bluuebunny/crossref_metadata_2025 huggingface dataset:
Compact Four-Port Dual-Sense Circularly Polarized Stack-Up Patch Antenna for UHF/MW-RFID MIMO System
Authors: Zhang Enze , Qiu Jinghui
Published: August 2021

A four-port dual-band dual circularly polarized (CP) stack-up patch antenna is introduced for multiple-input-multiple-output (MIMO) RFID application. The proposed antenna adopts two FR 4 substrates and one Rogers Ro4350b substrates. Two pairs of isolated ports work at FCC UHF/MW-RFID bands (0.902–0.928 and 2.4–2.485 GHz) with port isolations of 20 dB and 25 dB, respectively. Four inverted-F radiating elements fed with a 90° phase-delay feeding network realize the CP radiation at the FCC UHF-RFID band (0.902–0.928 GHz). The corner-truncated square slot and patch are implemented to obtain CP modes at the MW-RFID band. The relative impedance bandwidths in the FCC UHF and MW band are 10.9% and 9.4%, respectively, with peak gains of 4.1 and 7.2 dBic. The antenna’s MIMO performance of envelope correlation coefficient (ECC) is lower than 0.01, and diversity gain (DG) is close to 10 dB. Thanks to the stack-up configuration, the dual-band RFID antenna realizes good antenna performance with a compact size of 0.6 × 0.6 × 0.07 λ3.
Antagonistic Potential of Soil Streptomyces Isolates from Southern Thailand to Inhibit Foodborne Bacterial Pathogens
Authors: Chemoh Waenurama , Bin-Ismail Wahida , Dueramae Sawitree
Published: August 2021

Streptomyces are well known for their competence to produce thousands of bioactive secondary metabolites and enzymes. This study aimed to assess the inhibitory activities of crude extracts from diverse Streptomyces collected from rice soils in Narathiwat, Thailand, against foodborne bacterial pathogens. In total, 136 Actinomycete isolates were screened using a cross-streak method for the ability to produce effective metabolites against 5 pathogenic bacteria. Out of these, 19 (13.97%) isolates had antibacterial activity against at least one tested bacterium. Most of the isolates could strongly suppress the growth of S. aureus ATCC25923 and B. cereus MTCC430 except P. aeruginosa ATCC27853. On the basis of morphological, cultural, and biochemical characteristics, all potent isolates exhibited typical features that fitted the genus Streptomyces. Two of the 7 selected ethyl acetate crude extracts had good antagonistic activity against S. aureus ATCC25923 and B. cereus MTCC430 when tested using the agar well diffusion assay. Furthermore, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values of the 2 extracts evaluated using the colorimetric broth microdilution method ranged from 256 to >1,024 μg/ml against the tested bacteria. The partial nucleotide sequences of the 16S rRNA gene led to identifying both active isolates as Streptomyces species. These active Streptomyces isolates could provide an interesting source for generating innumerable natural compounds with antibacterial activity that can presumably be developed to fight bacterial pathogens in the near future.
Implementation of Computer-Based Vision Technology to Consider Visual Form of Ceramic Mural Art
Authors: Li Dazhuang , Alkathir Emad Saadi
Published: August 2021

As one of the cultural forms of human beings, ceramic murals transcend the dimension of time and space and transcend the single cognition of materialism in the sense of purely material materials. The emergence of computer vision technology has also provided conditions for developing ceramic murals in terms of concepts and technical forms. This article first studies the visual communication language research in ceramic mural art, at the same time comprehensively analyzes the design principles of ceramic mural art, and interprets the visual form of ceramic mural art from the perspective of actual projects in the thesis; then, it boldly analyzes the future of ceramic mural art Development trend. Finally, this article analyzes the composition in ceramic mural art, the graphics in ceramic mural art, the color in ceramic mural art, the scale in ceramic mural art, the lighting in ceramic mural art, and the design principles in ceramic mural art. The experimental results show that there are significant differences in the artistic design principles of ceramic muralsP<0.05, and there are significant differences in the artistic design principles of ceramic muralsP<0.05. Therefore, the artistic design principles of modern ceramic murals should mainly follow elegant and prominent forms.
Study on Fracture Distribution and Local Brittleness Characteristics Based on Stepwise Regression Method
Authors: Zhao Wanchun , Feng Xiaohan , Wang Tingting
Published: August 2021

The brittleness of rock is an important parameter that influences and controls the evolution mechanism of the fracture and formation of a fracture net. The existing methods of brittle characterization are describing the brittleness of rock mass as a whole. They lack reliability descriptions to guide the fracture strike and improve the volume of the reservoir. It is considered that the macroscopic brittle fracture of a rock is the process of continuous initiation and propagation of local fractures in the rock mass under the action of external loads. The macroscopic fracture is the appearance caused by a local rupture to a certain extent, and the local rupture is the root cause of macroscopic fracture. The study of the local brittleness of a rock can reveal the intrinsic nature of its fracture behavior and can reflect the evolution mechanism of fracture more directly and accurately. In this paper, coring sampling in field outcrop is first carried out, and the break evolution law of core is described by a CT scanner. The mineral compositions in the core are determined by a mineral analysis diffractometer. The regulation of the rock local brittleness with different mineral contents is analyzed. And a new method for local brittle region division and characterization of rock has been developed. This method gives the connotation relation of the rock brittle fracture as a whole induced by a local brittle fracture. And it provides a new approach to study the law of a rock fracture.
Research on the Distribution Rule of Percussion Response Pulse Width in Coin‐Tap Test
Authors: Li Jian , Xu Liping , Yu Xiaowen , Peng Jianjun , Huang Lei
Published: August 2021

