bluuebunny/crossref_metadata_2025 huggingface dataset:
SRG/ART-XC all-sky X-ray survey: Catalog of sources detected during the first year
Authors: Pavlinsky M. , Sazonov S. , Burenin R. , Filippova E. , Krivonos R. , Arefiev V. , Buntov M. , Chen C.-T. , Ehlert S. , Lapshov I. , Levin V. , Lutovinov A. , Lyapin A. , Mereminskiy I. , Molkov S. , Ramsey B. D. , Semena A. , Semena N. , Shtykovsky A. , Sunyaev R. , Tkachenko A. , Swartz D. A. , Vikhlinin A.
Published: September 2021

We present a first catalog of sources detected by theMikhail PavlinskyART-XC telescope on board the SRG observatory in the 4–12 keV energy band during its ongoing all-sky survey. The catalog comprises 867 sources detected on the combined map of the first two 6-month scans of the sky (December 2019–December 2020), ART-XC sky surveys 1 and 2, or ARTSS12. The achieved sensitivity to point sources varies between ~4 x 10-12erg s-1cm-2near the ecliptic plane and ~8 x 10-13erg s-1cm-2(4–12keV) near the ecliptic poles, and the typical localization accuracy is ~15”. Of the 750 sources of known or suspected origin in the catalog, 56% are extragalactic (mostly active galactic nuclei, AGN; and clusters of galaxies) and the rest are Galactic (mostly cataclysmic variables, CVs; and low- and high-mass X-ray binaries). For 114 sources, ART-XC has detected X-rays for the first time. Although the majority of these (~80) are expected to be spurious (given the adopted detection threshold), there can be a significant number of newly discovered astrophysical objects. We have started a program of optical follow-up observations of the new and previously unidentified X-ray sources, which has already led to the identification of several AGN and CVs. With the SRG all-sky survey planned to continue for a total of four years, we can expect the ART-XC survey in the 4–12 keV band to significantly surpass previous surveys that were carried out in similar (medium X-ray) energy bands in terms of the combination of angular resolution, sensitivity, and sky coverage.
Neue Therapiestrategien beim HER2-positiven fortgeschrittenen, inoperablen bzw. metastasierten Mammakarzinom
Authors: Lüftner Diana , Peipp Matthias
Published: September 2021

Trotz therapeutischer Fortschritte bei der Behandlung des HER2-positiven (HER2 = humaner epidermaler Wachstumsfaktor-Rezeptor 2) fortgeschrittenen/metastasierten Mammakarzinoms besteht weiterhin ein dringender Bedarf an wirksameren Therapieoptionen. Jenseits der zweiten Therapielinie gibt es derzeit keinen definierten, zugelassenen Therapiestandard. Eine der großen Herausforderungen ist die Überwindung von Therapieresistenzen. In Abhängigkeit vom zugrunde liegenden Resistenzmechanismus werden verschiedene Strategien für neue innovative Therapiekonzepte beim HER2-positiven Mammakarzinom verfolgt. Ein wichtiger Fokus liegt dabei auf spezifisch designten Antikörpern für eine gezielte Therapie, um diesen Herausforderungen erfolgreich zu begegnen. Mit Trastuzumab-Deruxtecan (T‑DXd, DS-8201a) befindet sich ein optimiertes Antikörper-Wirkstoff-Konjugat (ADC = Antibody Drug Conjugate) in der klinischen Prüfung, das vielversprechende Studienergebnisse bei bereits intensiv vorbehandelten Patienten mit fortgeschrittenem, inoperablem oder metastasiertem HER2-positivem Mammakarzinom zeigt. Aufgrund dieser Datenlage ist T‑DXd in den USA und Japan bereits für das HER2-positive fortgeschrittene, inoperable bzw. metastasierte Mammakarzinom zugelassen – in den USA nach mindestens 2 vorangegangenen anti-HER2 zielgerichteten Therapielinien und in Japan nach vorangegangener Chemotherapie. T‑DXd steht stellvertretend für ein erfolgreiches „Antikörper-Engineering“. Seit Anfang des Jahres ist T-DXd auch in Europa als Monotherapie beim inoperablen oder metastasierten HER2-positiven Mammakarzinom zugelassen bei Patienten, die mindestens 2 gegen HER2 gerichtete Vorbehandlungen erhalten haben. In der vorliegenden Publikation werden Strategien zur Verbesserung von Therapieoptionen beim HER2-positiven fortgeschrittenen, inoperablen bzw. metastasierten Mammakarzinom vorgestellt – unter anderem am Beispiel der Entwicklung von T‑DXd.
Nerve-Sparing Radical Hysterectomy: Kobayashi's Method
Authors: Yoshikawa Hiroyuki
Published: September 2021

