bluuebunny/crossref_metadata_2025 huggingface dataset:
Moderate Psoriatic Arthritis and Perspectives from Phosphodiesterase-4 Inhibition
Authors: Todd Joanna
Published: January 2023

Although there is no universally approved definition of moderate psoriatic arthritis (PsA), many clinicians see patients who they feel fit into this category: patients with limited joint involvement, but who might also show other manifestations of the disease, as well as a range of comorbidities. In his presentation, Dr Siebert described the challenges faced in treating this group of patients, who are mostly not captured in clinical trials. Recent advances in PsA treatment have focussed towards the severe end of the spectrum, suggesting that more must be learned around treatment options for patients with moderate disease. This represents a large unmet need. Given the heterogeneity of this patient population, a range of effective treatments is needed. Prof Gladman then presented data from longitudinal cohorts to illustrate the high burden of disease in patients with PsA who had a limited number of affected joints. By comparing patients with oligoarticular PsA (i.e., ≤4 affected joints) with those with polyarticular arthritis (≥5 affected joints), Prof Gladman showed that disease burden is not solely driven by the number of affected joints, but also by other PsA manifestations and/or comorbidities. There are clear gaps in our knowledge of PsA; to address these, population studies and trials of potential treatments are needed. Phosphodiesterase-4 (PDE4) inhibition is one potential treatment strategy that is currently being investigated. Dr Behrens described a post-hoc analysis of data pooled from three Phase III clinical trials that suggests the PDE4 inhibitor apremilast may be an effective treatment for patients with moderate PsA. It is hoped that this will be confirmed by the ongoing FOREMOST trial, a Phase IV study of apremilast in patients with oligoarticular PsA.
Anti-Programmed Death Receptor 1 Signalling Immunotherapy as a Part of Curative Intent Strategies for Stages I-III Non-Small Cell Lung Cancer
Authors: Moya Horno Irene , Viteri Santiago , Rubinstein Pablo , Maestre José , Alvarado Arnaldo , Koptseva Inessa , Simonetti Sara , Lugo Natalia , Cisneros José Luis , Rosell Rafael
Published: January 2023

Surgery provides the best chance of a cure for patients with early stage non-small cell lung cancer (NSCLC) and plays an important role in the multimodal treatment for locally advanced disease. However, many patients still relapse despite intended curative surgery, and no major advances in systemic therapy for resectable NSCLC have been achieved in the last decades. The incorporation of immunotherapy for the treatment of metastatic Stage IV NSCLC and the recent data on the efficacy of cancer consolidation with the anti-programmed death-ligand 1 (PD-L1) antibody durvalumab after concurrent chemoradiation for unresectable Stage III NSCLC open new opportunities for the use of immune checkpoint inhibitors in earlier stages of the disease. Multiple ongoing clinical trials are exploring the safety and efficacy of immunotherapy in Stage I–III resectable NSCLC, either as a postoperative (adjuvant) strategy or before surgical resection (neoadjuvant). The neoadjuvant setting is particularly interesting, as it represents an ideal chance to develop translational research.

Herein, the authors summarise the main ongoing research and available data on the use of anti-PD1/PD-L1 antibodies for Stage I–III NSCLC.
Immunomodulación: Conceptos Básicos Y Aplicaciones Clínicas
Authors: Legg Ewen
Published: January 2023

El tercer Encuentro Latinoamericano de Infecciones Respiratorias Recurrentes (ELAIR) tuvo lugar en Ciudad de México (México), los días 11 y 12 de mayo de 2017. ELAIR reunió a expertos de toda Latinoamérica y otros países, en la continuación de su extraordinario ejercicio didáctico acerca de los últimos avances en medicina respiratoria. En los últimos 15 años se ha progresado de modo espectacular en el tratamiento y la prevención de las infecciones de las vías respiratorias, gracias a la aparición de nuevos tratamientos. Queda por ver cómo podría afectar todo esto a los trastornos relacionados de sibilancias y asma en las personas predispuestas e hipersensibles. No obstante, los datos iniciales indican que unas tasas más bajas de infección en las vías respiratorias podrían reducir la aparición de los trastornos antes mencionados, que están íntimamente relacionados con las infecciones víricas. Es probable que los inmunomoduladores que preparan el sistema inmunológico para combatir las infecciones y reducen la inflamación desempeñen una función fundamental en la prevención secundaria (e incluso, posiblemente primaria) de las enfermedades atópicas.
Abordando La Amenaza Mundial De La Resistencia Antimicrobiana
Authors: Legg Ewen
Published: January 2023

El tercer Encuentro Latinoamericano de Infecciones Respiratorias Recurrentes (ELAIR) tuvo lugar en Ciudad de México, México, los días 11 y 12 de mayo de 2017. ELAIR reunió a expertos de toda Latinoamérica y otros países, continuando con un extraordinario ejercicio didáctico en cuanto a los vanguardistas avances de la medicina respiratoria. En los últimos 15 años se ha realizado un progreso espectacular, gracias a la aparición de nuevos tratamientos disponibles para gestionar y evitar infecciones en las vías respiratorias. Queda por ver cómo podría afectar todo esto a dolencias relacionadas como las sibilancias y el asma, en los sujetos predispuestos e hipersensibles. No obstante, los primeros datos sugieren que, tasas más bajas de infección en las vías respiratorias, podrían reducir el desarrollo de las condiciones antes mencionadas, estrechamente relacionadas con las infecciones víricas. Es probable que los inmunorreguladores que preparan el sistema inmunológico para combatir la infección y que, además, reducen la inflamación, jueguen un papel fundamental en la prevención secundaria (e incluso potencialmente primaria) de las enfermedades atópicas.
Exacerbación Del Asma Con Sibilancias Y Desencadenada Por Infección: ¿Es Posible La Prevención a Una Edad Temprana?
Authors: Legg Ewen
Published: January 2023

