bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics of Lumbar Bone Density in Middle-Aged and Elderly Subjects: A Correlation Study between T-Scores Determined by the DEXA Scan and Hounsfield Units from CT
Authors: Zhang Dejian , Wu Yao , Luo Shengfei , Wang Fangyong , Li Lizhuo
Published: December 2021

Purpose. To describe the characteristics of lumbar bone density in middle-aged and elderly subjects and explore whether there is a correlation between computed tomography (CT) values and the bone mineral density (BMD) T-scores of the lumbar vertebral cancellous bone. Methods. Forty-two subjects, including 25 males and 17 females, with a mean age of 56 years, who underwent BMD measurement and lumbar multislice spiral CT scan at the China Rehabilitation Research Center from January 2019 to December 2019 were selected. Dual-energy X-ray absorptiometry (DEXA) was applied to obtain the total BMD T-scores of the lumbar L1–L4 vertebrae. Results. The CT values decreased from L1 to L4 and were 145.91 ± 8.686 HU, 143.18 ± 8.598 HU, 137.39 ± 8.276 HU, and 135.23 ± 8.219 HU, respectively. The total CT value of L1–L4 was 140.43 ± 4.199 HU. The mean total BMD T-score of L1–L4 was −0.94. The CT values of the L1–L4 vertebrae were positively correlated with the total BMD T-scores of L1–L4 (r = 0.349,

P
<
0.001

). The CT value of the left third of the same vertebrae was the highest, and there was a strong positive correlation between the regional CT value of the lumbar spine and the entire vertebra CT values (r > 0.7). Conclusion. The CT values of the lumbar spine can assist the measurement of the T-scores of lumbar BMD, which could aid in early opportunistic screening for osteopenia and preventing osteoporosis and vertebral compression fractures in middle-aged and elderly subjects. This trial is registered with ChiCTR2100049571.
Clinical Characteristics of Pregnancy-Associated Central Serous Chorioretinopathy in the Chinese Population
Authors: Yu Jia , Li Lei , Jiang Chunhui , Chang Qing , Xu Gezhi
Published: December 2021

Purpose. To investigate the clinical characteristics of pregnancy-associated central serous chorioretinopathy (CSC) in the Chinese population. Methods. The medical records of patients diagnosed with pregnancy-associated CSC from February 2012 to October 2019 were retrospectively reviewed. Best-corrected visual acuity (BCVA), symptom duration, pregnancy-related medical information, and optical coherence tomography (OCT) images were collected. Results. Nine patients (11 eyes) were included. Five women were in their first pregnancy and four were in their second pregnancy, two of whom experienced CSC in their first pregnancy as well. The mean age was 35.00 ± 3.97 years. The mean symptom duration at the initial visit was 19.73 ± 13.65 days. The mean gestational age at the time of development of CSC was 27.11 ± 2.09 weeks. The mean BCVA (logarithm of the minimum angle of resolution (logMAR)) at the initial visit was 0.36 ± 0.18 (Snellen 20/45, range 20/100–20/25). All eyes showed subretinal hyperreflective fibrin on OCT images at the initial visit. Four patients (4 eyes) were lost to follow-up before fluid resolution. The mean BCVA at the final visit was logMAR 0.10 ± 0.15 (Snellen 20/25, range 20/50–20/20)). One eye in the oldest patient had persistent subretinal fluid at 26 months postpartum. The subretinal fluid resolved completely after half-dose photodynamic therapy (PDT); however, the ellipsoid zone at the fovea remained discontinuous at 30 months after half-dose PDT. The remaining six eyes all showed spontaneous resolution of subretinal fluid around delivery and regained intact ellipsoid zone. Conclusions. Pregnancy-associated CSC in Chinese developed mostly in the third trimester and usually recovered spontaneously around delivery with good final visual acuity. However, patients might require long-term follow-up until complete resolution of subretinal fluid and to detect recurrences. Half-dose PDT can be administered early if there is little reduction in the amount of subretinal fluid after delivery.
Fourth Hankel Determinant for a Subclass of Starlike Functions Based on Modified Sigmoid
Authors: Mashwani Wali Khan , Ahmad Bakhtiar , Khan Nazar , Khan Muhammad Ghaffar , Arjika Sama , Khan Bilal , Chinram Ronnason
Published: December 2021

In our present investigation, we obtain the improved third-order Hankel determinant for a class of starlike functions connected with modified sigmoid functions. Further, we investigate the fourth-order Hankel determinant, Zalcman conjecture, and also evaluate the fourth-order Hankel determinants for 2-fold, 3-fold, and 4-fold symmetric starlike functions.
Research on Students’ Adaptive Learning System Based on Deep Learning Model
Authors: Yang Xi , Zhou Zhihan , Xiao Yu
Published: December 2021

