bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic Path Flow Estimation Using Automatic Vehicle Identification and Probe Vehicle Trajectory Data: A 3D Convolutional Neural Network Model
Authors: Chen Can , Cao Yumin , Tang Keshuang , Li Keping
Published: February 2021

Dynamic path flows, referring to the number of vehicles that choose each path in a network over time, are generally estimated with the partial observations as the input. The automatic vehicle identification (AVI) system and probe vehicle trajectories are now popular and can provide rich and complementary trip information, but the data fusion was rarely explored. Therefore, in this paper, the dynamic path flow estimation is based on these two data sources and transformed into a feature learning problem. To fuse the two data sources belonging to different detection ways at the data level, the virtual AVI points, analogous to the real AVI points (turning movements at nodes with AVI detectors), are defined and selected to statically observe the dynamic movement of the probe vehicles. The corresponding selection principles and a programming model considering the distribution of real AVI points are first established. The selected virtual AVI points are used to construct the input tensor, and the turning movement-based observations from both the data sources can be extracted and fused. Then, a three-dimensional (3D) convolutional neural network (CNN) model is designed to exploit the hidden patterns from the tensor and establish the high-dimensional correlations with path flows. As the path flow labels commonly with noises, the bootstrapping method is adopted for model training and the corresponding relabeling principle is defined to purify the noisy labels. The entire model is extensively tested based on a realistic road network, and the results show that the designed CNN model with the presented data fusion method can perform well in training time and estimation accuracy. The robustness of a model to noisy labels is also improved through the bootstrapping method. The dynamic path flows estimated by the trained model can be applied to travel information provision, proactive route guidance, and signal control with high real-time requirements.
Dynamic Analysis of the Scraper Conveyor under Abnormal Operating Conditions Based on the Vibration and Speed Characteristics
Authors: Jiang Shoubo , Ren Weijian , Mao Qinghua , Zeng Qingliang , Yu Pengfei , Gao Kuidong , Wang Liang
Published: February 2021

The scraper conveyor is the key coal transportation equipment on the coal mining face. The conveyor often encounters the influence of abnormal working conditions, such as stuck chains, broken chains, and impact loads, which have a great effect on the smooth operation of the scraper chain and seriously affect the safety of coal production. If the chain breaks during the test, the broken link may fly out and hurt the tester. The test risk of the scraper conveyor under abnormal working conditions is relatively large; hence, the test research is impossible to carry out. The combination of experiment and simulation is used to carry out the research. The dynamic characteristic test bed of the chain drive system is created to collect the speed of the sprocket and the acceleration of the scraper. The two groups of data are obtained by simulation, and the accuracy of the simulation is verified by comparing the test data with the simulation data. The dynamic characteristics of the chain drive system under abnormal working conditions are analyzed by simulation. Results show that the longitudinal velocity of the link dramatically changes, the contact force increases by 5.4 times, and the link vibrates under impact loads. When the chain is stuck, the speed of the running direction suddenly changes, and the chainring vibrates. The contact force between the chainrings increases by 7.2 times compared with the smooth operation. When the chain is broken, the acceleration in the running direction of the link dramatically changes. This study provides a basis and reference for the further optimization design of the chain drive system and detection of the abnormal working conditions.
Transcriptomic Profiling Identifies a Risk Stratification Signature for Predicting Peritoneal Recurrence and Micrometastasis in Gastric Cancer
Authors: Lee In-Seob , Lee Heonyi , Hur Hoon , Kanda Mitsuro , Yook Jeong-Hwan , Kim Byung-Sik , Woo Yanghee , Kodera Yasuhiro , Kim Kwangsoo , Goel Ajay
Published: February 2021

Purpose:

Gastric cancer peritoneal carcinomatosis is fatal. Delay in detection of peritoneal metastases contributes to high mortality, highlighting the need to develop biomarkers that can help identify patients at high risk for peritoneal recurrence or metastasis.

Experimental Design:

We performed a systematic discovery and validation for the identification of peritoneal recurrence prediction and peritoneal metastasis detection biomarkers by analyzing expression profiling datasets from 249 patients with gastric cancer, followed by analysis of 426 patients from three cohorts for clinical validation.

Results:

Genome-wide expression profiling identified a 12-gene panel for robust prediction of peritoneal recurrence in patients with gastric cancer (AUC = 0.95), which was successfully validated in a second dataset (AUC = 0.86). Examination of 216 specimens from a training cohort allowed us to establish a six gene–based risk-prediction model [AUC = 0.72; 95% confidence interval (CI): 0.66–0.78], which was subsequently validated in an independent cohort of 111 patients with gastric cancer (AUC = 0.76; 95% CI: 0.67–0.83). In both cohorts, combining tumor morphology and depth of invasion further improved the predictive accuracy of the prediction model (AUC = 0.84). Thereafter, we evaluated the performance of the identical six-gene panel for its ability to detect peritoneal metastasis by analyzing 210 gastric cancer specimens (prior 111 patients plus additional 99 cases), which discriminated patients with and without peritoneal metastasis (AUC = 0.72). Finally, our biomarker panel was also remarkably effective for identifying peritoneal micrometastasis (AUC = 0.72), and its diagnostic accuracy was significantly enhanced when depth of invasion was included in the model (AUC = 0.85).

