bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combining two user-friendly machine learning tools increases species detection from acoustic recordings
Authors: Pérez-Granados Cristian , Feldman Mariano J. , Mazerolle Marc J. 
Published: November 2023

Passive acoustic monitoring usually generates large datasets that require machine learning algorithms to scan sound files, although the complexity of developing machine learning algorithms can be a barrier. We assessed the ability and speed of two user-friendly machine learning tools, Kaleidoscope Pro and BirdNET, for detecting the American toad ( Anaxyrus americanus (Holbrook, 1836)) in sound recordings. We developed a two-step approach, combining both tools to maximize species detection while minimizing the time needed for output verification. When considered separately, Kaleidoscope Pro successfully detected the American toad in 85.9% of recordings in the validation dataset, while BirdNET detected the species in 58.4% of recordings. Combining the two tools in the two-step approach increased the detection rate to 93.3%. We applied the two-step approach to a large acoustic dataset ( n = 6194 recordings). We started by scanning the dataset using Kaleidoscope Pro (species detected in 417 recordings), then we used BirdNET on the remaining recordings without confirmed presence. The two-step approach reduced the scanning time, the time needed for output verification, and added 37 additional species detections in 45 min. Our findings highlight that combining machine learning tools can improve species detectability while minimizing time and effort.
Relativistic model of anisotropic star with Bose–Einstein density depiction
Authors: Sarkar Susmita , Sarkar Nayan , Rudra Prabir , Rahaman Farook , Ghorui Tuhina 
Published: November 2023

AbstractIn this article, we present a new model for anisotropic compact stars confined to physical dark matter (DM) based on the Bose–Einstein DM density profile and a bag model type equation of state (EoS). The obtained solutions are physically well-behaved and represent the physical and stable matter configuration by satisfying the energy conditions, causality conditions, and essential conditions on the stability factor and adiabatic index. The solutions supporting the matter sphere are in an equilibrium state by satisfying the generalized TOV equation. We also find the surface redshift, compactness parameter at the surface, maximum mass, and interestingly, all these values are under the desired range that makes our solution more physically viable. Here, the radially symmetric profiles of energy density, radial and transverse pressures are demonstrated.
Von Neumann algebra description of inflationary cosmology
Authors: Seo Min-Seok 
Published: November 2023

AbstractWe study the von Neumann algebra description of the inflationary quasi-de Sitter (dS) space. Unlike perfect dS space, quasi-dS space allows the nonzero energy flux across the horizon, which can be identified with the expectation value of the static time translation generator. Moreover, as a dS isometry associated with the static time translation is spontaneously broken, the fluctuation in time is accumulated, which induces the fluctuation in the energy flux. When the inflationary period is given by $$(\epsilon _H H)^{-1}$$

(

ϵ
H

H
)

-
1

where $$\epsilon _H$$

ϵ
H

is the slow-roll parameter measuring the increasing rate of the Hubble radius, both the energy flux and its fluctuation diverge in the $$G \rightarrow 0$$

G
→
0

limit. Taking the fluctuation in the energy flux and that in the observer’s energy into account, we argue that the inflationary quasi-dS space is described by Type II$$_\infty $$

∞

algebra. As the entropy is not bounded from above, this is different from Type II$$_1$$

1

description of perfect dS space in which the entropy is maximized by the maximal entanglement. We also show that our result is consistent with the observation that the von Neumann entropy for the density matrix reflecting the fluctuations above is interpreted as the generalized entropy.
Rise and demise of the Urgonian platform in Switzerland
Authors: Godet Alexis , Adatte Thierry , Arnaud-Vanneau Annie , Bonvallet Lucie , De Kaenel Eric , Mojon Pierre-Olivier 
Published: November 2023