The coin‐tap method performs nondestructive testing by measuring the width of the tapping response pulse on the surface of the material. Existing studies have shown that defects in the material will cause the width of the tapping response pulse to increase. However, experiments have confirmed that different detection positions in the defective area will show different values of the width of the tapping response pulse, and the physical laws behind it have not been studied yet. To discuss its physical meaning, a mathematical model of the defective area is established, a method for calculating the width of the tapping response pulse is proposed, and a composite honeycomb structure with preset defects is used for data testing. Both the test results and the calculation results show that the pulse width of the tapping response will decrease with the increase of the defect depth and the deviation of the tapping position from the defect center. The consistency between the calculated results and the experimental results shows that the established defect model and pulse width calculation method can better explain the distribution law of the pulse width of the tapping response in the defective area.
Study on the Key Influential Factors on Water Huff-n-Puff in Ultralow-Permeability Reservoir
Authors: Wang Xiaoyan , Xie Kun , Zhang Jie , Zhang Yong , Zhang Yang , Wang Wei , Yan Xi , Zhao Fengxiang
Published: August 2021

Ultralow-permeability reservoirs are difficult to effectively develop using conventional technologies, so it generally produces using horizontal wells’ volume fracturing. Besides, oil wells also face the problems of short stable or no production period, rapid decline rate, and extremely low development degree. Water huff-n-puff of oil recovery technology is a quality and efficiency technology to improve the development effect of an ultralow-permeability reservoir. A systematic study on the related key influential factors of water huff-n-puff is done for improving the development effect of ultralow-permeability reservoirs. This manuscript studied the key influential factors of water huff-n-puff and related improving recovery methods using physical simulation experiments to put forward a beneficial condition for water huff-n-puff, combining with the field practice. The results show that imbibition and energy supplement are main mechanisms of water huff-n-puff; imbibition oil recovery is influenced by rock wettability, permeability, boundary condition, fracture length, water injection speed, and imbibition solution type; the stronger the water-wet reservoir rock is, the bigger the core permeability is, the longer the fracture length is, the larger the contacting area between imbibition solution and rock is, the stronger the ability of imbibition solution to change wettability, and to reduce the interfacial tension force between oil and water is, the better effect of water huff-n-puff is. So far, the field practice of water huff-n-puff has been conducted in 38 wells; the success rate can reach 92.1%, cycle oil increment of single well can reach 972 t, and accumulated oil in evaluation period can reach 36936 t, which further proves that water huff-n-puff can achieve a good effect. The effective methods to improve the development effect of an ultralow-permeability reservoir are changing reservoir physical property and supplying reservoir energy. Higher reservoir energy is good for oil flow, and better physical property can improve the displacement effect and imbibition function of injection solution. Artificial fracturing, higher injection-production ratio, and pretreatment of temporary stoppage fracturing are good methods to improve the development effect of water huff-puff.
SAN‐GAL: Spatial Attention Network Guided by Attribute Label for Person Re‐identification
Authors: Hou Shaoqi , Liu Chunhui , Yin Kangning , Ding Yiyin , Wang Zhiguo , Yin Guangqiang
Published: August 2021

Person Re‐identification (Re‐ID) is aimed at solving the matching problem of the same pedestrian at a different time and in different places. Due to the cross‐device condition, the appearance of different pedestrians may have a high degree of similarity; at this time, using the global features of pedestrians to match often cannot achieve good results. In order to solve these problems, we designed a Spatial Attention Network Guided by Attribute Label (SAN‐GAL), which is a dual‐trace network containing both attribute classification and Re‐ID. Different from the previous approach of simply adding a branch of attribute binary classification network, our SAN‐GAL is mainly divided into two connecting steps. First, with attribute labels as guidance, we generate Attribute Attention Heat map (AAH) through Grad‐CAM algorithm to accurately locate fine‐grained attribute areas of pedestrians. Then, the Attribute Spatial Attention Module (ASAM) is constructed according to the AHH which is taken as the prior knowledge and introduced into the Re‐ID network to assist in the discrimination of the Re‐ID task. In particular, our SAN‐GAL network can integrate the local attribute information and global ID information of pedestrians without introducing additional attribute region annotation, which has good flexibility and adaptability. The test results on Market1501 and DukeMTMC‐reID show that our SAN‐GAL can achieve good results and can achieve 85.8% Rank‐1 accuracy on DukeMTMC‐reID dataset, which is obviously competitive compared with most Re‐ID algorithms.
Research on Logistics Distribution Vehicle Scheduling Based on Heuristic Genetic Algorithm
Authors: Wang Chun-Li , Wang Yang , Zeng Ze-Yu , Lin Cheng-Yu , Yu Qiu-Li
Published: August 2021

