bluuebunny/crossref_metadata_2025 huggingface dataset:
Konsep Perilaku Keputusan Pembelian Game Online
Authors: Asnawi Aisah , Tehuayo Erlinda , Marsulam Abdul Hafid
Published: June 2023

E-Sport sports have been recognized as sports since 2020. The rise of technological developments makes game applications more very diverse and competitive. Data shows that the number of online game players increases every year. The increase in players is an opportunity for manufacturers to offer increasingly challenging game applications and various features in games that are economically profitable. This study aims to determine the effect of online promotions conducted by the company, the involvement of reference groups, and the comfort of game applications made on the purchasing decision of the online game application. This study uses a quantitative method, Partial Least Square (PLS). The sample was purposive sampling, with many respondents of as many as 30 game players. The results showed that game manufacturers' online promotions largely determine gamers' purchasing decisions. However the most decisive factor is the reference group for gamers in purchasing a game application. While the ease of the application also determines the number of consumers who download the application.

 

Keywords: Reference Group, Ease Of Application, Purchasing Decisions, Online Promotions

 

Abstrak

Olahraga e-sport diakui sebagai cabang olahraga sejak tahun 2020. Maraknya perkembangan tekhnologi membuat aplikasi game menjadi lebih sangat beragam dan kompetitif. Data menunjukkan bahwa jumlah pemain game online meningkat setiap tahun. Hal ini merupakan kesempatan bagi produsen untuk menawarkan aplikasi game yang semakin menantang dan berbagai fitur pada game yang menguntungkan secara ekonomi. Tujuan dari penelitian ini adalah untuk mengetahui pengaruh promosi online yang dilakukan oleh perusahaan, keterlibatan kelompok referensi dan kenyamanan aplikasi game yang dibuat terhadap keputusan pembelian aplikasi game online tersebut. Penelitian ini menggunakan metode kuantitatif yaitu Partial Least Square (PLS). Sampel yang digunakan adalah purposive sampling dengan jumlah responden sebanyak 30 orang pemain game. Hasil penelitian menunjukkan bahwa promosi secara online yang digunakan oleh produsen game sangat menentukan keputusan pembelian dikalangan gamer. Namun faktor yang paling menentukan adalah kelompok referensi yang menjadi acuan bagi gamer dalam pembelian sebuah aplikasi game. Sedangkan kemudahan aplikasi juga ikut menentukan banyaknya konsumen yang mendownload aplikasi tersebut.

 

Kata Kunci: Kelompok Referensi, Kemudahan Aplikasi, Keputusan Pembelian, Promosi Online
Pemanfaatan Limbah Plastik Menjadi Modul Pembentuk Dinding Terawang Dari Limbah Plastik
Authors: Leksono Erick Teguh , Dewanto Rully Ario , Fadhlan Muhammad
Published: June 2023

Pemanfaatan Limbah Plastik Menjadi Modul Pembentuk Dinding Terawang / Roster Pada Bangunan yang Bernilai Jual Tinggi di Desa Ciangsana, Gunung Puteri, Bogor, Jawa Barat merupakan program Pengabdian kepada Masyarakat (PkM) untuk meningkatkan manajemen pengolahan limbah plastik yang meliputi pelatihan dan pendampingan proses Potensi Limbah Plastik pengolahan limbah plastik menjadi aneka modul dinding trawang/roster, pengelolaan keuangan, permodalan, metode pengemasan, teknik penjualan dan manajemen pemasaran serta kewirausahaan bagi para pengolah limbah plastik Permasalahannya tidak dapat mengolah limbah plastik menjadi produk bernilai tambah yang tinggi. Inovasi pengolahan limbah plastik berupa pengolahan limbah plastik menjadi aneka modul dinding trawang/roster yang menggabungkan beberapa fungsi desain produk yang estetik dan komprehensif. Solusinya melakukan strategi penumbuhan kelompok usaha baru pengolahan limbah pastik, melalui proses pelatihan, manajemen usaha, pemasaran, pendampingan lanjutan. Kontribusi mendasar khalayak sasaran adalah meningkatnya nilai tambah limbah plastik untuk menjadi produk bernilai jual tinggi yang dikelola oleh UMKM CINTA berbasis kelompok masyarakat. Rencana luaran berupa jasa, sistem, produk/barang, atau luaran lainnya yang ditargetkan berupa :  produk aneka modul dinding trawang/roster dari limbah plastik, dan UMKM berbasis  kelompok masyarakat. Pelatihan dan pendampingan dalam program ini meliputi : Pelatihan pertama Penyuluhan dan Praktek Pengolahan limbah pastik, Pelatihan kedua Penyuluhan dan Praktek Pengemasan, Pelatihan ketiga Penyuluhan dan Praktek Permodalan serta Keuangan, Pelatihan keempat Penyuluhan dan Praktek Penjualan serta Pemasaran online serta offline, Program PKM ini berlangsung dari tgl 26 November – 20 Desember 2022. Akhirnya diharapkan setelah pelatihan di atas muncul banyak wirausaha yang menggerakkan potensi ekonomi local berbasis limbah plastik.
Pengenalan Rangkaian Listrik (Seri Dan Paralel) Dan Pengenalan Dasar Dasar Komputer (Tik) Pada Siswa SD Muhammadiyah 4 Palembang
Authors: Fitriani Endah , Fithri Normaliaty , Mukti Aan Restu , Nova Wardani Kiky Rizky , Makmuri M Kumroni
Published: June 2023

