bluuebunny/crossref_metadata_2025 huggingface dataset:
Establishment of an Immune-Related Gene Signature for Risk Stratification for Patients with Glioma
Authors: He Jimin , Zeng Chun , Long Yong
Published: August 2021

Glioma is a frequently seen primary malignant intracranial tumor, characterized by poor prognosis. The study is aimed at constructing a prognostic model for risk stratification in patients suffering from glioma. Weighted gene coexpression network analysis (WGCNA), integrated transcriptome analysis, and combining immune-related genes (IRGs) were used to identify core differentially expressed IRGs (DE IRGs). Subsequently, univariate and multivariate Cox regression analyses were utilized to establish an immune-related risk score (IRRS) model for risk stratification for glioma patients. Furthermore, a nomogram was developed for predicting glioma patients’ overall survival (OS). The turquoise module (

cor
=
0.67

;

P
<
0.001

) and its genes (

n
=
1092

) were significantly pertinent to glioma progression. Ultimately, multivariate Cox regression analysis constructed an IRRS model based on VEGFA, SOCS3, SPP1, and TGFB2 core DE IRGs, with a C-index of 0.811 (95% CI: 0.786-0.836). Then, Kaplan-Meier (KM) survival curves revealed that patients presenting high risk had a dismal outcome (

P
<
0.0001

). Also, this IRRS model was found to be an independent prognostic indicator of gliomas’ survival prediction, with HR of 1.89 (95% CI: 1.252-2.85) and 2.17 (95% CI: 1.493-3.14) in the Cancer Genome Atlas (TCGA) and Chinese Glioma Genome Atlas (CGGA) datasets, respectively. We established the IRRS prognostic model, capable of effectively stratifying glioma population, convenient for decision-making in clinical practice.
Effect of Xinyi Biyan Pill in Adjuvant Treatment of Patients with Chronic Rhinosinusitis and Its Influence on Serum Inflammatory Factors and Immune Function
Authors: Bao Qingfu , Zhou Yu , Zhang Lei
Published: August 2021

Objective. To explore the effect of Xinyi Biyan Pill in adjuvant treatment of patients with chronic rhinosinusitis (CRS) and its influence on serum inflammatory factors and immune function. Methods. From January 2017 to April 2020, 112 CRS patients admitted to this hospital were randomly divided into the control group (n = 52) and the study group (n = 60). The control group was treated with endoscopic sinus surgery (ESS), after the operation, levofloxacin capsules were taken orally, budesonide nasal spray was given, and the nasal cavity was flushed with normal saline; on the basis of that mentioned above, the study group was treated with Xinyi Biyan Pill orally after the surgery. The clinical efficacy and the symptom relief time of nasal congestion and runny nose, hyposmia, mucosal edema, and vesicles disappearance of the two groups after treatment were observed; the serum inflammatory factors’ (C-reactive protein (CRP), interleukin-6 (IL-6), and interleukin-8 (IL-8)) and immune function indexes’ (total immunoglobulin E (TIgE), eosinophil cationic protein (ECP), CD3+, CD4+, and CD4+/CD8+) expression levels before and after treatment in the two groups were detected; the recurrence of CRS after 1 year of treatment in the two groups was recorded. Result. After treatment, the total clinical effective rate of the study group (92.98%) was significantly higher than that of the control group (78.00%) (

P
<
0.05

). After treatment, the symptom relief time of nasal congestion and runny nose, hyposmia, mucosal edema, and vesicle disappearance in the study group was shorter than that in the control group (

P
<
0.05

). After treatment, the expression levels of serum CRP, IL-6, and IL-8 in the two groups were significantly lower than those before treatment, and the study group was significantly lower than the control group (

P
<
0.05

). After treatment, the expression levels of serum TIgE and ECP of the two groups were significantly lower than those before treatment, the expression levels of serum CD3+, CD4+, and CD4+/CD8+ of the two groups were significantly higher than those before treatment, and the study group had significant changes compared with the control group (

P
<
0.05

). After 1 year of treatment, the recurrence rate of CRS in the study group (1.79%) was significantly lower than that in the control group (12.00%) (

P
<
0.05

). Conclusion. Xinyi Biyan Pill has a significant clinical effect in adjuvant treatment of CRS patients. It can effectively reduce the expression level of serum inflammatory factors, improve the body’s immune function, and prevent short-term recurrence. It is worthy of clinical promotion.
LstFcFedLear: A LSTM‐FC with Vertical Federated Learning Network for Fault Prediction
Authors: Zhang Xiangquan , Ma Zhili , Wang Anmin , Mi Haifeng , Hang Junjun
Published: August 2021

The firefighting IoT platform links multiple firefighting subsystems. The data of each subsystem belongs to the sensitive data of the profession. Failure prediction is a crucial topic for firefighting IoT platforms, because failures may cause equipment injuries. Currently, in the maintenance of fire IoT terminal equipment, fault prediction based on equipment time series has not been included. The use of intelligent technology to continuously predict the failure of firefighting IoT equipment can not only eliminate the intervention of regular maintenance but also provide early warning of upcoming failures. In order to solve this problem, we propose a vertical federated learning framework based on LSTM fault classification network (LstFcFedLear). The advantage of this framework is that it can encrypt and integrate the data on the entire firefighting IoT platform to form a new dataset. After the synthesized data is trained through each model, the optimal model parameters can be finally updated. At the same time, it can ensure that the data of each business system is not leaked. The framework can predict when IoT equipment will fail in the future and then provide what measures should be used. The experimental results show that the LstFcFedLear model provides an effective method for fault prediction, and its results are comparable to the baseline.
Spoofing Attack Detection Using Machine Learning in Cross-Technology Communication
Authors: Sun Quan , Miao Xinyu , Guan Zhihao , Wang Jin , Gao Demin
Published: August 2021

