bluuebunny/crossref_metadata_2025 huggingface dataset:
A Hilbert transform approach for controlled jump-diffusions with financial applications
Authors: Ge Yingming , Li Lingfei
Published: July 2020

We propose a new computational method for a class of controlled jump-diffusions for financial applications. In the first step of our method, we apply piecewise constant policy approximation where we partition the time horizon into small time intervals and the control is constant on each interval. In the second step, we develop a Hilbert transform approach to solve a discrete time dynamic programming problem. We provide rigorous error bounds for the piecewise constant policy approximation for controlled jump-diffusions, generalizing previous results for diffusions. We also apply our method to solve two classical types of financial problems: option pricing under uncertain volatility and/or correlation models and optimal investment, including utility maximization and mean-variance portfolio selection. Through various numerical examples, we demonstrate the properties of our method and show that it is a computationally efficient choice for low-dimensional problems. Our method also compares favorably with some popular approaches.
Resolving Food-Web Structure
Authors: Pringle Robert M. , Hutchinson Matthew C.
Published: July 2020

Food webs are a major focus and organizing theme of ecology, but the data used to assemble them are deficient. Early debates over food-web data focused on taxonomic resolution and completeness, lack of which had produced spurious inferences. Recent data are widely believed to be much better and are used extensively in theoretical and meta-analytic research on network ecology. Confidence in these data rests on the assumptions ( a) that empiricists correctly identified consumers and their foods and ( b) that sampling methods were adequate to detect a near-comprehensive fraction of the trophic interactions between species. Abundant evidence indicates that these assumptions are often invalid, suggesting that most topological food-web data may remain unreliable for inferences about network structure and underlying ecological and evolutionary processes. Morphologically cryptic species are ubiquitous across taxa and regions, and many trophic interactions routinely evade detection by conventional methods. Molecular methods have diagnosed the severity of these problems and are a necessary part of the cure.
Violence in Latin America: An Overview of Research and Issues
Authors: Vilalta Carlos
Published: July 2020

In this review of violence in Latin America, I have attempted to organize the region's scholarly literature around the most influential and leading research issues. Three main lines of research have materialized from this overview. First, one line of research is concerned with the difference between the old patterns of violence and the so-called new violence. Second, a line of research focuses on the state's responses to violence. Third, a similar, although much broader, line of research focuses on the public's responses to violence. The article describes a number of paradoxes and paradigms around the study of violence in the region. Further work toward organization and synthesis of research and issues in the region is necessary.
AHA/ACC-defined stage 1 hypertensive adults do not display cutaneous microvascular endothelial dysfunction
Authors: Dillon Gabrielle A. , Greaney Jody L. , Shank Sean , Leuenberger Urs A. , Alexander Lacy M.
Published: July 2020

This is the first study to pharmacologically assess the mechanistic regulation of endothelial function in adults with hypertension, classified according to the 2017 clinical guidelines set for by the American Heart Association (AHA) and American College of Cardiology (ACC). Compared with that in normotensive adults, nitric oxide-mediated endothelium-dependent dilation is impaired in adults with stage 2, but not stage 1, hypertension. Adults lacking a nighttime dip in blood pressure demonstrated reductions in endothelium-dependent dilation.
Differential effects of tobacco cigarettes and electronic cigarettes on endothelial function in healthy young people
Authors: Haptonstall Kacey P. , Choroomi Yasmine , Moheimani Roya , Nguyen Kevin , Tran Elizabeth , Lakhani Karishma , Ruedisueli Isabella , Gornbein Jeffrey , Middlekauff Holly R.
Published: July 2020

In our study of otherwise healthy young people, baseline flow-mediated dilation (FMD), a predictor of atherosclerosis and increased cardiovascular risk, was not different among tobacco cigarette (TC) smokers or electronic cigarette (EC) vapers who had refrained from smoking, compared with nonsmokers. However, acutely smoking one TC impaired FMD in smokers, whereas vaping a similar EC “dose” (as estimated by change in plasma nicotine levels) did not. Finally, although it is reassuring that acute EC vaping did not acutely impair FMD, it would be premature and dangerous to conclude that ECs do not lead to atherosclerosis or increase cardiovascular risk.
Sex-specific alterations in blood-borne factors in physically inactive individuals are detrimental to endothelial cell functions
Authors: Sapp Ryan M. , Landers-Ramos Rian Q. , Shill Daniel D. , Springer Catherine B. , Hagberg James M.
Published: July 2020

Serum from sedentary women caused impaired endothelial migration, whereas serum from sedentary men elicited increased endothelial reactive oxygen species production as compared with serum from their endurance-trained counterparts. Select CVD-related circulating microRNAs (ci-miRs) were higher in men than women, while ci-miRs-140–5p and 145–5p were also higher in sedentary versus trained men and/or women. Our data suggest that alterations in circulating factors may contribute to the protective effects of habitual exercise and sex on vascular health.
Quantal biomechanical effects in speech postures of the lips
Authors: Gick Bryan , Mayer Connor , Chiu Chenhao , Widing Erik , Roewer-Després François , Fels Sidney , Stavness Ian
Published: July 2020

This article provides additional evidence that speech motor control is organized in a modular fashion and that biomechanics constrain the kinds of motor modules that may emerge. It also suggests that speech can be a fruitful domain for the study of modularity and that a better understanding of speech motor modules will be useful for speech research. Finally, it suggests that biomechanical modeling can serve as a useful complement to experimental work when studying modularity.
Role of the somatosensory cortex in motor memory consolidation
Authors: Wali Manasi
Published: July 2020

