bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variable selection when estimating effects in external target populations
Authors: Webster-Clark Michael , Ross Rachael K , Keil Alexander P , Platt Robert W 
Published: April 2024

Abstract
External validity is an important part of epidemiologic research. To validly estimate effects in specific external target populations using a chosen effect measure (ie, “transport”), some methods require that one account for all effect measure modifiers (EMMs). However, little is known about how including other variables that are not EMMs (ie, non-EMMs) in adjustment sets affects estimates. Using simulations, we evaluated how inclusion of non-EMMs affected estimation of the transported risk difference (RD) by assessing the impacts of covariates that (1) differ (or not) between the trial and the target, (2) are associated with the outcome (or not), and (3) modify the RD (or not). We assessed variation and bias when covariates with each possible combination of these factors were used to transport RDs using outcome modeling or inverse odds weighting. Inclusion of variables that differed in distribution between the populations but were non-EMMs reduced precision, regardless of whether they were associated with the outcome. However, non-EMMs associated with selection did not amplify bias resulting from omission of necessary EMMs. Including all variables associated with the outcome may result in unnecessarily imprecise estimates when estimating treatment effects in external target populations.
Sexual conflict and social networks in bed bugs: effects of social experience
Authors: Yan Janice L , Rosenbaum Jack R , Esteves Selena , Dobbin Maggie L , Dukas Reuven 
Published: April 2024

Abstract
Living in groups can provide essential experience that improves sexual performance and reproductive success. While the effects of social experience have drawn considerable scientific interest, commonly used behavioral assays often do not capture the dynamic nature of interactions within a social group. Here, we conducted 3 experiments using a social network framework to test whether social experience during early adulthood improves the sexual competence of bed bugs (Cimex lectularius) when placed in a complex and competitive group environment. In each experiment, we observed replicate groups of bed bugs comprising previously socialized and previously isolated individuals of the same sex, along with an equal number of standardized individuals of the opposite sex. Regardless of whether we controlled for their insemination history, previously isolated males mounted and inseminated females at significantly higher rates than previously socialized males. However, we found no evidence of social experience influencing our other measures of sexual competence: proportion of mounts directed at females, ability to overcome female resistance, and strength of opposite-sex social associations. We similarly did not detect effects of social experience on our female sexual competence metrics: propensity to avoid mounts, rate of successfully avoiding mounts, opposite-sex social association strength, and rate of receiving inseminations. Our findings indicate that early social experience does not improve sexual competence in male and female bed bugs.
AbLEF: antibody language ensemble fusion for thermodynamically empowered property predictions
Authors: Rollins Zachary A , Widatalla Talal , Waight Andrew , Cheng Alan C , Metwally Essam 
Published: April 2024

Abstract

Motivation
Pre-trained protein language and/or structural models are often fine-tuned on drug development properties (i.e. developability properties) to accelerate drug discovery initiatives. However, these models generally rely on a single structural conformation and/or a single sequence as a molecular representation. We present a physics-based model, whereby 3D conformational ensemble representations are fused by a transformer-based architecture and concatenated to a language representation to predict antibody protein properties. Antibody language ensemble fusion enables the direct infusion of thermodynamic information into latent space and this enhances property prediction by explicitly infusing dynamic molecular behavior that occurs during experimental measurement.

Results
We showcase the antibody language ensemble fusion model on two developability properties: hydrophobic interaction chromatography retention time and temperature of aggregation (Tagg). We find that (i) 3D conformational ensembles that are generated from molecular simulation can further improve antibody property prediction for small datasets, (ii) the performance benefit from 3D conformational ensembles matches shallow machine learning methods in the small data regime, and (iii) fine-tuned large protein language models can match smaller antibody-specific language models at predicting antibody properties.

