bluuebunny/crossref_metadata_2025 huggingface dataset:
Modified K‐line for Making Decisions Regarding the Surgical Approach in Patients with K‐line (‐) OPLL
Authors: Liu Xizhe , Tan Bizhi , Xiao Bin , Zou Xuenong , Liu Shaoyu
Published: May 2021

Objective

To investigate whether the modified K‐line can be used to predict the clinical outcome and to determine the surgical approach for K‐line (−) patients with cervical ossification of the posterior longitudinal ligament (OPLL).

Methods

A new modified K‐line was defined as the line connecting the midpoints of the spinal cord at C4 and C6 on the lateral cervical radiographs. A total of four consecutive patients (three men and one woman) with cervical myelopathy due to OPLL were included in this research. The patients were diagnosed with OPLL with K‐line (−) while they were also classified as modified K‐line (+). Preoperative modified K‐line was used to predict the surgical outcome in K‐line (−) patients with OPLL according to the original K‐line. And a modified laminoplasty with C3 laminectomy and C4‐6 bilateral open‐door laminoplasty was adopted to perform on all the patients. The Japanese Orthopaedic Association scores before surgery and at 1‐year follow‐up after surgery were evaluated and the recovery rate was calculated. The visual analogue scale (VAS) scores were also evaluated before surgery and after surgery. Furthermore, cervical plain radiographs in neutral position before surgery and after surgery were obtained to measure C2–C7 angles for assessing the cervical sagittal alignment.

Results

The results showed that good neurological improvement could be achieved in all K‐line (−) patients who underwent C3 laminectomy with C4–C6 bilateral open‐door laminoplasty. The Postoperative JOA scores improved from 13.5 to 16.5, from 11 to 16.5, from 13 to 16, and from 12.5 to 13, respectively. The mean recovery rate was 65.4% in the K‐line (−) patients. And the VAS scores dropped from 3 to 1, 5 to 2, 5 to 3, and 4 to 2, respectively. The JOA and VAS scores showed satisfaction in all patients at the 1‐year follow‐up. Relatively satisfactory and stable cervical sagittal alignment was observed on postoperative lateral radiography in all patients at the 3‐month follow‐up period. There were no postoperative complications associated with this technique found in all the patients.

Conclusions

Modified K‐line may predict the clinical outcome of this modified laminoplasty and offer guidance regarding the choice of surgical method for K‐line (−) patients with OPLL. Additionally, C3 laminectomy with C4–C6 bilateral open‐door laminoplasty should be recommended for the use in patients with K‐line (−) OPLL, who were also classified as modified K‐line (+). However, further studies with more cases will be required to reveal its generalizability and availability.
Establishment of visual assessment for the severity of dark circles in Chinese Han women
Authors: Tan Yimei , Jiang Yanwen , Chen Jiaping , Sun Hua , Qiu Yuchen
Published: May 2021

Objective

To establish a visual assessment scale for the severity of dark circles' pigmented and vascular type in Chinese women.

Materials and method

A total of 269 healthy Chinese women from Shanghai with different degrees of dark circles', both pigmented and vascular types, were evaluated by visual assessment. Photographs of their dark circles were analyzed by image analysis.

Results

The visual assessment evaluation on classification and severity showed a favorable agreement between the successive measured results. Significant differences from very slight to severe dark circles for pigmented type and vascular type were observed. The severity level by visual assessment was significantly positively correlated with ΔE values while negatively correlated with ΔL values (P < .01) in both pigmented and vascular types. Besides, Δa values of vascular type were significantly positively correlated with the ΔE values for dark circles' vascular type. Values between ΔE and ΔL also showed a significant negative correlation (P < .01).

Conclusion

The five‐point visual assessment scale for dark circles of vascular and pigmented types was verified and proved to have good repeatability. The image analysis's objective result proved significant and consistent with the visual assessment and color parameters. This scale could be a useful and effective tool in diagnosing dark circles' severity.
Developing an Artificial Intelligence (A.I)‐based descriptor of facial appearance that fits with the assessments of makeup experts
Authors: Flament Frederic , Zhang Yuze , Yu Zhi , Jiang Ruowei , Houghton Jeff , Sarda Duthil Lauren , Arcin Vincent , Daniel Raja , Perrier Jean‐Charles , Niviere Joel , Moyano German , Thenin Audrey , Garcia Maxime‐Stephane , Adam Anne‐Sophie , Chibout Salim , Blin Xavier , Delaunay Caroline , Aarabi Pahram
Published: May 2021

Objective

To develop an A.I‐based automatic descriptor that detects and grades, from selfie pictures, 23 facial signs, hairs included, as a help to making‐up procedures.

Material and Methods

The selfie images taken in very different conditions by 3326 women and men were used to create (90% of dataset) and validate (10% of dataset) a new algorithm architecture to appraise and grade 23 different facial signs such as lips, nose, eye color, eyebrows, eyelashes, and hair color as defined by makeup artists. Each selfie image was annotated by 12 experts and defined references to train Artificial Intelligence (A.I)‐based algorithm.

Results

As some the 23 signs present a continuous or discontinuous feature, these were analyzed by two different statistical approaches. The results provided by the automatic descriptor system were not only in good agreement with the expert's assessments but were even found of a better precision and reproducibility. This automatic descriptor system has proven a good and robust accuracy despite the very variable conditions in the acquisition of selfie pictures.

