bluuebunny/crossref_metadata_2025 huggingface dataset:
Profile and outcomes of patients with mediastinal hematoma after cardiac catheterization: A retrospective analysis
Authors: Luo Xiao‐Liang , Yang Wei‐Xian , Zhang Jun , Yuan Jian‐Song , Wan Jun‐Yi , Qiao Shu‐Bin
Published: January 2022

Objective

To provide a comprehensive introduction of mediastinal hematoma.

Background

Mediastinal hematoma is a rare complication that is usually not considered in the differential diagnosis of chest pain after cardiac catheterization.

Methods

From January 1, 2006, to December 31, 2013, at Fuwai Hospital, 126,265 patients underwent coronary angiography (CAG); 121,215 of them underwent CAG via the radial artery. Ultimately, 10 patients with mediastinal hematoma due to cardiac catheterization were included. Patients' clinical characteristics, diagnosis, treatment, and prognosis were retrospectively analyzed.

Results

The incidences of mediastinal hematoma in cardiac catheterization and transradial cardiac catheterization were 0.79‱ and 0.74‱, respectively. A super slide hydrophilic guidewire was used in all 10 patients with mediastinal hematoma. These patients felt chest pain and dyspnea during/after the procedure, and computed tomography (CT) was used to diagnose mediastinal hematoma. Among them, two patients had a neck hematoma. The post‐procedural hemoglobin level decreased substantially in all patients. Antiplatelet therapy was discontinued for 8–20 days in three patients without stents implanted, and then only oral aspirin was prescribed. Aspirin was transiently discontinued for 2 days in one patient undergoing percutaneous coronary intervention. The others continued taking dual antiplatelet drugs. Two patients received blood transfusion. There was no case of stent thrombosis, and surgery was not indicated for any patient. No complication was observed after discharge during the 9.0 ± 2.5‐year follow‐up.

Conclusion

CT should be performed as early as possible in patients with suspected mediastinal hematoma. The prognosis of mediastinal hematoma is usually good with early diagnosis and suitable therapy.
Predictors and clinical significance of periprocedural myocardial infarction following rotational atherectomy
Authors: Hong Xu‐Lin , Li Ya , Fu Guo‐Sheng , Zhang Wen‐Bin
Published: January 2022

Objectives

To investigate the potential predictors and clinical significance of periprocedural myocardial infarction (PMI), as defined by the latest Fourth Universal Definition of Myocardial Infarction (2018), following rotational atherectomy (RA).

Background

PMI is not uncommon in patients undergoing RA, although the predictors and prognostic impact are unknown.

Methods

Data from 229 consecutive patients who had undergone RA before drug‐eluting stent (DES) implantation in a single center were analyzed. Patients' demographic information, clinical, angiographic, and procedural characteristics, and 1‐year follow‐up outcomes were collected retrospectively.

Results

The overall incidence of PMI in patients undergoing RA was 48.5%. Age (adjusted odds ratio [OR]: 1.024, 95% confidence interval [CI]: 1.001–1.047, p = 0.043) and ejection fraction (adjusted OR: 0.977, 95% CI: 0.962–0.993, p = 0.004) were independent predictors of PMI in RA, although PMI was not associated with an increased risk of major adverse cardiovascular and cerebrovascular events (MACCEs) at the 1‐year follow‐up in patients undergoing RA.

Conclusion

Age and ejection fraction were independently associated with an elevated risk of PMI in patients undergoing RA. However, post‐RA microinfarcts were not associated with an increased risk of MACCEs over the short‐term follow‐up period.
Validation of cardiogenic shock phenotypes in a mixed cardiac intensive care unit population
Authors: Jentzer Jacob C. , Soussi Sabri , Lawler Patrick R. , Kennedy Jason N. , Kashani Kianoush B.
Published: January 2022

Background

Proposed phenotypes have recently been identified in cardiogenic shock (CS) populations using unsupervised machine learning clustering methods. We sought to validate these phenotypes in a mixed cardiac intensive care unit (CICU) population of patients with CS.

Methods

We included Mayo Clinic CICU patients admitted from 2007 to 2018 with CS. Agnostic K means clustering was used to assign patients to three clusters based on admission values of estimated glomerular filtration rate, bicarbonate, alanine aminotransferase, lactate, platelets, and white blood cell count. In‐hospital mortality and 1‐year mortality were analyzed using logistic regression and Cox proportional‐hazards models, respectively.

Results

We included 1498 CS patients with a mean age of 67.8 ± 13.9 years, and 37.1% were females. The acute coronary syndrome was present in 57.3%, and cardiac arrest was present in 34.0%. Patients were assigned to clusters as follows: Cluster 1 (noncongested), 603 (40.2%); Cluster 2 (cardiorenal), 452 (30.2%); and Cluster 3 (hemometabolic), 443 (29.6%). Clinical, laboratory, and echocardiographic characteristics differed across clusters, with the greatest illness severity in Cluster 3. Cluster assignment was associated with in‐hospital mortality across subgroups. In‐hospital mortality was higher in Cluster 3 (adjusted odds ratio [OR]: 2.6 vs. Cluster 1 and adjusted OR: 2.0 vs. Cluster 2, both p < 0.001). Adjusted 1‐year mortality was incrementally higher in Cluster 3 versus Cluster 2 versus Cluster 1 (all p < 0.01).

