥50% (n=40).

Conclusions

Reversal of LV remodeling after HIIT could be a significant mediating factor for 10‐year survival in patients with HF with reduced EF and those with HF with mid‐range EF.
High Prevalence of New Clinically Significant Findings in Patients With Embolic Stroke of Unknown Source Evaluated by Cardiac Magnetic Resonance Imaging
Authors: Kotadia Irum D. , O'Dowling Robert , Aboagye Akosua , Crawley Richard J. , Bodagh Neil , Gharaviri Ali , O'Hare Daniel , Solis‐Lemus Jose Alonso , Roney Caroline H. , Sim Iain , Ramsey Deborah , Newby David , Chiribiri Amedeo , Plein Sven , Sztriha Laszlo , Scott Paul , Masci Pier‐Giorgio , Harrison James , Williams Michelle C. , Birns Jonathan , Somerville Peter , Bhalla Ajay , Niederer Steven , O'Neill Mark , Williams Steven E.
Published: January 2024

Background

Embolic stroke of unknown source (ESUS) accounts for 1 in 6 ischemic strokes. Current guidelines do not recommend routine cardiac magnetic resonance (CMR) imaging in ESUS, and beyond the identification of cardioembolic sources, there are no data assessing new clinical findings from CMR in ESUS. This study aimed to assess the prevalence of new cardiac and noncardiac findings and to determine their impact on clinical care in patients with ESUS.

Methods and Results

In this prospective, multicenter, observational study, CMR imaging was performed within 3 months of ESUS. All scans were reported according to standard clinical practice. A new clinical finding was defined as one not previously identified through prior clinical evaluation. A clinically significant finding was defined as one resulting in further investigation, follow‐up, or treatment. A change in patient care was defined as initiation of medical, interventional, surgical, or palliative care. From 102 patients recruited, 96 underwent CMR imaging. One or more new clinical findings were observed in 59 patients (61%). New findings were clinically significant in 48 (81%) of these patients. Of 40 patients with a new clinically significant cardiac finding, 21 (53%) experienced a change in care (medical therapy, n=15; interventional/surgical procedure, n=6). In 12 patients with a new clinically significant extracardiac finding, 6 (50%) experienced a change in care (medical therapy, n=4; palliative care, n=2).

Conclusions

CMR imaging identifies new clinically significant cardiac and noncardiac findings in half of patients with recent ESUS. Advanced cardiovascular screening should be considered in patients with ESUS.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT04555538.
Value and Variability of Pulse Shape Indicator for Estimating Mean Arterial Pressure in the Radial and Femoral Arteries
Authors: Jozwiak Mathieu , Millasseau Sandrine , Teboul Jean‐Louis , Lombardi Romain , Devanlay Raphaël , Umbdenstock Emilien , Morand Lucas , Dellamonica Jean , Chemla Denis
Published: January 2024

Background

The form factor (FF) is a pulse shape indicator that corresponds to the fraction of pulse pressure added to diastolic blood pressure to estimate the time‐averaged mean arterial pressure (MAP). Our invasive study assessed the FF value and variability at the radial and femoral artery levels and evaluated the recommended fixed FF value of 0.33.

Methods and Results

Hemodynamically stable patients were prospectively included in 2 intensive care units. FF was documented at baseline and during dynamic maneuvers. A total of 632 patients (64±16 years of age, 66% men, MAP=81±14 mm Hg) were included. Among them, 355 (56%) had a radial catheter and 277 (44%) had a femoral catheter. The FF was 0.34±0.06. In multiple linear regression, FF was influenced by biological sex (
P
<0.0001) and heart rate (
P
=0.04) but not by height, weight, or catheter location. The radial FF was 0.35±0.06, whereas the femoral FF was 0.34±0.05 (
P
=0.08). Both radial and femoral FF were higher in women than in men (
P
<0.05). When using the 0.33 FF value to estimate MAP, the error was −0.4±4.0 mm Hg and −0.1±2.9 mm Hg at the radial and femoral level, respectively, and the MAP estimate still demonstrated high accuracy and good precision even after changes in norepinephrine dose, increase in positive end‐expiratory pressure level, fluid administration, or prone positioning (n=218).