To study the genetic algorithm, this paper solves the problem of shop scheduling under the premise of layout Flying − V. Firstly, double‐layer coding is used for optimization. When calculating fitness, the time to return to the mouth P&D approaches the optimum through the greedy idea. Individual screening is carried out through the roulette method. Different crossover and genetic operators are used for different coding layers. Through thinking of elitism and catastrophe and the immigration operator to ensure the diversity of the algorithm in the calculation process, it can achieve the recommendation of the number of cars to control the cost. The stability of the algorithm is good. It can recommend a better picking sequence and number of carts for various types of picking problems.
Research on the Evolution Mechanism of Congestion in the Entrances and Exits of Parking Facilities Based on the Improved Spatial Autoregressive Model
Authors: Yu Hongru , Deng Shejun , Lu Caoye , Tang Yucheng , Yu Shijun , Liu Lu , Ji Tao
Published: August 2021

The entrance and exit area of parking facilities has the characteristics of high concentration of urban traffic and prominent traffic intertwining phenomenon, which easily induces rapid congestion of mixed heterogeneous traffic at specific times and local locations and quickly spreads to the entire road section or even a larger area. In order to better understand the congestion distribution characteristics and propagation effects of access section of the parking entrance and exit from the mid and microperspective, a 5 m 

∗

 lane width pixel grid is used to divide the frontage road research. It also proposes a spatially robust autoregressive model and complex network tools suitable for analysis of local traffic flow to analyze it. The results show that as spatial scale increases, the congestion propagation decreases sharply and spatial adjacency within the fourth order can account for more than 90% of the propagation; the frontage road to the entrance and exit is the place where the congestion first happens, and the congestion gradually attenuates as it propagates to the inner lane and the upstream of the road segments; the lateral congestion propagation attenuates faster, so the area affected by congestion is mainly distributed in the outermost lane. This paper can provide theoretical guidance for alleviating traffic congestion in the entrance and exit areas of parking facilities and has theoretical and empirical significance.
Impact of Cooling on Water and Salt Migration of High-Chlorine Saline Soils
Authors: Tian Runze , Zhang Yu , Xu Anhua , Li Xuemei , Hou Yunlong , Tai Bowen
Published: August 2021

Secondary salinization is a common problem in saline soil projects. In order to grasp the mechanism of water and salt migration of high-chlorine saline soil during the cooling process, the saline soils along the Qarhan-Golmud Highway in the Qinghai-Tibet Plateau were selected as test samples. Firstly, the basic physical parameter test and the soluble salt chemical experiment were carried out and obtained liquid and plastic limits, dry density, etc. Secondly, freezing temperature experiments and water-salt migration experiments under one-way cooling conditions were conducted according to the actual environmental conditions, and after the temperature gradient line of the soil sample was stable, water content and labile salt chemistry experiments were conducted to obtain the distribution of water and salt contents of soil samples. Finally, the effect of crystallization-water phase transition on water and salt migration and the effect of chloride salt on the temperature of crystallization-water phase transition were considered, and a mathematical model applicable to the water and salt migration of highly chlorinated saline soils under the effect of unidirectional cooling was established and solved with COMSOL Multiphysics software, and the correctness of the model was verified by comparing the simulation results with the experimental results. The study found that (1) during the one-way cooling process, both water and salt showed a tendency to migrate to the cold end. The MC (saline soil with medium chlorine content) with an initial water content of 16.9% and Cl− content of 3.373% was measured to reach a 17.6% water content and 3.76% Cl− content at the cold (top) end after the experiment. The HC (saline soil with high chlorine content) with an initial water content of 6.6% and Cl− content of 17.928% was measured to reach a 6.83% water content and 18.8% Cl− content after the experiment and (2) after the one-way cooling experiment of the MC, the water content at a distance of 1–2 cm from the cold end has abrupt changes, which may be caused by a small amount of crystallization—water phase transition at this location. At the same time, according to the temperature change graph during the cooling process, the phase change temperature was set to −9°C in the numerical simulation process to match the experimental results.
Vehicle Reidentification Based on MAPANet and k-Reciprocal Encoding
Authors: Tian Shuai , Tian Xuedong
Published: August 2021

Vehicle reidentification has important applications in intelligent monitoring systems. However, due to many factors, such as inaccurate vehicle image detection and viewing angle changes, distinguishing features cannot be effectively obtained when the vehicle is reidentified. To improve the recognition ability and robustness of vehicle reidentification, this study proposes a new multiattention part alignment network (MAPANet). The network uses different channels in the feature map to perceive different characteristics of the image clustering of the channels and achieves fine-grained attention to the vehicle. It can automatically locate the distinguishing subregions in the vehicle image and avoid the need for a large number of additional manual pretreatment steps. Moreover, an unsupervised reranking method based on multiple metrics is proposed. The k-reciprocal encoding algorithm can optimize the performance of the sorted list in the reordering problem, recalculate the interclass and intraclass distances of vehicle pictures, and improve sorting results. The experiments in this paper are carried out on the VeRi-776 and VehicleID datasets, and the mean average precision (mAP) results on the two datasets are 72.83% and 75.25%, respectively.
Stability Analysis of Rock Slope Based on Improved Principal Component Analysis Model: Taking Fuwushan Slope as an Example
Authors: Huang Lihua , Mao Liudan , Zhu YiRong , Wang YuLing
Published: August 2021

