bluuebunny/crossref_metadata_2025 huggingface dataset:
Patients with Severe Lactic Acidosis in the Intensive Care Unit: A Retrospective Study of Contributing Factors and Impact of Renal Replacement Therapy
Authors: Van De Ginste Lyssa , Vanommeslaeghe Floris , Hoste Eric A.J. , Kruse Jan M. , Van Biesen Wim , Verbeke Francis
Published: September 2021

Introduction: Hyperlactatemia is a regular condition in the intensive care unit, which is often associated with adverse outcomes. Control of the triggering condition is the most effective treatment of hyperlactatemia, but since this is mostly not readily possible, extracorporeal renal replacement therapy (RRT) is often tried as a last resort. The present study aims to evaluate the factors that may contribute to the decision whether to start RRT or not and the potential impact of the start of RRT on the outcome in patients with severe lactic acidosis (SLA) (lactate ≥5 mmol/L). Materials and Methods: We conducted a retrospective single-center cohort analysis over a 3-year period including all patients with a lactate level ≥5 mmol/L. Patients were considered as treated with RRT because of SLA if RRT was started within 24 h after reaching a lactate level ≥5 mmol/L. Results: Overall, 90-day mortality in patients with SLA was 34.5%. Of the 1,203 patients who matched inclusion/exclusion criteria, 11% (n = 133) were dialyzed within 24 h. The propensity to receive RRT was related to the lactate level and to the SOFA renal and cardio score. The most frequently used modality was continuous RRT. Patients who were started on RRT versus those who did not have 2.3 higher odds of mortality, even after adjustment for the propensity to start RRT. Conclusions: Our analysis confirms the high mortality rate of patients with SLA. It adds that odds for mortality is even higher in patients who were started on RRT versus not. We suggest keeping an open mind to the factors that may influence the decision to start dialysis and bear in mind that without being a bridge to correction of the underlying condition, dialysis is unlikely to affect the outcome.
Design and simulation of cascaded H-bridge multilevel inverter with energy storage
Authors: Ting Tan Chee , Rasin Zulhani , Ching Chan Sia
Published: September 2021

Stand-alone power system provides a solution for the user in rural areas that are disconnected from the utility grid which requires power electronics device for the power conversion. This work proposes a design of 5-level cascaded H-bridge inverter with energy storage to realize DC-AC power conversion for such system. The DC-DC bidirectional converter is designed to control the charging and discharging of current into/from the battery during the buck and boost mode of operation. At the DC side, dual-loop control strategy using PI controllers is designed to control the current and voltage. The inner loop current controller controls the recharging/discharging of current for the battery, while the outer voltage controller controls the DC link voltage at 200 V for each of the H-bridge unit. At the AC side, multiple feedback loop control strategy regulates the inverter output voltage at 240 Vrms under various load change. The modelling and design of the system is implemented under Matlab Simulink environment. From the results, the battery storage unit works well with the DC link voltage to achieve a balance power transfer within the system between the PV source, load and battery storage under variation of PV power and loading condition.
Electro mechanical properties changes of LDPE doped with industrial type MgO for cable insulation purposes
Authors: Haggag Sherif , Nasrat Loai , Ismail Hanafy
Published: September 2021

This manuscript introduces the changes of a comprehensive electromechanical properties bundle for low density polyethylene compounded to microscale magnesia (LDPE/MgO) to obtain electrical cables insulating material. Composites of various filler loading weight ratios were prepared by melt intercalation technique; multiple samples were produced in sets as they were cut with definite dimensions as per recommendations of the related testing standard then electrically and mechanically examined following the instruction dictated by the code while preserving typical test condition for all sets. Dielectric strength, volume resistivity, capacitance, and loss angle were the tests of the electrical test pack, while elongation, tensile strength, and melt flow rate were the mechanical and rheological tests applied. Test’s findings were compared to each other’s and to the base material to identify the differentiation. Electrical test results show improvements in the composite features at low loading percentages, whereas the mechanical tests revealed a deterioration in the mechanical properties along with all ratios under investigation. The research aims to determine the compositing benefit extents and drawbacks when a conventional compounding method and inexpensive filler are used, incurring marginal cost impact.
Image mixed gaussian and impulse noise elimination based on sparse representation model
Authors: Hussein Ahmed Abdulqader , Hussain Sabahaldin A. , Reja Ahmed Hameed
Published: September 2021

A modified mixed Gaussian plus impulse image denoising algorithm based on weighted encoding with image sparsity and nonlocal self-similarity priors regularization is proposed in this paper. The encoding weights and the priors imposed on the images are incorporated into a variational framework to treat more complex mixed noise distribution. Such noise is characterized by heavy tails caused by impulse noise which needs to be eliminated through proper weighting of encoding residual. The outliers caused by the impulse noise has a significant effect on the encoding weights. Hence a more accurate residual encoding error initialization plays the important role in overall denoising performance, especially at high impulse noise rates. In this paper, outliers free initialization image, and an easier to implement a parameter-free procedure for updating encoding weights have been proposed. Experimental results demonstrate the capability of the proposed strategy to recover images highly corrupted by mixed Gaussian plus impulse noise as compared with the state of art denoising algorithm. The achieved results motivate us to implement the proposed algorithm in practice.
Performance evaluation of SIFT against common image deformations on iban plaited mat motif images
Authors: Joseph Silvia , Hipiny Irwandi , Ujir Hamimah , Samson Juan Sarah Flora , Minoi Jacey-Lynn
Published: September 2021

