bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying Veterans Who Benefit From Nirmatrelvir-Ritonavir: A Target Trial Emulation
Authors: Yan Lei , Bui David , Li Yuli , Rajeevan Nallakkandi , Rowneki Mazhgan , Berry Kristin , Argraves Stephanie , Huang Yuan , Hynes Denise M , Cunningham Francesca , Huang Grant D , Aslan Mihaela , Ioannou George N , Bajema Kristina L 
Published: June 2024

Abstract

Background
Nirmatrelvir-ritonavir is recommended for persons at risk for severe coronavirus disease 2019 (COVID-19) but remains underutilized. Information on which eligible groups are likely to benefit from treatment is needed.

Methods
We conducted a target trial emulation study in the Veterans Health Administration comparing nirmatrelvir–ritonavir treated versus matched untreated veterans at risk for severe COVID-19 who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from April 2022 through March 2023. We measured incidence of any hospitalization or all-cause mortality at 30 days. Outcomes were measured for the entire cohort, as well as among subgroups defined by 30-day risk of death or hospitalization, estimated using an ensemble risk prediction model.

Results
Participants were 87% male with median age 66 years and 16% unvaccinated. Compared with matched untreated participants, those treated with nirmatrelvir-ritonavir (n = 24 205) had a lower 30-day risk for hospitalization (1.80% vs 2.30%; risk difference [RD], −0.50% points [95% confidence interval {CI}: −.69 to −.35]) and death (0.11% vs 0.30%; RD, −0.20 [95% CI: −.24 to −.13]). The greatest reductions in combined hospitalization or death were observed in the highest risk quartile (RD −2.85 [95% CI: −3.94 to −1.76]), immunocompromised persons (RD −1.91 [95% CI: −3.09 to −.74]), and persons aged ≥75 years (RD −1.16 [95% CI: −1.73 to −.59]). No reductions were observed in the 2 lowest risk quartiles or persons younger than 65 years.

Conclusions
Nirmatrelvir-ritonavir was effective in reducing 30-day hospitalization and death in older veterans, those at highest predicted risk for severe outcomes, and immunocompromised groups. Benefit was not observed in younger veterans or groups at lower predicted risk for hospitalization and death.
Mapping of lymph node metastasis from esophageal squamous cell carcinoma after neoadjuvant treatment: a prospective analysis from a high-volume institution in China
Authors: Wang Cai-Zhang , Zhang Han-Lu , Shang Qi-Xin , Gu Yi-Min , Yang Yu-Shang , Wang Wen-Ping , Hu Yang , Yuan Yong , Chen Long-Qi 
Published: June 2024

Summary
The study aimed to describe the prevalence of lymph node metastases per lymph node station for esophageal squamous cell carcinoma (ESCC) after neoadjuvant treatment. Clinicopathological variables of ESCC patients were retrieved from the prospective database of the Surgical Esophageal Cancer Patient Registry in West China Hospital, Sichuan University. A two-field lymphadenectomy was routinely performed, and an extensive three-field lymphadenectomy was performed if cervical lymph node metastasis was suspected. According to AJCC/UICC 8, lymph node stations were investigated separately. The number of patients with metastatic lymph nodes divided by those who underwent lymph node dissection at that station was used to define the percentage of patients with lymph node metastases. Data are also separately analyzed according to the pathological response of the primary tumor, neoadjuvant treatment regimens, pretreatment tumor length, and tumor location. Between January 2019 and March 2023, 623 patients who underwent neoadjuvant therapy followed by transthoracic esophagectomy were enrolled. Lymph node metastases were found in 212 patients (34.0%) and most frequently seen in lymph nodes along the right recurrent nerve (10.1%, 58/575), paracardial station (11.4%, 67/587), and lymph nodes along the left gastric artery (10.9%, 65/597). For patients with pretreatment tumor length of &gt;4 cm and non-pathological complete response of the primary tumor, the metastatic rate of the right lower cervical paratracheal lymph nodes is 10.9% (10/92) and 10.6% (11/104), respectively. For patients with an upper thoracic tumor, metastatic lymph nodes were most frequently seen along the right recurrent nerve (14.2%, 8/56). For patients with a middle thoracic tumor, metastatic lymph nodes were most commonly seen in the right lower cervical paratracheal lymph nodes (10.3%, 8/78), paracardial lymph nodes (10.2%, 29/285), and lymph nodes along the left gastric artery (10.4%, 30/289). For patients with a lower thoracic tumor, metastatic lymph nodes were most frequently seen in the paracardial station (14.2%, 35/247) and lymph nodes along the left gastric artery (13.1%, 33/252). The study precisely determined the distribution of lymph node metastases in ESCC after neoadjuvant treatment, which may help to optimize the extent of lymphadenectomy in the surgical management of ESCC patients after neoadjuvant therapy.
Hybrid convergent procedure with proactive oesophageal cooling for the treatment of long-standing persistent atrial fibrillation: a case series
Authors: Velasco Alejandro , Buch Chirag , Hui Dawn , Joseph Christopher , Onsager David , Zagrodzky William , Kulstad Erik , Nayak Hemal M 
Published: June 2024

