bluuebunny/crossref_metadata_2025 huggingface dataset:
Communication‐Efficient Modeling with Penalized Quantile Regression for Distributed Data
Authors: Hu Aijun , Li Chujin , Wu Jing
Published: January 2021

In order to deal with high‐dimensional distributed data, this article develops a novel and communication‐efficient approach for sparse and high‐dimensional data with the penalized quantile regression. In each round, the proposed method only requires the master machine to deal with a sparse penalized quantile regression which could be realized fastly by proximal alternating direction method of multipliers (ADMM) algorithm and the other worker machines to compute the subgradient on local data. The advantage of the proximal ADMM algorithm is that it could make every parameter of iteration to have closed formula even in high‐dimensional case, which greatly improves the speed of calculation. As for the communication efficiency, the proposed method does not sacrifice any statistical accuracy and provably improves the estimation error obtained by centralized method, provided the penalty levels are chosen properly. Moreover, the asymptotic properties of the proposed estimation and the convergence of the algorithm are convincible. Especially, it presents extensive experiments on both the numerical simulations and the HIV drug resistance data analysis, which all confirm the significant efficiency of our proposed method in quantile regression for distributed data by comparative and empirical analysis.
Total Anomalous Pulmonary Venous Connection with Lethal Pulmonary Venous Obstruction Managed by Multidisciplinary Cooperation
Authors: Ito Kana , Chida-Nagai Ayako , Sasaki Osamu , Kato Nobuyasu , Umazume Takeshi , Kawaguchi Satoshi , Cho Kazutoshi , Izumi Gaku , Yamazawa Hirokuni , Takeda Atsuhito
Published: January 2021

Background. Total anomalous pulmonary venous connection (TAPVC) is a critical congenital heart disease for which emergency surgery is required after birth. In cases of no intervention, TAPVC is associated with a high mortality rate in the first year of life. Although foetal echocardiographic techniques for diagnosing TAPVC have improved, TAPVC remains one of the most difficult congenital heart diseases to diagnose via foetal echocardiography. Here, we report a case of TAPVC with pulmonary venous obstruction (PVO), which was diagnosed via foetal echocardiography. Case Presentation. On foetal echocardiography at 32 weeks’ gestation, a large atrial septal defect, enlarged superior vena cava, and continuous flow pattern in the vertical vein from the common chamber were observed in the foetus. Paediatric cardiologists and cardiac surgeons, neonatologists, and obstetricians planned to perform a caesarean section and emergency heart surgery. The male infant was born at 37 weeks’ gestation via caesarean section, and postnatal echocardiography revealed PVO at the confluence of the superior vena cava and common chamber. Similarly, chest computed tomography confirmed the foetal diagnosis. The postnatal diagnoses were TAPVC type Ib, PVO, atrial septal defect, and patent ductus arteriosus. Surgical repair of the TAPVC was initiated within the first 3 hours of life. Screening brain echocardiography and head computed tomography revealed intracranial haemorrhage and hydrocephalus. Therefore, the patient underwent emergency bilateral external drainage on day 13. On day 48, a ventriculoperitoneal shunt was inserted owing to progressive brain ventricular dilatation. The patient was discharged home on postoperative day 68. Conclusions. Although the prognosis of TAPVC with PVO remains poor, continuous observation through foetal echocardiography and early interdepartmental collaboration can result in good outcomes.
Protein-Protein Interaction Analysis through Network Topology (Oral Cancer)
Authors: Wahab Khattak Fazal , Salamah Alhwaiti Yousef , Ali Amjad , Faisal Mohammad , Siddiqi Muhammad Hameed
Published: January 2021

Oral cancer is a complex disorder. Its creation and spreading are due to the interaction of several proteins and genes in different biological thoroughfares. To study biological pathways, many high-yield methods have been used. Efforts to merge several data found at separate levels related to biological thoroughfares and interlinkage networks remain elusive. In our research work, we have proposed a technique known as protein-protein interaction network for analysis and exploring the genes involved in oral cancer disorders. The previous studies have not fully analyzed the proteins or genes involved in oral cancer. Our proposed technique is fully interactive and analyzes the data of oral cancer disorder more accurately and efficiently. The methods used here enabled us to observe the wide network consists of one mighty network comprising of 208 nodes 1572 edges which connect these nodes and various detached small networks. In our study, TP53 is a gene that occupied an important position in the network. TP53 has a 113-degree value and 0.03881821 BC value, indicating that TP53 is centrally localized in the network and is a significant bottleneck protein in the oral cancer protein-protein interaction network. These findings suggested that the pathogenesis of oral cancer variation was organized by means of an integrated PPI network, which is centered on TP53. Furthermore, our identification shows that TP53 is the key role-playing protein in the oral cancer network, and its significance in the cellular networks in the body is determined as well. As TP53 (tumor protein 53) is a vital player in the cell division process, the cells may not grow or divide disorderly; it fulfills the function of at least one of the gene groups in oral cancer. However, the latter progression in the area is any measure; the intention of developing these networks is to transfigure sketch of core disease development, prognosis, and treatment.
Robustness Analysis of a Type of Iterative Algorithm for R-L Fractional Nonlinear Control Systems in the Sense of

L

p

Norm
Authors: Li Yanfang , Liu Xianghu , Xu Guangjun
Published: January 2021

The paper is concerned with the robustness analysis of a type of iterative algorithm for R-L fractional nonlinear control systems in the sense of

L

p

norm. Firstly, according to the Laplace transform and M-L function, the concept of mild solutions of the system is derived. Secondly, we give the sufficient conditions of robustness analysis of the

