bluuebunny/crossref_metadata_2025 huggingface dataset:
Applied Research on the Combination of Weighted Network and Supervised Learning in Acupoints Compatibility
Authors: Qiu Xia , Zhong Xiaoying , Zhang Honglai
Published: October 2021

To enhance the depth of excavation and promote the intelligence of acupoint compatibility, a method of constructing weighted network, which combines the attributes of acupoints and supervised learning, is proposed for link prediction. Medical cases of cervical spondylosis with acupuncture treatment are standardized, and a weighted network is constructed according to acupoint attributes. Multiple similarity features are extracted from the network and input into a supervised learning model for prediction. And, the performance of the algorithm is evaluated through evaluation indicators. The experiment finally screened 67 eligible medical cases, and the network model involved 141 acupoint nodes with 1048 edge. Except for the Preferential Attachment similarity index and the Decision Tree model, all other similarity indexes performed well in the model, among which the combination of PI index and Multilayer Perception model had the best prediction effect with an AUC value of 0.9351, confirming the feasibility of weighted networks combined with supervised learning for link prediction, also as a strong support for clinical point selection.
Association between Serum 25-Hydroxyvitamin D Level and Stroke Risk: An Analysis Based on the National Health and Nutrition Examination Survey
Authors: Wang Lan , Li Shu , Sanika G. H. Anuja , Zhao Jinsheng , Zhang Hui , Zhao Lin , Wang Wenfeng
Published: October 2021

Background. To analyze the association between serum 25-hydroxyvitamin D level (25(OH)D) and stroke risk based on the National Health and Nutrition Examination Survey (NHANES). Methods. Between 2007 and 2018, the baseline information of participants from NHNES was collected. Univariate analysis was used to identify the covariates. Multivariate logistic regression model was used to analyze the association between serum 25(OH)D level and the stroke risk. Results. Of the 8,523 participants, there were 310 participants with stroke and 8,213 participants without stroke. The multivariate logistic analysis showed that serum 25(OH)D deficiency (odds ratio (OR): 1.993, 95% confidence intervals (CI): 1.141-3.481, and

P
=
0.012

) was the significant risk factors for stroke. Subgroup analysis showed that non-Hispanic whites with serum 25(OH)D deficiency (OR: 2.501, 95% CI: 1.094-5.720, and

P
=
0.001

) and insufficiency (OR: 1.853, 95% CI: 1.170-2.934, and

P
=
0.006

) were associated with a higher risk of stroke than those with normal 25(OH)D levels. Conclusions. Serum 25(OH)D deficiency may be associated with an increased risk of stroke.
Improvement of Gas Drainage Efficiency via Optimization of Sealing Depth of Cross‐Measure Boreholes
Authors: Li Pu , Cheng Zhiheng , Chen Liang , Wang Hongbing , Cao Jialin
Published: October 2021

The sealing depth of a gas‐drainage borehole is critically important as it directly affects the efficiency of the whole drainage system. In order to determine the shortest reasonable sealing depth, in this paper, a theoretical drainage model using different sealing depths was proposed. Based on theoretical analysis presented, two parts of the fractures system surrounding the drainage borehole were proposed, i.e. the fractures induced by roadway excavation and the fractures induced by borehole drilling. A series of geological in‐situ tests and simulations research were conducted to determine the stress and fracture distributions in the surrounding rock of the borehole. The depths of crushing zones, plastic zones and stress concentration zones were determined as 5 m, 2 m and 12 m, respectively. Meanwhile, stress simulation shows that the depth of the stress concentration zone was 12 m from the roadway wall and the stress peak was located at the depth of 8 m, which can be verified by the results of drilling penetration velocity analysis. To determine the optimum sealing depth, gas drainage holes with different sealing depths were drilled in the field. The field results revealed that the crushing zones were the main area for air leakage, and the stress concentration induced by roadway excavation assisted in the reduction of air leakage. Therefore, the optimized sealing depth should both cover the plastic zone and the stress concentration zone. The research achievements can provide a quantitative method for the determination of optimum sealing depth in cross‐measure drainage boreholes.
Coarse Particle Motion Characteristics in a Double‐Stage Slurry Pump Considering Leakage Flow
Authors: Jia Hao , Wang Yuqi , Zhu Zuchao , Su Xianghui , Tang Zhenji
Published: October 2021

Along with the pressing demand for the long‐distance transportation of coarse particles in the deep‐sea mining industry, evaluating the slurry pump’s passing through and erosive wear by studying the particle motion characteristics and the slurry behavior is becoming increasingly important. Research on the influence of leakage flow through the clearance and balancing devices on the motion characteristic of granular grain flow is of great significance but has been seldom studied. This study coupled the discrete element method with the CFD method to investigate the comprehensive effect of a double‐stage slurry pump’s main flow and leakage flow on the motion characteristics of particles with a 10 mm diameter. Results show that the leakage flow occupation in main flow falls from 26%–27% to 8%–9% for the two stages, with the flow rate increasing from 80 m3/h to 200 m3/h. In the first stage with leakage, accumulation of coarse particles was observed at the impeller eye, which should be paid much attention to slurry pumps’ operation to eliminate the chance of blockage. In the nonleak situation, although the increment of the average kinetic energy of particles through the impeller is more significant than in the leak case, most of them dissipate primarily by more than 10% collision in the bowl diffuser. In the leak or nonleak case, the average kinetic energy of particles was more than twice through the first stage but only 1.1 times through the second stage. The selection of stages in the slurry pump design should consider the limitation of particle velocity improvement.
Tibial Condyle Valgus Osteotomy for Ipsilateral Knee Osteoarthritis after Hip Arthrodesis
Authors: Fukuhara Daisuke , Inoue Hiroaki , Nakagawa Shuji , Arai Yuji , Takahashi Kenji
Published: October 2021