Abstract

Background
The hybrid convergent procedure is approved to treat symptomatic patients with long-standing persistent atrial fibrillation (AF). Despite direct visualization during surgical ablation as well as the use of luminal oesophageal temperature (LET) monitoring, oesophageal injury is still possible. A dedicated device for proactive oesophageal cooling has recently been cleared by the Food and Drug Administration to reduce the likelihood of ablation-related oesophageal injury resulting from radiofrequency cardiac ablation procedures. This report describes the first uses of proactive oesophageal cooling for oesophageal protection during the epicardial ablation portion of hybrid convergent procedures.

Case summary
Five patients with long-standing persistent AF underwent hybrid convergent ablations with the use of proactive oesophageal cooling as means of oesophageal protection. All cases were completed successfully with no adverse effects. Most notably, cases were shorter when compared to cases using LET monitoring, likely due to lack of pauses for overheating of the oesophagus that would otherwise be required to prevent damage to the oesophagus.

Discussion
This report describes the first uses of proactive oesophageal cooling for oesophageal protection during the epicardial ablation portion of five hybrid convergent procedures. Use of cooling enabled uninhibited deployment of lesions without the need to pause energy delivery due to elevated temperatures in the oesophagus, providing a feasible alternative to LET monitoring.
Therapy duration and improvement of ventricular function in de novo heart failure: the Heart Failure Optimization study
Authors: Veltmann Christian , Duncker David , Doering Michael , Gummadi Siva , Robertson Michael , Wittlinger Thomas , Colley Byron J , Perings Christian , Jonsson Orvar , Bauersachs Johann , Sanchez Robert , Maier Lars S 
Published: June 2024

Abstract

Background and Aims
In patients with de novo heart failure with reduced ejection fraction (HFrEF), improvement of left ventricular ejection fraction (LVEF) is expected to occur when started on guideline-recommended medical therapy. However, improvement may not be completed within 90 days.

Methods
Patients with HFrEF and LVEF ≤ 35% prescribed a wearable cardioverter-defibrillator between 2017 and 2022 from 68 sites were enrolled, starting with a registry phase for 3 months and followed by a study phase up to 1 year. The primary endpoints were LVEF improvement &gt; 35% between Days 90 and 180 following guideline-recommended medical therapy initiation and the percentage of target dose reached at Days 90 and 180.

Results
A total of 598 patients with de novo HFrEF [59 years (interquartile range 51–68), 27% female] entered the study phase. During the first 180 days, a significant increase in dosage of beta-blockers, renin–angiotensin system inhibitors, and mineralocorticoid receptor antagonists was observed (P &lt; .001). At Day 90, 46% [95% confidence interval (CI) 41%–50%] of study phase patients had LVEF improvement &gt; 35%; 46% (95% CI 40%–52%) of those with persistently low LVEF at Day 90 had LVEF improvement &gt; 35% by Day 180, increasing the total rate of improvement &gt; 35% to 68% (95% CI 63%–72%). In 392 patients followed for 360 days, improvement &gt; 35% was observed in 77% (95% CI 72%–81%) of the patients. Until Day 90, sustained ventricular tachyarrhythmias were observed in 24 wearable cardioverter-defibrillator carriers (1.8%). After 90 days, no sustained ventricular tachyarrhythmia occurred in wearable cardioverter-defibrillator carriers.

Conclusions
Continuous optimization of guideline-recommended medical therapy for at least 180 days in HFrEF is associated with additional LVEF improvement &gt; 35%, allowing for better decision-making regarding preventive implantable cardioverter-defibrillator therapy.
Electroanatomical adaptations in the guinea pig heart from neonatal to adulthood
Authors: Haq Kazi T , McLean Kate , Salameh Shatha , Swift Luther M , Posnack Nikki Gillum 
Published: June 2024

Abstract

Aims
Electroanatomical adaptations during the neonatal to adult phase have not been comprehensively studied in preclinical animal models. To explore the impact of age as a biological variable on cardiac electrophysiology, we employed neonatal and adult guinea pigs, which are a recognized animal model for developmental research.