Abstract
Defined in the Provence region of France, the rudist-bearing Urgonian Limestone is typical of northern Tethyan shallow-marine carbonate series, and is dated based on benthic fauna and flora, calcareous nannofossils and ammonites. This contribution reports on recent findings that refine the stratigraphy of the Urgonian Limestone in the western Swiss Jura and the Helvetic Alps of Switzerland. In the former location, the high-resolution facies and isotope analysis of samples permits the identification of major periods of subaerial exposure, while a diverse assemblage of calcareous nannofossils indicates a Barremian age for the Urgonian deposits. In the latter location, biostratigraphical data indicate a Late Barremian–Early Aptian age for Urgonian deposits, while the repartition of facies along a proximal-to-distal transect highlights the Late Barremian progradation of the platform. The detailed understanding of the stratigraphy of Urgonian deposits in these regions inscribes them into a broader context that acknowledges palaeoclimatic and palaeoenvironmental conditions. A warmer and more humid climate prone to continental weathering and transport of nutrients to an epicontinental sea characterized the Early Barremian; this was detrimental to the health of carbonate-producing benthic ecosystems. In the Late Barremian, a reduced nutrient supply allowed Urgonian communities to thrive.
Monitoring Glucocorticoid Receptor in Plasma-derived Extracellular Vesicles as a Marker of Resistance to Androgen Receptor Signaling Inhibition in Prostate Cancer
Authors: Gentile Emanuela , Hahn Andrew W. , Song Jian H. , Hoang Anh , Shepherd Peter D. A. , Ramachandran Sumankalai , Navone Nora M. , Efstathiou Eleni , Titus Mark , Corn Paul G. , Lin Sue-Hwa , Logothetis Christopher J. , Panaretakis Theocharis 
Published: November 2023

Abstract

Disease progression following androgen ablation was shown to be associated with upregulation of the glucocorticoid receptor (GR). Longitudinal monitoring of GR expression in circulating extracellular vesicles (EV) may reflect changes in the tumor cell and facilitates detection of acquired resistance. We utilized LNCaP, LREX cells and a patient-derived xenograft, MDA PDX 322-2-6a, for in vitro and in vivo experiments. Plasma-derived EVs were isolated from patients with localized high-risk prostate cancer undergoing androgen ablation. The mRNA levels of GR in EVs and their responsive genes were detected by transcriptome analysis, qRT-PCR and the protein levels by Western blot analysis. We detected changes in GR expression at mRNA and protein levels in EVs derived from LNCaP and LREX cells in in vitro studies. In in vivo experiments, LNCaP and the PDX MDA 322-2-6a–bearing mice were treated with enzalutamide. GR levels in plasma-derived EVs were increased only in those tumors that did not respond to enzalutamide. Treatment of mice bearing enzalutamide-resistant tumors with a GR inhibitor in combination with enzalutamide led to a transient pause in tumor growth in a subset of tumors and decreased GR levels intracellular and in plasma-derived EVs. In a subgroup of patients with high-risk localized prostate cancer treated with androgen signaling inhibition, GR was found upregulated in matching tissue and plasma EVs. These analyses showed that GR levels in plasma-derived EVs may be used for monitoring the transition of GR expression allowing for early detection of resistance to androgen ablation treatment.

Significance:
Longitudinal monitoring of GR expression in plasma-derived EVs from patients with prostate cancer treated with androgen signaling inhibitors facilitates early detection of acquisition of resistance to androgen receptor signaling inhibition in individual patients.
Abstract 13876: Women Face Unique Obstacles During Pediatric Cardiology Fellowship Training
Authors: West Caroline L , Yu Sunkyung , Lowery Ray , Goldberg Caren S , Balasubramanian Sowmya 
Published: November 2023

Background:
There are persistent disparities in career advancement for women physicians in pediatric cardiology. We sought to explore differences by gender in fellowship experience, as these may set the foundation for long-term gender inequity.

Aims:
To describe and compare fellowship experiences, career aspirations and family obligations of men and women in pediatric cardiology training.

Methods:
We performed a national survey of pediatric cardiology fellows examining mentorship, scholarly and DEI work, clinical experiences, career intentions and family commitments. Descriptive analyses were performed.

Results:
A total of 176 responses were included in the analysis (men=74, women=102). Most fellows were white (69%) and aged 30-34 years old (68%).

Men and women reported similar mentorship, scholarly and clinical experiences, and influential factors in their decision to pursue subspecialty training. More women plan to pursue advanced imaging training (42% vs. 24%, p=0.04), to have administrative responsibilities (27% vs. 14%, p=0.06), and to work part time during their career (28% vs. 5.6%, p=0.001). Men reported greater interest in teaching (93% vs. 83%, p=0.04).
While similar proportions of men and women were married, the spouses of women were more likely to be employed (91% vs. 71%, p=0.002). Among fellows with children, more women than men planned for additional children (75% vs. 25%, p=0.0004). Among fellows without children, more men than women planned for additional children (93% vs. 74%, p=0.01). Women were more likely to report delay in childbearing due to training (71% vs. 40%, p=0.0002), that childbearing decisions were influenced by the risk of radiation exposure (22% vs. 0%, p<.0001), and the use of assistive reproductive technologies (11% vs. 1%, p=0.01).

