bluuebunny/crossref_metadata_2025 huggingface dataset:
Design Simulation and Preparation of White OLED Microdisplay Based on Microcavity Structure Optimization
Authors: Duan Liangfei , Wang Guanghua , Duan Yu , Lei Denglin , Qian Fuli , Yang Qiming
Published: May 2021

White-light OLED devices play an important application in information display fields. Optical interference of the microcavity structure has an important effect on device performances. According to the design of the band structure, ITO/MoO3 composite films were used as the anode, and Mg : Ag (1%) composite films were prepared by coevaporation as the translucent cathode; CuPc was used as the hole injection layer and anode passivation layer, NPB as the hole transmission layer and yellow light main material, rubrene as yellow dopant material, ADN as blue light main material, DSA-Ph as blue dopant material, and TPBi and Alq3 as the electron transport layers. We realized the change of the microcavity structure by adjusting the thickness of each organic functional layer film and simulated and calculated the optimized thickness of each organic film layer and influence on OLED device performances using the SimOLED software system. The optimized OLED microdisplay structure is Si(CMOS)/ITO (35 nm)/MoO3 (2 nm)/CuPc (5 nm)/2-TNATA (20 nm)/NPB (10 nm)/NPB : rubrene (1.5%)ADN : DSA-Ph (5%) (25 nm)/TPBi (15 nm)/Alq3 (1.2 nm)/Mg (13 nm) : Ag (1%). The optimized OLED microdisplay was prepared by the vacuum coating system, and the photoelectric performances of the OLED device were characterized by a spectral testing system consisting of the Photo Research PR655 spectrometer and Keithley 2400 program-controlled power supply. The effect of the microcavity structure on OLED device performances was studied. The results show that the variation of the film thickness of each organic functional layer has an important effect on the performances of OLED microdisplay, such as brightness and color coordinate, and the OLED microdisplay reaches a higher brightness of 3342 cd/m2 under the normal working voltage at 5.0 V after the structure is optimized, with CIE coordinate (0.28, 0.37), which is closer to the energy point of standard white light.
Feature Selection on Elite Hybrid Binary Cuckoo Search in Binary Label Classification
Authors: Zhao Maoxian , Qin Yue
Published: May 2021

For the low optimization accuracy of the cuckoo search algorithm, a new search algorithm, the Elite Hybrid Binary Cuckoo Search (EHBCS) algorithm, is improved by feature weighting and elite strategy. The EHBCS algorithm has been designed for feature selection on a series of binary classification datasets, including low-dimensional and high-dimensional samples by SVM classifier. The experimental results show that the EHBCS algorithm achieves better classification performances compared with binary genetic algorithm and binary particle swarm optimization algorithm. Besides, we explain its superiority in terms of standard deviation, sensitivity, specificity, precision, and

F

-measure.
Understanding the Anticontagion Process and Reopening of China during COVID‐19 via Coevolution Network of Epidemic and Awareness
Authors: Li Lingbo , Fan Ying , Zeng An , Di Zengru
Published: May 2021

The novel coronavirus (COVID‐19) pandemic is intensifying all over the world, but some countries, including China, have developed extensive and successful experience in controlling this pandemic. In this context, some questions arise naturally: What can countries caught up in the epidemic learn from China’s experience? In regions where the outbreak is under control, what would lead to a resurgence of the epidemic? To address these issues, we investigate China’s experience in anticontagion interventions and reopening process, focusing on the coevolution of epidemic and awareness during COVID‐19 outbreak. Through an empirical analysis based on large‐scale data and simulation based on a metapopulation and multilayer network model, we ascertain the impact of human movements and awareness diffusion on the epidemic, elucidate the inherent patterns and effective interventions of different epidemic prevention methods, and highlight the crunch time of each measure. The results are also employed to analyze COVID‐19 evolution in other countries so as to find unified rules in complex situations around the world and provide advice on anticontagion and reopening policies. Our findings explain some key mechanisms of epidemic prevention and may help the epidemic analysis and decision‐making in various countries suffering from COVID‐19.
The Characteristics of Gas-Water Two-Phase Radial Flow in Clay-Silt Sediment and Effects on Hydrate Production
Authors: Lu Cheng , Qin Xuwen , Yu Lu , Geng Lantao , Mao Wenjing , Bian Hang , Meng Fanle
Published: May 2021

Many hydrate-bearing sediments in the Shenhu area of the South China Sea are featured with unconsolidated clayed silt, small particle size, and high content of clay, which can pose a great challenge for gas production. In order to investigate the gas-water relative permeability in clay-silt sediments, through a radial flow experiment, samples from the target sediment in the Shenhu area were selected and studied. The results show that the irreducible water saturation is high and the influence of the gas-water interaction is obvious. The relative permeability analysis shows that the two-phase flow zone is narrow and maximum gas relative permeability is below 0.1. The flow pattern in clay-silt sediment is more complicated, and the existing empirical models are inadequate for flow characterization. The depressurization method to extract a hydrate reservoir with clay-silt sediments faces the problem of insufficient production capacity. Compared with the ordinary hydrate reservoir with sandstone sediment, the hydrate reservoir with clay-silt sediment has a low permeability and poor gas flow capacity. The gas-water ratio abnormally decreases during the production. It is urgent to enhance production with cost-effective measures.
Forecasting Travel Speed in the Rainfall Days to Develop Suitable Variable Speed Limits Control Strategy for Less Driving Risk
Authors: Wang Ping , Zhang Yajie , Wang Saisai , Li Li , Li Xiaohui
Published: May 2021