Decorative plaited mat is one of the many examples of rich plait work often seen on Borneo handicraft products. The plaited mats are decorated with simple and complex motif designs; each has its own special meaning and taboos. The motif designs are used as a reflection of environment and the traditional beliefs in the Iban community. In line with efforts from UNESCO’s and Sarawak Government’s, digitization, and the use of IR4.0 technologies to preserve and promote this cultural heritage is encouraged. Towards this end goal, we present a novel image dataset containing 10 Iban plaited mat motif classes. The plaited mat motifs are made of diagonal and symmetrical shapes, as well as geometric and non-geometric patterns. Classification’s accuracy using scale-invariant feature transform (SIFT) features was evaluated against 6 common image deformations: zoom+rotation, viewpoint, image blur, JPEG compression, scale and illumination, across multiple threshold values. Varying degrees of each deformation were applied to a digitally cleaned (and cropped) image of each mat motif class. We used RANSAC to remove outliers from the noisy SIFT matching result. The optimal threshold value is 2.0e-2 with a reported 100.0% matching accuracy for the scale change and zoom+rotation set.
Enhancement of WiMAX networks using OPNET modeler platform
Authors: Alfaisaly Noor Nateq , Naeem Suhad Qasim , Neama Azhar Hussein
Published: September 2021

Worldwide interoperability microwave access (WiMAX) is an 802.16 wireless standard that delivers high speed, provides a data rate of 100 Mbps and a coverage area of 50 km. Voice over internet protocol (VoIP) is flexible and offers low-cost telephony for clients over IP. However, there are still many challenges that must be addressed to provide a stable and good quality voice connection over the internet. The performance of various parameters such as multipath channel model and bandwidth over the Star trajectoryWiMAX network were evaluated under a scenario consisting of four cells. Each cell contains one mobile and one base station. Network performance metrics such as throughput and MOS were used to evaluate the best performance of VoIP codecs. Performance was analyzed via OPNET program14.5. The result use of multipath channel model (disable) was better than using the model (ITU pedestrian A). The value of the throughput at 15 dB was approximately 1600 packet/sec, and at -1 dB was its value 1300 packet/se. According to data, the Multipath channel model of the disable type the value of the MOS was better than the ITU Pedestrian A type.
The stability of cannon position on tank prototype using PID controller
Authors: Arief Putra Dimas Farid , Muharom Ahmad Syahril
Published: September 2021

Tank is a war vehicle made of steel that can be operated on various fields. With various fields and a large amount of terrain that the tank had to pass, this made it necessary for the tank to be able to stabilize the cannon so that the cannon be able to fire right on the target. This study discusses the stability of the position of the cannon on the tank prototype using the PID control system. PID values are obtained by using the Ziegler-Nichols tuning formula and simulink. The system using Arduino MEGA 2560 as microcontroller, gyroscope & accelerometer for the feedback sensor and cannon that driven using three servos that representing the x-axis, y-axis and z-axis. The highest average error value is 4.67 degrees with an overall average value of 2.29 degrees and an accuracy percentage of 98% when the tank tilted randomly on the x-axis, y-axis and z-axis.
Automatic dependent bug reports assembly for bug tracking systems by threshold-based similarity
Authors: Luaphol B. , Polpinij J. , Kaneampornpan M.
Published: September 2021

Bug reports contain essential information for fixing problems that occur in software. Many studies have proposed methods for automatic analysis of bug reports. One such task could affect the completion of software bug fixing, known as “bug dependency”. Although this problem was mentioned by many researches, most of them discussed about the related bugs but not really dealt with dependency issue in bug reports. One possible solution used for addressing this issue is to assemble all relevant/dependent bug reports together before analysis of the next processing stages. This study presents a method of assembling dependent bug reports. The main mechanism is called “threshold-based similarity analysis”, and the three similarity techniques of cosine similarity (CS) multi aspect TF (MATF), and BM25 are compared with feedback, precision and likelihood value. As the BM25 with the threshold as 0.5 gives the best results, it was used to compare with the state of the art method. The results show that our method increases precision and likelihood values by 12% and 12.4% respectively. Therefore, our results can be used to encourage developers to recognize all dependent bugs in the same problem domain.
Less memory and high accuracy logarithmic number system architecture for arithmetic operations
Authors: Md Naziri Siti Zarina , Ismail Rizalafande Che , Md Isa Mohd Nazrin , Hussin Razaidi
Published: September 2021

