bluuebunny/crossref_metadata_2025 huggingface dataset:
A new and gauge-invariant littlest Higgs model with T-parity
Authors: Illana José Ignacio , Pérez-Poyatos José María
Published: December 2021

We inspect the Littlest Higgs model with T-parity, based on a global symmetry SU(5) spontaneously broken to SO(5), in order to elucidate the pathologies it presents due to the non-trivial interplay between the gauge invariance associated to the heavy modes and the discrete T-parity symmetry. In particular, the usual Yukawa Lagrangian responsible for providing masses to the heavy ‘mirror’ fermions is not gauge invariant. This is because it contains an SO(5) quintuplet of right-handed fermions that transforms nonlinearly under SU(5), hence involving in general all SO(5) generators when a gauge transformation is performed and not only those associated to its gauge subgroup. Part of the solution to this problem consists of completing the right-handed fermion quintuplet with T-odd ‘mirror partners’ and a gauge singlet, what has been previously suggested for other purposes. Furthermore, we find that the singlet must be T-even, the global symmetry group must be enlarged, an additional nonlinear sigma field should be introduced to parametrize the spontaneous symmetry breaking and new extra fermionic degrees of freedom are required to give a mass to all fermions in an economic way while preserving gauge invariance. Finally, we derive the Coleman–Weinberg potential for the Goldstone fields using the background field method.
Application of the Point-Like Contact Model: Resistance Oscillations of the Domain Wall in Magnetic Nanowires and Junctions Due to Mean Free Path Effects
Authors: Useinov Artur
Published: December 2021

This work is focused on determining the electrical resistance, which is induced by single domain wall (DW) in magnetic nanowire (NW) with a negligible defect. The provided model covers a wide range of NW diameters. The obtained result demonstrates a few-order rapid reduction of the DW resistance accompanied by its possible deviations versus the diameter growth ranging from 1.2[Formula: see text]nm to 15.2[Formula: see text]nm. The origin of these deviations, which are also identified as oscillations, is referred to the nonuniform electron scattering on the DW due to the intermixing electron scattering conditions: ballistic for one spin channel and quasi-ballistic for other one with opposite spin direction. It may happen when the DW width by value is approximately in between two lengths: a mean free path (MFP) with the spin down and spin up. The indirect evidence of this finding also comes from the fact that homogeneous NWs show the most valuable DW resistance oscillations by magnitude rather than segmented magnetic NWs. In addition to the approach, where DW width is constant, the other reasonable model is used when the DW can be constrained for some conditions. The same results are valid for magnetic junctions with DW. Finally, resistance simulation in the diffusive range, when a diameter of the NW (or point-like junction) is larger than any of spin-resolved MFP of electrons, successfully follows experimental data for the single and double DW resistances available in literature.
Explaining Machine Learning Models for Clinical Gait Analysis
Authors: Slijepcevic Djordje , Horst Fabian , Lapuschkin Sebastian , Horsak Brian , Raberger Anna-Maria , Kranzl Andreas , Samek Wojciech , Breiteneder Christian , Schöllhorn Wolfgang Immanuel , Zeppelzauer Matthias
Published: December 2021

Machine Learning (ML) is increasingly used to support decision-making in the healthcare sector. While ML approaches provide promising results with regard to their classification performance, most share a central limitation, their black-box character. This article investigates the usefulness ofExplainable Artificial Intelligence(XAI) methods to increase transparency in automatedclinical gait classificationbased on time series. For this purpose, predictions of state-of-the-art classification methods are explained with a XAI method called Layer-wise Relevance Propagation (LRP). Our main contribution is an approach that explains class-specific characteristics learned by ML models that are trained for gait classification. We investigate several gait classification tasks and employ different classification methods, i.e., Convolutional Neural Network, Support Vector Machine, and Multi-layer Perceptron. We propose to evaluate the obtained explanations with two complementary approaches: a statistical analysis of the underlying data using Statistical Parametric Mapping and a qualitative evaluation by two clinical experts. A gait dataset comprising ground reaction force measurements from 132 patients with different lower-body gait disorders and 62 healthy controls is utilized. Our experiments show that explanations obtained by LRP exhibit promising statistical properties concerning inter-class discriminativity and are also in line with clinically relevant biomechanical gait characteristics.
Computer-Assisted Cohort Identification in Practice
Authors: Kassaie Besat , Irving Elizabeth L. , Tompa Frank Wm.
Published: December 2021

The standard approach to expert-in-the-loop machine learning is active learning, where, repeatedly, an expert is asked to annotate one or more records and the machine finds a classifier that respects all annotations made until that point. We propose an alternative approach,
IQRef
, in which the expert iteratively designs a classifier and the machine helps him or her to determine how well it is performing and, importantly, when to stop, by reporting statistics on a fixed, hold-out sample of annotated records. We justify our approach based on prior work giving a theoretical model of how to re-use hold-out data. We compare the two approaches in the context of identifying a cohort of EHRs and examine their strengths and weaknesses through a case study arising from an optometric research problem. We conclude that both approaches are complementary, and we recommend that they both be employed in conjunction to address the problem of cohort identification in health research.
Mass Spectrometry Analysis of NMC622/Graphite Li-Ion Cells Electrolyte Degradation Products after Storage and Cycling
Authors: Rigaud Sébastien , Martinez Ana Cristina , Lombard Tristan , Grugeon Sylvie , Tran-Van Pierre , Pilard Serge , Laruelle Stephane
Published: December 2021