In order to reduce driving risk in the rainfall days, developing the variable speed limits (VSL) is effective. However, it is hard to develop suitable VSL aligning with travel speed of mainstream that it affected by the traffic flow, rainfall intensity, individual travel speed, peak hours, working days, random events, and so on. In this paper, the average travel speed and traffic flow of each road section are calculated from the toll collection data of Xi’an Ring Road from May to July in 2018 in Shaanxi Province, China. The weather data are collected and extrapolated to the corresponding road sections. Travel speed, traffic flow, and rainfall intensity are integrated to predict the fluctuation trend of travel speed through the proposed deep belief-radial basis function network. The experimental results show that a significant decrease happens in the travel speed in the rainfall day during peak hours. Furthermore, the deep learning algorithm that considers more factors such as the rainfall intensity and traffic flow could improve the prediction accuracy. Then, a VSL method and an expressway risk coefficient evaluation method based on estimation of average travel speed are proposed. The experimental results show that the variable 85th percentile speed limit method proposed in this paper can reduce the risk of expressway driving. This can promote road safety in the development of intelligent transportation system (ITS) in future.
Comparison of Vascular Morphometry in Jawbones and Long Bones: Micro‐CT Study in a Rat Model Treated with Zoledronic Acid
Authors: Wang Jing Yi , Yu Ru Qing , Huo Lei , Rao Nian Jing , Lu Weijia William , Zheng Li Wu
Published: May 2021

The study was aimed at investigating the effect of zoledronic acid on vascular morphometry in jawbones and long bones on a rat model. Twenty‐four skeletal mature Sprague‐Dawley female rats were administered oncologic dose of zoledronic acid (ZA) or normal saline for 4 weeks and then subjected to tooth extraction on the mandible and maxilla and a bone defect creation on the femur. After the surgical procedures, ZA or saline treatment was continued until sacrifice at week 2, week 4, and week 8 postoperatively. Vascular perfusion with MICROFIL was performed on all the animals. Micro‐CT analysis demonstrated a tendency of decreased vessel density and vessel number in ZA‐treated groups but no statistical difference. In conclusion, the neovessel formation is suppressed but not significantly by ZA treatment, indicating that angiogenesis inhibition may contribute to the development of MRONJ but does not play a key role.
Research on Optimal Control Strategy for Unpowered Downslope of High‐Voltage Inspection Robot Based on Motor Temperature Rise in Complexity Microgrid Networks
Authors: Yang Zhiyong , Fang Qiao , Zhang Zihao , Liu Xing , Xu Xianjin , Yan Yu , Miao Chen
Published: May 2021

In order to avoid the motor damage caused by excessive temperature rise of armature winding of the walking motor during braking of high‐voltage inspection robot in complexity microgrid networks, an unpowered downhill speed and energy recovery optimization control strategy is proposed based on temperature rise characteristics of the walking motor. Firstly, the thermal equivalent circuit model of the walking motor is established, and the mapping relationship between the armature winding temperature of the walking motor and ambient temperature is solved; secondly, the influence of armature winding temperature on unpowered downhill speed and energy recovery control strategy of robot is analyzed; thirdly, according to the temperature of front and rear wheel walking motors and the temperature difference between them, the optimal control strategy of unpowered downhill speed and energy recovery of robot is put forward; fourthly, by adjusting the duty ratio u of the energy consumption speed control system and the front wheel feedback brake distribution factor λ, the temperature difference between the front and rear wheel walking motors is reduced. Through the experimental analysis on the simulated line, it is verified that the unpowered downhill speed and energy recovery optimization control method based on the temperature rise characteristics of the walking motor can effectively reduce the temperature difference between the front and rear wheels.
Two-Echelon Location-Routing Problem with Time Windows and Transportation Resource Sharing
Authors: Wang Yong , Sun Yaoyao , Guan Xiangyang , Guo Yanyong
Published: May 2021

In this work, a two-echelon location-routing problem with time windows and transportation resource sharing (2E-LRPTWTRS) is solved by selecting facility locations and optimizing two-echelon vehicle routes. The optimal solutions improve the efficiency of a logistics network based on the geographical distribution and service time windows of logistics facilities and customers. Furthermore, resource utilization is maximized by enabling resource sharing strategies within and among different logistics facilities simultaneously. The 2E-LRPTWTRS is formulated as a biobjective optimization model, and obtaining the smallest number of required delivery vehicles and the minimum total operating cost are the two objective functions. A two-stage hybrid algorithm composed of k-means clustering and extended multiobjective particle swarm optimization algorithm is proposed for 2E-LRPTWTRS optimization. A self-adaptive mechanism of flight parameters is introduced and adopted during the iterative process to balance the evolution of particles and improve the efficiency of the two-stage hybrid algorithm. Moreover, 20 small-scale instances are used for an algorithm comparison with multiobjective genetic algorithm and nondominated sorting genetic algorithm-II, and the solutions demonstrate the superiority of the proposed algorithm in optimizing logistics networks. The proposed optimization model and hybrid algorithm are tested by employing a real-world case of 2E-LRPTWTRS in Chongqing, China, and the optimization results verify the positive role of the developed model and algorithm in improving logistics efficiency, reducing operating cost, and saving transportation resources in the operations of two-echelon logistics networks.
Correlation of Peripheral Blood Parameters and Immune-Related Adverse Events with the Efficacy of Immune Checkpoint Inhibitors
Authors: Bai Rilan , Li Lingyu , Chen Xiao , Chen Naifei , Song Wei , Zhang Yongfei , Lv Zheng , Han Fujun , Zhao Yuguang , Li Wei , Cui Jiuwei
Published: May 2021

