bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of acute pain after orthopedic trauma: a practice management guideline from the Eastern Association for the Surgery of Trauma and the Orthopedic Trauma Association
Authors: Murphy Patrick B , Kasotakis George , Haut Elliott R , Miller Anna , Harvey Edward , Hasenboehler Eric , Higgins Thomas , Hoegler Joseph , Mir Hassan , Cantrell Sarah , Obremskey William T , Wally Meghan , Attum Basem , Seymour Rachel , Patel Nimitt , Ricci William , Freeman Jennifer J , Haines Krista L , Yorkgitis Brian K , Padilla-Jones Brandy B
Published: February 2023

Objectives

Fracture is a common injury after a traumatic event. The efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) to treat acute pain related to fractures is not well established.

Methods

Clinically relevant questions were determined regarding NSAID use in the setting of trauma-induced fractures with clearly defined patient populations, interventions, comparisons and appropriately selected outcomes (PICO). These questions centered around efficacy (pain control, reduction in opioid use) and safety (non-union, kidney injury). A systematic review including literature search and meta-analysis was performed, and the quality of evidence was graded per the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The working group reached consensus on the final evidence-based recommendations.

Results

A total of 19 studies were identified for analysis. Not all outcomes identified as critically important were reported in all studies, and the outcome of pain control was too heterogenous to perform a meta-analysis. Nine studies reported on non-union (three randomized control trials), six of which reported no association with NSAIDs. The overall incidence of non-union in patients receiving NSAIDs compared with patients not receiving NSAIDs was 2.99% and 2.19% (p=0.04), respectively. Of studies reporting on pain control and reduction of opioids, the use of NSAIDs reduced pain and the need for opioids after traumatic fracture. One study reported on the outcome of acute kidney injury and found no association with NSAID use.

Conclusions

In patients with traumatic fractures, NSAIDs appear to reduce post-trauma pain, reduce the need for opioids and have a small effect on non-union. We conditionally recommend the use of NSAIDs in patients suffering from traumatic fractures as the benefit appears to outweigh the small potential risks.
Exploration of parental rewards in incentivizing children's physical activity
Authors: Kybartas Tyler J. , Ferrara Paula-Marie M. , Coe Dawn P.
Published: February 2023

The purpose of this study was to explore the prevalence, varieties, and motivations behind parent-selected incentivization for children's physical activity (PA). Parents ( n = 90; 30.0 ± 8.5 years) of children (8.7 ± 2.1 years) completed a web-based survey that included items regarding the use of PA rewards, children's moderate-to-vigorous PA (MVPA, min·week−1), access to electronic devices, and demographic characteristics. Open-ended questions were used to determine the type of activity rewarded, type of reward given, and parents’ reasoning for not using PA rewards. Independent sample t-tests were used to determine differences between reward groups (reward and no reward) and parent-reported children's MVPA. Open-ended responses underwent thematic analysis. Over half (55%) of the respondents provided PA rewards. There was no difference between reward groups for MVPA. Parents reported their children having access to various technology modes, including TV, tablets, video game systems, computers, and cellphones. Most of the parents (78.2%) reported restricting their child's technology time in some capacity. Rewarded PAs were thematized as “children responsibilities”, “non-sport activity”, and “sport”. Two themes regarding types of rewards included “tangible” and “nontangible”. Two underlying themes as to why parents did not give rewards were deemed “built-in-habit” and “enjoyment”. Rewarding children's PA is prevalent among this sample of parents. Substantial variety exists regarding the type of PA incentivized and the type of reward provided. Future studies should explore whether parents use reward structures and how they conceptualize nontangible, electronics-based rewards versus tangible rewards to incentivize children's PA to promote lifelong behavior.
Analytic solutions of scalar field cosmology, mathematical structures for early inflation and late time accelerated expansion
Authors: Ildes Medine , Arik Metin
Published: February 2023

We study the most general cosmological model with real scalar field which is minimally coupled to gravity. Our calculations are based on Friedmann–Lemaitre–Robertson–Walker (FLRW) background metric. Field equations consist of three differential equations. We switch independent variable from time to scale factor by change of variable $${\dot{a}}/a=H(a)$$

a
˙

/
a
=
H

(
a
)

. Thus a new set of differential equations are analytically solvable with known methods. We formulate Hubble function, the scalar field, potential and energy density when one of them is given in the most general form. a(t) can be explicitly found as long as methods of integration techniques are available. We investigate the dynamics of the universe at early times as well as at late times in light of these formulas. We find mathematical machinery which turns on and turns off early accelerated expansion. On the other hand late time accelerated expansion is explained by cosmic domain walls. We have compared our results with recent observations of type Ia supernovae by considering the Hubble tension and absolute magnitude tension. Eighty-nine percent of present universe may consist of domain walls while rest is matter.
Goldstino condensation at large N
Authors: Farakos Fotis , Morittu Matteo
Published: February 2023

We analyze the standard fermionic 4D Volkov–Akulov action with N global non-linear supersymmetries. We find that the stationary points of the system are described by an effective potential, written in terms of two composite real scalar fields, which approaches the exact quantum effective potential in the large N limit. We identify the existence of at least two stationary points, one representing the original supersymmetry breaking configuration and the other one corresponding to goldstino condensation, where supersymmetry is restored in the deep IR.
Optoelectronic and structural properties of ITO/Ag/ITO transparent electrodes using ultraviolet laser annealing
Authors: Rajendran Manikandan , Lin Keh-Moh , Hsiao Wen-Tse
Published: February 2023