P

D

α

-type ILC algorithm with uncertain disturbances and then study the robust analysis of the second-order

P

D

α

-type ILC algorithm. At last, two fractional examples are given to demonstrate the results.
Systematic Monitoring and Evaluating the Wear of Alumina Wheel When Grinding the Workpiece of Cr12
Authors: You Fangyi , Zhou Wang , Wang Xuan , Dai Qiulian
Published: January 2021

The performance of the grinding wheel demonstrably affects the machining efficiency and the quality of the workpiece. Therefore, it is essential to evaluate the wear of the wheel and then operate the dressing or replacement in time. The wear procession of the wheel was monitored and evaluated systematically in this paper. A surface grinding experiment was performed by using an alumina wheel to grind the workpiece made of Cr12. The grinding force and the grinding temperature were monitored and measured while the wheel grinds the workpiece. The surface topography of the wheel was also being observed. The distribution of the gray value of pixels in the image of the wheel surface was analyzed by the method of the histogram. Processing of the binary image of the wheel was performed after determining the gray threshold of the gray value. Then, the blockading and the wearing area on the grinding wheel were calculated. Moreover, the relation of the projection area of a single abrasive derived from theory and derived by image recognition was studied. The results of the grinding experiment show that wheel performance degradation occurs when the material removal volume reaches 210 mm3/mm. At this time, the ratio of blockage area on the grinding wheel reaches 13.4%. The percentage of the wearing area is 9.5%. The method of image recognition combined with grinding temperature is workable to realize monitoring and evaluating the wear of wheels on site without unloading them.
Optimized Conditions for Flavonoid Extraction from Pomelo Peel Byproducts under Enzyme- and Ultrasound-Assisted Extraction Using Response Surface Methodology
Authors: Nguyen Tram Anh Mai , Van Hung Pham , Thi Lan Phi Nguyen
Published: January 2021

Pomelo (Citrus maxima (Burm.) Merrill) peel, which has been considered as a byproduct, is a potential source of flavonoids. In this study, the extraction conditions of total flavonoids from peels of Da Xanh pomelo were optimized using the response surface methodology with the Box–Behnken design. The combination of two novel extraction methods, including enzyme-assisted and ultrasound-assisted extractions, was used for the optimization. The results indicated that the optimal extraction condition was a liquid-to-solid ratio of 142.99 mL/g, enzyme concentration of 3.45%, and the time of 65.23 min for incubation and of 69.26 min for sonication treatment. Total phenolic and total flavonoid contents of the pomelo peel extracts, under optimal condition of the combined method (16.79 mg GAE/g and 10.69 mg RE/g, respectively), were significantly higher than those of the conventional method (6.58 mg GAE/g and 2.42 mg RE/g, respectively). The naringin and hesperidin contents of extracts under optimal condition increased by 5.70% and 1.20%, respectively, compared to the extracts under the conventional method.
Design of Sanda Action Reconstruction Model Based on 3D Images
Authors: Zhao Hongwei
Published: January 2021

In order to improve the training level of Sanda movement, this article uses an image analysis method to reconstruct the detailed characteristics of the movement and apply them to the actual training process. Since the traditional wavelet reconstruction method is affected by the accuracy of the decomposition scale, this paper proposes an improved method of Sanda action based on 3D image reconstruction. First, the method relies on frame adjacent phase compensation and digital image stabilization techniques to perform digital frame operations on the image. Then, scanning and corner detection are used for image reconstruction, where adjacent phase compensation methods are used to match feature points and gray pixels. Image extraction is performed by extracting key feature points of the action 3D image, and a fast frame detection method is used to stabilize the image of the digital image, thereby improving the image quality of image reconstruction. The experimental results show that the method has good image output effect and has a high application value in Sanda guidance and optimization.
Public Health Effects of Radioactive Airborne Effluents from Nuclear and Coal-Fired Power Plant
Authors: Purevsuren Boldsaikhan , Kim Juyoul
Published: January 2021

It has been well known that nuclear power plant and coal-fired power plant release some amount of radioactive materials during their normal operations. The purpose of this study was to compare radiation exposure doses to the public as a consequence of airborne effluents released from nuclear and coal-fired power plants under the normal operation. NRCDose3 was used to estimate radiation exposure doses to the public from gaseous effluents of nuclear power plant during its normal operation while CAP88-PC was used to calculate doses to the public living around coal-fired power plant. The results showed that radiation exposure doses from nuclear power plant were less than those from coal-fired power plant and regulatory annual limits. Effective dose by external exposure, skin equivalent dose, and organ equivalent dose from gaseous effluents of nuclear power plant were 2.93 × 10−4 mSv/y, 2.90 × 10−3 mSv/y, and 1.78 × 10−2 mSv/y, respectively. On the contrary, the corresponding effective dose by external exposure, external skin dose, and organ dose from coal-fired power plant were 1.13 × 10−2 mSv/y, 5.33 × 10−2 mSv/y, and 1.17 × 10−1 mSv/y, respectively.
A Parallel Bioinspired Algorithm for Chinese Postman Problem Based on Molecular Computing
Authors: Wang Zhaocai , Bao Xiaoguang , Wu Tunhua
Published: January 2021

