bluuebunny/crossref_metadata_2025 huggingface dataset:
First Experience Using the Sheathless Hyperion Guiding Catheter System Designed for Direct Insertion
Authors: Borrie Andrew , Fairley Sarah , Harding Scott A.
Published: February 2022

Background. Use of sheathless guiding catheters for transradial PCI has the potential to reduce radial trauma and allow use of larger catheters to facilitate complex PCI. The new sheathless Hyperion guide catheter (SHGC) system allows direct insertion of the SHGC using a 20G needle or IV cannula, a 0.025″ Silverway wire, and a dilator. We report the first clinical experience. Methods. We prospectively evaluated outcomes in consecutive patients undergoing PCI using radial access and the SHGC catheter at our institution between June 2020 and June 2021. There were no exclusion criteria. Results. The study included 120 patients, mean age 67 ± 12.6 years, 79.2% male. Insertion of a SHGC was attempted in 128 radial arteries and was successful in all cases. The SHGC was inserted directly in 74 (57.8%), following initial sheath removal in 24 (20.5%) and through the initial sheath in 30 (26.2%). Coronary artery engagement with a SHGC was successful in 126 (98.4%). A total of 150 lesions were treated, the majority being complex: 16.1% chronic total occlusions, 37.1% calcified, 30.6% bifurcation, and 43.5% long lesions. Angiographic success was achieved in 149 (99.2%) lesions. Periprocedural myocardial infarction occurred in 5 (4.2%) patients. There was no in-hospital urgent revascularisation or death and no major bleeding or vascular complications. Occlusion occurred in 2 (1.6%) radial arteries. Conclusion. This first clinical experience with the SHGC demonstrates that direct insertion is safe and effective and that the use of the SHGC allows complex interventions to be undertaken transradially with a high success rate.
Traveller Recurrence and Inter- versus Intratraveller Speed Variability: Analysis with Bluetooth Data
Authors: Jenelius Erik
Published: February 2022

This paper proposes a linear mixed model of route speed distributions that separates the variability into an intertraveller component, consistent across days and time intervals for each recurrent traveller, and an intratraveller component representing uncertainty. The intratraveller variability corresponds to travel time uncertainty, while the total variability is typically captured by empirical measurements and used in travel time reliability assessments. The intratraveller and the total variability differ if there are systematic differences in speed between different recurrent travellers. The paper also investigates to what degree vehicles traversing a route during the morning or evening peak over multiple days are recurrent travellers. Using data from Bluetooth and Wifi sensors on 26 routes in Stockholm, Sweden, over a three-month period, we find that the traveller recurrence is higher towards the city in the morning peak and out from the city in the afternoon. Model estimation results show that the relative intratraveller variability is also significantly higher in the commute direction (towards the city in the morning and out from the city in the afternoon) and on routes with high congestion levels. The relations revealed in this paper may be used to estimate the relevant intratraveller variance based on the total variance and readily available route attributes. Without this correction, the costs associated with travel time variability may be overestimated.
Matching Learning-Based Relay Selection for Substation Power Internet of Things
Authors: Wang Wei , Wang Ruiqiuyu , Zhang Hao , Zhou Zhenyu , He Yanhua
Published: February 2022

Wireless sensor network (WSN) can effectively solve the problems of weak coverage, blind coverage, and low survivability of smart substation communication networks by deploying multiple relay nodes and adopting multihop transmission. However, there are still some challenges in the traditional relay selection strategy of WSN in substation, including incomplete information and the selection conflicts among multisource nodes. In this paper, we propose a matching learning-based relay selection mechanism for WSN-based substation power Internet of things (SPIoT). Firstly, considering the electromagnetic interference caused by the operation of high-voltage equipment, a multihop transmission model of SPIoT is built. Furthermore, based on the upper confidence bound (UCB) algorithm and matching theory, a matching learning-based relay selection (MLRS) algorithm is proposed to minimize the energy consumption of SPIoT devices. Simulation results demonstrate that MLRS outperforms existing algorithms in terms of energy consumption and optimal selection probability.
A Study on the Effects of Plastic Waste Strips and Lime on Strength Characteristics of Expansive Soil
Authors: Amena Shelema , Chakeri Dekebi
Published: February 2022

Expansive soils are known for their volume changes due to fluctuation in the moisture content of the natural ground. This volume change causes huge destruction to many infrastructures. To avoid such damages, expansive soils should be well treated so that they become safe against bearing capacity failure and excessive settlement. In addition, everywhere plastic environmental pollution is a critical issue, which needs a proper way of utilization. This study primarily aimed at utilizing waste plastic materials with lime as subgrade pavement materials, which is cost‐effective and environmentally friendly. Plastic water bottles are used as reinforcement with lime to improve the plasticity and strength properties of the expansive soils. Various laboratory tests are conducted using plastic waste strips with 0.25%, 0.5%, 0.75%, and 1% proportions as soil reinforcement and constant 5% of lime. Finally, significant improvements in CBR, unconfined compressive strength, and free swell are observed at 5% lime and 0.75% plastic waste strips. This study found that stabilizing expansive soil using plastic waste strips and lime has a great influence on the plasticity and strength parameters of the soil. This technique helps to reduce plastic pollution and minimize the cost of stabilizers used to stabilize the subgrade soil.
Automatic Classification of Basic Nursing Teaching Resources Based on the Fusion of Multiple Neural Networks
Authors: Hou Tingting , Madina Zamira
Published: February 2022