Indium tin oxide (ITO) is widely used in the optoelectronic industry as a transparent conductive oxide owing to its excellent optical and electrical properties. To improve the physical properties of ITO, highly conductive ITO/Ag/ITO multilayer electrodes were prepared using radio frequency (RF) magnetron sputtering at room temperature. Then, laser annealing was performed on the multilayer electrodes with scanning intervals of 0.01, 0.02, 0.05 and 0.1 mm. The structural properties of the multilayer electrodes were characterized by X-ray diffraction, and their optical and electrical properties were characterized by ultraviolet (UV) visible spectrophotometry and a four-point probe station, respectively. The results demonstrated that the multilayer films had a polycrystalline structure, and ITO (222) and Ag (111) preferred orientations were identified after laser annealing. In addition, the crystalline size of the Ag layers increased slightly, implying that the defect density within the Ag layers was reduced, resulting in a significant increase in its conductivity. A significantly low electrical resistivity of 5.35 [Formula: see text]/sq and high optical transmittance of 85% were achieved. The Haacke index value was [Formula: see text], which was much better than the value of [Formula: see text] before laser annealing.
Chicken Feet: A Model for Practising Locoregional Flaps of the Hand
Authors: EFANOV Johnny I. , LE Lan Anh T. , YUSOFF Siti K. M. , TEO Wendy Zi Wei , LIM Jin Xi , CHONG Alphonsus Khin Sze
Published: February 2023

Background: The aim of this study was to determine the feasibility of the chicken foot model for surgical trainees interested in practising the designing, harvesting and inset of locoregional flaps of the hand.

Methods: A descriptive study was performed to demonstrate the technical aspects of harvesting four locoregional flaps in a chicken foot model: fingertip volar V–Y advancement flap, four-flap and five-flap Z-plasty, cross-finger flap and first dorsal metacarpal artery (FDMA) flap. The study was performed in a surgical training laboratory on non-live chicken feet. No participants were involved in this study, apart from authors performing the descriptive techniques.

Results: All flaps were successfully performed. Anatomical landmarks, soft tissue texture and flap harvest, as well as inset closely resembled clinical experience with patients. Maximal flap sizes were 12 × 9 mm for volar V–Y advancement, 5 mm limbs for Z-plasties, 22 × 15 mm for cross-finger flaps and 22 × 12 mm for FDMA flaps. The maximal webspace deepening with four-flap/five-flap Z-plasty was 20 mm and the FDMA pedicle length and diameter was 25 and 1 mm, respectively.

Conclusions: Chicken feet can be effectively used as simulation models for hand surgical training with respect to gaining familiarity with the use of locoregional flaps of the hand. Further research requires testing for reliability and validity of the model on junior trainees.
Intracapsular Chondroma Occurring in Metacarpophalangeal Joint of the Hand: A Rare Presentation
Authors: JANG Min Gu , HEO Youn Moo , KIM A. Youn
Published: February 2023

Extraskeletal chondroma comprises synovial chondromatosis, intracapsular chondroma and soft tissue chondroma, its presentation in the hand, however, is very rare. A 42-year-old woman presented with a mass around right fourth metacarpophalangeal (MCP) joint. She had no pain or discomfort in activities. The radiographs showed soft tissue swelling, but no calcification or ossifying lesions. The magnetic resonance imaging (MRI) showed a lobulated juxta-cortical encircling mass existing around the fourth MCP joint. We did not suspect any cartilage-forming tumour in MRI. The mass was easily removed because there was no adhesion with surrounding tissues and the specimen had the appearance of a cartilage. The histological diagnosis was chondroma. Based on the tumour location and histological results, we diagnosed it as intracapsular chondroma. Although intracapsular chondroma is very rare-ly seen in the hands, it is important to consider an intracapsular chondroma when differentiating a tumour in the hand because it is difficult to diagnose one in an imaging examination.

Level of Evidence: Level V (Therapeutic)
Faking it and Breaking it: Responsible AI is needed Now
Authors: Trim Michelle
Published: February 2023

Frauds, fakes, forgeries… these are not new problems for the public to contend with. Purveyors of designer goods such as handbags and shoes have developed keen skills to spot clever knockoffs, though some copies are so good that their authenticity seems less important to folks buying them to wear. Forging currency is an incredibly serious crime, and yet it is the crux of many movies and stories. In antiquities and in art, making forgeries gets a different sort of respect as doing so effectively requires great skill akin to that practiced by the original artisans themselves. In academia, as well as politics [8], plagiarism is one of the worst offenses one can commit because faking one's intellectual achievements [7] threatens the attainment of credentials and offices while getting away with plagiarism can threaten the institution's reputation. So, with so much practice living life negotiating the real from the fake, why are the latest advancements in machine-based image and text generation so concerning? One reason might have to do with computing's penchant for outsourcing messy, qualitative evaluation methods to external, seemingly neutral metrics. Like all sciences, computing must constantly grapple with the myth of objectivity [15].
Reflections on the Design of Systems that Impact Computers and Society
Authors: Lopez Patty
Published: February 2023

