julilili42/papers huggingface dataset:
High efficacy and safety of endocardial pulsed electrical field ablation via contact force-controlled catheters for mitral isthmus ablation
2024-05-01

Abstract Background A new technology of a pulsed field generator enables established contact force-controlled radiofrequency (RF) catheters to apply point by point monopolar pulsed electrical field (PEF) energy for linear lesions in atrial fibrillation (AF) ablation. Purpose We evaluated this novel monopolar PEF ablation technique for creating lateral mitral isthmus ablation lines in case of perimitral flutter or complex AF patients non responder to pulmonary vein isolation (PVI). Methods Patients (n=44, age 65±11 years) referred for ablation/re-ablation of AF with spontaneous or inducible perimitral atrial flutter (n=34, 77%) or persistent AF and severe enlarged atrium (n=7) or de novo longstanding persistent AF (n=3) without signs of atrial fibrosis were included in our patient cohort for lateral mitral isthmus ablation with PEF applications. After 3D high density voltage mapping of the left atrium with multipolar microelectrode catheters, and confirmation/completion of PVI, an endocardial lateral mitral isthmus line was performed. Using contact force sensing catheter, 25A PEF energy pulses were applied targeting a minimum of 10g contact force and an interlesion distance ≤5mm. Before PEF application 0.2 mg nitroglycerin was intravenously injected. If the inferolateral mitral isthmus line to the left inferior pulmonary vein could not be blocked, a more superior lateral line to the left superior pulmonary vein was performed. If the mitral isthmus could not be blocked by endocardial PEF application or conduction recurred after adenosine injection an additional epicardial ablation via RF application in the coronary sinus was performed. Results Exclusively endocardial PEF application blocked the lateral mitral line in 37 out of 42 cases (88%) with 23±14 PEF applications. After an unsuccessful inferior lateral mitral line, in 34% of cases a second superior lateral mitral line have to be performed. Only in five cases additional epicardial RF applications via coronary sinus were necessary to complete the mitral isthmus block. Block time between superior lateral mitral anulus and infero lateral coronary sinus was 196±48 ms. One pericardial tamponade which could be successfully drained, and no other serious complication occurred throughout all procedures (no ST segment elevation, no tamponade requiring surgery, no cerebrovascular event). Limited follow-up will be available at the time of presentation. Conclusion Blockade of left atrial mitral isthmus line with PEF application via contact force-sensing catheters for ablation of complex atrial fibrillation patients is very efficient and safe. Especially the high efficacy of exclusively endocardial PEF application for creation of a lateral mitral isthmus block in most patients is very promising. However, the long term permanence of the linear lines have to be awaited.
First and second-generation endometrial ablation devices: A network meta-analysis
2024-05-01

Objective First-generation and second-generation endometrial ablation (EA) techniques, along with medical treatment and invasive surgery, are considered successful lines of management for abnormal uterine bleeding (AUB). We set out to determine the efficacy of first and second-generation ablation techniques compared with medical treatment, invasive surgery and different modalities of the EA techniques themselves. Design Systematic review and network meta-analysis using a frequentist network. Data sources We searched Medline (Ovid), PubMed, ClinicalTrials.gov, Cochrane CENTRAL, Web of Science, EBSCO and Scopus for all published studies up to 1 March 2021 using relevant keywords. Eligibility criteria We included all randomised controlled trials (RCTs) that compared premenopausal women with AUB receiving the intervention of second-generation EA techniques. Data extraction and synthesis 49 high-quality RCTs with 8038 women were included. We extracted and pooled the data and then analysed to estimate the network meta-analysis models within a frequentist framework. We used the random-effects model of the netmeta package in R (V.3.6.1) and the ‘Meta-Insight’ website. Results Our network meta-analysis showed many varying results according to specific outcomes. The uterine balloon ablation had significantly higher amenorrhoea rates than other techniques in both short (hydrothermal ablation (risk ratio (RR)=0.51, 95% CI 0.37; 0.72), microwave ablation (RR=0.43, 95% CI 0.31; 0.59), first-generation techniques (RR=0.44, 95% CI 0.33; 0.59), endometrial laser intrauterine therapy (RR=0.18, 95% CI 0.10; 0.32) and bipolar radio frequency treatments (RR=0.22, 95% CI 0.15; 0.31)) and long-term follow-up (microwave ablation (RR=0.11, 95% CI 0.01; 0.86), bipolar radio frequency ablation (RR=0.12, 95% CI 0.02; 0.90), first generation (RR=0.12, 95% CI 0.02; 0.90) and endometrial laser intrauterine thermal therapy (RR=0.04, 95% CI 0.01; 0.36)). When calculating efficacy based only on calculated bleeding scores, the highest scores were achieved by cryoablation systems (p-score=0.98). Conclusion Most second-generation EA systems were superior to first-generation systems, and statistical superiority between devices depended on which characteristic was measured (secondary amenorrhoea rate, treatment of AUB, patient satisfaction or treatment of dysmenorrhoea). Although our study was limited by a paucity of data comparing large numbers of devices, we conclude that there is no evidence at this time that any one of the examined second-generation systems is clearly superior to all others.
Meningioma: International Consortium on Meningiomas consensus review on scientific advances and treatment paradigms for clinicians, researchers, and patients
2024-05-02