Methods and results
Electrocardiogram recordings were collected in vivo from anaesthetized animals. A Langendorff-perfusion system was employed for the optical assessment of action potentials and calcium transients. Optical data sets were analysed using Kairosight 3.0 software. The allometric relationship between heart weight and body weight diminishes with age, it is strongest at the neonatal stage (R2 = 0.84) and abolished in older adults (R2 = 1E−06). Neonatal hearts exhibit circular activation, while adults show prototypical elliptical shapes. Neonatal conduction velocity (40.6 ± 4.0 cm/s) is slower than adults (younger: 61.6 ± 9.3 cm/s; older: 53.6 ± 9.2 cm/s). Neonatal hearts have a longer action potential duration (APD) and exhibit regional heterogeneity (left apex; APD30: 68.6 ± 5.6 ms, left basal; APD30: 62.8 ± 3.6), which was absent in adults. With dynamic pacing, neonatal hearts exhibit a flatter APD restitution slope (APD70: 0.29 ± 0.04) compared with older adults (0.49 ± 0.04). Similar restitution characteristics are observed with extrasystolic pacing, with a flatter slope in neonates (APD70: 0.54 ± 0.1) compared with adults (younger: 0.85 ± 0.4; older: 0.95 ± 0.7). Neonatal hearts display unidirectional excitation–contraction coupling, while adults exhibit bidirectionality.

Conclusion
Postnatal development is characterized by transient changes in electroanatomical properties. Age-specific patterns can influence cardiac physiology, pathology, and therapies for cardiovascular diseases. Understanding heart development is crucial to evaluating therapeutic eligibility, safety, and efficacy.
Superior vena cava isolation using a pentaspline pulsed-field ablation catheter: feasibility and safety in patients undergoing atrial fibrillation catheter ablation
Authors: Ollitrault Pierre , Chaumont Corentin , Font Jonaz , Manninger Martin , Conti Sergio , Matusik Paweł T , Mulder Bart A , Ferchaud Virginie , Pellissier Arnaud , Al Khoury Mayane , Milliez Paul , Champ-Rigot Laure , Anselme Frédéric 
Published: June 2024

Abstract

Aims
Superior vena cava (SVC) isolation during atrial fibrillation catheter ablation is limited by the risk of collateral damage to the sinus node and/or the phrenic nerve. Due to its tissue-specificity, we hypothesized the feasibility and safety of pulsed-field ablation (PFA)–based SVC isolation.

Methods and results
One hundred and five consecutive patients undergoing PFA-based AF catheter ablation were prospectively included. After pulmonary vein isolation (±posterior wall isolation and electrical cardioversion), SVC isolation was performed using a standardized workflow. Acute SVC isolation was achieved in 105/105 (100%) patients after 6 ± 1 applications. Transient phrenic nerve stunning occurred in 67/105 (64%) patients but without phrenic nerve palsy at the end of the procedure and at hospital discharge. Transient high-degree sinus node dysfunction occurred in 5/105 (4.7%) patients, with no recurrence at the end of the procedure and until discharge. At the 3-month follow-up visit, no complication occurred.

Conclusion
SVC isolation using a pentaspline PFA catheter is feasible and safe.
Mid-term performance of His bundle pacing and usefulness of backup leads
Authors: Herbert Julia , Kovacsovics Arianne , Brito Rita , Masson Nicolas , Burri Haran 
Published: June 2024

Abstract
Ventricular backup leads may be considered in selected patients with His bundle pacing (HBP), but it remains unknown to what extent this is useful. A total of 184 HBP patients were studied. At last follow-up, 147 (79.9%) patients retained His bundle capture at programmed output. His bundle pacing lead revision was performed in 5/36 (13.9%) patients without a backup lead and in 3/148 (2.0%) patients with a backup lead (P = 0.008). One patient without a backup lead had syncope due to atrial oversensing. Thus, implantation of ventricular backup leads may avoid lead revision and adverse events in selected HBP patients.
A temporal sequence of heterochronic gene activities promotes stage-specific developmental events in Caenorhabditis elegans
Authors: Ivanova Maria , Moss Eric G 
Published: June 2024