Having spent the past year post-retirement working with my alma mater, New Mexico State University's (NMSU) Computer Science department to broaden computing, increase student engagement, and to improve graduation completion, as well as reflecting on the state of computing in society at large, I thought I'd share some observations. In March of this year, I had the opportunity to participate in the SIGCSE 2022 Technical Symposium. I was struck by Dr. Shaundra Daily's plenary keynote, entitled "Diversifying Computing: Real Change Must Come from Within", and her use of the phrase "navigating systems that were not designed for me" as she described her exploration of STEM as a first-generation college student, as both a dance and an engineering student, and as a graduate student preparing for motherhood lacking flexibility during her pregnancy, no maternity leave, no livable stipend, and a lack of affordable childcare, as well as the coping strategies she needed to develop to deal with academic culture. In my work with NMSU this past spring, co-teaching a problem solving course, my work this fall advising CS students, and my board roles serving on the National Academy of Science, Engineering, and Medicine's Roundtable for Systemic Change in Undergraduate STEM Education co-chairing the "Culture of STEM" workgroup, on the Computing Alliance of Hispanic Serving Institution's (CAHSI) Advisory Board, and on the Computing Research Association for Widening Participation (CRA-WP), co-editing the "Expanding the Pipeline" column, it's clear that system design adversely impacts society in terms of determining not only who gets to participate in the design of computer hardware and software, but also who gets to advance in social and economic mobility. Academic institutions are complex systems in need of an overhaul, by the University of California's academic workers strike for better pay and benefits. The design and commercialization of AI without fully understanding the implications of bias and ethics is inherently a system design problem. The application to everything from AI generated art and images (and how to spot deep fakes), the ability of large language models (LLMs) to create volumes of text generated articles that appear legitimate with the capacity to spread hate and misinformation globally are but just a few examples of the potentially horrific impact to society, because humans cannot work at the pace and scale to validate and/or authenticate them, with few if any meaningful domestic and international laws or policies in place to safeguard us.
Steering or Sleepwalking? The Strange Disappearance of Social Responsibility
Authors: Schuler Douglas
Published: February 2023

Many of you have read Moshe Vardi's recent column in the July 2022 Communications of the ACM entitled
An Association of the Members, by the Members, for the Members.
In the column Vardi discussed the need for a more transparent and accountable ACM and he used the example of the strange disappearance of social responsibility. In January 2018, Vardi's column "Computer Professionals for Social Responsibility,' argued that "ACM must be more active in addressing social responsibility issues raised by computing technology." In response to that column, he was asked "to convene a task force and formulate recommendations on how ACM can become a leading voice on social responsibility of computing professionals." I along with several others was invited to discuss this initiative with ACM leadership in February 2019 at ACM's headquarters and the short article I prepared for that meeting is included below Vardi presented the task force recommendations to the ACM Executive Committee in April 2019 and, in his words, the response from ACM leadership was a "thundering silence." I had been very optimistic about participating in the meeting on this critical topic and disappointed when it was shelved. In July 2019 all of the participants in the April meeting received the note that basically said not to worry: other groups were doing similar things in relation to out-of-control tech (rendering any work ACM would undertake as redundant) and that ACM itself was already involved in several activities that could be seen to fall under the heading of "social responsibility."
Open Source Responsibilities
Authors: Blumenthal Johanna
Published: February 2023

Early one July morning, my husband and I were sipping our coffee and catching up on news when he made a comment that I couldn't ignore. He said something to the effect of: "what an immature response".
Whistleblowers in an Academic Gift Culture - A Commentary on the Scandal in Academia
Authors: Heron Michael James , Belford Pauline Helen
Published: February 2023

The Scandal in Academia is an extended fictional case-study intended for use as a teaching and discussion aid for educational practitioners looking to introduce elements of computer ethics into their curricula. Inspired by Epstein's Case of the Killer Robot, it is a full-cycle scenario involving many individuals which touches upon the complexity and interrelations of modern computer ethics. It has been trialed and evaluated as a teaching tool by the authors and with multiple groups since then. However its utility as a general resource is limited without the academic context that supports deeper investigation of the material. It is to address this issue that the authors offer this commentary on the Scandal, with a focus on the eleventh and twelth newspaper items presented within. This paper focuses primarily on the articles
Hacker is Postgraduate Student
and
Clean Out at Scandal Linked Journals.
Naringin Prevents Cognitive Dysfunction in Aging Rats by Inhibiting Toll‐Like Receptor 4 (TLR4)/NF‐κB Pathway and Endoplasmic Reticulum Stress
Authors: Dai Xiao-jie , Jia Yi , Cao Rui , Zhou Mei-ning
Published: February 2023