Motor memories become resistant to interference by the process of consolidation, which leads to long-term retention. Studies have shown involvement of the somatosensory cortex in motor learning-related plasticity, but not directly in motor memory consolidation. This Neuro Forum article reviews evidence from a continuous theta-burst transcranial magnetic stimulation (cTBS) study by Kumar and colleagues (Kumar N, Manning TF, Ostry DJ. PLoS Biol 17: e3000469, 2019) that demonstrates the role of somatosensory, rather than motor, cortex in human motor memory consolidation during implicit motor learning.
On the Security Analysis of a Hopfield Chaotic Neural Network-Based Image Encryption Algorithm
Authors: Hu Yingchun , Yu Simin , Zhang Zeqing
Published: July 2020

In this paper, the security analysis of a color image encryption algorithm based on Hopfield chaotic neural network is given. The original chaotic image encryption algorithm includes permutation encryption and diffusion encryption. The result of cryptanalysis shows that the chaotic sequences generated by this algorithm are independent of plaintext image, and there exist equivalent permutation key and equivalent diffusion key. Therefore, according to chosen-plaintext attack, the equivalent diffusion key and the equivalent permutation key can be obtained by choosing two special plaintext images and the corresponding ciphertext images, respectively, and the plaintext image is further recovered from the ciphertext image. Theoretical analysis and numerical simulation experiment results verify the effectiveness of the analytical method. Finally, some improved suggestions for the original encryption algorithm are proposed to promote the security.
Classification of Building Damage Triggered by Earthquakes Using Decision Tree
Authors: Li Shaodan , Tang Hong
Published: July 2020

Field survey is a labour-intensive way to objectively evaluate the grade of building damage triggered by earthquakes. In this paper, we present a decision-tree-based approach to classify the type of building damage by using multiple-source remote sensing from both pre- and postearthquakes. Specifically, the boundary of buildings is delineated from preearthquake multiple-source satellite images using an unsupervised learning method. Then, building damage is classified into four types using decision tree method from postearthquake UAV images, that is, basically intact buildings, slightly damaged buildings, partially collapsed buildings, and completely collapsed buildings. Furthermore, the slightly damaged buildings are determined by the detected roof-holes using joint color and height features. Two experimental areas from Wenchuan and Ya’an earthquakes are used to verify the proposed method.
Secretor Status of ABO Antigens in Saliva of a Defined Group of Iranian Patients with Pemphigus Vulgaris: A Case-Control Study
Authors: Bakhtiari Sedigheh , Yadegari Zahra , Kaviyani Marziyeh , Namazi Zahra , Bakhshi Mahin
Published: July 2020

Introduction. Pemphigus is a chronic inflammatory and autoimmune disease which can cause blisters and mucocutaneous erosions. ABO secretor refers to those who secrete ABO blood group antigens based on their blood type in body fluids such as saliva, sweat, tears, semen, and serum. Previous studies showed that nonsecretor people are more prone to certain autoimmune diseases. Aim. The aim of this study was to determine the ABO secretor status in the saliva of patients with pemphigus vulgaris. Materials and Methods. This case-control study was conducted on 35 patients with pemphigus vulgaris and 35 healthy controls. The two groups were matched for age and gender. Pemphigus vulgaris diagnosis was confirmed by histopathology and direct immunofluorescence microscopy. ABO blood grouping was done, and 5 ml of unstimulated saliva was collected to determine secretor status. Secretors were recognized from nonsecretors by the Wiener agglutination inhibition test. Results were extracted by using statistical chi-square and Fisher’s exact tests. Results. 16 male and 19 female patients aged 49.43 ± .12.37 years were compared with 16 male and 19 female controls aged 46.43 ± 11.88 years. The most frequent blood group among case and control groups was O (54.3% and 60%, respectively). There was no significant difference in blood groups (P=0.73). 90% of the samples were ABO secretors. The patient group included 31 (88.6%) and the control group included 32 (91.4%) ABO secretors; there was no significant difference between the two groups (P=1.000). Conclusion. In this study, we observed that the people with nonsecretor status in comparison with the people with secretor status are not more susceptible to develop pemphigus vulgaris.
Correlation between Parental-Reported Tooth Grinding and Sleep Disorders: Investigation in a Cohort of 741 Consecutive Children
Authors: Segù M. , Pollis M. , Santagostini A. , Meola F. , Manfredini D.
Published: July 2020

Purpose. A possible relationship between sleep bruxism (SB) and several sleep disorders has been suggested in children, which could influence sleep quality and quality of life. This study aims to assess such correlations in a large sample of school children.Methods. Parents of 741 consecutive children aged between 8 and 12 years filled the Sleep Disturbance Scale for Children (SDSC). It evaluated 45 items grouped in 8 components: duration of night-time sleep, sleep latency, bedtime problems, sleep quality, night awakenings, nocturnal symptoms, morning symptoms, and daytime sleepiness. An item evaluating parental-reported tooth grinding was also included. Correlation analysis was performed between parental-reported tooth grinding and all the other items.Results. A significant correlation between parental-reported tooth grinding and several sleep disorders concerning bedtime problems, night awakenings, nocturnal symptoms, and morning symptoms has been found. In general, correlation strength of significant pairs was low, ranging from 0.092 (sleep apnea) to 0.234 (movement while falling asleep).Conclusions. Parental-reported tooth grinding in children is correlated, even if weakly, with some sleep disorders concerning the sphere of bedtime problems, night awakenings, nocturnal symptoms, breathing symptoms, and morning symptoms. Further studies are needed to confirm these findings, with particular regard to the consistency of correlation outcomes between the parental reports and the sleep laboratory measures.
Linear versus Circular Stapler for Gastrojejunal Anastomosis in Laparoscopic Roux-En-Y Gastric Bypass: An Analysis of 211 Cases
Authors: Burla Laurin , Weibel Pascal , Baum Cornelia , Huber Markus , Gürtler Thomas , Weber Markus
Published: July 2020

