bluuebunny/crossref_metadata_2025 huggingface dataset:
Construction of Artificial Intelligence Music Teaching Application Model Using Deep Learning
Authors: Chu Xiaoli
Published: July 2022

This paper investigates AI-based interactive music design and proposes a new music learning mode. It aids in the development of students’ inquiry skills and allows teachers to take the lead. At the same time, this paper systematically introduces the status of DL theory’s application in music teaching evaluation and uses DL theory to develop a mathematical model for an AI music teaching evaluation system. The construction method of an AI music teaching evaluation model based on DL is detailed in this paper. The model can assess the quality of AI music teaching after the network has been trained. The designed instructional quality evaluation NN is trained and measured in this paper to verify the model’s performance. The experimental results show that this model has a prediction accuracy of 94.79 percent, which is approximately 8.52 percent higher than the traditional methods. It has some practicality and feasibility, and it can serve as a useful benchmark for the development of various instructional quality evaluation systems.
Performance Development and Evaluation of Solar Air Collector with Novel Phase Change Material
Authors: Vedanarayanan V. , Srinivasan J. Dilli , Arulvendhan K. , Kumaran P. Thirusenthil , Selvakumar R. , Maridurai T. , Sudhakar M. , Al Obaid Sami , Alfarraj Saleh , Raj M. M. , Raghavan Ishwarya Komalnu
Published: July 2022

Experiments were carried out on an evacuated tube solar air collector connected to intrinsic thermal power storage to provide warm air unless solar radiation was available. As a phase change material, stearic acid was employed (PCM). Water has been used as a base fluid for converting sunlight into electricity gain to warm air, and the solar collector’s manifold was connected to the intrinsic thermal energy store. The most significant temperature variation between warm air and ecologic air was 38°C and 22°C, respectively, during direct and indirect solar radiation. A circular fin arrangement was used to achieve a flow rate of 0.020 kg s-1. The efficiency of minimum airflow rates (0.020 kg s-1) was 0.08–0.48 times that of maximum airflow rates (0.04 kg s-1). Because of the PCM’s better heat-storing capability, this system has a benefit over sensible storage systems in that it may be used after sunset.
Thyroid Dysfunction as a Predictive Indicator in Camrelizumab of Advanced Esophageal Squamous Cell Carcinoma
Authors: Chen Ying , Zhuang Lei , Zhang Danhong , Du Xianghui , Sheng Liming
Published: July 2022

Thyroid dysfunction (TD) induced by programmed death-1 (PD-1) or programmed cell death-ligand 1 (PD-L1) immune checkpoint inhibitors (ICIs) has been widely reported. However, the effects of ICI-induced TD on the survival of patients with esophageal squamous cell carcinoma (ESCC) have not been described. Herein, a retrospective study was conducted, which 82 patients with advanced metastatic or recurrent ESCC treated with camrelizumab were enrolled. Twenty patients (24.4%) experienced TD during camrelizumab treatment with or without chemotherapy. The median onset time of TD was 1.7 months. The incidence of TD was 35.6% in patients who previously received thoracic radiotherapy versus 10.8% in patients who did not (P =0.009). Patients with TD had significantly longer median progression-free survival (5.5 months vs 3.5 months, P =0.035) and overall survival (26.7 months vs 11.5 months, P <0.001). TD is frequently observed in ESCC patients treated with camrelizumab and especially in patients who received radiotherapy previously. ESCC patients with TD during ICIs treatment often have better prognosis.
Iris Ring Melanoma Presenting as Scleral Pigmentation
Authors: Zupan Matej , Lavrič Alenka , Pižem Jože , Andrejčič Katrina Novak
Published: July 2022

To report a patient with a very rare variant of iris melanoma that grows in the shape of a ring (ring melanoma). A 65-year-old patient was examined because of a pigmented lesion on the sclera. After a complete ophthalmic and ultrasound examination, a ring melanoma was diagnosed. Enucleation of the affected eye was performed, and histology report confirmed iris ring melanoma. This type of malignancy represents an exceedingly rare variant of uveal melanoma, and because of atypical clinical picture, it can be easily overlooked or misdiagnosed, which often delays adequate treatment. Gonioscopy, transillumination, and ultrasound help us to recognize and diagnose ring melanoma. Suspicion should be raised with a clinical picture that shows unilateral pigmentary glaucoma. The objective of this presentation is to describe and outline the challenging diagnosis and management of this rare disease entity.
A Novel Machine Learning Technique for Selecting Suitable Image Encryption Algorithms for IoT Applications
Authors: Shafique Arslan , Mehmood Abid , Alawida Moatsum , Khan Abdul Nasir , Khan Atta Ur Rehman
Published: July 2022

The Internet of Things connects billions of intelligent devices that can interact with one another without human intervention, and during communication, a large amount of data is exchanged between the devices. As a result, it is critical to secure digital data using an encryption technique that provides a suitable degree of security. Numerous existing encryption techniques do not offer sufficient security. Therefore, it is critical to figure out which encryption technique is most appropriate for a particular kind of data. When it comes to manually deciding which encryption technique to use, the process might take a long time. In this research, we present a novel technique for selecting Encryption Algorithms (EAs) based on a particular application using pattern recognition and machine learning techniques. To accomplish this goal, we also prepare a dataset. Several machine learning techniques, such as Support Vector Machines (SVMs), Linear Regression (LR),