Automatic classification is one of the hot topics in the field of information retrieval and natural language processing, but it still faces many problems to be solved. The classic automated classification approach has a sluggish classification speed and poor processing accuracy for resources with a large quantity of data. Based on this, an automated classification approach based on the integration of various neural networks for fundamental nursing teaching materials was presented. The automatic classification method of teaching resources was designed by extracting the characteristics of teaching resources, establishing the model of multiple neural network integration, and designing the classification index of basic nursing teaching resources. The experimental findings suggest that this technique has higher chi-square test parameters and better outcomes for the automated classification of large instructional materials than the classic rough set automatic classification method.
Analysis of Clinical Effect after Treatment of Patients with Femoral Neck Fracture Using Total or Hemihip Arthroplasty
Authors: Zhao Xin , Zhang Yongfeng , Chen Ting , Jia Jianzhang
Published: February 2022

Objective. To investigate the difference in clinical outcomes between total hip arthroplasty (THA) and hemiarthroplasty (HA) in patients with femoral neck fracture. Method. To retrospectively analyze 96 patients (96 hips) with femoral neck fracture treated in our hospital and distinguish them into THA group (50 patients with 50 hips) and HA group (46 patients with 46 hips) according to the difference of their chosen surgical procedure, and to compare the difference in perioperative indexes, postoperative hip function, occurrence of near and long-term complications, long-term imaging performance, and revision rate between the two groups. Result. The operating time, intraoperative blood loss, and total drainage were greater in the THA group than in the HA group (

P
<
0.05

). At 6 months after surgery, the Harris score of the hip joint was higher in the HA group than in the THA group. At 3 years after surgery, the Harris score was higher in the THA group than in the HA group (

P
<
0.05

). At 3 years after surgery, the excellent hip function rates were 86.00% and 67.39% in the THA and HA groups, respectively, with statistically significant difference between the groups. The incidence of long-term complications was significantly lower in the THA group than in the HA group (

P
<
0.05

). The anteversion and abduction angles of patients in the HA group were smaller than those in the THA group at 6 months after surgery (

P
<
0.05

). The WOMAC scores of the THA group were better than those of the HA group at 3 years after surgery (

P
<
0.05

). Conclusion. Compared with hemiarthroplasty, total hip arthroplasty has a longer operative time and more postoperative bleeding, but the complication rate is relatively lower in the long term, and the patients have better long-term hip function recovery, so total hip arthroplasty is recommended for patients with femoral neck fracture with an expected survival time longer than 3 years.
Long Noncoding RNAs Regulate Hyperammonemia-Induced Neuronal Damage in Hepatic Encephalopathy
Authors: Cheon So Yeong , Jo Danbi , Kim Young-Kook , Song Juhyun
Published: February 2022

Background. Hyperammonemia can result in various neuropathologies, including sleep disturbance, memory loss, and motor dysfunction in hepatic encephalopathy. Long noncoding RNA (lncRNA) as a group of noncoding RNA longer than 200 nucleotides is emerging as a promising therapeutic target to treat diverse diseases. Although lncRNAs have been linked to the pathogenesis of various diseases, their function in hepatic encephalopathy has not yet been elucidated. Research Design and Methods. To identify the roles of lncRNAs in hepatic encephalopathy brain, we used a bile duct ligation (BDL) mouse model and examined the alteration of neuronal cell death markers and neuronal structure-related proteins in BDL mouse cortex tissue. Furthermore, analysis of the transcriptome of BDL mouse brain cortex tissues revealed several lncRNAs critical to the apoptosis and neuronal structural changes associated with hepatic encephalopathy. Results. We confirmed the roles of the lncRNAs, ZFAS1, and GAS5 as strong candidate lncRNAs to regulate neuropathologies in hepatic encephalopathy. Our data revealed the roles of lncRNAs, ZFAS1, and GAS5, on neuronal cell death and neural structure in hyperammonemia in in vivo and in vitro conditions. Conclusion. Thus, we suggest that the modulation of these lncRNAs may be beneficial for the treatment of hepatic encephalopathy.
An Efficient Multidocument Blind Signcryption Scheme for Smart Grid-Enabled Industrial Internet of Things
Authors: Abdullah Ako Muhammad , Ullah Insaf , Khan Muhammad Asghar , Alsharif Mohammed H. , Mostafa Samih M. , Wu Jimmy Ming-Tai
Published: February 2022

The smart grid-enabled industrial Internet of Things (SG-IIoT) is a hybrid data communication network connected with the power grid that collects and analyzes data from transmission lines, distribution substations, and consumers. In the IIoT setting, SG provides predictive information to its supplier and customers on how to effectively manage the power based on this aggregated data. To achieve this goal, every virtual or physical entity in the SG-IIoT must be linked and accessible over the Internet, which can be susceptible to numerous cyberattacks. In this paper, we propose a multidocument blind signcryption scheme to simultaneously resolve the security and efficiency issues. The proposed scheme performs the blind signature and encryption operation on multiple digital documents in one step because SG-IIoT outputs a large amount of data that needs to be blind signed and encrypted in a batch. The proposed scheme employs the concept of hyperelliptic curve cryptography (HECC), which is lightweight owing to the smaller key size. The comparative analysis in both security and efficiency with the relevant existing scheme authenticates the viability of the proposed scheme.
Fire-Net: A Deep Learning Framework for Active Forest Fire Detection
Authors: Seydi Seyd Teymoor , Saeidi Vahideh , Kalantar Bahareh , Ueda Naonori , Halin Alfian Abdul
Published: February 2022

