bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on Expert System of Japanese Auxiliary Teaching Based on BP Neural Network
Authors: Chu Huanhuan
Published: June 2022

College Japanese teaching is the cradle of Japanese professional development. With the rising frequency of interactions with Japan in our country in the fields of politics, economy, trade, and other fields, Japanese as a professional discipline is exhibiting popularization, universalization, and folkization features. However, the ever-emerging trend of Japanese as an application tool for worldwide communication has rendered professional Japanese instruction in colleges insufficient. To meet the needs and growth of society, as well as to address the problems of teacher shortages and a lack of attention to students’ fundamental knowledge in the reform of Japanese language teaching in colleges, the study uses an expert system as the theoretical foundation and combines BP neural network technology to design an auxiliary teaching system with a friendly interface, strong versatility, and extensibility for Japanese language teachers and students. Teachers can use this technique to organize the test by classifying and summarizing the test questions based on the knowledge points and complexity of the questions. Students can utilize this system to learn on their own, and by identifying weak links in their knowledge points, they can practice more effectively and create a multiplier impact with half the work. Finally, the whole system is designed and implemented in accordance with the software development process. It has been demonstrated that the system can provide realistic results and has good application value after a huge quantity of data testing and operation.
Seismic Performance and Mechanical Mechanism of Steel‐Enhanced Damping Concrete Core Wall with Concealed Steel Plate Bracings under Oblique Loading
Authors: Hu Zhangqi , Chen Taohua , Wang Mengfu , Lu Weirong , He Ran
Published: June 2022

This article focuses on the seismic performance and mechanical mechanisms of core walls under biaxial earthquakes. Through the oblique loading test (biaxial loading test) on one 1/6 scale steel‐enhanced damping concrete core wall with steel plate bracings, the failure patterns, the load‐bearing capacities, the yield mechanisms, and the strain distributions, etc. were investigated. Comparisons were made with the available test results of the authors’ previously unidirectional tested core walls and the tests completed by other scholars. The oblique tested core walls exhibited lower initial stiffness, but higher yield displacements, loading capacities, and ultimate displacements. A much more serious damage was also found in the wall limbs of oblique tested core walls by comparing with the unidirectional test core walls. Then finite element analysis (FEA) was also carried out to study the axial compression ratio (n), coupling beam span‐depth ratio (l/h) on the stress distributions, and effective width of the end wall limbs (be). From the analysis results, it can be indicated that l/h affects much the stress distributions of oblique test core wall, which would be in eccentric force states if the coupling beam span‐depth ratio was small, while the axial compression ratio does not affect the stress distributions dramatically. be varies with loading steps, the minimum value (be, min) of which increases with the decrease of l/h, and be, min will grow along with n.
Evaluation of Music Education in Universities and Colleges: Implementing Decision Tree Algorithm
Authors: Yang Lurong , Xiao Jin
Published: June 2022

The ensuring and improvement of value in advanced education is a perpetual cycle for the structure and development of college. Nature of music training guidance is remembered for school educating quality. The utilization of showing quality assessment instruments is vital because of music schooling’s one-of-a-kind concentration. This paper fosters a choice tree calculation-based assessment file framework for school MUSIC training instructing quality. Master meeting and scientific pecking order process are utilized to decide the assessment record and weight of framework for evaluating the nature of music training. To rearticulate it in an unexpected way, this paper centers around choice tree calculation stream and designs in the event that we examine information mining hypothesis overall. In order to show the value and quality evaluation framework, we established the “selection tree model” and adjusted the C4.5 calculation. In order to create a choice “Decision Tree Classifier,” we mainly establish a data mining algorithm. The model’s accuracy and materialness were checked by applying it to homeroom showing assessment information from 125 instructors. In the last investigation, key dynamic ascribes that affect how well music instruction educators are assessed and are featured, and in light of these discoveries, a sound exhortation is given.
Evaluation of the Distribution of Candida Species in Patients with Dysplastic and Nondysplastic Oral Lichen Planus Lesions
Authors: Rezazadeh Fahimeh , Beirami Morteza , Zareshahrabadi Zahra , Sedarat Hossein , Zomorodian Kamiar
Published: June 2022