Conclusion

Such automatic descriptor system seems providing a valuable help in making‐up procedures and may extend to other activities such as Skincare or Haircare. As such it should allow large investigations to better evaluate the consumers’ needs of esthetical improvements.
Random Response of Wake-Oscillator Excited by Fluctuating Wind
Authors: Deng Mao Lin , Mu Gen Jin , Zhu Wei Qiu
Published: May 2021

Many wake-oscillator models applied to study vortex-induced vibration (VIV) are assumed to be excited by ideal wind that is assumed to be uniform flow with constant velocity. However, in the field of wind engineering, the real wind is generally described as being composed of mean wind and fluctuating wind. A wake-oscillator excited by fluctuating wind should be treated as a randomly excited and dissipated multi-degree-of-freedom (DOF) nonlinear system. The study of such a system is challenging and so far there is no exact solution available. The present paper aims to carry out the study on the stochastic dynamics of VIV. The stochastic averaging method of quasi-integrable Hamiltonian systems under wideband random excitation is applied to study both the original Hartlen–Currie wake-oscillator model and a modified version excited by fluctuating wind. The probability and statistics of the random response of wake-oscillator in resonant (lock-in) case and in non-resonant case are analytically obtained, and the analytical results are confirmed using numerical simulation of the original system.
MoO3 films grown on stepped sapphire (0001) by molecular beam epitaxy
Authors: Novotný Petr , Lamb H. Henry
Published: May 2021

MoO3 films were grown on stepped c-plane sapphire substrates by molecular beam epitaxy using MoO3 vapor from a conventional Knudsen cell. Stepped sapphire (0001) substrates were prepared by ex situ annealing at 1100–1300 °C in dry air. Step bunching typically resulted in multistepped surfaces with wide atomically smooth terraces. Ex situ annealing at 1100 °C followed by in vacuo annealing at 700 °C provided clean substrates for growth. Ultrathin films were grown at 450 °C via a self-limiting process that represents a balance between the incident MoO3 flux and the desorption flux. Elongated bilayer islands (0.7-nm thick) were formed on sapphire (0001) terraces. Monocrystalline α-MoO3 (010) thin films [(010)α-MoO3∥(0001)sapphire] were grown at 450 °C using a higher incident MoO3 flux and characterized by atomic force microscopy, x-ray photoelectron spectroscopy, x-ray diffraction, and cross-sectional transmission electron microscopy. The step-terrace surface morphology of the monocrystalline films strongly suggests multilayer growth.
In Vitro
pH Activity of Ibrexafungerp against Fluconazole-Susceptible and -Resistant
Candida
Isolates from Women with Vulvovaginal Candidiasis
Authors: Sobel Jack D. , Borroto-Esoda Katyna , Azie Nkechi , Angulo David
Published: May 2021

The vaginal environment with candidiasis has a pH of 3.8 to 4.5 and this has a negative effect on the activity of antifungals. Ibrexafungerp was evaluated against 187
Candida
isolates, including fluconazole-sensitive and -resistant
Candida albicans
,
Candida glabrata
,
Candida krusei
,
Candida parapsilosis
, and
Candida tropicalis
with the media adjusted to pH 7.0 and pH 4.5.
An Exposed Outer Membrane Hemin-Binding Protein Facilitates Hemin Transport by a TonB-Dependent Receptor in Riemerella anatipestifer
Authors: Liu Mafeng , Liu Siqi , Huang Mi , Wang Yaling , Wang Mengying , Tian Xiu , Li Ling , Yang Zhishuang , Wang Mingshu , Zhu Dekang , Jia Renyong , Chen Shun , Zhao Xinxin , Yang Qiao , Wu Ying , Zhang Shaqiu , Huang Juan , Ou Xumin , Mao Sai , Gao Qun , Sun Di , Yu Yan Ling , Cheng Anchun
Published: May 2021

In vertebrates, hemin from hemoglobin is an important iron source for infectious bacteria. Many bacteria can obtain hemin from hemoglobin, but the mechanisms of hemin acquisition from hemoglobin differ among bacteria.
Antimicrobial Resistance Gene Transfer from Campylobacter jejuni in Mono- and Dual-Species Biofilms
Authors: Ma Luyao , Konkel Michael E. , Lu Xiaonan
Published: May 2021

Antimicrobial-resistant
C. jejuni
has been listed as a high priority of public health concern worldwide. To tackle the rapid evolution of AMR in
C. jejuni
, it is of great importance to understand the extent and characteristics of HGT in
C. jejuni
biofilms, which serve as the main survival strategy of this microbe in the farm-to-table continuum.
Characterization of Membrane Topology and Retention Signal of Pestiviral Glycoprotein E1
Authors: Mu Yu , Radtke Christina , Tews Birke Andrea , Meyers Gregor
Published: May 2021

The shortage of specific antibodies against E1, making detection and further analysis of E1 difficult, resulted in a lack of knowledge on E1 compared to Ernsand E2 with regard to biosynthesis, structure, and function. It is known that pestiviruses bud intracellularly.
DOE JGI Metagenome Workflow
Authors: Clum Alicia , Huntemann Marcel , Bushnell Brian , Foster Brian , Foster Bryce , Roux Simon , Hajek Patrick P. , Varghese Neha , Mukherjee Supratim , Reddy T. B. K. , Daum Chris , Yoshinaga Yuko , O’Malley Ronan , Seshadri Rekha , Kyrpides Nikos C. , Eloe-Fadrosh Emiley A. , Chen I-Min A. , Copeland Alex , Ivanova Natalia N.
Published: May 2021

The DOE JGI Metagenome Workflow is designed for processing metagenomic data sets starting from Illumina fastq files. It performs data preprocessing, error correction, assembly, structural and functional annotation, and binning.
Does sex affect second ACL injury risk? A systematic review with meta-analysis
Authors: Patel Akash D , Bullock Garrett S , Wrigley Jordan , Paterno Mark V , Sell Timothy C , Losciale Justin M
Published: May 2021

Objective

To determine sex-based differences in risk of a second ACL injury (overall and by laterality) following primary ACL reconstruction in athletes who are attempting to return to sport.

