Predictive utility of residual SYNTAX score for clinical outcomes after successful primary percutaneous coronary intervention.

BACKGROUND: In patients presenting with ST-segment elevation myocardial infarction (STEMI), the prevalence of having concomitant severe non-culprit lesion(s) is ≥40%. While timely primary PCI (pPCI) for the culprit lesion is the standard practice, management of the non-culprit lesions remains unsettled. RESULTS: This prospective multi-center observational study recruited 492 acute STEMI patients who underwent successful pPCI for the culprit lesion. Culprit-only versus complementary non-culprit lesion(s) PCI (either immediate or staged during the same hospital stay) was according to the operator's discretion. Clinical, echocardiographic, and angiographic data were collected and tabulated. The residual SYNTAX score (rSS) was completed by the time of discharge considering the residual lesions after all in-hospital revascularization procedures. Through a minimum follow-up of 12 months, older age, presentation with heart failure Killip class ≥ II, lower estimated glomerular filtration rate (eGFR) on admission, lower left ventricular ejection fraction (LVEF), and higher rSS by discharge were significantly associated with recurrent MACE. In multivariate regression analysis, Killip class ≥ II, LVEF, and rSS were found to be independent predictors for recurrent MACE. In the Receiver Operating Characteristics curve, an rSS of >8 had a sensitivity of 70.1%, and specificity of 75.3% to predict 1-year MACE. CONCLUSIONS: Residual syntax score proved to be an independent predictor for recurrent MACE through the subsequent year post STEMI. Patients with rSS >8 seem to be at the highest risk for adverse events and are likely to be the most deserving for completing revascularization to reduce the disease burden.

Note similarities affect syntactic stability in zebra finches.

The acquisition of an acoustic template is a fundamental component of vocal imitation learning, which is used to refine innate vocalizations and develop a species-specific song. In the absence of a model, birds fail to develop species typical songs. In zebra finches (Taeniopygia guttata), tutored birds produce songs with a stereotyped sequence of distinct acoustic elements, or notes, which form the song motif. Songs of untutored individuals feature atypical acoustic and temporal structure. Here we studied songs and associated respiratory patterns of tutored and untutored male zebra finches to investigate whether similar acoustic notes influence the sequence of song elements. A subgroup of animals developed songs with multiple acoustically similar notes that are produced with alike respiratory motor gestures. These birds also showed increased syntactic variability in their adult motif. Sequence variability tended to occur near song elements which showed high similarity in acoustic structure and underlying respiratory motor gestures. The duration and depth of the inspirations preceding the syllables where syntactic variation occurred did not allow prediction of the following sequence of notes, suggesting that the varying duration and air requirement of the following expiratory pulse is not predictively encoded in the motor program. This study provides a novel method for calculation of motor/acoustic similarity, and the results of this study suggest that the note is a fundamental acoustic unit in the organization of the motif and could play a role in the neural code for song syntax.

Seeing the Forest but Naming the Trees: An Object-Over-Place Bias in Learning Noun Labels.

Objects and places are foundational spatial domains represented in human symbolic expressions, like drawings, which show a prioritization of depicting small-scale object-shape information over the large-scale navigable place information in which objects are situated. Is there a similar object-over-place bias in language? Across six experiments, adults and 3- to 4-year-old children were asked either to extend a novel noun in a labeling phrase, to extend a novel noun in a prepositional phrase, or to simply match pictures. To dissociate specific object and place information from more general figure and ground information, participants either saw scenes with both place information (a room) and object information (a block in the room), or scenes with two kinds of object information that matched the figure-ground relations of the room and block by presenting an open container with a smaller block inside. While adults showed a specific object-over-place bias in both extending novel noun labels and matching, they did not show this bias in extending novel nouns following prepositions. Young children showed this bias in extending novel noun labels only. Spatial domains may thus confer specific and foundational biases for word learning that may change through development in a way that is similar to that of other word-learning biases about objects, like the shape bias. These results expand the symbolic scope of prior studies on object biases in drawing to object biases in language, and they expand the spatial domains of prior studies characterizing the language of objects and places.

Outcomes of myocardial revascularization in patients with obesity and multivessel coronary artery disease.