The Chinese postman problem is a classic resource allocation and scheduling problem, which has been widely used in practice. As a classical nondeterministic polynomial problem, finding its efficient algorithm has always been the research direction of scholars. In this paper, a new bioinspired algorithm is proposed to solve the Chinese postman problem based on molecular computation, which has the advantages of high computational efficiency, large storage capacity, and strong parallel computing ability. In the calculation, DNA chain is used to properly represent the vertex, edge, and corresponding weight, and then all possible path combinations are effectively generated through biochemical reactions. The feasible solution space is obtained by deleting the nonfeasible solution chains, and the optimal solution is solved by algorithm. Then the computational complexity and feasibility of the DNA algorithm are proved. By comparison, it is found that the computational complexity of the DNA algorithm is significantly better than that of previous algorithms. The correctness of the algorithm is verified by simulation experiments. With the maturity of biological operation technology, this algorithm has a broad application space in solving large‐scale combinatorial optimization problems.
Jackstone in the Kidney: An Unusual Calculus
Authors: Goonewardena Serozsha , Jayarajah Umesh , Kuruppu Sanka Nalinda , Fernando Manoj Hilary
Published: January 2021

Jackstones are stones in the urinary tract that have the characteristic appearance resembling six-pointed toy jacks. They are nearly always reported to occur in the urinary bladder, and the occurrence in less capacious renal pelvis is unusual. We report a solitary, typical jackstone in the renal pelvis without significant outflow obstruction that was successfully treated with retrograde intrarenal surgery followed by extracorporeal shockwave lithotripsy. This highlights the complex pathophysiological mechanisms in stone formation which needs to be further studied. It is important to recognize the characteristic shape of the renal calculi on the radiological investigation in the diagnosis of the jackstones.
Navigated Recovery of Fractured Dental Injection Needles: Case Report and Suggestions for Management during Pandemic Crises
Authors: Schorn Lara , Sproll Christoph , Depprich Rita , Kübler Norbert R. , Rana Majeed , Singh Daman D. , Lommen Julian
Published: January 2021

Dislocation of a fractured hypodermic needle is a complication requiring immediate and adequate emergency treatment. In this case report, 3D navigation is evaluated for its use to recover a quickly moving fractured needle. The needle was recovered safely, but it could be demonstrated that navigational planning has to be conducted right before surgery and other navigational tools, such as ultrasound, should be considered as well. Furthermore, an approach is suggested for treatment during pandemic crises such as COVID-19.
Research on Deformation Prediction of Foundation Pit Based on PSO‐GM‐BP Model
Authors: Cui Dongge , Zhu Chuanqu , Li Qingfeng , Huang Qiyun , Luo Qi
Published: January 2021

Deformation prediction is significant to the safety of foundation pits. Against with low accuracy and limited applicability of a single model in forecasting, a PSO‐GM‐BP model was established, which used the PSO optimization algorithm to optimize and improve the GM (1, 1) model and the BP network model, respectively. Combining a small amount of measured data during the excavation of a bottomless foundation pit in a Changsha subway station, the calculations based on the PSO‐GM model, the PSO‐BP network model, and the PSO‐GM‐BP model compared. The results show that both the GM (1, 1) and BP neural network models can predict accurate results. The prediction optimized by the particle swarm algorithm is more accurate and has more substantial applicability. Due to its reliable accuracy and wide application range, the PSO‐GM‐BP model can effectively guide the construction of foundation pits, and it also has certain reference significance for other engineering applications.
Combined Schwannoma and Kappa-Restricted Plasma Cell Neoplasm: A Case Report and Review of the Literature
Authors: Cannatella Jeffrey John , Pandey Soumya
Published: January 2021

The patient is a 78-year-old woman with a popliteal soft tissue mass that was tender to palpation with shooting pain on physical examination. A schwannoma was seen on biopsy with subsequent excision demonstrating a concomitant kappa-restricted plasma cell neoplasm. Follow-up did not show evidence of a systemic plasma cell neoplasm. MRI studies showed no evidence of focal lesions, although PET-CT revealed presence of multiple lytic lesions. The patient is currently being monitored every six months. This case is the first kappa-restricted plasma cell neoplasm reported in association with a schwannoma and the first reported in the extremities.
An Exact Solution to the Quadratic Damping Strong Nonlinearity Duffing Oscillator
Authors: Salas Alvaro H. , El-Tantawy S. A. , Aljahdaly Noufe H.
Published: January 2021

The nonlinear equations of motion such as the Duffing oscillator equation and its family are seldom addressed in intermediate instruction in classical dynamics; this one is problematic because it cannot be solved in terms of elementary functions before. Thus, in this work, the stability analysis of quadratic damping higher-order nonlinearity Duffing oscillator is investigated. Hereinafter, some new analytical solutions to the undamped higher-order nonlinearity Duffing oscillator in the form of Weierstrass elliptic function are obtained. Posteriorly, a novel exact analytical solution to the quadratic damping higher-order nonlinearity Duffing equation under a certain condition (not arbitrary initial conditions) and in the form of Weierstrass elliptic function is derived in detail for the first time. Furthermore, the obtained solutions are camped to the Runge–Kutta fourth-order (RK4) numerical solution.
Treatment and Imaging Modalities of Giant Coronary Aneurysms Resulting from Kawasaki Disease and Presenting as Acute Inferior Wall Myocardial Infarction
Authors: Abu Akel Mahmood , Hellman Yaron M. , Sawaed Shtiwi , Sharoni Erez , Eitan Amnon , Flugelman Moshe Y.
Published: January 2021