With the rapid development of deep learning in recent years, recommendation algorithm combined with deep learning model has become an important direction in the field of recommendation in the future. Personalized learning resource recommendation is the main way to realize students’ adaptation to the learning system. Based on the in-depth learning mode, students’ online learning action data are obtained, and further learning analysis technology is used to construct students’ special learning mode and provide suitable learning resources. The traditional method of introducing learning resources mainly stays at the level of examination questions. What ignores the essence of students’ learning is the learning of knowledge points. Students’ learning process is affected by “before” and “after” learning behavior, which has the characteristics of time. Among them, bidirectional length cyclic neural network is good at considering the “front” and “back” states of recommended nodes when recommending prediction results. For the above situation, this paper proposes a recommendation method of students’ learning resources based on bidirectional long-term and short-term memory cyclic neural network. Firstly, recommend the second examination according to the knowledge points, predict the scores of important steps including the accuracy of the recommended examination of the target students and the knowledge points of the recommended examination, and finally cooperate with the above two prediction results to judge whether the examination questions are finally recommended. Through the comparative experiment with the traditional recommendation algorithm, it is found that the student adaptive learning system based on the deep learning model proposed in this paper has better stability and interpretability in the recommendation results.
Publishing Triangle Counting Histogram in Social Networks Based on Differential Privacy
Authors: Lv Tianzi , Li Huanzhou , Tang Zhangguo , Fu Fangzhou , Cao Jian , Zhang Jian
Published: December 2021

The continuous expansion of the number and scale of social networking sites has led to an explosive growth of social network data. Mining and analyzing social network data can bring huge economic value and social benefits, but it will result in privacy leakage and other issues. The research focus of social network data publishing is to publish available data while ensuring privacy. Aiming at the problem of low data availability of social network node triangle counting publishing under differential privacy, this paper proposes a privacy protection method of edge triangle counting. First, an edge-removal projection algorithm TSER based on edge triangle count sorting is proposed to obtain the upper bound of sensitivity. Then, two edge triangle count histogram publishing methods satisfying edge difference privacy are given based on the TSER algorithm. Finally, experimental results show that compared with the existing algorithms, the TSER algorithm can retain more triangles in the original graph, reduce the error between the published data and the original data, and improve the published data availability.
Linkable Ring Signature Scheme Using Biometric Cryptosystem and NIZK and Its Application
Authors: Mao Xuechun , You Lin , Cao Chengtang , Hu Gengran , Hu Liqin
Published: December 2021

Biometric encryption, especially based on fingerprint, plays an important role in privacy protection and identity authentication. In this paper, we construct a privacy-preserving linkable ring signature scheme. In our scheme, we utilize a fuzzy symmetric encryption scheme called symmetric keyring encryption (SKE) to hide the secret key and use non-interactive zero-knowledge (NIZK) protocol to ensure that we do not leak any information about the message. Unlike the blind signature, we use NIZK protocol to cancel the interaction between the signer (the prover) and the verifier. The security proof shows that our scheme is secure under the random oracle model. Finally, we implement it on a personal computer and analyze the performance of the constructed scheme in practical terms. Based on the constructed scheme and demo, we give an anonymous cryptocurrency transaction model as well as mobile demonstration.
Plasma S-Adenosylmethionine Is Associated with Lung Injury in COVID-19
Authors: Kryukov Evgeny Vladimirovich , Ivanov Alexander Vladimirovich , Karpov Vladimir Olegovich , Vasil’evich Aleksandrin Valery , Dygai Alexander Mikhaylovich , Kruglova Maria Petrovna , Kostiuchenko Gennady Ivanovich , Kazakov Sergei Petrovich , Kubatiev Aslan Amirkhanovich
Published: December 2021

Objective. S-Adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH) are indicators of global transmethylation and may play an important role as markers of severity of COVID-19. Methods. The levels of plasma SAM and SAH were determined in patients admitted with COVID-19 (

n
=
56

,

mean
 
age
=
61

). Lung injury was identified by computed tomography (CT) in accordance with the CT0-4 classification. Results. SAM was found to be a potential marker of lung damage risk in COVID-19 patients (

SAM
>
80
 
nM

; CT3,4 vs. CT 0-2: relative ratio (RR) was 3.0;

p
=
0.0029

).

SAM
/
SAH
>
6.0

was also found to be a marker of lung injury (CT2-4 vs. CT0,1:

RR
=
3.47

,

p
=
0.0004

). There was a negative association between SAM and glutathione level (

ρ
=
−
0.343

,

p
=
0.011

). Interleukin-6 (IL-6) levels were associated with SAM (

ρ
=
0.44

,

p
=
0.01

) and SAH (

ρ
=
0.534

,

p
=
0.001

) levels. Conclusions. A high SAM level and high methylation index are associated with the risk of lung injury in patients with COVID-19. The association of SAM with IL-6 and glutathione indicates an important role of transmethylation in the development of cytokine imbalance and oxidative stress in patients with COVID-19.
Design of New High Step-Up DC-DC Converter Topology for Solar PV Applications
Authors: Thangavelu Shanthi , Umapathy Prabha
Published: December 2021

A new topology for high step-up nonisolated DC-DC converter for solar PV applications is presented in this paper. The proposed high-voltage gain converter topology has many advantages like low-voltage stress on the switches, high gain with low duty ratio, and a continuous input current. The analytical waveforms of the proposed converter are presented in continuous and discontinuous modes of operation. Voltage stress analysis is conducted. The voltage gain and efficiency of the converter in presence of parasitic elements are also derived. Performance comparison of the proposed high-gain converter topology with the recently reported high-gain converter topologies is presented. Validation of theoretical analysis is done through the test results obtained from the simulation of the proposed converter. For the maximum duty ratio of 80%, the output voltage of 670 V is observed, and the voltage gain obtained is 14. Comparison of theoretical and simulation results is presented which validates the performance of the proposed converter.
Spread of Misinformation in Social Networks: Analysis Based on Weibo Tweets
Authors: Luo Han , Cai Meng , Cui Ying
Published: December 2021

