bluuebunny/crossref_metadata_2025 huggingface dataset:
CIRCUMVALLATE PLACENTA COMPLICATING TO PRETERM PREMATURE RUPTURE OF MEMBRANES: A CASE REPORT
Authors: Das Dr. Badal , Pada Das Dr. Krishna , Ranjan Das Rajiv , Roy Dr. Debobroto , Sarkar Dr. Arpita , Sarkar Dr. Arpita
Published: December 2021

Circumvallate placenta, a morphological
abnormality of placenta can be defined as a thickened
placenta with a raised margin in an annular shape and it is
thought to be the result of a membranous fold of chorion
and amnion. A 23-year-old primigravida mother was
presented with grossly reduced liquor due to preterm
premature rupture of membranes at 32 weeks of gestation.
The preterm baby was delivered by emergency caesarean
section (category-2 caesarean section). A thorough gross
examination of the placenta was done and a thickened
circumvallate placenta was noted with a firm white
annular margin and normal umbilical cord insertion.
Histopathological findings were consistent with the
diagnosis of circumvallate placenta. Routine gross
examination of placenta is of immense important for better
understanding of pregnancy complications due to
placental abnormalities like circumvallate placenta.
EXPERIMENTAL STUDY OF HIGH STRENGTH CONCRETE OF M90 GRADE USING UNPROCESSED FLY ASH AND SILICA FUME
Authors: Sapkal Ajit R. , Jadhav Alankar V. , Nagendra M.V.
Published: December 2021

– Concrete is the most widely used construction
material in overall world due to its various advantages in the
infrastructural industries. The production of cement causes
atmospheric and environmental pollution by emitting carbon
dioxide into the atmosphere. Pozzolonic by products from
electrical industries are supplimentory cementitious
materials such as GGBS, fly ash, slag, Rice Husk are utilized
in recent years as cement alternative material for growing
HSC with progressed workability, energy and durability
with decreased permeability. High strength concrete (HSC)
is made with adding mineral admixtures like silica fume, fly
ash in the concrete. Using cementitious materials such as
unprocessed fly ash and silica fume in the High strength
concrete mix gives benefits in various ways. Also these
materials reduces emission of carbon dioxide in the
atmosphere. So that, It gives an environment friendly
concrete for the sustainable development. Preparing high
strength concrete by using these cementitious materials with
super plasticizers gives required strength.
AUTOMOTIVE HEALTH TRACKING USING IOT AND ARDUINO
Authors: Prakash Prakhar
Published: December 2021

This paper is concerned with the development
of an embedded system for detecting the vehicle condition by
monitoring the internal parameters used in evaluating the
vehicle's current health condition. An in-vehicle embedded
system is being developed in this project to generate a vehicle
health report (VHR) whenever the user requires it. It
predicts future errors, allowing the driver to travel without
interruption and avoid accidents. As a result, it warns the
driver of potential errors and assists him in driving safely.
The data needed to generate the health report is made up of
parameter values (outputs of in-built sensors) from various
systems inside the vehicle. Our framework is based on the
Arduino and IoT stages, which are used to separate various
parameters, for example, motor warming and fuel pipe
blockage, for safe and cautious driving. The data is sent to
IoT, where it can be checked by both the vehicle
manufacturer via distributed computing and the vehicle
owner via the Android application. The equipment unit
consists of an Arduino, a WI-FI module, a portable Androidbased device, and a unique parameter checking sensors
module. The ESP8266 WiFi Module is a self-contained SOC
with integrated TCP/IP protocol stack that can give any
microcontroller access to your WiFi network, which is used
in current generation automotive.
INVESTIGATION ON PREPARATION, CHARACTERIZATION AND PROPERTY EVALUATION OF FGM AL-SI ALLOY CASTINGS PRODUCED BY CAST-DECANTCAST (CDC) PROCESS
Authors: Anandavel Dr. B. , Anburaj Dr J , Thillairajan Dr K , Devakannan V
Published: December 2021

Aim of this research paper is to study the
microstructural behavior and mechanical properties of
Functionally Gradient (FG) layer of Al-Si alloy castings
produced by CDC process. The effect of decantation time
on the thickness of functionally gradient castings of Al-4.5
wt % Si alloy as an inner layer and Al-Si alloy with 12.5 wt
%Si as outer layers was studied by CDC process. The
three different combinations of FGM castings were
characterized for microstructural and wear behavior using
metallurgical characterization and mechanical testing.
From the microstructural and wear behavior of FGM
casting at outer layer, FG layer and inner layer, it is
observed that the FG layer of FGM casting showed very
wear resistance compared to other two layers in the FGM
casting.
OPTICAL CHARACTER RECOGNITION FOR ELECTRONIC INVOICES USING AWS SERVICES
Authors: M. Patel Sameer , S. Pai Sarvesh , B. Jain Mittal , P. Vasani Vaibhav
Published: December 2021