Design

Systematic review with meta-analysis.

Data sources

Systematic search of five databases conducted in August 2019.

Eligibility criteria for selecting studies

Studies reporting sex-based differences in the incidence of second ACL injury in athletes attempting to return-to-sports and who were followed for at least 1 year following primary ACL reconstruction.

Results

Nineteen studies were included in this review, with seven studies excluded from the primary meta-analysis due to high risk of bias. The remaining 12 studies (n=1431 females, n=1513 males) underwent meta-analysis, with all 19 studies included in a sensitivity analysis. Total second ACL injury risk was 21.9% (females: 22.8%, males: 20.3%). Females were found to have 10.7% risk of an ipsilateral ACL injury and 11.8% risk of a contralateral ACL injury. Males were found to have 12.0% risk of an ipsilateral ACL injury and 8.7% risk of a contralateral ACL injury. No statistically significant differences were observed for total second ACL injury risk (risk difference=−0.6%, 95% CI −4.9 to 3.7, p=0.783, I2=41%) or contralateral ACL injury risk (risk difference=1.9%, 95% CI −0.5% to 4.4%, p=0.113, I2=15%) between sexes. Females were found to have a 3.4% absolute risk reduction in subsequent ipsilateral ACL injury risk compared with males (risk difference=−3.4%, 95% CI −6.7% to −0.02%, p=0.037, I2=35%).

Conclusion

Both sexes have >20% increased risk of experiencing a second ACL injury. Any difference in the absolute risk of either a subsequent ipsilateral or contralateral ACL injury between sexes appears to be small.

Registration

PROSPERO (CRD42020148369)
The Legendre’s Symbol Modulo
p
and Its Some Elementary Results
Authors: Li Jianghua , Zhang Yuan
Published: May 2021

The main purpose of this article is using the elementary methods and the properties of the character sums to study the calculating problem of the number of the solutions for one kind congruence equation modulo

p

(an odd prime) and give some interesting identities and asymptotic formulas for it.
Seismic Behavior of Innovative Precast Superimposed Concrete Shear Walls with Spiral Hoop and Bolted Steel Connections
Authors: Wu Xi , Wang Meng-fu , Liu Ze-long
Published: May 2021

Owing to the desirable bond strength and excellent workability, spiral hoop and bolted steel connectors are introduced to enhance the connecting performance of superimposed reinforced concrete shear wall (SRCSW) system. In order to investigate the seismic performance of SRCSWs, applying such connecting methods under flexure‐shear interaction and flexural dominated status, two groups of precast (PC) specimens were constructed: one‐story and two‐story specimens. Seismic behavior in terms of crack patterns, load‐displacement response, ductility, stiffness degradation, strain response, and deformation results of SRCSWs is evaluated by the quasistatic cyclic test. It is shown that the wall specimens with the proposed connectors exhibited similar failure mode to that of the cast‐in‐place (CIP) walls and possessed adequate seismic performance such as lateral resistance, ultimate drift ratio, and lateral stiffness besides the ease of erection. The strain responses and deformation results of the PC specimens under reversed cyclic loading were presented to evaluate the effectiveness of the introduced connections. The test results indicated that the PC walls adopting bolted steel connectors behaved better in force transmission and exhibited greater integrity characteristic compared with the specimens having spiral hoop connectors. Lastly, simplified finite element models considering the nonlinear slip behavior within the connection joint of SRCSWs were established and verified, which could provide sufficient accuracy and efficiency to predict the seismic response of the proposed wall system.
MR‐Guided Microwave Ablation in T1 Renal Cell Carcinoma: Initial Results in Clinical Routine
Authors: Li Zhaonan , Jiao De-Chao , Wang Chaoyan , Zhang Wenguang , Li Jing , Han Xinwei
Published: May 2021

Objective. Percutaneous tumor ablation is usually performed using computed tomography (CT) or ultrasound (US) guidance, although reliable visualization of the target tumor could be challenging. Magnetic resonance‐ (MR‐) guided ablation provides more reliable visualization of the target tumors and allows multiplanar imaging of the treatment process, making it the modality of choice, in particular if lesions are small. Methods. From March 2016 to January 2018, 32 patients scheduled for percutaneous treatment of T1 RCC underwent MR‐guided MWA. Complications were classified according to the Clavien grade. Kaplan–Meier survival estimates were calculated to evaluate progression‐free survival (PFS). Results. Technical success was achieved in all lesions. The mean energy and procedure duration were 61.6 ± 8.7 kJ and 118.2 ± 26.7 min, respectively. The glomerular filtration rate (GFR) dropped rapidly after 1 month of treatment and slowly recovered within three months (P < 0.05). Postoperative pain and fever were the most common adverse events after treatment. Perirenal hematoma, thermal injury of the psoas muscle, and abdominal distension were common complications after MWA, and the incidence rates were 9.4% (3/32), 6.3% (2/32), and 6.3% (2/32), respectively. According to the Clavien grade classification, serious complications include hydrothorax, bowel injury, and renal failure, all of which have a probability of 3.1%. Of note, the three serious complications occurred in one patient. The 1‐, 2‐, and 3‐year PFS rates were 96.9%, 93.8%, and 83.9%, respectively. The mean PFS rates were 33.972 months (95% CI: 33.045, 35.900). Conclusion. Microwave ablation is feasible under MR guidance and provides effective treatment of RCC in one session.
Numerical Simulation Analysis of Combined Seismic Response for Rock‐Lining‐Water in Hydraulic Tunnel
Authors: Liu Guoqing , Zhang Yanhong , Xiao Ming
Published: May 2021