SD Muhamamdiyah 4 merupakan salah satu sekolah yang menerapkan proses pembelajaran di Rumah dan Disekolah, Salah satu pembelajaran di Sekolah berdasarkan kurikulum pelajaran IPA kelas 6 SD, terdapat pembelajaran rangkaian listrik. Salah satunya terkait dengan rangkaian listrik seri , rangkaian listrik parallel, dan rangkaian listrik campuran. Sedangkan pembelajaran komputer belum ada dalam kurikulum SD Muhammadiyah, dari hasil diskusi dengan guru dan siswa terdapat beberapa permasalahan dalam belajar komputer atau teknologi pada umunya. Para siswa sudah sangat aktif dalam memegang HP. Memberikan pengetahuan tentang konsep dasar rangkaian listrik, khususnya listrik dinamis dan mengenalkan dasar komputer agar bisa menarik minat tentang teknologi. Dengan melakukan praktek secara langsung, siswa siswi dapat lebih memahami bagaimana prinsip rangkaian listrik seri dan parallel dan aplikasinya dalam kehidupan sehari-hari , dan lebih megenal alat-alat komputer secara langsung.
Automatic Power-up Items Placement on Shooter Game using Convolutional Neural Network
Authors: Nugraha Alvin Satria , Setiawan Abas , Wijanarto Wijanarto
Published: June 2023

- A shooter game is a popular game genre with various components. To make a shooter game more attractive, some power-ups items can support players to achieve their goals. Power-ups items provide more power to players, some of which include ammo, extra lives, and invulnerability. The location of power-ups items should be in a special place so that it neither too easy to find nor too difficult to find. Item placement could be done manually by a human or a technical artist. It will need a relatively long time and high cost. In this paper, we try to mimic technical artist vision when placing an item. Visual images have been collected by scanning spatially the forest terrain by using a virtual camera on top. Each image data comply with the item placement rules according to the Tomb Raider and Uncharted 4 games. Convolutional Neural Network (CNN) is used to find out which images can be occupied by power-up items or not. From several experimental scenarios, the use of the Global Average Pooling layer is proven to produce a model that is not overfitting. The best CNN models are developed and got an accuracy of 90.5% with an architecture that includes the Global Average Pooling layer. That model is applied to the new forest terrain so that power-up items can automatically be placed in an appropriate location.
Developing Smart City 5.0 Framework To Produce Competency
Authors: Gamayanto Indra , Nurhindarto Aris
Published: June 2023

Abstract - Smart cities are essential things that must be applied in the face of globalization and competition. In smart city 5.0, three important things discussed are human resource development, smart marketing, and information technology. These three things cannot be separated from each other because they are related. Furthermore, the smart city 5.0 article is a development from the previous article, namely smart city 1.0-3.0. Smart City 5.0 provides four important formulas for developing a smart city and a framework to guide its implementation. The four formulas and the resulting framework will develop in the next article, namely intelligent intelligence. It will continue to make prototypes and smart city intelligence applications. The result of this article is a framework that is a concept and strategy in developing a smart region that is part of a smart city. This article is still under development and research will continue. Furthermore, the development of this research will certainly require several more stages in reaching the top of the research, namely a big picture of a smart city and performance measurement for each process contained in a smart city. Therefore, it takes the right steps and formulas to produce a smart city 5.0 framework Keywords - Smart city, Human resource, Marketing, Technology, Innovation
A Raindrop in a Raging Fire? Soft Power as a Tool for Japan-South Korea Reconciliation
Authors: Vassao Luna
Published: June 2023

Japan and South Korea have experienced rising tensions for generations. Beginning with the Japanese annexation of Korea in 1910, contemporary relations are shaped by mutual mistrust. Nevertheless, both countries face common security threats, namely North Korean and China; and both are pushed by the United States to cooperate on an international level. It is increasingly important for Japan and South Korea to take steps toward reconciliation. Analyzing the significant barriers to rapprochement, this article explores soft power as a potential method for improving relations between the two countries.
The effect of low-abundance OTU filtering methods on the reliability and variability of microbial composition assessed by 16S rRNA amplicon sequencing
Authors: Nikodemova Maria , Holzhausen Elizabeth A. , Deblois Courtney L. , Barnet Jodi H. , Peppard Paul E. , Suen Garret , Malecki Kristen M.
Published: June 2023

PCR amplicon sequencing may lead to detection of spurious operational taxonomic units (OTUs), inflating estimates of gut microbial diversity. There is no consensus in the analytical approach as to what filtering methods should be applied to remove low-abundance OTUs; moreover, few studies have investigated the reliability of OTU detection within replicates. Here, we investigated the reliability of OTU detection (% agreement in detecting OTU in triplicates) and accuracy of their quantification (assessed by coefficient of variation (CV)) in human stool specimens. Stool samples were collected from 12 participants 22–55 years old. We applied several methods for filtering low-abundance OTUs and determined their impact on alpha-diversity and beta-diversity metrics. The reliability of OTU detection without any filtering was only 44.1% (SE=0.9) but increased after filtering low-abundance OTUs. After filtering OTUs with <0.1% abundance in the dataset, the reliability increased to 87.7% (SE=0.6) but at the expense of removing 6.97% reads from the dataset. When filtering was based on individual sample, the reliability increased to 73.1% after filtering OTUs with <10 copies while removing only 1.12% of reads. High abundance OTUs (>10 copies in sample) had lower CV, indicating better accuracy of quantification than low-abundance OTUs. Excluding very low-abundance OTUs had a significant impact on alpha-diversity metrics sensitive to the presence of rare species (observed OTUs, Chao1) but had little impact on relative abundance of major phyla and families and alpha-diversity metrics accounting for both richness and evenness (Shannon, Inverse Simpson). To increase the reliability of microbial composition, we advise removing OTUs with <10 copies in individual samples, particularly in studies where only one subsample per specimen is available for analysis.
Cysteinyl-leukotrienes promote cutaneous Leishmaniasis control
Authors: Noronha Letícia Paula Trajano , Martins Monique Daiane Andrade , Castro-Junior Archimedes Barbosa , Thorstenberg Maria Luiza , Costa-Soares Laís , Rangel Thuany Prado , Carvalho-Gondim Felipe , Rossi-Bergmann Bartira , Savio Luiz Eduardo Baggio , Canetti Claudio de Azevedo , Coutinho-Silva Robson
Published: June 2023

