bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk Factors Associated With Bleeding in Children With Cardiac Disease Receiving Extracorporeal Membrane Oxygenation: A Multi-Center Data Linkage Analysis
Authors: Ankola Ashish A. , Bailly David K. , Reeder Ron W. , Cashen Katherine , Dalton Heidi J. , Dolgner Stephen J. , Federman Myke , Ghassemzadeh Rod , Himebauch Adam S. , Kamerkar Asavari , Koch Josh , Kohne Joseph , Lewen Margaret , Srivastava Neeraj , Willett Renee , Alexander Peta M. A.
Published: January 2022

Background: Bleeding is a common complication of extracorporeal membrane oxygenation (ECMO) for pediatric cardiac patients. We aimed to identify anticoagulation practices, cardiac diagnoses, and surgical variables associated with bleeding during pediatric cardiac ECMO by combining two established databases, the Collaborative Pediatric Critical Care Research Network (CPCCRN) Bleeding and Thrombosis in ECMO (BATE) and the Extracorporeal Life Support Organization (ELSO) Registry.

Methods: All children (<19 years) with a primary cardiac diagnosis managed on ECMO included in BATE from six centers were analyzed. ELSO Registry criteria for bleeding events included pulmonary or intracranial bleeding, or red blood cell transfusion >80 ml/kg on any ECMO day. Bleeding odds were assessed on ECMO Day 1 and from ECMO Day 2 onwards with multivariable logistic regression.

Results: There were 187 children with 114 (61%) bleeding events in the study cohort. Biventricular congenital heart disease (94/187, 50%) and cardiac medical diagnoses (75/187, 40%) were most common, and 48 (26%) patients were cannulated directly from cardiopulmonary bypass (CPB). Bleeding events were not associated with achieving pre-specified therapeutic ranges of activated clotting time (ACT) or platelet levels. In multivariable analysis, elevated INR and fibrinogen were associated with bleeding events (OR 1.1, CI 1.0–1.3, p = 0.02; OR 0.77, CI 0.6–0.9, p = 0.004). Bleeding events were also associated with clinical site (OR 4.8, CI 2.0–11.1, p < 0.001) and central cannulation (OR 1.75, CI 1.0–3.1, p = 0.05) but not with cardiac diagnosis, surgical complexity, or cannulation from CPB. Bleeding odds on ECMO day 1 were increased in patients with central cannulation (OR 2.82, 95% CI 1.15–7.08, p = 0.023) and those cannulated directly from CPB (OR 3.32, 95% CI 1.02–11.61, p = 0.047).

Conclusions: Bleeding events in children with cardiac diagnoses supported on ECMO were associated with central cannulation strategy and coagulopathy, but were not modulated by achieving pre-specified therapeutic ranges of monitoring assays.
Correlation-Based Discovery of Disease Patterns for Syndromic Surveillance
Authors: Rapp Michael , Kulessa Moritz , Loza Mencía Eneldo , Fürnkranz Johannes
Published: January 2022

Early outbreak detection is a key aspect in the containment of infectious diseases, as it enables the identification and isolation of infected individuals before the disease can spread to a larger population. Instead of detecting unexpected increases of infections by monitoring confirmed cases, syndromic surveillance aims at the detection of cases with early symptoms, which allows a more timely disclosure of outbreaks. However, the definition of these disease patterns is often challenging, as early symptoms are usually shared among many diseases and a particular disease can have several clinical pictures in the early phase of an infection. As a first step toward the goal to support epidemiologists in the process of defining reliable disease patterns, we present a novel, data-driven approach to discover such patterns in historic data. The key idea is to take into account the correlation between indicators in a health-related data source and the reported number of infections in the respective geographic region. In an preliminary experimental study, we use data from several emergency departments to discover disease patterns for three infectious diseases. Our results show the potential of the proposed approach to find patterns that correlate with the reported infections and to identify indicators that are related to the respective diseases. It also motivates the need for additional measures to overcome practical limitations, such as the requirement to deal with noisy and unbalanced data, and demonstrates the importance of incorporating feedback of domain experts into the learning procedure.
The Occurrence of Bedding-Parallel Fibrous Calcite Veins in Permian Siliciclastic and Carbonate Rocks in Central Thailand
Authors: Chenrai Piyaphong , Assawincharoenkij Thitiphan , Warren John , Sa-nguankaew Sannaporn , Meepring Sriamara , Laitrakull Kasira , Cartwright Ian
Published: January 2022

Bedding-parallel fibrous calcite veins crop out at two Permian carbonate localities in the Phetchabun area, central Thailand, within the Nam Duk and Khao Khwang Formations. Samples are studied to determine their petrographic, geochemical and isotopic character, depositional and diagenetic associations and controls on the formation of fibrous calcite across the region. Biomarker and non-biomarker parameters are used to interpret organic matter sources in the vein-hosting units, the depositional environment and levels of source rock maturation in order to evaluate source rock potential in the two Formations. Carbon and oxygen isotope values of the veins and the host are determined to discuss the source of carbonates and diagenetic conditions. The petroleum assessment from the Khao Khwang and Nam Duk Formations suggests that both Formations are a petroleum potential source rock with type II/III kerogen deposited in an estuarine environment or a shallow marine environment and a slope-to-basin marine environment or an open marine environment, respectively. The bedding-parallel fibrous calcite veins from the Khao Khwang and Nam Duk Formations are divided into two types: 1) beef and, 2) cone-in-cone veins. The carbon and oxygen isotope compositions from the fibrous calcite veins suggest that the calcite veins could be precipitated from a carbon source generated in the microbial methanogenic zone. The results in this study provide a better understanding of the interrelationship between the bedding-parallel fibrous calcite veins and petroleum source rock potential.
The Application of an Improved Fuzzy Comprehensive Evaluation in Coal Quality Rating: The Case Study of China
Authors: Cai Feng , Yang Lingling , Yuan Yuan , Taghizadeh-Hesary Farhad
Published: January 2022

