bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of estimated busses arrival time on public transportation using real-time monitoring
Authors: Yuniar R N , Kencan P A , Ruth E , Budi A H S
Published: May 2020

The purpose of this study is to create a system that can inform the bus position and provide information about the arrival time of the bus. We propose real time monitoring of the position and estimated time of arrival of Damri buses using the Haversine formula. GPS devices that are applied to each bus are monitored by utilizing passengers’ cellular applications. The results show information about the position of the bus and estimated time of arrival of the bus at each stop. This research can help estimate the arrival time, especially in providing information about the certainty of bus arrival to prospective passengers who are waiting at each stop according to the bus destination.
A non-empirical lattice-relaxation estimation of TM3+doped α-Al2O3
Authors: Novita M , Nuvitalia D , Cholifah N , Ogasawara K
Published: May 2020

We investigated the effect of lattice relaxation in the trivalent transition metal ions doped α-Al2O3crystal (α-Al2O3: TM3+). The transition metal ions are Sc3+, Ti3+, V3+, Cr3+, Mn3+, Fe3+, and Co3+. The lattice relaxation effect was considered by comparing two different methods such as Shannon’s crystal radii methods and Cambridge Serial Total Energy Package (CASTEP) methods. In the Shannon’s crystal radii methods, the lattice relaxation effect was estimated as the ratio of the crystal radii of the substituted ion and the replaced ion. On the other hand, in the CASTEP method, the lattice relaxation effect was estimated by geometry optimization. The detail results show that in the case of Shannon’s crystal radii method, the lattice relaxation ratio was ca. 111.0 - 100.5%. Whereas in the case of CASTEP method, the lattice relaxation ratio was ca. 107.8 - 102.1%. However, the lattice relaxation ratio of α-Al2O3: Sc3+, Ti3+, V3+, Cr3+, Mn3+, Fe3+, and Co3+is unique depends on the ion type.
An affordable mobile robot soccer (ReROSO): A student’s project of robotics trainer for sophomore
Authors: Renaldy M , Wahyudin D
Published: May 2020

Nowadays, the education system in Indonesia as an emerging country is on the advanced stage. There are many private high schools include the robotics system in their extra curriculum. However, robotics is a complex system. Therefore, it is difficult to do so for the nonengineering school’s students. Hence, developing a robotics kit to assist students on how to learn robotic system will give some benefits. This paper presents the final project of a student of Electrical Engineering Education, that is an affordable robot trainer for learning robotics system in HS. It has features that learners have the flexibility to modify, and easy to program as well as to operate. The testing of ReROSO gave the evidence that event though it was constructed using a low-cost of robotics part. The result also proves that the design of ReROSO is adequate to teach robotics for the sophomore.
Automatic farmer pest repellent with Arduino ATmega2560 based on sound displacement technique
Authors: Ningsih S R , Budi A H S , Nugraha A T , Winata T
Published: May 2020

Increasing pest population is the main cause of reduced crop yields and causes farmers to suffer heavy losses. The purpose of this study is to realize a tool that can help repel bird and mouse pests automatically. The prototype of this tool is controlled using the Arduino ATmega 2560 which will regulate the performance of sensors and servo motors as a mechanical system that pulls bells producing sound to repel birds and controls the buzzer to repel rice field pests. This tool works if the ultrasonic sensor or PIR sensor detects the presence of pests. The power source used is in the form of an accumulator with an output voltage of 12 volts, a servo motor as a motor driver for bells, and a buzzer to repel bird and mouse pests. The testing process carried out on this prototype shows that overall this tool can perform its functions properly.
Green Chemistry principle: Ionic Liquids as a material teaching for vocational students
Authors: Yulianti I , Hamidah I , Komaro M
Published: May 2020

The development of human civilization is characterized by the type of material used by society. The rapid development of material engineering and technology produces a variety of advanced materials such as smart materials, natural materials, chemical materials, nanomaterials, advanced materials, and environmentally friendly materials. Ionic Liquids (ILs) have criteria that are expected to be environmentally friendly because of their Green Chemistry (GC). The vocational syllabus needs to be reconstructed to be able to adapt this material technological progress. The purpose of this study was to determine the opinions of lecturers on the adoption of Ionic Liquid material teaching materials in vocational education in an effort to deal with the use of environmentally friendly materials that are indispensable in the industrial field. The subject of the study was taken through a purposive sampling method. There were 5 lecturers in one of the private polytechnics. Data collection through questionnaires is intended to determine the views of lecturers on ionic fluid material teaching materials and analyze the material requirements to be adopted into the vocational curriculum. The investigation results show that the interest and willingness of the lecturer to study and disseminate reached a score of 80%, this means that the lecturer needed the Ionic Liquid material. However, the teacher’s understanding score still needs to be improved, so that it is necessary to design an Ionic Liquid teaching material that is interesting and easy to understand by both lecturers and students. The implications of this study can be used as recommendations in learning to be able to enrich the syllabus by adding Ionic Liquid material teaching material as an indispensable teaching material along with technological advances in industry 4.0.
An increase in crashworthiness capability using pyramid arrangement of the crush initiator
Authors: Dionisius F , Rohmat Y N , Yusuf M M , Suliono S , Haris E , Endramawan T
Published: May 2020

