bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 4146303: A Single-Dose of a Novel CasX-Editor Lowers APOC3 Levels In Vivo
Authors: Karanth Santhosh , Bucher Simon , Smekalova Elena , Saraya Jennifer , Stein Shannon , Sato Anna , Bale ShyamSundhar , Krupa Oleh , Mauriello Anthony , Ripley-Phipps Sterling , Miller Katherine , Su Ali , Mrak Anna , Karmarkar Maitreyee , Eggers Michelle , Bardai Farah , Narsineni Lokesh , Li Yuexuan , Langner Heera , Szulwach Keith , Goh Natalie , Mok Amanda , Reimer Kirsten , Oakes Benjamin , Khakoo Aarif , Mirotsou Maria
Published: November 2024

Background:
Apolipoprotein C-III (APOC3) is a key regulator of lipid metabolism that inhibits the catabolism and clearance of triglyceride (TG)-rich lipoproteins in the blood. Loss-of-function APOC3 variants are associated with significantly lower TG levels and a reduced risk of heart disease, underscoring the potential of APOC3 inactivation as a therapeutic strategy for patients with familial chylomicronemia syndrome (FCS) and severe hypertriglyceridemia (SHTG). Here, we developed STX-1400 lead molecules as a novel investigational gene editing treatment using a highly engineered CRISPR-CasX mRNA and a guide RNA (gRNA) encapsulated into lipid nanoparticles (LNPs) to edit the APOC3 gene and knock out its hepatic expression.

Methods:
STX-1400 lead molecules were evaluated for editing potency and resulting functional effects on APOC3 reduction in vitro in primary human hepatocytes (PHHs) and primary cynomolgus hepatocytes (PCHs). In vivo studies were conducted in PXB mice, a humanized liver mouse model. Liver biopsies and serum samples were collected at two weeks post-dose. Human APOC3 mRNA and APOC3 protein levels were measured in liver biopsies and serum samples, respectively. Lipid profile evaluation, which included measuring TGs and total cholesterol (TC) levels, was also performed.

Results:
Treatment of PHHs with LNPs containing STX-1400 lead molecules showed a dose-dependent increase in editing activity; up to 90% editing at the APOC3 locus was associated with >70% reduction in secreted APOC3 protein levels. Potency was also observed in PCHs, with up to 70% editing. A single dose of LNPs encapsulating STX-1400 lead molecules delivered into PXB humanized mice resulted in >60% editing at the APOC3 locus in the liver, which was associated with >90% reduction of serum hAPOC3 protein levels, accompanied by reduction in TG and TC levels.

Conclusions:
These data demonstrate that the STX-1400 lead molecules efficiently knock down hepatic expression of APOC3 in preclinical models. This work suggests that the CRISPR-CasX-based editor approach could be developed as a single dose therapy for the treatment of hypertriglyceridemia.
Abstract 4146311: Cardiac Thickening, Cell Free DNA, and Rejection in the 2
nd
Porcine Cardiac Xenograft
Authors: Tully Andrew , Mohiuddin Muhammad , Galindo Javier , Cipriano Sarah , Saharia Kapil , Lankford Allison , Dickfeld Timm , Asadi Sadegh , Hicks Albert , Hong-Zohlman Susie , Gupta Anuj , Grazioli Alison , Feller Erika , Griffith Bartley , Ananthram Manjula
Published: November 2024

Introduction/Background:
A 58-year-old man with inotrope dependent heart failure was declined for allotransplant and MCS at multiple centers and was transplanted with a 10 gene-edited porcine cardiac xenograft under FDA expanded access Investigational New Drug (eIND) approval. After requiring perioperative transfusions, by post operative day (POD) 13, endomyocardial biopsy revealed antibody and complement deposition without damage or cellular infiltrate. Hemodynamic decompensation on POD 29 prompted biopsy revealing antibody mediated rejection (AMR). The patient required ECMO support POD31 and chose comfort care POD 40.

Research Questions/Hypothesis:
The cardiac xenograft doubled in mass from implant to autopsy. Donor derived cell free DNA (cfDNA) correlated temporally with the rejection findings. These processes are hypothesized to correlate.

Approach:
Routine TTE measurements of diastolic LV posterior wall dimension (LVPWd), intraventricular septal dimension (IVSd), LV mass, and LV mass index were taken. Donor derived cfDNA was measured weekly and PRN (Care Dx Inc., Brisbane, CA). Pearson correlation coefficient analysis was conducted in GraphPad Prism 10 (Dotmatics, Boston, MA).

