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Abstract The spread of American Bullfrog has a significant impact on the surrounding ecosystem. It is important to study the mechanisms of their spreading so that proper mitigation can be applied when needed. This study analyzes data from national surveys on bullfrog distribution. We divided the data into 25 regional clusters. To assess the spread within each cluster, we constructed temporal sequences of spatial distribution using the agglomerative clustering method. We employed Elementary Cellular Automata (ECA) to identify rules governing the changes in spatial patterns. Each cell in the ECA grid represents either the presence or absence of bullfrogs based on observations. For each cluster, we counted the number of presence location in the sequence to quantify spreading intensity. We used a Convolutional Neural Network (CNN) to learn the ECA rules and predict future spreading intensity by estimating the expected number of presence locations over 400 simulated generations. We incorporated environmental factors by obtaining habitat suitability maps using Maxent. We multiplied spreading intensity by habitat suitability to create an overall assessment of bullfrog invasion risk. We estimated the relative spreading assessment and classified it into four categories: rapidly spreading, slowly spreading, stable populations, and declining populations.

In this paper, we apply the Fourier neural operator (FNO) paradigm to ocean circulation and prediction problems. We aim to show that the complicated non-linear dynamics of an ocean circulation can be captured by a flexible, efficient, and expressive structure of the FNO networks. The machine learning model (FNO3D and the recurrent FNO2D networks) trained by simulated data as well as real data takes spatiotemporal input and predicts future ocean states (sea surface current and sea surface height). For this, the double gyre ocean circulation model driven by stochastic wind stress is considered to represent an ideal ocean circulation. In order to generate the training and test data that exhibits rich spatiotemporal variability, the initial states are perturbed by Gaussian random fields. Experimental results confirm that the trained models yield satisfactory prediction accuracy for both types of FNO models in this case. Second, as the training set, we used the HYCOM reanalysis data in a regional ocean. FNO2D experiments demonstrated that the 5-day input to 5-day prediction yields the averaged root mean square errors (RMSEs) of 5.0 cm/s, 6.7 cm/s, 7.9 cm/s, 8.9 cm/s, and 9.4 cm/s in surface current, calculated consecutively for each day, in a regional ocean circulation of the East/Japan Sea. Similarly, the RMSEs for sea surface height were 2.3 cm, 3.5 cm, 4.2 cm, 4.6 cm, and 4.9 cm, for each day. We also trained the model with 15-day input and 10-day prediction, resulting in comparable performance. Extensive numerical tests show that, once learned, the resolution-free FNO model instantly forecasts the ocean states and can be used as an alternative fast solver in various inference algorithms.

Background and Aims In patients with acute coronary syndrome (ACS), dual antiplatelet therapy (DAPT) with aspirin and a potent P2Y12 inhibitor is recommended for 12 months after drug-eluting stent (DES) implantation. Monotherapy with a potent P2Y12 inhibitor after short-term DAPT is an attractive option to better balance the risks of ischaemia and bleeding. Therefore, this study evaluated the efficacy and safety of ticagrelor monotherapy after short-term DAPT, especially in patients with ACS. Methods Electronic databases were searched from inception to 11 November 2023, and for the primary analysis, individual patient data were pooled from the relevant randomized clinical trials comparing ticagrelor monotherapy after short-term (≤3 months) DAPT with ticagrelor-based 12-month DAPT, exclusively in ACS patients undergoing DES implantation. The co-primary endpoints were ischaemic endpoint (composite of all-cause death, myocardial infarction, or stroke) and bleeding endpoint [Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding] at 1 year. Results Individual patient data from two randomized clinical trials including 5906 ACS patients were analysed. At 1 year, the primary ischaemic endpoint did not differ between the ticagrelor monotherapy and ticagrelor-based DAPT groups [1.9% vs. 2.5%; adjusted hazard ratio (HR) 0.79; 95% confidence interval (CI) 0.56–1.13; P =.194]. The incidence of the primary bleeding endpoint was lower in the ticagrelor monotherapy group (2.4% vs. 4.5%; adjusted HR 0.54; 95% CI 0.40–0.72; P <.001). The results were consistent in a secondary aggregate data meta-analysis including the ACS subgroup of additional randomized clinical trials which enrolled patients with ACS as well as chronic coronary syndrome. Conclusions In ACS patients undergoing DES implantation, ticagrelor monotherapy after short-term DAPT was associated with less major bleeding without a concomitant increase in ischaemic events compared with ticagrelor-based 12-month DAPT. Study registration PROSPERO (ID: CRD42023476470). [ABSTRACT FROM AUTHOR]