Aiming at the problems of low accuracy, low efficiency, and many parameters required in the current calculation of rock slope stability, a prediction model of rock slope stability is proposed, which combines principal component analysis (PCA) and relevance vector machine (RVM). In this model, PCA is used to reduce the dimension of several influencing factors, and four independent principal component variables are selected. With the help of RVM mapping the nonlinear relationship between the safety factor of slope stability and the principal component variables, the prediction model of rock slope stability based on PCA-RVM is established. The results show that under the same sample, the maximum relative error of the PCA-RVM model is only 1.26%, the average relative error is 0.95%, and the mean square error is 0.011, which is far lower than that of the RVM model and the GEP model. By comparing the results of traditional calculation method and PCA-RVM model, it can be concluded that the PCA-RVM model has the characteristics of high prediction accuracy, small discreteness, and high reliability, which provides reference value for accurately predicting the stability of rock slope.
Organoid Models for Salivary Gland Biology and Regenerative Medicine
Authors: Zhao Chen , Meng Cuida , Cui Na , Sha Jichao , Sun Liwei , Zhu Dongdong
Published: August 2021

The salivary gland is composed of an elegant epithelial network that secrets saliva and maintains oral homeostasis. While cell lines and animal models furthered our understanding of salivary gland biology, they cannot replicate key aspects of the human salivary gland tissue, particularly the complex architecture and microenvironmental features that dictate salivary gland function. Organoid cultures provide an alternative system to recapitulate salivary gland tissue in vitro, and salivary gland organoids have been generated from pluripotent stem cells and adult stem/progenitor cells. In this review, we describe salivary gland organoids, the advances and limitations, and the promising potential for regenerative medicine.
Prognostic Nomogram Based on Circular RNA‐Associated Competing Endogenous RNA Network for Patients with Lung Adenocarcinoma
Authors: Li Yang , Sun Rongrong , Li Rui , Chen Yonggang , Du He
Published: August 2021

Evidence is increasingly indicating that circular RNAs (circRNAs) are closely involved in tumorigenesis and cancer progression. However, the function and application of circRNAs in lung adenocarcinoma (LUAD) are still unknown. In this study, we constructed a circRNA‐associated competitive endogenous RNA (ceRNA) network to investigate the regulatory mechanism of LUAD procession and further constructed a prognostic signature to predict overall survival for LUAD patients. Differentially expressed circRNAs (DEcircRNAs), differentially expressed miRNAs (DEmiRNAs), and differentially expressed mRNAs (DEmRNAs) were selected to construct the ceRNA network. Based on the TargetScan prediction tool and Pearson correlation coefficient, we constructed a circRNA‐associated ceRNA network including 11 DEcircRNAs, 8 DEmiRNAs, and 49 DEmRNAs. GO and KEGG enrichment indicated that the ceRNA network might be involved in the regulation of GTPase activity and endothelial cell differentiation. After removing the discrete points, a PPI network containing 12 DEmRNAs was constructed. Univariate Cox regression analysis showed that three DEmRNAs were significantly associated with overall survival. Therefore, we constructed a three‐gene prognostic signature for LUAD patients using the LASSO method in the TCGA‐LUAD training cohort. By applying the signature, patients could be categorized into the high‐risk or low‐risk subgroups with significant survival differences (HR: 1.62, 95% CI: 1.12‐2.35, log‐rank p = 0.009). The prognostic performance was confirmed in an independent GEO cohort (GSE42127, HR: 2.59, 95% CI: 1.32‐5.10, log‐rank p = 0.004). Multivariate Cox regression analysis proved that the three‐gene signature was an independent prognostic factor. Combining the three‐gene signature with clinical characters, a nomogram was constructed. The primary and external verification C‐indexes were 0.717 and 0.716, respectively. The calibration curves for the probability of 3‐ and 5‐year OS showed significant agreement between nomogram predictions and actual observations. Our findings provided a deeper understanding of the circRNA‐associated ceRNA regulatory mechanism in LUAD pathogenesis and further constructed a useful prognostic signature to guide personalized treatment of LUAD patients.
Targeting the Atf7ip–Setdb1 Complex Augments Antitumor Immunity by Boosting Tumor Immunogenicity
Authors: Hu Hai , Khodadadi-Jamayran Alireza , Dolgalev Igor , Cho Hyunwoo , Badri Sana , Chiriboga Luis A. , Zeck Briana , Lopez De Rodas Gregorio Miguel , Dowling Catríona M. , Labbe Kristen , Deng Jiehui , Chen Ting , Zhang Hua , Zappile Paul , Chen Ze , Ueberheide Beatrix , Karatza Angeliki , Han Han , Ranieri Michela , Tang Sittinon , Jour George , Osman Iman , Sucker Antje , Schadendorf Dirk , Tsirigos Aristotelis , Schalper Kurt A. , Velcheti Vamsidhar , Huang Hsin-yi , Jin Yujuan , Ji Hongbin , Poirier John T. , Li Fei , Wong Kwok-Kin
Published: August 2021