Cross-technology communication (CTC) technique can realize direct communication among heterogeneous wireless devices (e.g., WiFi, ZigBee, and Bluetooth in the 2.4 G ISM band) without gateway equipment for forwarding, which makes heterogeneous wireless communication more convenient and greatly reduces communication costs. However, compared with the traditional homogeneous network model, CTC technique also makes it easier to implement spoofing attacks in heterogeneous networks. WiFi devices with long communication distances and sufficient energy supply can directly launch spoofing attacks against ZigBee devices, which brings severe security concerns for heterogeneous wireless communications. In this paper, we focus on the CTC spoofing attack, especially spoofing attacks from WiFi to ZigBee and propose a machine learning-based method to detect spoofing attacks for heterogeneous wireless networks by using physical-layer information. First, we model the received signal strength (RSS) data of legitimate ZigBee devices to construct a one-class support vector machine (OSVM) classifier for detecting CTC spoofing attacks depending on the obtained training samples. Then, we simulated CTC spoofing attacks in a live testbed and evaluated the performance of our detection method. Results show that our approach is highly effective in spoofing detection. Even if the distance between the legitimate ZigBee device and WiFi attacker is near each other (i.e., less than 2 m) and does not require a large number of samples, the detection rate and precision of our method are both over 90%. Finally, we employ the OSVM classifier to obtain samples of spoofing attacks and then explore using SVM to further improve the performance of the classifier.
Image Segmentation Method for an Illumination Highlight Region of Interior Design Effects Based on the Partial Differential Equation
Authors: Wang Lina , Liu Yaoming , Qian Zhike
Published: August 2021

The saliency calculation model based on the principle of partial differential equations sometimes highlights areas with high contrast in the background, and the salient targets obtained occasionally have holes. The above problems can be solved by combining the improved convex hull calculation center saliency map. This paper designs a single-target color image segmentation algorithm based on partial differential equations. First, we calculate the basic saliency map according to the uniqueness of the color and the spatial distribution of the color; second, we then use the superpixel to improve the convex hull and calculate the central saliency map according to the principle; finally, the basic saliency map and the central saliency map are calculated. The weighted fusion is used to obtain the comprehensive saliency map, and the threshold method is used to segment the comprehensive saliency map to obtain the final target image. This paper designs an evaluation standard suitable for the segmentation of the illuminated highlight area of the effect image. It compares the experimental results of the segmentation method in this paper with the SLIC (Simple Linear Iterative Clustering) method and the traditional superpixel method to segment the illuminated highlight area. The segmentation method is applied to the image enhancement experiment. Based on the fuzzy means clustering algorithm, a fuzzy clustering objective function including brightness, color, and distance parameters is designed, which improves the weight of the brightness value in the clustering and improves the edge fit of the segmentation of the lighting highlight area of the rendering. The segmentation method produced by combining the clustering method with the superpixel biased clustering method can improve the output effect of the illuminated highlight area of the effect image after segmentation. We perform color equalization processing on the image to be segmented to reduce the impact of light, then set the closed value of the brightness information component, perform segmentation judgment, and expand the long and short axes of the ellipse model in the high-brightness area to further reduce the impact of light. The experimental results prove that the above method has a better segmentation effect than the traditional ellipse model and can accurately segment the gesture image. Compared with the existing mainstream saliency calculation models, this algorithm is closer to the true value image in terms of visual effects and has obvious advantages in terms of accuracy.
Optimization Study of Multidimensional Big Data Matrix Model in Enterprise Performance Evaluation System
Authors: Fu Honglin
Published: August 2021

This paper uses a multidimensional big data matrix model to optimize the analysis and conduct a systematic construction of the enterprise performance evaluation system. The adoption of new research methods and perspectives to promote the study of the use of performance information is of great significance to achieve the effectiveness, science, and sustainability of corporate performance management. To solve the problem of objectivity and scientificity of performance information use, this part attempts to analyze performance information use from the perspective of the multidimensional big data matrix, focusing on the techniques and methods in the process of promoting performance information use from the multidimensional big data matrix and tries to construct a system model of enterprise performance information use from two dimensions: the use of performance information sources and the use of performance information results. Based on multiple theoretical hypotheses, a theoretical and empirical basis is provided for the division of demand dimensions of enterprise performance evaluation system. Through social capital theory, three dimensions of network social capital, cognitive social capital, and structural social capital are hypothesized, and the logistic regression method is applied for empirical study. The results show that these three dimensions have significant effects on the knowledge demand of enterprise performance evaluation systems. It is verified that the multidimensional big data matrix can enhance the quality of performance information sources and improve the objectivity of performance information. In the performance information source use dimension, the analysis verified that the collection and preprocessing technology of big data can realize the automation, real‐time, and diversification of information collection and preprocessing, and enhance the objectivity of performance information. Big data helps to improve the quality and effectiveness of performance information results use. In the dimension of using performance information results, the distributed computing and analysis processing technology of big data can assist the decision support system, and the use of information can be shifted from micromanagement to decision support, to realize the scientific use of performance information and improve the quality of enterprise management decisions.
Machine-to-Machine Communication for Device Identification and Classification in Secure Telerobotics Surgery
Authors: Lokhande Meghana P. , Patil Dipti Durgesh , Patil Lalit V. , Shabaz Mohammad
Published: August 2021