Availability and implementation
AbLEF codebase is available at https://github.com/merck/AbLEF.
Formation process of organic–inorganic layered hybrid materials from vacuum-deposited bilayer thin films of CH3(CH2)11NH3I and SnI2 by post-annealing
Authors: Abe Ren , Maruyama Shingo , Kaminaga Kenichi , Matsumoto Yuji 
Published: April 2024

Abstract
We investigated the formation process of Sn-based 2D organic–inorganic layered hybrid materials from sequentially vacuum-deposited bilayer thin films of CH3(CH2)11NH3I (DDAI) and SnI2 by post-annealing. DDA2SnI4 or DDASnI3 was selectively formed depending on the DDAI/ SnI2 molar ratio and the annealing temperature. It was revealed that DDASnI3 is formed via the phase transformation of DDA2SnI4 that has been formed at a low temperature from a SnI2-rich bilayer thin film by a temperature increase.
Successful Treatment of Carbapenem-Resistant Acinetobacter baumannii Meningitis With Sulbactam-Durlobactam
Authors: Tamma Pranita D , Immel Shanan , Karaba Sara M , Soto Caitlin L , Conzemius Rick , Gisriel Emily , Tekle Tsigereda , Stambaugh Haley , Johnson Emily , Tornheim Jeffrey A , Simner Patricia J 
Published: April 2024

Abstract

Background
The treatment of carbapenem-resistant Acinetobacter baumannii/calcoaceticus complex (CRAB) presents significant treatment challenges.

Methods
We report the case of a 42-year-old woman with CRAB meningitis who experienced persistently positive cerebrospinal fluid (CSF) cultures for 13 days despite treatment with high-dose ampicillin-sulbactam and cefiderocol. On day 13, she was transitioned to sulbactam-durlobactam and meropenem; 4 subsequent CSF cultures remained negative. After 14 days of sulbactam-durlobactam, she was cured of infection. Whole genome sequencing investigations identified putative mechanisms that contributed to the reduced cefiderocol susceptibility observed during cefiderocol therapy. Blood and CSF samples were collected pre-dose and 3-hours post initiation of a sulbactam-durlobactam infusion.

Results
The CRAB isolate belonged to sequence type 2. An acquired blaOXA-23 and an intrinsic blaOXA-51-like (ie, blaOXA-66) carbapenemase gene were identified. The paradoxical effect (ie, no growth at lower cefiderocol dilutions but growth at higher dilutions) was observed by broth microdilution after 8 days of cefiderocol exposure but not by disk diffusion. Potential markers of resistance to cefiderocol included mutations in the start codon of piuA and piuC iron transport genes and an A515V substitution in PBP3, the primary target of cefiderocol. Sulbactam and durlobactam were detected in CSF at both timepoints, indicating CSF penetration.

Conclusions
This case describes successful treatment of refractory CRAB meningitis with the administration of sulbactam-durlobactam and meropenem and highlights the need to be cognizant of the paradoxical effect that can be observed with broth microdilution testing of CRAB isolates with cefiderocol.
Application of machine learning in the preoperative radiomic diagnosis of ameloblastoma and odontogenic keratocyst based on cone-beam CT
Authors: Song Yang , Ma Sirui , Mao Bing , Xu Kun , Liu Yuan , Ma Jingdong , Jia Jun 
Published: April 2024

Abstract

Objectives
Preoperative diagnosis of oral ameloblastoma (AME) and odontogenic keratocyst (OKC) has been a challenge in dentistry. This study uses radiomics approaches and machine learning (ML) algorithms to characterize cone-beam CT (CBCT) image features for the preoperative differential diagnosis of AME and OKC and compares ML algorithms to expert radiologists to validate performance.

Methods
We retrospectively collected the data of 326 patients with AME and OKC, where all diagnoses were confirmed by histopathologic tests. A total of 348 features were selected to train six ML models for differential diagnosis by a 5-fold cross-validation. We then compared the performance of ML-based diagnoses to those of radiologists.

Results
Among the six ML models, XGBoost was effective in distinguishing AME and OKC in CBCT images, with its classification performance outperforming the other models. The mean precision, recall, accuracy, F1-score, and area under the curve (AUC) were 0.900, 0.807, 0.843, 0.841, and 0.872, respectively. Compared to the diagnostics by radiologists, ML-based radiomic diagnostics performed better.

Conclusions
Radiomic-based ML algorithms allow CBCT images of AME and OKC to be distinguished accurately, facilitating the preoperative differential diagnosis of AME and OKC.