Results/Data:
POD 26 TTE measurements indicated thickening graft. POD 30 cfDNA began elevating. cfDNA correlated moderately with LVPWd (r = 0.43, p=0.4) and IVSd (r= 0.5, p=0.31) less so with LV mass (r= 0.28, p=0.59) and LV mass index (r=0.34, p=0.51)

Conclusions:
Xenograft cardiac thickening measured on TTE preceded elevation in cfDNA. Both were moderately correlated and temporally corresponded to biopsy diagnosed AMR and ultimate graft failure. Future xenograft surveillance will likely benefit from multimodal approach.
Abstract 4147623: PORTAL VEIN PULSATILITY INDEX, INDEPENDENT OF INFERIOR VENA CAVA DILATATION, PREDICTS ACUTE KIDNEY INJURY IN PATIENTS WITH ACUTE HEART FAILURE
Authors: Gonzalez Macedo Eder , Latapi Ruiz Esparza Ximena , Hernandez Pastrana Sarai , Diaz Braiana , Garcia Villarejo Mariana , Neri Bale Raul Rodrigo , Santiago Hernández Alberto , Gopar-Nieto Rodrigo , Sierra Lara Martinez Jorge Daniel , Arias-Mendoza Alexandra , Araiza Diego
Published: November 2024

Background:
The VExUS score is a useful tool for assessing systemic venous congestion that has shown the ability to predict acute kidney injury (AKI) in various populations (post cardiac surgical, CKD&ACS patients). Among the variables included in VExUS, inferior vena cava diameter (IVCD) is of particular importance, as the finding of a non-dilated IVCD (<20 mm) assigns a VExUS score of 0 (indicating no venous congestion). However, multiple factors in addition to congestion status may affect the IVCD, which may result in an errouneous assessment of congestion. Previous studies have suggested that portal vein pulsatility index (PVPI) and renal vein doppler are associated with volume status; however, no previous studies have assessed the PVPI, independently of IVCD, in the prediction of AKI.

Hypothesis:
We hypothezise that PVPI may predict AKI independently of the IVCD in patients with AHF.

Methods:
A prospective, single-center study was conducted, including patients admitted to the emergency room from July 2023 to January 2024 with the diagnosis of AHF, and in whom VExUS evaluation was performed during the first 8 hours of admission.

For the analysis of the primary endpoint, patients were divided into four groups based on the presence or absence of a dilated inferior vena cava (cutoff <20 mm) and a PVPI ≥30%. We calculated the differences in time to the development of AKI for each group using survival analysis, Log-rank test and depicted the results using Kaplan-Meier curves. All statistical analyses were conducted using STATA v14.1.

Results:
A total sample of 189 patients was available for analysis (Figure 1). The mean age was 58.3 years (45.7–70.9), and the proportion of men was 73.6% (137), 5.9% patients had CKD stage IV (n = 11) and 18.8% CHF (n = 35). The median of serum creatinine at admission was 1.1 mg/dL (0.8 – 1.56) and NT-proBNP 4422 (1266 – 10783).

Conclusion:
PVPI, independent of dilatation of IVC, is a predictor of AKI in patients with AHF.
Abstract 4147630: Towards transplantation of hearts from donation after circulatory death - stem cell derived therapy for ameliorating donor organ damage
Authors: Yan Liangliang , Wang I-wen , Li Ping , Wang Meijing
Published: November 2024

The use of heart transplantation (HTx), a key life-saving therapy for end-stage heart failure, is limited by the shortage of acceptable donor hearts. Although donation after circulatory death (DCD) offers a potentially promising resource for clinical transplantation, its adoption for HTx is concerned by warm ischemic damage during the death process. Mesenchymal stem cell (MSC)-derived paracrine action has been proved to mediate cardioprotection. Based on our previous study showing that MSC conditioned media (MSC CM) and MSC-exosomes (MSC Exo) confer improved donor heart preservation during cold ischemic storage, we

aimed

to test the effect of MSC CM and MSC Exo on
ex vivo
recovery of ischemia-damaged myocardium and on promoting the implanted DCD heart function using an
in vivo
murine heterotopic heart transplantation model.

Methods:
Donor hearts from adult male C57BL/6 mice with 0, 30’ or 50’
in vivo
warm ischemia (WI) were divided into (n=5-7/group): 1) no WI; 2) 30’-WI; 3) 50’-WI; 4) no WI+4h cold storage at 0-4°C (no WI+CS); 5) 30’-WI+CS; 6) 50’-WI+CS; 7) 50’-WI+CS+vehicle; 8) 50’-WI+CS+MSC CM; and 9) 50’-WI+CS+MSC Exo. The CM and Exo were obtained from cultivation of human bone marrow-MSCs in serum-free media for 72h and was added into preservation solution. Donor hearts were implanted into C57BL/6 male recipients using cervical heterotopic heart transplantation. At 24h post-surgery, left ventricular (LV) function was detected in transplanted hearts. Abdominal artery pressure was measured in recipients to validate technical reproducibility of the HTx model. Mitochondrial structure was detected by electron microscopy on the fixed human LV (hDCD&hDBD).

Results:
WI significantly impaired LV function in transplanted DCD hearts vs. no-WI (Fig. A, B). Intriguingly, markedly improved graft function was observed in MSC CM- or Exo-treated DCD hearts vs. vehicle (Fig. C). Short and disrupted cristae in mitochondria were noticed in hDCD vs. hDBD (Fig. D).

Conclusions:
Our results represent the initial evidence that MSC secretome (CM&Exo) mediates ex vivo cardiac repair in DCD hearts and validate an approach on MSC derived therapy to rescue marginal DCD donor hearts and improve post-transplant graft function.
Abstract 4147634: Important Role of Prediabetes in Stroke Patients including ESUS
Authors: Boettger Priyanka , Lemm Henning , Buerke Michael
Published: November 2024

Stroke including ESUS is one of the common causes of disability and death worldwide. Furthermore, diabetes mellitus and prediabetes are among the main risk factors for cerebrovascular events. If the criteria for apparent diabetes mellitus is not met, a glucose metabolism disorder may still exist. Prediabetes can be present as impaired fasting glucose (IFG), impaired glucose tolerance or an increased, but not yet diabetic, HbA1c.