Substantial progress has been made in understanding how tumors escape immune surveillance. However, few measures to counteract tumor immune evasion have been developed. Suppression of tumor antigen expression is a common adaptive mechanism that cancers use to evade detection and destruction by the immune system. Epigenetic modifications play a critical role in various aspects of immune invasion, including the regulation of tumor antigen expression. To identify epigenetic regulators of tumor antigen expression, we established a transplantable syngeneic tumor model of immune escape with silenced antigen expression and used this system as a platform for a CRISPR–Cas9 suppressor screen for genes encoding epigenetic modifiers. We found that disruption of the genes encoding either of the chromatin modifiers activating transcription factor 7–interacting protein (Atf7ip) or its interacting partner SET domain bifurcated histone lysine methyltransferase 1 (Setdb1) in tumor cells restored tumor antigen expression. This resulted in augmented tumor immunogenicity concomitant with elevated endogenous retroviral (ERV) antigens and mRNA intron retention. ERV disinhibition was associated with a robust type I interferon response and increased T-cell infiltration, leading to rejection of cells lacking intact Atf7ip or Setdb1. ATF7IP or SETDB1 expression inversely correlated with antigen processing and presentation pathways, interferon signaling, and T-cell infiltration and cytotoxicity in human cancers. Our results provide a rationale for targeting Atf7ip or Setdb1 in cancer immunotherapy.
Renovation of Intestinal Barrier by Polydatin in Experimentally Induced Ulcerative Colitis: Comparative Ultrastructural Study with L-Carnosine
Authors: Ebrahim Hasnaa Ali , Elsherbini Dalia Mahmoud Abdelmonem
Published: August 2021

Ulcerative colitis (UC) is a chronic inflammatory bowel disease associated with intestinal epithelial barrier impairment. Polydatin (PD), a natural product isolated from Polygonum cuspidatum, is known to have an anti-inflammatory, antioxidant, and antiapoptotic effect. We attempted to compare the protective impact of PD pretreatment on alterations to the intestinal epithelial barrier and the colonic wall’s ultrastructure accompanying ulcerative colitis to other conventional drugs in practice, primarily L-carnosine, which has not been addressed before. The rats were divided into 5 groups; 3 of them were treated with sulphasalazine (500 mg/kg), L-carnosine (30 mg/kg), and PD (45 mg/kg). All groups were administered their respective drugs 3 days before the UC was induced by acetic acid intra-rectally, and the treatment was continued until the 11th day. The disease activity index (DAI) was estimated, and a macroscopic scoring was established for the harvested colonic tissue. The tissues were extracted and processed for hematoxylin and eosin staining, caspase-3 immunohistochemical staining, electron microscopy, and biochemical analysis evaluating proinflammatory markers (IL-1β, TNF-α, and IL-6), myeloperoxidase (MPO), oxidative stress, and lipid peroxidation. Histopathological examination of colonic tissue showed that PD pretreatment effectively restored mucosal epithelial cells, intercellular tight junctions, goblet cells, and maintained the intestinal epithelial and endothelial barriers. PD suppressed MPO, proinflammatory markers, and malondialdehyde but enhanced superoxide dismutase and glutathione levels. It also hampered apoptosis, as evidenced by a reduction in caspase-3 expression. PD showed a significantly better response in preserving the intestinal epithelial barrier against acetic acid-induced colitis as compared to sulphasalazine and L-carnosine. These findings demonstrate the therapeutic role of PD for patients with UC.
Association between Pancreatic Burnout and Liver Cirrhosis in Alcoholic Chronic Pancreatitis
Authors: Hirth Michael , Göltl Philipp , Weiss Christel , Ebert Matthias P. , Schneider Alexander
Published: August 2021

Background/Objectives: In chronic pancreatitis (CP), progressive fibrosis of the pancreas leads to exocrine and endocrine insufficiency and, finally, to pancreatic burnout. Alcohol consumption is associated with fibrosis in the pancreas and the liver, and the activation of stellate cells plays a central role in the induction of fibrosis in both organs. However, the relationship between pancreatic burnout and liver cirrhosis (LC) is still poorly understood in patients with alcoholic CP (ACP). Methods: We performed a single-center, retrospective, cross-sectional study with 537 CP patients. We analyzed the clinical presence of early and advanced pancreatic burnout and stated LC in cases of typical alterations in histology, liver stiffness measurement, cross-sectional imaging, or ultrasound. We analyzed further clinical parameters. Results: The frequency of advanced pancreatic burnout was 6.5% for ACP (20/306) and 4% for non-ACP (8/206; p = 0.20; χ2 test). Advanced pancreatic burnout was not associated with the amount of alcohol consumption (p = 0.34) but with the disease duration (p = 0.0470) and rate of calcification (p = 0.0056). Furthermore, advanced pancreatic burnout was associated with LC (p < 0.0001) but cannot be explained by the amount of alcohol consumption. In ACP with alcohol consumption >80 g/day, an isolated LC was significantly more frequently detectable (14%, without pancreatic burnout) than an isolated advanced pancreatic burnout (1%, without LC). These results were confirmed by multivariable analyses. Conclusions: We identified a close association between LC and pancreatic burnout. The disease duration positively correlates with the development of pancreatic burnout. The liver seems to be more vulnerable to alcohol than the pancreas.
Gut Microbiota Development: Influence of Diet from Infancy to Toddlerhood
Authors: Laursen Martin Frederik
Published: August 2021