Advances in knowledge
ML and radiomic approaches with high-resolution CBCT images provide new insights into the differential diagnosis of AME and OKC.
Machine learning in cardiac stress test interpretation: a systematic review
Authors: Hadida Barzilai Dor , Cohen-Shelly Michal , Sorin Vera , Zimlichman Eyal , Massalha Eias , Allison Thomas G , Klang Eyal 
Published: April 2024

Abstract
Coronary artery disease (CAD) is a leading health challenge worldwide. Exercise stress testing is a foundational non-invasive diagnostic tool. Nonetheless, its variable accuracy prompts the exploration of more reliable methods. Recent advancements in machine learning (ML), including deep learning and natural language processing, have shown potential in refining the interpretation of stress testing data. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic review of ML applications in stress electrocardiogram (ECG) and stress echocardiography for CAD prognosis. Medical Literature Analysis and Retrieval System Online, Web of Science, and the Cochrane Library were used as databases. We analysed the ML models, outcomes, and performance metrics. Overall, seven relevant studies were identified. Machine-learning applications in stress ECGs resulted in sensitivity and specificity improvements. Some models achieved rates of above 96% in both metrics and reduced false positives by up to 21%. In stress echocardiography, ML models demonstrated an increase in diagnostic precision. Some models achieved specificity and sensitivity rates of up to 92.7 and 84.4%, respectively. Natural language processing applications enabled the categorization of stress echocardiography reports, with accuracy rates nearing 98%. Limitations include a small, retrospective study pool and the exclusion of nuclear stress testing, due to its well-documented status. This review indicates the potential of artificial intelligence applications in refining CAD stress testing assessment. Further development for real-world use is warranted.
Myocardial viability on trial
Authors: Bolognese Leonardo , Reccia Matteo Rocco 
Published: April 2024

Abstract
The concept of myocardial viability is usually referred to areas of the myocardium, which show contractile dysfunction at rest and in which contractility is expected to improve after revascularization. The traditional paradigm states that an improvement in function after revascularization leads to improved health outcomes and that assessment of myocardial viability in patients with ischaemic left ventricular dysfunction (ILVD) is a prerequisite for clinical decisions regarding treatment. A range of retrospective observational studies supported this ‘viability hypothesis’. However, data from prospective trials have diverged from earlier retrospective studies and challenge this hypothesis. Traditional binary viability assessment may oversimplify ILVD’s complexity and the nuances of revascularization benefits. A conceptual shift from the traditional paradigm centred on the assessment of viability as a dichotomous variable to a more comprehensive approach encompassing a thorough understanding of ILVD’s complex pathophysiology and the salutary effect of revascularization in the prevention of myocardial infarction and ventricular arrhythmias is required.
Role of glucagon-like peptide-1 agonists in obesity and heart failure with preserved ejection fraction
Authors: Temporelli Pier Luigi 
Published: April 2024

Abstract
Heart failure with preserved ejection fraction (HFpEF) currently represents the majority of all heart failure cases in the community. Glucagon-like peptide-1 agonists represent a class of medications used to treat type 2 diabetes mellitus and, in some cases, obesity. This class includes semaglutide. In the available data from the Semaglutide Treatment Effect in People with Obesity (STEP) trials that were done, looking at weight loss effects of semaglutide, there was a 30–40% reduction in C-reactive protein levels, and that suggests that there is a significant anti-inflammatory effect. Recently, the STEP-HFpEF trial enrolled 529 non-diabetic patients with HFpEF and obesity who were randomly assigned to once-weekly semaglutide (2.4 mg) or placebo for 52 weeks. A statistically significant improvement in the quality of life score and in weight loss was observed. Statistically significant improvements were also seen in the 6 min walk distance, levels of C-reactive protein, and N-terminal pro–B-type natriuretic peptide levels. Interestingly, the Semaglutide Effects on Cardiovascular Outcomes in People with Overweight or Obesity trial has shown that semaglutide produced a consistent reduction of around 20% vs. placebo across major cardiovascular event endpoints over the ∼3-year follow-up in patients with overweight or obesity and cardiovascular disease but not diabetes.
Taboo in cardiology: renin–angiotensin–aldosterone system antagonists worsening renal failure
Authors: Cice Gennaro , Calo' Leonardo 
Published: April 2024