Conclusions

We observed similar phenotypes in CICU patients with CS as previously reported, identifying a gradient in both in‐hospital and 1‐year mortality by cluster. Identifying these clinical phenotypes can improve mortality risk stratification for CS patients beyond standard measures.
Acute heart failure as an atypical presentation of Takayasu arteritis: The value of multi‐modality imaging
Authors: Djafari Naeini Sepideh , Bayat Fariba , Houshmand Golnaz
Published: January 2022

Takayasu arteritis (TA) is an inflammatory disease that affects the aorta and the major branch arteries. Here, we describe an atypical presentation of the disease with heart failure.
Nutrition‐related risk and severe hypoglycemia in older adult outpatients with and without diabetes
Authors: Kimura Yoshinobu , Kimura Naoya , Akazawa Manabu
Published: January 2022

In this study, 17 patients with severe hypoglycemia were assessed for nutrition‐related risk using the Geriatric Nutritional Risk Index (GNRI). The results showed that 13 of the 17 patients had nutrition‐related risk. Hypoglycemia should be noted in patients with problems on GNRI, with or without diabetes.
The Impact of Research Culture on Mental Health & Diversity in STEM
Authors: Limas Juanita C. , Corcoran Linda C. , Baker Alexander N. , Cartaya Ana E. , Ayres Zoë J.
Published: January 2022

The onset of COVID‐19, coupled with the finer lens placed on systemic racial disparities within our society, has resulted in increased discussions around mental health. Despite this, mental health struggles in research are still often viewed as individual weaknesses and not the result of a larger dysfunctional research culture. Mental health interventions in the science, technology, engineering, and mathematics (STEM) academic community often focus on what individuals can do to improve their mental health instead of focusing on improving the research environment. In this paper, we present four aspects of research that may heavily impact mental health based on our experiences as research scientists: bullying and harassment; precarity of contracts; diversity, inclusion, and accessibility; and the competitive research landscape. Based on these aspects, we propose systemic changes that institutions must adopt to ensure their research culture is supportive and allows everyone to thrive.
A Rhein‐Based Rh(III) Arene Complex with Anti‐tumor Cell Proliferative Activity Inhibits RNA Demethylase FTO
Authors: Liu Lu , Kong Yaqiong , He Liang , Wang Xiuxiu , Wang Meng‐Meng , Xu Hongjiao , Yang Cai‐Guang , Su Zhi , Zhao Jing , Mao Zong‐Wan , Huang Yue , Liu Hong‐Ke
Published: January 2022

Comprehensive Summary

Metallodrugs with fine‐tuned coordination between metals and bioactive ligands can achieve cytotoxic effects in cancer therapy and have been considered as a new approach for drug design. However, it has yet to be elucidated whether these metallodrugs target epitranscriptomic proteins for gene expression regulation. This report describes a rhein‐based Rh(III)‐arene complex, Rh1, that exhibited promising antiproliferative effects in several tumor cell lines. Rh1 induced cell death through the autophagy, cell cycle arrest, and accumulation of intracellular reactive oxygen species (ROS). In addition, Rh1 upregulated the global N6‐methyladenosine (m6A) levels in A549 cells in the fat mass‐ and obesity‐associated protein (FTO)‐dependent manner. Collectively, the metal‐based FTO inhibitor Rh1 effectively suppressed tumor cell proliferation and modulated the abundance of cellular m6A, highlighting the potential of metal‐based agents to target and regulate epitranscriptomics for tumor suppression.
Tailored risk assessment of 90‐day acute heart failure readmission or all‐cause death to heart failure with preserved versus reduced ejection fraction
Authors: Park Jaeyoung , Zhong Xiang , Babaie Sarijaloo Farnaz , Wokhlu Anita
Published: January 2022

Background

After incident heart failure (HF) admission, patients are vulnerable to readmission or death in the 90‐day post‐discharge. Although risk models for readmission or death incorporate ejection fraction (EF), patients with HF with preserved EF (HFpEF) and those with HF with reduced EF (HFrEF) represent distinct cohorts. To better assess risk, this study developed machine learning models and identified risk factors for the 90‐day acute HF readmission or death by HF subtype.

Methods and Results

Approximately 1965 patients with HFpEF and 1124 with HFrEF underwent an index admission. Acute HF rehospitalization or death occurred in 23% of HFpEF and 28% of HFrEF groups. Of the 101 variables considered, multistep variable selection identified 24 and 25 significant factors associated with 90‐day events in HFpEF and HFrEF, respectively. In addition to risk factors common to both groups, factors unique to HFpEF patients included cognitive dysfunction, low‐pulse pressure, β‐blocker, and diuretic use, and right ventricular dysfunction. In contrast, factors unique to HFrEF patients included a history of arrhythmia, acute HF on presentation, and echocardiographic characteristics like left atrial dilatation or elevated mitral E/A ratio. Furthermore, the model tailored to HFpEF (area under the curve [AUC] = 0.770; 95% confidence interval [CI] 0.767–0.774) outperformed a model for the combined groups (AUC = 0.759; 95% CI 0.756–0.763).