Forest conservation is crucial for the maintenance of a healthy and thriving ecosystem. The field of remote sensing (RS) has been integral with the wide adoption of computer vision and sensor technologies for forest land observation. One critical area of interest is the detection of active forest fires. A forest fire, which occurs naturally or manually induced, can quickly sweep through vast amounts of land, leaving behind unfathomable damage and loss of lives. Automatic detection of active forest fires (and burning biomass) is hence an important area to pursue to avoid unwanted catastrophes. Early fire detection can also be useful for decision makers to plan mitigation strategies as well as extinguishing efforts. In this paper, we present a deep learning framework called Fire-Net, that is trained on Landsat-8 imagery for the detection of active fires and burning biomass. Specifically, we fuse the optical (Red, Green, and Blue) and thermal modalities from the images for a more effective representation. In addition, our network leverages the residual convolution and separable convolution blocks, enabling deeper features from coarse datasets to be extracted. Experimental results show an overall accuracy of 97.35%, while also being able to robustly detect small active fires. The imagery for this study is taken from Australian and North American forests regions, the Amazon rainforest, Central Africa and Chernobyl (Ukraine), where forest fires are actively reported.
Effect of Printing Layer Thickness and Postprinting Conditions on the Flexural Strength and Hardness of a 3D‐Printed Resin
Authors: Alshamrani Abdullah A. , Raju Raju , Ellakwa Ayman
Published: February 2022

Background. Recently, dentists can utilize three‐dimensional printing technology in fabricating dental restoration. However, to date, there is a lack of evidence regarding the effect of printing layer thicknesses and postprinting on the mechanical properties of the 3D‐printed temporary restorations with the additive manufacturing technique. So, this study evaluated the mechanical properties of a 3D‐printed dental resin material with different printing layer thicknesses and postprinting methods. Methods. 210 specimens of a temporary crown material (A2 EVERES TEMPORARY, SISMA, Italy) were 3D‐printed with different printing layer thicknesses (25, 50, and 100 μm). Then, specimens were 3D‐printed using DLP technology (EVERES ZERO, DLP 3D printer, SISMA, Italy) which received seven different treatment conditions after printing: water storage for 24 h or 1 month, light curing or heat curing for 5 or 15 minutes, and control. Flexural properties were evaluated using a three‐point bending test on a universal testing machine (ISO standard 4049). The Vickers hardness test was used to evaluate the microhardness of the material system. The degree of conversion was measured using an FT‐IR ATR spectrophotometer. Statistical analysis was performed using two‐way analysis of variance (ANOVA) and Tukey’s honestly significant difference (HSD) test (p ≤ 0.05). Results. The 100 μm printing layer thickness had the highest flexural strength among the other thickness groups. As a combined effect printing thickness and postprinting conditions, the 100 μm with the dry storage group has the highest flexural strength among the tested groups (94.60 MPa). Thus, the group with 100 μm thickness that was heat cured for 5 minutes (HC 5 min 100 μm) has the highest VHN value (VHN = 17.95). Also, the highest mean DC% was reported by 50 μm layer thickness (42.84%).Conclusions. The thickness of the 100 μm printing layer had the highest flexural strength compared to the 25 μm and 50 μm groups. Also, the postprinting treatment conditions influenced the flexural strength and hardness of the 3D‐printed resin material.
An Uncertain Programming Model for Fixed Charge Transportation Problem with After‐Sale Service
Authors: Zhu Kai , Fan Yue , Shen Jiayu , Li Yuyi , Yin Mingfeng
Published: February 2022

This paper constructs an uncertain mathematical model for the fixed charge transportation problem in which several kinds of items are transported from different sources to various destinations via different methods. In addition, after‐sale service such as product return and exchange that help to raise the customer’s satisfaction is considered during the trade to meet the reality. Meanwhile, some indeterministic factors may occur during the transportation process; probability theory is not the best option due to the lack of adequate historical data. In the light of this statement, some parameters like supplies, demands, return rate, and exchange rate are all defined as uncertain variables to formulate the uncertain programming model. After that, the equivalent deterministic models are derived with the help of uncertainty theory. Finally, some numerical experiments are implemented via three algorithms; the optimal values are displayed and compared to show the application of this problem. The study of this paper provides an applicable method for the decision maker.
Multimodel Integrated Enterprise Credit Evaluation Method Based on Attention Mechanism
Authors: Zhang Lei , Song Qiankun
Published: February 2022

Due to the difficulty of credit risk assessment, the current financing and loan difficulties of small- and medium-sized enterprises (SMEs) are particularly prominent, which hinders the operation and development of enterprises. Based on the previous researches, this paper first screens out features by correlation coefficient method and gradient boosting decision tree (GBDT). Then, with the help of SE-Block, the attention mechanism is added to the feature tensor of the subset separated from metadata. On this foundation, two models, XGBoost and LightGBM, are used to train four subsets, respectively, and Bayesian ridge regression is used to fuse the training results of single models under different subsets. In the simulation experiment, the AUC value of the NN-ATT-Bayesian-Stacking model reaches 0.9675 and the distribution of prediction results is ideal. The model shows good robustness, which could make a reliable assessment for the financing and loans of SMEs.
Ultrasensitive and Selective Electrochemical Detection of Dopamine Based on CuO/PVA Nanocomposite-Modified GC Electrode
Authors: Azharudeen A. Mohamed , Roy Arpita , Karthiga R. , Prabhu S. Arun , Prakash M. G. , Badhusha A. Mohamed Ismail , Ali Huma , Katubi Khadijah Mohammedsaleh , Islam Md. Rabiul
Published: February 2022

