bluuebunny/crossref_metadata_2025 huggingface dataset:
Distribution of Flow in an Arteriovenous Fistula Using Reduced-Order Models
Authors: Ventre Jeanne , Abou Taam Salam , Fullana José Maria , Lagrée Pierre-Yves
Published: May 2021

The creation of a communication between an artery and a vein (arteriovenous fistula or AVF), to speed up the blood purification during hemodialysis of patients with renal insufficiency, induces significant rheological and mechanical modifications of the vascular network. In this study, we investigated the impact of the creation of an AVF with a zero-dimensional network model of the vascular system of an upper limb and a one-dimensional model around the anastomosis. We compared the simulated distribution of flow rate in this vascular system with Doppler ultrasound measurements. We studied three configurations: before the creation of the AVF, after the creation of the AVF, and after a focal reduction due to a hyper flow rate. The zero-dimensional model predicted the bounds of the diameter of the superficial vein that respects the flow constraints, assuming a high capillary resistance. We indeed highlighted the importance of knowing the capillary resistance as it is a decisive parameter in the models. We also found that the model reproduced the Doppler measurements of flow rate in every configuration and predicted the distribution of flow in cases where the Doppler was not available. The one-dimensional model allowed studying the impact of a venous constriction on the flow distribution, and the capillary resistance was still a crucial parameter.
Deep learning applied to lung ultrasound videos for scoring COVID-19
patients: A multicenter study
Authors: Mento Federico , Perrone Tiziano , Fiengo Anna , Smargiassi Andrea , Inchingolo Riccardo , Soldati Gino , Demi Libertario
Published: May 2021

In the current pandemic, lung ultrasound (LUS) played a useful role in evaluating patients affected by COVID-19. However, LUS remains limited to the visual inspection of ultrasound data, thus negatively affecting the reliability and reproducibility of the findings. Moreover, many different imaging protocols have been proposed, most of which lacked proper clinical validation. To address these problems, we were the first to propose a standardized imaging protocol and scoring system. Next, we developed the first deep learning (DL) algorithms capable of evaluating LUS videos providing, for each video-frame, the score as well as semantic segmentation. Moreover, we have analyzed the impact of different imaging protocols and demonstrated the prognostic value of our approach. In this work, we report on the level of agreement between the DL and LUS experts, when evaluating LUS data. The results show a percentage of agreement between DL and LUS experts of 85.96% in the stratification between patients at high risk of clinical worsening and patients at low risk. These encouraging results demonstrate the potential of DL models for the automatic scoring of LUS data, when applied to high quality data acquired accordingly to a standardized imaging protocol.
Local management matters for coral reefs
Authors: Knowlton Nancy
Published: May 2021

Impacts of marine heatwaves are worse when seaweeds and sea urchins are abundant
Lack of characteristic hexagonal surface structure on a newly isolated influenza C virus
Authors: Martin M L , Palmer E L , Kendal A P
Published: May 2021

The hexagonal surface structure believed to be characteristic for influenza C virus was not initially observed for a newly isolated virus of this type. After a few additional egg passages of the virus, however, the hexagonal structure could be readily seen on many virions.
Statistical determination of endotoxin content in influenza virus vaccine by the limulus amoebocyte lysate test
Authors: Rastogi S C , Hochstein H D , Seligmann E B
Published: May 2021

To determine laboratory-to-laboratory variability of the limulus amoebocyte lysate (LAL) test for evaluating endotoxin content in influenza virus vaccine, a collaborative study was designed. Participants were six influenza virus vaccine manufacturers and the Bureau of Biologics (BoB). Lysate lot 116, Reference Influenza Virus Vaccine for Endotoxin Assay E-1, and four test vaccines having different ratios of LAL activity relative to reference E-1 were supplied by the BoB. Each laboratory used its normal test procedure. All vaccines were coded. One pair (reference and test) of vaccines per day was tested for 4 days a week over a 4-week period. All data were analyzed at the BoB. The degree of variability experienced by testing laboratories was estimated by the study. This estimate did not conflict with experience gained from previous routine testing in any of the participating laboratories. A statistical approach to the evaluation of LAL data from testing influenza virus vaccine for endotoxin content was developed based upon the overall variation obtained from the collaborative study.
Modified indirect fluorescent-antibody test for aspergillosis
Authors: Gordon M A , Lapa E W , Kane J
Published: May 2021

Diffuse fluorescence in an indirect fluorescent-antibody test for antibody to Aspergillus fumigatus was eliminated by using germlings, rather than hyphae, as antigen. The modified method yielded diagnostic titers larger than or equal to 1:32 in 24 of 25 known cases, was highly specific, and showed good correlation with clinical status and results of immunodiffusion. This technique, which uses the germling antigen, inactivation of test serum at 59 +/- 1 degrees C, and anti-immunoglobulin G conjugate, is a sensitive, specific, and reliable quantitative indicator of aspergillosis and is useful in following the course of the disease.
New blood culture medium
Authors: Shih C N , Balish E
Published: May 2021