In order to explore the influence of internal water on the seismic response of hydraulic tunnel, the combined mechanical analysis models of multimaterial including surrounding rock, lining structure, and internal water are built. Based on the explicit central difference method, the dynamic finite element analysis methods for rock, lining, and water are discussed, respectively. The dynamic contact force method is used to simulate the rock‐lining contact interaction, and the arbitrary Lagrange‐Euler (ALE) method is used to simulate the lining‐water coupling interaction. Then a numerical simulation analysis method for combined seismic response of rock‐lining‐water system in hydraulic tunnel is proposed, and the detailed solving steps are given. This method is used to study the seismic stability characteristics of the water diversion tunnel in a hydropower station, and the displacement, stress, and damage failure characteristics of the lining structure under the conditions of no water, static water, and dynamic water are comparatively analyzed. The results show that the hydrostatic pressure restricts the seismic response of the lining, while the hydrodynamic pressure exacerbates its seismic response and leads to damage, separation, and slip failure appearing on the haunch, which can provide a scientific reference for the seismic design of hydraulic tunnel with high water head and large diameter.
The Prevalence of Glaucoma and Its Related Factors in Rural Residents: A Cross-Sectional Study in Jiangxi, China
Authors: Zhou Xiaojun , Zhu Qin , Yi Jinglin , Li Jiajunni , Li Qi , Kuang Jie , Lu Yuanan , Zhou Rui , Chen Jiayan
Published: May 2021

Background. This study aims to investigate the prevalence of glaucoma and its related factors among residents aged 40 and over in Jiangxi Province, China, and provide a scientific basis for the prevention and control of glaucoma. Methods. The cluster sampling method was used to randomly select six townships. Similarly, eight villages were randomly selected from each sample township. A total of 5385 rural residents from 48 villages were collected for a questionnaire survey. A logistic regression model was used to explore the personal behavioral factors related to glaucoma. Results. Among the 5385 participants, the prevalence rate of glaucoma was 1.4%. The logistic regression model found that alcohol consumption, vegetable consumption, physical exercise, daily reading time, and frequent reading environment were related to glaucoma. Conclusion. To prevent the occurrence of glaucoma, it is important for rural residents to reduce the frequency of alcohol consumption, increase the frequency of vegetable consumption and physical exercise, control the length of daily reading, and read in a moderately lit environment.
A Novel Resource Productivity Based on Granular Neural Network in Cloud Computing
Authors: Mahan Farnaz , Rozehkhani Seyyed Meysam , Pedrycz Witold
Published: May 2021

In recent years, due to the growing demand for computational resources, particularly in cloud computing systems, the data centers’ energy consumption is continually increasing, which directly causes price rise and reductions of resources’ productivity. Although many energy‐aware approaches attempt to minimize the consumption of energy, they cannot minimize the violation of service‐level agreements at the same time. In this paper, we propose a method using a granular neural network, which is used to model data processing. This method identifies the physical hosts’ workloads before the overflow and can improve energy consumption while also reducing violation of service‐level agreements. Unlike the other techniques that use a single criterion, namely, worked on the basis of the history of using the processor, we simultaneously use all the productivity rates criteria, that is, processor productivity rates, main memory, and bandwidth. Extensive real‐world simulations using the CloudSim simulator show the high efficiency of the proposed algorithm.
Real Time Arrhythmia Monitoring and Classification Based on Edge Computing and DNN
Authors: Liu Mingxin , Shao Ningning , Zheng Chaoxuan , Wang Ji
Published: May 2021

In this paper, we investigate how to incorporate intelligence into the human‐centric IoT edges to detect arrhythmia, a heart condition often associated with morbidity and even mortality. We propose a classification algorithm based on the intrapatient convolutional neural network model and the interpatient attention residual network model to automatically identify the type of arrhythmia in the edges. As the imbalance categories in the MIT‐BIH arrhythmia database which needs to be used in the algorithm, we slice and overlap the original ECG signal to homogenize the heartbeat sets of different types, and then the preprocessed data was used to train the two proposed network models; the results reached an overall accuracy rate of 99.03% and an F1 value of 0.87, respectively. The proposed algorithm model can be used as a real‐time diagnostic tool for the remote E‐health system in next generation wireless communication networks.
A Multipath Processing Technology Based on Multiparameter-Combined Observation in GNSS
Authors: Zhou T. Y. , Lian B. W.
Published: May 2021

In the Global Navigation Satellite System (GNSS), the multipath error affected by many aspects is the main error source that affects satellite navigation, and it is difficult to establish a much more accurate model to analyze it. Based on the ground multipath reflection model, it firstly deeply studies the influence of GNSS satellite orbit parameters on multipath fading frequency and establishes a multipath signal model related to satellite orbit parameters. Secondly, the influence of carrier phase cycle slip, receiver clock adjustment, and GNSS satellite orbit on multiparameter- (MP-) combined observations is analyzed in detail based on the measured data. Finally, aiming at the common phenomenon of code-carrier divergence in the Beidou system, the elevation-based pseudorange correction model and a sidereal filtering are built to correct the MP errors; experiments with measured data show that there is a fluctuation range reduction of 35.7% after sidereal filtering when the receiver reaches a steady state.
Topical Application of bFGF Alone for the Regeneration of Chronic Tympanic Membrane Perforations: A Preliminary Case Series
Authors: Lou Zihan , Lou Zhengcai , Jin Kangfeng , Sun Junzhi , Chen Zhengnong
Published: May 2021