Objectives. This study is aimed at identifying and determining the distribution of isolated Candida species in patients with dysplastic and nondysplastic oral lichen planus (OLP) lesions in comparison with those of healthy controls. Material and Methods. This study includes patients with OLP, aged (more than 18 years old), who have had informed consent. Samples of the oral, tongue, and buccal mucus by rubbing with a sterile swab and sterilely next to the lamp flame. Demographic information was obtained using patient records to determine the species of Candida in both groups, and two tests of fertile tube production by Candida albicans and dye production in the dye medium were used. A biopsy from OLP lesions has been taken from each patient after swab sampling and was sent to the pathology department for further histopathological analysis. In the end p value, less than 0/05 was considered significant. Result. In this study, 40 lichen planus patients were compared with 32 control patients. The female/male ratio in OLP and healthy groups was 22/18 and 17/15, respectively. Among the OLP patients, 23 cases (56%) were dysplastic, and the other 17 (44%) patients were nondysplastic. The mean (±standard deviation (SD)) age of patients was 48.83 (±9.34) years, and the mean age of the control group was 40.21 (±10.32). There were no significant differences based on age (p > 0.05). The highest frequency was related to tongue in both groups (22 (55%)) and buccal mucosa was the least common. There was a significant relationship between the location of the lesion and OLP (p = 0.05). 18 (45%) were erosive, and 22 (55%) were nonerosive. However, no significant difference was observed between erosive and nonerosive types in the OLP group (p = 0/07). Regarding the type of Candida, all cases in the patient’s group were related to Candida albicans [40 (100%)], and the correlation was not found in this regard (p > 0/05). About colony count, the mean for the case and control groups was 26.68 and 23.25, respectively. Also, no significant relationship was found between colony count and groups in this study (p = 0.3). There was no significant difference between gender and dysplastic or nondysplastic (p > 0.05). Conclusion. According to the statistical studies performed in this study, the presence of Candida in patients with dysplastic and nondysplastic lichen planus is not significantly different, and this rate is not higher than healthy individuals and in cases where the results are positive. The predominant species of Candida is the Candida albicans. In this study, the highest frequency was related to tongue in both groups. There was only a significant relationship between the location of the lesion and OLP.
Improved CenterNet for Accurate and Fast Fitting Object Detection
Authors: He Huimin , Na Qionglan , Su Dan , Zhao Kai , Lou Jing , Yang Yixi
Published: June 2022

Accurate and fast detection of typical fittings is the prerequisite of condition monitoring and fault diagnosis. At present, most successful fitting detectors are anchor‐based, which are challenging to meet the requirements of edge deployment. In this paper, we propose a novel anchor‐free method called HRM‐CenterNet. Firstly, the lightweight MobileNetV3 is introduced into CenterNet to extract multi‐scale features of different layers. In addition, the lightweight receptive field enhancement module is proposed for the deep layer features to further enhance the characterization power of global features and generate more accurate heatmaps. Finally, the high‐resolution feature fusion network with iterative aggregation is designed to reduce the loss of spatial semantic information in subsampling and further improve the accuracy of small and occlusion objects. Experiments are carried out on the TFITS and PASCAL VOC datasets. The results show that the size of the network is more than 60% lower than that of CenterNet. Compared with other detectors, our method achieves comparable accuracy with all accurate models at a much faster speed and meets the performance requirements of real‐time detection.
Effects of Early Nursing Monitoring on Pregnancy Outcomes of Pregnant Women with Gestational Diabetes Mellitus under Internet of Things
Authors: Lu Linlin , Huang Tinglan
Published: June 2022

To analyze the effect of early nursing intervention based on fetal heart signal extraction algorithm and Internet of Things (IoT) wireless communication technology on the adverse pregnancy outcomes of pregnant women with gestational diabetes mellitus (GDM) and newborns, 88 pregnant women diagnosed with GDM who underwent the 75 g glucose tolerance test at 24-28 gestational weeks in the hospital were selected as the research objects. According to the different intervention methods, the patients were divided into 44 cases of the experimental group (nursing intervention based on maternal and infant monitoring system) and 44 cases of the control group (outpatient follow-up intervention). The results showed that the compliance score and diet compliance rate of patients in the experimental group were signally higher than those in the control group at 1 and 3 months after intervention (

P
<
0.05

). The levels of fasting blood glucose (FBG), blood glucose 2 hours after the meal, and hemoglobin A1c (HbA1c) in the experimental group were lower than those in the control group at 1 and 3 months after intervention (

P
<
0.05

). The number of giant babies, hypoglycemia, hyperbilirubinemia, fetal distress, premature delivery, and birth weight in the experimental group was all lower than those in the control group, while the Apgar scores were higher than that in the control group (

P
<
0.05

). To sum up, the intervention based on the intelligent maternal and infant monitoring system could timely help pregnant women adjust their diet structure and optimize the management of blood glucose and blood lipids, thus effectively improving the adverse pregnancy outcome and maintaining the health of pregnant women and newborns.
Targeted Nursing Combined with Endoscopic Submucosal Injection of Carbon Nanoparticles in the Treatment of Colorectal Cancer
Authors: Yin Libo
Published: June 2022

Aim. To evaluate the effectiveness of targeted nursing in an endoscopic submucosal injection of carbon nanoparticles to locate colorectal cancer. Methods. From September 2017 to September 2019, 82 patients with colorectal cancer who underwent endoscopic submucosal injection of carbon nanoparticles for locating the tumor were recruited and assigned via the random number table method (1 : 1) to receive either conventional nursing (control group) or targeted nursing (observation group). Outcome measures included psychological status, compliance, nursing satisfaction, quality of life, and daily living ability. Results. After intervention, the self-rating anxiety scale (SAS) scores and self-rating depression scale (SDS) scores were decreased in both groups, with lower results in the observation group (

P

 < 0.001). Patients given target nursing were associated with higher compliance and nursing satisfaction of patients versus conventional nursing (

P

 < 0.05). Patients receiving targeted nursing had a better quality of life versus those receiving conventional nursing (

P

 < 0.001). Targeted nursing resulted in a higher Barthel index (BI) in patients versus conventional nursing 1 d, 7 d, and 14 d after nursing (

P

 < 0.05). Conclusion. Targeted nursing alleviates the negative emotions of patients with colorectal cancer and improves their compliance, nursing satisfaction, daily living ability, and quality of life.
Transmission Design in Secure URLLC Network Assisted by Reconfigurable Intelligent Surfaces
Authors: Wang YuanYuan , Zhou Feng , Wang Rugang
Published: June 2022

