bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Web Openings on Flexural Behaviour of Underground Metro Station RC Beams under Static and Cyclic Loading
Authors: Liu Ting-jin , Chen Si-wei , Feng Zi-hang , Liu Hong-yuan
Published: February 2020

This paper investigates the influence of multiple transverse web openings on the flexural behaviour of underground metro station reinforced concrete (RC) beams. This problem is outlined with an actual underground engineering project, in which the web opening used in the RC beams violates the current specifications. A total of five beams with different numbers of web openings are fabricated and tested under static and cyclic loading conditions, thereby simulating actual operations in unfavourable conditions. The results suggest that the existence of the openings decreases the loadbearing capacity, ductility, stiffness, and energy dissipation ability of the RC beams. Moreover, the results show that the corners of the openings are the weakest parts of the beams. However, additional reinforcements around the openings can partially mitigate the impact of the openings on the loadbearing and seismic performance of the RC beams. The laboratory experiments presented herein not only provide guidelines for the use of RC beams with web openings in actual engineering projects, especially underground projects where RC beams with web openings have seldom been investigated, but also shed light on improving the related design specifications.
A New Method for Designing Dense Skeleton Asphalt Mixture Based on Meso Parameter
Authors: Shi Liwan , Wang Duanyi , Wang Junfeng , Jiang Zhonghai , Liang Hehao , Qin Xiao
Published: February 2020

At present, research on the internal structures of asphalt mixtures has mostly focused on the statistical analysis of their mesostructural components such as aggregates, voids, and asphalt mortars, in addition to the verification of the mechanical behaviour of the mixture through simulations. Furthermore, the capacity of the research has not risen to a level where a design method to guide the design and optimisation of the asphalt mixture gradation has been formulated. After an in‐depth analysis of the existing evaluation parameters and standards for the asphalt mixture skeleton, this study proposes a new method for precise designing a dense skeleton asphalt mixture (DSAM) based on meso parameter. The results indicate that the application of digital image processing (DIP) techniques to adjust the gradation increases the average coordination number () and reduces the ratio of the quantity of coarse aggregate without contact point to the total quantity of coarse aggregate (C value). This can effectively improve the meso parameters of the mixture so that the quality of the main skeleton is significantly enhanced; the process also has higher precision and demands less test work. VCAmix(IMAGE) ≤ VCADRC and >1.6 while C < 20% can be used as qualitative and quantitative evaluation criterion for forming better main skeleton structure of coarse aggregate. The new method of designing a DSAM based on meso parameter is intuitive and convenient, which considerably reduces the blindness and tediousness in the design of the asphalt mixture gradation. The engineering example also proves that the asphalt mixture has an excellent pavement performance and verifies the feasibility of the proposed design method.
The Correlation between Corneal Findings and Disease Severity in Keratoconus per Scheimpflug Corneal Tomography
Authors: Shehata Ahmed E. M. , Foster James W. , Jun Albert S. , Soiberman Uri S.
Published: February 2020

Purpose. This study aims to correlate the clinical signs of keratoconus (KC) which include superficial apical scarring, Fleischer rings, and Vogt striae with best spectacle-corrected visual acuity (BSCVA) and corneal tomography findings.Patients and methods. A retrospective observational study. 72 consecutive KC patients seen by the senior author over the course of one year were included in this case series. Eyes with pellucid marginal degeneration, postrefractive ectasia, history of a corneal graft, prior corneal collagen cross-linking, intracorneal ring segments or hydrops were excluded from analysis. Subsequently, the final analysis included only treatment-naïve KC eyes with varying degrees of disease severity.Results. BSCVA with manifest refraction was 0.5 logMAR higher in eyes with apical scarring (p<0.001). Eyes with apical scarring had worse vision than eyes with Fleischer rings alone (0.43 logMAR higher in the former,p<0.009). Eyes with apical scarring had higher keratometry readings (K2 = 64.56 ± 12.89 D versus 49.07 ± 6.61 D,p<0.001); this was also true for eyes with Fleischer rings compared with ring-free eyes (K2 = 56.23 ± 11.52 D versus 48.91 ± 7.79 D,p<0.001) and eyes with Vogt striae (K2 = 56.19 ± 10.27 D versus 50.68 ± 9.21 D,p=0.01). Atopic disease was a risk factor for scarring: odds ratio (OR) = 2.87 (p=0.03). The OR of observing Fleischer rings in KC eyes was 12% per year (p=0.001). Additionally, each mm of corneal apex displacement from the pupillary center led to a 0.76 logMAR increase in visual acuity (p=0.001).Conclusion. The presence of apical scarring and Fleischer rings on biomicroscopy can aid the clinician in making the distinction between severe or long-standing disease (respectively). Apical scarring is a sign of advanced disease and is associated with worse BSCVA and tomography findings. Fleischer rings are markers of intermediate disease and their presence correlates with disease duration.
Prevalence and Genotype Distribution of Giardia duodenalis in Rabbits in Shandong Province, Eastern China
Authors: Li Tao-Shan , Zou Yang , Peng Jun-Jie , Wang Li-Qun , Zhang Hai-Sheng , Cong Wei , Zhu Xing-Quan , Sun Xiao-Lin
Published: February 2020

