bluuebunny/crossref_metadata_2025 huggingface dataset:
Symptomatic improvement after radiofrequency catheter ablation for typical atrial flutter
Authors: O'Callaghan P A , Meara M , Kongsgaard E , Poloniecki J , Luddington L , Foran J , Camm A J , Rowland E , Ward D E
Published: July 2021

OBJECTIVE

To assess the changes in quality of life, arrhythmia symptoms, and hospital resource utilisation following catheter ablation of typical atrial flutter.

DESIGN

Patient questionnaire to compare the time interval following ablation with a similar time interval before ablation.

SETTING

Tertiary referral centre.

PATIENTS

63 consecutive patients were studied. Four patients subsequently underwent an ablate and pace procedure, two died of co-morbid illnesses, and two were lost to follow up. The remaining 55 patients form the basis of the report.

RESULTS

Patients were followed for a mean (SD) of 12 (9.5) months. Atrial flutter ablation resulted in an improvement in quality of life (3.8 v 2.5, p < 0.001) and reductions in symptom frequency score (2.0v 3.5, p < 0.001) and symptom severity score (2.0 v 3.8, p < 0.001) compared with preablation values. There was a reduction in the number of patients visiting accident and emergency departments (11%v 53%, p < 0.001), requiring cardioversion (7% v 51%, p < 0.001), or being admitted to hospital for a rhythm problem (11%v 56%, p < 0.001). Subgroup analysis confirmed that patients with atrial flutter and concomitant atrial fibrillation before ablation and those with atrial flutter alone both derived significant benefit from atrial flutter ablation. Patients with concomitant atrial fibrillation had an improvement in quality of life (3.5 v 2.5, p < 0.001) and reductions in symptom frequency score (2.3 v 3.5, p < 0.001) and symptom severity score (2.2v 3.7, p < 0.001) compared with preablation values.

CONCLUSIONS

Ablation of atrial flutter is recommended both in patients with atrial flutter alone and in those with concomitant atrial fibrillation.
DNA methylation-based prediction of response to immune checkpoint inhibition in metastatic melanoma
Authors: Filipski Katharina , Scherer Michael , Zeiner Kim N. , Bucher Andreas , Kleemann Johannes , Jurmeister Philipp , Hartung Tabea I. , Meissner Markus , Plate Karl H. , Fenton Tim R. , Walter Jörn , Tierling Sascha , Schilling Bastian , Zeiner Pia S. , Harter Patrick N.
Published: July 2021

Background

Therapies based on targeting immune checkpoints have revolutionized the treatment of metastatic melanoma in recent years. Still, biomarkers predicting long-term therapy responses are lacking.

Methods

A novel approach of reference-free deconvolution of large-scale DNA methylation data enabled us to develop a machine learning classifier based on CpG sites, specific for latent methylation components (LMC), that allowed for patient allocation to prognostic clusters. DNA methylation data were processed using reference-free analyses (MeDeCom) and reference-based computational tumor deconvolution (MethylCIBERSORT, LUMP).

Results

We provide evidence that DNA methylation signatures of tumor tissue from cutaneous metastases are predictive for therapy response to immune checkpoint inhibition in patients with stage IV metastatic melanoma.

Conclusions

These results demonstrate that LMC-based segregation of large-scale DNA methylation data is a promising tool for classifier development and treatment response estimation in cancer patients under targeted immunotherapy.
Initiating technology dependence to sustain a child’s life: a systematic review of reasons
Authors: Alexander Denise , Quirke Mary Brigid , Berry Jay , Eustace-Cook Jessica , Leroy Piet , Masterson Kate , Healy Martina , Brenner Maria
Published: July 2021

Background

Decision-making in initiating life-sustaining health technology is complex and often conducted at time-critical junctures in clinical care. Many of these decisions have profound, often irreversible, consequences for the child and family, as well as potential benefits for functioning, health and quality of life. Yet little is known about what influences these decisions. A systematic review of reasoning identified the range of reasons clinicians give in the literature when initiating technology dependence in a child, and as a result helps determine the range of influences on these decisions.

Methods

Medline, EMBASE, CINAHL, PsychINFO, Web of Science, ASSIA and Global Health Library databases were searched to identify all reasons given for the initiation of technology dependence in a child. Each reason was coded as a broad and narrow reason type, and whether it supported or rejected technology dependence.

Results

53 relevant papers were retained from 1604 publications, containing 116 broad reason types and 383 narrow reason types. These were grouped into broad thematic categories: clinical factors, quality of life factors, moral imperatives and duty and personal values; and whether they supported, rejected or described the initiation of technology dependence. The majority were conceptual or discussion papers, less than a third were empirical studies. Most discussed neonates and focused on end-of-life care.