Early life is a critical period as our gut microbiota establishes here and may impact both current and future health. Thus, it is of importance to understand how different factors govern the complex microbial colonization patterns in this period. The gut microbiota changes substantially during infancy and toddlerhood in terms of both taxonomic composition and diversity. This developmental trajectory differs by a variety of factors, including term of birth, mode of birth, intake of antibiotics, presence of furred pets, siblings and family members, host genetics, local environment, geographical location, and maternal and infant/toddler diet. The type of milk feeding and complementary feeding is particularly important in early and late infancy/toddlerhood, respectively. Breastfeeding, due to the supply of human milk oligosaccharide into the gut, promotes the growth of specific human milk oligosaccharide (HMO)-utilizing Bifidobacterium species that dominate the ecosystem as long as the infant is primarily breastfed. These species perform saccharolytic fermentation in the gut and produce metabolites with physiological effects that may contribute to protection against infectious and immune-related diseases. Formula feeding, due to its lack of HMOs and higher protein content, give rise to a more diverse gut microbiota that contains more opportunistic pathogens and results in a more proteolytic metabolism in the gut. Complementary feeding, due to the introduction of dietary fibers and new protein sources, induces a shift in the gut microbiota and metabolism away from the milk-adapted and toward a more mature and diverse adult-like community with increased abundances of short chain fatty acid-producing bacterial taxa. While the physiological implication of these complementary diet-induced changes remains to be established, a few recent studies indicate that an inadequately matured gut microbiota may be causally related to poor growth and development. Further studies are required to expand our knowledge on interactions between diet, gut microbiota, and health in the early life setting.
Family History is Important to Identify Patients with Monogenic Causes of Adult-Onset Chronic Kidney Disease
Authors: Granhøj Jeff , Tougaard Birgitte , Lildballe Dorte L. , Rasmussen Maria
Published: August 2021

Monogenic causes of chronic kidney disease (CKD) are more prevalent in adults than previously thought, as causative gene variants are found in almost 10% of unselected patients with CKD. Even so, genetic testing in patients with adult-onset CKD is uncommon in clinical practice and the optimal criteria for patient selection remain unclear. A family history of kidney disease emerges as one marker associated with a high diagnostic yield of genetic testing. We present 3 cases of adult-onset CKD with underlying monogenic causes exemplifying different modes of inheritance. Case 1 is a 60-year-old male with slowly progressive CKD initially ascribed to hypertension and diabetes despite a family history with several affected first-degree relatives. A pathogenic MUC1 variant was found, and thus we identified the first Danish family of MUC1-associated autosomal dominant tubulointerstitial kidney disease. Case 2 is a 40-year-old female with nephrocalcinosis, nephrolithiasis, and unexplainable hypercalcemia consistent with vitamin D intoxication. The family history indicated autosomal recessive inheritance, and genetic testing revealed 2 pathogenic CYP24A1 variants in compound heterozygous form associated with idiopathic infantile hypercalcemia. Case 3 is a 50-year-old male with microscopic hematuria, proteinuria, and hearing loss. Electron microscopy of renal biopsy showed thin basal membrane syndrome, and the family history indicated X-linked inheritance. A novel missense variant in COL4A5 was identified, suggesting an atypical late-onset form of X-linked Alport syndrome. This case series illustrates the heterogeneous presentations of monogenic kidney disease in adults and emphasizes the importance of family history for initiating genetic testing to identify underlying monogenic causation. Moreover, we discuss the potential impact of genetic diagnostics on patient management and genetic family counseling.
Impact of Delivery Mode on Infant Gut Microbiota
Authors: Korpela Katri
Published: August 2021

Microbial colonization of the neonate is an important feature of normal birth. The gut microbiota has a central role in the programming of the host’s metabolism and immune function, with both immediate and long-term health consequences. During vaginal birth, the infant is exposed to diverse maternal microbes, of which specific faecal microbes colonize the infant’s gut. C-section eliminates the infant’s contact with maternal microbes, preventing vertical transmission of gut microbes. Consequently, infants are colonized by bacteria from the environment, including potential pathogens from the hospital environment. Recent studies have shown that intrapartum antibiotic exposure has a C-section-like effect on the infant gut microbiota. While the composition of the gut microbiota largely normalizes during the first year of life, epidemiological studies suggest that the aberrant early microbial exposures have long-term immunological and metabolic consequences. Because of the high prevalence of procedures that prevent normal gut microbiota development, effective methods to normalize the gut microbiota of neonates are urgently needed. Even more importantly, attention should be paid to the microbiota imbalance in C-section-born and antibiotic-exposed infants in clinical practice. Breastfeeding and probiotics are particularly important for infants with disrupted gut colonization.
A pilot study of the ticagrelor role in ischemic stroke secondary prevention
Authors: Zeinhom Mohamed G. , Aref Hany M. , El-khawas Hala , Roushdy Tamer M. , Shokri Hossam M. , elbassiouny Ahmed
Published: August 2021

