bluuebunny/crossref_metadata_2025 huggingface dataset:
MODEL OF PROJECT-BASED AND COGNITIVE COMPETENCIES-INFUSED LEARNING IN THE GRAMMAR CLASS OF ELESP
Authors: Oktavyana Annisa , Sulistyaningrum Siti Drivoka , Dewanti Ratna
Published: April 2022

Model of learning is a guideline that teachers will use to let their teaching more comprehensive and practical to facilitate the achievement of the learning goal. A dynamic approach suited to teaching in which students explore real-world problems and challenges, simultaneously developing 21st-century skills while working in small collaborative groups is Project-Based Learning. The purpose of the study is to analyze the used model of Project-Based and Cognitive competencies-infused learning in the grammar class of English Language Education Study Program. This study employed a qualitative design where the data are the components of the existing models of learning in grammar classes of English Language Education Study Program. Besides, online class observation and grammar class syllabus documents are used as instruments. The findings of analysis revealed that Methods that generally used in the online class observation are Computer-Assisted Instruction (CAI), Scaffolding, Reciprocal method, Cooperative Learning while mostly used Lecturing, General Discussion, and Presentation to delivering material. The indicator that could be seen in syllabus document and class observations was Critical Thinking from Cognitive competences indicators. The Project-Based Learning indicators could also be seen directly from syllabus documents and online class observations. Intellectual Challenge and Accomplishment was mostly dominated seen in the model.
CATEGORY SHIFT USED IN NOUN PRHASE AND ITS QUALITY IN THE NOVEL DIVERGENT
Authors: Alfani Septi Dwi , Hilman Evert Haryanto Hilman , Harared Nico Harared
Published: April 2022

The aims of this research were to find the type of category shift, and quality assessment of noun phrase translation in the novel Divergent. Based on theory Catford (1965). Also, theory Nababan (2012) for quality assessment. This research used a descriptive–qualitative method. To achieve the aims of this study, the researcher used some techniques to analyze the data such as reading and collecting data, underlining the type of category shift in the text of the novel, categorizing types of translation shift, assessing translation accuracy, assessing translation readability and acceptability. Based on the data analysis, it was found that 92% of the data were accurate because the category shift of noun phrase in the target language has equivalent meaning with the source language; 6% of the data were less accurate because the category shift of noun phrase had no equal meaning with the source language and the equivalence seemed less natural, and 2% of the data were not accurate. Meanwhile, 93% of the data were readable because the translation was very easy to understand; 5% of the data were less readable because the translation was not very easy to understand, and 2% of the data were unreadable because the translation was difficult to understand. Furthermore, 92% of the data were acceptable because the translation sounds natural; the words, phrases, clauses, and sentences of the source text, 6% of data were less acceptable, and 2% of data were not acceptable. The dominant data of category shift are the structure shift which got the percentage of 56%, followed by intra-system shift 32%, class shift 8%, and unit shift 4 %.
INVESTIGATING EFL HIGH SCHOOL STUDENTS' METACOGNITIVE AWARENESS IN WRITING
Authors: Krisdianata Yoannes Yuka , Kuswandono Paulus
Published: April 2022

Metacognitive awareness was beneficial when implemented in learning activities, especially in writing skills. This research was conducted to explore students’ metacognitive awareness in writing. The participants were 30 high school students. Metacognitive knowledge and regulation from Brown (1987) and Knospe (2018) were employed to get a report on students’ awareness in writing. Metacognitive knowledge is formed from declarative knowledge, procedural knowledge, and conditional knowledge, all of which consisted of planning, monitoring, and evaluating. A cross-sectional survey method was conducted to investigate the data collected. Questionnaires were used to collect the data, then analyzed partially using descriptive analysis, and reported in tables. The data displays that the declarative knowledge and task were respectively 35.1 % and 17.3%; procedural knowledge was 27.7 %; and, conditional knowledge was at 14.2%. Likewise, the results from Metacognitive regulation reported by senior high school students were planning 14.4%, monitoring 24%, and evaluating 11.1%, all of which are categorized at a low level of understanding. The result showed that high school students demonstrated a low level of metacognitive knowledge and regulation in writing descriptive text.
GENTLEMAN’S RESTRICTED CODES AND ELABORATED CODES IN THE “KINGSMAN: THE GOLDEN CIRCLE” MOVIE
Authors: Domisianus Toar Dayan , Ena Ouda Teda
Published: April 2022

The present study aims to analyse the content of the Kingsman: The Golden Circle movie (2017). The use of restricted codes and elaborated code by the main character Gary ‘Eggsy’ Unwin in the movie and how they convey the concept of English gentleman was investigated by applying the descriptive qualitative method. The movie script and the scenes in the movie were the data that were being analysed. Data were collected through observation using a non-participatory technique. The data were analysed using the Barthesian semiotic analysis method. It was found that there were seven types of restricted codes namely secrecy, intimacy, novelty, jocularity, sympathy, expressiveness, and nominative. While the use of elaborated code was found in the forms of verbal and non-verbal communications. The findings in this research showed that the main character employed the restricted codes and the elaborated codes to express proximity and to convey the idea of the new English gentleman of the 21st century.
FEMALE REPRESENTATION IN SELECTED DISNEY RENAISSANCE STORIES
Authors: Daulay Resneri , Ulfah Helmatun Fauza
Published: April 2022