With the aim of establishing a data simultaneous comparison, the Principal Component Analysis (PCA) statistical tool was applied to LiNi0.6Mn0.2Co0.2O2/graphite Li-ion cells electrolyte’s decomposition products detected by UHPLC-ESI-HRMS. Herein, we illustrate how the chemometric tool associated with mass spectrometry data can be relevant to provide information about the presence of unusual molecules. Indeed, pristine Triton X-100 surfactant molecules used in the electrode elaboration process were detected after the impregnation stage. However, as they chemically react and oxidize at a potential lower than 4.5 V vs Li/Li+, only surfactant derivatives and classical ageing molecules were observed, respectively, after storage and cycling stages at 55 °C, leading to a triangle-type correlation circle. On the other hand, global schemes of LiPF6-based electrolyte degradation pathways were elaborated from a comparative study with literature to help interpret results in future electrolyte ageing studies.
Reduction Mechanism of Solid Electrolyte Interphase Formation on Lithium Metal Anode: Fluorine-Rich Electrolyte
Authors: Wu Yu , Sun Qintao , Liu Yue , Yu Peiping , Ma Bingyun , Yang Hao , Xie Miao , Cheng Tao
Published: December 2021

Metallic lithium is considered a promising anode that can significantly increase the energy density of rechargeable lithium-based batteries, but problems like uncontrollable growth of lithium dendrites and formation of dead lithium impede its application. Recently, a low-concentration single-salt two-solvent electrolyte, 1 M LiTFSI/FDMA/FEC, has attracted attention because a high coulombic efficiency can be achieved even after many cycles owing to the formation of a robust solid electrolyte interface (SEI). However, the reaction mechanism and SEI structure remain unclear, posing significant challenges for further improvement. Here, a hybrid ab initio and reactive force field (HAIR) method revealed the underlying reaction mechanisms and detailed formation pathway. 1 ns HAIR simulation provides critical information on the initial reduction mechanism of solvent (FDMA and FEC) and salt (LiTFSI). FDMA and FEC quickly decompose to provide F- that builds LiF as the major component of the inner layer of inorganic SEI, which has been demonstrated to protect Li anode. Decomposition of FDMA also leads to a significant nitrogen-containing composition, producing Li-N-C, LixN, and other organic components that increase the conductivity of SEI to increase performance. XPS analysis confirms evolution of SEI morphology consistent with available experiments. These results provide atomic insight into SEI formation, which should be beneficial for the rational design of advanced electrolytes.
Integrated Analysis of Circular RNA-Associated ceRNA Network Reveals Potential circRNA Biomarkers in Human Breast Cancer
Authors: Sheng Han , Pan Huan , Yao Ming , Xu Longsheng , Lu Jianju , Liu Beibei , Shen Jianfen , Shen Hui
Published: December 2021

Circular RNA (circRNA) is closely related to tumorigenesis and cancer progression. Yet, the roles of cancer-specific circRNAs in the circRNA-related ceRNA network of breast cancer (BRCA) remain unclear. The aim of this study was to construct a ceRNA network associated with circRNA and to explore new therapeutic and prognostic targets and biomarkers for breast cancer. We downloaded the circRNA expression profile of BRCA from Gene Expression Omnibus (GEO) microarray datasets and downloaded the miRNA and mRNA expression profiles of BRCA from The Cancer Genome Atlas (TCGA) database. Differentially expressed mRNAs (DEmRNAs), differentially expressed miRNAs (DEmiRNAs), and differentially expressed circRNAs (DEcircRNAs) were identified, and a competitive endogenous RNA (ceRNA) regulatory network was constructed based on circRNA–miRNA pairs and miRNA–mRNA pairs. Gene ontology and pathway enrichment analyses were performed on mRNAs regulated by circRNAs in ceRNA networks. Survival analysis and correlation analysis of all mRNAs and miRNAs in the ceRNA network were performed. A total of 72 DEcircRNAs, 158 DEmiRNAs, and 2762 DE mRNAs were identified. The constructed ceRNA network contains 60 circRNA–miRNA pairs and 140 miRNA–mRNA pairs, including 40 circRNAs, 30 miRNAs, and 100 mRNAs. Functional enrichment indicated that DEmRNAs regulated by DEcircRNAs in ceRNA networks were significantly enriched in the PI3K-Akt signaling pathway, microRNAs in cancer, and proteoglycans in cancer. Survival analysis and correlation analysis of all mRNAs and miRNAs in the ceRNA network showed that 13 mRNAs and 6 miRNAs were significantly associated with overall survival, and 48 miRNA–mRNA interaction pairs had a significant negative correlation. A PPI network was established, and 21 hub genes were determined from the network. This study provides an effective bioinformatics basis for further understanding of the molecular mechanisms and predictions of breast cancer. A better understanding of the circRNA-related ceRNA network in BRCA will help identify potential biomarkers for diagnosis and prognosis.
The Trend of Malaria Cases, Positivity Rate, and Determinant Factors in the Amhara Regional State, Ethiopia: A Mixed Method
Authors: Yenew Chalachew , Mulatu Sileshi , Alamneh Asaye
Published: December 2021