Conclusions

There is a lack of empirical studies on this topic, scant knowledge about the experience of older children and their families in particular; and little written on choices made outside ‘end-of-life’ care. This review provides a sound basis for empirical research into the important influences on a child’s potential technology dependence.
Safety and efficacy results of the Flow Redirection Endoluminal Device (FRED) stent system in the treatment of intracranial aneurysms: US pivotal trial
Authors: McDougall Cameron G , Diaz Orlando , Boulos Alan , Siddiqui Adnan H , Caplan Justin , Fifi Johanna T , Turk Aquilla S , Kayan Yasha , Jabbour Pascal , Kim Louis J , Hetts Steven W , Cooke Daniel L , Dowd Christopher F
Published: July 2021

Objective

To evaluate the safety and effectiveness of the Flow Redirection Endoluminal Device (FRED) flow diverter in support of an application for Food and Drug Administration approval in the USA.

Methods

145 patients were enrolled in a prospective, single-arm multicenter trial. Patients with aneurysms of unfavorable morphology for traditional endovascular therapies (large, wide-necked, fusiform, etc) were included. The trial was designed to demonstrate non-inferiority in both safety and effectiveness, comparing trial results with performance goals (PGs) established from peer-reviewed published literature. The primary safety endpoint was death or major stroke (National Institutes of Health Stroke Scale score ≥4 points) within 30 days of the procedure, or any major ipsilateral stroke or neurological death within the first year. The primary effectiveness endpoint was complete occlusion of the target aneurysm with ≤50% stenosis of the parent artery at 12 months after treatment, and in which an alternative treatment of the target intracranial aneurysm had not been performed.

Results

145 patients underwent attempted placement of a FRED device, and one or more devices were placed in all 145 patients. 135/145 (93%) had a single device placed. Core laboratory adjudication deemed 106 (73.1%) of the aneurysms large or giant. A safety endpoint was experienced by 9/145 (6.2%) patients, successfully achieving the safety PG of <15%. The effectiveness PG of >46% aneurysm occlusion was also achieved, with the effectiveness endpoint being met in 80/139 (57.6%)

Conclusion

As compared with historically derived performance benchmarks, the FRED flow diverter is both safe and effective for the treatment of appropriately selected intracranial aneurysms.

Clinical registration number

NCT01801007
Increased nitric oxide metabolites in exhaled breath condensate after exposure to tobacco smoke
Authors: Balint B , Donnelly L E , Hanazawa T , Kharitonov S A , Barnes P J
Published: July 2021

BACKGROUND

Cigarette smoking reduces the level of exhaled nitric oxide (NO) in healthy subjects, although the mechanism is unclear. NO is a highly reactive molecule which can be oxidised or complexed with other biomolecules, depending on the microenvironment. The stable oxidation end products of NO metabolism are nitrite and nitrate. This study investigated the effect of smoking on NO metabolites in exhaled breath condensate.

METHODS

Fifteen healthy current smokers were recruited together with 14 healthy non-smokers. Measurement of exhaled NO, lung function, and collection of exhaled breath condensate were performed. Nitrite, nitrite + nitrate, S-nitrosothiols, and nitrotyrosine levels were measured. The effect of inhaling two cigarettes in smokers was also evaluated. The mean level of exhaled NO in smokers was significantly lower than in non-smokers (4.3 (0.3) ppb v 5.5 (0.5) ppb, p<0.05).

RESULTS

There was no difference in the levels of nitrite, nitrite + nitrate, S-nitrosothiols, and nitrotyrosine in the exhaled breath condensate at the baseline visit between smokers and non-smokers. After smoking, nitrite + nitrate levels were significantly but transiently increased (from 20.2 (2.8) μM to 29.8 (3.4) μM, p<0.05). There was no significant change in the levels of exhaled NO, nitrite, S-nitrosothiols, or nitrotyrosine 30 and 90 minutes after smoking.

CONCLUSIONS

These findings suggest that acute smoking can increase the level of nitrate, but not nitrite, S-nitrosothiols, or nitrotyrosine in breath condensate. The deleterious effect of oxidant radicals induced by smoking may contribute to the epithelial damage of airways seen in smokers.
Prevalence of untreated asthma in a population sample of 6000 older adults in Bristol, UK
Authors: Dow L , Fowler L , Phelps L , Waters K , Coggon D , Kinmonth A L , Holgate S T
Published: July 2021

BACKGROUND

A study was undertaken to estimate the prevalence of untreated asthma in older adults.

METHODS

A cross sectional population based survey of 6000 men and women aged 65 years and over was performed in 21 general practices in north Bristol, south west England. The main outcome measure was untreated asthma as defined by a two stage process comprising a respiratory questionnaire (symptoms suggestive of asthma or doctor diagnosed asthma not receiving respiratory treatment) followed by lung function tests (significant reversibility following bronchodilators or corticosteroids and/or significant within day variability in peak expiratory flow).

RESULTS

4792 of the 6000 participants (80%) completed the respiratory questionnaire and, of those not receiving respiratory treatment, 55 reported a previous doctor diagnosis of asthma and a further 696 had symptoms suggestive of asthma. Lung function testing in 280 of 501 randomly selected individuals from these groups resulted in 38 being defined as having asthma and an estimated population prevalence for untreated asthma of 2.4% (95% CI 1.6% to 3.6%) in men and 1.2% (95% CI 0.7% to 2.1%) in women. Most subjects (84%) with untreated asthma had moderate or severe disease. Untreated asthma was most common in individuals with doctor diagnosed asthma (21%) and those with breathlessness or wheeze (13–20%).

