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BACKGROUND There is uncertainty regarding the impact of statins on the risk of atherosclerotic cardiovascular disease (ASCVD) and its major complication, acute heart failure (AHF). OBJECTIVES The aim of this study was to investigate whether previous statin therapy translates into lower AHF events and improved survival from AHF among patients presenting with an acute coronary syndrome (ACS) as a first manifestation of ASCVD. METHODS Data were drawn from the International Survey of Acute Coronary Syndromes Archives. The study participants consisted of 14,542 Caucasian patients presenting with ACS without previous ASCVD events. Statin users before the index event were compared with nonusers by using inverse probability weighting models. Estimates were compared by test of interaction on the log scale. Main outcome measures were the incidence of AHF according to Killip class and the rate of 30-day all-cause mortality in patients presenting with AHF. RESULTS Previous statin therapy was associated with a significantly decreased rate of AHF on admission (4.3% absolute risk reduction; risk ratio [RR]: 0.72; 95% CI: 0.62-0.83) regardless of younger (40-75 years) or older age (interaction P = 0.27) and sex (interaction P = 0.22). Moreover, previous statin therapy predicted a lower risk of 30-day mortality in the subset of patients presenting with AHF on admission (5.2 % absolute risk reduction; RR: 0.71; 95% CI: 0.50-0.99). CONCLUSIONS Among adults presenting with ACS as a first manifestation of ASCVD, previous statin therapy is associated with a reduced risk of AHF and improved survival from AHF. (C) 2022 by the American College of Cardiology Foundation.

Background It remains uncertain whether female sex is itself a strong risk factor for worse outcomes in acute coronary syndromes (ACS). Purpose We hypothesized that sex differences in vulnerability to heart failure after ACS may modify the association between sex and outcomes. Methods Data were drawn from the ISACS-Archives network of registries. The study population consisted of 87,812 patients with known time from symptom onset to hospital presentation. Participants were stratified by ACS subtypes: STEMI and NSTE-ACS Data on presenting heart failure symptoms were collected from medical record abstraction. Heart failure was categorized as Killip class >2. Time from symptom onset to hospital presentation was categorized as early (≤120 minutes) or late (>120 minutes). Primary outcome measure was 30-day mortality. Estimates were performed using a parametric balancing strategy by weighting and compared by test of interaction on the log scale. Results Among the study sample, 30922 (35.2%) patients were women. Patient outcomes varied according to subtype of ACS. The mortality rates at 30-days were significantly higher among women vs men in STEMI (RR:1.65; 95% CI: 1.56–1.73) compared with NSTE-ACS (RR:1.18; 95% CI: 1.09–1.28; P interaction Conclusions Women exhibit substantially more vulnerability to heart failure in STEMI than men: a greater percentage of women have heart failure, and women with heart failure have higher 30-day mortality than men with heart failure. This finding was not seen in NSTE-ACS. heart failure on initial assessment is a key feature to explain the sex gap in mortality after ACS. Funding Acknowledgement Type of funding sources: None.

Background: Although a family history (FHx) is an accepted risk factor for cardiovascular (CV) disease, few studies have examined the predictive strength of a positive FHx after adjusting for other conventional risk factors and medications Methods: We analyzed 12,922 patients with ACSs, without evidence of prior CV disease enrolled in the ISACS-TC registry between January 2010 to January 2021. Main outcome measures were the adjusted rates of STEMI and 30-day mortality from STEMI using multivariable logistic regression models Results: Overall, 3,147 patients (24,4%) self-reported an FHx of CV disease, defined as first-degree relative with premature CV events (men, age

Background Patients with diabetes and non-ST elevation acute coronary syndrome (NSTE-ACS) have an increased risk of mortality and adverse outcomes following percutaneous coronary intervention (PCI). Purpose We aimed to investigate the impact of early, within 24 hours PCI compared with only routine medical treatment on clinical outcomes in a large international cohort of patients with NSTE-ACS and diabetes. Methods We identified 1,250 patients with diabetes and NSTE-ACS from a registry-based population between October 2010 and April 2016. The primary endpoint was 30-day all-cause mortality. The secondary endpoint was the composite outcome of 30-day all-cause mortality and left ventricular dysfunction (ejection fraction