We report a case of tibial condylar valgus osteotomy (TCVO) for ipsilateral knee osteoarthritis (OA) after hip arthrodesis. A 58-year-old woman developed right purulent hip arthritis at one month of age and underwent right hip fusion at 16 years old. She visited our department at the age of 57 because her right knee joint pain worsened. The range of motion for her right knee was 80° and -5° of flexion and extension, respectively, and she experienced medial weight-bearing pain. A plain X-ray image showed that the right knee joint had end-stage knee OA with a bone defect inside the tibia, and the tibial plateau shape was the pagoda type. There was a marked instability in her right knee with a valgus of 9° and varus of 7° on stress photography. She underwent TCVO on her right knee and was allowed full load four weeks after surgery. Computed tomography imaging showed bone union nine months after surgery. Two years after the operation, there was no correction loss, and she could walk independently without pain. In general, total knee arthroplasty (TKA) is indicated for end-stage knee OA; however, there are problems, such as early loosening due to the increased mechanical load on the knee after hip OA. In this case, since a good course was obtained, TCVO is considered a treatment option for terminal knee OA after hip arthrodesis.
Amplification Effect of Ground Motion in Offshore Meandering Sedimentary Valley
Authors: Wang Hailiang , Yan Shaomin , Liu Zhongxian , Cheng Xinglei
Published: October 2021

A sedimentary valley has a visible amplification effect on a seismic response, and the current 2D topographies cannot truthfully reflect the twists and turns of a large‐scale river valley. Taking a sinusoidal curved valley site as a model, the dynamic finite element analysis method and the introduction of a viscoelastic artificial boundary were developed to study the 3D seismic response of the dimensional topographies in the homogeneous curved valley to vertical incident P, SV, and SH waves. The results showed that the bending sedimentary valley site earthquake presented significant features simultaneously, depending on the number of valley bends, the frequency of the excitations, the shear wave velocity of sedimentary soil, and the depth of the river valley. The surface displacement amplitudes of three‐dimensional meandering sedimentary valleys are significantly different from those of sedimentary basins. The amplification area of the meandering valley is related to the angle between the valley axis and wave vibration direction, and the amplification effect is significant when the angle is small. The movement in the main direction showed a center focus, and the secondary y‐direction displacement showed both a central focus and an edge effect. When the frequency of the incident wave was close to the natural vibration frequency in a specific direction, the movement in this direction significantly increased because of the resonance effect. The displacement amplitude of the surface was proportional to the depth of the river valley, and the surface displacement was presented in different forms based on the frequency of the excitations. The results provided some guidance for the earthquake resistance of the curved valley site.
Intelligent Prediction Algorithm of Cross-Border E-Commerce Logistics Cost Based on Cloud Computing
Authors: Gao Wanli
Published: October 2021

Cross-border e-commerce logistics cost prediction algorithm does not consider logistics distribution scheduling, and logistics information interchange is not enough, which leads to confusion of logistics cost parameters and large deviation. Therefore, an intelligent prediction algorithm of cross-border e-commerce logistics cost based on cloud computing is designed. Introduce cloud computing platforms, optimize the scheduling of cross-border e-commerce logistics distribution tasks, and select the targets for the scheduling of cross-border e-commerce logistics distribution tasks from the aspects such as the shortest waiting time required by customers, the degree of resource load balance, and the costs consumed in completing cross-border e-commerce logistics distribution tasks, and design logistics scheduling process. On this basis, the logistics distribution data are classified, the association rules between the data are mined, and the monitoring of abnormal values in the cost forecasting process is completed. In order to eliminate the interference caused by the difference of different cost management interval, the function value is calculated by weighted Euclidean distance. Design feedback forecast mechanism to realize intelligent forecast algorithm of cross-border e-commerce logistics cost. Experimental results show that the proposed algorithm has better accuracy of cross-border e-commerce logistics cost prediction and higher completion rate of logistics tasks.
Serum Levels of PDGF, EGF, and sFlt-1 in Patients with Polycystic Ovary Syndrome and Their Predictive Effects on Pregnancy Outcomes
Authors: Gao Jiefan , Song Yangyang , Wang Donghui , Zhang Dan , Huang Xiao
Published: October 2021