Interpolation is another important procedure for logarithmic number system (LNS) addition and subtraction. As a medium of approximation, the interpolation procedure has an urgent need to be enhanced to increase the accuracy of the operation results. Previously, most of the interpolation procedures utilized the first degree interpolators with special error correction procedure which aim to eliminate additional embedded multiplications. However, the interpolation procedure for this research was elevated up to a second degree interpolation. Proper design process, investigation, and analysis were done for these interpolation configurations in positive region by standardizing the same co-transformation procedure, which is the extended range, second order co-transformation. Newton divided differences turned out to be the best interpolator for second degree implementation of LNS addition and subtraction, with the best-achieved BTFP rate of +0.4514 and reduction of memory consumption compared to the same arithmetic used in european logarithmic microprocessor (ELM) up to 51%.
Uso de ferramentas on-line no ensino presencial: reflexões pré-pós-pandemia
Authors: Bastos Erick Leite
Published: September 2021

Esse artigo traz algumas reflexões sobre o uso de ferramentas de ensino on-line no ensino presencial. O autor compartilha suas as dúvidas sobre a melhor forma de conciliar as lições aprendidas com o ensino on-line durante o distanciamento social imposto pela pandemia de COVID-19 e o retorno das aulas presenciais. Além disso, são abordados aspectos práticos da criação de conteúdo on-line e do uso de material e ferramentas da internet no processo de ensino-aprendizagem.
Integração de tecnologia educacional na USP
Authors: Haar Ewout ter
Published: September 2021

Analisamos a integração de tecnologia educacional na Universidade de São Paulo, focando na adoção e uso de ambientes virtuais de aprendizagem (AVA), traçando seu desenvolvimento e manutenção nas últimas duas décadas. É proposto um arcabouço analítico para situar os principais marcos do uso das tecnologias online pela USP e que busca navegar entre os extremos de determinismo tecnológico e um instrumentalismo ingênuo. As formas de uso do principal AVA da USP, a plataforma e-Disciplinas, são exploradas por meio de indicadores de adoção e tipos de uso. A pandemia de 2020 acelerou repentinamente uma tendência existente de maior adoção e usos mais complexos do sistema.
Avaliação de Programas Educacionais no Contexto da Educação Remota e COVID 19
Authors: Reis Francisco José Candido dos , Navarro Anderson Marliere
Published: September 2021

No início de 2020 o mundo foi surpreendido pelo surgimento e rápido avanço da Covid-19. O impacto sobre os programas educacionais foi enorme. Sendo o distanciamento social uma das poucas formas de mitigar o avanço da pandemia, o ensino remoto emergencial (ERE) passou a ser uma imposição. Neste contexto ganha grande relevância avaliar estas iniciativas a fim de promover rapidamente as mudanças necessárias para que se consiga, minimamente, cumprir os objetivos dos programas educacionais.

Neste artigo discutiremos os fundamentos para a avaliação de programas educacionais no contexto da ERE e da Covid-19. Apresentaremos os princípios básicos de uma avaliação de programas educacionais que são aplicáveis desde a uma aula isoladamente, até ao curso como um todo. Discutiremos a aplicação dos modelos experimentais, Kirkpatrick, modelo lógico e CIPP (Contexto, Insumo, Processo e Produto).

A avaliação das atividades educacionais que utilizaram o ERE, implementado durante a pandemia em 2020, é uma oportunidade para rever práticas e induzir mudanças substanciais no processo de formação das próximas gerações de profissionais da saúde e dos docentes.
Desenvolvimento Docente para Educação Remota Emergencial em 2020: a experiência da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP)
Authors: Carmona Fábio , Bollela Valdes Roberto
Published: September 2021

Após a suspensão das aulas presenciais em 2020, devido à pandemia da Covid-19, foi necessário viabilizar educação remota emergencial para milhares de estudantes de todos os níveis do ensino no Brasil. Quase ninguém estava preparado para enfrentar um desafio desta grandeza. Por conta da falta de familiaridade com as estratégias de educação mediada por tecnologia, única modalidade de ensino disponível naquele momento, essa situação logo trouxe à tona sinais de fadiga e estresse entre professores e estudantes. Era perceptível também a necessidade, por parte dos professores, de treinamento para apropriarem-se dos recursos existentes na universidade para a educação remota. A energia dispendida para preparação das aulas, atividades e avaliações no contexto da educação remota era enorme e seria necessário adquirir competências básicas para manter os processos de ensino-aprendizagem e avaliação dos estudantes acontecendo e com boa qualidade.  Estes sinais e pedidos de ajuda, por parte dos professores e estudantes, começam a ficar evidentes no final de maio de 2020 na Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP). Estudantes reclamavam de sobrecarga de conteúdo, sobreposição e desorganização das atividades propostas para o ambiente virtual e estavam muito ansiosos com a avaliação que teriam ao final do semestre. Por outro lado, víamos professores inseguros para oferecerem atividades online, ou em dúvida sobre como cuidar de vários aspectos, tais como registro de frequência, participação ativa nas aulas, e, principalmente, avaliação do estudante. Enfim, como utilizar recursos de educação remota, partindo de pouca ou quase nenhuma experiência prévia? Neste contexto, o Centro de Desenvolvimento Docente para o Ensino (CDDE) da FMRP-USP identifica as necessidades dos docentes e propõe um treinamento voltado para a plataforma e-Disciplinas da USP, assegurando os princípios básicos de boa educação e avaliação dos estudantes. Daí nasce o módulo básico de educação remota para profissões da saúde, que busca atender docentes com diferentes necessidades na FMRP-USP. Para aqueles professores com maior expertise em educação a distância, realizamos dois cursos completos empregando o ensino híbrido a partir da estratégia da sala de aula invertida, mas de maneira remota (remote flipped classroom). Para um público mais iniciante ou que não teria condições de se dedicar ao curso completo, disponibilizamos ajuda personalizada. Esta é a experiência que apresentamos neste artigo e que servirá de base para adequações necessárias para o enfrentamento do desafio da educação durante e após a fase mais aguda da pandemia da Covid-19.
O futuro da Educação na Universidade: avanços possíveis e necessários
Authors: Carmona Fabio , Cesaretti Mário Luís Ribeiro , Oliveira Anamaria Siriani de , Bollela Valdes Roberto
Published: September 2021