Optical Character Recognition is basically
the mechanical or electronic conversion of printed or
handwritten text into machine understandable text. The
complication of Optical Character Recognition in
different conditions remains as relevant as it was in the
past few years. At the present time of automation and
innovations, Keyboarding remains the most common
way of inputting or feeding data into computers. This is
probably the most time consuming and labor-intensive
operation in the industry. Automating the process of
recognition of documents, credit cards, electronic
invoices, and license plates of cars – all of this could help
in saving time for analyzing and processing data. With
the increased research and development of machine
learning, the quality of text recognition is continuously
growing better. Our paper is focused on providing a
brief explanation of the different stages involved in the
process of optical character recognition and through the
proposed application; we aim to automate the process of
extraction of important texts from electronic invoices.
The main goal of the project is to develop a real time
OCR web application with a micro service architecture,
which would help in extracting necessary information
from an invoice.
PSYCHOLOGICAL STATE OF INDIVIDUALS IN SEEKING THE SELF: A CRITICAL STUDY OF 21ST CENTURY LITERATURE
Authors: Mayavan Dr L
Published: December 2021

In psychology, personality crisis is
the inability in adolescents to establish ego
identification. The psychologist Erikson coined the
term. Identity unity vs. function ambiguity is the
stage of psycho-social growth in which identity
conflicts arise. Psychological literary criticism had
its base in the psychoanalytical thoughts put
forward by Sigmund Freud. After Freud, some
theories by Neo-Freudians such as Jung and Adler
also became a part of it. Critics, who choose
Psychological literary criticism, champion one
particular psychological theory and apply it to
works of all the authors. Considering this,
Fromm's Humanistic Psychoanalysis has a lot of
scope to be used as a theory for Psychological
literary criticism. The current study aims to fill
this gap in the psychological literature, linking
Maslow’s theory to contemporary theory and
research on personality and well-being.
Prevalence of Scoliosis in Hypermobile Ehlers-Danlos Syndrome
Authors: Gillas Fabrice , Mekki Ahmed , Foy Malika , Carlier Robert , Benistan Karelle
Published: December 2021

Objective: The main purpose of this study was to evaluate the prevalence, form, and severity of scoliosis in a population of adults meeting the 2017 criteria for hypermobile Ehlers-Danlos syndrome (hEDS). The second objective was to compare the prevalence of scoliosis versus other criteria at initial hEDS diagnosis.

Methods: A retrospective study looking at the frequency and severity of scoliosis in adults (N=28) meeting the 2017 diagnostic criteria for hEDS through analysis of a full spine EOS® X-ray (EOS imaging, Paris, France) performed at the initial diagnosis. Severity was defined by the Cobb angle.

Results: At the initial diagnosis, the mean age was 30.1 years (standard deviation [SD]: ±10.18 years). Twenty-nine percent (n=8/28) of patients fulfilling hEDS criteria presented with scoliosis. Thirty-two percent (n=9/28) of patients had scoliotic inflection and 39% (n=11/28) had no scoliosis. Scoliosis was mild-to-moderate with a mean Cobb angle of 13.6° (SD: ±3.5°). None of the patients had severe scoliosis requiring surgery. Compared to the 2017 diagnostic criteria, it is noteworthy that scoliosis prevalence in this present study population ranks at the level of the most frequent ones.

Conclusion: This study provides interesting information regarding frequency of scoliosis and scoliotic inflection in a group of patients with hEDS. Although the patients did not present with severe forms of scoliosis at initial diagnosis, the results highlight the importance of systematically looking for scoliosis in adult and young patients, in order to follow progression and ensure appropriate management.
Review of Rifaximin: A Summary of the Current Evidence and Benefits Beyond Licensed Use
Authors: Nathwani Rooshi , Mullish Benjamin , Kockerling David , Cole Alexander , Selvapatt Nowlan , Dhar Ameet
Published: December 2021

Antibiotic resistance in patients with cirrhosis continues to draw significant attention. With a propensity to frequent hospitalisations, patients with cirrhosis are subject to frequent antibiotic prescription. This increases their risk of developing resistance to one or more antimicrobial agents, making management of their condition particularly challenging. Despite advancements being made in the management of liver disease, mortality rates continue to rise: almost 5-fold in those <65 years of age while remaining the leading cause of death in those 35–49 years of age. Alternative therapeutic options to prevent disease progression and cirrhosis-associated complications are urgently required; rifaximin is one such example. The medication use in patients with cirrhosis demonstrates additional benefits beyond current licensed use in the UK, that being for the prevention of hepatic encephalopathy and traveller’s diarrhoea; rifaximin has especially been explored beyond current licensed use in the context of enteric-driven pathologies. Through the therapy’s key central action as a broad-spectrum antimicrobial, rifaximin has the ability to modulate the gut–liver axis via removal of gut microbial products associated with the progression of cirrhosis and its sequalae.

The benefits of rifaximin use continues to gather momentum, given its non-absorbable nature and well-tolerated side-effect profile, and these require consideration. With broad-spectrum antimicrobial properties, its use may assist in overcoming the conundrum posed of antibiotic resistance amongst patients with cirrhosis. This literature review discusses the chemical and antimicrobial properties of rifaximin, its licenced indication for use, and its reported benefits beyond this, as well as concerns regarding rifaximin resistance.
Which Biologic Therapies to Treat Active Rheumatoid Arthritis and When?
Authors: Blundell Anna , Sofat Nidhi
Published: December 2021