Polycystic ovary syndrome (PCOS) is a neuroendocrine disease with complex etiology characterized by infrequent menstruation, follicular developmental disorders, insulin resistance, and hyperandrogenism. PCOS patients often suffer from anovulatory infertility, and even after successful pregnancy promotion, spontaneous abortion is easy to occur. At present, PCOS is mainly diagnosed by auxiliary examinations such as sex hormones and B ultrasonography, and there is a lack of specific serological markers for the diagnosis of diseases. Similarly, there is a lack of effective evaluation methods for the risk of abortion in PCOS patients. Therefore, it is extremely important to explore the factors that affect the occurrence of abortion in PCOS patients and to find specific indicators that can guide the pregnancy outcome of PCOS patients. The purpose of this study was to investigate the serum levels of platelet-derived growth factor (PDGF), epidermal growth factor (EGF), and soluble fms-like tyrosine kinase-1 (sFlt-1) in PCOS patients and analyze their predictive effects on the pregnancy outcomes of PCOS patients. The results showed that serum PDGF, EGF, and sFlt-1 levels were secreted abnormally in PCOS patients with abortion and were closely related to the pregnancy outcome of PCOS patients. The combination of the three levels has the highest value in predicting the pregnancy outcome of PCOS patients, which is worth promoting.
Anti‐Inflammatory Activity and Chemical Analysis of Different Fractions from Solidago chilensis Inflorescence
Authors: de Brito Thais Morais , Amendoeira Fabio Coelho , de Oliveira Temistocles Barroso , Doro Laís Higino , Garcia Esdras Barbosa , da Silva Naína Monsores Felix , da Silva Chaves Amanda , Muylaert Flavia Fontenelle , Pádua Tatiana Almeida , Rosas Elaine Cruz , Henriques Maria das Graças M. O. , da Silva Frutuoso Valber , Valverde Simone Sacramento , Ferraris Fausto Klabund
Published: October 2021

Solidago chilensis Meyen (Compositae) is a species native to South America (Brazil) popularly known as arnica. In Brazilian popular medicine, inflorescences and rhizomes of this plant have been used since the end of the 19th century to replace the exogenous and hepatotoxic Arnica montana L. in the treatment of edema and inflammatory pathologies. Although the anti‐inflammatory activity of S. chilensis is evidenced in the literature, there is a lack of studies with enriched fractions or compounds isolated from it. The objective of the current study was to characterize phytochemically and to evaluate the pharmacological action in vivo and in vitro of the crude extract and the different fractions (hexane, dichloromethane, acetal, butanolic, and aqueous) isolated from the inflorescence of S. chilensis. The inflorescence crude extract (ScIE) and fractions were administered by intraperitoneal route to mice at different doses. In an LPS‐induced pleurisy model, inhibition of leukocyte influx was observed for the ScIE and all fractions tested, as compared to controls. Dichloromethane (ScDicF), butanolic (ScButF), and aqueous (ScAquF) were selected for further analysis as they showed the best inhibitory effects in leukocyte migration and inflammatory cytokine and chemokine production: TNF‐α, CXCL1/KC, CXCL2/MIP‐2, and CCL11/eotaxin‐1. In LPS‐stimulated J774A.1 cell line, ScIE and the ScDicF exhibited an inhibitory effect on nitric oxide (NO) production and downmodulated the COX‐2 expression; ScAquF failed to modulate NO production and COX‐2 expression. In phytochemical analysis, HPLC‐UV‐DAD chromatograms of ScDicF and ScAquF showed the main peaks with UV spectrum characteristics of flavonoids; chlorogenic acid and isoquercetin were the most present phytochemicals identified in the ScAquF, and a high number of n‐alkanes was found in ScHexF. Our study was the first to address biological effects and correlate them to phytochemically characterized fractions from inflorescences of S. chilensis.
New Properties on Degenerate Bell Polynomials
Authors: Kim Taekyun , San Kim Dae , Lee Hyunseok , Park Seongho , Kwon Jongkyum
Published: October 2021

The aim of this paper is to study the degenerate Bell numbers and polynomials which are degenerate versions of the Bell numbers and polynomials. We derive some new identities and properties of those numbers and polynomials that are associated with the degenerate Stirling numbers of both kinds.
[Retracted] An Empirical Study on the Artificial Intelligence‐Aided Quantitative Design of Art Images
Authors: Zhang Wen , Tsai Sang-Bing
Published: October 2021

This paper presents an indepth analysis and research on the quantitative design of fine art images through artificial intelligence algorithms. A CycleGAN‐based network model for automatic generation of sketches of fine art images is constructed to extract the edge and contour features of fine art images. The network uses 512 × 1024 high‐resolution art images as input and Pitchman as a discriminator. To further enhance the sketch generation effect, a bilateral filtering algorithm is added to the generator model for noise reduction, and then a K‐means algorithm is used for color quantization to solve the problem of cluttered lines in the generated sketches. The experimental results show that the network model can effectively realize the automatic generation of art image sketches and can retain the detailed part of the costume information well. A rendering platform is built to realize the application of art image generation algorithms and coloring algorithms. The platform integrates the functions of image preprocessing, sketch generation, and sketch coloring, demonstrates the results of the main research content of this paper, and finally increases the interest of the system through the rendering function of the art image grid, which further improves the practicality of the platform.
[Retracted] Study on the Influence of Compression Ratio on the Rail Contact Fatigue Resistance Property and Its Mechanism
Authors: Li Zhiqiang
Published: October 2021

Contact fatigue resistance properties of four commercial steel rails were systematically studied and compared. The contact fatigue limit cycles, fracture toughness, and fatigue crack growth rate of the corresponding rails with different compression ratios were tested and analyzed, which showed a close relationship between them. Moreover, microstructures of the rails were carefully observed by using the TEM to elucidate the scientific mechanisms. Observations and obtained results indicated that pearlite lamellar spacing further decreased with the rise of compression ratio, which greatly and rightly contributed to the improved fatigue resistance property.
Study of the Effects of Heating on Organic Matter and Mineral Phases in Limestones
Authors: May-Crespo J. , Martínez-Torres P. , Quintana P. , Alvarado-Gil J. J. , Vilca-Quispe L. , Camacho N.
Published: October 2021