Social networks are filled with a large amount of misinformation, which often misleads the public to make wrong decisions, stimulates negative public emotions, and poses serious threats to public safety and social order. The spread of misinformation in social networks has also become a widespread concern among scholars. In the study, we took the misinformation spread on social media as the research object and compared it with true information to better understand the characteristics of the spread of misinformation in social networks. This study adopts a deep learning method to perform content analysis and emotion analysis on misinformation dataset and true information dataset and adopts an analytic network process to analyze the differences between misinformation and true information in terms of network diffusion characteristics. The research findings reveal that the spread of misinformation on social media is influenced by content features and different emotions and consequently produces different changes. The related research findings enrich the existing research and make a certain contribution to the governance of misinformation and the maintenance of network order.
Based on Consortium Blockchain to Design a Credit Verifiable Cross University Course Learning System
Authors: Chen Chin-Ling , Wang Tianyi , Tsaur Woei-Jiunn , Weng Wei , Deng Yong-Yuan , Cui Jianfeng
Published: December 2021

In recent years, the attention of online cross-university courses has been increasing, and students in universities want to increase their knowledge and professional skills by taking online courses from different universities, which raises the issue of course credit verification. In the past, the credits obtained by students in online courses lack endorsement from the education department, and the students’ learning process could not be verified. Therefore, the credits of online courses in one university could not be recognized by other universities. The education departments of some countries and regions implement credit conversion rules to convert the credits obtained by students in online courses into university credits or certificates endorsed by the education department. However, these schemes rely too much on the authority of the education department, and the process of students obtaining credits cannot be verified. In addition, the centralized storage method makes the data of education departments at risk of leakage or tampering. With the emergence of blockchain technology, some researchers have proposed the use of blockchain to store students’ credits, making it possible to reach consensus among multiple parties on the blockchain while ensuring that credits are not tampered with, but these schemes cannot test the learning process of students and the recognition of credits still relies on the authority of the education department. To solve the above problems, this paper proposes a cross-university course learning system with verifiable credits based on Hyperledger Fabric consortium blockchain technology, and the consortium includes many universities. The credits obtained by students in the course and the hash value of the learning records are stored on the blockchain, and the data on the blockchain is jointly maintained by the universities in the system. One university can verify the homework and final examination of students to check the real ability of students, thus recognizing the credits from other universities, and at the same time, to protect the privacy of students, the important data of students are encrypted for transmission.
Procyanidin B2 Alleviates Palmitic Acid-Induced Injury in HepG2 Cells via Endoplasmic Reticulum Stress Pathway
Authors: Li Yi-Ming , Zhao Shao-Yang , Zhao Huan-Huan , Wang Bao-Hua , Li Sai-Mei
Published: December 2021

Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome featuring ectopic lipid accumulation in hepatocytes. NAFLD has been a severe threat to humans with a global prevalence of over 25% yet no approved drugs for the treatment to date. Previous studies showed that procyanidin B2 (PCB2), an active ingredient from herbal cinnamon, has an excellent hepatoprotective effect; however, the mechanism remains inconclusive. The present study aimed to investigate the protective effect and underlying mechanism of PCB2 on PA-induced cellular injury in human hepatoma HepG2 cells. Our results showed that PA-induced oxidative stress, calcium disequilibrium, and subsequent endoplasmic reticulum stress (ERS) mediated cellular injury, with elevated protein levels of GRP78, GRP94, CHOP, and hyperphosphorylation of PERK and IRE1α as well as the increased ratio of Bax/Bcl-2, which was restored by PCB2 in a concentration-dependent manner, proving the excellent antiapoptosis effect. In addition, 4-phenylbutyric acid (4-PBA), the ER stress inhibitor, increased cell viability and decreased protein levels of GRP78 and CHOP, which is similar to PCB2, and thapsigargin (TG), the ER stress agonist, exhibited conversely meanwhile partly counteracted the hepatic protection of PCB2. What is more, upregulated protein expression of p-IKKα/β, p-NF-κB p65, NLRP3, cleaved caspase 1, and mature IL-1β occurred in HepG2 cells in response to PA stress while rescued with the PCB2 intervention. In conclusion, our study demonstrated that PA induces ERS in HepG2 cells and subsequently activates downstream NLRP3 inflammasome-mediated cellular injury, while PCB2 inhibits NLRP3/caspase 1/IL-1β pathway, inflammation, and apoptosis with the presence of ERS, thereby promoting cell survival, which may provide pharmacological evidence for clinical approaches on NAFLD.
New Generation of Smart Highway: Framework and Insights
Authors: Liu Chenglong , Du Yuchuan , Ge Yiheng , Wu Difei , Zhao Cong , Li Yishun
Published: December 2021

