bluuebunny/crossref_metadata_2025_split huggingface dataset:
behaviorMate: AnIntranetof Things Approach for Adaptable Control of Behavioral and Navigation-Based Experiments
Authors: Bowler John C. , Zakka George , Yong Hyun Choong , Li Wenke , Rao Bovey , Liao Zhenrui , Priestley James B. , Losonczy Attila 
Published: December 2023

1AbstractInvestigators conducting behavioral experiments often need precise control over the timing of the delivery of stimuli to subjects and to collect the precise times of the subsequent behavioral responses. Furthermore, investigators want fine-tuned control over how various multi-modal cues are presented. behaviorMate takes an “Intranet of Things” approach, using a networked system of hardware and software components for achieving these goals. The system outputs a file with integrated timestamp-event pairs that investigators can then format and process using their own analysis pipelines. We present an overview of the electronic components and GUI application that make up behaviorMate as well as mechanical designs for compatible experimental rigs to provide the reader with the ability to set up their own system. A wide variety of paradigms are supported, including goal-oriented learning, random foraging, and context switching. We demonstrate behaviorMate’s utility and reliability with a range of use cases from several published studies and benchmark tests. Finally, we present experimental validation demonstrating different modalities of hippocampal place field studies. Both treadmill with burlap belt and virtual reality with running wheel paradigms were performed to confirm the efficacy and flexibility of the approach. Previous solutions rely on proprietary systems that may have large upfront costs or present frameworks that require customized software to be developed. behaviorMate uses open-source software and a flexible configuration system to mitigate both concerns. behaviorMate has a proven record for head-fixed imaging experiments and could be easily adopted for task control in a variety of experimental situations.
Deep representation learning of electrocardiogram reveals novel insights in cardiac structure and functions and connections to cardiovascular diseases
Authors: Yeung Ming Wai , van de Leur Rutger R , Benjamins Jan Walter , Vessies Melle B. , Ruijsink Bram , Puyol-Antón Esther , van Tintelen J. Peter , Verweij Niek , van Es Rene , van der Harst Pim 
Published: December 2023

AbstractBackgroundConventional approaches to analysing electrocardiograms (ECG) in fragmented parameters (such as the PR interval) ignored the high dimensionality of data which might result in omission of subtle information content relevant the cardiac biology. Deep representation learning of ECG may reveal novel insights.MethodsWe finetuned an unsupervised variational auto-encoder (VAE), originally trained on over 1.1 million 12-lead ECG, to learn the underlying distributions of the median beat ECG morphology of 41,927 UK Biobank participants. We explored the relationship between the latent representations (latent factors) and traditional ECG parameters, cardiac magnetic resonance (CMR)-derived structural and functional phenotypes. We assessed the association of the latent factors with various cardiac and cardiometabolic diseases and further investigated their predictive value for cardiovascular mortality. Finally, we studied genetic components of the latent factors by genome wide association study (GWAS).ResultsThe latent factors showed differential correlation patterns with conventional ECG parameters with the highest correlations observed in factor 8 and PR interval (r=0.76). Multivariable analyses of the ECG latent factors recapitulated CMR-derived parameters with a better performance for the left ventricle than the right. We saw higher performance in models for structural parameters than functional parameters and observed the highest adjusted R2of 0.488 for left ventricular LV end-diastolic mass (LVEDM). The latent factors showed strong association with cardiac diseases. This included bundle branch block and latent factor 28 (OR= 2.72 [95% confidence interval CI,2.46-3.01] per standard deviation, SD change); per SD change of latent factor 27 was associated with cardiomyopathy (OR=2.38, 95%CI 1.97-2.89) and heart failure (OR=1.94, 95%CI 1.71-2.21). In the GWAS of the latent factors, we identified 170 genetic loci with 29 not previously associated with electrocardiographic traits. Following up with bioinformatic analyses, we found the genetic signals involved in cardiac development, contractility and electrophysiology.ConclusionsDeep representation learning of 12-lead ECG provided not only clinically meaningful but also novel insights into cardiac biology and cardiovascular health.Graphical abstract
Treating Rheumatoid Arthritis in Zanzibar: a cost effectiveness study comparing conventional, biologic, and targeted-synthetic disease modifying anti-rheumatic drugs
Authors: Said Sanaa S. , Kühl Melf-Jakob , Fevang Bjorg-Tilde Svanes , Nystad Tone Wikene , Johansson Kjell Arne 
Published: December 2023

