bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical Revascularization With Cardiopulmonary Bypass on a Patient With Severe COVID-19
Authors: Montandrau Olivier , Arana Hannan , Ehooman Franck , Bouattour Karim , Cherruault Marlène , Ouechani Wisalle , Hamdaoui Ismahane , Dufour Guillaume , Kattou Fehmi , Philip Ivan , Beaussier Marc
Published: October 2020

The coronavirus disease 2019 (COVID-19) may lead to an acute respiratory distress syndrome by an inappropriate cytokine response and may predispose to a prothrombotic state through multiple pathways. Both can complicate the management of cardiac surgery with cardiopulmonary bypass, which is known to activate the hemostatic system and to exacerbate systemic inflammatory response. Little is known about the impact of cardiac surgery with cardiopulmonary bypass on viral pneumonia, particularly with the new coronavirus. In this article, we describe the case of a diabetic patient with COVID-19 and a concomitant 3-vessel disease with a formal indication for surgical revascularization, who unexpectedly presented with a high heparin resistance during cardiopulmonary bypass. Emphasis is placed on the importance of multidisciplinary team discussions before surgery, on the thorough preoperative assessment, and on the perioperative management, particularly regarding mechanical ventilation and anticoagulation.
Comparison of the accuracy of 11 intraocular lens power calculation formulas
Authors: Carmona-González David , Castillo-Gómez Alfredo , Palomino-Bautista Carlos , Romero-Domínguez Marta , Gutiérrez-Moreno María Ángeles
Published: October 2020

Purpose

To compare the accuracy of 11 intraocular lens (IOL) power calculation formulas (SRK-T, Hoffer Q, Holladay I, Haigis, Holladay II, Olsen, Barrett Universal II, Hill-RBF, Ladas Super formula, EVO and Kane).

Setting

Private university hospital (QuironSalud, Madrid, Spain).

Design

Retrospective case series

Methods

Data were compiled from 481 eyes of 481 patients who had undergone uneventful cataract surgery with IOL insertion. Preoperative biometric measurements were made using an IOL Master® 700. Respective ULIB IOL constants ( http://ocusoft.de/ulib/c1.htm ) for each of 4 IOL models implanted were used to calculate the predictive refractive outcome for each formula. This was compared with the actual refractive outcome determined 3 months postoperatively. The primary outcome was mean absolute prediction error (MAE). The study sample was divided according to axial length (AL) into three groups of eyes: short (⩽22.00 mm), normal (22.00–25.00 mm) and long (⩾25.00 mm).

Results

The Barrett Universal II and Haigis formulas yielded the lowest MAEs over the entire AL range ( p < .01, except EVO) as well as in the long ( p < .01, all formulas) and normal ( p < .01, except Haigis, Holladay II, Olsen and LSF) eyes. In the short eyes, the lower MAEs were provided by Haigis and EVO ( p < .01 except Hoffer Q, SRK/T and Holladay I).

Conclusions

Barrett Universal II was the most accurate for IOL power calculation in the normal and long eyes. For short eyes, the formulas Haigis and EVO seem best at predicting refractive outcomes.
The Physiological Parameters of Three Cordyline terminalis Cultivars as Influenced by Substrate and Deficit Irrigation
Authors: Alidust Janali , Sedaghathoor Shahram
Published: October 2020

The effect of different substrates and deficit-irrigation intervals were explored on the physiological parameters of 3 Cordyline terminalis cultivars in a factorial experiment with 3 factors including 4 substrates, 3 irrigation intervals (2, 7, and 10 days) and 3 cultivars (green, red, and tricolor) in 3 replications. The results showed that plants had the highest growth under the irrigation interval of 2 days and the lowest growth under the irrigation interval of 10 days. The highest growth was obtained from plants grown in garden soil, and among cultivars, “tricolor” exhibited the highest growth, plant height, and leaf number. The interaction between substrate and irrigation interval revealed that plants grown in garden soil and irrigated every other day produced the highest chlorophyll and carotenoid content. Trilateral effects of “substrate × irrigation interval × cultivar” indicated that the highest catalase activity was related to “garden soil + perlite × irrigation interval of 10 days × Green.”
Brain structural and functional alterations in MOG antibody disease
Authors: Zhuo Zhizheng , Duan Yunyun , Tian Decai , Wang Xinli , Gao Chenyang , Ding Jinli , Zheng Fenglian , Zhang Tian , Zhang Xinghu , Barkhof Frederik , Shi Fu-Dong , Liu Yaou
Published: October 2020

Background:

The impact of myelin oligodendrocyte glycoprotein antibody disease (MOGAD) on brain structure and function is unknown.

Objectives:

The aim of this study was to study the multimodal brain MRI alterations in MOGAD and to investigate their clinical significance.

Methods:

A total of 17 MOGAD, 20 aquaporin-4 antibody seropositive neuromyelitis optica spectrum disorders (AQP4 + NMOSD), and 28 healthy controls (HC) were prospectively recruited. Voxel-wise gray matter (GM) volume, fractional anisotropy (FA), mean diffusivity (MD), and degree centrality (DC) were compared between groups. Clinical associations and differential diagnosis were determined using partial correlation and stepwise logistic regression.

