bluuebunny/crossref_metadata_2025 huggingface dataset:
Intraoperative Posterior Chamber Irrigation to Enhance Vitreous Cavity Support during Phacoemulsification Cataract Surgery after Vitrectomy
Authors: Lyu Jiao , Zhao Peiquan
Published: February 2020

Purpose. To report the effectiveness of an intraoperative posterior chamber irrigation technique to enhance vitreous cavity support during postvitrectomy phacoemulsification cataract surgery. Methods. The irrigation technique was performed during phacoemulsification cataract surgery on 10 postvitrectomy eyes (9 patients) with moderate or hard density cataracts and with low vitreous cavity support. A cohesive viscoelastic tamponade was applied to pressurize the anterior chamber to start the procedure. The vitreous cavity was then irrigated using a 26-gauge flushing cannula injecting balanced salt solution under the iris through the zonules, until the vitreous cavity pressure balanced and exceeded the anterior chamber pressure and viscoelastic flowed out from the corneal incision. Intraoperative performance with the irrigation technique, postoperative visual acuity, and anatomy, and complications were retrospectively evaluated. Results. The irrigation procedure instantly enhanced posterior segment pressure before capsulorhexis in 4 eyes, before phacoemulsification in 4 eyes, after phacoemulsification in 2 eyes, before intraocular lens implantation in 6 eyes, and after implantation in 3 eyes. Phacoemulsification cataract surgery was facilitated by the irrigation technique, with a stabilized anterior chamber and robust vitreous cavity support. No complications occurred intraoperatively and postoperatively. At a 3-month follow-up, favorable visual and anatomic outcomes were achieved in all eyes. Conclusions. The irrigation technique balanced the pressure of anterior and posterior segments. Thus, vitreous cavity support and anterior chamber depth were well stabilized during phacoemulsification cataract surgery in postvitrectomy eyes.
High-Efficiency Min-Entropy Estimation Based on Neural Network for Random Number Generators
Authors: Lv Na , Chen Tianyu , Zhu Shuangyi , Yang Jing , Ma Yuan , Jing Jiwu , Lin Jingqiang
Published: February 2020

Random number generator (RNG) is a fundamental and important cryptographic element, which has made an outstanding contribution to guaranteeing the network and communication security of cryptographic applications in the Internet age. In reality, if the random number used cannot provide sufficient randomness (unpredictability) as expected, these cryptographic applications are vulnerable to security threats and cause system crashes. Min-entropy is one of the approaches that are usually employed to quantify the unpredictability. The NIST Special Publication 800-90B adopts the concept of min-entropy in the design of its statistical entropy estimation methods, and the predictive model-based estimators added in the second draft of this standard effectively improve the overall capability of the test suite. However, these predictors have problems on limited application scope and high computational complexity, e.g., they have shortfalls in evaluating random numbers with long dependence and multivariate due to the huge time complexity (i.e., high-order polynomial time complexity). Fortunately, there has been increasing attention to using neural networks to model and forecast time series, and random numbers are also a type of time series. In our work, we propose several new and efficient approaches for min-entropy estimation by using neural network technologies and design a novel execution strategy for the proposed entropy estimation to make it applicable to the validation of both stationary and nonstationary sources. Compared with the 90B’s predictors officially published in 2018, the experimental results on various simulated and real-world data sources demonstrate that our predictors have a better performance on the accuracy, scope of applicability, and execution efficiency. The average execution efficiency of our predictors can be up to 10 times higher than that of the 90B’s for

10

6

sample size with different sample spaces. Furthermore, when the sample space is over

2

2

and the sample size is over

10

8

, the 90B’s predictors cannot give estimated results. Instead, our predictors can still provide accurate results. Copyright© 2019 John Wiley & Sons, Ltd.
Curcumin-Activated Mesenchymal Stem Cells Derived from Human Umbilical Cord and Their Effects on MPTP-Mouse Model of Parkinson’s Disease: A New Biological Therapy for Parkinson’s Disease
Authors: Wang Yun-Liang , Liu Xin-Shan , Wang Shan-Shan , Xue Peng , Zeng Zhi-Lei , Yang Xiao-Peng , Zhang Si-Miao , Zheng Wei , Hua Linlin , Li Jin-Feng , Wang Hai-Tao , Guo Shang
Published: February 2020

Background. The aim of this study was to investigate the effects of human umbilical cord mesenchymal stem cell activated by curcumin (hUC-MSCs-CUR) on Parkinson’s disease (PD). hUC-MSCs can differentiate into many types of adult tissue cells including dopaminergic (DA) neurons. CUR could protect DA neurons from apoptosis induced by 6-hydroxydopamine (6-OHDA). Therefore, we used the hUC-MSCs activated by CUR for the treatment of PD in an animal model. Methods. The hUC-MSCs-CUR was transplanted into the MPTP-induced PD mouse models via the tail vein. We found that hUC-MSCs-CUR significantly improved the motor ability, increased the tyrosine hydroxylase (TH), dopamine (DA), and Bcl-2 levels, and reduced nitric oxide synthase, Bax, and cleaved caspase 3 expression in PD mice. The supernatant of hUC-MSCs-CUR (CM-CUR) was used to stimulate the SH-SY5Y cellular model of PD; cell proliferation, differentiation, TH, and neuronal-specific marker microtubular-associated protein 2 (MAP2) expressions were examined. Results. Our data showed that CM-CUR significantly promoted cell proliferation and gradually increased TH and MAP2 expression in SH-SY5Y PD cells. The beneficial effects could be associated with significant increase of rough endoplasmic reticulum in the hUC-MSCs-CUR, which secretes many cytokines and growth factors beneficial for PD treatment. Conclusions. Transplantation of hUC-MSCs-CUR could show promise for improving the motor recovery of PD.
A Novel Framework for Selecting Informative Meteorological Stations Using Monte Carlo Feature Selection (MCFS) Algorithm
Authors: Niaz Rizwan , Almanjahie Ibrahim M. , Ali Zulfiqar , Faisal Muhammad , Hussain Ijaz
Published: February 2020