At present, the determination of dopamine (DA) is enormously necessary for the human body. Since then, it has played a crucial role in the brain that affects mood, sleep, memory, learning, and concentration. Dopamine insufficiency is a threat to human health. Dopamine recognition is important to avoid this problem. Copper oxide (CuO) nanoparticles are one of the potentials which can be used in the detection of dopamine level in the sample. In this work, CuO was synthesized by a simple chemical precipitation technique and modified by polyvinyl alcohol (PVA) as a capping agent. The nanomaterials manufactured are used for the detection of dopamine in 0.1 M PBS medium at room temperature. The CuO/PVA-modified electrode shows better electrocatalytic activity than CuO/GCE (glassy carbon electrode). The constructed dopamine biosensor of copper oxide-PVA nanocomposites also has extraordinary selectivity, stability, sensitivity (183.12 μA mM-1 cm-2), and a minimum level detection limit of 0.017 μM, is inexpensive, and has minimal effort and rapid detection of dopamine.
In‐Plane Instability of Parabolic Arches under Uniformly Distributed Vertical Load Coupled with Temperature Gradient Field
Authors: Pan Zhenyu , Deng Deyuan , Feng Changsheng , Lu Hanwen , Chen Zhou , Zhou Jinman , Jiang Angfeng
Published: February 2022

In civil engineering, arches, such as steel arch roofs and arch bridges, are often subjected to linear temperature gradient field. It is known that the in‐plane instability of parabolic arches is caused by the significant axial force. The arch under the linear temperature gradient field produces complex axial force, and so the instability of arches would be affected by temperature gradient field significantly. However, the analytical solutions of in‐plane instability of parabolic arches being subjected to the uniformly distributed vertical load and the temperature gradient field are not solved in the opening literature. In this paper, in‐plane instability of a fixed steel parabolic arch under linear temperature gradient field and vertical uniform load is analyzed theoretically. Firstly, the cross‐sectional effective centroid and effective stiffness of the cross section for arches under the linear temperature gradient field are derived. Secondly, the preinstability internal force analysis of the parabolic arch under the linear temperature gradient field and the vertical uniform load is carried out based on the force methods. Novel theoretical solutions for in‐plane instability load for fixed steel parabolic arches under the linear temperature gradient field and the vertical uniform load are obtained. It is found that the gradient temperature, slenderness, and rise‐span ratio have important influences on the critical in‐plane instability load of the shallow parabolic arch, while there is no significant effect on the deep parabolic arch.
MidSiot: A Multistage Intrusion Detection System for Internet of Things
Authors: Dat-Thinh Nguyen , Xuan-Ninh Ho , Kim-Hung Le
Published: February 2022

Internet of Things (IoT) has been thriving in recent years, playing an important role in a multitude of various domains, including industry 4.0, smart transportation, home automation, and healthcare. As a result, a massive number of IoT devices are deployed to collect data from our surrounding environment and transfer these data to other systems over the Internet. This may lead to cybersecurity threats, such as denial of service attacks, brute-force attacks, and unauthorized accesses. Unfortunately, many IoT devices lack solid security mechanisms and hardware security supports because of their limitations in computational capability. In addition, the heterogeneity of devices in IoT networks causes nontrivial challenges in detecting security threats. In this article, we present a collaborative intrusion detection system (IDS), namely, MidSiot, deployed at both Internet gateways and IoT local gateways. Our proposed IDS consists of three stages: (1) classifying the type of each IoT device in the IoT network; (2) differentiating between benign and malicious network traffic; and (3) identifying the type of attacks targeting IoT devices. The last two stages are handled by the Internet gateways, whereas the first stage is on the local gateway to leverage the computational resources from edge devices. The evaluation results on three popular IDS datasets (IoTID20, CIC-IDS-2017, and BOT-IoT) indicate our proposal could detect seven common cyberattacks targeting IoT devices with an average accuracy of 99.68% and outperforms state-of-the-art IDSs. This demonstrates that MidSiot could be an effective and practical IDS to protect IoT networks.
The Application of Magnetic Resonance Imaging in Skeletal Age Assessment
Authors: Alshamrani Khalaf
Published: February 2022

Aim of the Study. To assess whether skeletal age can be determined from left-hand magnetic resonance imaging (MRI) using the Greulich & Pyle (G&P). Method. The study includes 80 patients identified from an endocrine clinic, two males and two females from each of 5 age groups (<5, 5 to 7, 8 to 10, 11 to 13, and 14 to 16 years). Skeletal age as determined from an open MRI scanner and radiographs performed on the same day was compared for each child. Two observers assess the skeletal age from radiographs and MRI images independently. After a period of at least three weeks, observers determined the skeletal age of all patients independently. All of the images were in different and random orders, on both of the assessment occasions. The agreement was assessed using the interclass correlation coefficient and Bland Altman plots. Problem Statement. The recurrent use of left-hand radiography in children with chronic conditions might result in the patient being exposed to the same image several times throughout the course of their lives. Use of radiation-free methods such as magnetic resonance imaging (MRI) may be able to assist in reducing the risks associated with radiation exposure, if done properly. Results. Patients’ age ranged from 3 to 16 years, in which the mean of the chronological age was 9.3 years (±2.9) and 9.8 years (±2.7) in girls and boys, respectively. The interrater agreement for skeletal age determination was 0.984 for radiographs and 0.976 for MRI scans. Using the G&P technique, for Observer 1, intraobserver agreement for radiographs and DXA was 0.993 and 0.983, respectively, and 0.995 and 0.994, respectively, for Observer 2. Plotting the rater readings against the line of equality shows no significant differences between readings acquired from radiographs and MRI scans. Conclusion. For the study contribution, it is possible to employ open compact MRI to determine the skeletal age of a person. Our results showed that left-hand MRI scans were of better quality than the radiographs.
Assessment of Manual Abilities Using the Box and Block Test in Children with Bilateral Cerebral Palsy
Authors: Zapata-Figueroa Vanessa , Ortiz-Corredor Fernando
Published: February 2022

