bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between asymptomatic intracranial arterial stenosis and insulin resistance or diabetes mellitus: a cross-sectional study in rural Shandong, China
Authors: Wang Qiao , Zhao Yuanyuan , Wang Xiang , Ji Xiaokang , Sang Shaowei , Shao Sai , Ma Xiaotong , Wang Guangbin , Lv Ming , Xue Fuzhong , Du Yifeng , Sun Qinjian
Published: December 2020

Introduction

Recent studies have shown that insulin resistance (IR) is correlated to atherosclerosis development. However, few studies have investigated the association between IR and asymptomatic intracranial arterial stenosis (aICAS).

Research design and methods

This cross-sectional study enrolled 2007 rural residents in China who were aged ≥40 years without a clinical history of stroke and transient ischaemic attack. We used transcranial Doppler ultrasonography in combination with magnetic resonance angiography to diagnose aICAS (stenosis ≥50%). IR was defined as a homeostasis model assessment of insulin resistance ≥3.0 based on the 75th percentile for all the participants. Multivariate logistic regression models were employed to assess the relationship of diabetic parameters with aICAS in all participants, as well as with aICAS in non-diabetic participants, and further stratified by sex.

Results

After adjusting for age, gender, smoking habit, drinking habit, low-density lipoprotein cholesterol, raised blood pressure, triglycerides, high-density lipoprotein cholesterol and waist circumference, diabetes mellitus (DM) (OR=2.09, 95% CI 1.31 to 3.32), fasting plasma glucose (FPG) (OR=1.34, 95% CI 1.14 to 1.57), and IR (OR=1.75, 95% CI 1.11 to 2.75) were associated with aICAS in the total study population; however, these relationships remained significant only in men after the analyses were stratified by sex (DM: OR=3.40, 95% CI 1.62 to 7.13; FPG: OR=1.64, 95% CI 1.26 to 2.13; IR: OR=3.04, 95% CI 1.44 to 6.42). When further excluding the diabetic participants from the total study population, positive associations between IR and aICAS were similarly observed only in men (OR=4.65, 95% CI 1.69 to 12.82).

Conclusions

IR might predict the prevalence of aICAS independently of major cardiovascular risk factors and metabolic syndrome components among men living in rural China.
Spectrum of nutrition-specific and nutrition-sensitive determinants of child undernutrition: a multisectoral cross-sectional study in rural Mozambique
Authors: Aiga Hirotsugu , Nomura Marika , Langa José Paulo M , Mahomed Mussagy , Marlene Rosa , Alage Albertina , Trindade Nilton , Buene Dino , Hiraoka Hiroshi , Nakada Shunichi , Arinde Edgar , Varimelo José , Chivale Américo Jeremias
Published: December 2020

Background

Despite an increasing need for multisectoral interventions and coordinations for addressing malnutrition, evidence-based multisectoral nutrition interventions have been rarely developed and implemented in low-income and middle-income countries. To identify key determinants of undernutrition for effectively designing a multisectoral intervention package, a nutrition survey was conducted, by comprehensively covering a variety of variables across sectors, in Niassa province, Mozambique.

Methods

A cross-sectional household survey was conducted in Niassa province, August–October 2019. Anthropometric measurements, anaemia tests of children under 5 years of age and structured interviews with their mothers were conducted. A total of 1498 children under 5 years of age participated in the survey. We employed 107 background variables related to possible underlying and immediate causes of undernutrition, to examine their associations with being malnourished. Both bivariate (χ2test and Mann-Whitney’s U test) and multivariate analyses (logistic regression) were undertaken, to identify the determinants of being malnourished.

Results

Prevalence rates of stunting, underweight and wasting were estimated at 46.2%, 20.0% and 7.1%, respectively. Timely introduction of solid, semi-solid or soft foods to children of 6–8 months of age was detected as a determinant of being not stunted. Mother–child cosleeping and ownership of birth certificate were a protective factor from and a promoting factor for being underweight, respectively. Similarly, availability and consumption of eggs at the household level and cough during the last 2 weeks among children were likely to be a protective factor from and a promoting factor for being wasted, respectively.

Conclusion

Timely introduction of solid, semi-solid or soft foods could serve as an entry point for the three sectors to start making joint efforts, as it requires the interventions from all health, agriculture and water sectors. To enable us to make meaningful interprovincial, international and inter-seasonal comparisons, it is crucially important to develop a standard set of variables related to being malnourished.
Effect of bicyclol on blood biomarkers of NAFLD: a systematic review and meta-analysis
Authors: Li Hu , Liu Nan-Nan , Peng Zong-Gen
Published: December 2020

Objective

Non-alcoholic fatty liver disease (NAFLD) is a global epidemic without effective therapeutic agents in the clinic. This meta-analysis aimed to assess the efficacy of the marketed hepatoprotectant bicyclol at improving blood biomarkers in patients with NAFLD.

Design

Electronic databases were searched for randomised controlled trials (RCTs) published up to August 2020 using bicyclol to treat NAFLD. The risk of bias, quality of evidence and publication bias were evaluated. Blood biomarkers, including alanine transaminase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), triglyceride (TG) and total cholesterol (TC), were analysed using Review Manager V.5.3 software. Outcomes with significant heterogeneity (I2≥75%) were divided into the bicyclol monotherapy subgroup and combination treatment subgroup.