Spatial distribution of meteorological stations has a significant role in hydrological research. The meteorological data play a significant role in drought monitoring; in this regard, accurate and suitable provision of meteorological stations is becoming crucial to improve and strengthen the skill of drought prediction. In this perspective, the choice of meteorological stations in a specific region has substantial importance for accurate estimation and continuous monitoring of drought hazards at the regional level. However, installation and data mining on a large number of meteorological stations require high cost and resources. Therefore, it is necessary to rank and find dependencies among existing meteorological stations in a particular region for further climatological analysis and reanalysis of databases. In this paper, the Monte Carlo feature selection and interdependency discovery (MCFS-ID) algorithm-based framework is proposed to identify the important meteorological station in a particular region. We applied the proposed framework on 12 meteorological stations situated in varying climatological regions of Punjab (Pakistan). We employed the drought index SPTI on 1-, 3-, 6-, 9-, 12-, 24-, and 48-month time-scale data to find the interdependencies among meteorological stations at various locations. We found that Sialkot has significance regional importance for studying SPTI-3, SPTI-6, and SPTI-48 indices. This regional importance is based on scores of relative importance (RI); for example, the RI values for SPTI-3, SPTI-6, and SPTI-48 indices are 0.1570, 0.1080, and 0.0270, respectively. Furthermore, the Jhelum station has more relative importance (RI = 0.1410 and 0.1030) for SPTI-1 and SPTI-9 indices, while varying concentration behaviour is observed in the remaining time scales.
Combining Imbalance Learning Strategy and Multiclassifier Estimator for Bug Report Classification
Authors: Guo Shikai , Wang Siwen , Wei Miaomiao , Chen Rong , Guo Chen , Li Hui
Published: February 2020

Since a large number of bug reports are submitted to the bug repository every day, efficiently assigning bug reports to the correct developer is a considerable challenge. Because of the large differences between the different components of different projects, the current bug classification mainly relies on the components of the bug report to dispatch bug reports to the designated developer or developer community. Unfortunately, the component information of the bug report is filled in by default according to the bug submitter and the result is often incorrect. Thus, an automatic technology that can identify high-impact bug reports can help developers to be aware of them early, rectify them quickly, and minimize the damages they cause. In this paper, we propose a method based on the combination of imbalanced learning strategies such as random undersampling (RUS), random oversampling (ROS), synthetic minority oversampling technique (SMOTE), and AdaCost algorithms with multiclass classification methods, OVO and OVA, to solve bug reports component classification problem. We investigate the effectiveness of different combinations, i.e., variants, each of which includes a specific imbalance learning strategy and a specific classification algorithm. We mainly perform an analytical study on five open bug repositories (Eclipse, Mozilla, GCC, OpenOffice, and NetBeans). The results show that different variants have different performance for bug reports component identification and the best performance variants are combined with the imbalanced learning strategy RUS and the OVA method based on the SVM classifier.
Bioinformatics Analysis to Screen the Key Prognostic Genes in Tumor Microenvironment of Bladder Cancer
Authors: Zhang Zhao , Chen Dongshan , Li Zeyan , Liu Zhao , Yan Lei , Xu Zhonghua
Published: February 2020

Bladder cancer (BLCA) is the fifth most common cancer and has the features of low survival rate and high morbidity and mortality. The Cancer Genome Atlas (TCGA) is a pool of global gene expression profile and contains huge amounts of cancer genomics data, which makes it possible to inquire the relationship between gene expression and prognosis of a series of malignant tumors including BLCA. Immune and stromal cells are two major components of tumor microenvironment (TME) which play an important role in judging the prognosis of tumor and influencing the progression of malignant, inflammatory, and metabolic disorders. In our study, we conducted a quantitative analysis of immune and stromal elements based on the ESTIMATE algorithm and thus divided BLCA cases into high and low groups. Then the differentially expressed genes closely related to tumor prognosis between groups were identified and had been shown to correlate with immune response and stromal alterations, which was further confirmed by functional enrichment analysis and protein‐protein interaction networks. We validated those genes through BLCA dates downloaded from ArrayExpress and thus got the marker genes to predict prognosis of BLCA. Additionally, immune cell infiltration analysis explored the correlation between the verified genes and immune cells. In conclusion, we identified a series of TME‐related genes that assess the prognosis and explored the interaction between TME and tumor prognosis to guide clinical individualized treatment.
On the Effect of Estimation Error for the Risk-Adjusted Charts
Authors: Ali Sajid , Altaf Naila , Shah Ismail , Wang Lichen , Raza Syed Muhammad Muslim
Published: February 2020

Control charts are a popular statistical process control (SPC) technique for monitoring to detect the unusual variations in different processes. Contrary to the classical charts, control charts have also been modified to include covariates using regression approaches. This study assesses the performance of risk-adjusted control charts under the complexity of estimation error by considering logistic and negative binomial regression models. To be more precise, risk-adjusted Cumulative Sum (CUSUM) and Exponentially Weighted Moving Average (EWMA) charts are used to evaluate the impact of the estimation error. To compute the average run length (ARL), Markov Chain Monte Carlo simulations are conducted. Furthermore, a bootstrap method is also used to compute the ARL assuming different Phase-I data sets to minimize the effect of estimation error on risk-adjusted control charts. The results for cardiac surgery and respiratory disease data sets show that the modified control charts improve the performance in detecting small shifts.
Understanding Electric Bikers’ Red-Light Running Behavior: Predictive Utility of Theory of Planned Behavior vs Prototype Willingness Model
Authors: Tang Tianpei , Wang Hua , Zhou Xizhao , Gong Hao
Published: February 2020