Conclusions

Despite higher FF in women and despite interindividual variability in FF, using a fixed FF value of 0.33 yielded accurate and precise estimations of MAP. This finding has potential implications for blood pressure monitoring devices and the study of pulse wave amplification.
Temporal Trend in Revascularization for Patients With Ischemic Cardiomyopathy and Multivessel Coronary Artery Disease
Authors: Alzahrani Anas H. , Alabbadi Sundos , Itagaki Shinobu , Egorova Natalia
Published: January 2024

Background

Current guidelines recommend revascularization in patients with ischemic cardiomyopathy (ICM). However, there is limited information about the trends and outcomes of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in ischemic cardiomyopathy patients with multivessel coronary artery disease.

Methods and Results

Using New Jersey state mandatory registries, 8083 patients with ischemic cardiomyopathy with CABG or PCI revascularization for multivessel coronary artery disease from 2007 to 2018 were included in the analysis. Joinpoint regression and multivariable logistic regression analyses were performed to assess the annual percentage change in trends and predictors of the 30‐day mortality rate, respectively. A decline in CABG procedures was observed from 2007 to 2011 (annual percentage change, −11.5%;
P
=0.003), followed by stabilization. The PCI trend remained unchanged from 2007 to 2010 and then increased significantly (annual percentage change, 3.2%;
P
=0.02). In the subsample of patients with proximal left anterior descending artery plus circumflex and right coronary artery, CABG was a predominant procedure until 2011, and the proportion of both procedures did not differ thereafter. In the subsample of patients with left anterior descending artery and any other artery stenosis, PCI remained dominant from 2007 to 2018, while in patients with left main and any other artery stenosis, CABG remained dominant from 2007 to 2018 (
P
<0.001). The 30‐day risk‐adjusted mortality rate was higher after PCI versus CABG for each year, but after adjustment for completeness of revascularization, there was no difference between groups.

Conclusions

The patterns of revascularization procedures for patients with ischemic cardiomyopathy with multivessel coronary artery disease have changed over the years, as evidenced by the changes in CABG and PCI trends. CABG and PCI had comparable 30‐day risk‐adjusted mortality risks.
Von Willebrand Factor Antigen Levels Predict Poor Outcomes in Patients With Stroke and Cancer: Findings From the Multicenter, Prospective, Observational SCAN Study
Authors: Kawano Tomohiro , Gon Yasufumi , Sakaguchi Manabu , Yamagami Hiroshi , Abe Soichiro , Hashimoto Hiroyuki , Ohara Nobuyuki , Takahashi Daisuke , Abe Yuko , Takahashi Tsutomu , Okazaki Shuhei , Todo Kenichi , Mochizuki Hideki , Sasaki Tsutomu ,   the SCAN Study Investigators
Published: January 2024

Background

Patients with acute ischemic stroke and active cancer have more severe neurological symptoms, elevated risks of stroke recurrence, and death compared with the general population. We examined whether von Willebrand factor (vWF) antigen levels at stroke onset were associated with the poor outcomes of patients with stroke and cancer.

Methods and Results

Using data from 90 patients with acute ischemic stroke and active cancer who were registered in the SCAN (Ischemic Stroke in Patients With Cancer and Neoplasia) study, a prospective multicenter, observational study in Japan, we divided patients into 2 groups according to their median vWF antigen levels (high, n=46; or low, n=44). The high‐vWF group had a significantly higher initial National Institutes of Health Stroke Scale score (median, 7 [interquartile range, 3–11.25] versus 3 [interquartile range, 1–8.5];
P
<0.05) and a significantly higher incidence of cryptogenic stroke (32 [70%] versus 16 [36%];
P
<0.01) and venous thromboembolism (7 [15%] versus 0 [0%];
P
<0.01), as well as multiple lesions (28 [62%] versus 12 [27%];
P
<0.001), than the low‐vWF group. We observed no significant difference in the rate of stroke recurrence within 1 year between the groups. However, increased vWF levels were an independent predictor of death within 1 year of stroke onset, after adjusting for potential confounders (odds ratio, 6.77 [95% CI, 1.49–30.78];
P
<0.05).