Color-induced changes in stones due to heating can be useful in determining the degree of degradation generated in their components and structure. We evaluate the effect of heating in three types of limestones, useful in building and restoration, corresponding to biomicrite (BC), biosparite (BS), and intramicrite (IM), in the range of temperature from 100°C to 600°C. Our analyses indicate that the strongest changes in reflectance occur in the samples of intramicrite, followed by biomicrite, being biosparite showing the smallest ones. Additionally, IM samples suffer the largest modifications in effective porosity due to the thermal treatment; in contrast, BS and BC samples show smaller temperature-induced alterations associated with smaller changes in reflectance. Moreover, we reveal that most of the thermally induced variations are associated, in this range of temperature, to the dehydroxylation of goethite that transforms into hematite, as well as by the burning and partial release of the organic matter present in the rock. Colorimetry analyses show that the sequence of thermally induced changes can be followed by the evolution of the three coordinates, L∗(lightness), a∗(red-green), and b∗(yellow-blue), of the CIE 1976 L∗a∗b∗space.
Image Enhancement Model Based on Deep Learning Applied to the Ureteroscopic Diagnosis of Ureteral Stones during Pregnancy
Authors: Miao Xiao-Yan , Miao Xiao-Nan , Ye Li-Yin , Cheng Hong
Published: October 2021

Objective. To explore the image enhancement model based on deep learning on the effect of ureteroscopy with double J tube placement and drainage on ureteral stones during pregnancy. We compare the clinical effect of ureteroscopy with double J tube placement on pregnancy complicated with ureteral stones and use medical imaging to diagnose the patient’s condition and design a treatment plan. Methods. The image enhancement model is constructed using deep learning and implemented for quality improvement in terms of image clarity. In the way, the relationship of the media transmittance and the image with blurring artifacts was established, and the model can estimate the ureteral stone predicted map of each region. Firstly, we proposed the evolution-based detail enhancement method. Then, the feature extraction network is used to capture blurring artifact-related features. Finally, the regression subnetwork is used to predict the media transmittance in the local area. Eighty pregnant patients with ureteral calculi treated in our hospital were selected as the research object and were divided into a test group and a control group according to the random number table method, 40 cases in each group. The test group underwent ureteroscopy double J tube placement, and the control group underwent ureteroscopy lithotripsy. Combined with the ultrasound scan results of the patients before and after the operation, the operation time, time to get out of bed, and hospitalization time of the two groups of patients were compared. The operation success rate and the incidence of complications within 1 month after surgery were counted in the two groups of patients. Results. We are able to improve the quality of the images prior to medical diagnosis. The total effective rate of the observation group was 100.0%, which is higher than that of the control group (90.0%). The difference between the two groups was statistically significant (

P
<
0.05

). The adverse reaction rate in the observation group was 5.0%, which was lower than 17.5% in the control group. The difference between the two groups was statistically significant (

P
<
0.05

). The comparison results are then prepared. Conclusions. The image enhancement model based on deep learning is able to improve medical diagnosis which can assist radiologists to better locate the ureteral stones. Based on our method, double J tube placement under ureteroscopy has a significant effect on the treatment of ureteral stones during pregnancy, and it has good safety and is worthy of widespread application.
The Association between Nutritional Alterations and Oral Lesions in a Pediatric Population: An Epidemiological Study
Authors: Cazzolla Angela Pia , Cosola Michele Di , Ballini Andrea , Santacroce Luigi , Lovero Roberto , Testa Nunzio Francesco , Lacarbonara Vitantonio , De Franco Annarosa , Troiano Giuseppe , Cantore Stefania , Di Comite Mariasevera , Nocini Riccardo , Muzio Lorenzo Lo , Crincoli Vito , Dioguardi Mario
Published: October 2021

The oral conditions of an individual are the result of different factors, including the subject’s genotype, oral hygiene habits, the type of diet, and lifestyle, such as smoking. Nutrition in the first years of life can affect dental health for a long time. To prevent mouth diseases, it is also important to eliminate unfavorable eating behaviour and to amplify protective ones. Eating habits, especially in pediatric age, are an easily modifiable and controllable factor, and diet, in addition to influencing the health of the oral cavity, plays a fundamental role in systemic health. Indeed, a sugar‐rich diet can lead to conditions, such as diabetes, being overweight, and obesity. The present research was an epidemiological study, with the aim of highlighting some of the associations between nutrition and oral health. In particular, we studied those lesions of hard and soft tissues that are diagnosed most frequently by dentists: caries, enamel hypoplasia, periodontal disease, and aphotoxic lesions and their associations with nutritional deficiencies and excesses including proteins, vitamin A, vitamin D, B vitamins, and iron and calcium minerals. To perform this study, we recruited 70 patients from the pediatric and orthodontic clinics, aged between 3 and 15 years (y), with mean age of 10.4 y.o. The study was conducted by providing a questionnaire to pediatric patients’ (supported from their parents or guardians) on individual eating habits, followed by an accurate oral cavity specialistic examination. The nutritional data were processed by using Grana Padano Observatory (OGP) software, freely provided online by the OPG. The statistical tests performed were the chi‐square (χ2) for independence, and Cramér’s V test was used to evaluate the associations between eating habits and oral pathologies. The results showed that certain nutritional vitamin deficiencies and nutritional excesses were associated with definite oral pathologies.
A Multicenter Phase II Trial of Ipilimumab and Nivolumab in Unresectable or Metastatic Metaplastic Breast Cancer: Cohort 36 of Dual Anti–CTLA-4 and Anti–PD-1 Blockade in Rare Tumors (DART, SWOG S1609)
Authors: Adams Sylvia , Othus Megan , Patel Sandip Pravin , Miller Kathy D. , Chugh Rashmi , Schuetze Scott M. , Chamberlin Mary D. , Haley Barbara J. , Storniolo Anna Maria V. , Reddy Mridula P. , Anderson Scott A. , Zimmerman Collin T. , O'Dea Anne P. , Mirshahidi Hamid R. , Ahnert Jordi Rodon , Brescia Frank J. , Hahn Olwen , Raymond Jane M. , Biggs David D. , Connolly Roisin M. , Sharon Elad , Korde Larissa A. , Gray Robert J. , Mayerson Edward , Plets Melissa , Blanke Charles D. , Chae Young Kwang , Kurzrock Razelle
Published: October 2021