A growth medium with a specific oxidation-reduction potential containing peptone, dextrose, sodium succinate, sodium lactate, gelatin, sodium bicarbonate and blue tetrazolium, an indicator dye, in a tris(hydroxymethyl)aminomethane buffer was used to detect the presence of microorganisms in blood. The procedure involved the introduction of blood (and bacteria) into the growth medium with the dye in its colorless state. As the bacteria grew, they converted the dye to a visible blue color (formazan) with their reductases. The growth medium served as its own contamination control, since microbial growth and be detected by a color change before it was used for blood culture. The experiments described herein demonstrate that the composition of this medium (with the dye) provides a unique system that is able to make a reliable and rapid detection of both gram-positive and gram-negative microorganisms and yeasts (Candida albicans) commonly associated with bacteremia.
New human adenovirus (candidate adenovirus type 35) causing fatal disseminated infection in a renal transplant recipient
Authors: Stalder H , Hierholzer J C , Oxman M N
Published: May 2021

An antigenically distinct adenovirus is described which was isolated in March 1973 from the lungs and kidney of a 61-year-old woman who died of diffuse interstitial adenovirus pneumonia 55 days after receiving a cadaveric renal allograft. Complement fixation, hemagglutination inhibition, and serum neutralization tests on sequential serum specimens from the patient confirmed that the adenovirus infection occurred in coincidence with her clinical illness and failed to document concomitant infection by any other common respiratory agent. Pathological and virological findings indicated that the pneumonia was only one manifestation of a disseminated adenovirus infection, the source of which may have been a latent infection pre-existing in the donor kidney. The adenovirus, purified by terminal dilution and plaque procedures, has antigenic, morphological, biological, biophysical, host susceptibility, and hemagglutinating properties characteristic of adenovirus group 1A. Buoyant densities in CsCl are 1.340 g/ml for the virion, 1,300 g/ml for the group complement-fixing (hexon) antigen, and 1.290 g/ml for the major soluble complete hemagglutinin (dodecon). The virus was serologically distinct from adenoviruses 1 to 34 in reciprocal serum neutralization tests with antisera to these viruses. We propose this virus as candidate adenovirus type 35 (holden).
Simple method for distinguishing gonococcal colony types
Authors: Juni E , Heym G A
Published: May 2021

Gonococcal colony types can be distinguished by a new procedure that makes use of a dissecting microscope with a concave mirror and a fluorescent lamp. Critical adjustment of the mirror angle results in illumination similar to that obtained in the dark-field microscope. When the concave mirror is set at a certain angle, colonies of the lenticular types 1 and 2 refract the light coming through them in such a way that an edge of the microscope stage is focused in each colony. By contrast, colonies of types 3 and 4, which are relatively flat, fail to refract incident light. Although distinguishable from each other by differences in color, type 3 and 4 colonies do not display the focusing effect typical for type 1 and 2 colonies and appear uniformly illuminated. This new technique permits the rapid identification and isolation of even a single type 1 or 2 colony in a field of type 3 or 4 colonies, making it possible to obtain and maintain competent colonies (type 1 or 2) for the genetic transformation assay for Neisseria gonorrhoeae strain identification as well as for other purposes.
Nosocomial urinary tract infections caused by two O-serotypes of Providencia stuartii in one hospital
Authors: Whiteley G R , Penner J L , Stewart I O , Stokan P C , Hinton N A
Published: May 2021

Providencia stuartii nosocomial urinary tract infections occurring in the same hospital over an 18-month period of retrospective study were shown, by serotyping and biotyping, to have been caused by two endemic strains. Two episodes, involving 38 patients in one ward and 11 patients in another, were caused by a mannitol-positive strain of serotype O55. Transmission of the strain through the movements of one patient appeared to have been the basis for the introduction of the agent from one ward to the other. In another episode, involving two patients in a third ward, the infections were caused by a mannitol-negative strain of serotype O49. The study demonstrated the usefulness of serotyping and biotyping in epidemiological studies of infections caused by P. stuartii.
Clinical evaluation of commercial conjugates for direct immunofluorescence of herpes simplex virus
Authors: Gittzus J G , Rubin S J
Published: May 2021

Commercially prepared antibody conjugates that are now available allow extensive application of direct immunofluorescence for diagnosing herpetic infections. Five of these conjugates--Microbiological Associates bivalent herpes antiserum (MBA-bivalent), MBA anti-herpes types 1 (MBA-1) and 2 (MBA-2), and Flow Laboratories anti-herpes types 1 (Flow-1) and 2 (Flow-2)--were compared for antibody titer, diagnostic accuracy, and nonspecific background staining on known infected tissue. Four of these were tested simultaneously on 75 clinical specimens. No attempt was made to differentiate between herpes simplex virus type 1 or type 2 infections. All antisera were comparable in titer and exhibited fluorescence with both herpes simplex virus types 1 and 2 antigens. The most significant difference was excessive nonspecific staining consistently seen with the MBA-2 conjugate. Overall, Flow-2 and MBA-bivalent antisera were preferable.
Evaluation of two rapid methods for identification of commonly encountered nonfermenting or oxidase-positive, Gram-negative rods
Authors: Dowda H
Published: May 2021

The ability of the expanded API-20E and the Oxi-Ferm System to identify 176 isolates of nonfermenting or oxidase-positive, gram-negative rods from 17 species or groups was studied. The expanded API-20E, without referral to a computer reference center, was able to identify 61.4% of the isolates to the species level. If reference to the computer center was utilized, an additional 25% could be identified. Of the isolates examined, 13.6% were misidentified, partially identified, or assigned no identification. Those assigned to the incorrect genus constituted 0.5% of the isolates tested; those assigned to the correct genus, but the wrong species, constituted 0.5%; 4.5% were placed in the correct genus with no species given; and 7.9% were assigned no identification. The Oxi-Ferm System was able to assign 75% of the isolates to the correct species without further testing, and an additional 19.3% required additional testing for correct identification. Those assigned to the incorrect genus represented 3.4% of the isolates tested; 1.1% were assinged to the correct genus, but the wrong species; and 1.1% were assigned to the correct genus, with no species indicated.
Teaching Emerging Diseases: A Strategy for Succeeding with Nonmajors
Authors: FASS MARION FIELD
Published: May 2021