Objective. The aim of this study was to determine the correlation between manual dexterity evaluated with the Box and Block Test (BBT) and the performance of daily activities in children with bilateral cerebral palsy (CP). Methods. The BBT was applied to 162 children with cerebral palsy of bilateral distribution aged 6 to 13 years. The level of performance was evaluated according to the Manual Ability Classification System (MACS), Gross Motor Function Classification System (GMFCS), and Pediatric Evaluation of Disability Inventory (PEDI) in the domains of self-care, mobility, and social function. Correlations between the findings of the BBT and the PEDI were determined, and additionally, some specific toileting tasks of the PEDI were evaluated. Results. The results of the BBT were lower in the lowest functional levels of the MACS (

p
≤
0.001

). The BBT showed a strong correlation with the domains’ self-care (

r
=
0.8

), mobility (

r
=
0.7

), and social function (

r
=
0.6

) of the PEDI. The BBT was different between children who were able and children who were not able to perform the toileting tasks that were evaluated. A lower capacity in the BBT obtained in children with functional status GMFCS III, IV, and V was associated with poor performance in toileting tasks evaluated in the PEDI. Conclusion. The results of the BBT are correlated with the activities of daily living of children with bilateral CP. The data obtained from this test is used to predict the performance of daily activities of these patients in settings such as school and home and helps to identify contextual factors that influence the level of independence in children with bilateral CP.
Management of Systemic Therapies and Hepatic Arterial Infusion Chemotherapy in Patients with Advanced Hepatocellular Carcinoma Based on Sarcopenia Assessment
Authors: Yamasaki Takahiro , Saeki Issei , Yamauchi Yurika , Matsumoto Toshihiko , Suehiro Yutaka , Kawaoka Tomokazu , Uchikawa Shinsuke , Hiramatsu Akira , Aikata Hiroshi , Kobayashi Kazufumi , Kondo Takayuki , Ogasawara Sadahisa , Chiba Tetsuhiro , Takami Taro , Chayama Kazuaki , Kato Naoya , Sakaida Isao
Published: February 2022

Background: Sarcopenia, defined as the loss of skeletal muscle mass (MM), physical performance, and strength, has been associated with poor clinical outcomes in hepatocellular carcinoma (HCC) patients treated with several therapies. As systemic therapies, including molecular targeted agents, have a strong impact on sarcopenia, we aimed to review the impact of sarcopenia in patients receiving systemic therapies, especially sorafenib and hepatic arterial infusion chemotherapy (HAIC). Summary: Several studies have demonstrated that sarcopenia is associated with poor clinical outcomes in patients receiving sorafenib or lenvatinib, while HAIC has no association with overall survival (OS) and sarcopenia. Furthermore, based on our previous study, we developed the management of sorafenib score (MS score) to stratify patients’ survival according to the positivity of three parameters (skeletal MM, disease control of sorafenib, and post-sorafenib therapy), ranging from 0 to 3. Patients with an MS score ≥2 (median survival time [MST], 16.4 months) showed significantly longer survival than those with an MS score ≤1 (MST, 8.4 months) (p < 0.001). This result indicates that patients need at least two positive parameters to prolong OS. Although performance status (PS) has been used in the Barcelona Clinic Liver Cancer staging system, we consider that the assessment of sarcopenia has the potential to replace PS. Key Messages: Sarcopenia is associated with poor clinical outcomes in patients of HCC receiving sorafenib or lenvatinib. The MS score, based on the positivity of three prognostic factors, including skeletal MM, in patients receiving sorafenib, can be a reliable indicator of prolonged survival.
Performance of the Liver Maximum Function Capacity Test, Fibrinogen, and Transient Elastography in Patients with Acute Liver Injury
Authors: Kreimeyer Henriette , Buechter Matthias , Best Jan , Gieseler Robert K. , Katsounas Antonios , Sowa Jan-Peter , Gerken Guido , Canbay Ali , Manka Paul , Bechmann Lars P.
Published: February 2022