To date, electric bikers’ (e-bikers’) red-light running (RLR) behavior is often viewed as one of the main contributors to e-bike-related accidents, especially for traffic scenarios with high e-bike ridership. In this paper, we aim to understand e-bikers’ RLR behavior based on structural equation modeling. Specifically, the predictive utility of the theory of planned behavior (TPB), prototype willingness model (PWM), and their combined form, TPB-PWM model, is used to analyze e-bikers’ RLR behavior, and a comparison analysis is made. The analyses of the three modeling approaches are based on the survey data collected from two online questionnaires, where more than 1,035 participant-completed questionnaires are received. The main findings in this paper are as follows: (i) Both PWM and TPB-PWM models could work better in characterizing e-bikers’ RLR behavior than the TPB model. The former two models explain more than 80% (81.3% and 81.4%, respectively) of the variance in e-bikers’ RLR behavior, which is remarkably higher than that of the TPB model (only 74.3%). (ii) It is also revealed that RLR willingness contributes more on influencing the RLR behavior than RLR intention, which implies that such behavior is dominated by social reactive decision-making rather than the reasoned one. (iii) Among the examined psychological factors, attitude, perceived behavioral control, past behavior, prototype perceptions (favorability and similarity), RLR intention, and RLR willingness were the crucial predictors of e-bikers’ RLR behavior. Our findings also support designing of more effective behavior-change interventions to better target e-bikers’ RLR behavior by considering the influence of the identified psychological factors.
A Note on Conformable Double Laplace Transform and Singular Conformable Pseudoparabolic Equations
Authors: Eltayeb Hassan , Mesloub Said
Published: February 2020

In this work, we combine conformable double Laplace transform and Adomian decomposition method and present a new approach for solving singular one-dimensional conformable pseudoparabolic equation and conformable coupled pseudoparabolic equation. Furthermore, some examples are given to show the performance of the proposed method.
Perceptions and Impact of the 2017 Canadian Guideline for Opioid Therapy and Chronic Noncancer Pain: A Cross-Sectional Study of Canadian Physicians
Authors: Busse Jason W. , Douglas Joyce , Chauhan Tara S. , Kobeissi Bilal , Blackmer Jeff
Published: February 2020

Background. Physician adherence to guideline recommendations for the use of opioids to manage chronic pain is often limited. Objective. In February 2018, we administered a 28-item online survey to explore perceptions of the 2017 Canadian guideline for opioid therapy and chronic noncancer pain and if physicians had altered practices in response to recommendations. Results. We invited 34,322 Canadian physicians to complete our survey, and 1,128 responded for a response rate of 3%; 687 respondents indicated they prescribed opioids for noncancer pain and answered survey questions about the guideline and their practice. Almost all were aware of the guideline, 94% had read the document, and 89% endorsed the clarity as good or excellent. The majority (86%) felt the guideline was feasible to implement, but 66% highlighted resistance by patients, and 63% the lack of access to effective nonopioid treatment as barriers. Thirty-six percent of respondents mistakenly believed the guideline recommended mandatory tapering for patients using high-dose opioid therapy (≥90 mg morphine equivalent per day), and 58% felt they would benefit from support for opioid tapering. Seventy percent of respondents had changed practices to align with guideline recommendations, with 51% engaging some high-dose patients in opioid tapering and 43% reducing the number of new opioid starts. Conclusion. There was high awareness of the 2017 Canadian opioid guideline among respondents, and preliminary evidence that recommendations have changed practice to better align with the evidence. Ongoing education is required to avoid the misunderstanding that opioid tapering is mandatory, and research to identify effective strategies to manage chronic noncancer pain is urgently needed.
A Phase II Pilot Trial to Evaluate CoBaT-Y017 Safety and Efficacy against Uncomplicated Falciparum Malaria versus Artemether‐Lumefantrine in Benin Subjects
Authors: Noudjiegbe Adrien N. , Alikekere Femi N. , Tchehouenou Henri , Langa Yéman , Ota Daniel S. , Degbelo Jean-Eudes , Allabi Aurel C. E.
Published: February 2020

Background. Considering the promising results of Phase I clinical trials with herbal medicine CoBaT-Y017, a Phase II study was conducted with Plasmodium falciparum malaria‐infected patients, for efficacy and safety evaluation of CoBaT-Y017 compared with Artemether‐Lumefantrine used as a positive control. Methods. A single‐blind randomized trial was conducted on 25 eligible males aged 18–40 years randomly assigned to two treatment groups: CoBaT-Y017 or Artemether‐Lumefantrine. The first group received 35 ml of CoBaT-Y017 in 1.5 L mineral water administered daily for four consecutive days; the second group received oral Artemether‐Lumefantrine, using WHO‐recommended therapeutic dose regimens. For both drugs, efficacy for parasite clearance and safety were evaluated clinically, haematologically, and biochemically on days 1–4, 7, 14, 21, and 28. Clinical‐ and laboratory‐adverse events (AEs) were recorded until day 28. Results. 13 and 12 patients were randomized into CoBaT-Y017 arm and Artemether‐Lumefantrine arm, respectively. In all patients, parasitaemia was adequately neutralized with CoBaT-Y017 group patients’ parasite clearance lagging slightly behind that of Artemether‐Lumefantrine’s group, but without a statistically significant difference (HR = 1.08, 95% CI 0.47–2.51, P = 0.85). Physical and laboratory examinations did not show any significant changes in vital signs, biochemical, and haematological parameters. In the Artemether‐Lumefantrine arm, 100% (12/12) of patients experienced, at least, one adverse event versus 61.5% (8/13) in the CoBaT-Y017 arm. Conclusion. CoBaT-Y017 exhibited similar antimalarial efficacy against P. falciparum to that of Artemether‐Lumefantrine, with good tolerability and safety.
SEM BSE 3D Image Analysis of Human Incus Bone Affected by Cholesteatoma Ascribes to Osteoclasts the Bone Erosion and VpSEM dEDX Analysis Reveals New Bone Formation
Authors: Relucenti Michela , Miglietta Selenia , Bove Gabriele , Donfrancesco Orlando , Battaglione Ezio , Familiari Pietro , Barbaranelli Claudio , Covelli Edoardo , Barbara Maurizio , Familiari Giuseppe
Published: February 2020