Objectives. The objectives of this study were to evaluate the trend of malaria cases and test positivity rate and explore determinant factors in the Amhara Regional State, Ethiopia. Methods. A mixed study design (retrospective record data review and case study) was employed among 67 malaria officers from all zones in the region by using proportional allocation and the 1995 to 2020 malaria document review. 1995 to 2020 trend analysis was conducted using RStudio-1.2.5033. Vignette Focus Group Discussions (FGDs) were used to dig the possible factors for malaria case buildup using the purposive sampling technique, and a qualitative content analysis was used. Results. The overall mean test positivity rate (TPR) was 21.9%, and about 80% of the land of the region was malarious, and 68% of the population was at risk of malaria in the study area from the data records of 1995 to 2020. The year 2012 to 2016 had the peak confirmed malaria cases, while the year 2016 to 2018 dramatically reduced followed by an increase in 2019/2020. The vignette FGDs identified that poor performance on Larval Source Management (LSM) and net utilization, no stock of some antimalarial medicine and supply, quality of malaria diagnosis services, the low commitment of leaders, and climatic anomalies facilitated surge of the disease in 2019/2020. No real accountability at all levels, low coverage of targeted vector control interventions, resource constraint, data quality and use for informed decision making, security issues and Internally Displaced Population (IDP) in various parts of the country, and the COVID-19 pandemic were the possible causes for case buildup. Conclusions. This result revealed that the malaria incidence rate showed a remarkable decline. However, the average TPR was 21.9%. Hence, it provided the ongoing feedback, mass fever test and treatment, training to health professionals, and ongoing supportive supervision (SS) and mentorship, improved net utilization and indoor residual spraying (IRS) operation and close follow-up and conducted sensitization workshop, spot messages were transferred through mass media, and temporary case treatment and prevention centers at farm sites established may surpass the threshold of malaria.
High Expression of PDE8B and DUOX2 Associated with Ability of Metastasis in Thyroid Carcinoma
Authors: Sun Zhenguo , Yuan Xiaoshuai , Du Peng , Chen Peng
Published: December 2021

Background. Hormone is an independent factor that induces differentiation of thyroid cancer (TC) cells. The thyroid-stimulating hormone (TSH) could promote the progression and invasion in TC cells. However, few genes related to hormone changes are studied in poorly differentiated metastatic TC. This study is aimed at constructing a gene set’s coexpression correlation network and verifying the changes of some hub genes involved in regulating hormone levels. Methods. Microarray datasets of TC samples were obtained from public Gene Expression Omnibus (GEO) databases. R software and bioinformatics packages were utilized to identify the differentially expressed genes (DEGs), important gene module eigengenes, and hub genes. Subsequently, the Gene Ontology (GO) enrichment analysis was constructed to explore important biological processes that are associated with the mechanism of poorly differentiated TC. Finally, some hub gene expressions were validated through real-time PCR and immunoblotting. Results. Gene chip with category number GSE76039 was analyzed, and 1190 DEGs were screened with criteria of

P
<
0.05

and

∣

log

2

foldchange
∣
>
2

. Our analysis showed that human dual oxidase 2 (DUOX2) and phosphodiesterase 8B (PDE8B) are the two important hub genes in a coexpression network. In addition, the validated experimental results showed that the expression levels of both DUOX2 and PDE8B were elevated in poorly differentiated metastatic TC tissues. Conclusion. This study identified and validated that DUOX2 and PDE8B were significantly associated with the metastasis ability of thyroid carcinoma.
The Influence of the Mandibular Chin Angle on the Occurrence of Mandibular Condylar Fracture: A Retrospective Study
Authors: Nayak Sunil S. , Arun S. , Taranath Kamath Abhay , Jaladhigere Lakshmanagowda Bharath , Dubey Eshita , Koshy Jonathan
Published: December 2021

Background. Condylar fractures are commonly associated with symphysis/parasymphysis fractures. Condylar fractures have been attributed to direct and indirect traumatic forces, the direction and magnitude of the forces, and the condylar anatomy. The chief aim of this study was to determine the association between the newly defined mandibular chin angle and the occurrence of condylar fractures. Materials and Methods. A retrospective study was conducted to analyze two-dimensional computed tomography (2D CT) scans of patients with a history of chin trauma. The outcome was a symphysis/parasymphysis fracture with or without fracture of the mandibular condyle. The Mediff InstaRISPACS web-based platform was used to measure the chin angle. The cerebral aqueduct of Sylvius in the corresponding 2D CT midsagittal image was the standard reference plane to measure the chin angle. The SPSS Version 20 (IBM Corp, Armonk, NY) was used for data analysis. Results. The sample size included 120 2D CT scans of patients with symphysis/parasymphysis fractures (60 associated with condylar fractures and 60 without condylar fractures). The mean chin angle in the group without condylar fracture was 133.35 ± 3.87°, which was approximately 15° lesser than in the condylar fracture group (mean, 148.56 ± 5.49°), and these findings were statistically significant