Abstract Meningiomas are the most common primary intracranial tumors in adults and are increasing in incidence due to the aging population and increased access to neuroimaging. While most exhibit nonmalignant behavior, a subset of meningiomas are biologically aggressive and are associated with treatment resistance, resulting in significant neurologic morbidity and even mortality. In recent years, meaningful advances in our understanding of the biology of these tumors have led to the incorporation of molecular biomarkers into their grading and prognostication. However, unlike other central nervous system (CNS) tumors, a unified molecular taxonomy for meningiomas has not yet been established and remains an overarching goal of the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy-Not Official World Health Organization (cIMPACT-NOW) working group. Additionally, clinical equipoise still remains on how specific meningioma cases and patient populations should be optimally managed. To address these existing gaps, members of the International Consortium on Meningiomas including field-leading experts, have prepared this comprehensive consensus narrative review directed toward clinicians, researchers, and patients. Included in this manuscript are detailed overviews of proposed molecular classifications, novel biomarkers, contemporary treatment strategies, trials on systemic therapies, health-related quality-of-life studies, and management strategies for unique meningioma patient populations. In each section, we discuss the current state of knowledge as well as ongoing clinical and research challenges to road map future directions for further investigation.
A Parallel Rank-Adaptive Integrator for Dynamical Low-Rank Approximation
2024-05-02

.This work introduces a parallel and rank-adaptive matrix integrator for dynamical low-rank approximation. The method is related to the previously proposed rank-adaptive basis update and Galerkin (BUG) integrator but differs significantly in that all arising differential equations, both for the basis and the Galerkin coefficients, are solved in parallel. Moreover, this approach eliminates the need for a potentially costly coefficient update with augmented basis matrices. The integrator also incorporates a new step rejection strategy that enhances the robustness of both the parallel integrator and the BUG integrator. By construction, the parallel integrator inherits the robust error bound of the BUG and projector-splitting integrators. Comparisons of the parallel and BUG integrators are presented by a series of numerical experiments which demonstrate the efficiency of the proposed method, for problems from radiative transfer and radiation therapy.Keywordsdynamical low-rank approximationrank adaptivitytime integrationMSC codes68Q2568R1068U05
Goldfinder: Unraveling Networks of Gene Co-occurrence and Avoidance in Bacterial Pangenomes
2024-05-02