Giant coronary aneurysms are late sequelae of Kawasaki disease (KD). We describe a 53-year-old patient who presented with acute myocardial infarction and proximal aneurysms of all three coronary arteries. Coronary angiography demonstrated the aneurysms, but CT angiography allowed accurate assessment of the real dimensions of the aneurysms and making the decision on the preferred method of revascularization. The patient underwent coronary bypass surgery and is asymptomatic at follow-up.
Choroid Segmentation of Retinal OCT Images Based on CNN Classifier and

l

2

-

l

q

Fitter
Authors: He Fang , Chun Rachel Ka Man , Qiu Zicheng , Yu Shijie , Shi Yun , To Chi Ho , Chen Xiaojun
Published: January 2021

Optical coherence tomography (OCT) is a noninvasive cross-sectional imaging technology used to examine the retinal structure and pathology of the eye. Evaluating the thickness of the choroid using OCT images is of great interests for clinicians and researchers to monitor the choroidal thickness in many ocular diseases for diagnosis and management. However, manual segmentation and thickness profiling of choroid are time-consuming which lead to low efficiency in analyzing a large quantity of OCT images for swift treatment of patients. In this paper, an automatic segmentation approach based on convolutional neural network (CNN) classifier and

l

2

-

l

q

(

0
<
q
<
1

) fitter is presented to identify boundaries of the choroid and to generate thickness profile of the choroid from retinal OCT images. The method of detecting inner choroidal surface is motivated by its biological characteristics after light reflection, while the outer chorioscleral interface segmentation is transferred into a classification and fitting problem. The proposed method is tested in a data set of clinically obtained retinal OCT images with ground-truth marked by clinicians. Our numerical results demonstrate the effectiveness of the proposed approach to achieve stable and clinically accurate autosegmentation of the choroid.
Quality of Sleep and Its Correlates among Yemeni Medical Students: A Cross-Sectional Study
Authors: Attal Bothaina Ahmed , Bezdan Mohammed , Abdulqader Abdulwahab
Published: January 2021

Background. Sleep disturbance is particularly common among medical students worldwide and affects their wellbeing and academic performance. However, little is known about this issue in Yemen. This study looks at sleep quality and its association with personal and life-style factors and self-reported academic performance among medical students at the largest Yemeni university. Methods. A cross-sectional survey was conducted at Sana’a University, Yemen, in 2017. The Pittsburgh Sleep Quality Index (PSQI), consisting of 19 items and 7 components (

score
 
range
=
0
‐
3

), was used to assess sleep quality. The summation of the components’ scores yields the global PSQI score (

range
=
0
‐
21

). A global PSQI value higher than 5 indicates poor quality of sleep. Logistic regression was applied to look at relationships. Results. 240 male (41%) and female (59%) medical students took part in the study with 54% being preclinical and 46% clinical with an average age of 23.3 years (

SD
=
1.7

). The mean global score (SD) was 6.85 (2.8), and 68% of the students (

N
=
163

) were identified as poor sleepers. The mean global PSQI score (SD) and proportion of poor sleepers were higher among males (7.7 (2.8) and 81%, respectively) than females (6.27 (2.42) and 59.2%, respectively),

p
≤
0.001

. Good sleep quality was more likely (OR (95% CI)) among females (3.4 (1.3-8.8)), the unmarried (2.8 (1-7.8)), those in good health (2.3 (1.1-4.5)), and nonkhat chewers (4.9 (1.4-17.1)). Nonsmokers were less likely to have good quality sleep compared to occasional smokers (0.185 (0.071-.485)). Stress (30%) and academic workload (21%) were the most commonly reported causes of poor sleep quality. Almost two-thirds of the students (65%) mentioned that disturbed sleep undermined their academic performance. Conclusions. Poor sleep quality is common among Sana’a medical students and impacts their academic performance. Specific stress management and sleep hygiene promoting programs should be incorporated early on in medical education.
Data-Driven Control Based on the Interval Type-2 Intuition Fuzzy Brain Emotional Learning Network for the Multiple Degree-of-Freedom Rehabilitation Robot
Authors: Li Hongmei , Li Di , Chen Xiangjian , Pan Zhongqiang
Published: January 2021

A novel interval type-2 intuition fuzzy brain emotional learning network model (IT2IFBELC) which depends only on the input and output data is proposed for the rehabilitation robot, which is different from model-based control algorithms that require exact dynamic model knowledge of the rehabilitation robot. The proposed model takes advantage of the type-2 intuition fuzzy theory and brain emotional neural network, and this is no rule initially; then, the structure and parameters of IT2IFBELC are tuned online simultaneously by the gradient approach and Lyapunov function. The system input data streams are directly imported into the neural network through an interval type-2 intuition fuzzy inference system (IT2IFIS), and then the results are subsequently piped into sensory and emotional channels which jointly produce the final outputs of the network. That is, the whole controller is composed of three parts, including the ideal sliding mode controller, the interval type-2 intuition fuzzy brain emotional learning network controller, and a powerful robust compensation controller, and then one Lyapunov function is designed to guarantee the rapid convergence of the control systems. For further illustrating the superiority of this model, several models are studied here for comparison, and the results show that the interval type-2 intuition fuzzy brain emotional learning network model can obtain better satisfactory control performance and be suitable to deal with the influence of the uncertainty of the rehabilitation robot.
Impact of In Situ Soil in Soil‐Bentonite Cutoff Wall Backfill on Compressibility and Hydraulic Conductivity
Authors: Fan Ridong , Yang Yuling , Liu Songyu
Published: January 2021