After Prof. S. Okabayashi introduced Okabayashi Operation in 1921, several surgeons introduced numerous improvements in Japan. One of them is so-called the Tokyo Method which was improved and revised by Dr. Kyusaku Ogino (1950), Prof. Takashi Kobayashi, University of Tokyo (1961, 1970), and Prof. Shoichi Sakamoto, University of Tokyo (1981). The nerve-sparing radical hysterectomy without sacrificing radicality was introduced in 19611 and improved in 1970 by Prof. Kobayashi.2 The autonomic nerve pathway including hypogastric nerve (sympathetic nerve), pelvic splanchnic nerve (parasympathetic nerve), and pelvic nerve plexus as a junction of the two nerves and the branch of the plexus to the bladder (vesical nerve branch) are preserved except in advanced cases. He divided the process of nerve-sparing surgery into four steps for separating the autonomic nerve pathway from adjacent tissues along the pathway consisting of cardinal, sacrouterine, rectouterine/vaginal, and vesicouterine ligaments. The first step is separation of the cardinal ligament (deep uterine vessels) from the pelvic splanchnic nerve. The second step is separation of the medial side of severed cardinal ligament from the pelvic nerve plexus. The first and second steps are performed in the lateral side of the autonomic nerve system. The third step is separation of sacrouterine and rectouterine/vaginal ligaments from hypogastric nerve and pelvic nerve plexus. The third step is necessary for achieving high radicality, namely, for severing the sacrouterine and rectouterine/vaginal ligaments near the rectum without damage to the pelvic nerve plexus. The fourth step is separation of paravaginal tissues and posterior (deep) layer of the vesicouterine ligament from the vesical nerve branches of the plexus. The third and fourth steps are performed in the medial side of the autonomic nerve system.
Ophthalmic Segment Aneurysms: Surgical Treatment and Outcomes
Authors: Kachhara Rajneesh , Nair Suresh , Nigam Pulak
Published: September 2021

Background Surgical treatment of ophthalmic segment aneurysms (OSAs) remain challenging because of complex anatomy surrounding the aneurysm and entails extensive drilling of anterior clinoid process to define proximal neck of the aneurysm and carotid exposure in the neck for proximal control.

Materials and Methods Authors present a retrospective analysis of 36 aneurysms in 35 patients with OSAs operated surgically by first author. Surgical clipping was done for the aneurysms as primary modality of treatment along with wrapping and trapping as required.

Results Commonest age group was 40 to 60 years with female preponderance of 3:1. Maximum (23) patients presented with subarachnoid hemorrhage (WFNS Gr 1), followed by asymptomatic patients (six). There were 18 small, 14 large, and four giant aneurysms, 15 dorsal wall, 17 ventral wall, three proximal posterior wall, and one blister aneurysm. Good outcome, as measured by Glasgow Outcome Score (GOS) was achieved in 29 patients.

Conclusion OSAs are technically demanding aneurysms, but with due diligence to surgical principles, good outcomes may be obtained.
Correction to: Fiscal Policy, Multidimensional Poverty, and Equity in Uganda: A Child-Lens Analysis
Authors: Cuesta Jose , Jellema Jon , Ferrone Lucia
Published: September 2021

The article ‘Fiscal Policy, Multidimensional Poverty, and Equity in Uganda: A Child-Lens Analysis’, written by Jose Cuesta, Jon Jellema and Lucia Ferrone was originally published electronically on the publisher’s internet portal on 18 of May 2021 without open access. With the author(s)’ decision to opt for Open Choice the copyright of the article changed on 14 of September 2021 to © The Author(s), 2021 and the article is forthwith distributed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0.
The Fish Health Risk Indicator: linking water quality and river flow data with fish health to improve our predictive capacity around fish death events
Authors: Davie Alec W. , Pera Joe B.
Published: September 2021

Severe drought conditions contributed to three mass fish mortality events in the Darling River near Menindee, part of the Murray–Darling Basin, Australia, during the summer of 2018–19. An independent assessment recommended the need for improved modelling approaches to identify when sections of rivers may be more susceptible to fish kill events. We present a geographic information system (GIS)-based tool that combines meteorological forecasts with river flow and algal biomass datasets to identify river reaches where additional stresses on fish health may produce an increased risk of mass fish deaths. At present the tool is still in development and will require the addition of extra datasets and testing using historical datasets to further validate its accuracy. Despite the tool being in its development stage, the decision support tool has been widely accepted and provides natural resource managers with a rapid way to understand and communicate risks to fish health, supporting improved water management options across the Murray–Darling Basin that may ultimately help reduce the frequency and severity of large-scale fish mortality events.
Intermolecular latency regulates the essential C-terminal signal peptidase and sortase of the
Porphyromonas gingivalis
type-IX secretion system
Authors: Mizgalska Danuta , Goulas Theodoros , Rodríguez-Banqueri Arturo , Veillard Florian , Madej Mariusz , Małecka Ewelina , Szczesniak Katarzyna , Ksiazek Miroslaw , Widziołek Magda , Guevara Tibisay , Eckhard Ulrich , Solà Maria , Potempa Jan , Gomis-Rüth F. Xavier
Published: September 2021

Significance

Selected gram-negative bacteria employ a type-IX secretion system to shuttle virulence proteins with a C-terminal domain (CTD) as a secretion signal across the outer membrane. Upon secretion, the CTD is cleaved and replaced with lipopolysaccharide by PorU, the only known bifunctional signal peptidase and sortase. We discovered that PorU transits between active monomers and latent dimers and determined the structure of the ∼260-kDa dimer. PorU consists of seven domains, including a gingipain-type catalytic domain, which is regulated by a long “latency β-hairpin” that forms an intermolecular β-barrel with the symmetric protomer. Homology modeling followed by in vivo validation revealed that PorU functions as a monomer through a cysteine–histidine catalytic dyad. Thus, dimerization provides an intermolecular mechanism for PorU regulation.
Simulated and experimental studies of a multi-band symmetric metamaterial absorber with polarization independence for radar applications
Authors: Ali Hema O. , Al-Hindawi Asaad M. , Abdulkarim Yadgar I. , Nugoolcharoenlap Ekasit , Tippo Tossapol , Alkurt Fatih Özkan , Altintaș Olcay , Karaaslan Muharrem
Published: September 2021