Coal quality rating can help reduce greenhouse gas emissions, solving the global warming problem. It becomes more important as the carbon neutrality by the mid-21st century agreement is accepted by 195 countries, including China. In this paper, an improved fuzzy comprehensive evaluation method is introduced for coal quality rating. The data used in this work are of the Hostolgoi coalfield of the Xinjiang Province of China. Six industrial analysis indicators are determined as evaluation factors by taking the coal samples of different coal seam depths in the mining area. The super-standard multiple methods and the double-weight super-standard weighting method are combined to form a comprehensive weight. The results show that most of the coal samples of this coal mine are at grades I–II, and the overall coal is with good-quality stability. The evaluation results can improve the coal utilization efficiency and provide scientific guidance for evaluating and exploiting coal resources in coal geological exploration.
Modeling the Price of Emergency Power Transmission Lines in the Reserve Market Due to the Influence of Renewable Energies
Authors: Iranmehr Hamid , Aazami Rahmat , Tavoosi Jafar , Shirkhani Mohammadamin , Azizi Amir-Reza , Mohammadzadeh Ardashir , Mosavi Amir H. , Guo Wei
Published: January 2022

The law of free access to the transmission network obliges the transmission network to be in orbit, and on the other hand, the high loads in the transmission network, and economic uncertainties cause that the owners of transmission companies, don’t have sufficient motivation and resources to rebuild and develop the network. The main objective of this paper is the modeling the price of emergency power transmission lines in the reserve markets. This paper presents a method for calculating the reference price that a transmission line owner uses to bid on a price in excess of the nominal capacity of the transmission line under his ownership. For this purpose, first, the effects of operating a transmission line at a power greater than the rated power are described. After that, the reduction rate of the transmission line due to operation in these conditions is calculated, and finally the price determination is calculated based on the reduction rate of the generated life. In the next stage, this excess capacity is entered the two-stage model of energy market and reservation considering renewable energy sources as a price offer function. Numerical results of 6-Shin network show that the entry of renewable energy sources reduces energy costs, but the costs of the reserve market increases due to uncertainty. However, despite the emergency capacity, these costs are reduced due to the use of cheap resources in the network.
Preparation of Mn/Mg/Ce Ternary Ozone Catalyst and Its Mechanism for the Degradation of Printing and Dyeing Wastewater
Authors: Zhang Shuai , Ren Huixue , Fu Kaifang , Cheng Wenqing , Wu Daoji , Luo Congwei , Jiang Shengyun , Li Jie , Zhang Mingyue
Published: January 2022

The printing and dyeing wastewater produced by different dyes, as well as different printing and dyeing processes, have different components. These wastewater have high toxicity, high organic concentration, and deep chromaticity. Ozone catalytic oxidation is a very promising technical method for wastewater treatment. In this paper, Mn/Mg/Ce ternary catalyst was prepared, and the ozone catalytic oxidation treatment of actual and simulated printing and dyeing wastewater was performed to study the performance of four different carrier catalysts, namely, molecular sieve (MS), silica gel (SG), attapulgite (ATP), and nano alumina (Al2O3), by simulated dynamic test. The effects of reaction time, pH, and catalyst dosage on methyl orange degradation were studied. The results showed that under the optimum treatment conditions (120 min, pH 11, and 12.5 g/L catalyst dosage), the degradation rate of methyl orange reached 96% and the removal rate of the chemical oxygen demand of printing and dyeing wastewater reached 48.7%. This study shows that the treatment effect of ozone catalytic oxidation on printing and dyeing wastewater is remarkably improved after catalyst addition. This study provides a new choice of ozone catalyst for the degradation of printing and dyeing wastewaters in the future.
Response of Root Exudates of Bruguiera gymnorrhiza (L.) to Exposure of Polycyclic Aromatic Hydrocarbons
Authors: Liu Beibei , Wu Lin , Pan Pan , Li Ruilong , Lin Bigui
Published: January 2022

Root exudates play a pivotal role in the behaviors of polycyclic aromatic hydrocarbons (PAHs) in mangrove sediments, but the knowledge of how mangrove root exudates response to PAHs pollutants is limited. This study examined the root exudates of Bruguiera gymnorrhiza (L.) (B. gymnorrhiza) under exposure in phenanthrene, pyrene, and benzo[a]pyrene solution through a 45 days hydroponic cultivation. The results showed that the root exudates of B. gymnorrhiza were mainly hydrocarbon compounds. Tartaric acid was the dominant low molecular weight organic acids (LMWOAs) in root exudates. Under PAHs stress, the proportion of hydrocarbon compounds in root exudates decreased, while the proportion of amide compounds increased. At the first 15 days exposure, the amounts of dissolved organic carbon, soluble total sugars, total organic acids and LWMOAs all increased and reached the maximum values, subsequently, the amounts of root exudates had dropped. The degradation rates of PAHs followed the sequence of phenanthrene > pyrene > benzo [a] pyrene, and the presence of root exudates can significantly enhance the degradation of PAHs. The results illustrated that PAHs stress can significantly change the concentrations and species of root exudates. This study provides the scientific reference for understanding the ability of B. gymnorrhiza response to PAHs stress.
Long-Term Suppression of Hardwood Regeneration by Chinese Privet (Ligustrum sinense)
Authors: Turner Taylor N. , Dean Thomas J. , Kuehny Jeff S.
Published: January 2022