Purpose:

Metaplastic breast cancer (MpBC) is a rare aggressive subtype that responds poorly to cytotoxics. Median survival is approximately 8 months for metastatic disease. We report results for advanced MpBC treated with ipilimumab + nivolumab, a cohort of S1609 for rare cancers (DART: NCT02834013).

Patients and Methods:

Prospective, open-label, multicenter phase II (two-stage) trial of ipilimumab (1 mg/kg i.v. every 6 weeks) plus nivolumab (240 mg i.v. every 2 weeks) for advanced MpBC. Primary endpoint was objective response rate (ORR). Secondary endpoints included progression-free survival (PFS), overall survival (OS), and toxicity.

Results:

Overall, 17 evaluable patients enrolled. Median age was 60 years (26–85); median number of prior therapy lines was 2 (0–5). ORR was 18%; 3 of 17 patients achieved objective responses (1 complete, 2 partial responses; 2 spindle cell, 1 chondromyxoid histology), which are ongoing at 28+, 33+, and 34+ months, respectively. Median PFS and OS were 2 and 12 months, respectively. Altogether, 11 patients (65%) experienced adverse events (AE), including one grade 5 AE. Eight patients (47%) developed an immune-related AE (irAE), with adrenal insufficiency observed in all 3 responders. Responses occurred in tumors with low tumor mutational burden, low PD-L1, and absent tumor-infiltrating lymphocytes.

Conclusions:

The ipilimumab and nivolumab combination showed no new safety signals and met its primary endpoint with 18% ORR in advanced, chemotherapy-refractory MpBC. All responses are ongoing at >2 to almost 3 years later. The effect of ipilimumab and nivolumab was associated with exceptional responses in a subset of patients versus no activity. This combination warrants further investigation in MpBC, with special attention to understanding mechanism of action, and carefully designed to weigh against the significant risks of irAEs.
The Role of Ultrasonography in the Diagnosis and Decision Algorithm for the Management of Pneumothorax after Transbronchial Lung Cryobiopsy
Authors: Coelho David Barros , Boaventura Rita , Meira Leonor , Guimarães Susana , Moura Conceição Souto , Mota Patrícia , Melo Natália , Carvalho André , Pereira José Miguel , Magalhães Adriana , Morais António , Novais Bastos Helder
Published: October 2021

Background: Pneumothorax is one of the main complications of transbronchial lung cryobiopsy (TBLC). Chest ultrasound (CUS) is a radiation-free alternative method for pneumothorax detection. Objective: We tested CUS diagnostic accuracy for pneumothorax and assessed its role in the decision algorithm for pneumothorax management. Secondary objectives were to evaluate the post-procedure pneumothorax occurrence and risk factors. Methods: Eligible patients underwent TBLC, followed by chest X-ray (CXR) evaluation 2 h after the procedure, as our standard protocol. Bedside CUS was performed within 30 min and 2 h after TBLC. Pneumothorax by CUS was defined by the absence of lung sliding and comet-tail artefacts and confirmed with the stratosphere sign on M-mode. Pneumothorax size was determined through lung point projection on CUS and interpleural distance on CXR and properly managed according to clinical status. Results: Sixty-seven patients were included. Nineteen pneumothoraces were detected at 2 h after the procedure, of which 8 (42.1%) were already present at the first CUS evaluation. All CXR-detected pneumothoraces had a positive CUS detection. There were 3 discordant cases (κ = 0.88, 95% CI: 0.76–1.00, p < 0.001), which were detected by CUS but not by inspiration CXR. We calculated a specificity of 97.5% (95% CI: 86.8–99.9) and a sensitivity of 100% (95% CI: 87.2–100) for CUS. Pneumothorax rate was higher when biopsies were taken in 2 lobes and if histology had pleural representation. Final diagnosis was achieved in 79.1% of patients, with the most frequent diagnosis being hypersensitivity pneumonitis. Regarding patients with large-volume pneumothorax needing drainage, the rate of detection was similar between CUS and CRX. Conclusion: CUS can replace CXR in detecting the presence of pneumothorax after TBLC, and the lung point site can reliably indicate its size. This useful method optimizes time spent at the bronchology unit and allows immediate response in symptomatic patients, helping to choose optimal treatment strategies, while preventing ionizing radiation exposure.
Impact of Ghrelin on Ventricular Arrhythmia and Related Mechanism After Myocardial Infarction
Authors: Hu Zhengtao , Zhang Ting , Mei Yong , Sun Nan , Lv Kun , Wang Deguo
Published: October 2021