The capacity of machine objects to communicate autonomously is seen as the future of the Internet of Things (IoT), but machine-to-machine communication (M2M) is also gaining traction. In everyday life, security, transportation, industry, and healthcare all employ this paradigm. Smart devices have the ability to detect, handle, store, and analyze data, resulting in major network issues such as security and reliability. There are numerous vulnerabilities linked with IoT devices, according to security experts. Prior to performing any activities, it is necessary to identify and classify the device. Device identification and classification in M2M for secure telerobotic surgery are presented in this study. Telerobotics is an important aspect of the telemedicine industry. The major purpose is to provide remote medical care, which eliminates the requirement for both doctors and patients to be in the same location. This paper aims to propose a security and energy-efficient protocol for telerobotic surgeries, which is the primary concern at present. For secure telerobotic surgery, the author presents an Efficient Device type Detection and Classification (EDDC) protocol for device identification and classification in M2M communication. The periodic trust score is calculated using three factors from each sensor node. It demonstrates that the EDDC protocol is more effective and secure in detecting and categorizing rogue devices.
Identification of Potential Biomarkers Associated with Acute Myocardial Infarction by Weighted Gene Coexpression Network Analysis
Authors: Wang Yan , Zhang Xiangyang , Duan Min , Zhang Chenguang , Wang Ke , Feng Lili , Song Linlin , Wu Sheng , Chen Xuyan
Published: August 2021

Background. In the general population, acute myocardial infarction (AMI) represents a significant cause of mortality. This study is aimed at identifying novel diagnostic biomarkers to aid in treating and diagnosing AMI. Methods. The Gene Expression Omnibus (GEO) database was explored to extract two microarray datasets, GSE66360 and GSE48060, which were subsequently merged into a single cohort. Both AMI and control samples were analyzed for differentially expressed genes (DEGs), which were subsequently subjected to weighed gene coexpression network analysis (WGCNA) to identify the most significant module. Gene Ontology (GO) and pathway analyses subsequently carried out the most significant gene modules along with construction of a protein‐protein interaction network (PPI). Cytoscape plugin cytoHubba allowed for the prediction of the top 4 key genes according to the network maximal clique centrality (MCC) algorithm. The expression levels and diagnostic value of the four key genes were additionally verified in the GSE62646 dataset. Results. A WCGNA analysis revealed 878 DEGs which were clustered into 6 modules. The module with the most significance in AMI was colored blue. Subsequent GO and KEGG pathway enrichment analysis on blue module genes revealed that they were primarily enriched in the inflammation‐related pathways. These findings, in combination with PPI and coexpression networks, resulted in the identification of the top four genes by cytoHubba, which included leukocyte immunoglobulin‐like receptor B2 (LILRB2), toll‐like receptor 2 (TLR2), neutrophil cytosolic factor 2 (NCF2), and S100A9. Among them, LILRB2, NCF2, and S100A9 were validated in the GSE62646 dataset. Conclusions. The results suggested that LILRB2, NCF2, and S100A9 could be potential gene biomarkers for AMI.
Human Resource Petri Net Allocation Model Based on Artificial Intelligence and Neural Network
Authors: Dai Weihuang , Hu Yi , Zhu Zijiang , Liao Xiaofang
Published: August 2021

The reasonable allocation and use of human resources is an important content in the process of complex system analysis and design. This paper studies the human resource allocation model of Petri net based on artificial intelligence and neural network. In this paper, combined with the characteristics of human resource scheduling, human resource mobility, concurrency, and obvious classification characteristics, the human resource allocation model based on Petri net is implemented. In this paper, the model is trained with the python version of human resource analysis data set. The training parameters are 100, the error coefficient is 0.001, and the learning speed is 0.01. First, the coding rules of human resource data are established. Then, the parameters are input into the model, and the human resource data are trained in the model. Finally, the results of the model output layer are analyzed. The research study shows that the average prediction accuracy of this model is 78.85%. Model training requires the addition of 25 neurons for every 0.01 increase to improve the accuracy of predicting dynamic data of human resources. If the accuracy rate exceeds 75%, the increase in the number of neurons cannot be compensated for by the increase in the accuracy rate, but it is most efficient when the amount of data for human resource scheduling is 2000 to 4000. Therefore, this system can effectively allocate small- and medium-sized human resources and has a high accuracy.
The Impact of LED Colour Rendering on Reaction Time of Human Eyes in Tunnel Interior Zone
Authors: Dong Li-Li , Lou Qi , Liu Peng , Xu Wen-Hai
Published: August 2021