Conclusion

The UF 90‐day post‐discharge acute HF
Re
admission or
Death
Risk
Assessment (UF90‐RADRA) models help identify HFpEF and HFrEF patients at higher risk who may require proactive outpatient management.
Network intrusion detection based on ensemble classification and feature selection method for cloud computing
Authors: Krishnaveni Sivamohan , Sivamohan Sivanandam , Sridhar Subramanian , Prabhakaran Subramani
Published: January 2022

Cloud computing security is the most critical factor for providers, cloud users, and organizations. The various novel approaches apply host‐based or network‐based methods to increase cloud security performance and detection rate. However, due to the virtual and distributed environment of the cloud, conventional network intrusion detection systems (NIDS) have been unreliable in handling these security attacks. Therefore, we design a methodology that incorporates feature selection and classification using ensemble techniques to provide efficient and accurate intrusion detection to address these problems. This proposed model combines the three most effective feature selection techniques (gain‐ratio, chi‐squared, and information gain) to offer a qualifying result and four top classifiers (SVM, LR, NB, and DT) using enhanced weighted majority voting. Moreover, we proposed an experimental technique using a new dataset called Honeypot. All experiments utilized three datasets: Honeypots, Kyoto, and NSL: KDD. In addition, the results of this experimental study were compared with other approaches and performed the statistical significance analysis. Finally, the results reveal that the proposed intrusion detection based on the Honeypot dataset was better and more efficient than other methods because we have an accuracy of 98.29%, FAR of 0.012%, DR of 97.9%, and AUC = 0.9921.
QoE‐aware mobile computation offloading in mobile edge computing
Authors: Sivasakthi Dharmalingam Adhimuga , Gunasekaran Raja
Published: January 2022

Due to the rapid development of smart phone utilization, the use of fast response with delay sensitive applications leads to high traffic demands. These issues are not yet fulfill by current researchers. When there is a massive crowd of users gathering in hotspot areas such as, railway stations, corporate centers, and malls requires service accessing social networks, then there cause uncertain traffic with congestion and network delay. In this article, an Efficient Offloading Mechanism (EOM) is proposed to transfer the user's intensive computations to picocells, where each picocell (PE) is integrated with the functionalities of edge. Moreover, a novel distributed multihop mesh middle layer (DMMM) framework is proposed for seamless communication, where the self‐healing network provides high resilience, immediate response, and multiuser content sharing and saves battery power. Generally, a picocell is a distributed antenna system that is an alternative to the repeater utilized to extend wireless services to 100 users. An Adaptive Ant Optimization (AAO) algorithm is developed for backhaul routing conflicts. Simulation outcomes of EdgeCloudSim prove that the offloading tiny devices incorporated with considerable additional computational capacities to fulfill all the demands within 15 ms delay from each network.
Functional Loss and Mortality in Randomized Clinical Trials for Amyotrophic Lateral Sclerosis: To Combine, or Not to Combine—That is the Estimand
Authors: van Eijk Ruben P.A. , Roes Kit C.B. , de Greef‐van der Sandt Inez , van den Berg Leonard H. , Lu Ying
Published: January 2022

Amyotrophic lateral sclerosis is a rapidly progressive disease leading to death in, on average, 3–5 years after first symptom onset. Consequently, there are frequently a non‐negligible number of patients who die during the course of a clinical trial. This introduces bias in end points such as daily functioning, muscle strength, and quality of life. In this paper, we outline how the choice of strategy to handle death affects the interpretation of the trial results. We provide a general overview of the considerations, positioned in the estimand framework, and discuss the possibility that not every strategy provides a clinically relevant answer in each setting. The relevance of a strategy changes as a function of the intended trial duration, hypothesized treatment effect, and population included. It is important to consider this trade‐off at the design stage of a clinical trial, as this will clarify the exact research question that is being answered, and better guide the planning, design, and analysis of the study.
Metformin promotes histone deacetylation of optineurin and suppresses tumour growth through autophagy inhibition in ocular melanoma
Authors: Zhuang Ai , Chai Peiwei , Wang Shaoyun , Zuo Sipeng , Yu Jie , Jia Shichong , Ge Shengfang , Jia Renbing , Zhou Yixiong , Shi Wodong , Xu Xiaofang , Ruan Jing , Fan Xianqun
Published: January 2022

Objective

To explore the therapeutic potential and the underlying mechanism of metformin, an adenosine monophosphate‐activated kinase (AMPK) activator, in ocular melanoma.

Methods

CCK8, transwell, and colony formation assays were performed to detect the proliferation and migration ability of ocular melanoma cells. A mouse orthotopic xenograft model was built to detect ocular tumor growth in vivo. Western blot, immunofluorescence, and electron microscopy were adopted to evaluate the autophagy levels of ocular melanoma cells, and high‐throughput proteomics and CUT & Tag assays were performed to analyze the candidate for autophagy alteration.

Results

Here, we revealed for the first time that a relatively low dose of metformin induced significant tumorspecific inhibition of the proliferation and migration of ocular melanoma cells both in vitro and in vivo. Intriguingly, we found that metformin significantly attenuated autophagic influx in ocular melanoma cells. Through high‐throughput proteomics analysis, we revealed that optineurin (OPTN), which is a key candidate for autophagosome formation and maturation, was significantly downregulated after metformin treatment. Moreover, excessive OPTN expression was associated with an unfavorable prognosis of patients. Most importantly, we found that a histone deacetylase, SIRT1, was significantly upregulated after AMPK activation, resulting in histone deacetylation in the OPTN promoter.

