bluuebunny/crossref_metadata_2025 huggingface dataset:
SCALPEL: Exploring the Limits of Tag-enforced Compartmentalization
Authors: Roessler Nick , DeHon André
Published: September 2021

We present Secure Compartments Automatically Learned and Protected by Execution using Lightweight metadata (SCALPEL), a tool for automatically deriving compartmentalization policies and lowering them to a tagged architecture for hardware-accelerated enforcement. SCALPEL allows a designer to explore high-quality points in the privilege-reduction vs. performance overhead tradeoff space using analysis tools and a detailed knowledge of the target architecture to make best use of the available hardware. SCALPEL automatically implements hundreds of compartmentalization strategies across the privilege-performance tradeoff space, all without manual tagging or code restructuring. SCALPEL uses two novel optimizations for achieving highly performant policies: the first is an algorithm for packing policies into working sets of rules for favorable rule cache characteristics, and the second is a rule prefetching system that allows it to exploit the highly predictable nature of compartmentalization rules. To create policies, SCALPEL introduces a quantitative privilege metric (the Overprivilege Ratio) that is used to drive its algorithmic compartment generation. We implement SCALPEL on a FreeRTOS stack and target a tag-extended RISC-V core. Our results show that SCALPEL-created policies can reduce overprivilege by orders of magnitude with hundreds of logical compartments while imposing low overheads (<5%).
Early Childhood Obesity: A Developmental Perspective
Authors: Pesch Megan H. , Lumeng Julie C.
Published: September 2021

Childhood obesity is a multifactorial disease, shaped by child, familial, and societal influences; prevention efforts must begin early in childhood. Viewing the problem of childhood obesity through a developmental lens is critical to understanding the nuances of a child's interactions with food and their environment across the span of growth and development. Risk factors for childhood obesity begin prior to birth, compounding across the life course. Some significant risk factors are unmodifiable (e.g., genetics) while others are theoretically modifiable. Social inequities, however, hinder many families from easily making modifications to a range of risk factors. The objective of this review is to provide background and an overview of the literature on childhood obesity in early childhood (birth to 5 years of age) in a developmental context. Special focus is placed on unique developmental considerations, child eating behaviors, and parental feeding behaviors in infancy, toddlerhood, and preschool ages.
Virus Structures and Dynamics by Magic-Angle Spinning NMR
Authors: Porat-Dahlerbruch Gal , Goldbourt Amir , Polenova Tatyana
Published: September 2021

Techniques for atomic-resolution structural biology have evolved during the past several decades. Breakthroughs in instrumentation, sample preparation, and data analysis that occurred in the past decade have enabled characterization of viruses with an unprecedented level of detail. Here we review the recent advances in magic-angle spinning (MAS) nuclear magnetic resonance (NMR) spectroscopy for structural analysis of viruses and viral assemblies. MAS NMR is a powerful method that yields information on 3D structures and dynamics in a broad range of experimental conditions. After a brief introduction, we discuss recent structural and functional studies of several viruses investigated with atomic resolution at various levels of structural organization, from individual domains of a membrane protein reconstituted into lipid bilayers to virus-like particles and intact viruses. We present examples of the unique information revealed by MAS NMR about drug binding, conduction mechanisms, interactions with cellular host factors, and DNA packaging in biologically relevant environments that are inaccessible by other methods.
Conquering the Host: Determinants of Pathogenesis Learned from Murine Gammaherpesvirus 68
Authors: Wang Yiping , Tibbetts Scott A. , Krug Laurie T.
Published: September 2021

Gammaherpesviruses are an important class of oncogenic pathogens that are exquisitely evolved to their respective hosts. As such, the human gammaherpesviruses Epstein-Barr virus (EBV) and Kaposi sarcoma herpesvirus (KSHV) do not naturally infect nonhuman primates or rodents. There is a clear need to fully explore mechanisms of gammaherpesvirus pathogenesis, host control, and immune evasion in the host. A gammaherpesvirus pathogen isolated from murid rodents was first reported in 1980; 40 years later, murine gammaherpesvirus 68 (MHV68, MuHV-4, γHV68) infection of laboratory mice is a well-established pathogenesis system recognized for its utility in applying state-of-the-art approaches to investigate virus-host interactions ranging from the whole host to the individual cell. Here, we highlight recent advancements in our understanding of the processes by which MHV68 colonizes the host and drives disease. Lessons that inform KSHV and EBV pathogenesis and provide future avenues for novel interventions against infection and virus-associated cancers are emphasized.
Alterations in skeletal muscle repair in young adults with type 1 diabetes mellitus
Authors: Dial Athan G. , Grafham Grace K. , Monaco Cynthia M. F. , Voth Jennifer , Brandt Linda , Tarnopolsky Mark A. , Hawke Thomas J.
Published: September 2021