Biological disease-modifying anti-arthritis drugs (bDMARD) have transformed rheumatoid arthritis (RA) treatment and allowed many patients to reach clinical remission. With the huge growth in the development of different bDMARDs, there is now a need to decide on which treatment should be prescribed to achieve optimal patient outcomes. Decisions are made by weighing up the comparative efficacy of each agent against risks, namely the risk of bacterial infections. The most powerful tools for investigating the comparative efficacy of bDMARDs are head-to-head trials that directly compare one therapy to another; however, very few trials of this type exist. Furthermore, the heterogeneity of RA calls for consideration of the comparative efficacy of therapies on an individual basis. Many studies have found associations between specific biomarkers and response to different bDMARDs to enable stratification of patient groups, although many results have not been reproducible in different cohorts. Combining predictors to create models of treatment response may be the ultimate key to finding reliable biomarkers with enough predictive power to enable a personalised medicine approach to treating RA in the clinic.
Cardio-Metabolic Benefits of Walnuts in Type 2 Diabetes Mellitus: A Literature Review
Authors: Njike Valentine Y , Kela Genevieve Cecile , Khan Nisar , Ayettey Rockiy , Tindong Maxime , Treu Judith A , Costales Victoria
Published: December 2021

Diabetes and its complications are main causes of morbidity and mortality among adults in the USA. An increase in the number of individuals with diabetes is primarily attributed to changes in dietary patterns including increased consumption of obesogenic foods and beverages. Many individuals who are overweight and obese show signs of insulin resistance and are at increased risk of Type 2 diabetes mellitus (T2DM) and cardiovascular disease. Lifestyle interventions (i.e., physical activity and nutrition) are the cornerstone of T2DM management and prevention. Prior research attests to the health benefits of consuming nuts, which have a substantial amount of mono- and polyunsaturated fatty acids, for individuals at risk for or with T2DM, and walnuts appear to be particularly promising. Walnuts are rich in nutrients, minerals, antioxidants, and vitamins that can contribute to improved cardio-metabolic risk factors in individuals at risk for or with T2DM. This review assesses the cardio-metabolic benefits of walnuts in T2DM. The authors’ review indicates that the reported effects of walnuts on glycaemic control have been inconclusive, with several studies showing association with improved glycaemic control while others show no effect. Despite their high energy density and potential to contribute to weight gain, the authors’ review suggests that walnuts can contribute to satiety without association with weight gain. This review also suggests that walnut consumption has been associated with improved low-density lipoprotein cholesterol levels and endothelial function but has not been associated with blood pressure improvement. Meta-analyses are warranted to quantitatively assess impact of walnut consumption on these cardio-metabolic risk factors in T2DM.
A Review of Primary Immune Deficiency Disorders
Authors: Darian Talin , `Freij Joudeh B , Seth Divya , Poowuttikul Pavadee , Secord Elizabeth
Published: December 2021

This scenario-based review of primary immunodeficiency diseases (PIDD) discusses the differential diagnosis, usual presentations, work-up, and treatment of children with the most commonly encountered immune disorders. Newborn screening (NBS) for severe combined immunodeficiency (SCID) is covered, as are later presenting disorders caused by B cell defects and disorders of the innate immune system.
The Role of Dexmedetomidine for the Prevention of Acute Kidney Injury in Critical Care
Authors: Ruegg Gion , Luethi Nora , Cioccari Luca
Published: December 2021

Acute kidney injury (AKI) occurs in up to 50% of patients admitted to the intensive care unit and is associated with increased mortality. Currently, there is no effective pharmacotherapy for prevention or treatment of AKI. In animal models of sepsis and ischaemia-reperfusion, α2-agonists like dexmedetomidine (DEX) exhibit anti-inflammatory properties and experimental data indicate a potential protective effect of DEX on renal function. However, clinical trials have yielded inconsistent results in critically ill patients. This review discusses the pathophysiological mechanisms involved in AKI, the renal effects of DEX in various intensive care unit-related conditions, and summarises the available literature addressing the use of DEX for the prevention of AKI.
Drug-induced agranulocytosis (clinical observation)
Authors: Sokolova N. A. , Pozdnyakova L. V. , Tatarinova I. S.
Published: December 2021

The majority of agranulocytosis cases are caused by drugs, including nonsteroidal anti-inﬂammatory drugs, antibiotics, antithyroid agents, etc. Here, we report a case of severe agranulocytosis in a 67-year-old woman following nonsteroidal anti-inﬂammatory therapy which was successfully managed using recombinant human granulocyte colony-stimulating factor. Although metamizole, has been in use since 1922 in the management of postoperative pain, colic pain, cancer pain and migraine, agranulocytosis as a direct side effect of metamizole therapy has been rarely reported. It is important to keep in mind this rare but potentially life-threatening adverse effect of metamizole, when initiating therapy.
Fysik och kemi i fokus för kommunikationen mellan lärare och barn i förskolan
Authors: Fridberg Marie , Jonsson Agneta , Redfors Andreas , Thulin Susanne
Published: December 2021

Den här artikeln sammanfattar resultaten från tre studier om förskollärares och barns samtal under naturvetenskapliga aktiviteter, där kreativt skapande varit en del av upplägget. Resultatet visar hur möjligheten till lärande kan hindras när förskollärare och barn har fokus på olika delar i en undervisningssituation och ger exempel på vad man som lärare kan tänka på för att gemensamt fokus ska bibehållas. Studierna pekar även ut möjliga fallgropar att som förskollärare vara medveten om i arbetet med ett naturvetenskapligt lärande, till exempel abstraktioner. Slutligen diskuteras de kommunikationsmönster som kunnat identifieras hos förskollärare och barn i de naturvetenskapliga aktiviteterna.
Insights to Heart Development and Cardiac Disease Models Using Pluripotent Stem Cell Derived 3D Organoids
Authors: Pang Jeremy Kah Sheng , Ho Beatrice Xuan , Chan Woon-Khiong , Soh Boon-Seng
Published: December 2021

