bluuebunny/crossref_metadata_2025 huggingface dataset:
Study on the Mechanism of Capillary Leakage Caused by Hypoxia-Inducible Factor-1α through Inducing High Expression of Matrix Metalloproteinase-9
Authors: Li Huili , Huang He , Cui Yunliang , Li Weiwei , Zhang Shuliu , Chen Yugang
Published: September 2021

Purposes. This study mainly explored the mechanism of capillary leakage caused by hypoxia-inducible factor-1α through inducing high expression of matrix metalloproteinase-9. Method. We established a monolayer endothelial cell model by culturing human umbilical vein endothelial cells (HUVEC) in vitro, used tumor necrosis factor (TNFα) and HIF-1α inhibitor 2-methoxyestradiol (2ME2) to act on HUVEC, and at the same time constructed siRNA-transfected HUVEC to interfere with the expression of HIF-1α. The permeability of monolayer endothelial cells was measured by transwell chamber method, the concentration of MMP-9 in the supernatant was measured by ELISA method, the expression of key molecules related to permeability (HIF- 1α, MMP-9, claudin-5, and ZO-1) was measured by RT-PCR and Western blot method, and the localization and expression of claudin-5 and ZO-1 were measured by immunofluorescence method. We searched for 7 HIF-1α hypoxia response elements within 4000 bp before the transcription start site in the MMP-9 promoter region, constructed the MMP-9 promoter-luciferase reporter gene recombinant plasmid, transfected and stimulated HUVEC with TNFα, and detected the effect of 7 hypoxia response element plasmids on the transcription activity of MMP-9 promoter. Results. Under the action of TNFα, the permeability of monolayer endothelial cells increased, and the concentration of MMP-9 in the cell supernatant increased. 2ME2 and HIF-1α-siRNA transfection can improve the above situation (

P
<
0.05

). 2ME2 and HIF-1α-siRNA transfection can inhibit the high expression of HIF-1α and MMP-9 caused by TNFα, thereby increasing the expression of claudin-5 and ZO-1 (

P
<
0.05

). 2ME2 and HIF-1α-siRNA transfection can reduce the inhibition of TNFα on the expression of cell membrane protein claudin-5 and tight junction protein ZO-1. Element 1, element 5, and element 7 are the sites where HIF-1α interacts with MMP-9 at the transcription level. Conclusion. This study shows that HIF-1α can increase the permeability of monolayer epithelial cells by inducing the high expression of MMP-9, leading to capillary leakage. Its target is at the −3798 bp, −1878 bp, and −1489 bp points of the transcription initiation site in the MMP-9 promoter region.
Profiling of Indigenous Biosurfactant-Producing Bacillus Isolates in the Bioremediation of Soil Contaminated by Petroleum Products and Olive Oil
Authors: Elenga-Wilson Paola Sandra , Kayath Christian Aimé , Mokemiabeka Nicaise Saturnin , Nzaou Stech Anomene Eckzechel , Nguimbi Etienne , Ahombo Gabriel
Published: September 2021

Petroleum is, up to this date, an inimitable nonrenewable energy resource. Petroleum leakage, which arises during transport, storage, and refining, is the most important contaminant in the environment, as it produces harm to the surrounding ecosystem. Bioremediation is an efficient method used to treat petroleum hydrocarbon-contaminated soil using indigenous microorganisms. The degradation characteristics for a variety of hydrocarbons (hexane, benzene, gasoline, and diesel) were qualitatively and quantitatively investigated using Bacillus isolates. Microbiological and biochemical methods have been used including isolation of oil-degrading bacteria, enzymatic activities, the determination of physicochemical parameters, biosurfactant production and extraction assay, oil displacement assay, antimicrobial assay of the biosurfactants, and bioremediation kinetics. Consequently, of the 60 isolates capable of degrading different hydrocarbons at fast rates, 34 were suspected to be Bacillus isolates capable of growing in 24 h or 48 h on BH medium supplemented with 2% of hexane, benzene, gasoline, diesel, and olive oil, respectively. Among the 34 isolates, 61% (21/34) are capable of producing biosurfactant-like molecules by using gasoline, 70% (24/34) with diesel oil, 85% (29/34) with hexane, and 82% (28/34) with benzene. It was found that biosurfactant-producing isolates are extractable with HCl (100%), ammonium sulphate (95%), chloroform (95%), and ethanol (100%). Biosurfactants showed stability at 20°C, 37°C, 40°C, and 60°C. Biosurfactant secreted by Bacillus strains has shown an antagonistic effect in Escherichia coli, Shigella flexneri 5a M90T, and Bacillus cereus. The selected isolates could therefore be safely used for biodegradation. Substrate biodegradation patterns by individual isolates were found to significantly differ. The study shows that benzene was degraded faster, followed by hexane, gasoline, and finally diesel. The Bacillus consortium used can decrease hydrocarbon content from 195 to 112 (g/kg) in 15 days.
Postresection Period-Specific Hazard of Recurrence as a Framework for Surveillance Strategy in Patients with Hepatocellular Carcinoma: A Multicenter Outcome Study
Authors: Kim Ha Il , An Jihyun , Kim Ji Yoon , Shin Hyun Phil , Park Seo Young , Song Gi-Won , Lee Han Chu , Shim Ju Hyun
Published: September 2021