Though preclinical models of type 1 diabetes (T1D) exhibit impaired muscle regeneration, this has yet to be investigated in humans with T1D. Here, we investigated the impact of damaging exercise (eccentric quadriceps contractions) in 18 physically active young adults with and without T1D. Pre- and postexercise (48 h and 96 h), the participants provided blood samples, vastus lateralis biopsies, and performed maximal voluntary quadriceps contractions (MVCs). Skeletal muscle sarcolemmal integrity, extracellular matrix (ECM) content, and satellite cell (SC) content/proliferation were assessed by immunofluorescence. Transmission electron microscopy was used to quantify ultrastructural damage. MVC was comparable between T1D and controls before exercise. Postexercise, MVC was decreased in both groups, but subjects with T1D exhibited moderately lower strength recovery at both 48 h and 96 h. Serum creatine kinase, an indicator of muscle damage, was moderately higher in participants with T1D at rest and exhibited a small elevation 96 h postexercise. Participants with T1D showed lower SC content at all timepoints and demonstrated a moderate delay in SC proliferation after exercise. A greater number of myofibers exhibited sarcolemmal damage (disrupted dystrophin) and increased ECM (laminin) content in participants with T1D despite no differences between groups in ultrastructural damage as assessed by electron microscopy. Finally, transcriptomic analyses revealed dysregulated gene networks involving RNA translation and mitochondrial respiration, providing potential explanations for previous observations of mitochondrial dysfunction in similar cohorts with T1D. Our findings indicate that skeletal muscle in young adults with moderately controlled T1D is altered after damaging exercise, suggesting that longer recovery times following intense exercise may be necessary.
Impact of lifestyle interventions targeting physical exercise and caloric intake on cirrhosis regression in rats
Authors: Lafoz Erica , Campreciós Genís , García-Calderó Héctor , Anton Aina , Vilaseca Marina , Ruart Maria , Guasch Eduard , Garrabou Glòria , Delgado Teresa C. , Martínez-Chantar María-Luz , García-Martínez Rita , Gracia-Sancho Jordi , Hernández-Gea Virginia , García-Pagán Juan Carlos
Published: September 2021

We have developed two advanced cirrhosis regression experimental models with persistent relevant fibrosis and portal hypertension and an associated deteriorated metabolism that mimic what happens in patients. LI, despite improving metabolism, did not enhance the regression process in our cirrhotic models. CR did not further reduce PP, hepatic fibrosis, or HSC activation. MEE exhibited a profibrogenic effect in the liver blunting cirrhosis regression. One of the potential explanations of this worsening could be ammonia accumulation.
Increased circulating cytokeratin 19 fragment levels in preterm neonates receiving mechanical ventilation are associated with poor outcome
Authors: Panahabadi Sarah , Heindel Katrin , Mueller Andreas , Holdenrieder Stefan , Kipfmueller Florian
Published: September 2021

Invasive mechanical ventilation and oxygen toxicity are postnatal contributors to chronic lung disease of prematurity, also known as bronchopulmonary dysplasia (BPD). Cyfra 21-1 is a soluble fragment of cytokeratin 19, which belongs to the cytoskeleton stabilizing epithelial intermediate filaments. As a biomarker of structural integrity, Cyfra 21-1 might be associated with airway injury and lung hypoplasia in neonates. Serum Cyfra 21-1 concentrations for 80 preterm and 80 healthy term newborns were measured within 48 h after birth. Preterm infants with the combined endpoint BPD/mortality had significantly higher Cyfra 21-1 levels compared with those without fulfilling BPD/mortality criteria ( P = 0.01). Also, severe RDS (>grade III) was associated with higher Cyfra levels ( P = 0.01). Total duration of oxygen therapy was more than five times longer in neonates with high Cyfra 21-1 levels ( P = 0.01). Infants with higher Cyfra 21-1 values were more likely to receive mechanical ventilation (50% vs. 17.5%). However, the duration of mechanical ventilation was similar between groups. The median Cyfra value was 1.93 ng/mL (IQR: 1.68–2.53 ng/mL) in healthy term neonates and 8.5 ng/mL (IQR: 3.6–16.0 ng/mL) in preterm infants. Using ROC analysis, we calculated a Cyfra cutoff > 8.5 ng/mL to predict BPD/death with an AUC of 0.795 ( P = 0.004), a sensitivity of 88.9%, and a specificity of 55%. Mortality was predicted with a cutoff > 17.4 ng/mL (AUC: 0.94; P = 0.001), a sensitivity of 100%, and a specificity of 84%. These findings suggest that Cyfra 21-1 concentration might be useful to predict poor outcome in premature infants.
Exposure to carbon black nanoparticles during pregnancy aggravates lipopolysaccharide-induced lung injury in offspring: an intergenerational effect
Authors: Tang Qianghu , Tu Baijie , Jiang Xuejun , Zhang Jun , Bai Lulu , Meng Pan , Zhang Longbin , Qin Xia , Wang Bin , Chen Chengzhi , Zou Zhen
Published: September 2021

Carbon black nanoparticles (CBNPs) are one of the most frequently used nanoparticles. Exposure to CBNPs during pregnancy (PrE to CBNPs) can directly induce inflammation, lung injury, and genotoxicity in dams and results in abnormalities in offspring. However, whether exposure to CBNPs during pregnancy enhances the susceptibility of offspring to environmental stimuli remains unknown. To address this issue, in this study, we intranasally treated pregnant mice with mock or CBNPs from gestational day ( GD) 9 to GD18, and F1 and F2 offspring were normally obtained. By intratracheal instillation of mice with lipopolysaccharide (LPS) to trigger a classic animal model for acute lung injury, we intriguingly found that after LPS treatment, F1 and F2 offspring after exposure during pregnancy to CBNPs both exhibited more pronounced lung injury symptoms, including more degenerative histopathological changes, vascular leakage, elevated MPO activity, and activation of inflammation-related signaling transduction, compared with F1 and F2 offspring in the mock group, suggesting PrE to CBNPs would aggravate LPS-induced lung injury in offspring, and this effect was intergenerational. We also observed that PrE to CBNPs upregulated the mRNA expression of DNA methyltransferases (Dnmt) 1/3a/3b and DNA hypermethylation in both F1 and F2 offspring, which might partially account for the intergenerational effect. Together, our study demonstrates for the first time that PrE to CBNPs can enhance sensitivity to LPS in both F1 and F2 offspring, and this intergenerational effect may be related to DNA hypermethylation caused by CBNPs.
Applications of Fixed Point Theory to Investigate a System of Fractional Order Differential Equations
Authors: Khan Zareen A. , Ahmad Israr , Shah Kamal
Published: September 2021