Collisions on vehicles could cause injury to passengers such as being thrown from a passenger room. To prevent this, a vehicle structure was not too strong which called by crashworthiness criteria through maximum impact force. This study was conducted to determine the smallest structural strength through maximum impact force in a square column with 0.8 mm in thickness. The column was given holes with 3 mm in diameter as crush initiators. The hole was arranged in pyramid pattern with different level and begun with 1 hole in the square column. The research used the quasi-static concept experimentally with 30 mm/min in movement speed of actuator. The machine used Universal Testing Machine (UTM) with 200 kN in capacities. The result showed that the pyramid arrangement with the highest level had the greatest maximum impact force 22.124 kN. Comparison of differences between the highest levels with the lowest levels reached 4.86%. While the difference between the highest level with a square column with 1 hole was 14.24%. So that the more holes arranged in a pyramid would reduce the maximum impact force during a collision.
Bit Error Rate performance analysis for Free Space Optic communication
Authors: Basudewa M I , Bagaskara Z H , Damita S S A , Putra R F , Ahmadi D
Published: May 2020

This paper discusses the comparison of 4 modulation in Free Space Optic communication namely; Pulse Position Modulation (PPM), Pulse Amplitude Modulation (PAM), and On Off Keying Modulation (OOK). By Utilizing a light source with a length of 1550 nm, a simulation measured by Bit Error-Rate using Signal-to-Noise Ratio (SNR) in several distance. In this research, researchers used a quantitative approach by MATLAB simulation and using correlational studies to compare BER, SNR, distance and visibility. The results show that PPM is the most effective modulation in comparison with others.
Design and realization of multi-section sum and diff 8 ways Wilkinson Power Divider at S-Band frequency for 3 dimensional radar application
Authors: Herfiah S , Hariyadi T , Pantjawati A B
Published: May 2020

The Wilkinson Power Divider (WPD) is one of the most common components used in array antenna feeding networks. It is lossless if the output ports are matched, reciprocal, and largely isolated. Many designs and modifications such as multi-section, open circuited stubs, or tapered transmission were proposed to increase the bandwidth of the conventional WPD. In this paper, we will discuss the design of multi-section sum and diff Wilkinson Power Divider for 3-dimensional radar application using CST Studio Suite 2018. The WPD operates at S-Band Frequency, realized in microstrip using substrate Rogers R0-4003C (lossy) with thickness 1.524 mm and relative permittivity 3.55. The simulation and measurement results are met the desired specification, which are less than -20 dB return loss, more than -10 dB insertion loss, less than - 20 dB port isolation, and 180º phase difference.
Design of microstrip antenna C-band frequency for ground surveillance radar
Authors: Salazar H Y , Hariyadi T , Pantjawati A B
Published: May 2020

This paper presents designing of a conformal antenna using a number of microstrip patches in C band frequency range 4 GHz to 8 GHz. The type of microstrip C-band antenna was chosen because it is suitable for use on portable surveillance radar systems. Single element patches antenna with a carved slit is used to obtain a horizontal polarization. In this paper, an microstrip patch antenna C-band frequency for 3-dimensional radar application was designed using CST Studio Suite 2018. The antenna operates at frequency 5.6 GHz, with 40.55 x 22.65 mm dimension using substrate Rogers RO-4350B (lossy) with thickness 1. 524 mm and relative permittivity 3.66. The bandwidth obtained from the simulation is 200 MHz, the return loss values below -20 dB, VSWR less than 2, 5.6 dB gain, and has directional radiation pattern.
Perceived Gender Match and Accepting Alcohol Offers From Peers in Emerging Adulthood
Authors: MacCalman Michelle , Harper Leia A , Anderson Kristen G
Published: May 2020

Aims

Emerging adulthood (ages 18–25) has been associated with elevated alcohol use, yet little is known regarding gender identity and drinking contexts in this population. Our goals were to examine the effects of perceived gender match on alcohol use decision-making in social settings among emerging adults.

Methods

Participants (N = 135; 64% white, 11 transgender) completed measures of alcohol consumption, alcohol expectancies and motives, and the Collegiate-Simulated Intoxication Digital Elicitation using an established Internet panel. We conducted a series of univariate analyses to examine the relation between perceived gender match and behavioral willingness (BW) to accept alcohol in a social context.

Results

Participants identifying as men were significantly more likely to accept offers of alcohol when compared with women. While men and women did not differ in terms of BW when participants perceived a gender-matched actor making the offer, when there was a gender mismatch, women had significantly lower BW when compared with men. Though transgender participants were more likely to endorse hazardous drinking behaviors, there were no observable effects of transgender identity on BW.

Conclusion

In this sample, we found that men have a higher BW for alcohol than women and that trans identified persons are at increased risk for alcohol misuse. These findings support the need for more research examining the effect of gender identity on patterns of alcohol use and decision-making in mixed-gender contexts for emerging adults.
What Protects Those at High Risk from Criminal Justice Contact Despite the Odds? A Negative Case Analysis
Authors: Doherty Elaine Eggleston , Bersani Bianca E
Published: May 2020

Criminal justice contact is a prevalent, if not expected, life event for many high-risk individuals with deleterious consequences; yet, many individuals at high risk are able to avoid this contact (i.e. negative cases exist). In this study, we draw on the life course framework and utilize negative case analysis to (1) estimate the prevalence of criminal justice avoidance within a sample of structurally high-risk Black men and (2) explore the individual, familial and contextual factors in childhood and adolescence that distinguish these negative cases. One’s own ‘on-time’ and one’s siblings’ education emerge as particularly strong protective factors suggesting that the presence of unique protection, as opposed to the absence of risk, may be most salient. Theoretical implications are discussed.
Excess Lipin enzyme activity contributes to TOR1A recessive disease and DYT-TOR1A dystonia
Authors: Cascalho Ana , Foroozandeh Joyce , Hennebel Lise , Swerts Jef , Klein Christine , Rous Stef , Dominguez Gonzalez Beatriz , Pisani Antonio , Meringolo Maria , Gallego Sandra F , Verstreken Patrik , Seibler Philip , Goodchild Rose E
Published: May 2020