K

-Nearest Neighbour (KNN), Naïve Bayes (NB), Decision Trees (DT), and Random Forests (RF), are evaluated. Based on the evaluation, the SVM has been chosen as the best option for the intended technique because its classification accuracy is 98.7%. The experimental results, including accuracy, precision, recall, and F1-score, are used to gauge the performance of the suggested technique. The proposed technique is also compared with the existing techniques to demonstrate its effectiveness.
Experimental Study on the Effect of Speed Strength Training on the Special Strikes of Chinese Female Boxers
Authors: Bu Xiangui
Published: July 2022

The aim of this study was to design a 12‐week intervention experiment with a speed strength training program and conventional training to test and analyze the effects of speed strength training on punching speed, punching power, and punching effectiveness of female boxers and to provide empirical support for the targeted improvement of special striking effectiveness of female boxers. By using the experimental method, a controlled experiment was conducted with 20 athletes from the Chinese women’s boxing team as the study subjects, and the targeted experimental intervention was conducted. Through experiment, speed power training had no significant effect on the improvement of basic movement ability of female boxers. In addition, speed power training could effectively improve the speed power level of athletes in the experimental group, and the speed power level of the control group was not significantly improved. Lastly, speed power training improved the punching effect of the experimental group, and the effect of the control group was not significant. Conclusion of this study includes the following: (1) speed strength training improved the speed strength level of the athletes, but it did not have a significant effect on improving basic movement ability. (2) The improvement of speed strength could improve the striking speed of female boxers, and the speed strength training also achieved good results. (3) The improvement of speed strength had a positive effect on the special striking power of female boxers. (4) Speed strength training improved the special striking effect of female boxers athletes’ special hitting effect.
[Retracted] Model of Markov‐Based Piano Note Recognition Algorithm and Piano Teaching Model Construction
Authors: Fu Teng
Published: July 2022

Piano note recognition is a process that converts music audio files into digital music files automatically, which is critical for piano assistant training and automatic recording of musical pieces. The Merle spectral coefficients, for example, have been used to implement the majority of the existing examples. The piano is one of the most popular forms of student education in today’s world. Piano teachers should be aware of the implications. We can only truly adapt piano teaching to the educational purposes of higher education institutions if we implement a systematic, progressive, practical, and innovative philosophy of piano teaching. The Markov model is a statistical model that is widely used in speech signal processing. This thesis develops a set of mathematical models for piano speech recognition based on the Markov model, learns them systematically and scientifically, and achieves a better teaching effect. It is demonstrated that the Markov method detects the corresponding endpoints with an accuracy of 72.83 percent, which is 16.42 percent better than the a priori method. In terms of amplitude and phase, the Markov model shows a significant improvement. The findings of this study can be used to improve piano playing techniques taught to students in accordance with their favourite popular music, depending on the theme.
Partial Molar Pregnancy Presenting as a Tubal Ectopic Pregnancy
Authors: Ayyash Mariam , Kole Monica , Le Quoc , Shen Yulei , Swain Monique
Published: July 2022

Background. Tubal molar pregnancy is extremely rare, with no more than 200 cases reported in the literature. The incidence is approximated at 1.5 per 1,000,000 pregnancies. Case. We report the case of a 22-year-old woman with an overall initial stable clinical presentation who was noted to have a ruptured ectopic pregnancy. She was surgically treated, and pathology revealed partial hydatidiform molar ectopic pregnancy. At the time of surgical intervention, the treating physicians had not considered molar ectopic pregnancy within the differential diagnosis, since this is a very rare presentation. Once the pathology was discovered, the patient was contacted to be scheduled for close follow-up and counseling to reduce progression to choriocarcinomas. Conclusion. This case report highlights the importance of sending, reviewing, and following up on pathologic specimens for all patients undergoing surgical intervention for presumed ectopic pregnancy and ensuring that appropriate follow-up is in place for those patients.
PCSK9 Modulates Macrophage Polarization-Mediated Ventricular Remodeling after Myocardial Infarction
Authors: Wang Feifei , Li Min , Zhang Aidong , Li Hairui , Jiang Can , Guo Jun
Published: July 2022

Background and Aims. An increasing number of high-risk patients with coronary heart disease (similar to acute myocardial infarction (AMI)) are using PCSK9 inhibitors. However, whether PCSK9 affects myocardial repair and the molecular mechanism of PCSK9 modulation of immune inflammation after AMI are not known. The present research investigated the role of PCSK9 in the immunomodulation of macrophages after AMI and provided evidence for the clinical application of PCSK9 inhibitors after AMI to improve cardiac repair. Methods and Results. Wild-type C57BL6/J (WT) and PCSK9-/- mouse hearts were subjected to left anterior descending (LAD) coronary artery occlusion to establish an AMI model. Correlation analysis showed that higher PCSK9 expression indicated worse cardiac function after AMI, and PCSK9 knockout reduced infarct size, improved cardiac function, and attenuated inflammatory cell infiltration compared to WT mice. Notably, the curative effects of PCSK9 inhibition were abolished after the systemic depletion of macrophages using clodronate liposomes. PCSK9 showed a regulatory effect on macrophage polarization in vivo and in vitro. Our studies also revealed that activation of the TLR4/MyD88/NF-κB axis was a possible mechanism of PCSK9 regulation of macrophage polarization. Conclusion. Our data suggested that PCSK9 modulated macrophage polarization-mediated ventricular remodeling after myocardial infarction.
In-Depth Research and Analysis of Multilabel Learning Algorithm
Authors: Li Daowang , Wang Canwei
Published: July 2022