A nonmajors course on emerging diseases served to introduce students to basic concepts in microbiology and to improve scientific literacy. The course used a range of learner-centered approaches to encourage students to take responsibility for their own learning. Evaluations demonstrated both student satisfaction and an increased understanding of important issues in microbiology.
Central precocious puberty after resection of a virilising adrenocortical oncocytic tumour
Authors: Madi Lee Rima , Fisch Shvalb Naama , Sade Zaltz Chen , Levy-Shraga Yael
Published: May 2021

Adrenocortical oncocytic tumours are a histological subtype of adrenal neoplasms with a distinctive morphological appearance. Since these tumours are composed of cells of the adrenal cortex, they may act as functional tumours with excess hormone production. They may cause Cushing’s syndrome, inappropriate virilisation or precocious puberty. Though rare during childhood, adrenocortical oncocytic tumours should be suspected in a child with peripheral precocious puberty and marked elevation of dehydroepiandrosterone sulfate levels. We describe a 6-year girl who presented with peripheral precocious puberty due to a functional adrenocortical oncocytic tumour. Three months after tumour removal, she developed true central precocious puberty. This report highlights that peripheral precocious puberty may trigger central precocious puberty, particularly after resolution of the underlying cause of the peripheral precocious puberty.
Transcranial direct current stimulation (tDCS), a treatment option for tinnitus in profound hearing loss
Authors: Vasudevan Harini , Palaniswamy Hari Prakash , Praharaj Samir Kumar
Published: May 2021

A 45-year-old man presented with a history of sudden sensory neural hearing loss and severe tinnitus in his left ear. Audiological investigations revealed a profound hearing loss on his left ear and mild conductive hearing loss on his right. Tinnitus pitch and loudness were matched to a 4 kHz narrow-band noise at 50dBHL and subjective tinnitus questionnaires revealed that he had a catastrophic handicap (grade IV). Traditional audiological treatment approaches (tinnitus maskers, hearing aid and sound therapy) that stimulate the cochlea to induce cortical reorganisation were futile. Hence, a top-down approach (transcranial direct current stimulation (tDCS)) to directly modulate the cortical centres was attempted. tDCS was provided for a sum of 15 sessions across 2 phases. There was a substantial improvement in the tinnitus loudness, distress and depression scores which maintained for 3 months post-treatment. tDCS is a potential treatment for phantom perceptions (tinnitus) in cases of profound sensory neural hearing loss where there is no residual sensory ability. Tailor-made approaches seem to be more appropriate until a standard protocol for tDCS in tinnitus is established.
Novel manifestations of Farber disease mimicking neuronopathic Gaucher disease
Authors: Mhatre Shweta , Muranjan Mamta , Karande Sunil , Balaji Harish
Published: May 2021

Diagnosis of rare disorders requires heightened clinical acumen. When such disorders present with atypical or novel features, it adds to the diagnostic challenge. A 9-month-old female infant who had received a diagnosis of neonatal hepatitis due to cytomegalovirus infection at 2 months of age presented to our institute with developmental delay, fever, vomiting, feeding difficulty, breathlessness and features of elevated intracranial pressure due to hydrocephalus. Key examination findings with cholestatic jaundice as an early manifestation led to suspicion of type 4 Farber disease. Observation of hydrocephalus, hypertension, bilateral pinguecula and Erlenmeyer flask deformity of the femur were unusual findings for Farber disease. The child had few features (pinguecula, Erlenmeyer flask deformity and hydrocephalus) overlapping with Gaucher disease. Alternatively, prosaposin deficiency (Farber disease type 7) was another differential diagnosis. Diagnosis of Farber disease was confirmed by detection of foamy macrophages on skin biopsy and two homozygous missense variants inASAH1gene.
Growth arrest of a refractory vestibular schwannoma after anti-PD-1 antibody treatment
Authors: Kouzel Martinez Frank , Graffeo Christopher Salvatore , Carlstrom Lucas P , Link Michael J
Published: May 2021

A 25-year-old man presented with left-sided hearing loss, blurred vision and papilloedema. Imaging revealed a large, left-sided, contrast-enhancing cerebellopontine mass causing obstructive hydrocephalus, consistent with vestibular schwannoma (VS). Following an incomplete resection via retrosigmoid craniotomy at an outside facility, he was referred to our department, and cerebrospinal fluid diversion followed by repeat resection was recommended. A subtotal resection was achieved, and the patient was subsequently treated with adjuvant stereotactic radiosurgery (SRS). Progressive interval growth was observed on serial post-SRS MRI studies; correspondingly, at 31 months after treatment, the patient was initiated on antiprogrammed-death receptor 1 (PD-1) antibody treatment with pembrolizumab. Growth arrest was noted on subsequent serial imaging studies, which have been maintained for a total of 30 months since initiation of a 18-month anti-PD-1 course of therapy. Additional case accumulation and translational study is required to better characterise this therapeutic strategy; however, PD-1/programmed death-ligand 1 inhibition may offer a promising salvage therapy for refractory VS.
FIP1L1-PDGFRAfusion gene in a patient with asthma and rhinitis
Authors: Sato Megumi , Kato Ruri , Jokoji Ryu , Tachibana Isao
Published: May 2021