The occurrence of disparities in society with female characters, Disney stories told about the existence of heroine characters in the Disney renaissance era. Disney stories had become part of a show culture that has evolved into the reproduction of gender roles. This study was conducted to find the female representation as a heroine depicted in the Disney renaissance as well as to analyze the reasons how Disney heroines struggle in claiming their equality as a woman in their society. This study was categorized into qualitative and descriptive research methods. Furthermore, this study used the theory of the renowned feminist existentialism by Simone de Beauvoir, one of the Feminist icons and Philosophers of existentialism, with her book; The Second Sex, Beauvoir represented the section of the independent woman; a woman could choose independence, which means continuing to carry out the process toward freedom without having the insight of a predetermined goal. Therefore, this study aimed to elaborate how the female representation as the women to fight their equality to their desire for freedom. Thus, the heroine character was expected to be able to contribute to society in terms of gender awareness, including women.
Uncovering N4-Acetylcytidine-Related mRNA Modification Pattern and Landscape of Stemness and Immunity in Hepatocellular Carcinoma
Authors: Liu Sicheng , Zhang Yaguang , Qiu Lei , Zhang Su , Meng Yang , Huang Canhua , Chen Zhixin , Zhang Bo , Han Junhong
Published: April 2022

N4-acetylcytidine (ac4C) is an ancient and conserved RNA modification. Previously, ac4C mRNA modification has been reported promoting proliferation and metastasis of tumor cells. However, it remains unclear whether and how ac4C-related mRNA modification patterns influencing the prognosis of hepatocellular carcinoma (HCC) patients. Hereby, we constructed an ac4Cscore model and classified patients into two groups and investigated the potential intrinsic and extrinsic characteristics of tumor. The ac4Cscore model, including COL15A1, G6PD and TP53I3, represented ac4C-related mRNA modification patterns in HCC. According to ac4Cscore, patients were stratified to high and low groups with distinct prognosis. Patients subject to high group was related to advanced tumor stage, higher TP53 mutation rate, higher tumor stemness, more activated pathways in DNA-repair system, lower stromal score, higher immune score and higher infiltrating of T cells regulatory. While patients attributed to low group were correlated with abundance of T cells CD4 memory, less aggressive immune subtype and durable therapy benefit. We also found ac4Cscore as a novel marker to predict patients’ prognosis with anti-PD1 immunotherapy and/or mTOR inhibitor treatment. Our study for the first time showed the association between ac4C-related mRNA modification patterns and tumor intrinsic and extrinsic characteristics, thus influencing the prognosis of patients.
Phenolic Compounds From the Stems and Leaves of Berchemia lineata (L.) DC
Authors: Li Yitong , Chen Yu , Xie Wenli , Li Xueni , Mei Gui , Xu Jing , Zhao Xiangpei , Teng Hongli , Yang Guangzhong
Published: April 2022

Eight new phenolic compounds, named bercheminols A-H (1–8), and eleven known analogues were isolated from the stems and leaves of Berchemia lineata (L.) DC. Their structures including the absolute configurations were elucidated by extensive spectroscopic analysis, chemical method, and quantum chemical calculations. Compound 1 possesses an unprecedented 3,4-dihydro-11H-benzo[b]pyrano[4,3-e] oxepin-11-one skeleton. The other new compounds belong to three structural types of natural products, including naphthopyrones (2–5), flavonoids (6–7), and bibenzyl (8). The α-glucosidase inhibitory activities of the isolated compounds were assayed. As a result, vittarin-B (9), rubrofusarin-6-O-β-D-glucopyranoside (11), quercetin (14), kaempferol (15), and dihydrokaempferol (17) showed moderate inhibitory activities against α-glucosidase with IC50 values of 22.5, 28.0, 36.5, 32.7, and 31.9 μM, respectively.
The Presence of Calcified Raphe Is an Independent Predictor of Adverse Long-Term Clinical Outcomes in Patients With Bicuspid Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement
Authors: Lee Yung-Tsai , Yin Wei-Hsian , Tsao Tien-Ping , Lee Kuo-Chen , Hsiung Ming-Chon , Tzeng Yun-Hsuan , Wei Jeng
Published: April 2022

Objective

Current guidelines recommend that transcatheter aortic valve replacement (TAVR) for bicuspid aortic valve (BAV) with aortic stenosis (AS) should only be performed in selected patients. However, we consider it even more crucial to identify what the really important factors are while determining long-term outcomes in patients with BAV undergoing TAVR, which is precisely the aim of this study.

Methods

We retrospectively evaluated consecutive patients who underwent TAVR with balloon-expandable Sapien XT or Sapien 3 valves (Edwards Lifesciences, Irvine, CA) for the treatment of severe bicuspid AS. The primary end points were major adverse cardiac and cerebral events (MACCE), that is, mortality, non-fatal myocardial infarction (MI), disabling stroke, valve failure needing reintervention, or clinically relevant valve thrombosis during follow-up.

Results

A total of 56 patients who underwent TAVR with Sapien XT (n = 20) or Sapien 3 (n = 36) were included. The device and procedural success rates were similar between the two TAVR valves; however, the newer-generation Sapien 3 yielded a trend toward better long-term clinical outcomes than the early-generation Sapien XT did (MACCE rates 35 vs. 11%, p = 0.071). In the multivariate Cox proportional hazards analyses, the presence of calcified raphe > 4 mm was the only independent predictor of long-term MACCE (hazard ratio: 6.76; 95% confidence interval: 1.21–37.67, p = 0.029).