Introduction: In spite of the high frequency of recurrence of hepatocellular carcinoma (HCC) after resection, little evidence exists to directly help to plan a reasonable schedule for the frequency and intensity of postoperative surveillance for recurrence. Methods: 1,918 consecutive patients with Child-Turcott-Pugh class A who had T1- or T2-staged HCCs detected by active surveillance and underwent curative resection for their tumors at 3 teaching hospitals in Korea, followed by recurrence screening at 6-monthly or shorter intervals. To set an evidence-based timetable for postoperative surveillance, we investigated the annual hazard rate of recurrence through postoperative year 10 in patients undergoing hepatectomy for HCC, and the clinical and morphological phenotypes associated with early versus late recurrence. Results: The estimated hazard rate for recurrence peaked during year 0–1 (21.7%), with a subsequent gradual decrease through 5 years, followed by stabilization at <7.0% until year 10, except in the case of cirrhotics, who had a rate of 10.5% during year 4–5. Multivariate time-to-recurrence analysis by recurrence period revealed that serum alpha-fetoprotein ≥200 ng/mL, larger size of tumor, tumor multiplicity, microvascular invasion, capsular invasion, and higher METAVIR fibrosis stage were significantly related to disease recurrence within 5 years after resection, while cirrhosis (METAVIR F4) alone was related to disease recurrence beyond 5 years (Ps < 0.05). Post-relapse overall survival was better in the latter group (p = 0.033). Conclusions: Our chronological and morphological insights into recurrence after resection of primary HCCs may help implement an optimal intensity of surveillance for recurrence.
Désiré Bourneville: A Socialist in Charcot’s Inner Circle
Authors: Coutinho Leo , Walusinski Olivier , Teive Helio A. Ghizoni
Published: September 2021

Désiré Bourneville was one of Jean-Martin Charcot’s most important disciples. His previous works as an alienist allowed him to influence his master’s interest in hysteria, which led to the creation of a service regarded as a neurological mecca. During his time under Charcot, Bourneville, a passionate left-wing radical, had to coexist with characters representative of the conservative, bourgeois Parisian society. The aim of this study is to describe Bourneville’s life and work, as well as the ambiguity of a progressive man such as him, immersed within the economic and cultural elites.
Surfactant Treatment of Late Preterm Infants during Emergency Transport: A Retrospective, Observational Study
Authors: Cavallin Francesco , Carlone Giorgia , Doglioni Nicoletta , Villani Paolo Ernesto , Vecchiato Luca , Lago Paola , Trevisanuto Daniele
Published: September 2021

Background: In late preterm infants born in nontertiary hospitals, the occurrence of respiratory distress syndrome requires postnatal transport. This study aimed to investigate the impact of the timing of surfactant administration in late preterm infants needing postnatal transport. Methods: This is a retrospective study evaluating surfactant administration in late preterm infants during emergency transports by the Eastern Veneto Neonatal Emergency Transport Service between January 2005 and December 2019. The outcome measures included short-term clinical complications, stabilization time, oxygen concentration, duration of mechanical ventilation and noninvasive respiratory support, length of hospital stay, bronchopulmonary dysplasia, intraventricular hemorrhage, and sepsis. Results: Surfactant was administered to 155/303 neonates (51.1%) at 3 different time points: at a referring hospital (50 neonates), when the transport team arrived (25 neonates), or at a referral hospital (80 neonates). Stabilization time was longer in neonates receiving surfactant by the transport team (adjusted mean difference 17 min, 95% confidence interval, 4–29 min; p = 0.01). Decrease in oxygen concentrations during the transport was larger in neonates receiving surfactant at a referring hospital (adjusted mean difference −11%, 95% confidence interval, −15 to −3%; p = 0.01). The other outcome measures were not statistically different according to the timing of surfactant administration. Conclusions: In late preterm infants with respiratory distress needing postnatal transfer, stabilization time was longer when the first surfactant was administered by the transport team, but such delay did not affect safety and clinical outcomes.
MicroRNA-22 Level in Patients with Multiple Sclerosis and Its Relationship with Vitamin D and Vitamin D Receptor Levels
Authors: Khedr Ahmed M.B. , Shaker Olfat Gamil , Hassan Amr , Hussein Mona , Kamal Yasmine S. , Azouz Taha Abdelraziq
Published: September 2021

Introduction: Multiple sclerosis (MS) is known to be a multifactorial disorder. Numerous observational studies have suggested the implication of multiple genetic and environmental factors in the pathogenesis of MS. The aim of this work was to evaluate expression of the microRNA-22 (miRNA-22) level, in relation to vitamin D (VD) and VD receptor (VDR) levels in patients with MS during remission state. Methods: This case-control study was conducted in 50 patients with clinically definite MS and 50 age- and sex-matched healthy controls. miRNA-22 expression was assessed in both MS patients and controls using quantitative RT-PCR. The serum level of VD and VDR was assessed in both MS patients and controls using ELISA techniques. Results: The miRNA-22 level was significantly downregulated in MS patients in comparison to controls (p value <0.001). MS patients had also significantly lower VD and VDR levels in comparison to controls (p value <0.001 and <0.001, respectively). Patients with secondary progressive MS (SPMS) have a significantly higher miRNA-22 level than patients with relapsing remitting MS (RRMS) (p value = 0.042). There was a statistically significant positive correlation between the miRNA-22 level and EDSS (p value = 0.033). There was also a statistically significant positive correlation between the miRNA-22 level and VDR level (p value = 0.002). Conclusion: The miRNA-22 level was significantly downregulated in MS patients, but it had a positive correlation with disability status. Patients with SPMS have a significantly higher miRNA-22 level than patients with RRMS. VD and VDR levels were significantly lower in MS patients than controls. The miRNA-22 level was positively correlated with the VDR level.
New Method of Content Based Image Retrieval based on 2-D ESPRIT Method and the Gabor Filters
Authors: Youness Chawki , Khalid El Asnaoui , Mohammed Ouanan , Brahim Aksasse
Published: September 2021