Soil‐bentonite cutoff walls, consisting of excavated in situ soil and bentonite as backfills, are used extensively as vertical barriers for groundwater pollution control. Sand mixed with high‐quality natural sodium bentonite (NaB) is commonly used as a research object to investigate the hydraulic and compression properties of soil‐bentonite backfills. However, pure sand could rarely be found in real conditions, and natural NaB may not be available readily in some countries such as China, India, and Turkey. This paper presents a comprehensive laboratory investigation on the compressibility and hydraulic conductivity (k) of soil‐bentonite backfills created by simulated in situ soil and low‐quality sodium activated calcium bentonite (SACaB). The simulated in situ soils are prepared using sand‐natural clay mixtures with sand to natural clay mass ratios ranging from 0.5 to 6.0, and the bentonite content (BC) in the base mixture ranges from 0 to 15%. The result indicates that BC dominates the compression index (Cc) of the backfill, and a unique relationship between void ratio at effective vertical compression stress of 1 kPa and compression index is proposed for various types of soil‐bentonite backfills. An increase in either BC or clay size fraction (CF) in simulated in situ contributes to reducing k, but the impact of CF in simulated in situ soil on k tends to be insignificant for backfill with BC higher than 6%. A new characteristic parameter based on the concept of void ratio of bentonite (eb), named apparent void ratio of clay size fraction (eC), is developed for predicting soil‐bentonite backfills created by in situ soils and bentonites with various contents.
Repartidores de plataformas
Authors: Gutiérrez Francisca
Published: January 2021

La pandemia de COVID 19 ha impulsado significativamente el mercado de las plataformas digitales de reparto. Empresas como Rappi, PedidosYa y UberEats han visto multiplicarse la demanda por sus servicios, en un contexto donde las medidas de distanciamiento social implementadas para evitar el contagio han forzado a las personas a mantenerse en sus domicilios. Continuar leyendo...
Phase I Trial of DNA Methyltransferase Inhibitor Guadecitabine Combined with Cisplatin and Gemcitabine for Solid Malignancies Including Urothelial Carcinoma (SPIRE)
Authors: Crabb Simon J. , Danson Sarah , Catto James W.F. , Hussain Syed , Chan Danna , Dunkley Denise , Downs Nichola , Marwood Ellice , Day Laura , Saunders Geoff , Light Michelle , Whitehead Amy , Ellis Deborah , Sarwar Naveed , Enting Deborah , Birtle Alison , Johnson Bernadette , Huddart Robert , Griffiths Gareth
Published: January 2021

Purpose:

Preclinical data indicate that DNA methyltransferase inhibition will circumvent cisplatin resistance in various cancers.

Patient and Methods:

SPIRE comprised a dose-escalation phase for incurable metastatic solid cancers, followed by a randomized dose expansion phase for neoadjuvant treatment of T2–4a N0 M0 bladder urothelial carcinoma. The primary objective was a recommended phase II dose (RP2D) for guadecitabine combined with gemcitabine and cisplatin. Treatment comprised 21-day gemcitabine and cisplatin cycles (cisplatin 70 mg/m2, i.v., day 8 and gemcitabine 1,000 mg/m2, i.v., days 8 + 15). Guadecitabine was injected subcutaneously on days 1–5, within escalation phase cohorts, and to half of 20 patients in the expansion phase. Registration ID: ISRCTN 16332228.

Results:

Within the escalation phase, dose-limiting toxicities related predominantly to myelosuppression requiring G-CSF prophylaxis from cohort 2 (guadecitabine 20 mg/m2, days 1–5). The most common grade ≥3 adverse events in 17 patients in the dose-escalation phase were neutropenia (76.5%), thrombocytopenia (64.7%), leukopenia (29.4%), and anemia (29.4%). Addition of guadecitabine to gemcitabine and cisplatin in the expansion phase resulted in similar rates of severe hematologic adverse events, similar cisplatin dose intensity, but modestly reduced gemcitabine dose intensity. Radical treatment options after chemotherapy were not compromised. Pharmacodynamics evaluations indicated guadecitabine maximal target effect at the point of cisplatin administration. Pharmacokinetics were consistent with prior data. No treatment-related deaths occurred.

Conclusions:

The guadecitabine RP2D was 20 mg/m2, days 1–5, in combination with gemcitabine and cisplatin and required GCSF prophylaxis. Gene promoter methylation pharmacodynamics are optimal with this schedule. Addition of guadecitabine to gemcitabine and cisplatin was tolerable, despite some additional myelosuppression, and warrants further investigation to assess efficacy.
Ocular Pathology and Occasionally Detectable Intraocular Severe Acute Respiratory Syndrome Coronavirus-2 RNA in Five Fatal Coronavirus Disease-19 Cases
Authors: Reinhold Aja , Tzankov Alexandar , Matter Matthias S. , Mihic-Probst Daniela , Scholl Hendrik P.N. , Meyer Peter
Published: January 2021