Introduction: ST-Segment Elevation Myocardial Infarction (STEMI) complicated by symptoms of acute “de novo” heart failure is associated with excess mortality. Yet whether development of heart failure and its outcomes differ by sex is unknown Hypothesis: We postulated that men and women have distinct cardiovascular responses to acute myocardial ischemia and hypothesized that women are at higher risk to develop acute heart failure and carry a concomitant worse survival compared with their male counterparts Methods: We examined the relationship among sex, acute heart failure and related outcomes after STEMI in patients with no prior history of heart failure recorded at baseline. Patients were recruited from a network of hospitals in the ISACS-TC registry (NCT01218776). Main outcome measures were incidence of Killip class 2 or higher at hospital presentation and risk-adjusted 30-day mortality rates estimated using inverse probability of weighting (IPW) and logistic regression models. Results: The study population consisted of 10,443 patients (3,112 women). After covariate adjustment and matching for age, cardiovascular risk factors, comorbidities, disease severity and delay to hospital presentation, the incidence of “de novo” heart failure at hospital presentation was significantly higher for women than for men (25.1% vs 20.0%, OR, 1.34; 95%CI: 1.21- 1.48). Women with “de novo” heart failure had higher 30-day mortality compared with their male counterparts (25.1% vs. 20.6%: OR, 1.29; 95%CI, 1.05 - 1.58). The sex-related difference in mortality rates were still apparent in patients with “de novo” heart failure undergoing reperfusion therapy after hospital presentation (21.3% vs.15.7%; OR, 1.45; 95% CI, 1.07 - 1.96). Conclusions: Women are at higher risk to develop “de novo” heart failure after STEMI and women with “de novo” heart failure have worse survival compared with their male counterparts. As so, “de novo” heart failure is a key feature to explain mortality gap after STEMI among women and men

[EN] Despite dedicated research has been carried out to adequately map the distribution of the sperm whale in the Mediterranean Sea, unlike other regions of the world, the species population status is still presently uncertain. The analysis of two years of continuous acoustic data provided by the ANTARES neutrino telescope revealed the year-round presence of sperm whales in the Ligurian Sea, probably associated with the availability of cephalopods in the region. The presence of the Ligurian Sea sperm whales was demonstrated through the real-time analysis of audio data streamed from a cabled-to- shore deep-sea observatory that allowed the hourly tracking of their long-range echolocation behaviour on the Internet. Interestingly, the same acoustic analysis indicated that the occurrence of surface shipping noise would apparently not condition the foraging behaviour of the sperm whale in the area, since shipping noise was almost always present when sperm whales were acoustically detected. The continuous presence of the sperm whale in the region confirms the ecological value of the Ligurian sea and the importance of ANTARES to help monitoring its ecosystems, The authors acknowledge the financial support of the funding agencies: Centre National de la Recherche Scientifique (CNRS), Commissariat a lenergie atomique et aux energies alternatives (CEA), la Commission Europeenne (FEDER fund and Marie Curie Program), Institut Universitaire de France (IUF), IdEx program and UnivEarthS Labex program at Sorbonne Paris Cite (ANR-10-LABX-0023 and ANR-11-IDEX-0005-02), Region Ile-de-France (DIM-ACAV), Region Alsace (contrat CPER), Region Provence-Alpes-Cote d'Azur, Departement du Var and Ville de La Seyne-sur-Mer, France; Bundesministerium fur Bildung und Forschung (BMBF), Germany; Istituto Nazionale di Fisica Nucleare (INFN), Italy; Stichting voor Fundamenteel Onderzoek der Materie (FOM), Nederlandse organisatie voor Wetenschappelijk Onderzoek (NWO), the Netherlands; Council of the President of the Russian Federation for young scientists and leading scientific schools supporting grants, Russia; National Authority for Scientific Research (ANCS), Romania; Ministerio de Economia y Competitividad (MINECO), Prometeo and Grisolia programs of Generalitat Valenciana and MultiDark, Spain; Agence de l'Oriental and CNRST, Morocco. We also acknowledge the technical support of Ifremer, AIM and Foselev Marine for the sea operation and the CC-IN2P3 for the computing facilities

Background We hypothesized that female sex is a treatment effect modifier of blood flow and related 30‐day mortality after primary percutaneous coronary intervention ( PCI ) for ST ‐segment–elevation myocardial infarction and that the magnitude of the effect on outcomes differs depending on delay to hospital presentation. Methods and Results We identified 2596 patients enrolled in the ISACS ‐ TC (International Survey of Acute Coronary Syndromes in Transitional Countries) registry from 2010 to 2016. Primary outcome was the occurrence of 30‐day mortality. Key secondary outcome was the rate of suboptimal post‐ PCI Thrombolysis in Myocardial Infarction ( TIMI ; flow grade 0–2). Multivariate logistic regression and inverse probability of treatment weighted models were adjusted for baseline clinical covariates. We characterized patient outcomes associated with a delay from symptom onset to hospital presentation of ≤120 minutes. In multivariable regression models, female sex was associated with postprocedural TIMI flow grade 0 to 2 (odds ratio [ OR ], 1.68; 95% CI , 1.15–2.44) and higher mortality ( OR, 1.72; 95% CI , 1.02–2.90). Using inverse probability of treatment weighting, 30‐day mortality was higher in women compared with men (4.8% versus 2.5%; OR , 2.00; 95% CI , 1.27–3.15). Likewise, we found a significant sex difference in post‐ PCI TIMI flow grade 0 to 2 (8.8% versus 5.0%; OR , 1.83; 95% CI , 1.31–2.56). The sex gap in mortality was no longer significant for patients having hospital presentation of ≤120 minutes ( OR , 1.28; 95% CI , 0.35–4.69). Sex difference in post‐ PCI TIMI flow grade was consistent regardless of time to hospital presentation. Conclusions Delay to hospital presentation and suboptimal post‐ PCI TIMI flow grade are variables independently associated with excess mortality in women, suggesting complementary mechanisms of reduced survival. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 01218776.