The pangenome is the set of all genes present in a prokaryotic species. Most pangenomes contain many accessory genes that are present in only some of the species members. Genes need to function together, and it has been suggested that selection for certain gene combinations affects the structure of prokaryotic pangenomes. Nevertheless, genes might also co-occur simply due to being linked on the genome, and efficient tools are needed to distinguish linkage from co-selection. Here we present Goldfinder, an approach to infer co-occurrence and co-avoidance between gene pairs by taking the phylogenetic relationships of the species into account. The approach is implemented in an efficient Python script available at https://github.com/fbaumdicker/goldfinder . We also provide scripts for clustering co-occurring genes and for visualizing the resulting co-occurrence and co-avoidance networks in Cytoscape. In comparison to the co-occurrence inference tool Coinfinder, Goldfinder finds fewer co-occurring pairs in a real species pangenome, suggesting that fewer spurious associations due to phylogenetic dependencies are detected. We conclude that Goldfinder is a fast and accurate tool to infer gene co-occurrence and co-avoidance, which will enable large-scale analyses to infer co-selected genes across bacterial pangenomes.
Short communication: Lifetime musical activity and resting-state functional connectivity in cognitive networks
2024-05-02

Background Participation in multimodal leisure activities, such as playing a musical instrument, may be protective against brain aging and dementia in older adults (OA). Potential neuroprotective correlates underlying musical activity remain unclear. Objective This cross-sectional study investigated the association between lifetime musical activity and resting-state functional connectivity (RSFC) in three higher-order brain networks: the Default Mode, Fronto-Parietal, and Salience networks. Methods We assessed 130 cognitively unimpaired participants (≥ 60 years) from the baseline cohort of the DZNE-Longitudinal Cognitive Impairment and Dementia Study (DELCODE) study. Lifetime musical activity was operationalized by the self-reported participation in musical instrument playing across early, middle, and late life stages using the Lifetime of Experiences Questionnaire (LEQ). Participants who reported musical activity during all life stages ( n = 65) were compared to controls who were matched on demographic and reserve characteristics (including education, intelligence, socioeconomic status, self-reported physical activity, age, and sex) and never played a musical instrument ( n = 65) in local (seed-to-voxel) and global (within-network and between-network) RSFC patterns using pre-specified network seeds. Results Older participants with lifetime musical activity showed significantly higher local RSFC between the medial prefrontal cortex (Default Mode Network seed) and temporal as well as frontal regions, namely the right temporal pole and the right precentral gyrus extending into the superior frontal gyrus, compared to matched controls. There were no significant group differences in global RSFC within or between the three networks. Conclusion We show that playing a musical instrument during life relates to higher RSFC of the medial prefrontal cortex with distant brain regions involved in higher-order cognitive and motor processes. Preserved or enhanced functional connectivity could potentially contribute to better brain health and resilience in OA with a history in musical activity. Trial registration German Clinical Trials Register ( DRKS00007966 , 04/05/2015).
Soil salinization trend from 2003 to 2022 across the globe response to climate change
2024-05-02

<title>Abstract</title> Climate change affects soil salinization and is responsible for food production threats and unsustainable development. However, global salinization trend and its temporal response to climate remains unclear. Here we show global soil salinization changes from 2003 to 2022 at 500 m resolution estimated by a machine learning approach, remote sensing, climate, and geographical data. Globally, soil showed a stable trend with an average trend slope value of -0.00002 ± 0.000024 dS m<sup>-1</sup>. The trend shows a large variability across the globe depending on local water regimes, and soil salinization has intensified in semi-arid and humid areas. Soil salinization trends are influenced by soil hydro-thermal conditions. Reduced terrestrial water reserves intensify salinization, and soil moisture patterns drive salinization through a three-year lag time and a three-year accumulation effect. A soil salinity change equation was proposed describing vegetation, soil moisture, climate, and topography which can be used for guiding salinization trend evaluation. Our findings reveal the global soil salinization trend and its response to climate change, providing detailed guidance for improving soil quality under different climate and hydrological conditions.
Thin Films of Conjugated Chalcogenadiazole: Growth, Structure, and Optical Properties of Substituted Selenadiazoloquinoxaline
2024-05-02