P
<
0.05

. Conclusion. Individuals with a high chin angle are potentially at a higher risk of sustaining associated condylar fractures.
On Wiener Polarity Index and Wiener Index of Certain Triangular Networks
Authors: Adnan Mr. , Bokhary Syed Ahtsham Ul Haq , Imran Muhammad
Published: December 2021

A topological index of graph

G

is a numerical quantity which describes its topology. If it is applied to the molecular structure of chemical compounds, it reflects the theoretical properties of the chemical compounds. A number of topological indices have been introduced so far by different researchers. The Wiener index is one of the oldest molecular topological indices defined by Wiener. The Wiener index number reflects the index boiling points of alkane molecules. Quantitative structure activity relationships (QSAR) showed that they also describe other quantities including the parameters of its critical point, density, surface tension, viscosity of its liquid phase, and the van der Waals surface area of the molecule. The Wiener polarity index has been introduced by Wiener and known to be related to the cluster coefficient of networks. In this paper, the Wiener polarity index

W

p

G

and Wiener index

W

G

of certain triangular networks are computed by using graph-theoretic analysis, combinatorial computing, and vertex-dividing technology.
Assessment of Metabolic Dysfunction in Sepsis in a Retrospective Single-Centre Cohort
Authors: Goutay Julien , Perche Juliette , Toussaint Aurelia , Drumez Elodie , Howsam Michael , Bourel Claire , Brassart Benoit , Pierre Alexandre , Caplan Morgan , Durand Arthur , Houard Marion , Nseir Saad , Favory Raphael , Preau Sébastien
Published: December 2021

Objective. Our primary aim was to assess selected metabolic dysfunction parameters, both independently and as a complement to the SOFA score, as predictors of short-term mortality in patients with infection admitted to the intensive care unit (ICU). Methods. We retrospectively enrolled all consecutive adult patients admitted to the eight ICUs of Lille University Hospital, between January 2015 and September 2016, with suspected or confirmed infection. We selected seven routinely measured biological and clinical parameters of metabolic dysfunction (maximal arterial lactatemia, minimal and maximal temperature, minimal and maximal glycaemia, cholesterolemia, and triglyceridemia), in addition to age and the Charlson’s comorbidity score. All parameters and SOFA scores were recorded within 24 h of admission. Results. We included 956 patients with infection, among which 295 (30.9%) died within 90 days. Among the seven metabolic parameters investigated, only maximal lactatemia was associated with higher risk of 90-day hospital mortality in SOFA-adjusted analyses (SOFA-adjusted OR, 1.17; 95%CI, 1.10 to 1.25;

p
<
0.001

). Age and the Charlson’s comorbidity score were also statistically associated with a poor prognosis in SOFA-adjusted analyses. We were thus able to develop a metabolic failure, age, and comorbidity assessment (MACA) score based on scales of lactatemia, age, and the Charlson’s score, intended for use in combination with the SOFA score. Conclusions. The maximal lactatemia level within 24 h of ICU admission is the best predictor of short-term mortality among seven measures of metabolic dysfunction. Our combined “SOFA + MACA” score could facilitate early detection of patients likely to develop severe infections. Its accuracy requires further evaluation.
Network Pharmacology Study on Molecular Mechanisms of Zhishi Xiebai Guizhi Decoction in the Treatment of Coronary Heart Disease
Authors: Gao Jin , Pan Yujing , Zhao Yuxi , Li Haoyang , Mi Zishuo , Chen Hao , Tan Xiaodong
Published: December 2021

Background. Coronary heart disease is characterized by the formation of arterial plaque. If not taken seriously, it will cause serious consequences such as myocardial infarction and heart failure. Zhishi Xiebai Guizhi Decoction first appeared in “Synopsis of Prescriptions of the Golden Chamber” and is a representative prescription for the treatment of coronary heart disease. This study aims to explain the mechanism of Zhishi Xiebai Guizhi Decoction in the treatment of coronary heart disease through network pharmacology and clinical trials. Methods. We first identified the core compounds of Zhishi Xiebai Guizhi Decoction and their potential targets through TCMSP. Then, We analyzed the molecular targets of Zhishi Xiebai Guizhi Decoction in coronary heart disease with OMIM and GeneCards databases. After the common targets were screened out, we manage to figure out the pathways of these target genes through STRING. Finally, we verify the treatment results in clinical trials. Results. Through network pharmacology analysis, we discovered that several core compounds of Zhishi Xiebai Guizhi Decoction have anti-inflammatory effects and are of great significance to treatment of cardiovascular diseases. The mechanism may be closely related to PPARγ, inflammation, TNF signaling pathway, AMPK signaling pathway, and PI3K-Akt signaling pathway. Clinical trials have also proved the key role of inflammation. Conclusions. Zhishi Xiebai Guizhi Decoction may play a role in treating coronary heart disease by activating PPARγ. TNF signaling pathway, AMPK signaling pathway, and PI3K-Akt signaling pathway are potential mechanisms as well. The application of network pharmacology can provide a novel method for the research of Chinese herbal medicine. We hope that Zhishi Xiebai Guizhi Decoction will be recognized as a complementary or alternative treatment for coronary heart disease.
A First-Principles Study of Gas Molecule Adsorption on Carbon-, Nitrogen-, and Oxygen-Doped Two-Dimensional Borophene
Authors: Qin Xinmao , Yan Wanjun , Li Dongxiang , Zhang Zhongzheng , Chen Shaobo
Published: December 2021