In this work, we focus on the secure transmission in reconfigurable intelligent surface- (RIS-) aided ultrareliable low-latency communications (URLLC) network. Specifically, we investigate the average effective secrecy rate (AESR) optimization via jointly designing the transmit beamforming, the artificial noise covariance at the transmitter (Tx), and the phase shifter at the RIS. Particulary, the AESR in URLLC network contains not only the commonly used information rate expression based on long codewords but also two penalty terms about the decoding error probability introduced by finite block-length coding. Thus, the AESR is a nonconcave objective. In addition, the unit modulus constraint of the reflecting coefficient at the RIS is nonconvex, which makes the formulated problem difficult to handle. To solve the formulated highly nonconvex problem, we first decouple the complicated objective into a linear function by introducing several slack variables. Then, we address the nonconvex constraints by the first-order expression and the penalty concave-convex procedure (PCCP) technique. Thus, an alternating optimization (AO) technique is proposed to solve the reformulated problem, where the convergence can be guaranteed by rigorous proof, and the computational complexity is a polynomial function of the main system parameters. Simulation results demonstrated the performance of the proposed design as well as the superiority of RIS in improving the secrecy performance when comparing with other baselines.
A Microblog Content Credibility Evaluation Model Based on the Influence of Sentiment Polarity
Authors: Yao Jinglong , Xing Ling , Wu Honghai
Published: June 2022

False content in microblogs affects users’ judgment of facts. An evaluation of microblog content credibility can find false information as soon as possible, which ensures that social networks maintain a positive environment. The influence of sentiment polarity can be used to analyze the correlation between sentiment polarity in comments and Weibo content through semantic features and sentiment features in comments, to improve the effect of content credibility assessment. This paper proposes a Weibo content credibility evaluation model, CEISP (Credibility Evaluation based on the Influence of Sentiment Polarity). The semantic features of microblog content are extracted by a bidirectional-local information processing network. Bidirectional long short-term memory (BiLSTM) is used to mine the sentiment features of comments. The attention mechanism is used to capture the impact of different sentiment polarities in comments on microblog content, and the influence of sentiment polarities is obtained for the credibility assessment of microblog content. The experimental results on real datasets show that the evaluation performance of the CEISP model is improved compared with the comparison model. Compared with the existing Att-BiLSTM model, the evaluation accuracy of the CEISP model is improved by 0.0167.
Identification and Verification of Key Tumor Genes Associated with Diagnosis and Prognosis of Breast Cancer Based on Bioinformatics Analysis
Authors: Yu Feng , Pan Xian-jun , Luo Jie
Published: June 2022

Breast cancer (BC) is the most common cancer and the most frequent cause of cancer death among women worldwide. The aim of the present study was to identify the critical genes for the diagnosis and prognosis of BC. Two mRNA expression data (GSE29431 and GSE42568) were acquired from the GEO database. The determination of differently expressed genes (DEGs) between BC specimens and nontumor specimens was completed via the LIMMA package of R. GO annotation and KEGG pathway enrichment analyses were applied to explore the function of DEGs. Kaplan-Meier methods were used to determine the prognostic value of DEGs in BC using TCGA datasets. The diagnostic value of the survival-related DGEs were confirmed using ROC assays in two GEO datasets. RT-PCR was used to examine the expression of the critical genes in BC cells and normal breast cells. CCK-8 experiments were applied to explore the function of the critical genes in BC cells. In this study, we identified 31 DEGs between BC specimens and nontumor specimens. KEGG analysis revealed 31 DEGs were involved in PPAR signal path, AMPK signal path, glycerolipid metabolism, adipocytokine signaling pathway, phenylalanine metabolism, tyrosine metabolic process, and glycine, serine, and threonine metabolic process. Four DEGs including CRYAB, DEFB132, MAOA, and RBP4 were observed to be associated with clinical outcome of BC patients. Their diagnostic values were also confirmed in both GSE29431 and GSE42568 datasets. In addition, we analyzed TCGA datasets and confirmed that the results were consistent with GEO datasets. Finally, the results of RT-PCR confirmed that the expression of CRYAB and RBP4 was distinctly downregulated in BC cells. CCK-8 analysis revealed that overexpression of CRYAB and RBP4 distinctly suppressed the proliferation of BC cells. Overall, our findings suggested CRYAB and RBP4 as critical genes for the diagnosis and prognosis of BC patients. They may be used as novel biomarkers for BC patients.
Bioinformatics Analysis for Identifying Differentially Expressed MicroRNAs Derived from Plasma Exosomes Associated with Radiotherapy Resistance in Non-Small-Cell Lung Cancer
Authors: Zeng Lirong , Zeng Guilin , Ye Zhong
Published: June 2022

Objective. To explore the differentially expressed microRNAs (DEmiRs) derived from plasma exosomes related to radiotherapy resistance and their corresponding pathways in non-small-cell lung cancer (NSCLC). Methods. Plasma samples from NSCLC patients were retrieved and analyzed. The patients were divided into 3 groups based on the tumor regression grade criteria, assessed by radiological imaging after radiotherapy. TRG1 referred to tumor shrinkage of ≤30% after radiotherapy, TRG2 as