Objective. Naringin is a flavonoid derived from Chinese herbs. According to earlier studies, naringin may have the potential to alleviate aging‐induced cognitive dysfunction. Therefore, this study attempted to explore the protective effect and underlying mechanism of naringin on aging rats with cognitive dysfunction. Methods. After the construction of a model of aging rats with cognitive dysfunction through subcutaneous injection of D‐galactose (D‐gal; 150 mg/kg), intragastric administration of naringin (100 mg/kg) was performed for treatment. Behavioral tests, including Morris water maze test (MWM), novel object recognition test (NORT), and fear conditioning test, were used to measure the cognitive function; ELISA and biochemical tests were used to determine the levels of interleukin (IL)‐1β, IL‐6, monocyte chemoattractant protein‐1 (MCP‐1), brain‐derived neurotrophic factor (BDNF), nerve growth factor (NGF), malondialdehyde (MDA), and glutathione peroxidase (GSH‐Px) in the hippocampus of rats in each group, respectively; H&E staining was used to observe the pathological changes in the hippocampus; Western blot was used to examine the expression of toll‐like receptor 4 (TLR4)/NF‐κB pathway‐related proteins and endoplasmic reticulum (ER) stress‐related proteins in the hippocampus. Results. The model was successfully constructed by subcutaneous injection of D‐gal (150 mg/kg). The behavioral test results showed that naringin could ameliorate the cognitive dysfunction and alleviate the histopathological damage of hippocampus. Moreover, naringin significantly improve the inflammatory response (the levels of IL‐1β, IL‐6, and MCP‐1 were decreased), oxidative stress response (MDA level was increased while GSH‐Px activity was decreased), and ER stress (the expression of glucose‐regulated protein 78 (GRP78), C/‐EBP homologous protein (CHOP), and transcription factor 6 (ATF6) expression was downregulated), and increased the levels of neurotrophic factors BDNF and NGF in D‐gal rats. Besides, further mechanistic studies revealed the downregulation of naringin on TLR4/NF‐κB pathway activity. Conclusion. Naringin may inhibit inflammatory response, oxidative stress, and ER stress by downregulating TLR4/NF‐κB pathway activity, thereby improving cognitive dysfunction and alleviating histopathological damage of hippocampus in aging rats. Briefly, naringin is an effective drug for the treatment of cognitive dysfunction.
New Cure Rate Survival Models Generated by Poisson Distribution and Different Regression Structures with Applications to Cancer Data Set
Authors: Esmailian Mahdy , Azimi Reza , Gallardo Diego I. , Nasiri Parviz
Published: February 2023

A new cure rate model is presented by assuming that, conditional on

η

, the number of competing causes of the event of interest follows the Poisson distribution, where

η

is assumed a random variable with gamma and generalized exponential distributions. For the time-to-event of the concurrent causes, we assumed the recently introduced truncated Nadarajah–Haghighi model. The model is parameterized directly in terms of the cure term, and then different symmetric and asymmetric link functions are used to assess the effects of covariates, such as logit, probit, log-log, Cauchit, Aranda-Ordaz, skewed probit, and skewed logit. Parameters estimation for the model is approached based on the traditional maximum likelihood estimation method. We achieve a simulation study in order to investigate the performance of these estimators under different scenarios. Finally, the model is illustrated in data sets related to two kinds of cancers (melanoma and colon cancer).
Augmenting Feature Representation with Gradient Penalty for Robust Text Categorization
Authors: Wang Depei , Cheng Lianglun , Wang Zhuowei
Published: February 2023

The capabilities of deep models are constantly mined for extraction and representation of features among text classification tasks. However, these models are sensitive to changes in input data, resulting in poor robustness. Meanwhile, the model lacks information interaction and weak representation ability. In this work, for feature extraction, a joint model that consists of a convolutional neural network, a bidirectional gated recurrent unit, and an attention mechanism is proposed. This new model can improve versatility and fully discover category information in text. For feature representation, a projector under the supervised contrastive learning method is introduced. The method can improve the representation of an encoder and realize aggregation of the same category. Considering the robustness of the PCRA, the gradient penalty is added to a contrastive loss function. Experiments are performed on four datasets to assess the proposed model (PCRA and PCRA‐GP) using an accuracy metric. The experimental results show that our model is suitable for variable‐length and bilingual texts. Compared with the baseline model, it remains competitive, and it reaches SOTA on the 20 Newsgroups dataset. Moreover, the performance of the model is evaluated under different hyperparameters to clarify its working mechanism.
Neoadjuvant Chemotherapy Followed by Cytoreductive Surgery and HIPEC Improves Survival in Peritoneal Metastatic Gastric Cancer
Authors: Akturk Esen Selin , Ozgun Yigit Mehmet , Hasturk Denizcan , Ucar Gokhan , Bostanci Erdal Birol , Sendur Mehmet Ali Nahit , Uncu Dogan
Published: February 2023

Introduction: This study examined the difference in overall survival (OS) between peritoneal metastatic gastric cancer (PMGC) patients who underwent neoadjuvant chemotherapy followed by cytoreductive surgery ± hyperthermic intraperitoneal chemotherapy (CRS ± HIPEC) and those who did not have surgery but instead received palliative chemotherapy. Methods: This retrospective study included 80 patients who were followed up with the diagnosis of PMGC, those undergoing neoadjuvant chemotherapy followed by CRS ± HIPEC (CRS ± HIPEC group) and those receiving chemotherapy only (non-surgical group), in the medical oncology clinic between April 2011 and December 2021. Clinicopathological features, treatments, and OS of the patients were compared. Results: There were 32 patients in the SRC CRS ± HIPEC group and 48 in the non-surgical group. In the CRS ± HIPEC group, CRS + HIPEC was performed on 20 patients, and only CRS was performed on 12 patients. All of the patients who underwent CRS + HIPEC, and 5 of the patients who underwent only CRS received neoadjuvant chemotherapy. While the median OS was 19.7 (15.5–23.8) months in the CRS ± HIPEC group, the median OS was 6.8 (3.5–10.2) months in the non-surgical group (p < 0.001). Conclusion: As a result, CRS + HIPEC significantly improves survival in PMGC patients. With experienced surgical centres and appropriate patient selection, the life expectancy of patients with PM can be extended.
Advances in Technical Aspects of Deep Brain Stimulation Surgery
Authors: Schulder Michael , Mishra Akash , Mammis Antonios , Horn Andres , Boutet Alexandre , Blomstedt Patric , Chabardes Stephan , Flouty Oliver , Lozano Andres M. , Neimat Joseph S. , Ponce Francisco , Starr Philip A. , Krauss Joachim K. , Hariz Marwan , Chang Jin Woo
Published: February 2023