Conclusions

Elevated vWF antigen levels were associated with adverse outcomes in patients with cancer‐associated stroke and may represent a useful biomarker to guide future therapeutic interventions.
Impella Versus Intra‐Aortic Balloon Pump in Patients With Cardiogenic Shock Treated With Venoarterial Extracorporeal Membrane Oxygenation: An Observational Study
Authors: Yeo Ilhwan , Axman Rachel , Lu Daniel Y. , Feldman Dmitriy N. , Cheung Jim W. , Minutello Robert M. , Karas Maria G. , Iannacone Erin M. , Srivastava Ankur , Girardi Natalia I. , Naka Yoshifumi , Wong Shing‐Chiu , Kim Luke K.
Published: January 2024

Background

Venoarterial extracorporeal membrane oxygenation (VA‐ECMO) is increasingly used for patients with cardiogenic shock. Although Impella or intra‐aortic balloon pump (IABP) is frequently used for left ventricular unloading (LVU) during VA‐ECMO treatment, there are limited data on comparative outcomes. We compared outcomes of Impella and IABP for LVU during VA‐ECMO.

Methods and Results

Using the Nationwide Readmissions Database between 2016 and 2020, we analyzed outcomes in 3 groups of patients with cardiogenic shock requiring VA‐ECMO based on LVU strategies: extracorporeal membrane oxygenation (ECMO) only, ECMO with IABP, and ECMO with Impella. Of 15 980 patients on VA‐ECMO, IABP and Impella were used in 19.4% and 16.4%, respectively. The proportion of patients receiving Impella significantly increased from 2016 to 2020 (6.5% versus 25.8%;
P
‐trend<0.001). In‐hospital mortality was higher with ECMO with Impella (54.8%) compared with ECMO only (50.4%) and ECMO with IABP (48.4%). After adjustment, ECMO with IABP versus ECMO only was associated with lower in‐hospital mortality (adjusted odds ratio [aOR], 0.83;
P
=0.02). ECMO with Impella versus ECMO only had similar in‐hospital mortality (aOR, 1.09;
P
=0.695) but was associated with more bleeding (aOR, 1.21;
P
=0.007) and more acute kidney injury requiring hemodialysis (aOR, 1.42;
P
<0.001). ECMO with Impella versus ECMO with IABP was associated with greater risk of acute kidney injury requiring hemodialysis (aOR, 1.49;
P
=0.002), higher in‐hospital mortality (aOR, 1.32;
P
=0.001), and higher 40‐day mortality (hazard ratio, 1.25;
P
<0.001).

Conclusions

In patients with cardiogenic shock on VA‐ECMO, LVU with Impella, particularly with 2.5/CP, was not associated with improved survival at 40 days but was associated with increased adverse events compared with IABP. More data are needed to assess Impella platform‐specific comparative outcomes of LVU.
High‐Sensitivity C‐Reactive Protein Is Associated With Heart Failure Hospitalization in Patients With Metabolic Dysfunction‐Associated Fatty Liver Disease and Normal Left Ventricular Ejection Fraction Undergoing Coronary Angiography
Authors: Zhou Xiao‐Dong , Chen Qin‐Fen , Targher Giovanni , Byrne Christopher D. , Shapiro Michael D. , Tian Na , Xiao Tie , Sung Ki‐Chul , Lip Gregory Y. H. , Zheng Ming‐Hua
Published: January 2024

Background

Systemic chronic inflammation plays a role in the pathophysiology of both heart failure with preserved ejection fraction (HFpEF) and metabolic dysfunction‐associated fatty liver disease. This study aimed to investigate whether serum hs‐CRP (high‐sensitivity C‐reactive protein) levels were associated with the future risk of heart failure (HF) hospitalization in patients with metabolic dysfunction‐associated fatty liver disease and a normal left ventricular ejection fraction.