Bone erosion is considered a typical characteristic of advanced or complicated cholesteatoma (CHO), although it is still a matter of debate if bone erosion is due to osteoclast action, being the specific literature controversial. The purpose of this study was to apply a novel scanning characterization approach, the BSE 3D image analysis, to study the pathological erosion on the surface of human incus bone involved by CHO, in order to definitely assess the eventual osteoclastic resorptive action. To do this, a comparison of BSE 3D image of resorption lacunae (resorption pits) from osteoporotic human femur neck (indubitably of osteoclastic origin) with that of the incus was performed. Surface parameters (area, mean depth, and volume) were calculated by the software Hitachi MountainsMap© from BSE 3D-reconstructed images; results were then statistically analyzed by SPSS statistical software. Our findings showed that no significant differences exist between the two groups. This quantitative approach implements the morphological characterization, allowing us to state that surface erosion of the incus is due to osteoclast action. Moreover, our observation and processing image workflow are the first in the literature showing the presence not only of bone erosion but also of matrix vesicles releasing their content on collagen bundles and self-immuring osteocytes, all markers of new bone formation on incus bone surface. On the basis of recent literature, it has been hypothesized that inflammatory environment induced by CHO may trigger the osteoclast activity, eliciting bone erosion. The observed new bone formation probably takes place at a slower rate in respect to the normal bone turnover, and the process is uncoupled (as recently demonstrated for several inflammatory diseases that promote bone loss) thus resulting in an overall bone loss. Novel scanning characterization approaches used in this study allowed for the first time the 3D imaging of incus bone erosion and its quantitative measurement, opening a new era of quantitative SEM morphology.
Single-Nucleotide Polymorphisms in XPO5 are Associated with Noise-Induced Hearing Loss in a Chinese Population
Authors: Wang Ning , Wang Boshen , Guo Jiadi , Zhang Suhao , Han Lei , Zhang Juan , Zhu Baoli
Published: February 2020

Objectives.The purpose of this study was to investigate the correlation between single-nucleotide polymorphism (SNP) in 3′UTR of XPO5 gene and the occurrence of noise-induced hearing loss (NIHL), and to further explore the regulatory mechanism of miRNAs in NIHL on XPO5 gene. Methods.We conducted a case-control study involving 1040 cases and 1060 controls. The effects of SNPs on XPO5 expression were studied by genotyping, real-time polymerase chain reaction (qPCR), cell transfection, and the dual-luciferase reporter assay. Results.We genotyped four SNPs (rs2257082, rs11077, rs7755135, and rs1106841) in the XPO5 gene. The rs2257082 AG/GG carriers have special connection to an increased risk of noise-induced hearing loss compared to the AA carriers. The rs11077TG/GG carriers had a significantly increased association with NIHL susceptibility than the TT carriers. There was a higher risk of NIHL in the XPO5 gene rs7755135 CC carriers than in the TT carriers. No statistically significant correlation was obtained with respect to SNPrs1106841. Functional experiments showed that the rs11077 change might inhibit the interaction between miRNAs (miRNA-4763-5p, miRNA-5002-3p, and miRNA-617) and XPO5, with rs11077G allele resulting in overexpression of XPO5. Conclusion. The genetic polymorphism, rs11077, within XPO5 is associated with the risk of noise-induced hearing loss in a Chinese population.
Targeted Brain Tumor Radiotherapy Using an Auger Emitter
Authors: Pirovano Giacomo , Jannetti Stephen A. , Carter Lukas M. , Sadique Ahmad , Kossatz Susanne , Guru Navjot , Demétrio De Souza França Paula , Maeda Masatomo , Zeglis Brian M. , Lewis Jason S. , Humm John L. , Reiner Thomas
Published: February 2020

Purpose:

Glioblastoma multiforme is a highly aggressive form of brain cancer whose location, tendency to infiltrate healthy surrounding tissue, and heterogeneity significantly limit survival, with scant progress having been made in recent decades.

Experimental Design:

123I-MAPi (Iodine-123 Meitner-Auger PARP1 inhibitor) is a precise therapeutic tool composed of a PARP1 inhibitor radiolabeled with an Auger- and gamma-emitting iodine isotope. Here, the PARP inhibitor, which binds to the DNA repair enzyme PARP1, specifically targets cancer cells, sparing healthy tissue, and carries a radioactive payload within reach of the cancer cells' DNA.