Multilabel learning (MLL), as a hot topic in the field of machine learning, has attracted wide attention from many scholars due to its ability to express output space polysemy. In recent years, a large number of achievements about MLL have emerged. Among these achievements, there are several typical issues worthy of attention. Firstly, the correlation among labels plays a key role in improving MLL model training process. Many MLL algorithms try to fully and effectively use the correlation among labels to improve the performance. Secondly, existing MLL evaluation metrics, which is different from those in binary classification, often reflects the generalization performance of MLL classifiers in some aspects. How to choose metrics in algorithms to improve their generalization performance and fairness is another issue that should be concerned. Thirdly, in many practical MLL applications, there are many unlabeled instances due to their labeling cost in training datasets. How to use the wealth information contained in the correlation among unlabeled instances may contribute to reducing of the labeling cost in MLL and improving performance. Fourthly, labels assigned to instances may not be equally descriptive in many applications. How to describe the importance of each label in output space to an instance has become one of research points that many scholars have paid attention to in recent years. This paper reviews the MLL-related research results of correlation among labels, evaluation metric, multilabel semisupervised learning, and label distribution learning (LDL) from a theoretical and algorithmic perspective. Finally, the related research work on MLL is summarized and discussed.
Metabolomics-Based Pharmacodynamic Analysis of Zhuang Yao Shuang Lu Tong Nao Granules in a Rat Model of Ischemic Cerebral Infarction
Authors: Zhai Yang , Chen Yangling , Luo Yihui , Mei Xiaoping , Wu Lin , Mo Xueni , Zou Min , Zhou Mingzhao , Wu Yangling , Zheng Guangshan , Yang Peng , He Qingyu , Chen Rui
Published: July 2022

This study used a metabolomic approach to reveal changes in the levels of metabolic biomarkers and related metabolic pathways before and after Zhuang Yao Shuang Lu Tong Nao granule (YHT) treatment in rats with cerebral ischemia. The neurological deficit scores were significantly higher in the MCAO_R group than in the NC group, indicating that the mice had significantly impaired motor functions. The YHT group had significantly lower scores than the MCAO_R group, suggesting that YHT significantly improved motor function in rats. TTC staining of the brain tissue revealed that YHT significantly reduced the area of cerebral infarction in the treated rats. The MCAO_R group was better separated from the NC rent, sham, and YHT groups via metabolomic PCA. Moreover, there were significant differences in the differential metabolites between the MACO_R and YHT groups. Eighteen common differential metabolites were detected between the MACO_R and NC groups, MACO_R and sham groups, and MACO_R and YHT groups, indicating that YHT significantly increased the levels of various metabolites in the serum of cerebral ischemic stroke (CIS) rats. Moreover, a total of 23 metabolic pathways were obtained. We identified 11 metabolic pathways with the most significant effects in the bubble plots. In conclusion, from a systems biology perspective, this metabolomics-based study showed that YHT could be used to treat ischemic stroke by modulating changes in endogenous metabolites.
A Three-Stage Anomaly Detection Framework for Traffic Videos
Authors: Chen Junzhou , Wang Jiancheng , Pu Jiajun , Zhang Ronghui
Published: July 2022

As reported by the United Nations in 2021, road accidents cause 1.3 million deaths and 50 million injuries worldwide each year. Detecting traffic anomalies timely and taking immediate emergency response and rescue measures are essential to reduce casualties, economic losses, and traffic congestion. This paper proposed a three-stage method for video-based traffic anomaly detection. In the first stage, the ViVit network is employed as a feature extractor to capture the spatiotemporal features from the input video. In the second stage, the class and patch tokens are fed separately to the segment-level and video-level traffic anomaly detectors. In the third stage, we finished the construction of the entire composite traffic anomaly detection framework by fusing outputs of two traffic anomaly detectors above with different granularity. Experimental evaluation demonstrates that the proposed method outperforms the SOTA method with 2.07% AUC on the TAD testing overall set and 1.43% AUC on the TAD testing anomaly subset. This work provides a new reference for traffic anomaly detection research.
Identification of Alzheimer’s Disease Progression Stages Using Topological Measures of Resting-State Functional Connectivity Networks: A Comparative Study
Authors: Wu Zhanxiong , Wu Jinhui , Chen Xumin , Li Xun , Shen Jian , Hong Hui
Published: July 2022

Resting-state functional magnetic resonance imaging (rs-fMRI) has been widely employed to examine brain functional connectivity (FC) alterations in various neurological disorders. At present, various computational methods have been proposed to estimate connectivity strength between different brain regions, as the edge weight of FC networks. However, little is known about which model is more sensitive to Alzheimer’s disease (AD) progression. This study comparatively characterized topological properties of rs-FC networks constructed with Pearson correlation (PC), dynamic time warping (DTW), and group information guided independent component analysis (GIG-ICA), aimed at investigating the sensitivity and effectivity of these methods in differentiating AD stages. A total of 54 subjects from Alzheimer’s Disease Neuroimaging Initiative (ANDI) database, divided into healthy control (HC), mild cognition impairment (MCI), and AD groups, were included in this study. Network-level (global efficiency and characteristic path length) and nodal (clustering coefficient) metrics were used to capture groupwise difference across HC, MCI, and AD groups. The results showed that almost no significant differences were found according to global efficiency and characteristic path length. However, in terms of clustering coefficient, 52 brain parcels sensitive to AD progression were identified in rs-FC networks built with GIG-ICA, much more than PC (6 parcels) and DTW (3 parcels). This indicates that GIG-ICA is more sensitive to AD progression than PC and DTW. The findings also confirmed that the AD-linked FC alterations mostly appeared in temporal, cingulate, and angular areas, which might contribute to clinical diagnosis of AD. Overall, this study provides insights into the topological properties of rs-FC networks over AD progression, suggesting that FC strength estimation of FC networks cannot be neglected in AD-related graph analysis.
PAX2/Renal Coloboma Syndrome Expresses Extreme Intrafamilial Phenotypic Variability
Authors: Giovanella Silvia , Pasini Andrea , Ligabue Giulia , Testa Francesca , Mori Giacomo , Tagliafico Enrico , Magistroni Riccardo
Published: July 2022