BACKGROUND: There is uncertainty regarding the best revascularization approach-whether coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI)-for obese patients suffering from multi-vessel coronary artery disease. RESULTS: 406 patients with low and intermediate SYNTAX scores (SS) underwent PCI with drug-eluting stents (n = 200, 100 with SS ≤ 22, and 100 with SS 23-32) and CABG (n = 206, 100 with SS ≤ 22, and 106 with SS 23-32). Patients were also categorized by body mass index (BMI): normal weight (12%, 48 patients), overweight (41.6%, 169 patients), and obese (46.6%, 189 patients). The follow-up period averaged 9 ± 1.9 years. The endpoints of the study were as follows: major adverse cardiac and cerebrovascular events, a repeat revascularization, diminished left ventricular ejection fraction (LVEF), and high SS (≥ 33) observed over time. When comparing PCI and CABG in overweight individuals, the risk of myocardial infarction (MI) following PCI was greater than after CABG (Hazard Ratio [HR] 2.7, 95% Confidence Interval [CI] 1.1-6.7, p = 0.03). In patients with overweight and Class I obesity, CABG was associated with the risk of coronary atherosclerosis progression (SS ≥ 33) (HR 4.4, 95% CI 1.5-13, p = 0.009 and HR 4.9, 95% CI 1.9-12, p = 0.001, respectively); whereas PCI was connected with the likelihood of repeat revascularization (HR 2.7, 95% CI 1.6-4.55, p < 0.0001 and HR 2, 95% CI 1.3-3.1, p = 0.002, respectively). At the same time, for stented patients, Class III obesity was associated with the risk of repeat revascularization (HR 2.5, 95% CI 1.02-6, p = 0.044). CONCLUSION: There were no significant weight-related impacts on long-term outcomes among patients who underwent surgery. Whereas in stented patients, Class III obesity was associated with the risk of repeat revascularization. When comparing PCI and CABG, for overweight and Class I obesity patients, CABG was associated with a likelihood of coronary atherosclerosis progression (SS ≥ 33), while PCI was linked to the risk of repeat revascularization. For overweight patients, CABG outperformed PCI in terms of the risk of MI. For other adverse events in patients of different weight categories, PCI and CABG did not reveal any significant benefits.

Exploring Campus Configuration and Patient Arrival Behaviors at Large Hospitals: An Integrated Post-Occupancy Evaluation (POE) Protocol.

BACKGROUND: This study addresses the challenges in hospital navigation, particularly focusing on the sequence of arrival experiences through foot traffic or driving within a medical campus. While previous research has emphasized wayfinding in interiors, this study recognizes the importance of transition from outdoor to indoor spaces in the hospital arrival zone. OBJECTIVES: Twofold research efforts include: (1) Exploring vehicular and pedestrian behaviors in a hospital arrival zone using Space Syntax Analyses (SSA), and (2) Validating the SSA results using empirical data collected from onsite observations and behavior mapping. METHODS: A series of axial map analyses were conducted on the hospital campus and building arrival zone regarding spatial connectivity and integration, depth of spaces, and wayfinding intelligibility based on vehicular and pedestrian movement paths. Systematic behavioral data collection includes vehicle shadowing (10 h) and pedestrian mapping (20 h) in the building arrival zone. RESULTS: Space Syntax Analyses indicates high intelligibility scores for vehicles (R = .91) and pedestrian (R = .78) circulation patterns; traffic situations were visualized via axial maps. A dataset of 219 vehicles and 2,096 pedestrian behaviors was analyzed and visualized using diagrams and heatmaps, identifying different occupancy patterns within the space. Correlational analyses indicated strong correlations between the results: connectivity and integration scores are significantly correlated with both vehicular and pedestrian traffic volumes. CONCLUSION: Preliminary findings of the study validated an integrated protocol to evaluate the impacts of campus configuration and building approach design on patient arrival and spatial navigation at large hospitals, serving as a POE protocol involving SSA.

Language Markers of Dementia and Their Role in Early Diagnosis of Alzheimer's Disease: Exploring Grammatical and Syntactic Competence via Sentence Repetition.