30
%
<
TRG
<
50
%

, and TRG3 as

TRG
≥
50

%. High-throughput sequencing and bioinformatics analysis were used to compare the DEmiRs between the three groups. The miRanda, PITA, and RNAhybrid software were used to identify potential target genes of the DEmiRs. GO function enrichment and KEGG pathway enrichment analyses were performed on the target gene set. Results. There were 24 DEmiRs (12 were upregulated and 12 downregulated) between the TRG1 and TRG2 groups, 11 between the TRG1 and TRG3 groups (6 upregulated and 5 downregulated), and 35 between the TRG2 and TRG3 groups. The common DEmiRs between the three groups were miR-92a-3p. GO analysis showed that the target genes of the DEmiRs were mainly enriched in unicellular organism processes, cell transformation, cell localization, and their establishment. KEGG enrichment analysis showed that target genes were significantly enriched in the Ras signaling pathway and associated with endocytosis. Among the 135 identified target genes of miR-92a-3p, 4 were involved in the PI3K-Akt signaling pathway (the downstream pathway of the Ras gene) and 3 in the cAMP signaling pathway (the upstream pathway of the Ras gene). Further, 2 other target genes were involved in the Rap1 signaling pathway (the upstream pathway of PI3K-Akt). Conclusion. By assessing the expression and functional profile of DEmiRs in the plasma exosomes of NSCLC patients after radiotherapy, miR-92a-3p was identified as a promising target affecting radiotherapy outcomes through the Ras signaling pathway.
Evaluation of Physical Education Teaching Effect Based on Action Skill Recognition
Authors: Ding Xia , Peng Wei , Yi Xiaoling
Published: June 2022

In order to improve the effect of physical education teaching in modern colleges and universities, this paper combines the movement skill recognition algorithm to construct a physical education effect evaluation system and studies the multispectral image reproduction system in practical application. Moreover, this paper gives a detailed description of more advanced functional modules in the system, such as spectral acquisition, spectral reflectance reconstruction, and spectral color correction. In addition, this paper focuses on the algorithm design of the color appearance matching module. By adding the “color appearance transformation” on the source side and the “color appearance inversion” on the reproduction side, the source image and the reproduced image can achieve color appearance matching in the observation condition-independent space. The simulation experiment verifies that the physical education effect evaluation system based on action skill recognition meets the actual needs of physical education and has a good role in promoting the recognition of physical skills and the improvement of physical education effect.
The Safety and Feasibility of Laparoscopic Gastrectomy after Neoadjuvant Chemotherapy for Locally Advanced Gastric Cancer
Authors: Ge Rui , Liu Kai , Zhang Weihan , Yang Kun , Chen Xiaolong , Zhao Linyong , Zhou Zongguang , Hu Jiankun
Published: June 2022

Background. Neoadjuvant chemotherapy is incrementally applied to remedy locally advanced gastric cancer. However, NACT also enhances the difficulty of laparoscopic lymph node dissection. The objective of our study was to evaluate the safety and feasibility of laparoscopic gastrectomy for locally advanced gastric cancer after neoadjuvant chemotherapy. Methods. From July 2017 to December 2019, 153 patients who received neoadjuvant chemotherapy and underwent the subsequent surgical procedure were retrospectively enrolled and analyzed in the Gastrointestinal Surgery Department of West China Hospital. According to surgical methods, all the patients were sectionalized into two groups: laparoscopic assistant gastrectomy (LAG, 77 patients) and traditional open gastrectomy (OG, 76 patients). The demographic parameters, preoperative, surgical, pathological, and neoadjuvant chemotherapy features were compared between the two groups. Results. A total of 153 patients accepted neoadjuvant chemotherapy and surgical resection in our study. There was no statistically significant difference in demographic parameters and preoperative and neoadjuvant chemotherapy characteristics between the two groups. The LAG group illustrated less intraoperative blood loss (91.1 ± 53.1 ml vs. 125.7 ± 116.9 ml,

p
=
0.010

) and shorter postoperative hospital stays (7.9 ± 2.1 days vs. 125.7 ± 116.9 days,

p
=
0.009

), when compared to the OG group. Moreover, there was no disparity with respect to operative duration, number of harvested lymph nodes, and postoperative complication rates between the two groups. When considering the Clavien–Dindo classification, no statistically significant difference was indicated in all stratifications with regard to postoperative complications. Conclusion. Laparoscopic gastrectomy for locally advanced gastric cancer after neoadjuvant chemotherapy is safe and feasible without increasing postoperative adverse events.
English Multimedia Online Teaching Resource Processing System Based on Intelligent Cloud Platform
Authors: He Ying
Published: June 2022

In order to improve the quality of online English teaching, starting from English online teaching resources, this paper applies cloud computing technology to the teaching resource integration process to design a comprehensive cloud storage control method based on user habits. Moreover, this paper uses the user habit extraction algorithm to extract the user’s habit information and then realizes the control of cloud storage with the help of these habit information. After that, the system can realize intelligent management of cloud storage in space by analyzing the information and converting it into corresponding cloud storage control instructions. In addition, this paper constructs an integrated system of English multimedia network teaching resources under the support of cloud storage technology. Finally, this paper uses simulation experiments to verify that the integrated system of English multimedia network teaching resources based on cloud storage has a good effect.
Moving Beyond Patient-Level Drivers of Racial/Ethnic Disparities in Childhood Cancer
Authors: Ji Xu , Sohn Heeju , Sil Soumitri , Castellino Sharon M.
Published: June 2022

