bluuebunny/crossref_metadata_2025 huggingface dataset:
Gene Instability-Related lncRNA Prognostic Model of Melanoma Patients via Machine Learning Strategy
Authors: Yan Kexin , Wang Yutao , Shao Yining , Xiao Ting
Published: May 2021

Background. Melanoma is a common tumor characterized by a high mortality rate in its late stage. After metastasis, current treatment methods are relatively ineffective. Many studies have shown that long noncoding RNA (lncRNA) may participate in gene mutation and genomic instability in cancer. Methods. We downloaded transcriptome data, mutation data, and clinical follow-up data of melanoma patients from The Cancer Genome Atlas. We divided samples into groups according to the number of somatic cell mutations and then performed a differential analysis to screen out the differentially expressed genes. We then divided samples into genomic unstable and genomic stable groups. We compared lncRNA expression profiles in these groups and constructed a protein-coding genes network coexpressed with selected lncRNA to analyze the pathways enriched by these genes. Two machine learning methods, least absolute shrinkage and selector operation (LASSO) and support vector machine-recursive feature elimination (SVM-RFE), were applied to conduct the lncRNA-related prognostic model. Afterward, we performed survival analysis, risk correlation analysis, independent prognostic analysis, and clinical subgroup model validation. Finally, through wound healing assay and transwell assay, the function of AATBC was verified by A375 cell lines. Results. We screened 61 prognostic-related lncRNAs and constructed an lncRNA-mRNA coexpression network based on these lncRNAs. Seven lncRNAs were selected as common characteristic factors based on the two machine learning methods. The model formula was as follows: risk score = 0.085

∗

AATBC + 0.190

∗

AC026689.1−0.117

∗

AC083799.1 + 0.036

∗

AC091544.6−0.039

∗

LINC01287−0.291

∗

SPRY4.AS1 + 0.056

∗

ZNF667.AS1. The seven lncRNAs in this formula are key candidates. Cell experiments have verified that knocking down AATBC in A375 cell lines can reduce the proliferation and invasion ability of melanoma cells. Conclusion. The lncRNA we identified provides a new way to study lncRNA’s role in the genomic instability of melanoma. Our findings may provide essential candidate biomarkers for the diagnosis and treatment of melanoma.
Cancer-Associated Fibroblasts Regulate Bladder Cancer Invasion and Metabolic Phenotypes through Autophagy
Authors: Dong Dahai , Yao Yu , Song Jinlei , Sun Lijiang , Zhang Guiming
Published: May 2021

Recently, both cancer-associated fibroblasts (CAFs) and autophagy have been proven to play an important role in tumor development, including bladder cancer (BCa). However, the real mechanisms remain largely unclear. Here, we reconstruct a mimic tumor microenvironment to explore the interaction between CAFs and the BCa cell line T24 using a coculture system. Autophagy in CAFs was induced or inhibited by rapamycin or siRNA, respectively. After coculture with CAFs, T24 cell proliferation, invasion, and aerobic glycolysis were tested in vitro. Rapamycin induced and siAtg5 inhibited autophagy in CAFs. Enhanced autophagy in CAFs promoted cell proliferation and invasion in T24 cells in vitro, while there was no significant difference between the autophagy-inhibited group and the controls. Lactate concentration was elevated in both rapamycin-treated and siAtg5-treated groups compared with the control group. In addition, the expression levels of MCT1, MCT4, HK2, SLC2A1, and MMP-9 were all increased in T24 cells in the autophagy-enhanced group. Our results indicated that CAFs could regulate BCa invasion and metabolic phenotypes through autophagy, providing us with new alternative treatments for BCa in the future.
Thermal Structure Strength Analysis of Nozzle of Solid Rocket Motor with the Coupled Algorithm
Authors: Wang Chunguang , Tian Weiping , Zhang Kaining
Published: May 2021

In order to achieve the thermal structural integrity analysis of the solid rocket motor nozzle accurately and efficiently, the multifield (flow-thermal-mechanical) coupled numerical investigation was carried out based on the mesh-based parallel code coupled interface. The numerical simulation process and finite element model of the coupled algorithm and engineering algorithm were obtained, while the physical model was simplified appropriately. The coupled interface parameters, internal flow field, temperature field, and stress field of the coupled algorithm were compared with the engineering algorithm results, and the effectiveness and accuracy of the numerical simulation were validated. The numerical investigations shown that both the temperature field and stress field obtained by the coupled algorithm were slightly lower than which obtained by the engineering algorithm. These were considered to be impacted by the Bartz empirical formula and the one-dimensional isentropic flow assumption. Further experimental investigations shown that the exterior surface temperature and strain of the nozzle throat obtained by the coupled algorithm were much closer to the experimental results, which further verified the accuracy of the coupled algorithm.
Locomotion Mode Recognition with Inertial Signals for Hip Joint Exoskeleton
Authors: Du Gang , Zeng Jinchen , Gong Cheng , Zheng Enhao
Published: May 2021