Leishmaniasis is a neglected tropical parasitic disease with few approved medications. Cutaneous leishmaniasis (CL) is the most frequent form, responsible for 0.7 - 1.0 million new cases annually worldwide. Leukotrienes are lipid mediators of inflammation produced in response to cell damage or infection. They are subdivided into leukotriene B4 (LTB4) and cysteinyl leukotrienes LTC4 and LTD4 (Cys-LTs), depending on the enzyme responsible for their production. Recently, we showed that LTB4 could be a target for purinergic signaling controlling Leishmania amazonensis infection; however, the importance of Cys-LTs in the resolution of infection remained unknown. Mice infected with L. amazonensis are a model of CL infection and drug screening. We found that Cys-LTs control L. amazonensis infection in susceptible (BALB/c) and resistant (C57BL/6) mouse strains. In vitro, Cys-LTs significantly diminished the L. amazonensis infection index in peritoneal macrophages of BALB/c and C57BL/6 mice. In vivo, intralesional treatment with Cys-LTs reduced the lesion size and parasite loads in the infected footpads of C57BL/6 mice. The anti-leishmanial role of Cys-LTs depended on the purinergic P2X7 receptor, as infected cells lacking the receptor did not produce Cys-LTs in response to ATP. These findings suggest the therapeutic potential of LTB4 and Cys-LTs for CL treatment.
Cross-sectional investigation of mycological diagnosis challenges in Saudi Arabia
Authors: Khateb Aiah Mustafa , Alkhaibari Shatha Ali
Published: June 2023

Background

The global incidence of fungal infection has increased dramatically over the last two decades. Fungal diseases threaten both immunocompetent, and immunocompromised patients. The current fungal diagnostics status in Saudi Arabia needs to be evaluated, especially with the increase of the immunosuppressed population. This cross-sectional study investigated the gaps in mycological diagnosis on a national level.

Materials and methods

The call interview questionnaire responses were collected to evaluate the demand for fungal assays, diagnostic methods’ quality, and mycological expertise of laboratory technologists in both public and private medical intuitions. The data were analyzed using (IBM SPSS ® software version 22.0).

Results

A total of 57 hospitals from all Saudi regions participated in the questionnaire; however, only 32% received or processed mycological samples. Most participants were from the Mecca region (25%), Riyadh region (19%), and Eastern region (14%). The top fungal isolates identified were Candida spp., Aspergillus spp., and dermatophyte. Fungal investigation is highly requested by intensive care, dermatology, and obstetrics and gynecology units. Most laboratories rely on fungal culture and microscopic examination, which mostly identify Candida to the genus level, and use 37°C incubators for culture (67%). Antifungal susceptibility testing (AST) and serological and molecular methods are rarely performed and mostly outsourced. Using accurate identification and AST are the primary factors to improve fungal diagnosis in respect to turnaround time and cost. The three major obstacles identified were availability of facility (47%), reagents and kits (32%), and good training (21%).

Conclusions

The results indicated that fungal diagnosis demand was relatively higher in high-population regions. This study highlighted the gaps in fungal diagnostics reference laboratories to encourage their improvement in Saudi hospitals.
Impact of plaque and luminal morphology in balloon angioplasty of the femoropopliteal artery: an intravascular ultrasound analysis
Authors: Zou Yuchi , Tong Qiang , Wang Xuehu , Jiang Chuli , Dai Yuanbin , Zhao Yu , Cheng Jun
Published: June 2023

Objective

To assess the effect of plaque and luminal morphologies in balloon angioplasty of femoropopliteal lesions using intravascular ultrasound (IVUS).

Methods

This retrospective, observational study analyzed 836 cross-sectional images using IVUS, from 35 femoropopliteal arteries of patients who underwent endovascular treatment between September 2020 and February 2022. Pre- and post-balloon angioplasty images were matched per 5 mm. Post-balloon angioplasty images were grouped into successful (n = 345) and unsuccessful (n = 491) groups. Plaque and luminal morphologies (such as severity of calcification, vascular remodeling, and plaque eccentricity) were extracted before the balloon angioplasty procedure to identify the predictors of unsuccessful balloon angioplasty. Additionally, 103 images with severe dissection were analyzed using IVUS and angiography.

Results

In univariate analyses, the predictive factors for unsuccessful balloon angioplasty were vascular remodeling (p < .001), plaque burden (p < .001), lumen eccentricity (p < .001), and balloon/vessel ratio (p = .01). Predictive factors for severe dissections were the guidewire route (p < .001) and balloon/vessel ratio (p = .04). In multivariate analysis, the predictive factors for unsuccessful balloon angioplasty included lumen eccentricity (odds ratio [OR]: 3.99, 95% confidence interval [CI]: 1.28–12.68, p = .02) and plaque burden (OR: 1.03, 95% CI: 1.02–1.04; p < .001). For severe dissections, the independent risk factor was an eccentric guidewire route (OR: 2.10, 95% CI: 1.22–3.65, p = .01).