El tercer Encuentro Latinoamericano de Infecciones Respiratorias Recurrentes (ELAIR) tuvo lugar en Ciudad de México, México, los días 11 y 12 de mayo de 2017. ELAIR reunió a expertos de toda Latinoamérica y otros países, continuando con un extraordinario ejercicio didáctico en cuanto a los vanguardistas avances de la medicina respiratoria. En los últimos 15 años se ha realizado un progreso espectacular gracias a la aparición de nuevos tratamientos disponibles para gestionar y evitar infecciones en las vías respiratorias. Queda por ver cómo podría afectar todo esto a las afecciones relacionadas de las sibilancias y el asma en los sujetos predispuestos e hipersensibles. No obstante, los primeros datos sugieren que las tasas más bajas de infección en las vías respiratorias podrían reducir el desarrollo de las afecciones antes mencionadas, estrechamente relacionadas con las infecciones víricas. Es probable que los inmunorreguladores que preparan el sistema inmunológico para combatir la infección y que además reducen la inflamación jueguen un papel fundamental en la prevención secundaria (e incluso potencialmente primaria) de las enfermedades atópicas.
Considering the Patient Perspective: Challenges Facing Women with Axial Spondyloarthritis and Psoriatic Arthritis
Authors: Amisten Stefan
Published: January 2023

This symposium took place during the 2019 European League Against Rheumatism (EULAR) congress in Madrid, Spain, and focussed on the unique challenges facing women with axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA), highlighting differences in diagnosis, disease course, and treatment response between men and women.

Compared to men, women have a longer delay to axSpA diagnosis, higher disease activity, lower quality of life, and experience more fatigue, peripheral involvement, and functional impairment, despite less radiological damage and a lower treatment response to biologicals. In addition, axSpA in general is associated with depression, anxiety, reduced work productivity, and an increased risk of adverse pregnancy outcomes.

Women with PsA typically present with a higher number of involved joints than men, poorer patient-reported outcomes, and a lower quality of life. They also report higher disability scores, more fatigue, a higher prevalence of depression, and often delay or abandon decisions to start a family or to breastfeed their infants. Although a treat-to-target approach is endorsed by both EULAR and Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) guidelines for the management of PsA, minimal disease activity (MDA) is less frequently achieved by women compared to men.

Biologic anti-TNF drugs are efficacious in both SpA and PsA. However, during pregnancy and breastfeeding, most anti-inflammatory biologics used for the management of PsA and SpA are not recommended because of the risk of drug transfer across the placenta to the fetus or via the breastmilk to the infant. Exceptions are the TNF inhibitors adalimumab and certolizumab pegol, a PEGylated Fab’ fragment of a humanised monoclonal antibody, for which use in pregnancy and breastfeeding has been documented by clinical and registry data.

In conclusion, efficacious treatment strategies do exist that allow women with axSpA or PsA to achieve satisfactory disease control, also during pregnancy and when breastfeeding.
Türkiye Toplumunun Aynası: TBMM Üyelerinin Sosyolojik Özellikleri (2002-2018)
Authors: MERTOĞLU Rıza
Published: January 2023

Prosopografi olarak bilinen yöntemin öncüsü olan Lewis Bernstein Namier, İngiliz siyasetinin derinliklerini keşfedebilmek için yalnızca siyasi hareketlerin öncülerine odaklanmak yerine, parlamentodaki her bir bireyin ayrıntılı biyografilerini çıkarmıştı. Bu yöntemle Namier, insanların neden siyasete atıldığı sorusuna bir yanıt bulmayı amaçlıyor ve aynı zamanda parlamenterler arasındaki kişisel, bölgesel yahut sosyolojik bağları açıklamaya çalışıyordu. Böylelikle, elbette ideolojik yaklaşımların önemli bir payı olsa da bireylerin politikaya girme arzusunun içinde gizlenmiş dürtülerin birtakım ‘ortak paydalar ve çıkarlar’ olduğu anlaşılıyordu. Namier’in öncülüğünü yaptığı bu yöntemi kendisine rehber edinmiş bu çalışmada benzer bir deneme Türkiye siyasetine ve Türkiye Büyük Millet Meclisi üyelerine uyarlanmaya çalışıldı. Yalnızca siyasi partilerin liderlerine veya ön plana çıkmış isimlerine odaklanmaktan ziyade, yaş, cinsiyet, medeni hal, memleket ve meslek gibi temel ssosyo-demografik özellikler çerçevesinde, 2002 ile 2018 yılları arasındaki her bir milletvekiline odaklanan bu çalışma neticesinde, ideolojik zıtlıklarıyla bilinen siyasal yapıların dahi esasında sosyo-demografik bakımdan birbirine son derece yakın oldukları ve her ne kadar politikacılara dair dünya genelinde mevcut olan olumsuz bakış Türkiye’de de egemen olsa da, siyasetçilerin esasında o toplumun özelliklerini fazlasıyla barındırdığı yansıtılmaya gayret edildi.
Hitchcock's Undertexts: Objects and Language
Authors: Peucker Brigitte
Published: January 2023