CONCLUSION

Untreated asthma in the elderly is a common and important problem. Opportunistic use of appropriate lung function tests in older people with a history of doctor diagnosed asthma or wheeze or breathlessness at rest could identify untreated asthmatics who might benefit from treatment.
Method for manipulating peak flow measurements producing falsely raised readings
Authors: Ross S , Cochran D P
Published: July 2021

Methods by which patients can artificially produce raised peak flow measurements have been described. We recently observed a patient manipulating the peak flow meter in a way that had not been described before. A study was therefore undertaken to determine if this technique could repeatedly produce clinically significant changes in peak flow readings. Fifteen adults, using a mini-Wright peak flow meter, made five measurements using the correct technique followed by five manipulated measurements under observation. Significant increases in peak flow measurements were observed in 14 of the 15 subjects. The mean increase in peak flow rate using the incorrect technique was 56% (range –4% to 86%). Clinicians should be aware that patients might employ this technique to manipulate measurements which could have consequences for management.
Fibrosing alveolitis in patients with rheumatoid arthritis as assessed by high resolution computed tomography, chest radiography, and pulmonary function tests
Authors: Dawson J K , Fewins H E , Desmond J , Lynch M P , Graham D R
Published: July 2021

BACKGROUND

Fibrosing alveolitis (FA) is a common and serious complication of rheumatoid arthritis (RA). Before the availability of high resolution computed tomographic (HRCT) scanning, it was difficult to diagnose accurately without recourse to biopsy. Prospective studies have reported a prevalence of interstitial lung disease (ILD) of 19–44%. The term ILD used by these authors encompasses a variety of appearances on HRCT scans. This prospective study used HRCT scanning to determine the true prevalence of FA in hospital outpatients with RA, and to study associated clinical characteristics.

METHODS

One hundred and fifty consecutive patients with RA were selected from a hospital outpatient department, irrespective of the presence or absence of chest disease. All underwent a detailed clinical assessment, chest HRCT scanning, and conventional chest radiography within 4 weeks of full pulmonary function tests.

RESULTS

Seventy percent of patients were current or reformed cigarette smokers. Twenty eight (19%) had FA, most frequently of reticular pattern, and 12 of this group (43%) also had emphysematous bullae. None of the previously suggested risk factors for developing FA were confirmed. Fifty four percent of patients with HRCT evidence of FA had bilateral basal chest crackles, 82% had a reduced carbon monoxide transfer factor (Tlco), 14% had restrictive pulmonary function tests, and 14% had bilateral chest radiographic signs of FA.

CONCLUSIONS

HRCT evidence of FA was present in 19% of hospital outpatients with RA. Abnormalities on chest examination or on full pulmonary function tests, even without restrictive changes or chest radiographic abnormalities, should prompt physicians to request a chest HRCT scan when investigating dyspnoea in patients with RA.
Prognostic value of CD4+ lymphocytes in pleural cavity of patients with non-small cell lung cancer
Authors: Takahashi K , Saito S , Kamamura Y , Katakawa M , Monden Y
Published: July 2021

BACKGROUND

For patients with non-small cell lung cancer the TNM staging system and other conventional prognostic factors fail to predict accurately the outcome of treatment and survival. This study attempts to determine the prognostic value for survival of the proportions of CD4+ lymphocytes in the pleural cavity (PLY) of patients with resectable non-small cell lung cancer.

METHODS

Lymphocytes in the pleural cavity separated from 51 patients with non-small cell lung cancer were examined by flow cytometry to measure the proportions of CD4+ PLY. Univariate and multivariate analyses were performed to assess the association between the proportion of CD4+ PLY and survival.

RESULTS

The 5 year survival rate of patients with percentage CD4+ PLY of ⩽30% was 84% whereas that of patients with %CD4+ PLY >30% was 26.9%. The difference in survival between the %CD4+ PLY ⩽30% and %CD4+ PLY >30% groups was significant (p<0.0001). The %CD4+ PLY in those who survived for 5 years was significantly lower than that in the patients who died within 5 years (p<0.0001). The difference in survival between patients with stage IA and IB lung cancer with %CD4+ PLY ⩽30% and those with %CD4+ PLY >30% was also significant (p =0.015). Multivariate analysis showed that the proportion of CD4+ PLY (hazard ratio=6.9, 95% CI 0.045 to 0.47) and nodal status (hazard ratio=22.7, 95% CI 0.006 to 1.806) are significant and independent prognostic factors for the survival of patients with lung cancer.