Introduction: Ghrelin is an endogenous peptide with potential protective effects on ischemic heart. Methods: Synthetic ghrelin was administered (100 μg·kg-1 subcutaneous injection, twice daily) for 4 weeks in a rat model of myocardial infarction (MI) with coronary artery occlusion. At the 5th week, electrocardiogram, monophasic action potentials and autonomic nerve function were evaluated. Cardiac tyrosine hydroxylase (TH) was determined by immunofluorescence staining. Results: MI significantly increased sympathetic nerve activity (SNA) and ventricular arrhythmias, and prolonged APD dispersion and APD alternans (p < 0.01). Ghrelin treatment significantly increased ventricular fibrillation threshold (VFT), shortened APD dispersion and APD alternans, inhibited SNA and promoted vagus nerve activities (p < 0.01). Ghrelin also markedly reversed abnormal expression of TH in the peri-infarcted area of the heart (p < 0.01). Discussion/Conclusion: Ghrelin provides a sustained electrophysiological protection by the increase of VFT and improvement of APD dispersion and APD alternans. The mechanism may be related to the regulation of autonomic nerve and sympathetic nerve remodeling. Thus, ghrelin represents a novel drug to prevent ventricular arrhythmia in ischemic heart disease.
The Efficiency of Temporary Uterine Artery Ligation on Prevention of the Bleeding in Cesarean Section
Authors: Erin Recep , İssak Ahmed , Baki Erin Kübra , Kulaksiz Deniz , Bayoğlu Tekin Yeşim
Published: October 2021

Objective: We aimed to evaluate the effect of temporary ligation of the uterine artery on postpartum bleeding during uncomplicated cesarean section. Design: This was a prospective, randomized, and controlled study. We recruited a total of 200 patients, including 100 cases and 100 controls. Methods: The bilateral uterine artery was temporarily clamped 2 cm below the uterine incision in the study group and compared with controls. Patient demographics, the amount of intraoperative bleeding, the duration of the operation, the closure time of the uterine incision, the need for additional uterotonics, the need for additional sutures, and the hemoglobin values before and after birth were assessed. Results: The mean value of the amount of bleeding in the clamped and control groups was 267.3 ± 131.8 mL and 390.2 ± 116.4 mL, respectively. The amount of bleeding was significantly decreased for clamped group (p < 0.001). A significant reduction occurred in the results of pre- and postoperative values of hemoglobin and hematocrit difference, operation duration, and the closing time of the uterine incision in the experimental group which has temporary uterine artery clamping. Limitations: The cases of recurrent cesareans were not included in this study. Conclusion: Temporary uterine artery ligation can be used to reduce the amount of bleeding during uncomplicated cesarean delivery and prevent postpartum hemorrhage.
Endoscopic Ureteral Dilation Balloon Catheter for a Difficult Ureter: A New Novel Approach
Authors: Li Jun , Zheng Zhongwei , Sheng Chang , Xia Qier
Published: October 2021

Objectives: This study aims to assess the safety and efficacy of INNOVEXTM ureteral dilation balloon catheter to promote the likelihood of passing the ureter to complete primary ureteroscopy (URS). Methods: This was a prospective case series of patients during URS between August 2018 and January 2020 at the Pudong New District People’s Hospital. A 12-Fr INNOVEXTM ureteral dilation balloon catheter was used to dilate the ureter when a 5° Wolf 6.0/7.5-Fr ureteroscope encounters an unpredictable hindrance to retrograde access for ureteral stones. Patients with documented ureteral strictures, radiation therapy, or urothelial cancer were excluded from the analysis. The primary outcomes were to characterize the use, safety, and efficacy of ureteral dilation balloon catheter to promote stone treatment during URS. Results: Eight hundred and sixty-two patients underwent primary URS of ureteral stones over the study period. The use of a ureteral dilation balloon catheter to promote ureteral access was performed in 65 (7.54%) cases and effectively allowed completion of the procedure in 58 (89.23%) cases. No ureteral perforation and access loss occurred during the operation. Seven patients required ureteral stent placement for passive ureteral dilation, with definitive stone treatment later. Postoperative radiographic follow-up was available for 63 (96.92%) cases, and no ureteral stenosis was observed after balloon dilation. Conclusion: The use of a new ureteral dilation balloon catheter before endoscopic treatment of ureteral stones was associated with a high success rate and few complications. The convenient use method under direct vision at the whole process may increase the willingness of doctors to use it. In addition, it may reduce the need for secondary procedures for patients undergoing URS to manage ureteral stones.
Evaluation of the Postoperative Analgesic Effect of 2 Different Blocks after Pediatric Circumcision Surgery
Authors: Mutlu Mehmet , Turkmen Seray
Published: October 2021