Conclusion

TAVR performed by a skilled heart team, while using newer-generation balloon-expandable Sapien 3 valve, may yield better long-term clinical outcomes compared to TAVR using early-generation Sapien XT valve. Moreover, the presence of calcified raphe >4 mm is an independent determinant of adverse clinical outcomes.
Association Between Changes in Post-hospital Cardiac Symptoms and Changes in Acute Coronary Syndrome-Induced Symptoms of Post-traumatic Stress
Authors: von Känel Roland , Meister-Langraf Rebecca E. , Zuccarella-Hackl Claudia , Znoj Hansjörg , Pazhenkottil Aju P. , Schmid Jean-Paul , Barth Jürgen , Schnyder Ulrich , Princip Mary
Published: April 2022

Background

After acute coronary syndrome (ACS), one in eight patients develops clinically significant symptoms of Post-traumatic stress disorder (PTSD). We hypothesized that changes in cardiac symptoms from 3 to 12 months after ACS are associated with changes in ACS-induced PTSD symptoms.

Methods

At 3 (n = 154) and/or 12 months (n = 106) post-ACS, patients (n = 156, mean age 59 years, 85% men) completed a clinical interview assessing chest tightness/pain (at rest and/or during exertion), heartbeat symptoms (heart palpitations, racing of heart, heart stumbling or skipping a beat) and PTSD symptoms during the prior 4 weeks. Random mixed regression models examined the association between the onset (or remission) from 3 to 12 months in cardiac symptoms with changes in PTSD symptoms, adjusting for a range of potential predictors of ACS-induced PTSD symptoms.

Results

The onset of chest tightness/pain [estimate = 0.588, 95% confidence interval: 0.275, 0.090; p < 0.001] and of heartbeat symptoms [0.548 (0.165, 0.931); p = 0.005] from 3 to 12 months was independently associated with an increase in total PTSD symptoms. There were also independent associations between the onset of chest tightness/pain and heartbeat symptoms with an increase in PTSD symptom clusters. Specifically, the onset of chest tightness/pain showed associations with an increase in re-experiencing [0.450 (0.167, 0.733); p = 0.027] and avoidance/numbing [0.287 (0.001, 0.574); p = 0.049]. The onset of heartbeat symptoms showed associations with an increase in re-experiencing [0.392 (0.045, 0.739); p = 0.002], avoidance/numbing [0.513 (0.161, 0.864); p = 0.004] and hyperarousal [0.355 (0.051, 0.659); p = 0.022]. An increase in the total number of cardiac symptoms (score range 0–6) was also associated with an increase in total PTSD symptoms [0.343 (0.202, 0.484); p < 0.001]. Psychotherapy in the post-hospital period moderated the association between the change in heartbeat symptoms and the change in total PTSD symptoms [−0.813 (−1.553, −0.074); p = 0.031 for interaction]; the association between the onset of heart beat symptoms and an increase in total PTSD symptoms was weaker in patients who attended psychotherapy [0.437 (−0.178, 1.052); p = 0.16] than in those who did not [0.825 (0.341, 1.309); p < 0.001].

Conclusion

Changes in cardiac symptoms between 3 and 12 months after hospitalization are associated with changes in ACS-induced PTSD symptoms. ClinicalTrials.gov #NCT01781247.
Integrating Potential Land Use Conflict Into Ecological Security Pattern in Response to Land Use/Cover Changes at a County Scale in Yangtze River Delta, China
Authors: Peng Wanting , Zhang Zhiduo , He Geng , Liu Xiuyu , Wang Wei , Cai Yongli , López-Carr David
Published: April 2022

Identifying key ecological nodes/corridors and priority restoration areas (KENPRA) is the key link for optimizing land use and ecological security patterns (ESPs). However, few studies have considered future land use/cover change (LUCC) and urban sprawl in identifying KENPRA for ESP maintenance. To optimize KENPRA, we took Quanjiao County, Anhui Province, China as a case study area, a typical unit for Chinese Land Spatial Planning and a suburb of Yangtze River Delta agglomeration challenging LUCC and ecological security pattern maintenance. A comprehensive framework for optimizing KENPRA has been established by integrating ESP and land use conflict (LUC) to adapt to land use change for corresponding urbanization processes. A CA-Markov model was used to predict future land use under different KENPRA-based scenarios in 2030. The results found that the total area of 4,357.2 ha priority restoration areas and 17 key ecological nodes was KENPRA, which were approximately 50% and concentrated in intensive LUC areas. The result of the simulation model showed that KENPRA-based scenarios integrating LUC indicated less urban expansion and better effectiveness for maintaining ESPs in 2030. The findings and proposed framework provide new and important information and implications for planners and policymakers to understand and improve land planning/policy; the results also can provide better understanding of the coupled human–nature system linking LUCC, ecosystem services, and land and restoration planning.
Characterization of Pyrolysis Kinetics of Continental Shale: Comparison and Enlightenment of the Parallel Reaction Model and the Overall Reaction Model
Authors: Jiang Jun , Li Jijun , Wang Yiwei , Chen Xudong , Wang Min , Lu Shuangfang , You Hang , Zheng Ketao , Yan Chenxu , Li Zhongcheng , Yu Limin
Published: April 2022