Introduction: In December 2019, the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic broke out. The virus rapidly spread globally, resulting in a major world public-health crisis. The major disease manifestation occurs in the respiratory tract. However, further studies documented other systemic involvement. This study investigates histopathologic eye changes in postmortem material of coronavirus disease 2019 (COVID-19) patients. Methods: Sections of formalin-fixed, paraffin-embedded eyes from 5 patients (10 eyes) who died of COVID-19 at the University Hospital in Basel were included. Gross examination and histological evaluation were performed by 3 independent ophthalmopathologists. Immunohistochemical staining was performed using antibodies against fibrin, cleaved caspase 3, and ACE-2. Five enucleated eyes of patients not infected with SARS-CoV-2 served as control group. All cases have been studied for presence of SARS-CoV-2 RNA by means of reverse transcription PCR and RNA in situ hybridization (ISH). The choroidal vessels of one case were analyzed with electron microscope. Results: Ophthalmopathologically, 8 eyes from 4 patients displayed swollen endothelial cells in congested choroidal vessels. No further evidence of specific eye involvement of SARS-CoV-2 was found in any of the patients. In the 8 eyes with evidence of changes due to SARS-CoV-2, immunohistochemical staining demonstrated fibrin microthrombi, apoptotic changes of endothelial and inflammatory cells. In control eyes, ACE-2 was detectable in the conjunctiva, cornea, retina, and choroidea and displayed significantly lower amounts of stained cells as in COVID-19 eyes. SARS-CoV-2 RNA was detectable in both bulbi of 2/5 patients, yet ISH failed to visualize viruses. Electron microscopy showed no significant results due to the artifacts. Discussion/Conclusion: As already described in other organs of COVID-19 patients, the ophthalmological examination revealed-microthrombi, that is, hypercoagulation and vasculopathy most probably due to endothelial damage. A possible viral spread to the endothelial cells via ACE-2 provides one pathophysiological explanation. The expression of ACE-2 receptors in the conjunctiva hints toward its susceptibility to infection. To what extend eyes, function is disrupted by SARS-CoV-2 is subject to further studies, especially in the clinic.
Electrocardiographic Strain Pattern Is a Major Determinant of Rehospitalization for Heart Failure After Transcatheter Aortic Valve Replacement
Authors: Heger Joé , Trimaille Antonin , Kibler Marion , Marchandot Benjamin , Peillex Marilou , Carmona Adrien , Matsushita Kensuke , Trinh Annie , Reydel Antje , Zeyons Floriane , Petit‐Eisenmann Hélène , Jesel Laurence , Ohlmann Patrick , Morel Olivier
Published: January 2021

Background

Electrocardiographic strain pattern (ESP) has recently been associated with increased adverse outcome in aortic stenosis and after surgical aortic valve replacement. Our study sought to determine the impact and incremental value of ESP pattern in predicting adverse outcome after transcatheter aortic valve replacement.

Methods and Results

A total of 585 patients with severe aortic stenosis (mean age, 83±7 years; men, 39.8%) were enrolled for transcatheter aortic valve replacement from November 2012 to May 2018. ESP was defined as ≥1‐mm concave down‐sloping ST‐segment depression and asymmetrical T‐wave inversion in the lateral leads. The primary end points of the study were all‐cause mortality, rehospitalization for heart failure, myocardial infarction, and stroke. A total of 178 (30.4%) patients were excluded because of left bundle‐branch block (n=103) or right bundle‐branch block (n=75). Among the 407 remaining patients, 106 had ESP (26.04%). At a median follow‐up of 20.00 months (11.70–29.42 months), no impact of electric strain on overall and cardiac death could be established. By contrast, incidence of rehospitalization for heart failure was significantly higher (33/106 [31.1%] versus 33/301 [11%];
P
<0.001) in patients with ESP. By multivariate analyses, ESP remained a strong predictor of rehospitalization for heart failure (hazard ratio, 2.75 [95% CI, 1.61–4.67];
P
<0.001).

Conclusions

In patients with aortic stenosis who were eligible for transcatheter aortic valve replacement, ESP is frequent and associated with an increased risk of postinterventional heart failure regardless of preoperative left ventricular hypertrophy. ESP represents an easy, objective, reliable, and low‐cost tool to identify patients who may benefit from intensified postinterventional follow‐up.
Ablation of Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy: Treatment Strategy, Characteristics of Consecutive Atrial Tachycardia and Long‐Term Outcome
Authors: Dinshaw Leon , Münkler Paula , Schäffer Benjamin , Klatt Niklas , Jungen Christiane , Dickow Jannis , Tamenang Annika , Schleberger Ruben , Pecha Simon , Pinnschmidt Hans , Patten Monica , Reichenspurner Hermann , Willems Stephan , Meyer Christian
Published: January 2021

Background

Atrial fibrillation (AF) is common in patients with hypertrophic cardiomyopathy (HCM) and is associated with a deterioration of clinical status. Ablation of symptomatic AF is an established therapy, but in HCM, the characteristics of recurrent atrial arrhythmias and the long‐term outcome are uncertain.

Methods and Results

Sixty‐five patients with HCM (aged 64.5±9.9 years, 42 [64.6%] men) underwent AF ablation. The ablation strategy included pulmonary vein isolation in all patients and ablation of complex fractionated atrial electrograms or subsequent atrial tachycardias (AT) if appropriate. Paroxysmal, persistent AF, and a primary AT was present in 13 (20.0%), 51 (78.5%), and 1 (1.5%) patients, respectively. Twenty‐five (38.4%) patients developed AT with a total number of 54 ATs. Stable AT was observed in 15 (23.1%) and unstable AT in 10 (15.3%) patients. The mechanism was characterized as a macroreentry in 37 (68.5%), as a localized reentry in 12 (22.2%), a focal mechanism in 1 (1.9%), and not classified in 4 (7.4%) ATs. After 1.9±1.2 ablation procedures and a follow‐up of 48.1±32.5 months, freedom of AF/AT recurrences was demonstrated in 60.0% of patients. No recurrences occurred in 84.6% and 52.9% of patients with paroxysmal and persistent AF, respectively (
P
<0.01). Antiarrhythmic drug therapy was maintained in 24 (36.9%) patients.