Purpose. Although laparoscopic Roux-en-Y gastric bypass (LRYGB) is a frequently performed bariatric procedure, there is still no consensus on its technical implementation. Methods. 211 patients treated with LRYGB in a single institution between March 2011 and October 2016 were analyzed retrospectively. A subgroup analysis for the linear (LSA) versus circular stapler technique (CSA) for gastrojejunal anastomosis (GJA) was performed to evaluate complications and outcomes. Results. 128 (60.6%) patients received GJA with CSA and 83 (39.4%) with LSA. Average weight loss one year after surgery, respectively, BMI after one year of follow-up (kg/m2), showed no significant difference. Median surgery time was significantly shorter in the LSA group. If the procedure was performed with CSA, significantly more wound infections occurred. Conclusions. Both the circular and the linear stapler techniques for gastrojejunal anastomosis in laparoscopic Roux-en-Y gastric bypass are safe methods with comparable outcomes. A disadvantage of CSA is the significantly higher rate of wound infections, a circumstance which requires increased attention.
Olive Leaf Polyphenols Attenuate the Clinical Course of Experimental Autoimmune Encephalomyelitis and Provide Neuroprotection by Reducing Oxidative Stress, Regulating Microglia and SIRT1, and Preserving Myelin Integrity
Authors: Giacometti Jasminka , Grubić-Kezele Tanja
Published: July 2020

Numerous evidences suggest that plant polyphenols may have therapeutic benefits in regulating oxidative stress and providing neuroprotection in many neurodegenerative diseases, including multiple sclerosis (MS). However, these mechanisms are not yet completely understood. In this study, we investigated the effect of olive leaf polyphenols on oxidative stress through oxidation marker level and activity (TBARS, SOD, and GPX) and their protein expression (SOD1, SOD2, and GPX1), as well as the protein expression of Sirtuin 1 (SIRT1) and microglia markers (Iba-1, CD206, and iNOS) and myelin integrity (proteolipid protein expression) in the brain of rats with induced experimental autoimmune encephalomyelitis (EAE) and subjected to olive leaf therapy. Experiments were performed in male EAE DA rats, which were randomly divided into 2 main groups: EAE groups treated with the therapy of olive leaf (EAE+TOL) and untreated EAE control groups. The EAE treated groups consumed olive leaf tea instead of drinking water (ad libitum) from the beginning to the end of the experiment. In addition, olive leaf extract was injected intraperitoneally (i.p.) for the 10 continuous days and started on the 8th day after EAE induction. The clinical course was monitored in both groups until the 30th day after EAE induction. Our results demonstrated that TOL attenuated the clinical course of EAE; reduced the oxidative stress (by decreasing the concentration of MDA); upregulated antioxidant enzymes (SOD1, SOD2, and GPX1), SIRT1 (overall and microglial), and anti-inflammatory M2 microglia; downregulated proinflammatory M1 type; and preserved myelin integrity. These data support the idea that TOL may be an effective therapeutic approach for treating MS and other neurodegenerative diseases.
A One-Sided Competition Mathematical Model for the Sterile Insect Technique
Authors: Ben Dhahbi Anis , Chargui Yassine , Boulaaras Salah Mahmoud , Ben Khalifa Sana
Published: July 2020

We study a simple mathematical model describing the dynamics of a wild-type pest insects population experiencing competition from sterile insects (one-sided competition). This model can be used for conceiving control strategies based on the Sterile Insect Technique (SIT) or the Incompatible Insect Technique (IIT), aiming to reduce or eradicate Red Palm Weevil (RPW) populations in some target regions. We show that suppression may occur for continuous and periodic release strategies for various intraspecific and interspecific submodels except in the case of a single release strategy where a strong Allee effect is required.
Estimating Conveyance Efficiency and Maize Productivity of Traditional Irrigation Systems in Usa River Catchment, Tanzania
Authors: Haymale Humuri K. , Njau Karoli N. , Kahimba Frederick C.
Published: July 2020

Estimating the conveyance efficiency of traditional irrigation schemes systems is very important. It is because of understanding the volume of water lost along with the transportation facility, enhancing water usage and productivity, hence making better decisions about the utilization of water resources. The objective of the study was to determine water abstraction permit compliances and estimate conveyance efficiency and crop and water productivity of traditional irrigation systems in northern Tanzania. The task involved measurement of irrigation water flows to determine the amount of water abstraction, inflow (head) and outflow (tail) between the canals to determine the conveyance efficiency of the main, secondary, and tertiary canals of the traditional irrigation systems. Moreover, water and yield obtained at the farm level were determined. Results indicate that approximately 72% of water transported reaches the destined farm which produced maize (Zea mays L) yields of 1054.5 kg/ha, 892.4 kg/ha, and 875.156 kg/ha at downstream, midstream, and upstream which equals 0.41 kg/m3, 0.15 kg/m3, and 0.09 kg/m3, respectively, while about 28% of water is lost along the canals through evaporation, seepage, and deep percolation and overtopping. Consequently, water measured at furrow intakes in total was 3,500 L/s, equal to 23% more than the permitted amount of 2856.14 L/s at Usa River Catchment. Interventions to minimize water losses starting at the furrow’s intakes are urgently required in the current trend of the increasing demand for water resources for food production and schemes performance. Subsequently, more effective conveyance technologies and water management strategies other than canal lining are required.
Monitoring N : P Ratio and Cd, Cu, Pb, and Zn Contents in Different Types of Anaerobic Digestates: A Six-Year Study Case
Authors: Roß Christina-Luise , Nielsen Kerstin , Krieger Jorita , Hoffmann Marieke , Sensel-Gunke Karen , Ellmer Frank , Kautz Timo
Published: July 2020