Native hardwood regeneration in the southeast United States is hindered by repeat disturbance events and the presence of invasive species. Our study aimed to determine the ability of native species in an unmanaged urban forest fragment to persist following high winds from hurricane Gustav in 2008 and subsequent salvage logging. In 2009, researchers estimated the density and composition of the regeneration and overstory trees as well as percent crown cover of invasive Chinese privet. Percent Chinese privet cover was visibly high, leading them to believe it may be inhibiting native hardwood establishment. Ten years later in 2019, we returned to the plots to take repeat measurements. Forest composition remains the same and privet crown cover remains high. There has been no increase in regenerating individuals, and overstory trees per hectare and basal area remains low. These results confirm that the heavy Chinese privet presence is persistent long term and will require management to promote reproduction of native overstory tree species.
Identification and Validation of DEPDC1B as an Independent Early Diagnostic and Prognostic Biomarker in Liver Hepatocellular Carcinoma
Authors: Fan Xiaoyan , Wen Junye , Bao Lei , Gao Fei , Li You , He Dongwei
Published: January 2022

Liver hepatocellular carcinoma (LIHC) is one of the most lethal tumors worldwide, and while its detailed mechanism of occurrence remains unclear, an early diagnosis of LIHC could significantly improve the 5-years survival of LIHC patients. It is therefore imperative to explore novel molecular markers for the early diagnosis and to develop efficient therapies for LIHC patients. Currently, DEPDC1B has been reported to participate in the regulation of cell mitosis, transcription, and tumorigenesis. To explore the valuable diagnostic and prognostic markers for LIHC and further elucidate the mechanisms underlying DEPDC1B-related LIHC, numerous databases, such as Oncomine, Gene Expression Profiling Interactive Analysis (GEPIA), UALCAN, Kaplan-Meier plotter, and The Cancer Genome Atlas (TCGA) were employed to determine the association between the expression of DEPDC1B and prognosis in LIHC patients. Generally, the DEPDC1B mRNA level was highly expressed in LIHC tissues, compared with that in normal tissues (p < 0.01). High DEPDC1B expression was associated with poor overall survival (OS) in LIHC patients, especially in stage II, IV, and grade I, II, III patients (all p < 0.05). The univariate and multivariate Cox regression analysis showed that DEPDC1B was an independent risk factor for OS among LIHC patients (HR = 1.3, 95% CI: 1.08–1.6, p = 0.007). In addition, the protein expression of DEPDC1B was validated using Human Protein Atlas database. Furthermore, the expression of DEPDC1B was confirmed by quantitative real-time polymerase chain reaction (qRT-PCR) assay using five pairs of matched LIHC tissues and their adjacent noncancerous tissues. The KEGG pathway analysis indicated that high expression of DEPDC1B may be associated with several signaling pathways, such as MAPK signaling, the regulation of actin cytoskeleton, p53 signaling, and the Wnt signaling pathways. Furthermore, high DEPDC1B expression may be significantly associated with various cancers. Conclusively, DEPDC1B may be an independent risk factor for OS among LIHC cancer patients and may be used as an early diagnostic marker in patients with LIHC.
Collapsing Focal Segmental Glomerulosclerosis in Viral Infections
Authors: Muehlig Anne K. , Gies Sydney , Huber Tobias B. , Braun Fabian
Published: January 2022

Collapsing glomerulopathy represents a special variant of the proteinuric kidney disease focal segmental glomerulosclerosis (FSGS). Histologically, the collapsing form of FSGS (cFSGS) is characterized by segmental or global condensation and obliteration of glomerular capillaries, the appearance of hyperplastic and hypertrophic podocytes and severe tubulointerstitial damage. Clinically, cFSGS patients present with acute kidney injury, nephrotic-range proteinuria and are at a high risk of rapid progression to irreversible kidney failure. cFSGS can be attributed to numerous etiologies, namely, viral infections like HIV, cytomegalovirus, Epstein–Barr-Virus, and parvovirus B19 and also drugs and severe ischemia. Risk variants of the APOL1 gene, predominantly found in people of African descent, increase the risk of developing cFSGS. Patients infected with the new Corona-Virus SARS-CoV-2 display an increased rate of acute kidney injury (AKI) in severe cases of COVID-19. Besides hemodynamic instability, cytokine mediated injury and direct viral entry and infection of renal epithelial cells contributing to AKI, there are emerging reports of cFSGS associated with SARS-CoV-2 infection in patients of mainly African ethnicity. The pathogenesis of cFSGS is proposed to be linked with direct viral infection of podocytes, as described for HIV-associated glomerulopathy. Nevertheless, there is growing evidence that the systemic inflammatory cascade, activated in acute viral infections like COVID-19, is a major contributor to the impairment of basic cellular functions in podocytes. This mini review will summarize the current knowledge on cFSGS associated with viral infections with a special focus on the influence of systemic immune responses and potential mechanisms propagating the development of cFSGS.
Diseases of Gastropoda
Authors: O’Brien Michelle F. , Pellett Sarah
Published: January 2022