Background: Acute liver failure (ALF) occurs as a rare, sudden, extensive loss of liver function in a previously healthy liver. In advanced cases, ALF may require liver transplantation (LT). Available prognostic parameters have limited accuracy to decide, which patient to consider for LT. The liver maximum function capacity test (LiMAx) can accurately determine liver function and was assessed as predictor of survival, along with coagulation parameters and liver stiffness in nonacetaminophen-induced ALF. Methods: Various liver function tests, including LiMAx measurements, coagulation factors, and transient elastography (TE), were analyzed retrospectively for associations with clinical outcome in 34 patients with ALF or acute hepatitis (AH). Data were compared between patients with spontaneous recovery (SR) and non-SR (3-month mortality/LT; NSR). Results: The analysis included 34 patients (22 ALF, 12 AH; 19 males, 15 females; age 36.7 ± 14.6 years) with drug-induced liver injury (DILI) (n = 12), autoimmune hepatitis (AIH; n = 13), AIH-DILI overlap (n = 1), viral (n = 9), or cryptogenic liver failure (n = 1). Thirty-one patients recovered spontaneously, 2 patients died, and 1 patient underwent LT. The LiMAx was 197.6 (±68.4) for SR versus 92.33 (±65.0) for NSR (p = 0.0157). Fibrinogen was significantly lower in patients with NSR than in SR patients (209.0 vs. 106.3; p = 0.02). Mean liver stiffness measured by TE was 39.3 for NSR and 17.3 for SR (p = 0.26). KCC was fulfilled in only 4 patients (3 SR, 1 NSR). LiMAx results correlated positively with serum fibrinogen and antithrombin III concentrations and correlated negatively with liver stiffness. No other analyzed factor could differentiate between SR and NSR. Conclusion: Decision-making in ALF remains challenging. LiMAx and fibrinogen might predict the prognosis in patients with nonacetaminophen-induced ALF and in combination could be feasible tools to decide if LT is necessary.
The Neurodiversity Approach(es): What Are They and What Do They Mean for Researchers?
Authors: Dwyer Patrick
Published: February 2022

This paper presents the concepts of “neurodiversity” and the “neurodiversity approaches” towards disability and discusses how confusion regarding the meaning of these concepts exacerbates debate and conflict surrounding the neurodiversity approaches. For example, some claim the neurodiversity approaches focus solely on society and deny contributions of individual characteristics to disability (a controversial stance), whereas this paper joins other literature in acknowledging the contributions of both individual and society to disability. This paper also addresses other controversies related to neurodiversity, such as uncertainty regarding the scope of the approaches – to whom do they apply? – and their implications for diagnostic categories. Finally, it provides recommendations for developmental researchers who wish to carry out neurodiversity-aligned research: scholars are urged to study both individual neurodivergent people and the contexts around them; to consider both strengths and weaknesses; to recognize their own biases; and to listen to and learn from neurodivergent people.
Strategies to Reduce Low-Value Cardiovascular Care: A Scientific Statement From the American Heart Association
Authors: Kini Vinay , Breathett Khadijah , Groeneveld Peter W. , Ho P. Michael , Nallamothu Brahmajee K. , Peterson Pamela N. , Rush Pam , Wang Tracy Y. , Zeitler Emily P. , Borden William B. ,   on behalf of the American Heart Association Council on Quality of Care and Outcomes Research
Published: February 2022

Low-value health care services that provide little or no benefit to patients are common, potentially harmful, and costly. Nearly half of the patients in the United States will receive at least 1 low-value test or procedure annually, creating risk of avoidable complications from subsequent cascades of care and excess costs to patients and society. Reducing low-value care is of particular importance to cardiovascular health given the high prevalence and costs of cardiovascular disease in the United States. This scientific statement describes the current scope and impact of low-value cardiovascular care; reviews existing literature on patient-, clinician-, health system–, payer-, and policy-level interventions to reduce low-value care; proposes solutions to achieve meaningful and equitable reductions in low-value care; and suggests areas for future research priorities.
Depressive Symptoms and Incident Heart Failure in the Jackson Heart Study: Differential Risk Among Black Men and Women
Authors: Gaffey Allison E. , Cavanagh Casey E. , Rosman Lindsey , Wang Kaicheng , Deng Yanhong , Sims Mario , O’Brien Emily C. , Chamberlain Alanna M. , Mentz Robert J. , Glover LáShauntá M. , Burg Matthew M.
Published: February 2022

Background

Associations between depression, incident heart failure (HF), and mortality are well documented in predominately White samples. Yet, there are sparse data from racial minorities, including those who are women, and depression is underrecognized and undertreated in the Black population. Thus, we examined associations between baseline depressive symptoms, incident HF, and all‐cause mortality across 10 years.

Methods and Results

We included Jackson Heart Study (JHS) participants with no history of HF at baseline (n=2651; 63.9% women; median age, 53 years). Cox proportional hazards models tested if the risk of incident HF or mortality differed by clinically significant depressive symptoms at baseline (Center for Epidemiological Studies–Depression scores ≥16 versus <16). Models were conducted in the full sample and by sex, with hierarchical adjustment for demographics, HF risk factors, and lifestyle factors. Overall, 538 adults (20.3%) reported high depressive symptoms (71.0% were women), and there were 181 cases of HF (cumulative incidence, 0.06%). In the unadjusted model, individuals with high depressive symptoms had a 43% greater risk of HF (
P
=0.035). The association remained with demographic and HF risk factors but was attenuated by lifestyle factors. All‐cause mortality was similar regardless of depressive symptoms. By sex, the unadjusted association between depressive symptoms and HF remained for women only (
P
=0.039). The fully adjusted model showed a 53% greater risk of HF for women with high depressive symptoms (
P
=0.043).

Conclusions

Among Black adults, there were sex‐specific associations between depressive symptoms and incident HF, with greater risk among women. Sex‐specific management of depression may be needed to improve cardiovascular outcomes.
Accelerometer‐Derived Daily Life Movement Classified by Machine Learning and Incidence of Cardiovascular Disease in Older Women: The OPACH Study
Authors: Nguyen Steve , Bellettiere John , Wang Guangxing , Di Chongzhi , Natarajan Loki , LaMonte Michael J. , LaCroix Andrea Z.
Published: February 2022

Background

Current physical activity guidelines focus on volume and intensity for CVD prevention rather than common behaviors responsible for movement, including those for daily living activities. We examined the associations of a machine‐learned, accelerometer‐measured behavior termed daily life movement (DLM) with incident CVD.