Depending on the quality of the input substrates, process parameters, and postfermentation treatments, digestates may contain a broad spectrum of potentially toxic elements. We suspected that these contents may vary on a broad scale even under seemingly stable process conditions at the biogas plant. Digestates from four biogas plants were therefore continuously analyzed for their contents of phosphorus, nitrogen, cadmium, copper, lead, and zinc over a period of six years. The input substrates varied between the plants (e.g., cattle and pig slurry and rye and maize silage), but were the same for each plant over the whole period. The N : P ratio of the digestates ranged from 2 to 24, with the digestate coming from cofermentation of pig slurry and energy crops (“DG Pig”) having the widest range of N : P ratio over the years. Heavy metal loads of all digestates and during all evaluations did not exceed the limits set by European or German legislation, but as previously expected, showed a large variability especially if cattle or pig manure were used as substrates. Copper content of Cattle slurry before digestion was 897.7 mg kg−1 DM in one case, and zinc content of DG Pig reached 590.2 mg kg−1 DM also once during the investigation. As a result, we strongly recommend to monitor especially phosphorus, copper, and zinc contents in digestates very closely and in short intervals.
Practices and Attitudes of Dental Loupes and Their Relationship to Musculoskeletal Disorders among Dental Practitioners
Authors: Aboalshamat Khalid , Daoud Ola , Mahmoud Lina Ayman , Attal Sakina , Alshehri Rahaf , Bin Othman Duaa , Alzahrani Reem
Published: July 2020

Objective. A dental loupe is a tool used by many dentists and dental students to improve visual field and performance. This study aims to assess the practices and attitudes about dental magnification loupes and their relationship to musculoskeletal disorders.Materials and Methods. A cross-sectional study was conducted involving 400 dental students and dentists in four dental colleges in Jeddah, Saudi Arabia. The mean age was 28.35 years (SD = 8.50), and 56% of the participants were male. Also, 70.75% were students or interns, while 29.25% were dentists. Data gathering was conducted using a questionnaire that was composed of four sections: demographic, magnification devices usage, attitude toward dental loupes, and the Nordic questionnaire to assess musculoskeletal disorders.Results. A total of 66% of participants had used dental magnification tools before, but only 12.25% were using dental loupes at the time of the study. The main reported advantages of dental loupes were comfort in vision (59.25%) and improved work accuracy (53%), while the main disadvantage was difficulty in visual measurement (28.5%). A total of 73.25% reported that price was the main barrier to the use of dental loupes. Lower back (63.5%), neck (65.25%), and shoulder (46.25%) pain were the most frequently reported areas of discomfort. There was a significant relationship (<0.05) between the use of dental loupes and lowered levels of reported discomfort in the lower back, neck, shoulders, elbows, upper back, and feet.Conclusion. There are few dental professionals who use dental loupes in Saudi Arabia. There was a significant relationship between dental loupes use and reduction of musculoskeletal disorders among dental students and dentists.
Experimental and Mathematical Modeling of Monotonic Behavior of Calcareous Sand
Authors: Zhang Haotian , Luo Zongmu , Qiu Yanyu , Liu Huachao , Gu Juan , Tang Jian
Published: July 2020

The prominent performance of wave elimination and energy absorption makes calcareous sand important and useful in infrastructure construction and protection engineering. Due to the high compressibility induced by remarkable intragranular void and irregular shape, calcareous sand presents different mechanical behaviors from common terrestrial sands. Considerable efforts have been made to explore the static and dynamic mechanical properties of calcareous sand. In this paper, a series of monotonous experiments have been performed on calcareous sand utilizing the electrohydraulic servo‐controlled test apparatus designed by the Global Digital Systems Ltd (GDS). The effects of confining pressure and relative density on the mechanical properties of dry, drained, and undrained saturated sand were studied, and the underlying micromechanism of deformation and failure was discussed. It can be found that the residual stress of dry calcareous sand is independent of the relative density, while the peak stress and residual stress of drainage saturated sand have a positive correlation with the relative density. The increase of confining pressure makes the strain softening more remarkable and heightens the peak stress and residual stress. The stress‐strain curve of calcareous sand can be divided into two portions: prepeak portion and postpeak softening portion. For the dry sand and drainage saturated sand, the softened part can be partitioned into three phases, i.e., accelerated phase, steady phase, and degradation phase, while the undrained saturated sand tends to hyperbolic softening. A mathematical model composed of a hyperbolic function and an inverted S‐shaped function was formulated to describe the multiphase characteristic, in which the setting of parameter p expands its applicability. The experimental result validated the model, showing that the model can better describe the monotonic stress‐strain relationship of calcareous sand. Besides, the physical meanings of model parameters were discussed.
Stability Analysis of the Left Bank Slope of Baihetan Hydropower Station Based on the MF‐DFA Method
Authors: Mao Haoyu , Zhang Min , Li Biao , Xu Nuwen
Published: July 2020