CONCLUSIONS

The proportion of CD4+ PLY may help to select patients who are likely to have a poorer prognosis after surgery and therefore may be suitable for consideration of adjuvant treatments. These results need confirmation in a larger prospective study.
Pulmonary alveolar proteinosis: a complete response to GM-CSF therapy
Authors: Barraclough R M , Gillies A J
Published: July 2021

Pulmonary alveolar proteinosis is a rare condition traditionally requiring treatment with whole lung lavage. The case is presented of a young man who obtained complete remission following treatment with granulocyte-macrophage colony stimulating factor, a new treatment option.
Alternative methods for assessing bronchodilator reversibility in chronic obstructive pulmonary disease
Authors: Hadcroft J , Calverley P M A
Published: July 2021

BACKGROUND

Bronchodilator reversibility testing is recommended in all patients with chronic obstructive pulmonary disease (COPD) but does not predict improvements in breathlessness or exercise performance. Two alternative ways of assessing lung mechanics—measurement of end expiratory lung volume (EELV) using the inspiratory capacity manoeuvre and application of negative expiratory pressure (NEP) during tidal breathing to detect tidal airflow limitation—do relate to the degree of breathlessness in COPD. Their usefulness as end points in bronchodilator reversibility testing has not been examined.

METHODS

We studied 20 patients with clinically stable COPD (mean age 69.9 (1.5) years, 15 men, forced expiratory volume in one second (FEV1) 29.5 (1.6)% predicted) with tidal flow limitation as assessed by their maximum flow-volume loop. Spirometric parameters, slow vital capacity (SVC), inspiratory capacity (IC), and NEP were measured seated, before and after nebulised saline, and at intervals after 5 mg nebulised salbutamol and 500 μg nebulised ipratropium bromide. The patients attended twice and the treatment order was randomised.

RESULTS

Mean FEV1, FVC, SVC, and IC were unchanged after saline but the degree of tidal flow limitation varied. FEV1improved significantly after salbutamol and ipratropium (0.11 (0.02) l and 0.09 (0.02) l, respectively) as did the other lung volumes with further significant increases after the combination. Tidal volume and mean expiratory flow increased significantly after all bronchodilators but breathlessness fell significantly only after the combination treatment. The initial NEP score was unrelated to subsequent changes in lung volume.

CONCLUSIONS

NEP is not an appropriate measurement of acute bronchodilator responsiveness. Changes in IC were significantly larger than those in FEV1and may be more easily detected. However, our data showed no evidence for separation of “reversible” and “irreversible” groups whatever outcome measure was adopted.
The seasonal dynamics of a High Arctic plant–visitor network: temporal observations and responses to delayed snow melt
Authors: Gillespie Mark A.K. , Cooper Elisabeth J.
Published: July 2021

Plant–visitor food webs provide important insights into species interactions, and more information about their seasonal dynamics is vital to understanding the resilience of species to external pressures. Studies of Arctic networks can also improve our understanding of species responses to the pressures of climate change. This study provides the first description of a plant – insect visitor network in Svalbard, a High Arctic archipelago already experiencing the consequences of climate change. A subset of the network was collected from experimental plots where the snow melt date was delayed with snow fences. The deep snow plots delayed flowering and we expected this to disrupt plant–visitor interactions compared with ambient snow conditions. However, the composition of flowers and insect visitors were similar between regimes, and the network tracked patterns of overall flowering phenology. Nevertheless, the deep snow significantly reduced the average overlap between flower availability and insect activity, reducing the probability of an interaction. We suggest that at a landscape scale, Arctic pollinators will benefit from patchy changes to snow melt that maintain heterogeneity in the timing of flowering but changes that increase homogeneity in snowmelt across the landscape may negatively impact some species.
Effect of autocorrelation function model on spatial prediction of geological interfaces
Authors: Qi Xiaohui , Wang Hao , Chu Jian , Chiam Kiefer
Published: July 2021

This study evaluated the performances of various autocorrelation function (ACF) models in predicting the geological interface using a well-known conditional random field method. Prediction accuracies and uncertainties were compared between a flexible Matérn model and two classical ACF models: the Gaussian model and the single exponential model. The rockhead data of Bukit Timah granite from boreholes at two sites in Singapore as well as simulated data were used for the comparisons. The results showed that the classical models produce a reasonable prediction uncertainty only when its smoothness coefficient is consistent with that of the geological data. Otherwise, the classical models may produce prediction errors much larger than that of the Matérn model. On the other hand, the prediction accuracy of the Matérn model is affected by the spacing of the boreholes. When the borehole spacing is relatively small (< 0.4 × scale of fluctuation), the Matérn model can reasonably quantify the prediction uncertainty. However, when the borehole spacing is large, the prediction by the Matérn model becomes less accurate as compared with the prediction using the classical models with the right value of smoothness coefficient due to the large estimation error of the smoothness coefficient.
Machine learning potentials for extended systems: a perspective
Authors: Behler Jörg , Csányi Gábor
Published: July 2021

In the past two and a half decades machine learning potentials have evolved from a special purpose solution to a broadly applicable tool for large-scale atomistic simulations. By combining the efficiency of empirical potentials and force fields with an accuracy close to first-principles calculations they now enable computer simulations of a wide range of molecules and materials. In this perspective, we summarize the present status of these new types of models for extended systems, which are increasingly used for materials modelling. There are several approaches, but they all have in common that they exploit the locality of atomic properties in some form. Long-range interactions, most prominently electrostatic interactions, can also be included even for systems in which non-local charge transfer leads to an electronic structure that depends globally on all atomic positions. Remaining challenges and limitations of current approaches are discussed.