Este artigo traz uma reflexão sobre transformações possíveis e necessárias, a partir das experiências vividas por docentes, estudantes e instituições de ensino ao longo do ano de 2020, na medida em que sobreviviam, aprendiam e se adaptavam à pandemia da COVID-19. Não resta dúvidas de que a maneira de ensinar deverá estar alicerçada em conhecimentos pedagógicos, práticas colaborativas, na tecnologia educacional, infraestrutura de informática e práticas avaliativas que favoreçam a aprendizagem, através do feedback e da interação mais próxima entre aprendiz e professor. O futuro aponta para o ensino híbrido que deve auxiliar os estudantes a alcançarem a competência para a prática profissional. O desenvolvimento de habilidades interpessoais será fundamental, em especial na formação de profissionais da área da saúde. A oferta de oportunidades para o desenvolvimento docente e a estruturação de comunidades de prática para a aprendizagem colaborativa também serão essenciais.

A maior flexibilização dos currículos e a mediação tecnológica do processo de ensino e aprendizagem devem favorecer intercâmbios e a internacionalização das instituições de ensino.  Deste modo, tanto o ensino de graduação, pós-graduação lato e stricto-sensu tende a ampliar seu escopo e deixará de ficar circunscrito aos seus nichos de origem, expandindo-se para a realização de convênios nacionais e internacionais.

Os espaços universitários e os momentos presenciais deverão estar adaptados a nova realidade, que permita ao estudante a aquisição de competências clínicas e relacionais essenciais e que requerem atividades presenciais em cenários da prática profissional. Na área da saúde garantir estes momentos de formação seguirá como um requisito fundamental, assim, as salas de aula, os laboratórios e os campos de estágios devem ser seguros, permitindo uma orientação e supervisão direta por parte dos docentes e preceptores. Além disso, será necessário reafirmar que não existe dilema entre a formação de profissionais da saúde e a segurança do paciente, como houve a partir da suspensão das atividades práticas da maioria dos estudantes dos cursos da saúde no Brasil. Formar profissionais da saúde, num contexto de emergência sanitária, tem importância equivalente a cuidar de pessoas em qualquer cenário. Isso vale também para o acesso a equipamentos de proteção individual e a vacinas. Os desafios estão lançados e as possibilidades de avanço emergem e precisam ser aproveitadas a partir de um trabalho coeso entre gestores universitários, corpo docente, técnico administrativo e discentes.
Blame and Complicity in International Relations: Making Non-intervention Morally Bearable
Authors: Balzacq Thierry , Rousseau Elise
Published: September 2021

On various occasions, states have condemned other nations or groups for mass atrocities they commit; but this rarely leads to any step to redress the untoward situation. This article therefore asks: What functions does blame serve when the blamers lack – or are reluctant to use – the power or authority to punish transgressors? Unlike approaches that focus on the effects of blaming on the wrongdoer, we argue that openly attributing responsibility for wrongdoings to another state or non-state actor has become a normative strategy to shape the way a government is perceived domestically and abroad. Specifically, international blame serves two main objectives: an immediate, communicative function, that is, to express moral protest, and a future-oriented purpose, that is, to dispel future indictment of complicity. We suggest that a corollary of this normative strategy is to make non-intervention morally acceptable. Thus, while in principle the blamer might stand up for the violated norm and value the victims, the strategic use of blame tends to legitimate inaction, by diverting attention away from blaming’s deontic commitments. The article therefore warns against the instrumental use of blame as an act of supererogation (that is, an act that is not compulsory but whose performance is praiseworthy), and as a form of moral clearance (whereby the blamer acknowledges the issue but leaves responsibility for finding solution to the international society). Rather, while blaming ascribes responsibility for the act to an agent, we argue, it also puts the blamer in a specific moral situation: the necessity to take measures that interrupt the unfolding action. Our analysis leads us to put forward a plausible norm that broadens the scope of complicity in international politics: states become complicit in the wrongdoing of other actors (states or non-states) whenever they violate moral obligations that blaming demands. In other words, to blame is to commit oneself to act, though the exact nature of this action varies.
White Cannibalism in the Illegal Slave Trade
Authors: Barcia Manuel
Published: September 2021