Abstract
The heterochronic genes of the nematode Caenorhabditis elegans control the succession of postembryonic developmental events. The 4 core heterochronic genes lin-14, lin-28, hbl-1, and lin-41 act in a sequence to specify cell fates specific to each of the 4 larval stages. It was previously shown that lin-14 has 2 activities separated in time that promote L1 and L2 developmental events, respectively. Using the auxin-inducible degron system, we find that lin-28 and hbl-1 each have 2 activities that control L2 and L3 events which are also separated in time. Relative to events they control, both lin-28 and hbl-1 appear to act just prior to or concurrently with events of the L2. Relative to each other, lin-28 and hbl-1 appear to act simultaneously. By contrast, the lin-14 activity controlling L2 events precedes those of lin-28 and hbl-1 controlling the same events, suggesting that lin-14's regulation of lin-28 is responsible for the delay. Likewise, the activities of lin-28 and hbl-1 controlling L3 fates act well in advance of those fates, suggesting a similar regulatory gap. lin-41 acts early in the L3 to affect fates of the L4, although it was not possible to determine whether it too has 2 temporally separated activities. We also uncovered a feedback phenomenon that prevents the reactivation of heterochronic gene activity late in development after it has been downregulated. This study places the heterochronic gene activities into a timeline of postembryonic development relative to one another and to the developmental events whose timing they control.
Medicare Advantage enrollment and outcomes of post-acute nursing home care among patients with dementia
Authors: Kim Daeho , Meyers David J , Keohane Laura M , Varma Hiren , Achola Emma M , Trivedi Amal N 
Published: June 2024

Abstract
Enrollment in Medicare Advantage (MA) has been rapidly growing. We examined whether MA enrollment affects the outcomes of post-acute nursing home care among patients with Alzheimer's disease and related dementias (ADRD). We exploited year-to-year changes in MA penetration rates within counties from 2012 through 2019. After adjusting for patient-level characteristics and county fixed effects, we found that MA enrollment was not associated with days spent at home, nursing home days, likelihood of becoming a long-stay resident, hospital days, hospital readmission, or 1-year mortality. There was a modest increase in successful discharge to the community by 0.73 percentage points (relative increase of 2.4%) associated with a 10-percentage-point increase in MA enrollment. The results are consistent among racial/ethnic subgroups and dual-eligible patients. These findings suggest an imperative need to monitor and improve quality of managed care among enrollees with ADRD.
Age validation of yellowfin and bigeye tuna using post-peak bomb radiocarbon dating confirms long lifespans in the western and central Pacific Ocean
Authors: Andrews Allen H , Eveson J Paige , Welte Caroline , Okamoto Kei , Satoh Keisuke , Krusic-Golub Kyne , Lougheed Bryan C , Macdonald Jed I , Roupsard Francois , Farley Jessica H 
Published: June 2024

Abstract
Age-reading protocols for tuna species using annual growth zones in thin-cut transverse otolith sections have produced greater age estimates than previous methods. Lifespan estimates for yellowfin (YFT) and bigeye (BET) tuna (Thunnus albacares and T. obesus) were validated up to 16–18 years in the western North Atlantic Ocean using bomb 14C dating and the current study extends the approach to YFT and BET of the western and central Pacific Ocean (WCPO). Archived otoliths from young-of-the-year (YOY) tuna caught in the WCPO were analysed for 14C to establish a reference chronology covering 30 years (1989–2019). This YOY 14C time series exhibited strong concordance with existing coral-otolith 14C references for the tropical-subtropical Pacific Ocean and was combined as a single chronology. Otolith cores from YFT aged 1–14 years and BET aged 1–13 years from presumed annual counts were analysed for 14C. These measurements aligned with the reference chronology for the calculated hatch years for both species. These findings provide strong evidence that growth zones in thin-sectioned otoliths are deposited annually for YFT and BET of the WCPO and that age interpretation is correct using the current age reading protocol with little to no bias.
Precise error bounds for numerical approximations of fractional HJB equations
Authors: Chowdhury Indranil , Jakobsen Espen R 
Published: June 2024