Graphic Abstract
Large-scale and Robust Code Authorship Identification with Deep Feature Learning
Authors: Abuhamad Mohammed , Abuhmed Tamer , Mohaisen David , Nyang Daehun
Published: July 2021

Successful software authorship de-anonymization has both software forensics applications and privacy implications. However, the process requires an efficient extraction of authorship attributes. The extraction of such attributes is very challenging, due to various software code formats from executable binaries with different toolchain provenance to source code with different programming languages. Moreover, the quality of attributes is bounded by the availability of software samples to a certain number of samples per author and a specific size for software samples. To this end, this work proposes a deep Learning-based approach for software authorship attribution, that facilitates large-scale, format-independent, language-oblivious, and obfuscation-resilient software authorship identification. This proposed approach incorporates the process of learning deep authorship attribution using a recurrent neural network, and ensemble random forest classifier for scalability to de-anonymize programmers. Comprehensive experiments are conducted to evaluate the proposed approach over the entire Google Code Jam (GCJ) dataset across all years (from 2008 to 2016) and over real-world code samples from 1,987 public repositories on GitHub. The results of our work show high accuracy despite requiring a smaller number of samples per author. Experimenting with source-code, our approach allows us to identify 8,903 GCJ authors, the largest-scale dataset used by far, with an accuracy of 92.3%. Using the real-world dataset, we achieved an identification accuracy of 94.38% for 745 C programmers on GitHub. Moreover, the proposed approach is resilient to language-specifics, and thus it can identify authors of four programming languages (e.g., C, C++, Java, and Python), and authors writing in mixed languages (e.g., Java/C++, Python/C++). Finally, our system is resistant to sophisticated obfuscation (e.g., using C Tigress) with an accuracy of 93.42% for a set of 120 authors. Experimenting with executable binaries, our approach achieves 95.74% for identifying 1,500 programmers of software binaries. Similar results were obtained when software binaries are generated with different compilation options, optimization levels, and removing of symbol information. Moreover, our approach achieves 93.86% for identifying 1,500 programmers of obfuscated binaries using all features adopted in Obfuscator-LLVM tool.
Lowering barriers to active learning: a novel approach for online instructional environments
Authors: Rhodes Ashley
Published: July 2021

The value of active learning for increasing student comprehension and retention of science, technology, e,ngineering, and mathematics (STEM) concepts within undergraduate courses has proven to be beneficial many times over; however, barriers still exist for both instructors and students. For example, instructors are often left to decide what type of active learning activities to incorporate and how to implement them yet receive little to no formal training about how to do this effectively. Additionally, student resistance to active learning persists, which adds to the pressure faced by some instructors. Compounding these issues is the absence of high-speed Internet in some regions, which makes accessing active learning activities, many of which are offered through online commercial programs, impractical if not impossible for some students. This problem was highlighted during the pandemic when courses transitioned to being partially or fully online. In this article, I describe a novel active learning method that encourages students to cognitively engage with physiology concepts by using digital images to build structures and processes using an approach that is more accessible to everyone, regardless of Internet capabilities. This approach also provides instructors an option for creating their own active learning activity that may be more suitable for their specific level of students or learning outcomes.
Keeping environmental physiology education up and running during the COVID-19 pandemic
Authors: Tyler Christopher James , Debevec Tadej , Cheung Stephen S.
Published: July 2021

The COVID-19 pandemic provoked a need for rapid adaptation of teaching strategies and learning environments. Thus novel approaches, predominantly based on online/virtual platforms are needed to minimize the negative effects of the pandemic on teaching (and learning). Herein we describe our recent web-based symposium series on environmental physiology and ergonomics initiative as an example of such a strategy. We outline the ideas behind this series and its implementation, which could serve as an example of a useful joint interactive virtual educational environment that could be applied to any physiology subspecialty. Based on the feedback received from all stakeholders involved in the process, we strongly believe that such an approach can provide an excellent platform for all educational levels from undergraduate students up to seasoned academics. Importantly, the unrestricted availability (free registration and publication of recordings and student handouts) is an important consideration for the democratization of science and the inclusion of financially less well-supported students and academics.
Learning processes in anatomy and physiology: a qualitative description of how undergraduate students link actions and outcomes in a two-semester course sequence
Authors: Johnson Staci N. , Gallagher Eliza D.
Published: July 2021

This qualitative study investigated processes used by undergraduate students over a course sequence in anatomy and physiology (A&P). Longitudinal data for each participant include weekly written reflections and interviews at the beginning, middle, and end of the two-semester sequence. The themes that emerged describe three variations of approach to learning the course content. In some cases, the focus was on completing tasks and actions without connecting those to a specific outcome. In other cases, the focus was on outcomes without specific references to what steps might lead to that outcome. A third approach explicitly linked tasks and actions to one or more of nine different outcomes, including both personal and course expectations. Two other themes emerged as salient in combination with the three approaches: self-identified shortcomings with their study approaches and affective responses to the course and content. Affective responses included both positive affect such as enjoyment or excitement and negative affect such as frustration or dislike. Understanding the approaches that students take to learning, combined with their affect and shortcomings in those approaches, can inform instructor decisions about course activities and resources that support specific learning outcomes. It also provides a foundational knowledge base for the development of context-specific instruments for quantifying student learning processes in A&P.
Anatomists Assemble! Integrating superheroes into the anatomy and physiology classroom
Authors: Grachan Jeremy J. , Quinn Melissa M.
Published: July 2021