The new generation of smart highway (NGSH) has become an irresistible global trend to improve transport efficiency and safety. The exploration of the features and framework for NGSH can guide us to upgrade the current highway system. This paper summarizes the fundamental features of the NGSH from the perspective of the interactive evolution of automobile industry and road transport. In line with the popularity of automated and connected vehicles, the primary technical features of the NGSH are proposed as (I) complete elements sensing, (II) cyber-physical systems, (III) cooperative vehicle-infrastructure applications, and (IV) 5th generation mobile communication technology. The corresponding physical framework and data flow are introduced, in which three data attributes (data accuracy, dimensionality, and freshness) are highlighted to describe the data requirements for various scenarios. The development path of the NGSH is further discussed in terms of the different vehicle automation levels. The characteristics of five levels of NGSH are identified from R1 to R5. Different combinations of NGSH level and vehicle automation level lead to distinct system functions. Several urgent problems in the current stage are pointed out in terms of system compatibility, standard specification, and information security. This paper provides new insights for sustainable and reproducible highway reformation, drawing some implications for NGSH design.
Finite Volume Method for the Launch Safety of Energetic Materials
Authors: Yu Yanchun , Yan Han , Chen Weidong , Ma Jingxin
Published: December 2021

It is important to examine the ignition of energetic materials for launch safety. Given that there is a paucity of experimental tests, numerical simulations are important for analysing energetic materials. A computer program based on the finite volume method and viscoelastic statistical crack mechanics model is developed to study the ignition of energetic materials. The trends of temperature and stress of energetic materials subjected to projectile base pressure are studied by numerical examples. The results are compared with those in an extant study, which verified the correctness of the proposed method. Additionally, the relationships between the temperature increase and nonimpact ignition of energetic materials were analysed. The results show that when the temperature at the bottom of the explosive rises to a certain value, it will cause the explosive to ignite. This research has significance to the study of the base gap of explosives, and it provides a reference for launch safety evaluation of energetic materials.
BEvote: Bitcoin-Enabled E-Voting Scheme with Anonymity and Robustness
Authors: Lu Ning , Xu Xin , Choi Chang , Fei Tianlong , Shi Wenbo
Published: December 2021

When building the large-scale distributed decision control system based on mobile terminal devices (MTDs), electronic voting (E-voting) is a necessary technique to settle the dispute among parties. Due to the inherent insecurity of Internet, it is difficult for E-voting to attain complete fairness and robustness. In this study, we argue that Bitcoin blockchain offers better options for a more practical E-voting. We first present a coin mixing-based E-voting system model, which can cut off the relationship between the voter’s real identity and its Bitcoin address to achieve strong anonymity. Moreover, we devise a secret sharing-based E-voting protocol, which can prevent voting number from being leaked ahead and further realize strong robustness. We establish the probable security theory to prove its security. In addition, we use the experimental evaluation to demonstrate its efficiency.
Predictors of Delayed Graft Function in Renal Transplantation
Authors: Kernig Karoline , Albrecht Veronica , Dräger Desirée-Louise , Führer Andreas , Mitzner Steffen , Kundt Günther , Hakenberg Oliver W.
Published: December 2021

Purpose: This study aimed to analyze our data on delayed graft function (DGF) and to identify associated factors. Methods: This is a retrospective case-control study of all patients transplanted in our center over a period of 11 years (January 1, 2003, to December 31, 2014) comparing patients with immediate graft function (n = 332) to those with DGF (n = 165). DGF was defined as the need for hemodialysis within the first 7 days after transplantation. Donor and recipient characteristics as well as procedural factors were compared by univariate and multivariate logistic regression analyses. Results: Overall, 33% of patients had DGF. The rate of DGF declined from 2003 to 2011. In cases with DGF, donors and recipients were significantly older (p = 0.004 and p = 0.005, respectively), had longer cold ischemia times (p = 0.039), more revision surgeries (p < 0.001), and more HLA mismatches (p = 0.001), especially in the DR locus (p = 0.002). Neither donor nor recipient gender, waiting time, nor CMV status had any influence. In multivariable analysis, significant risk factors were ischemia time and mismatches at the HLA-DR loci. Conclusions: DGF is a common complication in renal transplantation which occurred in 33% of our cases. Important factors identified were donor and recipient age, ischemia time, HLA mismatching, and revision surgery.
Does Madopar Have a Role in the Treatment of Prolonged Disorders of Consciousness? A Call for Randomized Controlled Trials
Authors: Saleh Christian , Andrykiewicz Agnieszka , Hund-Georgiadis Margret
Published: December 2021

It is suggested that dopaminergic treatment may contribute to accelerated improvement in patients with a disorder of consciousness (DoC). Dopamine is an important stimulatory neurotransmitter, which plays a key role in alertness, arousal, behavior, emotion, cognition, and motor function. We discuss our experience with Madopar in 2 patients with DoC and review the literature on dopaminergic medication in patients with DoC.
Impact of Educational Nursing Intervention on Compression Therapy Adherence and Recurrence of Venous Leg Ulcers: A Quasi-Experimental Study
Authors: Behairy Amoura Soliman , Masry Samah E.
Published: December 2021