We develop a simple new design for a multi-band metamaterial absorber (MTMA) for radar applications. Computer Simulation Technology (CST) Studio Suite 2018 was used for the numerical analysis and absorption study. The simulated results show four high peaks at 5.6 GHz, 7.6 GHz, 10.98 GHz, and 11.29 GHz corresponding to absorption characteristics of 100%, 100%, 99%, and 99%, respectively. Furthermore, two different structures were designed and compared with the proposed MTMA. The proposed structure remained insensitive for any incident angle and polarization angle from 0° to 60°. Moreover, negative constitutive parameters were retrieved numerically. To support the simulated results, the proposed design was fabricated by using a computer numerical control-based printed circuit board prototyping machine and tested experimentally in a microwave laboratory. The absorption mechanism of the proposed MTMA is presented through the surface current and electric field distributions. The novelties of the proposed structure are a simple and new design, ease of fabrication, low cost, durability, suitability for real-time applications and long-term stability given the fabrication technique and non-destructive measurement method and very high absorption. The proposed structure has potential applications in C and X band frequency ranges.
Effects of rain noise from metal roofs on speech identification
Authors: Chen Yan , Li Xin
Published: September 2021

Recently metal roofs were widely utilized in rainwater harvesting, and noise produced by rain on metal roofs cannot be ignored. The goal of this article is to demonstrate the effects of rain noise from the metal roofs on speech identification. Two recordings of rain noise from metal roofs and a speech corpus simulated two actual acoustical listening environments. Two experiments were carried out to investigate the interference of rain noise on speech identification in two different acoustical listening environments. Two different simplified ordinary classroom model were carried out in the article. The experiment 1 was in a classroom with a metal roof and experiment 2 was in two point in a simplified ordinary classroom which is close to other building with metal roofs. Some results were shown speech identification all dropped significantly with SNR reduces.
An Optimal Selection Algorithm Based on Q-Learning For Dual Media Communication System With Full-Duplex Relays
Authors: Wang Huifang , Zhang Shujuan , Chen Zhixiong , Huo Meiru , Fan Lei , Zhang Lixia
Published: September 2021

Full-duplex communication technology can make full use of spectrum resources through simultaneous co-frequency transmission, but the interference of the signal sent by the device itself degrades performance. The paper proposes a joint antenna and relay selection algorithm based on Q-learning, which selects the best relay with the best transmit-receive configuration for the communication between the source and the target. Specifically, by learning the dual-medium cooperative communication environment to obtain feedback in terms of interruption probability and channel capacity, so as to determine the best relay and antenna. Finally, the paper verifies the effectiveness of the algorithm by simulation.
Research on RGB-D image recognition technology based on feature fusion and machine learning
Authors: Sun Qingbo
Published: September 2021

The three-dimensional RGB-D image contains not only the color and texture information of the two-dimensional image, but also contains the surface geometry information of the target. This article analyzes the RGB-D image recognition methods, including stereo vision technology, structured light technology, etc. By studying the application points of RGB-D image recognition technology under the background of feature fusion and machine learning, the purpose is to improve the richness of image recognition content and provide reference for the smooth development of the follow-up work.
A Novel Fault Location Algorithm in Distribution Network Based on Power-on Signal and Power-off Signal
Authors: Ge Xiaojun , Chen Minyu , Mao Yaming , Lu Lizhen , He Xing , Ai Qian
Published: September 2021

In recent years, with the continuous promotion of clean and low-carbon energy strategy, power system’s operation mode has been transformed gradually. Consequently, the extended time of fault location when it occurs will jeopardize the fault restoration of distribution system and reduce the grid resilience. Hence, this paper proposes a novel fault location algorithm based on the combination of power-on signal and power-off signal, which can improve the efficiency of the fault location. First, the principle of numbering node is presented, making it convenient for computer to identify the relationship between device in the distribution network. Then, some assumptions and principles of the algorithm are shown, together with the termination condition of the proposed algorithm. Finally, case study involving an actual distribution network is carried out. Results show that the proposed algorithm is able to achieve accurate fault location meanwhile improve the efficiency of fault location.
Detection of the Impurities in Bottled Mineral Water Based on Computer Vision System
Authors: Liu Haoran
Published: September 2021

Bottled mineral water is an indispensable drink in our daily life. It’s important for us to guarantee quality of the products. In this study, a computer vision based detection system is established to detect the impurities in bottled mineral water. With the help of high speed industrial camera, the images of RGB model images could be obtained in real-time. The recorded images are transformed into HSI color format to reduce the effect of environmental brightness on the industrial assembly line. The corresponding threshold of the hue and saturation for bottled mineral water are set, according to which the image segmentation is carried out. After Gaussian filtering, the image decomposition and edge detection are applied to the images. The impurities in the bottled mineral water could be determined, marked by red dots. Based on the detection results, unqualified products will be removed from the industrial assembly line. By using this system, the accuracy and efficiency could be improved for the detection of impurities in bottled mineral water.
Chinese text multi-classification based on Sentences Order Prediction improved Bert model
Authors: Fu Guanping , Sun Jianwei
Published: September 2021