Based on the left bank slope of Baihetan hydropower station in Southwestern China, a high‐precision microseismic monitoring system was established. An early warning model of surrounding rock mass deformation and failure based on MF‐DFA was proposed. The results showed that the multifractal characteristics of the microseismic and blasting waveform time series in the left bank slope were obvious, and the multifractal spectrum width of the blasting waveform is much larger than that of microseismic waveform. Before the slope cracks increased, the multifractal time‐varying response characteristics of microseismic waveform showed strong regularity, which could be regarded as a precursor of surrounding rock mass deformation. Before the deformation and failure of surrounding rock mass, the multifractal spectrum width Δα showed an increasing trend while the multifractal spectrum of microseismic waveforms Δf(α) presented a decreasing trend, which can be regarded as a precursor of surrounding rock mass deformation; when deformation and failure occurred, Δα showed a decreasing trend and Δf(α) showed an increasing trend, which can be regarded as a deformation failure period; after the occurrence of deformation and failure, both Δα and Δf(α) showed a steady trend, and Δf(α) would approach to the zero line, which can be regarded as a stable period.
Traditional Chinese Medicine Da‐Cheng‐Qi‐Tang Ameliorates Impaired Gastrointestinal Motility and Intestinal Inflammatory Response in a Mouse Model of Postoperative Ileus
Authors: Chen Chunqiu , Li Min , Liu Xiaohong , Fan Jianwei , Zhang Hong , Lin Sisi , Yin Lu , Fichna Jakub , Li Yongyu
Published: July 2020

This study was to explore the therapeutic effect and mechanism of the traditional Chinese medicine with the formula Da‐Cheng‐Qi‐Tang (T‐DCQT) and a modified Da‐Cheng‐Qi‐Tang (M‐DCQT) in a postoperative ileus (POI) mouse model. POI was induced via small bowel manipulation, and T‐DCQT or M‐DCQT was given by enema. The intestinal motility was measured with a charcoal mixture gavage. The intestinal tissues were collected for further studies by histopathological, qPCR, immunohistochemical staining, and Western blotting. Levels of inflammatory cytokines in blood were determined using a high‐throughput liquid chip. We found that gastrointestinal dysfunction was alleviated after administration of either a T‐DCQT or M‐DCQT enema. Increased expression of NF‐κB, p38 MAPK, and TLR4 in the intestinal tissues of POI mice were reversed following treatment. IL‐1α, IL‐6, MIP‐1β, and IL‐17 levels were significantly reduced at 24 h and 48 h following treatment, while the MCP‐1 level was only observed to be reduced at 24 h after the treatment. Furthermore, compared with the T‐DCQT effect, M‐DCQT treatment was more effective in alleviating the increased IL‐6, MIP‐1β, and IL‐1α levels. So, we draw a conclusion that T‐DCQT or M‐DCOT could ameliorate the POI‐associated inflammatory response and improve GI motility in a POI mouse model.
Association of Serum Biomarker Levels and BDNF Gene Polymorphism with Response to Selective Serotonin Reuptake Inhibitors in Indian Patients with Major Depressive Disorder
Authors: Ramesh Varsha , Venkatesan Vettriselvi , Chellathai Darling , Silamban Santhi
Published: July 2020

Introduction: Depression is a major public health problem. Response to selective serotonin reuptake inhibitor (SSRI) treatment varies considerably between patients. In the context of polygenic diseases like depression, measurement of a panel of biomarkers involved in the pathophysiology of depression might help predict outcome to treatment with SSRIs. Objective: The objective was to establish the relationship between serum biomarker levels and the brain-derived neurotrophic factor (BDNF) val66met polymorphism and response to SSRIs in patients with major depressive disorder. Methods: 50 patients with moderate to severe depression were recruited from the Department of Psychiatry, Sri Ra­machandra Institute of Higher Education and Research. Blood samples were collected, and Hamilton Depression Rating Scale scoring was done at baseline and after 8 weeks of treatment with SSRIs. Baseline and post-treatment levels of high-sensitivity C-reactive protein (hsCRP), BDNF and neuregulin 1β1 (NRG1β1) were analysed using commercially available ELISA kits. Genotyping of the BDNF Val66Met polymorphism was performed using a PCR-RFLP method. Results: Following treatment, there was a significant decrease in the mean hsCRP and NRG1β1 levels and a significant increase in the mean BDNF level. Responders had significantly lower baseline hsCRP and higher baseline BDNF levels when compared to non-responders. Response rates were significantly higher in the Val/Val group when compared to the Val/Met group. Conclusions: Baseline serum levels of hsCRP and BDNF predicted response to SSRIs in major depressive disorder, and Val/Val patients responded better when compared to patients carrying the Met allele.
Personalized Approach of Severe Eosinophilic Asthma Patients Treated with Mepolizumab and Benralizumab
Authors: Bergantini Laura , d’Alessandro Miriana , Cameli Paolo , Bianchi Francesco , Sestini Piersante , Bargagli Elena , Refini Rosa Metella
Published: July 2020