Medical research in the recent years has achieved significant progress due to the increasing prominence of organoid technology. Various developed tissue organoids bridge the limitations of conventional 2D cell culture and animal models by recapitulating in vivo cellular complexity. Current 3D cardiac organoid cultures have shown their utility in modelling key developmental hallmarks of heart organogenesis, but the complexity of the organ demands a more versatile model that can investigate more fundamental parameters, such as structure, organization and compartmentalization of a functioning heart. This review will cover the prominence of cardiac organoids in recent research, unpack current in vitro 3D models of the developing heart and look into the prospect of developing physiologically appropriate cardiac organoids with translational applicability. In addition, we discuss some of the limitations of existing cardiac organoid models in modelling embryonic development of the heart and manifestation of cardiac diseases.
Notoginsenoside R1 Protects Against High Glucose-Induced Cell Injury Through AMPK/Nrf2 and Downstream HO-1 Signaling
Authors: Du Fawang , Huang Huiling , Cao Yalin , Ran Yan , Wu Qiang , Chen Baolin
Published: December 2021

Notoginsenoside R1 (NGR1), the primary bioactive compound found in Panax notoginseng, is believed to have antihypertrophic and antiapoptotic properties, and has long been used to prevent and treat cardiovascular diseases. However, its potential role in prevention of diabetic cardiomyopathy remains unclear. The present study aimed to investigate the mechanism of NGR1 action in high glucose-induced cell injury. H9c2 cardiomyocytes were cultured in a high-glucose medium as an in-vitro model, and apoptotic cells were visualized using TUNEL staining. Expression of Nrf2 and HO-1 was measured using Western blotting or reverse transcription-quantitative PCR (RT-qPCR). The Nrf2 small interfering (si) RNA was transfected into cardiomyocytes using Opti-MEM containing Lipofectamine® RNAiMAX. NGR1 protected H9c2 cardiomyocytes from cell death, apoptosis and hypertrophy induced by high glucose concentration. Expression of auricular natriuretic peptide and brain natriuretic peptide was remarkably reduced in NGR1-treated H9C2 cells. Western blot analysis showed that high glucose concentration markedly inhibited AMPK, Nrf2 and HO-1, and this could be reversed by NGR1 treatment. However, the cardioprotective effect of NGR1 was attenuated by compound C, which reverses Nrf2 and HO-1 expression levels, suggesting that AMPK upregulates Nrf2 and HO-1 gene expression, protein synthesis and secretion. Transfection of H9C2 cells with Nrf2 siRNA markedly reduced the cardioprotective effect of NGR1 via reduced expression of HO-1. These results indicated that NGR1 attenuated high glucose-induced cell injury via AMPK/Nrf2 signaling and its downstream target, the HO-1 pathway. We conclude that the cardioprotective effects of NGR1 result from upregulation of AMPK/Nrf2 signaling and HO-1 expression in cardiomyocytes. Our findings suggest that NGR1 treatment might provide a novel therapy for diabetic cardiomyopathy.
Distinct Metagenomic Signatures in the SARS-CoV-2 Infection
Authors: Liu Yijun , Zhang Hongyang , Tang Xiaojun , Jiang Xuejun , Yan Xiaojuan , Liu Xizhao , Gong Jiang , Mew Kenley , Sun Hao , Chen Xiufeng , Zou Zhen , Chen Chengzhi , Qiu Jingfu
Published: December 2021

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause gastrointestinal symptoms in the patients, but the role of gut microbiota in SARS-CoV-2 infection remains unclear. Thus, in this study, we aim to investigate whether SARS-CoV-2 infection affects the composition and function of gut microbiota. In this study, we demonstrated for the first time that significant shifts in microbiome composition and function were appeared in both SARS-CoV-2-infected asymptomatic and symptomatic cases. The relative abundance of Candidatus_Saccharibacteria was significantly increased, whereas the levels of Fibrobacteres was remarkably reduced in SARS-CoV-2-infected cases. There was one bacterial species, Spirochaetes displayed the difference between patients and asymptomatic cases. On the genus level, Tyzzerella was the key species that remarkably increased in both symptomatic and asymptomatic cases. Analyses of genome annotations further revealed SARS-CoV-2 infection resulted in the significant ‘functional dysbiosis’ of gut microbiota, including metabolic pathway, regulatory pathway and biosynthesis of secondary metabolites etc. We also identified potential metagenomic markers to discriminate SARS-CoV-2-infected symptomatic and asymptomatic cases from healthy controls. These findings together suggest gut microbiota is of possible etiological and diagnostic importance for SARS-CoV-2 infection.
Total Laboratory Automation and Three Shifts Reduce Turnaround Time of Cerebrospinal Fluid Culture Results in the Chinese Clinical Microbiology Laboratory
Authors: Zhang Weili , Wu Siying , Deng Jin , Liao Quanfeng , Liu Ya , Xiong Li , Shu Ling , Yuan Yu , Xiao Yuling , Ma Ying , Kang Mei , Li Dongdong , Xie Yi
Published: December 2021

Background

Total laboratory automation (TLA) has the potential to reduce specimen processing time, optimize workflow, and decrease turnaround time (TAT). The purpose of this research is to investigate whether the TAT of our laboratory has changed since the adoption of TLA, as well as to optimize laboratory workflow, improve laboratory testing efficiency, and provide better services of clinical diagnosis and treatment.