Results:

The high relative biological efficacy of Auger electrons within their short range of action is leveraged to inflict DNA damage and cell death with high precision. The gamma ray emission of 123I-MAPi allows for the imaging of tumor progression and therapy response, and for patient dosimetry calculation. Here we demonstrated the efficacy and specificity of this small-molecule radiotheranostic in a complex preclinical model. In vitro and in vivo studies demonstrate high tumor uptake and a prolonged survival in mice treated with 123I-MAPi when compared with vehicle controls. Different methods of drug delivery were investigated to develop this technology for clinical applications, including convection enhanced delivery and intrathecal injection.

Conclusions:

Taken together, these results represent the first full characterization of an Auger-emitting PARP inhibitor which demonstrate a survival benefit in mouse models of GBM and confirm the high potential of 123I-MAPi for clinical translation.
Targeting DNA Repair to Drive Immune Responses: It's Time to Reconsider the Strategy for Clinical Translation
Authors: Takahashi Nobuyuki , Surolia Ira , Thomas Anish
Published: February 2020

PARP inhibition induces robust local and systemic antitumor immune responses and curative responses when combined with immune checkpoint blockade in many preclinical studies. However, the combination has not markedly improved antitumor effect compared with individual agents in clinical trials to date. We propose that the data from these trials indicate a lack of synergistic interaction of PARP inhibition and immune checkpoint blockade, with implications for reexamining our current strategies for clinical translation. As current mouse models do not recapitulate the genomic heterogeneity or tumor microenvironment of human cancers, better models are urgently needed. Tumor-extrinsic factors modulate immune checkpoint blockade response and they may be better assessed in early-phase clinical trials with frequent tissue and blood sampling. Further work is also needed to uncover the dose and schedule dependency of DNA repair modulation on the immune system. In homologous recombination repair–deficient tumors, randomized trials should be prioritized to address whether the benefit is superior to that of PARP inhibitor monotherapy. In tumors that are not homologous recombination repair deficient, research biopsies should be integrated to early-phase clinical trials to discover biomarkers that can predict clinical benefit. These considerations are relevant to the variety of adjunctive therapeutics being combined with immune checkpoint blockade to improve probability, duration, and potency of antitumor activity.
Nuclear Imaging Exams Authorized by the Brazilian Health Care System and Nuclear Imaging Equipment Distribution in the State of Rio Grande do Sul
Authors: Silva da Silva Patrícia , dos Santos Rosa Roger , Bordin Ronaldo
Published: February 2020

Introduction: For nuclear imaging exams to be funded by the Brazilian public health care system (Sistema Único de Saúde, SUS), the institution must be first authorized by the National Nuclear Energy Commission (Comissão Nacional de Energia Nuclear, CNEN) to secure the safe use of radiation. Objective: To describe the distribution of equipment used in nuclear imaging exams and the quantity of exams funded by the SUS according to the macroregions defined by Rio Grande do Sul Health Department from 2013 to 2015. To check the consistency of data from the Department of Informatics of the Ministry of Health (Departamento de Informática do Sistema Único de Saúde, DATASUS) and the CNEN in November 2015. Methods: Secondary data from DATASUS and the CNEN were used. The region of health, the macroregion, and its respective estimated population were obtained from the Brazilian Institute of Geography and Statistics. Results: The Porto Alegre metropolitan area showed the largest concentration of gamma cameras. The number of exams was higher in philanthropic institutions with a valid register at the Brazilian Ministry of Health and federal funded organizations. Some regions had less CNEN-authorized institutions than SUS-authorized ones. Conclusion: The distribution of equipment and exams was uneven in the state.
Filling a gap in Andean Cat Leopardus jacobita (Cornalia, 1865) (Mammalia: Carnivora: Felidae) distribution range: new record in La Rioja province, Argentina
Authors: Tellaeche Cintia Gisele , Guerisoli María de las Mercedes , Napolitano Constanza , Di Nucci Dante Luis , Reppucci Juan Ignacio
Published: February 2020

A pelt of an Andean Cat specimen was discovered in La Rioja Province, Argentina, a region with no previous data recorded, located in a large distribution gap between the two currently identified evolutionarily significant units (ESU).  This new record not only improves our knowledge about the species distribution but can also provide relevant genetic information for a better understanding of the relationship between the two ESU.
Temporal overlap between two sympatric carnivores in northwestern Peru and southwestern Ecuador
Authors: García-Olaechea Alvaro , Hurtado Cindy M.
Published: February 2020

The coexistence of sympatric species is determined by differences in their ecological niche.  Thus, for taxonomically and ecologically similar species to coexist, they must segregate in at least one of the three most important dimensions of the ecological niche: space, time or diet.  The Pampas Cat Leopardus colocola and the Sechuran Fox Lycalopex sechurae are sympatric species; and they are the most common medium-sized carnivores in the Sechura Desert and in the lowland seasonally dry tropical forest of Peru and Ecuador.  We evaluated the activity pattern of both mesocarnivores using camera trapping and temporal overlap analysis in both arid ecosystems.  We found a high degree of activity overlap and no statistically significant difference in the activity pattern of both species (Δ = 0.85 with 95% CI = 0.81 – 0.94; W = 0.531, SD = 2, P = 0.767), both being cathemeral.  There is, however, a contrasting pattern in the daytime activity of these species in the dry forest.  These results suggest that the different diet composition may be the main dimension that is facilitating the coexistence of both mesocarnivores in the arid ecosystems of northern Peru and southern Ecuador.
Comparison of BNP and NT-proBNP in Patients With Heart Failure and Reduced Ejection Fraction
Authors: Rørth Rasmus , Jhund Pardeep S. , Yilmaz Mehmet B. , Kristensen Søren Lund , Welsh Paul , Desai Akshay S. , Køber Lars , Prescott Margaret F. , Rouleau Jean L. , Solomon Scott D. , Swedberg Karl , Zile Michael R. , Packer Milton , McMurray John J.V.
Published: February 2020

Background:

Both BNP (B-type natriuretic peptide) and NT-proBNP (N-terminal pro B-type natriuretic peptide) are widely used to aid diagnosis, assess the effect of therapy, and predict outcomes in heart failure and reduced ejection fraction. However, little is known about how these 2 peptides compare in heart failure and reduced ejection fraction, especially with contemporary assays. Both peptides were measured at screening in the PARADIGM-HF trial (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure).