A total of nine immature–low maturity oil shale samples from Fushun and Maoming, the main oil shale producing areas in China, and three mature shale samples from the Jiyang Depression, China, were selected for use in hydrocarbon generation thermal simulation experiments in an open system and a closed system. The parallel first–order reaction kinetic model and the overall nth–order reaction kinetic model were used to calibrate the pyrolysis kinetic parameters of the samples. This comparative study revealed following conclusion. The generation period of the gaseous hydrocarbons (C1–5) was the longest, and the generation period of the heavy hydrocarbon (C14+) was the shortest. The activation energy of the hydrocarbon generation reaction was closely related to the maturity of the organic matter, i.e., the higher the maturity of the sample, the higher the activation energy of the reaction, which indicates that oil shale/shale oil conversion requires higher temperature conditions. The parallel first–order reaction model regards the hydrocarbon generation reaction as a series of first–order reactions, and it has a better fitting effect for the longer hydrocarbon generation period reactions, such as generating gaseous hydrocarbons (C1–5) and light components (C6–14) from organic matter. The overall nth–order reaction treats the reaction as a nth–order reaction, and the nth–order reaction has a better fitting effect for reactions with a narrow hydrocarbon generation window, such as generating heavy components from organic matter. In the process of generating hydrocarbons from organic matter, the order of the reaction is the sum of the orders of the sub–reactions. The more hydrocarbon–generating parent material, the higher order of hydrocarbon–generating reaction. The reaction order sequence of the generation of different hydrocarbons from organic matter is as follows: generation of gaseous hydrocarbons > generation of light hydrocarbons > generation of heavy hydrocarbons.
The Hydrocarbon Potential of Carboniferous Reservoirs in the Jimsar Sag, Northwest China: Implications for a Giant Volcanic-Petroleum Reserves
Authors: Gong Deyu , Song Yong , Peng Miao , Liu Chaowei , Wang Ruiju , Wu Wei’an
Published: April 2022

As an unconventional petroleum reservoir, the volcanic reservoir is essential for finding large-scale oil and gas reserves in deep sedimentary basins. Based on basin modeling, organic geochemistry, and organic petrology, this study evaluates the exploration potential of the Carboniferous volcanic-petroleum system in the Jimsar Sag of the southeastern Junggar Basin. The Carboniferous source rocks in the study area were developed in the Lower Carboniferous Songkharsu Formation, a set of marine–terrigenous transitional source rocks, lithologically composed of carbonaceous mudstone, mudstone, and coal. The kerogen is characterized by type II2–III, indicating a gas-prone source rock. Carbonaceous mudstones, mudstone, and coal are classified as medium–good, medium, and poor source rocks, respectively. The hydrocarbon-generating potential is close to that of the Kelameili gas field. The Carboniferous-reservoir oil in well J15 is characterized by 13C-enriched stable carbon isotopes, relatively high ƩC31–35/C30 and Pr/Ph ratios, relatively low density, gammacerane index, regular C29-sterane content, and undetected β-carotene, indicating a Songkharsu origin. The Carboniferous-reservoired gas from well J3301 has stable carbon isotope composition enriched in 13C, similar to the gas from the Kelameili gas field, and should be from the Songkharsu source rock. This set of source rocks is widely distributed in the Jimsar Sag with considerable thickness, among which thickness >100 m reaches 580 km2, accounting for 38.7% of the whole sag. The Songkharsu source rocks entered the main oil-generating window at the end of the Early Jurassic. The area of Songkharsu source rocks in the Jimsar Sag with gas-generating intensity greater than 20 × 108 m3/km2 reaches 1,015 km2, whereas that with oil-generating intensity greater than 500 × 104 t/km2 reaches 1,146 km2. However, 13 Carboniferous volcanic lithological traps were found in the sag, covering an area of 230 km2. The Carboniferous volcanic-petroleum system in the Jimsar Sag has the resource potential to form large and medium oil and gas fields, which could become a critical replacement field for volcanic oil and gas exploration in the Junggar Basin after the Klameili gas field.
Emotional Intelligence Scale for International Students: A Proposal for a Developed Version
Authors: AL-Qadri Abdo Hasan , Zhao Wei , Li Miao , Al-khresheh Mohammad , Boudouaia Azzeddine
Published: April 2022

In higher education, making international students aware of their EI could improve emotional awareness, adaptability, and functioning, thereby assisting in day-to-day interactions and adapting to life in a foreign country. Incorporating an Emotional Intelligence Scale (EIS) could aid in the on boarding of international students. This study aimed to develop and validate an EIS capable of accurately measuring EI amongst international students attending a teaching university in Northwest China. The sample consisted of 482 male and female undergraduate and graduate students ranging in age from 18 to 40. The multivariate statistical technique was used for data reduction or factor analysis. Exploratory and confirmatory factor analyses showed that the 24-item distributed among the four-factor model was a good fit based on the modification indices. The four factors considered were Understanding and Regulation, Positive Affect, Optimism, and Utilization. Techniques employed to assess the reliability of the EIS included Cronbach’s alpha coefficient, test/re-test stability, Composite Reliability (CR), and Average Variance Extracted (AVE). Of interest, there were no statistically significant differences between post-graduate/graduate students or different genders. Findings indicated that the EIS might effectively be employed to measure EI in this target population.
Economic Boundary Analysis of Echelon Utilization of Retired Power Battery Considering Replacement Cost
Authors: Wang Yali , Ye Ze , Wei Wen , Wu Yongfei , Liu Aijun , Dai Shuangfeng
Published: April 2022