Conclusion

High plaque burden and luminal eccentricity were risk factors for failed femoropopliteal artery balloon angioplasty. Additionally, eccentric guidewire routes predicted severe dissection.
Transport of nitrite from large arteries modulates regional blood flow during stress and exercise
Authors: Muskat J. C. , Babbs C. F. , Goergen C. J. , Rayz V. L.
Published: June 2023

Background

Acute cardiovascular stress increases systemic wall shear stress (WSS)–a frictional force exerted by the flow of blood on vessel walls–which raises plasma nitrite concentration due to enhanced endothelial nitric oxide synthase (eNOS) activity. Upstream eNOS inhibition modulates distal perfusion, and autonomic stress increases both the consumption and vasodilatory effects of endogenous nitrite. Plasma nitrite maintains vascular homeostasis during exercise and disruption of nitrite bioavailability can lead to intermittent claudication.

Hypothesis

During acute cardiovascular stress or strenuous exercise, we hypothesize enhanced production of nitric oxide (NO) by vascular endothelial cells raises nitrite concentrations in near-wall layers of flowing blood, resulting in cumulative NO concentrations in downstream arterioles sufficient for vasodilation.

Confirmation and implications

Utilizing a multiscale model of nitrite transport in bifurcating arteries, we tested the hypothesis for femoral artery flow under resting and exercised states of cardiovascular stress. Results indicate intravascular transport of nitrite from upstream endothelium could result in vasodilator-active levels of nitrite in downstream resistance vessels. The hypothesis could be confirmed utilizing artery-on-a-chip technology to measure NO production rates directly and help validate numerical model predictions. Further characterization of this mechanism may improve our understanding of symptomatic peripheral artery occlusive disease and exercise physiology.
Predictive value of CHA2DS2-VASc score in radial artery occlusion after transradial coronary angiography
Authors: Nadir Aydın , AY Nuray Kahraman
Published: June 2023

Background

Radial artery occlusion is the most common complication of transradial catheterization. RAO is characterized by thrombus formation due to catheterization and endothelial damage. CHA2DS2-VASc scores are the current scoring systems used to determine the risk of thromboembolism in patients with atrial fibrillation. The aim of this study was to investigate the relationship of CHA2DS2-VASc score with radial artery occlusion.

Methods

This prospectively designed study was included 500 consecutive patients who underwent coronary artery transradial catheterization for diagnostic or interventional procedures. The diagnosis of radial artery occlusion was made by palpation examination and Doppler ultrasound at the twenty-fourth hour after the procedure. Independent predictors of radial artery occlusion were determined by logistic regression analysis.

Results

Radial artery occlusion was observed at a rate of 9%. The CHA2DS2-VASc score was higher in the group of the patients who developed radial artery occlusion (p < 0.001). Arterial spasm (OR: 2.76, 95% CI 1.18–6.45, p: 0.01), catheterization time (OR: 1.03, 95% CI 1.005–1.057, p: 0.01) and CHA2DS2-VASc score ≥ 3 (OR: 1.44, 95% CI 1.17–1.78, p: 0.00) as significant independent predictors of radial artery occlusion. A high CHA2DS2-VASc score was associated with the continuity of the occlusion after the treatment (OR:1.37, 95% CI 1.01–1.85, p: 0.03).

Conclusions

An easily applicable CHA2DS2-VASc score of ≥3 has a predictive value for radial artery occlusion.
De novo heterozygous pathogenic FBN1 variant in an autopsy case of multiple aneurysms and right renal artery dissection: a case report
Authors: MacGowan Taylor , McClinchey Taylor , Parcha Vibhu , Vatta Matteo , Litovsky Silvio , Arora Pankaj , Benson Paul V.
Published: June 2023

Background

Marfan syndrome is a potentially fatal inherited autosomal dominant condition impacting the cardiovascular and the skeletal system with an estimated 25% cases caused by sporadic genetic variations. Given the genetic inheritance pattern, an autopsy of probands with Marfan syndrome–associated mortality is critical to establish the phenotypic expression and clinical implications of the particular genetic variant, especially for first-degree relatives. We present the findings of a Marfan syndrome proband decedent presenting with sudden onset abdominal pain and unexplained retroperitoneal abdominal hemorrhage.

Methods

An autopsy was performed to inform the blood relatives of the phenotypic expression and penetrance of the potentially heritable condition. A clinical laboratory improvement amendment (CLIA)-certified clinical grade genetic sequencing was performed to identify pathogenic variants in genes associated with aortopathy.

Results

The autopsy showed intra-abdominal and retroperitoneal hemorrhage due to infarction of the right kidney caused by dissection of the right renal artery. Genetic testing identified a heterozygous pathogenic FBN1 gene variant. The specific variant is FBN1 NM_000138.4 c.2953G > A p.(Gly985Arg).

Conclusions

We report a case of a previously undiagnosed Marfan syndrome death due to a de novo FBN1 variant, c.2953G > A.
Carotid geometry is independently associated with complicated carotid artery plaques
Authors: Strecker Christoph , Kopczak Anna , Saam Tobias , Sepp Dominik , Hennemuth Anja , Mayerhofer Ernst , Poli Sven , Ziemann Ulf , Poppert Holger , Schindler Andreas , Harloff Andreas
Published: June 2023

Introduction

Complicated carotid artery plaques (cCAPs) are associated with an increased risk of rupture and subsequent stroke. The geometry of the carotid bifurcation determines the distribution of local hemodynamics and could thus contribute to the development and composition of these plaques. Therefore, we studied the role of carotid bifurcation geometry in the presence of cCAPs.