TOR1A/TorsinA mutations cause two incurable diseases: a recessive congenital syndrome that can be lethal, and a dominantly-inherited childhood-onset dystonia (DYT-TOR1A). TorsinA has been linked to phosphatidic acid lipid metabolism in Drosophila melanogaster. Here we evaluate the role of phosphatidic acid phosphatase (PAP) enzymes in TOR1A diseases using induced pluripotent stem cell-derived neurons from patients, and mouse models of recessive Tor1a disease. We find that Lipin PAP enzyme activity is abnormally elevated in human DYT-TOR1A dystonia patient cells and in the brains of four different Tor1a mouse models. Its severity also correlated with the dosage of Tor1a/TOR1A mutation. We assessed the role of excess Lipin activity in the neurological dysfunction of Tor1a disease mouse models by interbreeding these with Lpin1 knock-out mice. Genetic reduction of Lpin1 improved the survival of recessive Tor1a disease-model mice, alongside suppressing neurodegeneration, motor dysfunction, and nuclear membrane pathology. These data establish that TOR1A disease mutations cause abnormal phosphatidic acid metabolism, and suggest that approaches that suppress Lipin PAP enzyme activity could be therapeutically useful for TOR1A diseases.
Large-Scale Structural Covariance Networks Predict Age in Middle-to-Late Adulthood: A Novel Brain Aging Biomarker
Authors: Kuo Chen-Yuan , Lee Pei-Lin , Hung Sheng-Che , Liu Li-Kuo , Lee Wei-Ju , Chung Chih-Ping , Yang Albert C , Tsai Shih-Jen , Wang Pei-Ning , Chen Liang-Kung , Chou Kun-Hsien , Lin Ching-Po
Published: May 2020

The aging process is accompanied by changes in the brain’s cortex at many levels. There is growing interest in summarizing these complex brain-aging profiles into a single, quantitative index that could serve as a biomarker both for characterizing individual brain health and for identifying neurodegenerative and neuropsychiatric diseases. Using a large-scale structural covariance network (SCN)-based framework with machine learning algorithms, we demonstrate this framework’s ability to predict individual brain age in a large sample of middle-to-late age adults, and highlight its clinical specificity for several disease populations from a network perspective. A proposed estimator with 40 SCNs could predict individual brain age, balancing between model complexity and prediction accuracy. Notably, we found that the most significant SCN for predicting brain age included the caudate nucleus, putamen, hippocampus, amygdala, and cerebellar regions. Furthermore, our data indicate a larger brain age disparity in patients with schizophrenia and Alzheimer’s disease than in healthy controls, while this metric did not differ significantly in patients with major depressive disorder. These findings provide empirical evidence supporting the estimation of brain age from a brain network perspective, and demonstrate the clinical feasibility of evaluating neurological diseases hypothesized to be associated with accelerated brain aging.
Aminoglycosides and Capreomycin in the Treatment of Multidrug-resistant Tuberculosis: Individual Patient Data Meta-analysis of 12 030 Patients From 25 Countries, 2009–2016
Authors: Cegielski J Peter , Chan Pei-Chun , Lan Zhiyi , Udwadia Zarir F , Viiklepp Piret , Yim Jae-Joon , Menzies Dick
Published: May 2020

Background

As new drugs are developed for multidrug-resistant tuberculosis (MDR-TB), the role of currently used drugs must be reevaluated.

Methods

We combined individual-level data on patients with pulmonary MDR-TB published during 2009–2016 from 25 countries. We compared patients receiving each of the injectable drugs and those receiving no injectable drugs. Analyses were based on patients whose isolates were susceptible to the drug they received. Using random-effects logistic regression with propensity score matching, we estimated the effect of each agent in terms of standardized treatment outcomes.

Results

More patients received kanamycin (n = 4330) and capreomycin (n = 2401) than amikacin (n = 2275) or streptomycin (n = 1554), opposite to their apparent effectiveness. Compared with kanamycin, amikacin was associated with 6 more cures per 100 patients (95% confidence interval [CI], 4–8), while streptomycin was associated with 7 (95% CI, 5–8) more cures and 5 (95% CI, 4–7) fewer deaths per 100 patients. Compared with capreomycin, amikacin was associated with 9 (95% CI, 6–11) more cures and 5 (95% CI, 2–8) fewer deaths per 100 patients, while streptomycin was associated with 10 (95% CI, 8–13) more cures and 10 (95% CI, 7–12) fewer deaths per 100 patients treated. In contrast to amikacin and streptomycin, patients treated with kanamycin or capreomycin did not fare better than patients treated with no injectable drugs.