Introduction: Ticagrelor is one of the most recent antiplatelet drugs used to treat ischemic heart disease. Its efficacy may equal or exceed aspirin in improving clinical outcomes in patients with acute ischemic stroke who are ineligible for rt-PA. Aim of the Work: We aimed at evaluating the safety (as a primary endpoint) and efficacy (as a secondary endpoint) of a 180 mg loading dose of ticagrelor given within 9 h from the onset of first-ever ischemic stroke. Methods: We conducted an open-label, randomized prospective controlled clinical trial between May 2019 and September 2020 on patients who presented with their first-ever ischemic stroke and were recruited from the emergency department, of Kafr el-sheik University Hospitals, Egypt. Eligible patients randomly received aspirin or ticagrelor loading and maintenance doses. Treatment began within 9 h of stroke onset. Results: Aspirin was given to 84 patients; ticagrelor was given to 85. There was no significant difference between the 2 groups regarding the hemorrhagic and nonhemorrhagic complications. Patients who received ticagrelor had a better outcome regarding NIHSS improvement at 2 days and 1 week or discharge and a favorable mRS score after 1 week or discharge and at 90-day follow-up. Conclusion: Ticagrelor was noninferior to aspirin regarding safety profile. Compared with aspirin, ticagrelor had a better clinical outcome based on NIHSS and mRS in first-ever acute ischemic stroke patients who received it within 9 h from symptom onset, leading to a shorter hospital stay.
Pulsed-Field Ablation in Ventricular Myocardium Using a Focal Catheter
Authors: Yavin Hagai D. , Higuchi Koji , Sroubek Jakub , Younis Arwa , Zilberman Israel , Anter Elad
Published: August 2021

Background:

Pulsed-field ablation (PFA) is a rapid and nonthermal energy with higher selectivity to myocardial tissue in comparison to radiofrequency ablation. However, its effects on ventricular myocardium and titration of lesion dimensions have not been well studied. This study examined the effect of PFA on ventricular myocardium and the influence of application repetition on lesion dimensions.

Methods:

An 8-Fr lattice catheter with a compressible 9-mm nitinol tip was used with a PFA generator (Affera, Inc) applying a bipolar and biphasic waveform (±1.3–2.0 kV, 4 second per application). We examined the impact of single applications (1×) versus 4 repetitive applications (4×) interspaced by 10 seconds. The latter was performed to determine whether repetitions of a similar electrical field can increase lesion dimensions. Experiments were performed in an in vivo porcine model and a survival period of 24 hours (n=6) or 23±5.4 days (n=6) for evaluation of early and late histopathologic effects.

Results:

PFA in ventricular myocardium showed repetition dependency. Acute lesion depth and volume increased from 5.6±1.43 mm and 860±362 mm3 to 8.8±0.74 mm and 2383±548 mm3 for 1× and 4× applications, respectively (
P
<0.001 for both comparisons). This effect was maintained in the chronic lesion phase with lesion depth and volume of 3.9±0.92 mm and 655±286 mm3 compared with 7.3±0.83 mm and 2170±488 mm3, respectively (
P
<0.001 for both comparisons). Acute lesions showed well demarcated necrotic core without coagulation necrosis while chronic lesions showed tissue thinning with fibro-fatty replacement.

Conclusions:

PFA in ventricular myocardium exhibits repetition dependency as lesion dimension increases with consecutive applications of a similar electrical field.
Cardiovascular Disease Risk–Based Statin Utilization and Associated Outcomes in a Primary Prevention Cohort: Insights From a Large Health Care Network
Authors: Saeed Anum , Zhu Jianhui , Thoma Floyd , Marroquin Oscar , Aiyer Aryan , Agarwala Anandita , Virani Salim S. , Gulati Martha , Lee Joon S. , Reis Steven , Saba Samir , Ballantyne Christie , Mulukutla Suresh
Published: August 2021

Background:

Current American College of Cardiology/American Heart Association guidelines recommend using the 10-year atherosclerotic cardiovascular disease (ASCVD) risk to guide statin therapy for primary prevention. Real-world data on adherence and consequences of nonadherence to the guidelines in primary are limited. We investigated the guideline-directed statin intensity (GDSI) and associated outcomes in a large health care system, stratified by ASCVD risk.

Methods:

Statin prescription in patients without coronary artery disease, peripheral vascular disease, or ischemic stroke were evaluated within a large health care network (2013–2017) using electronic medical health records. Patient categories constructed by the 10-year ASCVD risk were borderline (5%–7.4%), intermediate (7.5%–19.9%), or high (≥20%). The GDSI (before time of first event) was defined as none or any intensity for borderline, and at least moderate for intermediate and high-risk groups. Mean (±SD) time to start/change to GDSI from first interaction in health care and incident rates (per 1000 person-years) for each outcome were calculated. Cox regression models were used to calculate hazard ratios for incident ASCVD and mortality across risk categories stratified by statin utilization.

Results:

Among 282 298 patients (mean age ≈50 years), 29 134 (10.3%), 63 299 (22.4%), and 26 687 (9.5%) were categorized as borderline, intermediate, and high risk, respectively. Among intermediate and high-risk categories, 27 358 (43%) and 8300 (31%) patients did not receive any statin, respectively. Only 17 519 (65.6%) high-risk patients who were prescribed a statin received GDSI. The mean time to GDSI was ≈2 years among the intermediate and high-risk groups. At a median follow-up of 6 years, there was a graded increase in risk of ASCVD events in intermediate risk (hazard ratio=1.15 [1.07–1.24]) and high risk (hazard ratio=1.27 [1.17–1.37]) when comparing no statin use with GDSI therapy. Similarly, mortality risk among intermediate and high-risk groups was higher in no statin use versus GDSI.