Objective. We aimed to retrospectively analyze the predictors of immune checkpoint inhibitors (ICIs)-efficacy in patients with advanced pancancer who were treated with various ICIs in the real world and focused on the correlation between ICIs-efficacy and immune-related adverse events (irAEs). Methods. We retrospectively analyzed data from 103 patients with advanced pancancer treated receiving various ICIs in the First Hospital of Jilin University from January 1, 2016 to August 1, 2020. Survival probabilities of progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan–Meier curves and log-rank tests and the multivariate Cox proportional hazards model. Receiver-operating characteristic curve was used to determine a cutoff value for parameters and area under the curve. Correlations between the two variables were analyzed by logistic regression. Results. All patients were analyzed for survival predictors of OS, while 87 of 103 patients experienced evaluable disease progression of immunotherapy and were included in the analysis of predictors of PFS. First, we found that lower platelet (cutoff = 201.5 × 109/L) and lactate dehydrogenase (LDH) (cutoff = 227 U/L) were independently associated with significantly improved PFS, while lower platelet-lymphocyte ratio (cutoff = 206.5), absolute monocyte count (cutoff = 0.62 × 109/L), and LDH (cutoff = 194.5 U/L) were significantly and independently associated with better OS. In the analysis of the immune cell subgroup, a lower absolute countof CD8+CD28−suppressor T cells was an independent factor associated with better PFS (6.60 vs.4.13 months (mo), hazard ratios (HR) = 3.17,

p

 = 0.0038), and OS (29.4 vs. 9.57 mo, HR = 3.05,

p

 = 0.03). Second, the results of the analysis for irAEs showed that patients with any grade irAEs had higher objective response rate (30% vs. 10%, HR = 4.34,

p

 = 0.009), disease control rate (69.7% vs. 50%, HR = 2.3,

p

 = 0.028), PFS (8.37 vs. 3.77 mo, HR = 2.02,

p

 = 0.0038), and OS (24.77 vs.13.83 mo, HR = 1.84,

p

 = 0.024). Moreover, the groups with irAEs of grade ≥2 and with “multi-site” irAEs had significantly better PFS and OS (

p

 < 0.05) compared with the other groups. We also proved that endocrine irAEs (usually thyroid dysfunction) were significantly associated with better mPFS (

p

 = 0.01), and hepatic irAEs were significantly associated with better mOS (

p

 = 0.023). Conclusions. This retrospective study explored the availability and effectiveness of some cost-effective and readily available blood biochemical parameters in routine clinical practice to predict the ICIs-efficacy and demonstrated the predictive role of different categories of irAEs on efficacy.
An Unusual Case of Concurrent Central Retinal Vein and Cilioretinal Artery Occlusion in a Healthy Patient
Authors: Goh Eunice Jin Hui , Goh Kong Yong
Published: May 2021

It is rare for young, healthy patients to have retinal venous or arterial occlusions and even rarer for both to occur in concert. Such an occurrence should prompt a rapid and extensive workup to prevent further complications. We present our patient, a 37-year-old Lebanese male, who reported a 3-day history of blurring of vision in his left eye. He had no medical or ocular history and is a nonsmoker. Examination of the left fundus revealed inferior macular edema and retinal whitening associated with tortuous retinal veins. He was diagnosed with a combined central retinal vein and cilioretinal artery occlusion. Emergency treatment was done for an acute arterial occlusion. Embolic and thrombotic causes were excluded with investigations. The only positive result was homozygosity for 677C>T mutation of the 5,10 methylenetetrahydrofolate reductase (MTHFR) enzyme gene. MTHFR enzyme breaks down homocysteine, which is atherogenic and prothrombotic. This mutation can lead to a prothrombotic state, precipitating this occurrence. In fact, the Lebanese population is known to have the highest incidence of such mutations, but there are surprisingly few reports on retinal vascular occlusions attributed to this. He was promptly treated with antiplatelet therapy, possibly preventing a full-blown central retinal vein occlusion. After 4 weeks, his vision improved to 6/6 bilaterally. Examination showed less tortuous veins, no more retinal whitening, resolution of macula edema and visual field defect. Hyperhomocysteinemia can be significant in patients without ischemic risk factors. It is vital to manage these patients promptly, preventing future sight and life-threatening events.
A Rare Case of Cutaneous Mucoepidermoid Carcinoma of the Eyelid: A Case Report and Literature Review
Authors: Su Robin , Abrou Ayad , Abowd Michael
Published: May 2021

Mucoepidermoid carcinoma (MEC) is most commonly found to affect the salivary glands and rarely affects other organ systems. In this report, we present an especially rare case of cutaneous MEC affecting the eyelid. A 72-years-old female patient presented with a painless, cyst-like, progressively enlarging lesion of the left upper eyelid. Biopsy revealed characteristic features of MEC, including a mixture of mucus-secreting cells and epidermoid cells. The 3 mm MEC lesion was excised by Mohs micrographic surgery, leaving a 0.8 × 1.1 cm eyelid defect that was repaired by oculoplastic reconstruction. To date, the patient has been in remission for 4 years with good functional and aesthetic outcomes. This case represents the longest reported remission among only 9 previously reported cases of cutaneous MEC of the eyelid and highlights the therapeutic and aesthetic efficacy of Mohs micrographic surgery. We also offer a literature review of the 9 previously reported cases of eyelid MEC and a discussion of patient presentation, treatment comparisons, remission success, and key points in the management of MEC of the eyelid.
Comparative Cytogenetic Analysis of Three Eumeninae Species (Hymenoptera, Vespidae)
Authors: Tavares Mara G. , Teixeira Gisele A.
Published: May 2021