Conclusions:

Our novel transcriptomic signature for risk stratification and identification of high-risk patients with peritoneal carcinomatosis might serve as an important clinical decision making in patients with gastric cancer.
Late-Onset Kidney Biopsy-Associated Retroperitoneal Hemorrhage in Lupus Nephritis: A Case Report of Pseudoaneurysm and Microaneurysm Formations
Authors: Hansrivijit Panupong , Gadhiya Kinjal P. , Zelonis Sandra D. , Cinicola John T.
Published: February 2021

Late-onset retroperitoneal hemorrhage from renal intraparenchymal pseudoaneurysm (RIP) following a kidney biopsy is an extremely rare complication but should not be ignored, especially in high-risk populations. Here, we introduce a 32-year-old Caucasian female who presented with sudden-onset left-sided flank pain. She had recently been diagnosed with systemic lupus erythematosus (SLE) and had undergone a computed tomography (CT)-guided core needle biopsy of the left kidney 9 days earlier. The results were consistent with lupus nephritis class III or IV. Initial vitals were within normal limits. She appeared pale and her left flank was tender to palpation without discoloration or abdominal distention. Laboratory investigations showed a hemoglobin level of 7.1 g/dL. The CT scan of the abdomen and pelvis revealed a large hyperdense left perinephric collection consistent with perinephric hematoma with a moderate amount of retroperitoneal stranding most prominent on the left side extending across the midline to the right side. Contrast extravasation was suspected in the lower pole of the left kidney consistent with active bleeding site. Emergent renal angiography revealed a 2 × 1 cm intraparenchymal pseudoaneurysm in the lower pole of the left kidney along with a few small microaneurysms. Coil embolization of the pseudoaneurysm was successfully performed without any complications. In conclusion, SLE or lupus nephritis in this patient may be the predisposing factors for microaneurysm and RIP formations. RIP is an unusual complication after percutaneous kidney biopsy that carries a significant mortality rate if ruptured, causing retroperitoneal hemorrhage. Clinicians should be vigilant when encountering high-risk patients with persistent hematuria, flank pain, or abdominal pain within four weeks after a kidney biopsy.
Two Cases of Probable Neuro-Behçet’s Disease with Longitudinally Extensive Transverse Myelitis
Authors: Fujiwara Shunya , Manabe Yasuhiro , Nakano Yumiko , Omote Yoshio , Yunoki Taijun , Kono Syoichiro , Narai Hisashi , Abe Koji
Published: February 2021

We report 2 cases of probable neuro-Behçet’s disease (NBD) with longitudinally extensive transverse myelitis (LETM). In both cases, the patients presented paraplegia, as well as sensory, bladder, and rectal disturbances. Magnetic resonance imaging (MRI) of patient 1 showed continuous high signal intensity extending from the midbrain to the entire spinal cord in the central part of the cord on T2-weighted imaging (T2WI). Spinal MRI of patient 2 revealed high signal intensity extending from Th2 to Th10 in the central part of the cord on T2WI. Both patients received high-dose methylprednisolone. A continuous lesion from the midbrain to the entire spinal cord as in patient 1 has not been previously reported. Patient 2 dramatically improved by infliximab therapy. The present cases suggest that NBD should be considered as a differential diagnosis in patients with LETM.
The Effect of Peroral Endoscopic Myotomy in Achalasia Patients with Prior Endoscopic Intervention: A Systematic Review and Meta-Analysis
Authors: Zhong Chunyu , Ni Bowen , Liu Sixiu , Tan Shali , Lü Muhan , Peng Yan , Liu Li , Tang Xiaowei
Published: February 2021

Background: Peroral endoscopic myotomy (POEM) has been reported to be effective in achalasia patients with prior failed endoscopic intervention (PFI). We performed this meta-analysis to compare and summarize the clinical outcome of POEM in patients with or without prior endoscopic intervention. Method: We searched relevant studies published up to March 2020. Meta-analysis for technical success, clinical success, Eckardt score, lower esophageal sphincter (LES) pressure, clinical reflux, and adverse event were conducted based on a random-effects model. Results: Eight studies enrolling 1,797 patients who underwent POEM were enrolled, including 1,128 naïve achalasia patients and 669 patients with PFI. In the PFI group, the pooled estimated rate of technical success was 97.7% (95% confidence interval [CI], 95.8–98.8%), the pooled clinical success rate was 91.0% (95% CI, 88.0–93.4%), and the pooled adverse events rate was 23.5% (95% CI, 10.6–44.1%). The Eckardt score significantly decreased by 5.95 points (95% CI, 5.50–6.40, p < 0.00001) and the LES pressure significantly reduced by 19.74 mm Hg (95% CI, 14.10–25.39, p < 0.00001) in the PFI group. There were no difference in the technical success, clinical success, and adverse events rate between the treatment-naïve group and PFI group, with a risk ratio of 1.0 (95% CI, 0.99–1.01, p = 0.89), 1.02 (95% CI, 0.98–1.06, p = 0.36), and 0.88 (95% CI, 0.67–1.16, p = 0.38), respectively. Conclusions: POEM is an effective and safe treatment for achalasia patients with prior endoscopic intervention. Randomized clinical trials are needed to further verify the efficiency and safety of the POEM in those patients.
Is the Erosion-Protective Effect Still Maintained when Tin Concentrations Are Reduced in Mouth Rinse Solutions?
Authors: Moser Corina , Baumann Tommy , Lussi Adrian , Carvalho Thiago Saads
Published: February 2021