Racial/ethnic disparities in childhood cancer survival persist despite advances in cancer biology and treatment. Survival rates are consistently lower among non-Hispanic Black and Hispanic children as compared with non-Hispanic White children across a range of hematologic cancers and solid tumors. We provide a framework for considering complex systems and social determinants of health in research examining the drivers of racial/ethnic disparities in childhood cancer survival, given that pediatric patients’ interactions with the healthcare system are filtered through their caregiver, family, and societal structure. Dismantling the multi-level (patient, family, healthcare system, and structural) barriers into modifiable drivers is critical to developing policies and interventions toward equitable health outcomes. This commentary highlights areas at the family, healthcare system, and society levels that merit closer examination and proposes actions and interventions to support improvements across these levels.

See recently published article in the November issue of CEBP, Racial/Ethnic Disparities in Childhood Cancer Survival in the United States p. 2010.
cDC1 Vaccines Drive Tumor Rejection by Direct Presentation Independently of Host cDC1
Authors: Ferris Stephen T. , Ohara Ray A. , Ou Feiya , Wu Renee , Huang Xiao , Kim Sunkyung , Chen Jing , Liu Tian-Tian , Schreiber Robert D. , Murphy Theresa L. , Murphy Kenneth M.
Published: June 2022

As a cell-based cancer vaccine, dendritic cells (DC), derived from peripheral blood monocytes or bone marrow (BM) treated with GM-CSF (GMDC), were initially thought to induce antitumor immunity by presenting tumor antigens directly to host T cells. Subsequent work revealed that GMDCs do not directly prime tumor-specific T cells, but must transfer their antigens to host DCs. This reduces their advantage over strictly antigen-based strategies proposed as cancer vaccines. Type 1 conventional DCs (cDC1) have been reported to be superior to GMDCs as a cancer vaccine, but whether they act by transferring antigens to host DCs is unknown. To test this, we compared antitumor responses induced by GMDCs and cDC1 in Irf8 +32–/– mice, which lack endogenous cDC1 and cannot reject immunogenic fibrosarcomas. Both GMDCs and cDC1 could cross-present cell-associated antigens to CD8+ T cells in vitro. However, injection of GMDCs into tumors in Irf8 +32–/– mice did not induce antitumor immunity, consistent with their reported dependence on host cDC1. In contrast, injection of cDC1s into tumors in Irf8 +32–/– mice resulted in their migration to tumor-draining lymph nodes, activation of tumor-specific CD8+ T cells, and rejection of the tumors. Tumor rejection did not require the in vitro loading of cDC1 with antigens, indicating that acquisition of antigens in vivo is sufficient to induce antitumor responses. Finally, cDC1 vaccination showed abscopal effects, with rejection of untreated tumors growing concurrently on the opposite flank. These results suggest that cDC1 may be a useful future avenue to explore for antitumor therapy.

See related Spotlight by Hubert et al., p. 918
Effect of oXiris-CVVH on the Clinical Outcomes of Patients with Septic Shock: An Inverse Probability of Treatment-Weighted Analysis
Authors: Xie Jing , Xiao Wenbiao , Lin Jiandong
Published: June 2022

Background: Limited previous studies had proved that oXiris-continuous veno-venous hemofiltration (CVVH) could decrease endotoxins and inflammatory factors, thereby improving circulation’s stability. However, conclusive data are lacking regarding the comparison between oXiris membrane (with the function of removing endotoxins and decreasing inflammatory factors) and AN69 filters (with the only function of decreasing inflammatory) on the mortality of patients with septic shock. The potential mechanisms of oXiris that might influence the mortality of septic shock patients remain unexplored. Methods: This is a single-center, retrospective cohort study. The experimental group (30 patients with septic shock) was treated with oXiris-CVVH, and the control group (46 patients with septic shock) was treated with AN69 filter-CVVH. We employed the inverse probability of treatment-weighting method (IPTW), doubly robust estimation, and mediating effect analysis to analyze those clinical outcomes, with a special focus on the results of 28-day mortality, 72-h lactate, the need for norepinephrine (NE) in the next 72 h. Results: A total of 76 patients with septic shock who received blood purification therapies were enrolled. After IPTW, differences in patient characteristics have been minimized. The 28-day mortality in the control group is higher than in the treatment group (73.3% vs. 47.3%, p < 0.001; median survival time: 10 vs. ≥28 days, log-rank p = 0.0366). And the 25% decrease and the 50% decrease in demand for NE in the next 72 h are different between the treatment and control groups (median time of 25% decrease in demand: 24 vs. >72 h, log-rank p = 0.0126; median time of 50% decrease in demand: 24 vs. >72 h, log-rank p = 0.0322). The 72-h lactic acid level and white blood cell (WBC) counts in the oXiris group are lower than in the control group. The 72-h lactate fully mediated the effects of oXiris on 28-day mortality after confounds adjustment. Conclusions: For septic shock patients, the use of oXiris-CVVH was associated with lower mortality and appeared to reduce lactate, NE dosage, PCT, and WBC counts, as compared to AN69-CVVH.
Do Stroke Care Processes Modify Clinical Outcomes in Patients with Stroke-Associated Pneumonia? A Registry Cohort Study in England and Wales
Authors: Lobo Chaves Marco Antonio , Gittins Matthew , Bray Benjamin , Vail Andy , Smith Craig J.
Published: June 2022