Abstract
The renin–angiotensin–aldosterone system (RAAS) allows normal kidneys to maintain a stable function in every situation of daily life but also intervenes to help when critical situations occur that reduce the filtrate. A typical example is heart failure with reduced ejection function (HFrEF) which inexorably becomes complicated over time with renal failure in what is now commonly defined as cardiorenal syndrome. Renin–angiotensin–aldosterone system antagonists have long been irreplaceable in the treatment of HFrEF due to their beneficial haemodynamic and prognostic effects. However, their use often leads to an acute reduction in the filtrate which often scares the clinician and sometimes leads them to suspend their use. In reality, no guideline has ever clearly indicated when a decline in renal function in a patient taking RAAS antagonists should be acceptable and not lead us to fear the associated acute kidney injury. Usually the nephrologist, called for advice, recommends reducing or suspending the RAAS antagonists, knowing that this will improve the filtration and reassure everyone. But is this the right solution? Are we certain that this choice leads to a better prognosis? This article will try to give a reasonable answer to one of the most frequent doubts that arise in our daily practice.
Percutaneous repair of tricuspid regurgitation
Authors: Mangieri Antonio , Colombo Antonio 
Published: April 2024

Abstract
Tricuspid regurgitation (TR) is common both in patients with left side valvular heart disease and in patients with permanent atrial fibrillation and is associated with increased mortality, morbidity, and an increased risk of hospitalization. Surgery for isolated tricuspid repair is a viable option but burdened by a high-operative risk and a post-operative course characterized by high morbidity. Recently, percutaneous interventional techniques have emerged as a viable option in selected high-risk patients who may clinically benefit from tricuspid valve repair. The purpose of this article is to provide an overview of the current state of transcatheter restorative treatment of TR by providing an overview of new devices in clinical development.
Prevention of thromboembolism after a fracture: is aspirin enough?
Authors: Spoladore Roberto , Milani Martina , Spreafico Luigi Paolo , Agnelli Giancarlo , Savonitto Stefano 
Published: April 2024

Abstract
Venous thromboembolism (VTE) is a serious complication that can arise during and after hospitalization, particularly following surgery under general anaesthesia. Particularly at risk are major orthopaedic surgical procedures such as elective knee or hip replacement and the treatment of hip fractures. In these patients, current guidelines recommend (low or low-moderate level of evidence) aspirin as a possible alternative to anticoagulant therapy for the prophylaxis of long-term venous thromboembolism after an initial period with anticoagulant drugs. Several randomized trials and meta-analyses demonstrate no significant differences in the risk of VTE when comparing aspirin with anticoagulants. However, it must be considered that most recommendations are based on elective orthopaedic surgery and that trials after fractures have excluded patients at high thrombotic risk. Consequently, the overall incidence of major clinical events (death and pulmonary embolism) was ∼1% with wide confidence margins in even large non-inferiority studies. The incidence of asymptomatic VTE, especially distal, appears to be higher with aspirin. Patient preference and lower costs could play an important role in the choice in favour of aspirin.
Moderate aortic stenosis in the dysfunctional ventricle: should it be treated?
Authors: Sciatti Edoardo , Calabrese Alice , Duino Vincenzo , D'isa Salvatore , Di Odoardo Luca Antonio Felice , D'elia Emilia , Senni Michele 
Published: April 2024

Abstract
Moderate aortic stenosis is associated with a worse prognosis than milder degrees. Pathophysiologically, this condition in a dysfunctional ventricle could lead to a further mechanism of haemodynamic worsening, so its treatment should lead to clinical advantages for the patient. The low risk of complications associated with percutaneous correction of aortic valve disease (transcatheter aortic valve implantation) should also be considered, which would seem to favour an interventional approach even in the aforementioned condition. However, sparse data and small population studies make this approach still controversial. Three randomized controlled trials are underway to shed definitive light on the topic.
Real-world validation of smartphone-based photoplethysmography for rate and rhythm monitoring in atrial fibrillation
Authors: Gruwez Henri , Ezzat Daniel , Van Puyvelde Tim , Dhont Sebastiaan , Meekers Evelyne , Bruckers Liesbeth , Wouters Femke , Kellens Michiel , Van Herendael Hugo , Rivero-Ayerza Maximo , Nuyens Dieter , Haemers Peter , Pison Laurent 
Published: April 2024

Abstract

Aims
Photoplethysmography- (PPG) based smartphone applications facilitate heart rate and rhythm monitoring in patients with paroxysmal and persistent atrial fibrillation (AF). Despite an endorsement from the European Heart Rhythm Association, validation studies in this setting are lacking. Therefore, we evaluated the accuracy of PPG-derived heart rate and rhythm classification in subjects with an established diagnosis of AF in unsupervised real-world conditions.