For the strong noise interference brought by the NSP mechanism (Next Sentences Prediction) in Bert to the model, in order to improve the classification effect of the Bert model when it is used in text classification, an SOP (Sentences Order Prediction) mechanism is used to replace the Bert model of the NSP mechanism-Multi-classification of Chinese news texts. At first, use randomly sorted adjacent sentence pairs for segment embedding. Then use the Transformer structure of the Bert model to encode the Chinese text, and obtain the final CLS vector as the semantic vector of the text. Finally, connect the different semantic vectors to the multi-category Classification. After ablation experiments, the improved SOP-Bert model obtained the highest F1 value of 96.69. The results show that this model is more effective than the original Bert model on text multi-classification problems.
Research and practice on information Technology of landslide early warning, restoration and reinforcement
Authors: Ma Rui , Wang Hanhui , Yan Fugen , Liu Chengkun , Hu Binbin
Published: September 2021

China is one of the countries with the most serious geological disasters in the world, and landslide is the main geological disaster. China has carried out many years of research in the field of landslide and made a lot of achievements, but the information integration and visualization are not systematic, especially in the data fusion, technology integration, deduction simulation and other aspects. Starting from the framework of the software platform, this paper focuses on the research of key technologies such as multi-data fusion, whole-chain technology integration, deduction simulation; establishes landslide early warning information software platform, and carries out the application practice in the demonstration area, which is of reference significance for the information construction of landslide early warning, repair and reinforcement, to improve the landslide disaster prevention and mitigation capacity in China has a realistic significance.
Age-Specific Prevalence and Factors Associated With Normal Blood Pressure Among US Adults
Authors: Muntner Paul , Jaeger Byron C , Hardy Shakia T , Foti Kathryn , Reynolds Kristi , Whelton Paul K , Bowling C Barrett
Published: September 2021

Background

The mean systolic blood pressure (SBP) for US adults increases with age. Determining characteristics of US adults ≥65 years with normal blood pressure (BP) may inform approaches to prevent this increase.

Methods

We analyzed US National Health and Nutrition Examination Survey 2011–2018 data (n = 21,581). BP was measured up to 3 times and averaged. Normal BP was defined as SBP <120 mm Hg and diastolic BP (DBP) <80 mm Hg among participants not taking antihypertensive medication. Those with SBP ≥120 mm Hg, DBP ≥80 mm Hg, self-reporting having hypertension or taking antihypertensive medication were categorized as having elevated BP or hypertension.

Results

The prevalence of normal BP was 57.8%, 25.3%, 11.2%, and 5.0% among US adults who were 18–44, 45–64, 65–74, and ≥75 years, respectively. After multivariable adjustment, in US adults ≥65 years of age, normal BP vs. elevated BP/hypertension was more common among those with moderate and no vs. heavy alcohol consumption (prevalence ratio [PR] 3.03; 95% confidence interval [CI] 1.25–7.36 and 2.53; 95% CI 0.96–6.65, respectively), ≥150 vs. <150 minutes of physical activity per week (PR = 1.44; 95% CI 1.01–2.05), overweight and normal weight vs. obesity (PR = 1.88; 95% CI 1.22–2.90 and 2.94; 95% CI 1.89–4.59, respectively), and a high Dietary Approaches to Stop Hypertension score (PR = 1.43; 95% CI 1.00–2.05). US adults ≥65 years with normal BP vs. elevated BP/hypertension were less likely to have good or fair/poor vs. excellent/very good self-rated health, diabetes, albuminuria, atherosclerotic cardiovascular disease, and heart failure.

Conclusions

Among US adults ≥65 years, normal BP was associated with healthy lifestyle factors and a lower prevalence of adverse health conditions.
Reflections on public slavery and social death
Authors: Rossi Benedetta
Published: September 2021

It is tempting to see public slaves as sharing characteristics of both slave and free and, therefore, as embodying an intermediate position that proves binary approaches to slavery and freedom wrong. This article argues that this temptation should be resisted. Based on an analysis of cases from different regions and periods, it agrees broadly with Patterson's clear distinction between slave and free statuses, but not with his interpretation of elite slaves as 'the ultimate slaves'. Public slaves were unusual slaves. A close analysis of their circumstances, and of the circumstances of other categories of slaves endowed with particular influence or autonomy in their societies, reveals that the social death metaphor suits certain contexts better than other. It does not accurately capture the historical diversity of the statuses and conditions of enslaved persons through time, and hence is unhelpful for the purpose of comparative generalisation.
Hybridization: a ‘double-edged sword’ for Neotropical plant diversity
Authors: Schley Rowan J , Twyford Alex D , Pennington R Toby
Published: September 2021

Hybridization can facilitate both evolutionary diversification and extinction and has had a critical role in plant evolution, with c. 25% of species known to hybridize in some temperate floras. However, in the species-rich Neotropical flora, the role of hybridization in the evolution of diversity remains unclear. Our review examines studies of hybridization in seed plants from across the Neotropics and explores its outcomes on Neotropical plant evolution. We review studies on a per-biome basis and a spectrum of evolutionary outcomes from hybridization are evident across Neotropical biomes and taxa. These range from short-term impacts, such as the broadening of ecological amplitude in hybrid progeny with transgressive phenotypes and genetic swamping, through to long term impacts, such as the generation of new lineages. Among these studies certain themes emerge, such as the pervasive hybridization among species-rich plant radiations from the Andean páramos, suggesting a role for hybridization in rapid diversification events. Finally, we highlight that hybridization is relatively understudied in the Neotropical flora, despite its remarkable species richness. The advent of genomic techniques can facilitate the study of hybridization and its effects in understudied biomes and plant groups. The increasing availability of genomic resources will eventually allow comparisons between tropical and temperate floras and therefore shed light on the evolutionary impacts of hybridization across the latitudinal biodiversity gradient.
Calcium silicate accelerates cutaneous wound healing with enhanced re-epithelialization through EGF/EGFR/ERK-mediated promotion of epidermal stem cell functions
Authors: Li Bingmin , Tang Haowen , Bian Xiaowei , Ma Kui , Chang Jiang , Fu Xiaobing , Zhang Cuiping
Published: September 2021

Background

Human epidermal stem cells (hESCs) play an important role in re-epithelialization and thereby in facilitating wound healing, while an effective way to activate hESCs remains to be explored. Calcium silicate (CS) is a form of bioceramic that can alter cell behavior and promote tissue regeneration. Here, we have observed the effect of CS on hESCs and investigated its possible mechanism.