Conclusions

Overall, we revealed for the first time that metformin significantly inhibited the progression of ocular melanoma, and verified that metformin acted as an autophagy inhibitor through histone deacetylation of OPTN. This study provides novel insights into metformin ‐ guided suppression of ocular melanoma and the potential mechanism underlying the dual role of metformin in autophagy regulation.
Interactions with soil fungi alter density dependence and neighborhood effects in a locally abundant dipterocarp species
Authors: Segnitz R. Max , Russo Sabrina E. , Peay Kabir G.
Published: January 2022

Seedling recruitment can be strongly affected by the composition of nearby plant species. At the neighborhood scale (on the order of tens of meters), adult conspecifics can modify soil chemistry and the presence of host microbes (pathogens and mutualists) across their combined canopy area or rooting zones. At local or small spatial scales (on the order of one to few meters), conspecific seed or seedling density can influence the strength of intraspecific light and resource competition and also modify the density‐dependent spread of natural enemies such as pathogens or invertebrate predators. Intrinsic correlation between proximity to adult conspecifics (i.e., recruitment neighborhood) and local seedling density, arising from dispersal, makes it difficult to separate the independent and interactive factors that contribute to recruitment success. Here, we present a field experiment in which we manipulated both the recruitment neighborhood and seedling density to explore how they interact to influence the growth and survival of Dryobalanops aromatica, a dominant ectomycorrhizal tree species in a Bornean tropical rainforest. First, we found that both local seedling density and recruitment neighborhood had effects on performance of D. aromatica seedlings, though the nature of these impacts varied between growth and survival. Second, we did not find strong evidence that the effect of density on seedling survival is dependent on the presence of conspecific adult trees. However, accumulation of mutualistic fungi beneath conspecifics adults does facilitate establishment of D. aromatica seedlings. In total, our results suggest that recruitment near adult conspecifics was not associated with a performance cost and may have weakly benefitted recruiting seedlings. Positive effects of conspecifics may be a factor facilitating the regional hyperabundance of this species. Synthesis: Our results provide support for the idea that dominant species in diverse forests may escape the localized recruitment suppression that limits abundance in rarer species.
Insect herbivory increases from forest to alpine tundra in Arctic mountains
Authors: Zvereva Elena L. , Zverev Vitali , Kozlov Mikhail V.
Published: January 2022

Current theory holds that the intensity of biotic interactions decreases with increases in latitude and elevation; however, empirical data demonstrate great variation in the direction, strength, and shape of elevational changes in herbivory. The latitudinal position of mountains may be one important source of this variation, but the acute shortage of data from polar mountains hampers exploration of latitude effects on elevational changes in herbivory. Here, we reduce this knowledge gap by exploring six elevation gradients located in three Arctic mountain ranges to test the prediction that a decrease in herbivory occurs with increasing elevation from forest to alpine tundra. Across the 10 most abundant evergreen and deciduous woody plant species, relative losses of foliage to insect herbivores were 2.2‐fold greater at the highest elevations (alpine tundra) than in mid‐elevation birch woodlands or low‐elevation coniferous forests. Plant quality for herbivores (quantified by specific leaf area) significantly decreased with elevation across all studied species, indicating that bottom‐up factors were unlikely to shape the observed pattern in herbivory. An experiment with open‐top chambers established at different elevations showed that even a slight increase in ambient temperature enhances herbivory in Arctic mountains. Therefore, we suggest that the discovered increase in herbivory with elevation is explained by higher temperatures at the soil surface in open habitats above the tree line compared with forests at lower elevations. This explanation is supported by the significant difference in elevational changes in herbivory between low and tall plants: herbivory on low shrubs increased fourfold from forest to alpine sites, while herbivory on trees and tall shrubs did not change with elevation. We suggest that an increase in herbivory with an increase in elevation is typical for high‐latitude mountains, where inverse temperature gradients, especially at the soil surface, are common. Verification of this hypothesis requires further studies of elevational patterns in herbivory at high latitudes.
Left ventricular mass index‐to‐QRS‐voltage ratio predicts outcomes in heart failure with preserved ejection fraction
Authors: Kinugasa Yoshiharu , Nakamura Kensuke , Kamitani Hiroko , Hirai Masayuki , Yanagihara Kiyotaka , Kato Masahiko , Nagai Toshiyuki , Yoshikawa Tsutomu , Saito Yoshihiko , Takeishi Yasuchika , Yamamoto Kazuhiro , Anzai Toshihisa
Published: January 2022

Aims

Increased left ventricular mass index (LVMI) disproportionate to electrocardiographic QRS voltage has been reported to be associated with cardiac fibrosis and amyloid infiltration to myocardium. This study aimed to assess whether the LVMI‐to‐QRS‐voltage ratio predicts clinical outcomes in heart failure with preserved ejection fraction (HFpEF).

Methods and results

The Japanese Heart Failure Syndrome with Preserved Ejection Fraction (JASPER) registry is a nationwide, observational, and prospective registration of Japanese patients hospitalized with HFpEF (EF ≥ 50%). LVMI was assessed by echocardiography using the cube formula. QRS voltage was assessed by Sokolow–Lyon voltage criteria. We divided 290 patients in the registry who met inclusion criteria into five groups according to the quintile values of their LVMI‐to‐QRS‐voltage ratio. In the highest quintile group (≥71.8 g/m2/mV), approximately 50% of the patients had concentric hypertrophy and 30% had eccentric hypertrophy. These patients had the highest proportion of atrial fibrillation (61.4%) and history of pacemaker implantation (12.1%) among the five groups (P < 0.05). During the mean follow‐up of 587 ± 300 days, 31.4% of all patients met the composite endpoint of all‐cause death or rehospitalization for HF. Even after adjustment for demographic and baseline variables, the highest quintile group had a significantly higher incidence of the composite endpoints than the lowest quintile group (<30.7 g/m2/mV) (hazard ratio: 2.205, 95% confidence interval: 1.106–4.395, P < 0.05).