Background: New anti-IL-5 antibodies, mepolizumab and benralizumab, have recently been approved for severe asthma, sharing the same inclusion criteria. Objective: To contribute on biomarkers research leading to the personalized choice, we investigated L-selectin, Krebs von den Lungen (KL-6), and lymphocyte subsets as bioindicators of airway hyper-responsiveness and remodeling. Materials and Methods: A cohort of 28 patients affected by severe eosinophilic asthma were treated with anti-IL-5 drugs. According to clinical parameters, patients were subdivided into early and partial responders. Lymphocytes subsets were analyzed through flow cytometry, while KL-6 and sL-selectin were analyzed on serum samples. Clinical, functional, and immunological data at baseline (T0), after 1 month (T1), and 6 months of therapy were collected in a database. Results: All treated patients showed an increase in the percentage of forced expiratory volume in the first second (FEV1) and FEV1/forced vital capacity ratio and a decrease of peripheral eosinophils for both drugs after 1 month of treatment. Mepolizumab-treated patients also showed decreased CD8+ and NKT-like cell percentages and a significant increase in sL-selectin concentrations between T0 and T1. Stratifying the cohort of our patients in early and partial responders at T0, they showed a reduction of peripheral eosinophils, sL-selectin and KL-6, while no differences were found at T0 between early and partial responders patients treated with benralizumab. Conclusions: This real-life study provides new insights for the personalized approach to severe asthma therapy. Although preliminary, the results indicate that besides eosinophils, KL-6 and sL-selectin are useful as biomarkers of early response that can also involve in the pathogenesis of severe asthma.
Beatmungsassoziierte Pneumonie: Elektronische Nase und künstliche Intelligenz als Potenzial für die Zukunft
Authors: Knoch Johannes
Published: July 2020

Background: Ventilator-associated pneumonia (VAP) is a significant cause of mortality in the intensive care unit. Early diagnosis of VAP is important to provide appropriate treatment and reduce mortality. Developing a noninvasive and highly accurate diagnostic method is important. The invention of electronic sensors has been applied to analyze the volatile organic compounds in breath to detect VAP using a machine learning technique. However, the process of building an algorithm is usually unclear and prevents physicians from applying the artificial intelligence technique in clinical practice. Clear processes of model building and assessing accuracy are warranted. The objective of this study was to develop a breath test for VAP with a standardized protocol for a machine learning technique. Methods: We conducted a case-control study. This study enrolled subjects in an intensive care unit of a hospital in southern Taiwan from February 2017 to June 2019. We recruited patients with VAP as the case group and ventilated patients without pneumonia as the control group. We collected exhaled breath and analyzed the electric resistance changes of 32 sensor arrays of an electronic nose. We split the data into a set for training algorithms and a set for testing. We applied eight machine learning algorithms to build prediction models, improving model performance and providing an estimated diagnostic accuracy. Results: A total of 33 cases and 26 controls were used in the final analysis. Using eight machine learning algorithms, the mean accuracy in the testing set was 0.81 ± 0.04, the sensitivity was 0.79 ± 0.08, the specificity was 0.83 ± 0.00, the positive predictive value was 0.85 ± 0.02, the negative predictive value was 0.77 ± 0.06, and the area under the receiver operator characteristic curves was 0.85 ± 0.04. The mean kappa value in the testing set was 0.62 ± 0.08, which suggested good agreement. Conclusions: There was good accuracy in detecting VAP by sensor array and machine learning techniques. Artificial intelligence has the potential to assist the physician in making a clinical diagnosis. Clear protocols for data processing and the modeling procedure needed to increase generalizability.
Clinicopathological Features of Autoimmune Hepatitis with IgG4-Positive Plasma Cell Infiltration
Authors: Arase Yoshitaka , Matsumoto Koshi , Anzai Kazuya , Tsuruya Kota , Sugiyama Satoru , Yoshihara Shihou , Hirose Shunji , Uojima Haruki , Hidaka Hisashi , Nakazawa Takahide , Deguchi Ryuzo , Kojima Seiichiro , Takashimizu Shinji , Shiraishi Koichi , Shirai Takayuki , Kagawa Tatehiro
Published: July 2020

Background: We aimed to elucidate the characteristics and prognosis of autoimmune hepatitis (AIH) patients with immunoglobulin (Ig) G4-positive plasma cell infiltration. Methods: We enrolled 84 AIH patients. The number of IgG- and IgG4-positive plasma cells was immunohistochemically counted per high-power field in the portal area. Patients with 3 or more IgG4-positive plasma cells on average and a ratio of IgG4 to IgG-positive plasma cells ≥5% were defined as IgG4-associated AIH (IgG4-AIH), and their clinicopathological characteristics and prognosis were compared to those of the remaining classical-AIH patients. Results: Ten (11.9%) and 74 patients (88.1%) were categorized as IgG4-AIH and classical-AIH patients, respectively. The median age of the IgG4-AIH patients was 67 years, the majority was female (80.0%), and the distribution was similar to that of the classical-AIH patients. The IgG4-AIH patients exhibited significantly more severe phenotypes in portal inflammation, interface hepatitis, fibrosis, and rosette formation. All clinical laboratory data were similar except for serum IgG4 levels, which were higher in IgG4-AIH patients (168.5 vs. 22.9 mg/dL, p = 0.014). During a median follow-up period of 139 months, the relapse rate was significantly lower in the IgG4-AIH group than in the classical-AIH group (11.1 vs. 49.2%; p = 0.048). Twelve (16.2%) and 6 (8.1%) classical-AIH patients underwent liver-related events and liver-related deaths, respectively. In contrast, none of the IgG4-AIH patients progressed to severe liver disease. Conclusions: The IgG4-AIH patients had more severe inflammation and advanced fibrosis in the liver. However, their prognosis was not poor compared to that of classical-AIH patients. IgG4-AIH may have a phenotype distinct from classical-AIH.
Mid to Late Life Hypertension Trends and Cerebral Small Vessel Disease in the Framingham Heart Study
Authors: Petrea Rodica Elena , O’Donnell Adrienne , Beiser Alexa S. , Habes Mohammad , Aparicio Hugo , DeCarli Charles , Seshadri Sudha , Romero Jose Rafael
Published: July 2020