Conclusions

AF ablation in patients with HCM is effective for long‐term rhythm control, and especially patients with paroxysmal AF undergoing pulmonary vein isolation have a good clinical outcome. ATs after AF ablation are frequently observed in HCM. Freedom of atrial arrhythmia is achieved by persistent AF ablation in a reasonable number of patients even though the use of antiarrhythmic drug therapy remains high.
In Search of an Optimal Subset of ECG Features to Augment the Diagnosis of Acute Coronary Syndrome at the Emergency Department
Authors: Bouzid Zeineb , Faramand Ziad , Gregg Richard E. , Frisch Stephanie O. , Martin‐Gill Christian , Saba Samir , Callaway Clifton , Sejdić Ervin , Al‐Zaiti Salah
Published: January 2021

Background

Classical ST‐T waveform changes on standard 12‐lead ECG have limited sensitivity in detecting acute coronary syndrome (ACS) in the emergency department. Numerous novel ECG features have been previously proposed to augment clinicians' decision during patient evaluation, yet their clinical utility remains unclear.

Methods and Results

This was an observational study of consecutive patients evaluated for suspected ACS (Cohort 1 n=745, age 59±17, 42% female, 15% ACS; Cohort 2 n=499, age 59±16, 49% female, 18% ACS). Out of 554 temporal‐spatial ECG waveform features, we used domain knowledge to select a subset of 65 physiology‐driven features that are mechanistically linked to myocardial ischemia and compared their performance to a subset of 229 data‐driven features selected by multiple machine learning algorithms. We then used random forest to select a final subset of 73 most important ECG features that had both data‐ and physiology‐driven basis to ACS prediction and compared their performance to clinical experts. On testing set, a regularized logistic regression classifier based on the 73 hybrid features yielded a stable model that outperformed clinical experts in predicting ACS, with 10% to 29% of cases reclassified correctly. Metrics of nondipolar electrical dispersion (ie, circumferential ischemia), ventricular activation time (ie, transmural conduction delays), QRS and T axes and angles (ie, global remodeling), and principal component analysis ratio of ECG waveforms (ie, regional heterogeneity) played an important role in the improved reclassification performance.

Conclusions

We identified a subset of novel ECG features predictive of ACS with a fully interpretable model highly adaptable to clinical decision support applications.

Registration

URL:
https://www.clinicaltrials.gov
; Unique Identifier: NCT04237688.
Vascular Aging Detected by Peripheral Endothelial Dysfunction Is Associated With ECG‐Derived Physiological Aging
Authors: Toya Takumi , Ahmad Ali , Attia Zachi , Cohen‐Shelly Michal , Ozcan Ilke , Noseworthy Peter A , Lopez‐Jimenez Francisco , Kapa Suraj , Lerman Lilach O , Friedman Paul A , Lerman Amir
Published: January 2021

Background

An artificial intelligence algorithm that detects age using the 12‐lead ECG has been suggested to signal “physiologic age.” This study aimed to investigate the association of peripheral microvascular endothelial function (PMEF) as an index of vascular aging, with accelerated physiologic aging gauged by ECG‐derived artificial intelligence–estimated age.

Methods and Results

This study included 531 patients who underwent ECG and a noninvasive PMEF assessment using reactive hyperemia peripheral arterial tonometry. Abnormal PMEF was defined as reactive hyperemia peripheral arterial tonometry index ≤2.0. Accelerated or delayed physiologic aging was calculated by the Δ age (ECG‐derived artificial intelligence–estimated age minus chronological age), and the association between Δ age and PMEF as well as its impact on composite major adverse cardiovascular events were investigated. Δ age was higher in patients with abnormal PMEF than in patients with normal PMEF (2.3±7.8 versus 0.5±7.7 years;
P
=0.01). Reactive hyperemia peripheral arterial tonometry index was negatively associated with Δ age after adjustment for cardiovascular risk factors (standardized β coefficient, –0.08;
P
=0.048). The highest quartile of Δ age was associated with an increased risk of major adverse cardiovascular events compared with the first quartile of Δ age in patients with abnormal PMEF, even after adjustment for cardiovascular risk factors (hazard ratio, 4.72; 95% CI, 1.24–17.91;
P
=0.02).

Conclusions

Vascular aging detected by endothelial function is associated with accelerated physiologic aging, as assessed by the artificial intelligence–ECG Δ age. Patients with endothelial dysfunction and the highest quartile of accelerated physiologic aging have a marked increase in risk for cardiovascular events.
Diffusion-Weighted Imaging Lesions After Intracerebral Hemorrhage and Risk of Stroke
Authors: Murthy Santosh B. , Zhang Cenai , Gupta Ajay , Cho Sung-Min , Rivera-Lara Lucia , Avadhani Radhika , Gruber Joshua , Iadecola Costantino , Falcone Guido J. , Sheth Kevin N. , Qureshi Adnan I. , Goldstein Joshua N. , Hanley Daniel F. , Kamel Hooman , Ziai Wendy C.
Published: January 2021

Background and Purpose:

Punctate ischemic lesions noted on diffusion-weighted imaging (DWI) are associated with poor functional outcomes after intracerebral hemorrhage (ICH). Whether these lesions increase long-term risk of stroke is poorly understood.

Methods:

We pooled individual patient data from the ATACH-2 trial (Antihypertensive Treatment of Acute Cerebral Hemorrhage) and the MISTIE III trial (Minimally Invasive Surgery Plus Alteplase for Intracerebral Hemorrhage Evacuation Phase 3). We included subjects with a magnetic resonance imaging scan. The exposure was a DWI lesion. The primary outcome was any stroke, defined as a composite of ischemic stroke or recurrent ICH, whereas secondary outcomes were incident ischemic stroke and recurrent ICH. Using multivariate Cox regression analysis, we evaluated the risk of stroke.