As a large number of new energy electric vehicles are retired, the sequential utilization of retired power batteries has become one of the important means to improve the economic benefits of batteries, but there is a problem of disunity between available capacity and cycle life. Therefore, a peak-load power distribution method based on the principle of equal life of retired power batteries was proposed, which could effectively avoid the life difference caused by the battery difference and reduce the replacement cost. At the same time, in order to give reasonable investment suggestions for the stepwise utilization of retired power batteries, three economic boundary value models, including the payback period, peak–valley price difference, and investment cost, were constructed based on the leveling cost. Through the simulation of a 60 MW/160 MWh lithium iron phosphate decommissioned battery storage power station with 50% available capacity, it can be seen that when the cycle number is 2000 and the peak–valley price difference is above 0.8 yuan/kWh, it has investment value.
EpCAM Is Essential to Maintaining the Immune Homeostasis of Intestines via Keeping the Expression of pIgR in the Intestinal Epithelium of Mice
Authors: Lei Zili , Liu Wanwan , Nie Ya , Yang Yanhong , Chen Guibin , Huang Li , Wu Huijuan , Lei Yuting , Chen Lei , Hu Qing , Rong Hedong , Yu Siping , Song Qi , Tong Fengxue , Guo Jiao
Published: April 2022

EpCAM deficiency causes congenital tufting enteropathy (CTE) which is considered as one kinds of very early onset inflammatory bowel disease (IBD). However, functions of EpCAM on regulating the immunity of intestines are still unclear. To study the mechanism of EpCAM on maintaining the intestinal immune homeostasis, the intestines of WT and EpCAM-/-mice at E18.5, P0 and P3 stages were collected for morphological, histological and gene expression tests. Serious inflammation was detected in the small intestines of P3 EpCAM-/-mice. Compared to WT mice, genes related to inflammatory factors and immunity cells, including TNFα, IL-1β, IL-6, IL-8rb, MIP2, MCP1, Ly6d and Ly6g, were all significantly upregulated and the expression of intestinal abundance matrix metalloproteinases (MMPs) was also significantly increased in the intestines of EpCAM-/-mice at E18.5, P0 and P3 stages. Signals of p38, ERK1/2 and JNK were hyper-activated in the intestines of EpCAM-/-mice. The expression of pIgR was significantly decreased and the expression and activation of transcriptional factors which promote the expression of pIgR were also reduced in the intestines of EpCAM-/-mice compared to WT controls. In conclusion, EpCAM could maintain the immune homeostasis of intestinesviakeeping the expression of pIgR in the intestinal epithelium.
Shear Banding in Binary Cu-Zr Metallic Glass: Comparison of the G-Phase With L-Phase
Authors: Shen Yidi , Johnson William L. , Samwer Konrad , Corona Sydney L. , Goddard William A. , An Qi
Published: April 2022

We identified two glass phases formed in three undercooled liquids of elemental Ag, binary Cu-Ag, and binary Cu-Zr alloys using molecular dynamics (MD) simulations: 1) The homogeneous L-phase arises from quenching quickly from high temperature liquid. 2) The heterogeneous solid-like G-phase arises from the isothermal equilibration at temperatures below the melting point. The G-phase exhibits a core-shell structure with the ordered cores surrounded by percolating liquid-like shells. The distinguishable structures between these two phases are expected to different mechanical behavior. The present study reports MD simulations to compare the shear deformation of these two phases in binary Cu2Zr system. At room temperature, the G-phase exhibits a higher critical stress, a higher critical strain, and higher shear modulus than the L-phase, suggesting that the G-phase has improved strength and rigidity compared to the homogeneous L-phase. The plastic yielding mechanism of both the G-phase and L-phase is accompanied by shear band formation. However, the formation of shear band in G-phase is confined by the cores to a highly localized region and characterized by local mechanical melting. In contrast, the shear band in L-phase exhibits greater width and much more homogenous character. We conclude that the mechanical properties of a metallic glass will vary significantly according to the type of glassy phase formed during processing.
Establishment and Implementation of Potential Fluid Therapy Balance Strategies for ICU Sepsis Patients Based on Reinforcement Learning
Authors: Su Longxiang , Li Yansheng , Liu Shengjun , Zhang Siqi , Zhou Xiang , Weng Li , Su Mingliang , Du Bin , Zhu Weiguo , Long Yun
Published: April 2022

Objective

Fluid therapy for sepsis patients has always been a problem that puzzles clinicians, that is, knowing when patients need fluid infusion and when they need negative fluid balance. Different clinicians may have different judgment criteria and make different decisions. Recently, studies have suggested that different fluid treatment strategies can cause different clinical outcomes. This study is intended to establish and verify a model for judging the direction of fluid therapy based on machine learning.

Method

This study included 2705 sepsis patients from the Peking Union Medical College Hospital Intensive Care Medical Information System and Database (PICMISD) from January 2016 to April 2020. The training set and test set (January 2016 to June 2019) were randomly divided. Twenty-seven features were extracted for modeling, including 25 state features (bloc, vital sign, laboratory examination, blood gas assay and demographics), 1 action feature (fluid balance) and 1 outcome feature (ICU survival or death). SARSA was used to learn the data rules of the training set. Deep Q-learning (DQN) was used to learn the relationship between states and actions of the training set and predict the next balance. A double-robust estimator was used to evaluate the average expected reward of the test set in the deep Q-learning model. Lastly, we verified the difference between the predicted fluid therapy model and the actual treatment for the patient's prognoses, with sepsis patient data from July 2019 to April 2020 as the validation set.