Methods:

Eligibility criteria in PARADIGM-HF included New York Heart Association functional class II to IV, left ventricular ejection fraction ≤40%, and elevated natriuretic peptides: BNP ≥150 pg/mL or NT-proBNP ≥600 pg/mL (for patients with HF hospitalization within 12 months, BNP ≥100 pg/mL or NT-proBNP ≥400 pg/mL). BNP and NT-proBNP were measured simultaneously at screening and only patients who fulfilled entry criteria for both natriuretic peptides were included in the present analysis. The BNP/NT-proBNP criteria were not different for patients in atrial fibrillation. Estimated glomerular filtration rate <30 mL/min per 1.73 m
2
was a key exclusion criterion.

Results:

The median baseline concentration of NT-proBNP was 2067 (Q1, Q3: 1217–4003) and BNP 318 (Q1, Q3: 207–559), and the ratio, calculated from the raw data, was ≈6.25:1. This ratio varied considerably according to rhythm (atrial fibrillation 8.03:1; no atrial fibrillation 5.75:1) and with age, renal function, and body mass index but not with left ventricular ejection fraction. Each peptide was similarly predictive of death (all-cause, cardiovascular, sudden and pump failure) and heart failure hospitalization, for example, cardiovascular death: BNP hazard ratio, 1.41 (95% CI, 1.33–1.49) per 1 SD increase,
P
<0.0001; NT-proBNP, 1.45 (1.36–1.54);
P
<0.0001.

Conclusions:

The ratio of NT-proBNP to BNP in heart failure and reduced ejection fraction appears to be greater than generally appreciated, differs between patients with and without atrial fibrillation, and increases substantially with increasing age and decreasing renal function. These findings are important for comparison of natriuretic peptide concentrations in heart failure and reduced ejection fraction.
Effects of Percutaneous Coronary Intervention on Death and Myocardial Infarction Stratified by Stable and Unstable Coronary Artery Disease
Authors: Chacko Liza , P. Howard James , Rajkumar Christopher , Nowbar Alexandra N. , Kane Christopher , Mahdi Dina , Foley Michael , Shun-Shin Matthew , Cole Graham , Sen Sayan , Al-Lamee Rasha , Francis Darrel P. , Ahmad Yousif
Published: February 2020

Background:

In patients presenting with ST-segment–elevation myocardial infarction, percutaneous coronary intervention (PCI) reduces mortality when compared with fibrinolysis. In other forms of coronary artery disease (CAD), however, it has been controversial whether PCI reduces mortality. In this meta-analysis, we examine the benefits of PCI in (1) patients post–myocardial infarction (MI) who did not receive immediate revascularization; (2) patients who have undergone primary PCI for ST-segment–elevation myocardial infarction but have residual coronary lesions; (3) patients who have suffered a non–ST-segment–elevation acute coronary syndrome; and (4) patients with truly stable CAD with no recent infarct. This analysis includes data from the recently presented International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) and Complete versus Culprit-Only Revascularization Strategies to Treat Multivessel Disease after Early PCI for STEMI (COMPLETE) trials.

Methods and Results:

We systematically identified all randomized trials of PCI on a background of medical therapy for the treatment of CAD. The ISCHEMIA trial, presented in November 2019, was eligible for inclusion. Data were combined using a random-effects meta-analysis. The primary end point was all-cause mortality. Forty-six trials, including 37 757 patients, were eligible. In the 3 unstable scenarios, PCI had the following effects on mortality: unrevascularized post-MI relative risk (RR) 0.68 (95% CI, 0.45–1.03);
P
=0.07; multivessel disease following ST-segment–elevation myocardial infarction (RR, 0.84 [95% CI, 0.69–1.04];
P
=0.11); non–ST-segment–elevation acute coronary syndrome (RR, 0.84 [95% CI, 0.72–0.97];
P
=0.02). Overall, in these unstable scenarios PCI was associated with a significant reduction in mortality (RR, 0.84 [95% CI, 0.75–0.93];
P
=0.02). In unstable CAD, PCI also reduced cardiac death (RR, 0.69 [95% CI, 0.53–0.90];
P
=0.007) and MI (RR, 0.74 [95% CI, 0.62–0.90];
P
=0.002). For stable CAD, PCI did not reduce mortality (RR, 0.98 [95% CI, 0.87–1.11]), cardiac death (RR, 0.89 [95% CI, 0.71–1.12];
P
=0.33), or MI (RR, 0.96 [95% CI, 0.86–1.08];
P
=0.54).

Conclusions:

PCI prevents death, cardiac death, and MI in patients with unstable CAD. For patients with stable CAD, PCI shows no evidence of an effect on any of these outcomes.
T-Cell–Derived miRNA-214 Mediates Perivascular Fibrosis in Hypertension
Authors: Nosalski Ryszard , Siedlinski Mateusz , Denby Laura , McGinnigle Eilidh , Nowak Michal , Cat Aurelie Nguyen Dinh , Medina-Ruiz Laura , Cantini Marco , Skiba Dominik , Wilk Grzegorz , Osmenda Grzegorz , Rodor Julie , Salmeron-Sanchez Manuel , Graham Gerard , Maffia Pasquale , Graham Delyth , Baker Andrew H. , Guzik Tomasz J.
Published: February 2020

Rationale:

Despite increasing understanding of the prognostic importance of vascular stiffening linked to perivascular fibrosis in hypertension, the molecular and cellular regulation of this process is poorly understood.