This article explores the way in which the generative capacity of language inflects objects and props in several films by Alfred Hitchcock, focusing in particular on Rope (1948) and Strangers on a Train (1951). Camera angle and framing, the duration of the shot, the close-up or the long shot – all give shape to the filmed object. But why is language – or its absence – not mentioned among the set of operations that determines cinematic objects? In the form of dialogue or imaged writing (words or letters visible in the frame), it notably contextualizes the object in Hitchcock's films. Language in relation to objects can be punning; it can extend the image, evoking another, unimaged object through the use of rhyme, and it may act as a verbal solution to a puzzle. When imaged as writing, language is materialized, itself an object. At their most macabre, Hitchcock films stage an oscillation between a word's literal and figurative use, generating an undertext that extends beyond the joke the film's surface makes available. This discussion teases out several functions of language in Hitchcock films as it impacts the viewer's understanding of objects, moments when language creates undertexts that are clearly intentional but resist interpretation.
Tender Violence, Coercive Simplicity, Geschlecht III: An Introduction
Authors: Ng Julia , Waltham-Smith Naomi
Published: January 2023

This introduction to the special issue asks, in the company of Jacques Derrida’s recently ‘rediscovered’ seminar Geschlecht III, what it might mean to read this text against the grain of everything that is said in the German word Geschlecht, including the gesture of having made an archival discovery and its attendant enforcements of recovered origins, philological-genealogical authority, familial unity and consonance of signification. It reflects on how returning to Heidegger gives Derrida the opportunity to take stock of the risks and structural inequities inherent in texts and their legacies, and from which Heidegger retreats in the very instances he insists on his own attention to textual and philosophical idiomaticity. We explore how, for Derrida, Heidegger is indebted to a tradition of thinking sameness in difference that coerces conciliation in the name of achieving a ‘tender duality’ between pairs. With Derrida, we argue that Heidegger’s thinking on the two-in-need-of-compromise conceals a violence of domination or subordination to the gentle tones of simplicity and gathering. We ask, finally, what it means to specify (domestic, racial, anthropocentric) unicity as ‘good’ and what this implies for reading archives and legacies once we understand such specification as a form of coercion and violence.
Existence in its Sexual Being
Authors: Glendinning Simon
Published: January 2023

In ‘Geschlecht: Sexual Difference, Ontological Difference’, Derrida develops a reading of Heidegger’s ‘neutral’ term ‘Dasein’ that highlights its openness to a conception of sexual difference that is not yet binary. I explore this theme in relation to two further lines of thought. The first draws Heidegger’s remarks on Dasein’s factually concrete existence into correspondence with the European humanist tradition and the implications this reveals concerning a still binary determination of sex difference in Heidegger’s conception of existence in its sexual being. The second engages with Derrida’s own affirmation of a beyond binary conception of existence in its sexual being, a conception elaborated in this article in terms of singular sexual styles that are strictly irreducible to the organic bodily characteristics and behaviour of a living human being.
Unflappable
Authors: Waltham-Smith Naomi
Published: January 2023

Taking off from the Flügelschlag or coup d’aile in Trakl’s poem to which the ‘ Ein’ of ‘Ein Geschlecht’ responds with the Grundton (fundamental or tonic) of the Gedicht (poem), the article tracks the figure of this noisy wing-flap as a metaphor for the force of reading (aloud) from Geschlecht III to exchanges between Derrida and Cixous in Voiles, Insister, ‘ Fourmis’ and other texts. Alongside figures of take-off, there are also repeated images in these texts of frozen flights and broken or belimed wings which may be connected with the quasi-methodological remarks about the irreducible violence of reading in Glas. This more rigorously deconstructive thought of the coup d’aile moreover implicates a certain sonorousness in reading and thus ought to be understood in tension with the silencing of the gathering ‘Ein Geschlecht’. In conclusion — making a series of leaps within Derrida’s writing — a connection is made between this force of reading and the Cixousian puisse that Derrida analyses as the deconstruction of possibility.
Analysis of risk factors of atrial fibrillation in endocrinopathies
Authors: Naumova M. V. , Babaeva A. R. , Davydov S. I.
Published: January 2023

Atrial fibrillation (AF) is one of the most common forms of cardiac arrhythmia among the population, especially in middle-aged and elderly people. Recently enough data has been accumulated to indicate the difference in the mechanisms of AF occurrence depending on the individual hormonal status, which requires a personalized approach to assessing AF risk factors. The purpose of this article is to analyze the current state of the issue regarding the role of endocrinopathies in the pathogenesis of AF. The authors have presented modern clinical data indicating the influence of endocrine pathology on the risk of AF and its outcomes. It has been shown that diabetes mellitus, obesity and related metabolic syndrome, thyroid dysfunction, sex hormones abnormalities in women are associated with an increased risk of AF, as well as with a high risk of adverse cardiovascular events in the setting of AF. Along with this, the contribution of traditional factors of cardiovascular risk and the importance of their modification to reduce the incidence of AF is shown. The presented analysis shows the importance of taking into account endocrine pathology for the prevention of AF, timely diagnosis and rational therapy of this arrhythmia.
Difficulties in differential diagnosis of myasthenia gravis (clinical case)
Authors: Lobzin S. V. , Alibekov A. R. , Klocheva E. G. , Sharapova A. L. , Goldobin V. V.
Published: January 2023