Background: Earlier research focuses primarily on the cognitive changes due to Alzheimer's disease (AD); however, little is known with regard to changes in language competence across the lifespan. Objective: The present study aims to investigate the decline of language skills at the grammatical and syntactic levels due to changes in cognitive function. Methods: We administered the Litmus Sentence Repetition Task (SRT) to 150 native speakers of Greek who fall into five groups: 1) young healthy speakers, 2) cognitively intact elder healthy speakers, 3) speakers with subjective cognitive impairment (SCI), 4) speakers with mild cognitive impairment (MCI); and 5) speakers with AD dementia at the mild/moderate stages. All participants underwent a physical and neurological examination and cognitive screening with a standardized neuropsychological battery to assess cognitive status comprehensively and evaluate aspects like working memory, executive function, attention and memory to appropriately classify them. Results: The data analysis revealed that the SRT had high discriminatory value in the development of AD; specifically, both accuracy and grammaticality indices were related to cognitive decline. Additionally, syntax significantly affected the performance of speakers with structures such as clitics being particularly challenging and in most structures the performance of speakers with MCI drops significantly compared to speakers with SCI. Conclusions: Linguistic indices revealed subtle early signs of cognitive decline that can be helpful in the early detection of AD, thus facilitating the clinical process offering support to language-based assessment tools such as sentence repetition, a non-invasive type of assessment to evaluate symptoms of AD.

Distinct circulating cytokine levels in patients with angiography-proven coronary artery disease compared to disease-free controls.

Background: Systemic inflammation has a critical role in the development of symptomatic coronary artery disease (CAD). Identification of inflammatory pathways may provide a platform for novel therapeutic approaches. We sought to determine whether there are differences in circulating cytokine profiles between patients with CAD and disease-free controls as well as according to the severity of the disease. Methods: Case-control study's population consisted of 452 patients who underwent diagnostic invasive coronary angiography due to clinical indications. We measured the serum concentrations of 48 circulating cytokines. Extent of CAD was assessed using the SYNTAX Score in 116 patients. Cytokine differences between groups were tested using Mann-Whitney U test and associations with CAD were explored using a logistic regression model. Results: Overall, 310 patients had angiographically verified CAD whereas 142 had no angiographically-detected coronary atherosclerosis. In multivariable logistic regression models adjusted for age, sex, hypertension, atrial fibrillation, history of smoking and treatment for diabetes and hyperlipidemia, increased levels of interleukin 9 (OR 1.359, 95%CI 1.046-1.766, p = 0.022), IL-17 (1.491, 95%CI 1.115-1.994, p = 0.007) and tumor necrosis factor alpha (TNF-α) (OR 1.440, 95%CI 1.089-1.904, p = 0.011) were independently associated with CAD. Patients with SYNTAX Score>22 had increased levels of stromal cell-derived factor 1 alfa (SDF-1α), beta-nerve growth factor (ß-NGF), IL-3 and decreased level of IL-17 compared to those with score ≤22 when adjusted for smoking and use of beta-blockers. Conclusions: Patients with CAD have distinct circulating cytokine profiles compared to disease-free controls. Distinct cytokines may have pivotal roles at different stages of coronary atherosclerosis. ClinicalTrials.gov Identifier: NCT03444259 (https://clinicaltrials.gov/study/NCT03444259).

Feature reassembly and L1 preemption: Acquiring CLLD in L2 Italian and L2 Romanian.

This study investigates feature acquisition and feature reassembly associated with Clitic Left Dislocation (CLLD). The article compares the acquisition of CLLD in second language (L2) Italian to L2 Romanian to examine effects of first language (L1) transfer, construction frequency and the type of interface involved (external vs. internal interface) within the same syntactic construction. The results from an acceptability judgment task and a written elicitation task show that while English near-native speakers of Italian/Romanian acquired the L2 constraints on CLLD, which is [+anaphor] for Italian and [+specific] for Romanian, data from both Romanian L2 learners of Italian and Italian L2 learners of Romanian showed persistent L1 transfer effects. Target-like acquisition for these groups requires both grammatical expansion and retraction; Romanian CLLD requires the addition of an L1-unavailable [+specific] feature and the loss of a [+anaphor] feature, while Italian CLLD requires the addition of an L1-unavailable [+anaphor] and the loss of a [+specific] feature. The reported findings extend evidence in favour of the Feature Reassembly Hypothesis to the syntax-discourse interface, as reassembly of interpretational features associated with CLLD proved more difficult than feature acquisition. While learners at the near-native levels were able to broaden the contexts that allow a clitic in the L2 (grammatical expansion), L1 preemption difficulties were attested as well. This was the case regardless of the frequency of the relevant construction in the input and the type of L2 feature that needed to be added/removed.