Introduction: It is not known whether modern stroke unit care reduces the impact of stroke complications, such as stroke-associated pneumonia (SAP), on clinical outcomes. We investigated the relationship between SAP and clinical outcomes, adjusting for the confounding effects of stroke care processes and their timing. Methods: The Sentinel Stroke National Audit Programme provided patient data for all confirmed strokes between April 2013 and December 2018. SAP was defined as new antibiotic initiation for suspected pneumonia within the first 7 days from stroke admission. We compared outcomes after SAP versus non-SAP in appropriate multilevel mixed models. Each model was adjusted for patient and clinical characteristics, as well as markers of stroke care and their timing within the first 72 h. The appropriate effect estimates and corresponding 95% confidence intervals (CIs) were reported. Results: Of 201,778 patients, SAP was present in 14.2%. After adjustment for timing of acute stroke care processes and clinical characteristics, adverse outcomes remained for SAP versus non-SAP patients. In these adjusted analyses, patients with SAP maintained an increased risk of longer length of in-hospital stay (IRR of 1.27; 95% CI: 1.25, 1.30), increased odds of worse functional outcome at discharge (OR of 2.9; 95% CI: 2.9, 3.0), and increased risk of in-hospital mortality (HR of 1.78; 95% CI: 1.74, 1.82). Conclusion: We show for the first time that SAP remains associated with worse clinical outcomes, even after adjusting for processes of acute stroke care and their timing. These findings highlight the importance of continued research efforts aimed at preventing SAP.
Circular RNA hsa_circ_0068252 Functions in Cisplatin Resistance and Immune Response via miR-1304-5p/PD-L1 Axis in Non-Small Cell Lung Cancer
Authors: Li Jingjing , Xu Jinhua , Wu Guofeng , Ren Yajun , Wang Xue , Zhang Qianyun
Published: June 2022

Background: Research suggests that circRNAs play important roles in non-small cell lung cancer (NSCLC). The function of hsa_circ_0068252 in NSCLC, especially in cisplatin (DDP) resistance and the mechanisms, was explored in this study. Methods: NSCLC patient samples and two NSCLC cell lines along with corresponding DDP-resistant cell lines were used. Expression levels of circ_0068252 were detected. SiRNA for circ_0068252 and inhibitor for miRNA were used in all functional analyses. A co-culture system of NSCLC cells with CD8+ T cells was used. The cellular location of circ_0068252 was detected and its target miRNA was predicted and verified. Finally, the mechanism responsible for circ_0068252 function on PD-L1 was analyzed using luciferase reporter assay in the two DDP-resistant cell lines, as well as in the co-culture system. The cytotoxicity of T cells was detected by lactate dehydrogenase assay. Results: Our findings revealed that a high level of circ_0068252 was correlated with poor prognosis of NSCLC and DDP resistance. Knockdown of circ_0068252 could promote the sensitivity of DDP-resistant NSCLC cells to DDP. Moreover, knockdown of circ_0068252 could regulate the immune microenvironment which was mediated via CD8+ T cells. Finally, circ_0068252 could up-regulate PD-L1 expression by adsorbing miR-1304-5p. Conclusion: The circ_0068252/miR-1304-5p/PD-L1 signal axis participates in the regulation of DDP resistance and immune escape of NSCLC cells. Our results suggest that circ_0068252 may be a potential diagnostic marker and therapeutic target for DDP-resistant NSCLC.
Mammakarzinom: Therapie-Deeskalation auf Grundlage der Ki-67 Dynamik unter endokriner Therapie – schon bereit für den Einsatz in der Routine?
Authors: Kolberg-Liedtke Cornelia , Kolberg Hans-Christian
Published: June 2022

Purpose: To our knowledge, WSG-ADAPT-HR+/HER2– (NCT01779206; n = 5,625 registered) is the first trial combining the 21-gene expression assay (recurrence score [RS]) and response to 3-week preoperative endocrine therapy (ET) to guide systemic therapy in early breast cancer. Materials and Methods: Baseline and postendocrine Ki67 (Ki67post) were evaluated centrally. In the endocrine trial, all patients received exclusively ET: patients with pathologic regional lymph node status (pN) 0-1 (ie, 0-3 involved lymph nodes) entered control arm if RS ≤ 11 and experimental arm if RS12-25 with ET response (Ki67post ≤ 10%). All other patients (including N0-1 RS12-25 without ET response) received dose-dense chemotherapy (CT) followed by ET in the CT trial. Primary end point of the endocrine trial was noninferiority of 5-year invasive disease-free survival (5y-iDFS) in experimental (v control) arm; secondary end points included distant DFS, overall survival, and translational research. Results: Intention-to-treat population comprised 2,290 patients (n = 1,422 experimental v n = 868 control): 26.3% versus 34.6% premenopausal and 27.4% versus 24.0% pN1. One-sided 95% lower confidence limit of the 5y-iDFS difference was –3.3%, establishing prespecified noninferiority (P = .05). 5y-iDFS was 92.6% (95% CI, 90.8 to 94.0) in experimental versus 93.9% (95% CI, 91.8 to 95.4) in control arm; 5-year distant DFS was 95.6% versus 96.3%, and 5-year overall survival 97.3% versus 98.0%, respectively. Differences were similar in age and nodal subgroups. In N0-1 RS12-25, outcome of ET responders (ET alone) was comparable with that of ET nonresponders (CT) for age > 50 years and superior for age ≤ 50 years. ET response was more likely with aromatase inhibitors (mostly postmenopausal) than with tamoxifen (mostly premenopausal): 78.1% versus 41.1% (P < .001). ET response was 78.8% in RS0-11, 62.2% in RS12-25, and 32.7% in RS > 25 (n = 4,203, P < .001). Conclusion: WSG-ADAPT-HR+/HER2– demonstrates that guiding systemic treatment by both RS and ET response is feasible in clinical routine and spares CT in pre- and postmenopausal patients with ≤ 3 involved lymph nodes.
Do All Patients with Congenital Adrenal Hyperplasia Need to Be on Hydrocortisone Three Times a Day in Order to Have Normal Growth?
Authors: Logan Lauren A. , Nebesio Todd D. , Eckert George J. , Eugster Erica A.
Published: June 2022