Methods and Results

The study enrolled consecutive individuals with metabolic dysfunction‐associated fatty liver disease and normal left ventricular ejection fraction who underwent coronary angiography for suspected coronary heart disease. The study population was subdivided into non‐HF, pre‐HFpEF, and HFpEF groups at baseline. The study outcome was time to the first hospitalization for HF. In 10 019 middle‐aged individuals (mean age, 63.3±10.6 years; 38.5% women), the prevalence rates of HFpEF and pre‐HFpEF were 34.2% and 34.5%, with a median serum hs‐CRP level of 4.5 mg/L (interquartile range, 1.9–10 mg/L) and 5.0 mg/L (interquartile range, 2.1–10.1 mg/L), respectively. Serum hs‐CRP levels were significantly higher in the pre‐HFpEF and HFpEF groups than in the non‐HF group. HF hospitalizations occurred in 1942 (19.4%) patients over a median of 3.2 years, with rates of 3.7% in non‐HF, 20.8% in pre‐HFpEF, and 32.1% in HFpEF, respectively. Cox regression analyses showed that patients in the highest hs‐CRP quartile had a ≈4.5‐fold increased risk of being hospitalized for HF compared with those in the lowest hs‐CRP quartile (adjusted‐hazard ratio, 4.42 [95% CI, 3.72–5.25]).

Conclusions

There was a high prevalence of baseline pre‐HFpEF and HFpEF in patients with metabolic dysfunction‐associated fatty liver disease and suspected coronary heart disease. There was an increased risk of HF hospitalization in those with elevated hs‐CRP levels.
The Language Network Reliably “Tracks” Naturalistic Meaningful Nonverbal Stimuli
Authors: Sueoka Yotaro , Paunov Alexander , Tanner Alyx , Blank Idan A. , Ivanova Anna , Fedorenko Evelina
Published: January 2024

The language network, comprised of brain regions in the left frontal and temporal cortex, responds robustly and reliably during language comprehension but shows little or no response during many nonlinguistic cognitive tasks (e.g., Fedorenko & Blank, 2020). However, one domain whose relationship with language remains debated is semantics—our conceptual knowledge of the world. Given that the language network responds strongly to meaningful linguistic stimuli, could some of this response be driven by the presence of rich conceptual representations encoded in linguistic inputs? In this study, we used a naturalistic cognition paradigm to test whether the cognitive and neural resources that are responsible for language processing are also recruited for processing semantically rich nonverbal stimuli. To do so, we measured BOLD responses to a set of ∼5-minute-long video and audio clips that consisted of meaningful event sequences but did not contain any linguistic content. We then used the intersubject correlation (ISC) approach (Hasson et al., 2004) to examine the extent to which the language network “tracks” these stimuli, that is, exhibits stimulus-related variation. Across all the regions of the language network, meaningful nonverbal stimuli elicited reliable ISCs. These ISCs were higher than the ISCs elicited by semantically impoverished nonverbal stimuli (e.g., a music clip), but substantially lower than the ISCs elicited by linguistic stimuli. Our results complement earlier findings from controlled experiments (e.g., Ivanova et al., 2021) in providing further evidence that the language network shows some sensitivity to semantic content in nonverbal stimuli.
Animals and Amour-Propre in Rousseau’s Second Discourse
Authors: Grimwade Robert
Published: January 2024

This article explores the role of human-animal relations in the emergence of amour-propre, as presented in Rousseau’s Discourse on the Origin and Foundation of Inequality Among Men (also known as the Second Discourse). Rousseau’s natural vegetarianism thesis is used to elucidate and interrogate fundamental pivots in his conjectural history of human development. The implications of the connection between amour-propre and human-animal relations are explored in relation to anthropocentrism, human exceptionalism, and the disavowal of nonhuman suffering in Western culture.