Eosinophilia in asthma or rhinitis is usually considered to be reactive to the allergic diseases. We report a 33-year-old man with asthma and rhinitis, and progressive hypereosinophilia. Fluorescence in situ hybridization analysis detected interstitial chromosomal deletion at 4q12 in cells of the bone marrow. The patient was diagnosed as myeloproliferative neoplasm with aFIP1L1-PDGFRAfusion gene, and successfully treated with the tyrosine kinase inhibitor, imatinib. Clonal expansion of eosinophils due to theFIP1L1-PDGFRAfusion gene could underlie refractory mechanisms in patients with bronchial asthma or allergic rhinitis.
Ocular ischaemic syndrome following coil embolisation for direct carotid cavernous fistula
Authors: Gunna Nithin Teja , Paritala Anusha , Takkar Brijesh , Sheth Jenil
Published: May 2021

A 36-year-old man presented with proptosis and external ophthalmoplegia of the left globe following road traffic injury. Cerebral angiogram revealed moderate flow direct carotid cavernous fistula on left side for which coil embolisation was done repeatedly. Subsequently, the patient developed decreased vision in left eye and developed features of left-sided ocular ischaemic syndrome. The patient was treated conservatively with spontaneous reversal of ocular ischaemic syndrome and complete regain of visual function.
Assessing vaccine introduction and uptake timelines in Gavi-supported countries: are introduction timelines accelerating across vaccine delivery platforms?
Authors: Luthra Karuna , Zimmermann Jin Anna , Vasudevan Prarthana , Kirk Karen , Marzetta Carol , Privor-Dumm Lois
Published: May 2021

Background

Previous studies identified factors influencing regulatory approval to introduction timelines for individual vaccines. However, introduction and uptake timelines have not been comprehensively assessed across the portfolio of Gavi-supported vaccines.

Methods

We analysed median times between introduction milestones from vaccine licensure to country introduction and uptake across six vaccine-preventable diseases (VPDs), three delivery platforms and 69 Gavi-supported countries. Data were gathered from public, partner and manufacturer records. VPDs and prequalified vaccines analysed includedHaemophilus influenzaetype b (DTwP-HepB-Hib, pentavalent), pneumococcal disease (pneumococcal conjugate vaccine, PCV), rotavirus diarrhoea (rotavirus vaccine, RVV), cervical cancer (human papillomavirus vaccine, HPV), polio (inactivated polio vaccine, IPV) and meningococcal meningitis (meningococcal group A conjugate vaccine, MenA).

Results

Median time from first vaccine licensure to first Gavi-supported country introduction across VPDs at a ‘global level’ (Gavi-supported countries) was 5.4 years. Once licensed, MenA vaccines reached first introduction fastest (campaign=0.6 years; routine immunisation (RI)=1.7 years). Most introductions were delayed. Country uptake following first introduction was accelerated for more recently Gavi-supported RI vaccines compared with older ones.

Conclusion

Factors accelerating timelines across delivery platforms included rapid product prequalifications by WHO, strong initial recommendations by the WHO Strategic Advisory Group of Experts (SAGE) on Immunization, achieving target product profiles on first vaccine licensure within a VPD and completing several VPD milestones at a global level prior to licensure. Milestones required for introduction in Gavi-supported countries should start prior or in parallel to licensure to accelerate uptake of vaccines delivered through diverse delivery platforms.
Critical care nutrition and COVID-19: a cause of malnutrition not to be underestimated
Authors: Eden Timothy , McAuliffe Shane
Published: May 2021

Malnutrition in critical care is highly prevalent and well documented to have adverse implications on morbidity and mortality. During the current COVID-19 pandemic, the evolving literature has been able to identify high risk groups in whom unfavourable outcomes are more common, for example, obesity, premorbid status, male sex, members from the Black, Asian and Minority Ethnic (BAME) community and others. Nutritional status and provision precritical and pericritical phase of COVID-19 illness is gaining traction in the literature assessing how this can influence the clinical course. It is therefore of importance to understand and address the challenges present in critical care nutrition and to identify and mitigate factors contributing to malnutrition specific to this patient group. We report a case of significant disease burden and the associated cachexia and evidence of malnutrition in a young 36-year-old male with Somalian heritage with no pre-existing medical conditions but presenting with severe COVID-19 during the first wave of the pandemic (March 2020). We highlight some key nutritional challenges during the critical phase of illness signposting to some of the management instigated to counter this. These considerations are hoped to provide further insight to help continue to evolve nutritional management when treating patients with COVID-19.
Associations between degree-of-worry, self-rated health and acute hospitalisation after contacting a medical helpline: a Danish prospective cohort study
Authors: Jensen Andrea Nedergaard , Kristiansen Maria , Tolstrup Janne Schurmann , Gamst-Jensen Hejdi
Published: May 2021

Objectives

Self-rated health (SRH) is a strong predictor for healthcare utilisation among chronically ill patients. However, its association with acute hospitalisation is unclear. Individuals’ perception of urgency in acute illness expressed as degree-of-worry (DOW) is however associated with acute hospitalisation. This study examines DOW and SRH, respectively, and their association with acute hospitalisation within 48 hours after calling a medical helpline.

Design

A prospective cohort study.

Setting

The Medical Helpline 1813 (MH1813) in the Capital Region of Denmark, Copenhagen.

Participants

Adult (≥18 years of age) patients and relatives/close friends calling the MH1813 between 24 January and 9 February 2017. A total of 6812 callers were included.