Eumeninae represents the largest subfamily within Vespidae, with 3,600 species described. Of these, only 18 have been cytogenetically analysed. In the present study, we used both classical and molecular techniques to characterise and compare the karyotypes of 3 Eumeninae species, namely, Ancistrocerus sp., Pachodynerus grandis, and Pachodynerus nasidens. Ancistrocerus sp. presented a haploid chromosome number of n = 12, with the first 2 chromosomes of the karyotype being almost entirely heterochromatic and much larger than the remaining chromosomes. The 2 Pachodynerus species presented the same chromosome number (n = 11 and 2n = 22) but displayed different karyotypic formulae. Additionally, chromosomal polymorphisms were observed in the analysed P. nasidens female. In the 3 species, heterochromatin was located in one of the chromosome arms. Fluorochrome staining revealed a balanced composition of AT and GC bases within the chromatin for each of the 3 species, except for few regions that were visibly GC-rich. All species had a single 18S rDNA site that co-localised with GC-rich regions; however, this localisation varied from species to species and not all GC-rich regions corresponded to ribosomal genes. Based on the cytogenetic data obtained here, we discuss the possible numerical/structural rearrangements that may be involved in the karyotypic evolution of the 3 studied species. In addition to the first description of the molecular cytogenetic characteristics of the Eumeninae subfamily and the genus Pachodynerus, this study also provides a relevant contribution towards the discussion of chromosomal evolution in Eumeninae wasps.
Pars-plana-Vitrektomie bei proliferativer diabetischer Retinopathie: Unterschiede zwischen jüngeren und älteren Patienten
Authors: Mrugala Viktoria , Augustin Albert J.
Published: May 2021

Background: Proliferative diabetic retinopathy (PDR) is one of the most common cause of vision loss in diabetic patients, and the incidence age of PDR patients gradually gets younger. This study aims to compare the characteristics of PDR and outcomes following vitrectomy in young and senior patients. Methods: This is a retrospective case series study. Data of 116 eyes of 92 patients who underwent vitrectomy for PDR from February 2012 to February 2017 were reviewed, which were divided into young and senior patient groups. All patients were followed up for 24 months at least. Results: There were 62.1% of eyes with tractional retinal detachment secondary to PDR in the young patient group, while only 12.1% of eyes in the senior patient group with this surgery indication. (P < 0.001) The best corrected visual acuity increased in 41 eyes (70.7%), stable in 9 eyes (15.5%), and decreased in 8 eyes (13.8%) in young patients at the final follow-up. And it increased in 47 eyes (81.0%), stable in 2 eyes (3.4%), and decreased in 9 eyes (15.5%) in senior patients (P = 0.085). Postoperative complications mainly included recurrent vitreous hemorrhage (24.1%), retinal detachment (3.4%), neovascular glaucoma (NVG) (27.6%) and nuclear sclerosis (53.4%) in young patients, and it was 19.0, 0.0, 1.7 and 3.4% in senior patients respectively. Summary: PDR of young patients is more severe than that of senior patients, and vitrectomy is an effective and safe method for PDR treatment. NVG is a main and severe complication besides nuclear sclerosis in young patients, and the incidence of NVG is higher compared to that in senior patients.
Corpos estranhos ou não-corpos: reflexões sobre a participação do corpo no ensino não presencial
Authors: Carneiro Cristiana , Scherer Larissa Costa Beber
Published: May 2021

O presente artigo se propõe a tecer uma reflexão sobre a participação do corpo no ensino não presencial. Partindo da premissa que o corpo é pulsional, e que a relaçãoprofessor aluno se fará a partir das marcas desse encontro/desencontro entre corpos, interroga as possíveis incidências da não presença física no ensino remoto. Discutindo a sexualidade infantil como pano de fundo da relação adulto-criançae a alteridade que ela convoca, situa a estranheza como fator de potência e impotência no inédito trabalho não presencial que a pandemia impôs realizar.
Abstract 12572: Early Surgical Treatment versus Initial Conservative Management for Asymptomatic Severe and Very Severe Aortic Stenosis: A Meta-analysis
Authors: Yokoyama Yujiro , Takagi Hisato , Kuno Toshiki
Published: May 2021

Background:
Although current guidelines generally recommend watchful waiting strategy for patients with asymptomatic severe aortic stenosis (AS) until symptoms develop, the optimal timing of surgical intervention remains controversial.

Objective:
This study aimed to compare the outcomes of early surgery vs. conservative strategy for patients with asymptomatic severe AS.

Methods:
MEDLINE and EMBASE were searched through February, 2020 to identify clinical trials that investigatedearly surgery and conservative strategy for patients with asymptomatic severe AS. From each study, we extracted the hazard ratio (HR) of all-cause mortality and cardiovascular mortality. Subgroup analyses were conducted by dividing into severe AS (peak aortic jet velocity [Vmax] ≥4.0 m/s, mean aortic pressure gradient [PG] ≥40 mmHg, or aortic valve area [AVA] ≤1.0 cm
2
) and very severe AS (Vmax ≥4.5 m/s, mean PG ≥50 mmHg, or AVA ≤0.75 cm
2
) groups.

Results:
1 randomized controlled, 7 observational trials were identified. Pooled analyses demonstrated that all-cause mortality and cardiovascular mortality for early surgery were significantly lower compared to conservative strategy (HR [95% Confidence Interval [CI]] =0.49 [0.36-0.68];
P
<0.0001, HR [95% CI] =0.42 [0.22-0.82];
P
=0.01, respectively). Subgroup analyses showed significant reduction for early surgery in all-cause mortality (severe AS: HR [95% CI] =0.52 [0.35-0.78];
P
=0.001, very severe AS: HR [95% CI] =0.38 [0.17-0.85];
P
=0.02).