Conclusions

When aminoglycosides are used to treat MDR-TB and drug susceptibility test results support their use, streptomycin and amikacin, not kanamycin or capreomycin, are the drugs of choice.
Respiratory Syncytial Virus (RSV) Neutralizing Antibodies at Birth Predict Protection from RSV Illness in Infants in the First 3 Months of Life
Authors: Buchwald Andrea G , Graham Barney S , Traore Awa , Haidara Fadima Cheick , Chen Man , Morabito Kaitlyn , Lin Bob C , Sow Samba O , Levine Myron M , Pasetti Marcela F , Tapia Milagritos D
Published: May 2020

Background

Respiratory syncytial virus (RSV) is a leading cause of viral pneumonia and bronchiolitis during the first 6 months of life. Placentally transferred antibodies can prevent severe RSV illness, and maternal immunization may reduce illness in young infants. Identification of protective antibody levels facilitates the advancement of vaccine candidates and maternal immunization.

Methods

We conducted a nested case-control study with 587 Malian mother–infant pairs, followed from birth to age 6 months. RSV cases were infants who developed influenza-like illness (ILI) or pneumonia and were RSV-positive by polymerase chain reaction. Cases were matched to healthy controls and RSV-negative ILI controls. RSV-A and RSV-B neutralizing antibodies were measured in maternal, cord blood, and infant sera at age 3 and 6 months.

Results

Maternal antibodies were efficiently transferred to infants. Maternal and infant RSV titers were strongly correlated. Infant antibody titers against RSV-A were 3 times higher than those against RSV-B. At birth, infants who remained healthy had significantly higher RSV-A and RSV-B titers compared with infants who subsequently contracted RSV. RSV-A inhibitory concentration (IC)80 titer >239 or RSV-B titer >60 at birth was significantly associated with being a healthy control compared with an RSV case within the first 3 months of life. RSV-A IC80 titers in cord blood were associated with decreased episodes of pneumonia.

Conclusions

Maternally acquired RSV antibodies were associated with protection of infants against community-detected cases of RSV-ILI and pneumonia. RSV titers in cord blood can predict whether an infant will be infected with RSV or remain uninfected.
The Penicillin Allergy Delabeling Program: A Multicenter Whole-of-Hospital Health Services Intervention and Comparative Effectiveness Study
Authors: Chua Kyra Y L , Vogrin Sara , Bury Susan , Douglas Abby , Holmes Natasha E , Tan Nixon , Brusco Natasha K , Hall Rebecca , Lambros Belinda , Lean Jacinta , Stevenson Wendy , Devchand Misha , Garrett Kent , Thursky Karin , Grayson M Lindsay , Slavin Monica A , Phillips Elizabeth J , Trubiano Jason A
Published: May 2020

Background

Penicillin allergies are associated with inferior patient and antimicrobial stewardship outcomes. We implemented a whole-of-hospital program to assess the efficacy of inpatient delabeling for low-risk penicillin allergies in hospitalized inpatients.

Methods

Patients ≥ 18 years of age with a low-risk penicillin allergy were offered a single-dose oral penicillin challenge or direct label removal based on history (direct delabeling). The primary endpoint was the proportion of patients delabeled. Key secondary endpoints were antibiotic utilization pre- (index admission) and post-delabeling (index admission and 90 days).

Results

Between 21 January 2019 and 31 August 2019, we assessed 1791 patients reporting 2315 antibiotic allergies, 1225 with a penicillin allergy. Three hundred fifty-five patients were delabeled: 161 by direct delabeling and 194 via oral penicillin challenge. Ninety-seven percent (194/200) of patients were negative upon oral penicillin challenge. In the delabeled patients, we observed an increase in narrow-spectrum penicillin usage (adjusted odds ratio [OR], 10.51 [95% confidence interval {CI}, 5.39–20.48]), improved appropriate antibiotic prescribing (adjusted OR, 2.13 [95% CI, 1.45–3.13]), and a reduction in restricted antibiotic usage (adjusted OR, 0.38 [95% CI, .27–.54]). In the propensity score analysis, there was an increase in narrow-spectrum penicillins (OR, 10.89 [95% CI, 5.09–23.31]) and β-lactam/β-lactamase inhibitors (OR, 6.68 [95% CI, 3.94–11.35]) and a reduction in restricted antibiotic use (OR, 0.52 [95% CI, .36–.74]) and inappropriate prescriptions (relative risk ratio, 0.43 [95% CI, .26–.72]) in the delabeled group compared with the group who retained their allergy label.

Conclusions

This health services program using a combination of direct delabeling and oral penicillin challenge resulted in significant impacts on the use of preferred antibiotics and appropriate prescribing.
Long-term health-related quality of life after McKeown and Ivor Lewis esophagectomy for esophageal carcinoma
Authors: Jezerskyte E , Saadeh L M , Hagens E R C , Sprangers M A G , Noteboom L , van Laarhoven H W M , Eshuis W J , Hulshof M C C M , van Berge Henegouwen M I , Gisbertz S S
Published: May 2020

Introduction

Both cervical (McKeown) and intrathoracic (Ivor Lewis) anastomosis of transthoracic esophagectomy are surgical procedures that can be performed for distal esophageal or gastro-esophageal junction (GEJ) cancer. The purpose of this study was to investigate the long-term health-related quality of life (HR-QoL) after McKeown and Ivor Lewis esophagectomy in a tertiary referral center.

Methods

Disease-free patients >1 year following a McKeown or an Ivor Lewis esophagectomy with a two-field lymphadenectomy for a distal or GEJ carcinoma visiting the outpatient clinic between 2014 and 2018 were asked to complete the EORTC QLQ-C30 and EORTC QLQ-OG25 questionnaires. HR-QoL was investigated in both groups.