Methods and Results

Older women (n=5416; mean age, 79±7 years; 33% Black, 17% Hispanic) in the Women’s Health Initiative OPACH (Objective Physical Activity and Cardiovascular Health) study without prior CVD wore ActiGraph GT3X+ accelerometers for up to 7 days from May 2012 to April 2014 and were followed for physician‐adjudicated incident CVD through February 28th, 2020 (n=616 events). DLM was defined as standing and moving in a confined space such as performing housework or gardening. Cox models estimated hazard ratios (HR) and 95% CI, adjusting for age, race and ethnicity, education, alcohol use, smoking, multimorbidity, self‐rated health, and physical function. Restricted cubic splines examined the linearity of the DLM‐CVD dose‐response association. We examined effect modification by age, body mass index, Reynolds Risk Score, and race and ethnicity. Adjusted HR (95% CIs) across DLM quartiles were: 1.00 (reference), 0.68 (0.55–0.84), 0.70 (0.56–0.87), and 0.57 (0.45–0.74); p‐trend<0.001. The HR (95% CI) for each 1‐hour increment in DLM was 0.86 (0.80–0.92) with evidence of a linear dose‐response association (p non‐linear>0.09). There was no evidence of effect modification by age, body mass index, Reynolds Risk Score, or race and ethnicity.

Conclusions

Higher DLM was independently associated with a lower risk of CVD in older women. Describing the beneficial associations of physical activity in terms of common behaviors could help older adults accumulate physical activity.
Long‐Term Cardiovascular Health After Pregnancy in Danish Women With Congenital Heart Disease. A Register‐Based Cohort Study Between 1993 and 2016
Authors: Kloster Stine , Tolstrup Janne S. , Nielsen Dorte Guldbrand , Søndergaard Lars , Johnsen Søren Paaske , Ersbøll Annette Kjær
Published: February 2022

Background

Little is known about the impact of pregnancy on long‐term cardiovascular health in individuals with congenital heart disease (CHD). We aimed to determine if giving birth in patients with CHD is associated with higher risk of long‐term cardiovascular morbidity.

Methods and Results

We studied a cohort of 1262 individuals with CHD giving birth (live or still) from 1993 to 2015 using Danish nationwide registers. We randomly sampled a comparison cohort matched on age of women with CHD who had not given birth at the time. We balanced the 2 cohorts on baseline demographic (eg, education) and clinical variables (eg, CHD severity) using inverse probability of treatment weighting. Individuals were followed for critical (eg, heart failure), other cardiovascular morbidity (eg, arrhythmia), and cardiac surgery/interventions after pregnancy. Individuals were followed for median 6.0 years (interquartile range 3.2–9.2). Among individuals giving birth the incidence rate per 1000 person‐years was 1.6, 10.0, and 6.0 for critical and other cardiovascular morbidity and cardiac surgery, respectively. There was no overall difference in risk of neither critical and other cardiovascular morbidity nor cardiac surgery among individuals who gave birth and individuals who did not; adjusted hazard ratios (aHR) were 0.74 (95% CI, 0.37–1.48), 0.88 (95% CI, 0.65–1.19), and 0.78 (95% C,I 0.54–1.12), respectively. However, individuals with obstetric complications had a higher long‐term risk of other cardiovascular morbidity (aHR, 1.85; 95% CI, 1.07–3.20).

Conclusions

Giving birth seemed not to be associated with a higher risk of long‐term cardiovascular morbidity among women with CHD. However, individuals having obstetric complications had a higher risk of other cardiovascular morbidity in the long term.
S‐Nitrosoglutathione Reductase Deficiency Causes Aberrant Placental S‐Nitrosylation and Preeclampsia
Authors: Kulandavelu Shathiyah , Dulce Raul A. , Murray Christopher I. , Bellio Michael A. , Fritsch Julia , Kanashiro‐Takeuchi Rosemeire , Arora Himanshu , Paulino Ellena , Soetkamp Daniel , Balkan Wayne , Van Eyk Jenny E. , Hare Joshua M.
Published: February 2022

Background

Preeclampsia, a leading cause of maternal and fetal mortality and morbidity, is characterized by an increase in S‐nitrosylated proteins and reactive oxygen species, suggesting a pathophysiologic role for dysregulation in nitrosylation and nitrosative stress.

Methods and Results

Here, we show that mice lacking S‐nitrosoglutathione reductase (

GSNOR
−⁄−

), a denitrosylase regulating protein S‐nitrosylation, exhibit a preeclampsia phenotype, including hypertension, proteinuria, renal pathology, cardiac concentric hypertrophy, decreased placental vascularization, and fetal growth retardation. Reactive oxygen species, NO, and peroxynitrite levels are elevated. Importantly, mass spectrometry reveals elevated placental S‐nitrosylated amino acid residues in

GSNOR
−⁄−

mice. Ascorbate reverses the phenotype except for fetal weight, reduces the difference in the S‐nitrosoproteome, and identifies a unique set of S‐nitrosylated proteins in

GSNOR
−⁄−

mice. Importantly, human preeclamptic placentas exhibit decreased GSNOR activity and increased nitrosative stress.