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Machine learning has shown enormous potential for computer-aided drug discovery. Here we show how modern convolutional neural networks (CNNs) can be applied to structure-based virtual screening. We have coupled our densely connected CNN (DenseNet) with a transfer learning approach which we use to produce an ensemble of protein family-specific models. We conduct an in-depth empirical study and provide the first guidelines on the minimum requirements for adopting a protein family-specific model. Our method also highlights the need for additional data, even in data-rich protein families. Our approach outperforms recent benchmarks on the DUD-E dataset and an independent test set constructed from the ChEMBL database. Using a clustered cross-validation on DUD-E, we achieve an average AUC ROC of 0.92 and a 0.5% ROC enrichment factor of 79. This represents an improvement in early enrichment of over 75% compared to a recent machine learning benchmark. Our results demonstrate that the continued improvements in machine learning architecture for computer vision apply to structure-based virtual screening.

As the world becomes more connected and instrumented, high dimensional, heterogeneous and time-varying data streams are collected and need to be analyzed on the fly to extract the actionable intelligence from the data streams and make timely decisions based on this knowledge. This requires that appropriate classifiers are invoked to process the incoming streams and find the relevant knowledge. Thus, a key challenge becomes choosing online, at run-time, which classifier should be deployed to make the best possible predictions on the incoming streams. In this paper, we survey a class of methods capable to perform online learning in stream-based semantic computing tasks: multi-armed bandits (MABs). Adopting MABs for stream mining poses, numerous new challenges requires many new innovations. Most importantly, the MABs will need to explicitly consider and track online the time-varying characteristics of the data streams and to learn fast what is the relevant information out of the vast, heterogeneous and possibly highly dimensional data streams. In this paper, we discuss contextual MAB methods, which use similarities in context (meta-data) information to make decisions, and discuss their advantages when applied to stream mining for semantic computing. These methods can be adapted to discover in real-time the relevant contexts guiding the stream mining decisions, and tract the best classifier in presence of concept drift. Moreover, we also discuss how stream mining of multiple data sources can be performed by deploying cooperative MAB solutions and ensemble learning. We conclude the paper by discussing the numerous other advantages of MABs that will benefit semantic computing applications.

The Underwater Radiated Noise (URN) from ships has gained growing attention in the last years. The evaluation of the acoustic impact of shipping activity (as well as of other anthropogenic noise types) on marine fauna has become an important issue for society and regulators. The normative framework on the subject is not yet in place, but it is in rapid evolution and in the process of being finalized soon, as reflected by the research efforts being deployed on the subject by the E.U. (see the completed SILENV project and the ongoing AQUO and SONIC projects). In parallel, at an international level, the same subject has been covered by the International Maritime Organisation (IMO) through the activity of a dedicated Working Group. A key aspect of the control problem for URN from ships is a proper characterization of the source represented by the vessel. This item presents peculiar aspects due to the environment in which radiation occurs, but it is also driven by the complex features and large dimensions of the ship source. An important issue is the directivity of the emission, which influences: the patterns of the radiation, the distance at which the presence of the ship is perceived and the acoustic impact of the vessel. In this paper, experimental surveys performed at sea within the SILENV project are analysed to derive the directivity patterns of different ships in different conditions at different frequencies. The work covers the measurement procedure adopted, as well as the post-processing techniques and the uncertainties affecting the results.

The rising concern about the environmental impact of ship noise on the marine fauna recently pushed national and international bodies to face the problem. In the last decade a few mass strandings of cetaceans due to sea trials of navy sonars (Frantzis (1998)), enforced the interest on noise pollution effects on marine mammals. The problem of evaluating the impact of underwater noise from ships is very complex due to the difficulties in characterising the whole noise chain (source, transmission path, receiver). Standards have been recently issued aimed at the measurement of underwater noise emitted from commercial ships. As regards the transmission path, problems are linked to the correct evaluation of the transmission loss which is influenced by many environmental parameters (water temperature, salinity, pressure, bottom composition etc.) which cannot be easily monitored during measurements. Finally the actual sensibility to noise of the marine mammals it is not completely known, especially for species belonging to the Mysticetes (Baleen Whales). These problems have been analysed in the SILENV collaborative project (Ships oriented Innovative soLutions to rEduce Noise & Vibrations), devoted to the holistic analysis of noise emissions from the ship [radiation inside the ship and outside (in air and in water)].