We propose, in this paper, a new method for Content Based Image Retrieval (CBIR) by exploiting the digital image content. Our method is based on the representation of the digital image content by a characteristics vector of the indexed image. Indeed, we have exploited the image texture to extract its characteristics and for constructing a new descriptor vector by combining the Bidimensional High Resolution Spectral Analysis 2-D ESPRIT (Estimation of Signal Parameters via Rotationnal Invariance Techniques) method and Gabor filter. To evaluate the performance, we have tested our approach on Brodatz image database. The results show that the representation of the digital image content appears significant in research of imaging information.
A Developed Graphical User Interface for Power System Stability and Robustness Studies
Authors: Djamel Eddine Ghouraf , Abdellatif Naceri , Mohamed Abid , Wahiba Kabi
Published: September 2021

This paper present the realization and development of a graphical user interface (GUI) to studied the stability and robustness of power systems (analysis and synthesis), using Conventional Power System Stabilizers (CPSS - realized on PID scheme) or advanced controllers (based on adaptive and robust control), and applied on automatic excitation control of powerful synchronous generators, to improve dynamic performances and robustness. The GUI is a useful average to facilitate stability study of power system with the analysis and synthesis of regulators, and resolution of the compromise: results precision / calculation speed. The obtained Simulation results exploiting our developed GUI realized under MATLAB shown considerable improvements in static and dynamic performances, a great stability and enhancing the robustness of power system, with best precision and minimum operating time. This study was performed for different types of powerful synchronous generators.
Analysis of Secure Medical Image Communication with Digital Signature and Reversible Watermarking
Authors: Umamageswari A. , Suresh G.R.
Published: September 2021

Protection of Medical image contents becomes the important issue in computer network security. Digital Watermarking has becomes a promising technique for medical content authentication, it allows to embed relevant information with the image, which provides confidentiality, integrity and authentication by embedding Digital Signature (DS) with the Medical image. In this paper we focus on need for reversible watermarking, Medical Image Compression and security related problems in medical images, it comparing the performances of various lossless watermarking techniques for various medical image modalities like MRI (Magnetic Resonance Imaging), US (Ultrasonic), CT (Computed Tomography), Endoscopic and Angiographic images. Region of Interest (ROI) supporting lossless watermarking systems only considered for discussions. Performance of all lossless watermarking with Digital Signature is analyzed by means of four parameters Capacity Rate, PSNR (Peak Signal to Noise ratio), NPCR (Number of Pixel Change Rate) and Compression Ratio (CR). This Paper also introduces new mechanism for open network security for medical images. This lossless watermarking is responsible for recovering the altered medical image content of the system.
Performance Analysis of ZigBee Mesh WSN in Carbon Monoxide Gas Monitoring System
Authors: Fuad Muhammad , Iqbal Muhammad , Rahmat Mamat , Sukoco Heru , Alatas Husin
Published: September 2021

The need for air pollutant monitoring system is very substantial especially in the developing countries such as Indonesia. In this research, we have performed a test of such system for carbon monoxide gas based on wireless sensor network (WSN) using ZigBee. This system is working with a mesh topology where each sensor node can communicate with one another. There are seven nodes that serve as sensor nodes and one node serving as Coordinator. Each sensor node has five components that represent of gas sensors. We measure three performance metrics during the test, i.e. throughput, delay, and packet loss. The system has been successfully implemented which is capable of displaying information in real time. The experiment resulted in an average carbon monoxide value of 25.1 ppm and showed a good performance. It showed a throughput more than 1.017 kbps, delay and packet loss ratio less than 409 ms and 5 %, respectively.
Design of Dual Band Sleeve Dipole Antenna for Mobile Jammer Applications
Authors: Rahim Tariq , Xu Jiaodong
Published: September 2021

A multi band sleeve dipole antenna for jammer application is proposed. The antenna can cover band in which mobile and other wireless devices operate. The design antenna shows very good omni-directional characteristics and scattering parameter S11 value less than -10db. The dipole is made of two concentric hallow cylinder with different radius and different lengths. The antenna is fed at the center with coaxial cable pass through the bottom cylinder and thus avoids the use of complicated balun network. The impedance bandwidth and the radiation pattern are measured and analyzed both at 900 MHz and 1.8 GHz. The antenna can also be used GSM/DCS/WCDMA/CDMA2000/ TD-SCDMA /WLAN applications at both indoor and outdoor platform.
Digital Image Based Identification of Rice Variety Using Image Processing and Neural Network
Authors: Sumaryanti Lilik , Musdholifah Aina , Hartati Sri
Published: September 2021

The increased of consumer concern on the originality of rice  variety and the quality of rice leads to originality certification of rice by existing institutions. Technology helps human to perform evaluations of food grains using images of objects. This study developed a system used as a tool to identify rice varieties. Identification process was performed by analyzing rice images using image processing. The analyzed features for identification consisted of six color features, four morphological features, and two texture features. Classifier used LVQ neural network algorithm. Identification results using a combination of all features gave average accuracy of 70,3% with the highest classification accuracy level of 96,6% for Mentik Wangi and the lowest classification accuracy of 30%  for Cilosari.
Transient Analysis of the Self Excited Induction Generator Subjected to Grid Disturbances
Authors: Imadouchene Malika
Published: September 2021