Conclusion(s):
Women and men in pediatric cardiology fellowship have similar training experiences and career aspirations yet differ in their plans to raise families. Women face unique obstacles to childbearing and child raising during training. Motherhood in pediatric cardiology may be a vulnerable period during career development and advancement.
Economic Modeling Analysis of an Intensive GDMT Optimization Program in Hospitalized Heart Failure Patients
Authors: Dixit Neal M. , Parikh Neil U. , Ziaeian Boback , Fonarow Gregg C. 
Published: November 2023

BACKGROUND:
The STRONG-HF trial (Safety, Tolerability and Efficacy of Up-Titration of Guideline-Directed Medical Therapies for Acute Heart Failure) demonstrated substantial reductions in the composite of mortality and morbidity over 6 months among hospitalized patients with heart failure (HF) who were randomized to intensive guideline-directed medical therapy (GDMT) optimization compared with usual care. Whether an intensive GDMT optimization program would be cost-effective for patients with HF with reduced ejection fraction is unknown.

METHODS:
Using a 2-state Markov model, we evaluated the effect of an intensive GDMT optimization program on hospitalized patients with HF with reduced ejection fraction. Two population models were created to simulate this intervention, a clinical trial model, based on the participants in the STRONG-HF trial, and a real-world model, based on the Get With The Guidelines–HF registry of patients admitted with worsening HF. We then modeled the effect of a 6-month intensive triple therapy GDMT optimization program comprised of cardiologists, clinical pharmacists, and registered nurses. Hazard ratios from the intervention arm of the STRONG-HF trial were applied to both population models to simulate clinical and financial outcomes of an intensive GDMT optimization program from a US health care sector perspective with a lifetime time horizon. Optimal quadruple GDMT use was also modeled.

RESULTS:
An intensive GDMT optimization program was extremely cost-effective with incremental cost-effectiveness ratios <$10 000 per quality-adjusted life-year in both models. Optimal quadruple GDMT implementation resulted in the most gains in life-years with incremental cost-effectiveness ratios of $60 000 and $54 000 in the clinical trial and real-world models, respectively.

CONCLUSIONS:
An intensive GDMT optimization program for patients hospitalized with HF with reduced ejection fraction would be cost-effective and result in substantial gains in clinical outcomes, especially with the use of optimal quadruple GDMT. Clinicians, payers, and policymakers should prioritize the creation of such programs.
Meta-Analysis of Penetrance and Systematic Review on Transition to Disease in Genetic Hypertrophic Cardiomyopathy
Authors: Topriceanu Constantin-Cristian , Pereira Alexandre C. , Moon James C. , Captur Gabriella , Ho Carolyn Y. 
Published: November 2023

BACKGROUND:
Hypertrophic cardiomyopathy (HCM) is characterized by unexplained left ventricular hypertrophy and is classically caused by pathogenic or likely pathogenic variants (P/LP) in genes encoding sarcomere proteins. Not all subclinical variant carriers will manifest clinically overt disease because penetrance (proportion of sarcomere or sarcomere-related P/LP variant carriers who develop disease) is variable, age dependent, and not reliably predicted.

METHODS:
A systematic search of the literature was performed. We used random-effects generalized linear mixed model meta-analyses to contrast the cross-sectional prevalence and penetrance of sarcomere or sarcomere-related genes in 2 different contexts: clinically-based studies on patients and families with HCM versus population or community-based studies. Longitudinal family/clinical studies were additionally analyzed to investigate the rate of phenotypic conversion from subclinical to overt HCM during follow-up.

RESULTS:

In total, 455 full-text manuscripts and articles were assessed. In family/clinical studies, the prevalence of sarcomere variants in patients diagnosed with HCM was 34%. The penetrance across all genes in nonproband relatives carrying P/LP variants identified during cascade screening was 57% (95% CI, 52%–63%), and the mean age at HCM diagnosis was 38 years (95% CI, 36%–40%). Penetrance varied from ≈32% for
MYL3
(myosin light chain 3) to ≈55% for
MYBPC3
(myosin-binding protein C3), ≈60% for
TNNT2
(troponin T2) and
TNNI3
(troponin I3), and ≈65% for
MYH7
(myosin heavy chain 7). Population-based genetic studies demonstrate that P/LP sarcomere variants are present in the background population but at a low prevalence of <1%. The penetrance of HCM in incidentally identified P/LP variant carriers was also substantially lower at ≈11%, ranging from 0% in Atherosclerosis Risk in Communities to 18% in UK Biobank. In longitudinal family studies, the pooled phenotypic conversion across all genes was 15% over an average of ≈8 years of follow-up, starting from a mean of ≈16 years of age. However, short-term gene-specific phenotypic conversion varied between ≈12% for
MYBPC3
and ≈23% for
MYH7
.