The Portuguese schooner Arrogante was captured in late November 1837 by HMS Snake, off the coast of Cuba. At the time, the Arrogante had more than 330 Africans on board, who had been shipped from the Upper Guinea coast. Once the vessel arrived in Montego Bay, Jamaica, the British authorities apprenticed those who had survived. Shortly after landing, however, the Arrogante’s sailors were accused of slaughtering an African man, cooking his flesh, and forcing the rest of those enslaved on board to eat it. Furthermore, they were also accused of cooking and eating themselves the heart and liver of the same man. This article focuses not so much on the actual event, as on the transatlantic process that followed, during which knowledge was produced and contested, and relative meanings and predetermined cultural notions associated with Europeans and Africans were probed and queried.
A double-headed Luther? A Lutheran response to The Holy Trinity by Stephen R. Holmes
Authors: Mackenzie Jon
Published: September 2021

The narrative flow of The Holy Trinity by Stephen R. Holmes delineates a twoperiod history of the development of the doctrine: an earlier period of orthodoxy becomes replaced by a new heterodoxy which saw itself as an extension of the preceding tradition but which Holmes himself decries as a divergence. This essay seeks to temper the simple two-stage periodisation that Holmes erects by analysing the important position of Martin Luther in the historical narrative, showing him to span the divide between the two periods and raising questions as to the ease with which heterodoxy and orthodoxy can be held apart in Holmes’s account.
A conversation overheard: reflecting on the Trinitarian grammar of intimacy and substance
Authors: Colwell John E.
Published: September 2021

In response to Stephen Holmes, this paper reviews the Trinitarian contributions of the Cappadocian Fathers and Augustine with the goal, following Robert Jenson and Colin Gunton in particular, of reasserting the key distinctions between them and some aspects of the heritage of these distinctions in Western theology and popular piety. The paper also acknowledges some of their commonalities, including the common inadequacies in their expressions of the doctrine of the Spirit.
The book of Ruth and the house of David
Authors: Goswell Gregory R.
Published: September 2021

Recent scholarly evaluation of the Ruth narrative has paid little attention to the Davidic connection that is explicit in the canonical book. However, if the story is read in relation to the house of David, its leading theme is the providential preservation of the family that became the Judean royal house. This thesis is supported by the fact that two out of the three traditional canonical positions assigned to the book of Ruth assume a connection with David. The genealogy in Ruth 4:18–22 forges an explicit link between the family history of the book of Ruth and David. The link with David does more than endorse the book’s message that otherwise has nothing to do with David (e.g. a critique of exogamous marriage). God’s control of events in the Ruth narrative and his ‘kindness’ toward the ancestors of David prefigure his later dealings with David and his house. Finally, key scenes in Ruth 1 and 3 (Ruth’s refusal to part from Naomi, and Ruth’s appeal to Boaz) find parallels in the life of David.
Lepidaploa restingae (Asteraceae: Vernonieae), a new species from Northeastern Brazil
Authors: SOARES GLEISON , LOEUILLE BENOÎT
Published: September 2021

Lepidaploa restingae, a new species from the restinga vegetation in Northeastern Brazil, is described and illustrated. This new species differs from morphologically related species by the branch indument, leaf morphology, number of phyllary series and corolla lobe indument. Taxonomic comments, a distribution map and a preliminary conservation status for the new species are provided.
Essential but Ill-Prepared: How the COVID-19 Pandemic Affects the Mental Health of the Grocery Store Workforce
Authors: Mayer Brian , Arora Mona , Helm Sabrina , Barnett Melissa
Published: September 2021

Objectives:

Frontline essential workers face elevated risks of exposure to COVID-19 because of the interactive nature of their jobs, which require high levels of interaction with the general public and coworkers. The impact of these elevated risks on the mental health of essential workers, especially outside the health care sector, is not well studied. To address this knowledge gap, we examined correlations between perceptions of workplace risks and mental health distress among grocery store workers in Arizona.

Methods:

We collected the first statewide sample of essential workers outside the health care sector focused on mental health and well-being. A total of 3344 grocery store workers in Arizona completed an online survey in July 2020. We used multiple regression models to identify demographic and work-based correlates of mental health distress.

Results:

Levels of mental health distress among respondents were high: 557 of 3169 (17.6%) reported severe levels and 482 of 3168 (15.2%) reported moderate levels. Perceptions of workplace safety were strongly correlated with significantly reduced levels of mental health distress (ß = −1.44; SE = 0.20) and reduced perceived stress (ß = −0.97; SE = 0.16). Financially disadvantaged workers and employees aged <55 reported high levels of mental health distress. Perceptions of safety and protection in the workplace were significantly correlated with availability of safety trainings, social distancing, and policies governing customer behaviors.