A first-principles study was performed to investigate the adsorption properties of gas molecules (CO, CO2, NO, and NO2) on carbon- (C-), nitrogen- (N-), and oxygen-doped (O) borophene. The adsorption energies, adsorption configurations, Mulliken charge population, surface work functions, and density of states (DOS) of the most stable doped borophene/gas-molecule configurations were calculated, and the interaction mechanisms between the gas molecules and the doped borophene were further analyzed. The results indicated that most of the gas molecules exhibited strong chemisorption at the VB site (the center of valley bottom B–B bond) of the doped borophene (compared to pristine borophene). Electronic property analysis of the C-doped borophene/CO2 and the NO2 adsorption system revealed that there were numerous charge transfers from the C-doped borophene to the CO2 and NO2 molecules. This indicated that C-doped borophene was an electron donor, and the CO2 and NO2 molecules served as electron acceptors. In contrast to variations in the adsorption energies, electronic properties, and surface work functions of the different gas, C-, N-, and O-doped borophene adsorption systems, we concluded that the C-, N-, and O-doped borophene materials will improve the sensitivity of CO, CO2, and NO2 molecule; this improvement of adsorption properties indicated that C-, N-, and O-doped borophene materials are excellent candidates for surface work functions transistor to detect gas molecules.
Effects of a Brain-Computer Interface-Operated Lower Limb Rehabilitation Robot on Motor Function Recovery in Patients with Stroke
Authors: Li Chao , Wei Jinyu , Huang Xiaoqun , Duan Qiang , Zhang Tingting
Published: December 2021

Purpose. To observe the effect of a brain-computer interface-operated lower limb rehabilitation robot (BCI-LLRR) on functional recovery from stroke and to explore mechanisms. Methods. Subacute-phase stroke patients were randomly divided into two groups. In addition to the routine intervention, patients in the treatment group trained on the BCI-LLRR and underwent the lower limb pedal training in the control group, both for the same time (30 min/day). All patients underwent assessment by instruments such as the National Institutes of Health Stroke Scale (NIHSS) and the Fugl–Meyer upper and lower limb motor function and balance tests, at 2 and 4 weeks of treatment and at 3 months after the end of treatment. Patients were also tested before treatment and after 4 weeks by leg motor evoked potential (MEP) and diffusion tensor imaging/tractography (DTI/DTT) of the head. Results. After 4 weeks, the Fugl–Meyer leg function and NIHSS scores were significantly improved in the treatment group vs. controls (

P
<
0.01

). At 3 months, further significant improvement was observed. The MEP amplitude and latency of the treatment group were significantly improved vs. controls. The effect of treatment on fractional anisotropy values was not significant. Conclusions. The BCI-LLRR promoted leg functional recovery after stroke and improved activities of daily living, possibly by improving cerebral-cortex excitability and white matter connectivity.
TEX10 Promotes the Tumorigenesis and Radiotherapy Resistance of Urinary Bladder Carcinoma by Stabilizing XRCC6
Authors: Luo Sheng , Wang Wenjin , Feng Jingfang , Li Rui
Published: December 2021

Urinary bladder carcinoma refers to the commonest carcinoma with weak prognostic result for the patient as impacted by the limited treatment possibilities and challenging diagnosing process. Nevertheless, the molecular underpinning of bladder carcinoma malignant progression is still not clear. As a novel core part of pluripotency circuitry, testicular expression 10 (TEX10) plays an actively noticeable effect on reprogramming, early embryo development, and embryonic stem cell self-renewal. Nevertheless, TEX10 expressions and functions within bladder carcinoma are still not known. The present work is aimed at revealing TEX10 expression and biological function within urinary bladder carcinoma and elucidating the potential mechanisms. Results showed that TEX10 is abundant in urinary bladder carcinoma, and its protein level was related to poor disease-free survival in a positive manner. Reduced TEX10 level inhibited urinary bladder carcinoma cell proliferating process and metastasis in vitro and xenograft tumorigenicity in vivo. Notably, TEX10 might regulate carcinoma cell proliferating process and metastasis via XRCC6, thereby controlling the signaling of Wnt/β-catenin and DNA repair channel. Moreover, TEX10 gene knockout reduced the radiotherapy resistance of urinary bladder carcinoma. In brief, this work revealed that TEX10 could exert a significant carcinogenic effect on urinary bladder carcinoma tumorigenesis and radiotherapy resistance through the activation of XRCC6-related channels. Accordingly, targeting TEX10 is likely to offer a novel and feasible therapeutically related strategy for inhibiting urinary bladder carcinoma tumorigenicity.
Hypertension May Reduce the Infection Risk but Increase the Severity of COVID-19: Based on the Current Data in China
Authors: Li Bo , Zeng Lu , Sun Nengjun , Zhao Yunhe , Zhao Faming , Bian Hongjun , Yi Wei , Yang Jing , Li Bin , Su Guohai
Published: December 2021