Objective: As a preventive measure, tin (Sn2+)-containing products have a great potential to prevent enamel surface loss during erosive challenges, but adverse effects of high Sn2+ concentrations, such as astringent feeling of the teeth, are reported. Therefore, the main aim of this in vitro study was to develop a solution with lower Sn2+ concentrations that can still prevent dental erosion. Methods: A total of 162 enamel specimens were prepared from human premolars, which were selected from a pool of extracted teeth. The specimens were randomly distributed to 9 groups (each group n = 18 enamel specimens) according to the different test treatments: a humid chamber (no treatment) as the negative control, the commercial Elmex® Erosion Protection mouth rinse as the positive control, and 7 solutions either with lower Sn2+ concentrations and/or containing flavoring. The experiment included 4 cycles, consisting of pellicle formation by incubating the specimens with 200 μL of human saliva at 37°C for 1 h, then placing the specimens in the treatment for 2 min (60 mL, 30°C, shaking at 70 rpm), and later submitting them to an erosive challenge for 1 min in citric acid (60 mL 1%, pH 3.6, 30°C). Surface hardness was measured with a Vickers diamond and surface reflection intensity was measured with a reflectometer. Results: The control group performed significantly worse than all other solutions containing Sn2+. In general, there were no significant differences among the Sn2+-containing groups, and they presented similar protective effects on the enamel even when Sn2+ concentrations were reduced and flavorings were added. Conclusion: Sn2+ concentrations in mouth rinses may be lowered to 200 ppm without compromising the anti-erosive properties of the solution.
Safety and Effectiveness of Endoscopic Band Ligation for Colonic Diverticular Bleeding in Elderly Patients
Authors: Okamoto Takeshi , Nakamura Kenji , Yamamoto Kazuki , Yoshimoto Takaaki , Takasu Ayaka , Shiratori Yasutoshi , Ikeya Takashi , Okuyama Shuhei , Takagi Koichi , Fukuda Katsuyuki
Published: February 2021

Introduction: Colonic diverticulosis increases with age, leading to a higher risk of colonic diverticular bleeding (CDB) in the elderly. As life expectancy continues to increase, the need for endoscopic hemostasis for CDB in the elderly can also be expected to increase. However, there have been no reports to date on the feasibility of endoscopic hemostasis for elderly CDB patients. Several recent studies have addressed the effectiveness of endoscopic band ligation (EBL) for CDB. In this study, we evaluate the safety and effectiveness of EBL in elderly CDB patients compared to younger CDB patients. Methods: We retrospectively analyzed the medical records of consecutive patients treated with EBL for the first time at a tertiary referral center between March 2011 and November 2017. Patients were grouped according to age into those at least 75 years old (the Elderly) and those <75 years old (the Nonelderly). Patient characteristics, technical success, and complications were compared between the two groups. Results: EBL was performed in 153 patients during the study period (49 Elderly patients and 104 Nonelderly patients). Elderly patients were less likely to be male (p < 0.001) and had lower hemoglobin levels on admission (p < 0.001). Bleeding on the right side of the splenic flexure was observed more frequently in the Nonelderly (p = 0.002). Charlson Comorbidity Index (CCI) and use of antithrombotic agents were significantly higher in the Elderly (p < 0.001 and p < 0.001, respectively). Active bleeding tended to be observed more frequently in the Elderly (p = 0.054), while the difference was not significant. There were no significant differences in the shock index, procedure time, or units of packed red blood cells transfused between the 2 groups. No significant differences in the technical success rate (97.1 vs. 98%, p = 0.76), early rebleeding rate (10.2 vs. 14.4%, p = 0.47), or other complications (2 vs. 1%, p = 0.58) were observed. Perforation and abscess formation were not observed in either group. Female gender, left-sidedness, higher CCI, and lower hemoglobin level were all significantly more frequently observed in the Elderly on multiple logistic regression analysis. Discussion/Conclusion: EBL may be similarly safe and effective for the treatment of CDB in the elderly as in the nonelderly.
Effect of an Intensive Weight-Loss Lifestyle Intervention on Kidney Function: A Randomized Controlled Trial
Authors: Díaz-López Andrés , Becerra-Tomás Nerea , Ruiz Verónica , Toledo Estefania , Babio Nancy , Corella Dolores , Fitó Montse , Romaguera Dora , Vioque Jesús , Alonso-Gómez Ángel M. , Wärnberg Julia , Martínez J. Alfredo , Serra-Majem Luís , Estruch Ramon , Tinahones Francisco J. , Lapetra José , Pintó Xavier , Tur Josep A. , López-Miranda José , Cano Ibañez Naomi , Delgado-Rodríguez Miguel , Matía-Martín Pilar , Daimiel Lidia , de Paz Jose Antonio , Vidal Josep , Vázquez Clotilde , Ruiz-Canela Miguel , Bulló Mònica , Sorlí José V. , Goday Albert , Fiol Miquel , García-de-la-Hera Manoli , Tojal Sierra Lucas , Pérez-Farinós Napoleón , Zulet Maria Ángeles , Sánchez-Villegas Almudena , Sacanella Emilio , Fernández-García José Carlos , Santos-Lozano José Manuel , Gimenez-Gracia Miquel , del Mar Bibiloni Maria , Diez-Espino Javier , Ortega-Azorin Carolina , Castañer Olga , Morey Marga , Torres-Collado Laura , Sorto Sanchez Carolina , Muñoz Miguel Ángel , Ros Emilio , Martinez-Gonzalez Miguel A. , Salas-Salvadó Jordi ,   the PREDIMED-Plus Investigators
Published: February 2021

