bluuebunny/crossref_metadata_2025_split huggingface dataset:
Statistical features of systems driven by non-Gaussian processes: theory & practice
Authors: Lucente Dario , Puglisi Andrea , Viale Massimiliano , Vulpiani Angelo 
Published: November 2023

Abstract
Nowadays many tools, e.g. fluctuation relations, are available to characterize the statistical properties of non-equilibrium systems. However, most of these tools rely on the assumption that the driving noise is normally distributed. Here we consider a class of Markov processes described by Langevin equations driven by a mixture of Gaussian and Poissonian noises, focusing on their non-equilibrium properties. In particular, we prove that detailed balance does not hold even when correlation functions are symmetric under time reversal. In such cases, a breakdown of the time reversal symmetry can be highlighted by considering higher order correlation functions. Furthermore, the entropy production may be different from zero even for vanishing currents. We provide analytical expressions for the average entropy production rate in several cases. We also introduce a scale dependent estimate for entropy production, suitable for inference from experimental signals. The empirical entropy production allows us to discuss the role of spatial and temporal resolutions in characterizing non-equilibrium features. Finally, we revisit the Brownian gyrator introducing an additional Poissonian noise showing that it behaves as a two dimensional linear ratchet. It has also the property that when Onsager relations are satisfied its entropy production is positive although it is minimal. We conclude discussing estimates of entropy production for partially accessible systems, comparing our results with the lower bound provided by the thermodynamic uncertainty relations.
The connectivity of the human frontal pole cortex, and a theory of its involvement in exploit versus explore
Authors: Rolls Edmund T , Deco Gustavo , Huang Chu-Chung , Feng Jianfeng 
Published: November 2023

Abstract
The frontal pole is implicated in humans in whether to exploit resources versus explore alternatives. Effective connectivity, functional connectivity, and tractography were measured between six human frontal pole regions and for comparison 13 dorsolateral and dorsal prefrontal cortex regions, and the 360 cortical regions in the Human Connectome Project Multi-modal-parcellation atlas in 171 HCP participants. The frontal pole regions have effective connectivity with Dorsolateral Prefrontal Cortex regions, the Dorsal Prefrontal Cortex, both implicated in working memory; and with the orbitofrontal and anterior cingulate cortex reward/non-reward system. There is also connectivity with temporal lobe, inferior parietal, and posterior cingulate regions. Given this new connectivity evidence, and evidence from activations and damage, it is proposed that the frontal pole cortex contains autoassociation attractor networks that are normally stable in a short-term memory state, and maintain stability in the other prefrontal networks during stable exploitation of goals and strategies. However, if an input from the orbitofrontal or anterior cingulate cortex that expected reward, non-reward, or punishment is received, this destabilizes the frontal pole and thereby other prefrontal networks to enable exploration of competing alternative goals and strategies. The frontal pole connectivity with reward systems may be key in exploit versus explore.
Effects of individual metabolic brain network changes co-affected by T2DM and aging on the probabilities of T2DM: protective and risk factors
Authors: Li Yu-Lin , Wu Jia-Jia , Li Wei-Kai , Gao Xin , Wei Dong , Xue Xin , Hua Xu-Yun , Zheng Mou-Xiong , Xu Jian-Guang 
Published: November 2023