Outcome measures

The primary outcome measure was acute hospitalisation. Callers rated their DOW (1=minimum worry, 5=maximum worry) and SRH (1=excellent, 5=poor). Covariates included age, sex, Charlson Comorbidity Score and reason for calling. Logistic regression was conducted to measure the associations in three models: (1) crude; (2) age-and-sex-adjusted; (3) full fitted model (age, sex, comorbidity, reason for calling, DOW/SRH).

Results

Of 6812 callers, 492 (7.2%) were acutely hospitalised. Most callers rated their health as being excellent to good (65.3%) and 61% rated their worry to be low (DOW 1–3). Both the association between DOW and acute hospitalisation and SRH and acute hospitalisation indicated a dose–response relationship: DOW 1=ref, 3=1.8 (1.1;3.1), 5=3.5 (2.0;5.9) and SRH 1=ref, 3=0.8 (0.6;1.4), 5=1.6 (1.1;2.4). The association between DOW and acute hospitalisation decreased slightly, when further adjusting for SRH, whereas the estimates for SRH weakened markedly when including DOW.

Conclusions

DOW and poor SRH were associated with acute hospitalisation. However, DOW had a stronger association with hospitalisation than SRH. This suggests that DOW may capture acutely ill patients’ perception of urgency better than SRH in relation to acute hospitalisation after calling a medical helpline.

Trial registration number

NCT02979457.
Do screening tools assess palliative care needs and 12-month mortality in patients admitted to hepatology in-patient wards?
Authors: Low Joseph , Carroll Catherine , Wilson Jo , Craig Rachel , Vadera Shree , Cococcia Sara , Thorburn Douglas , Stone Patrick , Marshall Aileen , Vickerstaff Victoria
Published: May 2021

Background

Many liver patients have unmet palliative care needs, but liver clinicians are unclear whom to refer to specialist palliative care (SPC). The Supportive and Palliative Care Indicator Tool (SPICT) and the Bristol Prognostic Screening Tool (BPST) could help identify suitable patients, but neither has been tested for this role. This study evaluated their role as screening tools for palliative care needs and for predicting 12-month mortality.

Methods

A case note review of hepatology in-patients, who were not peritransplant and post-transplant status, was conducted in one tertiary unit. Main outcomes were clinical judgement of need for SPC referral, BPST scores, SPICT attribution of caseness and 12-month survival status. Discriminatory ability of tools was assessed using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the receiver operating characteristic (AUROC) curve.

Results

117 medical notes were reviewed for survival analysis, 47 of which were additionally assessed for suitability for SPC referral, using clinical judgement. SPICT (sensitivity=93%; PPV=93%; AUROC=0.933) and BPST (sensitivity=59%, PPV=79%, AUROC=0.693) demonstrated excellent and good performance, respectively, in predicting patients’ need for SPC referral. SPICT and BPST only had moderate ability at predicting death at 12 months (PPV: 54% and 56%, respectively).

Conclusion

SPICT and BPST show potential as screening tools for identifying patients for referral to SPC. Further work is needed to determine how to implement these tools in a clinical setting.
Assessment of cardiovascular risk tools as predictors of cardiovascular disease events in systemic lupus erythematosus
Authors: Sivakumaran Jagan , Harvey Paula , Omar Ahmed , Tayer-Shifman Oshrat , Urowitz Murray B , Gladman Dafna D , Anderson Nicole , Su Jiandong , Touma Zahi
Published: May 2021

Background

SLE is an independent risk factor for cardiovascular disease (CVD). This study aimed to determine which among QRISK2, QRISK3, Framingham Risk Score (FRS), modified Framingham Risk Score (mFRS) and SLE Cardiovascular Risk Equation (SLECRE) best predicts CVD.

Methods

This is a single-centre analysis on 1887 patients with SLE followed prospectively according to a standard protocol. Tools’ scores were evaluated against CVD development at/within 10 years for patients with CVD and without CVD. For patients with CVD, the index date for risk score calculation was chosen as close to 10 years prior to CVD event. For patients without CVD, risk scores were calculated as close to 10 years prior to the most recent clinic appointment. Proportions of low-risk (<10%), intermediate-risk (10%–20%) and high-risk (>20%) patients for developing CVD according to each tool were determined, allowing sensitivity, specificity, positive/negative predictive value and concordance (c) statistics analysis.

Results

Among 1887 patients, 232 CVD events occurred. QRISK2 and FRS, and QRISK3 and mFRS, performed similarly. SLECRE classified the highest number of patients as intermediate and high risk. Sensitivities and specificities were 19% and 93% for QRISK2, 22% and 93% for FRS, 46% and 83% for mFRS, 47% and 78% for QRISK3, and 61% and 64% for SLECRE. Tools were similar in negative predictive value, ranging from 89% (QRISK2) to 92% (SLECRE). FRS and mFRS had the greatest c-statistics (0.73), while QRISK3 and SLECRE had the lowest (0. 67).