Methods

Using a mouse full-thickness skin excision model, we explored the therapeutic effect of CS on wound healing and re-epithelialization. In vitro, hESCs were cultured with diluted CS ion extracts (CSIEs), and the proliferation, migration ability and stemness of hESCs were evaluated. The effects of CS on the epidermal growth factor (EGF), epidermal growth factor receptor (EGFR) and extracellular signal-related kinase (ERK) signaling pathway were also explored.

Results

In vivo, CS accelerated wound healing and re-epithelialization. Immunohistochemistry demonstrated that CS upregulated cytokeratin 19 and integrin β1 expression, indicating that CS improved hESCs stemness. In vitro studies confirmed that CS improved the biological function of hESCs. And the possible mechanism could be due to the activation of the EGF/EGFR/ERK signaling pathway.

Conclusion

CS can promote re-epithelialization and improve the biological functions of hESCs via activating the EGF/EGFR/ERK signaling pathway.
Determination of Commonly Used Multiclass Pesticide Residues in Tobacco and Cigarette Smoke by Ultra-Performance Liquid Chromatography–Tandem Mass Spectrometry
Authors: Xiong Wei , Tao Xiaoqiu , Zhang Haiyan , Huang Mei , Shao Jimin
Published: September 2021

A novel method has been developed for the simultaneous determination of multiclass pesticide residues in tobacco and cigarette smoke, using a modified QuEChERS (quick, easy, cheap, effective, rugged and safe) procedure and ultra-performance liquid chromatography–tandem mass spectrometry (UPLC–MS/MS). Cigarette mainstream smoke particulate was collected on a Cambridge filter pad. Pesticide residues was extracted with an aqueous solution, back extracted into acetonitrile after freezing, purified by dispersive solid phase extraction with primary-secondary amine adsorbents and analyzed by UPLC–MS/MS. The obtained mean recoveries of 16 pesticides commonly used on tobacco at three fortification levels (5.9, 94.1 and 352.9 ng g−1) ranged from 69.3 to 115.9% with relative standard deviations between 2.4 and 11.3%. The limits of detection ranged from 0.14 to 13.28 ng g−1. Finally, the proposed method was applied to study the pesticide smoke transfer ratio in 2 cigarettes with pesticide standard spiked and 51 cigarettes with one or more pesticide residues. The transfer ratio of pesticides residue in tobacco into the smoke might be much less than that from artificially spiked tobacco (<25%) with spiking levels varied from 1.88 to 9.41 μg g−1. The transfer ratio of pesticide from artificially spiked tobacco into cigarette mainstream smoke was from 0.0 to 56.5%, and pesticide residues from tobacco into cigarette smoke were from 0.0 to 26.1% using the ISO smoking method (ISO 3308 2012).
Changing Patterns of Bloodstream Infections in the Community and Acute Care Across 2 Coronavirus Disease 2019 Epidemic Waves: A Retrospective Analysis Using Data Linkage
Authors: Zhu Nina J , Rawson Timothy M , Mookerjee Siddharth , Price James R , Davies Frances , Otter Jonathan , Aylin Paul , Hope Russell , Gilchrist Mark , Shersing Yeeshika , Holmes Alison
Published: September 2021

Background

We examined community- and hospital-acquired bloodstream infections (BSIs) in coronavirus disease 2019 (COVID-19) and non–COVID-19 patients across 2 epidemic waves.

Methods

We analyzed blood cultures of patients presenting to a London hospital group between January 2020 and February 2021. We reported BSI incidence, changes in sampling, case mix, healthcare capacity, and COVID-19 variants.

Results

We identified 1047 BSIs from 34 044 blood cultures, including 653 (62.4%) community-acquired and 394 (37.6%) hospital-acquired. Important pattern changes were seen. Community-acquired Escherichia coli BSIs remained below prepandemic level during COVID-19 waves, but peaked following lockdown easing in May 2020, deviating from the historical trend of peaking in August. The hospital-acquired BSI rate was 100.4 per 100 000 patient-days across the pandemic, increasing to 132.3 during the first wave and 190.9 during the second, with significant increase in elective inpatients. Patients with a hospital-acquired BSI, including those without COVID-19, experienced 20.2 excess days of hospital stay and 26.7% higher mortality, higher than reported in prepandemic literature. In intensive care, the BSI rate was 421.0 per 100 000 intensive care unit patient-days during the second wave, compared to 101.3 pre–COVID-19. The BSI incidence in those infected with the severe acute respiratory syndrome coronavirus 2 Alpha variant was similar to that seen with earlier variants.