Results

A total of 89 patients were included after McKeown and 115 after Ivor Lewis esophagectomy. Median follow-up was 2.4 years (IQR 1.7–3.6). Patients after McKeown esophagectomy reported more problems with ‘eating with others’ compared to patients after Ivor Lewis esophagectomy (mean scores: 49.9 vs. 38.8). This difference was both clinically relevant and significant after correction for multiple testing (β = 11.1, 95% CI 3.105–19.127, P = 0.042). Patients in both groups reported a poorer HR-QoL (≥10 points) than the general population with respect to nausea and vomiting, dyspnea, appetite loss, financial difficulties, problems with eating, reflux, eating with others, choked when swallowing, trouble with coughing, and weight loss.

Conclusion

Long-term HR-QoL of disease-free patients following a McKeown or Ivor Lewis esophagectomy for a distal or GEJ carcinoma is largely comparable. Irrespective of the surgical technique, patients’ HR-QoL following esophagectomy is compromised. When given the choice, patients should be informed that after a McKeown esophagectomy more problems while eating with others can occur.
Prevalence and clinical significance of esophageal abnormalities in children with celiac disease
Authors: Smolander Meri , Nurminen Samuli , Repo Marleena , Kivelä Laura , Kivistö Juho E , Hiltunen Pauliina , Huhtala Heini , Pauniaho Satu-Liisa , Kurppa Kalle
Published: May 2020

Variable endoscopic and histological findings of esophageal lining are often detected in celiac disease, with unknown significance. We investigated the frequency and significance of such abnormalities in children. Macroscopic esophageal findings as reported by endoscopist and histological results by pathologist were compared between 316 celiac disease patients and 378 disease controls who had undergone upper gastrointestinal endoscopy with systematic esophageal biopsy sampling. Association between esophageal abnormalities and other clinical and histological characteristics of the disease was evaluated in celiac disease patients. Endoscopic esophageal findings were reported least often (3.8%) of all diseases in celiac disease, whereas histopathologic abnormalities were frequent (16.8%, n = 53). Children with celiac disease and esophageal histopathology reported more reflux than those with normal esophagus (5.7 vs. 0.8%, P = 0.032), whereas the groups were comparable in the frequency and severity of other symptoms, demographic data, prevalence of celiac disease-associated and other coexisting chronic conditions, family history of celiac disease, anthropometric and laboratory parameters, and degree of villous atrophy. Only 2 (3.7%) out of the 53 children with histologic findings had esophageal symptoms at diagnosis, and altogether seven were treated with acid blockers. Four children had increased number (≥15 eosinophils per high-power field) of esophageal eosinophils, but none of them had definite eosinophilic esophagitis. The remaining 45 children had only unspecific inflammation in the esophagus and reported no esophageal problems during a median of 6.9 years follow-up. To conclude, although relatively common, histopathological esophageal findings in celiac disease are mostly unspecific and without major clinical significance even in a long-term follow-up.
Stroke in acute type A aortic dissection: the Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD)
Authors: Chemtob Raphaelle A , Fuglsang Simon , Geirsson Arnar , Ahlsson Anders , Olsson Christian , Gunn Jarmo , Ahmad Khalil , Hansson Emma C , Pan Emily , Arnadottir Linda O , Mennander Ari , Nozohoor Shahab , Wickbom Anders , Zindovic Igor , Pivodic Aldina , Jeppsson Anders , Hjortdal Vibeke , Gudbjartsson Tomas
Published: May 2020

OBJECTIVES

Stroke is a serious complication in patients with acute type A aortic dissection (ATAAD). Previous studies investigating stroke in ATAAD patients have been limited by small cohorts and have shown diverging results. We sought to identify risk factors for stroke and to evaluate the effect of stroke on outcomes in surgical ATAAD patients.

METHODS

The Nordic Consortium for Acute Type A Aortic Dissection database included patients operated for ATAAD at 8 Scandinavian Hospitals between 2005 and 2014.

RESULTS

Stroke occurred in 177 (15.7%) out of 1128 patients. Patients with stroke presented more frequently with cerebral malperfusion (20.6% vs 6.3%, P < 0.001), syncope (30.6% vs 17.6%, P < 0.001), cardiogenic shock (33.1% vs 20.7%, P < 0.001) and pericardial tamponade (25.9% vs 14.7%, P < 0.001) and more often underwent total aortic arch replacement (10.7% vs 4.7%, P = 0.016), compared to patients without stroke. In the 86 patients presenting with cerebral malperfusion, 38.4% developed stroke. Thirty-day and 5-year mortality in patients with and without stroke were 27.1% vs 13.6% and 42.9% vs 25.6%, respectively. Stroke was an independent predictor of early- [odds ratio 2.02, 95% confidence interval (CI) 1.34–3.05; P < 0.001] and midterm mortality (hazard ratio 1.68, 95% CI 1.27–2.23; P < 0.001).

CONCLUSIONS

Stroke in ATAAD patients is associated with increased early- and midterm mortality. Preoperative cerebral malperfusion and impaired haemodynamics, as well as total aortic arch replacement, were more frequent among patients who developed stroke. Importantly, a large proportion of patients presenting with cerebral malperfusion did not develop a permanent stroke, indicating that signs of cerebral malperfusion should not be considered a contraindication for surgery.
Initial and long-term antithrombotic therapy after left atrial appendage closure with the WATCHMAN
Authors: Ledwoch Jakob , Sievert Kolja , Boersma Lucas V A , Bergmann Martin W , Ince Hüseyin , Kische Stephan , Pokushalov Evgeny , Schmitz Thomas , Schmidt Boris , Gori Tommaso , Meincke Felix , Protopopov Alexey Vladimir , Betts Timothy R , Mazzone Patrizio , Foley David , Grygier Marek , De Potter Tom , Sievert Horst ,   for the EWOLUTION Investigators
Published: May 2020

Aims

Evidence regarding post-procedural antithrombotic regimen other than used in randomized trials assessing percutaneous left atrial appendage (LAA) closure is limited. The present work aimed to compare different antithrombotic strategies applied in the real-world EWOLUTION study.