We investigate a nonlinear system of pantograph-type fractional differential equations (FDEs) via Caputo-Hadamard derivative (CHD). We establish the conditions for existence theory and Ulam-Hyers-type stability for the underlying boundary value system (BVS) of FDE. We use Krasnoselskii’s and Banach’s fixed point theorems to obtain the desired results for the existence of solution. Stability is an important aspect from a numerical point of view we investigate here. To justify the main work, relevant examples are provided.
A Case Report of Perceptual Disturbances with Incidental Calcifications in the Cerebellum
Authors: Manzoor Sarah , Sangha Lillian , Badh Pavandeep , Azizi Heela , Jolayemi Ayodeji
Published: September 2021

Background. The cerebellum has extensive connections with motor and nonmotor areas of the nervous system. These nonmotor areas include the cognitive, affective, and perceptual areas of the central nervous system. Extensive literature has emerged cognitive documents and mood disorders in patients with cerebellar dysfunction. Perceptual disturbances consistent with cerebellar connections with perceptual areas have not been as widely documented. Case Presentation. We present the case of a 58-year-old female presenting with new onset isolated auditory hallucinations and incidental findings of cerebellar calcifications. Conclusion. In light of this case, we discuss an expanding body of evidence that suggests the likely role of the cerebellum in perceptual functioning.
A Note on Small Amplitude Limit Cycles of Liénard Equations Theory
Authors: Bouattia Yassine , Boudjehem Djalil , Makhlouf Ammar , Zubair Sulima Ahmed , Idris Sahar Ahmed
Published: September 2021

In this paper, we demonstrate using a counterexample for a theorem of the small amplitude limit cycles in some Liénard systems and show that that there will be no solutions unless we add an extra condition. A new condition is derived for some specific Liénard systems where a violation of the small amplitude limit cycles theorem takes place.
Compound Fault Diagnosis of Gearbox Based on RLMD and SSA-PNN
Authors: Liang Shitong , Ma Jie
Published: September 2021

In order to solve the difficulty in the classification of gearbox compound faults, a gearbox fault diagnosis method based on the sparrow search algorithm (SSA) improved probabilistic neural network (PNN) is proposed. Firstly, the gearbox fault signal is decomposed into a series of product functions (PFs) by robust local mean decomposition (RLMD). Then, the permutation entropy of PFs, which contains much fault information, is calculated to construct the feature vector and input it into the SSA-PNN model. The experimental results show that compared with the traditional fault diagnosis methods based on EMD-BP and EEMD-PNN, the gearbox fault diagnosis method based on RLMD and SSA-PNN has higher diagnosis accuracy.
[Retracted] Compensated Fuzzy Neural Network‐Based Music Teaching Ability Assessment Model
Authors: Chen Xu
Published: September 2021

College is the main place to carry out music teaching, and it is important to assess the music teaching ability in college effectively. Based on this, this paper firstly analyzes the necessity of music teaching ability assessment and briefly summarizes the application of neural network and deep learning technology in music teaching ability assessment and secondly designs an assessment model based on compensated fuzzy neural network algorithm and analyzes the accuracy of the model, finds out the causes of forming abnormal output by analysing the general dimensional conditions of the algorithm of the model, and proposes corresponding correction. Finally, the reliability and feasibility of the music teaching ability assessment model were experimentally verified by combining with teaching practice. The research results confirm the feasibility of the compensated fuzzy neural network algorithm in music teaching ability assessment, which has important reference significance for improving the quality of music teaching in colleges and universities.
Effects of Elemental Mercury Vapor Inhalation on Arterial Blood Gases, Lung Histology, and Interleukin-1 Expression in Pulmonary Tissues of Rats
Authors: Raffee Liqaa A. , Alawneh Khaled Z. , Alassaf Ruba A. , Alzoubi Abdallah , Alshehabat Musa A. , Alabdallah Nadeem , Al-Mistarehi Abdel-Hameed
Published: September 2021

We investigated the effects of elemental mercury vapor inhalation on arterial blood gases (ABGs), lung histology, and interleukin-1 (IL-1) expression in pulmonary tissues in rats. A total of 42 Sprague Dawley rats were divided randomly into three groups. Rats in the first group were used as the control (CG). A short-term group (STG) and a long-term group (LTG) were exposed to 500 μg/m3 of mercury vapor 2 hrs/day for 21 days and 65 days, respectively. After exposure periods were completed, arterial blood samples were obtained, and ABGs were measured. Lung tissue sections were prepared for histology evaluation and immune-stained to detect IL-1 expression. There was a significant decrease in body weight in both STG (15%) and LTG (22%) compared with the CG. In the LTG, six out of 14 (43%) rats died, including two males and four females, while none of the rats in the STG died during the experiment. In both STG and LTG, a significant acid-base imbalance was characterized by a significant decrease in blood pH values and a significant increase in PCO2 values. Both PO2 and SpO2 blood values were significantly decreased in the STG and LTG, while no changes were observed in HCO3 values in all groups. Histological evaluation of lung tissues revealed severe lesions characterized by pulmonary emphysema and inflammatory cellular infiltrate. IL-1 expression in lung tissues was not significantly different between exposed rats and control subjects. These results indicate significant alterations in blood acid-base status characterized by severe respiratory acidosis with hypoxemia and no evidence of compensatory alkalosis in rats after exposure to short- and long-term elementary mercury vapor.
Assessment of Risk Factors for Falls among Patients with Parkinson’s Disease
Authors: Wilczyński Jacek , Ścipniak Magdalena , Ścipniak Kacper , Margiel Kamil , Wilczyński Igor , Zieliński Rafał , Sobolewski Piotr
Published: September 2021