Conclusions

The pandemic have impacted the patterns of community- and hospital-acquired BSIs, in COVID-19 and non–COVID-19 patients. Factors driving the patterns are complex. Infection surveillance needs to consider key aspects of pandemic response and changes in healthcare practice.
Prevalence, progression and implications of breast artery calcification in patients with chronic kidney disease
Authors: Van Berkel Brecht , Van Ongeval Chantal , Van Craenenbroeck Amaryllis H , Pottel Hans , De Vusser Katrien , Evenepoel Pieter
Published: September 2021

Breast arterial calcification (BAC) is increasingly recognized as a specific marker of medial calcification. The present retrospective observational cohort study aimed to define the prevalence, progression rate, risk factors and clinical implications of BAC in chronic kidney disease (CKD) patients across stages of disease. The presence and extent of BAC were determined on mammograms in 310 females (58.7 ± 10.8 years, Caucasian) with CKD across various stages of disease [CKD G2–5D n = 132; transplant (Tx) recipients n = 178]. In a subset of 88 patients, repeat mammography was performed, allowing us to calculate the annualized BAC rate. Overall, BAC was observed in 34.7% of the patients. BAC prevalence (P = 0.02) and BAC score (P = 0.05) increased along the progression of CKD. In the overall cohort, patients with BAC were characterized by older age, more cardiovascular disease, more inflammation, higher pulse pressure and borderline higher prevalence of diabetes and were more often treated with a vitamin K antagonist (VKA). The BAC progression rate was significantly lower in Tx patients as compared with CKD G5D. Progressors were characterized by more inflammation, worse kidney function, higher BAC score and higher serum phosphate level (Tx only) at baseline and were more often treated with a VKA. Major adverse cardiovascular event-free survival was significantly worse in Tx patients with BAC. In conclusion, BAC is common among CKD patients, progresses at a slower pace in Tx patients as compared with CKD 5D and associates with dismal cardiovascular outcomes. BAC score, kidney function, serum phosphate at baseline and VKA usage seem to be important determinants of progression.
Low-molecular-weight heparin use in coronavirus disease 2019 is associated with curtailed viral persistence: a retrospective multicentre observational study
Authors: Pereyra David , Heber Stefan , Schrottmaier Waltraud C , Santol Jonas , Pirabe Anita , Schmuckenschlager Anna , Kammerer Kerstin , Ammon Daphni , Sorz Thomas , Fritsch Fabian , Hayden Hubert , Pawelka Erich , Krüger Philipp , Rumpf Benedikt , Traugott Marianna T , Glaser Pia , Firbas Christa , Schörgenhofer Christian , Seitz Tamara , Karolyi Mario , Pabinger Ingrid , Brostjan Christine , Starlinger Patrick , Weiss Günter , Bellmann-Weiler Rosa , Salzer Helmut J F , Jilma Bernd , Zoufaly Alexander , Assinger Alice
Published: September 2021

Aims 

Anticoagulation was associated with improved survival of hospitalized coronavirus disease 2019 (COVID-19) patients in large-scale studies. Yet, the development of COVID-19-associated coagulopathy (CAC) and the mechanism responsible for improved survival of anticoagulated patients with COVID-19 remain largely elusive. This investigation aimed to explore the effects of anticoagulation and low-molecular-weight heparin (LMWH) in particular on patient outcome, CAC development, thromboinflammation, cell death, and viral persistence.

Methods and results

Data of 586 hospitalized COVID-19 patients from three different regions of Austria were evaluated retrospectively. Of these, 419 (71.5%) patients received LMWH and 62 (10.5%) received non-vitamin-K oral anticoagulants (NOACs) during hospitalization. Plasma was collected at different time points in a subset of 106 patients in order to evaluate markers of thromboinflammation (H3Cit-DNA) and the cell death marker cell-free DNA (cfDNA). Use of LMWH was associated with improved survival upon multivariable Cox regression (hazard ratio = 0.561, 95% confidence interval: 0.348–0.906). Interestingly, neither LMWH nor NOAC was associated with attenuation of D-dimer increase over time, or thromboinflammation. In contrast, anticoagulation was associated with a decrease in cfDNA during hospitalization, and curtailed viral persistence was observed in patients using LMWH leading to a 4-day reduction of virus positivity upon quantitative polymerase chain reaction [13 (interquartile range: 6–24) vs. 9 (interquartile range: 5–16) days, P = 0.009].

Conclusion 

Time courses of haemostatic and thromboinflammatory biomarkers were similar in patients with and without LMWH, indicating either no effects of LMWH on haemostasis or that LMWH reduced hypercoagulability to levels of patients without LMWH. Nonetheless, anticoagulation with LMWH was associated with reduced mortality, improved markers of cell death, and curtailed viral persistence, indicating potential beneficial effects of LMWH beyond haemostasis, which encourages use of LMWH in COVID-19 patients without contraindications.
Remdesivir induces persistent mitochondrial and structural damage in human induced pluripotent stem cell-derived cardiomyocytes
Authors: Kwok Maxwell , Lee Carrie , Li Hung Sing , Deng Ruixia , Tsoi Chantelle , Ding Qianqian , Tsang Suk Ying , Leung Kam Tong , Yan Bryan P , Poon Ellen N
Published: September 2021

Aims

Remdesivir is a prodrug of an adenosine triphosphate analogue and is currently the only drug formally approved for the treatment of hospitalized coronavirus disease of 2019 (COVID-19) patients. Nucleoside/nucleotide analogues have been shown to induce mitochondrial damage and cardiotoxicity, and this may be exacerbated by hypoxia, which frequently occurs in severe COVID-19 patients. Although there have been few reports of adverse cardiovascular events associated with remdesivir, clinical data are limited. Here, we investigated whether remdesivir induced cardiotoxicity using an in vitro human cardiac model.