Materials and Methods

Laboratory data was extracted from our laboratory information system in two 6-month periods: pre-TLA (July to December 2019) and post-TLA (July to December 2020), respectively.

Results

The median TAT for positive cultures decreased significantly from pre-TLA to post-TLA (65.93 vs 63.53, P<0.001). For different types of cultures, The TAT of CSF changed the most (86.76 vs 64.30, P=0.007), followed by sputum (64.38 vs 61.41, P<0.001), urine (52.10 vs 49,57, P<0.001), blood (68.49 vs 66.60, P<0.001). For Ascites and Pleural fluid, there was no significant difference (P>0.05). Further analysis found that the incidence of broth growth only for pre-TLA was 12.4% (14/133), while for post-TLA, it was 3.4% (4/119). The difference was statistically significant (P=0.01). The common isolates from CSF samples were Cryptococcus neoformans, coagulase-negative Staphylococcus, Acinetobacter baumannii, and Klebsiella pneumonia.

Conclusion

Using TLA and setting up three shifts shortened the TAT of our clinical microbiology laboratory, especially for CSF samples.
Rapid Detection of blaKPC, blaNDM, blaOXA-48-like and blaIMP Carbapenemases in Enterobacterales Using Recombinase Polymerase Amplification Combined With Lateral Flow Strip
Authors: Wang Fang , Wang Lei , Chen Huimin , Li Na , Wang Yan , Li Yan , Liang Wei
Published: December 2021

The emergence of carbapenemase-producing Enterobacterales (CPE) infections is a major global public health threat. Rapid and accurate detection of pathogenic bacteria is essential to optimize treatment and timely avoid further transmission of these bacteria. Here, we aimed to develop a rapid on site visualization detection method for CPE using improved recombinase polymerase amplification (RPA) combined with lateral flow strip (LFS) method, based on four most popular carbapenemase genes: blaKPC, blaNDM, blaOXA-48-like, and blaIMP. All available allelic variants of the above carbapenemases were downloaded from the β-lactamase database, and the conserved regions were used as targets for RPA assay. Five primer sets were designed targeting to each carbapenemase gene and the RPA amplification products were analyzed by agarose gel electrophoresis. FITC-labeled specific probes were selected, combined with the best performance primer set (Biotin-labeled on the reverse primer), and detected by RPA-LFS. Mismatches were made to exclude the false positive signals interference. This assay was evaluated in 207 clinically validated carbapenem-resistant Enterobacterales (CRE) isolates and made a comparison with conventional PCR. Results showed that the established RPA-LFS assay for CPE could be realized within 30 min at a constant temperature of 37°C and visually detected amplification products without the need for special equipment. This assay could specifically differentiate the four classes of carbapenemases without cross-reactivity and shared a minimum detection limit of 100 fg/reaction (for blaKPC, blaNDM, and blaOXA-48-like) or 1000 fg/reaction (for blaIMP), which is ten times more sensitive than PCR. Furthermore, the detection of 207 pre-validated clinically CRE strains using the RPA-LFS method resulted in 134 blaKPC, 69 blaNDM, 3 blaOXA-48-like, and 1 blaIMP. The results of the RPA-LFS assay were in consistent with PCR, indicating that this method shared high sensitivity and specificity. Therefore, the RPA-LFS method for CPE may be a simple, specific, and sensitive method for the rapid diagnosis of carbapenemase Enterobacterales.
This Is the Way the World Ends, Not With a Bang but Bonds and Bullets
Authors: Chen James Ming
Published: December 2021

This article explores instinctive frames of human decision-making in environmental and resource economics. Higher-moment asset pricing combines rational, mathematically informed economic reasoning with psychological and biological insights. Leptokurtic blindness and skewness preference combine in particularly challenging ways for carbon mitigation. At their worst, human heuristics may generate perverse decisions. Information uncertainty and the innate preference for bonds-and-bullets portfolios may impair responses to catastrophic climate change.
Ischemic and Bleeding Outcomes According to the Academic Research Consortium High Bleeding Risk Criteria in All Comers Treated by Percutaneous Coronary Interventions
Authors: Doomun Daphné , Doomun Ianis , Schukraft Sara , Arroyo Diego , Cook Selma , Huwyler Tibor , Wenaweser Peter , Stauffer Jean-Christophe , Goy Jean-Jacques , Togni Mario , Puricel Serban , Cook Stéphane
Published: December 2021

Background: The Academic Research Consortium have identified a set of major and minor risk factors in order to standardize the definition of a High Bleeding Risk (ACR-HBR).

Aims: The aim of this study is to stratify the bleeding risk in patients included in the Cardio-Fribourg registry, according to the Academic Research Consortium for High Bleeding Risk (ACR-HBR) definition, and to report ischemic and hemorrhagic events at 2-year of clinical follow-up.