Anatomy and physiology courses are sometimes seen as difficult, which can lead to a lack of motivation in students to learn and engage in the course material. Students may also see the material as “dry,” have issues forming personal connections, or struggle to connect the content to the real world. These issues may lead to students not performing well in the course or feeling that the health field is not ideal for them. Popular culture, especially mainstream superheroes, can serve as an option for mending these gaps by being a gateway to connecting to many students’ lives. Superheroes can be integrated into the classroom through relevant, creative, and unique examples that include clinical correlates, modern scientific innovations, and some real-life “supers” living among us. Real anatomy and physiology can still be taught and explained through discussing these “incredible” examples and also present an opportunity for students to be creative in generating their own anatomical and physiological explanations for various superpowers. Superheroes also help open the classroom up to being a place of acceptance, primarily through their secret identities, which cover a broad range of idols that students can look up to, whether it is their career or based on a character’s race or sexual orientation. Professors can become the superhero in their classroom and help students become more engaged and interested in the material.
Glucose-dependent activation, activity, and deactivation of beta cell networks in acute mouse pancreas tissue slices
Authors: Stožer Andraž , Skelin Klemen Maša , Gosak Marko , Križančić Bombek Lidija , Pohorec Viljem , Slak Rupnik Marjan , Dolenšek Jurij
Published: July 2021

We assessed concentration-dependence in coupled β cells, degree of functional heterogeneity, and uncovered possible specialized subpopulations during the different phases of the response to glucose at the level of many individual cells. To this aim, we combined acute mouse pancreas tissue slices with functional multicellular calcium imaging over a wide range from threshold (7 mM) and physiological (8 and 9 mM) to supraphysiological (12 and 16 mM) glucose concentrations, classical physiological, and advanced network analyses.
Altered islet prohormone processing: a cause or consequence of diabetes?
Authors: Ramzy Adam , Kieffer Timothy J.
Published: July 2021

Peptide hormones are first produced as larger precursor prohormones that require endoproteolytic cleavage to liberate the mature hormones. A structurally conserved but functionally distinct family of nine prohormone convertase enzymes (PCs) are responsible for cleavage of protein precursors, of which PC1/3 and PC2 are known to be exclusive to neuroendocrine cells and responsible for prohormone cleavage. Differential expression of PCs within tissues defines prohormone processing; whereas glucagon is the major product liberated from proglucagon via PC2 in pancreatic α-cells, proglucagon is preferentially processed by PC1/3 in intestinal L cells to produce glucagon-like peptides 1 and 2 (GLP-1, GLP-2). Beyond our understanding of processing of islet prohormones in healthy islets, there is convincing evidence that proinsulin, pro-islet amyloid polypeptide (proIAPP), and proglucagon processing is altered during prediabetes and diabetes. There is predictive value of elevated circulating proinsulin or proinsulin-to-C-peptide ratio for progression to type 2 diabetes, and elevated proinsulin or proinsulin-to-C-peptide ratio is predictive for development of type 1 diabetes in at-risk groups. After onset of diabetes, patients have elevated circulating proinsulin and proIAPP, and proinsulin may be an autoantigen in type 1 diabetes. Furthermore, preclinical studies reveal that α-cells have altered proglucagon processing during diabetes, leading to increased GLP-1 production. We conclude that despite strong associative data, current evidence is inconclusive on the potential causal role of impaired prohormone processing in diabetes and suggest that future work should focus on resolving the question of whether altered prohormone processing is a causal driver or merely a consequence of diabetes pathology.
How development sculpts hippocampal circuits and function
Authors: Cossart Rosa , Khazipov Roustem
Published: July 2021

In mammals, the selective transformation of transient experience into stored memory occurs in the hippocampus, which develops representations of specific events in the context in which they occur. In this review, we focus on the development of hippocampal circuits and the self-organized dynamics embedded within them since the latter critically support the role of the hippocampus in learning and memory. We first discuss evidence that adult hippocampal cells and circuits are sculpted by development as early as during embryonic neurogenesis. We argue that these primary developmental programs provide a scaffold onto which later experience of the external world can be grafted. Next, we review the different sequences in the development of hippocampal cells and circuits at anatomical and functional levels. We cover a period extending from neurogenesis and migration to the appearance of phenotypic diversity within hippocampal cells and their wiring into functional networks. We describe the progressive emergence of network dynamics in the hippocampus, from sensorimotor-driven early sharp waves to sequences of place cells tracking relational information. We outline the critical turn points and discontinuities in that developmental journey, and close by formulating open questions. We propose that rewinding the process of hippocampal development helps understand the main organization principles of memory circuits.
Modified Arthroscopic Suture Fixation of Posterior Cruciate Ligament Tibial Avulsion Fracture in the Setting of Multiligament Knee Injury in Teenager
Authors: Quesado Miguel , Esteves Ana Sofia , da Silva Nuno Vieira , Costa Tiago , Ferreira Nuno , Nogueira Hélder
Published: July 2021