Results

Twelve RCTs involving 1008 patients were finally included. No serious adverse events were reported in the bicyclol-treated groups. The total effective rate of bicyclol intervention for NAFLD was significantly higher than that of the control group. The decreases in the levels of AST (mean difference (MD) = −15.20; 95% CI −20.51 to −9.90; I2=74%), TBIL (MD = −1.72; 95% CI −2.72 to −0.72; I2=0%) and TC (MD = −0.52; 95% CI −0.70 to −0.34; I2=67%) treated by bicyclol were significantly higher than those in the control group. When a high heterogeneity existed (I2≥75%), subgroup analyses were conducted and revealed significantly decreased ALT levels (MD = −34.07; 95% CI −36.70 to −31.43; I2=0%) merely in the bicyclol monotherapy subgroup, while TG level (MD = −0.39; 95% CI −0.45 to −0.33; I2=0%) was decreased in the bicyclol combination therapy subgroup.

Conclusions

The study presents the evidence of bicyclol monotherapy and/or combination therapy for improving liver function and blood lipid biomarkers in patients with NAFLD. This preliminary study predicts that bicyclol might be an alternative drug for NAFLD therapy in the future.
Randomised controlled trial of conditioning regimen for cord blood transplantation for adult myeloid malignancies comparing high-dose cytarabine/cyclophosphamide/total body irradiation with versus without G-CSF priming: G-CONCORD study protocol
Authors: Terakura Seitaro , Konuma Takaaki , Tanaka Masatsugu , Ozawa Yukiyasu , Onizuka Makoto , Nanno Satoshi , Onishi Yasushi , Aotsuka Nobuyuki , Kondo Tadakazu , Kawakita Toshiro , Kato Jun , Kobayashi Takeshi , Nishida Tetsuya , Yamaguchi Takuhiro , Kuwatsuka Yachiyo , Takahashi Satoshi
Published: December 2020

Introduction

A better long-term quality of life after umbilical cord blood transplantation (CBT) is observed compared with transplants from other alternative donors, whereas graft failure and relapses after CBT are still major issues. To minimise graft failure and relapse after CBT, intensification of conditioning by the addition of high-dose cytosine arabinoside (CA) and concomitant continuous use of granulocyte-colony stimulating factor (G-CSF) are reported to convey a significantly better survival after CBT in some retrospective studies. To confirm the effect of G-CSF plus CA combination, in addition to the standard conditioning regimen, cyclophosphamide (CY)/total body irradiation (TBI), we design a randomised controlled study comparing CA/CY/TBI with versus without G-CSF priming (G-CSF combined conditioned cord blood transplantation [G-CONCORD] study).

Methods and analysis

This is a multicentre, open-label, randomised phase III study that aimed to compare G-CSF+CA/CY/TBI as a conditioning regimen for CBT with CA/CY/TBI. Patients with acute myeloid leukaemia or myelodysplastic syndrome, aged 16–55 years, are eligible. The target sample size is 160 and the registration period is 4 years. The primary endpoint is the 2-year disease-free survival rate after CBT. The secondary endpoints are overall survival, relapse, non-relapse mortality, acute and chronic graft-versus-host disease, engraftment rate, time to neutrophil recovery, short-term adverse events, incidence of infections and causes of death.

This study employs a single one-to-one web-based randomisation between the with-G-CSF versus without-G-CSF groups after patient registration. Combination of high-dose CA and CY/TBI in both groups is used for conditioning.

Ethics and dissemination

The study protocol was approved by the central review board, Nagoya University Certified Review Board, after the enforcement of the Clinical Trials Act in Japan. The manuscripts presenting data from this study will be submitted for publication in quality peer-reviewed medical journals. Study findings will be disseminated via presentations at national/international conferences and peer-reviewed journals.

Trial registration numbers

UMIN000029947 and jRCTs041180059.
Multicentre, prospective registry study of amyotrophic lateral sclerosis in mainland China (CHALSR): study protocol
Authors: He Ji , Fu Jia yu , Chen Lu , He Jing , Dang Jingxia , Zou Zhangyu , Ma Sha , Li Nan , Fan Dongsheng
Published: December 2020

Introduction

Amyotrophic lateral sclerosis (ALS) is a representative rare disease characterised by progressive, fatal motor neuron degeneration. Due to the unknown aetiology and variability of the phenotypes, there are no accurate reports concerning the epidemiology or clinical characteristics of the disease. The low prevalence, as previously reported, makes it difficult to carry out studies with large samples. The aim of this study was to explore the natural history and clinical features of ALS in mainland China through a multicentre, prospective cohort study. The findings will both offer a better understanding of ALS and also support the development of a model to study other rare diseases.

Methods and analysis

Patients from 88 representative hospitals in different parts of mainland China will be recruited through a specially designed online data system (http://www.chalsr.net/). We aim to recruit 4752 ALS patients over a 3-year period. Baseline data will be recorded, and follow-up data will be collected every 3 months. The primary outcome is effective survival. Overall survival and indices of disease progression will be measured as the secondary outcomes.

Ethics and dissemination

Ethical approval has been obtained from the ethics committee of Peking University Third Hospital (M2019388). Informed written consent will be obtained from each participant. Dissemination of the study protocol and data will take place primarily through a specially designed online data system (http://www.chalsr.net/). The collective results of the study will be published in peer-reviewed journals and shared in scientific presentations.