ABSTRACTTo evaluate the cost effectiveness of six disease modifying anti-rheumatic drug (DMARD) treat-to-target treatment strategies for patients with rheumatoid arthritis in Zanzibar.A Markov model was used to calculate the cost-effectiveness of various DMARD strategies in the treatment of rheumatoid arthritis over a three-year period. A health-provider perspective was used and only outpatient costs were considered. The Clinical Disease Activity Index (CDAI) was utilized for measurement of efficacy and values were obtained from literature. Quality Adjusted Life Years (QALYs) were obtained from 122 patients attending the rheumatology clinic at Mnazi Mmoja Hospital. Data on costs were obtained from the central medical stores and hospital administration. Treatment strategies were given in sequential approach based on treat to target goals of therapy. This included methotrexate monotherapy, methotrexate + sulfasalazine + hydroxychloroquine, methotrexate followed by one or two biologic/targeted-synthetic DMARDs (b/tsDMARDs). Probabilistic and one way sensitivity analysis were performed. Scenario analysis was undertaken comparing drug prices from India and Scandinavia.Costs of therapy/patient/three years ranged from USD 634 for methotrexate monotherapy and USD 5011 for methotrexate and two consecutive b/tsDMARDs. The highest and lowest effects were 2.209 and 2.079 QALYs gained from methotrexate therapy + two consecutive b/tsDMARDs and methotrexate monotherapy, respectively. From a healthcare perspective methotrexate monotherapy was the cost-effective option at a willingness to pay of USD 282. Pairwise comparison also favored methotrexate monotherapy as the feasible option. We found that increasing the willingness to pay led to a change in the most acceptable option from methotrexate monotherapy to methotrexate followed by b/tsDMARD.Methotrexate monotherapy is the cost-effective option for the management of rheumatoid arthritis in Zanzibar. Other options may be feasible if the willingness to pay threshold is increased or the drug prices are lowered, particularly for the b/tsDMARDs.
Respiratory rates among rural Gambian children: a community-based cohort study
Authors: Mogeni Polycarp , Amima Sharon , Gunther Jennifer , Pinder Margaret , Tusting Lucy S. , D’Alessandro Umberto , Cousens Simon , Lindsay Steve W. , Bradley John 
Published: December 2023

AbstractBackgroundAlthough ranges of normal respiratory rates (RR) have been described for children under five years old living in the tropics, there are few datasets recording rates in older children. The present study was designed to capture the changes in RR with age and to examine its association with nutritional status and environmental factors.MethodsA cohort of rural Gambian children aged from six months to 14 years had their RR recorded during home visits twice weekly during two annual rainy seasons. Measurements were made by trained field assistants using an electronic timer during a one-minute period. Age, sex, nutritional status, health status, time of day of data collection were recorded. A generalized additive model for location, scale and shape was used to construct the RR reference curves and a linear mixed effect model used to examine factors associated with RR. We also assessed the agreement between repeat measurements taken from a subset of study subject.ResultsA total of 830 children provided 67,512 RR measurements. The median age was 6.07 years (interquartile range (IQR), 4.21–8.55) and 400 (48.2%) were female. The centile chart showed a marked nonlinear decline in RR measurements with increasing age up to six years old, after which the decline was minimal (predicted median RR of 31 breaths/minute (IQR: 29–34) among one-year-olds, 22 breaths/minute (IQR: 21–23) among six-year-olds and 21 breaths/minute (IQR: 21-22) among 13-year-olds. Age (non-linear effect, p<0.001), stunting (0.84 breaths/minute [95%CI: 0.40-1.28, p<0.001]), ambient temperature (0.38 breaths/minute [95%CI: 0.33-0.42, p<0.001] for every 1°C increase in ambient temperature) and time of day when RR measurements were taken (non-linear effect, p<0.001) were independent predictors of respiratory rate. Strikingly, children with signs of illness were associated with higher intra-observer variability.InterpretationWe constructed a RR reference chart for children aged one to 13 years and proposed a cutoff of >26 breaths/minute for raised RR among children aged >5 years bridging an important gap in this age group. Although time of data collection, nutritional status and ambient temperature were predictors of RR, the evidence is not clinically significant to warrant a change in the current WHO guidelines owing to the prevailing uncertainty in the measurement of RR. The finding that RR between repeat measurements were more variable among children with signs of illness suggests that a single RR measurements may be inadequate to reliably assess the status of sick children - a population in which accurate diagnosis is essential to enable targeted interventions with lifesaving treatment.
Manual Chest PRESSURE during Direct Current Cardioversion for Atrial Fibrillation: A Randomised Control Trial (PRESSURE-AF)
Authors: Ferreira David , Mikhail Philopatir , Lim Joyce , Ray Max , Dwivedi Jovita , Brienesse Stephen , Butel-Simoes Lloyd , Meere William , Bland Adam , Howden Niklas , Malaty Michael , Kunda Mercy , Kelty Amy , McGee Michael , Boyle Andrew , Sverdlov Aaron L , William Maged , Attia John , Jackson Nicholas , Morris Gwilym , Barlow Malcolm , Leitch James , Collins Nicholas , Ford Thomas , Wilsmore Bradley 
Published: December 2023