Renal coloboma syndrome (RCS) is a disease characterized by kidney and ocular anomalies (kidney hypodysplasia and coloboma). RCS is caused, in half of the cases, by mutations in the paired box 2 (PAX2) gene, a critical organogenesis transcriptional factor. We report the case of a newborn with kidney hypodysplasia in a negative parental context where mother and father were phenotypically unaffected at the initial evaluation. The maternal family presented an important history of kidney disease with undefined diagnosis. Molecular characterization identified a PAX2 variant, classified as likely pathogenic. This variant segregates with the disease, and it was also found in the newborn, explaining his severe symptoms. It is noteworthy that the mother shows the same PAX2 variant, with an apparently negative kidney phenotype, displaying the possibility of an extreme variable expressivity of the disease. This feature suggests extreme caution in segregation analysis and family counseling of PAX2 pedigrees.
Multimodal Imaging of Vitelliform Lesions in Multiple Myeloma: A Case Report
Authors: Baltmr Abeir , Lotery Andrew
Published: July 2022

We report the case of a patient with multiple myeloma who presented acutely with bilateral vitelliform-like macular lesions. This 85-year-old Caucasian lady was referred for treatment of presumed bilateral neovascular age-related macular degeneration (nAMD). Interestingly, this was a few months after starting on chemotherapy for multiple myeloma. We performed a clinical examination and multimodal imaging. This comprised colour fundus photography, fundus autofluorescence, near-infrared fundus photography, spectral-domain optical coherence tomography, and optical coherence tomography angiography. These tests excluded nAMD and demonstrated instead vitelliform-like macular lesions. Subfoveal vitelliform-like macular lesions, believed to be subretinal deposition of immunoglobulin, are one of the retinal signs of multiple myeloma. This can present acutely mimicking nAMD. These retinal lesions can be a presenting manifestation of the disease or may present later on during the course of the disease. Therefore, acute presentation of vitelliform macular lesions in an elderly patient should arouse suspicion. Serum protein electrophoresis is recommended to detect multiple myeloma at an early stage.
Análise da exposição dos presidenciáveis do segundo turno das eleições de 2018 no Twitter
Authors: Torres Jéssica Vieira , Farias Luis Alberto de
Published: July 2022

O artigo busca analisar a exposição dos candidatos Jair Bolsonaro e Fernando Haddad no Twitter durante o segundo turno das eleições presidenciais brasileiras de 2018. Para tanto, por meio de análise de conteúdo das publicações de seus perfis oficiais, foram verificados os temas recorrentes, a interação gerada (curtidas, retweets e comentários) e o layout das publicações. A análise confirmou as hipóteses de que há características comuns entre as postagens de ambos os candidatos, de que as críticas ao oponente geram mais interações do que propostas/agenda política e de que os candidatos utilizam mais as redes sociais para se autopromover do que para expor seus planos.
Profissão youtuber: consequências sociais e precarização do trabalho em comunicação social
Authors: Sammur Jullie Tenório Ed Din , Cortez Pedro Afonso , Paganotti Ivan
Published: July 2022

O objetivo deste trabalho é realizar uma revisão crítica dos impactos do YouTube no potencial desempenho profissional em comunicação social nessa plataforma. Analisamos o conteúdo de 35 artigos sobre o assunto nas bases de dados Scielo e Web of Science. Os resultados evidenciam que o YouTube oferece um vasto campo de atuação não só para comunicadores licenciados, mas também para profissionais de outras áreas de atuação. Isso implica consequências socialmente complexas, que aumentam a disseminação da informação e afetam a atividade da comunicação social, com potencial precarização social do trabalho.
Thirty-Day and 90-Day Episode of Care Spending Following Heart Failure Hospitalization Among Medicare Beneficiaries
Authors: Reinhardt Samuel W. , Clark Katherine A.A. , Xin Xin , Parzynski Craig S. , Riello III Ralph J. , Sarocco Phil , Ahmad Tariq , Desai Nihar R.
Published: July 2022

BACKGROUND:

Despite growing interest in value-based models, utilization patterns and costs for heart failure (HF) admissions are not well understood. We sought to characterize Medicare spending for patients with HF for 30- and 90-day episodes of care (which include an index hospitalization and 30 or 90 days following discharge) and to describe the patterns of post-acute care spending.

METHODS:

Using Medicare fee-for-service administrative claims data from 2016 to 2018, we performed a retrospective analysis of patients discharged after hospitalization with primary discharge diagnoses of systolic HF, diastolic HF, hypertensive heart disease (HHD) with HF, and HHD with HF and chronic kidney disease. We analyzed coding patterns across these groups over time, median 30- and 90-day payments, and costs allocated to index hospitalization and postacute care.

RESULTS:

The study included 935 962 patients discharged following hospitalization for HF (systolic HF: 178 603; diastolic HF: 165 156; HHD with HF: 226 929; HHD with HF and chronic kidney disease: 365 274). The proportion of HHD codes increased from 26% of HF hospitalizations in 2016 to 91% in 2018. There was substantial spending on 30-day (median $13 330, interquartile range $9912–$22 489) and 90-day episodes (median $21 658, interquartile range $12 423–$37 630) for HF with significant variation, such that the third quartile of patients incurred costs 3 times the amount of the first quartile. Across all codes, the index hospitalization accounted for ≈70% of 30-day and 45% of 90-day spending. Sixty-one percent of postacute care spending occurred 31 to 90 days following discharge, with readmissions and observation stays (36%) and skilled nursing facilities (27%) comprising the largest categories.