Conclusions:
We demonstrated that early surgery was associated with significant reduction in all-cause and cardiovascular mortality in patients with severe AS. Further randomized trials are warranted to confirm our findings.
Abstract 13062: Epicardial Fat Associates With Endothelial Dysfunction, but Not With Coronary Calcium Score: From the Elsa-brasil Cohort Study
Authors: Martins Karina P , Barreto Sandhi , Bos Daniel , PEDROSA JESIANA , Mesquita Douglas , Foppa Murilo , Duncan Bruce , Ribeiro Antonio , Brant Luisa C
Published: May 2021

Introduction:
Epicardial fat has been related to coronary artery disease (CAD) independent of visceral or subcutaneous fat. The mechanism responsible for this association has not yet been elucidated. Our objective was to evaluate the association between automatically measured epicardial fat volume (EFV), cardiovascular risk factors, coronary artery calcium (CAC) and endothelial function in participants of ELSA-Brasil.

Methods and Results:
The sample comprised 470 (mean age 55± 8y, 52.3% men) participants from ELSA-MG, one of the Investigation Centers of the cohort, who had valid computed tomography scans and endothelial function evaluated by peripheral arterial tonometry (PAT). The mean EFV was 111 (IQ 86-144) mL. CAC=0 was detected in 55% of participants. In the multivariable analyses between cardiovascular risk factors and EFV, the following associations were observed with higher EFV: female sex; and increased age, waist circumference and triglycerides (p <0.001 for all). In multivariable analyses, higher EFV remained associated with worse endothelial function - basal pulse amplitude (q2=1.22, CI95% 1.07-1.40, p=0.004; q3=1.50, CI95% 1.30-1.74, p<0.001; q4=1.50, CI95% 1.28-1.79, p<0.001) and PAT ratio (q2=0.87, CI95% 0.81-0.95, p<0.001; q3=0.86, CI95% 0.79-0.94, p<0.001; q4=0.80, CI95% 0.73-0.89, p<0.001), but not with CAC.

Conclusions:
Higher EFV was associated with impaired endothelial function, but not with higher CAC. Our results suggest that the mechanism by which epicardial fat deposits relates to CAD may be different from the pathway of CAC, which relates to calcified plaques. A possible mechanism may be through the enhancement of endothelial dysfunction, microvascular disease and predominantly lipidic non-calcified plaques.
Abstract 13131: Cardiovascular Manifestations and Outcomes in Systemic Lupus Erythematosus: The Cleveland Clinic Contemporary Experience
Authors: Wang Tom Kai Ming , Chan Nicholas , Khayata Mohamed , Flanagan Patrick , Grimm Richard A , Griffin Brian P , Husni Elaine M , Littlejohn Emily , Xu Bo
Published: May 2021

Background:
Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disease affecting multiple organs including the heart, which when affected portends poor prognosis. Given the advances in therapies and vigilance for cardiovascular screening for SLE patients, we evaluated the contemporary cardiovascular characteristics, manifestations and outcomes in SLE patients at our tertiary referral center.

Methods:
Consecutive patients from the prospective SLE bio-repository at our center between October 2012 and March 2020 were included. Cardiovascular data pertaining to manifestations, investigations, management and outcomes were collected.

Results:
258 SLE patients were studied, with mean age 42.2 ± 14.7 years and 233 (90.3%) females. Cardio-respiratory symptoms were present in 92 (35.7%), most commonly dyspnea in 62 (24.0%) and chest pain in 53 (20.5%). Cardiac manifestations occurred in 97 (37.6%) patients, with pericardial disease in 38 (14.7%), valvular disease in 20 (7.8%), stroke/transient ischemic attack in 20 (7.8%), coronary heart disease in 17 (6.6%) and heart failure hospitalizations in 13 (5.0%) (Table 1). During a mean follow-up of 3.0 ± 2.2 years, there were 5 (1.9%) deaths, 19 (7.4%) developed cardiac events (table 1), 6 (2.3%) had cardiovascular procedures (3 cardiac surgeries, 2 percutaneous interventions and 1 device), and 44 (17.1%) had SLE-related hospitalizations.

Conclusion:
Cardiac manifestations remain prevalent in SLE, especially for pericardial, valvular and atherosclerotic diseases. With appropriate contemporary SLE and cardiovascular management, subsequent medium term adverse cardiovascular outcomes are low.
Abstract 13154: Cardiovascular Risk in Users of Mirabegron Relative to Users of Antimuscarinic Treatments for Overactive Bladder: Findings From a Non-interventional, Real-world Data Safety Study
Authors: Hoffman Veena , Hallas Jesper , Linder Marie , Margulis Andrea , Suehs Brandon T , Arana Alejandro , Enger Cheryl , Horter Libby , Odsbu Ingvild , Olesen Morten , Perez Gutthann Susana , Xu Yihua , Kristiansen Nina S , Appenteng Kwame , de Vogel Stefan , Seeger John D
Published: May 2021

Introduction:
During clinical trials, mirabegron, a β3-adrenoreceptor agonist, was associated with increased heart rate and systolic/diastolic blood pressure vs placebo in patients with overactive bladder (OAB). We studied the association between mirabegron and cardiovascular (CV) outcomes in an observational post-marketing safety study using real-world data.

Methods:
The study population was identified within five data sources: Danish and Swedish National Registers, Clinical Practice Research Datalink (UK), Optum (US), and Humana (US). Episodes of time when patients were new users of mirabegron or antimuscarinic medications (AMs) from 2012 to 2018 were sourced from prescription/dispensing information and matched on propensity scores. Major adverse CV events (MACE), acute myocardial infarction (AMI), stroke, and CV and all-cause mortality were identified from register linkage or validated through medical record review or physician questionnaires. Incidence rates of these outcomes during person-time of current use were estimated along with hazard ratios (HRs) from Cox models.