Results

The training set and test set were extracted from the same database, and the distribution of liquid balance was similar. Actions were divided into five intervals corresponding to 0–20, 20–40, 40–60, 60–80, and 80–100% percentiles of fluid balance. The higher the reward of Q(s, a) calculated by SARSA from the training set, the lower the mortality rate. Deep Q-learning indicates that both fluid balance differences that are too high and too low show an increase in mortality. The more consistent the fluid balance prediction with the real result, the lower the mortality rate. The smaller the difference between the prediction and the reality, the lower the mortality rate. The double-robust estimator shows that the model has satisfactory stability. The validation set indicates that the mortality rate of patients in the “predicted negative fluid balance and actual negative fluid balance” subgroup was the lowest, which was statistically significant, indicating that the model can be used for clinical verification.

Conclusion

We used reinforcement learning to propose a possible prediction model for guiding the direction of fluid therapy for sepsis patients in the ICU. This model may accurately predict the best direction for fluid therapy, thereby improving patient prognosis.
Idiopathic Myointimal Hyperplasia of the Mesenteric Veins: A Case Report and Scoping Review of Previously Reported Cases From Clinical Features to Treatment
Authors: Li Hui , Shu Hong , Zhang Hong , Cui Mingming , Gao Yuying , Tian Feng
Published: April 2022

Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is a rare and poorly understood disease. It is characterized by non-thrombotic and non-inflammatory occlusion of the mesenteric veins secondary to intimal smooth muscle hyperplasia. The etiology of IMHMV is unknown, and its clinical presentations include abdominal pain, bloody diarrhea, and weight loss. IMHMV is commonly mistaken for inflammatory bowel disease because of the similarity in symptoms and endoscopic findings. Herein, we report the case of a 64-year-old man with IMHMV and present an overview of all reported cases of IMHMV. In this review, we analyzed 70 cases to summarize the etiology, clinical manifestations, and diagnosis of IMHMV and hope to raise clinicians’ awareness of this entity.
Comparison of FibroScan-Aspartate Aminotransferase (FAST) Score and Other Non-invasive Surrogates in Predicting High-Risk Non-alcoholic Steatohepatitis Criteria
Authors: Lee Jae Seung , Lee Hye Won , Kim Beom Kyung , Park Jun Yong , Kim Do Young , Ahn Sang Hoon , Jang Jae Young , Park Soo Young , Lee Hyun Woong , Lee Chun Kyon , Kim Seung Up
Published: April 2022

Identification of non-alcoholic steatohepatitis (NASH) with high activity and fibrosis is a major priority in patients with non-alcoholic fatty liver disease. We validated the predictive value of the FibroScan-aspartate aminotransferase (FAST) score and other non-invasive fibrosis surrogates in predicting high-risk NASH criteria. This multicenter retrospective study recruited 251 biopsy-proven non-alcoholic fatty liver disease (NAFLD) patients (132 [52.6%] men) between 2011 and 2014. The FAST score was calculated using transient elastography data and aspartate aminotransferase (AST) levels. The NAFLD fibrosis score (NFS), fibrosis-4 index (FIB-4), and AST to platelet ratio index (APRI) were calculated using biochemical data. The area under the receiver operating characteristic curves (AUCs) of the FAST score, liver stiffness, NFS, FIB-4, and APRI were 0.752, 0.718, 0.609, 0.650, and 0.722 for NAFLD activity score (NAS) ≥5 (n = 117, 46.6%); 0.788, 0.754, 0.649, 0.701, and 0.747 for fatty liver inhibition of progression-NASH with histologic activity ≥3 (n = 202, 80.5%); 0.807, 0.806, 0.691, 0.732, and 0.760 for severe disease with activity ≥3 and/or fibrosis ≥3 (n = 132, 52.6%); and 0.714, 0.812, 0.748, 0.738, and 0.669 for NASH with NAS ≥4 and fibrosis ≥2 (n = 70, 27.9%), respectively. The FAST score had the highest AUC for the most high-risk NASH criteria, except for in predicting NAS ≥4 and fibrosis ≥2. The liver stiffness value showed consistently acceptable performance in predicting all high-risk NASH criteria. The FAST score has acceptable performance in identifying high-risk NASH. However, liver stiffness alone was not inferior to the FAST score.
Fungal Community Development in Decomposing Fine Deadwood Is Largely Affected by Microclimate
Authors: Brabcová Vendula , Tláskal Vojtěch , Lepinay Clémentine , Zrůstová Petra , Eichlerová Ivana , Štursová Martina , Müller Jörg , Brandl Roland , Bässler Claus , Baldrian Petr
Published: April 2022

Fine woody debris (FWD) represents the majority of the deadwood stock in managed forests and serves as an important biodiversity hotspot and refuge for many organisms, including deadwood fungi. Wood decomposition in forests, representing an important input of nutrients into forest soils, is mainly driven by fungal communities that undergo continuous changes during deadwood decomposition. However, while the assembly processes of fungal communities in long-lasting coarse woody debris have been repeatedly explored, similar information for the more ephemeral habitat of fine deadwood is missing. Here, we followed the fate of FWD of Fagus sylvatica and Abies alba in a Central European forest to describe the assembly and diversity patterns of fungal communities over 6 years. Importantly, the effect of microclimate on deadwood properties and fungal communities was addressed by comparing FWD decomposition in closed forests and under open canopies because the large surface-to-volume ratio of FWD makes it highly sensitive to temperature and moisture fluctuations. Indeed, fungal biomass increases and pH decreases were significantly higher in FWD under closed canopy in the initial stages of decomposition indicating higher fungal activity and hence decay processes. The assembly patterns of the fungal community were strongly affected by both tree species and microclimatic conditions. The communities in the open/closed canopies and in each tree species were different throughout the whole succession with only limited convergence in time in terms of both species and ecological guild composition. Decomposition under the open canopy was characterized by high sample-to-sample variability, showing the diversification of fungal resources. Tree species-specific fungi were detected among the abundant species mostly during the initial decomposition, whereas fungi associated with certain canopy cover treatments were present evenly during decomposition. The species diversity of forest stands and the variability in microclimatic conditions both promote the diversity of fine woody debris fungi in a forest.
Antimicrobial-Resistant Escherichia coli Distribution and Whole-Genome Analysis of Sequence Type 131 Escherichia coli Isolates in Public Restrooms in Taiwan
Authors: Chang Szu-Min , Chen Jenn-Wei , Tsai Chin-Shiang , Ko Wen-Chien , Scaria Joy , Wang Jiun-Ling
Published: April 2022