Methods

We investigated the association of individual vessel geometry with carotid artery plaque types in the Carotid Plaque Imaging in Acute Stroke (CAPIAS) study. After excluding arteries without plaque or with insufficient MRI quality, 354 carotid arteries from 182 patients were analyzed. Individual parameters of carotid geometry [i.e., internal carotid artery (ICA)/common carotid artery (CCA) ratio, bifurcation angle, and tortuosity) were derived from time-of-flight MR images. The lesion types of carotid artery plaques were determined according to the American Heart Association classification of lesions by multi-contrast 3T-MRI. The association between carotid geometry and a cCAP was studied using logistic regression after adjusting for age, sex, wall area, and cardiovascular risk factors.

Results

Low ICA/CCA ratios (OR per SD increase 0.60 [95%CI: 0.42–0.85]; p = 0.004) and low bifurcation angles (OR 0.61 [95%CI: 0.42–0.90]; p = 0.012) were significantly associated with the presence of cCAPs after adjusting for age, sex, cardiovascular risk factors, and wall area. Tortuosity had no significant association with cCAPs. Only ICA/CCA ratio remained significant in a model containing all three geometric parameters (OR per SD increase 0.65 [95%CI: 0.45–0.94]; p = 0.023).

Conclusions

A steep tapering of the ICA relative to the CCA and, to a lesser extent, a low angle of the carotid bifurcation were associated with the presence of cCAPs. Our findings highlight the contribution of bifurcation geometry to plaque vulnerability. Thus, assessment of carotid geometry could be helpful in identifying patients at risk of cCAPs.
Risk prediction in patients with classical low-flow, low-gradient aortic stenosis undergoing surgical intervention
Authors: Tessari Fernanda Castiglioni , Lopes Maria Antonieta Albanez A. de M. , Campos Carlos M. , Rosa Vitor Emer Egypto , Sampaio Roney Orismar , Soares Frederico José Mendes Mendonça , Lopes Rener Romulo Souza , Nazzetta Daniella Cian , de Brito Jr Fábio Sândoli , Ribeiro Henrique Barbosa , Vieira Marcelo L. C. , Mathias Wilson , Fernandes Joao Ricardo Cordeiro , Lopes Mariana Pezzute , Rochitte Carlos E. , Pomerantzeff Pablo M. A. , Abizaid Alexandre , Tarasoutchi Flavio
Published: June 2023

Introduction

Classical low-flow, low-gradient aortic stenosis (LFLG-AS) is an advanced stage of aortic stenosis, which has a poor prognosis with medical treatment and a high operative mortality after surgical aortic valve replacement (SAVR). There is currently a paucity of information regarding the current prognosis of classical LFLG-AS patients undergoing SAVR and the lack of a reliable risk assessment tool for this particular subset of AS patients. The present study aims to assess mortality predictors in a population of classical LFLG-AS patients undergoing SAVR.

Methods

This is a prospective study including 41 consecutive classical LFLG-AS patients (aortic valve area ≤1.0 cm2, mean transaortic gradient <40 mmHg, left ventricular ejection fraction <50%). All patients underwent dobutamine stress echocardiography (DSE), 3D echocardiography, and T1 mapping cardiac magnetic resonance (CMR). Patients with pseudo-severe aortic stenosis were excluded. Patients were divided into groups according to the median value of the mean transaortic gradient (≤25 and >25 mmHg). All-cause, intraprocedural, 30-day, and 1-year mortality rates were evaluated.

Results

All of the patients had degenerative aortic stenosis, with a median age of 66 (60–73) years; most of the patients were men (83%). The median EuroSCORE II was 2.19% (1.5%–4.78%), and the median STS was 2.19% (1.6%–3.99%). On DSE, 73.2% had flow reserve (FR), i.e., an increase in stroke volume ≥20% during DSE, with no significant differences between groups. On CMR, late gadolinium enhancement mass was lower in the group with mean transaortic gradient >25 mmHg [2.0 (0.0–8.9) g vs. 8.5 (2.3–15.0) g; p = 0.034), and myocardium extracellular volume (ECV) and indexed ECV were similar between groups. The 30-day and 1-year mortality rates were 14.6% and 43.8%, respectively. The median follow-up was 4.1 (0.3–5.1) years. By multivariate analysis adjusted for FR, only the mean transaortic gradient was an independent predictor of mortality (hazard ratio: 0.923, 95% confidence interval: 0.864–0.986, p = 0.019). A mean transaortic gradient ≤25 mmHg was associated with higher all-cause mortality rates (log-rank p = 0.038), while there was no difference in mortality regarding FR status (log-rank p = 0.114).

Conclusions

In patients with classical LFLG-AS undergoing SAVR, the mean transaortic gradient was the only independent mortality predictor in patients with LFLG-AS, especially if ≤25 mmHg. The absence of left ventricular FR had no prognostic impact on long-term outcomes.
Curriculum transformations in South Africa: some discomforting truths on interminable poverty and inequalities in schools and society
Authors: Ngobeni Norah Risana , Chibambo Mackenzie Ishmael , Divala Joseph Jinja
Published: June 2023

In this study, we argue that the different curriculum reforms South Africa embarked on have not really helped break the existing socio-economic inequalities. Precisely, the various reforms (e.g., C2005, NCS, and CAPS) initiated by the South African government have been proved to be a flop and uninspiring considering that schools have remained spaces where inequalities, violence, vandalism, harassment, stratification, and various crimes continue to exist. Outside the schooling spaces, unemployment, poverty, xenophobia, robbery, GBVs, and different forms of crime have characterized South African society. Many educational researchers have also argued that these issues could symbolize a broken education system that is guided by shoddy policies. Accordingly, we sought to establish key issues that confront South African educational system to explain how these reproduce the apartheid-era-like inequalities. In the main, we established that neoliberal-minimalist policies have significantly influenced socio-economic inequalities in South Africa. We also established that educational researchers have failed to identify neoliberalism as the root cause of South Africa's inequalities. To achieve our goals, we utilized document analysis to explain and understand how various policies, practices, and powerful individuals have influenced these injustices. Theoretically, these debates have been guided by Paul Freire's “Critical Pedagogy” and Bourdieu's “Social-cultural Capital” mainly for their ability to illuminate power relations, exclusions, and inequalities through Symbolic Violence and depravations.
Diagnostic efficacy of a combination of the Chinese thyroid imaging reporting and data system and shear wave elastography in detecting category 4a and 4b thyroid nodules
Authors: Li Huizhan , Xue Jiping , Zhang Yanxia , Miao Junwang , Jing Liwei , Kang Chunsong
Published: June 2023