Results:

Of 505 patients with ICH with magnetic resonance imaging, 466 were included. DWI lesions were noted in 214 (45.9%) subjects, and 34 incident strokes (20 ischemic stroke and 14 recurrent ICH) were observed during a median follow-up of 324 days (interquartile range, 91–374). Presence of a DWI lesion was associated with a 6.9% (95% CI, 2.2–11.6) absolute increase in risk of all stroke (hazard ratio, 2.6 [95% CI, 1.2–5.7]). Covariate adjustment with Cox regression models also demonstrated this increased risk. In the secondary analyses, there was an increased risk of ischemic stroke (hazard ratio, 3.5 [95% CI, 1.1–11.0]) but not recurrent ICH (hazard ratio, 1.7 [95% CI, 0.6–5.1]).

Conclusions:

In a heterogeneous cohort of patients with ICH, presence of a DWI lesion was associated with a 2.5-fold heightened risk of stroke among ICH survivors. This elevated risk persisted for ischemic stroke but not for recurrent ICH.
Evaluating the scientific impact of research infrastructures: The
role of current research information systems
Authors: Fabre Renaud , Egret Daniel , Schöpfel Joachim , Azeroual Otmane
Published: January 2021

Research infrastructures (RIs) offer researchers a multitude of research opportunities and services and play a key role in the performance, innovative strength, and international competitiveness of science. As an important part of the generation and use of new knowledge and technologies, they are essential for research policies. Because of their strategic importance and their need for significant funding, there is a growing demand for the assessment of their scientific output and impact. Current research information systems (CRIS) have contributed for many years now to the evaluation of universities and research organizations. Based on studies on the application of CRIS to infrastructures and on a recent French report on the scientometric assessment of RI, this paper analyzes the potential of CRIS and their data models and standards (in particular the international CERIF format and the German RDC model) for the monitoring and evaluation of RIs. The interaction between functional specificities of RI and standards for their assessment is outlined, with reference to their own potential to stimulate and share innovation in the networks located inside and outside RIs. This societal challenge, more than an academic issue, is on the way to further harmonization and consolidation of shared and common RI metrics.
Reinhart Koselleck, la génération 45 et le cas Schmitt
Authors: Hoock Jochen
Published: January 2021

Resume

Tout au long de sa vie Reinhart Koselleck a insisté sur son appartenance à une génération marquée par la guerre et par une défaite l’une et l’autre inscrites dans une ère concentrationnaire et postconcentionnaire pour laquelle l’expérience primaire est la condition essentielle de tout travail critique de l’historien et du mémorialiste. L’article décrit les étapes de ce parcours intellectuel, qui aurait dû aboutir à la rédaction d’une Historik, une théorie de l’histoire, qu’il n’a jamais écrite. Quelle a été surtout le rôle du débat autour de l’Etat séculier et de l’historicité du droit, tel qu’il s’est développé au cours des années 1950 dans les cercles autour d’Ernst Forsthoff et de Carl Schmitt ? Quelle forme prendra-t-il sous la pression de l’évolution de la société civile au cours des deux décennies suivantes pour se concrétiser finalement dans une réflexion autour de la notion de « travail de mémoire », dont l’enquête sur l’iconographie des monuments aux morts constituera la dernière étape dans le parcours de l’historien.
Turn-Taking and Disagreement: A Comparison of American English and Mandarin Chinese
Authors: Zhu Weihua , Boxer Diana
Published: January 2021

This study compares turn-taking and disagreement behaviors in spontaneous conversations in American English and Mandarin Chinese. The English and Chinese speakers observed some turn-taking rules and employed weak disagreement, but differed in the deployment of extended concurrent speech and strong disagreement. Analysis of the Chinese speakers’ reactions reveals nothing negative. This was confirmed by the Chinese speakers’ viewpoints that were explicitly stated in follow-up interviews, which signal that they perceived the practice of extended concurrent speech and strong disagreement in the collected conversations as politic. Furthermore, the similarities and differences between the speakers’ turn-taking and disagreement behaviors appear to be constrained by contextual factors. This discloses the interplay of context, practice, and perception. These findings can raise our awareness of potential issues that might occur in intercultural encounters and the importance of understanding cross-cultural pragmatic differences to avoid miscommunication.
Two new species of Centaurea sect. Microlophus (Asteraceae, Cardueae) from Iran

Authors: RANJBAR MASSOUD , ASKARI ALI , MOHAMMADI SOMAYEH
Published: January 2021

Centaurea dezfulica and C. kuhdashtensis are described and illustrated as new species. They belong to C. sect. Microlophus and are endemic to NW Iran. Centaurea dezfulica is closely related to C. pabotii but distinguished from the latter species by densely hispid hairs, plant height 45–50 cm, upper cauline leaves decurrent, segments of lower cauline leaves in 7–8 pairs, larger involucres, 20–23 × 10–20 mm, inner phyllaries obtuse, appendage 2–3 mm long, larger spinule (1–2 mm long) and short central florets and achene. Centaurea kuhdashtensis is distinguished from C. koeieana by loosely hispid hairs, larger lower cauline leaves, pinnatipartite-pinnatilobate, or pinnatifid median [lower] cauline leaves, segments of lower cauline leaves in 15–17 pairs, and those of basal cauline leaves in 14–15 pairs. An updated key to C. dezfulica and C. kuhdashtensis and their closely related taxa in Iran is also provided.