Results:

In comparison with HC, MOGAD had GM atrophy in frontal and temporal lobe, insula, thalamus, and hippocampus, and WM fiber disruption in optic radiation and anterior/posterior corona radiata; DC decreased in cerebellum and increased in temporal lobe. Compared to AQP4 + NMOSD, MOGAD presented lower GM volume in postcentral gyrus and decreased DC in cerebellum. Hippocampus/parahippocampus atrophy associated with Expanded Disability Status Scale ( R = −0.55, p = 0.04) and California Verbal Learning Test ( R = 0.62, p = 0.031). The differentiation of MOGAD from AQP4 + NMOSD achieved an accuracy of 95% using FA in splenium of corpus callosum and DC in occipital gyrus.

Conclusion:

Distinct structural and functional alterations were identified in MOGAD. Hippocampus/parahippocampus atrophy associated with clinical disability and cognitive impairment.
Languages, secessionism and party competition in Catalonia: A case of de-ethnicising outbidding?
Authors: Sanjaume-Calvet Marc , Riera-Gil Elvira
Published: October 2020

This article explores party strategies in electoral competition in Catalonia in order to test the existence of ethnic outbidding ( Chandra, 2005 ; Zuber and Szöcsik, 2015 ). We contribute with original findings on this case by addressing the evolution of political parties’ discourses through a qualitative analysis of their manifestos for the last five regional elections campaigns (2006–2017), covering a period of strong territorial conflict between Catalonia and Spain. Our analysis aims to measure the impact of secessionism growth on parties’ ethnic competition in Catalonia and compares the strategies of secessionist, federalist and centralist parties. In order to measure ethnicity, we focus on language, the most salient identity marker in Catalan politics, and link the evolution of parties’ territorial positions to that of their treatment of national identities and the Catalan and Castilian languages – both official languages in Catalonia – in their manifestos. Our findings include diverse strategies that do not entirely fit in with ethnic competition theories. First, we find that territorial outbidding does not always imply ethnic outbidding: political parties generally do not use the main identity marker in Catalonia (language) for outbidding purposes. Second, we find some evidence of ethnic outbidding in majority nationalist parties, but not in minority nationalist parties.
Influences on help-seeking decisions for behavioral child sleep problems: Why parents do and do not seek help
Authors: Newton Adam T , Corkum Penny V , Blunden Sarah , Reid Graham J
Published: October 2020

Objectives:

Behavioral sleep problems affect 25% of children and impact functioning, but little is known about help-seeking for these problems. We identified (1) predictors for sleep problem perception and help-seeking, using nested-logit regression and (2) reasons why parents did not seek professional help for sleep problems, using chi-square.

Methods:

Parents ( N = 407) of children (2–10-years-old) completed the study online. Parents indicated whether their child had no sleep problem, a mild problem, or a moderate-to-severe problem and completed additional questionnaires on parent/child functioning.

Results:

Overall, 5.4% ± 2.2% of parents sought professional help for a child sleep problem. Greater child sleep problem severity and greater child socioemotional problems were significant predictors of parents perceiving a sleep problem. Among parents who perceived a sleep problem, greater parental socioemotional problems significantly predicted professional help-seeking. Parents who perceived no problem or a mild sleep problem reported not needing professional help as the main reason for not seeking help; parents who perceived a moderate-to-severe problem reported logistic barriers most often (e.g. treatment unavailability, cost).

Conclusions:

Problem perception and help-seeking predictors resemble the children’s mental health literature. Differences in barriers, based on problem severity, suggest differential help-seeking interventions are needed (e.g. education vs access).
Emotional eating: Really hungry or just angry?
Authors: Ekim Ayfer , Ocakci Ayse Ferda
Published: October 2020

The aim of this study was to investigate the effect of parenting styles and academic self-efficacy on emotional eating behaviours within a sample of adolescents. The sample of this cross-sectionally designed study consisted of 584 adolescents between the ages of 12–17 years. In order to collect necessary data, the Emotional Eating Scale for Child and Adolescent, the Parenting Style Scale and Academic Self-efficacy Scale were utilized. In this sample, Emotional Eating Scale’s total score of girls was higher than boys, and emotional eating was not related to body mass index. Parenting styles and academic self-efficacy predicted 34% of the variants seen in emotional eating behaviours of adolescents. While a positive relation existed between emotional eating and negligent parenting style, a negative significant relation occurred between permissive and democratic type of parenting styles and emotional eating. In addition, emotional eating behaviours decreased, whereas academic self-efficacy perception increased accordingly. The results showed that emotional eating behaviours of adolescents were in relation with parenting styles and academic self-efficacy. A good understanding of the multifactorial structure of emotional eating in adolescents will help to develop essential programmes in order to design effective coping mechanisms.
Critical theory in the Anthropocene: Marcuse, Marxism and ecology
Authors: Stevenson Nick
Published: October 2020