CONCLUSIONS:
The penetrance of P/LP variants is highly variable and influenced by currently undefined and context-dependent genetic and environmental factors. Additional longitudinal studies are needed to improve our understanding of true lifetime penetrance in families and in the community and to identify drivers of the transition from subclinical to overt HCM.
Inflammation and Cholesterol as Predictors of Cardiovascular Events Among 13 970 Contemporary High-Risk Patients With Statin Intolerance
Authors: Ridker Paul M , Lei Lei , Louie Michael J. , Haddad Tariq , Nicholls Stephen J. , Lincoff A. Michael , Libby Peter , Nissen Steven E. ,   on behalf of the CLEAR Outcomes Investigators
Published: November 2023

BACKGROUND:
Among patients treated with statin therapy to guideline-recommended cholesterol levels, residual inflammatory risk assessed by high-sensitivity C-reactive protein (hsCRP) is at least as strong a predictor of future cardiovascular events as is residual risk assessed by low-density lipoprotein cholesterol (LDLC). Whether these relationships are present among statin-intolerant patients with higher LDLC levels is uncertain but has implications for the choice of preventive therapies, including bempedoic acid, an agent that reduces both LDLC and hsCRP.

METHODS:
The multinational CLEAR-Outcomes trial (Cholesterol Lowering via Bempedoic Acid, an ACL-Inhibiting Regimen Outcomes Trial) randomly allocated 13 970 statin-intolerant patients to 180 mg of oral bempedoic acid daily or matching placebo and followed them for a 4-component composite of incident myocardial infarction, stroke, coronary revascularization, or cardiovascular death, and for all-cause mortality. Quartiles of increasing baseline hsCRP and LDLC were assessed as predictors of future adverse events after adjustment for traditional risk factors and randomized treatment assignment.

RESULTS:
Compared with placebo, bempedoic acid reduced median hsCRP by 21.6% and mean LDLC levels by 21.1% at 6 months. Baseline hsCRP was significantly associated with the primary composite end point of major cardiovascular events (highest versus lowest hsCRP quartile; hazard ratio [HR], 1.43 [95% CI, 1.24–1.65]), cardiovascular mortality (HR, 2.00 [95% CI, 1.53–2.61]), and all-cause mortality (HR, 2.21 [95% CI, 1.79–2.73]). By contrast, the relationship of baseline LDLC quartile (highest versus lowest) to future events was smaller in magnitude for the primary composite cardiovascular end point (HR, 1.19 [95% CI, 1.04–1.37]) and neutral for cardiovascular mortality (HR, 0.90 [95% CI, 0.70–1.17]) and all-cause mortality (HR, 0.95 [95% CI, 0.78–1.16]). Risks were high for those with elevated hsCRP irrespective of LDLC level. Bempedoic acid demonstrated similar efficacy in reducing cardiovascular events across all levels of hsCRP and LDLC.

CONCLUSIONS:
Among contemporary statin-intolerant patients, inflammation assessed by hsCRP predicted risk for future cardiovascular events and death more strongly than hyperlipidemia assessed by LDLC. Compared with placebo, bempedoic acid had similar efficacy for reducing cardiovascular risk across hsCRP and LDLC strata.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02993406.
Prognostic Utility of Cardiovascular Magnetic Resonance–Based Phenotyping in Patients With Muscular Dystrophy
Authors: Kashyap Niharika , Nikhanj Anish , Labib Dina , Prosia Easter , Rivest Sandra , Flewitt Jacqueline , Pfeffer Gerald , Bakal Jeffrey A. , Siddiqi Zaeem A. , Coulden Richard A. , Thompson Richard , White James A. , Oudit Gavin Y. 
Published: November 2023

Background
The prognostic utility of cardiovascular magnetic resonance imaging, including strain analysis and tissue characterization, has not been comprehensively investigated in adult patients with muscular dystrophy.