Background/objective. Most researchers consider that basic fibroblast growth factor (bFGF) facilitates the repair of chronic tympanic membrane (TM) perforations in chronic otitis media (COM). However, the addition of biological materials affects bFGF levels. This study was performed to compare the effects of bFGF alone and myringoplasty for the repair of chronic perforations. Study design. A prospective cohort control study. Materials and methods. Patients with chronic central perforations who met the inclusion criteria were divided into two groups, i.e., bFGF alone group and underlay myringoplasty group. In the bFGF alone group, the epithelium was removed circumferentially around the perforation edge to create fresh edges. Approximately, 0.1–0.15 mL of bFGF solution was applied twice daily for 3 months to the TM, to keep the edges moist without a scaffold. In the myringoplasty group, the perichondrium graft was placed underneath the TM remnant by endoscopy. TM closure and hearing outcomes were evaluated at 12 weeks after surgery or at the end of bFGF treatment. Results. A total of 29 patients consisting 13 in the bFGF alone group and 16 in the myringoplasty group were finally included in the analysis. Of the 13 patients in the bFGF alone group, the perforations were small in 6 and medium in 7; the etiology was secondary to COM in 11 and to trauma in 2. One patient with an unhealed perforation continued bFGF treatment until 6 months, while the others stopped at 3 months. Of the seven medium-sized perforations, none of the five COM perforations closed, while the two traumatic perforations achieved complete closure within 2 and 4 weeks, respectively. The successful closure rate was 28.6% (2/7). Successful closure was achieved in 66.7% (4/6) of the six small perforations with COM, with a mean closure time of 4.75 weeks. Of the 16 patients in the myringoplasty group, all perforations were medium-sized and were secondary to COM in 15 cases and traumatic in 1 case; all achieved complete closure. Conclusions. bFGF alone facilitated the repair of chronic traumatic perforations and small perforations with COM, but not medium-sized perforations with COM. These observations indicated that the regenerative conditions of traumatic perforations are better than those of COM perforations when using bFGF alone, and that graft materials could play a critical role in the regeneration of larger-sized chronic perforations with COM.
Steroid Pulse Therapy for Severe Central Nervous System Involvement in Shiga Toxin-Producing Escherichia coli-Related Hemolytic Uremic Syndrome
Authors: Rosazza Chiara , Cappellari Alberto M , Gandini Cristiano , Scola Elisa , Ardissino Gianluigi
Published: May 2021

We report on the case of a 7-year-old boy with Shiga toxin-producing Escherichia coli-related hemolytic uremic syndrome (STEC-HUS), initially presenting with abdominal pain as the only clinical feature and thus requiring differential diagnosis with a surgical emergency. Diagnosis of STEC-HUS was made with the appearance of bloody diarrhea and renal function impairment, and the clinical picture rapidly progressed to multiorgan failure. Relatively late and severe central nervous system (CNS) involvement was present, characterized by subacute encephalitis progressing to coma, which became apparent when the acute phase of thrombotic microangiopathy was resolving. Therefore, neurologic manifestations were thought to be related to reperfusion damage to the CNS and high-dose IV steroid pulse therapy was empirically administered. Following this therapeutic scheme, neurologic involvement resolved with no sequelae. This case offers several points of discussion on the clinical presentation and the diagnostic approach to STEC-HUS, on the related neurologic complications, and on a novel approach to their management.
A New Reliability Ratio Weighted Bit Flipping Algorithm for Decoding LDPC Codes
Authors: Aqil Chakir , Akharraz Ismail , Ahaitouf Abdelaziz
Published: May 2021

In this study, we propose a “New Reliability Ratio Weighted Bit Flipping” (NRRWBF) algorithm for Low‐Density Parity‐Check (LDPC) codes. This algorithm improves the “Reliability Ratio Weighted Bit Flipping” (RRWBF) algorithm by modifying the reliability ratio. It surpasses the RRWBF in performance, reaching a 0.6 dB coding gain at a Binary Error Rate (BER) of 10−4 over the Additive White Gaussian Noise (AWGN) channel, and presents a significant reduction in the decoding complexity. Furthermore, we improved NRRWBF using the sum of the syndromes as a criterion to avoid the infinite loop. This will enable the decoder to attain a more efficient and effective decoding performance.
Analyzing the Quality of Business English Teaching Using Multimedia Data Mining
Authors: Xin Yanyan
Published: May 2021

Data continually act as a substantial role in business and industry for its daily activities to smoothly functional. The data volume is growing with the passage of time and rising of information technology. Using data mining techniques for quality evaluation and business English teaching is essential in the modern world. These technologies are introduced in the classroom, especially in online classes during the COVID-19 pandemic. To analyze the quality of business English teaching, this paper uses multimedia and data mining technologies. Initially, the multimedia data are collected during classes, and the association rule recommendation algorithm using data mining is applied. Based on collaborative filtering algorithms in association rules, indicators for teaching quality evaluation in colleges and universities are set up. Next, the actual teaching data of a university is used. Taking business English as an example, the algorithm that has been built is tested. The application of the algorithm is tested, and the teaching process of College Business English is evaluated. Finally, the conclusion is drawn that data mining technology can describe the behavior of teaching well and evaluate it, and it has the potential of popularization.
Trusted QoS Assurance Approach for Composite Service
Authors: Cai Meng , Cui Ying , Yu Yang , Xue Ying , Luo Han
Published: May 2021