Introduction. The aim of this study was to assess the risk factors for falls in patients with Parkinson’s disease. Materials and Methods. The study comprised 53 participants (52.8% women and 47.2% men). The Hoehn and Yahr 5‐point disability scale was used to assess the severity of Parkinson’s disease. The Tinetti Balance and Gait Scale were used to evaluate the risk of falls. The Katz scale was used to test the independence of people with PD. The Falls Efficacy Scale‐International Short Form (FES‐I) was implemented to assess fear of falling. Results. The majority of participants was at a high risk of falls, being at the same level for women and men. A significant relationship was noted between the risk of falls and subjective assessment of mobility (χ2 = 31.86, p < 0.001), number of falls (χ2 = 37.92, p < 0.001), independence of the subjects (χ2 = 19.28, p < 0.001), type of injury suffered during the fall (χ2 = 36.93, p < 0.001), external factors (χ2 = 33.36, p < 0.001), and the level of fear of falling (χ2 = 8.88, p < 0.001). A significant relationship also occurred between the number of falls and the fear of falling (χ2 = 33.49, p < 0.001) and between the number of falls and disease severity (χ2 = 45.34, p < 0.001). The applied physiotherapy did not reduce the risk of falls (χ2 = 3.18, p = 0.17). Conclusions. Individuals who rated their mobility as good or excellent were at a low risk of falls. People who fell more times were at a high risk of falling. People more independent were at a low risk of falls. Previous injuries were the most associated with being at risk of falling. Uneven surfaces and obstacles on one’s path are the external factors most associated with the risk of falling. People with low levels of fall anxiety were at a low risk of falls. Most people with low fall anxiety have never fallen. Additionally, the majority of patients with stage 1 of the disease have not fallen at all. The reason for the ineffectiveness of physiotherapy may be due to the exercise programs used and the lack of systematic implementation of them. PD is different for each patient; thus, it is important to select individually customized physiotherapy depending on motor and nonmotor symptoms, as well as general health of a patient.
Application of Music Therapy in General Surgical Treatment
Authors: Liang Jing , Tian Xiaofeng , Yang Wei
Published: September 2021

With the increasing application of music therapy in clinical practice, the effectiveness of music therapy in improving the negative emotions of patients, relieving pain, and adjusting the physiological state has also been receiving increasing recognization. Moreover, music therapy as adjuvant therapy for conventional treatment can achieve a better improvement in patient satisfaction and facilitate the acceptance of make music therapy by the medical industry. In addition to inevitable trauma, general surgery is criticized for its long treatment cycles and postoperative pain. With the continuous development of fast‐track surgery (FTS), music therapy has received more attention in general surgical treatment. This study reviews the development history and prospects of music therapy in general surgery.
Management of Inflammatory Root Resorption of Maxillary Central Incisors following Traumatic Avulsion
Authors: Sadeghi Seyed Mohsen , Moradi Samaneh , Soltani Samaneh
Published: September 2021

Background. Avulsion is among the most severe types of dental trauma, which often occurs at young ages and can compromise the long-term prognosis of the traumatized tooth. Case Report. Herein, we report replantation of two avulsed teeth. Our patient was an 11-year-old boy with two avulsed maxillary central incisors due to a bicycle fall 2 months earlier. The patient was referred to us after rigid splinting of his teeth by a surgeon. Long-term calcium hydroxide (CH) therapy was performed for the patient, and after healing of periodontal ligament (PDL), apexification was performed for both teeth followed by root canal therapy. During the 2-year follow-up, both teeth were functional and had no radiographic or clinical evidence of resorption or ankylosis. Conclusion. The reported case highlights the favorably high tissue healing potential following severe dental trauma, given that appropriate treatment is performed. Correct endodontic management can guarantee the long-term prognosis of teeth following severe dental trauma.
Accuracy of Algorithms and Visual Inspection for Detection of Trigger Asynchrony in Critical Patients : A Systematic Review
Authors: Bandeira Monique , Almeida Alícia , Melo Lívia , de Moura Pedro Henrique , Ribeiro Silva Emanuelle Olympia , Silva Jakson , Dornelas de Andrade Armèle , Brandão Daniella , Campos Shirley
Published: September 2021

Objective. This study aimed to summarize the accuracy of the different methods for detecting trigger asynchrony at the bedside in mechanically ventilated patients. Method. A systematic review was conducted from 1990 to 2020 in PubMed, Lilacs, Scopus, and ScienceDirect databases. The reference list of the identified studies, reviews, and meta-analyses was also manually searched for relevant studies. The reference standards were esophageal pressure catheter and/or electrical activity of the diaphragm. Studies were assessed following the QUADAS-2 recommendations, while the review was prepared according to the PRISMA criteria. Results. One thousand one hundred and eleven studies were selected, and four were eligible for analysis. Esophageal pressure was the predominant reference standard, while visual inspection and algorithms/software comprised index tests. The trigger asynchrony, ineffective expiratory effort, double triggering, and reverse triggering were analyzed. Sensitivity and specificity ranged from 65.2% to 99% and 80% to 100%, respectively. Positive predictive values reached 80.3 to 100%, while the negative predictive values reached 92 to 100%. Accuracy could not be calculated for most studies. Conclusion. Algorithms/software validated directly or indirectly using reference standards present high sensitivity and specificity, with a diagnostic power similar to visual inspection of experts.
H19 Overexpression Improved Efficacy of Mesenchymal Stem Cells in Ulcerative Colitis by Modulating the miR-141/ICAM-1 and miR-139/CXCR4 Axes
Authors: Zhao Ming-li , Chen Tao , Zhang Teng-hui , Tian Feng , Wan Xiao
Published: September 2021