The politics of the Anthropocene has been widely debated within recent sociological theory. This article seeks to argue that Marxism, critical theory and especially the work of Herbert Marcuse have a great deal to contribute to these debates. Here, I seek to link together the recent revival of interest in the idea of the commons by the alter-globalisation movement and Marxist social theory in an attempt to challenge some of the dominant assumptions in respect of the nature/culture division and the neoliberal dominance of mainstream politics. The more critical politics of the commons would suggest both a radical politics fit for the twenty-first century and a way of understanding the environmental crisis located within critical understandings of the histories of capitalism and social movements. This is suggestive of a civilisation-based politics focused on questions of emancipation informed by political economy, a critique of the dominant consumer society and culture rather than questions of deconstruction. In the final section, I seek to explore how Marcuse’s concerns remain linked to contemporary global ethical movements for change.
Innovative capacity and sustainable food tourist influx to African-ethnic restaurants: The dynamic capabilities perspective
Authors: Otengei Samson Omuudu , Ahebwa Wilber Manyisa
Published: October 2020

The paper presents findings on how innovative capacity influences sustainable food tourist inflows to African-ethnic Restaurants (AERs) in East Africa. Informed by the Dynamic Capabilities Theory, a multiple case study approach was adopted to capture what the owner- managers bring to the research inquiry. This helped in an in-depth understanding of patterns and relationships of meanings. The study reveals that continuous food quality improvement, adoption of new technology, innovative authenticity assurance, customer involvement and personalized service, and engagement of dynamic tour and travel agents are strategically relevant in influencing sustainable food tourist inflows to AERs. Continuous use of popular flavourings, fresh materials, and adoption of best culinary practices such as “marinating” are a major reason for tourists’ re-visits to AERs. The findings further reveal that adoption of new technology for fast food preparation, attractive food presentation, and apposite service temperature lead to tourist attraction. It also emerged that the ability to respond to guest unique requests and specification is a valuable capability. In addition, the use of traditional paraphernalia, indigenous ingredients and, hiring creative traditional chefs is critical in retaining food tourists. Moreover, provision of diversity through an elaborate African buffet, eclectic cuisine, and regular menu reviews was found to be vital in attracting visitors to AERs. Thus, the study through innovative capabilities-based model, provides a theoretical explanation for food tourists’ influx to AERs, and presents implications for policy and practice.
Kernel-based estimation of individual location densities from smartphone data
Authors: Finazzi Francesco , Paci Lucia
Published: October 2020

Localizing people across space and over time is a relevant and challenging problem in many modern applications. Smartphone ubiquity gives the opportunity to collect useful individual data as never before. In this work, the focus is on location data collected by smartphone applications. We propose a kernel-based density estimation approach that exploits cyclical spatio-temporal patterns of people to estimate the individual location density at any time, uncertainty included. Model parameters are estimated by maximum likelihood cross-validation. Unlike classic tracking methods designed for high spatio-temporal resolution data, the approach is suitable when location data are sparse in time and are affected by non-negligible errors. The approach is applied to location data collected by the Earthquake Network citizen science project which carries out a worldwide earthquake early warning system based on smartphones. The approach is parsimonious and is suitable to model location data gathered by any location-aware smartphone application.
Multi-class classification of biomechanical data: A functional LDA approach based on multi-class penalized functional PLS
Authors: Aguilera-Morillo M. Carmen , Aguilera Ana M.
Published: October 2020

A functional linear discriminant analysis approach to classify a set of kinematic data (human movement curves of individuals performing different physical activities) is performed. Kinematic data, usually collected in linear acceleration or angular rotation format, can be identified with functions in a continuous domain (time, percentage of gait cycle, etc.). Since kinematic curves are measured in the same sample of individuals performing different activities, they are a clear example of functional data with repeated measures. On the other hand, the sample curves are observed with noise. Then, a roughness penalty might be necessary in order to provide a smooth estimation of the discriminant functions, which would make them more interpretable. Moreover, because of the infinite dimension of functional data, a reduction dimension technique should be considered. To solve these problems, we propose a multi-class approach for penalized functional partial least squares (FPLS) regression. Then linear discriminant analysis (LDA) will be performed on the estimated FPLS components. This methodology is motivated by two case studies. The first study considers the linear acceleration recorded every two seconds in 30 subjects, related to three different activities (walking, climbing stairs and down stairs). The second study works with the triaxial angular rotation, for each joint, in 51 children when they completed a cycle walking under three conditions (walking, carrying a backpack and pulling a trolley). A simulation study is also developed for comparing the performance of the proposed functional LDA with respect to the corresponding multivariate and non-penalized approaches.
VoI-informed decision-making for SHM system arrangement
Authors: Zhang Wei-Heng , Qin Jianjun , Lu Da-Gang , Thöns Sebastian , Faber Michael Havbro
Published: October 2020