Background: Deep brain stimulation has become an established technology for the treatment of patients with a wide variety of conditions, including movement disorders, psychiatric disorders, epilepsy, and pain. Surgery for implantation of DBS devices has enhanced our understanding of human physiology, which in turn has led to advances in DBS technology. Our group has previously published on these advances, proposed future developments, and examined evolving indications for DBS. Summary: The crucial roles of structural MR imaging pre-, intra-, and post-DBS procedure in target visualization and confirmation of targeting are described, with discussion of new MR sequences and higher field strength MRI enabling direct visualization of brain targets. The incorporation of functional and connectivity imaging in procedural workup and their contribution to anatomical modelling is reviewed. Various tools for targeting and implanting electrodes, including frame-based, frameless, and robot-assisted, are surveyed, and their pros and cons are described. Updates on brain atlases and various software used for planning target coordinates and trajectories are presented. The pros and cons of asleep versus awake surgery are discussed. The role and value of microelectrode recording and local field potentials are described, as well as the role of intraoperative stimulation. Technical aspects of novel electrode designs and implantable pulse generators are presented and compared.
Vessel Safety Monitoring System (VSMS) Based on LoRA for the Safety of Indonesian Traditional Fishers
Authors: Nofandi Faris , Mahendra R , Purwanti Endang Pudji
Published: February 2023

Based on data obtained from Indonesian fisheries statistics, over ten years, it is known that 90% of the fishing fleet in Indonesia is dominated by fishing vessels under 30 GT. Generally, these vessels are not equipped with the calculations of the shipping architect or planning drawings. the large percentage of shipping disasters or vessel accidents in Indonesia, including fishing vessel accidents, is caused by several factors: 43.67% due to human error, 32.37% due to nature, 23.94% due to technical factors. Accidents due to bad weather cannot be avoided during fishing operations. However, with the quality of human resources and technical factors that have improved, it is hoped that vessel accidents can be avoided or minimized. According to the Global Maritime Distress and Safety System (GMDSS), vessels with the IMO standard are already based on satellite communications. Vessels required to use the GMDSS standard are vessels with a size of 300 GT and above. We develop a Vessel Safety Monitoring System (VSMS) which has a lower cost, which can be used to determine the vessel’s position and is added by using a distress button system such as the satellite-based GMDSS system. the communication from the coast guard post to the vessel uses the LoRA module based on radio frequency, although without pressing the distress button on the vessel, the device on the vessel will continue to send location, vessel's speed, and rpm to the coast guard station. If the distress button is pressed, the location will still be sent, the buzzer at the coast guard post will turn on, and the vessel's location can be seen on the local web server so that the coast guard post officers can immediately find out the coordinates of the vessel. It can minimize the time to search for the vessel's location because the vessel's coordinates are known. Based on the results of the Vessel Safety Monitoring System (VSMS) test, 10 data transmission from the vessel to the coast guard post can work on the land and the sea it can send nine types of data with 0 - 50 meters distance, it can send 1 type of data with a 0 - 100 meters distance, with an average delivery delay of 5 seconds. The amount of data and the delivery delay affects the working distance of the tool. The distress function or the danger signal requires data transmission for 0-15 seconds manually or automatically until the alarm goes off at the coast guard post since the vessel's danger signal is activated from the vessel to the coast guard post
Evidence-Based Assessment of Congenital Heart Disease Genes to Enable Returning Results in a Genomic Study
Authors: Griffin Emily L. , Nees Shannon N. , Morton Sarah U. , Wynn Julia , Patel Nihir , Jobanputra Vaidehi , Robinson Scott , Kochav Stephanie M. , Tao Alice , Andrews Carli , Cross Nancy , Geva Judith , Lanzilotta Kristen , Ritter Alyssa , Taillie Eileen , Thompson Alexandra , Meyer Chris , Akers Rachel , King Eileen C. , Cnota James F , Kim Richard W. , Porter George A. , Brueckner Martina , Seidman Christine E. , Shen Yufeng , Gelb Bruce D. , Goldmuntz Elizabeth , Newburger Jane W. , Roberts Amy E. , Chung Wendy K.
Published: February 2023

Background:

Congenital heart disease (CHD) is the most common major congenital anomaly and causes significant morbidity and mortality. Epidemiologic evidence supports a role of genetics in the development of CHD. Genetic diagnoses can inform prognosis and clinical management. However, genetic testing is not standardized among individuals with CHD. We sought to develop a list of validated CHD genes using established methods and to evaluate the process of returning genetic results to research participants in a large genomic study.