The present paper analyzes the consequences of short grid voltages interruptions on grid-connected self-induction generator, particularly, on the currents and electromagnetic torque of the generator. These effects depend on several variables such as the phase difference between the grid voltages and those of the generator, the magnitude of the grid voltage and the generator currents at the instant of reconnection to the grid. The approach has been used for studying the effects of these grid disturbances on the self-excited induction generator; is a numerical approach. In the numerical approach, which is based on the dynamic d-q model of the induction generator, the effect of magnetic saturation is accurately accounted for. This numerical model has been validated by experimental measurements taken from an induction generator test bench. The analysis focuses on the amplitudes of the peaks of the currents and torque during short interruptions especially at the reconnection of the grid voltage. The results obtained from the numerical model are compared to the measured ones.
A Bandwidth Degradation Technique to Reduce Call Dropping Probability in Mobile Network Systems
Authors: Monica CH. , Bhavani K.V.L.
Published: September 2021

A generic video telephony may require more than 40 kbps whereas a low motion video telephony may require about 25 kbps for data transmission. From the designing point of view these requirements demands for an alternative resource planning, especially for bandwidth allocation in wireless networks. In wireless network where bandwidth is a scare resource, the system may need to block incoming user if all of the bandwidth has been used to provide highest quality of service to existing users. However this bandwidth resource planning may be unacceptable for larger application. This work aims towards a realization of a mobile network using W-CDMA multi access technique supporting multilevel quality of services. The bandwidth allocation to multiple users is adjusted dynamically according to the required network condition so as to increase bandwidth utilization. The work analyzes the performance deriving the degradation period ratio, mean degradation time and degradation state for the implemented wireless network. The proposed work is aim to implement on Matlab tool for its functional verification considering various mobility patterns.
Layer Recurrent Neural Network based Power System Load Forecasting
Authors: Mittal Nikita , Saxena Akash
Published: September 2021

This paper presents a straight forward application of Layer Recurrent Neural Network (LRNN) to predict the load of a large distribution network. Short term load forecasting provides important information about the system’s load pattern, which is a premier requirement in planning periodical operations and facility expansion. Approximation of data patterns for forecasting is not an easy task to perform. In past, various approaches have been applied for forecasting. In this work application of LRNN is explored. The results of proposed architecture are compared with other conventional topologies of neural networks on the basis of Root Mean Square of Error (RMSE), Mean Absolute Percentage Error (MAPE) and Mean Absolute Error (MAE). It is observed that the results obtained from LRNN are comparatively more significant.
A Cascade Multilevel Z-Source Inverter for Photovoltaic System
Authors: P Thirumalini , Arulmozhiyal R. , Murali M
Published: September 2021

This paper describes a multilevel Z-source inverter for solar photovoltaic applications. The conventional power conversion topology performs either buck or boost the input voltage for non linear load depending upon duty ratio and modulation index in a multiple stage conversion with the help of impedance source passive network (L and C), which is usually known as Z-Source, which couples the n level source with input to the power source and increase the power efficiency. The multilevel z network capabilities of inverter are operated in the shoot through state of duty cycle and it acts as a filter to reduces the level of harmonics, stabilize power factor and to increase the output AC voltage range of inverter. To overcome further harmonics, multilevel level operation z source inverter compensates the fundamental level of harmonic in renewable. Proposed work as a whole involves the simulation part to design multilevel inverter. The output of the simulation is obtained by Simulink model using MATLAB.
A Hybrid the Nonsubsampled Contourlet Transform and Homomorphic Filtering for Enhancing Mammograms
Authors: Taifi Khaddouj , Ahdid Rachid , Fakir Mohamed , Safi Said
Published: September 2021

Mammogram is important for early breast cancer detection. But due to the low contrast of microcalcifications and noise, it is difficult to detect microcalcification. This paper presents a comparative study in digital mammography image enhancement based on three different algorithms: homomorphic filtering, unsharp masking and our proposed methods. This latter use a hybrid method Combining contourlet and homomorphic filtering. Performance of the given technique has been measured in terms of distribution separation measure (DSM), target-to-background enhancement measure based on standard deviation (TBES) and target-to-background enhancement measure based on entropy (TBEE). The proposed methods were tested with the referents mammography data Base MiniMIAS. Experimental results show that the proposed method improves the visibility of microcalcification.
Tissue-like P system based DNA-GA for clustering
Authors: Hou Caiping , Liu Xiyu
Published: September 2021

In recent years, DNA GA algorithm is drawing attention from scholars. The algorithm combines the DNA encoding and Genetic Algorithm, which solve the premature convergence of genetic algorithms, the weak local search capability and binary Hamming cliff problems effectively.How to design a more effective way to improve the performance of DNA-GA algorithm is more worth studying. As is known to all,the tissue-like P system can search for the optimal clustering partition with the help of its parallel computing advantage effectivel. This paper is under this premise and presents DNA-GA algorithm based on tissue-like P systems (TPDNA-GA) with a loop structure of cells, which aims to combine the parallelism and the evolutionary rules of tissue-like P systems to improve performance of the DNA-GA algorithm. The objective of this paper is to use the TPDNA-GA algorithm to support clustering in order to find the best clustering center.This algorithm is of particular interest to when dealing with large and heterogeneous data sets and when being faced with an unknown number of clusters. Experimental results show that the proposed TPDNA-GA algorithm for clustering is superior or competitive to classical k-means algorithm and several evolutionary clustering algorithms.
O que a pesquisa latino-americana de comunicação deve ao Brasil: relato pessoal de uma experiência intercultural
Authors: Martín-Barbero Jesús
Published: September 2021

