Serum Levels of Soluble Adhesion Molecules as Prognostic Factors for Acute Liver Failure

Background/Aims: In patients with septic shock, the degree of liver dysfunction is correlated with serum levels of soluble intercellular adhesion molecule (sICAM)-1. We aimed to assess the usefulness of serum levels of soluble adhesion molecules as prognostic factors for acute liver failure (ALF). Methods: Serum levels of soluble platelet endothelial cell adhesion molecule (sPECAM)-1, sICAM-3, soluble endothelial (sE) selectin, sICAM-1, soluble platelet selectin, and soluble vascular cell adhesion molecule-1 on admission were measured in 37 ALF patients and 34 healthy controls. Results: Twenty-two ALF patients (59%) reached to fatal outcomes. Serum levels of sPECAM-1, sICAM-3, sE-selectin and sICAM-1 were higher in ALF patients than healthy controls. In 37 ALF patients, by the multivariate logistic regression analysis, ratio of direct to total bilirubin (per 0.1 increase; OR 0.11, 95% CI 0.01-0.99), serum sPECAM-1 level (per 100 ng/ml increase; OR 4.37, 95% CI 1.23-15.5) and serum sICAM-1 level (per 100 ng/ml increase; OR 0.49, 95% CI 0.27-0.89) were associated with fatal outcomes. Using receiver operating characteristics curve, each area under the curve of serum sPECAM-1 and sICMA-1 levels as prognostic factors was 0.71 and 0.74, respectively. Conclusion: Serum sPECAM-1 and sICAM-1 levels may be useful for predicting the prognosis of ALF

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Qualitative spatial reasoning about directions in a corridor containing a single turn

An experiment was conducted to investigate the process of reasoning about directions in an egocentric space. Each participant walked through a corridor containing an angular turn ranging in size from 0° to 90°, in 15° increments. A direction was given to participants at the entrance of the corridor and they were asked to answer this direction at the end of this corridor. Considering the fact that participants had to reason the direction in the featureless corridor, two hypotheses were proposed: (i) reasoning about directions falls into qualitative reasoning by using a small number of coarse angular categories (four 90° categories or eight 45° categories: 90° categories consist of front, back, left, right; 45° categories consist of 90° categories and the four intermediates) that reference axes generate; (ii) reasoning about directions would be done by recalling the rotation angle from the traveling direction to the direction that participants tried to answer. In addition, the configuration of reference axes that participants employed was examined. Both hypotheses were supported, and the data designated that reference axes consisted of eight directions: a pair of orthogonal axes and diagonals.\ud \u

An experimental analysis of direction judgment in a curved corridor

An experiment was conducted to investigate direction judgment in a curved corridor. Each participant walked through the curved corridor. A direction was presented to participants at the entrance, and they were asked to point this direction at two points within the corridor. The present study proposed two hypotheses : (a) participants underestimate the change of their traveling direction while walking; (b) participants use four-direction reference axes (front, back, left, and right) for direction judgment. Both hypotheses were supported, and it was suggested that participants estimated the change of their traveling direction to be approximately 90% of the actual change

A Cluster-Aware Transfer Learning for Bayesian Optimization of Personalized Preference Models

Obtaining personalized models of the crowd is an important issue in various applications, such as preference acquisition and user interaction customization. However, the crowd setting, in which we assume we have little knowledge about the person, brings the cold start problem, which may cause avoidable unpreferable interactions with the people. This paper proposes a cluster-aware transfer learning method for the Bayesian optimization of personalized models. The proposed method, called Cluster-aware Bayesian Optimization, is designed based on a known feature: user preferences are not completely independent but can be divided into clusters. It exploits the clustering information to efficiently find the preference of the crowds while avoiding unpreferable interactions. The results of our extensive experiments with different data sets show that the method is efficient for finding the most preferable items and effective in reducing the number of unpreferable interactions

Budd-Chiari Syndrome with Multiple Thrombi due to a Familial Arg42Ser Mutation in the Protein C Gene

A 34-year-old Japanese woman was admitted to our hospital complaining of developing bilateral pedal edema. Imaging studies led to a diagnosis of Budd-Chiari syndrome combined with internal jugular vein thrombus. We investigated the cause of thrombosis and found that the anticoagulant activity of protein C was decreased. Genetic analysis showed the presence of a c.125C>A (Arg42Ser) substitution in the protein C gene (PROC) of the proband, which generates an Arg42Ser mutation that replaces the scissile bond Arg42-Ala43 normally cleaved by a furin-like processing protease. Her father and younger brother also carried this mutation, although they had no evidence of thrombosis