Brain and grammar: revealing electrophysiological basic structures with competing statistical models.

Acoustic, lexical, and syntactic information are simultaneously processed in the brain requiring complex strategies to distinguish their electrophysiological activity. Capitalizing on previous works that factor out acoustic information, we could concentrate on the lexical and syntactic contribution to language processing by testing competing statistical models. We exploited electroencephalographic recordings and compared different surprisal models selectively involving lexical information, part of speech, or syntactic structures in various combinations. Electroencephalographic responses were recorded in 32 participants during listening to affirmative active declarative sentences. We compared the activation corresponding to basic syntactic structures, such as noun phrases vs. verb phrases. Lexical and syntactic processing activates different frequency bands, partially different time windows, and different networks. Moreover, surprisal models based on part of speech inventory only do not explain well the electrophysiological data, while those including syntactic information do. By disentangling acoustic, lexical, and syntactic information, we demonstrated differential brain sensitivity to syntactic information. These results confirm and extend previous measures obtained with intracranial recordings, supporting our hypothesis that syntactic structures are crucial in neural language processing. This study provides a detailed understanding of how the brain processes syntactic information, highlighting the importance of syntactic surprisal in shaping neural responses during language comprehension.

Association of Preprocedural SYNTAX Score With Outcomes in Impella-Assisted High-Risk Percutaneous Coronary Intervention.

Background: Patients with complex coronary artery disease, as defined by high SYNTAX scores, undergoing percutaneous coronary intervention (PCI) have poorer outcomes when compared with patients with lower SYNTAX I scores. This study aimed to assess if mechanical circulatory support using Impella mitigates the effect of the SYNTAX I score on outcomes after high-risk percutaneous coronary intervention (HRPCI). Methods: Using data from the PROTECT III study, patients undergoing Impella-assisted HRPCI between March 2017 and March 2020 were divided into 3 cohorts based on SYNTAX I score-low (≤22), intermediate (23-32), and high (≥33). Procedural and clinical outcomes out to 90 days were compared between groups. Multivariable regression analysis was used to assess the impact of SYNTAX I score on major adverse cardiovascular and cerebrovascular events (MACCE) at 90 days. Results: A total of 850 subjects with core laboratory-adjudicated SYNTAX I scores were identified (low: n = 310; intermediate: n = 256; high: n = 284). Patients with high SYNTAX I scores were older than those with low or intermediate SYNTAX I scores (72.7 vs 69.7 vs 70.1 years, respectively; P < .01). After adjustment for covariates, high SYNTAX I score remained a significant predictor of 90-day MACCE (hazard ratio [HR], 2.14; 95% CI, 1.42-3.69; P < .01 vs low), whereas intermediate SYNTAX I score was not (HR, 0.92; 95% CI, 0.47-1.77; P = .80 vs low). These findings persisted after adjustment for post-PCI SYNTAX I score. Conclusions: A high SYNTAX I score was associated with higher rates of 90-day MACCE in patients who underwent Impella-assisted HRPCI. Further research is needed to understand the patient and procedural factors driving this finding.

New Modifiable Risk Factors Influencing Coronary Artery Disease Severity.

Cardiovascular diseases (CVDs) remain the leading cause of death worldwide with coronary artery disease (CAD) being the first culprit in this group. In terms of CAD, not only its presence but also its severity plays a role in the patient's treatment and prognosis. CAD complexity can be assessed with the indicator named the SYNTAX score (SS). A higher SS is associated with major adverse cardiovascular event (MACE) occurrence in short- and long-term observations. Hence, the risk factors affecting CAD severity based on SS results may help lower the risk among patients with already developed CAD to reduce their impact on coronary atherosclerosis progression. The well-established risk factors of CAD are consistent with those associated with the coronary plaque burden. However, recently, it was shown that new indicators exist, which we present in this paper, that significantly contribute to CAD complexity such as inflammatory parameters, C-reactive protein (CRP), ratios based on blood smear results, and uric acid. Moreover, microbiota alteration, vitamin D deficiency, and obstructive sleep apnea (OSA) also predicted CAD severity. However, sometimes, certain indicators were revealed as significant only in terms of chronic coronary syndromes (CCSs) or specific acute coronary syndromes (ACSs). Importantly, there is a need to apply the interdisciplinary and translational approach to the novel CAD severity risk assessment to maximize the impact of secondary prevention among patients at risk of coronary atherosclerosis progression.