Structural health monitoring systems have been widely implemented to provide real-time continuous data support and to ensure structural safety in the context of structural integrity management. However, the quantification of the potential benefits of structural health monitoring systems has not yet attracted widespread attention. At the same time, there is an urgent need to develop strategies, such as optimizing the monitoring period, monitoring variables, and other factors, to maximize the potential benefits of structural health monitoring systems. Considering the continuity of structural health monitoring information, a framework is developed in this article to support decision-making for structural health monitoring systems arrangement in the context of structural integrity management, which integrates the concepts of value of information and risk-based inspection planning based on an approach which utilizes a conjugate prior probability distribution for updating of the probabilistic models of structural performances based on structural health monitoring information. An example considering fatigue degradation of steel structures is investigated to illustrate the application of the proposed framework. The considered example shows that the choice of monitoring variables, the monitoring period, and the monitoring quality may be consistently optimized by the application of the proposed framework and approach. Finally, discussions and conclusions are provided to clarify the potential benefits of the proposed framework with a special view to practical applications of structural health monitoring systems.
How the Institutional and Policy Context Shapes the Establishment of Nurse Practitioner Roles and Practice in New Zealand’s Primary Health Care Sector
Authors: Adams Sue , Carryer Jenny
Published: October 2020

The implementation of the nurse practitioner (NP) workforce in primary health care (PHC) in New Zealand has been slow, despite ongoing concerns over persisting health inequalities and a crisis in the primary care physician workforce. This article, as part of a wider institutional ethnography, draws on the experiences of one NP and two NP candidates, as they struggle to establish and deliver PHC services in areas of high need, rural, and Indigenous Māori communities in New Zealand. Using information gathered initially by interview, we develop an analysis of how the institutional and policy context is shaping their experiences and limiting opportunities for the informants to provide meaningful comprehensive PHC. Their work (time and effort), with various health organizations, was halted with little rationale, and seemingly contrary to New Zealand’s strategic direction for PHC stipulated in the Primary Health Care Strategy 2001. The tension between the extant biomedical model, known as primary care, and the broader principles of PHC was evident. Our analysis explored how the perpetuation of the neoliberal health policy environment through a “hands-off” approach from central government and district health boards resulted in a highly fragmented and complex health sector. Ongoing policy and sector perseverance to support privately owned physician-led general practice; a competitive contractual environment; and significant structural health sector changes, all restricted the establishment of NP services. Instead, commitment across the health sector is needed to ensure implementation of the NP workforce as autonomous mainstream providers of comprehensive PHC services.
Huaier Extractum Promotes Dendritic Cells Maturation and Favors them to Induce Th1 Immune Response: One of the Mechanisms Underlying Its Anti-Tumor Activity
Authors: Pan Jun , Jiang Zhou , Wu Dang , Yang Chenghui , Wang Zhen , Huang Jian
Published: October 2020

Huaier, a sandy beige mushroom with anti-tumor effects, has been applied into Traditional Chinese Medicine for more than 1600 years. Previous studies showed that Huaier exerted its anti-tumor effects not only by direct action on tumor cells, but also indirectly by modulation of immune function. In the present study, we found that Huaier treatment significantly repressed tumor growth in mice with 4T1 breast cancer and resulted in significant accumulation of CD4+ T cells and mature dendritic cells (DCs) in the tumor microenvironment. In vitro experiments demonstrated that Huaier treatment promoted both DC2.4 and bone marrow derived DCs (BMDCs) to express costimulatory molecules, enhance production of IL-1β and IL-12p70, while it inhibited their phagocytic activities, suggesting that Huaier treatment promotes maturation of DCs. Furthermore, we found Huaier-treated DCs profoundly stimulated proliferation of alloreactive CD4+ T cells and drove them to differentiate into Th1 subset. Expression of PI3K, Akt, p-Akt, JNK, and p-JNK was up-regulated, while p-p38 MAPK was down-regulated in Huaier-treated BMDCs, suggesting that Huaier promotes maturation of DCs with potent ability to activate Th1 immune response via modulation of MAPK and PI3K/Akt signaling pathways. Our findings provide further evidence for the mechanisms underlying the anti-tumor activity of Huaier.
A comparative study on the mechanical properties of polymeric monofilaments
Authors: Guo Haiyang , Dafaalah Alrayah Hassan , Liu Yanping , Zhang Yumei , Qiu Gao
Published: October 2020

This paper presents a comparative study on the mechanical properties of seven monofilaments of 0.12 mm diameter made with different polymeric materials including PET, PBT, PE, PP, and PA6 in order to assess their suitability for being spacer yarns for developing high-quality spacer fabrics. Their support capability and elasticity corresponding to fabric compression resistance and resilience, respectively, were evaluated by analyzing the tensile stress–strain relationships and residual strains of monofilaments subjected to cyclic tensile loading. Slack and taut heat setting on the monofilaments were also considered to select a proper heat setting method for their spacer fabrics. The mechanical properties of the monofilaments were explained by using the supramolecular structure information from X-ray diffraction and sonic orientation tests. The results showed that PET monofilaments have much higher moduli than the other monofilaments and possess better support capability as spacer yarns for spacer fabrics. PET monofilaments also have better elasticity under small deformation below 5% strain than the other monofilaments, but their elasticity is inferior under large deformation above 5% strain. PET monofilaments are suitable for being spacer yarns to achieve high compression resistance and resilience for spacer fabrics. The PET monofilament with higher molecular weight possessed the lower Young’s modulus which is good for the knitting process. PET monofilaments with high molecular weight and taut heat setting are recommended for producing spacer fabrics with high compression resistance and resilience, especially for small fabric deformation.
Using a high-pressure water jet-assisted tunnel boring machine to break rock
Authors: Zhang Jinliang , Li Yongchang , Zhang Yuansheng , Yang Fengwei , Liang Chao , Tan Shunhui
Published: October 2020