Objectives:

To study the functional role of microRNA-214 (miR-214) in the induction of perivascular fibrosis and endothelial dysfunction driving vascular stiffening.

Methods and Results:

Out of 381 miRs screened in the perivascular tissues in response to Ang II (angiotensin II)-mediated hypertension, miR-214 showed the highest induction (8-fold,
P
=0.0001). MiR-214 induction was pronounced in perivascular and circulating T cells, but not in perivascular adipose tissue adipocytes. Global deletion of miR-214
−
/−
prevented Ang II-induced periaortic fibrosis,
Col1a1
,
Col3a1, Col5a1
, and
Tgfb1
expression, hydroxyproline accumulation, and vascular stiffening, without difference in blood pressure. Mechanistic studies revealed that miR-214
−/−
mice were protected against endothelial dysfunction, oxidative stress, and increased Nox2, all of which were induced by Ang II in WT mice. Ang II-induced recruitment of T cells into perivascular adipose tissue was abolished in miR-214
−/−
mice. Adoptive transfer of miR-214
−/−
T cells into RAG1
−/−
mice resulted in reduced perivascular fibrosis compared with the effect of WT T cells. Ang II induced hypertension caused significant change in the expression of 1380 T cell genes in WT, but only 51 in miR-214
−/−
. T cell activation, proliferation and chemotaxis pathways were differentially affected. MiR-214
−/−
prevented Ang II-induction of profibrotic T cell cytokines (
IL-17
,
TNF-α, IL-9
, and
IFN-γ
) and chemokine receptors (CCR1, CCR2, CCR4, CCR5, CCR6, and CXCR3). This manifested in reduced in vitro and in vivo T cell chemotaxis resulting in attenuation of profibrotic perivascular inflammation. Translationally, we show that miR-214 is increased in plasma of patients with hypertension and is directly correlated to pulse wave velocity as a measure of vascular stiffness.

Conclusions:

T-cell–derived miR-214 controls pathological perivascular fibrosis in hypertension mediated by T cell recruitment and local profibrotic cytokine release.
The Use of Sex-Specific Factors in the Assessment of Women’s Cardiovascular Risk
Authors: Agarwala Anandita , Michos Erin D. , Samad Zainab , Ballantyne Christie M. , Virani Salim S.
Published: February 2020

Cardiovascular disease (CVD) is the leading cause of death among women in the United States. As compared with men, women are less likely to be diagnosed appropriately, receive preventive care, or be treated aggressively for CVD. Sex differences between men and women have allowed for the identification of CVD risk factors and risk markers that are unique to women. The 2018 American Heart Association/American College of Cardiology Multi-Society cholesterol guideline and 2019 American College of Cardiology/American Heart Association guideline on the primary prevention of CVD introduced the concept of risk-enhancing factors that are specific to women and are associated with an increased risk of incident atherosclerotic CVD in women. These factors, if present, would favor more intensified lifestyle interventions and consideration of initiation or intensification of statin therapy for primary prevention to mitigate the increased risk. In this primer, we highlight sex-specific CVD risk factors in women, stress the importance of eliciting a thorough obstetrical and gynecological history during cardiovascular risk assessment, and provide a framework for how to initiate appropriate preventive measures when sex-specific risk factors are present.
Sex Differences in Primary and Secondary Prevention of Cardiovascular Disease in China
Authors: Xia Shijun , Du Xin , Guo Lizhu , Du Jing , Arnott Clare , Lam Carolyn S.P. , Huffman Mark D. , Arima Hisatomi , Yuan Yiqiang , Zheng Yang , Wu Shulin , Guang Xuefeng , Zhou Xianhui , Lin Hongbo , Cheng Xiaoshu , Anderson Craig S. , Dong Jianzeng , Ma Changsheng
Published: February 2020

Background:

Despite improvements in diagnostic and therapeutic interventions to combat cardiovascular disease (CVD) in recent decades, there are significant ongoing access gaps and sex disparities in prevention that have not been adequately quantified in China.

Methods:

A representative, cross-sectional, community-based survey of adults (aged ≥45 years) was conducted in 7 geographic regions of China between 2014 and 2016. Logistic regression models were used to determine sex differences in primary and secondary CVD prevention, and any interaction by age, education level, and area of residence. Data are presented as adjusted odds ratios (ORs) and 95% CIs.

Results:

Of 47 841 participants (61.3% women), 5454 (57.2% women) had established CVD and 9532 (70.5% women) had a high estimated 10-year CVD risk (≥10%). Only 48.5% and 48.6% of women and 39.3% and 59.8% of men were on any kind of blood pressure (BP)–lowering medication, lipid-lowering medication, or antiplatelet therapy for primary and secondary prevention, respectively. Women with established CVD were significantly less likely than men to receive BP-lowering medications (OR, 0.79 [95% CI, 0.65–0.95]), lipid-lowering medications (OR, 0.69 [95% CI, 0.56–0.84]), antiplatelets (OR, 0.53 [95% CI, 0.45–0.62]), or any CVD prevention medication (OR, 0.62 [95% CI, 0.52–0.73]). Women with established CVD, however, had better BP control (OR, 1.31 [95% CI, 1.14–1.50]) but less well-controlled low-density lipoprotein cholesterol (OR, 0.66 [95% CI, 0.57–0.76]), and were less likely to smoke (OR, 13.89 [95% CI, 11.24–17.15]) and achieve physical activity targets (OR, 1.92 [95% CI, 1.61–2.29]). Conversely, women with high CVD risk were less likely than men to have their BP, low-density lipoprotein cholesterol, and bodyweight controlled (OR, 0.46 [95% CI, 0.38–0.55]; OR, 0.60 [95% CI, 0.52–0.69]; OR, 0.55 [95% CI, 0.48–0.63], respectively), despite a higher use of BP-lowering medications (OR, 1.21 [95% CI, 1.01–1.45]). Younger patients (<65 years) with established CVD were less likely to be taking CVD preventive medications, but there were no sex differences by area of residence or education level.