Methods and Results

We prospectively enrolled 148 patients with dystrophinopathies (including heterozygotes), limb‐girdle muscular dystrophy, and type 1 myotonic dystrophy (median age, 36.0 [interquartile range, 23.0–50.0] years; 51 [34.5%] women) over 7.7 years in addition to an age‐ and sex–matched healthy control cohort (n=50). Cardiovascular magnetic resonance markers, including 3‐dimensional strain and fibrosis, were assessed for their respective association with major adverse cardiac events. Our results showed that markers of contractile performance were reduced across all muscular dystrophy groups. In particular, the dystrophinopathies cohort experienced reduced left ventricular (LV) ejection fraction and high burden of replacement fibrosis. Patients with type 1 myotonic dystrophy showed a 26.8% relative reduction in LV mass with corresponding reduction in chamber volumes. Eighty‐two major adverse cardiac events occurred over a median follow‐up of 5.2 years. Although LV ejection fraction was significantly associated with major adverse cardiac events (adjusted hazard ratio [aHR], 3.0 [95% CI, 1.4–6.4]) after adjusting for covariates, peak 3‐dimensional strain amplitude demonstrated greater predictive value (minimum principal amplitude: aHR, 5.5 [95% CI, 2.5–11.9]; maximum principal amplitude: aHR, 3.3 [95% CI, 1.6–6.8]; circumferential amplitude: aHR, 3.4 [95% CI, 1.6–7.2]; longitudinal amplitude: aHR, 3.4 [95% CI, 1.7–6.9]; and radial strain amplitude: aHR, 3.0 [95% CI, 1.4–6.1]). Minimum principal strain yielded incremental prognostic value beyond LV ejection fraction for association with major adverse cardiac events (change in
χ
2
=13.8;
P
<0.001).

Conclusions
Cardiac dysfunction is observed across all muscular dystrophy subtypes; however, the subtypes demonstrate distinct phenotypic profiles. Myocardial deformation analysis highlights unique markers of principal strain that improve risk assessment over other strain markers, LV ejection fraction, and late gadolinium enhancement in this vulnerable patient population.
Associations of Cerebrovascular Regulation and Arterial Stiffness With Cerebral Small Vessel Disease: A Systematic Review and Meta‐Analysis
Authors: Scheuermann Britton C. , Parr Shannon K. , Schulze Kiana M. , Kunkel Olivia N. , Turpin Vanessa‐Rose G. , Liang Jia , Ade Carl J. 
Published: November 2023

Background
Cerebral small vessel disease (cSVD) is a major contributing factor to ischemic stroke and dementia. However, the vascular pathologies of cSVD remain inconclusive. The aim of this systematic review and meta‐analysis was to characterize the associations between cSVD and cerebrovascular reactivity (CVR), cerebral autoregulation, and arterial stiffness (AS).

Methods and Results

MEDLINE, Web of Science, and Embase were searched from inception to September 2023 for studies reporting CVR, cerebral autoregulation, or AS in relation to radiological markers of cSVD. Data were extracted in predefined tables, reviewed, and meta‐analyses performed using inverse‐variance random effects models to determine pooled odds ratios (ORs). A total of 1611 studies were identified; 142 were included in the systematic review, of which 60 had data available for meta‐analyses. Systematic review revealed that CVR, cerebral autoregulation, and AS were consistently associated with cSVD (80.4%, 78.6%, and 85.4% of studies, respectively). Meta‐analysis in 7 studies (536 participants, 32.9% women) revealed a borderline association between impaired CVR and cSVD (OR, 2.26 [95% CI, 0.99–5.14];
P
=0.05). In 37 studies (27 952 participants, 53.0% women) increased AS, per SD, was associated with cSVD (OR, 1.24 [95% CI, 1.15–1.33];
P
<0.01). Meta‐regression adjusted for comorbidities accounted for one‐third of the AS model variance (
R
2
=29.4%,
P
moderators
=0.02). Subgroup analysis of AS studies demonstrated an association with white matter hyperintensities (OR, 1.42 [95% CI, 1.18–1.70];
P
<0.01).

Conclusions
The collective findings of the present systematic review and meta‐analyses suggest an association between cSVD and impaired CVR and elevated AS. However, longitudinal investigations into vascular stiffness and regulatory function as possible risk factors for cSVD remain warranted.