Methods and results

A total of 998 patients with successful WATCHMAN implantation were available for the present analysis. The composite ischaemic endpoint of stroke, transitory ischaemic attack, systemic embolism and device thrombus, and the bleeding endpoint defined as at least major bleeding were assessed during an initial period (from implant until first medication change) and long-term period (from first change up to 2 years). The antithrombotic medication chosen in the initial phase was dual antiplatelet therapy (DAPT) in 60%, oral anticoagulation (OAC) in 27%, single antiplatelet therapy (SAPT) in 7%, and no medication in 6%. In the second long-term phase, SAPT was used in 65%, DAPT in 23%, no therapy in 8%, and OAC in 4%. No significant differences were found between the groups regarding the ischaemic endpoint both in the initial period (Kaplan–Meier estimated rate 2.9% for DAPT vs. 4.3% for OAC vs. 3.9% for SAPT or no therapy) and in the second period (4.2% for SAPT vs. 1.8% for DAPT vs. 3.5% for no therapy). With respect to bleeding events, the only difference was found in the initial phase with a higher incidence in patients under SAPT or no therapy.

Conclusions

Tailored antithrombotic treatment using even very reduced strategies such as SAPT or no therapy showed no significant differences regarding ischaemic complications after LAA closure.
Predictors of recurrence of atrial fibrillation within the first 3 months after ablation
Authors: Zink Matthias Daniel , Chua Winnie , Zeemering Stef , di Biase Luigi , Antoni Bayes de Luna , David Callans , Hindricks Gerhard , Haeusler Karl Georg , Al-Khalidi Hussein R , Piccini Jonathan P , Mont Lluís , Nielsen Jens Cosedis , Escobar Luis Alberto , de Bono Joseph , Van Gelder Isabelle C , de Potter Tom , Scherr Daniel , Themistoclakis Sakis , Todd Derick , Kirchhof Paulus , Schotten Ulrich
Published: May 2020

Aims

Freedom from atrial fibrillation (AF) at 1 year can be achieved in 50–70% of patients undergoing catheter ablation. Recurrent AF early after ablation most commonly terminates spontaneously without further interventional treatment but is associated with later recurrent AF. The aim of this investigation is to identify clinical and procedural factors associated with recurrence of AF early after ablation.

Methods and results

We retrospectively analysed data for recurrence of AF within the first 3 months after catheter ablation from the randomized controlled AXAFA–AFNET 5 trial, which demonstrated that continuous anticoagulation with apixaban is as safe and as effective compared to vitamin K antagonists in 678 patients undergoing first AF ablation. The primary outcome of first recurrent AF within 90 days was observed in 163 (28%) patients, in which 78 (48%) patients experienced an event within the first 14 days post-ablation. After multivariable adjustment, a history of stroke/transient ischaemic attack [hazard ratio (HR) 1.54, 95% confidence interval (CI) 0.93–2.6; P = 0.11], coronary artery disease (HR 1.85, 95% CI 1.20–2.86; P = 0.005), cardioversion during ablation (HR 1.78, 95% CI 1.26–2.49; P = 0.001), and an age:sex interaction for older women (HR 1.01, 95% CI 1.00–1.01; P = 0.04) were associated with recurrent AF. The P-wave duration at follow-up was significantly longer for patients with AF recurrence (129 ± 31 ms vs. 122 ± 22 ms in patients without AF, P = 0.03).

Conclusion

Half of all early AF recurrences within the first 3 months post-ablation occurred within the first 14 days post-ablation. Vascular disease and cardioversion during the procedure are strong predictors of recurrent AF. P-wave duration at follow-up was longer in patients with recurrent AF.

Trial registration

Clinicaltrials.gov identifier NCT02227550
The hidden layers of microbial community structure: extracting the concealed diversity dimensions from our sequencing data
Authors: Fasolo Andrea , Treu Laura , Stevanato Piergiorgio , Concheri Giuseppe , Campanaro Stefano , Squartini Andrea
Published: May 2020

Microbial metabarcoding is the standard approach to assess communities’ diversity. However reports are often limited to simple OTU abundances for each phylum, giving rather one-dimensional views of microbial assemblages, overlooking other accessible aspects. The first is masked by databases incompleteness; OTU picking involves clustering at 97% (near-species) sequence identity, but different OTUs regularly end up under a same taxon name. When expressing diversity as number of obtained taxonomical names, a large portion of the real diversity lying within the data remains underestimated. Using the 16S sequencing results of an environmental transect across a gradient of 17 coastal habitats we first extracted the number of OTUs hidden under the same name. Further, we observed which was the deepest rank yielded by annotation, revealing for which microbial groups are we missing most knowledge. Data were then used to infer an evolutionary aspect: what is, in each phylum the success of the present time individuals (abundances for each OTU) in relation to their prior evolutionary success in differentiation (number of OTUs). This information reveals whether the past speciation/diversification force is matched by the present competitiveness in reproduction/persistence. The final layer explored is functional diversity, i.e. abundances of groups involved in specific environmental processes.
parSMURF, a high-performance computing tool for the genome-wide detection of pathogenic variants
Authors: Petrini Alessandro , Mesiti Marco , Schubach Max , Frasca Marco , Danis Daniel , Re Matteo , Grossi Giuliano , Cappelletti Luca , Castrignanò Tiziana , Robinson Peter N , Valentini Giorgio
Published: May 2020