Thin films of π-conjugated organic molecules are of high interest for organic optoelectronics. Due to their strong and tunable absorption spectrum and good charge carrier mobilities, thiadiazolo-heteroacenes are considered to be a prospective class of materials for these applications. Additional chemical modification of these molecules by heavy Se atoms and extending the π-conjugation hold promise to further tune the optical properties and structural arrangement through the heavy atom effect and secondary interactions. Therefore, understanding the thin film growth behavior as well as the optical properties of such derivatives is crucial for future applications. In this study, thin films of dibenzoselenadiazoloquinoxaline (dbSeQ) were grown under ultra-high vacuum conditions by organic molecular beam deposition on native silicon oxide substrates at different temperatures. Their optical properties, structure, and morphology were examined by optical spectroscopy, time-resolved fluorescence spectroscopy, ellipsometry, time-resolved surface-sensitive X-ray scattering, and microscopy techniques.
Insights into discrepancies in professional identities and role models in undergraduate medical education in the context of affective burden
2024-05-02

Introduction International evidence strongly suggests that medical students are at high risk of mental health problems. This distress, which can be mediated by a variety of individual, interpersonal and contextual factors within the curriculum, can be mitigated by effective coping strategies and interventions. Central to this discourse is the recognition that the challenges of professional identity formation can contribute significantly to medical students' distress. The focus of our study is therefore to examine discrepancies in professional identities and role models in undergraduate medical education in relation to affective burden. Methods Medical students at different stages of university education and high school graduates intending to study medicine were surveyed in a cross-sectional study. The study employed Osgood and Hofstätter's polarity profile to evaluate the self-image of participants, the image of an ideal and real physician, and their correlation with depression (PHQ-9) and anxiety (GAD-7). Results Out of the 1535 students recruited, 1169 (76.2%) participated in the study. Students rated their self-image as somewhere between a more critical real image of physicians and a more positive ideal image. Medical students at all training levels consistently rated the ideal image as remaining constant. Significant correlations were found between the professional role models of medical students and affective symptoms, particularly for the discrepancy between the ideal image of a physician and their self-image. Furthermore, 17% and nearly 15% reported significant symptoms of depression and anxiety, respectively. Discussion Our study adds to the growing body of knowledge on professional identity formation in medicine and socialisation in the medical environment. The study highlights the importance of discrepancies between self-image and ideal image in the experience of depressive and anxiety symptoms. Primary prevention-oriented approaches should incorporate these findings to promote reflective competence in relation to professional role models and strengthen the resilience of upcoming physicians in medical training.
Susceptibility of Melanoma Cells to Targeted Therapy Correlates with Protection by Blood Neutrophils
2024-05-02

Elevated levels of peripheral blood and tumor tissue neutrophils are associated with poorer clinical response and therapy resistance in melanoma. The underlying mechanism and the role of neutrophils in targeted therapy is still not fully understood. Serum samples of patients with advanced melanoma were collected and neutrophil-associated serum markers were measured and correlated with response to targeted therapy. Blood neutrophils from healthy donors and patients with advanced melanoma were isolated, and their phenotypes, as well as their in vitro functions, were compared. In vitro functional tests were conducted through nonadherent cocultures with melanoma cells. Protection of melanoma cell lines by neutrophils was assessed under MAPK inhibition. Blood neutrophils from advanced melanoma patients exhibited lower CD16 expression compared to healthy donors. In vitro, both healthy-donor- and patient-derived neutrophils prevented melanoma cell apoptosis upon dual MAPK inhibition. The effect depended on cell–cell contact and melanoma cell susceptibility to treatment. Interference with protease activity of neutrophils prevented melanoma cell protection during treatment in cocultures. The negative correlation between neutrophils and melanoma outcomes seems to be linked to a protumoral function of neutrophils. In vitro, neutrophils exert a direct protective effect on melanoma cells during dual MAPK inhibition. This study further hints at a crucial role of neutrophil-related protease activity in protection.
The bispecific B7H3xCD3 antibody CC-3 induces T cell immunity against bone and soft tissue sarcomas
2024-05-03