Gastropods (class Gastropoda) form the largest of the classes in the phylum Mollusca and inhabit terrestrial, fresh water and marine environments. A large number of these species are of major conservation importance and are an essential component of ecosystems. Gastropods may be deemed as pests, having a negative impact in horticulture and agriculture, whereas others may be used as a food source for human consumption and therefore are beneficial. Gastropods are susceptible to primary diseases and also act as intermediate hosts for diseases which affect other animals, including humans. The diseases described include two that are notifiable to the World Organisation for Animal Health (OIE): Xenohaliotis californiensis and Abalone viral ganglioneuritis caused by Haliotid herpesvirus-1 (HaHV-1). Research into the diseases of gastropods has often focused on those species that act as intermediate disease hosts, those that are used in research or those cultured for food. In this paper we review the viral, bacterial, fungal, parasitic and miscellaneous conditions that have been reported in gastropods and mention some of the factors that appear to predispose them to disease. The pathogenicity of a number of these conditions has not been fully ascertained and more research is needed into specifying both the etiological agent and significance in some of the diseases reported.
Large-Scale Structure-Based Screening of Potential T Cell Cross-Reactivities Involving Peptide-Targets From BCG Vaccine and SARS-CoV-2
Authors: Tarabini Renata Fioravanti , Rigo Mauricio Menegatti , Faustino Fonseca André , Rubin Felipe , Bellé Rafael , Kavraki Lydia E , Ferreto Tiago Coelho , Amaral Antunes Dinler , de Souza Ana Paula Duarte
Published: January 2022

Although not being the first viral pandemic to affect humankind, we are now for the first time faced with a pandemic caused by a coronavirus. The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been responsible for the COVID-19 pandemic, which caused more than 4.5 million deaths worldwide. Despite unprecedented efforts, with vaccines being developed in a record time, SARS-CoV-2 continues to spread worldwide with new variants arising in different countries. Such persistent spread is in part enabled by public resistance to vaccination in some countries, and limited access to vaccines in other countries. The limited vaccination coverage, the continued risk for resistant variants, and the existence of natural reservoirs for coronaviruses, highlight the importance of developing additional therapeutic strategies against SARS-CoV-2 and other coronaviruses. At the beginning of the pandemic it was suggested that countries with Bacillus Calmette-Guérin (BCG) vaccination programs could be associated with a reduced number and/or severity of COVID-19 cases. Preliminary studies have provided evidence for this relationship and further investigation is being conducted in ongoing clinical trials. The protection against SARS-CoV-2 induced by BCG vaccination may be mediated by cross-reactive T cell lymphocytes, which recognize peptides displayed by class I Human Leukocyte Antigens (HLA-I) on the surface of infected cells. In order to identify potential targets of T cell cross-reactivity, we implemented anin silicostrategy combining sequence-based and structure-based methods to screen over 13,5 million possible cross-reactive peptide pairs from BCG and SARS-CoV-2. Our study produced (i) a list of immunogenic BCG-derived peptides that may prime T cell cross-reactivity against SARS-CoV-2, (ii) a large dataset of modeled peptide-HLA structures for the screened targets, and (iii) new computational methods for structure-based screenings that can be used by others in future studies. Our study expands the list of BCG peptides potentially involved in T cell cross-reactivity with SARS-CoV-2-derived peptides, and identifies multiple high-density “neighborhoods” of cross-reactive peptides which could be driving heterologous immunity induced by BCG vaccination, therefore providing insights for future vaccine development efforts.
Ability to Swim (Not Morphology or Environment) Explains Interspecific Differences in Crinoid Arm Regrowth
Authors: Stevenson Angela , Ó Corcora Tadhg C. , Harley Christopher D. G. , Baumiller Tomasz K.
Published: January 2022

Regrowth of body parts occurs in almost every phylum of the animal kingdom, but variation in this process across environmental, morphological, and behavioral gradients remains poorly understood. We examined regeneration patterns in feather stars – a group known for a wide range of morphologies and behaviors and up to a forty-fold difference in arm regeneration rates – and found that the variation in arm regeneration rates is best explained by swimming ability, not temperature, food supply, morphology (total number of arms and number of regenerating arms), or degree of injury. However, there were significant interactive effects of morphology on rates of regeneration of the main effect (swimming ability). Notably, swimmers grew up to three-fold faster than non-swimmers. The temperate feather star Florometra serratissima regenerated faster under warmer scenarios, but its rates fell within that of the tropical species suggesting temperature can account for intraspecific but not interspecific differences. We urge comparative molecular investigations of crinoid regeneration to identify the mechanisms responsible for the observed interspecific differences, and potentially address gaps in stem cell research.
Environmental DNA Monitoring of Biodiversity Hotspots in Danish Marine Waters
Authors: Staehr Peter A. U. , Dahl Karsten , Buur Helle , Göke Cordula , Sapkota Rumakanta , Winding Anne , Panova Marina , Obst Matthias , Sundberg Per
Published: January 2022