Myasthenia gravis is a rare autoimmune disease, the clinical picture of myasthenia gravis is manifested by fluctuating weakness, pathological muscle fatigue and it is difficult for clinicians to diagnose it appropriately. The article presents a clinical case of misdiagnosis of late-onset myasthenia gravis, it provides a chronology of the development of symptoms of the disease and an analysis of the difficulties of differential diagnosis. Despite the typical manifestations of myasthenia gravis, the patient did not receive propriate pathogenetic therapy for a long time, while he was prescribed drugs that block neuromuscular conduction and worsen the course of the disease.
Psychological and sociological characteristics of students suffering from nightmares
Authors: Kostin R. K. , Rozhnov I. A. , Korabel'nikova E. A. , Yakushina I. I.
Published: January 2023

Aim. To assess the impact of nightmarish dreams on various aspects of medical students' lives.

Materials and methods. A sociological survey was conducted among students of 1–6 courses of five medical universities using an online form which included the following questionnaires: the Pittsburgh Sleep Quality Index, the Hamburg Nightmare Questionnaire, the Insomnia Severity Scale, the Hospital Anxiety and Depression Scale, the Beck Anxiety and Depression Scale. Academic performance was assessed according to the average score of the student's record book according to a 5-point system.

Results and conclusions. A high prevalence of both insomnia and nightmares among medical students was found. The high frequency of nightmares was associated with high levels of anxiety and depression. The frequency of nightmares was associated with deterioration of sleep quality, frequency and degree of sleep impairment. Nightmarish dreams had a negative impact on the quality of cognitive activity assessed by academic performance.
Clinical case of late manifestation of Wilson's disease
Authors: Klocheva E. G. , Goldobin V. V. , Alexandrov M. V. , Chistova I. V. , Popovskaya I. N. , Zhukova M. V.
Published: January 2023

A clinical case of late manifestation of Wilson's disease. Etiology, features of neurological and somatic manifestation of disease, complexity of differential diagnosis in late manifestation of Wilson's disease are considered. Particular attention is paid to methods of diagnosis and treatment.
Significados de frontera a través de los procesos de territorialización de migrantes establecidos en la región Soconusco, México
Authors: Arévalo Peña Martha LIliana
Published: January 2023

This article aims to present the concept of the border based on migrants settled in Tapachula and Ciudad Hidalgo (municipal seat of Suchiate). From qualitative, ethnographic, and phenomenological research, the meaning of the border is studied from the real, the symbolic, and the imaginary through the territorialization processes that include experiences and ways of internal and external appropriation of housing and the city. The relevance of the topic is based on reflecting on the construction of a border concept based on the experiences narrated by the migrants. The concept of border is extrapolated beyond the external physical, that is, migrants experience internal borders in their being that are reflected outside in their territorialization processes, which implies a latent reality of great importance in migration studies.
THEORY OF GENERALIZED CONNECTEDNESS (g-Tg-CONNECTEDNESS) IN GENERALIZED TOPOLOGICAL SPACES (Tg-SPACES)
Authors: KHODABOCUS Mohammad Irshad , SOOKIA Noor-ul-hacq
Published: January 2023

In this paper, the definitions of novel classes of generalized connected sets (briefly, g-Tg-connected sets) and generalized disconnected sets
(briefly, g-Tg-disconnected sets) in generalized topological spaces (briefly, Tg-spaces) are defined in terms of generalized sets (briefly, g-Tg -sets) and, their
properties and characterizations with respect to set-theoretic relations are presented. The basic properties and characterizations of the notions of local, pathwise, local pathwise and simple g-Tg-connectedness are also presented. The study shows that local pathwise g-Tg -connectedness implies local g-Tg-connectedness, pathwise g-Tg-connectedness implies g-Tg-connectedness, and g-Tg-connectedness is a Tg-property. Diagrams establish the various relationships amongst these types of
g-Tg-connectedness presented here and in the literature, and a nice application supports the overall theory.
Laser speckle contrast imaging to monitor microcirculation: An effective method to predict outcome in patients with sepsis and septic shock
Authors: Ruan Zhengshang , Li Ran , Dong Wenwen , Cui Zhilei , Yang Hui , Ren Rongrong
Published: January 2023

Background: This study examines the microcirculation of patients with sepsis and septic shock using Laser Speckle Contrast Imaging (LSCI) technology, to enhance monitoring and predict outcomes of sepsis and septic shock.

Methods: From 01 July 2021, to 31 January 2022, 44 patients diagnosed with septic shock and sepsis were included in the study, their clinical data were collected, and LSCI was used to monitor the mean peripheral blood flow perfusion index (PI).