Background: Circumcision is a painful day-case surgery. Regional anesthesia techniques are used effectively for anesthesia and postoperative analgesia after pediatric circumcision surgery. Objective: Our prospective observational study aimed to compare postoperative analgesic efficiency of a dorsal penile nerve (DPN) block with a transversus abdominis plane (TAP) block after male pediatric circumcision surgery and complications related to each block. Study Design: We enrolled 80 male children under the age of 10 years with American Society of Anesthesiologists I–II status scheduled for circumcision in this prospective observational study. A TAP or DPN block was performed after induction of general anesthesia before surgery with ultrasound (US) guidance. Postoperative pain was assessed with Faces Pain Scale-Revised and the Faces, Legs, Activity, Cry and Consolability scale. Results: There was no statistically significant difference between the groups regarding 30-min pain score levels (p > 0.05). But, the 1st hour, 2nd hour, 6th hour, 12th hour, and 24th-hour pain score levels in the TAP block group were statistically significantly higher than those of the DPN block group (p < 0.05). The 1st rescue analgesic requirement in the TAP block group was at the 6th hour postoperative. There was no need for rescue analgesia in the DPN block group during the postoperative 24-h follow-up. Discussion: A US-guided DPN block provided effective and long-lasting postoperative analgesia for circumcision surgery with statistically significantly lower pain score levels than a US-guided TAP block. Conclusion: This study found that a TAP block alone was insufficient to provide adequate postoperative analgesia for circumcision surgery compared to DPN block.
Departments of Pediatrics Approach at the Beginning of the COVID-19 Pandemic
Authors: Vala Beatriz Simões , Costa Mariana Lopes , Aquino Joana , Xavier Bilhota
Published: October 2021

Introduction: The novel coronavirus pandemic poses a challenge to healthcare systems’ balance. Since children apparently have milder disease courses, COVID-19 guidelines were not easily adapted to pediatrics. We intend to characterize how the national departments of pediatrics adapted to the pandemic at the beginning and describe the measures that were taken to protect healthcare workers. Methods: An unvalidated online questionnaire was sent to all departments of pediatrics directors of Portuguese public health system hospitals regarding course of actions taken between April and May 2020 to face the new coronavirus pandemic. Neonatology units were excluded. Results: Thirty-eight questionnaires were included (93% of public health system departments). All departments divided the pediatric emergency unit into non-COVID-19 and COVID-19 areas: 68% in different areas, 47% divided the same space with a physical barrier and 16% with a line on the floor. Healthcare workers were divided into non-COVID-19 and COVID-19 teams in 71% of the departments. Personal protective equipment mostly used in COVID-19 areas consisted of face shield/goggles (97%) and respirators (95%). Others wore surgical masks (8%). The main clinical criteria for testing were Direção-Geral da Saúde criteria (84%). Presential appointments were maintained in 68% of departments with selected follow-up (81%) and priority-first appointments (73%). Discussion: National departments of pediatrics faced the pandemic differently and measures taken in the emergency department were more similar. Personal protective equipment was adequate in all wards with occasional overuse, considering national and international guidelines.
Developing Historical Competency: Teaching German History Through History Films At University Putra Malaysia (BA German Programme)
Authors: Schaar Torsten , Wen Chang Shi
Published: October 2021

History films personalize, dramatize and emotionalize historical events and characters. They revive the past by exemplifying it in the present, engage ongoing discourses of history and as a result have proven to be the most influential medium in conveying history to large audiences. History films are regarded as an attractive, motivating and efficient (supplementary) teaching and learning medium in history as well as in foreign language classes. As part of the course “Historical Survey of Germany” (BA German-programme at University Putra Malaysia) history film projects on important periods and events in German history were conducted. The article introduces a film project on World War II and describes the pedagogical approach which aims to develop three core competencies of historical understanding – Content Knowledge, Historical Empathy/Perspective Recognition and Narrative Analysis. It discusses selected general findings provided as qualitative data in group and individual assignments. While the responses to questions related to Content Knowledge and Narrative Analysis show that students achieved higher competency levels, the participants showed shortcomings in the rational examination of historical characters, their perspectives and motivations for their actions. Time, practice and guidance can be identified as key factors in developing historical literacy competencies further.
Postprocedural Troponin Elevation and Mortality After Transcatheter Aortic Valve Implantation
Authors: Schindler Matthias , Stöckli Florin , Brütsch Rico , Jakob Philipp , Holy Erik , Michel Jonathan , Manka Robert , Vogt Paul , Templin Christian , Kasel Markus , Ruschitzka Frank , Stähli Barbara E.
Published: October 2021

Background

This study sought to investigate the role of postprocedural troponin elevations in mortality prediction after transcatheter aortic valve implantation and to define the threshold at which clinically relevant postprocedure myocardial injury determines mortality.

Methods and Results

A total of 1333 consecutive patients with transcatheter aortic valve implantation with available postprocedural high‐sensitivity cardiac troponin T measurements were included in the analysis. The threshold at which postprocedure myocardial injury determines long‐term mortality was identified using restricted cubic spline analysis. A >18.3‐fold increase of troponin above the upper reference limit was identified as threshold for relevant postprocedure myocardial injury. Associations remained significant in a landmark analysis between 30 days and 2 years (hazard ratio [HR], 1.61, [95% CI, 1.13–2.28];
P
=0.01), after adjusting for known confounders (adjusted HR, 1.90 [95% CI, 1.40–2.57];
P
<0001), and in subgroups of patients with coronary artery disease (adjusted HR, 2.17 [95% CI, 1.44–3.29];
P
<0.001), renal dysfunction (adjusted HR, 1.88 [95% CI, 1.35–2.62];
P
<0.001), and intermediate/high surgical risk (adjusted HR, 2.70 [95% CI, 1.40–5.22];
P
=0.003).