Trial registration number

NCT04328675
Association between statin use and outcomes in patients with coronavirus disease 2019 (COVID-19): a nationwide cohort study
Authors: Butt Jawad Haider , Gerds Thomas Alexander , Schou Morten , Kragholm Kristian , Phelps Matthew , Havers-Borgersen Eva , Yafasova Adelina , Gislason Gunnar Hilmar , Torp-Pedersen Christian , Køber Lars , Fosbøl Emil Loldrup
Published: December 2020

Objective

To investigate the association between recent statin exposure and risk of severe COVID-19 infection and all-cause mortality in patients with COVID-19 in Denmark.

Design and setting

Observational cohort study using data from Danish nationwide registries.

Participants

Patients diagnosed with COVID-19 from 22 February 2020 to 17 May 2020 were followed from date of diagnosis until outcome of interest, death or 17 May 2020.

Interventions

Use of statins, defined as a redeemed drug prescription in the 6 months prior to COVID-19 diagnosis.

Primary and secondary outcome measures

All-cause mortality, severe COVID-19 infection and the composite.

Results

The study population comprised 4842 patients with COVID-19 (median age 54 years (25th–75th percentile, 40–72), 47.1% men), of whom 843 (17.4%) redeemed a prescription of statins. Patients with statin exposure were more often men and had a greater prevalence of comorbidities. The median follow-up was 44 days. After adjustment for age, sex, ethnicity, socioeconomic status and comorbidities, statin exposure was not associated with a significantly different risk of mortality (HR 0.96 (95% CI 0.78 to 1.18); 30-day standardised absolute risk (SAR), 9.8% (8.7% to 11.0%) vs 9.5% (8.2% to 10.8%); SAR difference, −0.4% (−1.9% to 1.2%)), severe COVID-19 infection (HR 1.16 (95% CI 0.95 to 1.41); 30-day SAR, 13.0% (11.8% to 14.2%) vs 14.9% (12.8% to 17.1%); SAR difference, 1.9% (−0.7% to 4.5%)), and the composite outcome of all-cause mortality or severe COVID-19 infection (HR 1.05 (95% CI 0.89 to 1.23); 30-day SAR, 17.6% (16.4% to 18.8%) vs 18.2% (16.4% to 20.1%); SAR difference, 0.6% (−1.6% to 2.9%)). The results were consistent across subgroups of age, sex and presumed indication for statin therapy. Among patients with statin exposure, there was no difference between statin drug or treatment intensity with respect to outcomes.

Conclusions

Recent statin exposure in patients with COVID-19 infection was not associated with an increased or decreased risk of all-cause mortality or severe infection.
Assembly Line ICU: what the Long Shops taught us about managing surge capacity for COVID-19
Authors: Oakley Callum , Pascoe Craig , Balthazor Daivd , Bennett Davinia , Gautam Nandan , Isaac John , Isherwood Peter , Matthews Tracie , Murphy Nick , Oelofse Tessa , Patel Jaimin , Snelson Catherine , Richardson Carla , Willson Jeremy , Wyton Fiona , Veenith Tonny , Whitehouse Tony
Published: December 2020

Objectives

To safely expand and adapt the normal workings of a large critical care unit in response to the COVID-19 pandemic.

Methods

In April 2020, UK health systems were challenged to expand critical care capacity rapidly during the first wave of the COVID-19 pandemic so that they could accommodate patients with respiratory and multiple organ failure. Here, we describe the preparation and adaptive responses of a large critical care unit to the oncoming burden of disease. Our changes were similar to the revolution in manufacturing brought about by ‘Long Shops’ of 1853 when Richard Garrett and Sons of Leiston started mass manufacture of traction engines. This innovation broke the whole process into smaller parts and increased productivity. When applied to COVID-19 preparations, an assembly line approach had the advantage that our ICU became easily scalable to manage an influx of additional staff as well as the increase in admissions. Healthcare professionals could be replaced in case of absence and training focused on a smaller number of tasks.

Results

Compared with the equivalent period in 2019, the ICU provided 30.9% more patient days (2599 to 3402), 1845 of which were ventilated days (compared with 694 in 2019, 165.8% increase) while time from first referral to ICU admission reduced from 193.8±123.8 min (±SD) to 110.7±76.75 min (±SD). Throughout, ICU maintained adequate capacity and also accepted patients from neighbouring hospitals. This was done by managing an additional 205 doctors (70% increase), 168 nurses who had previously worked in ICU and another 261 nurses deployed from other parts of the hospital (82% increase).

Our large tertiary hospital ensured a dedicated non-COVID ICU was staffed and equipped to take regional emergency referrals so that those patients requiring specialist surgery and treatment were treated throughout the COVID-19 pandemic.

Conclusions

We report how the challenge of managing a huge influx of patients and redeployed staff was met by deconstructing ICU care into its constituent parts. Although reported from the largest colocated ICU in the UK, we believe that this offers solutions to ICUs of all sizes and may provide a generalisable model for critical care pandemic surge planning.
Effects of the lower jaw position on athletic performance of elite athletes
Authors: Haughey John Patrick , Fine Peter
Published: December 2020

When an athlete wears a mouthguard, the position of the lower jaw is changed by virtue of the teeth being unable to occlude. Little research is available in in this area, which have indicated both positive impact and no positive impact.