Results: The average peripheral blood flow PI of septic shock patients was significantly lower than that of septic patients, with a cutoff value of 26.25. The average peripheral blood flow PI negatively correlated with acute physiology and chronic health evaluation (APACHE) Ⅱ score (p = .01 < .05), sequential organ failure assessment (SOFA) score (p < .01), and lactic acid levels (p = .01 < .05). We report average peripheral blood flow no correlation with age, mean arterial pressure, body temperature, oxygen saturation, heart rate, and body mass index. There was no correlation with procalcitonin, C-reactive protein (CRP), red blood cell distribution width, or platelet distribution width (p > .05). PI significantly correlated with the group sepsis and septic shock (p < .001, r = −.865). And PI significantly correlated with the outcome or mortality (p = .007 < .05, r = −.398). The ROC curve was calculated for PI and the sensitivity was 81.3%, and the specificity was 75% when PI cutoff value chooses 20.88.

Conclusion: LSCI technology successfully detected the fingertip microcirculation of patients with septic shock. LSCI can reliably differentiate patients with sepsis vs patients with septic shock. Additionally, the average peripheral blood PI negatively correlated with APACHE Ⅱ, SOFA score, and lactate acid levels, providing useful and supplementary information for the diagnosis and monitoring of septic shock. Trial registration: Chictr2100046761. Registered on May 28, 2021.

Clinical Trial Registration:clinicaltrials.gov, identifier Chictr2100046761
Impaired Diastolic Function Predicts Improved Ischemic Myocardial Flow by Mechanical Left Ventricular Unloading in a Swine Model of Ischemic Heart Failure
Authors: Sakata Tomoki , Watanabe Shin , Mazurek Renata , Mavropoulos Spyros , Romeo Francisco , Yamada Kelly P. , Ishikawa Kiyotake
Published: January 2023

Background: Impact of mechanical left ventricular (LV) unloading on myocardial tissue perfusion and its regulating factors remain unclear. This study was conducted to elucidate the predictors of regional blood flow (RBF) improvement by mechanical LV unloading.

Materials and Methods: One to four weeks after percutaneous induction of myocardial infarction (MI), Yorkshire pigs (n = 15) underwent mechanical LV unloading using Impella CP. Hemodynamic parameters were collected prior to LV unloading. RBF in infarct, border and remote myocardium were measured by fluorescent microsphere injections before and 120 min after LV unloading.

Results: RBF showed variable responses to mechanical LV unloading. While infarct RBF improved in general (0.33 ± 0.13 to 0.42 ± 0.19 mL/min/g, p = 0.06), there were a few pigs that showed little improvement. Meanwhile, there were no clear trends in the border (1.07 ± 0.47 to 1.02 ± 0.65 mL/min/g, p = 0.73) and remote myocardial RBF (1.25 ± 0.52 to 1.23 ± 0.68 mL/min/g, p = 0.85). In the simple linear regression analysis, cardiac output, mean pulmonary arterial wedge pressure, mean left atrial pressure, minimum LV pressure, end-diastolic LV pressure, maximum dP/dt, slope of end-diastolic pressure-volume relationship (EDPVR) and end-diastolic wall stress were significantly associated with % change of infarct RBF. In the multiple regression model, slope of EDPVR and maximum dP/dt remained as independent predictors of infarct RBF change.

Conclusion: Steeper EDPVR and lower maximum dP/dt were associated with increased blood perfusion in the infarct area after LV unloading. Our data suggests mechanical LV unloading is more beneficial in post-MI patients with high diastolic pressure associated with increased LV stiffness and in those with worse cardiac contractility.
The loss of left atrial contractile function predicts a worse outcome in HFrEF patients
Authors: Mandoli Giulia Elena , Pastore Maria Concetta , Benfari Giovanni , Setti Martina , Maritan Luca , Diviggiano Enrico Emilio , D’Ascenzi Flavio , Focardi Marta , Cavigli Luna , Valente Serafina , Cameli Matteo
Published: January 2023

Background

In chronic heart failure, high intracardiac pressures induce a progressive remodeling of small pulmonary arteries up to pulmonary hypertension. At the end of left atrial conduit function, pulmonary and left heart end-systolic pressures equalization might affect left atrial systole. In this single-center prospective study, we aimed to investigate whether peak atrial contraction strain (PACS), measured by speckle tracking echocardiography, was independently associated with prognosis in heart failure with reduced ejection fraction (HFrEF).

Materials and methods

Outpatients with HFrEF and sinus rhythm referred to our echo-labs were enrolled. After clinical and echocardiographic evaluation, off-line speckle tracking echocardiography analysis was performed. Primary and secondary endpoint were cardiovascular death and heart failure hospitalization, respectively. Spline knotted survival model identified the optimal prognostic cut-off for PACS.

Results

The 152 patients were stratified based on PACS <8% (n = 76) or PACS ≥8% (n = 76). Patients with PACS <8% had lower left ventricle and left atrial reservoir strain and higher New York Heart Association (NYHA) class and left atrial volume index (LAVI). Over a mean follow-up of 3.4 ± 2 years, 117 events (51 cardiovascular death, 66 heart failure hospitalizations) were collected. By univariate and multivariate Cox analysis, PACS emerged as a strong and independent predictor of cardiovascular death and heart failure hospitalization, after adjusting for age, sex, left ventricle strain, and E/e’, LAVI (HR 0.6 per 5 unit-decrease in PACS). Kaplan–Meier curves showed a sustained divergence in event-free survival rates for the two groups.