Background

Several prediction problems in computational biology and genomic medicine are characterized by both big data as well as a high imbalance between examples to be learned, whereby positive examples can represent a tiny minority with respect to negative examples. For instance, deleterious or pathogenic variants are overwhelmed by the sea of neutral variants in the non-coding regions of the genome: thus, the prediction of deleterious variants is a challenging, highly imbalanced classification problem, and classical prediction tools fail to detect the rare pathogenic examples among the huge amount of neutral variants or undergo severe restrictions in managing big genomic data.

Results

To overcome these limitations we propose parSMURF, a method that adopts a hyper-ensemble approach and oversampling and undersampling techniques to deal with imbalanced data, and parallel computational techniques to both manage big genomic data and substantially speed up the computation. The synergy between Bayesian optimization techniques and the parallel nature of parSMURF enables efficient and user-friendly automatic tuning of the hyper-parameters of the algorithm, and allows specific learning problems in genomic medicine to be easily fit. Moreover, by using MPI parallel and machine learning ensemble techniques, parSMURF can manage big data by partitioning them across the nodes of a high-performance computing cluster. Results with synthetic data and with single-nucleotide variants associated with Mendelian diseases and with genome-wide association study hits in the non-coding regions of the human genome, involhing millions of examples, show that parSMURF achieves state-of-the-art results and an 80-fold speed-up with respect to the sequential version.

Conclusions

parSMURF is a parallel machine learning tool that can be trained to learn different genomic problems, and its multiple levels of parallelization and high scalability allow us to efficiently fit problems characterized by big and imbalanced genomic data. The C++ OpenMP multi-core version tailored to a single workstation and the C++ MPI/OpenMP hybrid multi-core and multi-node parSMURF version tailored to a High Performance Computing cluster are both available at https://github.com/AnacletoLAB/parSMURF.
Giant Gaussian process models of geomagnetic palaeosecular variation: a directional outlook
Authors: Brandt Daniele , Constable Catherine , Ernesto Marcia
Published: May 2020

Assessment of long-term palaeosecular variation (PSV) of the geomagnetic field is frequently based on simplified versions of a class of statistical models known as giant Gaussian processes (GGP) used to represent temporal variations in spherical harmonic descriptions of the field. Here we propose a new type of analysis to assess the shape and dispersion of the directional distributions caused by PSV. The quantities analysed in this study are equal-area coordinates of rotated distributions of palaeomagnetic directions, ${x_E}$ (east−west) and ${x_N}\ $(north−south) and their standard deviations (${\sigma _E}$ and ${\sigma _N}$). These are easy to determine, and can readily be numerically predicted for any GGP model, avoiding the need for the numerous simulations generally used to determine the scatter and/or elongation of directional distributions. Mean predictions of $\overline {{x_N}} $ for a simplified GGP model are different from the expected geocentric axial dipole (GAD) directions, in agreement with inclination differences noted in previous studies. The best estimates for palaeomagnetic inclination are the expected directions from the mean of virtual geomagnetic poles (VGPs) calculated using an iterative angular cut-off process. Predictions of ${\sigma _{\rm E}}$ and ${\sigma _{\rm N}}$ vary with latitude and are symmetric about the Equator. The N–S direction (${\sigma _{\rm N}}$) is always larger than E–W (${\sigma _{\rm E}}$), but the difference decreases from a maximum at the Equator to the poles, where ${\sigma _{\rm N}} = \ {\sigma _{\rm E}}$. A simplified GGP model is used to show that the parameter α (affecting variances in all Gauss coefficients) is positively correlated with ${\sigma _{\rm E}}$ and ${\sigma _{\rm N}}\ $ while the β parameter, the ratio of dipole to quadrupole family standard deviations, modifies the latitudinal dependence of ${\sigma _{\rm E}}$ and ${\sigma _{\rm N}}$. Experimental error in ${\sigma _{\rm E}}$ and ${\sigma _{\rm N}}$ can be accommodated using the common statistical parameters found in palaeomagnetic data sets, as ${\alpha _{95}}$ from site-mean directions. Predictions of simplified GGP models are compared with both numerical simulations and real data spanning the last 10 Ma. The latitudinal dependence of the proposed measures of PSV (${\sigma _{\rm E}}$ and ${\sigma _N}$) provide useful diagnostics for testing the validity of a GGP model. For the past 10 Ma the best-fitting GGP model with a mean GAD field set to $g_1^0 = \ - 18\ \mu T$ has α = 6.7 µT and β = 4.2. These new directional diagnostics will be used to investigate changes in overall geomagnetic field behaviour over other geological time intervals.
Enhanced magnetic fields within a stratified layer
Authors: Hardy Colin M , Livermore Philip W , Niesen Jitse
Published: May 2020