Recognizing locomotion modes is a crucial step in controlling lower-limb exoskeletons/orthoses. Our study proposed a fuzzy-logic-based locomotion mode/transition recognition approach that uses the onrobot inertial sensors for a hip joint exoskeleton (active pelvic orthosis). The method outputs the recognition decisions at each extreme point of the hip joint angles purely relying on the integrated inertial sensors. Compared with the related studies, our approach enables calibrations and recognition without additional sensors on the feet. We validated the method by measuring four locomotion modes and eight locomotion transitions on three able-bodied subjects wearing an active pelvic orthosis (APO). The average recognition accuracy was 92.46% for intrasubject crossvalidation and 93.16% for intersubject crossvalidation. The average time delay during the transitions was 1897.9 ms (28.95% one gait cycle). The results were at the same level as the related studies. On the other side, the study is limited in the small sample size of the subjects, and the results are preliminary. Future efforts will be paid on more extensive evaluations in practical applications.
Natural Phytochemicals as Novel Therapeutic Strategies to Prevent and Treat Parkinson’s Disease: Current Knowledge and Future Perspectives
Authors: Balakrishnan Rengasamy , Azam Shofiul , Cho Duk-Yeon , Su-Kim In , Choi Dong-Kug
Published: May 2021

Parkinson’s disease (PD) is the second‐most common neurodegenerative chronic disease affecting both cognitive performance and motor functions in aged people. Yet despite the prevalence of this disease, the current therapeutic options for the management of PD can only alleviate motor symptoms. Research has explored novel substances for naturally derived antioxidant phytochemicals with potential therapeutic benefits for PD patients through their neuroprotective mechanism, targeting oxidative stress, neuroinflammation, abnormal protein accumulation, mitochondrial dysfunction, endoplasmic reticulum stress, neurotrophic factor deficit, and apoptosis. The aim of the present study is to perform a comprehensive evaluation of naturally derived antioxidant phytochemicals with neuroprotective or therapeutic activities in PD, focusing on their neuropharmacological mechanisms, including modulation of antioxidant and anti‐inflammatory activity, growth factor induction, neurotransmitter activity, direct regulation of mitochondrial apoptotic machinery, prevention of protein aggregation via modulation of protein folding, modification of cell signaling pathways, enhanced systemic immunity, autophagy, and proteasome activity. In addition, we provide data showing the relationship between nuclear factor E2‐related factor 2 (Nrf2) and PD is supported by studies demonstrating that antiparkinsonian phytochemicals can activate the Nrf2/antioxidant response element (ARE) signaling pathway and Nrf2‐dependent protein expression, preventing cellular oxidative damage and PD. Furthermore, we explore several experimental models that evaluated the potential neuroprotective efficacy of antioxidant phytochemical derivatives for their inhibitory effects on oxidative stress and neuroinflammation in the brain. Finally, we highlight recent developments in the nanodelivery of antioxidant phytochemicals and its neuroprotective application against pathological conditions associated with oxidative stress. In conclusion, naturally derived antioxidant phytochemicals can be considered as future pharmaceutical drug candidates to potentially alleviate symptoms or slow the progression of PD. However, further well‐designed clinical studies are required to evaluate the protective and therapeutic benefits of phytochemicals as promising drugs in the management of PD.
Some New Variants of Relative Regularity via Regularly Closed Sets
Authors: Raina Sehar Shakeel , Das A. K.
Published: May 2021

Every topological property can be associated with its relative version in such a way that when smaller space coincides with larger space, then this relative property coincides with the absolute one. This notion of relative topological properties was introduced by Arhangel’skii and Ganedi in 1989. Singal and Arya introduced the concepts of almost regular spaces in 1969 and almost completely regular spaces in 1970. In this paper, we have studied various relative versions of almost regularity, complete regularity, and almost complete regularity. We investigated some of their properties and established relationships of these spaces with each other and with the existing relative properties.
Nomogram for Predicting the Relationship between the Extent of Visceral Pleural Invasion and Survival in Non-Small-Cell Lung Cancer
Authors: Wang Fan , Li Pei , Li Fengsen
Published: May 2021

Objective. Although visceral pleural invasion (VPI) has already been incorporated into the TNM staging system, few studies have been conducted to evaluate the prognostic value of the extent of VPI for the survival of non-small-cell lung cancer (NSCLC) patients. Thus, we utilized the Surveillance, Epidemiology, and End Results (SEER) database to assess the correlation between the extent of VPI and survival in NSCLC. Methods. We identified and incorporated the extent of VPI to build a prognostic nomogram in this study. Patients in the SEER database diagnosed with NSCLC (n = 87,045) from 2010 to 2015 were further analyzed and randomly assigned into either the training group (n = 60,933) or validation group (n = 26,112). Clinical variables were calculated by means of multivariate Cox regressions and incorporated into the predictive model. Subsequently, the accuracy and discrimination of nomogram were further assessed through the concordance index (C-index), calibration curves, and Kaplan–Meier curves. Results. Multivariate analysis demonstrated that the extent of visceral pleural invasion was an independent and unfavorable prognostic factor. The C-indexes of the training and validation groups were 0.772 (95% CI: 0.770–0.774) and 0.769 (95% CI: 0.765–0.773), respectively, which revealed that the nomogram had sufficient credibility and stable predictive accuracy. The calibration curve displayed consistency between the actual and predictive values in both training and validation groups. Conclusion. The prognostic nomogram with the extent of VPI could offer an accurate risk evaluation for patients with NSCLC. Independent external validation of this research should be conducted in the future.
Analysis of Tai Chi Ideological and Political Course in University Based on Big Data and Graph Neural Networks
Authors: Li Chun yan , Zheng Lu
Published: May 2021