Following the healing of venous leg ulcers, the primary problems for nursing and patients are adhering to compression therapy and preventing ulcer recurrence. As a result, it is important that patients comprehend their situation. The purpose of this study is to see how an educational nursing intervention affected compression therapy adherence and recurrence of venous leg ulcers in patients with chronic venous leg ulcers. A quasi-experimental design was used, including an intervention, a control group, and before and after assessments. This study was conducted in one of Egypt’s largest teaching hospitals associated with Menoufia University. The 20-month study included 80 adult patients with healed venous leg ulcers. Each participant was randomized to either a control (got regular leg ulcer information) or study (received educational interventions) group. The following tools were used in the study: bio-sociodemographic variables, knowledge evaluation, compression therapy adherence scale, and recurrence follow-up, after 3, 6, and 12 months of implementation. Furthermore, there is a statistically significant difference between the study groups during the pretest (r = 0.885, 0.774, and 0.477, p = 0.002). The use of nursing education increased patients’ understanding and adherence to compression treatment substantially. As a consequence, those with chronic venous leg ulcers may be able to avoid recurrent venous leg ulcers.
The Dot-Probe Attention Bias Task as a Method to Assess Psychological Well-Being after Anesthesia: A Study with Adult Female Long-Tailed Macaques (Macaca fascicularis)
Authors: Cassidy Lauren C. , Bethell Emily J. , Brockhausen Ralf R. , Boretius Susann , Treue Stefan , Pfefferle Dana
Published: December 2021

Understanding the impact routine research and laboratory procedures have on animals is crucial to improving their well-being and to the success and reproducibility of the research they are involved in. Cognitive measures of welfare offer insight into animals’ internal psychological state, but require validation. Attention bias – the tendency to attend to one type of information over another – is a cognitive phenomenon documented in humans and animals that is known to be modulated by affective state (i.e., emotions). Hence, changes in attention bias may offer researchers a deeper perspective of their animals’ psychological well-being. The dot-probe task is an established method for quantifying attention bias in humans (by measuring reaction time to a dot-probe replacing pairs of stimuli), but has yet to be validated in animals. We developed a dot-probe task for long-tailed macaques (Macaca fascicularis) to determine if the task can detect changes in attention bias following anesthesia, a context known to modulate attention and trigger physiological arousal in macaques. Our task included the following features: stimulus pairs of threatening and neutral facial expressions of conspecifics and their scrambled counterparts, two stimuli durations (100 and 1,000 ms), and counterbalancing of the dot-probe’s position on the touchscreen (left and right) and location relative to the threatening stimulus. We tested 8 group-housed adult females on different days relative to being anesthetized (baseline and 1-, 3-, 7-, and 14-days after). At baseline, monkeys were vigilant to threatening content when stimulus pairs were presented for 100 ms, but not 1,000 ms. On the day immediately following anesthesia, we found evidence that attention bias changed to an avoidance of threatening content. Attention bias returned to threat vigilance by the third day postanesthesia and remained so up to the last day of testing (14-days after anesthesia). We also found that attention bias was independent of the type of stimuli pair (i.e., whole face vs. scrambled counterparts), suggesting that the scrambled stimuli retained aspects of the original stimuli. Nevertheless, whole faces were more salient to the monkeys as responses to these trials were generally slower than to scrambled stimulus pairs. Overall, our study suggests it is feasible to detect changes in attention bias following anesthesia using the dot-probe task in nonhuman primates. Our results also reveal important aspects of stimulus preparation and experimental design.
Inflammatory Monocyte Counts Determine Venous Blood Clot Formation and Resolution
Authors: Shahneh Fatemeh , Christian Probst Hans , Wiesmann Sabine C. , A-Gonzalez Noelia , Ruf Wolfram , Steinbrink Kerstin , Raker Verena K. , Becker Christian
Published: December 2021

Background:

Monocytes are thought to be involved in venous thrombosis but the role of individual monocyte subpopulations on thrombus formation, clot inflammation, and degradation is an important unresolved issue. We investigate the role of inflammatory Ly6C
hi
monocytes in deep vein thrombosis and their potential therapeutic impact.

Methods:

Frequencies and compositions of blood monocytes were analyzed by flow cytometry in CCR2
−/−
(C-C chemokine receptor type 2) and wild-type mice of different ages and after treatment with the NR4A1 (nuclear receptor group 4 family A member 1, Nur77) agonist CnsB (cytosporone B). TF (tissue factor) sufficient and deficient Ly6C
hi
monocytes were adoptively transferred into aged CCR2
−
/−
mice. Thrombus formation and size were followed by ultrasound over a 3-week period after surgical reduction of blood flow (stenosis) in the inferior vena cava.

Results:

Reduced numbers of peripheral monocytes in aged (>30 w) CCR2
−/−
mice are accompanied by reduced thrombus formation after inferior vena cava ligation. Reducing the number of inflammatory Ly6C
hi
monocytes in wild-type mice by CsnB treatment before ligation, similarly suspends clotting, while later treatment (d1 or d4) reduces thrombus growth and accelerates resolution. We describe how changes in inflammatory monocyte numbers affect the gradual differentiation of monocytes in thrombi and show that only tissue factor-competent Ly6C
hi
monocytes restore thrombosis in aged CCR2
−
/−
mice.