The concept of tunnel boring machine (TBM) disc cutter rock breaking coupled with high-pressure water jets has been proposed to overcome the difficulties that occur when TBMs encounter extremely hard rocks. Thus, to meet actual engineering requirements for the TBM construction of tunnels as part of the Wan’anxi water diversion project in Longyan City (Fujian Province, China), experiments were conducted on high-pressure water jet-assisted TBM disc cutter rock breaking. By varying kerf depth and width under different water jet parameters and performing disc cutter rock breaking tests on rock surfaces with no kerf, single kerf, and double kerfs, the effects of different kerf depths on the disc cutter rock breaking process, load, and efficiency were examined. The test results showed that high-pressure water jets can generate the regular kerfs required for the coupled disc cutter rock breaking of granite. Employing the coupled rock breaking method also resulted in a decrease in specific energy and an approximately 40% decrease in the normal force of the disc cutter, thereby significantly improving rock breaking efficiency. These results provide key technical parameters for the design and manufacture of high-pressure water jet-assisted rock-breaking TBMs and serves as a reference for similar processes.
Permanent magnet energy harvesting pedal based on compliant lever and energy storage structure
Authors: Zhang Yi-He , Lee Chul-Hee
Published: October 2020

The rapid development of low-power electronic sensors and integrated circuits has made the energy supply module complex and costly to a greater extent. The traditional energy supply method is based on external wiring or built-in batteries, which gives rise to a series of problems such as high costs of installation and maintenance, and environmental pollution. Mini-type energy generators absorb the ambient energy to power wireless devices, which is a promising energy supplying method. This method has the advantage of low installation cost and battery-free maintenance. This study proposed a digital design of a Step-type electromagnetic energy harvesting device. Two design goals should be considered to make the energy generator work well. First, the pedal can drive the energy generator to generate electricity during the stepping and rebounding process. Second, the pedal should have a small pedaling displacement, so as not to affect the normal walking state of pedestrians. To achieve the above goals, this research designed a compliant lever structure with elastic energy storage function and displacement amplification function. The pseudo-rigid body model is used to conceptually design the flexible mechanism. The electromagnetic force of the iron core at different positions is calculated by simulation analysis and verified by experiments. Based on these results, this device can be used effectively as a monitoring system host node at the doorways of hospital wards.
Primary leiomyosarcoma is a rare cause of femoral triangle mass: A case report
Authors: Xu Yingjiang , Xie Weiping , Shang Dan
Published: October 2020

Objectives

Primary leiomyosarcoma in the femoral vein is an extremely rare vascular disorder and is often misdiagnosed. In order to improve the knowledge and treatment of this disease, a case of leiomyosarcoma in the femoral vein was reported.

Methods

We report the case of a 58-year-old woman with a leiomyosarcoma of the femoral vein and treated successfully by surgical resection. After surgery, no recurrence had been noted follow-up.Subsequently, we reviewed information derived from 31 previously published cases from 1954 to 2019.

Results

A total of 31 patients diagnosed with femoral vein leiomyosarcoma were presented in previous studies; in all of these patients, 14 (45.2%, 14/31) patients were men. Of these, the median age was 51.6 years old (ranging from 3 to 84).

Conclusions

Complete resection with adjuvant chemotherapeutic was the main strategy to treat the disease. Prognosis remains poor if metastasis was present, especially pulmonary metastasis.
Paclitaxel exposure and long-term mortality of patients treated with the Zilver PTX drug-eluting stent
Authors: Stern Jordan R , Tran Kenneth , Chandra Venita , Harris E John , Lee Jason T
Published: October 2020

Objectives

Paclitaxel-eluting stents have demonstrated improved patency over balloon angioplasty and bare metal stenting for endovascular interventions in the femoral-popliteal segment. Recently, concerns have arisen regarding the safety of paclitaxel use and its association with mortality. This study aims to examine real-world, long-term mortality, and patency of patients treated with the Zilver PTX drug-eluting stent.

Methods

Patients treated with the PTX stent after FDA approval between 2013 and 2015 were identified from an institutional database. Demographic, procedural, and device information was collected and initial- and lifetime-exposure dose of paclitaxel was calculated. The primary outcome was all-cause mortality and its association with paclitaxel exposure. Long-term patency was also evaluated.

Results

Seventy-nine procedures involving PTX placement were performed on 64 individual patients during the study period, with 15 (23.4%) having bilateral procedures. Average age was 70 years, and 71.9% were male. Forty-five patients (70.3%) were claudicants, and 19 (29.7%) had chronic, limb-threatening ischemia. An average of 2.3 PTX stents, totaling 203 mm in length, were placed per procedure. Paclitaxel exposure was 1.87 mg/procedure initially (range 0.38–4.03 mg), and average lifetime exposure was 4.65 mg/patient (range 0.38–27.91 mg). Average follow-up was 59.6 months. Kaplan–Meier estimated survival was 96.9%, 81.2% and 71.7% at one , three, and five years. On multivariate analysis, no specific factors were associated with overall morality including initial paclitaxel dose (HR 0.99, 95% CI 0.99–1.00) and lifetime paclitaxel exposure (HR 0.98, 95% CI 0.89–1.08). Kaplan–Meier primary patency was 76.2%, 60.1%, and 29.3% at one, two, and five years, respectively. Secondary patency was 92.2%, 85.4%, and 75.2% at the same intervals.