Overexpression of C-X-C motif chemokine receptor 4 (CXCR4) and intercellular cell adhesion molecule-1 (ICAM-1) may promote homing of mesenchymal stem cells (MSC). In this study, we treated ulcerative colitis animals with MSC preconditioned with or without H19 and compared the therapeutic effect of MSC and MSC-H19. We evaluated the regulatory relationship of H19 vs. miR-141/miR-139 and miR-141/miR-139 vs. ICAM-1/CXCR4. We established an ulcerative colitis mouse model to assess the effect of MSC and MSC-H19. H19 was found to bind to miR-141 and miR-139. The activity of H19 was strongly decreased in cells c-transfected with miR-141/miR-139 and WT H19. ICAM-1 was confirmed to be targeted by miR-141 and CXCR4 was targeted by miR-139. The H19 expression showed a negative regulatory relationship with the miR-141 and miR-139 expression but a positive regulatory relationship with the ICAM-1 and CXCR4 expression. In summary, the overexpression of H19 in MSC downregulated miR-139 and miR-141, thus increasing the activity of their targets ICAM-1 and CXCR4, respectively, to exhibit therapeutic effects in ulcerative colitis.
Associated Mirror Therapy Enhances Motor Recovery of the Upper Extremity and Daily Function after Stroke: A Randomized Control Study
Authors: Zhuang Jin-Yang , Ding Li , Shu Bei-Bei , Chen Dan , Jia Jie
Published: September 2021

Bimanual cooperation plays a vital role in functions of the upper extremity and daily activities. Based on the principle of bilateral movement, mirror therapy could provide bimanual cooperation training. However, conventional mirror therapy could not achieve the isolation of the mirror. A novel paradigm mirror therapy called associated mirror therapy (AMT) was proposed to achieve bimanual cooperation task-based mirror visual feedback isolating from the mirror. The study was aimed at exploring the feasibility and effectiveness of AMT on stroke patients. We conducted a single-blind, randomized controlled trial. Thirty-six eligible patients were equally assigned into the experimental group (EG) receiving AMT and the control group (CG) receiving bimanual training without mirroring for five days/week, lasting four weeks. The Fugl-Meyer Assessment Upper Limb subscale (FMA-UL) for upper extremity motor impairment was used as the primary outcome. The secondary outcomes were the Box and Block Test (BBT) and Functional Independence Measure (FIM) for motor and daily function. All patients participated in trials throughout without adverse events or side effects. The scores of FMA-UL and FIM improved significantly in both groups following the intervention. Compared to CG, the scores of FMA-UL and FIM were improved more significantly in EG after the intervention. The BBT scores were improved significantly for EG following the intervention, but no differences were found in the BBT scores of CG after the intervention. However, no differences in BBT scores were observed between the two groups. In summary, our study suggested that AMT was a feasible and practical approach to enhance the motor recovery of paretic arms and daily function in stroke patients. Furthermore, AMT may improve manual dexterity for poststroke rehabilitation.
Edge Computing Assisted an Efficient Privacy Protection Layered Data Aggregation Scheme for IIoT
Authors: Ma Rong , Feng Tao , Fang Junli
Published: September 2021

The emergence of edge computing has improved the real time and efficiency of the Industrial Internet of Things. In order to achieve safe and efficient data collection and application in the Industrial Internet of Things, a lot of computing and bandwidth resources are usually sacrificed. From the perspective of low computing and communication overhead, this paper proposes an efficient privacy protection layered data aggregation scheme for edge computing assisted IIoT by combining the Chinese Remainder Theorem (CRT), improved Paillier homomorphic algorithm, and hash chain technology (edge computing assisted an efficient privacy protection layered data aggregation scheme for IIoT, EE-PPDA). In EE-PPDA, first, a layered aggregation architecture based on edge computing is designed. Edge nodes and cloud are responsible for local aggregation and global aggregation, respectively, which effectively reduces the amount of data transmission. At the same time, EE-PPDA achieves data confidentiality through improved Paillier encryption, ensuring that neither attackers nor semitrusted nodes (e.g., edge nodes and clouds) can know the private data of a single device, and it can resist by simply using hash chains to resist tampering and pollution attacks ensure data integrity. Second, according to the CRT, the cloud can obtain the fine-grained aggregation results of subregions from the global aggregation results, thereby providing fine-grained data services. In addition, the EE-PPDA scheme also supports fault tolerance. Even if some IIoT devices or communication links fail, the cloud can still decrypt incomplete aggregated ciphertexts and obtain the expected aggregation results. Finally, the performance evaluation shows that the proposed EE-PPDA scheme has less calculation and communication costs.
Trend Analysis of Multidrug-Resistant Bacterial Pathogens Causing Neonatal Sepsis at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: A Retrospective Study
Authors: Jemal Mohabaw , Tinshku Fetene , Nigussie Yeshwas , Kefyalew Birhanetinsae , Alemu Chalie , Belay Martha , Belachew Teshome , Ayelegn Birhanu
Published: September 2021