Introduction: Large randomized trials testing the effect of a multifactorial weight-loss lifestyle intervention including Mediterranean diet (MedDiet) on renal function are lacking. Here, we evaluated the 1-year efficacy of an intensive weight-loss intervention with an energy-reduced MedDiet (erMedDiet) plus increased physical activity (PA) on renal function. Methods: Randomized controlled “PREvención con DIeta MEDiterránea-Plus” (PREDIMED-Plus) trial is conducted in 23 Spanish centers comprising 208 primary care clinics. Overweight/obese (n = 6,719) adults aged 55–75 years with metabolic syndrome were randomly assigned (1:1) to an intensive weight-loss lifestyle intervention with an erMedDiet, PA promotion, and behavioral support (intervention) or usual-care advice to adhere to an energy-unrestricted MedDiet (control) between September 2013 and December 2016. The primary outcome was 1-year change in estimated glomerular filtration rate (eGFR). Secondary outcomes were changes in urine albumin-to-creatinine ratio (UACR), incidence of moderately/severely impaired eGFR (<60 mL/min/1.73 m2) and micro- to macroalbuminuria (UACR ≥30 mg/g), and reversion of moderately (45 to <60 mL/min/1.73 m2) to mildly impaired GFR (60 to <90 mL/min/1.73 m2) or micro- to macroalbuminuria. Results: After 1 year, eGFR declined by 0.66 and 1.25 mL/min/1.73 m2 in the intervention and control groups, respectively (mean difference, 0.58 mL/min/1.73 m2; 95% CI: 0.15–1.02). There were no between-group differences in mean UACR or micro- to macroalbuminuria changes. Moderately/severely impaired eGFR incidence and reversion of moderately to mildly impaired GFR were 40% lower (HR 0.60; 0.44–0.82) and 92% higher (HR 1.92; 1.35–2.73), respectively, in the intervention group. Conclusions: The PREDIMED-Plus lifestyle intervention approach may preserve renal function and delay CKD progression in overweight/obese adults.
Postinfektiöse Myasthenia gravis bei einer COVID-19-Patientin
Authors: Huber Meret , Rogozinski Sophia , Puppe Wolfram , Framme Carsten , Höglinger Günter , Hufendiek Karsten , Wegner Florian
Published: February 2021

Ziel: In der vorliegenden Arbeit berichten wir über den Fall einer jungen Frau mit postinfektiösem Auftreten einer Myasthenia gravis nach einer COVID-19-Infektion mit leichten respiratorischen Symptomen und Anosmie/Ageusie einen Monat vor der Aufnahme in unsere neurologische Abteilung. Methoden: Die Patientendaten stammten aus den Krankenakten der Medizinischen Hochschule Hannover. Die schriftliche Einverständniserklärung der Patientin lag vor. Ergebnisse: Die 21-jährige Patientin stellte sich mit subakut aufgetretenen, vertikal versetzten Doppelbildern infolge einer rechtsseitigen partiellen Nervus-okulomotorius-Parese und Ptosis vor. Etwa vier Wochen zuvor waren leichte respiratorische Symptome, Kopf- und Gliederschmerzen ohne Fieber sowie eine Anosmie/Ageusie aufgetreten. Bereits während der etwa zehn Tage anhaltenden letztgenannten Symptome hatte die Patientin «müde Augen» und fluktuierende Doppelbilder bemerkt. Die klinische Untersuchung einschließlich eines positiven Tests mit Edrophoniumchlorid und der Nachweis erhöhter Acetylcholinrezeptor-Antikörpern deuteten auf einen ätiologischen Zusammenhang mit der okulären Manifestation einer Myasthenia gravis hin. Mit drei verschiedenen serologischen Tests (Abbott, DiaSorin, Euroimmun) wurden Antikörper (IgA/IgG) gegen SARS-CoV-2 im Serum nachgewiesen, was für dieses spezifische Coronavirus als Erreger der vorausgegangenen Infektion bei dieser Patientin spricht. Durch Gabe von intravenösen Immunglobulinen und oralem Pyridostigmin wurde das myasthene Syndrom erfolgreich behandelt. Schlussfolgerung: Dies ist der erste Fallbericht über eine postinfektiöse Myasthenia gravis als neurologische Komplikation bei einer COVID-19-Patientin.
Insuficiencia cardíaca en tiempo de pandemia por COVID-19
Authors: López-Miro-Espinosa Flavio
Published: February 2021

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as a new threat to healthcare systems. In this setting, heart failure units have faced an enormous challenge: taking care of their patients while at the same time avoiding patients’ visits to the hospital. Objective: The aim of this study was to evaluate the results of a follow-up protocol established in an advanced heart failure unit at a single center in Spain during the coronavirus disease 2019 (COVID-19) pandemic. Methods: During March and April 2020, a protocolized approach was implemented in our unit to reduce the number of outpatient visits and hospital admissions throughout the maximum COVID-19 spread period. We compared emergency room (ER) visits, hospital admissions, and mortality with those of January and February 2020. Results: When compared to the preceding months, during the COVID pandemic there was a 56.5% reduction in the ER visits and a 46.9% reduction in hospital admissions, without an increase in mortality (9 patients died in both time periods). A total of 18 patients required a visit to the outpatient clinic for decompensation of heart failure or others. Conclusion: Our study suggests that implementing an active-surveillance protocol in acutely decompensated heart failure units during the SARS-CoV-2 pandemic can reduce hospital admissions, ER visits and, potentially, viral transmission, in a cohort of especially vulnerable patients.
Os segredos do léxico litúrgico: glossário do primeiro inventário de bens da catedral de Mariana
Authors:   Universidade de São Paulo. Faculdade de Filosofia, Letras e Ciências Humanas, Dores Marcus Vinícius Pereira das
Published: February 2021

O Livro de Inventários da Catedral de Mariana – fonte documental chancelada pela UNESCO como Memória do Mundo – é um importante manuscrito do Arquivo Eclesiástico da Arquidiocese de Mariana – Dom Oscar de Oliveira (Mariana, Minas Gerais, Brasil). Da edição de parte desse manuscrito, foi elaborado um glossário com o objetivo de recuperar, registrar e popularizar alguns itens lexicais presentes neste texto. O intuito deste glossário é auxiliar pesquisadores que trabalham com fontes eclesiásticas os quais, em seu labor, deparam-se com nomeações desconhecidas ou duvidosas. O glossário é composto pelos itens lexicais referentes aos bens móveis e de consumo e às vestimentas litúrgicas que faziam parte do patrimônio da Catedral de Mariana na época de elaboração do primeiro inventário registrado no Livro de Inventários da Catedral de Mariana. Fazem parte também do glossário alguns outros itens referentes à Igreja Católica, ao clero, à arte sacra e à religiosidade em geral.
ensino de italiano no Espírito Santo: um breve panorama do Núcleo de Línguas da UFES
Authors: Cestaro Janine , Finardi Kyria
Published: February 2021