Tai Chi martial arts education is one of the components of school education. Its educational value is not only to require students to master basic Tai movement technical skills and improve their physical fitness but also to bring students’ ideological progress and cultivate students to respect teachers and lectures. Excellent moral qualities such as politeness, keeping promises, observing the rules, and acting bravely, as well as the cultivation of the spirit of unity and cooperation, and the quality of will also have a certain meaning. However, the scientific Tai Chi ideological and political courses and the construction of Wude education interactive classrooms lack relevant research. Therefore, this article builds a Tai Chi ideological and political interactive classroom system based on big data technology and graph neural network. First, the spatio-temporal graph convolutional neural network is used to reason about the relationship between Tai Chi action categories and strengthen the low-dimensional features of semantic categories and their co-occurrence expressions used for semantic enhancement of current image features. In addition, in order to ensure the efficiency of the Tai Chi scene analysis network, an efficient dual feature extraction basic module is proposed to construct the backbone network, reducing the number of parameters of the entire network and the computational complexity. Experiments show that this method can obtain approximate results, while reducing the amount of floating-point operations by 42.5% and the amount of parameters by 50.2% compared with the work of the same period, and achieves a better balance of efficiency and performance. Secondly, based on the big data of historical Tai Chi classrooms, this article constructs an interactive classroom system that can effectively improve the quality of Tai Chi ideological and political courses.
Group Invariant Solutions for Flow and Heat Transfer of Power-Law Nanofluid in a Porous Medium
Authors: Javaid Saba , Aziz Asim
Published: May 2021

The present work covers the flow and heat transfer model for the power-law nanofluid in the presence of a porous medium over the penetrable plate. The flow is caused by the impulsive movement of the plate embedded in Darcy’s type porous medium. The flow and heat transfer model has been examined with the effect of linear thermal radiation and the internal heat source or sink in the flow regime. The Rosseland approximation is utilized for the optically thick nanofluid. To form the closed-form solutions for the governing partial differential equations of conservation of mass, momentum, and energy, the Lie symmetry analysis is used to get the reductions of governing equations and to find the group invariants. These invariants are then utilized to obtain the exact solution for all three cases, i.e., shear thinning fluid, Newtonian fluid, and shear thickening fluid. In the end, all solutions are plotted for thecu-water nanofluid and discussed briefly for the different emerging flow and heat transfer parameters.
Toll-Like Receptor Homolog CD180 Expression Is Diminished on Natural Autoantibody-Producing B Cells of Patients with Autoimmune CNS Disorders
Authors: Hayden Zsófia , Erdő-Bonyár Szabina , Bóné Beáta , Balázs Noémi , Bodó Kornélia , Illes Zsolt , Berki Timea , Simon Diána
Published: May 2021

Purpose. Decreased expression of TLR homolog CD180 in peripheral blood B cells and its potential role in antibody production have been described in autoimmune diseases. Effectiveness of anti-CD20 therapy in neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) strengthens the role of B cells in the pathogenesis. Therefore, we aimed to investigate the CD180 expression of peripheral blood B cell subsets in NMOSD and MS patients and analyze the levels of natural anti-citrate synthase (CS) IgG autoantibodies and IgG antibodies induced by bacterial infections reported to play a role in the pathogenesis of NMOSD or MS. Methods. We analyzed the distribution and CD180 expression of peripheral blood B cell subsets, defined by CD19/CD27/IgD staining, and measured anti-CS IgM/G natural autoantibody and antibacterial IgG serum levels in NMOSD, RRMS, and healthy controls (HC). Results. We found decreased naïve and increased memory B cells in NMOSD compared to MS. Among the investigated four B cell subsets, CD180 expression was exclusively decreased in CD19+CD27+IgD+ nonswitched (NS) memory B cells in both NMOSD and MS compared to HC. Furthermore, the anti-CS IgM natural autoantibody serum level was lower in both NMOSD and MS. In addition, we found a tendency of higher anti-CS IgG natural autoantibody levels only in anti-Chlamydia IgG antibody-positive NMOSD and MS patients. Conclusions. Our results suggest that reduced CD180 expression of NS B cells could contribute to the deficient natural IgM autoantibody production in NMOSD and MS, whereas natural IgG autoantibody levels show an association with antibacterial antibodies.
Feedback Control of Injection Rate of the Injection Molding Machine Based on PID Improved by Unsaturated Integral
Authors: Yang An , Guo Weigang , Han Tianlong , Zhao Congrong , Zhou Hongwei , Cai Jianping
Published: May 2021

In conventional proportional–integral–derivative (PID) control, the integral term occupies a significant amount of controller memory, which prolongs the calculation time. The integral term easily leads to overshooting and oscillation, while the derivative term reduces the controller′s anti‐interference ability. In view of these problems, a PID expression with a recurrence relationship was derived, and the integral and differential terms of the conventional PID model were improved using an unsaturated integral and passivation differential to achieve a good control effect. Then, the improved PID was applied to the injection speed control of an injection molding machine, which is usually controlled using conventional PID control that featured difficulty in mathematical modeling, a nonlinear relationship between the input and the output, and high system complexity. Taking an injection molding machine as the control object, the transfer function of the injection system was constructed. Then, the improved PID was simulated using Matlab/Simulink. Lastly, the improved PID was verified using experiments. The simulation and the experimental results showed that the control model had a rapid response, no overshoot, and a high precision.
Electrospun Core-Shell Hollow Structure Cocatalysts for Enhanced Photocatalytic Activity
Authors: Guo Fengyun , Guo Ziyi , Gao Lei , Qi Dongming , Yue Guichu , Wang Nü , Zhao Yong , Li Ni , Xiong Jie
Published: May 2021