Background: The impact of rosuvastatin versus atorvastatin on new-onset diabetes mellitus (NODM) among patients treated with high-intensity statin therapy for coronary artery disease (CAD) remains to be clarified. This study aimed to evaluate the risk of NODM in patients with CAD treated with rosuvastatin compared to atorvastatin in the randomized LODESTAR trial. Methods: In the LODESTAR trial, patients with CAD were randomly assigned to receive either rosuvastatin or atorvastatin using a 2-by-2 factorial randomization. In this post-hoc analysis, the 3-year incidence of NODM was compared between rosuvastatin and atorvastatin treatment in the as-treated population with high-intensity statin therapy as the principal population of interest. Results: Among 2932 patients without diabetes mellitus at baseline, 2377 were included in the as-treated population analysis. In the as-treated population with high-intensity statin therapy, the incidence of NODM was not significantly different between the rosuvastatin and atorvastatin groups (11.4% [106/948] versus 8.8% [73/856], hazard ratio [HR] = 1.32, 95% confidence interval [CI] = 0.98 to 1.77, P = 0.071). When the risk of NODM with rosuvastatin versus atorvastatin was assessed according to the achieved low-density lipoprotein cholesterol (LDL-C) level, the risk of NODM began to increase at a LDL-C level below 70 mg/dL. The incidence of NODM was significantly greater in the rosuvastatin group than it was in the atorvastatin group when the achieved LDL-C level was < 70 mg/dL (13.9% versus 8.0%; HR = 1.79, 95% CI 1.18 to 2.73, P = 0.007). Conclusions: Among CAD patients receiving high-intensity statin therapy, the incidence of NODM was not significantly different between rosuvastatin and atorvastatin. However, a drug effect of the statin type on NODM was observed when the achieved LDL-C level was < 70 mg/dL. Trial registration: ClinicalTrials.gov, Identifier: NCT02579499. [ABSTRACT FROM AUTHOR]

Background The optimal statin treatment strategy that is balanced for both efficacy and safety has not been clearly determined in older adults with coronary artery disease (CAD). Methods In the post hoc analysis of the LODESTAR (low-density lipoprotein cholesterol-targeting statin therapy versus intensity-based statin therapy in patients with coronary artery disease) trial, the impact between a treat-to-target strategy versus a high-intensity statin therapy strategy was compared in older adults (aged 75 years or older). The goal of treat-to-target low-density lipoprotein cholesterol (LDL-C) level was 50–70 mg/dl. The primary endpoint comprised the three-year composite of all-cause death, myocardial infarction, stroke or coronary revascularisation. Results Among 4,400 patients with CAD enrolled in the LODESTAR trial, 822 (18.7%) were aged 75 years or older. Poor clinical outcomes and risk factors for atherosclerosis were more frequently observed in older adults than in younger population (<75 years old). Among these older adults with CAD, the prescription rate of high-intensity statin was significantly lower in the treat-to-target strategy group throughout the study period (P  < 0.001). The mean LDL-C level for three years was 65 ± 16 mg/dl in the treat-to-target strategy group and 64 ± 18 mg/dl in the high-intensity statin group (P  = 0.34). The incidence of primary endpoint occurrence was 10.9% in the treat-to-target strategy group and 12.0% in the high-intensity statin group (hazard ratio 0.92, 95% confidence interval 0.61–1.38, P  = 0.69). Conclusions High-intensity statin therapy is theoretically more necessary in older adults because of worse clinical outcomes and greater number of risk factors for atherosclerosis. However, the primary endpoint occurrence with a treat-to-target strategy with an LDL-C goal of 50–70 mg/dl was comparable to that of high-intensity statin therapy and reduced utilisation of a high-intensity statin. Taking efficacy as well as safety into account, adopting a tailored approach may be considered for this high-risk population. Trial Registration ClinicalTrials.gov , NCT02579499. [ABSTRACT FROM AUTHOR]

Aim: This study evaluated the safety and efficacy of a moderate‐intensity statin with ezetimibe combination therapy versus high‐intensity statin monotherapy in patients with metabolic syndrome (MetS) and atherosclerotic cardiovascular disease. Materials and Methods: In this post‐hoc subgroup analysis of the RACING trial, patients were analysed based on the presence of MetS. MetS was defined as meeting at least three of the five following criteria: (a) elevated waist circumference; (b) elevated triglycerides; (c) reduced high‐density lipoprotein cholesterol; (d) elevated blood pressure; and (e) elevated fasting glucose. The primary outcome was a 3‐year composite of cardiovascular death, major cardiovascular events, or non‐fatal stroke. Results: Of the 3780 patients enrolled in the RACING trial, 1703 (45.1%) had MetS at baseline. The primary outcome rate was 10.1% and 10.3% in patients with MetS receiving ezetimibe combination therapy versus high‐intensity statin monotherapy (hazard ratio = 0.97; 95% confidence interval = 0.72‐1.32; p =.868). Lower rates of intolerance‐related drug discontinuation or dose reduction (3.9% vs. 8.0%; p <.001) and lower low‐density lipoprotein cholesterol levels (57 vs. 65 mg/dl; p <.001) were observed with ezetimibe combination therapy versus high‐intensity statin monotherapy. Furthermore, the rate of new‐onset diabetes was 18.5% and 19.1% in each group (p =.822). There were no significant interactions between MetS and therapy regarding study outcomes in the total population. Conclusions: In patients with MetS and atherosclerotic cardiovascular disease, a moderate‐intensity statin with ezetimibe combination therapy had comparable cardiovascular benefits with those of high‐intensity statin monotherapy. Meanwhile, ezetimibe combination therapy was associated with lower drug intolerance and low‐density lipoprotein cholesterol levels, but there was no apparent between‐group difference in new‐onset diabetes. [ABSTRACT FROM AUTHOR]