Neste texto, Jesús Martín-Barbero descreve pontos que aproximaram o Brasil de seu pensamento e contribuições brasileiras à pesquisa de comunicação latino-americana. Algumas das dimensões discutidas são: o aporte reflexivo para a compreensão do cenário político-cultural da comunicação, que permitiu pensar como a indústria cultural promoveu uma nova ideia de nação; um entendimento mais complexo, superando a razão dualista, das relações entre o popular e o massivo, que se expressou no país em duas linhas de investigação, a da contra-hegemonia comunicativa e a da competência do sujeito receptor, e também a contribuição das reflexões de autores brasileiros para a discussão dos processos de globalização contemporâneos.
Testemunhos ibéricos e norte-americanos
Authors: Cunha Isabel Ferin , Ledo Andión Margarita , Pinto Manuel , Straubhaar Joseph
Published: September 2021

Reunião de depoimentos em homenagem ao pesquisador Jesús Martín-Barbero, realizados por Isabel Ferin Cunha, Margarita Ledo Andión, Manuel Pinto e Joseph Straubhaar.
Extrativismo e Pandemia na América Latina e Caribe: uma leitura pelas lentes cinematográficas
Authors: Santos Larissa , Allain Gina Alessandra Chabes
Published: September 2021

A luta contra processos extrativistas na América Latina e Caribe tem suas raízes em processos coloniais, que dizimaram diversos povos através da exploração de seus territórios, ocasionando o extermínio de culturas milenares. A atual crise sanitária, econômica e política nos revela que apesar dos impactos de uma pandemia afetar a todos, certos territórios estão mais vulneráveis que outros. Da mesma forma, os impactos do extrativismo não se limitam aos sítios extrativos e áreas subjacentes. Esse artigo busca, a partir da análise de exemplos concretos de extrativismos e resistências, presentes na filmografia documental e de ficção analisada, traçar paralelos entre o extrativismo e a pandemia do covid-19, entendendo ambos processos como interconectados, urgentemente atuais e com inevitáveis repercussões futuras. Observamos que a atuação das indústrias extrativas tem um caráter transnacional e conta com forte apoio dos Estados, o que desafia a divisão clássica entre países industrializados e extrativistas. Vemos ainda uma conexão intrínseca entre campo e cidade necessária para viabilizar projetos extrativos, através do processo de urbanização que este acarreta e de agentes que circulam entre espaços de produção e circulação dos recursos extraídos. Finalmente, a partir da análise das táticas de luta contra o extrativismo, refletimos sobre as diferentes formas de resistência a empreendimentos extrativos de grande escala e a redefinição desta luta frente à pandemia.
Comparison of Resuscitation Outcomes Between 2‐ or 3‐Stacked Defibrillation Strategies With Minimally Interrupted Chest Compression and the Single Defibrillation Strategy: A Swine Cardiac Arrest Model
Authors: Kim Soyeong , Jung Woo Jin , Roh Young Il , Kim Tae Youn , Hwang Sung Oh , Cha Kyoung‐Chul
Published: September 2021

Background

There is controversy over whether the number and mode of electrical shock are optimal for successful defibrillation.

Methods and Results

Fifty‐four pigs were randomly assigned to 3 groups. After inducing ventricular fibrillation and a 2‐minute downtime, basic life support was initiated with a 30:2 compression/ventilation ratio for 8 minutes. Subsequently, 20 minutes of advanced life support, including asynchronous ventilation, every 10 chest compressions with 15 L/min of oxygen, was delivered. Animals of the single shock group received a single shock, animals of the 2‐stacked shock group received 2 consecutive shocks, and animals of the 3‐stacked shock group received 3 consecutive shocks. Animals with the return of spontaneous circulation underwent post–cardiac arrest care for 12 hours. The rates of successful defibrillation, return of spontaneous circulation, 24‐hour survival, and 48‐hour survival and neurological deficit score were compared between the groups. Hemodynamic parameters, arterial blood gas profiles, troponin I, and cardiac output were not different between the groups. There was a significant difference in chest compression fraction between the single and 3‐stacked shock groups (
P
<0.001), although there was no difference between the single and 2‐stacked shock groups (
P
=0.022) or the 2‐stacked and 3‐stacked shock groups (
P
=0.040). The rates of successful defibrillation, return of spontaneous circulation, 24‐hour survival, and 48‐hour survival were higher in the 2‐ and 3‐stacked shock groups than in the single shock group (
P
=0.021,
P
=0.015, and
P
=0.021, respectively). Neurological deficit score at 48 hours was not different between the groups.

Conclusions

A stacked shock strategy was superior to a single shock strategy for successful defibrillation and better resuscitation outcomes in treating ventricular fibrillation.
Methodological Rigor and Temporal Trends of Cardiovascular Medicine Meta‐Analyses in Highest‐Impact Journals
Authors: Mahtta Dhruv , Altibi Ahmed , Gad Mohamed M. , Samara Amjad , Barakat Amr F. , Bagur Rodrigo , Mansoor Hend , Jneid Hani , Virani Salim S. , Mamas Mamas A. , Masri Ahmad , Elgendy Islam Y.
Published: September 2021

Background

Well‐conducted meta‐analyses are considered to be at the top of the evidence‐based hierarchy pyramid, with an expansion of these publications within the cardiovascular research arena. There are limited data evaluating the trends and quality of such publications. The objective of this study was to evaluate the methodological rigor and temporal trends of cardiovascular medicine‐related meta‐analyses published in the highest impact journals.