Sarcomas are rare and heterogeneous malignancies that are difficult to treat. Approximately 50% of patients diagnosed with sarcoma develop metastatic disease with so far very limited treatment options. The transmembrane protein B7-H3 reportedly is expressed in various malignancies, including different sarcoma subtypes. In several cancer entities B7-H3 expression is associated with poor prognosis. In turn, B7-H3 is considered a promising target for immunotherapeutic approaches. We here report on the preclinical characterization of a B7-H3xCD3 bispecific antibody in an IgG-based format, termed CC-3, for treatment of different sarcoma subtypes. We found B7-H3 to be expressed on all sarcoma cells tested and expression on sarcoma patients correlated with decreased progression-free and overall survival. CC-3 was found to elicit robust T cell responses against multiple sarcoma subtypes, resulting in significant activation, release of cytokines and effector molecules. In addition, CC-3 promoted T cell proliferation and differentiation, resulting in the generation of memory T cell subsets. Finally, CC-3 induced potent target cell lysis in a target cell restricted manner. Based on these results, a clinical trial evaluating CC-3 in soft tissue sarcoma is currently in preparation.
Temperature flow in pseudo-Majorana functional renormalization for quantum spins
2024-05-03

We implement the temperature flow scheme first proposed by Honerkamp and Salmhofer [Phys. Rev. B 64, 184516 (2001)] into the pseudo-Majorana functional renormalization group method for quantum spin systems. Since the renormalization group parameter in this approach is a physical quantity, the temperature , the numerical efficiency increases significantly compared to more conventional renormalization group parameters, especially when computing finite-temperature phase diagrams. We first apply this method to determine the finite-temperature phase diagram of the Heisenberg model on the simple cubic lattice, where our findings support claims of a vanishingly small nonmagnetic phase around the high frustration point . Perhaps most importantly, we find the temperature flow scheme to be advantageous in detecting finite-temperature phase transitions as, by construction, a phase transition is never encountered at an artificial, unphysical cutoff parameter. Finally, we apply the temperature flow scheme to the dipolar XXZ model on the square lattice, where we find a rich phase diagram with a large nonmagnetic regime down to the lowest accessible temperatures. Wherever a comparison with error-controlled (quantum) Monte Carlo methods is applicable, we find excellent quantitative agreement with less than deviation from the numerically exact results.
Pre-hospital glycemia as a biomarker for in-hospital all-cause mortality in diabetic patients - a pilot study
2024-05-03

Abstract Background Type 2 Diabetes Mellitus (T2DM) presents a significant healthcare challenge, with considerable economic ramifications. While blood glucose management and long-term metabolic target setting for home care and outpatient treatment follow established procedures, the approach for short-term targets during hospitalization varies due to a lack of clinical consensus. Our study aims to elucidate the impact of pre-hospitalization and intra-hospitalization glycemic indexes on in-hospital survival rates in individuals with T2DM, addressing this notable gap in the current literature. Methods In this pilot study involving 120 hospitalized diabetic patients, we used advanced machine learning and classical statistical methods to identify variables for predicting hospitalization outcomes. We first developed a 30-day mortality risk classifier leveraging AdaBoost-FAS, a state-of-the-art ensemble machine learning method for tabular data. We then analyzed the feature relevance to identify the key predictive variables among the glycemic and routine clinical variables the model bases its predictions on. Next, we conducted detailed statistical analyses to shed light on the relationship between such variables and mortality risk. Finally, based on such analyses, we introduced a novel index, the ratio of intra-hospital glycemic variability to pre-hospitalization glycemic mean, to better characterize and stratify the diabetic population. Results Our findings underscore the importance of personalized approaches to glycemic management during hospitalization. The introduced index, alongside advanced predictive modeling, provides valuable insights for optimizing patient care. In particular, together with in-hospital glycemic variability, it is able to discriminate between patients with higher and lower mortality rates, highlighting the importance of tightly controlling not only pre-hospital but also in-hospital glycemic levels. Conclusions Despite the pilot nature and modest sample size, this study marks the beginning of exploration into personalized glycemic control for hospitalized patients with T2DM. Pre-hospital blood glucose levels and related variables derived from it can serve as biomarkers for all-cause mortality during hospitalization.