The duration and lifetime pattern of hypertension is related to risk of stroke and dementia. In turn, cerebral small vessel disease (CSVD) is the most frequent form of cerebrovascular disease underlying dementia and stroke. Thus, study of the relation of mid to late life hypertension trends with CSVD late in life will help understand hypertension’s role and inform preventive efforts of CSVD consequences. We studied 1686 Framingham Heart Study Offspring cohort participants free of stroke and dementia, who were examined in mid and late life, and had available brain magnetic resonance imaging during late life. We related hypertension trends between mid and late life (normotension–normotension N-N, normotension-hypertension N-H, hypertension-hypertension H-H) to cerebral microbleeds and covert brain infarcts (CBI), overall and stratified by brain topography. We used multivariable logistic regression analyses to calculate odds ratio and 95% CIs for CSVD measures. The prevalence of CSVD in late life was 8% for cerebral microbleeds and 13% for covert brain infarcts and increased with longer hypertension exposure across all brain regions. Compared with the trend pattern of N-N, both N-H and H-H trends had higher odds of mixed cerebral microbleeds (2.71 [1.08–6.80], and 3.44 [1.39–8.60], respectively); H-H also had higher odds of any cerebral microbleeds or covert brain infarcts (1.54 [1.12–2.20]), and any covert brain infarcts (1.55 [1.08–2.20]). The burden of CSVD also increased with longer hypertension exposure. Our results highlight hypertension having a major role in subclinical CSVD, across subtypes and brain regions, and call attention to improve recognition and treatment of hypertension early in life.
Determinants of Pericoronary Adipose Tissue Attenuation on Computed Tomography Angiography in Coronary Artery Disease
Authors: Sugiyama Tomoyo , Kanaji Yoshihisa , Hoshino Masahiro , Yamaguchi Masao , Hada Masahiro , Ohya Hiroaki , Sumino Yohei , Hirano Hidenori , Kanno Yoshinori , Horie Tomoki , Misawa Toru , Nogami Kai , Ueno Hiroki , Hamaya Rikuta , Usui Eisuke , Murai Tadashi , Lee Tetsumin , Yonetsu Taishi , Sasano Tetsuo , Kakuta Tsunekazu
Published: July 2020

Background

Recent studies have reported the association between pericoronary inflammation assessed by pericoronary adipose tissue attenuation (PCATA) on computed tomography angiography and worse outcomes in patients with coronary artery disease. We investigated the determinants predicting increased PCATA in patients with known or suspected coronary artery disease.

Methods and Results

A total of 540 patients who underwent computed tomography angiography and invasive coronary angiography were studied. Mean computed tomography attenuation values of PCAT (−190 to −30 Hounsfield units) (PCATA) were assessed at the proximal 40‐mm segments of all 3 major coronary arteries by crude analysis. Univariable and multivariable analyses were performed to determine the predictors of increased PCATA surrounding the proximal right coronary artery. Mean right coronary artery‐PCATA was −72.22±8.47 Hounsfield units and the average of 3‐vessel PCATA was −70.24±6.60 Hounsfield units. Multivariable linear regression analysis revealed that the independent determinants of right coronary artery‐PCATA were male (β coefficient=4.965,
P
<0.001), left ventricular mass index (β coefficient=0.040,
P
=0.025), and angiographically significant stenosis (diameter stenosis >50%) (β coefficient=2.418,
P
=0.008). Sex‐related determinants were NT‐proBNP level (N‐terminal pro‐B‐type natriuretic peptide; β coefficient <0.001,
P
=0.026), Agatston score (β coefficient=−0.002,
P
=0.010), left ventricular mass index (β coefficient=0.041,
P
=0.028), and significant stenosis (β coefficient=4.006,
P
<0.001) in male patients and left ventricular ejection fraction (β coefficient=−0.217,
P
=0.010) and significant stenosis (β coefficient=3.835,
P
=0.023) in female patients.

Conclusions

Right coronary artery‐PCATA was associated with multiple clinical characteristics, established risk factors, and the presence of significant stenosis. Our results suggest that clinically significant factors such as sex, left ventricular hypertrophy, ejection fraction, calcification, and epicardial stenosis should be taken into account in the assessment of pericoronary inflammation using computed tomography angiography.
Clinical Implications of Hepatic Hemodynamic Evaluation by Abdominal Ultrasonographic Imaging in Patients With Heart Failure
Authors: Yoshihisa Akiomi , Ishibashi Shinji , Matsuda Mitsuko , Yamadera Yukio , Ichijo Yasuhiro , Sato Yu , Yokokawa Tetsuro , Misaka Tomofumi , Oikawa Masayoshi , Kobayashi Atsushi , Yamaki Takayoshi , Kunii Hiroyuki , Takeishi Yasuchika
Published: July 2020

Background

It has been reported that liver stiffness assessed by transient elastography are correlated with right atrial pressure, which is associated with worse outcome in patients with heart failure (HF). We aimed to clarify clinical implications of hepatic hemodynamic evaluation (liver congestion and hypoperfusion) by abdominal ultrasonography in patients with HF.