CONCLUSIONS:

This patient episode-level analysis of contemporary Medicare beneficiaries is the first to examine 90-day spending, which will become an increasingly important pasyment benchmark with the expansion of the Medicare Bundled Payments for Care Improvement Program. Further investigation into the drivers of costs will be essential to provide high-value HF care.
Endovascular Treatment Versus Best Medical Management in Acute Basilar Artery Occlusion Strokes: Results From the ATTENTION Multicenter Registry
Authors: Tao Chunrong , Qureshi Adnan I. , Yin Yamei , Li Jie , Li Rui , Xu Pengfei , Sun Jun , Liao Geng , Yue Xincan , Shi Hongchao , Liu Yongchang , Ma Zhengfei , Zhang Jinhua , Xiao Guodong , Xu Bo , Xu Chenghua , Su Junfeng , Zhou Wensheng , Huang Shuchun , Yang Weimin , Chen Hongbing , Li Wei , Li Yongkun , Liu Dezhi , Yu Chuanqing , Yuan Guangxiong , Wang Chaobin , Liang Wenbao , Chen Chun , Shi Xueying , Wang Junjun , Wu Yingchun , Cai Xueli , Shen Chunyun , Li Kai , Fang Pu , Wang Ming , Chen Zhongjun , Li Tong , Cheng Guangsen , Sun Yaxuan , Wang Yan , Zhang Hui , Chen Jie , Xu Xiaohui , Wang Youmeng , Geng Wanjie , Ni Chuyuan , Chen Changchun , Liu Yan , Min Jie , Zhang Yongcheng , Liang Yong , Wen Chao , Baxter Blaise W. , Nogueira Raul G. , Hu Wei ,   on behalf of the ATTENTION (Endovascular Treatment for Acute Basilar Artery Occlusion) Trial Investigators
Published: July 2022

Background:

The authors compare the effectiveness and safety of endovascular treatment (EVT) versus best medical management (BMM) in strokes attributable to acute basilar artery occlusion (BAO).

Methods:

The present analysis was based on the ongoing, prospective, multicenter ATTENTION (Endovascular Treatment for Acute Basilar Artery Occlusion) trial registry in China. Our analytic sample comprised 2134 patients recruited at 48 sites between 2017 and 2021 and included 462 patients who received BMM and 1672 patients who received EVT. We performed an inversed probability of treatment weighting analysis. Qualifying patients had to present within 24 hours of estimated BAO. The primary clinical outcome was favorable functional outcome (modified Rankin Scale score, 0–3) at 90 days. We also performed a sensitivity analysis with the propensity score matching–based and the instrumental variable–based analysis.

Results:

In our primary analysis using the inversed probability of treatment weighting–based analysis, there was a significantly higher rate of favorable outcome at 90 days among EVT patients compared with BMM-treated patients (adjusted relative risk, 1.42 [95% CI, 1.19–1.65]; absolute risk difference, 11.8% [95% CI, 6.9–16.7]). The mortality was significantly lower (adjusted relative risk, 0.78 [95% CI, 0.69–0.88]; absolute risk difference, −10.3% [95% CI, −15.8 to −4.9]) in patients undergoing EVT. Results were generally consistent across the secondary end points. Similar associations were seen in the propensity score matching–based and instrumental variable–based analysis.

Conclusions:

In this real-world study, EVT was associated with significantly better functional outcomes and survival at 90 days. Well-designed randomized studies comparing EVT with BMM in the acute BAO are needed.

Registration:

URL:
www.chictr.org.cn
; Unique identifier: ChiCTR2000041117.
Association of Pulmonary Function With Late‐Life Cardiac Function and Heart Failure Risk: The ARIC Study
Authors: Ramalho Sergio H. R. , Claggett Brian L. , Washko George R. , Jose Estepar Raul San , Chang Patricia P. , Kitzman Dalane W. , Cipriano Junior Gerson , Solomon Scott D. , Skali Hicham , Shah Amil M.
Published: July 2022

Background

Pulmonary and cardiac functions decline with age, but the associations of pulmonary dysfunction with cardiac function and heart failure (HF) risk in late life is not known. We aimed to determine the associations of percent predicted forced vital capacity (ppFVC) and the ratio of forced expired volume in 1 second (FEV
1
) to forced vital capacity (FVC; FEV
1
/FVC) with cardiac function and incident HF with preserved or reduced ejection fraction in late life.

Methods and Results

Among 3854 HF‐free participants in the ARIC (Atherosclerosis Risk in Communities) cohort study who underwent echocardiography and spirometry at the fifth study visit (2011–2013), associations of FEV
1
/FVC and ppFVC with echocardiographic measures, cardiac biomarkers, and risk of HF, HF with preserved ejection fraction, and HF with reduced ejection fraction were assessed. Multivariable linear and Cox regression models adjusted for demographics, body mass index, coronary disease, atrial fibrillation, hypertension, and diabetes. Mean age was 75±5 years, 40% were men, 19% were Black, and 61% were ever smokers. Mean FEV
1
/FVC was 72±8%, and ppFVC was 98±17%. In adjusted analyses, lower FEV
1
/FVC and ppFVC were associated with higher NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide; both
P
<0.001) and pulmonary artery pressure (
P
<0.004). Lower ppFVC was also associated with higher left ventricular mass, left ventricular filling pressure, and high‐sensitivity C‐reactive protein (all
P
<0.01). Lower FEV
1
/FVC was associated with a trend toward higher risk of incident HF with preserved ejection fraction (hazard ratio [HR] per 10‐point decrease, 1.31; 95% CI, 0.98–1.74;
P
=0.07) and HF with reduced ejection fraction (HR per 10‐point decrease, 1.24; 95% CI, 0.91–1.70;
P
=0.18), but these associations did not reach statistical significance. Lower ppFVC was associated with incident HF with preserved ejection fraction (HR per 10‐unit decrease, 1.21; 95% CI, 1.04–1.41;
P
=0.013) but not with HF with reduced ejection fraction (HR per 10‐unit decrease, 0.90; 95% CI, 0.76–1.07;
P
=0.24).