Objectives

This study aims to explore the influence of the lower jaw position on athletic performance in elite athletes.

Methods

A repeated measures study compared two lower jaw positions, the athlete’s normal (habitual) bite and the lower jaw position when the muscles of mastication are at physiological rest (physiological rest bite). 15 athletes completed a medicine ball putt (upper body power), vertical jump (lower body power), sit and reach (composite hamstring flexibility), passive knee flexion (hamstring muscle length) and star excursion balance (stability and balance) tests in each condition.

Results

Paired t-tests showed the physiological rest bite had significant (p<0.05) positive effect on athletic performance for each test. On average the physiological rest bite provided an increase of lower body power (5.8%), upper body power (10%), hamstring flexibility (14%) and balance and stability (4.8%) compared to the habitual bite.

Conclusion

This study provides evidence of the need for further research to confirm if the lower jaw position can be optimised for athletic performance in athletes.
How well did Norwegian general practice prepare to address the COVID-19 pandemic?
Authors: Alsnes Ingvild Vatten , Munkvik Morten , Flanders W Dana , Øyane Nicolas
Published: December 2020

Objectives

We aimed to describe the quality improvement measures made by Norwegian general practice (GP) during the COVID-19 pandemic, evaluate the differences in quality improvements based on region and assess the combinations of actions taken.

Design

Descriptive study.

Setting

Participants were included after taking part in an online quality improvement COVID-19 course for Norwegian GPs in April 2020. The participants reported whether internal and external measures were in place: COVID-19 sign on entrance, updated home page, access to video consultations and/or electronic written consultations, home office solutions, separate working teams, preparedness for home visits, isolation rooms, knowledge on decontamination, access to sufficient supplies of personal protective equipment (PPE) and COVID-19 clinics.

Participants

One hundred GP offices were included. The mean number of general practitioners per office was 5.63.

Results

More than 80% of practices had the following preparedness measures: COVID-19 sign on entrance, updated home page, COVID-19 clinic in the municipality, video and written electronic consultations, knowledge on how to use PPE, and home office solutions for general practitioners. Less than 50% had both PPE and knowledge of decontamination. Lack of PPE was reported by 37%, and 34% reported neither sufficient PPE nor a dedicated COVID-19 clinic. 15% reported that they had an isolation room, but not enough PPE. There were no geographical differences.

Conclusions

Norwegian GPs in this study implemented many quality improvements to adapt to the COVID-19 pandemic. Overall, the largest potentials for improvement seem to be securing sufficient supply of PPE and establishing an isolation room at their practices.
Quantifying the effects of pop-up satellite archival tags on the swimming performance and behavior of young-adult mahi-mahi (Coryphaena hippurus)
Authors: McGuigan Charles J. , Schlenker Lela S. , Stieglitz John D. , Benetti Daniel D. , Grosell Martin
Published: December 2020

Pop-up satellite archival tags (PSATs) have been used to demonstrate habitat utilization and large-scale migrations of aquatic species and are a critical tool to manage highly migratory fish populations. Use of PSATs has increased in recent years; however, few studies have investigated the physiological and behavioral effects of carrying a PSAT. To address this gap, young-adult mahi-mahi (Coryphaena hippurus; 25–35 cm fork length) were tagged with miniature PSATs and assessed in a two-part experiment utilizing swim tunnel respirometry and behavioral analysis of free-swimming individuals. Swim tunnel respirometry revealed significant reductions in the critical and optimal swimming speeds of tagged fish (10.2% and 20.9%, respectively), as well as significant reductions in maximum metabolic rate and aerobic scope (16.1% and 21.4%, respectively). In contrast, mean and maximum velocity, acceleration, total distance traveled, survival, and feeding success of free-swimming tagged fish showed no impacts of tagging compared with untagged conspecifics held in the same tank. The results of this study highlight the importance of considering multiple methodologies to assess the impacts of tagging fish and provide insight into the data collected by PSATs deployed on wild fish.
Dynamic modeling and sensitivity analysis of a tubular pump unit during starting process
Authors: Xu Jian-Jian , Bai Dan
Published: December 2020

Dynamic characteristics and sensitivity analysis of a tubular pump unit during starting process are proposed in this paper. A dynamic model of the pump unit, suitable for describing its transient characteristics during starting process, is established by using rigid body dynamics, fluid dynamics and hydraulic theory. The extended Fourier amplitude sensitivity test (EFAST) analysis method is used to investigate the influence of unit parameters on system outputs. Simulation of the pump unit is carried out for the starting process to verify the sensitivity analysis and explore the dynamic characteristics of the pump unit. The dynamic responses of the system parameter (rotating speed, flow and head) are revealed by the start-up simulation. Research results provide theoretical guidance for the rational design and safe operation of tubular pump stations.
Software Shipping Time Estimation for Markovian Change-Point Reliability Model
Authors: Inoue Shinji , Yamada Shigeru
Published: December 2020

A Markovian software reliability model is known as one of the useful models which enable us to describe the details on the dynamic behavior of software reliability growth process with imperfect debugging activities. As the application of this model for software development management, we discuss software shipping time estimation based on the extended Markovian software reliability model considering with the effect of change-point, which is the testing-time when the characteristic of the software failure-occurrence or fault-detection phenomenon changes notably. Especially in our discussion on the software shipping time estimation, we derive an analytical software shipping policy under certain software reliability objective and show numerical examples of the application of the software shipping policy by using actual software reliability data. Finally, we give some useful consideration on the relationship between the software shipping time and the software reliability growth process for conducing quality-oriented software development management.
Collapse geometry in inhomogeneous FRW model
Authors: Chakraborty Sanjukta , Bose Akash , Chakraborty Subenoy
Published: December 2020