Giardia duodenalis is a zoonotic enteric parasite that can infect humans and a number of animal species including rabbits with a worldwide distribution. Infection with G. duodenalis can cause serious public health problems and significant economic losses to animal husbandry. So accurate understanding of the prevalence and genotype distribution of G. duodenalis in rabbits is necessary. In the present study, a total of 616 fecal samples were collected from rabbits in Shandong province, eastern China, and examined in G. duodenalis prevalence and genotypes by nested PCR amplification of β‐giardin (bg), glutamate dehydrogenase (gdh), and triosephosphate isomerase (tpi) gene loci of G. duodenalis. Sixty‐nine (11.2%) of the examined rabbit fecal samples were G. duodenalis-positive. Of them, the prevalence of G. duodenalis is 8.4% (41/490) in Rizhao city and 22.2% (28/126) in Weihai city. Breeds, region, and feeding modes were highly correlated with G. duodenalis infection in rabbits. Moreover, three genotypes (assemblages A, B, and E) were identified in rabbits at three gene loci, and the assemblage E was the dominant genotype, while the assemblage A was reported in rabbits in China for the first time. It is noticeable that two rabbits were found to be infected with two different G. duodenalis assemblages (assemblages A and E, assemblages B and E, respectively). These findings enrich the genotype distribution of G. duodenalis in rabbits and provide baseline data for preventing and controlling G. duodenalis infection in rabbits in eastern China.
Two Cardiac Arrests that Occurred after the Administration of Sugammadex: A Case of Kounis Syndrome
Authors: Yanai Machi , Ariyoshi Koichi
Published: February 2020

Kounis syndrome is a form of acute coronary syndrome caused by allergic reactions. No cases of cardiac arrest caused by Kounis syndrome that arose after the administration of sugammadex have been reported. A 71-year-old female suffered two cardiac arrests. The first occurred after sugammadex was administered at the end of an operation for a right radial distal fracture. The patient was resuscitated and transferred to our intensive care unit. She was subsequently discharged home. Five months later, she suffered a second cardiac arrest after sugammadex was administered at the end of an operation for a right femoral neck fracture at our hospital. Urgent coronary angiography revealed multiple coronary spasms. Kounis syndrome was diagnosed based on the patient’s elevated serum trypsin levels and a positive result in a skin allergy test of sugammadex. In cases of cardiac arrest with unclear etiologies, Kounis syndrome should be considered.
Chaotic Signal Denoising Based on Adaptive Smoothing Multiscale Morphological Filtering
Authors: Tang Guiji , Yan Xiaoli , Wang Xiaolong
Published: February 2020

Nonlinear time series denoising is the prerequisite for extracting effective information from observation sequence. An effective chaotic signal denoising method not only has a good signal-to-noise ratio (SNR) enhancement performance, but also can remain as a good unpredictable denoised signal. However, the inherent characteristics of chaos, such as extreme sensitivity to initial values and broadband spectrum, pose challenges for noise reduction of polluted chaotic signals. To address these issues, an adaptive smoothing multiscale morphological filtering (ASMMF) is proposed to reconstruct chaotic signals. In the process of noise reduction for contaminated chaotic signals, firstly, a multiscale morphological filter is constructed adaptively according to the multiscale permutation entropy (MPE) of morphological filter residuals, and the contaminated signals are filtered. Secondly, the weight coefficients of scale structural element are calculated by the residual sum of squares operation, and the chaotic signals are reconstructed. Finally, the resampled filter signals are smoothed by cubic B-spline interpolation operation. In the experiment, the Lorenz signal with white Gaussian noise, the measured sunspot, and the chaotic vibration signal are reconstructed by four comparison methods. The test results show that the proposed ASMMF method has obvious advantages in noise suppression and topological trajectory restoration.
Analysis of the Fiber Laydown Quality in Spunbond Processes with Simulation Experiments Evaluated by Blocked Neural Networks
Authors: Gramsch Simone , Sarishvili Alex , Schmeißer Andre
Published: February 2020

We present a simulation framework for spunbond processes and use a design of experiments to investigate the cause-and-effect relations of process and material parameters on the fiber laydown on a conveyor belt. The analyzed parameters encompass the inlet air speed and suction pressure, as well as the E modulus, density, and line density (titer) of the filaments. The fiber laydown produced by the virtual experiments is statistically quantified, and the results are analyzed by a blocked neural network. This forms the basis for the prediction of the fiber laydown characteristics and enables a quick ranking of the significance of the influencing effects. We conclude our research by an analysis of the nonlinear cause-and-effect relations. Compared to the material parameters, suction pressure and inlet air speed have a negligible effect on the fiber mass distribution in (cross)machine direction. Changes in the line density of the filament have a 10 times stronger effect than changes in E modulus or density. The effect of E modulus on the throwing range in machine direction is of particular note, as it reverses from increasing to decreasing in the examined parameter regime.
Advances in Research on the circRNA‐miRNA‐mRNA Network in Coronary Heart Disease Treated with Traditional Chinese Medicine
Authors: Lin Fei , Chen Heng-Wen , Zhao Guo-An , Li Yan , He Xuan-Hui , Liang Wan-Qian , Shi Zhuo-Lin , Sun Si-Yu , Tian Pan-Pan , Huang Ming-Yan , Liu Chao
Published: February 2020

There has been an increase in morbidity and mortality related to coronary heart disease (CHD) in China in recent years. Numerous clinical experiences and studies have shown that traditional Chinese medicine (TCM) plays an important role in the prevention, treatment, and prognosis of CHD. However, the mechanism of TCM in the treatment of CHD has not yet been elucidated. The circRNA‐miRNA‐mRNA network consists of miRNA that is competitively bound by circRNA, and miRNA regulates the transcription level of mRNA. Through literature review, we found that the circRNA‐miRNA‐mRNA network acts to contribute to certain effects to CHD such as myocardial hypertrophy, myocardial fibrosis, and heart failure. TCM contains constituents that act against CHD by antiatherosclerosis and apoptosis inhibition action, cardiac and cardiomyocyte protection, and these components also promote cell growth and protection of the vascular system by regulating miRNAs. Therefore, we consider that the circRNA‐miRNA‐mRNA network may be a new regulatory mechanism for the effective treatment of CHD by TCM.
Experimental Study of Shenfu Injection on the Prevention and Treatment of Paclitaxel Chemotherapy DRG Neuron Injury
Authors: Lv Panpan , Zhu Xi , Wang Jingyang , Li Guangping , Shen Xian Ying , Ke Jianlong , Wang Cui , Xiong Shaoquan
Published: February 2020