Results:
In total, 152,026 mirabegron episodes were matched to an equal number of AM episodes. The study population was 63.2% female and 72.6% were ≥65 years old. Baseline CV risk factors were similar between matched groups. There were no appreciable differences in the incidence rates of MACE, AMI, and stroke among current users of mirabegron relative to AMs (Table). The incidence rates of CV mortality (HR: 0.83, 95% confidence interval [CI]: 0.73, 0.95) and all-cause mortality (HR: 0.80, CI: 0.76, 0.84) were no higher with mirabegron vs AMs. Results restricted to episodes at high risk for CV events or stratified by age (<65, ≥65 years) or prior OAB medication use were consistent with overall findings.

Conclusions:
This large, multinational study found no higher risk of MACE, AMI, stroke, or CV or all-cause mortality among current users of mirabegron relative to users of AMs.
Abstract 13420: The LDL/apolipoprotein B Ratio Which is an Index for LDL Particle Size is a Strong Predictor for Neointimal Characteristics and In-stent Restenosis After Everolimus-eluting Stent Implantation
Authors: Akutsu Naotaka , Arai Riku , Fukamachi Daisuke , Okumura Yasuo
Published: May 2021

Introduction:
The smaller size of LDL particle has suggested the development of endothelial dysfunction, atherosclerosis and in-stent restenosis (ISR), but little is known regarding the impact of LDL particle size on neointimal formation leading to ISR.

Hypothesis:
The LDL-C/Apolipoprotein B (Apo B) ratio < 1.2 has been reported to indirectly represent a high proportion of sdLDL. It was hypothesized that in-stent neointimal proliferation in LDL/ApoB < 1.2 patients may be excessive and unstable.

Methods:
In 135 patients, we investigated the relationship between the LDL particle size and neointimal characteristics using optical coherence tomography (OCT) and coronary angioscopy (CAS) during follow-up angiography after stent implantation.

Results:
ISR was identified in 35 patients, who had a significantly lower LDL/ApoB ratio (0.99±0.25 vs. 1.17±0.25; p < 0.01) and higher proportion of yellow grade 2 and 3 by CAS than non-ISR group (n=100). Among the non-ISR group, LDL/ApoB < 1.2 group (n=59) had a significantly larger neointimal volume by OCT, and higher proportion of yellow grade 2 and 3 by CAS compared with LDL/ApoB > 1.2 group (n=41) (Figure).

Conclusions:
Smaller size of LDL strongly associated with the neointimal proliferation, the neointimal instability and ISR evidenced by multimodalities, suggesting that smaller ratio of LDL/ApoB could be a surrogate marker for the neointimal characteristics after stent implantation.
Abstract 13905: Gender Differences in Cardiac Implantable Electronic Devices (cieds) Among Systolic Heart Failure Hospitalizations: Aninsight From the National Inpatient Sample 2016 to 2017
Authors: Voruganti Dinesh C , Hassan Hafeez , Amanullah Aman M , Dugyala Sushma
Published: May 2021

Background:
Gender differences in systolic heart failure (HF) patients for the implantation of various cardiac implantable electronic devices (CIEDs) using ICD-10 have not been studied. We aim to explore the gender differences for each type of procedure.

Methods:
The National Inpatient Sample (NIS) 2016-2017 was used to obtain the hospitalizations with Systolic HF (ICD 10 CM codes I5020, I5021, I5022, I5023). Pacemaker/Defibrillator procedures were obtained using ICD 10 procedure codes. Demographic data were obtained using the variables provided in the NIS. All analysis was performed using SAS statistical software (9.4 Cary NC).

Results:
We identified 2,812,603 systolic HF hospitalizations from January 2016 to December 2017. Overall, two third of patients were male (62.9%). Table 1 elaborates on the demographics of these hospitalizations. Majority of hospitalizations were ascribed to white patient population (66% males were white & 63.2% females were white). Females were substantially higher Medicare beneficiaries (74.63% in females vs. 69.71% in males). Among the CIEDs, the males had a higher rates of procedure utilization compared to females (Table 2): Percutaneous insertion of defibrillator in right ventricle (1.6% in males vs. 1% in females); Insertion of defibrillator generator via sternotomy (1.1% in males vs. 0.7% in females); Percutaneous insertion of defibrillator lead in right atrium (1.1% in males vs. 0.7% in females); Cardiac resynchronization therapy-pulse generator via sternotomy (0.8% in males vs. 0.5% in females).

Conclusion:
Despite minimal differences in baseline characteristics, implantation of CIEDs appear to be underutilized in women. Further studies are required to confirm these findings and further explore gender differences.
Abstract 13932: Lung-targeted Sin3a Gene Therapy as a Promising Strategy to Restore Bmpr2 Expression in Pulmonary Arterial Hypertension
Authors: Bisserier Malik , Mathiyalagan Prabhu , Abdeldjebbar Yassine , Zhang Shihong , Elmastour Firas , Dorfmüller Peter , Humbert Marc , Sassi Yassine , Weber Thomas , Perros Frederic , Sahoo Susmita , Hadri Lahouaria
Published: May 2021

Background:
Pulmonary arterial hypertension (PAH) is a fatal lung disease of multifactorial etiology, with no curative treatment. Several studies have previously suggested that hypermethylation of the BMPR2 promoter may be associated with gene repression and disease progression. However, the underlying mechanisms have yet to be discovered. Sin3A/B (Switch-Independent 3) plays a critical role in the transcriptional regulation of genes through various epigenetic mechanisms. Here, we investigated for the first time the role of SIN3a in the regulation of BMPR2 methylation and expression in PAH.