Conclusions

Subclinical reductions in FEV
1
/FVC and ppFVC differentially associate with cardiac function and HF risk in late life.
Age‐Independent Cardiac Protection by Pharmacological Activation of Beclin‐1 During Endotoxemia and Its Association With Energy Metabolic Reprograming in Myocardium—A Targeted Metabolomics Study
Authors: Kim Matthew , Nikouee Azadeh , Zou Raymond , Ren Di , He Zhibin , Li Ji , Wang Lu , Djukovic Danijel , Raftery Daniel , Purcell Hayley , Promislow Daniel , Sun Yuxiao , Goodarzi Mohammad , Zhang Qing‐Jun , Liu Zhi‐Ping , Zang Qun Sophia
Published: July 2022

Background

We showed that Beclin‐1‐dependent autophagy protects the heart in young and adult mice that underwent endotoxemia. Herein, we compared the potential therapeutic effects of Beclin‐1 activating peptide, TB‐peptide, on endotoxemia‐induced cardiac outcomes in young adult and aged mice. We further evaluated lipopolysaccharide (lipopolysaccharide)‐induced and TB‐peptide treatment‐mediated alterations in myocardial metabolism.

Methods and Results

C57BL/6J mice that were 10 weeks and 24 months old were challenged by lipopolysaccharide using doses at which cardiac dysfunction occurred. Following the treatment of TB‐peptide or control vehicle, heart contractility, circulating cytokines, and myocardial autophagy were evaluated. We detected that TB‐peptide boosted autophagy, attenuated cytokines, and improved cardiac performance in both young and aged mice during endotoxemia. A targeted metabolomics assay was designed to detect a pool of 361 known metabolites, of which 156 were detected in at least 1 of the heart tissue samples. Lipopolysaccharide‐induced impairments were found in glucose and amino acid metabolisms in mice of all ages, and TB‐peptide ameliorated these alterations. However, lipid metabolites were upregulated in the young group but moderately downregulated in the aged by lipopolysaccharide, suggesting an age‐dependent response. TB‐peptide mitigated lipopolysaccharide‐mediated trend of lipids in the young mice but had little effect on the aged. (Study registration: Project DOI:
https://doi.org/10.21228/M8K11W
).

Conclusions

Pharmacological activation of Beclin‐1 by TB‐peptide is cardiac protective in both young and aged population during endotoxemia, suggest a therapeutic potential for sepsis‐induced cardiomyopathy. Metabolomics analysis suggests that an age‐independent protection by TB‐peptide is associated with reprograming of energy production via glucose and amino acid metabolisms.
Initiation of Dialysis Is Associated With Impaired Cardiovascular Functional Capacity
Authors: Arroyo Eliott , Umukoro Peter E. , Burney Heather N. , Li Yang , Li Xiaochun , Lane Kathleen A. , Sher S. Jawad , Lu Tzong‐shi , Moe Sharon M. , Moorthi Ranjani , Coggan Andrew R. , McGregor Gordon , Hiemstra Thomas F. , Zehnder Daniel , Lim Kenneth
Published: July 2022

Background

The transition to dialysis period carries a substantial increased cardiovascular risk in patients with chronic kidney disease. Despite this, alterations in cardiovascular functional capacity during this transition are largely unknown. The present study therefore sought to assess ventilatory exercise response measures in patients within 1 year of initiating dialysis.

Methods and Results

We conducted a cross‐sectional study of 241 patients with chronic kidney disease stage 5 from the CAPER (Cardiopulmonary Exercise Testing in Renal Failure) study and from the intradialytic low‐frequency electrical muscle stimulation pilot randomized controlled trial cohorts. Patients underwent cardiopulmonary exercise testing and echocardiography. Of the 241 patients (age, 48.9 [15.0] years; 154 [63.9%] men), 42 were predialytic (mean estimated glomerular filtration rate, 14 mL·min
−1
·1.73 m
−2
), 54 had a dialysis vintage ≤12 months, and 145 had a dialysis vintage >12 months. Dialysis vintage ≤12 months exhibited a significantly impaired cardiovascular functional capacity, as assessed by oxygen uptake at peak exercise (18.7 [5.8] mL·min
−1
·kg
−1
) compared with predialysis (22.7 [5.2] mL·min
−1
·kg
−1
;
P
<0.001). Dialysis vintage ≤12 months also exhibited reduced peak workload, impaired peak heart rate, reduced circulatory power, and increased left ventricular mass index (
P
<0.05 for all) compared with predialysis. After excluding those with prior kidney transplant, dialysis vintage >12 months exhibited a lower oxygen uptake at peak exercise (17.0 [4.9] mL·min
−1
·kg
−1
) compared with dialysis vintage ≤12 months (18.9 [5.9] mL·min
−1
·kg
−1
;
P
=0.033).