The core-shell NaYF4/Yb/Tm/TiO2 hollow composite fibers were prepared by coaxial electrospinning and high-temperature calcination. The composite fibers exhibit excellent photocatalytic activity under the dual synergistic of regulating the core-shell hollow microstructure and the composition by doping nanoparticles. Compared with commercial P25 and hollow fiber without nanoparticles, the degradation efficiency of rhodamine B using the core-shell composite fiber was significantly improved up to 99%. Moreover, the nanoparticles in the composite fibers can exist stably and maintain good structure and photocatalytic activity after repeated use. Therefore, the composite fiber has a wide application prospect in photocatalytic degradation of organic pollutants.
Energy Management of Fuel Cell Vehicles Based on Model Prediction Control Using Radial Basis Functions
Authors: Xin Weiwei , Zheng Weiguang , Qin Jirong , Wei Shangjun , Ji Chunyu
Published: May 2021

Energy management strategies can improve fuel cell hybrid electric vehicles’ dynamic and fuel economy, and the strategies based on model prediction control show great advantages in optimizing the power split effect and in real time. In this paper, the influence of prediction horizon on prediction error, fuel consumption, and real time was studied in detail. The framework of energy management strategy was proposed in terms of the model prediction control theory. The radial basis function neural network was presented as the predictor to obtain the short‐term velocity in the future. A dynamic programming algorithm was applied to obtain optimized control laws in the prediction horizon. Considering the onboard controller’s real‐time performance, we established a simple fuel cell vehicle mathematical model for simulation. Different prediction horizons were adopted on UDDS and HWFET to test the influence on prediction and energy management strategy. Simulation results showed the strategy performed well in fuel economy and real‐time performance, and the prediction horizon of around 20 s was appropriate for this strategy.
LSD1 and Aberrant DNA Methylation Mediate Persistence of Enteroendocrine Progenitors That Support BRAF-Mutant Colorectal Cancer
Authors: Miller Samuel A. , Policastro Robert A. , Sriramkumar Shruthi , Lai Tim , Huntington Thomas D. , Ladaika Christopher A. , Kim Daeho , Hao Chunhai , Zentner Gabriel E. , O'Hagan Heather M.
Published: May 2021

Despite the connection of secretory cells, including goblet and enteroendocrine (EEC) cells, to distinct mucus-containing colorectal cancer histologic subtypes, their role in colorectal cancer progression has been underexplored. Here, our analysis of The Cancer Genome Atlas (TCGA) and single-cell RNA-sequencing data demonstrates that EEC progenitor cells are enriched in BRAF-mutant colorectal cancer patient tumors, cell lines, and patient-derived organoids. In BRAF-mutant colorectal cancer, EEC progenitors were blocked from differentiating further by DNA methylation and silencing of NEUROD1, a key gene required for differentiation of intermediate EECs. Mechanistically, secretory cells and the factors they secrete, such as trefoil factor 3, promoted colony formation and activation of cell survival pathways in the entire cell population. Lysine-specific demethylase 1 (LSD1) was identified as a critical regulator of secretory cell specification in vitro and in a colon orthotopic xenograft model, where LSD1 loss blocks formation of EEC progenitors and reduces tumor growth and metastasis. These findings reveal an important role for EEC progenitors in supporting colorectal cancer.

Significance:

This study establishes enteroendocrine progenitors as a targetable population that promotes BRAF-mutant colorectal cancer and can be blocked by LSD1 inhibition to suppress tumor growth.
Personalized Single-Cell Proteogenomics to Distinguish Acute Myeloid Leukemia from Nonmalignant Clonal Hematopoiesis
Authors: Dillon Laura W. , Ghannam Jack , Nosiri Chidera , Gui Gege , Goswami Meghali , Calvo Katherine R. , Lindblad Katherine E. , Oetjen Karolyn A. , Wilkerson Matthew D. , Soltis Anthony R. , Sukumar Gauthaman , Dalgard Clifton L. , Thompson Julie , Valdez Janet , DeStefano Christin B. , Lai Catherine , Sciambi Adam , Durruthy-Durruthy Robert , Llanso Aaron , Gulati Saurabh , Wang Shu , Ooi Aik , Dagur Pradeep K. , McCoy J. Philip , Burr Patrick , Li Yuesheng , Hourigan Christopher S.
Published: May 2021

Genetic mutations associated with acute myeloid leukemia (AML) also occur in age-related clonal hematopoiesis, often in the same individual. This makes confident assignment of detected variants to malignancy challenging. The issue is particularly crucial for AML posttreatment measurable residual disease monitoring, where results can be discordant between genetic sequencing and flow cytometry. We show here that it is possible to distinguish AML from clonal hematopoiesis and to resolve the immunophenotypic identity of clonal architecture. To achieve this, we first design patient-specific DNA probes based on patient's whole-genome sequencing and then use them for patient-personalized single-cell DNA sequencing with simultaneous single-cell antibody–oligonucleotide sequencing. Examples illustrate AML arising from DNMT3A- and TET2-mutated clones as well as independently. The ability to personalize single-cell proteogenomic assessment for individual patients based on leukemia-specific genomic features has implications for ongoing AML precision medicine efforts.