Abstract
Neuroimaging markers for risk and protective factors related to type 2 diabetes mellitus are critical for clinical prevention and intervention. In this work, the individual metabolic brain networks were constructed with Jensen–Shannon divergence for 4 groups (elderly type 2 diabetes mellitus and healthy controls, and middle-aged type 2 diabetes mellitus and healthy controls). Regional network properties were used to identify hub regions. Rich-club, feeder, and local connections were subsequently obtained, intergroup differences in connections and correlations between them and age (or fasting plasma glucose) were analyzed. Multinomial logistic regression was performed to explore effects of network changes on the probability of type 2 diabetes mellitus. The elderly had increased rich-club and feeder connections, and decreased local connection than the middle-aged among type 2 diabetes mellitus; type 2 diabetes mellitus had decreased rich-club and feeder connections than healthy controls. Protective factors including glucose metabolism in triangle part of inferior frontal gyrus, metabolic connectivity between triangle of the inferior frontal gyrus and anterior cingulate cortex, degree centrality of putamen, and risk factors including metabolic connectivities between triangle of the inferior frontal gyrus and Heschl’s gyri were identified for the probability of type 2 diabetes mellitus. Metabolic interactions among critical brain regions increased in type 2 diabetes mellitus with aging. Individual metabolic network changes co-affected by type 2 diabetes mellitus and aging were identified as protective and risk factors for the likelihood of type 2 diabetes mellitus, providing guiding evidence for clinical interventions.
Safety and Immunogenicity of Bivalent RSVpreF Vaccine Coadministered With Seasonal Inactivated Influenza Vaccine in Older Adults
Authors: Athan Eugene , Baber James , Quan Karen , Scott Robert J , Jaques Anna , Jiang Qin , Li Wen , Cooper David , Cutler Mark W , Kalinina Elena V , Anderson Annaliesa S , Swanson Kena A , Gruber William C , Gurtman Alejandra , Schmoele-Thoma Beate ,   for the Study C3671006 Investigator Group, Argent Christopher , Arya Mark , Athan Eugene , Bird Paul , Bloch Mark , Bull Sheetal , Colquhoun David , De Silva Gustinna , Deshmukh Sachin , Eizenberg Peter , Gilfillan Christopher , Gunner Elizabeth , Hiew Valerie , Leah Amber , Leelasena Indika , Lickliter Jason , McGirr Anthony , Mohan Rahul , Morbey Claire , Murdoch Louise , Nelson Mark , Neville A Munro , O'Sullivan Matthew , Rook Christopher , Russo Marc , Ryan Philip , Scott Robert , Tai Sze , Tiong Florence , Voloshyna Olga , Wark Peter 
Published: November 2023

Abstract

Background
Respiratory syncytial virus (RSV) and influenza are both typically seasonal diseases, with winter peaks in temperate climates. Coadministration of an RSV vaccine and influenza vaccine could be a benefit, requiring 1 rather than 2 visits to a healthcare provider for individuals receiving both vaccines.

Methods
The primary immunogenicity objective of this phase 3, 1:1 randomized, double-blind, placebo-controlled study in healthy adults aged ≥65 years in Australia was to demonstrate noninferiority of immune responses with coadministration of the stabilized RSV prefusion F protein–based vaccine (RSVpreF) and seasonal inactivated influenza vaccine (SIIV) versus SIIV or RSVpreF administered alone, using a 1.5-fold noninferiority margin (lower bound 95% confidence interval &gt;.667). Safety and tolerability were evaluated by collecting reactogenicity and adverse event data.

Results
Of 1403 participants randomized, 1399 received vaccinations (median age, 70; range, 65‒91 years). Local reactions and systemic events were mostly mild or moderate when RSVpreF was coadministered with SIIV or administered alone. No vaccine-related serious adverse events were reported. Geometric mean ratios were 0.86 for RSV-A and 0.85 for RSV-B neutralizing titers at 1 month after RSVpreF administration and 0.77 to 0.90 for strain-specific hemagglutination inhibition assay titers at 1 month after SIIV. All comparisons achieved the prespecified 1.5-fold noninferiority margin.

Conclusions
The primary study objectives were met, demonstrating noninferiority of RSVpreF and SIIV immune responses when RSVpreF was coadministered with SIIV and that RSVpreF had an acceptable safety and tolerability profile when coadministered with SIIV. The results of this study support coadministration of RSVpreF and SIIV in an older-adult population.

Clinical Trials Registration
https://clinicaltrials.gov/study/NCT05301322.
Opportunistic Treatment of Hepatitis C Infection Among Hospitalized People Who Inject Drugs (OPPORTUNI-C): A Stepped Wedge Cluster Randomized Trial
Authors: Midgard Håvard , Malme Kristian Braathen , Pihl Charlotte Meinich , Berg-Pedersen Riikka Mari , Tanum Lars , Klundby Ingvild , Haug Anne , Tveter Ida , Bjørnestad Ronny , Olsen Inge Christoffer , Finbråten Ane-Kristine , Dalgard Olav 
Published: November 2023

Abstract

Background
We aimed to evaluate the efficacy of opportunistic treatment of hepatitis C virus (HCV) infection among hospitalized people who inject drugs (PWID).

Methods
We performed a pragmatic, stepped wedge cluster randomized trial recruiting HCV RNA positive individuals admitted for inpatient care in departments of internal medicine, addiction medicine, and psychiatry at three hospitals in Oslo, Norway. Seven departments were sequentially randomized to change from control conditions (standard of care referral to outpatient care) to intervention conditions (immediate treatment initiation). The primary outcome was treatment completion, defined as dispensing the final package of the prescribed treatment within six months after enrolment.