Increasing evidence has shown an unusual relationship between hypertension and COVID-19, which may not be as simple as previously thought. The purpose of our study was to determine the association of hypertension with the onset and development of COVID-19. A meta-analysis was performed to summarize the prevalence of hypertension in COVID-19 patients, as well as the usage of ACEIs/ARBs. Metaregression analyses were used to evaluate the association of hypertension with disease severity and mortality. PubMed and Google Scholar were searched for relevant studies. A total of 42 studies including 14138 patients were enrolled in the study. The proportion of hypertension in COVID-19 patients in China was 17.7% according to the enrolled studies, while it was 6.0% in a study containing 72314 confirmed cases, which are both much lower than in the general population. All of the data from the 11 provinces in China showed the same tendency. The proportions of hypertension were higher in severe/ICU patients and nonsurvivors than in nonsevere/ICU patients and survivors. The metaregression analyses suggested that both disease severity and risk of death were associated with the incidence of hypertension. A total of 27.6% of COVID-19 patients with hypertension received ACEI/ARB therapy. The proportion of deaths in COVID-19 patients with hypertension treated with ACEIs/ARBs was significantly lower than that in nonuse patients treated with ACEIs/ARBs. In conclusion, hypertension may reduce the infection risk of COVID-19 but increase the risk of developing worse clinical outcomes. The use of ACEIs/ARBs may benefit COVID-19 patients with hypertension.
Identification of Hub Genes and Immune Cell Infiltration Characteristics in Alzheimer’s Disease
Authors: Hu Ming , Wang Jianhua
Published: December 2021

The purpose of this study was to identify hub genes closely correlated with Alzheimer's disease (AD) and their association with immune cell infiltration. In this work, 119 overlapping differentially expressed genes (DEGs) were obtained from GSE5281 and GSE122063 datasets through differential expression analysis. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed on the 119 DEGs, revealing some important biological functions and key pathways. AD immune cell infiltration analysis revealed a significant difference in the proportion of immune cells between the AD group and the control group. Finally, correlation analysis between target hub genes and immune cells indicated that GFAP had a positive or negative correlation with some specific immune cells. Our results provided useful clues, which will help to explain the molecular mechanism of AD and search for precise prognostic markers and potential therapeutic targets.
Influence Diagnostics in Log-Normal Regression Model with Censored Data
Authors: Khaleeq Javeria , Amanullah Muhammad , Almaspoor Zahra
Published: December 2021

Dealing with the biological data, the skewed distribution is approximated by the Log-Normal Regression model (LNRM). Traditional estimation techniques for the LNRM are sensitive to unusual observations. These observations greatly affect the model analysis, which makes imprecise conclusions. To overcome this issue, we proposed to develop diagnostics measures based on local influence diagnostics to identify such curious observations in the LNRM under censoring. The proposed measures are derived by perturbing the case weight, response, and explanatory variables. Furthermore, we also consider the One-Step Newton-Raphson method and generalized cook’s distance. We study the Monte Carlo simulation and its application to real data to illustrate the developed approaches.
Empowering Patients for Healthy Nutrition, Physical Activity, and Self-Care Using the Diabetes Score Questionnaire
Authors: Hashim Muhammad Jawad , Mustafa Halla
Published: December 2021

Objectives: Lifestyle factors such as nutrition and physical activity play an important role in the management of diabetes mellitus. Unfortunately, adherence to lifestyle change remains low among patients with diabetes. The aim of this study was to evaluate the effectiveness of the Diabetes Score questionnaire in a clinical setting. Methods: The Diabetes Score is a 10-item shared decision-making tool designed to empower lifestyle change in individuals with diabetes. It yields an intuitive score from 0 to 100 based on a patient’s adherence to lifestyle recommendations. An observational study was conducted at an ambulatory health care center. After obtaining written informed consent, adult patients with type 2 diabetes mellitus were interviewed by a trained researcher using the Diabetes Score questionnaire. Patients’ Diabetes Score values were analyzed in reference to their glycemic control and other clinical and demographic factors. Results: A total of 60 individuals with type 2 diabetes participated in the study. The mean age was 56 years (minimum 43 years, maximum 70 years) with 60% being males. Higher Diabetes Scores correlated with better glycemic control (hemoglobin A1C; r = −0.23, p = 0.044) indicating the effect of lifestyle factors such as healthy nutrition, smaller portion sizes, active lifestyle, and aerobic exercise. The questionnaire showed internal consistency (alpha 0.66), construct validity, and high patient satisfaction (98%). Conclusion: Diabetes Score, a behavioral lifestyle questionnaire, correlates with glycemic control in type 2 diabetes. Diabetes Score can be used in clinical settings for measuring, discussing, and setting targets for lifestyle change among patients with diabetes.
Neuroendocrine Tumor of the Common Bile Duct: Case Report
Authors: Fernández-Ferreira Ricardo , Medina-Ceballos Emilio , Soberanis-piña Pamela Denisse , Conde-Flores Emilio , Arroyave-Ramírez Andrés Mauricio , Izquierdo-Tolosa Carlos Daniel , Motola-Kuba Daniel , Ruiz-Morales Jose Manuel , Dorantes-Heredia Rita
Published: December 2021