Conclusions:

In a real-world primary prevention cohort, over one-third of statin-eligible patients were not prescribed statin therapy. Among those receiving a statin, mean time to GDSI was ≈2 years. The consequences of nonadherence to guidelines are illustrated by greater incident ASCVD and mortality events. Further research can develop and optimize health care system strategies for primary prevention.
Influenza Vaccination After Myocardial Infarction: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial
Authors: Fröbert Ole , Götberg Matthias , Erlinge David , Akhtar Zubair , Christiansen Evald H. , MacIntyre Chandini R. , Oldroyd Keith G. , Motovska Zuzana , Erglis Andrejs , Moer Rasmus , Hlinomaz Ota , Jakobsen Lars , Engstrøm Thomas , Jensen Lisette O. , Fallesen Christian O. , Jensen Svend E , Angerås Oskar , Calais Fredrik , Kåregren Amra , Lauermann Jörg , Mokhtari Arash , Nilsson Johan , Persson Jonas , Stalby Per , Islam Abu K.M.M. , Rahman Afzalur , Malik Fazila , Choudhury Sohel , Collier Timothy , Pocock Stuart J. , Pernow John
Published: August 2021

Background:

Observational and small, randomized studies suggest that influenza vaccine may reduce future cardiovascular events in patients with cardiovascular disease.

Methods:

We conducted an investigator-initiated, randomized, double-blind trial to compare inactivated influenza vaccine with saline placebo administered shortly after myocardial infarction (MI; 99.7% of patients) or high-risk stable coronary heart disease (0.3%). The primary end point was the composite of all-cause death, MI, or stent thrombosis at 12 months. A hierarchical testing strategy was used for the key secondary end points: all-cause death, cardiovascular death, MI, and stent thrombosis.

Results:

Because of the COVID-19 pandemic, the data safety and monitoring board recommended to halt the trial before attaining the prespecified sample size. Between October 1, 2016, and March 1, 2020, 2571 participants were randomized at 30 centers across 8 countries. Participants assigned to influenza vaccine totaled 1290 and individuals assigned to placebo equaled 1281; of these, 2532 received the study treatment (1272 influenza vaccine and 1260 placebo) and were included in the modified intention to treat analysis. Over the 12-month follow-up, the primary outcome occurred in 67 participants (5.3%) assigned influenza vaccine and 91 participants (7.2%) assigned placebo (hazard ratio, 0.72 [95% CI, 0.52–0.99];
P
=0.040). Rates of all-cause death were 2.9% and 4.9% (hazard ratio, 0.59 [95% CI, 0.39–0.89];
P
=0.010), rates of cardiovascular death were 2.7% and 4.5%, (hazard ratio, 0.59 [95% CI, 0.39–0.90];
P
=0.014), and rates of MI were 2.0% and 2.4% (hazard ratio, 0.86 [95% CI, 0.50–1.46];
P
=0.57) in the influenza vaccine and placebo groups, respectively.

Conclusions:

Influenza vaccination early after an MI or in high-risk coronary heart disease resulted in a lower risk of a composite of all-cause death, MI, or stent thrombosis, and a lower risk of all-cause death and cardiovascular death, as well, at 12 months compared with placebo.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02831608.
Beyond Atherosclerosis and Fibromuscular Dysplasia: Rare Causes of Renovascular Hypertension
Authors: Persu Alexandre , Canning Caitriona , Prejbisz Aleksander , Dobrowolski Piotr , Amar Laurence , Chrysochou Constantina , Kądziela Jacek , Litwin Mieczysław , van Twist Daan , Van der Niepen Patricia , Wuerzner Gregoire , de Leeuw Peter , Azizi Michel , Januszewicz Magda , Januszewicz Andrzej
Published: August 2021

Renovascular hypertension is one of the most common forms of secondary hypertension. Over 95% of cases of renovascular hypertension are due either to atherosclerosis of the main renal artery trunks or to fibromuscular dysplasia. These two causes of renal artery stenosis have been extensively discussed in recent reviews and consensus. The aim of the current article is to provide comprehensive and up-to-date information on the remaining causes. While these causes are rare or extremely rare, etiologic and differential diagnosis matters both for prognosis and management. Therefore, the clinician cannot ignore them. For didactic reasons, we have grouped these different entities into stenotic lesions (neurofibromatosis type 1 and other rare syndromes, dissection, arteritis, and segmental arterial mediolysis) often associated with aortic coarctation and other arterial abnormalities, and nonstenotic lesions, where hypertension is secondary to compression of adjacent arteries and changes in arterial pulsatility (aneurysm) or to the formation of a shunt, leading to kidney ischemia (arteriovenous fistula). Finally, thrombotic disorders of the renal artery may also be responsible for renovascular hypertension. Although thrombotic/embolic lesions do not represent primary vessel wall disease, they are characterized by frequent macrovascular involvement. In this review, we illustrate the most characteristic aspects of these different entities responsible for renovascular hypertension and discuss their prevalence, pathophysiology, clinical presentation, management, and prognosis.