The characteristics of service computing environment, such as service loose coupling, resource heterogeneity, and protocol independence, propose higher demand for the trustworthiness of service computing systems. Trust provisioning for composite services has become a hot research spot worldwide. In this paper, quality of service (QoS) planning techniques are introduced into service composition-oriented QoS provisioning architecture. By QoS planning, the overall QoS requirement of the composite service is decomposed into separate QoS requirement for every constituent atom service, the QoS level of which can subsequently be satisfied through well-designed service entity selection policies. For any single service entity, its QoS level is variable when the deployment environment or the load of service node changes. To mitigate the uncertainty, we put forward QoS preprocessing algorithms to estimate the future QoS levels of service entities with their history execution data. Then, based on the modeling of composite service and QoS planning, we design three algorithms, which include the time preference algorithm, cost/availability (C/A) preference algorithm, and Euclidean distance preference algorithm, to select suitable atomic services meeting the user’s requirements. Finally, by combining genetic algorithm and local-search algorithm, we propose memetic algorithm to meet the QoS requirements of composite service. The effectiveness of the proposed methods by which the QoS requirements can be satisfied up to 90% is verified through experiments.
Prediction of College Students’ Psychological Crisis Based on Data Mining
Authors: Liu Jingjing , Shi Guangyuan , Zhou Jing , Yao Qiumei
Published: May 2021

The development of a college students’ psychological management system has become an essential indicator to monitor and prevent the psychological crisis. University student management databases accumulate massive data, but the conventional data processing tasks are restricted to simple statistical analysis, storage, and query management. This paper discusses the application of big data technology for the current psychological management system by investigating psychological crisis screening indicators. Data mining techniques are used to realize the dynamic management of psychological early warning data, real-time monitoring of high-risk groups’ psychology, and improvement of the accuracy and effectiveness of early identification and warning of students’ psychological crisis. Based on a combination of qualitative and quantitative analysis, we conduct a series of studies on three typical types of network public opinions, i.e., Internet rumors, online public opinions of college students, and emergent public health incidents in terms of the transmission mechanism, early warning, and decision-making mechanism, as well as the evolution mechanism of the network public opinion.
Sex Differentiation in Amphibians: Effect of Temperature and Its Influence on Sex Reversal
Authors: Ruiz-García Adrián , Roco Álvaro S. , Bullejos Mónica
Published: May 2021

The role of environmental factors in sexual differentiation in amphibians is not new. The effect of hormones or hormone-like compounds is widely demonstrated. However, the effect of temperature has traditionally been regarded as something anecdotal that occurs in extreme situations and not as a factor to be considered. The data currently available reveal a different situation. Sexual differentiation in some amphibian species can be altered even by small changes in temperature. On the other hand, although not proven, it is possible that temperature is related to the appearance of sex-reversed individuals in natural populations under conditions unrelated to environmental contaminants. According to this, temperature, through sex reversal (phenotypic sex opposed to genetic sex), could play an important role in the turnover of sex-determining genes and in the maintenance of homomorphic sex chromosomes in this group. Accordingly, and given the expected increase in global temperatures, growth and sexual differentiation in amphibians could easily be affected, altering the sex ratio in natural populations and posing major conservation challenges for a group in worldwide decline. It is therefore particularly urgent to understand the mechanism by which temperature affects sexual differentiation in amphibians.
Preoperative Acetazolamide Challenge in Pediatric Chiari I Malformation
Authors: Rossi Vincent , Wait Scott , Jernigan Sarah , Van Poppel Mark , Pfortmiller Deborah , Zeitouni Daniel , Henegar Martin M.
Published: May 2021

Purpose: In patients who present with headaches and Chiari 1 malformation without cranial nerve or brainstem dysfunction or syrinx formation, the decision to decompress can be difficult to make. We present a case series examining the use of acetazolamide as a diagnostic aid to determine candidacy for decompression. Methods: A single pediatric neurosurgeon’s (M.M.H.) experience from 2003 to 2018 was retrospectively reviewed. All cases evaluated in the clinic for CPT code of Chiari 1 malformation were analyzed. Inclusion criteria were patients with diagnosis of Chiari 1 malformation and headache-predominant symptoms who underwent an acetazolamide challenge test. Exclusion criteria included age over 18, syrinx, or significant clinical evidence of brainstem compression or cranial nerve dysfunction. Data were recorded with respect to response to acetazolamide. Surgical outcomes were assessed using the Chicago Chiari Outcome Scale (CCOS) pain category and the improve/same/worse (IWS) scale. Overall satisfaction from surgery was also recorded. Results: Forty-five patients met inclusion criteria and underwent acetazolamide challenge. Thirty-three (73.3%) patients showed improvement of their symptoms with acetazolamide challenge (responders). Of the 33 responders, 25 (75.8%) underwent Chiari decompression. The remaining 8 (24.2%) responders experienced persistent improvement of their symptoms after the acetazolamide trial and did not require intervention. Twelve (26.7%) patients did not improve with acetazolamide (nonresponders) of which 11 (91.7% of nonreponders) never required intervention. One nonresponder eventually underwent Chiari decompression due to progressively worsening and debilitating headaches. All twenty-five (100%) responders improved after surgery and 24 (96%) were satisfied with the outcome of surgery. The average responder CCOS pain score was 3.52 out of 4. The nonresponder who did not improve with acetazolamide had persistent severe headaches after decompression. The CCOS pain score for this nonresponder was 2 out of 4. Conclusion: Pediatric headache-predominant Chiari 1 malformation presents a difficult diagnostic dilemma. The authors describe a trial of acetazolamide as a preoperative diagnostic tool to aid the decision to decompress. Further studies will need to be performed to determine the effectiveness of preoperative acetazolamide in identifying which patients may benefit from surgical decompression.
Cold Agglutinin-Mediated Autoimmune Hemolytic Anemia in Association with Antiphospholipid Syndrome
Authors: Gelman Ram , Kharouf Fadi , Ishay Yuval , Gural Alexander
Published: May 2021