Conclusions

Lacking sufficient workplace protections, grocery store employees in Arizona experienced high levels of mental health distress during the COVID-19 pandemic. Providing clear federal and state policies to employers to guide implementation of workplace protections may help reduce sources of mental health distress.
The association of left ventricular histologically verified myocardial fibrosis with pulmonary hypertension in severe aortic stenosis
Authors: Gumauskiene Birute , Drebickaite Egle , Pangonyte Dalia , Vaskelyte Jolanta Justina , Padervinskiene Lina , Jakuska Povilas , Budrikis Algimantas , Ereminas Rokas , Ereminiene Egle
Published: September 2021

Objectives:

To evaluate the association between histologically verified left ventricular (LV) myocardial fibrosis (MF) and its bio- and functional markers with pulmonary hypertension (PH) in severe aortic stenosis (AS).

Methods:

About 34 patients with isolated severe AS underwent 2D echocardiography, cardiac magnetic resonance (CMR) imaging, and plasma NT-proBNP evaluation before aortic valve replacement (AVR). LV measurements were analyzed by CMR and LV strain using feature tracking software (Medis Suite QStrain 2.0). Myocardial biopsy sampled at the time of AVR was assessed by a histomorphometric analysis. PH was defined as pulmonary artery systolic pressure (PASP) ⩾ 45 mm Hg.

Results:

Patients with severe AS and PH (mean PASP 53 ± 3.7 mm Hg) had higher extent of diffuse MF versus patients without PH (12 (10.4–12.7)% vs 6.6 (4.6–8.2)% (p = 0.00)). The extent of diffuse MF correlated with LV dilatation ( r = 0.7, p = 0.02), indices of LV dysfunction (lower ejection fraction ( r = −0.6, p < 0.001), global longitudinal ( r = −0.5, p = 0.02) and circumferential strain ( r = −0.5, p = 0.05), elevated NT-proBNP ( r = 0.5, p = 0.005) and elevated PASP ( r = 0.6, p < 0.001)). Histological MF > 10% (AUC 94.9%), LV global longitudinal strain > −15.5% (AUC 86.3%), and NT-proBNP > 2090 ng/l (AUC 85.1%) were independent predictors of PH in severe AS.

Conclusions:

The extent of diffuse myocardial fibrosis in combination with reduced longitudinal left ventricular strain and increased plasma levels of NT-proBNP relates to pulmonary hypertension in severe aortic stenosis.
Association between long non-coding RNA (lncRNA) GAS5 polymorphism rs145204276 and cancer risk
Authors: Zhao Shushan , Liu Ping , Ruan Zhe , Li Jianhuang , Zeng Shan , Zhong Meizuo , Tang Lanhua
Published: September 2021

Objective

The long non-coding RNA (lncRNA) growth arrest‑specific transcript 5 (GAS5) plays an important role in various tumors, and an increasing number of studies have explored the association of the GAS5 rs145204276 polymorphism with cancer risk with inconclusive results.

Methods

PubMed, Medline, EMBASE, Cochrane databases, and Web of Science were searched, and nine studies involving 6107 cases and 7909 controls were deemed eligible. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated to evaluate the relationship between rs145204276 and cancer risk in six genetic models.

Results

The pooled results suggest that the variant allele del was not associated with overall cancer risk. However, the subgroup analysis showed that allele del was significantly associated with a 22% decreased risk of gastrointestinal cancer (OR = 0.78, 95% CI: 0.72–0.85). Both sensitivity analyses and trial sequential analyses (TSA) demonstrated that the subgroup results were reliable and robust. Moreover, False-Positive Report Probability (FPRP) analysis indicated that the results had true significant correlations.

Conclusion

These findings provide evidence that the GAS5 rs145204276 polymorphism is associated with the susceptibility to gastrointestinal cancer. Further studies with different ethnicities and larger sample sizes are warranted to confirm these results.
Renin–angiotensin system inhibitors and clinical outcomes in patients with atrial fibrillation and heart failure: a propensity score-matched study from the Chinese Atrial Fibrillation Registry
Authors: Lin Jing , He Liu , Qiao Qing , Du Xin , Ma Chang-Sheng , Dong Jian-Zeng
Published: September 2021

Objective

The effect of renin–angiotensin system inhibitors (RASIs) in patients with heart failure (HF) and atrial fibrillation (AF) remains unclear. This study aimed to investigate associations between RASI use and all-cause mortality and cardiovascular outcomes in patients with AF and HF.

Methods

Using data from the China Atrial Fibrillation Registry study, we included 938 patients with AF and HF with a left ventricular ejection fraction <50%. Cox regression models for RASIs vs. non-RASIs with all-cause mortality as the primary outcome were fitted in a 1:1 propensity score-matched cohort. A sensitivity analysis was performed by using a multivariable time-dependent Cox regression model. As an internal control, we assessed the relation between β-blocker use and all-cause mortality.

Results

During a mean follow-up of 35 months, the risk of all-cause mortality was similar in RASI users compared with non-users (hazard ratio: 0.92; 95% confidence interval: 0.67–1.26). Similar results were obtained in the sensitivity analysis. In contrast, β-blocker use was associated with significantly lower all-cause mortality in the same population.