Results
A total of 200 HCV RNA positive individuals were enrolled between 1 October 2019 and 31 December 2021 (mean age 47.4 years, 72.5% male, 60.5% injected past 3 months, 20.4% cirrhosis). Treatment completion was accomplished by 67 of 98 (68.4% [95% confidence interval {CI}: 58.2–77.4]) during intervention conditions and by 36 of 102 (35.3% [95% CI: 26.1–45.4]) during control conditions (risk difference 33.1% [95% CI: 20.0–46.2]; risk ratio 1.9 [95% CI: 1.4–2.6]). The intervention was superior in terms of treatment completion (adjusted odds ratio [aOR] 4.8 [95% CI: 1.8–12.8]; P = .002) and time to treatment initiation (adjusted hazard ratio [aHR] 4.0 [95% CI: 2.5–6.3]; P &lt; .001). Sustained virologic response was documented in 60 of 98 (61.2% [95% CI: 50.8–70.9]) during intervention and in 66 of 102 (64.7% [95% CI: 54.6–73.9]) during control conditions.

Conclusions
An opportunistic test-and-treat approach to HCV infection was superior to standard of care among hospitalized PWID. The model of care should be considered for broader implementation.
Clinical Trials Registration. NCT04220645
Deep-learning based analysis of intracoronary optical coherence tomography images: detection and characterization of lipid plaques
Authors: Volleberg R H J A , Rodgriguez Esteban G , Mol J H Q , Quax S , Isgum I , Sanchez C I , Van Ginneken B , Thannhauser J , Van Royen N 
Published: November 2023

Abstract

Background
Intracoronary optical coherence tomography (OCT) enables in vivo detection and characterization of atherosclerotic disease. However, manual assessment of OCT images is time-consuming and subject to intra- and interobserver variability. Therefore, automated and trustworthy methods for plaque assessment are warranted.

Purpose
To develop and validate an artificial intelligence based algorithm for detection and characterization of lipid plaques on OCT images.

Methods
From the prospective, observational PECTUS-obs study, we studied a representative subset of OCT pullbacks performed in fractional flow reserve-negative non-culprit lesions in patients presenting with myocardial infarction. Manual segmentation of cross-sectional frames (e.g. lumen, tunica intima including the fibrous cap, tunica media and lipid pools) was performed by trained experts. Pullbacks were randomly divided into a training and test set. For automated segmentation and analysis, a two-dimensional no-new U-shaped neural network (nnUNet) was constructed with 5-fold cross validation. To test the diagnostic performance of the nnUnet for detection of lipid plaques, sensitivity, specificity and Cohen’s kappa were calculated. As for plaque characterization, the lipid arc and minimal fibrous cap thickness were measured manually in the test set on each frame containing a lipid plaque. Values of lipid arc and minimal fibrous cap thickness obtained following automated assessment were compared to manual analysis using the intraclass correlation coefficient (ICC) for absolute agreement.

Results
In total, 1215 frames were used for training and 162 frames for testing of the nnUNet. Lipid plaques were present in 77 frames (47.5%) in the test set. Substantial agreement (κ=0.79) for detection of a lipid plaque was achieved with a sensitivity and specificity of 96.1% and 83.5%, respectively. As for plaque characterization, we found good reliability for lipid arc assessment (ICC 0.88, mean difference 6±32º) and moderate reliability for assessment of the minimal fibrous cap thickness (ICC 0.54, mean difference 23±140µm).

Conclusion
We developed a deep learning algorithm for automated analysis of intracoronary OCT images, that was able to accurately detect lipid plaques. Moreover, the algorithm showed promising results in terms of plaque characterization. With further refinements, the developed algorithm has the potential to reduce the time required for OCT interpretation, ultimately enabling more efficient, real-time use of this imaging modality in clinical practice.
Gender-related differences in absolute coronary flow and microvascular resistance in patients with angina and non-obstructed coronary arteries (ANOCA)
Authors: Belmonte M , Gallinoro E , Bertolone D , Paolisso P , Viscusi M M , Storozhenko T , Sakai K , Botti G , Barbato E , Vanderheyden M M , Collet C , De Bruyne B 
Published: November 2023

Abstract

Background
Women with angina more often have non-obstructive coronary artery disease (ANOCA) compared to males. Coronary microvascular dysfunction (CMD) is responsible for angina in a sizable proportion of ANOCA patients. Intracoronary continuous thermodilution allows direct quantification of absolute coronary flow (Q) and microvascular resistance (Rµ).