Methods and Results

Using the Medline database, we retrieved cardiovascular medicine‐related systematic reviews and meta‐analyses published in
The New England Journal of Medicine, The Lancet, Journal of the American Medical Association, The British Medical Journal, Annals of Internal Medicine, Circulation, European Heart Journal, and Journal of American College of Cardiology
between January 1, 2012 and December 31, 2018. Among 6406 original investigations published during the study period, meta‐analyses represented 422 (6.6%) articles, with an annual decline in the proportion of published meta‐analyses (8.7% in 2012 versus 4.6% in 2018,
P
trend
=0.002). A substantial number of studies failed to incorporate elements of Preferred Reporting Items for Systematic Reviews and Meta‐Analyses or Meta‐Analysis of Observational Studies in Epidemiology guidelines (51.9%) and only a minority of studies (10.4%) were registered in PROSPERO (International Prospective Register of Systematic Reviews). Fewer manuscripts failed to incorporate the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses or Meta‐Analysis of Observational Studies in Epidemiology elements over time (60.2% in 2012 versus 40.0% in 2018,
P
trend
<0.001) whereas the number of meta‐analyses registered at PROSPERO has increased (2.4% in 2013 versus 17.5% in 2018,
P
trend
<0.001).

Conclusions

The proportion of cardiovascular medicine‐related meta‐analyses published in the highest impact journals has declined over time. Although there is an increasing trend in compliance with quality‐based guidelines, the overall compliance remains low.
Newly Diagnosed Atrial Fibrillation in Acute Myocardial Infarction
Authors: Obayashi Yuki , Shiomi Hiroki , Morimoto Takeshi , Tamaki Yodo , Inoko Moriaki , Yamamoto Ko , Takeji Yasuaki , Tada Tomohisa , Nagao Kazuya , Yamaji Kyohei , Kaneda Kazuhisa , Suwa Satoru , Tamura Toshihiro , Sakamoto Hiroki , Inada Tsukasa , Matsuda Mitsuo , Sato Yukihito , Furukawa Yutaka , Ando Kenji , Kadota Kazushige , Nakagawa Yoshihisa , Kimura Takeshi ,   CREDO‐Kyoto AMI Registry Wave‐2 Investigators
Published: September 2021

Background

It remains controversial whether long‐term clinical impact of newly diagnosed atrial fibrillation (AF) in the acute phase of acute myocardial infarction (AMI) is different from that of prior AF diagnosed before the onset of AMI.

Methods and Results

The current study population from the CREDO‐Kyoto AMI (Coronary Revascularization Demonstrating Outcome Study in Kyoto Acute Myocardial Infarction) Registry Wave‐2 consisted of 6228 patients with AMI who underwent percutaneous coronary intervention. The baseline characteristics and long‐term clinical outcomes were compared according to AF status (newly diagnosed AF: N=489 [7.9%], prior AF: N=589 [9.5%], and no AF: N=5150 [82.7%]). Median follow‐up duration was 5.5 years. Patients with newly diagnosed AF and prior AF had similar baseline characteristics with higher risk profile than those with no AF including older age and more comorbidities. The cumulative 5‐year incidence of all‐cause death was higher in newly diagnosed AF and prior AF than no AF (38.8%, 40.7%, and 18.7%,
P
<0.001). The adjusted hazard ratios (HRs) for mortality of newly diagnosed AF and prior AF relative to no AF remained significant with similar magnitude (HR, 1.31; 95% CI, 1.12–1.54;
P
<0.001, and HR, 1.32; 95% CI, 1.14–1.52;
P
<0.001, respectively). The cumulative 5‐year incidence of stroke decreased in the order of newly diagnosed AF, prior AF and no AF (15.5%, 12.9%, and 6.3%, respectively,
P
<0.001). The higher adjusted HRs of both newly diagnosed AF and prior AF relative to no AF were significant for stroke, with a greater risk of newly diagnosed AF than that of prior AF (HR, 2.05; 95% CI, 1.56–2.69;
P
<0.001, and HR, 1.33; 95% CI, 1.00–1.78;
P
=0.048, respectively). The higher stroke risk of newly diagnosed AF compared with prior AF was largely driven by the greater risk within 30 days. The higher adjusted HRs of newly diagnosed AF and prior AF relative to no AF were significant for heart failure hospitalization (HR, 1.73; 95% CI, 1.35–2.22;
P
<0.001, and HR, 2.23; 95% CI, 1.82–2.74;
P
<0.001, respectively) and major bleeding (HR, 1.46; 95% CI, 1.23–1.73;
P
<0.001, and HR, 1.36; 95% CI, 1.15–1.60;
P
<0.001, respectively).

Conclusions

Newly diagnosed AF in AMI had risks for mortality, heart failure hospitalization, and major bleeding higher than no AF, and comparable to prior AF. The risk of newly diagnosed AF for stroke might be higher than that of prior AF.
Treatment Effect of Percutaneous Coronary Intervention in Men Versus Women With ST‐Segment–Elevation Myocardial Infarction
Authors: Sulaiman Samian , Kawsara Akram , Mohamed Mohamed O. , Van Spall Harriette G. C. , Sutton Nadia , Holmes David R. , Mamas Mamas A. , Alkhouli Mohamad
Published: September 2021

Background

Women are less likely to receive primary percutaneous coronary intervention (pPCI) than men. A potential reason is risk aversion because of the worse outcomes with pPCI among women. However, whether pPCI is associated with a comparable mortality benefit in men and women remains unknown.