Conclusions

RASI use was not associated with better outcomes in patients with AF and HF in this prospective cohort, which raises questions about their value in this specific subset. Trail Registration: ChiCTR-OCH-13003729.
Cryptogenic hemoptysis caused by isolated aortopulmonary collateral artery formation: a case report
Authors: Lang Yuan , Sun Chao , Dong Xiaoyan , Fang Yongshuang , Zeng Zeyu
Published: September 2021

Hemoptysis in children is caused by various factors, the most common of which is basic lung disease or heart disease. Aortopulmonary collateral arteries (APCAs) are blood vessels that originate from the aorta or its branches and provide blood flow to the pulmonary tissues. We herein report a rare case of APCAs without abnormal structures in the heart. The patient was a previously healthy boy with APCAs originating from the descending aorta. He had no history of congenital heart disease and developed repeated episodes of cryptogenic hemoptysis during his school-age years. Arteriography examination facilitated the diagnosis of APCAs. After embolization, the patient developed no further hemoptysis during 10 months of follow-up. Arteriography is of great significance in determining the cause of recurrent cryptogenic hemoptysis.
Histopathological features of SARS-CoV-2 infection and relationships with organoid technology
Authors: İnanç İrem , Erdemli Esra
Published: September 2021

Coronavirus disease 2019 (COVID-19) following infection by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has caused a global pandemic that is still having serious effects worldwide. This virus, which targets the lungs in particular, can also damage other tissues. Angiotensin converting enzyme 2 (ACE-2) plays a key role in viral entry into host cells. The presence of ACE-2 in various tissues may permit viral infection. Studies of COVID-19 often make use of postmortem tissues. Although this information provides various useful results, it is also necessary to conduct in vitro studies to understand optimal treatment approaches. Because the virus may show species-specific differences, in vitro technologies using human cells are particularly important. Organoid technologies, three-dimensional structures that can be obtained from human cells, are playing increasingly important roles in studies of SARS-CoV-2. This technology offers a significant advantage in terms of mimicking in vivo tissue structures and testing antiviral compounds. In this mini-review, we summarize studies of SARS-CoV-2 using both histopathological and organoid technology approaches.
Flow cytometric analysis of equine bronchoalveolar lavage fluid cells in horses with and without severe equine asthma
Authors: Kang Heng , Bienzle Dorothee , Lee Gary Kwok Cheong , Piché Érica , Viel Laurent , Odemuyiwa Solomon Olawole , Beeler-Marfisi Janet
Published: September 2021

Severe equine asthma (SEA) is a common, debilitating lower airway inflammatory disorder of older horses. Alveolar macrophages (AMs) survey inhaled particulates from barn sources causing them to switch from an anti-inflammatory to a proinflammatory phenotype, resulting in neutrophil recruitment to the lung. This proinflammatory switch may contribute to the development and prolongation of SEA. Validated antibodies to identify the cells involved in the pathogenesis of SEA are lacking. In this study, monoclonal antibodies against CD90, CD163, and CD206 were tested for reactivity with equine leukocytes by immunocytochemistry and flow cytometry. A multi-color flow cytometric assay was developed to identify leukocytes in equine bronchoalveolar lavage fluid (BALF). Four control and 4 SEA-susceptible horses had BALF collected before and after a 48-hour moldy hay challenge. Antibodies against CD90 uniquely labeled equine neutrophils, and antibodies against CD163 and CD206 identified equine macrophages. Postchallenge AM surface expression of CD163 increased in both groups of horses, but the increase was statistically significant in only the SEA-susceptible group ( P = .02). The surface expression of CD206 on AMs increased significantly in the SEA-susceptible group ( P = .03) but was unchanged in the control group ( P = .5). Increased expression of CD163 and CD206 during exacerbation of SEA suggested an association between AM phenotype and lung inflammation. However, functions of AMs in the pathogenesis of SEA remain to be elucidated.
Three-dimensional computational fluid dynamic analysis of a large-scale vertical axis wind turbine
Authors: Hand Brian
Published: September 2021

The vertical axis wind turbine (VAWT) configuration has many advantages for an offshore wind turbine Installation. In this paper, the three dimensional (3D) computational fluid dynamics analysis of a large-scale 5 MW VAWT is conducted. At the optimum tip-speed ratio (TSR), the VAWT maximum inline force was 75% larger than the maximum lateral force. It was found the dynamic stall effects cause the VAWT flow field to become increasingly asymmetrical at the mid-span plane, when the TSR is reduced. The attachment of end plates to the blade tips, resulted in a performance improvement during the upwind phase with the average blade torque coefficient in this range being increased by 4.71%. Conversely, during the blade downwind phase a reduction in performance was found due to the increase in drag from the end plates and the average blade torque coefficient in this phase was reduced by 23.1%.
A Solution to Drone Routing Problems using Docking Stations for Pickup and Delivery Services
Authors: Pachayappan Murugaiyan , Sudhakar Vijayakumar
Published: September 2021