Significance:

This study offers a proof of principle of patient-personalized customized single-cell proteogenomics in AML including whole-genome sequencing–defined structural variants, currently unmeasurable by commercial “off-the-shelf” panels. This approach allows for the definition of genetic and immunophenotype features for an individual patient that would be best suited for measurable residual disease tracking.
Quality of Life Effects of an Oral Fixed Combination of Netupitant and Palonosetron in Chemotherapy-Induced Nausea and Vomiting Prevention: Real-World Evidence in Patients with Breast Cancer Receiving Anthracycline-Cyclophosphamide-Based Chemotherapy
Authors: Schilling Jörg , Kurbacher Christian M. , Hanusch Claus , Busch Steffi , Holländer Martin , Kreiss-Sender Janine , Rezek Daniela , Flahaut Elisa , Karthaus Meinolf
Published: May 2021

Introduction: In a prospective non-interventional study involving 2,173 patients, we showed that use of the oral fixed combination of netupitant 300 mg and palonosetron 0.5 mg (NEPA) for prevention of chemotherapy (Ctx)-induced nausea and vomiting has beneficial effects on the quality of life (QoL) of patients with various types of cancers receiving highly or moderately emetogenic Ctx. Here, we report on the effects on QoL, effectiveness, and tolerability of NEPA in patients with breast cancer exposed to anthracycline-cyclophosphamide (AC)-based Ctx. Methods: This is a post hoc subanalysis of a prospective non-interventional study in 1,197 patients with breast cancer receiving up to 3 cycles of doxorubicin or epirubicin plus cyclophosphamide and NEPA. NEPA administration was per the summary of product characteristics. Results: In cycle 1 of Ctx, a large proportion of patients (84%) reported “no impact on daily life” (NIDL) due to vomiting; 53% of patients reported NIDL due to nausea. The complete response rate was 86/88/81% in the acute/delayed/overall phase in cycle 1, and NEPA was well tolerated throughout the study. Conclusion: The real-world beneficial effects of NEPA prophylaxis on QoL were confirmed for patients with breast cancer receiving AC. NEPA was effective with a good safety profile in this patient population in clinical practice.
Performance versus Risk Factor-Based Approaches to Coronary Artery Disease Screening in Waitlisted Kidney Transplant Candidates
Authors: Cheng Xingxing S. , Watford Daniel J. , Arashi Hiroyuki , Stedman Margaret R. , Chertow Glenn M. , Tan Jane C. , Fearon William F.
Published: May 2021

Introduction: Current screening algorithms for coronary artery disease (CAD) before kidney transplantation result in many tests but few interventions. Objective: The aim of this study was to study the utility of 6-minute walk test (6MWT), an office-based test of cardiorespiratory fitness, for risk stratification in this setting. Methods: We enrolled 360 patients who are near the top of the kidney transplant waitlist at our institution. All patients underwent CAD evaluation irrespective of 6MWT results. We examined the association between 6MWT and time to CAD-related events (defined as cardiac death, revascularization, nonfatal myocardial infarction, and removal from the waitlist for CAD), treating noncardiac death and waitlist removal for non-CAD reasons as competing events. Results: The 6MWT-based approach designated approximately 45% of patients as “low risk,” whereas a risk factor- or symptom-based approach designated 14 and 81% of patients as “low risk,” respectively. The 6MWT-based approach was not significantly associated with CAD-related events within 1 year (subproportional hazard ratio [sHR] 1.00 [0.90–1.11] per 50 m) but was significantly associated with competing events (sHR 0.70 [0.66–0.75] per 50 m). In a companion analysis, removing waitlist status from consideration, 6MWT result was associated with the development of CAD-related events (sHR 0.92 [0.84–1.00] per 50 m). Conclusions: The 6MWT designates fewer patients as high risk and in need of further testing (compared to risk factor-based approaches), but its utility as a pure CAD risk stratification tool is modulated by the background waitlist removal rate. CAD screening before kidney transplant should be tailored according to a patient’s actual chance of receiving a transplant.
Variation in the Care of Acute Liver Failure: A Survey of Intensive Care Professionals
Authors: Cardoso Filipe S. , Mcphail Mark J. , Karvellas Constantine J. , Fuhrmann Valentin , Germano Nuno , Auzinger Georg
Published: May 2021

Introduction: Acute liver failure (ALF) is a rare disease with potentially high mortality. We sought to assess the individual approach to ALF by intensive care unit (ICU) professionals. Methods: Cross-sectional survey of ICU professionals. Web-based survey capturing data on respondents’ demographics, characteristics of patients with ALF admitted to ICU, and their management. Results: Among 204 participants from 50 countries, 140 (68.6%) worked in Europe, 146 (71.6%) were intensivists, 142 (69.6%) admitted <25 patients with ALF per year, and 166 (81.8%) reported <25% of patients had paracetamol-related ALF. On patients’ outcomes, 126 (75.0%) reported an emergency liver transplantation (ELT) rate <25% and 140 (73.3%) a hospital mortality rate <50%. The approach to ALF in the ICU varied with age, region, level of training, type of hospital, and etiology (prescribing N-acetylcysteine for paracetamol toxicity, triggers for endotracheal intubation, measurement of and strategies for lowering serum ammonia, extracorporeal device deployment, and prophylactic antibiotics). Conclusions: The management of patients with ALF by ICU professionals differed substantially concerning the relevant clinical measures taken. Further education and high-quality research are warranted.
Humanização no cuidado em saúde mental: compreensões dos enfermeiros
Authors: Lima Deivson Wendell da Costa , Paixão Ana Karla Ramalho , Bezerra Kelianny Pinheiro , Freitas Rodrigo Jácob Moreira de , Azevedo Lívia Dayane Sousa , Morais Fátima Raquel Rosado
Published: May 2021