To determine the frequency of diabetes mellitus (DM) and prediabetes mellitus (PDM) in patients with cardiovascular events, we analyzed the aspects of prediabetes in a stroke population of one of the largest stroke centers in Germany and collected the data in a prospective manner over 6 months.

Among 714 included patients, 163 (30.8%) suffered a cryptogenic Stroke, including 98 (19%) ESUS. 185 (26%) TIA, 209 (39%) cardioembolic, 110 (21%) atherosclerotic, 40 (8%) lacunar and 7 (1%) other specific strokes were registered. >50% had a diabetic or prediabetic metabolic state, among which, the highest proportion was seen in lacunar strokes, followed by atherosclerotic infarctions. >80% of lacunar, >70% of atherosclerotic infarctions, 60% of ESUS, 50% of cardioembolic infarctions indicate DM or PDM. Both PDM and DM show a positive correlation with age. PDM is most common in 75-84y old patients. In the male population, PDM is most prevalent in the oldest patients (<85y) at >50%, and least prevalent in the youngest patients (<65y) at 15%. In this age group, women show a significantly higher frequency of DM and PDM. The highest number of female patients with glucose metabolism disorders is seen in the age group of 66-74y at >40%. In the oldest patient group, relatively speaking, more than twice as many men are affected by glucose metabolism disorders as women (52% vs. 24%).

In summary the largest relative proportion of prediabetics and diabetics is seen at 80% among the lacunar infarction group and the second largest proportion at 70% among those with atherosclerotic infarctions. Among ESUS and cryptogenic stroke patients show a proportion of over 60% with impaired glucose tolerance. PD presents a positive correlation with increasing age, just like other risk factors. 40% of the 75-84-year-olds have DM or PDM. Therefore, diabetogenic micro- and macroangiopathies could be a major contributing factor to the causes of stroke.
Abstract 4147638: Food Security, Depression, and the Association of Depression with Adherence to Cardiovascular Disease Risk Reduction Measures among Rural Caregivers of Patients with Chronic Diseases
Authors: Hammash Muna , Biddle Martha , Lennie Terry , Chung Misook , Moser Debra
Published: November 2024

Introduction:
Caregivers are at high risk of cardiovascular disease (CVD) and depression compared to non-caregivers. Food security has been suggested to be a risk factor for depression. Depression may be connected to poor self-care. Studies exploring food security, depression and its relationship to adherence to CVD risk reduction measures among rural caregivers are lacking.

Aims:
To determine: 1) the association between food security and depression in rural caregivers, and 2) the relationship between depression and caregiver burden, and reported adherence to recommended CVD risk reduction measures in rural caregivers of patients with chronic diseases.

Method:
In this cross-sectional study, 277 rural caregivers (mean age 54 ± 14 years; 76% were female; and 70% were married) provided self-reported data on their sociodemographic factors, food insecurity (US Household Food Security Survey Module), caregiver burden (Zarit Burden Interview), depression (Patient Health Questionnaire-9), and adherence to recommended CVD risk reduction measures (Medical Outcomes Study Specific Adherence Scale). Hierarchical regression analysis was performed.

Results:
In this study, food insecurity and high depressive symptoms were prevalent in 23% and 25% of rural caregivers, respectively. Food insecurity was associated with higher depressive symptoms (
β
= 0.21;
p
<.01), controlling for covariates. Caregivers who reported higher depressive symptoms had higher caregiver burden (
β
= 0.49;
p
<.01) and poor adherence to recommended CVD risk reduction measures (
β
= 0.18;
p
<.01) compared to those with low or no depressive symptoms, controlling for covariates.

Conclusion:
In rural caregivers, food insecurity was associated with higher depressive symptoms. Depressive symptoms were negatively associated with adherence to recommended CVD risk reduction behaviors. Greater attention should be given to food security and psychosocial factors to reduce CVD risk in this population.
Abstract 4148073: Expect the Unexpected: Type A Aortic Dissection in Pregnant Patient with Marfan Syndrome
Authors: Stucky Lauren , Rajpal Saurabh , Lastinger Lauren
Published: November 2024

Case Description:
A 26 yo woman with Marfan Syndrome (MFS,
FBN1
), ectopia lentis, aortic dilation and no family history of MFS or aortic dissection was evaluated for preconception counseling. She was asymptomatic, and the size of her aortic root (~4cm) and ascending aorta (~3.5cm) had been stable for over 5 years. She was counseled that risk of cardiac events during her pregnancy is high, but lower compared to those with aortic sizes >4.5cm. Once pregnant, she was followed closely with imaging every trimester (MRA at 25 weeks gestation showed stable aortic sizes). Cardio-obstetric recommendations included: CARPREG II score: 2, mWHO class: III, consideration of assisted second stage due to aortic root dilation. She was counseled on symptoms of aortic dissection and to seek emergency care should those symptoms arise. At 27 weeks gestation, she presented to the ED with intense chest and neck pain, shortness of breath, and headache. Emergent CT showed aortic root (4.1cm) and proximal ascending aortic dissection with propagation into the left main coronary artery
(Figure 1).
She underwent emergent C-section followed by aortic root and ascending aorta replacement and mechanical aortic valve replacement due to severe regurgitation. She was discharged in stable condition 8 days after an uncomplicated post-operative recovery. Her baby is recovering in the NICU.