Methods and Results

We selected patients admitted with a principal diagnosis of ST‐segment–elevation myocardial infarction in the National Inpatient Sample (2016–2018). We used propensity‐score matching to calculate average treatment effects of pPCI for in‐hospital mortality, major complications, length of stay, and cost. As a sensitivity analysis, we used logit models followed by a marginal command to calculate the average marginal effect. We included 413 500 weighted hospitalizations (30.7% women, 69.3% men). Women had more comorbidities except smoking and prior sternotomy. Compared with men, women were less likely to undergo angiography (81.0% versus 87.0%; adjusted odds ratio [OR], 0.77; 95% CI, 0.74–0.81;
P
<0.001) or pPCI (74.0% versus 82.0%; adjusted OR, 0.76; 95% CI, 0.73–0.79;
P
<0.001). There were no significant differences in average treatment effects of pPCI on mortality between men (−8.4% [−9.3% to −7.6%],
P
<0.001), and women (−9.5% [−10.8% to −8.3%],
P
<0.001) (
P
interaction=0.16). This persisted in age‐stratified analyses (≥85, 65–84, 45–64, <45 years) and sensitivity analysis, excluding emergent admissions. The average treatment effects of pPCI on major complications were comparable except for acute stroke, leaving against medical advice, and palliative encounter. There were no differences in the average treatment effects of pPCI on length of stay, but the proportional increase in cost with pPCI was higher in women.

Conclusions

pPCI results in a comparable reduction in in‐hospital mortality in men and women. Nonetheless, risk‐adjusted rates of pPCI remain lower in women in contemporary US practice.
New‐Onset Postoperative Atrial Fibrillation After Total Arch Repair Is Associated With Increased In‐Hospital Mortality
Authors: Zhao Rui , Wang Zhao , Cao Fangfang , Song Jian , Fan Shuya , Qiu Juntao , Fan Xiaohan , Yu Cuntao
Published: September 2021

Background

It is well established that postoperative atrial fibrillation (POAF) is associated with adverse postoperative outcomes after major cardiac operations. The purpose of this study was to investigate the incidence of new‐onset POAF after successful total arch repair surgery and the association between POAF and in‐hospital mortality.

Methods and Results

All consecutive patients undergoing total arch repair from September 2012 to December 2019 in Fuwai hospital were enrolled (n=1280). Patients diagnosed with preoperative atrial fibrillation were excluded. POAF was diagnosed as the new‐onset atrial fibrillation or flutter for more than 5 minutes based on continuous electrocardiogram monitoring. A logistic regression model was used to determine predictors of in‐hospital mortality. Multivariable adjustment, inverse probability of treatment weighting, and propensity score matching were used to adjust for confounders. POAF was diagnosed in 32.3% (411/1271) of this cohort population. The occurrence of new‐onset POAF was associated with age (odds ratio [OR], 1.05; 95% CI, 1.04–1.06;
P
<0.001), male sex (OR, 0.72; 95% CI, 0.52–0.98;
P
=0.035), and surgery duration (OR, 1.2; 95% CI, 1.12–1.28;
P
<0.001). The in‐hospital mortality was significantly higher in patients with POAF than those without POAF (10.7% versus 2.4%,
P
<0.001). Inverse probability of treatment weighting and propensity score matching analyses confirmed the results. The increased in‐hospital mortality in POAF group still existed among subgroup analysis based on different age, sex, hypertension, smoking, and hypokalemia, combined with cardiac surgery, and deep hypothermic circulatory arrest.

Conclusions

More careful attention should be given to POAF after total arch repair surgery. The incidence of POAF after total arch repair surgery was 32.3% and associated with increased in‐hospital mortality. The elderly female patient who experienced longer operation duration was at highest risk for POAF.
Sex Differences in Trends and In‐Hospital Outcomes Among Patients With Critical Limb Ischemia: A Nationwide Analysis
Authors: Elbadawi Ayman , Barssoum Kirolos , Megaly Michael , Rai Devesh , Elsherbeeny Ahmed , Mansoor Hend , Shishehbor Mehdi H. , Abdel‐Latif Ahmed , Gulati Martha , Elgendy Islam Y.
Published: September 2021

Background

Critical limb ischemia (CLI) represents the most severe form of peripheral artery disease and is associated with significant mortality and morbidity. Contemporary data comparing the sex differences in trends, revascularization strategies, and in‐hospital outcomes among patients with CLI are scarce.

Methods and Results

Using the National Inpatient Sample database years 2002 to 2015, we identified hospitalizations for CLI. Temporal trends for hospitalizations for CLI were evaluated. The differences in demographics, revascularization, and in‐hospital outcomes between both sexes were compared. Among 2 400 778 CLI hospitalizations, 43.6% were women. Women were older and had a higher prevalence of obesity, hypertension, heart failure, and prior stroke. Women were also less likely to receive any revascularization (34.7% versus 35.4%,
P
<0.001), but the trends of revascularization have been increasing among both sexes. Revascularization was associated with lower in‐hospital mortality among women (adjusted odds ratio [OR], 0.76; 95% CI, 0.71–0.81) and men (adjusted OR, 0.69; 95% CI, 0.65–0.73). On multivariable analysis adjusting for patient‐ and hospital‐related characteristics as well as revascularization, women had a higher incidence of in‐hospital mortality, postoperative hemorrhage, need for blood transfusion, postoperative infection, ischemic stroke, and discharge to facilities compared with men.