Methods:

Two-hundred ninety-five candidate CHD genes were evaluated using a ClinGen framework. Sequence and copy number variants involving genes in the CHD gene list were analyzed in Pediatric Cardiac Genomics Consortium participants. Pathogenic/likely pathogenic results were confirmed on a new sample in a clinical laboratory improvement amendments-certified laboratory and disclosed to eligible participants. Adult probands and parents of probands who received results were asked to complete a post-disclosure survey.

Results:

A total of 99 genes had a strong or definitive clinical validity classification. Diagnostic yields for copy number variants and exome sequencing were 1.8% and 3.8%, respectively. Thirty-one probands completed clinical laboratory improvement amendments-confirmation and received results. Participants who completed postdisclosure surveys reported high personal utility and no decision regret after receiving genetic results.

Conclusions:

The application of ClinGen criteria to CHD candidate genes yielded a list that can be used to interpret clinical genetic testing for CHD. Applying this gene list to one of the largest research cohorts of CHD participants provides a lower bound for the yield of genetic testing in CHD.
Sustained Mechanical Aspiration Thrombectomy for High Thrombus Burden Coronary Vessel Occlusion: The Multicenter CHEETAH Study
Authors: Mathews S. Jay , Parikh Sahil A. , Wu Willis , Metzger D. Christopher , Chambers Jeffrey W. , Ghali Magdi G.H. , Sumners Michael James , Kolski Brian C. , Pinto Duane S. , Dohad Suhail
Published: February 2023

Background:

Poor myocardial reperfusion due to distal embolization and microvascular obstruction after percutaneous coronary intervention is associated with increased risk of morbidity and mortality. Prior trials have not shown a clear benefit of routine manual aspiration thrombectomy. Sustained mechanical aspiration may mitigate this risk and improve outcomes. The objective of this study is to evaluate sustained mechanical aspiration thrombectomy before percutaneous coronary intervention in high thrombus burden acute coronary syndrome patients.

Methods:

This prospective study evaluated the Indigo CAT RX Aspiration System (Penumbra Inc, Alameda CA) for sustained mechanical aspiration thrombectomy before percutaneous coronary intervention at 25 hospitals across the USA. Adults presenting within 12 hours of symptom onset with high thrombus burden and target lesion(s) located in a native coronary artery were eligible. The primary end point was a composite of cardiovascular death, recurrent myocardial infarction, cardiogenic shock, or new or worsening New York Heart Association class IV heart failure within 30 days. Secondary end points included Thrombolysis in Myocardial Infarction thrombus grade, Thrombolysis in Myocardial Infarction flow, myocardial blush grade, stroke, and device-related serious adverse events.

Results:

From August 2019 through December 2020, a total of 400 patients were enrolled (mean age 60.4 years, 76.25% male). The primary composite end point rate was 3.60% (14/389 [95% CI, 2.0–6.0%]). Rate of stroke within 30 days was 0.77%. Final rates of Thrombolysis in Myocardial Infarction thrombus grade 0, Thrombolysis in Myocardial Infarction flow 3, and myocardial blush grade 3 were 99.50%, 97.50%, and 99.75%, respectively. No device-related serious adverse events occurred.

Conclusions:

Sustained mechanical aspiration before percutaneous coronary intervention in high thrombus burden acute coronary syndrome patients was safe and was associated with high rates of thrombus removal, flow restoration, and normal myocardial perfusion on final angiography.
Two‐Year Outcomes With a Next‐Generation Left Atrial Appendage Device: Final Results of the PINNACLE FLX Trial
Authors: Doshi Shephal K. , Kar Saibal , Sadhu Ashish , Horton Rodney , Osorio Jose , Ellis Christopher , Stone James , Shah Manish , Dukkipati Srinivas R. , Adler Stuart , Nair Devi G. , Kim Jamie , Wazni Oussama , Price Matthew J. , Holmes David R. , Shipley Robert , Christen Thomas , Allocco Dominic J. , Reddy Vivek Y. , Adler Stuart , Buchbinder Maurice , Chinitz Larry , Delurgio David , Desai Amish , Center Health , Doshi Shephal , Dukkipatti Srinivas R. , Ellis Christopher , Gibson Douglas , Holmes David , Horton Rodney , Huber Kenneth , Kar Saibal , Khairallah Farhat , Kim Jamie , Koneru Jayanthi , Mahoney Paul , Mansour Moussa , Mark George , Nair Devi , O’Neill William , Nicholson William , Osorio Jose , Price Matthew J. , Reddy Vivek Y. , Reiss James , Sadhu Ashish , Saliba Walid , Shah Manish , Shehata Michael , Stone James , Swarup Vijendra
Published: February 2023

Background

The PINNACLE FLX (Protection Against Embolism for Non‐valvular AF [Atrial Fibrillation] Patients: Investigational Device Evaluation of the Watchman FLX LAA [Left Atrial Appendage] Closure Technology) trial evaluated the safety and efficacy of a next‐generation left atrial appendage closure device (WATCHMAN FLX; Boston Scientific, Marlborough, MA). At 1 year, the study met the primary end points of safety and anatomical efficacy/appendage closure. This final report of the PINNACLE FLX trial includes the prespecified secondary end point of ischemic stroke or systemic embolism at 2 years, also making it the first report of 2‐year outcomes with this next‐generation left atrial appendage closure device.