Discussion:
While risk of aortic dissection in women with MFS is higher during pregnancy, recent studies suggest relative safety with aortic root diameters up to 4.5cm. Our case highlights that even at “lower risk” aortic sizes, aortic dissection remains an important risk for such women. Educating patients and providers about the acute symptoms of aortic dissection and forming an action plan for timely intervention can be lifesaving. Furthermore, some genetic mutations (e.g.
TGBR1/2
or
SMAD3
) and sequence variants within the
FBN1
gene may pose a higher risk of aortic dissection at smaller aortic diameters. Our patient’s pathogenic
FBN1
mutation (-c.2114-5T>G, previously classified as a VUS) highlights the importance of genetic testing: prophylactic surgery at sizes <4.5cm may be considered with high-risk genetic variants or a family history of aortic dissection.
Abstract 4148074: Radial Artery Pseudoaneurysm Following Transradial Cardiac Catheterization: A Systematic Review and Case Report
Authors: Chinedozi Ifeanyi , Sulague Ralf Martz , Athipathy Nikhita , Kumar Nivedita , Le Anson , Juboori Hiba , Darby Zachary , Kang Jin Kook , Kilic Ahmet , Lawton Jennifer
Published: November 2024

Introduction/Background:
Transradial cardiac catheterization (TRC) is recommended for patients with acute coronary syndrome over femoral artery catheterization. Randomized controlled trials show TRC has significantly lower rates of bleeding, vascular complications, and mortality in high-risk acute coronary syndrome patients. However, vascular complications like radial artery spasm, occlusion, arteriovenous fistula, perforation, and pseudoaneurysm (PSA) can still occur. Despite TRC's widespread adoption, recent data summarizing radial artery pseudoaneurysm post-TRC is lacking.

Research Question/Hypothesis
This review aims to identify at-risk patients, present a case of catheterization-related radial artery pseudoaneurysm, and provide diagnostic and management insights. We hypothesize that older patients with hypertension are at higher risk and that early detection and management are associated with low complication rates.

Methods/Approach:
Systematic searches were conducted in PubMed, Web of Science, EMBASE, and CINAHL databases. Two researchers independently selected articles, extracted data, and evaluated study quality on RA PSA post-TRC (2003–2023). A third reviewer resolved conflicts. The Joanna Briggs Institute (JBI) tool was used to evaluate bias risk. Additionally, a case report is presented.

Results:
From 3,262 records, 43 studies were selected, involving 67 patients (58.8% female, median age 73.5 years). Hypertension (39.5%) and atrial fibrillation (27.9%) were the most common comorbidities. Percutaneous interventions like stenting and angioplasty caused 58.1% of cases; diagnostic catheterizations accounted for 37.2%. Ultrasonography diagnosed 83.7% of cases. Symptoms appeared a few hours to four months post-TRC, with pulsatile mass (21.4%) and swelling (14.3%) being the most common, and pain and ecchymosis at 2.4% each. More than half of the patients (51.2%) required surgical intervention, but 66.7% recovered without deficits. Severe complications were rare, affecting fewer than 5%.

Conclusions:
A literature review of 43 articles with 67 patients suggests older female patients with hypertension may be more prone to radial artery pseudoaneurysm post-TRC. It typically presents as a pulsatile, painful swelling detectable by ultrasound. This complication precludes the use of the radial artery as a conduit for coronary artery bypass grafting. The review highlights the importance of vigilant post-catheterization monitoring to enable early detection and treatment.
Abstract 4148096: Discrimination Abilities of Euroscore and SYNTAX score for Prognostic Outcomes in patients with Stable Coronary Artery Disease: A Systematic Review and Meta-analysis
Authors: Upreti Prakash , Basit Jawad , Khan Muhammad Hammad , Ahmed Mushood , Hamza Mohammad , Sharif Muhammad Ans , Hanmandlu Ankit
Published: November 2024

Introduction:
There is a lack of good risk prediction models in patients with stable coronary artery disease (SCAD). We conducted a meta-analysis of validation studies to compare and determine the discrimination abilities of Euroscore (ES) and Syntax score (SS) for prognostic outcomes in patients with SCAD.

Methods:
A comprehensive literature search was conducted across MEDLINE, Cochrane and Embase from inception till May 2024. All studies that reported C-statistic/AUC for predicting all cause mortality, cardiac death or Major adverse cardiovascular events (MACE) for patients with stable coronary artery disease (SCAD) were included in the analysis. Studies lacking confidence intervals (CI) for C-statistic or those which reported C-statistics in patients with acute coronary syndromes or mixed SCAD and ACS patients were excluded. A generic inverse variance method was used to pool C-statistics and their corresponding standard errors (SEs). The SEs were calculated from CI wherever needed. A pooled C statistic of >0.8 was considered to be a good discrimination ability.