Conclusions

A high LVMI‐to‐QRS‐voltage ratio is independently associated with poor outcomes in patients with HFpEF.
Geochronology and geochemistry of the Triassic intrusive rocks in the Faku area, northern Liaoning, China: Constraints on the evolution of the Palaeo‐Asian Ocean
Authors: Shi Shao‐Shan , Shi Yi , Zhang Chao , Shi Jian‐Min , Jiang Shan
Published: January 2022

This study reports petrography, geochemistry, geochronology, and Lu–Hf isotopic analyses of Xiaofangshen, Lingshansibei, and Shidonggou plutons, which are located in the northern Liaoning Province, eastern segment of the northern margin of the North China Craton. In this study, we discuss their formation ages, petrogenesis, and tectonic environment. Petrographic characteristics suggest that these plutons are composed mainly of granitic rocks and are widely altered by later deformation. Zircon U–Pb dating results suggest formation ages of 248.2 ± 1.4 Ma, 245.1 ± 1.5 Ma, and 230.6 ± 2.5 Ma for the Xiaofangshen, Lingshansibei, and Shidonggou plutons, respectively. The geochemical characteristics indicate that both the Xiaofangshen and Lingshansibei plutons are metaluminous, high‐K calc‐alkaline‐shoshonitic granites that formed in a crustal thickening environment; the Shidonggou pluton is peraluminous, calc‐alkaline I‐type granite that formed in a post‐orogenic environment. All granitic plutons in the study area are enriched in large‐ion lithophile elements and light rare earth elements (REEs) and depleted in high‐field‐strength elements and heavy REEs. Combined with geochemical characteristics of the plutons and previous studies on the region, we conclude that the eastern part of the Palaeo‐Asian Ocean closed in the Late Permian to Early Triassic. The orogeny of the eastern segment of the northern margin of the North China Craton continued until the early Late Triassic.
A review on risk assessment in managed aquifer recharge
Authors: Imig Anne , Szabó Zsóka , Halytsia Olha , Vrachioli Maria , Kleinert Verena , Rein Arno
Published: January 2022

Managed aquifer recharge (MAR) refers to a suite of methods that is increasingly being applied worldwide for sustainable groundwater management to tackle drinking or irrigation water shortage or to restore and maintain groundwater ecosystems. The potential for MAR is far from being exhausted, not only due to geological and hydrogeological conditions or technical and economic feasibility but also due to its lack of acceptance by the public and policymakers. One approach to enable the safe and accepted use of MAR could be to provide comprehensive risk management, including the identification, analysis, and evaluation of potential risks related to MAR. This article reviews current MAR risk assessment methodologies and guidelines and summarizes possible hazards and related processes. It may help planners and operators select the appropriate MAR risk assessment approaches and support the risk identification process. In addition to risk assessment (and subsequent risk treatment) related to the MAR implementation phase, this review also addresses risk assessment for MAR operation. We also highlight the limitations and lessons learned from the application and development of risk assessment methodologies. Moreover, developments are recommended in the area of MAR-related risk assessment methodologies and regulation. Depending on data availability, collected methodologies may be applicable for MAR sites worldwide. Integr Environ Assess Manag 2022;18:1513–1529. © 2022 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

KEY POINTS

The past two decades have seen a marked increase in the literature on MAR-related risk assessment, and a further increase is expected, since more attractive strategies are being used worldwide for integrated groundwater management. The development of holistic risk management plans can improve social acceptability and contribute to safer implementation and operation of MAR schemes. In connection with holistic risk management, MAR can be seen as a viable option for reaching the United Nations Sustainable Development Goal #6. Widely lacking regulations worldwide for risk assessment of MAR schemes is identified to hinder MAR implementation and safe operation worldwide.
BDU‐net: Toward accurate segmentation of dental image using border guidance and feature map distortion
Authors: Zhang Fan , Zhu Junhua , Hao Pengyi , Wu Fuli , Zheng Yuanna
Published: January 2022

The importance of instance segmentation for each tooth is increasing in dental disease diagnosis and computer‐assisted treatment. However, most existing segmentation methods are mainly concerned with semantic feature extraction, while ignoring complex situations such as blurred boundaries and dislocation of teeth in panoramic radiographs. To address these problems, we propose a dual subnetworks structure based on border guidance and feature map distortion, called BDU‐net. Specifically, we embed the Disout method with the capability to distort features into the encoder to obtain multi‐scale feature maps with excellent generalization. Then, the distorted feature map is submitted to two subnetworks, each having a feature pyramid structure in a shared manner, including a border subnetwork that adjusts the segmentation boundaries and a region subnetwork that generates the region segmentation results. Experiments conducted on the teeth segmentation dataset show that the proposed BDU‐net performs better than the other approaches, especially for the case of teeth missing or dislocated teeth.
Neuromuscular disease detection based on feature extraction from time–frequency images of EMG signals employing robust hyperbolic Stockwell transform
Authors: Samanta Kaniska , Chatterjee Soumya , Bose Rohit
Published: January 2022