Conclusion

The reduction of PACS significantly and independently affects cardiovascular outcome in HFrEF. Therefore, its assessment, although limited to patients with sinus rhythm, could offer additive prognostic information for HFrEF patients.
The effects of experimental, meteorological, and physiological factors on short-term repeated pulse wave velocity measurements, and measurement difficulties: A randomized crossover study with two devices
Authors: Podrug Mario , Šunjić Borna , Bekavac Anamarija , Koren Pjero , Đogaš Varja , Mudnić Ivana , Boban Mladen , Jerončić Ana
Published: January 2023

Background

Large longitudinal studies with repeated pulse wave velocity (PWV) measurements, a direct measure of arterial stiffness, are required to realize the full potential of arterial stiffness in clinical practice. To facilitate such studies it is important to increase the power of a study by reducing within-subject variability of PWV, and to ease the use of a PWV device in clinical settings by minimizing PWV measurement difficulties.

Methods

We systematically investigated experimental setting and meteorological conditions, as well as physiological factors and participant characteristics, to determine whether and to what extent they affected: between- and within-subjects variability of PWV recordings, and measurement difficulties of a particular device. We conducted a 2-week longitudinal block-randomized cross-over study with two blinded observers and two commonly used devices: applanation tonometry SphygmoCor CvMS and oscillometric Arteriograph to assess carotid-femoral (cfPWV) or aortic (PWVao) PWV, respectively. Our sample had uniform and wide-spread distribution of age, blood pressures, hypertensive status and BMI. Each participant (N = 35) was recorded 12 times over 3 visiting days, 7 days apart. On each day, recordings were made twice in the morning (7–10 a.m.) and afternoon (16–18 p.m.). Data were analyzed using multilevel mixed-effects models, separately for each device.

Results

In addition to age and mean arterial pressure (MAP) that strongly affected both cfPWV and PWVao, other significant factors appeared to indicate a measurement approach. cfPWV as a more direct measure of arterial stiffness was additionally affected by hypertension status, outdoor temperature, interaction of MAP with outdoor temperature and the order of visit, with MAP within-subject variability contributing on average 0.27 m/s to difference in repeated measurements at 5°C and 0.004 m/s at 25°C. PWVao measurements derived at a single brachial site were more dependent on age than cfPWV and also depended on personal characteristics such as height and sex, and heart rate; with within-subject MAP variability adding on average 0.23 m/s to the difference in repeated measures. We also found that female sex significantly increased, and recording in afternoon vs. morning significantly decreased measurement difficulties of both devices.

Conclusion

We identified factors affecting PWV recordings and measurement-difficulties and propose how to improve PWV measuring protocols.
Research and application of pressure relief and permeability improvement in high gas outburst mines by directional drilling and hydraulic jet
Authors: Li Dingqi , Chen Yubo , Zhang Jiabao , Wang Mingzhong
Published: January 2023

Efficient gas extraction technology is an important topic for low permeability and high gas outburst coal seam. Based on the engineering background of Hudi Coal Mine with the soft and hard coal seams and the existing hydraulic permeability enhancement technology, a new construction process to improve coal seam permeability was proposed to effectively reduce coal seam gas content and the risk of coal and gas outburst. In this measure, the roadway in floor was replaced with a directional main borehole, directional branch boreholes were used to replace crossing holes, and soft coal was mined along soft sub layers via the directional drilling machine and directional hydraulic jet. Main boreholes are drilled parallel to the seam in the coal seam floor, and branch boreholes are drilled through the floor and coal seam. The numerical simulation was used to study the permeability improvement effect of different mining diameters by the proposed measure. The result showed that, as the mining diameter increased from 2 m to 4 m, the average influence diameter of coal seam porosity increased from 15.44 m to 19.65 m, and the average influence diameter of the permeability increased from 15.75 m to 20.07 m, which is three times the influence range of the ordinary borehole. The application of the proposed measure and its supporting equipment was carried out under the special coal seam and gas conditions of Hudi Coal Mine. Results show that the soft coal was mined efficiently along the soft sub layer using the main borehole, branch boreholes, and directional hydraulic jet. Compared the traditional hydraulic flushing in the borehole with the ordinary drilling machine, the average speed of mining soft sub layers increased from 0.5 t/h to 3.6 t/h, the equivalent mining diameter of soft sub layers increased from 1.2 m to 7.6 m, and the average flow of gas extraction increased from 0.41 m3/d to 6.25 m3/d. The conclusions obtained in this study can provide a reference for coal mine gas extraction with similar coal seam conditions.
A unified method of predicting soil deformations induced by various shaped-section tunnelling in clays
Authors: Zeng Bin , Ma Rui , Huang Da , Ye Siqiao , Yang Chao , Chai Hejun
Published: January 2023

A unified method of predicting soil deformations induced by general and special-section tunneling in clays is proposed. Assuming that the tunneling-induced ground loss can be divided into infinite ground loss elements, and the soil deformation induced by the overall ground loss is equal to the sum of deformation due to each unit ground loss, the soil deformation due to unit ground loss is first derived based on elasticity theory solution. The soil deformation induced by random shaped-section tunneling is then obtained by integrating along the overall ground loss distribution, and the expressions are presented in the Cartesian and polar coordinate forms, respectively. By means of several cases of single circular tunneling, the reliability of the unified method is well verified through comparing with the measured data, and the performance of this method is quantitatively evaluated against the error analysis of the predictions. Taking the double-O-tube (DOT) shield tunnel for example, the unified method is further applied to predict soil deformation induced by special-section tunneling. The results show that the shape of the surface settlement curve caused by DOT shield tunneling also presents an inverted Gaussian curve. With the increase of the soil depth, the settlement of soil above the DOT shield tunnel increases slightly first and then decreases, and the settlement trough width keeps decreasing, resulting in the change of the shape of the settlement curve from “V” to “W”.
Research on safety early warning of abnormal A-annular pressure of “three-high” gas wells based on data mining
Authors: Yan Hongqiao , Qi Junliang , Wu Shuncheng , Wang Shunyi , Zhong B. T.
Published: January 2023