The threat of antibiotic-resistant bacteria to public health may originate from public restrooms. To better understand the community burden of antimicrobial-resistantEscherichia coliand sequence type complex 131E. coli(STc131) in the public restroom, we performed a surveillance in public restrooms in southern Taiwan. Swabs were sampled from randomly selected public restrooms in Tainan, Taiwan in 2019. Antimicrobial susceptibility, phylogenetic grouping, and multiplex PCR were performed for the major ST complex in the B2 phylogenetic group. If STc131 isolates were identified, the whole-genome sequencing was performed. A total of 613 collection sites found 132 sites (21.5%) positive forE. coli. The most common phylogenetic group was A (30.9%) followed by B2 (30.3%). Ceftriaxone-resistantE. coliand extended-spectrum β-lactamases–producingE. coliwere found in 2.4 and 1.0% of total public restrooms, respectively. The isolates in rural areas had higher ceftriaxone non-susceptibility than those in the city centers (3.9 vs. 1.2%,P= 0.038). Nine STc131 isolates were found in public restrooms, and most (77.8%) belonged to the subtype fimH41, whereas 22.2% belonged to fimH30. With the inclusion of STc131 isolates from human and dog fecal colonization in Taiwan, whole-genome sequencing was performed in 35 isolates. A large cluster of fimH41 in SNP-tree and GrapeTree was found from different sources (human, dog, and environment) and geographical areas. In conclusion, our surveillance of antimicrobial-resistantE. colishowed a higher prevalence ofE. colidetected in public restrooms in the rural areas compared to those in city centers. The whole-genome sequence implies that fimH41 STc131 strains are successfully circulated in the community in Taiwan.
Lipid Alterations in Early-Stage High-Grade Serous Ovarian Cancer
Authors: Iurova M. V. , Chagovets V. V. , Pavlovich S. V. , Starodubtseva N. L. , Khabas G. N. , Chingin K. S. , Tokareva A. O. , Sukhikh G. T. , Frankevich V. E.
Published: April 2022

Epithelial ovarian cancer (OC) ranks first in the number of deaths among diseases of the female reproductive organs. Identification of OC at early stages is highly beneficial for the treatment but is highly challenging due to the asymptomatic or low-symptom disease development. In this study, lipid extracts of venous blood samples from 41 female volunteers, including 28 therapy-naive patients with histologically verified high-grade serous ovarian cancer at different stages (5 patients with I-II stages; 23 patients with III-IV stages) and 13 apparently healthy women of reproductive age, were profiled by high-performance liquid chromatography mass spectrometry (HPLC-MS). Based on MS signals of 128 differential lipid species with statistically significant level variation between the OC patients and control group, an OPLS-DA model was developed for the recognition of OC with 100% sensitivity and specificity R2 = 0.87 and Q2 = 0.80. The second OPLS-DA model was developed for the differentiation between I-II OC stages and control group with R2 = 0.97 and Q2 = 0.86 based on the signal levels of 108 differential lipid species. The third OPLS-DA model was developed for the differentiation between I-II OC stages and III-IV stages based on the signal levels of 99 differential lipid species. Various lipid classes (diglycerides, triglycerides, phosphatidylchlorines, ethanolamines, sphingomyelins, ceramides, phosphatidylcholines and phosphoinositols) in blood plasma samples display distinctly characteristic profiles in I-II OC, which indicates the possibility of their use as marker oncolipids in diagnostic molecular panels of early OC stages. Our results suggest that lipid profiling by HPLC-MS can improve identification of early-stage OC and thus increase the efficiency of treatment.
Perspectives for Combining Viral Oncolysis With Additional Immunotherapies for the Treatment of Melanoma
Authors: Cerqueira Otto Luiz Dutra , Antunes Fernanda , Assis Nadine G , Cardoso Elaine C , Clavijo-Salomón Maria A , Domingues Ana C , Tessarollo Nayara G , Strauss Bryan E
Published: April 2022

Melanoma is the deadliest type of skin cancer with steadily increasing incidence worldwide during the last few decades. In addition to its tumor associated antigens (TAAs), melanoma has a high mutation rate compared to other tumors, which promotes the appearance of tumor specific antigens (TSAs) as well as increased lymphocytic infiltration, inviting the use of therapeutic tools that evoke new or restore pre-existing immune responses. Innovative therapeutic proposals, such as immune checkpoint inhibitors (ICIs), have emerged as effective options for melanoma. However, a significant portion of these patients relapse and become refractory to treatment. Likewise, strategies using viral vectors, replicative or not, have garnered confidence and approval by different regulatory agencies around the world. It is possible that further success of immune therapies against melanoma will come from synergistic combinations of different approaches. In this review we outline molecular features inherent to melanoma and how this supports the use of viral oncolysis and immunotherapies when used as monotherapies or in combination.
The Effects of a Magic Intervention Program on Cognitive Function and Neurocognitive Performance in Elderly Individuals With Mild Cognitive Impairment
Authors: Lee Kuan-Ting , Wang Wei-Li , Lin Wen-Chin , Yang Yi-Ching , Tsai Chia-Liang
Published: April 2022

Objectives

Cognitive training is one of the management options for elderly individuals who suffer from mild cognitive impairment (MCI) and an effective way to improve executive function. This study aimed to evaluate the effectiveness of a magic intervention program as a method of cognitive training in improving cognitive function and neurocognitive performance in this group.