Methods and results

Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) were exposed to remdesivir under normoxic and hypoxic conditions to simulate mild and severe COVID-19, respectively. Remdesivir induced mitochondrial fragmentation, reduced redox potential, and suppressed mitochondrial respiration at levels below the estimated plasma concentration under both normoxic and hypoxic conditions. Non-mitochondrial damage such as electrophysiological alterations and sarcomere disarray were also observed. Importantly, some of these changes persisted after the cessation of treatment, culminating in increased cell death. Mechanistically, we found that inhibition of DRP1, a regulator of mitochondrial fission, ameliorated the cardiotoxic effects of remdesivir, showing that remdesivir-induced cardiotoxicity was preventable and excessive mitochondrial fission might contribute to this phenotype.

Conclusions

Using an in vitro model, we demonstrated that remdesivir can induce cardiotoxicity in hiPSC-CMs at clinically relevant concentrations. These results reveal previously unknown potential side-effects of remdesivir and highlight the importance of further investigations with in vivo animal models and active clinical monitoring to prevent lasting cardiac damage to patients.
Environmental risk factors and cardiovascular diseases: a comprehensive expert review
Authors: Münzel Thomas , Hahad Omar , Sørensen Mette , Lelieveld Jos , Duerr Georg Daniel , Nieuwenhuijsen Mark , Daiber Andreas
Published: September 2021

Non-communicable diseases (NCDs) are fatal for more than 38 million people each year and are thus the main contributors to the global burden of disease accounting for 70% of mortality. The majority of these deaths are caused by cardiovascular disease (CVD). The risk of NCDs is strongly associated with exposure to environmental stressors such as pollutants in the air, noise exposure, artificial light at night, and climate change, including heat extremes, desert storms, and wildfires. In addition to the traditional risk factors for CVD such as diabetes, arterial hypertension, smoking, hypercholesterolaemia, and genetic predisposition, there is a growing body of evidence showing that physicochemical factors in the environment contribute significantly to the high NCD numbers. Furthermore, urbanization is associated with accumulation and intensification of these stressors. This comprehensive expert review will summarize the epidemiology and pathophysiology of environmental stressors with a focus on cardiovascular NCDs. We will also discuss solutions and mitigation measures to lower the impact of environmental risk factors with focus on CVD.
High-dose intravenous iron reduces myocardial infarction in patients on haemodialysis
Authors: Petrie Mark C , Jhund Pardeep S , Connolly Eugene , Mark Patrick B , MacDonald Michael R , Robertson Michele , Anker Stefan D , Bhandari Sunil , Farrington Kenneth , Kalra Philip A , Wheeler David C , Tomson Charles R V , Ford Ian , McMurray John J V , Macdougall Iain C ,   for the PIVOTAL Investigators and Committees
Published: September 2021

Aims

To investigate the effect of high-dose iron vs. low-dose intravenous (IV) iron on myocardial infarction (MI) in patients on maintenance haemodialysis.

Methods and results

This was a pre-specified analysis of secondary endpoints of the Proactive IV Iron Therapy in Hemodialysis Patients trial (PIVOTAL) randomized, controlled clinical trial. Adults who had started haemodialysis within the previous year, who had a ferritin concentration <400 μg per litre and a transferrin saturation <30% were randomized to high-dose or low-dose IV iron. The main outcome measure for this analysis was fatal or non-fatal MI. Over a median of 2.1 years of follow-up, 8.4% experienced a MI. Rates of type 1 MIs (3.2/100 patient-years) were 2.5 times higher than type 2 MIs (1.3/100 patient-years). Non-ST-elevation MIs (3.3/100 patient-years) were 6 times more common than ST-elevation MIs (0.5/100 patient-years). Mortality was high after non-fatal MI (1- and 2-year mortality of 40% and 60%, respectively). In time-to-first event analyses, proactive high-dose IV iron reduced the composite endpoint of non-fatal and fatal MI [hazard ratio (HR) 0.69, 95% confidence interval (CI) 0.52–0.93, P = 0.01] and non-fatal MI (HR 0.69, 95% CI 0.51–0.93; P = 0.01) when compared with reactive low-dose IV iron. There was less effect of high-dose IV iron on recurrent MI events than on the time-to-first event analysis.

Conclusion

In total, 8.4% of patients on maintenance haemodialysis had an MI over 2 years. High-dose compared to low-dose IV iron reduced MI in patients receiving haemodialysis.

EudraCT Registration Number

2013-002267-25.
Applications of multimodality imaging for left atrial catheter ablation
Authors: Roney Caroline H , Sillett Charles , Whitaker John , Lemus Jose Alonso Solis , Sim Iain , Kotadia Irum , O'Neill Mark , Williams Steven E , Niederer Steven A
Published: September 2021