Conclusion

mFRS was superior to FRS and was not outperformed by the QRISK tools. SLECRE had the highest sensitivity but the lowest specificity. mFRS is an SLE-adjusted practical tool with a simple, intuitive scoring system reasonably appropriate for ambulatory settings, with more research needed to develop more accurate CVD risk prediction tools in this population.
The cosmic muon and detector simulation framework of the extreme energy events (EEE) experiment
Authors: Abbrescia M. , Avanzini C. , Baldini L. , Ferroli R. Baldini , Batignani G. , Battaglieri M. , Boi S. , Bossini E. , Carnesecchi F. , Cicalò C. , Cifarelli L. , Coccetti F. , Coccia E. , Corvaglia A. , De Gruttola D. , De Pasquale S. , Fabbri F. , Fulci A. , Galante L. , Garbini M. , Gemme G. , Gnesi I. , Grazzi S. , Hatzifotiadou D. , Rocca P. La , Liu Z. , Mandaglio G. , Maron G. , Mazziotta M. N. , Mulliri A. , Nania R. , Noferini F. , Nozzoli F. , Palmonari F. , Panareo M. , Panetta M. P. , Paoletti R. , Pellegrino C. , Pinazza O. , Pinto C. , Pisano S. , Riggi F. , Righini G. , Ripoli C. , Rizzi M. , Sartorelli G. , Scapparone E. , Schioppa M. , Scribano A. , Selvi M. , Serri G. , Squarcia S , Taiuti M. , Terreni G. , Trifirò A. , Trimarchi M. , Triolo A. S. , Vistoli C. , Votano L. , Ungaro M. , Williams M. C. S. , Zichichi A. , Zuyeuski R.
Published: May 2021

This paper describes the simulation framework of the extreme energy events (EEE) experiment. EEE is a network of cosmic muon trackers, each made of three multi-gap resistive plate chambers (MRPC), able to precisely measure the absolute muon crossing time and the muon integrated angular flux at the ground level. The response of a single MRPC and the combination of three chambers have been implemented in a GEANT4-based framework (GEMC) to study the telescope response. The detector geometry, as well as details about the surrounding materials and the location of the telescopes have been included in the simulations in order to realistically reproduce the experimental set-up of each telescope. A model based on the latest parametrization of the cosmic muon flux has been used to generate single muon events. After validating the framework by comparing simulations to selected EEE telescope data, it has been used to determine detector parameters not accessible by analysing experimental data only, such as detection efficiency, angular and spatial resolution.
Extraction of the specific shear viscosity of quark-gluon plasma from two-particle transverse momentum correlations
Authors: Gonzalez Victor , Basu Sumit , Marin Ana , Pan Jinjin , Ladron de Guevara Pedro , Pruneau Claude A.
Published: May 2021

The specific shear viscosity, $$\eta /s$$

η
/
s

, of the quark-gluon plasma formed in ultrarelativistic heavy-ion collisions at RHIC and LHC is estimated based on the progressive longitudinal broadening of transverse momentum two-particle correlators, $$G_2$$

G
2

, reported as a function of collision centrality by the STAR and ALICE experiments. Estimates are computed as a function of collision centrality using the Gavin ansatz which relates the $$G_2$$

G
2

longitudinal broadening to the specific shear viscosity. Freeze out times required for the use of the ansatz are computed using a linear fit of freeze out times reported as a function of the cubic root of the charged particle pseudorapidity density ($${\mathrm{d}}N_{\mathrm{ch}}$$

d

N
ch

/d$$\eta )^{1/3}$$

η
)

1
/
3

. Estimates of $$\eta /s$$

η
/
s

based on ALICE data exhibit little to no dependence on collision centrality at LHC energy, while estimates obtained from STAR data hint that $$\eta /s$$

η
/
s

might be a function of collision centrality at top RHIC energy.
LSTM Cell Implementation on FPGAs
Authors: Dec Grzegorz Rafał
Published: May 2021

This paper presents and discusses the implementation of an LSTM cell on an FPGA with an activation function inspired by the CORDIC algorithm. The realization is performed using both IEEE754 standard and 32-bit integer numbers. The case with floating-point arithmetic is analyzed with and without DSP blocks provided by the Xilinx design suite. The alternative implementation including the integer arithmetic was optimized for a minimal number of clock cycles. Presented implementation uses xc6slx150t-2fgg900 and achieves high calculations accuracy for both cases.
Periodic shadowing in iterated function systems
Authors: Darabi Ali
Published: May 2021

In this paper, we introduce the notion of periodic shadowing property on iterated function systems, IFSs for short, and then some results will be obtained and compare with similar ones in the references. Among those results, we prove that every strongly expansive IFS with the shadowing property has the periodic shadowing property. In addition, like the shadowing property, we show that every uniformly expanding IFS has the periodic shadowing property. However, the periodic shadowing property is fulfilled for the uniformly contracting IFS provided that it is expansive.
Effects of short-term graded dietary carbohydrate intake on intramuscular and whole body metabolism during moderate-intensity exercise
Authors: Maunder Ed , Bradley Helen E. , Deane Colleen S. , Hodgson Adrian B. , Jones Michael , Joanisse Sophie , Turner Alice M. , Breen Leigh , Philp Andrew , Wallis Gareth A.
Published: May 2021

The data presented here suggest that metabolic responses to steady-state aerobic exercise are somewhat resistant to short-term changes in dietary carbohydrate (CHO) intake within the 5–6.5 g CHO·kg−1·day−1 [46–61% energy intake (EI)] range. In contrast, reduction in short-term dietary CHO intake to ∼2.4 g CHO·kg−1·day−1 (21% EI) evoked clear changes indicative of increased fat and decreased CHO metabolism during exercise.
Intelligent Traffic Management System Based on the Internet of Vehicles (IoV)
Authors: Elsagheer Mohamed Samir A. , AlShalfan Khaled A.
Published: May 2021