The posterior cruciate ligament (PCL) avulsion fracture is a rare injury and occurs mainly in young patients. The development of arthroscopic techniques and fixation methods has improved the treatment of this entity. This report describes a modified arthroscopic suture fixation of a small tibial avulsion fracture of the PCL. A 17-year-old male, injured in a motorcycle crash, was admitted to the Emergency Department and diagnosed with left knee PCL tibial avulsion fracture, lateral collateral ligament (LCL) femoral avulsion fracture, and patella fracture. The PCL was fixed arthroscopically using a Knee Scorpion and two SutureTapes (Arthrex, Munich-Germany) through of an interlaced configuration at the base of the fragment using a transseptal approach and fixed distally over a cortical button on the anterior cortex. The LCL was repaired with two cannulated screws by a percutaneous approach. At 1 year of follow-up, the fragment was healed with tibiofemoral congruence, and the knee was stable with complete range of motion. The Tegner Lysholm Knee Scoring Scale (TLKSS) was 92.
[Retracted] A Predictive Model for the Risk of Cognitive Impairment in Patients with Gallstones
Authors: Liu Zhaofang , Li Chuanyan
Published: July 2021

Objectives. Gallstones can cause malnutrition in patients and further lead to cognitive impairment. This study is aimed at constructing a validated clinical prediction model for evaluating the risk of developing cognitive impairment from gallstones. Methods. The study was a single‐centre crosssectional study. Four models or methods (SVM‐RFE, random forest model, Lasso model, and logistics analysis) were analyzed and compared regarding their predictive performance. The model with the best classification performance and predictive power was selected. The AUC index, C‐index, and calibration curves were applied to the chosen model to further evaluate its classification and prediction performance. Finally, the nomogram was plotted, and the clinical usability, efficacy, and safety of the nomogram were assessed using decision curve analysis (DCA). Results. This study included a total of 294 patients with gallstones, of which 110 had cognitive impairment. Factors such as gender, age, education, place of birth, history of alcohol consumption, abdominal circumference, sarcopenia, diabetes, anaemia, depression, and Pittsburgh Sleep Quality Index (PSQI) were incorporated into the model for nomogram construction. The calibration curve showed that the nomogram had good classification performance. Furthermore, the C‐index of the model was 0.778 (95% CI, 0.674‐0.882) in the test group. The DCA curves indicated that the constructed model had strong clinical applicability, efficacy, and safety. Conclusions. This study constructed a cognitive impairment risk prediction model for patients with gallstones with good classification and predictive power. The constructed predictive model allows us to screen patients with gallstones and at high risk of cognitive impairment. These efforts might also help to further increase patient compliance, assist healthcare professionals to better manage patients with gallstones, and ultimately improve their overall health status and quality of life. Future clinical studies should further evaluate the accuracy and clinical usability of this model.
Response Time Analysis for Nonperiodic CAN Message Based on GI/G/1 Queue Model
Authors: Meng Fei , Zhu Ying , Chu Zhenzhong
Published: July 2021

Controller area network (CAN) has wide applications in modern industrial control systems. Automobile manufacturers use this communication protocol for vehicle control, which is subject to real-time and high-reliability performance. However, with the increasing actuators gathered in the vehicle, time delay will lead to a serious problem for the vehicle safety and performance control. Thus, the information transmission stability of the CAN message needs to be investigated. In order to find out the delay response time of nonperiodic CAN message in the vehicle bus area, the response of the message transmitted in the CAN bus is modeled based on the GI/G/1 queue theory. The test platform is developed to verify the methodology. In the experimental test, some conditions with different IDs, load ratios, and priorities are investigated. Experimental results are compared with the theoretical results, and the simulation results show that the method is valid and verify the real response delay time of nonperiodic CAN message.
On Hamilton-Connectivity and Detour Index of Certain Families of Convex Polytopes
Authors: Hayat Sakander , Malik Muhammad Yasir Hayat , Ahmad Ali , Khan Suliman , Yousafzai Faisal , Hasni Roslan
Published: July 2021

A convex polytope is the convex hull of a finite set of points in the Euclidean space

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. By preserving the adjacency-incidence relation between vertices of a polytope, its structural graph is constructed. A graph is called Hamilton-connected if there exists at least one Hamiltonian path between any of its two vertices. The detour index is defined to be the sum of the lengths of longest distances, i.e., detours between vertices in a graph. Hamiltonian and Hamilton-connected graphs have diverse applications in computer science and electrical engineering, whereas the detour index has important applications in chemistry. Checking whether a graph is Hamilton-connected and computing the detour index of an arbitrary graph are both NP-complete problems. In this paper, we study these problems simultaneously for certain families of convex polytopes. We construct two infinite families of Hamilton-connected convex polytopes. Hamilton-connectivity is shown by constructing Hamiltonian paths between any pair of vertices. We then use the Hamilton-connectivity to compute the detour index of these families. A family of non-Hamilton-connected convex polytopes has also been constructed to show that not all convex polytope families are Hamilton-connected.
Automatic 3D Pollen Recognition Based on Convolutional Neural Network
Authors: Wang Zhuo , Wang Zixuan , Wang Likai
Published: July 2021