In this paper, a novel technique for detection of healthy (H), myopathy, (M) and amyotrophic lateral sclerosis (ALS) electromyography (EMG) signals is proposed employing robust hyperbolic Stockwell transform (HST). HST is an efficient signal processing technique to analyze any nonstationary signal in joint time–frequency (T–F) plane. However, a major issue with HST is the optimum selection of Gaussian window parameters since the resolution in the T–F plane depends on the shape of the window. Considering the aforesaid fact, in this article, a genetic algorithm (GA) based optimized HST is proposed for improved EMG signal analysis in T–F plane. Several novel features were extracted from HST spectrum and features with high statistical significance were selected for classification using several benchmark classifiers. It was observed that optimized HST resulted in better classification accuracy of EMG signals which indicates its potential for clinical applications.
Skin's green autofluorescence at dorsal centremetacarpus may become a novel biomarker for diagnosis of lung cancer
Authors: Zhang Mingchao , Tao Yue , Chang Qing , Wang Kaixuan , Chu Tianqing , Ying Weihai
Published: January 2022

It is critical to discover novel biomarkers of lung cancer for establishing economical technology for diagnosis of lung cancer. Our study has suggested that the autofluorescence (AF) of the skin may become a novel biomarker of this type: First, development of lung cancer led to a significant increase in the skin's green AF in a mouse model of lung cancer; second, lung cancer patients had significantly higher skin's green AF at certain positions compared with healthy volunteers and pulmonary infection patients; and third, using the skin's green AF intensity at dorsal centremetacarpus as the variable, the areas under curve (AUC) for differentiating lung cancer patients and pulmonary infection patients and for differentiating lung cancer patients and healthy volunteers was 0.871 and 0.813, respectively. Collectively, our study has indicated that the skin's green AF at dorsal centremetacarpus may become a novel biomarker for establishing a ground‐breaking diagnostic strategy for lung cancer.
Impact of Covid‐19 on Maternal Health Seeking in Ghana
Authors: Asuming Patrick Opoku , Gaisie Deborah Aba , Agula Caesar , Bawah Ayaga Agula
Published: January 2022

The Covid‐19 pandemic is widely speculated to have disrupted the delivery of primary health care in low‐income countries. Yet, there is little rigorous empirical research identifying this effect. This paper estimates the impact of Covid‐19 on facility and skilled delivery and utilisation of antenatal care (ANC) services by comparing these outcomes for women who were pregnant/delivered before and during the Covid‐19 period. The results show that Covid‐19 led to 23% and 25% reductions, respectively, in the likelihood of facility delivery and four or more ANC visits during pregnancy. These findings highlight the need to build more resilient health systems in low‐income settings.
Correlation between vaccine coverage and the COVID‐19 pandemic throughout the world: Based on real‐world data
Authors: Huang Chao , Yang Lijun , Pan Jia , Xu Xiaomei , Peng Rong
Published: January 2022

The aim of the study was to examine the correlation between COVID‐19 vaccine coverage rates and outcomes of the COVID‐19 epidemic in the case of COVID‐19 variants based on real‐world data. The data came from Our World in Data, which is building the international COVID‐19 vaccination data set and is an open‐source data set for everyone to use. The vaccination data set uses the most recent official numbers from governments and health ministries worldwide. We assessed the correlation between COVID‐19 vaccine coverage rates and outcomes of the COVID‐19 epidemic with existing variants by performing temporal analysis and spatial analysis. Overall, new cases per million population, the reproduction rate of COVID‐19, new deaths from all causes per million population, excess mortality attributed to COVID‐19 pandemic, and hospital patients or intensive care unit (ICU) patients per million population were not decreased with the time course. However, at the same time point, new cases per million population, the reproduction rate of COVID‐19, new deaths per million population, and hospital patients or ICU patients per million population gradually decreased as the rate of vaccination coverage increased. High coverage percentages of COVID‐19 vaccination were negatively correlated with the reproduction rate of COVID‐19 (correlation coefficient −0.116) and ICU patients per million of the local population (correlation coefficient −0.055). Currently, there is no effective treatment for the COVID‐19 pandemic, and prevention of the COVID‐19 pandemic mainly depends on vaccines, especially when the rate of COVID‐19 vaccine coverage is over 60%. The benefits of preventing severe disease and preventing transmission of infection are likely to be obvious.
An analysis of antibody response following the second dose of CoronaVac and humoral response after booster dose with BNT162b2 or CoronaVac among healthcare workers in Turkey
Authors: Çağlayan Derya , Süner Ahmet F. , Şiyve Neslişah , Güzel Irmak , Irmak Çağlar , Işik Elif , Appak Özgür , Çelik Muammer , Öztürk Gamze , Alp Çavuş Sema , Ergör Gül , Sayiner Arzu , Ergör Alp , Demiral Yücel , Kiliç Bülent
Published: January 2022