Background. Neonatal sepsis is the most common cause of mortality and morbidity. It is a major global public health challenge, particularly in developing countries. Therefore, knowing the current status of bacterial isolates and their antimicrobial resistance profile is essential to physicians and health workers to implement appropriate intervention. The aims of this study was to assess a ten-year trend of bacterial prevalence isolates from blood culture among neonates (<1 month of age). Method. A hospital-based retrospective study was conducted on 1854 neonatal patients who were admitted at University of Gondar Specialized Comprehensive Hospital between 2010 and 2020. Sociodemographical and laboratory data were collected from medical records. Quality of the data was assured through standard operational procedures. Data were entered and analysed using SPSS version 20. Bivariate analysis was employed to determine strings of association between the outcome variable and sociodemographic variables. A

P

value less than 0.05 will be considered to be statically significant. Results. In a total of 1854 patients, 538 (29%) were culture positive. The overall neonatal sepsis infection rate was 287 (53.5%) for male and 249 (46.5%) for female. The highest proportion of neonatal sepsis infection rate was observed among the patients in the age range between 3 and 28 days and gestational at birth <37 weeks, 461(86%) and 278 (52%), respectively. Gestational at birth (

P

 ≤ 0.001, AOR = 5.81, CI: 4.63–7.29) is significantly associated with bacterial isolates. The predominant pathogens were Staphylococcus aureus, 18 (76.6%), Klebsiella pneumoniae, 146 (38%), and E. coli, 45 (11.7%) among the age range less than one weak. Klebsiella spp, S. aureus, and E. coli showed a high level of resistance to most tested antimicrobials. Amikacin, ciprofloxacin and norfloxacin, and erythromycin were the most effective antibiotics whereas ampicillin, amoxicillin, and cotrimoxazole were the least effective antibiotics for isolates. Conclusion. Neonatal sepsis infection is common in the 3–28 days of age range. S. aureus, E. coli, and K. pneumonia were the most common isolates. Most the bacterial pathogens were resistant to commonly prescribed antibiotics. Therefore, an antimicrobial sensitivity test for bacterial isolates is recommended to provide updated data for the physician in choosing the appropriate antibiotic for better patient treatment outcome.
Comprehensive Gene Expression Signature Using RNA-Seq in Airways of Mouse Model of Severe Asthma with Fungal Sensitization
Authors: Inoue Hideki , Akimoto Kaho , Ikeda Hitoshi , Sato Hiroki , Uno Tomoki , Uchida Yoshitaka , Kawahara Tomoko , Fukuda Yosuke , Hirai Kuniaki , Miyata Yoshito , Homma Tetsuya , Ohta Shin , Yamamoto Mayumi , Suzuki Shintaro , Tanaka Akihiko , Sagara Hironori
Published: September 2021

Introduction: Inhalation of fungal allergens induces airway epithelial damage following airway inflammation and excessive mucus secretion, which can lead to severe asthma with fungal sensitization (SAFS). Comprehensive gene expression analysis in Alternaria-exposed mouse airways, a model of SAFS, has not been conducted. Methods: BALB/c mice received intranasal administration of Alternaria extract or phosphate-buffered saline twice a week for 6 weeks. Lung sections and bronchoalveolar lavage fluid were obtained to assess airway inflammation. RNA-Seq in the central airway was performed, and gene ontology (GO) analysis and gene set enrichment analysis (GSEA) were conducted for pathway analyses. An in vitro experiment using human airway epithelial cell 16HBE14o- was performed to validate the RNA-Seq findings. Results: Eosinophilic airway inflammation with mucus overproduction and airway remodeling was observed in mice exposed to Alternaria. RNA-Seq analysis revealed 403 upregulated and 108 downregulated genes in airways of Alternaria-exposed mice. In GO analysis, the functions of immunoglobulin (Ig) receptor binding, Ig production, inflammatory response, and T-cell activation were upregulated, while those of keratinization and defense response to other organisms were downregulated. GSEA revealed positive enrichment in T-cell receptor complex, immunological synapse, antigen binding, mast cell activation, and Ig receptor binding, and negative enrichment in keratinization and cornification in Alternaria-exposed mice relative to control. Alternaria exposure to 16HBE14o- cells validated the downregulation of epithelial keratinization-related genes, including SPRR1A, SPRR1B, and KRT6B. Conclusion: RNA-Seq analysis showed that Alternaria exposure induced inflammatory response and impaired defense mechanisms in mice airway epithelium, which might be therapeutic targets for SAFS.
A Novel Visually Guided Radiofrequency Balloon Ablation Catheter for Pulmonary Vein Isolation: One-Year Outcomes of the Multicenter AF-FICIENT I Trial
Authors: Reddy Vivek Y. , Al-Ahmad Amin , Aidietis Audrius , Daly Matthew , Melton Iain , Hu Yan , Sulkin Matthew , Rackauskas Gediminas , Ebner Adrian , Hooks Darren A. , Sofi Aamir , Neužil Petr , Crozier Ian G.
Published: September 2021

Background:

A multielectrode saline-irrigated radiofrequency (RF) balloon catheter with an integrated camera system was designed to perform single-shot pulmonary vein (PV) isolation. To optimize ablation, simultaneous circumferential RF energy can be delivered, albeit with power output that is tailored to individual electrodes based on direct visualization of tissue-electrode contact. In a first-in-human multicenter clinical trial, we studied the feasibility, performance, safety, and efficacy of PV isolation using this novel ablation catheter to treat atrial fibrillation.

Methods:

AF-FICIENT-I was a prospective, 5-center, single-arm study. After transseptal puncture, the RF balloon was positioned over the wire at each pulmonary (PV) ostium using a 13.3F sheath. RF energy was titrated based on visual contact (6–10 W; up to 60 seconds per ablation). Electrical PV isolation was confirmed using either, (1) sensing mini-electrodes situated on the RF balloon itself or (2) a circular mapping catheter. Patients were clinically assessed for recurrent atrial arrhythmias lasting >30 s over 12 months, after a 3-month blanking period.