Results:
A total of 5 studies with a patient population of 5903 were included in the meta-analysis. For ES, the pooled C-statistic for all cause mortality (n=2666) was 0.69[0.51-0.87] while for cardiac death (n=2666) it was 0.77[0.60-0.71]. The discrimination ability of ES for MACE as reported by one study (n=305) was 0.54[0.49-0.60]. For SS, the summary AUC for all cause mortality (n=2936) was 0.77[0.69-0.85] while for cardiac death (n=305) it was 0.52[0.46-0.57]. The pooled AUC of SS for occurrence of MACE(n=2666) was 0.56[0.45-0.66].

Conclusion:
None of the two scores have a a good discrimination ability for risk stratification in SCAD patients. The predictive accuracy of SS is comparatively better than ES for all cause mortality. However, ES performs better for predicting cardiac death. Better risk prediction models with large scale external validations are needed.
Abstract Sa1107: Resuscitation of Lungs after Cardiac Arrest with Ex-Vivo Lung Perfusion: A Bench Study to Minimize Ventilator-Induced Lung Injury through Flow Modulation
Authors: Stiers Michiel , Guldentops Joris , Schepens Tom , Vercauteren Jan , Genbrugge Cornelia , Hoogmartens Olivier , Marinus Benoit , Neyrinck Arne , Sabbe Marc
Published: November 2024

Introduction:
Lung donation after uncontrolled circulatory death (uDCD) following a witnessed cardiac arrest is feasible after resuscitation and assessment with ex vivo lung perfusion (EVLP). This bench study explores the efficacy of expiratory flow modulation in minimizing damage caused by mechanical power during volume-controlled ventilation within the EVLP procedure.

Methods:
Donor lungs were simulated using the ASL 5000 lung simulator (IngMar Medical) and ventilated in volume-controlled mode using the ViX-ventilator (KU Leuven), set at 7 breaths per minute with a positive end-expiratory pressure of 5 cmH
2
O. (Figure 1) Baseline measurements were obtained to deliver tidal volumes (VT) of 300, 400, and 500 mL. These measurements were then compared to an intervention where expiratory flow was modulated using an in-house designed device, the flow modulator. Mechanical power (J/min) was calculated using the pressure-volume curve. Differences in power between the baseline and various levels of flow modulation were assessed using a one-sided t-test.

Results:
No clinically relevant differences were observed in VT delivery between baseline settings and during expiratory flow modulation. (Table 1) However, significant differences in mechanical power were noted between baseline and flow modulation across the three VT settings (p<0.001). The reduction in power varied from 10.9% to 58.5%, depending on the selected VT and the degree of flow modulation applied. Notably, the extent of power reduction increased with the level of flow modulation.

Conclusion:
Flow modulation in the expiratory circuit during volume-controlled ventilation in a bench set-up does not affect VT delivery and can significantly reduce mechanical power by up to 58.5%. This reduction in mechanical power could potentially reduce iatrogenic damage during EVLP. Consequently, this might extend preservation times and improve the resuscitation outcomes of uncontrolled DCD lungs. Emergency medicine has the opportunity to leverage this vital pool of donor lungs, moving towards a future with minimal transplant waitlists.
Abstract Su802: Feasibility of detecting CPR compression frequency using machine-learning software in video footage of CPR
Authors: Wetsch Wolfgang , Adams Niels-Benjamin , Schmitz Michael , Ecker Hannes
Published: November 2024

Background:
Several studies have demonstrated that video assisted cardiopulmonary resuscitation (V-CPR) is efficient in improving cardiopulmonary resuscitation (CPR) quality and patient outcome. However, currently the technique depends on 911 dispatchers who evaluate the video footage and may thus be subject to inter-operator variations.

Research Question:
We hypothesized that using an open-source machine learning supported software (“artificial intelligence” – AI) would be able to provide real-time feedback on CPR frequency in a video of CPR.

Aims:
To evaluate the feasibility and accuracy of a selected AI software to correctly detect the actual compression frequency in video footage of CPR performed in a CPR manikin.

Methods:
MediaPipe Pose Landmark Detection (Google LLC, Mountain View, CA, USA), an open-source AI software using machine-learning models to detect human body postures in images and videos, was programmed to assess compression frequency of nine videos showing CPR on a manikin, each with a different fixed compression frequency and compression depth. Camera angle and distance were standardized. Frequency was assessed from compression to compression with AI software and the manikin’s internal software (QCPR, Laerdal, Stavanger, Norway). After testing for Gaussian distribution, means were compared using Wilcoxon matched-pairs signed rank test.

Results:
There were high levels of agreement between compression frequencies derived from AI and manikin’s software (Statistic comparisons are presented in Figure 1, correlations of measurements are presented in Figure 2 ).

Conclusions:
In this pilot study, an open-source landmark detection AI software was able to assess CPR compression frequency with high agreement to actual frequency derived from a CPR manikin. Since the software used is currently not intended for medical use, further development is necessary before the technology can be evaluated for real-life CPR.
Abstract Su806: Enhancing Cardiac Arrest Registries and Research – A Framework for Handling Defibrillator Data
Authors: Orlob Simon , Kern Wolfgang , Hackl Benjamin , Eichlseder Michael , Klivinyi Christoph , Putzer Gabriel , Schreiber Nikolaus , Bohn Andreas , Martini Judith , Holler Martin , Wnent Jan , Graesner Jan-Thorsten
Published: November 2024

Background:
Cardiac arrest is the most time-sensitive medical condition, and survival probability is highly dependent on early, high-quality cardiopulmonary resuscitation (CPR) measures. Resuscitation registries are established tools for continuous quality improvement and serve as a source for research. Yet they lack comprehensive information on the quality of CPR measures themselves—such as the depth, rate, and release of chest compressions—and are limited in the temporal resolution of these measures. However, data on both are contained in the recordings of defibrillators.