Conclusions:

We conclude that the number of inflammatory Ly6C
hi
monocytes controls deep vein thrombosis formation, growth, and resolution and can be therapeutically manipulated with a NR4A1 agonist at all disease stages.
Abstract 10100: Early Prediction of Neurological Outcome at 30 Days After Return of Spontaneous Circulation From Out-of-Hospital Cardiac Arrest
Authors: Nishioka Norihiro , Kobayashi Daisuke , Kiguchi Takeyuki , Kitamura Tetsuhisa , Iwami Taku ,   the CRITICAL Study Group Investigators
Published: December 2021

Aim:
To develop and validate a model for early prediction of neurological outcomes in non-traumatic out-hospital cardiac arrest (OHCA) patients.

Methods:
We analyzed the data of adult non-traumatic cardiac arrest patients who experienced return of spontaneous circulation (ROSC) and were admitted to the intensive care unit between January 2013 and December 2017 from the database of a multicenter registry. We allocated 1329 patients who were admitted from 2013 to 2015 to the derivation set and 1025 patients admitted from 2016 to 2017 to the validation set. The primary outcome was the dichotomized Cerebral Performance Category at 30 days. We developed 2 models: model 1 including variables except for laboratory data and model 2 including all variables with laboratory data immediately available after ROSC. Logistic regression with least absolute shrinkage and selection operator regularization was used for model development. The C-statistics for discrimination, the prognostic ability, and calibration of the prediction model were assessed in the validation set. The reclassification of model 2 compared to model 1 was also evaluated by continuous net reclassification index (NRI).

Results:
The C-statistics [95% confidence intervals] of model 2 and 1 in validation set was 0.940 [0.921-0.959] and 0.935 [0.914-0.957], respectively (Figure 1). The calibration plot showed that both models were well-calibrated to observed neurological outcomes (Figure 2). The model 2 reclassified patients better than the model 1 (NRI: 0.663, p < 0.001). A web-based calculator based on these models was developed that allows clinicians to input the predictor variables needed for the probability of good or poor neurological outcomes (https://pcas-prediction.shinyapps.io/pcas_lasso/).

Conclusion:
The prediction tool including detailed in-hospital information showed good performance to predict neurological outcomes at 30 days in patients with ROSC after OHCA.
Abstract 17234: Cisplatin Induced Coronary Artery Atherosclerosis Leading To St-elevation Myocardial Infarction: A Case Report
Authors: Khalid Sheikh Bilal B , Mahmood Javaria
Published: December 2021

Introduction:
Cisplatin-based chemotherapeutic regimen (CBCR) is known for increasing risk of venous thromboembolic (TE) disease. We report a unique case of STEMI associated with CBCR which we believe was caused by coronary artery thrombosis.

Case description:
A 31-yo man with a past history of germ cell tumor presented with chest pain radiating to back and left arm. It started this morning and intensity did not worsen with exertion. He denied any dyspnea, diaphoresis or palpitations. He was non-smoker and non-obese. He denied any family history of premature coronary artery disease. He had undergone unilateral orchiectomy a year ago, and was currently receiving chemotherapy with bleomycin, etoposide and cisplatin; the last dose of his 3
rd
cycle was given the day before. EKG showed ST elevation in leads I, aVL, V4 and V5. Troponin I was high to 6.9 ng/ml (ULN 0.045 ng/ml). He received intravenous infusion of thrombolytic. An angiogram done the next day showed moderate mid-LAD disease with residual clot. A CT scan and an echocardiogram later showed left ventricular thrombus (LVT). He was kept on therapeutic enoxaparin along with aspirin. Follow up echocardiogram showed resolution of the thrombus. His chemotherapy was stopped, and he has been kept on active surveillance since then.

Discussion:
Most cases of CBCR-associated myocardial infarction that have been reported have been seen in the older population with other risk factors for coronary artery disease. Cases where angiographic data was available, coronary artery vasospasm appeared to be the culprit rather than a true plaque rupture. While the presence of LVT raises possibility of thromboembolism to coronaries causing MI, the angiographic findings support accelerated plaque formation to be the cause of infarction. In earlier reports, elevated pre-treatment level of von Willebrand factor has been postulated to have some role in the disease pathogenesis. Other possible mechanisms for pathogenesis include endothelial cell damage, platelet activation, and imbalance between thromboxane-prostacyclin levels. This case emphasizes the need to keep cardiac etiologies of chest pain in the differential when evaluating patients on CBCR as timely intervention is life saving and prevent morbidity.
Factors Associated With Racial and Ethnic Diversity Among Heart Failure Trial Participants: A Systematic Bibliometric Review
Authors: Wei Sunny , Le NhatChinh , Zhu Jie Wei , Breathett Khadijah , Greene Stephen J. , Mamas Mamas A. , Zannad Faiez , Van Spall Harriette G.C.
Published: December 2021

Background:

Heart failure has a disproportionate burden on patients who are Black, Indigenous, and people of color (BIPOC), but not much is known about representation of these groups in randomized controlled trials (RCTs). We explored temporal trends in and RCT factors associated with the reporting of race and ethnicity data and the enrollment of BIPOC in heart failure RCTs.

Methods:

We searched MEDLINE, EMBASE, and CINAHL for heart failure RCTs published in journals with an impact factor ≥10 between January 1, 2000 and June 17, 2020. We used the Cochran-Armitage and Jonchkeere-Terpstra tests to examine temporal trends, and multivariable regression to assess the association between trial characteristics and outcomes.