Mounting evidence from both seismology and numerical experiments on core composition suggests the existence of a layer of stably stratified fluid at the top of Earth’s outer core. In such a layer, a magnetostrophic force balance and suppressed radial motion lead to stringent constraints on the magnetic field, named Malkus constraints, which are a much more restrictive extension of the well known Taylor constraints. Here, we explore the consequences of such constraints for the structure of the core’s internal magnetic field. We provide a new simple derivation of these Malkus constraints, and show solutions exist which can be matched to any external potential field with arbitrary depth of stratified layer. From considerations of these magnetostatic Malkus constraints alone, it is therefore not possible to uniquely infer the depth of the stratified layer from external geomagnetic observations. We examine two models of the geomagnetic field defined within a spherical core, which obey the Taylor constraints in an inner convective region and the Malkus constraints in an outer stratified layer. When matched to a single-epoch geomagnetic potential field model, both models show that the toroidal magnetic field within the outer layer is about 100 times stronger compared to that in the inner region, taking a maximum value of 8 mT at a depth of 70 km. The dynamic regime of such a layer, modulated by suppressed radial motion but also a locally enhanced magnetic field, may therefore be quite distinct from that of any interior dynamo.
Methodology to identify the reference rock sites in regions of medium-to-high seismicity: an application in Central Italy
Authors: Lanzano Giovanni , Felicetta Chiara , Pacor Francesca , Spallarossa Daniele , Traversa Paola
Published: May 2020

To evaluate the site response using both empirical approaches (e.g. standard spectral ratio, ground motion models (GMMs), generalized inversion techniques, etc.) and numerical 1-D/2-D analyses, the definition of the reference motion, that is the ground motion recorded at stations unaffected by site-effects due to topographic, stratigraphic or basin effects, is needed. The main objective of this work is to define a robust strategy to identify the seismic stations that can be considered as reference rock sites, using six proxies for the site response: three proxies are related to the analysis of geophysical and seismological data (the repeatable site term from the residual analysis, the resonance frequencies from horizontal-to-vertical spectral ratios on noise or earthquake signals, the average shear wave velocity in the first 30 m); the remaining ones concern geomorphological and installation features (outcropping rocks or stiff soils, flat topography and absence of interaction with structures). We introduce a weighting scheme to take into account the availability and the quality of the site information, as well as the fulfillment of the criterion associated to each proxy. We also introduce a hierarchical index, to take into account the relevance of the proposed proxies in the description of the site effects, and an acceptance threshold for reference rock sites identification. The procedure is applied on a very large data set, composed by accelerometric and velocimetric waveforms, recorded in Central Italy in the period 2008–2018. This data set is composed by more than 30 000 waveforms relative to 450 earthquakes in the magnitude range 3.2–6.5 and recorded by more than 450 stations. A total of 36 out of 133 candidate stations are identified as reference sites: the majority of them are installed on rock with flat topography, but this condition is not sufficient to guarantee the absence of amplifications, especially at high frequencies. Seismological analyses are necessary to exclude stations affected by resonances. We test the impact of using these sites by calibrating a GMMs. The results show that for reference rock sites the median predictions are reduced down to about 45 per cent at short periods in comparison to the generic rock motions.
Products, Patents, Proportionality – How German Patent Law Responds to 21st Century Challenges
Authors: Schönbohm Julia , Ackermann-Blome Natalie
Published: May 2020

German patent law faces challenges in trying to accommodate a changing technological and economic reality. As a result, recent legislative initiatives have been dominated by discussions about adjusting the German Patent Act, especially with regard to the claim for an injunction. This article gives a brief overview of these new challenges as well as the legal background of injunctions in German patent law and the underlying case law. It also evaluates the proposed amendment of the provision on injunctions in the discussion draft of the Federal Ministry of Justice and Consumer Protection (BMJV) on the modernisation of patent law of 14 January 2020.
MicroRNA Signature of Epithelial-Mesenchymal Transition in Group B Streptococcal Infection of the Placental Chorioamniotic Membranes
Authors: Weed Samantha , Armistead Blair , Coleman Michelle , Liggit H Denny , Johnson Brian , Tsai Jesse , Beyer Richard P , Bammler Theodor K , Kretzer Nicole M , Parker Ed , Vanderhoeven Jeroen P , Bierle Craig J , Rajagopal Lakshmi , Adams Waldorf Kristina M
Published: May 2020

Background

Infection-induced preterm birth is a major cause of neonatal mortality and morbidity and leads to preterm premature rupture of placental chorioamniotic membranes. The loss of amniotic epithelial cells and tensile strength preceding membrane rupture is poorly understood. We hypothesized that intrauterine bacterial infection induces changes in microRNA (miRNA) expression, leading to amniotic epithelial cell loss and membrane weakening.

Methods

Ten pregnant pigtail macaques received choriodecidual inoculation of either group B Streptococcus (GBS) or saline (n = 5/group). Placental chorioamniotic membranes were studied using RNA microarray and immunohistochemistry. Chorioamniotic membranes from women with preterm premature rupture of membranes (pPROM) and normal term pregnancies were studied using transmission electron microscopy.

Results

In our model, an experimental GBS infection was associated with changes in the miRNA profile in the chorioamniotic membranes consistent with epithelial to mesenchymal transition (EMT) with loss of epithelial (E-cadherin) and gain of mesenchymal (vimentin) markers. Similarly, loss of desmosomes (intercellular junctions) was seen in placental tissues from women with pPROM.

Conclusions

We describe EMT as a novel mechanism for infection-associated chorioamniotic membrane weakening, which may be a common pathway for many etiologies of pPROM. Therapy based on anti-miRNA targeting of EMT may prevent pPROM due to perinatal infection.