Aims:
To develop a framework for healthcare providers to gain immediate case-specific feedback, reduce documentation efforts and make fine-grained information accessible for research.

Approach:
An open-source Python module named
CPRDAT
(Kern et al. Zenodo, https://doi.org/10.5281/zenodo.10057964) was designed. This module is capable of importing and extracting data from various defibrillators as well as data recorded by
VitalRecorder
(
VitalDB
, Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea) into a uniform data object. Methods were implemented to automatically process, analyze, and aggregate these time-series of physiological signals, with particular attention to CPR. To reduce manual annotation workload, classification algorithms were developed.

Plotting routines were developed to display the signals interactively in web applications, allowing healthcare providers to interact with the data through zooming, scaling, shifting, concatenating, merging and labelling.

Results:
The module was implemented into the German Resuscitation Registry, offering users a manufacturer-agnostic, data-driven, case-specific debriefing tool. Extracted information on CPR measures is stored in the registry. The framework, able to manage multiple time-series data sources, was further implemented in other settings, such as the analysis of laboratory data of a CPR swine model.

Conclusions:
The new module dramatically enhances the accessibility of physiologic time-series recordings. More fine-grained data will provide deeper insights into processes and CPR physiology. Finally, the open-source Python module abolishes barriers in research.
Relationship Between Race, Predelivery Cardiology Care, and Cardiovascular Outcomes in Preeclampsia/Eclampsia Among a Commercially Insured Population
Authors: Bolakale-Rufai Ikeoluwapo Kendra , Knapp Shannon M. , Tucker Edmonds Brownsyne , Khan Sadiya , Brewer LaPrincess C. , Mohammed Selma , Johnson Amber , Mazimba Sula , Addison Daniel , Breathett Khadijah
Published: November 2024

BACKGROUND:

It is unknown whether predelivery cardiology care is associated with future risk of major adverse cardiovascular events (MACE) in preeclampsia/eclampsia (PrE/E). We sought to determine the cumulative incidence of MACE by race and whether predelivery cardiology care was associated with the hazard of MACE up to 1 year post-delivery for Black and White patients with PrE/E.

METHODS:

Using Optum’s de-identified Clinformatics Data Mart Database, we identified Black and White patients with PrE/E who had a delivery between 2008 and 2019. MACE was defined as the composite of heart failure, acute myocardial infarction, stroke, and death. Cumulative incidence functions were used to compare the incidence of MACE by race. Regression models were used to assess the hazard of MACE by cardiology care for each race. Separate hazards were calculated for the first 14 days and the remainder of the year.

RESULTS:

Among 29 336 patients (83.4% White patients, 16.6% Black patients, 99.5% commercially insured, mean age: 30.9 years) with PrE/E, 11.2% received cardiology care (10.9% White patients, 13.0% Black patients). Black patients had higher incidence of MACE than White patients at 1 year post-delivery (2.7% versus 1.4%) with the majority within 14 days of delivery (Black patients: 58.7%; White patients: 67.8%). After adjusting for age and comorbidities, receipt of cardiology care was associated with a lower hazard of MACE for White patients within 14 days after delivery (hazard ratio, 0.31 [95% CI, 0.21–0.46];
P
<0.001) but not Black patients (hazard ratio, 1.00 [95% CI, 0.60–1.67];
P
=0.999). The effect of the interaction between race and cardiology care was significant in the first 14 days (
P
<0.001) but not the remainder of the year (
P
=0.56).

CONCLUSIONS:

Among a well-insured population of patients with PrE/E, Black patients had a higher cumulative incidence of MACE up to a year post-delivery. Cardiology care was associated with a lower hazard of MACE only for White patients during the first 14 days after delivery.
3. Qal versus hifʿil Forms of יס"ף
Authors: Hornkohl Aaron D.
Published: November 2024

Throughout the Hebrew Bible, qal and hifʿil forms of the root יס"ף compete in the meaning ‘add, do again’. Examining the distribution of unambiguous consonantal forms, it becomes clear that the qal form is the more archaic, the hifʿil common only in later forms of ancient Hebrew, biblical and extrabiblical, with confirmation from cognate sources. A whole swathe of evidence, however, is consonantally ambiguous. The stem morphology of prefix conjugation (i.e., yiqṭol and wayyiqṭol) forms can be determined only on the basis of plene orthography and vocalisation, and even then is often ambiguous. The discussion centres on the analysis of the equivocal data in light of the unequivocal, highlighting the importance of considering secondary processes and suggesting possible interpretations and ramifications.
6. עצ " ק versus עז
Authors: Hornkohl Aaron D.
Published: November 2024

The distribution of the Hebrew roots צע"ק and זע"ק reveals a significant diachronic trend in ancient Hebrew texts, indicating that the root זע"ק gradually supplanted צע"ק over time. While both roots are prominent in the Masoretic biblical tradition, as well as in late extrabiblical materials, צע"ק shows more prevalence in Classical Biblical Hebrew (CBH), particularly in the Torah. In contrast, Late Biblical Hebrew (LBH) exhibits marked preference for זע"ק. This shift is further supported by the absence of צע"ק in certain Dead Sea Scrolls and its rarity in Aramaic documents from the same period, suggesting influence of Aramaic on the transition towards זע"ק.