Results:

Of 414 RCTs meeting inclusion criteria, only 157 (37.9% [95% CI, 33.2%–2.8%]) reported race and ethnicity data. Among 158 200 participants in these 157 RCTs, 29 512 (18.7% [95% CI, 18.5%–18.9%]) were BIPOC. There was a temporal increase in reporting of race and ethnicity data (29.5% in 2000–2003 to 54.7% in 2016–2020,
P
<0.001) and in enrollment of BIPOC (14.4% in 2000–2003 to 22.2% in 2016–2020,
P
=0.038). Trial leadership by a woman was independently associated with twice the odds of reporting race and ethnicity data (odds ratio, 2.0 [95% CI, 1.1–3.8];
P
=0.028) and an 8.4% increase (95% CI, 1.9%–15.0%;
P
=0.013) in BIPOC enrollment.

Conclusions:

A minority of heart failure RCTs reported race and ethnicity data, and among these, BIPOC were under-enrolled relative to disease distribution. Both reporting of race and ethnicity as well as enrollment of BIPOC increased between 2000 and 2020. After multivariable adjustment, trials led by women had greater odds of reporting race and ethnicity and enrolling BIPOC.

Registration:

URL:
https://www.crd.york.ac.uk/PROSPERO/
; Unique identifier: CRD42021237497.
Association of Frailty With Treatment Selection and Long‐Term Outcomes Among Patients With Chronic Limb‐Threatening Ischemia
Authors: Butala Neel M. , Raja Aishwarya , Xu Jiaman , Strom Jordan B. , Schermerhorn Marc , Beckman Joshua A. , Shishehbor Mehdi H. , Shen Changyu , Yeh Robert W. , Secemsky Eric A.
Published: December 2021

Background

The optimal treatment strategy for patients with chronic limb‐threatening ischemia (CLTI) is often unclear. Frailty has emerged as an important factor that can identify patients at greater risk of poor outcomes and guide treatment selection, but few studies have explored its utility among the CLTI population. We examine the association of a health record‐based frailty measure with treatment choice and long‐term outcomes among patients hospitalized with CLTI.

Methods and Results

We included patients aged >65 years hospitalized with CLTI in the Medicare Provider Analysis and Review data set between October 1, 2009 and September 30, 2015. The primary exposure was frailty, defined by the Claims‐based Frailty Indicator. Baseline frailty status and revascularization choice were examined using logistic regression. Cox proportional hazards regression was used to determine the association between frailty and death or amputation, stratifying by treatment strategy. Of 85 060 patients, 35 484 (42%) were classified as frail. Frail patients had lower likelihood of revascularization (adjusted odds ratio [OR], 0.78; 95% CI, 0.75‒0.82). Among those revascularized, frailty was associated with lower likelihood of surgical versus endovascular treatment (adjusted OR, 0.76; CI, 0.72‒0.81). Frail patients experienced increased risk of amputation or death, regardless of revascularization status (revascularized: adjusted hazard ratio [HR], 1.34; CI, 1.30‒1.38; non‐revascularized: adjusted HR, 1.22; CI, 1.17‒1.27). Among those revascularized, frailty was independently associated with amputation or death irrespective of revascularization strategy (surgical: adjusted HR, 1.36; CI, 1.31‒1.42; endovascular: aHR, 1.29; CI, 1.243‒1.35).

Conclusions

Among patients hospitalized with CLTI, frailty is an important independent predictor of revascularization strategy and longitudinal adverse outcomes.
Model Based or Model Free? Comparing Adaptive Methods for Estimating Thresholds in Neuroscience
Authors: Audiffren Julien , Bresciani Jean-Pierre
Published: December 2021

The quantification of human perception through the study of psychometric functions Ψ is one of the pillars of experimental psychophysics. In particular, the evaluation of the threshold is at the heart of many neuroscience and cognitive psychology studies, and a wide range of adaptive procedures has been developed to improve its estimation. However, these procedures are often implicitly based on different mathematical assumptions on the psychometric function, and unfortunately, these assumptions cannot always be validated prior to data collection. This raises questions about the accuracy of the estimator produced using the different procedures. In the study we examine in this letter, we compare five adaptive procedures commonly used in psychophysics to estimate the threshold: Dichotomous Optimistic Search (DOS), Staircase, PsiMethod, Gaussian Processes, and QuestPlus. These procedures range from model-based methods, such as the PsiMethod, which relies on strong assumptions regarding the shape of Ψ, to model-free methods, such as DOS, for which assumptions are minimal. The comparisons are performed using simulations of multiple experiments, with psychometric functions of various complexity. The results show that while model-based methods perform well when Ψ is an ideal psychometric function, model-free methods rapidly outshine them when Ψ deviates from this model, as, for instance, when Ψ is a beta cumulative distribution function. Our results highlight the importance of carefully choosing the most appropriate method depending on the context.
Language Variation in Mandarin as a Heritage Language: Subject Personal Pronouns
Authors: Zhang Xinye
Published: December 2021