Collapsing process is studied in special type of inhomogeneous spherically symmetric space-time model (known as IFRW model), having no time-like Killing vector field. The matter field for collapse dynamics is considered to be perfect fluid with anisotropic pressure. The main issue of this investigation is to examine whether the end state of the collapse to be a naked singularity or a black hole. Finally, null geodesics is studied near the singularity.
War Video Games
Authors: Del-Moral M. Esther , RodrÍguez-GonzÁlez Christian
Published: December 2020

War video games recreate war situations with great realism, favoring the immersion of users and making them participants of the sufferings derived from war. While some of them help the players to understand the war, appealing to the hyper-realistic simulation, others are entertainment artifacts that banalize it. This research seeks to determine the edu-communicative potential of war video games, understood as the ability to drive critical thinking towards war. To do this, we adopt a qualitative methodology based on the study of 10 cases, using the WarVG-A (War video game evaluation) instrument to perform the content analysis, based on six dimensions (cognitive, personal-attitudinal, ethical, logical, argumentative, and expressive-communicative) with different indicators and categories. The results of the analysis indicate that these primary games terrorist tactics and historical adaptation, addressing war from a critical approach. Most evidence ethical dilemmas such as child soldiers, the economics of war (arms sales and conflict perpetuation). Economic and geo-political interests are the engines that drive wars, considered inevitable to defend themselves. The stereotypes that abound are gender and ethnic warmongers represented by photorealistic and cinematographic aesthetics. Only four of the selected playful artifacts can identify tools capable of driving critical thinking, inviting players to reflect on war from a more realistic position and emotionally involving them. However, the explicit representation of violence limits its use in school contexts.
Augmented Reality Gaming as a Tool for Subjectivizing Visitor Experience at Cultural Heritage Locations—Case Lights On!
Authors: Lehto Anttoni , Luostarinen Nina , Kostia Paula
Published: December 2020

This article discusses an augmented reality game as a way of subjectivizing visitor experience at cultural heritage locations. The text describes the starting point, development aims, and some initial user data of the Lights On! game while contextualizing the game's development with relevant discussion concerning the use of ludic and narrative augmented reality elements in enhancing the experience of place at historical sites. The initial user data were collected via an in-app questionnaire and learning diaries. The results indicate that the game was well suited for children, whose imaginations were stirred by gaming on-location at the sites. It seems that with an appropriate implementation, an AR game can offer visitors an alternative way of experiencing cultural heritage attractions that creates significant added value to the user.
Simulated sleep apnea alters hydrogen sulfide regulation of blood flow and pressure
Authors: Barrera Adelaeda , Morales-Loredo Humberto , Garcia Joshua M. , Fregoso Gisel , Pace Carolyn E. , Mendiola Perenkita J. , Naik Jay S. , Gonzalez Bosc Laura V. , Kanagy Nancy L.
Published: December 2020

These results suggest that CSE’s protective role in the vasculature is impaired by simulated sleep apnea, which also upregulates CSE in the carotid body. Thus, this enzyme system can exert both pro- and antihypertensive effects and may contribute to elevated SNS outflow in sleep apnea.
CORP: Standardizing methodology for assessing spontaneous baroreflex control of muscle sympathetic nerve activity in humans
Authors: Holwerda Seth W. , Carter Jason R. , Yang Huan , Wang Jing , Pierce Gary L. , Fadel Paul J.
Published: December 2020

The use of spontaneous bursts of muscle sympathetic nerve activity (MSNA) to assess arterial baroreflex control of sympathetic nerve activity has seen increased utility in studies of both health and disease. However, methods used for analyzing spontaneous MSNA baroreflex sensitivity are highly variable across published studies. Therefore, we sought to comprehensively examine methods of producing linear regression slopes to quantify spontaneous MSNA baroreflex sensitivity in a large cohort of subjects ( n = 150) to support a standardized procedure for analysis that would allow for consistent and comparable results across laboratories. The primary results demonstrated that 1) consistency of linear regression slopes was considerably improved when the correlation coefficient was above −0.70, which is more stringent compared with commonly reported criterion of −0.50, 2) longer recording durations increased the percentage of linear regressions producing correlation coefficients above −0.70 (1 min = 15%, 2 min = 28%, 5 min = 53%, 10 min = 67%, P < 0.001) and reaching statistical significance (1 min = 40%, 2 min = 69%, 5 min = 78%, 10 min = 89%, P < 0.001), 3) correlation coefficients were improved with 3-mmHg versus 1-mmHg and 2-mmHg diastolic blood pressure (BP) bin size, and 4) linear regression slopes were reduced when the acquired BP signal was not properly aligned with the cardiac cycle triggering the burst of MSNA. In summary, these results support the use of baseline recording durations of 10 min, a correlation coefficient above −0.70 for reliable linear regressions, 3-mmHg bin size, and importance of properly time-aligning MSNA and diastolic BP. Together, these findings provide best practices for determining spontaneous MSNA baroreflex sensitivity under resting conditions for improved rigor and reproducibility of results.
Sex differences in COVID-19: candidate pathways, genetics of ACE2, and sex hormones
Authors: Viveiros Anissa , Rasmuson Jaslyn , Vu Jennie , Mulvagh Sharon L. , Yip Cindy Y. Y. , Norris Colleen M. , Oudit Gavin Y.
Published: December 2020