The present era is marked by rapid improvement and advances in technology. One of the most essential areas that demand improvement is the traffic signal, as it constitutes the core of the traffic system. This demand becomes stringent with the development of Smart Cities. Unfortunately, road traffic is currently controlled by very old traffic signals (tri-color signals) regardless of the relentless effort devoted to developing and improving the traffic flow. These traditional traffic signals have many problems including inefficient time management in road intersections; they are not immune to some environmental conditions, like rain; and they have no means of giving priority to emergency vehicles. New technologies like Vehicular Ad-hoc Networks (VANET) and Internet of Vehicles (IoV) enable vehicles to communicate with those nearby and with a dedicated infrastructure wirelessly. In this paper, we propose a new traffic management system based on the existing VANET and IoV that is suitable for future traffic systems and Smart Cities. In this paper, we present the architecture of our proposed Intelligent Traffic Management System (ITMS) and Smart Traffic Signal (STS) controller. We present local traffic management of an intersection based on the demands of future Smart Cities for fairness, reducing commute time, providing reasonable traffic flow, reducing traffic congestion, and giving priority to emergency vehicles. Simulation results showed that the proposed system outperforms the traditional management system and could be a candidate for the traffic management system in future Smart Cities. Our proposed adaptive algorithm not only significantly reduces the average waiting time (delay) but also increases the number of serviced vehicles. Besides, we present the implemented hardware prototype for STS.
An Unusual and Rare Presentation of Pulmonary Aspergillosis: Endobronchial Aspergilloma
Authors: Ali Mohammed , Mujahid Aisha , Dadhwal Rahul , Vakil Abhay , Anjum Humayun , Surani Salim
Published: May 2021

Aspergillosis is a wide spectrum of the disease process that is caused by the fungus Aspergillus. Endobronchial aspergilloma is a very rare type of aspergillosis which is not yet included in the classification of aspergillosis. Due to its rare nature and a limited number of cases, there are no current treatment guidelines. Here we present the case of a 57-year-old female with an endobronchial aspergilloma. The patient was started on intravenous voriconazole and subsequently discharged on oral voriconazole.
Combustion Characteristics of Mui and Taru Basin Coal in a Fluidized Bed Combustor
Authors: Ondari Brian , Siagi Zachary , Kumar Anil
Published: May 2021

Coal reserves at Mui and Taru in Kitui and Kilifi counties in Kenya are estimated to provide over 400 million tons. Being new discoveries, their properties were investigated using the ASTM standards, while the combustion characteristics were studied in a fluidized bed combustor (FBC). Proximate analyses of the Mui1, Mui2, and Taru coal samples were as follows: moisture content 3.75, 5.48, and 3.53%; volatile matter 59.25, 58.05, and 55.10%; ash content 9.25, 11.48, and 24.63%; and fixed carbon 27.80, 25.00, and 16.75%, respectively. Ultimate analysis for Mui1, Mui2, and Taru coal samples is as follows: sulphur wt.% 1.94, 1.89, and 1.07; carbon 65.68, 60.98, and 51.10%; hydrogen 5.97, 5.70, and 5.09%; nitrogen 0.92, 0.94, and 1.00%; and oxygen 11.62, 12.33, and 11.13%, respectively. Temperature–weight loss analysis showed that for Mui and Taru basin coal, devolatilization starts at 200°C and 250°C, and combustion was complete at 750°C and 650°C, respectively. The maximum temperature obtained in FBC was 855°C at 700 mm height, just above the point of fuel feed, while the minimum was 440°C at height of 2230 mm. Maximum pressure drop was 1.02 mbars at 150 mm, while minimum was 0.67 mbars at 700 mm from the base. Gross calorific values were Mui1 coal, 27090 kJ/kg (grade A), Mui2 coal, 25196 kJ/kg (grade B), and the Taru coal, 21016 kJ/kg (grade C). Flue gas analysis for Taru and Mui coal gave hydrogen sulfide as 20 ppm and 6 ppm, maximum carbon monoxide of 2000 ppm at 600°C, and a decrease in oxygen as combustion progressed to a minimum of 15%, followed by an increase to 20.3%, suggesting depletion of coal. Based on the findings, the coal samples were suitable for commercial use.
Multiconstrained Gliding Guidance Based on Optimal and Reinforcement Learning Method
Authors: Zhe Luo , Xinsan Li , Lixin Wang , Qiang Shen
Published: May 2021

In order to improve the autonomy of gliding guidance for complex flight missions, this paper proposes a multiconstrained intelligent gliding guidance strategy based on optimal guidance and reinforcement learning (RL). Three-dimensional optimal guidance is introduced to meet the terminal latitude, longitude, altitude, and flight-path-angle constraints. A velocity control strategy through lateral sinusoidal maneuver is proposed, and an analytical terminal velocity prediction method considering maneuvering flight is studied. Aiming at the problem that the maneuvering amplitude in velocity control cannot be determined offline, an intelligent parameter adjustment method based on RL is studied. This method considers parameter determination as a Markov Decision Process (MDP) and designs a state space via terminal speed and an action space with maneuvering amplitude. In addition, it constructs a reward function that integrates terminal velocity error and gliding guidance tasks and uses Q-Learning to achieve the online intelligent adjustment of maneuvering amplitude. The simulation results show that the intelligent gliding guidance method can meet various terminal constraints with high accuracy and can improve the autonomous decision-making ability under complex tasks effectively.
Study of Human Motion Recognition Algorithm Based on Multichannel 3D Convolutional Neural Network
Authors: Ju Yang
Published: May 2021