We investigated the use of eDNA metabarcoding for supplementing traditional diver-based monitoring of biodiversity of marine boulder reefs within the photic zone. The applied sampling design made it possible to evaluate the usefulness of eDNA monitoring as a supplement for traditional monitoring. Specifically, this study aimed to (1) assess the local influence of boulder reefs on biodiversity across the North Sea to Baltic Sea transition zone and (2) investigate the importance of environmental gradients for patterns in community structure. On samples collected during August 2020, we compared the composition and abundance of species associated with nine reefs, representing an environmental gradient of salinity (16–33 psu), water temperature (16–21°C) and water depth (6–29 m). At each reef site, water was sampled near the bottom just above the reef and on average 2.6 km upstream and downstream (location) and sequenced with metabarcoding using COI, 18S and 12S rDNA primers. eDNA identified 400 species, diver-based observations identified 184 with an overlap of 70 species (12%) and 81 genera (18%). While eDNA identified many infaunal species, it did not detect several macroalgal species which dominated in the diver-based observations. Multivariate analysis of eDNA and diver-based community structure both distinguished between reef communities, with a significant match between patterns observed by the two methods (r = 0.37, p = 0.02). Furthermore, the eDNA approach made it possible to identify significant differences in species composition between upstream, above-reef and downstream locations, suggesting that eDNA leaves a local footprint in benthic habitats. Patterns in both eDNA and diver-based species composition and richness were significantly related to geographical distance, salinity, water temperature and water depth. Despite of low detection of macroalgae, the eDNA sampling provided a substantial supplement to traditional diver-based monitoring of biodiversity around benthic hotspots in the Danish marine waters and therefore we recommend to add eDNA methods to conventional monitoring programs in the future.
Nanoindentation Response of Ion-Irradiated Fe, Fe-Cr Alloys and Ferritic-Martensitic Steel Eurofer 97: The Effect of Ion Energy
Authors: Das Aniruddh , Altstadt Eberhard , Kaden Cornelia , Kapoor Garima , Akhmadaliev Shavkat , Bergner Frank
Published: January 2022

Nanoindentation of ion-irradiated nuclear structural materials and model alloys has received considerable interest in the published literature. In the reported studies, the materials were typically exposed to irradiations using a single ion energy varying from study to study from below 1 MeV to above 10 MeV. However, systematic investigations into the effect of self-ion energy are still insufficient, meaning that the possibilities to gain insight from systematic energy variations are not yet exhausted. We have exposed pure Fe, ferritic Fe-9Cr, martensitic Fe-9Cr and the ferritic-martensitic reduced-activation steel Eurofer 97 to ion irradiations at 300°C using 1, 2 and 5 MeV Fe2+ ions as well as 8 MeV Fe3+ ions and applied nanoindentation, using a Berkovich diamond indenter, to characterize as-irradiated samples and unirradiated references. The effect of the ion energy on the measured nanoindentation response is discussed for each material. Two versions of a primary-damage-informed model are applied to fit the measured irradiation-induced hardening. The models are critically compared with the experimental results also taking into account reported microstructural evidence. Related ion-neutron transferability issues are addressed.
The Role of Radiology in Progressive Fibrosing Interstitial Lung Disease
Authors: Abu Qubo Ahmad , Capaccione K. M. , Bernstein Elana J. , Padilla Maria , Salvatore Mary
Published: January 2022

In this article, we describe the role of radiology for diagnosis and follow-up of progressive fibrosing interstitial lung disease (PF-ILD). Patients with PF-ILD are at increased risk for early death without treatment. Clinical diagnosis of PF-ILD has been described in the literature. This manuscript reviews the radiographic diagnosis of PF-ILD and the unique CT characteristics associated with specific types of fibrosis. Ultimately, we believe that radiology has the potential to recognize progression early and thus make an important contribution to the multidisciplinary discussion for this important diagnosis.
Microcirculatory Response to Blood vs. Crystalloid Cardioplegia During Coronary Artery Bypass Grafting With Cardiopulmonary Bypass
Authors: Aykut Güclü , Ulugöl Halim , Aksu Uğur , Akin Sakir , Karabulut Hasan , Alhan Cem , Toraman Fevzi , Ince Can
Published: January 2022

Background: Blood cardioplegia attenuates cardiopulmonary bypass (CPB)-induced systemic inflammatory response in patients undergoing cardiac surgery, which may favorably influence the microvascular system in this cohort. The aim of this study was to investigate whether blood cardioplegia would offer advantages over crystalloid cardioplegia in the preservation of microcirculation in patients undergoing coronary artery bypass grafting (CABG) with CPB.

Methods: In this prospective observational cohort study, 20 patients who received crystalloid (n = 10) or blood cardioplegia (n = 10) were analyzed. The microcirculatory measurements were obtained sublingually using incident dark-field imaging at five time points ranging from the induction of anesthesia (T0) to discontinuation of CPB (T5).

Results: In the both crystalloid [crystalloid cardioplegia group (CCG)] and blood cardioplegia [blood cardioplegia group (BCG)] groups, perfused vessel density (PVD), total vessel density (TVD), and proportion of perfused vessels (PPV) were reduced after the beginning of CPB. The observed reduction in microcirculatory parameters during CPB was only restored in patients who received blood cardioplegia and increased to baseline levels as demonstrated by the percentage changes from T0 to T5 (%Δ)T0−T5 in all the functional microcirculatory parameters [%ΔTVDT0−T5(CCG): −10.86 ± 2.323 vs. %ΔTVDT0−T5(BCG): 0.0804 ± 1.107, p < 0.001; %ΔPVDT0−T5(CCG): −12.91 ± 2.884 vs. %ΔPVDT0−T5(BCG): 1.528 ± 1.144, p < 0.001; %ΔPPVT0−T5(CCG): −2.345 ± 1.049 vs. %ΔPPVT0−T5(BCG): 1.482 ± 0.576, p < 0.01].