Purpose. The purpose of this paper is investigating the effect and mechanism of Shenfu injection (a Traditional Chinese Medicine injection form) on prevention and treatment of paclitaxel chemotherapy in peripheral nerve injury. Methods. Wistar rat dorsal root ganglion cells were cultured in vitro and divided into groups of MOCK, PT, PT + LD, and PT + HD. Each group was cultured at a total serum concentration of 10%, including 10% blank serum in the MOCK group, 0.73 (IC30) μmol/L paclitaxel + 10% blank serum in the PT group, and 10% and 5% drug‐containing serum and equal amount of paclitaxel were added into the high‐ and low‐dosage groups, respectively. After culturing for 24 hours, the following tests were performed: (1) cell proliferation detected by using CCK‐8 and a microplate reader; (2) axon length detected by cellular immunostaining and detection analysis on antibody β‐tubulin III; and (3) changes in mitochondrial membrane potential by analyzing immunofluorescence staining with JC‐1 probe. Results. (1) Cell proliferation: OD values of the MOCK group and PT group were 0.43 ± 0.02 and 0.25 ± 0.03, respectively (P < 0.05), while OD values of groups PT + LD and PT + HD were 0.41 ± 0.05 and 0.46 ± 0.03, respectively, higher than group PT (P < 0.05). (2) Axon length: (171.19 ± 9.2) μm and (59.2 ± 6.1) μm (P < 0.05) in the MOCK group and PT group, respectively; and (124.2 ± 18.3) um and (154.5 ± 22.9) um in the PT + LD and PT + HD groups, respectively, higher than the PT group (P < 0.05). (3) Changes in mitochondrial membrane potential: the MOCK group showed red fluorescence. Compared with the MOCK group, the green fluorescence of the PT group was enhanced and the red fluorescence was weakened. The red fluorescence of the PT + LD and PT + HD groups was partially enhanced compared with the PT group. Conclusion. Shenfu injection can prevent the toxicity of DRG neurons induced by paclitaxel, and its mechanism may be related to the alleviation of mitochondrial dysfunction.
Hepatocellular Glycogen Accumulation in the Setting of Poorly Controlled Type 1 Diabetes Mellitus: Case Report and Review of the Literature
Authors: Aluko Atinuke , Enofe Ikponmwosa , Burch Jacob , Yam Julie , Khan Nazia
Published: February 2020

Glycogenic hepatopathy (GH) is the accumulation of glycogen in the hepatocytes and represents a rare complication in patients with diabetes mellitus (DM), most commonly type 1 DM. We present a case of a 23-year-old woman with a medical history of poorly controlled type 1 DM and gastroesophageal reflux disease (GERD) who presented with progressively worsening right-sided abdominal pain. Diagnostic workup resulted in a liver biopsy with hepatocytes that stained heavily for glycogen with no evidence of fibrosis or steatohepatitis. A diagnosis of glycogenic hepatopathy was made, and an aggressive glucose control regimen was implemented leading to resolution of symptoms and improvement in AST, ALT, and ALP. In addition to presenting this rare case, we offer a review of literature and draw important distinctions between glycogenic hepatopathy and other differential diagnoses with the aim of assisting providers in the diagnostic workup and treatment of glycogenic hepatopathy.
Monocyte/Lymphocyte Ratio and Cardiovascular Disease Mortality in Peritoneal Dialysis Patients
Authors: Wen Yueqiang , Zhan Xiaojiang , Wang Niansong , Peng FenFen , Feng Xiaoran , Wu Xianfeng
Published: February 2020

Objectives. The monocyte-to-lymphocyte ratio (MLR), as a new marker of the systemic inflammatory response, is associated with cardiovascular disease (CVD) mortality in the general population and hemodialysis patients. However, the association between the MLR and CVD mortality in peritoneal dialysis (PD) has received little attention. Methods. In this multicenter retrospective cohort study, 1753 incident PD patients from November 1, 2005, to June 30, 2017, with a baseline MLR were enrolled. The primary endpoint was CVD mortality. The association of MLR with CVD mortality was assessed using a multivariable-adjusted Cox model and the Fine and Gray competing risk model. Results. Of 1753 patients, the mean age was 51.1±14.9 years, 56.9% of patients were male, and the Charlson comorbidity index was 4.29±1.75. During the follow-up period of 31.2±18.4 months, 368 patients died, of which 200 (54.3%) deaths were caused by CVD events. CVD mortality rates for the lowest, middle, and highest MLR tertiles were 70.6, 78.4, and 88.9 per 1000 patient-years, respectively (P<0.001). Kaplan-Meier analysis revealed that survival rates were significantly different among the three MLR groups (log rank=22.41, P<0.001). After adjusting for confounding factors, the highest MLR tertile was significantly associated with a hazard ratio (HR) for CVD mortality of 1.45 (95% confidence interval, 1.13-2.51, P=0.016). The Fine and Gray method analysis showed that using all-cause mortality as competing risk, the highest MLR tertile remained an independent predictor of CVD mortality (HR=1.39, 95% CI 1.10-2.47, P=0.021). Conclusions. Higher MLR levels at the commencement of PD may be independently associated with increased CVD mortality in PD patients.
Hypomethylation-Linked Activation of PLCE1 Impedes Autophagy and Promotes Tumorigenesis through MDM2-Mediated Ubiquitination and Destabilization of p53
Authors: Chen Yunzhao , Xin Huahua , Peng Hao , Shi Qi , Li Menglu , Yu Jie , Tian Yanxia , Han Xueping , Chen Xi , Zheng Yi , Li Jun , Yang Zhihao , Yang Lan , Hu Jianming , Huang Xuan , Liu Zheng , Huang Xiaoxi , Zhou Hong , Cui Xiaobin , Li Feng
Published: February 2020