Methods: Between 2015 and 2017, consecutive patients undergoing percutaneous coronary intervention were prospectively included in the Cardio-Fribourg registry. Patients were considered high (HBR) or low (LBR) bleeding risk depending on the ARC-HBR definition. Primary endpoints were hierarchical major bleeding events as defined by the Bleeding Academic Research Consortium (BARC) grade 3–5, and ARC patient-oriented major adverse cardiac events (POCE) at 2-year follow-up.

Results: Follow-up was complete in 1,080 patients. There were 354 patients in the HBR group (32.7%) and 726 patients in the low-bleeding risk (LBR) group (67.2%). At 2-year follow-up, cumulative BARC 3–5 bleedings were higher in HBR (10.5%) compared to LBR patients (1.5%, p < 0.01) and the impact of HBR risk factors was incremental. At 2-year follow-up, POCE were more frequent in HBR (27.4%) compared to LBR group (18.2%, <0.01). Overall mortality was higher in HBR (14.0%) vs. LBR (2.9%, p < 0.01).

Conclusions: ARC-HBR criteria appropriately identified a population at a higher risk of bleeding after percutaneous coronary intervention. An increased risk of bleeding is also associated with an increased risk of ischemic events at 2-year follow-up.
Reduction of Pulmonary Hypertension After Transition to Sacubitril/Valsartan in Patients With Heart Failure With Preserved Ejection Fraction
Authors: Burgdorf Christof , Brockmöller Janine , Strampe Henrieke , Januszewski Monika , Remppis Bjoern Andrew
Published: December 2021

Objectives: Although the PARAGON-HF trial failed to reach its primary endpoint, subgroups of patients with heart failure with preserved ejection fraction (HFpEF) still appear to benefit from Sacubitril/Valsartan therapy. As HFpEF patients with pulmonary hypertension display a specifically high mortality and morbidity, we evaluated the effect of Sacubitril/Valsartan in this subgroup of HFpEF patients.

Methods: In this retrospective case-series of 18 patients with HFpEF and pulmonary hypertension, right heart catheterisation (RHC) for determination of invasive pulmonary pressure were performed at baseline (pre-Sacubitril/Valsartan) and 99 (71–156) days after transition from angiotensin-converting enzyme inhibitors and angiotensin receptor blockers to Sacubitril/Valsartan (post-Sacubitril/Valsartan). Results are given as median and interquartile range.

Results: After conversion to Sacubitril/Valsartan, RHC showed significantly reduced pulmonary artery pressure (PAP) and mean pulmonary capillary wedge pressure (PCWP) compared to pre-Sacubitril/Valsartan [PAP systolic/diastolic/mean 44 (38–55)/15 (11–20)/27 (23–33) mm Hg vs. 51 (41–82)/22 (13–29)/33 (28–52) mm Hg, p < 0.05 and p < 0.01, respectively; PCWP 16 (12–20) mm Hg vs. 22 (15–27) mm Hg, p < 0.05]. Median Sacubitril/Valsartan dosage was 24/26 mg BID (24/26 BID−49/51 mg BID). Clinically, New York Heart Association functional class improved in 12 of the 18 patients (p < 0.01) after conversion to Sacubitril/Valsartan. Echocardiographic parameters of left ventricular function and cardiovascular co-medication did not differ markedly between pre- and post-Sacubitril/Valsartan.

Conclusion: Sacubitril/Valsartan therapy is associated with an improvement of pulmonary hypertension in HFpEF patients.
Prognostic Significance of Triglyceride-Glucose Index for Adverse Cardiovascular Events in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis
Authors: Luo Jin-Wen , Duan Wen-Hui , Yu Yan-Qiao , Song Lei , Shi Da-Zhuo
Published: December 2021

Background: Insulin resistance (IR) represents a critical regulator in the development and progress of coronary artery disease (CAD). Triglyceride-glucose (TyG) index, a novel surrogate biomarker of IR, has been implicated in several cardiovascular diseases. Accordingly, we conduct a meta-analysis to elucidate the relationship between TyG index and adverse cardiovascular events in patients with CAD.

Methods: To identify the studies examining the predictive capacity of the TyG index for adverse cardiovascular events in the setting of CAD, we performed a comprehensive literature retrieval of Scopus, PubMed, EMBASE, and Web of Science, from the inception of databases to October 5, 2021. We pooled the adjusted hazard ratio (HR) along with 95% CI using a random-effects model. The primary outcome was a composite of major adverse cardiovascular events (MACEs), including all-cause death, cardiovascular death (CV death), myocardial infarction (MI), stroke, hospitalization for unstable angina or heart failure, and revascularization. The secondary outcomes were all-cause death, CV death, MI, stroke, and revascularization. Additionally, we conducted subgroup analyses stratified by diabetes status, age, body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), category of TyG index, sample size, follow-up duration, and study design.

Results: About 12 studies involving 28,795 patients with CAD were finally taken into the quantitative analysis. Our findings showed that there was a 2.14-fold higher risk of MACEs among CAD populations in the highest TyG group compared with those in the lowest TyG group (HR: 2.14, 95% CI: 1.69–2.71, P < 0.001). A greater risk of MACEs was observed in participants with higher BMI than those with lower BMI (P = 0.03 for interaction). In the analysis of secondary outcomes, we also observed a markedly increased risk of MI, stroke, and revascularization in the highest TyG group compared with the lowest TyG group. No evidence of a significant association between TyG index and CV mortality or all-cause mortality in patients with CAD was identified.