Methods

Twenty-four participants aged 60–80 years with MCI were recruited and randomly assigned to a magic intervention group or a control group. The magic intervention group received a 6-week magic intervention program. The primary endpoints were the scores for the cognitive assessment tests [e.g., Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)] for general cognitive function. The secondary endpoints were the behavioral [e.g., accuracy and reaction times] and the electroencephalographic [e.g., event-related potential (ERP) P3 amplitudes] performance during the Flanker task to assess attention and inhibitory control. All variables were measured before and after the magic intervention.

Results

The results showed that the 6-week magic intervention significantly improved the MoCA scores in the cognitive assessment tests although no significant pre-post intervention difference was observed in the MMSE scores. In terms of neurocognitive performance, the magic intervention had significantly positive effects on the accuracy, reaction times, and P3 amplitudes when performing the Flanker task.

Conclusion

The results of the present study showed that the 6-week magic intervention had beneficial effects on the cognitive and electrophysiological performance in the elderly subjects with MCI. For such a group, lifestyle intervention programs that encourage participation such as the magic practice and performance may be a viable suggestion to prevent the progression of MCI to Alzheimer’s disease.
Multimodality Monitoring for Delayed Cerebral Ischemia in Subarachnoid Hemorrhage: A Mini Review
Authors: Labak Collin M. , Shammassian Berje Haroutuon , Zhou Xiaofei , Alkhachroum Ayham
Published: April 2022

Aneurysmal subarachnoid hemorrhage is a disease with high mortality and morbidity due in large part to delayed effects of the hemorrhage, including vasospasm, and delayed cerebral ischemia. These two are now recognized as overlapping yet distinct entities, and supportive therapies for delayed cerebral ischemia are predicated on identifying DCI as quickly as possible. The purpose of this overview is to highlight diagnostic tools that are being used in the identification of DCI in the neurocritical care settings.
The Function of the Autonomic Nervous System in Asian Patients With Chronic Migraine
Authors: Shi Min , Luo Danqing , Guo Jun , Yang Dongdong , Li Zhaoying , Zhao Huan
Published: April 2022

Background

The pathogenic mechanisms underlying the autonomic nervous system (ANS) dysfunction in patients with chronic migraine (CM) remain unclear. This study investigated the pathogenesis of ANS dysfunction in this population.

Methods

A total of 60 patients diagnosed with CM and 60 healthy subjects were recruited to participate in this study. The pupil diameter, pupil contraction velocity, latency, amplitude, and the maximum gradient recovery time were examined before, at 2 min and at 5 min after the cold pressor test, which was combined with the pupillary light reflex method. A brain 3D T1-weighted structural imaging scan, resting-state functional magnetic resonance imaging scan, and diffusion tensor imaging (DTI) scan were also acquired.

Results

Patients with CM exhibited a longer recovery time to the maximum gradient at 2 min and at 5 min after cold pressing compared with the control group (P < 0.01 and P < 0.05, respectively). There was no significant difference in the pupil diameter, pupillary contraction velocity, latency, amplitude, blood pressure, or heart rate between the two groups (all P > 0.05). In the CM group, the regional homogeneity (ReHo) values of the left amygdala and left lateral hypothalamic area were significantly higher than those of other brain areas (P < 0.001, Alphasim corrected). The DTI scan of the whole brain area showed a lack of significant difference in DTI indices, including FA, MD, AD, and RD values between the two groups (P > 0.05, Alphasim corrected).

Conclusion

The dysfunction of the left amygdala and left lateral hypothalamic area may be related to ANS dysfunction in patients with CM.
Chronic Exposure to Dim Light at Night or Irregular Lighting Conditions Impact Circadian Behavior, Motor Coordination, and Neuronal Morphology
Authors: Delorme Tara C. , Srikanta Shashank B. , Fisk Angus S. , Cloutier Marie-Ève , Sato Miho , Pothecary Carina A. , Merz Chantal , Foster Russell G. , Brown Steven A. , Peirson Stuart N. , Cermakian Nicolas , Banks Gareth T.
Published: April 2022

Mistimed exposure to light has been demonstrated to negatively affect multiple aspects of physiology and behavior. Here we analyzed the effects of chronic exposure to abnormal lighting conditions in mice. We exposed mice for 1 year to either: a standard light/dark cycle, a “light-pollution” condition in which low levels of light were present in the dark phase of the circadian cycle (dim light at night, DLAN), or altered light cycles in which the length of the weekday and weekend light phase differed by 6 h (“social jetlag”). Mice exhibited several circadian activity phenotypes, as well as changes in motor function, associated particularly with the DLAN condition. Our data suggest that these phenotypes might be due to changes outside the core clock. Dendritic spine changes in other brain regions raise the possibility that these phenotypes are mediated by changes in neuronal coordination outside of the clock. Given the prevalence of artificial light exposure in the modern world, further work is required to establish whether these negative effects are observed in humans as well.