Purpose
To evaluate gender-related differences in the prevalence and pattern of CMD assessed with intracoronary continuous thermodilution in ANOCA patients. Specifically, we assessed resting and hyperemic Q (Qrest and Qhyper), R (Rµ,rest and Rµ,hyper), coronary flow reverse (CFR), and microvascular resistance reserve (MRR) in ANOCA patients stratified by gender.

Methods
Single-center, prospective study of patients with ANOCA. CMD was invasively assessed by intracoronary continuous thermodilution in the left anterior descending artery (LAD) and defined as CFR&lt;2.5.

Results
A total of 118 patients (n=49 females and n= 69 males) were enrolled. The mean patient age was 65 years. The mean fractional flow reserve (FFR) was 0.85±0.04, with no difference between the 2 genders. There was no difference in Rµ,rest, Qrest and Qhyper between the two genders. However, Rµ,hyper were higher in females compared to males (p=0.003). Among patients with ANOCA, CMD was more prevalent in females (28% vs 22%, p=0.014). Yet, in both females and males with CMD, a higher Qrest was observed compared to patients without CMD. In male patients, also Qhyper was lower in CMD patients versus those without CMD.

Conclusion
Among patients with ANOCA and investigated with intracoronary continuous thermodilution, CMD appeared more prevalent in females compared to males. Females had higher microvascular Rµ,hyper compared to males. In both genders, CMD was characterized by higher Qrest, suggestive of functional rather than structural CMD.
Mechanisms of very late stent thrombosis assessed by optical coherence tomographyin japanese patients
Authors: Mori H 
Published: November 2023

Abstract

Background
Although very late stent thrombosis (VLST) remains an important concern, the underlying etiology and clinical characteristics are not fully elucidated in Japanese patients who daily undergo intravascular imaging-guided percutaneous coronary intervention (PCI).

Objectives
The aim of this study was to explore the mechanisms of VLST in bare metal stents (BMSs) and drug eluting stents (DESs) in Japanese patients.

Methods
We identified 50 VLST lesions (BMS [n=16], 1ST generation DES [n=14], newer generation DES [n=20]) in patients managed in our institutes. The underlying mechanism of VLST was assessed by optical coherence tomography (OCT) and the major etiology of each lesion was determined.

Results
The median duration following stent implantation was 10 (range 1–20) years. The most frequent etiology of VLST was neoatherosclerotic rupture (44%) followed by neointimal erosion (24%). Edge disease (10%) and evagination (10%) were similarly observed. Malapposition (8%) was mostly acquired late by going back to the index procedure. Uncovered strut (2%) and in-stent calcified nodule (2%) were the least frequent etiologies. Regardless of etiology, signs of neoatherosclerosis were present in most (82%) lesions. Most patients received single (68%) or dual (8%) antiplatelet therapy or oral anticoagulation alone (4%), whereas considerable proportion of patients stopped any medication (20%). Regarding the treatment strategy, drug-coated balloon was the most frequent strategy (56%), followed by newer DES implantation (34%).

Conclusion
The mechanisms underlying VLST in Japanese patients were unique, with neoathersclerotic rupture and neointimal erosion accounting for two-thirds of cases of VLST. In these patients, biological responses seemed to be more relevant rather than index procedure-related factors.
Cost effectiveness analysis of drug coated balloon only angioplasty for de novo coronary artery disease intervention
Authors: Merinopoulos I , Gunawardena T , Corballis N , Tsampasian V , Vassiliou V , Eccleshall S , Ryding A , Xydopoulos G 
Published: November 2023

Abstract

Background
DCB angioplasty is an emergent technology for the treatment of coronary artery disease. There is lack of data regarding the cost-effectiveness of DCB-only angioplasty for treatment of de novo coronary artery disease as compared with 2nd DES. We aimed to perform a cost analysis of drug coated balloon (DCB)-only angioplasty versus drug eluting stent (DES), for de novo disease of all vessel sizes and all clinical indications.