A major safety accident will be triggered when the A-annular pressure value of high pressure, high productivity and high sulfur gas well exceeded the maximum allowable value. The A-annular pressure value of high pressure high productivity and high sulfur gas well once exceeded the allowable value will trigger a major safety accident. Therefore, this paper proposed a data mining based the gas well early warning strategy by analyzing the annular pressure mechanism and the change in the pattern of instantaneous gas volume, well temperature, and annular pressure in various conditions. To summarize, the law of gas well abnormal A-annular pressure is aimed at constructing a gas well safety warning rule for gas well stable production stage and shutdown period where the initial parameters setting in the early warning rule and adjustment optimization mechanism is also determined. Lastly, with the use of historical abnormal samples, the gas well early warning strategy bought up in this paper was verified. The example shown that compared with the traditional DCS system warning strategy, the gas well safety early warning strategy can identify the abnormal A-annular pressure phenomenon 82 h in advance thus achieving production safety management.
Hydrothermal fluid characteristics of the huayuan Pb-Zn orefield: Constraints from apatite major and trace element compositions
Authors: Tan Rui-Chang , Shao Yong-Jun , Wei Han-Tao , Zhang Jun-Ke , Yu Meng-Da , Xiong Yi-Qu
Published: January 2023

The Huayuan orefield in the SW Yangtze Block (SW China) is a world-class Pb-Zn orefield, with over 20 million tonnes (Mt) metal reserve. However, the Pb-Zn ore fluid source and evolution in Huayuan remain controversial. This study determined the major and trace element compositions of the newly-identified apatite from the Pb-Zn ores, using electron microprobe analysis (EMPA) and laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS). The apatite samples are of hydrothermal origin, and have high CaO (52.57–57.15 wt%), P2O5 (39.26–42.88 wt%) and F (1.82–3.90 wt%) but low Cl (< 0.42 wt%) contents. The samples have total rare Earth element content (ΣREE) of 74.07–1,255.34 ppm, and they all show negative Eu and weakly positive Ce anomalies. The result suggests that the apatite was formed in an environment with decreasing oxygen fugacity, and in relatively F-rich, Cl-poor, and REE-poor ore-forming fluid. We geochemically compared the apatite from Huayuan with those from different geneses by Fisher discriminant. The result suggests that the Huayuan apatite is distinct from typical magmatic and purely hydrothermal apatite, and that the ore-forming fluids may have had multiple sources. The mixing of fluids with different origins may have triggered significant metal ore deposition.
An update on brown adipose tissue and obesity intervention: Function, regulation and therapeutic implications
Authors: Liu Xiaomeng , Zhang Zhi , Song Yajie , Xie Hengchang , Dong Meng
Published: January 2023

Overweight and obesity have become a world-wide problem. However, effective intervention approaches are limited. Brown adipose tissue, which helps maintain body temperature and contributes to thermogenesis, is dependent on uncoupling protein1. Over the last decade, an in-creasing number of studies have found that activating brown adipose tissue and browning of white adipose tissue can protect against obesity and obesity-related metabolic disease. Brown adipose tissue has gradually become an appealing therapeutic target for the prevention and re-versal of obesity. However, some important issues remain unresolved. It is not certain whether increasing brown adipose tissue activity is the cause or effect of body weight loss or what the risks might be for sympathetic nervous system-dependent non-shivering thermogenesis. In this review, we comprehensively summarize approaches to activating brown adipose tissue and/or browning white adipose tissue, such as cold exposure, exercise, and small-molecule treatment. We highlight the functional mechanisms of small-molecule treatment and brown adipose tissue transplantation using batokine, sympathetic nervous system and/or gut microbiome. Finally, we discuss the causality between body weight loss induced by bariatric surgery, exercise, and brown adipose tissue activity.
Application of horizontal well discontinuous chemical flooding technology in Bohai oilfield
Authors: Jian Zhang , Dan Liang , Liqi Wang , Engao Tang , Xianjie Li , Wensen Zhao
Published: January 2023