Conclusions: The elevated TyG index is a promising predictive factor of adverse cardiovascular events in patients with CAD.

Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42021228521.
Seasonal Changes in Arctic Cooling After Single Mega Volcanic Eruption
Authors: Liu Bin , Zhao Chen , Zhu Ling , Liu Jian
Published: December 2021

To investigate the pure long-term influence of single mega volcanic eruption (SMVE) of universal significance on Arctic temperature changes in summer and winter, the Samalas eruption in Indonesia which is the largest eruption over the past millennium is selected as an ideal eruption for simulation study based on Community Earth System Model. The significant Arctic cooling lasts for 16 years after the Samalas eruption. The obvious Arctic cooling shifts from summer to winter, and this seasonal change of cooling after the SMVE only exists in the high-latitude Arctic region. The cooling range in Arctic summer is larger than that in winter during the first 2 years, due to the strong weakening effect of volcanic aerosol on summer incident solar radiation and the snow-ice positive feedback caused by the rapid expansion of summer sea ice, while the winter sea ice in the same period doesn’t increase obviously. Starting from the third year, the Arctic winter cooling is more intense and lasting than summer cooling. The direct weakening effect of aerosol on solar radiation, which is the main heat source in Arctic summer, is greatly weakened during this period, making summer cooling difficult to sustain. However, as the main heat source in Arctic winter, the sea surface upward longwave radiation, sensible heat, and latent heat transport still maintain a large decrease. Furthermore, sea ice expansion and albedo increase result in the decrease in solar radiation and heat absorbed and stored by the ocean in summer. And the isolation effect of sea ice expansion on air-sea heat transfer in winter during this period makes the heat transfer from the ocean to the atmosphere correspondingly reduce in winter, thus intensifying the Arctic winter cooling. Additionally, the Arctic Oscillation (AO) changes from the negative phase to the positive phase in summer after the SMVE (such as Samalas), while it is reversed in winter. This phase change of AO is also one of the reasons for the seasonal changes in Arctic cooling.
Integrated Hydrologic Modelling of Groundwater-Surface Water Interactions in Cold Regions
Authors: Yang Xiaofan , Hu Jinhua , Ma Rui , Sun Ziyong
Published: December 2021

Groundwater-surface water (GW-SW) interaction, as a key component in the cold region hydrologic cycle, is extremely sensitive to seasonal and climate change. Specifically, the dynamic change of snow cover and frozen soil bring additional challenges in observing and simulating hydrologic processes under GW-SW interactions in cold regions. Integrated hydrologic models are promising tools to simulate such complex processes and study the system behaviours as well as its responses to perturbations. The cold region integrated hydrologic models should be physically representative and fully considering the thermal-hydrologic processes under snow cover variations, freeze-thaw cycles in frozen soils and GW-SW interactions. Benchmarking and integration with scarce field observations are also critical in developing cold region integrated hydrologic models. This review summarizes the current status of hydrologic models suitable for cold environment, including distributed hydrologic models, cryo-hydrogeologic models, and fully-coupled cold region GW-SW models, with a specific focus on their concepts, numerical methods, benchmarking, and applications across scales. The current research can provide implications for cold region hydrologic model development and advance our understanding of altered environments in cold regions disturbed by climate change, such as permafrost degradation, early snow melt and water shortage.
Effects of Ice Freeze-Thaw Processes on U Isotope Compositions in Saline Lakes and Their Potential Environmental Implications
Authors: Zhang Pu , Cao Chenyang , Li Xiangzhong , Pei Xuezheng , Chen Chi , Liang Lihua , Ning Youfeng , Tan Liangcheng , Edwards R. Lawrence
Published: December 2021

The dissolved uranium (U) content in the water column of saline lakes varies little between ice-free seasons throughout the whole water column. Such uniformity allows for the potential absolute dating and/or paleohydrologic interpretations of lake sediments and biogenic shell materials using U isotopes. Before using these methods in cold regions, however, it is necessary to evaluate the effects that ice freeze-thaw processes have on the distribution of U isotopes in saline lake waters, and to determine the amount of variation in U isotopic values when such processes occur. In this paper, we collected ice and dissolved water samples from six lakes with variable salinity in February 2021. Five groundwater and three water samples from rivers into Qinghai Lake were sampled in November 2020. The sampled water was analyzed for dissolved concentrations of 238U and the activity ratio of 234U/238U ([234U/238U]AR). The results show that the 238U concentration of ice samples was less than that of the underlying water. The [234U/238U]AR of ice in the five saline lakes was similar to that of the underlying water with less than a 10‰ variation, suggesting no observable fractionation between ice and dissolved water. Thus, the ice freeze-thaw processes have almost no effect on the uranium content and [234U/238U]AR of the sampled saline lakes, which were characterized by a limited recharge volume from surface runoff, groundwater, and ice volume, namely the close saline lake in arid alpine background. The results from the indoor freeze-thaw experiments also showed that the U isotopic composition of Qinghai Lake waters and ice were similar with the 238U concentration of the ice was about 40% of that of the dissolved lake water, supporting the data obtained from natural saline lakes. The above results provide important insights into whether it is feasible to use U isotopes for absolute dating and/or paleohydrologic analysis of lake sediments or biogenic shell materials. In addition, the results are important for evaluating the [234U/238U]AR and uranium concentrations in seawater when there exists a process of melting polar ice, and for determining the initial delta 234U variations needed for dating of coral and other fossil materials.
Immuno-Endocrinology of COVID-19: The Key Role of Sex Hormones
Authors: Tramontana Flavia , Battisti Sofia , Napoli Nicola , Strollo Rocky
Published: December 2021