Conclusions

At a mean follow-up of five years, exposure to higher doses of paclitaxel from Zilver PTX does not appear to be associated with increased mortality compared to lower doses in real-world patients. Long-term patency rates confirm the efficacy of Zilver PTX, and further investigation may be warranted before abandoning paclitaxel use altogether.
Comparison between PeRcutanEous and surgical femoral aCcess for endovascuLar aOrtic repair in patientS with typE III aortic Dissection (PRECLOSE Trial)
Authors: Sahin Ahmet A , Guner Ahmet , Demir Ali R , Uzun Nedim , Onan Burak , Topel Cagdas , Çelik Ömer
Published: October 2020

Objectives

Aortic dissections are cardiovascular events with high mortality and morbidity rates. Management might be either with medical or interventional approach. Recently, thoracic endovascular intervention (TEVAR) becomes the first treatment of choice because of its better results and lower rates of complications in patients with type III aortic dissections. The intervention might be performed via femoral artery either with percutaneous or with surgical approach. Because of large sheath insertion to femoral artery, Pre-close technique is described in literature. The aim of this study was to investigate and compare the outcomes and safety of ‘Pre-close technique’ to surgical approach in patients with type III aortic dissections who underwent TEVAR with femoral access ≥22 F.

Methods

A total of 96 patients whom had type III aortic dissection and was performed TEVAR were retrospectively included in the study. Fifty-six patients had TEVAR with percutaneous approach and these patients are named as P-TEVAR group, and 40 patients had TEVAR with surgical approach and these patients are named as S-TEVAR group. Pre- and post-procedural data with complications and procedural data during TEVAR were evaluated for both groups and compared in between.

Results

The main finding was that there was no significant difference between S-TEVAR and P-TEVAR groups in terms of complications and technical success. Operating room time was significantly decreased in P-TEVAR group ( P < 0.001). Overall success rate for femoral approach in patients with Pre-close technique was 94.6% and was 100% for surgical approach. P-TEVAR group had post-operative complications in three patients and S-TEVAR group had in four patients.

Conclusions

Total percutaneous approach with Pre-close technique using Pro-Glide device is a safe and feasible method of femoral access in patients with type III aortic dissections.
Deep adversarial domain adaptation network
Authors: Wu Lan , Li Chongyang , Chen Qiliang , Li Binquan
Published: October 2020

The advantage of adversarial domain adaptation is that it uses the idea of adversarial adaptation to confuse the feature distribution of two domains and solve the problem of domain transfer in transfer learning. However, although the discriminator completely confuses the two domains, adversarial domain adaptation still cannot guarantee the consistent feature distribution of the two domains, which may further deteriorate the recognition accuracy. Therefore, in this article, we propose a deep adversarial domain adaptation network, which optimises the feature distribution of the two confused domains by adding multi-kernel maximum mean discrepancy to the feature layer and designing a new loss function to ensure good recognition accuracy. In the last part, some simulation results based on the Office-31 and Underwater data sets show that the deep adversarial domain adaptation network can optimise the feature distribution and promote positive transfer, thus improving the classification accuracy.
Early predictors for mechanical ventilation in COVID-19 patients
Authors: Li Wen , Lin Fengyu , Dai Minhui , Chen Lingli , Han Duoduo , Cui Yanhui , Pan Pinhua
Published: October 2020

Objective:

To identify potential predictors for invasive and non-invasive mechanical ventilation in coronavirus disease 2019 (COVID-19) patients.

Methods:

This study retrospectively analyzes data of 516 patients with confirmed COVID-19, who were categorized into three groups based on which mechanical ventilation method was used during the hospitalization period.

Results:

Among 516 confirmed cases with COVID-19, 446 patients did not receive mechanical ventilation, 38 patients received invasive mechanical ventilation (IMV) and 32 received non-invasive mechanical ventilation (NIMV). The median age of the included patients was 61 years old (interquartile range, 52–69). A total of 432 patients had one or more coexisting illnesses. The main clinical symptoms included fever (79.46%), dry cough (66.47%) and shortness of breath (46.90%). IMV and NIMV patients included more men, more coexisting illnesses and received more medication. Patients in the IMV group and NIMV had higher leukocyte and neutrophil count, lower lymphocyte count, higher aspartate aminotransferase (AST), lactate dehydrogenase (LDH), C-reactive protein (CRP), procalcitonin (PCT) and D-dimer levels and lower albumin (ALB) level. The univariate and multiple logistic regression analysis showed that the use of glucocorticoid, increased neutrophil count and LDH had a predictive role as indicators for IMV, and the use of glucocorticoid, increased neutrophil count and PCT had a predictive role as indicators for NIMV. The area under the curve (AUC) of use of glucocorticoid, increased neutrophil count and LDH was 0.885 (95% confidence interval (CI) 0.838–0.933, p < 0.0001), which provided the specificity and sensitivity 77.7% and 90.9%, respectively. AUC of the use of glucocorticoid, increased neutrophil count and PCT for NIMV was 0.888 (95% CI 0.825–0.952, p < 0.0001), which provided the specificity and sensitivity 70.3% and 96.4%, respectively.