Esophageal squamous cell carcinoma (ESCC) is one of the deadliest malignant diseases. Multiple studies with large clinic-based cohorts have revealed that variations of phospholipase C epsilon 1 (PLCE1) correlate with esophageal cancer susceptibility. However, the causative role of PLCE1 in ESCC has remained elusive. Here, we observed that hypomethylation-mediated upregulation of PLCE1 expression was implicated in esophageal carcinogenesis and poor prognosis in ESCC cohorts. PLCE1 inhibited cell autophagy and suppressed the protein expression of p53 and various p53-targeted genes in ESCC. Moreover, PLCE1 decreased the half-life of p53 and promoted p53 ubiquitination, whereas it increased the half-life of mouse double minute 2 homolog (MDM2) and inhibited its ubiquitination, leading to MDM2 stabilization. Mechanistically, the function of PLCE1 correlated with its direct binding to both p53 and MDM2, which promoted MDM2-dependent ubiquitination of p53 and subsequent degradation in vitro. Consequently, knockdown of PLCE1 combined with transfection of a recombinant adenoviral vector encoding wild-type p53 resulted in significantly increased levels of autophagy and apoptosis of esophageal cancer in vivo. Clinically, the upregulation of PLCE1 and mutant p53 protein predicted poor overall survival of patients with ESCC, and PLCE1 was positively correlated with p53 in ESCC cohorts. Collectively, this work identified an essential role for PLCE1- and MDM2-mediated ubiquitination and degradation of p53 in inhibiting ESCC autophagy and indicates that targeting the PLCE1–MDM2–p53 axis may provide a novel therapeutic approach for ESCC.

Significance:

These findings identify hypomethylation-mediated activation of PLCE1 as a potential oncogene that blocks cellular autophagy of esophageal carcinoma by facilitating the MDM2-dependent ubiquitination of p53 and subsequent degradation.
Revisiting Immunotherapy: A Focus on Prostate Cancer
Authors: Cha Ha-Ram , Lee Joo Hyoung , Ponnazhagan Selvarangan
Published: February 2020

Therapeutic interventions to harness the immune system against tumor cells have provided mixed results in the past for several solid tumors and hematologic malignancies. However, immunotherapy has advanced considerably over the last decade and is becoming an integral combination for treating patients with advanced solid tumors. In particular, prostate cancer immunotherapy has shown modest efficacy for patients in the past. With several key discoveries on immune mechanisms and advanced molecular diagnostic platforms recently, immunotherapy is re-emerging as a viable option for prostate cancer, especially castration-resistant prostate cancer (CRPC), to stimulate antitumor immunity. Combination of patient-tailored immunotherapy and immune checkpoint blockers with conventional cytotoxic agents and androgen receptor–targeted therapies should move the field forward. With a recent adaptation that the application of immune checkpoint inhibitors has been successful in the treatment of more than a dozen solid tumors, including melanoma, lymphoma, liver, cervical, gastrointestinal, and breast cancers, it is a timely endeavor to harness immunotherapy for prostate cancer. Here, we provide an account on the progression of immunotherapy with new discoveries and precision approaches for tumors, in particular CRPC, from mechanistic standpoint to emerging limitations and future directions.
A Tale of Two Diverse Qualtrics Samples: Information for Online Survey Researchers
Authors: Miller Carrie A. , Guidry Jeanine P.D. , Dahman Bassam , Thomson Maria D.
Published: February 2020

Background:

There is often a lack of transparency in research using online panels related to recruitment methods and sample derivation. The purpose of this study was to describe the recruitment and participation of respondents from two disparate surveys derived from the same online research panel using quota sampling.

Methods:

A commercial survey sampling and administration company, Qualtrics, was contracted to recruit participants and implement two Internet-based surveys. The first survey targeted adults aged 50 to 75 years and used sampling quotas to obtain diversity with respect to household income and race/ethnicity. The second focused on women aged 18 to 49 years and utilized quota sampling to achieve a geographically balanced sample.

Results:

A racially and economically diverse sample of older adults (n = 419) and a geographically diverse sample of younger women (n = 530) were acquired relatively quickly (within 12 and 4 days, respectively). With exception of the highest income level, quotas were implemented as requested. Recruitment of older adults took longer (vs. younger female adults). Although survey completion rates were reasonable in both studies, there were inconsistencies in the proportion of incomplete survey responses and quality fails.

Conclusions:

Cancer researchers, and researchers in general, should consider ways to leverage the use of online panels for future studies. To optimize novel and innovative strategies, researchers should proactively ask questions about panels and carefully consider the strengths and drawbacks of online survey features including quota sampling and forced response.

Impact:

Results provide practical insights for cancer researchers developing future online surveys and recruitment protocols.

See all articles in this CEBP Focus section, “Modernizing Population Science.”
Population-Based Registry Linkages to Improve Validity of Electronic Health Record–Based Cancer Research
Authors: Thompson Caroline A. , Jin Anqi , Luft Harold S. , Lichtensztajn Daphne Y. , Allen Laura , Liang Su-Ying , Schumacher Benjamin T. , Gomez Scarlett Lin
Published: February 2020

Background:

There is tremendous potential to leverage the value gained from integrating electronic health records (EHR) and population-based cancer registry data for research. Registries provide diagnosis details, tumor characteristics, and treatment summaries, while EHRs contain rich clinical detail. A carefully conducted cancer registry linkage may also be used to improve the internal and external validity of inferences made from EHR-based studies.