Conclusions

In this nationwide contemporary analysis of CLI hospitalizations, women were older and less likely to undergo revascularization. Women had a higher incidence of in‐hospital mortality and bleeding complications compared with men. Sex‐specific studies and interventions are needed to minimize these gaps among this high‐risk population.
The influence of ENSO on Arctic sea ice in large ensembles and observations
Authors: Clancy Robin , Bitz Cecilia , Blanchard-Wrigglesworth Ed
Published: September 2021

The El Niño-Southern Oscillation (ENSO) and its teleconnections form the leading mode of interannual variability in the global climate system, yet the small sample size of ENSO events during which we have reliable Arctic observations makes constraining its influence on Arctic sea ice challenging. We compare the influence of ENSO on Arctic sea ice in six models from the Multi-Model Large Ensemble Archive to that in observations. Each model simulates reduced Arctic sea ice area and volume in the seasons following an El Niño compared to a La Niña. The spatial patterns of sea ice concentration and thickness responses to ENSO are spatially heterogeneous, with regions of increased and decreased sea ice. The small sample size of ENSO events in observations is shown to preclude a statistically significant sea ice response from being identified. While models agree with one another on many aspects of the sea ice response to ENSO, some features are model-dependent. For example, the CESM1-LE alone displays a delayed melting response in summer, driven by reduced surface albedo and increased shortwave absorption. A positive Arctic Oscillation and a deepened Aleutian Low are common responses to ENSO across models and observations. These patterns of atmospheric variability are quantitatively shown to be key in linking ENSO to Arctic sea ice in most models, acting primarily through sea ice dynamics to generate anomalous sea ice thickness and concentration patterns.
Engaging with stakeholders to produce actionable science: a framework and guidance
Authors: Bamzai-Dodson Aparna , Cravens Amanda E. , Wade Alisa , McPherson Renee A.
Published: September 2021

Natural and cultural resource managers are increasingly working with the scientific community to create information on how best to adapt to the current and projected impacts of climate change. Engaging with these managers is a strategy that researchers can use to ensure that scientific outputs and findings are actionable (or useful and usable). In this article, the authors adapt Davidson’s wheel of participation to characterize and describe common stakeholder engagement strategies across the spectrum of Inform, Consult, Participate, and Empower. This adapted framework provides researchers with a standardized vocabulary for describing their engagement approach, guidance on how to select an approach, methods for implementing engagement, and potential barriers to overcome. While there is often no one “best” approach to engaging with stakeholders, researchers can use the objectives of their project and the decision context in which their stakeholders operate to guide their selection. Researchers can also revisit this framework over time as their project objectives shift and their stakeholder relationships evolve.
Genetic characterization of Carbapenem-Resistant Escherichia coli from China, 2015–2017
Authors: Li Fengtian , Ye Kun , Li Xin , Ye Liyan , Guo Ling , Wang Lifeng , Yang Jiyong
Published: September 2021

Background

The molecular characteristics of carbapenem-resistant Escherichia coli (CREco) remain unclear.

Methods

We conducted a multi-center bacterial resistance monitoring project from 2015 to 2017.The minimum inhibitory concentrations ofCREco were determined bybroth microdilution method. The genome sequencing of CREcoisolates was performed, and single-nucleotide polymorphism (SNP) was analyzed.

Results

A total of 144CREcoisolatescollected from 10 cities in China were involved in this study. ST167 (n = 43) is the most popular type, followed by ST410(n = 14), ST131(n = 9). There were 102 (70.83%) CREco isolates that produced various NDMs, including NDM-1 (n = 16), NDM-4(n = 1), NDM-5(n = 79), NDM-6(n = 2) and NDM-9(n = 4). In addition, 15 isolates produced KPC-2, three isolates wereIMP-4 positive, and three isolates produced OXA-48. Genetic relatedness and phylogenetic analysis showed that isolates with the same ST had a high degree of homology. Some STs (including ST167, ST410, ST131, ST46, ST405 and ST617) exhibited a trend of outbreak.

Conclusions

The majority of CREco belonged to ST167, followed by ST410 and ST131, and most of them carried various NDM-coding genes. The spread of high-risk clones of CREco has occurred in different regions of China.
How does air pollution affect urban settlement of the floating population in China? New evidence from a push-pull migration analysis
Authors: Zhao Zhihao , Lao Xin , Gu Hengyu , Yu Hanchen , Lei Ping
Published: September 2021

Background

Severe air pollution in China threatens human health, and its negative impact decreases the urban settlement intentions of migrants in destination cities. We establish a comprehensive framework based on the push-pull migration model to investigate this phenomenon.

Methods

We employ a logistic model to analyze air pollution’s impact on the settlement intentions of the floating population based on the CMDS 2017 in China, combining the city-level socioeconomic variables with the individual-level variables.

Results

Our results show that the annual average concentration of PM2.5 increases by 1 unit and that the probability of migrants’ settlement intentions will decrease by 8.7%. Using a heterogeneity analysis, we find that the following migrant groups are more sensitive to air pollution: males, people over 30 years old, less educated people, and migrants with nonagricultural hukou. With every 1 unit increase in PM2.5, each group’s settlement intentions decrease by 13.2, 16.7, 16.9, and 12.6%, respectively.

Conclusions

Our results are consistent with existing studies. This study discovers that both external environment and internal factors influence migrants’ settlement intentions. Specifically, the differences in population sizes, economic development levels, public services, infrastructure conditions, and environmental regulations between cities play a significant role in migration decisions. We also confirm heterogeneous sensitivities to air pollution of different migrant subgroups in terms of individual characteristics, family factors, migration features, social and economic attributes.