Methods
We compared total costs of patients treated with DCB or DES for first presentation of ST elevation myocardial infarction, non-ST elevation myocardial infarction or stable angina due to de novo disease between 1st January 2018 and 15th November 2019. The health economics analysis was undertaken from the National Health Service perspective, using the national annually published resource, the Personal Social Services Research Unit (PSSRU) and Unit Costs of Health and Social Care 2022. We defined total cost as the sum of 1) procedural devices-cost 2) procedural staff-cost 3) post-PCI hospital stay cost 4) antiplatelet regime cost. A cost minimisation analysis was performed to compare the costs of DCB and DES.

Results
We present 1952 all-comer, consecutive patients; 902 (1064 lesions) treated with DCB and 1050 (1186 lesions) treated with DES for de novo coronary artery disease. There were very few differences in terms of baseline clinical characteristics. The DCB group had more patients with history of stroke or heart failure while the DES group had more patients with history of smoking or chronic obstructive pulmonary disease. More scoring balloons were used in the DCB group while more intravascular imaging was used in the DES group. The average procedural duration was slightly shortened in the DCB group. The cost per patient was estimated to be £9.02 more expensive in the DCB group (£3153.00 versus £3143.98) (Fig 1). However, the cost per lesion treated was calculated to be £44.29 cheaper in the DCB group (£3007.56 versus £3051.85) (Fig 2). The results were consistent irrespective of duration of long-term antiplatelet medications. Apart from the deterministic analysis, the probabilistic sensitivity analysis showed that in terms of cost per lesion, DCB presents a 92.3% probability of being cost saving.

Conclusion
We have demonstrated for the first time that DCB-only angioplasty has similar cost to DES per patient and is cost-effective compared to DES in de novo coronary artery disease at the lesion level.DCB vs DES cost per patientDCB vs DES cost per lesion
NT-pro-BNP pre TAVI and relationship with long-term outcomes
Authors: Soerensen L M , Petersen J K , Strange J E , Schou M , Koeber L , De Backer O , Fosbol E 
Published: November 2023

Abstract

Background
Blood levels of NT-proBNP correlates with aortic valve stenosis and has been suggested as a future target for intervention or selection of patients for aortic valve replacement.

Purpose
To examine how levels of NT-proBNP pre-TAVI relates to risk of one-year rates of heart failure admission and mortality in patients undergoing TAVI.

Methods
With Danish nationwide registries, we identified all patients undergoing TAVI from 2014–2021 who had available pre-TAVI NT-pro-BNP measured up to one year prior to TAVI. According to NT-proBNP blood samples, patients were classified according to quartiles of pre-TAVI NT-proBNP levels. The quartiles were then converted into two final groups: Q1-3 including patients with NT-proBNP&lt; 420 pmol/L and Q4 including patients with a NT-proBNP ≥ 420 pmol/L. Groups were compared using cumulative incidence curves of post-TAVI heart failure admissions and Kaplan-Meier estimates to assess comparative all-cause mortality. Adjusted rates of outcomes were assessed, using multivariable Cox analysis, with patients with NT-proBNP&lt; 420 pmol/L serving as reference.

Results
We identified 1,140 patients undergoing a first-time TAVI procedure (53.1% male, median age 81 year) with an availabel NT-pro-BNP (19.5% of the national chohort of TAVI patients). Of these, 846 (74.21%) patients had a NT-proBNP &lt; 420 pmol/L (55.0% male, median age 81 year) and 294 (25.79%) patients with NT-proBNP ≥ 420 pmol/L (53.1% male, median age 82 year). The one-year cumulative incidence of heart failure was 9.1% and 23.1% for patients with a NT-proBNP &lt;420 pmol/L and ≥ 420 pmol/L, respectively (p&lt;0.001) (Figure 1). This corresponded to an adjusted hazard ratio of 1.91 (95% CI: 1.33–2.74). The one-year cumulative incidence of all-cause mortality was 6.0% and 14.6% for patients with a NT-proBNP &lt;420 pmol/L and ≥ 420 pmol/L, respectively (p&lt;0.001) (Figure 1). This corresponded to an adjusted hazard ratio of 1.85 (95% CI: 1.17-2.92).

Conclusion
In patients undergoing TAVI, a baseline NT-proBNP ≥ 420 pmol/L was associated with increased one-year rates of heart failure admissions and mortality post-TAVI. The results suggest that NT-proBNP is associated with adverse outcomes on the long-term and that this could be a target for intervention.Figure 1:HF admission and mortality