Methods:

We linked the EHRs of a large, multispecialty, mixed-payer health care system with the statewide cancer registry and assessed the validity of our linked population. For internal validity, we identify patients that might be “missed” in a linkage, threatening the internal validity of an EHR study population. For generalizability, we compared linked cases with all other cancer patients in the 22-county EHR catchment region.

Results:

From an EHR population of 4.5 million, we identified 306,554 patients with cancer, 26% of the catchment region patients with cancer; 22.7% of linked patients were diagnosed with cancer after they migrated away from our health care system highlighting an advantage of system-wide linkage. We observed demographic differences between EHR patients and non-EHR patients in the surrounding region and demonstrated use of selection probabilities with model-based standardization to improve generalizability.

Conclusions:

Our experiences set the foundation to encourage and inform researchers interested in working with EHRs for cancer research as well as provide context for leveraging linkages to assess and improve validity and generalizability.

Impact:

Researchers conducting linkages may benefit from considering one or more of these approaches to establish and evaluate the validity of their EHR-based populations.

See all articles in this CEBP Focus section, “Modernizing Population Science.”
Using Continuous Glucose Monitoring to Motivate Physical Activity in Overweight and Obese Adults: A Pilot Study
Authors: Liao Yue , Basen-Engquist Karen M. , Urbauer Diana L. , Bevers Therese B. , Hawk Ernest , Schembre Susan M.
Published: February 2020

Background:

Regular physical activity (PA) is associated with a lower risk of several types of cancers. However, two-thirds of overweight/obese adults are not sufficiently active; this, in combination with the unfavorable effect of excess body weight, puts them at a greater risk for cancer. One reason that these individuals do not engage in enough PA may be their lack of motivation to change their current behavior due to the perception of putting in effort for possible future gain without obvious short-term benefits. There is a need for innovative ways to help individuals recognize the immediate health benefits of PA and thus increase their motivation.

Methods:

This pilot intervention tested a PA education module that included a one-on-one counseling session highlighting the acute effects of PA on glucose patterns, followed by a 10-day self-monitoring period with a continuous glucose monitor (CGM) and a Fitbit tracker. Participants rated the acceptability of the education module on a 5-point Likert scale and completed surveys assessing stages of change for motivational readiness.

Results:

Nineteen overweight/obese adults (84% female) completed the study. Participants gave high ratings to the counseling session for improving their PA-related knowledge (mean = 4.22), increasing motivation (mean = 4.29), and providing personally relevant information (mean = 4.35). The summary acceptability scores for the self-monitoring period were 4.46 for CGM and 4.51 for Fitbit. Participants reported a significant decrease in the precontemplation stage and an increase in the action stage (P < 0.05).

Conclusions:

CGM is a feasible tool for PA interventions.

Impact:

Information from CGM could be used as biological-based feedback to motivate PA.

See all articles in this CEBP Focus section, “Modernizing Population Science.”
Assessing Cancer Treatment Information Using Medicare and Hospital Discharge Data among Women with Non-Hodgkin Lymphoma in a Los Angeles County Case–Control Study
Authors: Zhong Charlie , Seibold Petra , Chao Chun R. , Cozen Wendy , Song Joo Y. , Weisenburger Dennis , Bernstein Leslie , Wang Sophia S.
Published: February 2020

Background:

We assessed the ability to supplement existing epidemiologic/etiologic studies with data on treatment and clinical outcomes by linking to publicly available cancer registry and administrative databases.

Methods:

Medical records were retrieved and abstracted for cases enrolled in a Los Angeles County case–control study of non-Hodgkin lymphoma (NHL). Cases were linked to the Los Angeles County cancer registry (CSP), the California state hospitalization discharge database (OSHPD), and the SEER-Medicare database. We assessed sensitivity, specificity, and positive predictive value (PPV) of cancer treatment in linked databases, compared with medical record abstraction.

Results:

We successfully retrieved medical records for 918 of 1,004 participating NHL cases and abstracted treatment for 698. We linked 59% of cases (96% of cases >65 years old) to SEER-Medicare and 96% to OSHPD. Chemotherapy was the most common treatment and best captured, with the highest sensitivity in SEER-Medicare (80%) and CSP (74%); combining all three data sources together increased sensitivity (92%), at reduced specificity (56%). Sensitivity for radiotherapy was moderate: 77% with aggregated data. Sensitivity of BMT was low in the CSP (42%), but high for the administrative databases, especially OSHPD (98%). Sensitivity for surgery reached 83% when considering all three datasets in aggregate, but PPV was 60%. In general, sensitivity and PPV for chronic lymphocytic leukemia/small lymphocytic lymphoma were low.

Conclusions:

Chemotherapy was accurately captured by all data sources. Hospitalization data yielded the highest performance values for BMTs. Performance measures for radiotherapy and surgery were moderate.

Impact:

Various administrative databases can supplement epidemiologic studies, depending on treatment type and NHL subtype of interest.
Therapies in Inflammatory Bowel Disease Patients with Extraintestinal Manifestations
Authors: Juillerat Pascal , Manz Michael , Sauter Bernhard , Zeitz Jonas , Vavricka Stephan R. ,   on behalf of the Swiss IBDnet, an official working group of the Swiss Society of Gastroenterology
Published: February 2020

Extraintestinal manifestations (EIM) have become an important source of morbidity and disability as well as an identified risk factor for an unfavorably course of disease in inflammatory bowel diseases (IBD). Therefore, efforts have been put into a more global and interdisciplinary management of IBD patients in collaboration with rheumatologists, dermatologists, and ophthalmologists. A real therapeutic success has also been obtained with a more “systemic” IBD treatment associated with the development of monoclonal antibodies against TNF alpha and biological agents derived from the treatment of rheumatological disease (also called biological Disease-Modifying Antirheumatic Drugs). The prevalence of these EIM remains too low to undergo randomized controlled trials with this specific focus and therefore the evidence relies on case series and experts’ opinions, which lowers the level of evidence. After a careful review of the most recent literature, this paper aims to update the reader on the latest therapeutic management of IBD patients with EIM.
Sólon de Atenas: a cidadania antiga
Authors:   Universidade de São Paulo. Faculdade de Filosofia, Letras e Ciências Humanas, Barros Gilda Naécia Maciel de
Published: February 2020