The long reaction time of human eyes will increase the probability of traffic accidents in tunnels which can be reduced by improving lighting conditions. In recent years, light‐emitting diodes (LEDs) have replaced the traditional lighting source in a tunnel. Colour rendering index 2012 (CRI2012, a colour rendering evaluation index) is the most suitable evaluation method for colour rendering of LEDs. In order to study the impact of colour rendering of LEDs on the reaction time of human eyes, a driving simulation environment was designed. First, three CCTs (correlated colour temperatures), four CRI2012s, and eight colours of targets were assessed using mesopic photometry model MES‐2. The calculation results indicated that the contrast of targets had a positive correlation with CRI2012 and had a negative correlation with CCT. Then, reaction time experiment was conducted in simulated tunnel environments. There are 30 observers who participated. The results show that the LEDs with higher CRI2012 and lower CCT in tunnel is conducive to reducing the reaction time of human eyes. High CRI2012 enables drivers to accurately and quickly identify colours. This paper provides a reference for the design of light source parameters, roads, walls, and warning signs in the tunnel.
The Influence Mechanism of Information Interaction on Value Cocreation Based on the Smart Healthcare Context
Authors: Zhang Lan , Yang Xiu , Zhou Yuan , Sun Jialu , Lin Zixiang
Published: August 2021

In recent years, the Chinese government has issued a series of deepening reform policies around smart healthcare, established a diversified technical basis and environmental protection, and deeply excavated the derivative value of healthcare information, aiming to provide high-quality healthcare services for patients. Information interaction in the context of smart healthcare is a kind of health information interaction completed by users with smart healthcare applications as the hub. It is an application form of social behavior and has an impact on value cocreation. Based on the theory of information interaction and value cocreation, this paper systematically reviews the research on information interaction and value cocreation in the smart healthcare context, analyzes the information interaction mode and information interaction mechanism in the smart healthcare context, constructs a theoretical model of the impact of information interaction on value cocreation, and empirically tests the relationship between information interaction and value cocreation in the smart healthcare context. The research of this paper aims to provide high-quality information interaction services for smart healthcare users, promote the dimensional management of information behavior in the context of smart healthcare, and promote the continuous improvement of the operation and management of smart healthcare.
Prediction of Grain Yield in Henan Province Based on Grey BP Neural Network Model
Authors: Li Bingjun , Zhang Yifan , Zhang Shuhua , Li Wenyan
Published: August 2021

BP neural network (BPNN) is widely used due to its good generalization and robustness, but the model has the defect that it cannot automatically optimize the input variables. In response to this problem, this study uses the grey relational analysis method to rank the importance of input variables, obtains the key variables and the best BPNN model structure through multiple training and learning for the BPNN models, and proposes a variable optimization selection algorithm combining grey relational analysis and BP neural network. The predicted values from the metabolic GM (1, 1) model for key variables was used as input to the best BPNN model for prediction modeling, and a grey BP neural network model prediction model (GR-BPNN) was proposed. The long short-term memory neural network (LSTM), convolutional neural network (CNN), traditional BP neural network (BP), GM (1, N) model, and stepwise regression (SR) are also implemented as benchmark models to prove the superiority and applicability of the new model. Finally, the GR-BPNN forecasting model was applied to the grain yield forecast of the whole province and subregions for Henan Province. The forecasting results found that the growth rate of grain production in Henan Province slowed down and the center of gravity for grain production shifted northwards.
Electronic control of water resources using smart field irrigation systems
Authors: Badran Amera I. , Kashmoola Manar Y.
Published: August 2021

Most of the research showed that the reason behind the agricultural lesions is the over usage of water in irrigation the matter which cause the appearance of fungicide on plants and salinity of the soil. From this point emerged the need for adapt some systems to work in farms in order to reduces the expenses of the product, improve its quality and lessen the consumption of water. Internet webs have been a preceding means in such a scope; and they also showed flexibility in designing such systems. In this paper; a smart irrigation system that depend on the values of moisture content and the agricultural constants (Feld Capacity, Wilt Point of the plant, Bulk Density, Depth of the root of the plant, the consumption of each water dripper and the passing area) in making the decision of irrigation and running the water pump, depending on the quantity of water to be added and the duration of irrigation time, and it is better. Field humidity levels at 0.32. This system was built by using the microcontroller ESP-32S&ESP8266 and moister sensor. The data was uploaded to Adafruit server for the sake of remote monitoring by MQTT protocol.
Guard lines conformal slotted antenna array for multiband application
Authors: Chauhan Brajlata , Gupta Suresh Chandra , Vijay Sandip
Published: August 2021

This work investigated a miniaturized slotted conformal antenna array for multiband application. Three guard lines are incorporated to the side of main patch and top of main patch to reduce surface current for planner surface and observe the effect of guard line due to which it resonate at three frequencies in X band and Ku band to be useful for multiband. A rectangular slot is etched at center of patches to increase the current path for wide band application. A quarter wavelength feeding network is used with good agreement of impedance matching. The main lobe width and direction shows through the radiation pattern which remains stable even it is significantly curved. This structure is wrapped around a cylinder with a diameter of 41.4 mm in the circumferential direction. It is observed that the planner antenna array operating at 8.4 GHz, 11.2 GHz &18.2 GHz with a return loss of -20 dB to -45 dB with fractional BW of 25% at 3rd frequency range and the directivity from 3.4 dBi-6.8 dBi. By doing some alteration in dimensions for the conformal antenna producing fractional BW of 20% and the directivity 5.5 to 9.1 dBi at resonating frequencies of 8.4 GHz, 11.4 GHz, and 17.5 GHz. This proposed array is simulated on CST software.
An enhanced WPA2/PSK for preventing authentication cracking
Authors: Chen Chin-Ling , Punya Supaporn
Published: August 2021