Carcinoma of the extrahepatic biliary tract accounts for <2% of all cancers. Neuroendocrine tumor of the extrahepatic bile duct is very rare, and there are <200 cases reported since 1959. The preoperative diagnosis is infrequent (5.12%). The definite diagnosis relies on postoperative pathology which utilized immunohistochemistry study on many biomarkers to diagnose the histological subtypes of neuroendocrine neoplasms, such as chromogranin A, synaptophysin, and neuron-specific enolase. When the primary tumor has no metastases, radical removal of the lesion appears as curative treatment. The treatment of the carcinoid syndrome or other functioning syndrome is the first priority. We report a case of a 12-year-old Mexican woman with neuroendocrine tumor of the extrahepatic bile duct (common bile duct neuroendocrine tumor) seen in our hospital. Resection of the common bile duct, cholecystectomy, end to side Roux-en-y hepaticojejunostomy, and portal lymphadenectomy was performed. A review of the pertinent literature was performed. Given the rarity of the disease, treatment principles are based mainly on retrospective series and case reports. We present the eighth case in adolescence in the literature.
Clotting of Hemodialysis Access in Patients with COVID-19 in an Inner-City Hospital
Authors: Ouyang Jie , Bajracharya Siddhartha , John Sabu , Wagner John , Xu Jiehui , Luo Yiming , Thaxton Mariah , Salifu Moro , Yap Ernie , Mallappallil Mary
Published: December 2021

Background: An increased incidence of thrombotic complications in patients with coronavirus disease 2019 (COVID-19) has been reported. Severe acute kidney injury (AKI) is one of the major clinical manifestations of COVID-19 with the need for renal replacement therapy. It was observed that hemodialysis (HD) accesses tended to thrombose more often in the COVID-19 population than in non-COVID-19 patients. We hypothesize that the hypercoagulable state of COVID-19 is associated with higher incidence of access clotting. Method: In this retrospective single-centered study at Kings County Hospital in New York City, 1,075 patients with COVID-19 were screened, and 174 patients who received HD from January 3, 2021 to May 15, 2020 were enrolled to examine the risk factors of dialysis access clotting in patients with COVID-19. Results: Of the 174 patients, 109 (63%) were COVID-19 positive. 39 (22.6%) patients had dialysis access clotting at least once during their hospitalization, and they had significantly higher body mass index (BMI) (p = 0.001), higher rates of COVID-19 (p = 0.015), AKI (p < 0.001), higher platelet counts (p = 0.029), higher lactate dehydrogenase levels (p = 0.009), and lower albumin levels (p = 0.001) than those without access malfunctions. Low albumin levels (p = 0.008), AKI (p = 0.008), and high BMI (p = 0.018) were risk factors associated with HD access clotting among COVID-19 patients. Conclusion: Patients with COVID-19 who receive HD for AKI with high BMI are at a higher risk of clotting their HD access.
The Personal Impact of Daily Wound Care for Hidradenitis Suppurativa
Authors: Moloney Suzanne , McGrath Barry M. , Roshan Davood , Gethin Georgina
Published: December 2021

Background: Recurring nodules, abscesses, and lesions characterise hidradenitis suppurativa (HS): a chronic, inflammatory skin disorder. Globally the prevalence of HS is estimated to be around 1% of the population. Leakage, pain, and odour from HS wounds require substantial management. Little is known of the personal burdens that routine wound management imposes on the patient. Objectives: To evaluate how routine HS wound management impacts patients in terms of the time spent changing dressings, the number of dressings required per day, pain experienced during dressing changes, and negative impact on various domains of their personal lives. Methods: An anonymous online questionnaire was posted on closed social media patient support groups between April and May 2019. Pearson χ2 test was used to evaluate if Hurley stages influenced the personal impact of wound care routines on patients. Statistical significance was determined as p value <0.05. Results: In total, 908 people from 28 countries responded. Of these, 81% (n = 734) reported that regular dressing changes negatively impacted on their quality of life. Most patients, 82% (n = 744), experience pain during dressing changes. 16% (n = 142) of patients required five or more dressings daily, and 12% (n = 108) spend over 30 min daily tending to wounds. Patients indicated high levels of dissatisfaction with currently available wound dressings. Conclusion: HS wound management imposes a substantial personal burden on patients. There is a clear unmet need for HS-specific wound dressings and wound care provisions, and a greater awareness of the condition and its impact is needed among clinicians.
Therapeutic Response and Long-Term Renal Outcomes in Childhood Idiopathic Steroid-Resistant Nephrotic Syndrome: A Single-Center Study
Authors: Jung Jiwon , Lee Joo Hoon , Park Young Seo
Published: December 2021