O assunto tratado nessa obra foi objeto de pesquisas para a tese de doutoramento Sólon, uma Paideia para a Cidadania, apresentada à Faculdade de Educação da USP em 1973, mas mereceu, para a atual publicação, um reexame mais abrangente, tanto no que se refere à bibliografia quanto à forma. Assim, simplificamos o texto original, reelaborando-o, às vezes deixando de lado observações mais adequadas a um trabalho que visava, então, à obtenção de um grau acadêmico. Na verdade, com essa iniciativa, desejamos estimular uma reflexão específica sobre o tema "Cidadania e Educação", que, em nosso modo de ver, pode ser iluminada com a leitura dos autores antigos, a começar por Sólon, o ateniense.
Record of a 10-year old European Wildcat Felis silvestris silvestris Schreber, 1777 (Mammalia: Carnivora: Felidae) from Mt. Etna, Sicily, Italy
Authors: Anile Stefano , Devillard Sebastien , Nielsen Clayton Kent , Lo Valvo Mario
Published: February 2020

Longevity data for wild felids are lacking in the literature.  Here we report a camera trap recapture of a European Wildcat Felis silvestris at Mt. Etna in Sicily, Italy after nine years.  This individual was clearly identifiable as its tail ended with a white ring rather than the typical black ring and had a unique shape of the dorsal stripe.  At first capture on 26 May 2009, this cat was assessed as an adult, so that the likely minimum age of this individual at the time of recapture on 10 June 2018 must have been be at least 10 years.  This finding represents the oldest known European Wildcat in the wild and provides insight into age structure in wildcat populations.
Report of the National Heart, Lung, and Blood Institute Working Group on Hypertension
Authors: Sigmund Curt D. , Carey Robert M. , Appel Lawrence J. , Arnett Donna K. , Bosworth Hayden B. , Cushman William C. , Galis Zorina S. , Green Parker Melissa , Hall John E. , Harrison David G. , McDonough Alicia A. , Nicastro Holly L. , Oparil Suzanne , Osborn John W. , Raizada Mohan K. , Wright Jacqueline D. , Oh Young S.
Published: February 2020

The National Heart, Lung, and Blood Institute convened a multidisciplinary working group of hypertension researchers on December 6 to 7, 2018, in Bethesda, MD, to share current scientific knowledge in hypertension and to identify barriers to translation of basic into clinical science/trials and implementation of clinical science into clinical care of patients with hypertension. The goals of the working group were (1) to provide an overview of recent discoveries that may be ready for testing in preclinical and clinical studies; (2) to identify gaps in knowledge that impede translation; (3) to highlight the most promising scientific areas in which to pursue translation; (4) to identify key challenges and barriers for moving basic science discoveries into translation, clinical studies, and trials; and (5) to identify roadblocks for effective dissemination and implementation of basic and clinical science in real-world settings. The working group addressed issues that were responsive to many of the objectives of the National Heart, Lung, and Blood Institute Strategic Vision. The working group identified major barriers and opportunities for translating research to improved control of hypertension. This review summarizes the discussion and recommendations of the working group.
Randomized Dose-Response Study of the New Dual Endothelin Receptor Antagonist Aprocitentan in Hypertension
Authors: Verweij Pierre , Danaietash Parisa , Flamion Bruno , Ménard Joël , Bellet Marc
Published: February 2020

This study examined the dose-response characteristics of aprocitentan, a dual endothelin A/endothelin B receptor antagonist, in patients with essential hypertension. In a randomized, double-blind, parallel study design, eligible patients with a sitting diastolic blood pressure (BP) of 90–109 mm Hg received aprocitentan 5, 10, 25, or 50 mg, placebo, or lisinopril 20 mg as a positive control once daily for 8 weeks. Multiple automated office BP readings were obtained with patients resting unattended (unattended automated office BP) at baseline, weeks 2, 4, and 8. Ambulatory BP was monitored for 24 hours at baseline and week 8. After a single-blind placebo run-in period, 490 eligible patients were randomized to the double-blind phase, with 409 patients completing 8 weeks of therapy per protocol. Aprocitentan 10, 25, and 50 mg decreased sitting systolic/diastolic unattended automated office BP from baseline to week 8 (placebo-corrected decreases: 7.05/4.93, 9.90/6.99, and 7.58/4.95 mm Hg, respectively,
P
≤0.014 versus placebo), compared with an unattended automated office BP reduction of 4.84/3.81 mm Hg with lisinopril 20 mg. For patients with valid ambulatory BP, aprocitentan 10, 25, and 50 mg significantly decreased placebo-corrected 24-hour BP by 3.99/4.04, 4.83/5.89, and 3.67/4.45 mm Hg, respectively. Incidence of adverse events was similar in the aprocitentan groups (22.0%–40.2%) and the placebo group (36.6%). Aprocitentan produced dose-dependent decreases in hemoglobin, hematocrit, albumin, and uric acid, an increase in estimated plasma volume, but no change in weight versus placebo. These findings support further investigation of aprocitentan at doses of 10 to 25 mg in hypertension.