Methods:
Expression of SIN3a was analyzed by qRT-PCR and western blot in lung tissues from PAH patients and rodent models of PAH. Using a gain- and loss-of-function approach, we investigated the role of SIN3a on cell proliferation (BrdU assay) and migration (Boyden chamber assay), and BMPR2 levels in primary human pulmonary arterial smooth muscle cells (hPASMC) and endothelial cells (hPAEC). The methylation level was analyzed by MS-PCR. The therapeutic potential of SIN3a was tested
in vivo
in the Sugen/Hypoxia (SuHx) mouse and monocrotaline (MCT) rat models of PAH using an adeno-associated virus 1 encoding human SIN3a.

Results:
We found a significant downregulation of SIN3a expression in the lung samples from PAH patients, SuHx mice, and MCT rats. In hPASMC and hPAEC, our results showed that SIN3a inhibits cell proliferation, migration, and upregulates BMPR2 through two distinct pathways. In hPASMC, our data showed that SIN3a upregulates BMPR2 expression by inhibiting the methylation level of the BMPR2 promoter. In hPAEC, SIN3a restored BMPR2 expression independently of the methylation status by upregulating the FOXK2 transcription factor.
In vivo
, our results showed that restoring SIN3a expression by gene therapy significantly decreased MCT- and SuHx-induced PAH as illustrated by decreased vascular and RV remodeling, hypertrophy, PAP and RVSP.

Conclusions:
Altogether, our study revealed that SIN3a plays a critical role in the regulation of BMPR2 expression by modulating the lung epigenetic landscape. Additionally, our study identifies lung-targeted SIN3a gene therapy as a new promising therapeutic strategy for treating PAH patients.
Abstract 14051: Meta-analyses for the Effect of Renin-angiotensin-aldosterone System Inhibitors on Mortality and Testing Positive of Covid-19
Authors: Yokoyama Yujiro , Takagi Hisato , Aikawa Tadao , Kuno Toshiki
Published: May 2021

Introduction:
Some have hypothesized that the use of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin-receptor blockers (ARB) may modify susceptibility to coronavirus disease 2019 (COVID-19) in humans. Thus, we conducted two meta-analyses to compare mortality and susceptibility of COVID-19 between those who were treated with ACEI and/or ARB and those who were not treated with ACEI or ARB.

Methods:
MEDLINE and EMBASE were searched through June 2020 to identify clinical trials that investigated the mortality and testing positive rates for COVID-19 for those who were treated with ACEI or/and ARB and for those who were not treated with ACEI or ARB. The first analysis investigated the testing positive rate of COVID-19. The second analysis investigated the in-hospital mortality rate for patients with COVID-19.

Result:
3 eligible studies for the first analysis and 14 eligible studies for the second analysis were identified. The first analysis demonstrated that the testing positive rates were similar for those who were treated with ACEI and for those who were not treated with ACEI (odds ratio [OR] [confidence interval [CI]] =0.96 [0.88-1.04], p =0.69) and for those who were treated with ARB and for those who were not treated with ARB (OR [CI] =0.99 [0.91-1.08], p =0.35) (Figure 1A,B). The second analysis showed that in-hospital mortality for patients with positive COVID-19 was similar between for those who were on ACEI and/or ARB and for those who were not on ACEI or ARB (hazard ratio [HR] [95% [CI]] =0.88 [0.64-1.20], p =0.42) (Figure 2). The subanalysis by restricting studies only investigating patients with hypertension showed ACEI and/or ARB use was associated with a significant reduction of in-hospital mortality compared with no ACEI or ARB use (HR [CI] =0.65 [0.48-0.87]).

Conclusion:
Our analysis demonstrated that ACEI and/or ARB use was not associated with positive rates of COVID-19, and not associated with mortality of COVID-19 patients.
Abstract 14328: Relation of Lipoprotein(a) Levels to Incident Diabetes and Modification by Alirocumab Treatment: An Analysis of the Odyssey Outcomes Trial
Authors: Schwartz Gregory G , Szarek Michael , Baccara-dinet Marie , Bittner Vera A , Bhatt Deepak L , Diaz Rafael , Goodman Shaun G , Harrington Robert A , Jukema J Wouter W , Manvelian Garen , Pordy Robert , White Harvey D , Zeiher Andreas M , Steg Philippe G ,   The ODYSSEY OUTCOMES Investigators
Published: May 2021

Background:
Cohort studies and clinical trials have shown a greater
prevalence
of diabetes among subjects with lower levels of lipoprotein(a) [Lp(a)]. Some healthy cohort studies have shown a greater
incidence
of new onset diabetes (NOD) among those with lower Lp(a). It is unknown whether the risk of NOD associates with Lp(a) levels in patients (pts) with established cardiovascular disease or whether pharmacologic reduction of Lp(a) with PCSK9 inhibitors modulates this risk.

Objective:
Using data from the ODYSSEY OUTCOMES trial that compared the PCSK9 inhibitor alirocumab (ALI) with placebo (PBO) in pts with recent acute coronary syndrome, we examined whether NOD was related to baseline Lp(a) level and whether any such relationship was modified by ALI treatment.