Atrial arrhythmias, including atrial fibrillation and atrial flutter, may be treated through catheter ablation. The process of atrial arrhythmia catheter ablation, which includes patient selection, pre-procedural planning, intra-procedural guidance, and post-procedural assessment, is typically characterized by the use of several imaging modalities to sequentially inform key clinical decisions. Increasingly, advanced imaging modalities are processed via specialized image analysis techniques and combined with intra-procedural electrical measurements to inform treatment approaches. Here, we review the use of multimodality imaging for left atrial ablation procedures. The article first outlines how imaging modalities are routinely used in the peri-ablation period. We then describe how advanced imaging techniques may inform patient selection for ablation and ablation targets themselves. Ongoing research directions for improving catheter ablation outcomes by using imaging combined with advanced analyses for personalization of ablation targets are discussed, together with approaches for their integration in the standard clinical environment. Finally, we describe future research areas with the potential to improve catheter ablation outcomes.
Visual echocardiographic scoring system of the left ventricular filling pressure and outcomes of heart failure with preserved ejection fraction
Authors: Murayama Michito , Iwano Hiroyuki , Obokata Masaru , Harada Tomonari , Omote Kazunori , Kagami Kazuki , Tsujinaga Shingo , Chiba Yasuyuki , Ishizaka Suguru , Motoi Ko , Tamaki Yoji , Aoyagi Hiroyuki , Nakabachi Masahiro , Nishino Hisao , Yokoyama Shinobu , Tanemura Asuka , Okada Kazunori , Kaga Sanae , Nishida Mutsumi , Nagai Toshiyuki , Kurabayashi Masahiko , Anzai Toshihisa
Published: September 2021

Aims

Elevated left ventricular filling pressure (LVFP) is a powerful indicator of worsening clinical outcomes in heart failure with preserved ejection fraction (HFpEF); however, detection of elevated LVFP is often challenging. This study aimed to determine the association between the newly proposed echocardiographic LVFP parameter, visually assessed time difference between the mitral valve and tricuspid valve opening (VMT) score, and clinical outcomes of HFpEF.

Methods and results

We retrospectively investigated 310 well-differentiated HFpEF patients in stable conditions. VMT was scored from 0 to 3 using two-dimensional echocardiographic images, and VMT ≥2 was regarded as a sign of elevated LVFP. The primary endpoint was a composite of cardiac death or heart failure hospitalization during the 2 years after the echocardiographic examination. In all patients, Kaplan–Meier curves showed that VMT ≥2 (n = 54) was associated with worse outcomes than the VMT ≤1 group (n = 256) (P < 0.001). Furthermore, VMT ≥2 was associated with worse outcomes when tested in 100 HFpEF patients with atrial fibrillation (AF) (P = 0.026). In the adjusted model, VMT ≥2 was independently associated with the primary outcome (hazard ratio 2.60, 95% confidence interval 1.46–4.61; P = 0.001). Additionally, VMT scoring provided an incremental prognostic value over clinically relevant variables and diastolic function grading (χ2 10.8–16.3, P = 0.035).

Conclusions

In patients with HFpEF, the VMT score was independently and incrementally associated with adverse clinical outcomes. Moreover, it could also predict clinical outcomes in HFpEF patients with AF.
Right heart chambers geometry and function in patients with the atrial and the ventricular phenotypes of functional tricuspid regurgitation
Authors: Florescu Diana R , Muraru Denisa , Florescu Cristina , Volpato Valentina , Caravita Sergio , Perger Elisa , Bălșeanu Tudor A , Parati Gianfranco , Badano Luigi P
Published: September 2021

Aims

Atrial functional tricuspid regurgitation (A-FTR) is a recently defined phenotype of functional tricuspid regurgitation (FTR) associated with persistent/permanent atrial fibrillation. Differently from the classical ventricular form of FTR (V-FTR), patients with A-FTR might present with severely dilated right atrium and tricuspid annulus (TA), and with preserved right ventricular (RV) size and systolic function. However, the geometry and function of the right ventricle, right atrium, and TA in patients with A-FTR and V-FTR remain to be systematically evaluated. Accordingly, we sought to: (i) study the geometry and function of the right ventricle, right atrium, and TA in A-FTR by two- and three-dimensional transthoracic echocardiography; and (ii) compare them with those found in V-FTR.

Methods and results

We prospectively analysed 113 (44 men, age 68 ± 18 years) FTR patients (A-FTR = 55 and V-FTR = 58) that were compared to two groups of age- and sex-matched controls to develop the respective Z-scores. Severity of FTR was similar in A-FTR and V-FTR patients. Z-scores of RV size were significantly larger, and those of RV function were significantly lower in V-FTR than in A-FTR (P < 0.001 for all). The right atrium was significantly enlarged in both A-FTR and V-FTR compared to controls (P < 0.001, Z-scores > 2), with similar right atrial (RA) maximum volume (RAVmax) between A-FTR and V-FTR (P = 0.2). Whereas, the RA minimum volumes (RAVmin) were significantly larger in A-FTR than in V-FTR (P = 0.001).

Conclusion

Despite similar degrees of FTR and RAVmax size, A-FTR patients show larger RAVmin and smaller TA areas than V-FTR patients. Conversely, V-FTR patients show dilated, more elliptic and dysfunctional right ventricle than A-FTR patients.
Novel Insights From Interviewer Assessments of Personal Attributes, Home Environment, and Residential Context in NSHAP
Authors: Riley Alicia R , Waite Linda J , Cagney Kathleen A
Published: September 2021

Objectives

This study was aimed to describe the interviewer-assessed measures present in the 2015/2016 Round of National Social Life, Health, and Aging Project (NSHAP), outline strengths of interviewer-assessed measures, and explore how interviewer assessments in the domains of home environment and personal characteristics are associated with older adult health.

Method

Data come from the 2015/2016 Round of the NSHAP.

Results

We provide descriptive results from the interviewer assessments of personal attributes, indoor home environment, and outdoor residential context. We present an illustrative analysis of reports of falls, a health outcome that might be predicted by characteristics assessed by the interviewer, and we suggest directions for further research.

Discussion

Interviewer assessments collected in NSHAP are useful as proxy measures and can be used in combination with respondent’s reports and ecological measures to generate insights into healthy aging.