ABSTRACTBackgroundDirect current cardioversion is frequently used to return patients with atrial fibrillation (AF) to sinus rhythm. Chest pressure during cardioversion may improve the efficacy of cardioversion through decreasing transthoracic impedance and increasing cardiac energy delivery. We aimed to assess the efficacy and safety of upfront chest pressure during direct current cardioversion for atrial fibrillation with anterior-posterior pad positioning.Design, Setting and ParticipantsThis was a multi-center, investigator-initiated, patient and analysis blinded, randomised clinical trial. Recruitment occurred from 2021 to 2023. Follow-up was until hospital discharge. Recruitment occurred across three centers in New South Wales, Australia. Inclusion criteria were age ≥18, referred for cardioversion for AF, and anticoagulation for three weeks or transoesophageal echocardiography excluding left atrial appendage thrombus. Exclusion criteria were other arrhythmias requiring cardioversion, such as atrial flutter and atrial tachycardia.Intervention and OutcomesThe intervention arm received chest pressure during cardioversion from the first shock. The primary efficacy outcome was total joules required per patient encounter. Secondary efficacy outcomes included first shock success, transthoracic impedance, cardioversion success and sinus rhythm at 30 minutes post cardioversion.Results311 patients were randomised, 153 to control and 158 to intervention. There was no difference in total joules applied per encounter in the control arm versus intervention arm (356.4 ± 301 vs 413.8 ± 347, P=0.25). There was no difference in first shock success, total shocks provided, average impedance and cardioversion success.Conclusions and RelevanceThis study does not support the routine application of chest pressure for direct current cardioversion in atrial fibrillation. Reducing the complexity of cardioversion will improve the efficiency of the procedure for patients and healthcare systems.FundingNone to discloseTrial RegistrationACTRN12620001028998
Cerebral microhemorrhages in children with congenital heart disease: Prevalence, risk factors, and impact on neurodevelopmental outcomes
Authors: Andersen Kristen N. , Yao Sicong , White Brian R. , Jacobwitz Marin , Breimann Jake , Jahnavi Jharna , Schmidt Alexander , Baker Wesley B. , Ko Tiffany S. , Gaynor J. William , Vossough Arastoo , Xiao Rui , Licht Daniel J. , Shih Evelyn K. 
Published: December 2023