Biological sex is increasingly recognized as a critical determinant of health and disease, particularly relevant to the topical COVID-19 pandemic caused by the SARS-CoV-2 coronavirus. Epidemiological data and observational reports from both the original SARS epidemic and the most recent COVID-19 pandemic have a common feature: males are more likely to exhibit enhanced disease severity and mortality than females. Sex differences in cardiovascular disease and COVID-19 share mechanistic foundations, namely, the involvement of both the innate immune system and the canonical renin-angiotensin system (RAS). Immunological differences suggest that females mount a rapid and aggressive innate immune response, and the attenuated antiviral response in males may confer enhanced susceptibility to severe disease. Furthermore, the angiotensin-converting enzyme 2 (ACE2) is involved in disease pathogenesis in cardiovascular disease and COVID-19, either to serve as a protective mechanism by deactivating the RAS or as the receptor for viral entry, respectively. Loss of membrane ACE2 and a corresponding increase in plasma ACE2 are associated with worsened cardiovascular disease outcomes, a mechanism attributed to a disintegrin and metalloproteinase (ADAM17). SARS-CoV-2 infection also leads to ADAM17 activation, a positive feedback cycle that exacerbates ACE2 loss. Therefore, the relationship between cardiovascular disease and COVID-19 is critically dependent on the loss of membrane ACE2 by ADAM17-mediated proteolytic cleavage. This article explores potential mechanisms involved in COVID-19 that may contribute to sex-specific susceptibility focusing on the innate immune system and the RAS, namely, genetics and sex hormones. Finally, we highlight here the added challenges of gender in the COVID-19 pandemic.
Flexural Behavior of Slab‐Rib Integrated Bridge Decks with GFRP Skin and Polyurethane Foam Core
Authors: Li Jing , Wang Jun , Yadav Bishnu Prasad , Chen Jiye , Jin Qiang , Liu Weiqing
Published: December 2020

This paper presents experimental and analytical studies on flexural behavior of slab‐rib integrated Sandwich composite decks. The influences of layers of glass fiber‐reinforced polymer (GFRP) facesheets, foam densities, and the existence of webs and cross beams are discussed herein. The test results showed that the existence of vertical webs remarkably improved the debonding of the facesheets from the foam core, thus increasing the ultimate load by 59% compared with the specimens without webs. However, the existence of horizontal webs has insignificant effect on the failure mode and ultimate load. Increasing the number of layers of GFRP facesheets from 2 to 4 and 6 results in 100% and 214% increments in ultimate loads, respectively, while the specimen with lower density of foam had a higher ultimate load than the specimen with higher density of foam due to deformation compatibility between GFRP skins and foam core with low density. The analysis software Abaqus Explicit was used to simulate the flexural behavior of test specimens, and the numerical results agreed well with the test data. The verified finite element model was extended to analyze the influences of the number of GFRP layers on the top of decks and the height of vertical webs. Based on equivalent method and compatibility of shear deformation, the flexural and shear rigidities were estimated. Then, analytical solution for displacement of the slab‐rib integrated Sandwich composite decks subjected to four‐point load was derived out. Comparison of analytical and experimental results shows that the displacements can be precisely predicted by the present theoretical model.
Bianchi Type-
I
Bulk Viscosity with a DE Cosmological Model
Authors: Gusu Daba Meshesha
Published: December 2020

The finding article presents Bianchi type-

I

universe in the presence of bulk viscous and DE fluid nature of a cosmological model. The solutions of field equations were obtained by assuming hybrid expansion law. The physical significance of the obtained findings illustrates the dominance of bulk viscosity in early and dominance of dark energy fluid emergences in late. This leads to indicate the presence of bulk viscosity nature more effective in early time rather than late times, and also, it shows the dominance of dark energy in late times which grants the current observational result of the universe. Certain physical and geometrical properties of the model are also discussed.
Identification of Differentially Expressed Drought-Responsive Genes in Guar [Cyamopsis tetragonoloba (L.) Taub]
Authors: Alshameri Aref , Al-Qurainy Fahad , Gaafar Abdel-Rhman , Khan Salim , Nadeem Mohammad , Alansi Saleh , Shaikhaldein Hassan O. , Salih Abdalrhaman M.
Published: December 2020