Because of limited language input, different dominant languages, and learners’ differing backgrounds, the acquisition of heritage languages is distinguished from the acquisition of L1 and L2. Few studies of Chinese as a Heritage Language (CHL) have explored whether students can acquire native-like sociolinguistic competence and language-specific variables with educational input. Based on a sociolinguistic variationist perspective, this study investigates the acquisition of variation between null and overt subject personal pronouns (SPP s) by heritage learners in an undergraduate-level Mandarin program. A total of 11,970 tokens were collected through classroom observation, sociolinguistic interviews, and narratives. Measuring mixed-effects logistic regression with Rbrul (Johnson, 2009), results show that the overall usage pattern of SPP s by CHL students largely resembled that in the input provided by the language program. Results also demonstrate that linguistic constraints including coreference, person and number, and verb type, and social factors such as discourse context, first languages, course level, and age of arrival had a significant effect on SPP expression by CHL learners. Implications for CHL development and variationist studies in heritage languages are discussed.
A Novel and Simple Method of Managing Thoracic Esophageal Perforation: The “ASSIST” Approach
Authors: Chu Quyen D. , Candal Raquel , White Robert K.
Published: December 2021

Introduction

Thoracic esophageal perforation (TEP) remains a therapeutic challenge that carries with it a high mortality. Because of its rare occurrence and management is complex, most patients are referred to higher level of care. Management is variable, ranging from a stent placement to an esophagectomy. Unfortunately, stent capabilities may not be readily available and the different surgical approaches can be complex, time-consuming, and demanding on a septic patient. Given these challenges, we conceived a simple 6-step (1) Antibiotics, (2) Suture the cervical esophagus with a 0- chromic, (3) Suture the abdominal esophagus with a 3-0 chromic, (4) Insert nasogastric tube above the sutured cervical esophagus, (5) Support nutrition with a jejunostomy, and (6) Tubes (placement of bilateral chest tubes).

Methods

Six consecutive septic patients with TEP who underwent an ASSIST approach were evaluated. On day 14, patients were taken to the OR for an esophagogastroduodenoscopy to open the cervical and hiatal esophageal closure. Patients then underwent a repeat barium swallow prior to resuming per oral (PO) intake.

Results

Sepsis resolved in all patients. One patient died of advanced cirrhosis. None of the living patients required additional surgery and all resumed a normal diet.

Conclusions

The “ASSIST” method is a viable option for managing septic patients with thoracic esophageal perforation. This novel approach does not require a high level of technical expertise and conceivably be performed by most centers without the need for immediate transfer to specialized facilities.
Putting the Self in Self-Efficacy: Personal Factors in the Development of Early Teacher Self-Efficacy
Authors: Narayanan Madhu , Ordynans Jill G. , Wang Amber , McCluskey Matthew S. , Elivert Nathalie , Shields Anne L. , Ferrell Anne C.
Published: December 2021

The factors that influence the construction of a teacher’s sense of self-efficacy are complex. The authors used a qualitative research design to explore the reflections of a sample of 25 K-12 early career teachers as they made sense of their own abilities. The results show that theorized sources of self-efficacy—mastery experiences, vicarious experiences, and verbal persuasion—all remain important but are interpreted through each participant’s unique background and conception of identity. Teacher Self-Efficacy emerged as a construct that both influenced and was influenced by this collection of individual factors. This study provides insight into how each teacher’s unique experiences interact dynamically with school environments and personal stories to shape their sense of self-efficacy. The findings can influence how new teachers are supported by coaches and teacher educators to build the confidence and motivation necessary to persist through the challenges of teaching.
Camillus de Lellis (1550–1614), Patron Saint of Hospitals
Authors: Donnelly John Patrick
Published: December 2021

Camillus de Lellis was an Italian nobleman born in 1550 who served as a soldier fighting the Turks. Three times between 1571 and 1584, his abscessed leg forced him to seek care in a Roman hospital; each time he worked there during and after his treatment. He was disgusted by the bad care in the hospital and decided a religious order devoted to helping the sick was the best way to better physical and spiritual care. In 1585, he founded the Ministers of the Sick, today called the Order of Saint Camillus. It gained full papal approval as a religious order in 1591. By 1607, it had 242 members working in ten leading Italian cities.
Investigation of fabric movement in a tumble dryer for the development of drying methods for wool fabrics to save energy
Authors: Bao Wei , Shen Jinsong , Wu Xiongying , Ding Xuemei
Published: December 2021

Tumble dryers are widely used for drying garments, but felting shrinkage can be caused to wool garments during the tumble drying process. To dry wool fabrics or garments in tumble dryers, the flat dry function has been introduced in the dryers; however, the energy efficiency is very low. The current study investigated fabric movement at different rotation speeds in the tumble dryer and their resultant performances in terms of specific moisture extraction rate, evenness of drying, fabric shrinkage, and fabric smoothness. For shrink-resist-treated wool fabrics, tumble drying at the rotation speed to keep fabric movement in projectile motion accompanied with occasional tumbling could achieve better energy efficiency, drying uniformity, and fabric smoothness. For untreated wool fabrics, introducing vertical movement to the flat dry in the tumble dryer can improve the heat exchange between the fabric and hot air, resulting in an increase in energy efficiency of approximately 30% compared with motionless flat drying. Wool fabric shrinkage can be controlled at less than 2% with the smooth appearance of fabric at grade 3.5 after drying under the recommended drying condition. This study could help tumble dryer manufacturers design optimal drying methods for wool fabrics with the potential for the reduction of energy consumption.