AbstractBackgroundInfants with complex congenital heart disease (CHD) require life-saving corrective/palliative heart surgery in the first weeks of life. These infants are at risk for brain injury and poor neurodevelopmental outcomes. Cerebral microhemorrhages (CMH) are frequently seen after neonatal bypass heart surgery, but it remains unknown if CMH are a benign finding or constitute injury. Herein, we investigate the risk factors for developing CMH and their clinical significance.Methods192 infants with CHD undergoing corrective cardiac surgery with cardiopulmonary bypass (CPB) at a single institution were prospectively evaluated with pre-(n = 183) and/or postoperative (n = 162) brain magnetic resonance imaging (MRI). CMH severity was scored based on total number of microhemorrhages. Antenatal, perioperative, and postoperative candidate risk factors for CMH and neurodevelopmental (ND) outcomes were analyzed. Eighteen-month neurodevelopmental outcomes were assessed using the Bayley-III Scales of Infants and Toddler Development in a subset of patients (n = 82). Linear regression was used to analyze associations between risk factors or ND outcomes and presence/number of CMH.ResultsThe most common CHD subtypes were hypoplastic left heart syndrome (HLHS) (37%) and transposition of the great arteries (TGA) (33%). Forty-two infants (23%) had CMH present on MRI before surgery and 137 infants (85%) post-surgery. No parameters evaluated were significant risk factors for preoperative CMH. In multivariate analysis, cardiopulmonary bypass (CPB) duration (p < 0.0001), use of extracorporeal membrane oxygenation (ECMO) support (p < 0.0005), postoperative seizure(s) (p < 0.03), and lower birth weight (p < 0.03) were associated with new or worsened CMH postoperatively. Higher CMH number was associated with lower scores on motor (p < 0.03) testing at 18 months.ConclusionCMH is a common imaging finding in infants with CHD with increased prevalence and severity after CPB and adverse impact on neurodevelopmental outcomes starting at a young age. Longer duration of CPB and need for postoperative ECMO were the most significant risk factors for developing CMH. However, presence of CMH on preoperative scans indicates non-surgical risk factors that are yet to be identified. Neuroprotective strategies to mitigate risk factors for CMH may improve neurodevelopmental outcomes in this vulnerable population.
Association between frailty assessed by the Clinical Frailty Scale 2.0 and outcomes of acute stroke in older patients
Authors: Forti Paola , Ciani Marianna , Maioli Fabiola 
Published: December 2023

AbstractBackgroundFrailty is a geriatric syndrome characterized by an increased vulnerability to stressors and increased risk of adverse clinical outcomes. While older patients with acute stroke are routinely screened for prestroke disability using the modified Rankin Scale (mRS), because of its known association with stroke outcomes, prestroke frailty is still rarely assessed. The Clinical Frailty Scale (CFS) is a popoular tool for retrospective frailty assessment in the acute setting. The study hypothesis was that prestroke frailty measured with CFS was associated with stroke outcome of older patients independent of prestroke disability assessed with mRS.MethodsWe recruited 4086 individuals aged ≥65 years consecutively admitted with acute stroke to an Italian hospital. Prestroke disability (mRS ≥3) was assessed at admission. Prestroke CFS was retrospectively assessed using information from the medical records. Logistic models determined the association of CFS with poor functional outcome, prolonged discharge, unfavorable discharge setting, and poor rehabilitation potential. Cox models determined the association of CFS with 30-day and 1-month mortality. All models were adjusted for prestroke disability and other major confounders.ResultsParticipants were median age 81 years (25th-75th percentile, 75-87 years), 55.0% female, 82.6% with ischemic stroke, and 26.3% with prestroke disability. Overall prevalence of prestroke frailty (CFS ≥4) was 41.6%. Multivariable-adjusted logistic models showed that CFS was associated with increasing risk of all outcomes except prologed discharge. In severe frailty (CFS 7-8), OR (95%CI) was 3.44 (2.33-5.07) for poor functional outcome, 0.53 (0.38-0.75) for prolonged discharge, 1.89 (0.36-263) for unfavourable discharge, and 6.24 (3.80-10.26) for poor rehabilitation potential (reference CFS 1-3). In multivariable adjusted-Cox models, CFS was unrelated to 30-day mortality but HR (95%CI) of 1-year mortality was significant for both CFS 4-6 (1.70, 1.36-2.11) and CFS 7-8 (1.69, 1.25-2.30).ConclusionsPrestroke frailty measured with CFS was associated with higher risk of several adverse outcomes even after adjustment for prestroke disability and other major confounders.
Four dimensional-flow magnetic resonance imaging analysis of carotid-cavernous fistula, dural arteriovenous fistula and spinal arteriovenous fistula: Detecting shunt point and diagnosing based on flow dynamics analysis
Authors: Kawano Hiroto , Yamada Shigeki , Tsuji Atsushi , Kubo Takaaki , Teshigahara Akira , Ishida Shohei , Ninomiya Futa , Fujimoto Yuki , Kitamura Tomoaki , Shitara Satoshi , Yoshimura Yayoi , Takagi Kenji , Watanabe Yoshiyuki , Nozaki Kazuhiko , Yoshida Kazumichi 
Published: December 2023