Wi-Fi Protected Access 2 (WPA 2) currently is the most widely used mechanism for protecting the users in wireless networks. We have discussed the weakness of 4-way handshake procedure in Wi-Fi WPA2/PSK and proposed an enhance WPA2/PSK by adding timestamp parameter to prevent authentication cracking. The experiments have compared WPA2/PSK with Enhanced WPA2/PSK cracking and the result is also given.
Data mining techniques for lung and breast cancer diagnosis: A review
Authors: Ahmed Bakhan Tofiq
Published: August 2021

Today, cancer counted as the riskier disease than the other diseases in the globe. There are many cancer forms like leukemia, skin cancer, and stomach cancer but lung and breast cancer are the most common forms that many people suffered from. Cancer is the disease that cell has grown rapidly and abnormally that is why treating it is somehow tough in some cases but it can be controlled if it is detected in the initial stage. Data-mining classification algorithms had a vital role in predicting and recognizing both benign and malignant cell. Several classifiers are available to classify the usual and unusual cells such as decision-tree, artificial-neural net, SVM, and KNN. This paper presents a systematic review about the most well-known data-mining classification algorithms for lung and breast cancer diagnose. A brief review about KDD and the data-mining concept has demonstrated. The Decision-Tree (D-Tree), ANN, Support-vector-machine, and naïve Bayes classifier that is widely utilized in the biomedical field has been reviewed along with the some algorithms such as C4.5, Cart, and Iterative -Dichotomiser 3 ‘ID3’. A comparison has been done among various reviewed papers in terms of accuracy that used various data-mining classification algorithms to propose the lung and breast cancer diagnosis system. The experimental results of the reviewed papers showed that the Multilayer Perceptron (MLP) and Logistic Regression (LR) gave a higher accuracy of 99.04% and 98.1%, respectively.
¿Ser o no sucesor? A qué aspira la juventud rural de Rio Grande do Sul
Authors: Breitenbach Raquel , Corazza Graziela
Published: August 2021

(analytical)This research focused on whether rural youths living in Rio Grande do Sul in Brazil are projecting their futures in agriculture and intend to be successors of family farming establishments, in addition to highlighting the conditioning factors that are used to make these decisions. The research involved the application of a questionnaire applied in 2018 and 2019. The sample consisted of 743 young people aged 13 to 21 years who are children of farmers and high school students at the time. It was found that 47.9 % of the surveyed young people want to stay in the countryside and 45.2 % want to be successors. The succession process has been compromised by limits on the participation of rural youth in management and decision-making processes on their family's properties. The authors concludethat these young people significantly value being active and autonomous subjects on their families' properties.
Keywords: Social interaction, drawings, writing, numeracy.
Prevalence and Incidence of Heart Failure Among Urban Patients in China: A National Population-Based Analysis
Authors: Wang Hua , Chai Ke , Du Minghui , Wang Shengfeng , Cai Jian-Ping , Li Yingying , Zeng Ping , Zhu Wanrong , Zhan Siyan , Yang Jiefu
Published: August 2021

Background:

Large-scale and population-based studies of heart failure (HF) incidence and prevalence are scarce in China. The study sought to estimate the prevalence, incidence, and cost of HF in China.

Methods:

We conducted a population-based study using records of 50.0 million individuals ≥25 years old from the national urban employee basic medical insurance from 6 provinces in China in 2017. Incident cases were individuals with a diagnosis of HF (International Classification of Diseases code, and text of diagnosis) in 2017 with a 4-year disease-free period (2013–2016). We calculated standardized rates by applying age standardization to the 2010 Chinese census population.

Results:

The age-standardized prevalence and incidence were 1.10% (1.10% among men and women) and 275 per 100 000 person-years (287 among men and 261 among women), respectively, accounting for 12.1 million patients with HF and 3.0 million patients with incident HF ≥25 years old. Both prevalence and incidence increased with increasing age (0.57%, 3.86%, and 7.55% for prevalence and 158, 892, and 1655 per 100 000 person-years for incidence among persons who were 25–64, 65–79, and ≥80 years of age, respectively). The inpatient mean cost per-capita was $4406.8 and the proportion with ≥3 hospitalizations among those hospitalized was 40.5%. The outpatient mean cost per-capita was $892.3.

Conclusions:

HF has placed a considerable burden on health systems in China, and strategies aimed at the prevention and treatment of HF are needed.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: ChiCTR2000029094.
LAMP2
Cardiomyopathy: Consequences of Impaired Autophagy in the Heart
Authors: Alcalai Ronny , Arad Michael , Wakimoto Hiroko , Yadin Dor , Gorham Joshua , Wang Libin , Burns Elia , Maron Barry J. , Roberts William C. , Konno Tetsuo , Conner David A. , Perez‐Atayde Antonio R. , Seidman Jon G. , Seidman Christine E.
Published: August 2021

Background

Human mutations in the X‐linked lysosome‐associated membrane protein‐2 (
LAMP2
) gene can cause a multisystem Danon disease or a primary cardiomyopathy characterized by massive hypertrophy, conduction system abnormalities, and malignant ventricular arrhythmias. We introduced an
in‐frame LAMP2 gene exon 6 deletion
mutation (denoted L2
Δ6
) causing human cardiomyopathy, into mouse
LAMP2
gene, to elucidate its consequences on cardiomyocyte biology. This mutation results in
in‐frame
deletion of 41 amino acids, compatible with presence of some defective LAMP2 protein.