Discontinuous chemical flooding technology of horizontal wells is a long-term development mechanism of horizontal wells established by combining and applying various oil displacement systems in different stages. Discontinuous chemical flooding not only ensures the injection capacity of chemical flooding stage, but also saves the operation cost of chemical flooding, and maximizes the economic benefits of crude oil production while improving the oil recovery. Based on the reservoir physical properties and fluid physical parameters of Bohai B oilfield, the development scheme of discontinuous chemical flooding in horizontal wells is studied on the basis of laboratory experimental evaluation. According to the optimization results of injection parameters, four types of slugs are set, i.e., front slug, main slug, auxiliary slug and secondary slug. A variety of agent systems such as gel, pre crosslinked particles, polymer and acid solution are used. The slug adjustment timing is determined by the monitoring data and the analysis results of production dynamic characteristics. Under the conditions of 0.07 PV/a injection rate and 0.49 PV slug dosage, the recovery efficiency of discontinuous chemical flooding can be improved by 10.4% compared with water flooding. After the implementation of the field, the daily oil production of typical affected wells has shown a significant upward trend, with the peak increase of 135%–151% and the peak decrease of water cut of 15%. After 2 years and 6 months of implementation, chemical flooding has achieved a cumulative increase of 66,000 m3compared with basic water flooding, with the oil increase accounting for 41% of the output of the whole stage. The effect of water reduction and oil increase is remarkable. The research results show that discontinuous chemical flooding can be popularized and applied in the oil fields developed by horizontal wells, so as to control the rapid rising trend of water cut in the middle and high water cut stage and further improve the oil recovery.
Bi-level deep reinforcement learning for PEV decision-making guidance by coordinating transportation-electrification coupled systems
Authors: Xing Qiang , Chen Zhong , Wang Ruisheng , Zhang Ziqi
Published: January 2023

The random charging and dynamic traveling behaviors of massive plug-in electric vehicles (PEVs) pose challenges to the efficient and safe operation of transportation-electrification coupled systems (TECSs). To realize real-time scheduling of urban PEV fleet charging demand, this paper proposes a PEV decision-making guidance (PEVDG) strategy based on the bi-level deep reinforcement learning, achieving the reduction of user charging costs while ensuring the stable operation of distribution networks (DNs). For the discrete time-series characteristics and the heterogeneity of decision actions, the FEVDG problem is duly decoupled into a bi-level finite Markov decision process, in which the upper-lower layers are used respectively for charging station (CS) recommendation and path navigation. Specifically, the upper-layer agent realizes the mapping relationship between the environment state and the optimal CS by perceiving the PEV charging requirements, CS equipment resources and DN operation conditions. And the action decision output of the upper-layer is embedded into the state space of the lower-layer agent. Meanwhile, the lower-level agent determines the optimal road segment for path navigation by capturing the real-time PEV state and the transportation network information. Further, two elaborate reward mechanisms are developed to motivate and penalize the decision-making learning of the dual agents. Then two extension mechanisms (i.e., dynamic adjustment of learning rates and adaptive selection of neural network units) are embedded into the Rainbow algorithm based on the DQN architecture, constructing a modified Rainbow algorithm as the solution to the concerned bi-level decision-making problem. The average rewards for the upper-lower levels are ¥ -90.64 and ¥ 13.24 respectively. The average equilibrium degree of the charging service and average charging cost are 0.96 and ¥ 42.45, respectively. Case studies are conducted within a practical urban zone with the TECS. Extensive experimental results show that the proposed methodology improves the generalization and learning ability of dual agents, and facilitates the collaborative operation of traffic and electrical networks.
Research on interaction of controllable series compensation and traditional PSS to suppress low-frequency oscillation
Authors: Li Ming , Ren Wenbo , Chen Anqing , Gong Jiayuan , Wang Jingnan
Published: January 2023

In order to make the power transmission more stable and ensure the safe operation of the system, a study on the interaction of controllable series compensation and traditional PSS to suppress low-frequency oscillation is proposed. Firstly, the lead-slip angle is adjusted by the lead-lag module of the PSS limit stabilizer to eliminate the reverse modulation phenomenon, and the series compensation is used to optimize the parallel transmission lines and lines of different voltage levels to improve the stability of the long-distance transmission system. Secondly, the phase compensation method is used to set the parameters of the TCSC and PSS damping controllers, the characteristics of the rotor system are judged by the damping ratio, the sensitivity characteristic root is extracted, and the maximum parameters affecting the mode are determined; finally, the genetic algorithm is introduced to coordinate the damping controller to increase the oscillation. Mode damping, constraining the range of each tuning parameter, enabling coordinated optimization. Experiments show that the method in this paper can effectively suppress low-frequency oscillation and ensure the safety and stability of the power system.
Molecular identification of individual and seasonal variation in incidental ingestion of arthropods by free-ranging goats
Authors: Berman Tali Sarah , Inbar Moshe
Published: January 2023

The extent of direct interactions between large mammalian herbivores (LMH) and plant-dwelling arthropods (PDA), i.e., the ingestion of PDA by LMH, remains largely unexplored. Grazing LMH may ingest a variety of PDA, yet, it is unknown how different foraging strategies (i.e., browsing, grazing, etc.) influence the ingestion of PDA or whether individual variation within herds affects it. Here we examine how individual variation within a herd of browsing LMH impacts PDA ingestion. This was done using a DNA metabarcoding analysis on feces collected monthly from marked individuals within a herd of free-ranging goats. We found that goats frequently ingest PDA while feeding (all samples contains PDA), including a complex food-chain of herbivores, predators and parasites, which differed over the season and among individual goats. In total, 63 families of insects and 9 families of arachnids from 15 orders were ingested by the goats. Most ingested PDA were herbivores with reduced mobility, such as immature or sessile species. Highly mobile and noxious PDA were rarely detected. We show for the first time that ingestion of PDA by LMH is influenced by seasonal and individual variation within the herd and that it is common among LMH, regardless of feeding strategy or habitat.