Este trabalho analisa o ensino de italiano no Núcleo de Línguas (NL) da Universidade Federal do Espírito Santo (UFES) ao longo dos quatorze anos de sua oferta. Com esse objetivo, dados do número de turmas ofertadas foram levantados do sistema do NL desde 2003 com vistas tanto a descrever o percurso histórico do curso quanto suas demandas atuais, visando estabelecer índices de continuidade e abandono nos variados níveis em relação a horários, materiais didáticos utilizados e quadro de professores. O estudo usa uma metodologia mista com dados quantitativos e qualitativos, triangulados a fim de melhor entender o ensino de italiano nesse contexto. De maneira geral, os resultados sugerem que o curso de italiano do NL ocupa uma posição periférica em relação aos outros cursos de línguas estrangeiras ofertados pela instituição e aos cursos de italiano da Associação de Língua e Cultura Italiana do Espírito Santo (ALCIES) em Vitória. Com base nos resultados do estudo, concluímos com algumas sugestões para o ensino de italiano nesse contexto.
LncRNA ZNF593-AS Alleviates Contractile Dysfunction in Dilated Cardiomyopathy
Authors: Fan Jiahui , Li Huaping , Xie Rong , Zhang Xudong , Nie Xiang , Shi Xiaolu , Zhan Jiabing , Yin Zhongwei , Zhao Yanru , Dai Beibei , Yuan Shuai , Wen Zheng , Chen Chen , Wang Dao Wen
Published: February 2021

Rationale:

Previously, we identified the human cardiac long noncoding RNAs (lncRNAs) profile in patients with dilated cardiomyopathy (DCM), among which ZNF593-AS, also named as RP11-96L14.7 and ENST00000448923.2, showed good conservation among species.

Objective:

We aim to elucidate the mechanism underlying lncRNA in DCM and DCM that lead to heart failure, which might provide new insights into the mechanisms of DCM and possible treatment strategies in the future.

Methods and Results:

LncRNA expression was measured by real-time polymerase chain reaction and in situ hybridization assays. Coding potential was verified by bioinformatic and biologic assays. Recombinant adeno-associated virus with cardiac-specific promoter was used to deliver lncRNA in vivo, while cardiac structure and functions were assessed by echocardiography and catheter. Sarcomere shortening, calcium imaging, gene expression profiling, and pull-down assays were performed to investigate the underlying mechanisms. ZNF593-AS, which mainly localized in the cytoplasm of cardiomyocytes, was robustly decreased in the failing heart of patients with DCM, as well as in phenylephrine-treated human cardiomyocytes. Overexpression of mmu-ZNF593-AS significantly improved transverse aortic constriction-induced cardiac dysfunction in mice. Moreover, ZNF593-AS overexpression restored the aberrant Ca
2+
handling and contractility of cardiomyocytes from transverse aortic constriction-treated mice. Furthermore, we found that ZNF593-AS acted as a guide RNA scaffold and recruited HNRNPC (heterogeneous nuclear ribonucleoprotein C [C1/C2]) to RYR2 (ryanodine receptor type 2) mRNA, which, in turn, facilitated RYR2 mRNA stability, contributed to the improvement of cardiac Ca
2+
handling and contractile function in DCM.

Conclusions:

Our findings suggested that lncRNA-based therapeutics may protect against DCM.
MicroRNA-21–Dependent Macrophage-to-Fibroblast Signaling Determines the Cardiac Response to Pressure Overload
Authors: Ramanujam Deepak , Schön Anna Patricia , Beck Christina , Vaccarello Paula , Felician Giulia , Dueck Anne , Esfandyari Dena , Meister Gunter , Meitinger Thomas , Schulz Christian , Engelhardt Stefan
Published: February 2021

Background:

Cardiac macrophages (cMPs) are increasingly recognized as important regulators of myocardial homeostasis and disease, yet the role of noncoding RNA in these cells is largely unknown. Small RNA sequencing of the entire miRNomes of the major cardiac cell fractions revealed microRNA-21 (miR-21) as the single highest expressed microRNA in cMPs, both in health and disease (25% and 43% of all microRNA reads, respectively). MiR-21 has been previously reported as a key microRNA driving tissue fibrosis. Here, we aimed to determine the function of macrophage miR-21 on myocardial homeostasis and disease-associated remodeling.

Methods:

Macrophage-specific ablation of miR-21 in mice driven by Cx3cr1-Cre was used to determine the function of miR-21 in this cell type. As a disease model, mice were subjected to pressure overload for 6 and 28 days. Cardiac function was assessed in vivo by echocardiography, followed by histological analyses and single-cell sequencing. Cocultures of macrophages and cardiac fibroblasts were used to study macrophage-to-fibroblast signaling.

Results:

Mice with macrophage-specific genetic deletion of miR-21 were protected from interstitial fibrosis and cardiac dysfunction when subjected to pressure overload of the left ventricle. Single-cell sequencing of pressure-overloaded hearts from these mice revealed that miR-21 in macrophages is essential for their polarization toward a M1-like phenotype. Systematic quantification of intercellular communication mediated by ligand-receptor interactions across all cell types revealed that miR-21 primarily determined macrophage-fibroblast communication, promoting the transition from quiescent fibroblasts to myofibroblasts. Polarization of isolated macrophages in vitro toward a proinflammatory (M1-like) phenotype activated myofibroblast transdifferentiation of cardiac fibroblasts in a paracrine manner and was dependent on miR-21 in cMPs.