The paper proposes a mathematical model and a heuristic solution for planning optimal pickup and delivery routes in drone operations. In the proposed system, the drone is synchronized with the docking station for a charge during pickup and delivery services within a definite set distance radius. The optimization model presented here minimizes the distance traveled by the drone to complete the scheduled services. It also ensures the optimal use of the drone’s battery capacity, ensuring the safe return of the drone without running out of battery during operations. The solution quality and the computational performance of the Mixed-Integer Linear Programming (MILP) model proved satisfactory in addressing a variety of problems. A real-world case study is conducted to enumerate the practical implications which will be of benefit to drone service providers in the field of logistics.
Radial Head Lag: A Possible Biomechanical Mechanism for Osteochondritis Dissecans of the Capitellum in Baseball Pitchers
Authors: Rotman Dani , Kwak Jae-Man , Rojas Lievano Jorge , Hooke Alexander , Camp Christopher L. , Fitzsimmons James S. , O’Driscoll Shawn W.
Published: September 2021

Background:

Osteochondritis dissecans (OCD) of the capitellum is common in throwing athletes and is believed to result from repetitive overloading on the radiocapitellar (RC) joint, although the cause and mechanism remain unclear. The torsional forces (moments) generated by the triceps during elbow extension pull only on the ulna; therefore, the radial head moves passively across the capitellum and is effectively “dragged along” by the ulna. Any laxity in the proximal radioulnar joint could lead to asynchronous motion between the radius and ulna, resulting in the radial head lagging behind the coronoid and possibly malarticulating with the capitellum during such motion.

Hypothesis:

Radial head motion on the capitellum lags behind ulnohumeral joint motion during simulated throwing.

Study Design:

Controlled laboratory study.

Methods:

A total of 8 cadaveric elbows were tested under simulated throwing, including active extension of the elbow generated by pulling of the triceps under valgus stress, as well as during passive extension under valgus stress to serve as a reference. Ulnohumeral motion was tracked using a video camera. Radial head motion was tracked using an intra-articular, thin-film pressure sensor mounted on the capitellum, and the longitudinal movement of the center of force (COF) of the radial head was measured. Radial head motion was compared between passive and active motion for each 10° of elbow extension from 90° to 20°.

Results:

Elbow motion during simulated active extension reached an angular velocity of 366 deg/s. Radial head motion during simulated active extension significantly lagged compared with its motion during passive extension at every elbow extension angle examined between 70° and 20° ( P < .001). The maximal lag reached a mean of 4 mm (range, 2-7 mm). In other words, RC and ulnohumeral motion were asynchronous during simulated throwing.

Conclusion:

This study describes a novel phenomenon: motion of the radial head across the capitellum during rapid extension, such as in baseball pitching, lags behind that seen during passive elbow motion. According to a new proposed theory of OCD lesion development, this lag should result in RC incongruency and elevated shear forces on the capitellum due to edge loading.

Clinical Relevance:

We propose a new biomechanical explanation for OCD of the capitellum in baseball pitchers: radial head lag. Understanding this process is the first step in efforts to prevent this common injury.
Relationship Between Timing of Anterior Cruciate Ligament Reconstruction and Chondral Injuries: A Systematic Review and Meta-analysis
Authors: Prodromidis Apostolos D. , Drosatou Chrysoula , Mourikis Anastasios , Sutton Paul M. , Charalambous Charalambos P.
Published: September 2021

Background:

After anterior cruciate ligament (ACL) injury, the optimal timing of ACL reconstruction and the influence of this timing on chondral damage remain unclear.

Purpose:

To assess the effect of timing of ACL reconstruction on the presence of chondral injuries via a systematic review and meta-analysis.

Study Design:

Systematic review and meta-analysis; Level of evidence, 4.

Methods:

Two reviewers independently performed systematic literature searches of 5 online databases using the Cochrane methodology for systematic reviews. Eligibility criteria were any comparative study of patients aged >16 years that assessed the relationship between timing of primary ACL reconstruction surgery and rates of chondral injuries. Meta-analysis was conducted using a random-effects model.

Results:

After screening, 14 studies (n = 3559 patients) out of 2363 titles met the inclusion criteria: 3 randomized controlled trials (n = 272), 3 prospective cohort studies (n = 398), and 8 retrospective cohort studies (n = 2889). In analysis of the studies, chondral injury rates were compared between ACL reconstructions performed before and after 3 time points: 3, 6, and 12 months after injury (eg, ≤3 vs >3 months). The rates of chondral injury increased with each time point. The increase was mostly due to low-grade injuries at 3 months (estimated odds ratio, 1.914; 95% CI, 1.242-2.949; P = .003), with the increase in high-grade injuries becoming predominant after 12 months (estimated odds ratio, 3.057; 95% CI, 1.460-6.40; P = .003).

Conclusion:

Our findings suggest that delaying ACL reconstruction surgery results in a higher rate of chondral injuries and the severity of these lesions worsens with time. These findings are comparable with those of our previously published study, which demonstrated a higher risk of meniscal tears associated with delayed ACL surgery. When ACL reconstruction is indicated, surgery ≤3 months after injury is associated with a lower risk of intra-articular damage.

Registration:

CRD42016032846 (PROSPERO).