Antiphospholipid syndrome and cold agglutinin-mediated autoimmune hemolytic anemia are 2 distinct immune-mediated hematologic disorders. While no clear association exists between these 2 entities, complement activation is known to occur in both of them. Herein, we report a unique case of cold agglutinin hemolytic anemia in a patient with a known primary antiphospholipid syndrome.
Durable Physiological Changes and Decreased Syncope Burden 12 Months After Unifocal Right-Sided Ablation Under Computed Tomographic Guidance in Patients With Neurally Mediated Syncope or Functional Sinus Node Dysfunction
Authors: Debruyne Philippe , Rossenbacker Tom , Janssens Luc , Collienne Christine , Ector Joris , Haemers Peter , le Polain de Waroux Jean-Benoît , Bazelmans Christine , Boussy Tim , Wijns William
Published: May 2021

Background:

Cardioneuromodulation is a cardioneuroablative approach aiming to create adequate vagolysis of the sinoatrial node through partial ablation of the anterior right ganglionated plexus.

Methods:

We performed an interventional study in patients with recurrent neurally mediated syncope (group A) or functional sinus node dysfunction (group B). Syncope burden, ECG, 24-hour rhythm data, tilt table test, exercise test, and pharmacological challenge with atropine were assessed at baseline and at regular intervals to 12 months.

Results:

Fifty patients (31 in group A and 19 in group B) underwent cardioneuromodulation. The mean number of syncopes during the previous 12 months was 9.7±18.2. The procedure was associated with a lower rate of syncope (−95%) and presyncope (−95%) at 12 months versus baseline (
P
<0.001). Thirty-seven patients remained entirely free of syncope at 12 months, and the syncope-free survival curve remained stable between the 12- and 30-month follow-up. After a mean ablation time of 8±4 minutes, the P-P interval shortened by 247±146 ms (
P
<0.001). Basal heart rate (HR) increased by 18% (
P
<0.001) and remained stable between 6 and 12 months. At 12 months, the mean HR increased by 12% in the entire cohort (
P
<0.001), reached 23% in patients with baseline mean HR <70 beats per minute (
P
<0.01), and did not increase in patients with baseline HR >70 beats per minute. Maximum HR during exercise decreased by 10 beats per minute at 1 month (
P
<0.001) and was restored at 12 months.

Conclusions:

Cardioneuromodulation is a safe and fast treatment giving rise to a long-term partial sinus node vagolysis with no apparent short- or long-term safety concerns or undesirable persisting modifications of the intracardiac autonomous nervous system. The impact on vasoplegia is less clear. Cardioneuromodulation is associated with a good clinical outcome in most patients with neurally mediated syncope or functional sinus node dysfunction. These promising data require confirmation in a multicenter randomized trial.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02954666.
RETRO-MAPPING: A New Approach to Activation Mapping in Persistent Atrial Fibrillation Reveals Evidence of Spatiotemporal Stability
Authors: Mann Ian , Linton Nick W.F. , Coyle Clare , Howard James P. , Fudge Michael , Lim Elaine , Qureshi Norman , Koa-Wing Michael , Whinnett Zachary , Lim Phang Boon , Ng Fu Siong , Peters Nicholas S. , Francis Darrel P. , Kanagaratnam Prapa
Published: May 2021

Background:

The mechanisms underlying atrial fibrillation (AF) remain controversial. We developed Representation of Electrical Tracking or Origin-Mapping to characterize activation wavefronts by direction and uniformity, accumulating data as an orbital plot and analyzed as frequency histograms. We applied this technique to patients undergoing AF ablation to determine if AF activation is random.

Methods:

Patients undergoing persistent AF ablation were recruited, and an AFocusII was positioned at multiple left atrial locations and kept steady for 1 minute to collect electrograms. The AFocusII was returned to the original site and position after >10 minutes for a repeat 1-minute data collection. Data were exported to custom Representation of Electrical Tracking or Origin-Mapping software, and 30 seconds consecutive time windows at each location were studied using frequency histograms of wavefronts. R50 (the range in degrees containing 50% of the total activation) was used as a method to enable statistical comparisons of activation patterns. Electrogram characterization into categories of complex fractionated atrial electrograms by Ensite Precision was subjected to similar analysis.

Results:

Consecutive 30 seconds segments were studied at 161 locations in 18 pts. Mean overlap between frequency histograms was 79.5%±7.7 (95% CI, 78.3–80.7). Nine patients underwent delayed mapping at the same location, and mean overlap between the first 30 seconds and >10 minute interval was 73%±11.8 and 71.9%±13.6 for consecutive 30-second segments. Stability was confirmed using R50 (Bland-Altman mean difference: 0.87°; limits of agreement: −34.0 to 36.0;
r
=0.005;
P
=0.95). A greater variance in R50 was observed between different locations within a patient than the variance within the same locations (intraclass correlation=0.765;
P
<0.0001) and similarly for both complex fractionated atrial electrogram and bipolar voltage (
P
<0.0001). A larger area containing complex fractionated atrial electrogram (80–120 ms) showed weak positive correlation with increasing R50 (
r
=0.36,
P
<0.001) suggesting a relationship between activation pattern and electrogram characteristics.