Drought remains one of the most serious environmental stresses because of the continuous reduction in soil moisture, which requires the improvement of crops with features such as drought tolerance. Guar [Cyamopsis tetragonoloba (L.) Taub], a forage and industrial crop, is a nonthirsty plant. However, the information on the transcriptome changes that occur under drought stress in guar is very limited; therefore, a gene expression analysis is necessary in this context. Here, we studied the differentially expressed genes (DEGs) in response to drought stress and their metabolic pathways. RNA-Seq via an expectation-maximization algorithm was used to estimate gene abundance. Subsequently, an Empirical Analysis of Digital Gene Expression Data in the R Bioconductor package was used to identify DEGs. Blast2GO, InterProScan, and the Kyoto Encyclopedia of Genes and Genomes were used to explore functional annotation, protein analysis, enzymes, and metabolic pathways. Transcription factors were identified using the PlantTFDB database. Our study identified 499 upregulated and 191 downregulated genes in response to drought stress. Of those, 32 upregulated and six downregulated genes were deemed as novel genes exclusive to guar. An aggregate of 137 protein families, 306 domains, 12 repeats, and two sites were upregulated. The proton-dependent oligopeptide transporter family and transferase, aquaporin transporter, calcium/calmodulin-dependent/calcium-dependent protein kinase, aspartic peptidase A1 family, UDP-glucuronosyl/UDP-glucosyltransferase, and major intrinsic protein were the most upregulated protein families. The upregulated unigenes were associated with 88 enzymes and 77 KEGG pathways. Finally, the MYB-related, MYB, and ERF transcription factor families were upregulated. These data may be useful for understanding the plant molecular response to drought stress.
An Efficient Hierarchical Representation Approach of Remote Sensing Application Modeling Based on Distributed Environment
Authors: Zou Quan , Yu Wenyang , Li Guoqing
Published: December 2020

In Earth science, information science, space science, and other disciplines, scientists use the land surface parameter inversion method in their work, applying this to the atmosphere, vegetation, soil, drought, and so on. Multidisciplinary experts sometimes collaborate on a particular application. However, these remote sensing models do not have a unified method of description and management and cannot effectively achieve the sharing of models and data resources. It is also hard to meet user demand for global data and models in the current state, especially in the face of global problems and long-term series problems. In this paper, we examine the scientific questions of the computability and scalability of remote sensing models. This paper adopts a data dependency approach to describe a remote sensing model and implements a hierarchical unified description and management method using modelling based on four layers: a data-processing view, an atomic model view, an on-demand resource package view, and a workflow view. We choose three typical remote sensing models for disaster monitoring as use cases and describe the practical application process of the proposed method. The results demonstrate the advantages and powerful capabilities of this efficient method.
Perioperative Management and Preemptive ECMO Cannulation of a Parturient with Cystic Fibrosis Undergoing Cesarean Delivery
Authors: Franklin Dos Santos Thais , Rabassa Andrea , Aljure Oscar , Zbeidy Reine
Published: December 2020

Physiologic changes of pregnancy and cystic fibrosis pathology provide a unique set of circumstances. Pulmonary disease accounts for over 90% of the morbidity and mortality of patients with cystic fibrosis. These abnormalities create anesthetic challenges due to multiple organ systems being affected including the respiratory, gastrointestinal, cardiovascular, and genitourinary tracts, where patients present with chronic respiratory failure, pancreatic insufficiency, poor nutrition, and cardiac manifestations. We present the perianesthetic management of a parturient with cystic fibrosis who successfully underwent preterm cesarean delivery under neuraxial anesthesia with preemptive bilateral femoral venous sheaths placed for potential extracorporeal membrane oxygenation (ECMO) initiation.
Predicting Critical Bicycle-Vehicle Conflicts at Signalized Intersections
Authors: Darzian Rostami Alireza , Katthe Anagha , Sohrabi Aryan , Jahangiri Arash
Published: December 2020

Continuous development of urban infrastructure with a focus on sustainable transportation has led to a proliferation of vulnerable road users (VRUs), such as bicyclists and pedestrians, at intersections. Intersection safety evaluation has primarily relied on historical crash data. However, due to several limitations, including rarity, unpredictability, and irregularity of crash occurrences, quantitative and qualitative analyses of crashes may not be accurate. To transcend these limitations, intersection safety can be proactively evaluated by quantifying near-crashes using alternative measures known as surrogate safety measures (SSMs). This study focuses on developing models to predict critical near-crashes between vehicles and bicycles at intersections based on SSMs and kinematic data. Video data from ten signalized intersections in the city of San Diego were employed to train logistic regression (LR), support vector machine (SVM), and random forest (RF) models. A variation of time-to-collision called T2 and postencroachment time (PET) were used to specify monitoring periods and to identify critical near-crashes, respectively. Four scenarios were created using two thresholds of 5 and 3 s for both PET and T2. In each scenario, five monitoring period lengths were examined. The RF model was superior compared to other models in all different scenarios and across different monitoring period lengths. The results also showed a small trade-off between model performance and monitoring period length, identifying models with monitoring period lengths of 10 and 20 frames performed slightly better than those with lower or higher lengths. Sequential backward and forward feature selection methods were also applied that enhanced model performance. The best RF model had recall values of 85% or higher across all scenarios. Also, RF prediction models performed better when considering just the rear-end near-crashes with recalls of above 90%.
Comparative Analysis of the Clinical Features and Long-Term Outcomes of Pachychoroid Neovasculopathy and Type 1 Neovascular Age-Related Macular Degeneration
Authors: You Jong In , Kim Kiyoung
Published: December 2020