Conclusions:

Our data indicate a critical role of cMPs in pressure overload–induced cardiac fibrosis and dysfunction and reveal macrophage miR-21 as a key molecule for the profibrotic role of cMPs.
Cardiovascular Effects of Unilateral Nephrectomy in Living Kidney Donors at 5 Years
Authors: Price Anna M. , Moody William E. , Stoll Victoria M. , Vijapurapu Ravi , Hayer Manvir K. , Biasiolli Luca , Weston Chris J. , Webster Rachel , Wesolowski Roman , McGee Kirsty C. , Liu Boyang , Baig Shanat , Pickup Luke C. , Radhakrishnan Ashwin , Law Jonathan P. , Edwards Nicola C. , Steeds Richard P. , Ferro Charles J. , Townend Jonathan N.
Published: February 2021

Kidney donation reduces renal function by ≈30% allowing study of the cardiovascular effects of a reduced estimated glomerular filtration rate without comorbidities. We report 5-year results of a longitudinal, parallel-group, blinded end-point study of living kidney donors (n=50) and healthy controls (n=45). The primary end point, left ventricular mass, was measured using cardiac magnetic resonance. Secondary end points, 24-hour ambulatory blood pressure, and pulse wave velocity were measured using validated blood pressure monitors and the SphygmoCor device. Effect sizes were calculated as differences between change from baseline in the donor and control groups. In donors, estimated glomerular filtration rate was 95±15 mL/min per 1.73 m2 at baseline (predonation) and 67±14 mL/min per 1.73 m2 at 5 years. In controls, there was a −1±2 mL/min per 1.73 m2 decline per annum. Change in left ventricular mass at 5 years was not significantly different between donors and controls (mean difference, +0.40 g [95% CI, −4.68 to 5.49]
P
=0.876), despite an initial increase in mass in donors compared with controls at 12 months. Pulse wave velocity, which increased in donors at 12 months, returned to levels not different from controls at 5 years (mean difference, −0.24 m/s [95% CI, −0.69 to 0.21]). Change in ambulatory systolic blood pressure was not different in donors compared with controls (mean difference, +1.91 mm Hg [95% CI, −2.72 to 6.54]). We found no evidence that the reduction in estimated glomerular filtration rate after kidney donation was associated with a change in left ventricular mass detectable by magnetic resonance imaging at 5 years.
Survival and Causes of Death Among Veterans With Lower Extremity Revascularization With Paclitaxel‐Coated Devices: Insights From the Veterans Health Administration
Authors: Gutierrez Jorge Antonio , Rao Sunil V. , Jones William Schuyler , Secemsky Eric A. , Aday Aaron W. , Gu Lin , Schulteis Ryan D. , Krucoff Mitchell W. , White Roseann , Armstrong Ehrin J. , Banerjee Subhash , Tsai Shirling , Patel Manesh R. , Swaminathan Rajesh V.
Published: February 2021

BACKGROUND

The long‐term safety of paclitaxel‐coated devices (PCDs; drug‐coated balloon or drug‐eluting stent) for peripheral endovascular intervention is uncertain. We used data from the Veterans Health Administration to evaluate the association between PCDs, long‐term mortality, and cause of death.

METHODS AND RESULTS

Using the Veterans Administration Corporate Data Warehouse in conjunction with
International Classification of Diseases, Tenth Revision
(
ICD‐10
) Procedure Coding System, Current Procedural Terminology, and Healthcare Common Procedure Coding System codes, we identified patients with peripheral artery disease treated within the Veterans Administration for femoropopliteal artery revascularization between October 1, 2015, and June 30, 2019. An adjusted Cox regression, using stabilized inverse probability–weighted estimates, was used to evaluate the association between PCDs and long‐term survival. Cause of death data were obtained using the National Death Index. In total, 10 505 patients underwent femoropopliteal peripheral endovascular intervention; 2265 (21.6%) with a PCD and 8240 (78.4%) with a non‐PCD (percutaneous angioplasty balloon and/or bare metal stent). Survival rates at 2 years (77.4% versus 79.7%) and 3 years (70.7% versus 71.8%) were similar between PCD and non‐PCD groups, respectively. The adjusted hazard for all‐cause mortality for patients treated with a PCD versus non‐PCD was 1.06 (95% CI, 0.95–1.18,
P
=0.3013). Among patients who died between October 1, 2015, and December 31, 2017, the cause of death according to treatment group, PCD versus non‐PCD, was similar.

CONCLUSIONS

Among patients undergoing femoropopliteal peripheral endovascular intervention within the Veterans Administration Health Administration, there was no increased risk of long‐term, all‐cause mortality associated with PCD use. Cause‐specific mortality rates were similar between treatment groups.
Resource Use and Outcomes of Pediatric Congenital Heart Disease Admissions: 2003 to 2016
Authors: Edelson Jonathan B. , Rossano Joseph W. , Griffis Heather , Quarshie William O. , Ravishankar Chitra , O'Connor Matthew J. , Mascio Christopher E. , Mercer‐Rosa Laura , Glatz Andrew C. , Lin Kimberly Y.
Published: February 2021

Background

Children with congenital heart disease (CHD) are known to consume a disproportionate share of resources, yet there are limited data concerning trends in resource use and mortality among admitted children with CHD. We hypothesize that charges in CHD‐related admissions increased but that mortality improved over time.