The importance of automatic pollen recognition has been examined in several areas ranging from paleoclimate studies to some daily practice such as pollen hypersensitivity forecasting. This paper attempts to present an automatic 3D pollen image recognition method based on convolutional neural network. To achieve this purpose, high feature dimensions and complex posture transformation should be taken into account. Therefore, this work focuses on a three-part novel approach: constructing spatial local key points to obtain local stable points of pollen images, computing orientational local binary pattern using local stable points as the inputs, and identifying the pollen grains using convolutional neural network as the classifier. Experiments are performed on two standard pollen image datasets: Confocal-E dataset and Pollenmonitor dataset. It is concluded that the proposed approach can effectively extract the features of pollen images and is robust to posture transformation, slight occlusion, and pollution.
Transtibial Amputation with Removal of the Tibial Intramedullary Nail: Hardware Removal in a Retrograde Manner
Authors: Choi Youn-Ho , Park DoJoon
Published: July 2021

Transtibial amputation is the preferred strategy for treating a diabetic foot with an infection and necrosis. However, if a tibial intramedullary nail was previously inserted into the ipsilateral lower extremity, the nail must be removed to perform the transtibial amputation. In this special situation, the removal of the tibial intramedullary nail can cause various complications after transtibial amputation. We present a case and surgical technique report of a 46-year-old male with an uncontrolled diabetic foot with tibial intramedullary nail insertion. With the nail and ankle fixed by distal interlocking screws, a below-knee amputation was performed by removing the nail and the amputated limb together. This surgical method is expected to reduce postoperative complications such as infections and patella instability after the amputation of a diabetic foot.
Application Research of Internet of Things Technology in the Causes of Dragon Boat Sports Injury
Authors: Wang Shuai , Zhao Xia
Published: July 2021

In recent years, the Internet of Things technology can effectively innovate applications and services. The Internet of Things technology has become more and more popular. It provides an effective and direct bridge between the physical world and virtual objects in cyberspace. With the increase in the intensity of dragon boat training and the increasingly fierce competition, the possibility of injury is increasing. Dragon boat racing is a noncontact team sport based on strength and technology. The purpose of this paper is to solve the problem of people's lack of understanding of the sports injuries and causes of dragon boat athletes. We used the data fusion algorithm and cluster maintenance optimization algorithm to study the application of Internet of Things technology in the cause of dragon boat sports injury. In order to save energy, extend the network life cycle, shorten service interruption time, and increase data packet transmission, the cluster maintenance optimization algorithm in this paper mainly improves and optimizes the startup time of cluster maintenance, which depends on the maintenance cost. The experiment result shows that the etiological detection system proposed in this paper matches the actual sports injury results well. The experiment result shows that the research on the cause of injury in dragon boat sports based on Internet of Things technology can detect the damage law well and can have a more comprehensive understanding for the cause of injury, which helps to prevent injuries better and take effective treatments. In the analysis part, it can be concluded that the detection system is very accurate in detecting the cause, and the accuracy rate is basically 100%.
Association of Frailty Status and Functional Disability among Community‐Dwelling People Aged 80 and Older in Vietnam
Authors: Nguyen Thu Thi Hoai , Nguyen Anh Trung , Vu Thanh-Huyen Thi , Dau Nga Thi , Nguyen Phong Quy , Nguyen Thanh Xuan , Nguyen Tam Ngoc , Nguyen Huong Thi Thu , Pham Thang , Vu Huyen Thi Thanh
Published: July 2021

Objectives. This study investigated associations between frailty and functional disability in elder suburban Vietnamese. Method. Cross‐sectional analysis was carried out on 251 participants aged 80 and over in Soc Son district. We used the Instrumental Activities of Daily Living (IADL) scale including 8 items, and functional disability was defined as ≥3 IADL impairment. We defined frail as ≥3 out of 5 frailty components including weight loss > 5%, weak grip, exhaustion, low walking speed, and low physical activity. Results. Of 251 participants with a mean age of 84.6, 11.2% was classified as frail and 64.5% had ≥3 IADLs. Among the frailty components, low walking speed and low physical activity were significantly associated with increased odds of having ≥3 IADLs: ORs (95% CI) were 4.2 (2.3‐7.9) and 3.7 (1.7‐8.2). Conclusion. Frailty is associated with the higher likelihood of having functional disability. Further longitudinal studies are needed to examine the causal this relationship.
Fuzzy Observer-Based

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Output-Feedback Control for Stochastic Nonlinear Systems with Multiplicative Noise
Authors: Yang Wenxuan , Hou Ting
Published: July 2021

A design method is established for the mixed

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output-feedback control of stochastic nonlinear systems with multiplicative noise. Firstly, using T-S fuzzy rules, we obtain a fuzzy model to approximate the original nonlinear system. Then, by Schur’s complement, the suboptimal

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output-feedback control design is transformed into a two-step convex optimization problem. A numerical example is given to show the effectiveness of the proposed method.