Purpose. To evaluate the clinical characteristics and long-term prognosis of pachychoroid neovasculopathy (PCN) when compared with type 1 neovascular age-related macular degeneration (nAMD). Methods. We retrospectively analyzed 30 and 60 patients whose eyes were diagnosed as treatment-naïve PCN or type 1 nAMD, respectively. All subjects were followed up for 5 years. Baseline angiographic characteristics and long-term clinical outcomes were compared between the two groups. Results. PCN group consisted of patients of younger age and represented more choroidal vascular hyperpermeability, polypoidal lesion, and history of central serous chorioretinopathy (CSC) at the time of diagnosis (all

p

 < 0.01). During the 5-year follow-up period, individuals in the PCN group received significantly fewer injections and reported better visual acuity compared to individuals in the type 1 nAMD group. A progressive decrease in the subfoveal choroidal thickness was observed in the type 1 nAMD group, while the thick choroid was maintained in the PCN group during the 5-year follow-up period. Conclusions. PCN developed in younger patients with a higher propensity of forming polypoidal lesions and a history of CSC. Long-term outcomes revealed that PCN had a thicker choroid and better visual prognosis with fewer number of intravitreal injection than that of type 1 nAMD.
BMOP: Bidirectional Universal Adversarial Learning for Binary OpCode Features
Authors: Li Xiang , Nie Yuanping , Wang Zhi , Kuang Xiaohui , Qiu Kefan , Qian Cheng , Zhao Gang
Published: December 2020

For malware detection, current state-of-the-art research concentrates on machine learning techniques. Binaryn-gram OpCode features are commonly used for malicious code identification and classification with high accuracy. Binary OpCode modification is much more difficult than modification of image pixels. Traditional adversarial perturbation methods could not be applied on OpCode directly. In this paper, we propose a bidirectional universal adversarial learning method for effective binary OpCode perturbation from both benign and malicious perspectives. Benign features are those OpCodes that represent benign behaviours, while malicious features are OpCodes for malicious behaviours. From a large dataset of benign and malicious binary applications, we select the most significant benign and malicious OpCode features based on the feature SHAP value in the trained machine learning model. We implement an OpCode modification method that insert benign OpCodes into executables as garbage codes without execution and modify malicious OpCodes by equivalent replacement preserving execution semantics. The experimental results show that the benign and malicious OpCode perturbation (BMOP) method could bypass malicious code detection models based on the SVM, XGBoost, and DNN algorithms.
Restoration of T-cell Effector Function, Depletion of Tregs, and Direct Killing of Tumor Cells: The Multiple Mechanisms of Action of a-TIGIT Antagonist Antibodies
Authors: Preillon Julie , Cuende Julia , Rabolli Virginie , Garnero Lucile , Mercier Marjorie , Wald Noémie , Pappalardo Angela , Denies Sofie , Jamart Diane , Michaux Anne-Catherine , Pirson Romain , Pitard Vincent , Bagot Martine , Prasad Shruthi , Houthuys Erica , Brouwer Margreet , Marillier Reece , Lambolez Florence , Marchante Joäo R. , Nyawouame Florence , Carter Mathew J. , Baron-Bodo Véronique , Marie-Cardine Anne , Cragg Mark , Déchanet-Merville Julie , Driessens Gregory , Hoofd Catherine
Published: December 2020

TIGIT is an immune checkpoint inhibitor expressed by effector CD4+ and CD8+ T cells, NK cells, and regulatory T cells (Tregs). Inhibition of TIGIT-ligand binding using antagonistic anti-TIGIT mAbs has shown in vitro potential to restore T-cell function and therapeutic efficacy in murine tumor models when combined with an anti–PD(L)-1 antibody. In the current work, we demonstrate broader TIGIT expression than previously reported in healthy donors and patients with cancer with expression on γδ T cells, particularly in CMV-seropositive donors, and on tumor cells from hematologic malignancies. Quantification of TIGIT density revealed tumor-infiltrating Tregs as the population expressing the highest receptor density. Consequently, the therapeutic potential of anti-TIGIT mAbs might be wider than the previously described anti–PD(L)-1-like restoration of αβ T-cell function. CD155 also mediated inhibition of γδ T cells, an immune population not previously described to be sensitive to TIGIT inhibition, which could be fully prevented via use of an antagonistic anti-TIGIT mAb (EOS-448). In PBMCs from patients with cancer, as well as in tumor-infiltrating lymphocytes from mice, the higher TIGIT expression in Tregs correlated with strong antibody-dependent killing and preferential depletion of this highly immunosuppressive population. Accordingly, the ADCC/ADCP–enabling format of the anti-TIGIT mAb had superior antitumor activity, which was dependent upon Fcγ receptor engagement. In addition, the anti-TIGIT mAb was able to induce direct killing of TIGIT-expressing tumor cells both in human patient material and in animal models, providing strong rationale for therapeutic intervention in hematologic malignancies. These findings reveal multiple therapeutic opportunities for anti-TIGIT mAbs in cancer therapeutics.
Decidual-Like NK Cell Polarization: From Cancer Killing to Cancer Nurturing
Authors: Albini Adriana , Noonan Douglas M.
Published: December 2020

Natural killer (NK) cells accumulate at the fetal–maternal interface and represent 70% of immune cells in the decidua (dNK) at first-trimester pregnancy; they are immune-tolerant toward the semiallogenic fetus and are “nurturing” and nonkilling NK cells. A subset of NK cells in patients with cancer have features in common with dNK, which include expressing CD56, CD9, CD49a, and CXCR3, being poorly cytotoxic and proangiogenic, and mimicking the decidual nurturing role. In the oncologic patient, several factors can “decidualize” NK cells, turning them into immune-suppressant, growth-promoting proangiogenic cells. Here, we suggest ways to sharpen their blunted blades and intercept and curb their cancer-nurturing attitudes to restore their cytotoxic capabilities.