Methods and Results

This study, including patients <18 years old with CHD, examined inpatient admissions from the nationally representative Kids' Inpatient Database from 2003 to 2016 in order to assess the frequency, medical complexity, and outcomes of CHD hospital admissions. A total of 859 843 admissions of children with CHD were identified. CHD admissions increased by 31.8% from 2003 to 2016, whereas overall pediatric admissions decreased by 13.4%. Compared with non‐CHD admissions, those with CHD were more likely to be <1 year of age (80.5% versus 63.3%), and to have ≥1 complex chronic condition (39.7% versus 9.3%). For CHD admissions, mortality was higher (2.97% versus 0.31%) and adjusted median charges greater ($48 426 [interquartile range (IQR), $11.932–$161 048] versus $4697 [IQR, $2551–$12 301]) (
P
<0.0001 for all). Among CHD admissions, whereas adjusted median charges increased from $35 577 (IQR, $9303–$110 439) to $61 696 (IQR, $15 212–$219 237), mortality decreased from 3.2% to 2.7% (
P for trend
<0.0001). CHD admissions accounted for an increased proportion of all inpatient deaths, from 18.0% in 2003 to 24.5% in 2016.

Conclusions

Children admitted with CHD are 10 times more likely to die than those without CHD and have higher charges. Although the rate of mortality in CHD admissions decreased, children with CHD accounted for an increasing proportion of all pediatric inpatient deaths. Effective resource allocation is critical to optimize outcomes in these high‐risk patients.
National Weather Service Severe Weather Warnings as Threats-in-Motion
Authors: Stumpf Gregory J. , Gerard Alan E.
Published: February 2021

Threats-in-Motion (TIM) is a warning generation approach that would enable the NWS to advance severe thunderstorm and tornado warnings from the current static polygon system to continuously updating polygons that move forward with a storm. This concept is proposed as a first stage for implementation of the Forecasting a Continuum of Environmental Threats (FACETs) paradigm, which eventually aims to deliver rapidly updating probabilistic hazard information alongside NWS warnings, watches, and other products. With TIM, a warning polygon is attached to the threat and moves forward along with it. This provides more uniform, or equitable, lead time for all locations downstream of the event. When forecaster workload is high, storms remain continually tracked and warned. TIM mitigates gaps in warning coverage and improves the handling of storm motion changes. In addition, warnings are automatically cleared from locations where the threat has passed. This all results in greater average lead times and lower average departure times than current NWS warnings, with little to no impact to average false alarm time. This is particularly noteworthy for storms expected to live longer than the average warning duration (30 or 45 min) such as long-tracked supercells that are more prevalent during significant tornado outbreaks.
Operable, Low-Cost, High-Resolution, Patient-Specific 3D Printed Temporal Bones for Surgical Simulation and Evaluation
Authors: Freiser Monika E. , Ghodadra Anish , McCall Andrew A. , Shaffer Amber D. , Magnetta Michael , Jabbour Noel
Published: February 2021

Objectives:

Three-dimensional printed models created on a consumer level printer can be used to practice mastoidectomy and to discern mastoidectomy experience level. Current models in the literature for mastoidectomy are limited by expense or operability. The aims of this study were (1) to investigate the utility of an inexpensive model for mastoidectomy and (2) to assess whether the model can be used as an evaluation tool to discern the experience level of the surgeon performing mastoidectomy.

Methods:

Three-dimensional printed temporal bone models from the CT scan of a 7-year old patient were created using a consumer-level stereolithography 3D printer for a raw material cost of $10 each. Mastoidectomy with facial recess approach was performed by 4 PGY-2 residents, 4 PGY-5 residents, and 4 attending surgeons on the models who then filled out an evaluation. The drilled models were collected and then graded in a blinded fashion by 6 attending otolaryngologists.

Results:

Both residents and faculty felt the model was useful for training (mean score 4.7 out of 5; range: 4-5) and case preparation (mean score: 4.3; range: 3-5). Grading of the drilled models revealed significant differences between junior resident, senior resident, and attending surgeon scores ( P = .012) with moderate to excellent interrater agreement (ICC = 0.882).

Conclusion:

The described operable model that is patient-specific was rated favorably for pediatric mastoidectomy case preparation and training by residents and faculty. The model may be used to differentiate between experience levels and has promise for use in formative and summative evaluations.
Social workers helping each other during the COVID-19 pandemic: Online mutual support groups
Authors: Cabiati Elena
Published: February 2021

Social workers not only help service users, they also help each other, and they know the group as a space through which opportunities to give and receive help multiply. In Italy, the initiative ‘Social Workers Helping Each Other’ was launched to help practitioners stay resilient and mutually supportive during the COVID-19 pandemic. In these unprecedented and turbulent times, social workers have been called on to face new challenges and new concerns for service users and for themselves. The initiative consisted of online mutual support groups for social workers conducted through a virtual platform. Participants were 45 social workers divided into three groups on the basis of the social workers’ area of intervention. The author facilitated the groups, encouraging the development of reciprocal support dynamics typical of self-help and mutual aid groups. Group sessions were very rich in content, and the discussion focused on several topics following the participants’ needs. The content analysis revealed that the mutual support conversations among social workers focused on three main categories: practical and organizational; methodological and ethical; and personal and emotional. The groups offered supervision and mutual support based on experiential learning processes. The article presents the rationale, methods and outcomes of the experience. This initiative could inspire the development of online mutual support groups for social workers.
A Sexual Harm? HIV Transmission, ‘Biological’ GBH and Ancillary Sentencing Provisions in England and Wales
Authors: Giles Cameron
Published: February 2021