Results:

Six operators performed de novo PV isolation in 99 patients (95 paroxysmal/4 persistent; age, 58±11; men, 67.7%). Median times, including procedure, fluoroscopy, ablation (time from first RF to last RF application), and balloon (time elapsing between catheter introduction to removal from the body) times, were 85 (interquartile range, 62–118), 14 (interquartile range, 9–23), 31 (interquartile range, 20–53), and 43 minutes (interquartile range, 32–70), respectively. The 12-month Kaplan-Meier estimates of freedom from any atrial arrhythmia (atrial fibrillation, atrial flutter, or atrial tachycardia) or atrial fibrillation alone were 77.5% (95% CI, 67.6%–84.7%) and 84.1% (95% CI, 74.9%–90.1%), respectively. There were no device-related serious adverse events.

Conclusions:

The novel RF balloon catheter allowed visually guided, directional titration of ablative energy to safely isolate PVs with short procedure times.

Registration:

URL:
https://www.anzctr.org.au
; Unique identifier: ACTRN12615001340527.
Recovery of Conduction Following High-Power Short-Duration Ablation in Patients With Atrial Fibrillation: A Single-Center Experience
Authors: Mohanty Sanghamitra , Trivedi Chintan , Della Rocca Domenico G. , Gianni Carola , MacDonald Bryan , Quintero Mayedo Angel , Al-Ahmad Amin , Burkhardt John D. , Bassiouny Mohamed , Gallinghouse G. Joseph , Horton Rodney , Di Biase Luigi , Natale Andrea
Published: September 2021

Background:

Optimal duration of energy delivery in high-power short-duration (HPSD) ablation to create a durable lesion in atrial fibrillation (AF) is not clear yet. We evaluated the association of electrical reconnection with lesion duration in HPSD-ablation.

Methods:

HPSD ablation was defined as maximum temperature at 42 °C and power delivery at 45 W for 10 to 15 seconds (5 seconds in coronary sinus [CS] and left atrial posterior wall [LAPW] near the esophagus). In some patients, a mechanical tool was used to deflect the esophagus away from the ablation site.

Results:

Consecutive 1749 patients with AF (left atrial appendage and CS isolation: 1451) receiving redo ablation after a prior HPSD procedure were included. At the HPSD ablation, mean duration of lesion was significantly shorter in the LAPW facing esophagus compared with elsewhere (5.2±1.5 versus 12.5±1.7 seconds,
P
<0.001). Application duration was reduced to <10 seconds in 1221 (84%) patients receiving left atrial appendage and CS isolation. At the redo, recovery of conduction was noted in the CS (592, 40.8%), left atrial appendage (493, 34%), and PV and LAPW (249, 14.2%). Of the 249 patients with LAPW reconnection, 91% (n=227) had the conduction recovered in the area facing the esophagus. In 73 patients, esophageal displacement device was used during the HPSD ablation. Average duration of lesions in LAPW among those 73 patients was 9.2±2 seconds. PV-LAPW reconnection was observed in 3/73 (4.1%) patients.

Conclusions:

HPSD ablation with lesion duration of <10 seconds was associated with conduction recovery in the left atrial appendage, CS, and the LAPW area facing esophagus.
Three‐Dimensional Global Left Ventricular Myocardial Strain Reduced in All Directions in Subclinical Diabetic Cardiomyopathy: A Systematic Review and Meta‐Analysis
Authors: Ghoreyshi‐Hefzabad Seyed‐Mohammad , Jeyaprakash Prajith , Gupta Alpa , Vo Ha Q. , Pathan Faraz , Negishi Kazuaki
Published: September 2021

Background

Three‐dimensional (3D) speckle tracking echocardiography can identify subclinical diabetic cardiomyopathy without geometric assumption and loss of speckle from out‐of‐plane motions. There is, however, significant heterogeneity among the previous reports. We performed a systematic review and meta‐analysis to compare 3D strain values between adults with asymptomatic, subclinical diabetes mellitus (ie, patients with diabetes mellitus without known clinical manifestations of cardiac disease) and healthy controls.

Methods and Results

After systematic review of 5 databases, 12 valid studies (544 patients with diabetes mellitus and 489 controls) were eligible for meta‐analysis. Pooled means and mean difference (MD) using a random‐effects model for 3D global longitudinal, circumferential, radial, and area strain were calculated. Patients with diabetes mellitus had an overall 2.31 percentage points lower 3D global longitudinal strain than healthy subjects (16.6%, 95% CI, 15.7–17.6 versus 19.0; 95% CI, 18.2–19.7; MD, −2.31, 95% CI, −2.72 to −2.03). Similarly, 3D global circumferential strain (18.9%; 95% CI, 17.5–20.3 versus 20.5; 95% CI, 18.9–22.1; MD, −1.50; 95% CI, −2.09 to −0.91); 3D global radial strain (44.6%; 95% CI, 40.2–49.1 versus 48.2; 95% CI, 44.7–51.8; MD, −3.47; 95% CI, −4.98 to −1.97), and 3D global area strain (30.5%; 95% CI, 29.2–31.8 versus 32.4; 95% CI, 30.5–34.3; MD, −1.76; 95% CI, −2.74 to −0.78) were also lower in patients with diabetes mellitus. Significant heterogeneity was noted between studies for all strain directions (inconsistency factor [I
2
], 37%–78%). Meta‐regression in subgroup analysis of studies using the most popular vendor found higher prevalence of hypertension as a significant contributor to worse 3D global longitudinal strain. Higher hemoglobulin A
1c
was the most significant contributor to worse 3D global circumferential strain in patients with diabetes mellitus.