Limited data are available on the short‐ to midterm levels of antibodies to the CoronaVac vaccine and quantitative change in humoral response after homologous or heterologous booster doses. In this prospective cohort study, we evaluated the anti‐receptor‐binding domain (RBD) immunoglobulin G (IgG) levels after two doses of CoronaVac and heterologous/homologous booster administration among healthcare workers in a university hospital in Turkey. Quantitative anti‐RBD IgG antibody levels were measured at first and fourth months in 560 healthcare workers who had completed two doses of CoronaVac vaccine, and within 2 months after the third dose of CoronaVac or BNT162b2. Participants were asked to complete a questionnaire during the first blood draw. The seropositivity rate was 98.9% and 89.1%, and the median antibody level was 469.2 AU/ml and 166.5 AU/ml at first and fourth month, respectively. In the fourth month, a mean reduction of 61.4% ± 20% in antibody levels was observed in 79.8% of the participants. The presence of chronic disease (odds ratio [OR]: 1.76, 95% confidence interval [CI]: 1.15–2.69) and being in the 36–50 age group (OR: 2.11, 95% CI: 1.39–3.19) were identified as independent predictors for low antibody response. The antibody level increased 104.8‐fold (median: 17 609.4 vs. 168 AU/ml) and 8.7‐fold (median: 1237.9 vs. 141.4 AU/ml) in the participants who received BNT162b2 and CoronaVac, respectively. During the follow‐up, 25 healthcare workers (4.5%) were infected with severe acute respiratory syndrome coronavirus 2. Considering the waning immunity and circulating variants, a single booster dose of messenger RNA vaccine seems reasonable after the inactivated vaccine especially in risk groups.
Impact of Social Determinants of Health on Stereotactic Radiotherapy for Vestibular Schwannoma
Authors: Desai Amar D. , Shah Vraj P. , Tseng Christopher C. , Povolotskiy Roman , Wackym P. Ashley , Ying Yu‐Lan Mary
Published: January 2022

Objectives/Hypothesis

Linear accelerator (LINAC) and Gamma Knife (GK) are common stereotactic radiation therapies for treating vestibular schwannoma (VS). There is currently limited literature examining specific demographic and socioeconomic factors, which influence the type of stereotactic radiation therapy a patient with VS receives.

Study Design

Retrospective database review.

Methods

The National Cancer Database was queried for cases of VS between 2004 and 2016. Patient demographic characteristics were compared using chi‐squared and t‐tests between GK and LINAC treated groups. Multivariate regression analysis was performed to assess predictors of stereotactic radiation therapy received.

Results

Of the 6,208 included patients, 5,306 (85.5%) received GK and 902 (14.5%) received LINAC. The mean age of GK patients was significantly lower than that of LINAC patients (58.0 vs. 59.7, P < .001). Individuals treated with GK had greater proportions of private insurance (P < .001) and incomes greater than $63,332 (P = .003). A greater proportion of GK patients were treated in academic centers (P < .001), in high‐volume facilities (P < .001), in metropolitan areas (P < .001), and in the Northeastern United States (P < .001). On multivariate logistic regression analysis, region, metropolitan area, facility type, tumor size, and distance traveled by patients independently predict receipt of GK versus LINAC.

Conclusion

Differences in patient demographics and other social determinants of health influence choice of GK versus LINAC therapy for VS patients. Future studies focused on addressing barriers to care, which may influence postprocedural quality of life and clinical outcomes associated with these two treatments are necessary to better understand the impact of these social differences.

Level of Evidence

4 Laryngoscope, 132:2232–2240, 2022
Presence of exacerbating factors of persistent perceptual‐postural dizziness in patients with vestibular symptoms at initial presentation
Authors: Kabaya Kayoko , Tamai Hitomi , Okajima Akina , Minakata Toshiya , Kondo Masaki , Nakayama Meiho , Iwasaki Shinichi
Published: January 2022

Objective

To investigate the presence of exacerbating factors of persistent perceptual‐postural dizziness (PPPD) in patients with vestibular symptoms during the early period after vestibular symptoms onset, and to examine possible predictive factors for developing PPPD later.

Methods

One hundred and fifty‐five consecutive patients with vestibular symptoms who presented less than 90 days from the onset were included in this study. They filled out the Niigata PPPD Questionnaire (NPQ) that consists of 12 questions on the exacerbating factors of PPPD. The NPQ scores of patients who developed PPPD were compared with those of patients who did not develop PPPD during the follow‐up.

Results

Seventy‐eight of the155 patients (50.3%) showed positive NPQ scores (≥27 points). High NPQ scores were found in patients diagnosed with psychogenic dizziness and vestibular neuritis. During the follow up for an average of 543.3 days after the initial presentation, eight patients (10.3%) developed PPPD. Seven of these eight patients (87.6%) showed positive NPQ scores and all of them had all three exacerbating factors of PPPD at their initial presentation. The NPQ scores of the patients who developed PPPD (40.6 ± 11.6) were significantly higher than those of the patients who did not develop PPPD (26.4 ± 18.3; p <.05).

Conclusion

Approximately a half of the patients with vestibular symptoms had exacerbating factors of PPPD in the early stages of the disease. Patients who develop PPPD are likely to have its exacerbating factors in the initial stages after presentation.

Level of Evidence: 3.
Vocal fold mucus layer: Comparison of histological protocols for visualization in mice
Authors: An Ran , Robbins Daniel , Rey Federico E. , Thibeault Susan L.
Published: January 2022

Objectives

The epithelial associated mucus layer of vocal fold (VF) mucosa, plays an essential role in protecting and lubricating the tissue, as well as promoting normal voice quality. Serving as a habitat for laryngeal microbiota involved in the regulation of host immunity, VF mucus contributes to laryngeal health and disease. However, its unstable structure renders its' investigation challenging. We aim to establish a reproducible histological protocol to recover the natural appearance of the VF mucus layer for investigation.