Methods and Results:
Lp(a) was measured with a mass assay in 13,480 trial pts without diabetes at baseline; median (IQR) baseline Lp(a) was 21.9 mg/dL (6.9-61.1); median follow-up was 2.7 years. Intensive statin therapy was utilized in 89%. In the PBO group, NOD was greatest in Quartile 1 and least in Quartile 4 of baseline Lp(a) (
Figure
, 4.6 vs 3.1 cases per 100 pt-years, P
trend
0.0003). ALI lowered Lp(a) by a median of 23% from baseline. Absolute median reduction in Lp(a) with ALI ranged from nil in baseline Lp(a) Quartile 1 to 15 mg/dL in Quartile 4. Treatment HR (ALI/PBO) for NOD was neutral overall (0.95, 95% CI 0.85-1.05) but varied across baseline Lp(a) quartiles from 0.79 (0.64-0.96) in Quartile 1 to 1.09 (0.87-1.38) in Quartile 4 (
Figure
, P
trend
=0.025).

Conclusion:
In pts with recent acute coronary syndrome, there is greater NOD among those with lower baseline Lp(a) levels. ALI has an overall neutral effect on NOD: In pts with low baseline Lp(a), ALI has minimal effect on Lp(a) levels and tends to reduce NOD. In pts with high baseline Lp(a), ALI reduces Lp(a) levels with a non-significant excess of NOD. The findings may have implications for emerging therapies that reduce Lp(a) more substantially than PCSK9 inhibitors.
Abstract 14455: Hidden in Plain Sight: An Elusive Cause of Cardiogenic Shock
Authors: Chuzi Sarah , Tibrewala Anjan , Kuang Fei Li , Freed Benjamin , Vorovich Esther , Lomasney Jon W , Martin Karlyn , Khan Sadiya S
Published: May 2021

A 54-year-old man with chronic obstructive pulmonary disease (COPD) presented with three days of chest pain, dyspnea on exertion, and orthopnea. Physical examination revealed jugular venous distention and lower extremity edema. Cardiac biomarkers were elevated. The differential diagnosis for the clinical presentation included: acute coronary syndrome, and type II myocardial infarction or myocardial injury due to acute decompensated heart failure. External records demonstrated recurrent admissions for similar signs and symptoms, with negative coronary angiogram. Shortly after admission, the patient developed acute cardiogenic shock requiring venoarterial extracorporeal membrane oxygenation. Echocardiogram revealed biventricular failure and a possible mitral valve vegetation. The differential diagnosis was refined to include myocarditis (infectious and noninfectious causes), bacterial versus marantic endocarditis, and infiltrative cardiomyopathies. Transesophageal echocardiography revealed mass-like, bileaflet thickening of the mitral valve, not consistent with true vegetation. Infectious, rheumatologic, and hypercoagulable workups were negative. Given the lack of a unifying diagnosis, a right ventricular (RV) endomyocardial biopsy was pursued. This revealed myocardial necrosis and fibrosis, and a mural thrombus with extensive eosinophils. The primary data was then revisited, which revealed history of peripheral eosinophilia that was intermittently suppressed by steroids given for COPD. Cardiac magnetic resonance imaging (MRI) demonstrated diffuse biventricular subendocardial late gadolinium enhancement and RV thrombi. Evaluation for underlying causes of eosinophilia was negative leading to the diagnosis of Loeffler’s endocarditis due to idiopathic hypereosinophilic syndrome. This case demonstrates: (1) the important role of cardiac MRI in the evaluation of both unexplained myocardial injury and new cardiomyopathy, (2) a rare case of Loeffler’s endocarditis requiring mechanical circulatory support, and (3) the consequences of both availability bias and failure to fully “unpack” the primary diagnostic data, which rendered the true etiology of the patient’s cardiogenic shock “hidden in plain sight.”
Abstract 14681: Comparative Study Between International Guidelines in Detecting Pediatric Familial Hypercholesterolemia Through a Unique Community Health System in Kagawa, Japan
Authors: Matsunaga Keiji , Mizobuchi Asako , Tada Hayato , Sasaki Tsuyoshi , Asano Yoshihiro , Ito Sigeru , Yokota Ichiro , Kunikata Jun , Iwase Takashi , Kawashiri Masa-aki , Kusaka Takashi , Minamino Tetsuo
Published: May 2021

Introduction:
Familial hypercholesterolemia (FH) is an autosomal hereditary disease found in patients who have elevated low-density lipoprotein cholesterol (LDL-C) from birth. Early detection and treatment of FH during childhood potentially reduces the risk of premature cardiovascular events. In Kagawa prefecture, a unique community health system, involving three steps, has been conducted to prevent lifestyle-related diseases for 10-year-old children. This system includes universal lipid screening, selection by pediatricians, and next-generation sequencing (NGS) of FH-related genes in hospitals. The aim of this study is to compare 3 international guidelines to detect pediatric FH with this unique community health system in Kagawa.

Methods:
In Kagawa prefecture, the universal lipid screening of approximately 8,000 children at 10 years of age is performed annually, covering over 90% of the target group. After excluding secondary hypercholesterolemia, pediatric clinics introduced children with LDL-C >140mg/dL to 4 designated hospitals to perform NGS. We applied the guidelines of the Dutch Lipid Clinic Network (DLCN), Simon Broome (SB), and the Japanese Atherosclerosis Society (JAS) to children who received NGS in the unique community health system in Kagawa.

Results:
We performed NGS for 46 children from January 2018 to February 2020 (LDL-C 186.0±50.3 mg/dL; Male/F 27/19) and 26 (57%) had FH genetic mutations (23 LDL-R and 3 PCSK9 mutations). Seventeen children met FH criteria for DLCN (35%), 10 for Simon Broome (22%), and 11 for JAS (24%), respectively. The combination of NGS and either of the 3 guidelines increased the number of children diagnosed as FH up to 31 (67%).

Conclusion:
International guidelines detected only half of pediatric FH who were diagnosed by the unique community health system in Kagawa. Further investigation will be required to build an effective universal screening system for pediatric FH.