Conclusion:

Glucocorticoid, increased neutrophil and LDH were predictive indicators for IMV, whereas glucocorticoid, increased neutrophil and PCT were predictive indicators for NIMV. In addition, the above-mentioned mediators had the most predictive meaning for mechanical ventilation when combined. The reviews of this paper are available via the supplemental material section.
Definition and retrospective application of a clinical scoring system for COVID-19 triage at presentation
Authors: Duan Jun , Liang Mei , Li Yongpu , Wu Dan , Chen Ying , Gao Shui , Jia Ping , Yang Mei , Xia Wei , Wu Xiaolan , Li Quan , Zuo Fulin , Zhang Yahong , He Yongfang , Nie Jianghua , Zhou Wenxiu , Fu Xueqin , Peng Xiaobin , Ma Zhoujun , Fu Xiaofeng , Zeng Lingwei , You Wenyi , Fang Yuan , Zhu Lingmei , Liu Ping
Published: October 2020

Background:

A simple scoring system for triage of suspected patients with COVID-19 is lacking.

Methods:

A multi-disciplinary team developed a screening score taking into account epidemiology history, clinical feature, radiographic feature, and routine blood test. At fever clinics, the screening score was used to identify the patients with moderate to high probability of COVID-19 among all the suspected patients. The patients with moderate to high probability of COVID-19 were allocated to a single room in an isolation ward with level-3 protection. And those with low probability were allocated to a single room in a general ward with level-2 protection. At the isolation ward, the screening score was used to identify the confirmed and probable cases after two consecutive real-time reverse transcription polymerase chain reaction (RT-PCR) tests. The data in the People’s Hospital of Changshou District were used for internal validation and those in the People’s Hospital of Yubei District for external validation.

Results:

We enrolled 76 and 40 patients for internal and external validation, respectively. In the internal validation cohort, the area under the curve of receiver operating characteristics (AUC) was 0.96 [95% confidence interval (CI): 0.89–0.99] for the diagnosis of moderate to high probability of cases among all the suspected patients. Using 60 as cut-off value, the sensitivity and specificity were 88% and 93%, respectively. In the isolation ward, the AUC was 0.94 (95% CI: 0.83–0.99) for the diagnosis of confirmed and probable cases. Using 90 as cut-off value, the sensitivity and specificity were 78% and 100%, respectively. These results were confirmed in the validation cohort.

Conclusion:

The scoring system provides a reference on COVID-19 triage in fever clinics to reduce misdiagnosis and consumption of protective supplies. The reviews of this paper are available via the supplemental material section.
Coronavirus disease 2019 and slums in the Global South: lessons from Medellín (Colombia)
Authors: Molina-Betancur Juan Camilo , Martínez-Herrera Eliana , Pericàs Juan M. , Benach Joan
Published: October 2020

The coronavirus disease 2019 (COVID-19) pandemic is hitting the world’s most vulnerable people hardest, primarily the communities living in slums in the Global South. Lockdown, handwashing and social distancing are impossible privileges for many urban dwellers – measures which make structural inequities more visible, exacerbating racial, gender and class differences. There are many social determinants of health to explain these inequalities that trigger a high prevalence of infectious and chronic diseases. In Medellín (Colombia), it is a challenge to cope with this crisis, especially when the resources and aid provided by the government and institutions are limited. Yet, an organized social response is happening in some communes and slums, with high community participation, as a potentially effective key to control the pandemic. Once the emergency is over, communities in slums will have to face the social and economic reactivation, and effectively react to the multiple social and psychological consequences, new waves of COVID-19 or other pandemics.
Metabolic cost of inflammatory response of ruby-throated hummingbirds (Archilochus colubris)
Authors: Herrera M L Gerardo , Bayram Nadia , Welch Kenneth C
Published: October 2020

Animals with a slow pace of life and high mass-specific metabolic rates are expected to invest less in innate immune responses. We measured skin inflammation and the resting metabolic rate (RMR) of ruby-throated hummingbirds ( Archilochus colubris) after their immune system was challenged with phytohemagglutinin (PHA) and compared with the response of birds injected a saline solution. The PHA test measures the inflammatory process, a component of the innate response. Ruby-throated hummingbirds belong to a group that is under-represented in avian immunological studies characterized by a slow pace of life and fast metabolic rate. Hummingbirds developed an inflammatory response that lasted <28 h. PHA injection produced a significant increment of RMR (up to ~13%) with respect to RMR values after the injection of the saline solution indicating that immune response involved a metabolic cost for hummingbirds. This increment lies within the range of values previously reported for birds injected PHA (5%–29%).
Diversity, distribution and relative abundance of avifauna at Ansas Dam and surrounding farmland site Debre Berhan Town, Ethiopia
Authors: Shiferaw Alemayehu , Yazezew Dereje
Published: October 2020