Conclusions:

Large and variable gaps in primary and secondary CVD prevention exist in China, particularly for women. Effective CVD prevention requires an improved overall nationwide strategy and a special emphasis on women with established CVD, who have the greatest disparity and the most to benefit.
Body Mass Index in Young Women and Risk of Cardiomyopathy
Authors: Robertson Josefina , Lindgren Martin , Schaufelberger Maria , Adiels Martin , Björck Lena , Lundberg Christina E. , Sattar Naveed , Rosengren Annika , Åberg Maria
Published: February 2020

Background:

Incidence rates of cardiomyopathies, which are a common cause of heart failure in young people, have increased during the last decades. An association between body weight in adolescence and future cardiomyopathy among men was recently identified. Whether or not this holds true also for women is unknown. The aim was therefore to determine whether for young women being overweight or obese is associated with a higher risk of developing cardiomyopathy.

Methods:

This was a registry-based national prospective cohort study with data collected from the Swedish Medical Birth Register, 1982 to 2014, with up to 33 years of follow-up. Included women were of childbearing age (18–45 years) during the initial antenatal visit in their first or second pregnancy (n=1 393 346). We obtained baseline data on body mass index (BMI), smoking, education, and previous disorders. After exclusions, mainly because of previous disorders, the final sample was composed of 1 388 571 women. Cardiomyopathy cases were identified by linking the Medical Birth Register to the National Patient and Cause of Death registers.

Results:

In total, we identified 1699 cases of cardiomyopathy (mean age at diagnosis, 46.2 [SD 9.1] years) during the follow-up with an incidence rate of 5.9 per 100 000 observation years. Of these, 481 were diagnosed with dilated cardiomyopathy, 246 had hypertrophic cardiomyopathy, 61 had alcohol/drug-induced cardiomyopathy, and 509 had other forms. The lowest risk for being diagnosed with a cardiomyopathy was detected at a BMI of 21 kg/m
2
, with a gradual increase in risk with higher BMI, particularly for dilated cardiomyopathy, where a hazard ratio of 4.71 (95% CI, 2.81–7.89) was found for severely obese subjects (BMI ≥35 kg/m
2
), as compared with BMI 20 to <22.5.

Conclusions:

Elevated BMI among young women was associated with an increased risk of being diagnosed with a subsequent cardiomyopathy, especially dilated cardiomyopathy, starting already at mildly elevated body weight, whereas severe obesity entailed an almost 5-fold increase in risk. With the increasing numbers of persons who are overweight or obese, higher rates of cardiomyopathy can be expected in the future, along with an altered disease burden related to adiposity.
Aromatase Inhibitors and the Risk of Cardiovascular Outcomes in Women With Breast Cancer
Authors: Khosrow-Khavar Farzin , Filion Kristian B. , Bouganim Nathaniel , Suissa Samy , Azoulay Laurent
Published: February 2020

Background:

The association between aromatase inhibitors and cardiovascular outcomes among women with breast cancer is controversial. Given the discrepant findings from randomized controlled trials and observational studies, additional studies are needed to address this safety concern.

Methods:

We conducted a population-based cohort study using the UK Clinical Practice Research Datalink linked to the Hospital Episode Statistics and Office for National Statistics databases. The study population consisted of women newly diagnosed with breast cancer initiating hormonal therapy with aromatase inhibitors or tamoxifen between April 1, 1998, and February 29, 2016. We usedCox proportional hazards models with inverse probability of treatment and censoring weighting to estimate hazard ratios (HRs) with 95% CIs comparing new users of aromatase inhibitors with new users of tamoxifen for each of the study outcomes (myocardial infarction, ischemic stroke, heart failure, and cardiovascular mortality).

Results:

The study population consisted of 23 525 patients newly diagnosed with breast cancer, of whom 17 922 initiated treatment with either an aromatase inhibitor or tamoxifen (8139 and 9783, respectively). The use of aromatase inhibitors was associated with a significantly increased risk of heart failure (incidence rate, 5.4 versus 1.8 per 1000 person-years; HR, 1.86 [95% CI, 1.14–3.03]) and cardiovascular mortality (incidence rate, 9.5 versus 4.7 per 1000 person-years; HR, 1.50 [95% CI, 1.11–2.04]) compared with the use of tamoxifen. Aromatase inhibitors were associated with elevated HRs, but with CIs including the null value, for myocardial infarction (incidence rate, 3.9 versus 1.8 per 1000 person-years; HR, 1.37 [95% CI, 0.88–2.13]) and ischemic stroke (incidence rate, 5.6 versus 3.2 per 1000 person-years; HR, 1.19 [95% CI, 0.82–1.72]).

Conclusions:

In this population-based study, aromatase inhibitors were associated with increased risks of heart failure and cardiovascular mortality compared with tamoxifen. There were also trends toward increased risks, although nonsignificant, of myocardial infarction and ischemic stroke. The increased risk of cardiovascular events associated with aromatase inhibitors should be balanced with their favorable clinical benefits compared with tamoxifen.