AbstractBackground and purposeCarotid-cavernous fistulas (CCF), dural arteriovenous fistula (DAVF) and spinal arteriovenous fistula (SAVF) are rare vascular malformations that cause arteriovenous shunting. Detecting the shunt point and flow direction is necessary for shunt disease diagnosis and treatment. Hence, we propose a new shunt disease diagnostic way with four dimensional-flow magnetic resonance imaging (4D-flow MRI).Material and methodsThe 4D-flow MRI and the DSA (digital subtraction angiography) were performed on 23 patients, including 2 with CCF, 20 with intracranial DAVF, and 1 with SAVF. Catheter embolization was performed in 19 patients. The 4D-flow MRI assessment was conducted for pre- and post-treatment (n = 9), pretreatment only (n = 12) and post-treatment only (n = 2). We use two functions of 4D-flow imaging application, one is a two-dimensional (2D)-colormap, which indicates velocity distribution with color scale for detecting shunt point, and another one is a 2D-flow vector for diagnosing flow direction.ResultsShunt points are detected as red-colored lesions, with higher velocity compared with the surrounded area on 2D-colormap, with corresponding results to DSA findings. A 2D-flow vector indicates flow vectors of the main feeder, drainer, and influenced dural venous sinuses that could complement information obtained from other standard examinations. The post-therapeutic residual shunt flow analysis was consistent with DSA results except for one DAVF case.Conclusion2D-colormap helps detect the shunt point of vascular malformations. A 2D-flow vector makes it possible to diagnose CCF, DAVF and SAVF based on flow dynamic analysis. A 4D-flow MRI would be an additional measurement for shunt disease diagnoses.
Disturbances can facilitate prior invasions more than subsequent invasions in microbial communities
Authors: Lear Luke , Hesse Elze , Buckling Angus 
Published: December 2023

AbstractInvasions by microorganisms are commonly found to benefit from disturbance events. However, the importance of the relative timing and order of the invasion and disturbance for invader success remains uncertain. Here, by invading a stably coexisting community of five bacterial species at four different propagule pressures on eight separate occasions – four pre-disturbance and four post-disturbance – we experimentally tested the importance of timing and order for the invader’s success. Furthermore, we quantified the impact of the invader on the composition of the resident community. Across a range of invader densities, both pre- and post-disturbance invader success was greatest the closer in time to the disturbance. While the greatest invasion success occurred when the invasion immediately followed the disturbance, invasion resistance rapidly recovered, such that the three subsequent invasions had negligible success. As a consequence, overall invader success was greatest pre-than post-disturbance. We found that invasion day as well as success significantly affected resident diversity, such that it was lowest in communities invaded immediately after the disturbance, but was overall lower in communities invaded pre-disturbance. Overall, these results demonstrate that invading immediately after a disturbance is highly beneficial for invader success and results in the biggest change to community composition. Importantly however, they also show that this window of opportunity is very brief, and that, on average, an invader will have a greater success and effect on community composition if it invades before a disturbance.
A high-quality genome assembly of the ghost mothDruceiella hillmaniprovides new evidence of genome size augmentation in Hepialidae
Authors: Weng Yi-Ming , Lopez-Cacacho Isabel , Foquet Bert , Martinez Jose I. , Plotkin David , Sourakov Andrei , Kawahara Akito Y. 
Published: December 2023

AbstractGhost moths are an unusual family of primitive moths (Lepidoptera: Hepialidae) known for their large body size and crepuscular adult activity. These moths represent an ancient lineage, frequently have soil dwelling larvae, and are adapted to high elevations, deserts, and other extreme environments. Despite being rather speciose with more than 700 species, there is a dearth of genomic resources for the family. Here, we present the first high quality, publicly available hepialid genome, generated from an Andean species of ghost moth,Druceiella hillmani. Our genome assembly has a length of 2,586 Mbp with contig N50 of 28.1 Mb and N50 of 29, and BUSCO completeness of 97.1%, making it one of the largest genomes in the order Lepidoptera. Our assembly is a vital resource for future research on ghost moth genomics.