The diversity, distribution, and relative abundance of avifauna were studied at and Around Ansas Dam, Debre Berhan Town, Ethiopia, from early September 2018 to early February 2019, covering both wet and dry seasons. Line transect technique was employed to study the diversity, abundance and distribution of birds species in the farmland site while total count employed on the dam. Data were collected in both wet and dry seasons from 6:30 to10:00 early morning and 15:30 to 18.00 late afternoon, when birds are more active. The data were analyzed with Shannon-Weiner Index, Simpson Index, Evenness Index, and relative abundance. A total of 45 bird species (35 in the dam and 22 in the farmland) belonging to nine orders and 21 families were recorded during the study period. Order Passeriformes (37.8%) followed by order Charadriformes (24.4%) were represented highest number. From all identified species at Ansas Dam and surrounding farmland, Abyssinian longclaw, Black-headed siskins, White-tailed swallow, Blue-winged goose, and Spot-breasted lapwing were endemic birds to Ethiopia. The highest Shannon diversity (H′ = 2.1) was recorded in dam during the dry season while the lowest (H′ = 1.78) was recorded during wet season in farmland. However, the Simpson diversity Index of avian species indicated relatively higher avian species diversity during the dry season in dam (D = 0.80) than farmland (D = 0.71) habitat. Evenness was highest in the dam (E = 0.65) and lowest in the farmland (E = 0.58) habitat. More avian species similarity (SI = 0.42) at farmland and dam habitat during the wet season but least similarity (SI = 0.2) was observed during the dry season. Most birds had scored rare in the ordinal scale while few species with abundant and uncommon ranks in both habitats and seasons. Conservation of the different charismatic bird species should be taken as an important component of wildlife management plan in the area.
The Effects of Crinum asiaticum var. japonicum Baker Seeds on Neuroprotection and Antineuroinflammation in Neuronal Cell Lines
Authors: Lim Hye-Sun , Kim Yoonju , Kim Yu Jin , Sohn Eunjin , Kim Joo-Hwan , Jeong Soo-Jin
Published: October 2020

Crinum asiaticum var. japonicum Baker is a Korean herbal medicine that is traditionally prescribed for reducing fever and inflammation. In the present study, we investigated if the ethanol extract of C. asiaticum seeds (ECAS) influences the hallmarks of Alzheimer’s disease (AD) pathogenesis. ECAS markedly inhibited the activity of acetylcholinesterase (AChE). Concurrent treatment with hydrogen peroxide (H2O2) and ECAS significantly prevented the neuronal cell death by regulating phosphorylation of cyclic adenosine monophosphate response element-binding protein and p38 mitogen-activated protein kinase. ECAS revealed antineuroinflammatory effects by inhibiting nitric oxide production and suppressing inducible nitric oxide expression in lipopolysaccharide-stimulated BV-2 microglia. Furthermore, the high-performance liquid chromatographic analysis determined lycorine as a standard compound of ECAS. Our data suggest that ECAS has inhibitory effects on AD pathogenesis such as AChE activation, neuronal damage, and neuroinflammation.
Ipsilateral Reversible Cerebral Vasculopathy Secondary to Carotid Artery Revascularization: A Case Report
Authors: Shoskes Aaron , Mullaguri Naresh , Purohit Meghan , George Pravin , Newey Christopher Ryan
Published: October 2020

Background:

The emergence of neurologic symptoms after carotid revascularization is not uncommon and typically caused by perioperative ischemic stroke or hyperperfusion. Postoperative vasculopathy, including reversible cerebral vasoconstriction syndrome (RCVS) is a rare complication of carotid intervention and may be an under-identified cause of neurologic deficit after revascularization. We report a case of reversible postoperative vasculopathy following carotid revascularization as well as its management.

Case Presentation:

A 74 year old right-handed woman presented to the emergency department with sudden onset left arm weakness and episodic shaking while hypotensive. Computed tomography angiography revealed total occlusion of her right internal carotid artery. Transcranial Doppler monitoring demonstrated active embolic events in her right middle cerebral artery raising concern for continued stump embolization. She underwent carotid revascularization with carotid endarterectomy, mechanical thrombectomy, and carotid angioplasty and initially did well postoperatively. On postoperative day 5, she developed a fixed right gaze and left hemiparesis. Computed tomography revealed new right frontal lobe and basal ganglia infarcts, and angiography showed new right internal carotid, middle cerebral, and anterior cerebral artery vasoconstriction consistent with postoperative vasculopathy. Despite treatment with pressure augmentation and vasodilator therapy, her symptoms persisted resulting in left hemiplegia at discharge.

Discussion:

This case highlights postoperative vasculopathy (including RCVS) as a rare potential complication after carotid revascularization that should be considered in a patient with persistent acute neurologic symptoms. Information regarding incidence and predisposing risk factors is limited. Multiple diagnostic and therapeutic modalities may be necessary in the recognition and treatment of postoperative vasculopathy.