Syntactic and emotional interplay in second language: emotional resonance but not proficiency modulates affective influences on L2 syntactic processing.

Previous research has demonstrated the influence of emotions during linguistic processing, indicating the interactivity of both processes in the brain. However, little is known regarding such interplay in a second language (L2). This study addressed this question by examining the reading effects of syntactic violations while processing L2 emotional and neutral statements. Forty-six Spanish-English bilinguals with various levels of L2 proficiency and emotional resonance (i.e. capability for emotional experience in L2) were presented with a self-paced sentence reading task. Sentences contained positive (16), neutral (16) and negative (16) verbs, half of them presented in agreement and half in disagreement with the preceding pronoun. Analysis of verb reading times using linear mixed effects modelling revealed a significant interaction between syntactic violation, verb valence and emotional resonance, suggesting that stronger emotional L2 experience results in a higher saliency of negative verbs, reducing the impact of syntactic violations.

Syntactic Variation in Reduced Registers Through the Lens of the Parallel Architecture.

Diversion from the syntactic norm, as manifested in the absence of otherwise expected lexical and syntactic material, has been extensively studied in theoretical syntax. Such modifications are observed in headlines, telegrams, labels, and other specialized contexts, collectively referred to as "reduced" registers. Focusing on search queries, a type of reduced register, I propose that they are generated by a simpler grammar that lacks a full-fledged syntactic component. The analysis is couched in the Parallel Architecture framework, whose assumption of relative independence of linguistic components-their parallelism-and the rejection of syntactocentrism are essential to explain properties of queries.

A low-activity cortical network selectively encodes syntax.

Syntax, the abstract structure of language, is a hallmark of human cognition. Despite its importance, its neural underpinnings remain obscured by inherent limitations of non-invasive brain measures and a near total focus on comprehension paradigms. Here, we address these limitations with high-resolution neurosurgical recordings (electrocorticography) and a controlled sentence production experiment. We uncover three syntactic networks that are broadly distributed across traditional language regions, but with focal concentrations in middle and inferior frontal gyri. In contrast to previous findings from comprehension studies, these networks process syntax mostly to the exclusion of words and meaning, supporting a cognitive architecture with a distinct syntactic system. Most strikingly, our data reveal an unexpected property of syntax: it is encoded independent of neural activity levels. We propose that this "low-activity coding" scheme represents a novel mechanism for encoding information, reserved for higher-order cognition more broadly.

Syntax-like Structures in Maternal Contact Calls of Chestnut-Crowned Babblers (Pomatostomus ruficeps).

The combination of meaning-bearing units (e.g., words) into higher-order structures (e.g., compound words and phrases) is integral to human language. Despite this central role of syntax in language, little is known about its evolutionary progression. Comparative data using animal communication systems offer potential insights, but only a handful of species have been identified to combine meaningful calls together into larger signals. We investigated a candidate for syntax-like structure in the highly social chestnut-crowned babbler (Pomatostomus ruficeps). Using a combination of behavioral observations, acoustic analyses, and playback experiments, we test whether the form and function of maternal contact calls is modified by combining the core "piping" elements of such calls with at least one other call element or call. Results from the acoustic analyses (236 analysed calls from 10 individuals) suggested that piping call elements can be flexibly initiated with either "peow" elements from middle-distance contact calls or adult "begging" calls to form "peow-pipe" and "beg-pipe" calls. Behavioral responses to playbacks (20 trials to 7 groups) of natural peow-pipe and beg-pipe calls were comparable to those of artificially generated versions of each call using peow elements and begging calls from other contexts. Furthermore, responses to playbacks (34 trials to 7 groups) of the three forms of maternal contact calls (piping alone, peow-pipe, beg-pipe) differed. Together these data suggest that meaning encoded in piping calls is modified by combining such calls with begging calls or peow elements used in other contexts and so provide rare empirical evidence for syntactic-like structuring in a nonhuman animal.