Methods and Results

Left ventricular tissues from L2
Δ6
and wild‐type mice had equivalent amounts of
LAMP2
RNA, but a significantly lower level of LAMP2 protein. By 20 weeks of age male mutant mice developed left ventricular hypertrophy which was followed by left ventricular dilatation and reduced systolic function. Cardiac electrophysiology and isolated cardiomyocyte studies demonstrated ventricular arrhythmia, conduction disturbances, abnormal calcium transients and increased sensitivity to catecholamines. Myocardial fibrosis was strikingly increased in 40‐week‐old L2
Δ6
mice, recapitulating findings of human LAMP2 cardiomyopathy. Immunofluorescence and transmission electron microscopy identified mislocalization of lysosomes and accumulation of autophagosomes between sarcomeres, causing profound morphological changes disrupting the cellular ultrastructure. Transcription profile and protein expression analyses of L2
Δ6
hearts showed significantly increased expression of genes encoding activators and protein components of autophagy, hypertrophy, and apoptosis.

Conclusions

We suggest that impaired autophagy results in cardiac hypertrophy and profound transcriptional reactions that impacted metabolism, calcium homeostasis, and cell survival. These responses define the molecular pathways that underlie the pathology and aberrant electrophysiology in cardiomyopathy of Danon disease.
Clinical Risk Score for the Prediction of Incident Atrial Fibrillation: Derivation in 7 220 654 Taiwan Patients With 438 930 Incident Atrial Fibrillations During a 16‐Year Follow‐Up
Authors: Chao Tze‐Fan , Chiang Chern‐En , Chen Tzeng‐Ji , Liao Jo‐Nan , Tuan Ta‐Chuan , Chen Shih‐Ann
Published: August 2021

Background

Although several risk schemes have been proposed to predict new‐onset atrial fibrillation (AF), clinical prediction models specific for Asian patients were limited. In the present study, we aimed to develop a clinical risk score (Taiwan AF score) for AF prediction using the whole Taiwan population database with a long‐term follow‐up.

Methods and Results

Among 7 220 654 individuals aged ≥40 years without a past history of cardiac arrhythmia identified from the Taiwan Health Insurance Research Database, 438 930 incident AFs occurred after a 16‐year follow‐up. Clinical risk factors of AF were identified using Cox regression analysis and then combined into a clinical risk score (Taiwan AF score). The Taiwan AF score included age, male sex, and important comorbidities (hypertension, heart failure, coronary artery disease, end‐stage renal disease, and alcoholism) and ranged from −2 to 15. The area under the receiver operating characteristic curve of the Taiwan AF scores in the predictions of AF are 0.857 for the 1‐year follow‐up, 0.825 for the 5‐year follow‐up, 0.797 for the 10‐year follow‐up, and 0.756 for the 16‐year follow‐up. The annual risks of incident AF were 0.21%/year, 1.31%/year, and 3.37%/year for the low‐risk (score −2 to 3), intermediate‐risk (score 4 to 9), and high‐risk (score ≥10) groups, respectively. Compared with low‐risk patients, the hazard ratios of incident AF were 5.78 (95% CI, 3.76–7.75) for the intermediate‐risk group and 8.94 (95% CI, 6.47–10.80) for the high‐risk group.

Conclusions

We developed a clinical AF prediction model, the Taiwan AF score, among a large‐scale Asian cohort. The new score could help physicians to identify Asian patients at high risk of AF in whom more aggressive and frequent detections and screenings may be considered.
Angiotensin II Disrupts Neurovascular Coupling by Potentiating Calcium Increases in Astrocytic Endfeet
Authors: Boily Michaël , Li Lin , Vallerand Diane , Girouard Hélène
Published: August 2021

Background

Angiotensin II (Ang II), a critical mediator of hypertension, impairs neurovascular coupling. Since astrocytes are key regulators of neurovascular coupling, we sought to investigate whether Ang II impairs neurovascular coupling through modulation of astrocytic Ca
2+
signaling.

Methods and Results

Using laser Doppler flowmetry, we found that Ang II attenuates cerebral blood flow elevations induced by whisker stimulation or the metabotropic glutamate receptors agonist, 1S, 3R‐1‐aminocyclopentane‐
trans
‐1,3‐dicarboxylic acid (
P
<0.01). In acute brain slices, Ang II shifted the vascular response induced by 1S, 3R‐1‐aminocyclopentane‐
trans
‐1,3‐dicarboxylic acid towards vasoconstriction (
P
<0.05). The resting and 1S, 3R‐1‐aminocyclopentane‐
trans
‐1,3‐dicarboxylic acid–induced Ca
2+
levels in the astrocytic endfeet were more elevated in the presence of Ang II (
P
<0.01). Both effects were reversed by the AT1 receptor antagonist, candesartan (
P
<0.01 for diameter and
P
<0.05 for calcium levels). Using photolysis of caged Ca
2+
in astrocytic endfeet or pre‐incubation of 1,2‐Bis(2‐aminophenoxy)ethane‐
N,N,N',N'
‐tetra‐acetic acid tetrakis (acetoxymethyl ester), we demonstrated the link between potentiated Ca
2+
elevation and impaired vascular response in the presence of Ang II (
P
<0.001 and
P
<0.05, respectively). Both intracellular Ca
2+
mobilization and Ca
2+
influx through transient receptor potential vanilloid 4 mediated Ang II‐induced astrocytic Ca
2+
elevation, since blockade of these pathways significantly prevented the intracellular Ca
2+
in response to 1S, 3R‐1‐aminocyclopentane‐
trans
‐1,3‐dicarboxylic acid (
P
<0.05).