Conclusions

Initiating dialysis is associated with a significant impairment in oxygen uptake at peak exercise and overall decrements in ventilatory and hemodynamic exercise responses that predispose patients to functional dependence. The magnitude of these changes is comparable to the differences between low‐risk New York Heart Association class I and higher‐risk New York Heart Association class II to IV heart failure.
Effect of Incorporating 1 Avocado Per Day Versus Habitual Diet on Visceral Adiposity: A Randomized Trial
Authors: Lichtenstein Alice H. , Kris‐Etherton Penny M. , Petersen Kristina S. , Matthan Nirupa R. , Barnes Samuel , Vitolins Mara Z. , Li Zhaoping , Sabaté Joan , Rajaram Sujatha , Chowdhury Shilpy , Davis Kristin M. , Galluccio Jean , Gilhooly Cheryl H. , Legro Richard S. , Li Jason , Lovato Laura , Perdue Letitia H. , Petty Gayle , Rasmussen Anna M. , Segovia‐Siapco Gina , Sirirat Rawiwan , Sun April , Reboussin David M.
Published: July 2022

Background

Excess visceral adiposity is associated with increased risk of cardiometabolic disorders. Short‐term well‐controlled clinical trials suggest that regular avocado consumption favorably affects body weight, visceral adiposity, and satiety.

Methods and Results

The HAT Trial (Habitual Diet and Avocado Trial) was a multicenter, randomized, controlled parallel‐arm trial designed to test whether consuming 1 large avocado per day for 6 months in a diverse group of free‐living individuals (N=1008) with an elevated waist circumference compared with a habitual diet would decrease visceral adiposity as measured by magnetic resonance imaging. Secondary and additional end points related to risk factors associated with cardiometabolic disorders were assessed. The primary outcome, change in visceral adipose tissue volume during the intervention period, was not significantly different between the Avocado Supplemented and Habitual Diet Groups (estimated mean difference (0.017 L [−0.024 L, 0.058 L],
P
=0.405). No significant group differences were observed for the secondary outcomes of hepatic fat fraction, hsCRP (high‐sensitivity C‐reactive protein), and components of the metabolic syndrome. Of the additional outcome measures, modest but nominally significant reductions in total and low‐density lipoprotein cholesterol were observed in the Avocado Supplemented compared with the Habitual Diet Group. Changes in the other additional and post hoc measures (body weight, body mass index, insulin, very low‐density lipoprotein concentrations, and total cholesterol:high‐density lipoprotein cholesterol ratio) were similar between the 2 groups.

Conclusions

Addition of 1 avocado per day to the habitual diet for 6 months in free‐living individuals with elevated waist circumference did not reduce visceral adipose tissue volume and had minimal effect on risk factors associated with cardiometabolic disorders.

Registration

URL:
https://clinicaltrials.gov
; Unique identifier: NCT03528031.
Direct to Angio‐Suite Large Vessel Occlusion Stroke Transfers Achieve Faster Arrival‐to‐Puncture Times and Improved Outcomes
Authors: Regenhardt Robert W. , Rosenthal Joseph A. , Dmytriw Adam A. , Vranic Justin E. , Bonkhoff Anna K. , Bretzner Martin , Hirsch Joshua A. , Rabinov James D. , Stapleton Christopher J. , Patel Aman B. , Singhal Aneesh B. , Rost Natalia S. , Leslie‐Mazwi Thabele M. , Etherton Mark R.
Published: July 2022

Background

For patients with large vessel occlusion (LVO) stroke, time to treatment with endovascular thrombectomy is crucial to prevent infarction and improve outcomes. We sought to evaluate the hub arrival‐to‐puncture times and outcomes for transferred patients accepted directly to the angio‐suite (LVO to operating room, LVO2OR) versus those accepted through the emergency department in a hub‐and‐spoke telestroke network.

Methods

Consecutive patients transferred for endovascular thrombectomy with spoke computed tomography angiography–confirmed LVO, spoke Alberta Stroke Program Early Computed Tomography score >6, and last known well–to–hub arrival <6 hours were identified. Our LVO2OR protocol began implementation in January 2017. The LVO2OR cohort includes patients who underwent endovascular thrombectomy from July 2017 to October 2020; the emergency department cohort includes those from January 2011 to December 2016. Hub arrival‐to‐puncture time and 90‐day modified Rankin scale score were prospectively recorded.

Results

The LVO2OR cohort was composed of 91 patients, and the emergency department cohort was composed of 90 patients. LVO2OR patients had more atrial fibrillation (51% versus 32%;
P
=0.02) and more M2 occlusions (27% versus 10%;
P
=0.01). LVO2OR patients had faster median hub arrival‐to‐puncture time (11 versus 92 minutes;
P
<0.001), faster median telestroke consult‐to‐puncture time (2.4 versus 3.6 hours;
P
<0.001), greater Thrombolysis in Cerebral Infarction score 2b to 3 reperfusion (92% versus 69%;
P
<0.001), and greater 90‐day modified Rankin scale score <2 (35% versus 21%;
P
=0.04). In a multivariable model, LVO2OR significantly increased the odds of 90‐day modified Rankin scale score <2 (adjusted odds ratio, 2.77 [95% CI, 1.07–7.20];
P
=0.04) even when controlling for age, baseline modified Rankin scale score, atrial fibrillation, National Institutes of Health Stroke Scale score, M2 occlusion location, and Thrombolysis in Cerebral Infarction score 2b to 3.