Conclusions:

There appears to be preferential activation patterns during persistent AF indicating spatiotemporal stability. This has important implication to our mechanistic understanding of persistent AF.
Plasma Proteomic Profile Predicts Survival in Heart Failure With Reduced Ejection Fraction
Authors: Gui Hongsheng , She Ruicong , Luzum Jasmine , Li Jia , Bryson Timothy D. , Pinto Yigal , Sabbah Hani N. , Williams L. Keoki , Lanfear David E.
Published: May 2021

Background:

It remains unclear whether the plasma proteome adds value to established predictors in heart failure (HF) with reduced ejection fraction (HFrEF). We sought to derive and validate a plasma proteomic risk score (PRS) for survival in patients with HFrEF (HFrEF-PRS).

Methods:

Patients meeting Framingham criteria for HF with EF<50% were enrolled (N=1017) and plasma underwent SOMAscan profiling (4453 targets). Patients were randomly divided 2:1 into derivation and validation cohorts. The HFrEF-PRS was derived using Cox regression of all-cause mortality adjusted for clinical score and NT-proBNP (N-terminal pro-B-type natriuretic peptide), then was tested in the validation cohort. Risk stratification improvement was evaluated by C statistic, integrated discrimination index, continuous net reclassification index, and median improvement in risk score for 1-year and 3-year mortality.

Results:

Participants’ mean age was 68 years, 48% identified as Black, 35% were female, and 296 deaths occurred. In derivation (n=681), 128 proteins associated with mortality, 8 comprising the optimized HFrEF-PRS. In validation (n=336) the HFrEF-PRS associated with mortality (hazard ratio, 2.27 [95% CI, 1.84–2.82],
P
=6.3×10
-14
), Kaplan-Meier curves differed significantly between HFrEF-PRS quartiles (
P
=2.2×10
-6
), and it remained significant after adjustment for clinical score and NT-proBNP (hazard ratio, 1.37 [95% CI, 1.05–1.79],
P
=0.021). The HFrEF-PRS improved metrics of risk stratification (C statistic change, 0.009,
P
=0.612; integrated discrimination index, 0.041,
P
=0.010; net reclassification index=0.391,
P
=0.078; median improvement in risk score=0.039,
P
=0.016) and associated with cardiovascular death and HF phenotypes (eg, 6-minute walk distance, EF change). Most HFrEF-PRS proteins had little known connection to HFrEF.

Conclusions:

A plasma multiprotein score improved risk stratification in patients with HFrEF and identified novel candidates.
Persistent Right Venous Valve: Insights From Multimodality Imaging
Authors: Kadiyala Madhavi , Hui Kevin , Banga Sandeep , Loomba Rohit Seth , Pandian Natesa G. , Kutty Shelby
Published: May 2021

Anatomic variants in the right atrium are under-recognized and under-reported phenomena in cardiac imaging. In the fetus, right atrium serves as a conduit for oxygenated blood to be delivered to the left heart bypassing the right ventricle and the nonfunctional lungs. The anatomy in the fetal right atrium is designed for such purposeful circulation. The right and left venous valves are prominent structures in the fetal heart that direct inferior vena caval flow towards the foramen ovale. These anatomic structures typically regress and the foramen ovale closes after birth. However, the venous valves can persist leading to a range of anatomic, physiological, and pathological consequences in the adult. We describe various presentations of persistent venous valves, focusing on the right venous valve in this illustrated multimodality imaging article.
Ultra‐Fast‐Track Extubation in Adult Congenital Heart Surgery
Authors: Bianchi Paolo , Constantine Andrew , Costola Giulia , Mele Sara , Shore Darryl , Dimopoulos Konstantinos , Aw Tuan‐Chen
Published: May 2021

Background

In pediatric cardiac surgery, perioperative management has evolved from slow weaning of mechanical ventilation in the intensive care unit to “ultra‐fast‐track” anesthesia with early extubation (EE) in theater to promote a faster recovery. The strategy of EE has not been assessed in adults with congenital heart disease, a growing population of patients who often require surgery.

Methods And Results

Data were collected retrospectively on all patients >16 years of age who underwent adult congenital heart surgery in our tertiary center between December 2012 and January 2020. Coarsened exact matching was performed for relevant baseline variables. Overall, 711 procedures were performed: 133 (18.7%) patients underwent EE and 578 (81.3%) patients received conventional extubation. After matching, patients who received EE required less inotropic or vasopressor support in the early postoperative period (median Vasoactive‐inotropic score 0.5 [0.0–2.0] versus 2.0 [0.0–3.5];
P
<0.0001) and had a lower total net fluid balance than patients after conventional extubation (1168±723 versus 847±733 mL;
P
=0.0002). The overall reintubation rate was low at 0.3%. EE was associated with a significantly shorter postoperative length of stay in higher dependency care units before a “step‐down” to ward‐based care (48 [45–50] versus 50 [47–69] hours;
P
=0.004). Lower combined intensive care unit and high dependency unit costs were incurred by patients who received EE compared with patients who received conventional extubation (£3949 [3430–4222] versus £4166 [3893–5603];
P
<0.0001).

Conclusions

In adult patients undergoing surgery for congenital heart disease, EE is associated with a reduced need for postoperative hemodynamic support, a shorter intensive care unit stay, and lower health‐care‐related costs.