Conclusion: Blood cardioplegia ameliorates CPB-induced microcirculatory alterations better than crystalloid cardioplegia in patients undergoing CABG, which may reflect attenuation of the systemic inflammatory response. Future investigations are needed to identify the underlying mechanisms of the beneficial effects of blood cardioplegia on microcirculation.
Hyperglycemia and Angiotensin-Converting Enzyme 2 in Pulmonary Function in the Context of SARS-CoV-2 Infection
Authors: Vargas-Rodriguez Jose R. , Garza-Veloz Idalia , Flores-Morales Virginia , Badillo-Almaraz Jose I. , Rocha-Pizaña Maria R. , Valdés-Aguayo José J. , Martinez-Fierro Margarita L.
Published: January 2022

Since the appearance of the severe acute respiratory syndrome coronavirus (SARS-CoV) in 2003 in China, diabetes mellitus (DM) and hyperglycemia in patients infected with SARS-CoV, represent independent predictors of mortality. Therefore, metabolic control has played a major role in the prognosis of these patients. In the current pandemic of coronavirus disease 19 (COVID-19), multiple studies have shown that DM is one of the main comorbidities associated with COVID-19 and higher risk of complications and death. The incidence and prevalence of COVID-19 complications and death related with hyperglycemia in patients with or without DM are high. There are many hypotheses related with worse prognosis and death related to COVID-19 and/or hyperglycemia. However, the information about the interplay between hyperglycemia and angiotensin-converting enzyme 2 (ACE2), the critical receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in the context of SARS-CoV-2 infection, is almost null, but there is enough information to consider the possible participation of hyperglycemia in the glycation of this protein, unleashing a pool of reactions leading to acute respiratory distress syndrome and death in patients with COVID-19. In this document we investigated the current evidence related with ACE2 as a key element within the pathophysiological mechanism related with hyperglycemia extrapolating it to context of SARS-CoV-2 infection and its relationship with worse prognosis and death for COVID-19.
Artificial Intelligence-Aid Colonoscopy Vs. Conventional Colonoscopy for Polyp and Adenoma Detection: A Systematic Review of 7 Discordant Meta-Analyses
Authors: Pan Hui , Cai Mingyan , Liao Qi , Jiang Yong , Liu Yige , Zhuang Xiaolong , Yu Ying
Published: January 2022

Objectives: Multiple meta-analyses which investigated the comparative efficacy and safety of artificial intelligence (AI)-aid colonoscopy (AIC) vs. conventional colonoscopy (CC) in the detection of polyp and adenoma have been published. However, a definitive conclusion has not yet been generated. This systematic review selected from discordant meta-analyses to draw a definitive conclusion about whether AIC is better than CC for the detection of polyp and adenoma.

Methods: We comprehensively searched potentially eligible literature in PubMed, Embase, Cochrane library, and China National Knowledgement Infrastructure (CNKI) databases from their inceptions until to April 2021. Assessment of Multiple Systematic Reviews (AMSTAR) instrument was used to assess the methodological quality. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was used to assess the reporting quality. Two investigators independently used the Jadad decision algorithm to select high-quality meta-analyses which summarized the best available evidence.

Results: Seven meta-analyses met our selection criteria finally. AMSTAR score ranged from 8 to 10, and PRISMA score ranged from 23 to 26. According to the Jadad decision algorithm, two high-quality meta-analyses were selected. These two meta-analyses suggested that AIC was superior to CC for colonoscopy outcomes, especially for polyp detection rate (PDR) and adenoma detection rate (ADR).

Conclusion: Based on the best available evidence, we conclude that AIC should be preferentially selected for the route screening of colorectal lesions because it has potential value of increasing the polyp and adenoma detection. However, the continued improvement of AIC in differentiating the shape and pathology of colorectal lesions is needed.
Prognostic Value of Oral Epstein–Barr Virus DNA Load in Locoregionally Advanced Nasopharyngeal Carcinoma
Authors: He Yong-Qiao , Zhou Ting , Yang Da-Wei , Jia Yi-Jing , Yuan Lei-Lei , Zhang Wen-Li , Wang Tong-Min , Liao Ying , Xue Wen-Qiong , Zhang Jiang-Bo , Zheng Xiao-Hui , Li Xi-Zhao , Zhang Pei-Fen , Zhang Shao-Dan , Hu Ye-Zhu , Wang Fang , Cho William C. , Ma Jun , Sun Ying , Jia Wei-Hua
Published: January 2022

Background: Plasma Epstein–Barr virus (EBV) DNA load has been widely used for nasopharyngeal carcinoma (NPC) prognostic risk stratification. However, oral EBV DNA load, a non-invasive biomarker that reflects the EBV lytic replication activity, has not been evaluated for its prognostic value in NPC yet.