Conclusions

These results suggest that Ang II through its AT1 receptor potentiates the astrocytic Ca
2+
responses to a level that promotes vasoconstriction over vasodilation, thus altering cerebral blood flow increases in response to neuronal activity.
Percutaneous Coronary Intervention Outcomes Based on Decision‐Making Capacity
Authors: Singh Jarmanjeet , Kassis Nicholas , Ahuja Keerat R. , Sheth Chirag , Verma Beni R. , Saxena Saket , Krishnaswamy Amar , Ellis Stephen , Khatri Jaikirshan , Menon Venu , Kapadia Samir R.
Published: August 2021

Background

Long‐term outcomes of percutaneous coronary intervention (PCI) based on patients’ decision‐making ability have not been studied. Our objective was to assess long‐term outcomes after PCI in patients who provided individual versus surrogate consent.

Methods and Results

Data were collected retrospectively for patients who underwent PCI at Cleveland Clinic between January 1, 2015 and December 31, 2016. Inclusion criteria consisted of hospitalized patients aged ≥20 years who had PCI. Patients with outpatient PCI, or major surgery 30 days before or 90 days after PCI, were excluded. Patients who underwent PCI with surrogate consent versus individual consent were matched using the propensity analysis. Kaplan–Meier, log rank,
t
‐statistic, and χ
2
tests were used for statistical analysis. The study was approved by the Institutional Review Board at Cleveland Clinic, Ohio. Of 3136 patients who underwent PCI during the study period, 183 had surrogate consent. Propensity matching yielded 149 patients from each group. Two‐year all‐cause mortality was significantly higher in the surrogate consent group (38 [25.5%] versus 16 [10.7%] deaths, log‐rank
χ
2
=10.16,
P
<0.001). The 2‐year major adverse cardiac events rate was also significantly higher in the surrogate consent group (60 versus 36 events, log‐rank
χ
2
=8.36,
P
=0.003).

Conclusions

Patients with surrogate consent had significantly higher all‐cause mortality and higher major adverse cardiac events when compared with patients with individual consent. This study emphasizes the fact that patients with an inability to give consent are at high risk and may need special attention in postprocedural and postdischarge care.
Prognostic Value of Angiogenic Markers in Pregnant Women With Chronic Hypertension
Authors: Binder Julia , Palmrich Pilar , Kalafat Erkan , Pateisky Petra , Öztürk Ebru , Mittelberger Johanna , Khalil Asma
Published: August 2021

Background

Women with chronic hypertension face a 5‐ to 6‐fold increased risk of developing preeclampsia compared with normotensive women. Angiogenic markers, especially soluble fms‐like kinase 1 (sFlt‐1) and placental growth factor (PlGF), were identified as clinically useful markers predicting the development of preeclampsia, but data on the prediction of superimposed preeclampsia are scarce. Therefore, we aimed to evaluate the predictive value of the sFlt‐1/PlGF ratio for delivery because of superimposed preeclampsia in women with chronic hypertension.

Methods and Results

This retrospective study included 142 women with chronic hypertension and suspected superimposed preeclampsia. Twenty‐seven women (19.0%) delivered because of maternal indications only, 17 women (12.0%) because of fetal indications primarily, and 98 women (69.0%) for other reasons. Women who both delivered because of maternal indications and for fetal indications had a significantly higher sFlt‐1/PlGF ratio (median 99.9 and 120.2 versus 7.3, respectively,
P
<0.001 for both) and lower PlGF levels (median 73.6 and 53.3 versus 320.0 pg/mL, respectively,
P
<0.001 for both) compared with women who delivered for other reasons. SFlt‐1/PlGF ratio and PlGF were strong predictors for delivery because of superimposed preeclampsia, whether for maternal or fetal indications (
P
<0.05). Half of women with angiogenic imbalance (sFlt‐1/PlGF ratio ≥85 or PlGF levels <100 pg/mL) delivered because of maternal or fetal indications within 1.6 weeks (95% CI, 1.0–2.4 weeks).

Conclusions

Angiogenic marker imbalance in women with suspected superimposed preeclampsia can predict delivery because of maternal and fetal indications related to superimposed preeclampsia and is associated with a significantly shorter time to delivery interval.
Factor V Leiden and the Risk of Bleeding in Patients With Acute Coronary Syndromes Treated With Antiplatelet Therapy: Pooled Analysis of 3 Randomized Clinical Trials
Authors: Mahmoodi Bakhtawar K. , Eriksson Niclas , Ross Stephanie , Claassens Daniel M. F. , Asselbergs Folkert W. , Meijer Karina , Siegbahn Agneta , James Stefan , Pare Guillaume , Wallentin Lars , ten Berg Jurriën M.
Published: August 2021

Background

Whether factor V Leiden is associated with lower bleeding risk in patients with acute coronary syndromes using (dual) antiplatelet therapy has yet to be investigated.