Objectives

Differential diagnosis of benign and malignant thyroid imaging reporting and data system (TIRADS) category 4a and 4b nodules can be difficult using conventional ultrasonography (US). The objective of this study was to evaluate the diagnostic efficacy of a combination of the Chinese-TIRADS (C-TIRADS) and shear wave elastography (SWE) in detecting malignant nodules among category 4a and 4b thyroid nodules.

Methods

Among 409 thyroid nodules in 332 patients that we included in this study, 106 thyroid nodules were diagnosed as category 4a and 4b using C-TIRADS. We used SWE to measure the maximum Young’s modulus (Emax) values of category 4a and 4b thyroid nodules. We calculated the diagnostic efficacy of only the C-TIRADS, only SWE, and a combination of C-TIRADS with SWE, and compared these, while taking the pathology results as the gold standard.

Results

The area under the ROC curve (AUC), sensitivity, and accuracy values of the combination of C-TIRADS and SWE (0.870, 83.3%, and 84.0%, respectively) were all higher when compared with the values of only the C-TIRADS (0.785, 68.5%, and 78.3%, respectively) or only SWE (0.775, 68.5%, and 77.4%, respectively) in the diagnosis of category 4a and 4b thyroid nodules.

Conclusion

In this study, we found that the combination of C-TIRADS and SWE significantly improved the diagnostic efficacy in detecting malignant nodules among category 4a and 4b thyroid nodules, and this could provide a reference for further use of this combination by clinicians for diagnosis and treatment.
Captopril challenge test in the diagnosis of primary aldosteronism: consistency between 1- and 2- h sampling
Authors: Liu Xinyu , Guo Chao , Bian Jin , Hao Sufang , Lou Ying , Zhang Huimin , Zhou Xianliang , Cai Jun , Ma Wenjun
Published: June 2023

Objective

To examine the consistency of plasma aldosterone concentration at 1 and 2 h in the captopril challenge test (CCT) and to explore the possibility of replacing 2-h aldosterone concentration with 1-h aldosterone concentration for diagnosis of primary aldosteronism (PA).

Methods

This retrospective analysis included a total of 204 hypertensive patients suspected of having PA. Subjects received oral captopril challenge at 50 mg (25 mg if the systolic blood pressure was <120 mmHg), and plasma aldosterone concentration and direct renin concentration were measured at 1 and 2 h afterward (chemiluminescence immunoassay Liaison® DiaSorin, Italy). Sensitivity and specificity were used to reflect the diagnostic performance of 1-h aldosterone concentration using 2-h aldosterone concentration (11 ng/dl as the cutoff) as the reference. A receiver operating characteristic curve analysis was also conducted.

Results

Among the 204 included patients [median age of 57.0 (48.0–61.0) years, 54.4% men], a diagnosis of PA was established in 94 patients. Aldosterone concentration in the patients with essential hypertension was 8.40 (interquartile range 7.05–11.00) ng/dl at 1 h and 7.65 (5.98–9.30) ng/dl at 2 h (P < 0.001). In patients with PA, aldosterone concentration was 16.80 (12.58–20.50) ng/dl at 1 h and 15.55 (12.60–20.85) ng/dl at 2 h (P > 0.999). At a cutoff of 11 ng/dl, the sensitivity and specificity of using 1-h aldosterone concentration to diagnose PA were 87.2% and 78.2%, respectively. A higher cutoff of 12.5 ng/ml increased specificity to 90.0% but decreased sensitivity to 75.5%. A lower cutoff of 9.3 ng/ml increased sensitivity to 97.9% but decreased specificity to 65.4%.

Conclusions

When diagnosing PA with CCT, 1-h aldosterone concentration could not be used to replace 2-h aldosterone concentration.
Design and energy analysis of a flywheel-based boom energy regeneration system for hydraulic excavators
Authors: Li Jiansong , Li Shaohui , Ji Zhi , Wang Yunfei
Published: June 2023

The global energy crisis and growing environmental concerns provide a strong impetus for the development of fuel-efficient hydraulic excavators (HEs). The boom potential energy of a conventional HE is consumed by throttling in a lowering process, which is a major reason for energy inefficiency. To solve the issue, this paper presents a flywheel-based boom energy regeneration system for HEs using load-sensing systems. The otherwise wasted boom potential energy is regenerated by a pump/motor and stored in a flywheel. The recaptured energy is reused in the form of pressure energy released to the pump outlet. The energy efficiencies of a conventional load-sensing system and the proposed system were analyzed. A control strategy was proposed to optimize the energy-saving procedure. To obtain a more reliable simulation model, a coasting experiment of the flywheel was carried out to obtain the key parameters related to the friction of the flywheel. A 4-t HE in our laboratory was selected as a study case to investigate the energy-saving effect of the flywheel-based boom energy regeneration system. Numeric simulations showed that compared with a conventional load-sensing system, the energy-saving rate was about 32.7% in a typical digging and dumping cycle. These findings indicated that the flywheel-based boom energy regeneration system is promising for developing energy-efficient HEs.
Extraordinary concentrations of local endemism associated with arid-land springs
Authors: Fensham Roderick J. , Ponder Winston F. , Souza Valeria , Stevens Lawrence E.
Published: June 2023

Introduction: While the biodiversity value of springs is recognised, it has not been systematically compiled. The aim of the current study is to highlight the extraordinary endemism associated with the isolated habitat of arid-land springs at three locations in two continents.