The Current State of Coronary Revascularization: Coronary Artery Bypass Graft Surgery Versus Percutaneous Coronary Interventions.

PURPOSE OF REVIEW: The optimal revascularization strategy for coronary artery disease depends on various factors, such as disease complexity, patient characteristics, and preferences. Including a heart team in complex cases is crucial to ensure optimal outcomes. Decision-making between percutaneous coronary intervention and coronary artery bypass grafting must consider each patient's clinical profile and coronary anatomy. While current practice guidelines offer some insight into the optimal revascularization approach for the various phenotypes of coronary artery disease, the evidence to support either strategy continues to evolve and grow. Given the large amount of contemporary data on revascularization, this review aims to comprehensively summarize the literature on coronary artery bypass grafting and percutaneous coronary intervention in patients across the spectrum of coronary artery disease phenotypes. RECENT FINDINGS: Contemporary evidence suggests that for patients with triple vessel disease, coronary artery bypass grafting is preferred over percutaneous coronary intervention due to better long-term outcomes, including lower rates of death, myocardial infarction, and target vessel revascularization. Similarly, for patients with left main coronary artery disease, both percutaneous coronary intervention and coronary artery bypass grafting can be considered, as they have shown similar efficacy in terms of major adverse cardiac events, but there may be a slightly higher risk of death with percutaneous coronary intervention. For proximal left anterior descending artery disease, both percutaneous coronary intervention and coronary artery bypass grafting are viable options, but coronary artery bypass grafting has shown lower rates of repeat revascularization and better relief from angina. The Synergy Between PCI with Taxus and Cardiac Surgery score can help in decision-making by predicting the risk of adverse events and guiding the choice between percutaneous coronary intervention and coronary artery bypass grafting. European and American guidelines both agree with including a heart team that can develop and lay out individualized, optimal treatment options with respect for patient preferences. The debate between coronary artery bypass grafting versus percutaneous coronary intervention in multiple different scenarios will continue to develop as technology and techniques improve for both procedures. Risk factors, pre, peri, and post-procedural complications involved in both revascularization strategies will continue to be mitigated to optimize outcomes for those patients for which coronary artery bypass grafting or percutaneous coronary intervention provide ultimate benefit. Methods to avoid unnecessary revascularization continue to develop as well as percutaneous technology that may allow patients to avoid surgical intervention when possible. With such changes, revascularization guidelines for specific patient populations may change in the coming years, which can serve as a limitation of this time-dated review.

Change in left ventricular function and outcomes following high-risk percutaneous coronary intervention with Impella-guided hemodynamic support.

Introduction: High-risk percutaneous coronary interventions (HRPCI) are a potential treatment option for patients with reduced left ventricular ejection fraction (LVEF) and coronary artery disease. The extent to which such intervention is coupled with improvement in LVEF and associated with favorable outcomes is unknown. Methods: We aimed to characterize the incidence and correlates of LVEF improvement after Impella-guided HRPCI, and compare clinical outcomes in patients with versus without LVEF improvement. Data on consecutive patients undergoing Impella-guided HRPCI from a single center registry were analyzed. LVEF-improvement was defined as an absolute increase of LVEF of ≥10% measured at ≥30-days after intervention. The primary outcome was a composite of all-cause death, myocardial infarction or target vessel revascularization within 1-year. Results: Out of 161 consecutive patients undergoing Impella-guided HRPCI from June 2008 to December 2017, 43% (n = 70) demonstrated LVEF-improvement (baseline LVEF of 25.09 ± 6.19 to 33.30 ± 11.98 post intervention). Patients without LVEF-improvement had higher frequency of previous MI (61.5% vs. 37.1%, p = 0.0021), Q-waves on ECG (17.6% vs. 5.7%, p = 0.024) and higher SYNTAX scores (30.8 ± 17.6 vs. 25.2 ± 12.2; p = 0.043). After correction of these confounders by multivariable analysis, no significant differences were found regarding the composite endpoint in patients with versus without LVEF-improvement (34.9% vs. 38.3%; p = 0.48). Discussion: In this single-center retrospective analysis, we report the following findings. First, LVEF improvement of at least 10% was documented in over 40% of patients undergoing Impella supported high-risk PCI. Second, a history of MI, Q-waves on admission ECG, and higher baseline SYNTAX scores were independent correlates of no LVEF improvement. Third, one year rates of adverse CV events were substantial and did not vary by the presence or absence of LVEF improvement Prospective studies with longer follow-up are needed to elucidate the impact of LVEF improvement on clinical outcomes.