Methods and Results

Patients with nonvalvular atrial fibrillation with CHA
2
DS
2
‐VASc score ≥2 (men) or ≥3 (women), with an appropriate rationale for left atrial appendage closure, were enrolled to receive the left atrial appendage closure device at 29 US centers. Adverse events were assessed by an independent clinical events committee, and imaging was assessed by independent core laboratories. Among 395 implanted patients (36% women; mean age, 74 years; CHA
2
DS
2
‐VASc, 4.2±1.5), the secondary efficacy end point of 2‐year ischemic stroke or systemic embolism was met, with an absolute rate of 3.4% (annualized rate, 1.7%) and an upper 1‐sided 95% confidence bound of 5.3%, which was superior to the 8.7% performance goal. Two‐year rates of adverse events were as follows: 9.3% all‐cause mortality, 5.5% cardiovascular death, 3.4% all stroke, and 10.1% major bleeding (Bleeding Academic Research Consortium 3 or 5). There were no additional systemic embolisms, device embolizations, pericardial effusions, or symptomatic device‐related thrombi after 1 year.

Conclusions

The secondary end point of 2‐year stroke or systemic embolism was met at 3.4%. In these final results of the PINNACLE FLX trial, the next‐generation WATCHMAN FLX device demonstrated favorable safety and efficacy outcomes.
Sleep Irregularity and Subclinical Markers of Cardiovascular Disease: The Multi‐Ethnic Study of Atherosclerosis
Authors: Full Kelsie M. , Huang Tianyi , Shah Neomi A. , Allison Matthew A. , Michos Erin D. , Duprez Daniel A. , Redline Susan , Lutsey Pamela L.
Published: February 2023

Background

Sleep irregularity has been linked to incident cardiovascular disease. Less is known about associations of sleep regularity with atherosclerosis. We examined cross‐sectional associations of actigraphy‐assessed sleep duration and sleep timing regularity with subclinical atherosclerosis in the community‐based MESA (Multi‐Ethnic Study of Atherosclerosis).

Methods and Results

MESA Sleep Ancillary Study participants (N=2032; mean age, 68.6±9.2 years; 37.9% White) completed 7‐day wrist actigraphy. Participants underwent assessments of coronary artery calcium, carotid plaque presence, carotid intima‐media thickness, and the ankle‐brachial index. Sleep regularity was quantified by the 7‐day with‐in person SD of sleep duration and sleep onset timing. Relative risk regression models were used to calculate prevalence ratios and 95% CIs. Models are adjusted for demographics, cardiovascular disease risk factors, and other objectively assessed sleep characteristics including obstructive sleep apnea, sleep duration, and sleep fragmentation. After adjustment, compared with participants with more regular sleep durations (SD ≤60 minutes), participants with greater sleep duration irregularity (SD >120 minutes) were more likely to have high coronary artery calcium burden (>300; prevalence ratio, 1.33 [95% CI, 1.03–1.71]) and abnormal ankle‐brachial index (<0.9; prevalence ratio, 1.75 [95% CI, 1.03–2.95]). Compared with participants with more regular sleep timing (SD ≤30 minutes), participants with irregular sleep timing (SD >90 minutes) were more likely to have high coronary artery calcium burden (prevalence ratio, 1.39 [95% CI, 1.07–1.82]). Associations persisted after adjustment for cardiovascular disease risk factors and average sleep duration, obstructive sleep apnea, and sleep fragmentation.

Conclusions

Sleep irregularity, particularly sleep duration irregularity, was associated with several measures of subclinical atherosclerosis. Sleep regularity may be a modifiable target for reducing atherosclerosis risk. Future investigation into cardiovascular risk reduction interventions targeting sleep irregularity may be warranted.
SARC Gene Mutation Is Associated With Myocardial Fibrosis Measured by Histopathology and Cardiac Magnetic Resonance in Patients With Hypertrophic Cardiomyopathy
Authors: Huang Manyun , Zhang Jian , Song Changpeng , Wang Shuiyun , Zhou Zhou , Wang Hongyue , Zhao Shihua , Yin Kunlun , Li Li , Yang Shujuan , Zheng Xinxin , Lu Jie , Huang Xiaohong
Published: February 2023

Background

Sarcomere gene mutation and myocardial fibrosis are both associated with poorer clinical outcomes in patients with hypertrophic cardiomyopathy (HCM). The aim of this study was to determine the relationship between sarcomere gene mutation and myocardial fibrosis measured by both histopathology and cardiac magnetic resonance (CMR).

Methods and Results

Two hundred twenty‐seven patients with HCM who underwent surgical treatment, genetic testing, and CMR were enrolled. We retrospectively analyzed basic characteristics, sarcomere gene mutation, and myocardial fibrosis measured by CMR and histopathology. In our study, the mean age was 43 years, and 152 patients (67.0%) were men. A total of 107 patients (47.1%) carried a positive sarcomere gene mutation. The myocardial fibrosis ratio was significantly higher in the late gadolinium enhancement (LGE)+ group (LGE+ 14.3±7.5% versus LGE− 9.0±4.3%;
P
=0.001). Patients with HCM with SARC+ showed a high probability of fibrosis both in histopathology (myocardial fibrosis ratio 15.3±8.0% versus 12.4±6.5%;
P
=0.003) and CMR examination (LGE+ 98.1% versus 84.2%;
P
<0.001; LGE quantification 8.3% versus 5.8%;
P
<0.001). Linear regression analysis showed that sarcomere gene mutation (B=2.661;
P
=0.005) and left atrial diameter (B=0.240;
P
=0.001) were related factors for histopathological myocardial fibrosis. Also, the myocardial fibrosis ratio was significantly higher in the
MYH7
(myosin heavy chain) group (
MYH7
18.1±9.6% versus
MYBPC3
[myosin binding protein C] 13.1±5.2%;
P
=0.019).