Aiming at the problem that it is difficult to balance the speed and accuracy of human behaviour recognition, this paper proposes a method of motion recognition based on random projection. Firstly, the optical flow picture and Red, Green, Blue (RGB) picture obtained by the Lucas‐Kanade algorithm are used. Secondly, the data of optical flow pictures and RGB pictures are compressed based on a random projection matrix of compressed sensing, which effectively reduces power consumption. At the same time, based on random projection compression data, it can effectively find the optimal linear representation to reconstruct training samples and test samples. Thirdly, a multichannel 3D convolutional neural network is proposed, and the multiple information extracted by the network is fused to form an output recognizer. Experimental results show that the algorithm in this paper significantly improves the recognition rate of multicategory actions and effectively reduces the computational complexity and running time of the recognition algorithm.
Infants Diagnosed with Athyreosis on Scintigraphy May Have a Gland Present on Ultrasound and Have Transient Congenital Hypothyroidism
Authors: McGrath Niamh , Hawkes Colin Patrick , Ryan Stephanie , Mayne Philip , Murphy Nuala
Published: May 2021

Scintigraphy using technetium-99m (99mTc) is the gold standard for imaging the thyroid gland in infants with congenital hypothyroidism (CHT) and is the most reliable method of diagnosing an ectopic thyroid gland. One of the limitations of scintigraphy is the possibility that no uptake is detected despite the presence of thyroid tissue, leading to the spurious diagnosis of athyreosis. Thyroid ultrasound is a useful adjunct to detect thyroid tissue in the absence of 99mTc uptake. Aims: We aimed to describe the incidence of sonographically detectable in situ thyroid glands in infants scintigraphically diagnosed with athyreosis using 99mTc and to describe the clinical characteristics and natural history in these infants. Methods: The newborn screening records of all infants diagnosed with CHT between 2007 and 2016 were reviewed. Those diagnosed with CHT and athyreosis confirmed on scintigraphy were invited to attend a thyroid ultrasound. Results: Of the 488 infants diagnosed with CHT during the study period, 18/73 (24.6%) infants with absent uptake on scintigraphy had thyroid tissue visualised on ultrasound (3 hypoplastic thyroid glands and 15 eutopic glands). The median serum thyroid-stimulating hormone (TSH) concentration at diagnosis was significantly lower than that in infants with confirmed athyreosis (no gland on ultrasound and no uptake on scintigraphy) (74 vs. 270 mU/L), and median free T4 concentration at diagnosis was higher (11.9 vs. 3.9 pmol/L). Six of 10 (60%) infants with no uptake on scintigraphy but a eutopic gland on ultrasound had transient CHT. Conclusion: Absent uptake on scintigraphy in infants with CHT does not rule out a eutopic gland, especially in infants with less elevated TSH concentrations. Clinically, adding thyroid ultrasound to the diagnostic evaluation of infants who have athyreosis on scintigraphy may avoid committing some infants with presumed athyreosis to lifelong levothyroxine treatment.
Efficacy and Safety of Divaza for the Correction of Oxidative Disturbances in Patients with Cerebral Atherosclerosis: A Randomized Controlled Trial
Authors: Lashch Nataliia U. , Kamchatnov Pavel R. , Fedorova Tatiana N. , Muzychuk Olga A. , Khacheva Kristina K. , Pizova Nataliya V. , Malygin Alexander U. , Shavlovskaya Olga A. , Fateeva Victoria V. , Nikulina Kseniya V. , Abrosimov Аlbert V. , Gerasimova Yulia A. , Glushkov Konstantin S. , Lebedeva Anna V.
Published: May 2021

Objective: The objective of this study was to determine if Divaza, a drug with nootropic and antioxidant effects, was safe and effective for the correction of oxidative disturbances and to stabilize cognitive impairment in patients with cerebral atherosclerosis. Study Design: The study design consisted of a 12-week multicenter, randomized, double-blind, placebo-controlled, prospective trial in parallel groups. Setting: The setting in which the study was conducted comprised 10 clinical centers across the Russian Federation. Interventions: Patients were randomized into 2 groups and instructed to take either 2 tablets of the study drug or a placebo 3 times per day in conjunction with basic therapy. Outcomes: The primary outcome was a change in the average endogenous antioxidant potential after the completion of the study. The blood indicators of the oxidative stress (OS) were analyzed at the baseline and then after 12 weeks of therapy using iron-induced chemiluminescence analysis. The Montreal cognitive assessment test was used as a secondary outcome measure to evaluate cognitive impairment at the end of the study. Results: 124 outpatients with a mean age of 60.7 ± 7.6 years were enrolled and randomly assigned to receive Divaza (n = 65) or a placebo (n = 59). An improvement of cognitive function was observed in all patients of the Divaza group at the end of the treatment; this was significantly better than the placebo group (100 [100] vs. 89.5 [89.1]%, respectively, p = 0.0272 [p = 0.0128]). The administration of Divaza restored the activity of the endogenous antioxidant system. The change in the average level of lipoprotein resistance to oxidation after 12 weeks of therapy, compared to the baseline, was significantly higher in the Divaza group (14.8 ± 14.7 [14.8 ± 14.7] seconds latent period vs. 6.4 ± 16.9 [6.9 ± 16.7] seconds in the placebo group (p = 0.007 [p = 0.0107]). Conclusions: Divaza is a safe and effective therapeutic option for attenuating OS and recovery of cognitive impairment in patients with cerebral atherosclerosis.