Methods and results
Fifty consecutive patients were enrolled, 4 weeks before undergoing AF ablation. Patients used a handheld single-lead electrocardiography (ECG) device and a fingertip PPG smartphone application to record 3907 heart rhythm measurements twice daily during 8 weeks. The ECG was performed immediately before and after each PPG recording and was given a diagnosis by the majority of three blinded cardiologists. A consistent ECG diagnosis was exhibited along with PPG data of sufficient quality in 3407 measurements. A single measurement exhibited good quality more often with ECG (93.2%) compared to PPG (89.5%; P &lt; 0.001). However, PPG signal quality improved to 96.6% with repeated measurements. Photoplethysmography-based detection of AF demonstrated excellent sensitivity [98.3%; confidence interval (CI): 96.7–99.9%], specificity (99.9%; CI: 99.8–100.0%), positive predictive value (99.6%; CI: 99.1–100.0%), and negative predictive value (99.6%; CI: 99.0–100.0%). Photoplethysmography underestimated the heart rate in AF with 6.6 b.p.m. (95% CI: 5.8 b.p.m. to 7.4 b.p.m.). Bland–Altman analysis revealed increased underestimation in high heart rates. The root mean square error was 11.8 b.p.m.

Conclusion
Smartphone applications using PPG can be used to monitor patients with AF in unsupervised real-world conditions. The accuracy of AF detection algorithms in this setting is excellent, but PPG-derived heart rate may tend to underestimate higher heart rates.
Safety and efficacy of the second-generation cryoballoon for left atrial appendage electrical isolation in canines
Authors: Liu Chao , Li Changjin , Zhao Teng , Yu Manli , Huang Xinmiao , Cao Jiang , Huang Songqun , Guo Zhifu 
Published: April 2024

Abstract

Aims
Left atrial appendage electrical isolation (LAAEI) has demonstrated a significant enhancement in the success rate of atrial fibrillation (AF) ablation. Nevertheless, concerns persist about the safety of LAAEI, particularly regarding alterations in left atrial appendage (LAA) flow velocity and the potential risks of thrombus. This study aimed to assess the efficacy and safety of LAAEI, investigating changes in LAA flow velocity in canines.

Methods and results
The study comprised a total of 10 canines. The LAAEI procedure used by a 23 mm cryoballoon of the second generation was conducted at least 180 s. Intracardiac ultrasonography (ICE) was employed to quantify the velocity flow of the LAA both prior to and following LAAEI. Following a 3-month period, subsequent evaluations were performed to assess the LAA velocity flow and the potential reconnection. Histopathological examination was conducted. Left atrial appendage electrical isolation was effectively accomplished in all canines, resulting in a 100% acute success rate (10/10). The flow velocity in the LAA showed a notable reduction during LAAEI as compared with the values before the ablation procedure (53.12 ± 5.89 vs. 42.01 ± 9.22 cm/s, P = 0.007). After the follow-up, reconnection was observed in four canines, leading to a success rate of LAAEI of 60% (6/10). The flow velocity in the LAA was consistently lower (53.12 ± 5.89 vs. 44.33 ± 10.49 cm/s, P = 0.006), and no blood clot development was observed. The histopathological study indicated that there was consistent and complete injury to the LAA, affecting all layers of its wall. The injured tissue was subsequently replaced by fibrous tissue.

Conclusion
The feasibility of using cryoballoon ablation for LAAEI was confirmed in canines, leading to a significant reduction of LAA flow velocity after ablation. Some restoration of LAA flow velocity after ablation may be linked to the passive movement of the LAA and potential reconnecting. However, this conclusion is limited to animal study; more clinical data are needed to further illustrate the safety and accessibility of LAAEI in humans.