Registration—

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02603809.
Elevated Eosinophils as a Feature of Inflammation Associated With Hypertension in Virally Suppressed People Living With HIV
Authors: Masenga Sepiso K. , Elijovich Fernando , Hamooya Benson M. , Nzala Selestine , Kwenda Geoffrey , Heimburger Douglas C. , Mutale Wilbroad , Munsaka Sody M. , Zhao Shilin , Koethe John R. , Kirabo Annet
Published: February 2020

Background

People living with
HIV
(
PLWH
) are at increased risk of cardiovascular disease, including hypertension, which persists despite effective plasma viral suppression on antiretroviral therapy.
HIV
infection is characterized by long‐term alterations in immune function, but the contribution of immune factors to hypertension in
PLWH
is not fully understood. Prior studies have found that both innate and adaptive immune cell activation contributes to hypertension.

Methods and Results

We hypothesized that chronic inflammation may contribute to hypertension in
PLWH
. To test this hypothesis, we enrolled a cohort of 70
PLWH
(44% hypertensive) on a long‐term single antiretroviral therapy regimen for broad phenotyping of inflammation biomarkers. We found that hypertensive
PLWH
had higher levels of inflammatory cytokines, including tumor necrosis factor‐α receptor 1, interleukin‐6, interleukin‐17, interleukin‐5, intercellular adhesion molecule 1 and macrophage inflammatory protein‐1α. After adjustment for age, sex, and fat mass index, the circulating eosinophils remained significantly associated with hypertension. On the basis of these results, we assessed the relationship of eosinophils and hypertension in 2 cohorts of 50 and 81 039 similar
HIV
‐negative people; although eosinophil count was associated with prevalent hypertension, this relationship was abrogated by body mass index.

Conclusions

These findings may represent a unique linkage between immune status and cardiovascular physiological characteristics in
HIV
infection, which should be evaluated further.
Angina Hospitalization Rates in Women With Signs and Symptoms of Ischemia But no Obstructive Coronary Artery Disease: A Report from the WISE (Women's Ischemia Syndrome Evaluation) Study
Authors: Aldiwani Haider , Zaya Melody , Suppogu Nissi , Quesada Odayme , Johnson B. Delia , Mehta Puja K. , Shufelt Chrisandra , Petersen John , Azarbal Babak , Samuels Bruce , Anderson R. David , Shaw Leslee J. , Kar Saibal , Handberg Eileen , Kelsey Sheryl F. , Pepine Carl J. , Bairey Merz C. Noel
Published: February 2020

Background

Recurrent hospitalization is prevalent in women with signs and symptoms of ischemia and no obstructive coronary artery disease. We hypothesized that rates of angina hospitalization might have changed over time, given advances in diagnostic and therapeutic approaches.

Methods and Results

We evaluated 551 women enrolled in the WISE (Women's Ischemia Syndrome Evaluation) study with no obstructive coronary artery disease (CAD) for a follow‐up period of 9.1 years. We analyzed angina hospitalization rates using the Kaplan‐Meier method. Univariate analysis and multivariable Cox proportional hazard models were developed for prediction of angina hospitalization in women with signs and symptoms of angina and no CAD. A total of 223 women had nonobstructive CAD (>20–50% <stenosis) and 328 had no CAD (<20% stenosis). Among women with either no or nonobstructive CAD, the mean age was 56±11 years, 56% had hypertension, 46% dyslipidemia, 51% were smokers, and 10% had prior myocardial infarction. The rates of angina hospitalization for a maximum of 9.1 years showed near‐linear increases in both groups (
P
=0.03). Hypertension, dyslipidemia, nonobstructive CAD, use of nitrates, statins, and angiotensin‐converting enzyme inhibitors were univariate predictors of angina hospitalization. Adjusted multivariate hazard ratios for angina hospitalization were significant for use of nitrates 2.58 (1.80–3.69,
P
<0.0001), statins 1.80 (1.20–2.70,
P
=0.004), and angiotensin‐converting enzyme inhibitors/angiotensin II receptor blockers 1.81 (1.22–2.68,
P
=0.003).

Conclusions

Angina hospitalization rates continued at a relatively constant rate in all women with no obstructive CAD despite medical advances. Clinical trials aimed at reducing angina hospitalization rates and identifying the pathophysiological mechanisms contributing to angina symptoms in women with no CAD and women with no obstructive CAD.
Metabolomic Profiling of Left Ventricular Diastolic Dysfunction in Women With or at Risk for HIV Infection: The Women's Interagency HIV Study
Authors: Bravo Claudio A. , Hua Simin , Deik Amy , Lazar Jason , Hanna David B. , Scott Justin , Chai Jin Choul , Kaplan Robert C. , Anastos Kathryn , Robles Octavio A. , Clish Clary B. , Kizer Jorge R. , Qi Qibin
Published: February 2020

Background

People living with
HIV
have an increased risk of left ventricular diastolic dysfunction (
LVDD
) and heart failure.
HIV
‐associated
LVDD
may reflect both cardiomyocyte and systemic metabolic derangements, but the underlying pathways remain unclear.

Methods and Results

To explore such pathways, we conducted a pilot study in the Bronx and Brooklyn sites of the WIHS (Women's Interagency
HIV
Study) who participated in concurrent, but separate, metabolomics and echocardiographic ancillary studies. Liquid chromatography tandem mass spectrometry–based metabolomic profiling was performed on plasma samples from 125 HIV‐infected (43 with LVDD) and 35 HIV‐uninfected women (9 with LVDD). Partial least squares discriminant analysis identified polar metabolites and lipids in the glycerophospholipid‐metabolism and fatty‐acid‐oxidation pathways associated with
LVDD
. After multivariable adjustment,
LVDD
was significantly associated with higher concentrations of diacylglycerol 30:0 (odds ratio [
OR
], 1.60, 95% CI [1.01–2.55]); triacylglycerols 46:0 (
OR
1.60 [1.04–2.48]), 48:0 (
OR
1.63 [1.04–2.54]), 48:1 (
OR
1.62 [1.01–2.60]), and 50:0 (
OR
1.61 [1.02–2.53]); acylcarnitine C7 (
OR
1.88 [1.21–2.92]), C9 (
OR
1.99 [1.27–3.13]), and C16 (
OR
1.80 [1.13–2.87]); as well as lower concentrations of phosphocholine (
OR
0.59 [0.38–0.91]). There was no evidence of effect modification of these relationships by
HIV
status.