Conclusions

Three‐dimensional myocardial strain was reduced in all directions in asymptomatic diabetic patients. Hypertension and hemoglobin A
1c
were associated with worse 3D global longitudinal strain and 3D global circumferential strain, respectively.

Registration

URL:
https://www.crd.york.ac.uk/prospero
; unique identifier: CRD42020197825.
Enhanced Heart Failure in Redox‐Dead Cys17Ser PKARIα Knock‐In Mice
Authors: Islam M. M. Towhidul , Tarnowski Daniel , Zhang Min , Trum Maximilian , Lebek Simon , Mustroph Julian , Daniel Henriette , Moellencamp Johanna , Pabel Steffen , Sossalla Samuel , El‐Armouche Ali , Nikolaev Viacheslav O. , Shah Ajay M. , Eaton Philip , Maier Lars S. , Sag Can Martin , Wagner Stefan
Published: September 2021

Background

PKARIα (protein kinase A type I‐α regulatory subunit) is redox‐active independent of its physiologic agonist cAMP. However, it is unknown whether this alternative mechanism of PKARIα activation may be of relevance to cardiac excitation–contraction coupling.

Methods and Results

We used a redox‐dead transgenic mouse model with homozygous knock‐in replacement of redox‐sensitive cysteine 17 with serine within the regulatory subunits of PKARIα (KI). Reactive oxygen species were acutely evoked by exposure of isolated cardiac myocytes to AngII (angiotensin II, 1 µmol/L). The long‐term relevance of oxidized PKARIα was investigated in KI mice and their wild‐type (WT) littermates following transverse aortic constriction (TAC). AngII increased reactive oxygen species in both groups but with RIα dimer formation in WT only. AngII induced translocation of PKARI to the cell membrane and resulted in protein kinase A–dependent stimulation of
I
Ca
(L‐type Ca current) in WT with no effect in KI myocytes. Consequently, Ca transients were reduced in KI myocytes as compared with WT cells following acute AngII exposure. Transverse aortic constriction–related reactive oxygen species formation resulted in RIα oxidation in WT but not in KI mice. Within 6 weeks after TAC, KI mice showed an enhanced deterioration of contractile function and impaired survival compared with WT. In accordance, compared with WT, ventricular myocytes from failing KI mice displayed significantly reduced Ca transient amplitudes and lack of
I
Ca
stimulation. Conversely, direct pharmacological stimulation of
I
Ca
using Bay K8644 rescued Ca transients in AngII‐treated KI myocytes and contractile function in failing KI mice in vivo.

Conclusions

Oxidative activation of PKARIα with subsequent stimulation of
I
Ca
preserves cardiac function in the setting of acute and chronic oxidative stress.
The Stockholm Stroke Triage Project: Outcomes of Endovascular Thrombectomy Before and After Triage Implementation
Authors: Keselman Boris , Berglund Annika , Ahmed Niaz , Bottai Matteo , von Euler Mia , Holmin Staffan , Laska Ann-Charlotte , Mathé Jan M. , Sjöstrand Christina , Eriksson Einar E. , Mazya Michael V.
Published: September 2021

Background and Purpose:

The Stockholm Stroke Triage System (SSTS) is a prehospital algorithm for detection of endovascular thrombectomy (EVT)-eligible patients, combining symptom severity assessment and ambulance-to-hospital teleconsultation, leading to a decision on primary stroke center bypass. In the Stockholm Region (6 primary stroke centers, 1 EVT center), SSTS implementation in October 2017 reduced onset-to-EVT time by 69 minutes. We compared clinical outcomes before and after implementation of SSTS in an observational study.

Methods:

We prospectively recruited patients transported by Code Stroke ambulance within the Stockholm region under the SSTS, treated with EVT during October 2017 to October 2019, and compared to EVT patients from 2 previous years. Outcomes: shift in modified Rankin Scale (mRS) scores, mRS score 0 to 1, mRS score 0 to 2, and death (all 3 months), National Institutes of Health Stroke Scale (NIHSS) score change 24-hour post-EVT, recanalization (Thrombolysis in Cerebral Infarction 2b-3), and symptomatic intracranial hemorrhage. mRS outcomes were adjusted for age and baseline NIHSS.

Results:

Patients with EVT in the SSTS group (n=244) were older and had higher baseline NIHSS versus historical controls (n=187): median age 74 (interquartile range, 63–81) versus 71 (61–78); NIHSS score 17 (11.5–21) versus 15 (10–20). During SSTS, median onset-to-puncture time was 136 versus 205 minutes (
P
<0.001). Adjusted common odds ratio for lower mRS in SSTS patients was 1.7 (95% CI, 1.2–2.3) versus controls. During SSTS, 83/240 (34.6%) versus 44/186 (23.7%) reached 3-month mRS score 0 to 1 (
P
=0.014), adjusted common odds ratio 2.3 (95% CI, 1.4–3.6). Median NIHSS change 24-hour post-EVT was 6 versus 4 (
P
=0.005). Differences in Thrombolysis in Cerebral Infarction, symptomatic intracranial hemorrhage, and death were nonsignificant.

Conclusions:

With an onset to arterial puncture time reduction by 69 minutes, outcomes in thrombectomy-treated patients improved significantly after region-wide large artery occlusion triage system implementation. These results warrant replication studies in other geographic and organizational circumstances.