Abstract
We prove precise rates of convergence for monotone approximation schemes of fractional and nonlocal Hamilton–Jacobi–Bellman equations. We consider diffusion-corrected difference-quadrature schemes from the literature and new approximations based on powers of discrete Laplacians, approximations that are (formally) fractional order and second-order methods. It is well known in numerical analysis that convergence rates depend on the regularity of solutions, and here we consider cases with varying solution regularity: (i) strongly degenerate problems with Lipschitz solutions and (ii) weakly nondegenerate problems where we show that solutions have bounded fractional derivatives of order $\sigma \in (1,2)$. Our main results are optimal error estimates with convergence rates that capture precisely both the fractional order of the schemes and the fractional regularity of the solutions. For strongly degenerate equations, these rates improve earlier results. For weakly nondegenerate problems of order greater than one, the results are new. Here we show improved rates compared to the strongly degenerate case, rates that are always better than $\mathcal{O}\big (h^{\frac{1}{2}}\big )$.
On the Picard Group of the Stable Module Category for Infinite Groups
Authors: Gómez Juan Omar 
Published: June 2024

Abstract
We introduce the stable module $\infty $-category for groups of type $\Phi $ as an enhancement of the stable category defined by N. Mazza and P. Symonds. For groups of type $\Phi $ that act on a tree, we show that the stable module $\infty $-category decomposes in terms of the associated graph of groups. For groups that admit a finite-dimensional cocompact model for the classifying space for proper actions, we exhibit a decomposition in terms of the stable module $\infty $-categories of their finite subgroups. We use these decompositions to provide methods to compute the Picard group of the stable module category. In particular, we provide a description of the Picard group for countable locally finite $p$-groups.
Varied Prevalence of Antimalarial Drug Resistance Markers in Different Populations of Newly Arrived Refugees in Uganda
Authors: Tukwasibwe Stephen , Garg Shreeya , Katairo Thomas , Asua Victor , Kagurusi Brian A , Mboowa Gerald , Crudale Rebecca , Tumusiime Gerald , Businge Julius , Alula David , Kasozi Julius , Wadembere Ibrahim , Ssewanyana Isaac , Arinaitwe Emmanuel , Nankabirwa Joaniter I , Nsobya Samuel L , Kamya Moses R , Greenhouse Bryan , Dorsey Grant , Bailey Jeffrey A , Briggs Jessica , Conrad Melissa D , Rosenthal Philip J 
Published: June 2024

Abstract
Newly arrived refugees offer insights into malaria epidemiology in their countries of origin. We evaluated asymptomatic refugee children within 7 days of arrival in Uganda from South Sudan and the Democratic Republic of Congo (DRC) in 2022 for parasitemia, parasite species, and Plasmodium falciparum drug resistance markers. Asymptomatic P. falciparum infections were common in both populations. Coinfection with P. malariae was more common in DRC refugees. Prevalences of markers of aminoquinoline resistance (PfCRT K76T, PfMDR1 N86Y) were much higher in South Sudan refugees, of antifolate resistance (PfDHFR C59R and I164L, PfDHPS A437G, K540E, and A581G) much higher in DRC refugees, and of artemisinin partial resistance (ART-R; PfK13 C469Y and A675V) moderate in both populations. Prevalences of most mutations differed from those seen in Ugandans attending health centers near the refugee centers. Refugee evaluations yielded insights into varied malaria epidemiology and identified markers of ART-R in 2 previously little-studied countries.
Whole-Genome Sequencing of Invasive Neonatal Escherichia coli From Uppsala County, Sweden
Authors: Heydecke Anna , Myrelid Åsa , Normann Erik , Gullsby Karolina , Tano Eva , Sütterlin Susanne 
Published: June 2024

Abstract

Background
This study sought to investigate associations between virulence factors and phylogeny in all neonatal Escherichia coli bloodstream infections from patients admitted to the neonatal intensive care unit at Uppsala University Hospital between 2005 and 2020.

Methods
A total of 37 E. coli isolates from 32 neonates were whole-genome sequenced and analyzed for virulence factors related to extraintestinal E. coli; patient-related data were collected retrospectively from the medical records.

Results
E. coli isolates that belong to phylogroup B2 were associated with mortality (odds ratio [OR], 26; P &lt; .001), extreme prematurity with delivery before gestational week 28 (OR, 9; P &lt; .05), and shock (OR, 9; P &lt; .05) compared with isolates of non-B2 group. Female neonates were more often infected with isolates of phylogroup B2 E. coli compared with male neonates (OR, 7; P = .05). The identification of the genotoxin determinant clb coding for colibactin exhibited strong associations with mortality (OR, 67; P &lt; .005), gestational age (OR, 18; P &lt; .005), and shock (OR, 26; P &lt; .005).

Discussion
The study highlighted the correlation between neonatal E. coli bacteremia caused by phylogroup B2 and the role of colibactin. Results emphasize difference between male and female neonates in E. coli populations in bloodstream infections.