Conclusions

This study determined a troponin threshold for the identification of patients at increased mortality risk after transcatheter aortic valve implantation. The proposed definition of postprocedure myocardial injury advances risk stratification in patients with transcatheter aortic valve implantation and may assist in postprocedural patient management.
Solar Activity Is Associated With Diastolic and Systolic Blood Pressure in Elderly Adults
Authors: Wang Veronica A. , Zilli Vieira Carolina L. , Garshick Eric , Schwartz Joel D. , Garshick Michael S. , Vokonas Pantel , Koutrakis Petros
Published: October 2021

Background

Since solar activity and related geomagnetic disturbances modulate autonomic nervous system activity, we hypothesized that these events would be associated with blood pressure (BP).

Methods and Results

We studied 675 elderly men from the Normative Aging Study (Boston, MA) with 1949 BP measurements between 2000 and 2017. Mixed‐effects regression models were used to investigate the association of average 1‐day (ie, day of BP measurement) to 28‐day interplanetary magnetic field intensity, sunspot number, and a dichotomized measure of global geomagnetic activity (K
p
index) in 4‐day increments with diastolic and systolic BP. We adjusted for meteorological conditions and other covariates associated with BP, and in additional models adjusted for ambient air pollutants (particulate matter with an aerodynamic diameter ≤2.5 µm, black carbon, and particle number) and ambient particle radioactivity. There were positive associations between interplanetary magnetic field, sunspot number, and K
p
index and BP that were greatest with these exposures averaged over 16 through 28 days before BP measurement. An interquartile range increase of 16‐day interplanetary magnetic field and sunspot number and higher K
p
index were associated with a 2.5 (95% CI, 1.7‒3.2), 2.8 (95% CI, 2.1‒3.4), and 1.7 (95% CI, 0.8‒2.5) mm Hg increase, respectively, for diastolic BP as well as a 2.1 (95% CI, 0.7‒3.6), 2.7 (95% CI, 1.5‒4.0), and 0.4 (95% CI, −1.2 to 2.1) mm Hg increase, respectively, for systolic BP. Associations remained after adjustment for ambient air pollutants and ambient particle radioactivity.

Conclusions

Solar activity and solar‐driven geomagnetic disturbances were positively associated with BP, suggesting that these natural phenomena influence BP in elderly men.
Pragmatic Weight Management Program for Patients With Obesity and Heart Failure With Preserved Ejection Fraction
Authors: El Hajj Elia C. , El Hajj Milad C. , Sykes Brandon , Lamicq Melissa , Zile Michael R. , Malcolm Robert , O’Neil Patrick M. , Litwin Sheldon E.
Published: October 2021

Background

Obesity is associated with heart failure with preserved ejection fraction (HFpEF). Weight loss can improve exercise capacity in HFpEF. However, previously reported methods of weight loss are impractical for widespread clinical implementation. We tested the hypothesis that an intensive lifestyle modification program would lead to relevant weight loss and improvement in functional status in patients with HFpEF and obesity.

Methods and Results

Patients with ejection fraction >45%, at least 1 objective criteria for HFpEF, and body mass index ≥30 kg/m
2
were offered enrollment in an established 15‐week weight management program that included weekly visits for counseling, weight checks, and provision of meal replacements. At baseline, 15 weeks, and 26 weeks, Minnesota Living With Heart Failure score, 6‐minute walk distance, echocardiography, and laboratory variables were assessed. A total of 41 patients completed the study (mean body mass index, 40.8 kg/m
2
), 74% of whom lost >5% of their baseline body weight following the 15‐week program. At 15 weeks, mean 6‐minute walk distance increased from 223 to 281 m (
P
=0.001) and then decreased to 267 m at 26 weeks. Minnesota Living With Heart Failure score improved from 59.9 to 37.3 at 15 weeks (
P
<0.001) and 37.06 at 26 weeks. Changes in weight correlated with change in Minnesota Living With Heart Failure score (
r
=0.452;
P
=0.000) and 6‐minute walk distance (
r
=−0.388;
P
<0.001).

Conclusions

In a diverse population of patients with obesity and HFpEF, clinically relevant weight loss can be achieved with a pragmatic 15‐week program. This is associated with significant improvements in quality of life and exercise capacity.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02911337.
Scribal Errors and “Layout Genetics” in Dunhuang Buddhist Manuscripts
Authors: Moretti Costantino
Published: October 2021

This essay explores the mechanisms linked to the production of specific mistakes and textual alterations in Dunhuang Buddhist manuscripts, which provide information of codicological interest, in particular on the formal characteristics of a manuscript archetype, on its production phases/techniques, and its formal evolution. It also draws attention to the importance of surveying the alterations in the arrangement of textual and paratextual elements by means of a structural analysis revealing manuscript filiation based on formal characteristics, an approach that can help to explore not only the codicological evolution of a book in manuscript form, but also its philological ties with branches of a specific tradition.
Clothing, Conformity, and Power: Garment Imagery in the Book of Esther
Authors: Quick Laura , Lyell Ellena
Published: October 2021

Recent scholarship has shown a burgeoning interest in the narrative functions and implications of references to dress and adornment in the Hebrew Bible. Yet the many references to the various clothing items and associated acts of dressing and undressing in the book of Esther have been less explored. In fact, the book of Esther weaves a complex tapestry of garment imagery, and untangling this tapestry is essential to properly interpreting this text. Through dress, characters can communicate their conformity to certain conventional expectations, affecting the ways in which other characters relate and behave towards them. Characters can utilize dress to express their protest, or conversely hide their true intentions. Crucially, differences in clothing develop distinctions between the power and status of the various characters. Clothing therefore has discrete and important functions in the book of Esther, providing new access to understanding characterisation and plot.