Conclusions

In a hub‐and‐spoke telestroke network, accepting transferred patients directly to the angio‐suite was associated with dramatically reduced hub arrival‐to‐puncture time and may lead to improved 90‐day outcomes. Direct–to–angio‐suite protocols should continue to be evaluated in other geographic regions and telestroke network models.
Delirium Leads to Poor In‐Hospital and 90‐Day Outcomes Among Patients With Acute Ischemic Stroke With and Without Intravenous Thrombolysis or Intraarterial Therapy
Authors: Pan Alan P. , Agarwal Kathryn , Taffet George E. , Jones Stephen L. , Potter Thomas , Bako Abdulaziz , Tannous Jonika , McCane Charles D. , Ahmed Wamda O. , Garg Tanu , Gadhia Rajan , Misra Vivek , Volpi John , Chiu David , Vahidy Farhaan S.
Published: July 2022

Background

Delirium experienced poststroke is known to be associated with poor prognosis; however, the outcomes and functional consequences among patients with acute ischemic stroke (AIS) undergoing intravenous thrombolysis (intravenous tissue plasminogen activator) or intraarterial therapy are not well characterized.

Methods

Using data from 7 stroke centers with standardized delirium screening protocols, delirium was determined by a positive modified “Arousal, Attention, Abbreviated Mental‐Test, Acute Change Test” or Confusion Assessment Method for the Intensive Care Unit screen including diagnosis codes. Multivariable models were fit to estimate likelihoods of in‐hospital mortality, unfavorable discharge disposition, and longer length of stay among delirious patients with AIS, reported as adjusted odds ratios (aORs), adjusted incident rate ratios, and 95% CIs. A subset of patients with AIS with 90‐day modified Rankin scale (mRS) including those receiving intravenous tissue plasminogen activator or intraarterial therapy were analyzed for shifts in mRS scores associated with delirium, via ordinal logistic regression models.

Results

Between May 2016 and June 2021, AIS was the primary diagnosis in 12 409 hospitalization encounters representing 10 874 unique patients. Delirium was documented in 41.6% of AIS encounters, compared with 26.5% of age and mild cognitive impairment– or dementia‐matched non‐AIS encounters. Delirious (versus nondelirious) patients with AIS were older (median: 75 years versus 65 years), more frequently women (53.3% versus 48.7%), with a higher comorbidity burden (median Charlson Comorbidity Index: 7 versus 5). Delirious patients with AIS had higher odds of in‐hospital mortality (aOR, 2.66; [95% CI, 1.62–4.49]), unfavorable discharge disposition (aOR, 3.68; [95% CI, 3.15–4.30]), and longer length of stay (adjusted incidence rate ratio, 1.67; CI, 1.61–1.73). In the cohort of 2784 patients with treated and untreated AIS with 90‐day mRS, adjusted models indicated lower mRS (aOR, 0.54; CI, 0.46–0.63) associated with treatment, and higher mRS for delirious patients with AIS (aOR, 3.09; CI, 2.58–3.71). Among the subcohort of 948 patients with treated AIS, delirium remained significantly associated with higher mRS (aOR, 2.82; CI, 2.08–3.83).

Conclusion

Delirium is common among patients with AIS including those receiving intravenous tissue plasminogen activator or undergoing intraarterial therapy and prognosticates poor in‐hospital and 90‐day outcomes. Active screening and management of delirium may lead to improved stroke outcomes.
The Role of the Eagala Model in Promoting Psychological Wellbeing in Adolescents: A Mixed-Methods Approach
Authors: Coetzee Nicoleen , Boyce Sharon , Masenge Andries
Published: July 2022

The aim of the study was to determine if the Eagala model, an equine-assisted intervention, would enhance the psychological wellbeing of adolescents living in a township in South Africa. An embedded mixed-methods research design with convenience sampling was used. Participants were randomly assigned to an experimental or control group. The experimental group participated in the Eagala intervention. The Ryff Scale of Psychological Wellbeing (RSPWB) was used to collect quantitative data while letters to the horses were used as qualitative data. Independent t-tests indicated significant differences between the two groups on the overall score of the RSPWB and five of its dimensions. Using thematic analysis, qualitative themes that enhanced understanding of the quantitative findings were identified. The results confirmed the effectiveness of the Eagala intervention. A Kruskal-Wallis test, however, indicated that between four to eight sessions need to be attended in order for the intervention to be effective.
Expanding the Bounds of Christianity and Feminism
Authors: Hughes Rebecca C.
Published: July 2022

As headmistress of the London Missionary Society’s Girls’ Boarding School from 1915–1940 in Mbereshi, Zambia, Mabel Shaw (1889–1973) created an innovative educational programme that embraced local culture and empowered women. Shaw drew from theological, anthropological, and feminist perspectives to guide her understanding of Bemba culture. Shaw built upon fulfilment theology with its premise that all religions had an element of God’s truth in them. In doing so, Shaw differentiated Western culture from Christian culture, creating space to accommodate practices such as ancestor veneration and polygamy. While scholars have been reluctant to label Shaw as a feminist, this author argues she must be recognized as one. Shaw actively collaborated with Bemba women and raised them as Christian saints. Moreover, Shaw was unique in that she urged her British audiences to listen to African voices and to consider the value of adopting aspects of African worship.
Precolonial Beliefs in God, Nzambi, and Chthonic Beings: Evidence from Kongo Texts
Authors: MacGaffey Wyatt
Published: July 2022

Manuscripts in their own language by indigenous ethnographers at the beginning of the colonial period, not hitherto examined in detail, give unique insight into precolonial beliefs in the Kikongo-speaking region of what was then Belgian Congo, and the transition to Christianity. That transition depended in large part on translation, giving new meanings to old words. The texts suggest that Nzambi, now the Kongo name for the Christian God, was originally a personification of death. The power of life, on the other hand, was credited to bisimbi, chthonic forces that are simultaneously both material and immaterial. Although scholars have generally overlooked this issue, belief in these forces is foundational to what has usually been called traditional religion and its rituals, most of them now extinct. This Kongo configuration exemplifies, on a small scale, one that is found generally in West and Central Africa.