Objetivo: conhecer as compreensões dos enfermeiros sobre humanização no cuidado em saúde mental. Método: tratase de uma pesquisa exploratória, de abordagem qualitativa, realizada com 12 enfermeiros em um hospital psiquiátrico do interior do Nordeste, Brasil, no período de setembro de 2014 a março de 2015. Para a coleta de dados, utilizou-se entrevista semiestruturada, observação não participante e observação dos registros de Enfermagem, analisando-os a partir da Análise de Conteúdo de Bardin. Resultados: emergiram quatro categorias: acolhimento, autonomia, protagonismo e corresponsabilidade. O cuidado  humanizado aparece atrelado ao modelo manicomial, culminando em práticas focadas no uso da medicação, ações desarticuladas e sem participação do paciente no tratamento. A percepção da humanização é de dificuldade de atenção às pessoas em crises psíquicas, o que inviabiliza a produção do cuidado integral. Conclusão: o estudo contribui para a reflexão do cuidado de Enfermagem em saúde mental onde é preciso modificar as relações que o discurso biomédico mantém com os que buscam uma prática humanizada.
Alcoolismo: impactos na vida familiar
Authors: Cordeiro Ketlen Patrycia Alves , Souza Lavinia Luzia Gomes , Soares Raquel Schwenck de Mello Vianna , Fagundes Ludmila Cotrim , Soares Wellington Danilo
Published: May 2021

Objetivo: identificar os problemas acarretados pelo consumo excessivo do álcool, bem como as consequências que ele traz à família. Método: o instrumento utilizado foi uma entrevista semiestruturada, com roteiro composto por 12 questões elaboradas pelos próprios pesquisadores, para responder às temáticas propostas. Para a análise das entrevistas, utilizou-se a Análise do Conteúdo e, como ferramenta de análise, empregou-se o software NVivo11, destinado ao tratamento de dados em investigação qualitativa. Resultados: durante o tratamento das entrevistas, elaboraram-se uma árvore categorial, que apresenta o álcool como núcleo, e quatro nós categoriais como aspectos principais da entrevista, sendo eles: início do uso; consequências para a família; problemas pelo consumo excessivo e ajuda. Conclusão: podem-se depreender as consequências negativas que o uso excessivo do álcool gera para as relações familiares, sendo este o eixo da vida de um alcoolista mais devastado. Além disso, é importante salientar que o mesmo eixo familiar destruído é base para a retomada de uma mudança como respaldo para a procura de auxílio de entidades competentes, como os Alcóolicos Anônimos.
Polygenic Risk Score–Enhanced Risk Stratification of Coronary Artery Disease in Patients With Stable Chest Pain
Authors: Christiansen Morten Krogh , Winther Simon , Nissen Louise , Vilhjálmsson Bjarni Jóhann , Frost Lars , Johansen Jane Kirk , Møller Peter Loof , Schmidt Samuel Emil , Westra Jelmer , Holm Niels Ramsing , Jensen Henrik Kjærulf , Christiansen Evald Høj , Guðbjartsson Daníel Fannar , Hólm Hilma , Stefánsson Kári , Bøtker Hans Erik , Bøttcher Morten , Nyegaard Mette
Published: May 2021

Background:

Polygenic risk scores (PRSs) are associated with coronary artery disease (CAD), but the clinical potential of using PRSs at the single-patient level for risk stratification has yet to be established. We investigated whether adding a PRS to clinical risk factors (CRFs) improves risk stratification in patients referred to coronary computed tomography angiography on a suspicion of obstructive CAD.

Methods:

In this prespecified diagnostic substudy of the Dan-NICAD trial (Danish study of Non-Invasive testing in Coronary Artery Disease), we included 1617 consecutive patients with stable chest symptoms and no history of CAD referred for coronary computed tomography angiography. CRFs used for risk stratification were age, sex, symptoms, prior or active smoking, antihypertensive treatment, lipid-lowering treatment, and diabetes. In addition, patients were genotyped, and their PRSs were calculated. All patients underwent coronary computed tomography angiography. Patients with a suspected ≥50% stenosis also underwent invasive coronary angiography with fractional flow reserve. A combined end point of obstructive CAD was defined as a visual invasive coronary angiography stenosis >90%, fractional flow reserve <0.80, or a quantitative coronary analysis stenosis >50% if fractional flow reserve measurements were not feasible.

Results:

The PRS was associated with obstructive CAD independent of CRFs (adjusted odds ratio, 1.8 [95% CI, 1.5–2.2] per SD). The PRS had an area under the curve of 0.63 (0.59–0.68), which was similar to that for age and sex. Combining the PRS with CRFs led to a CRF+PRS model with area under the curve of 0.75 (0.71–0.79), which was 0.04 more than the CRF model (
P
=0.0029). By using pretest probability (pretest probability) cutoffs at 5% and 15%, a net reclassification improvement of 15.8% (
P
=3.1×10
−4
) was obtained, with a down-classification of risk in 24% of patients (211 of 862) in whom the pretest probability was 5% to 15% based on CRFs alone.

Conclusions:

Adding a PRS improved risk stratification of obstructive CAD beyond CRFs, suggesting a modest clinical potential of using PRSs to guide diagnostic testing in the contemporary clinical setting.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02264717.
Cardiovascular Events, Acute Hospitalizations, and Mortality in Patients With Type 2 Diabetes Mellitus Who Initiate Empagliflozin Versus Liraglutide: A Comparative Effectiveness Study
Authors: Thomsen Reimar W. , Knudsen Jakob S. , Kahlert Johnny , Baggesen Lisbeth M. , Lajer Maria , Holmgaard Pia H. , Vedin Ola , Ustyugova Anastasia , Sørensen Henrik T.
Published: May 2021

Background

In cardiovascular outcome trials, the sodium glucose cotransporter 2 inhibitor empagliflozin and glucagon‐like peptide‐1 (GLP‐1) receptor agonist liraglutide caused similar reductions in major adverse cardiac events (MACE). We compared clinical outcomes in routine clinical care.