Methods

Using a murine model, we compared the suitability of multiple fixation methods—methacarn, formalin, and cryopreservation followed by post‐fixation with formalin, paraformaldehyde (PFA), acetone, and two staining methods—Alcian Blue (pH 2.5)/Periodic Acid Schiff (AB/PAS) or PAS. Fixation and staining outcomes were evaluated based on the preservation of tissue morphology and mucus layer integrity. Mucin proteins, Muc1 and Muc4, were stained to validate the presence of mucus layer overlaying the VF mucosa.

Results

Methacarn fixation followed by PAS staining was capable of preserving and displaying the smooth and continuous mucus layer, ensuring the determination of mucus thickness and mucin staining.

Conclusions

Our study if the first to establish a histological protocol for the visualization of the in situ VF mucus layer whereby facilitating the study of VF mucus biology including VF surface hydration, ion/nutrients transports, biomechanical properties that maintains normal voice quality as well as VF pathophysiology and host‐microbe interactions in the larynx.

Level of Evidence

N/A.
Serum lipid analysis and isotopic enrichment is suggestive of greater lipogenesis in young long‐term cannabis users: A secondary analysis of a case–control study
Authors: Cisbani Giulia , Koppel Alex , Metherel Adam H. , Smith Mackenzie E. , Aji Kankana N. , Andreazza Ana C. , Mizrahi Romina , Bazinet Richard P.
Published: January 2022

Cannabis is now legal in many countries and while numerous studies have reported on its impact on cognition and appetite regulation, none have examined fatty acid metabolism in young cannabis users. We conducted an exploratory analysis to evaluate cannabis impact on fatty acid metabolism in cannabis users (n = 21) and non‐cannabis users (n = 16). Serum levels of some saturated and monounsaturated fatty acids, including palmitic, palmitoleic, and oleic acids were higher in cannabis users compared to nonusers. As palmitic acid can be derived from diet or lipogenesis from sugars, we evaluated lipogenesis using a de novo lipogenesis index (palmitate/linoleic acid) and carbon‐specific isotope analysis, which allows for the determination of fatty acid 13C signature. The significantly higher de novo lipogenesis index in the cannabis users group along with a more enriched 13C signature of palmitic acid suggested an increase in lipogenesis. In addition, while serum glucose concentration did not differ between groups, pyruvate and lactate were lower in the cannabis user group, with pyruvate negatively correlating with palmitic acid. Furthermore, the endocannabinoid 2‐arachidonoylglycerol was elevated in cannabis users and could contribute to lipogenesis by activating the cannabinoid receptor 1. Because palmitic acid has been suggested to increase inflammation, we measured peripheral cytokines and observed no changes in inflammatory cytokines. Finally, an anti‐inflammatory metabolite of palmitic acid, palmitoylethanolamide was elevated in cannabis users. Our results suggest that lipogenic activity is increased in cannabis users; however, future studies, including prospective studies that control dietary intake are required.
Coordination through revenue sharing contract in an E‐commerce supply chain with consumer preference
Authors: Liu Aijun , Li Dengxue , Jie Miao , Li Zengxian
Published: January 2022

The decision‐making and coordination of an e‐commerce supply chain (ECSC) with consumer preferences are studied. In this paper, the ECSC, consisting of a single manufacturer and a single e‐commerce platform, is considered, and the optimal decisions are made for two scenarios, namely, decentralized and centralized decision models. Then, a comparative analysis is performed for two models. The coordination mechanism of “revenue sharing” is proposed based on the decentralization, and finally, a numerical analysis is used to verify the conclusions. The theoretical results show that the e‐commerce platform is less profitable than the manufacturer because of its economies of scale. Interestingly, the quality of e‐commerce services under decentralized decision is instead the highest, and improving the service level of e‐commerce does not always benefit e‐commerce platforms. Meanwhile, a revenue sharing contract will reduce the price and profit gap between the manufacturer and the e‐commerce platform.
Inducing somatic cells into pluripotent stem cells is an important platform to study the mechanism of early embryonic development
Authors: Cui Guina , Xu Yanwen , Cao Shuyuan , Shi Kerong
Published: January 2022

The early embryonic development starts with the totipotent zygote upon fertilization of differentiated sperm and egg, which undergoes a range of reprogramming and transformation to acquire pluripotency. Induced pluripotent stem cells (iPSCs), a nonclonal technique to produce stem cells, are originated from differentiated somatic cells via accomplishment of cell reprogramming, which shares common reprogramming process with early embryonic development. iPSCs are attractive in recent years due to the potentially significant applications in disease modeling, potential value in genetic improvement of husbandry animal, regenerative medicine, and drug screening. This review focuses on introducing the research advance of both somatic cell reprogramming and early embryonic development, indicating that the mechanisms of iPSCs also shares common features with that of early embryonic development in several aspects, such as germ cell factors, DNA methylation, histone modification, and/or X chromosome inactivation. As iPSCs can successfully avoid ethical concerns that are naturally present in the embryos and/or embryonic stem cells, the practicality of somatic cell reprogramming (iPSCs) could provide an insightful platform to elucidate the mechanisms underlying the early embryonic development.