Methods and Results

We performed abdominal ultrasonography, right‐heart catheterization, and echocardiography, then followed up for cardiac events such as cardiac death or worsening HF in patients with HF. Regarding liver congestion, liver stiffness assessed by shear wave elastography (SWE) of the liver was significantly correlated with right atrial pressure determined by right‐heart catheterization (
R
=0.343;
P
<0.01), right atrial end‐systolic area, and inferior vena cava diameter determined by echocardiography. Regarding liver hypoperfusion, peak systolic velocity (PSV) of the celiac artery was correlated with cardiac index determined by right‐heart catheterization (
R
=0.291;
P
<0.001) and tricuspid annular plane systolic excursion determined by echocardiography. According to the Kaplan–Meier analysis, HF patients with high SWE and low PSV had the highest cardiac event rate (log‐rank
P
=0.033). In the Cox proportional hazard analysis, high SWE and low PSV were associated with high cardiac event rate (high SWE: hazard ratio [HR], 2.039; 95% CI, 1.131–4.290; low PSV: HR, 2.211; 95% CI, 1.199–4.449), and the combination of high SWE and low PSV was a predictor of cardiac events (HR, 4.811; 95% CI, 1.562–14.818).

Conclusions

Intrahepatic congestion and hypoperfusion determined by abdominal ultrasonography (liver SWE and celiac PSV) are associated with adverse prognosis in patients with HF.
Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic
Authors: Jasne Adam S. , Chojecka Pola , Maran Ilavarasy , Mageid Razaz , Eldokmak Mohamed , Zhang Qiang , Nystrom Karin , Vlieks Kelsey , Askenase Michael , Petersen Nils , Falcone Guido J. , Wira Charles R. , Lleva Paul , Zeevi Neer , Narula Reshma , Amin Hardik , Navaratnam Dhasakumar , Loomis Caitlin , Hwang David Y. , Schindler Joseph , Hebert Ryan , Matouk Charles , Krumholz Harlan M. , Spudich Serena , Sheth Kevin N. , Sansing Lauren H. , Sharma Richa
Published: July 2020

Background:

Anecdotal reports suggest fewer patients with stroke symptoms are presenting to hospitals during the coronavirus disease 2019 (COVID-19) pandemic. We quantify trends in stroke code calls and treatments at 3 Connecticut hospitals during the local emergence of COVID-19 and examine patient characteristics and stroke process measures at a Comprehensive Stroke Center (CSC) before and during the pandemic.

Methods:

Stroke code activity was analyzed from January 1 to April 28, 2020, and corresponding dates in 2019. Piecewise linear regression and spline models identified when stroke codes in 2020 began to decline and when they fell below 2019 levels. Patient-level data were analyzed in February versus March and April 2020 at the CSC to identify differences in patient characteristics during the pandemic.

Results:

A total of 822 stroke codes were activated at 3 hospitals from January 1 to April 28, 2020. The number of stroke codes/wk decreased by 12.8/wk from February 18 to March 16 (
P
=0.0360) with nadir of 39.6% of expected stroke codes called from March 10 to 16 (30% decrease in total stroke codes during the pandemic weeks in 2020 versus 2019). There was no commensurate increase in within-network telestroke utilization. Compared with before the pandemic (n=167), pandemic-epoch stroke code patients at the CSC (n=211) were more likely to have histories of hypertension, dyslipidemia, coronary artery disease, and substance abuse; no or public health insurance; lower median household income; and to live in the CSC city (
P
<0.05). There was no difference in age, sex, race/ethnicity, stroke severity, time to presentation, door-to-needle/door-to-reperfusion times, or discharge modified Rankin Scale.

Conclusions:

Hospital presentation for stroke-like symptoms decreased during the COVID-19 pandemic, without differences in stroke severity or early outcomes. Individuals living outside of the CSC city were less likely to present for stroke codes at the CSC during the pandemic. Public health initiatives to increase awareness of presenting for non-COVID-19 medical emergencies such as stroke during the pandemic are critical.
Potential of modern circulating cell-free DNA diagnostic tools for detection of specific tumour cells in clinical practice
Authors: Gašperšič Jernej , Videtič Paska Alja
Published: July 2020

Personalized medicine is a developing field of medicine that has gained in importance in recent decades. New diagnostic tests based on the analysis of circulating cell-free DNA (cfDNA) were developed as a tool of diagnosing different cancer types. By detecting the subpopulation of mutated DNA from cancer cells, it is possible to detect the presence of a specific tumour in early stages of the disease. Mutation analysis is performed by quantitative polymerase chain reaction (qPCR) or the next generation sequencing (NGS), however, cfDNA protocols need to be modified carefully in preanalytical, analytical, and postanalytical stages. To further improve treatment of cancer the Food and Drug Administration approved more than 20 companion diagnostic tests that combine cancer drugs with highly efficient genetic diagnostic tools. Tools detect mutations in the DNA originating from cancer cells directly through the subpopulation of cfDNA, the circular tumour DNA (ctDNA) analysis or with visualization of cells through intracellular DNA probes. A large number of ctDNA tests in clinical studies demonstrate the importance of new findings in the field of cancer diagnosis. We describe the innovations in personalized medicine: techniques for detecting ctDNA and genomic DNA (gDNA) mutations approved Food and Drug Administration companion genetic diagnostics, candidate genes for assembling the cancer NGS panels, and a brief mention of the multitude of cfDNA currently in clinical trials. Additionally, an overview of the development steps of the diagnostic tools will refresh and expand the knowledge of clinics and geneticists for research opportunities beyond the development phases.