The analysis of distribution patterns indicates that the use of צע"ק persisted in certain late biblical and extrabiblical texts despite the encroachment of זע"ק. This trend raises questions about the nature of linguistic change within CBH and LBH, suggesting that while some late texts maintain older linguistic features, they do not represent a consistent classical style. The observed differences in the usage of צע"ק and זע"ק between the Torah and the Prophets may reflect a genuine historical linguistic divergence, revealing a deeper complexity in the diachronic development of Hebrew. The persistence of צע"ק in specific contexts, such as poetic texts, further indicates the nuanced evolution of Hebrew language and its literary traditions over time. Turning to the Documentary Hypothesis, P patterns as classically as J in terms of the use of צע"ק over זע"ק.
Does habitus provide the framework for Scandinavian cooperation?
Authors: Pugh Jonathan
Published: November 2024

This article argues that habitus is the basis for Scandinavian cooperation. The article makes two contributions. First, it endeavours to contribute to the literature on Scandinavian cooperation by demonstrating, through the article’s empirical data, that shared habitus provides the structural framework for Scandinavian cooperation. Habitus drives together the bureaucratic, diplomatic, and political personnel of Denmark, Norway, and Sweden, including those who work within, or as state representatives, at International Organisations (IOs), despite them being members of differing communities of practice. Habitus also shapes Scandinavian approaches to practices within IOs and global politics. The second contribution the article makes is a theoretical one, to International Relations practice theory literature, through demonstrating the usefulness of habitus as a conceptual tool in examining the basis for close bonds and cooperation between groups of states.
From policy to practice: How NATO joined forces with NGOs for the protection of civilians
Authors: Charotte Daphné , Colli Francesca , Reykers Yf
Published: November 2024

North Atlantic Treaty Organization’s (NATO’s) active cooperation with non-governmental organisations (NGOs) on the protection of civilians (PoC) challenges the academic assumption that NATO’s decision-making structures are generally closed to civil society participation. What explains the decision of NATO officials to work with NGOs when developing a Policy for the PoC, and how did this cooperation take place? Combining insights from resource dependency and organisational learning theories, we explore whether and how concerns about public legitimacy and operational effectiveness can explain that NATO engaged with NGOs during its learning process on PoC. Methodologically, we combine data from 26 interviews with NATO officials and NGO representatives with a document analysis of 648 NATO publications. Our analysis shows that NATO’s collaboration with NGOs in the adoption of a PoC policy was very much a bottom-up process. Military commanders began engaging with NGOs on the ground during NATO’s International Security Assistance Force operation in Afghanistan (2001–2014). NGOs then gradually gained access to the formulation and institutionalisation of the PoC policy. While legitimacy concerns triggered NATO’s initial cooperation with NGOs, effectiveness concerns related to policy implementation facilitated stronger cooperation once the process was underway.
EXPRESS: Identifying Competitors in Geographical Markets Using the CSIS Method
Authors: Gu Xian , Kannan P. K.
Published: November 2024

Identifying the most relevant competitors in a geographical market is crucial for businesses with a significant offline presence, such as hotels, restaurants, and retail stores. The specific location of a business and the geographical density of potential competitors are critical factors in determining the competitive structure. However, this task can be challenging when the potential number of competitors is large and the competition is asymmetric. In this study, we apply the Conditional Sure Independence Screening (CSIS) method to a system of demand functions for competitor identification. This method offers significant computational efficiency by estimating a marginal regression for each potential competitor, rather than a full model consisting of all potential competitors. To validate the effectiveness of the CSIS method and explore the boundary conditions of its performance, we conduct extensive simulation analyses under different spatial data-generating processes. Our findings demonstrate that the CSIS method outperforms multiple other variable selection methods and remains robust under spatial misspecifications. Then we apply the CSIS method to hotel competition in two U.S. geographical regions, illustrating how the competitive structure varies across geographical densities and market segments. Finally, we highlight how managers can strategically use the results and outline the potential of the method for other non-geographical applications.
Complexity and psychology / Complejidad y psicología
Authors: Corral Roberto
Published: November 2024

This article explores the effects that complexity theory could have on the development of contemporary psychology. It specifically identifies the definition of the object of study, the main descriptors — the matter of mutually exclusive dichotomies — the method of knowing — the relationship between the objective and the subjective — and, finally, the problem of determinations. In all these dimensions, a brief discussion is given on the changes taking place in contemporary psychology, and on how complexity theory can help us systematize and clarify the relationship between the objective and the subjective.
User perspectives on library digitization and its impact on research capabilities
Authors: Elihaki Kanyika Martin , Sadykova Raikhan , Tuyenbayeva Kalima , Wema Evans
Published: November 2024