Methods and Results

We pooled data from 3 randomized clinical trials, conducted in patients with acute coronary syndromes, with adjudicated bleeding outcomes. Cox regression models were used to obtain overall and cause‐specific hazard ratios (HRs) to account for competing risk of atherothrombotic outcomes (ie, composite of ischemic stroke, myocardial infarction, and cardiovascular death) in each study. Estimates from the individual studies were pooled using fixed effect meta‐analysis. The 3 studies combined included 17 623 patients of whom 969 (5.5%) were either heterozygous or homozygous (n=23) carriers of factor V Leiden. During 1 year of follow‐up, a total of 1289 (7.3%) patients developed major (n=559) or minor bleeding. Factor V Leiden was associated with a lower risk of combined major and minor bleeding (adjusted cause‐specific HR, 0.75; 95% CI, 0.56–1.00;
P
=0.046; I
2
=0%) but a comparable risk of major bleeding (adjusted cause‐specific HR, 0.93; 95% CI, 0.62–1.39;
P
=0.73; I
2
=0%). Adjusted pooled cause‐specific HRs for the association of factor V Leiden with atherothrombotic events alone and in combination with bleeding events were 0.75 (95% CI, 0.55–1.02;
P
=0.06; I
2
=0%) and 0.75 (95% CI, 0.61–0.92;
P
=0.007; I
2
=0%), respectively.

Conclusions

Given that the lower risk of bleeding conferred by factor V Leiden was not counterbalanced by a higher risk of atherothrombotic events, these findings warrant future assessment for personalized medicine such as selecting patients for extended or intensive antiplatelet therapy.
Decision Threshold for Kryptor sFlt‐1/PlGF Ratio in Women With Suspected Preeclampsia: Retrospective Study in a Routine Clinical Setting
Authors: Andersen Lise Lotte Torvin , Helt Annemarie , Sperling Lene , Overgaard Martin
Published: August 2021

Background

The objective was to evaluate predictive performance and optimal decision threshold of the Kryptor soluble fms‐like tyrosine kinase‐1 (sFlt‐1)/placental growth factor (PlGF) ratio when implemented for routine management of women presenting with symptoms of preeclampsia.

Methods and Results

Observational retrospective study of a cohort of 501 women with suspected preeclampsia after 20 weeks of gestation. Women referred to maternity ward for observation of preeclampsia had an sFlt‐1/PlGF ratio test included in routine diagnostic workup. Maternal and offspring characteristic data included maternal risk factors, outcomes, delivery mode, and indication for suspected preeclampsia. Biochemical measurements to determine sFlt‐1/PlGF ratio were performed using the BRAHMS/Kryptor sFlt‐1/PlGF ratio immunoassays. Results were analyzed by area under receiver‐operating characteristic curve. Preeclampsia occurred in 150 of 501 (30%) of symptomatic women with an sFlt‐1/PlGF ratio determined before the time of diagnosis. Area under receiver‐operating characteristic curve for diagnosis of early‐onset preeclampsia within 1 and 4 weeks was 0.98 (95% CI, 0.96–1.00) and 0.95 (95% CI, 0.92–0.98), respectively. For late‐onset preeclampsia, predictive performance within 1 and 4 weeks was lower: 0.90 (95% CI, 0.85–0.94) and 0.85 (95% CI, 0.80–0.90), respectively. The optimal single sFlt‐1/PlGF ratio threshold for all preeclampsia and late‐onset preeclampsia within 1 and 4 weeks was 66. The negative and positive predictive values for ruling out and ruling in developing preeclampsia within 1 week were 96% and 70%, respectively.

Conclusions

The Kryptor sFlt‐1/PlGF ratio is a useful clinical tool ruling out and in preeclampsia within 1 week. Prediction within 4 weeks is superior for early‐onset preeclampsia. A single decision threshold of 66 is indicated for use in clinical routine.
Characteristics of Bicuspid Aortic Valve Disease and Stenosis: The National Echo Database of Australia
Authors: Lim Michelle S. , Strange Geoff , Playford David , Stewart Simon , Celermajer David S.
Published: August 2021

Background

Bicuspid aortic valve (BAV) is the most common congenital heart disease in adults but is clinically heterogeneous. We aimed to describe the echocardiographic characteristics of BAV and compare patients with BAV with moderate‐to‐severe aortic stenosis (AS) with those with tricuspid aortic valve (TAV) stenosis.

Methods and Results

Using the National Echo Database of Australia, patients in whom BAV was identified were studied. Those with moderate‐to‐severe AS (mean gradient >20 mm Hg [BAV‐AS]) were compared with those with TAV and moderate‐to‐severe AS (TAV‐AS). Of 264 159 adults whose aortic valve morphology was specified, 4783 (1.8%) had confirmed BAV (aged 49.6±17.4 years, 69% men). Of these, 42% had no AS, and 46% had no aortic regurgitation. Moderate‐to‐severe AS was detected in a greater proportion of patients with BAV with a recorded mean gradient (n=1112, 34%) compared with those with TAV (n=4377, 4%;
P
<0.001). Patients with BAV‐AS were younger (aged 55.3±16.7 years versus 77.3±11.0 years;
P
<0.001), and where measured had larger ascending aortic diameters (37±8 mm versus 35±5 mm;
P
<0.001). Age and sex‐adjusted mortality risk was significantly lower in patients with BAV‐AS (hazard ratio, 0.53; 95% CI, 0.45–0.63;
P
<0.001).

Conclusions

In this large study of patients across the spectrum of BAV disease, the largest proportion had no significant valvulopathy or aortopathy. Compared with those with TAV‐AS, patients with BAV were more likely to have moderate‐to‐severe AS, have larger ascending aortas, and were over 2 decades younger at the time of AS diagnosis. Despite this, patients with BAV appear to have a more favorable prognosis when AS develops, compared with those with TAV‐AS.

Registration

URL:
www.anzctr.org.au/
; Unique identifier: ACTRN12617001387314.