Conclusions

Therefore, deficiency of GSNOR creates dysregulation of placental S‐nitrosylation and preeclampsia in mice, which can be rescued by ascorbate. Coupled with similar findings in human placentas, these findings offer valuable insights and therapeutic implications for preeclampsia.
Central Apneas Are More Detrimental in Female Than in Male Patients With Heart Failure
Authors: Gentile Francesco , Borrelli Chiara , Sciarrone Paolo , Buoncristiani Francesco , Spiesshoefer Jens , Bramanti Francesca , Iudice Giovanni , Vergaro Giuseppe , Emdin Michele , Passino Claudio , Giannoni Alberto
Published: February 2022

Background

Central apneas (CA) are a frequent comorbidity in patients with heart failure (HF) and are associated with worse prognosis. The clinical and prognostic relevance of CA in each sex is unknown.

Methods and Results

Consecutive outpatients with HF with either reduced or mildly reduced left ventricular ejection fraction (n=550, age 65±12 years, left ventricular ejection fraction 32%±9%, 21% women) underwent a 24‐hour ambulatory polygraphy to evaluate CA burden and were followed up for the composite end point of cardiac death, appropriate implantable cardioverter‐defibrillator shock, or first HF hospitalization. Compared with men, women were younger, had higher left ventricular ejection fraction, had lower prevalence of ischemic etiology and of atrial fibrillation, and showed lower apnea‐hypopnea index (expressed as median [interquartile range]) at daytime (3 [0–9] versus 10 [3–20] events/hour) and nighttime (10 [3–21] versus 23 [11–36] events/hour) (all
P
<0.001), despite similar neurohormonal activation and HF therapy. Increased chemoreflex sensitivity to either hypoxia or hypercapnia (evaluated in 356 patients, 65%, by a rebreathing test) was less frequent in women (
P
<0.001), but chemoreflex sensitivity to hypercapnia was a predictor of apnea‐hypopnea index in both sexes. At adjusted survival analysis, daytime apnea‐hypopnea index ≥15 events/hour (hazard ratio [HR], 2.70; 95% CI, 1.06–7.34;
P
=0.037), nighttime apnea‐hypopnea index ≥15 events/hour (HR, 2.84; 95% CI, 1.28–6.32;
P
=0.010), and nighttime CA index ≥10 events/hour (HR, 5.01; 95% CI, 1.88–13.4;
P
=0.001) were independent predictors of the primary end point in women but not in men (all
P
>0.05), also after matching women and men for possible confounders.

Conclusions

In chronic HF, CA are associated with a greater risk of adverse events in women than in men.
Histamine H
2
Receptor Antagonists and Heart Failure Risk in Postmenopausal Women: The Women’s Health Initiative
Authors: Larson Sophia R. , Vasbinder Alexi L. , Reding Kerryn W. , Leary Peter J. , Branch Kelley R. , Shadyab Aladdin H. , Johnson Karen C. , Haring Bernhard , Wallace Robert , Manson JoAnn E. , Anderson Garnet , Cheng Richard K.
Published: February 2022

Background

Prior studies suggested lower risk of heart failure (HF) in individuals taking H
2
receptor antagonists (H2RA) compared with H2RA nonusers in relatively small studies. We evaluated the association of H2RA use and incident HF in postmenopausal women in the large‐scale WHI (Women’s Health Initiative) study.

Methods and Results

This study included postmenopausal women from the WHI without a history of HF at baseline. HF was defined as first incident hospitalization for HF and physician adjudicated. Multivariable Cox proportional hazards regression models evaluated the association of H2RA use as a time‐varying exposure with HF risk, after adjustment for demographic, lifestyle, and medical history variables. Sensitivity analyses examined (1) risk of HF stratified by the ARIC (Atherosclerosis Risk in Communities) score, (2) propensity score matching on H2RA use, (3) use of proton pump inhibitors rather than H2RA nonuse as the referent, and (4) exclusion of those taking diuretics at baseline. The primary analysis included 158 854 women after exclusion criteria, of whom 9757 (6.1%) were H2RA users. During median 8.2 years of follow‐up, 376 H2RA users (4.9 events/1000 person‐years) and 3206 nonusers (2.7 events/1000 person‐years) developed incident HF. After multivariable adjustment, there was no association between H2RA use and HF in the primary analysis (hazard ratio, 1.07; 95% CI, 0.94–1.22;
P
=0.31) or in any of the sensitivity analyses.

Conclusions

Clinical H2RA use was not associated with incident HF among postmenopausal women. Future studies are needed to evaluate potential effect modification by sex, HF severity, or patterns of use on H2RA exposure and HF risk.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT00000611.
Are Africans in Australia a Diaspora?
Authors: Fozdar Farida , Quicke Sarah Prout , Mickler David
Published: February 2022

Migration from the African continent to Australia has increased in volume and diversity in the last three decades, with the most recent census identifying 2.6 % of the total Australian population as either born in, or having at least one parent born in, Africa. In examining demographic and socioeconomic characteristics, and interrogating political, economic, social and cultural transnational practices, using an interdisciplinary approach that combines demography, political science and sociology, this paper seeks to identify in what ways and for what purposes this population might be considered a pan-African diaspora. We argue that there is some evidence of (i) pan-African consciousness underpinning the collective identity of African-Australian community organisations; (ii) governments, NGO s, communities and individuals engaging in activities that contribute meaningfully to Australian society, countries of origin and identity formation; (iii) significant diversity and important cleavages among these populations. Broader research is required to more adequately identify and measure the multifaceted transnational contributions of African-background peoples in Australia.