This study assessed user perspectives on library digitization and its impact on research capabilities. A survey design with both quantitative and qualitative approaches was employed. Simple random sampling was used to select respondents whereas purposive sampling was used to select key informants. Data were collected using online questionnaires and interviews. MS Excel was used to analyze quantitative data while qualitative data was analyzed using thematic method. Findings show that the majority of the respondents utilize library resources frequently with statistical analysis (MS = 0.387998, t = −1.45939, p < 0.146074) indicating there is no significant difference between education level and the frequency of library resources usage. Also, the majority of respondents have positive perceptions towards the use of library resources with t-statistic (6.599663291, is above 1.649982976 for one-tail and 1.967956506 for two-tail) indicating a significant difference between age and perceptions towards the use of library resources. Moreover, findings show capacity of a single document to be used by many users at once and information to be accessed at a fingerprint are major impacts of library digitization. Furthermore, findings reveal issues related to licensing, subscription costs, and copyright and overwhelming volume of information available as the major challenges user face when utilizing digital library resources. This study marks the pioneering exploration into the impacts of library digitization on research capabilities. The study therefore, recommends a continuous training to students to be able to access and critically evaluate the overwhelming amount of online information. Also, users should be trained on how to navigate copyright issues when accessing digital library resources. Additionally, libraries should consider expanding their collections by incorporating more open access resources. Moreover, parent institutions should make sure that they increase the budget to their digital libraries so that libraries can increase the subscriptions of all useful resources.
Influences on the physical activity behaviour of inpatients after stroke outside of staff-led rehabilitation sessions: a systematic review
Authors: Hartley Peter , Bond Katie , Dance Rachel , Kuhn Isla , McPeake Joanne , Forsyth Faye
Published: November 2024

Objective

To use behavioural science frameworks to synthesise evidence on the factors influencing physical activity of patients hospitalised after stroke outside of staff-led rehabilitation sessions.

Data Sources

A systematic review of qualitative and mixed-methods studies. MEDLINE, PsycINFO, CINAHL, and AMED were searched from inception to October 2024 for studies that explored influences on the physical activity of patients hospitalised after stroke.

Review Methods

Data were coded with reference to the Theoretical Domains Framework and the COM-B (‘capability’, ‘opportunity’, ‘motivation’ and ‘behaviour’) model. Thematic analysis was used to group data extracts into themes within each Theoretical Domains Framework domain. Risk of bias was assessed using the Mixed Methods Appraisal Tool.

Results

We identified 17 studies. There was no significant risk of bias concerns. We identified 19 themes across eight Theoretical Domains Framework domains and all COM-B model categories. The most frequently recognised themes were found in three Theoretical Domains Framework domains: Environmental Context and Resources (themes: 1 ­– availability of sufficient skilled staff to facilitate physical activity; 2 – design and use of the physical environment; 3 – lack of opportunities or incentives; 4 – passivity and institutionalisation; 5 – perceived and actual rules and culture of the ward); Skills (theme: physical impairments); and Social Influences (theme: activity influenced by family and friends).

Conclusions

The review highlights the complexity of the influences on the physical activity of patients hospitalised after stroke outside of staff-led rehabilitation sessions. It is likely multi-component interventions addressing a number of influences will be required to effectively improve physical activity. PROSPERO ID: CRD42022383506.
Anthropocene angst: Authentic geology and stratigraphic sincerity
Authors: Damianos Alexander
Published: November 2024

In March 2024, the Anthropocene Working Group’s proposal for a formal Anthropocene Series/Epoch of the Geologic Time Scale was formally rejected by the Subcommission on Quaternary Stratigraphy. What does the failed formalization effort reveal about the relationship between science and normativity under conditions of ‘climate crisis’? Drawing on four years of ethnographic observation of the Anthropocene Working Group, this article explains how the Group developed its proposal, why it failed, and what it reveals about the social construction of geological truth. The effort to formalize an Anthropocene unit was based on a coupling of science and politics, wherein geo-scientists could make normative assertions in the register of scientific fact. Ultimately, the Group failed because it was seen as appropriating incumbent geological techniques to advance claims about the future, transitioning geology from a descriptive science about the past to a site of warning.
White, Female Adultery across the Color Line in North Carolina during Slavery and Reconstruction, c. 1800–1870
Authors: Molloy Marie S.
Published: November 2024

This article focuses on female adultery across the color line between white, married women and enslaved men or free men of color in the context of US slavery. It explores white women's sexual transgression of the societal norms and legislative structures governing the southern family and racial and gender norms of the era. The cases in North Carolina subvert our understanding of white women's place within southern marriage and in relation to slavery, to reveal a complex picture, of white women's sexual agency in their adultery with black men, set within the restraints of southern marriage, and patriarchal dominance.
A Neoclassical Theory of Labor Exploitation: Some Comments
Authors: Basu Deepankar , Das Debarshi , Mukherjee Subhankar
Published: November 2024

In this note, we comment on two aspects of the analysis presented in Eswaran’s article “The Nature of Labor’s Vulnerability to Exploitation.” First, we compare Eswaran’s neoclassical views of labor exploitation with the standard Marxian understanding of labor exploitation. Second, we delve deeper into Eswaran’s model and raise a set of questions about his analysis.

JEL Classification: P12, J22, B14