Methods: The habitat endemism of the eukaryote species associated with the aquatic and terrestrial habitats at Ash Meadows in the USA, Byarri in Australia and Cuatro Ciénegas in Mexico was assembled based on their geographic distribution.

Results: The currently-known aquatic and semi-aquatic endemic species number 27 at Ash Meadows, 31 at Byarri and 34 at Cuatro Ciénegas. Terrestrial endemic species are represented by two species at Ash Meadows, five at Byarri and 26 at Cuatro Ciénegas. The terrestrial endemics are associated with the scalded areas surrounding the springs impregnated with soda and gypsum. The persistence of the endemics is astonishing given that the wetlands represent tiny islands of habitat (216 small wetlands over 40 km2 in the case of Byarri).

Discussion: A key factor for the persistence and radiation of endemic species is the stability and permanence of the wetlands over evolutionary time-scales. Genetic evidence indicates the presence of both paleo-endemics, species that persisted in spring wetlands as relics of previous mesic climates; and neo-endemics that have dispersed from more mesic environments and subsequently radiated in the spring wetlands as distinct forms. The former evolved from their relatives greater than 106 ya and the latter less than 106 ya. The concentration of endemic species in and around arid-land springs is among the highest concentrations of endemic organisms specialised to a particular habitat and substantiates the paramount conservation significance of desert springs.
Spatiotemporally anthropogenic PM2.5- and O3-related health economic losses via weather normalization technique and hierarchical policies in Chinese cities
Authors: Guo Jinyuan , Wang Teng , Li Fei , Qu Zhiguang , Yan Jingjing , Kong Shaojie
Published: June 2023

Introduction

With the promulgation of air pollution control policies, there are still many cities where the PM2.5 concentration exceeds 35 μg/m3, and O3 pollution is increasingly apparent.

Methods

The spatio-temporal evolution and differentiation characteristics of PM2.5 and O3 pollution were explored, and then compound pollution hotspot urban agglomerations were screened out. A weather normalization technique was used to identify the driving amount, the influence of meteorological factors, and the anthropogenic emissions quantitatively, on pollution in hotspot urban agglomeration. Furthermore, the health and economic losses due to PM2.5 and O3 in hot cities in 2015–2020 were quantified. Finally, a natural break-point classification method was used to establish the health loss rating systems for PM2.5 and O3.

Results and Discussion

The results showed the following: (1) From 2015 to 2020, 78%, 72%, 69%, 58%, 50%, and 41% of the annual mean PM2.5 concentration had exceeded 35 μg/m3, respectively, and 17%, 18%, 31%, 33%, 30%, and 17% of the annual mean O3 concentration exceeded 160 μg/m3, respectively, in 337 cities in China. (2) From 2015 to 2020, the health losses caused by PM2.5 and O3 were ranked as follows: Beijing–Tianjin–Hebei (BTH; 1968, 482 people) > Shandong Peninsula (SDP; 1,396, 480 people) > Central Plains (CP; 1,302, 314 people) > Yangtze River Delta (YRD; 987, 306 people) > Triangle of Central China (TC; 932, 275 people) > Guanzhong Plain (GZP; 869, 189 people). (3) The average economic losses associated with public health of the PM2.5 and O3 were ranked as follows: BTH (2.321 billion, 3.218 billion RMB, 1 RMB = 0.0.1474 USD on 20 January 2023) > SDP (1.607, 2.962 billion RMB) > YRD (1.075, 1.902 billion RMB) > TC (1.016 billion, 1.495 billion RMB) > CP (1.095, 1.453 billion RMB) > GZP (0.69, 0.828 billion RMB). Therefore, combining hot pollution factors, the regional characteristics of the priority control areas, and the national 14th 5-Year Plan, targeted control countermeasures were proposed.
Variants in JAZF1 are associated with asthma, type 2 diabetes, and height in the United Kingdom biobank population
Authors: DeWan Andrew T. , Cahill Megan E. , Cornejo-Sanchez Diana M. , Li Yining , Dong Zihan , Fabiha Tabassum , Sun Hao , Wang Gao , Leal Suzanne M.
Published: June 2023

Background: Asthma, type 2 diabetes (T2D), and anthropometric measures are correlated complex traits that all have a major genetic component.

Objective: To investigate the overlap in genetic variants associated with these complex traits.

Methods: Using United Kingdom Biobank data, we performed univariate association analysis, fine-mapping, and mediation analysis to identify and dissect shared genomic regions associated with asthma, T2D, height, weight, body mass index (BMI), and waist circumference (WC).

Results: We found several genome-wide significant variants in and around the JAZF1 gene that are associated with asthma, T2D, or height with two of these variants shared by the three phenotypes. We also observed an association in this region with WC when adjusted for BMI. However, there was no association with WC when it was not adjusted for BMI or weight. Additionally, only suggestive associations between variants in this region and BMI were observed. Fine-mapping analyses suggested that within JAZF1 there are non-overlapping regions harboring causal susceptibility variants for asthma, T2D, and height. Mediation analyses supported the conclusion that these are independent associations.