Background: Three times daily (TID) hydrocortisone (HC) is recommended as the optimal glucocorticoid regimen in growing children with congenital adrenal hyperplasia (CAH). However, a variety of other treatment schemes are used in the clinical setting. Objective: The aim of this study was to determine whether there are clinical differences between children being treated with TID HC versus those receiving other glucocorticoid regimens. Furthermore, we sought to determine whether there was evidence of a deleterious effect on growth in children receiving treatment with alternate regimens. Methods: Medical records of children followed in our pediatric endocrinology outpatient clinic for classic CAH secondary to 21-hydroxylase deficiency during the last 10 years were reviewed. Variables analyzed included sex, age at the most recent visit, glucocorticoid type, frequency and dose (mg/m2/day), height z-score, BMI z-score, ethnicity, most recent bone age, growth velocity z-score, and provider’s impression of compliance (good or poor). Results: Of 104 children (51% boys) with CAH, 50 (48%) were on TID HC, 43 (41%) were on prednisone or prednisolone, and 5 (5%) were on dexamethasone. An additional 6 (6%) were on HC administered either 2 or 4 times daily. No differences were seen between TID HC and alternate regimen groups with respect to sex, height z-score, BMI z-score, ethnicity, provider assessment of compliance, ratio of bone age to chronologic age, or growth velocity. The average height z-score was −0.40 ± 1.31 in the TID HC group compared to −0.87 ± 1.33 in the alternate regimen group (p = 0.075). Patients receiving TID HC were younger (p = 0.027) and on a lower glucocorticoid dose (p = 0.001) than those on alternate regimens. Conclusions: Less than half of our patients with CAH were receiving TID HC. Reassuringly, growth parameters and other indices of disease control were equivalent between patients on conventional HC dosing and other therapeutic approaches. These results suggest that a range of glucocorticoid treatment regimens may be equally viable in children with CAH.
Endothelial Cells Induced Progenitors Into Brown Fat to Reduce Atherosclerosis
Authors: Park Kyoungmin , Li Qian , Lynes Matthew D. , Yokomizo Hisashi , Maddaloni Ernesto , Shinjo Takanori , St-Louis Ronald , Li Qin , Katagiri Sayaka , Fu Jialin , Clermont Allen , Park Hyunseok , Wu I-Hsien , Yu Marc Gregory , Shah Hetal , Tseng Yu-Hua , King George L.
Published: June 2022

Background:

Insulin resistance (IR) can increase atherosclerotic and cardiovascular risk by inducing endothelial dysfunction, decreasing nitric oxide (NO) production, and accelerating arterial inflammation. The aim is to determine the mechanism by which insulin action and NO production in endothelial cells can improve systemic bioenergetics and decrease atherosclerosis via differentiation of perivascular progenitor cells (PPCs) into brown adipocytes (BAT).

Methods:

Studies used various endothelial transgenic and deletion mutant
ApoE
−/−
mice of insulin receptors, eNOS (endothelial NO synthase) and ETBR (endothelin receptor type B) receptors for assessments of atherosclerosis. Cells were isolated from perivascular fat and micro-vessels for studies on differentiation and signaling mechanisms in responses to NO, insulin, and lipokines from BAT.

Results:

Enhancing insulin’s actions on endothelial cells and NO production in
ECIRS1
transgenic mice reduced body weight and increased systemic energy expenditure and BAT mass and activity by inducing differentiation of PPCs into beige/BAT even with high-fat diet. However, positive changes in bioenergetics, BAT differentiation from PPCs and weight loss were inhibited by N(gamma)-nitro-L-arginine methyl ester (
L
-NAME), an inhibitor of eNOS, in
ECIRS1
mice and
eNOSKO
mice. The mechanism mediating NO’s action on PPC differentiation into BAT was identified as the activation of solubilized guanylate cyclase/PKGIα (cGMP protein-dependent kinase Iα)/GSK3β (glycogen synthase kinase 3β) pathways. Plasma lipidomics from
ECIRS1
mice with NO-induced increased BAT mass revealed elevated 12,13-diHOME production. Infusion of 12,13-diHOME improved endothelial dysfunction and decreased atherosclerosis, whereas its reduction had opposite effects in
ApoE
−
/−
mice.