Conclusions

Patients with HCM with positive sarcomere gene mutation had a higher myocardial fibrosis extent than patients without mutation, and a significant difference in myocardial fibrosis was also observed between the
MYBPC3
and
MYH7
groups. In addition, a high consistency was found between CMR–LGE and histopathological myocardial fibrosis in patients with HCM.
Isolation and characterization of the actinomycete, Nocardiopsis, from Haizhou Bay, and its application as a probiotic for Exopalaemon carinicauda (Holthuis, 1950) (Caridea, Palaemonidae)
Authors: Shen Shanrui , Mi Xiaoyan , Shen Qin , Chen Jing , Gao Huan , Lai Xiaofang
Published: February 2023

Actinomycetes, as the main producers of a variety of active metabolites and enzymes, have received extensive attention in aquaculture. An actinomycete had been isolated from Haizhou Bay and been identified by morphological analysis and 16S rRNA sequencing. Results showed that the actinomycete had the highest similarity (99.65%) with Nocardiopsis sp. and was named strain E10. Strain E10 produced an exo-enzyme with proteinase effect that showed strong antibacterial activity against Vibrio anguillarum. This strain E10 was tested as a probiotic for the culture of Exopalaemon carinicauda. After having been fed with a diet supplemented with strain E10 for 30 days, the final body weight (Wt), weight gain rate (WGR), special growth rate (SGR), survival rate (SR) and digestive enzymes (chymotrypsin, α-amylase and lipase) of E. carinicauda in all experimental groups showed no significant differences (). However, the antioxidant enzymes (total superoxide dismutase, catalase and peroxidase) and the non-specific immune-related enzymes (acid phosphatase, alkaline phosphatase and lysozyme) in the treatment groups increased significantly () compared with the control group. The cumulative mortality of the treatment groups (35.56% in 5 × 109 CFU/100 g) was significantly lower than that of the control treatment (73.33%) () post challenge with V. anguillarum for 14 days. The results indicated that strain E10 had no significant effect on the growth, but a significant improvement on the immunity of E. carinicauda. This study provides the data for ecological aquaculture of E. carinicauda.
Study on the Influence of Frozen Soil Change Characteristics on Pavement Materials in Cold Region
Authors: Shi Feng
Published: February 2023

The challenge of constructing roads on frozen ground in cold climes has long been acknowledged on a global scale. As a result, particular requirements for pavement materials and structures have been developed to address the special construction and usage conditions for highway pavement.
The influence of frozen soil change features on pavement materials in cold places is utilized to research the fluctuation law of subgrade temperature field under cement concrete and asphalt pavements because subgrade and pavement illnesses frequently occur in permafrost locations. The residual
tensile strength of regular emulsified asphalt dropped to 50% after 7 days of continuous immersion, while that of high-performance modified emulsified asphalt only reached 75%. However, the residual tensile strength of water-borne epoxy resin emulsified asphalt remained over 90%. Regardless
of how smooth or uneven the contact surface is, the results show that water-borne epoxy resin emulsified asphalt has good adhesive qualities. However, the water-borne epoxy resin emulsified asphalt still retained over 90% of its original tensile strength. Regardless of how smooth or uneven
the contact surface is, the results show that water-borne epoxy resin emulsified asphalt has good adhesive qualities.
Theoretical Investigation on 1-Ethyl-3-Methylimidazolium Fluoride: A Density Functional Theory Study
Authors: Wendi Zhang , Xianwei Hu , Chunbo Niu , Yifan Zhang , Zhongning Shi , Zhaowen Wang
Published: February 2023

The 1-ethyl-3-methylimidazolium fluoride is an ionic liquid that has multiple functions. The intramolecular interactions between the imidazole ring cation and the fluoride anion were not sufficiently understood. This work utilized quantum chemical analysis to determine its structures
and intramolecular bonds, especially concerning intramolecular hydrogen bonds. The geometric characteristics were determined, and NBO analysis was performed using a three-parameter hybrid functional (B3LYP) with 6-31++G (d) basis set of the EMIM+ monomer. The intramolecular interactions
between anions and cations of EMIMF were also studied using the geometries, bond orders, and topological analysis of the electron density concerning the density functional theory (DFT). We found that F− and EMIM+ formed an ionic bond inside the imidazole ring, F
atoms form hydrogen bonds with nearby hydrogen outside the imidazole ring. Notably, the bond between H6 and F20 was the strongest. NBO analysis revealed that the most stable hydrogen bond was consisted by the donor C3 atom with a lone pair and acceptor H6-F20. The generated hydrogen bond weakened
the strength of C–H stretching vibration. The topological parameters, bond order analysis, and electron density at BCPs provided a explanation for the strength of hydrogen bonds.