Conclusions

In this pilot study, women with or at risk of
HIV
with
LVDD
showed alterations in plasma metabolites in the glycerophospholipid‐metabolism and fatty‐acid‐oxidation pathways. Although these findings require replication, they suggest that improved understanding of metabolic perturbations and their potential modification could offer new approaches to prevent cardiac dysfunction in this high‐risk group.
Age‐Related Sex Differences in Clinical Presentation, Management, and Outcomes in ST‐Segment–Elevation Myocardial Infarction: Pooled Analysis of 15 532 Patients From 7 Arabian Gulf Registries
Authors: Shehab Abdulla , Bhagavathula Akshaya Srikanth , Alhabib Khalid F. , Ullah Anhar , Suwaidi Jassim Al , Almahmeed Wael , AlFaleh Hussam , Zubaid Mohammad
Published: February 2020

Background

No studies from the Arabian Gulf region have taken age into account when examining sex differences in ST‐segment–elevation myocardial infarction (
STEMI)
presentation and outcomes. We examined the relationship between sex differences and presenting characteristics, revascularization procedures, and in‐hospital mortality after accounting for age in patients hospitalized with
STEMI
in the Arabian Gulf region from 2005 to 2017.

Methods and Results

This study was a pooled analysis of 31 620 patients with a diagnosis of acute coronary syndrome enrolled in 7 Arabian Gulf registries. Of these, 15 532 patients aged ≥18 years were hospitalized with a primary diagnosis of
STEMI
. A multiple variable regression model was used to assess sex differences in revascularization, in‐hospital mortality, and 1‐year mortality. Odds ratios and 95% CIs were calculated. Women were, on average, 8.5 years older than men (mean age: 61.7 versus 53.2 years; absolute standard mean difference: 68.9%). The age‐stratified analysis showed that younger women (aged <65 years) with STEMI were more likely to seek acute medical care and were less likely to receive thrombolytic therapies or primary percutaneous coronary intervention and guideline‐recommended pharmacotherapy than men. Women had higher crude in‐hospital mortality than men, driven mainly by younger age (46–55 years, odds ratio: 2.60 [95% CI, 1.80–3.7];
P
<0.001; 56–65 years, odds ratio: 2.32 [95% CI, 1.75–3.08];
P
<0.001; and 66–75 years, odds ratio: 1.79 [95% CI, 1.33–2.41];
P
<0.001). Younger women had higher adjusted in‐hospital and 1‐year mortality rates than younger men (
P
<0.001).

Conclusions

Younger women (aged ≤65 years) with
STEMI
were less likely to receive guideline‐recommended pharmacotherapy and revascularization than younger men during hospitalization and had higher in‐hospital and 1‐year mortality rates.
Sex Differences Among Participants in the Latin American Stroke Registry
Authors: Arauz Antonio , Serrano Fabiola , Ameriso Sebastián F. , Pujol‐Lereis Virginia , Flores Alan , Bayona Hernán , Fernández Huberth , Castillo Alejandro , Ecos Rosa , Vazquez Jorge , Amaya Pablo , Ruíz Angélica , López Minerva , Zapata Carlos , Roa Luis , Marquez‐Romero Juan Manuel , Morelos Eugenia , Ochoa Marco A. , Leon Carolina , Romero Felipe , Ruíz‐Sandoval José Luis , Reyes Abraham , Barboza Miguel A. , Valencia‐Chávez Ana M. , Rosa Calle‐La María P. , Abanto‐Argomedo Carlos , Benavides‐Vásquez Larry , Otiniano‐Sinfuentes Ricardo , Mernes Ricardo , Otto Christian , Valderrama Jaime , Martínez Carlos F. , Rodríguez Jaime E. , Ropero Brenda V. , López‐Valencia German , Soriano Eduardo , Gonzalez‐Oscoy Rodrigo , Arteaga Carmen , Mendez Beatriz , Ramos Cristina , Torrealba Gabriel
Published: February 2020

Background

Reports on sex differences in stroke outcome and risk factors are scarce in Latin America. Our objective was to analyze clinical and prognostic differences according to sex among participants in the
LASE
(Latin American Stroke Registry).

Methods and Results

Nineteen centers across Central and South America compiled data on demographics, vascular risk factors, clinical stroke description, ancillary tests, and functional outcomes at short‐term follow‐up of patients included from January 2012 to January 2017. For the present study, all these variables were analyzed according to sex at hospital discharge. We included 4788 patients with a median in‐hospital stay of 8 days (interquartile range, 5–8); 2677 were male (median age, 66 years) and 2111 female (median age, 60 years). Ischemic stroke occurred in 4293: 3686 as cerebral infarction (77%) and 607 as transient ischemic attack cases (12.7%); 495 patients (10.3%) corresponded to intracerebral hemorrhage. Poor functional outcome (modified Rankin scale, 3–6) was present in 1662 (34.7%) patients and 38.2% of women (
P
<0.001). Mortality was present in 6.8% of the registry, with 7.8% in women compared with 6.0% in men (
P
=0.01). Death and poor functional outcome for all‐type stroke showed a higher risk in female patients (hazard ratio, 1.3,
P
=0.03; and hazard ratio, 1.1,
P
=0.001, respectively).

Conclusions

A worse functional outcome and higher mortality rates occurred in women compared with men in the
LASE
, confirming sex differences issues at short‐term follow‐up.