This article examines the scope and meaning of ‘sexual harm’ within the context of ancillary sentencing orders in England and Wales. It argues that the statutory definition provided in the Sexual Offences Act 2003, recently replicated in the Sentencing Act 2020, does not extend to the transmission of sexually communicable infections and that, subsequently, it is inappropriate for Sexual Harm Prevention Orders to be imposed with the aim of preventing transmissions of sexually transmitted infections (STIs). It suggests that recent case law reinforces this point and that the questions this raises reflect the broader need for further scrutiny of the aims and purposes of sentencing, and criminalisation more generally, in instances of STI transmission.
Value-Added Courses with industry endorsement for Bridging Curriculum Gap in the Outcome-Based Learning: An Effective Strategy to Post-graduate Studies
Authors: Arun Kumar B. R.
Published: February 2021

In outcome based education (OBE), curriculum design with industry involvement is most recommended approach which enables relevant execution of teaching learning process. Globally, acceptance of OBE is increasing since four decades. This article investigates the OBE curriculum design by adding Value-Added Courses (VACs) which are endorsed and participated by industry experts jointly with academicians. It is found that VACs are instrumental in reducing the curriculum gaps to attain program outcomes (POs) of any given curriculum along with targeted skills. Analysis presented in this article focuses on the program outcomes gap in the curriculum which enables identification, design and implementation of different VACs. Further, it determines that attainment achieved through VACs significantly reduces the curriculum gap. Hence it is one of the best tool which improves over all PO attainments and shows better path towards the expectation of industries. Proposed framework of analysis showed that VACs contribute to POs by nearly 20%. This article contributes a comprehensive idea for offering several VACs that boost the achievement of POs.
Comparison of clinical and serological features of RT-PCR positive and negative COVID-19 patients
Authors: Li Caiqin , Su Qi , Liu Jun , Chen Lei , Li Yuting , Tian Xiaoli , Li Weidong
Published: February 2021

Background

In December 2019, an outbreak of coronavirus disease 2019 (COVID-19) began in Wuhan, China, and led to a global epidemic. We aimed to compare the clinical and serological features of COVID-19 patients with positive and negative reverse transcriptase polymerase chain reaction (RT-PCR) tests.

Methods

This was a retrospective cohort study conducted from 9 February to 4 April 2020. COVID-19 patients at Leishenshan Hospital in Wuhan, China (125 total cases; 87 RT-PCR positive and 38 RT-PCR negative) were included. COVID-19 serology was assessed by colloidal gold assay. All cases were analyzed for demographic, clinical, and serological features.

Results

There were no significant differences in most demographic features, clinical symptoms, complications or treatments of RT-PCR positive and negative COVID-19 patients. Serum IgM/IgG was positive in 82 (94%) and 33 (87%) RT-PCR positive and negative cases, respectively. IgM was detectable as early as 3 days after symptom onset and was undetectable 60 days after symptom onset. By contrast, IgG could be detected only 10 days after symptom onset and reached its peak 60 days after symptom onset.

Conclusions

Serological tests performed during the appropriate time window of disease progression could be valuable auxiliary methods to RT-PCR in COVID-19 patients.
Cerebrospinal fluid changes and clinical features of aseptic meningitis in patients with Kawasaki disease
Authors: Hu Fan , Shi Xiaoqing , Fan Yang , Liu Hanmin , Zhou Kaiyu
Published: February 2021

Objective

To assess the distinguishing features of aseptic meningitis (AM) in patients with Kawasaki disease (KD) compared with bacterial meningitis (BM) patients.

Methods

Thirty-eight patients with KD and 126 patients with BM were retrospectively investigated. The following clinical manifestations and laboratory parameters were compared between the two groups: duration of fever before lumbar puncture, conjunctival injection, oral cavity changes, rash, cervical lymphadenopathy and extremity changes, vomiting, front fontanel bulging, neck stiffness, leukocyte number, hemoglobin level, platelet number, C-reactive protein level, cerebrospinal fluid (CSF) content, liver enzyme level, and urinalysis.

Results

Vomiting and neck stiffness were more prevalent in patients with BM. KD patients with AM showed elevated blood leukocyte numbers and C-reactive protein levels in the early febrile stage. CSF glucose was significantly lower in patients with BM compared with KD patients with AM. Receiver operating characteristic curve analysis showed that the optimal cutoff value of CSF glucose for discrimination of BM and AM/KD was 2.945 mmol/L, with a sensitivity of 84.2% and a specificity of 71.4%.

Conclusions

Detailed investigations of clinical manifestation and laboratory parameters are necessary to distinguish AM and BM in patients with KD. Decreased CSF glucose is a potential indicator of BM.
Red cell distribution width is associated with all-cause mortality in patients with acute stroke: a retrospective analysis of a large clinical database
Authors: Zhao Han , Zhao Yuanchen , Wu Zhipeng , Cheng Yisheng , Zhao Na
Published: February 2021

Objectives

This study aimed to evaluate the association between the red blood cell distribution width (RDW) and mortality in patients with stroke.

Methods

We conducted a retrospective cohort study on patients with stroke in the Medical Information Mart for Intensive Care Database III. Cox proportional hazards regression models were used to estimate hazard ratios of 30-day, 90-day, and 1-year mortality in relation to the RDW level.

Results

A total of 4134 patients were enrolled, including 2646 patients with ischemic stroke and 1668 with hemorrhagic stroke. After adjustment for potential confounders, the hazard ratio (95% confidence interval) of 30-day mortality for the second (RDW: 13.4%–14.3%) and third (>14.3%) tertiles was 1.15 (0.96, 1.37) and 1.40 (1.17, 1.68), respectively, compared with the reference group (<13.4%). A two-piecewise linear regression model was established and the inflection point of RDW was 16.7%. When RDW was >16.7%, an increase in RDW did not increase stroke mortality.

Conclusions

The RDW is a prognostic factor of patients with stroke. This finding needs to be confirmed in future prospective studies.