Methods and Results

EMPLACE (Cardiovascular and Renal Outcomes, and Mortality in Danish Patients with Type 2 Diabetes Who Initiate Empagliflozin Versus GLP‐1RA: A Danish Nationwide Comparative Effectiveness Study) is an ongoing nationwide population‐based comparative effectiveness cohort study in Denmark. For the present study, we included 14 498 new users of empagliflozin and 12 706 new users of liraglutide, 2015 to 2018. Co‐primary outcomes were expanded major adverse cardiac events (stroke, myocardial infarction, unstable angina, coronary revascularization, hospitalization for heart failure [HHF], or all‐cause death); HHF or all‐cause death; and first HHF or first initiation of loop‐diuretic therapy. Secondary outcomes included all‐cause hospitalization or death. We applied propensity score balancing and Cox regression to compute adjusted hazard ratios (aHRs) in on‐treatment (OT) and intention‐to‐treat (ITT) analyses. Cohorts were well balanced at baseline (median age 61 years, 59% men, diabetes mellitus duration 6.6 years, 30% with preexisting cardiovascular disease). During mean follow‐up of 1.1 years in OT and 1.5 years in ITT analyses, empagliflozin versus liraglutide was associated with a similar rate of expanded major adverse cardiac events (OT aHR, 1.02; 95% CI, 0.91–1.14; ITT aHR, 1.06; 95% CI, 0.96–1.17), and HHF or all‐cause death (OT aHR, 0.97; 95% CI, 0.85–1.11; ITT aHR, 1.02; 95% CI, 0.91–1.14); and a decreased rate of a first incident HHF or loop‐diuretic initiation (OT aHR, 0.80; 95% CI, 0.68–0.94; ITT aHR, 0.87; 95% CI, 0.76–1.00), and of all‐cause hospitalization or death (OT aHR, 0.93; 95% CI, 0.89–0.98; ITT aHR, 0.93; 95% CI, 0.90–0.97).

Conclusions

Empagliflozin and liraglutide initiators had comparable rates of expanded major adverse cardiac events, and HHF or all‐cause death, whereas empagliflozin initiators had a lower rate of a first HHF or loop‐diuretic initiation.
Long‐Term Cardiovascular Outcomes After Pregnancy in Women With Heart Disease
Authors: Siu Samuel C. , Lee Douglas S. , Rashid Mohammed , Fang Jiming , Austin Peter C. , Silversides Candice K.
Published: May 2021

Background

Women with heart disease are at risk for pregnancy complications, but their long‐term cardiovascular outcomes after pregnancy are not known.

Methods and Results

We examined long‐term cardiovascular outcomes after pregnancy in 1014 consecutive women with heart disease and a matched group of 2028 women without heart disease. The primary outcome was a composite of mortality, heart failure, atrial fibrillation, stroke, myocardial infarction, or arrhythmia. Secondary outcomes included cardiac procedures and new hypertension or diabetes mellitus. We compared the rates of these outcomes between women with and without heart disease and adjusted for maternal and pregnancy characteristics. We also determined if pregnancy risk prediction tools (CARPREG [Canadian Cardiac Disease in Pregnancy] and World Health Organization) could stratify long‐term risks. At 20‐year follow‐up, a primary outcome occurred in 33.1% of women with heart disease, compared with 2.1% of women without heart disease. Thirty‐one percent of women with heart disease required a cardiac procedure. The primary outcome (adjusted hazard ratio, 19.6; 95% CI, 13.8–29.0;
P
<0.0001) and new hypertension or diabetes mellitus (adjusted hazard ratio, 1.6; 95% CI, 1.4–2.0;
P
<0.0001) were more frequent in women with heart disease compared with those without. Pregnancy risk prediction tools further stratified the late cardiovascular risks in women with heart disease, a primary outcome occurring in up to 54% of women in the highest pregnancy risk category.

Conclusions

Following pregnancy, women with heart disease are at high risk for adverse long‐term cardiovascular outcomes. Current pregnancy risk prediction tools can identify women at highest risk for long‐term cardiovascular events.
The Tabula in the Collège de Sorbonne and the Discovery of the 1529 Bomberg Siddur
Authors: Kogel Judith
Published: May 2021

Interest was aroused recently concerning a booklet of 28 folios entitled Tabula in universum indicans libros singularum disciplinarum. Formerly considered a 17th-century catalogue, it actually reflects the contents of the library of the Collège de Sorbonne in the mid-16th century. A project, directed by Gilbert Fournier, will identify the authors and works mentioned in the document and localize the books in Parisian and French libraries. Entrusted with the rubric Rabbini Hebraeorum, I quickly realized that I needed to work simultaneously on the catalogue and the dispersion of the library of the Collège. This back and forth process led to the discovery of the 1529 Bomberg Ashkenazic Siddur.
Updating and assessing plant endemism in Egypt

Authors: EL-KHALAFY MOHAMED M. , SHALTOUT KAMAL H. , AHMED DALIA A.
Published: May 2021