Conclusion: Our findings indicate that variants in the JAZF1 are associated with asthma, T2D, and height, but the associated causal variant(s) are different for each of the three phenotypes.
Integrative profiling analysis reveals prognostic significance, molecular characteristics, and tumor immunity of angiogenesis-related genes in soft tissue sarcoma
Authors: Liu Binfeng , Li Chenbei , Feng Chengyao , Wang Hua , Zhang Haixia , Tu Chao , He Shasha , Li Zhihong
Published: June 2023

Background

Soft tissue sarcoma (STS) is a class of malignant tumors originating from mesenchymal stroma with a poor prognosis. Accumulating evidence has proved that angiogenesis is an essential hallmark of tumors. Nevertheless, there is a paucity of comprehensive research exploring the association of angiogenesis-related genes (ARGs) with STS.

Methods

The ARGs were extracted from previous literature, and the differentially expressed ARGs were screened for subsequent analysis. Next, the least absolute shrinkage and selection operator (LASSO) and Cox regression analyses were conducted to establish the angiogenesis-related signature (ARSig). The predictive performance of the novel ARSig was confirmed using internal and external validation, subgroup survival, and independent analysis. Additionally, the association of the ARSig with the tumor immune microenvironment, tumor mutational burden (TMB), and therapeutic response in STS were further investigated. Notably, we finally conducted in vitro experiments to verify the findings from the bioinformatics analysis.

Results

A novel ARSig is successfully constructed and validated. The STS with a lower ARSig risk score in the training cohort has an improved prognosis. Also, consistent results were observed in the internal and external cohorts. The receiver operating characteristic (ROC) curve, subgroup survival, and independent analysis further indicate that the novel ARSig is a promising independent prognostic predictor for STS. Furthermore, it is proved that the novel ARSig is relevant to the immune landscape, TMB, immunotherapy, and chemotherapy sensitivity in STS. Encouragingly, we also validate that the signature ARGs are significantly dysregulated in STS, and ARDB2 and SRPK1 are closely connected with the malignant progress of STS cells.

Conclusion

In sum, we construct a novel ARSig for STS, which could act as a promising prognostic factor for STS and give a strategy for future clinical decisions, immune landscape, and personalized treatment of STS.
CD38 marks the exhausted CD8+ tissue-resident memory T cells in hepatocellular carcinoma
Authors: Reolo Marie J. Y. , Otsuka Masayuki , Seow Justine Jia Wen , Lee Joycelyn , Lee Yun Hua , Nguyen Phuong H. D. , Lim Chun Jye , Wasser Martin , Chua Camillus , Lim Tony K. H. , Leow Wei Qiang , Chung Alexander , Goh Brian K. P. , Chow Pierce K. H. , DasGupta Ramanuj , Yeong Joe Poh Sheng , Chew Valerie
Published: June 2023

Introduction

Despite recent advances in immunotherapy for hepatocellular carcinoma (HCC), the overall modest response rate underscores the need for a better understanding of the tumor microenvironment (TME) of HCC. We have previously shown that CD38 is widely expressed on tumor-infiltrating leukocytes (TILs), predominantly on CD3+ T cells and monocytes. However, its specific role in the HCC TME remains unclear.

Methods

In this current study, we used cytometry time-of-flight (CyTOF), bulk RNA sequencing on sorted T cells, and single-cell RNA (scRNA) sequencing to interrogate expression of CD38 and its correlation with T cell exhaustion in HCC samples. We also employed multiplex immunohistochemistry (mIHC) for validating our findings.

Results

From CyTOF analysis, we compared the immune composition of CD38-expressing leukocytes in TILs, non-tumor tissue-infiltrating leukocytes (NIL), and peripheral blood mononuclear cells (PBMC). We identified CD8+ T cells as the dominant CD38-expressing TILs and found that CD38 expression was significantly higher in CD8+ TRM in TILs than in NILs. Furthermore, through transcriptomic analysis on sorted CD8+ TRM from HCC tumors, we observed a higher expression of CD38 along with T cell exhaustion genes, including PDCD1 and CTLA4, compared to the circulating memory CD8 T cells from PBMC. This was validated by scRNA sequencing that revealed co-expression of CD38 with PDCD1, CTLA4, and ITGAE (CD103) in T cells from HCC tumors. The protein co-expression of CD38 and PD-1 on CD8+ T cells was further demonstrated by mIHC on HCC FFPE tissues, marking CD38 as a T cell co-exhaustion marker in HCC. Lastly, the higher proportions of CD38+PD-1+ CD8+ T cells and CD38+PD-1+ TRM were significantly associated with the higher histopathological grades of HCC, indicating its role in the aggressiveness of the disease.

Conclusion

Taken together, the concurrent expression of CD38 with exhaustion markers on CD8+ TRM underpins its role as a key marker of T cell exhaustion and a potential therapeutic target for restoring cytotoxic T cell function in HCC.
The central inflammatory regulator IκBζ: induction, regulation and physiological functions
Authors: Feng Yanpeng , Chen Zhiyuan , Xu Yi , Han Yuxuan , Jia Xiujuan , Wang Zixuan , Zhang Nannan , Lv Wenjing
Published: June 2023

IκBζ (encoded by NFKBIZ) is the most recently identified IkappaB family protein. As an atypical member of the IkappaB protein family, NFKBIZ has been the focus of recent studies because of its role in inflammation. Specifically, it is a key gene in the regulation of a variety of inflammatory factors in the NF-KB pathway, thereby affecting the progression of related diseases. In recent years, investigations into NFKBIZ have led to greater understanding of this gene. In this review, we summarize the induction of NFKBIZ and then elucidate its transcription, translation, molecular mechanism and physiological function. Finally, the roles played by NFKBIZ in psoriasis, cancer, kidney injury, autoimmune diseases and other diseases are described. NFKBIZ functions are universal and bidirectional, and therefore, this gene may exert a great influence on the regulation of inflammation and inflammation-related diseases.