Methods: A total number of 1,194 locoregionally advanced NPC (LA-NPC) patients from south China were included from a prospective observational cohort (GARTC) with a median follow-up of 107.3 months. Pretreatment or mid-treatment mouthwashes were collected for EBV DNA detection by quantitative polymerase chain reaction (qPCR). The difference of pre- and mid-treatment oral EBV DNA load was tested by the Wilcoxon signed-rank test. The associations of oral EBV DNA load with overall survival (OS), progression-free survival (PFS), distant metastasis–free survival (DMFS), and locoregional relapse-free survival (LRFS) were assessed using the log-rank test and multivariate Cox regression.

Results: The high level of the oral EBV DNA load (>2,100 copies/mL) was independently associated with worse OS (HR = 1.45, 95% CI: 1.20–1.74, p < 0.001), PFS (HR = 1.38, 95% CI: 1.16–1.65, p < 0.001), DMFS (HR = 1.66, 95% CI: 1.25–2.21, p = 0.001), and LRFS (HR = 1.43, 95% CI: 1.05–1.96, p = 0.023). Similar and robust associations between oral EBV DNA load and prognosis were observed for patients in both the pretreatment and mid-treatment stages. The detection rate (71.7 vs. 48.6%, p < 0.001) and the median load of oral EBV DNA (13,368 vs. 382 copies/mL, p < 0.001) for patients in the pretreatment stage were significantly higher than those in the mid-treatment stage. The combination of the oral EBV DNA load and TNM staging provided a more precise risk stratification for the LA-NPC patients.

Conclusion: Oral EBV DNA load was an alternative non-invasive predictor of prognosis and may facilitate risk stratification for the LA-NPC patients.
Aging Brain and Hearing: A Mini-Review
Authors: Uchida Yasue , Nishita Yukiko , Otsuka Rei , Sugiura Saiko , Sone Michihiko , Yamasoba Tatsuya , Kato Takashi , Iwata Kaori , Nakamura Akinori
Published: January 2022

Brain reserve is a topic of great interest to researchers in aging medicine field. Some individuals retain well-preserved cognitive function until they fulfill their lives despite significant brain pathology. One concept that explains this paradox is the reserve hypothesis, including brain reserve that assumes a virtual ability to mitigate the effects of neuropathological changes and reduce the effects on clinical symptoms flexibly and efficiently by making complete use of the cognitive and compensatory processes. One of the surrogate measures of reserve capacity is brain volume. Evidence that dementia and hearing loss are interrelated has been steadily accumulating, and age-related hearing loss is one of the most promising modifiable risk factors of dementia. Research focused on the imaging analysis of the aged brain relative to auditory function has been gradually increasing. Several morphological studies have been conducted to understand the relationship between hearing loss and brain volume. In this mini review, we provide a brief overview of the concept of brain reserve, followed by a small review of studies addressing brain morphology and hearing loss/hearing compensation, including the findings obtained from our previous study that hearing loss after middle age could affect hippocampal and primary auditory cortex atrophy.
Asymmetric Distributions of Achromatic Bipolar Cells in the Mouse Retina
Authors: Sharpe Zachary J. , Shehu Angela , Ichinose Tomomi
Published: January 2022

In the retina, evolutionary changes can be traced in the topography of photoreceptors. The shape of the visual streak depends on the height of the animal and its habitat, namely, woods, prairies, or mountains. Also, the distribution of distinct wavelength-sensitive cones is unique to each animal. For example, UV and green cones reside in the ventral and dorsal regions in the mouse retina, respectively, whereas in the rat retina these cones are homogeneously distributed. In contrast with the abundant investigation on the distribution of photoreceptors and the third-order neurons, the distribution of bipolar cells has not been well understood. We utilized two enhanced green fluorescent protein (EGFP) mouse lines, Lhx4-EGFP (Lhx4) and 6030405A18Rik-EGFP (Rik), to examine the topographic distributions of bipolar cells in the retina. First, we characterized their GFP-expressing cells using type-specific markers. We found that GFP was expressed by type 2, type 3a, and type 6 bipolar cells in the Rik mice and by type 3b, type 4, and type 5 bipolar cells in the Lhx4 mice. All these types are achromatic. Then, we examined the distributions of bipolar cells in the four cardinal directions and three different eccentricities of the retinal tissue. In the Rik mice, GFP-expressing bipolar cells were more highly observed in the nasal region than those in the temporal retina. The number of GFP cells was not different along with the ventral-dorsal axis. In contrast, in the Lhx4 mice, GFP-expressing cells occurred at a higher density in the ventral region than in the dorsal retina. However, no difference was observed along the nasal-temporal axis. Furthermore, we examined which type of bipolar cells contributed to the asymmetric distributions in the Rik mice. We found that type 3a bipolar cells occurred at a higher density in the temporal region, whereas type 6 bipolar cells were denser in the nasal region. The asymmetricity of these bipolar cells shaped the uneven distribution of the GFP cells in the Rik mice. In conclusion, we found that a subset of achromatic bipolar cells is asymmetrically distributed in the mouse retina, suggesting their unique roles in achromatic visual processing.
Choice Bundling Increases Valuation of Delayed Losses More Than Gains in Cigarette Smokers
Authors: Stein Jeffrey S. , Brown Jeremiah M. , Tegge Allison N. , Freitas-Lemos Roberta , Koffarnus Mikhail N. , Bickel Warren K. , Madden Gregory J.
Published: January 2022