Conclusions:

Activation of eNOS and endothelial cells by insulin enhanced the differentiation of PPC to BAT and its lipokines and improved systemic bioenergetics and atherosclerosis, suggesting that endothelial dysfunction is a major contributor of energy disequilibrium in obesity.
The Establishment and Validation of Critical Nitrogen Concentration Dilution Curve of Garlic Based on Leaf Area Index
Authors: Mou Siwei , Liu Dan , Yang Baoping , Han Qingfang , Liu Xiaoxue
Published: June 2022

Irrational application of nitrogen fertilizer will increase the risk of environmental pollution, reduce crop yield and nitrogen use efficiency. Plant nitrogen diagnostic method can be used to improve nitrogen management in garlic cultivation. In this research, two representative garlic (Allium sativumL.) cultivars Cangshan and Gailiang in Guanzhong area were used as test materials for a two-year field experiment. The critical nitrogen concentration (Nc) dilution curve models was constructed and verified by analyzing the effects of six nitrogen application levels (0, 65, 130, 195, 260, 325 kg·ha−1) on leaf area index (LAI) and nitrogen concentration from regreening stage to late stage of garlic bolting. The results indicated that the relationship between Ncand LAI can be expressed by power function equation, Cangshan: Nc= 4.44LAI−0.51, Gailiang: Nc= 3.91LAI−0.4. Nitrogen nutrition index (NNI) increased with the rising of nitrogen level; meanwhile, the integrated NNI was closely related to relative yield. The maximum yield was obtained and the nitrogen nutrient index was close to 1 when the nitrogen level reached 195 kg·ha−1in Cangshan and 260 kg·ha−1in Gailiang, respectively. In general, Ncdilution curves depending on LAI can be used for precision nitrogen management of garlic in Guanzhong area.
A New Model for Isolating the Marine Heatwave Changes under Warming Scenarios
Authors: Wang Shengpeng , Jing Zhao , Sun Di , Shi Jian , Wu Lixin
Published: June 2022

Marine heatwaves (MHWs) exert devastating impacts on ecosystems. Understanding their responses to anthropogenic forcing has attracted rapidly growing scientific interest. Given the disparate adaptation capacity and mobility among marine species, it is crucial to disentangle changes of MHWs related to the rising mean temperature from those to the changing temperature variability. It has been suggested that the latter’s effects could be isolated by replacing a fixed baseline with a moving one for calculating the climatological mean and percentile metrics in MHW analysis. In this study, the effects of a moving baseline on MHW statistics (annual MHW days and cumulative intensity) changes in a warming climate are systematically evaluated based on simulations from simple stochastic climate models and a set of coupled general circulation models in the Community Earth System Model Large Ensemble project. On the one hand, a moving baseline does not necessarily remove the influences of rising mean temperature on MHW changes and will artificially cause negative trends in MHW statistics when the ocean exhibits an accelerated warming rate as in the RCP8.5 scenario. On the other hand, it always underestimates the effects of changing temperature variability on MHW changes. We propose a new model that adopts a “partial” moving baseline combined with a local linear detrending to isolate MHW changes caused by changing temperature variability.

Significance Statement

A new model is proposed to isolate marine heatwave changes caused by changing temperature variability from those by rising mean temperature under greenhouse warming.
Non-Invasive Liver Fibrosis Scores Are Associated With Contrast-Associated Acute Kidney Injury in Patients Undergoing Elective Percutaneous Coronary Intervention
Authors: He Hao-Ming , He Chen , You Zhe-Bin , Zhang Si-Cheng , Lin Xue-Qin , Luo Man-Qing , Lin Mao-Qing , Zhang Li-Wei , Lin Kai-Yang , Guo Yan-Song
Published: June 2022

Previous studies have demonstrated that non-invasive liver fibrosis scores (LFSs) are associated with kidney function deterioration. This study aimed to assess the predictive performance of LFSs in contrast-associated acute kidney injury (CA-AKI) in coronary artery disease (CAD) patients undergoing elective percutaneous coronary intervention (PCI). This retrospective study involved 5627 patients. The frequency of CA-AKI was 6.3% (n = 353). In a multivariate logistic analysis after adjustment, non-invasive LFSs, including fibrosis-5 score (FIB-5), fibrosis-4 score (FIB-4), aspartate aminotransferase to alanine aminotransferase ratio (AAR), and aspartate aminotransferase to platelet ratio index were independent risk factors for CA-AKI (all P < .05), whereas the Forns score was not ( P > .05). The highest predictive performance was observed for FIB-5 (area under the curve [AUC] = .644) compared to other LFSs. A restricted cubic spline analysis confirmed approximately linear relationships between LFSs and risks of CA-AKI. Furthermore, adding FIB-5 (AUC = .747; net reclassification improvement [NRI] = .441, P < .001; integrated discrimination improvement [IDI] = .008, P < .001) or AAR (AUC = .747; NRI = .419, P < .001; IDI = .006, P = .010) to an established clinical risk model could significantly improve the prediction of CA-AKI. The LFSs were significantly associated with CA-AKI, possibly serving as predictive tools for early identification of CAD patients undergoing elective PCI that are at high risk of CA-AKI.