Epidemiological evidence shows clear gender disparities in the Coronavirus 2019 Disease (COVID-19) severity and fatality. This may reflect the contribution of gender-related factors, such as sex hormones, to COVID-19 pathogenesis. However, the mechanism linking gender disparities to COVID-19 severity is still poorly understood. In this review, we will pinpoint several elements involved in COVID-19 pathogenesis that are regulated by the two main sex hormones, estrogen and androgen. These include tissue specific gene regulation of SARS-CoV2 entry factors, innate and adaptive immune responses to infection, immunometabolism, and susceptibility to tissue injury by cytopathic effect or hyper-inflammatory response. We will discuss the mechanistic link between sex hormone regulation of COVID-19 pathogenetic factors and disease severity. Finally, we will summarize current evidence from clinical studies and trials targeting sex hormones and their signalling in COVID-19. A better understanding of the role of sex hormones in COVID-19 may identify targets for therapeutic intervention and allow optimization of treatment outcomes towards gender-based personalised medicine.
Comprehensive Analysis of Adverse Events Associated With SGLT2is: A Meta-Analysis Involving Nine Large Randomized Trials
Authors: Qiu Mei , Zhao Li-Min , Zhan Ze-Lin
Published: December 2021

Recently, Lin and colleagues assessed the safety of sodium-glucose cotransporter 2 inhibitors (SGLT2is) by a meta-analysis [1], in which the authors assessed 16 kinds of adverse events (AE) reported in the published articles based on 10 randomized controlled trials. We conducted a further meta-analysis and targeted the association between use of SGLT2is and occurrences of various kinds of serious AE published in the Clinical Trials website (clinicaltrials.gov). Our meta-analysis revealed that use of SGLT2is was not significantly associated with occurrences of 980 kinds of serious AE but was significantly associated with lower risks of 29 kinds of serious AE, especially including several important respiratory diseases (e.g., asthma, chronic obstructive pulmonary disease, sleep apnoea syndrome, and pneumonia). These findings may cause more studies to evaluate the possibilities of gliflozins being used for prevention of these specific diseases.
Tumor-Associated Macrophages: New Horizons for Pituitary Adenoma Researches
Authors: Han Changxi , Lin Shaojian , Lu Xingyu , Xue Li , Wu Zhe Bao
Published: December 2021

Macrophages are one of the most common infiltrating immune cells and an essential component of tumor microenvironment. Macrophages and the soluble cytokines and chemokines produced play an important role in tumorigenesis, progression, invasion and metastasis in solid tumors. Despite the multiple studies in other solid tumors, there is little known about macrophages in pituitary adenomas. Recently, studies about pituitary adenoma-infiltrated macrophages have been emerging, including the immunohistochemical and immunophenotypic analysis of the pituitary adenomas and further studies into the mechanism of the crosstalk between macrophages and tumor cellsin vivoandin vitro. These studies have offered us new insights into the polarization of macrophages and its role in tumorigenesis, progression and invasion of pituitary adenomas. This review describes the advances in the field of pituitary adenoma-infiltrated macrophages and the prospect of targeting macrophages as cancer therapy in pituitary adenoma.
Investigation of Smart Home Energy Management System for Demand Response Application
Authors: Ma Yunlong , Chen Xiao , Wang Liming , Yang Jianlan
Published: December 2021

Electricity market reform provides the conditions for demand-side load resources to be incorporated into the supply–demand regulation, and the increase of residential-side electrification level makes residential load resources a high-quality resource for demand response (DR). Resident home appliances participate in the “two-way interaction” of the power grid in the form of DR, which can effectively alleviate the tension of power supply and consume clean energy, to improve the safe and stable operation of the power system. Firstly, this article summarizes the structure and functions of the home energy management system (HEMS). Secondly, it discusses the key technologies of the HEMS, starting from an advanced metering infrastructure (AMI) and DR technology. Finally, it analyzes the control strategies of the HEMS, including component models and various optimal scheduling algorithms, and describes the challenges of the HEMS.
A Kernel for Calculating PEM Fuel Cell Distribution of Relaxation Times
Authors: Kulikovsky Andrei
Published: December 2021

Impedance of all oxygen transport processes in PEM fuel cell has negative real part in some frequency domain. A kernel for calculation of distribution of relaxation times (DRT) of a PEM fuel cell is suggested. The kernel is designed for capturing impedance with negative real part and it stems from the equation for impedance of oxygen transport through the gas-diffusion transport layer (doi:10.1149/2.0911509jes). Using recent analytical solution for the cell impedance, it is shown that DRT calculated with the novel K2 kernel correctly captures the GDL transport peak, whereas the classic DRT based on the RC-circuit (Debye) kernel misses this peak. Using K2 kernel, analysis of DRT spectra of a real PEMFC is performed. The leftmost on the frequency scale DRT peak represents oxygen transport in the channel, and the rightmost peak is due to proton transport in the cathode catalyst layer. The second, third, and fourth peaks exhibit oxygen transport in the GDL, faradaic reactions on the cathode side, and oxygen transport in the catalyst layer, respectively.