Lipidomic-Based Algorithms Can Enhance Prediction of Obstructive Coronary Artery Disease.

Lipidomics emerges as a promising research field with the potential to help in personalized risk stratification and improve our understanding on the functional role of individual lipid species in the metabolic perturbations occurring in coronary artery disease (CAD). This study aimed to utilize a machine learning approach to provide a lipid panel able to identify patients with obstructive CAD. In this posthoc analysis of the prospective CorLipid trial, we investigated the lipid profiles of 146 patients with suspected CAD, divided into two categories based on the existence of obstructive CAD. In total, 517 lipid species were identified, from which 288 lipid species were finally quantified, including glycerophospholipids, glycerolipids, and sphingolipids. Univariate and multivariate statistical analyses have shown significant discrimination between the serum lipidomes of patients with obstructive CAD. Finally, the XGBoost algorithm identified a panel of 17 serum biomarkers (5 sphingolipids, 7 glycerophospholipids, a triacylglycerol, galectin-3, glucose, LDL, and LDH) as totally sensitive (100% sensitivity, 62.1% specificity, 100% negative predictive value) for the prediction of obstructive CAD. Our findings shed light on dysregulated lipid metabolism's role in CAD, validating existing evidence and suggesting promise for novel therapies and improved risk stratification.

Dissociating prosodic from syntactic delta activity during natural speech comprehension.

Decoding human speech requires the brain to segment the incoming acoustic signal into meaningful linguistic units, ranging from syllables and words to phrases. Integrating these linguistic constituents into a coherent percept sets the root of compositional meaning and hence understanding. One important cue for segmentation in natural speech is prosodic cues, such as pauses, but their interplay with higher-level linguistic processing is still unknown. Here, we dissociate the neural tracking of prosodic pauses from the segmentation of multi-word chunks using magnetoencephalography (MEG). We find that manipulating the regularity of pauses disrupts slow speech-brain tracking bilaterally in auditory areas (below 2 Hz) and in turn increases left-lateralized coherence of higher-frequency auditory activity at speech onsets (around 25-45 Hz). Critically, we also find that multi-word chunks-defined as short, coherent bundles of inter-word dependencies-are processed through the rhythmic fluctuations of low-frequency activity (below 2 Hz) bilaterally and independently of prosodic cues. Importantly, low-frequency alignment at chunk onsets increases the accuracy of an encoding model in bilateral auditory and frontal areas while controlling for the effect of acoustics. Our findings provide novel insights into the neural basis of speech perception, demonstrating that both acoustic features (prosodic cues) and abstract linguistic processing at the multi-word timescale are underpinned independently by low-frequency electrophysiological brain activity in the delta frequency range.

Exploring the linguistic complexity of third-grade numerical literacy.

Reading numbers aloud, a central aspect of numerical literacy, is a challenging skill to acquire, but the origins of this difficulty remain poorly understood. To investigate this matter, we examined the performance of 127 third- and fourth-grade children who read aloud, in Hebrew, numbers with 2-5 digits. We found several key observations. First, we observed a substantial variation among the 3rd graders-7% and 59% errors in the top and bottom deciles, respectively. Second, the task difficulty stemmed from syntactic processing: Most errors were distortions of the number's syntax, as opposed to digit substitutions or transpositions, and the main factor affecting a specific number's difficulty was not its magnitude, as is commonly assumed, but rather its syntactic structure. Third, number reading performance was not predicted by a school-like task that assessed syntactic-conceptual knowledge of the decimal system structure, but rather by knowledge of specific syntactic-verbal rules, suggesting that the syntactic-verbal knowledge is separate from the syntactic-conceptual knowledge. Last, there was a double dissociation between 4-digit numbers and 5-digit numbers, which in Hebrew have completely different syntactic structures: Half of the children showed a significant advantage in one number length compared to the other, with equal numbers of children preferring either length. This indicates that the different syntactic-verbal rules are learned relatively independently of each other, with little or no generalization from one rule to another. In light of these findings, we propose that schools should specifically teach number reading, with focus on specific syntactic-verbal rules.