Choice bundling, in which a single choice produces a series of repeating consequences over time, increases valuation of delayed monetary and non-monetary gains. Interventions derived from this manipulation may be an effective method for mitigating the elevated delay discounting rates observed in cigarette smokers. No prior work, however, has investigated whether the effects of choice bundling generalize to reward losses. In the present study, an online panel of cigarette smokers (N = 302), recruited using survey firms Ipsos and InnovateMR, completed assessments for either monetary gains or losses (randomly assigned). In Step 1, participants completed a delay-discounting task to establish Effective Delay 50 (ED50), or the delay required for an outcome to lose half of its value. In Step 2, participants completed three conditions of an adjusting-amount task, choosing between a smaller, sooner (SS) adjusting amount and a larger, later (LL) fixed amount. The bundle size (i.e., number of consequences) was manipulated across conditions, where a single choice produced either 1 (control), 3, or 9 consequences over time (ascending/descending order counterbalanced). The delay to the first LL amount in each condition, as well as the intervals between all additional SS and LL amounts (where applicable), were set to individual participants’ ED50 values from Step 1 to control for differences in discounting of gains and losses. Results from Step 1 showed significantly higher ED50 values (i.e., less discounting) for losses compared to gains (p < 0.001). Results from Step 2 showed that choice bundling significantly increased valuation of both LL gains and losses (p < 0.001), although effects were significantly greater for losses (p < 0.01). Sensitivity analyses replicated these conclusions. Future research should examine the potential clinical utility of choice bundling, such as development of motivational interventions that emphasize both the bundled health gains associated with smoking cessation and the health losses associated with continued smoking.
The Efficacy of Adjuvant Corticosteroids in Surgical Management of Chronic Subdural Hematoma: A Systematic Review and Meta-Analysis
Authors: Tang Guoqiang , Chen Jiabei , Li Bin , Fang Song
Published: January 2022

Objective: This systematic review aimed to assess the efficacy of adjuvant corticosteroids in managing patients with chronic subdural hematoma (CSDH) undergoing surgical intervention.

Methods: We searched for eligible studies electronically on the databases of PubMed, Embase, and Google Scholar. The last date of the search was 15th Jun 2021. Outcomes were pooled to calculate risk ratios (RR) with 95% confidence intervals (CI).

Results: Eleven studies were included. Four of them were randomized controlled trials (RCTs). Six studies reported data on good neurological outcomes but with variable definitions. Combining all studies, we noted no statistically significant difference in good neurological outcome with the use of adjuvant corticosteroids (RR: 0.91 95% CI: 0.74, 1.12 I2 = 92% p = 0.39). Similar results were obtained on subgroup analysis based on definition and study type. However, the use of adjuvant corticosteroids was associated with a significantly reduced risk of recurrence (RR: 0.51 95% CI: 0.40, 0.64 I2 = 0% p < 0.0001). The meta-analysis also demonstrated no statistically significant difference in mortality rates with the use of adjuvant corticosteroids (RR: 1.01 95% CI: 0.47, 2.21 I2 = 76% p = 0.97). The results did not differ between RCTs and non-RCTs. Limited studies reported data on complications, and pooled analysis indicated no significant increase in infectious, gastrointestinal, and neurological complications with the use of adjuvant corticosteroids.

Conclusion: The use of corticosteroids with surgery for CSDH might be associated with a reduction in recurrence rate. However, corticosteroids do not improve functional outcomes or mortality rates. Future studies should assess the impact of different corticosteroid regimens on patient outcomes, and should use standardized reporting of neurological outcomes with uniform follow-up duration.
High Fibrinogen to Albumin Ratio: A Novel Marker for Risk of Stroke-Associated Pneumonia?
Authors: Lin Gangqiang , Hu Minlei , Song Jiaying , Xu Xueqian , Liu Haiwei , Qiu Linan , Zhu Hanyu , Xu Minjie , Geng Dandan , Yang Lexuan , Huang Guiqian , He Jincai , Wang Zhen
Published: January 2022

Background:Stroke-associated pneumonia (SAP) is associated with poor prognosis after acute ischemic stroke (AIS).

Purpose:This study aimed to describe the parameters of coagulation function and evaluate the association between the fibrinogen-to-albumin ratio (FAR) and SAP in patients with AIS.

Patients and methods:A total of 932 consecutive patients with AIS were included. Coagulation parameters were measured at admission. All patients were classified into two groups according to the optimal cutoff FAR point at which the sum of the specificity and sensitivity was highest. Propensity score matching (PSM) was performed to balance potential confounding factors. Univariate and multivariate logistic regression analyses were applied to identify predictors of SAP.

Results:A total of 100 (10.7%) patients were diagnosed with SAP. The data showed that fibrinogen, FAR, and D-dimer, prothrombin time (PT), activated partial thromboplastin time (aPTT) were higher in patients with SAP, while albumin was much lower. Patients with SAP showed a significantly increased FAR when compared with non-SAP (P< 0.001). Patients were assigned to groups of high FAR (≥0.0977) and low FAR (<0.0977) based on the optimal cut-off value. Propensity score matching analysis further confirmed the association between FAR and SAP. After adjusting for confounding and risk factors, multivariate regression analysis showed that the high FAR (≥0.0977) was an independent variable predicting the occurrence of SAP (odds ratio =2.830, 95% CI = 1.654–4.840,P< 0.001). In addition, the FAR was higher in the severe pneumonia group when it was assessed by pneumonia severity index (P= 0.008).

Conclusions:High FAR is an independent potential risk factor of SAP, which can help clinicians identify high-risk patients with SAP after AIS.