This study aimed to update and assess the list of endemic plants in the Egyptian flora, based on information obtained during field trips, literature reviews, and herbaria consultations. Life forms, habitat, national distribution, rarity forms, local threats, and conservation status according to IUCN categories, were estimated for these plants. Twenty field visits were conducted from summer 2015 to spring 2020 to many locations all over Egypt. The recent list includes 42 species (belonging to 37 genera and 20 families inhabiting 10 main habitats). Rocky surfaces and sandy formations have the highest number of endemic species, most of them are therophytes. Sinaitico-Arabian sector is the richest in endemics (19 taxa), followed by the Marioutico-Arishian (17 taxa). Small geographic range-small habitat-non-abundant plants are the most represented rarity form. All endemics are exposed to at least one type of local threat, the most prominent threats being over-collecting and over-cutting. According to the guidelines of IUCN, 31 of the endemic taxa are threatened, thus requiring in situ and ex situ conservation. Out of them, 11 taxa are believed to be Extinct, five are Critically Endangered, and 15 Endangered. In addition, 11 taxa are evaluated as Data Deficient. Further studies are still needed to verify and fill the information gaps about the Egyptian endemics.
The real identity of the Malagasy Kalanchoe rosei (Crassulaceae subfam. Kalanchooideae) finally resolved, and the description of a new species, K. perrieri
Authors: SHTEIN RONEN , SMITH GIDEON F. , KLEIN DAVID-PAUL
Published: May 2021

The identity of the Malagasy Kalanchoe rosei (Crassulaceae subfam. Kalanchooideae) is resolved, inter alia through a rigorous review and interpretation of the type of the name, as well as associated preserved and living material. Apart from the autonymic variety, K. rosei var. rosei, two further varieties were at times often recognised, i.e., K. rosei var. seyrigii and K. rosei var. variifolia, both of which are now treated in K. variifolia. However, based on a comprehensive morphological investigation, even within K. rosei var. rosei, the autonymic variety therefore, we conclude that two distinct species can be identified. The one that does not include the type of the name K. rosei is here described as K. perrieri. In addition, as shown here, K. rosei is more closely related to K. peltigera, rather than to the material here described as K. perrieri, while material of K. variifolia is more distantly related. The typification of the names K. rosei and K. bouvieri is clarified.
Understanding the Roles of Convective Trigger Functions in the Diurnal Cycle of Precipitation in the NCAR CAM5
Authors: Cui Zeyu , Zhang Guang J. , Wang Yong , Xie Shaocheng
Published: May 2021

The wrong diurnal cycle of precipitation is a common weakness of current global climate models (GCMs). To improve the simulation of the diurnal cycle of precipitation and understand what physical processes control it, we test a convective trigger function described in Xie et al. with additional optimizations in the NCAR Community Atmosphere Model version 5 (CAM5). The revised trigger function consists of three modifications: 1) replacing the convective available potential energy (CAPE) trigger with a dynamic CAPE (dCAPE) trigger, 2) allowing convection to originate above the top of planetary boundary layer [i.e., the unrestricted air parcel launch level (ULL)], and 3) optimizing the entrainment rate and threshold value of the dynamic CAPE generation rate for convection onset based on observations. Results from 1° resolution simulations show that the revised trigger can alleviate the long-standing GCM problem of too early maximum precipitation during the day and missing the nocturnal precipitation peak that is observed in many regions, including the U.S. southern Great Plains (SGP). The revised trigger also improves the simulation of the propagation of precipitation systems downstream of the Rockies and the Amazon region. A further composite analysis over the SGP unravels the mechanisms through which the revised trigger affects convection. Additional sensitivity tests show that both the peak time and the amplitude of the diurnal cycle of precipitation are sensitive to the entrainment rate and dCAPE threshold values.
Stratified shear instabilities in diurnal warm layers
Authors: Hughes Kenneth G. , Moum James N. , Shroyer Emily L. , Smyth William D.
Published: May 2021

In low winds (≲2 m s−1), diurnal warm layers form but shear in the near-surface jet is too weak to generate shear instability and mixing. In high winds (≳8ms−1), surface heat is rapidly mixed downward and diurnal warm layers do not form. Under moderate winds of 3–5 m s−1, the jet persists for several hours in a state that is susceptible to shear instability. We observe low Richardson numbers of Ri ≈ 0.1 in the top 2 m between 10:00 and 16:00 local time (from 4 h after sunrise to 2 h before sunset). Despite Ri being well below the Ri = 1/4 threshold, instabilities do not grow quickly, nor do they overturn. The stabilizing influence of the sea surface limits growth, a result demonstrated by both linear stability analysis and two-dimensional simulations initialized from observed profiles. In some cases, growth rates are sufficiently small (≪1 h−1) that mixing is not expected even though Ri < 1/4. This changes around 16:00–17:00. Thereafter, convective cooling causes the region of unstable flow to move downward, away from the surface. This allows shear instabilities to grow an order of magnitude faster and mix effectively. We corroborate the overall observed diurnal cycle of instability with a freely evolving, two-dimensional simulation that is initialized from rest before sunrise.
Services Trade: The Great Gender Equaliser?
Authors: Johannesson Louise , Nordås Hildegunn Kyvik
Published: May 2021

Standing at 24% in 2018, India’s female labour force participation is only half of the global average (48%). At the same time, India has one of the widest gender wage gaps in the world and women are less likely to be employed in the formal sector compared to men. This article focuses on how international trade affects relative wages and formal employment between men and women in India. Using the Revealed Symmetrical Comparative Advantage index, sectors of comparative advantage and disadvantage are identified and matched to Indian labour force surveys that contain information on sectoral employment and earnings. We find that sectors of comparative advantage in services have the lowest gender wage gap, with women earning 24% less than their male counterparts, while women in manufacturing earned on average 40% less than male workers. Using the Oaxaca–Blinder decomposition, we find that the total gender wage gap in sectors of comparative advantage in services are minor while it is quite substantial in manufacturing, regardless of comparative advantage status. The article concludes that services trade goes hand in hand with a smaller gender wage gap as women leverage their skills better in services than in manufacturing.

JEL Codes: F16, F14