Purpose: We aimed to evaluate therapeutic response and long-term renal outcomes of childhood idiopathic steroid-resistant nephrotic syndrome (iSRNS). Methods: We retrospectively reviewed treatment regimens, especially calcineurin inhibitor (CNI), pathologic diagnoses, and long-term renal outcomes of iSRNS patients for 30 years. Results: Of 516 patients with idiopathic NS, 52 (10.1%) had iSRNS. Renal biopsies from 48 patients showed minimal change disease (MCD) in 23 (47.9%), focal segmental glomerulosclerosis in 24 (50.0%), and mesangioproliferative glomerulonephritis in 1 (2.1%). The median follow-up period was 66.5 (range, 4–275) months, and 90.4% of them were treated with a CNI. CNI induced remission in 70.2% within 50.4 ± 43.5 days. Of the patients with MCD and focal segmental glomerular sclerosis (FSGS), 86.4% (19/22) and 45.0% (9/20) (p = 0.005) responded to CNI, respectively. Mean time until remission after using CNI was longer with FSGS (90.4 ± 54.0 days) than with MCD (29.6 ± 26.3 days) (p = 0.010). CNI-responsive patients with FSGS or MCD showed preserved renal function, and CNI nonresponsive MCD patients also showed preserved renal function during follow-up. However, end-stage renal disease (ESRD) progressed in 8 out of 11 patients with FSGS nonresponsive to the CNI for an average of 44.9 ± 18.4 months after diagnosis. Conclusion: Different response rates and times for remission were achieved with the CNI according to the pathology of iSRNS. All MCD patients regardless of CNI response and all CNI-responsive patients with FSGS showed excellent renal outcomes, while almost all FSGS patients nonresponsive to CNI eventually progressed to ESRD.
COVID-19 Pandemic Impact on Severe Alopecia Areata Patients
Authors: Gheisari Mehdi , Zahedi Khatere , Tehranchinia Zohreh , Moravvej Hamideh , Abdollahimajd Fahimeh , Dadkhahfar Sahar
Published: December 2021

Introduction: The pandemic of COVID-19 has several implications for patients with chronic stress-sensitive diseases such as alopecia areata (AA). On the other hand, the vulnerability of AA patients using immunosuppressives to a more severe infection is in the shadow of ambiguity. This teledermatology study aimed to evaluate the course and outcome of AA in patients during this challenging period. Methods: Patients with AA who had previously received systemic therapy included in this study. Information about demographic data, AA history, characteristics, and treatments, hair loss progression, Corona Disease Anxiety Scale (CDAS), adherence to protective measures against the COVID-19, possible infection, and its features obtained via a telephone call. Results: A total of 57 patients participated. The majority (84.2%) of the participants had mild anxiety assessed by CDAS. Two patients (3.5%) had got infected with COVID-19. Twenty-one (36.8%) participants experienced hair loss progression. Hair loss progression correlated with drug dose reduction (OR: 46.09, 95% CI 5.48–387.14, p < 0.001) although it did not influence by the level of anxiety evaluated by the CDAS (p > 0.05). Conclusion: The anxiety perceived by severe AA patients about COVID-19 is mild; however, many experience hair loss progressions owing to their drug dose reduction.
The Association of Frailty with Poverty in Older Adults: A Systematic Review
Authors: Hayajneh Audai A. , Rababa Mohammad
Published: December 2021

Introduction: Suffering from both frailty and poverty may have significant negative consequences on older adults’ lives. This study aimed to conduct a systematic review to investigate the relationship between frailty and low income among older adults. Methods: This systematic review was guided by the PRISMA guidelines and was aimed at exploring the frailty in older adults with low income and evaluating the robustness of the synthesis. Cross-sectional and longitudinal studies published in English between 2008 and 2020 were identified using search terms entered into the following databases: CINAHL, Medline, Google Scholar, and PubMed. Results: Nine articles met the inclusion criteria. This review revealed a positive relationship between frailty and poverty. Such a relationship could be explained through 3 dimensions of the relationship between frailty and poverty among older adults identified based on the findings of the reviewed studies. Discussion/Conclusion: The social life, environmental conditions, and financial issues were positively correlated and coexisted with both frailty and poverty. Frailty should be treated on a holistic basis, considering financial issues. Among these financial issues is poverty, which disrupts older adults’ social activities, hinders them from building successful social relationships, and reduces their quality of life.
Soluble Guanylate Cyclase-Mediated Relaxation in Aortas from Rats with Renovascular Hypertension
Authors: Tawa Masashi , Shimosato Takashi , Nakagawa Keisuke , Okamura Tomio , Ohkita Mamoru
Published: December 2021

Soluble guanylate cyclase (sGC) plays an important role in nitric oxide (NO)-mediated regulation of vascular tone; however, NO bioavailability is often reduced in diseased blood vessels. Accumulating evidence suggests that a shift of sGC from the NO-sensitive form to the NO-insensitive form could be an underlying cause contributing to this reduction. Herein, we investigated the impact of renovascular hypertension on NO-sensitive and NO-insensitive sGC-mediated relaxation in rat aortas. Renovascular hypertension was induced by partially clipping the left renal artery (2-kidneys, 1-clip; 2K1C) for 10 weeks. Systolic, diastolic, and mean arterial pressures were significantly increased in the 2K1C group when compared with the sham group. In addition, plasma thiobarbituric acid reactive substances and aortic superoxide generation were significantly enhanced in the 2K1C group when compared with those in the sham group. The vasorelaxant response of isolated aortas to the sGC stimulator BAY 41-2272 (NO-sensitive sGC agonist) was comparable between the sham and 2K1C groups. Likewise, the sGC activator BAY 60-2770 (NO-insensitive sGC agonist)-induced relaxation did not differ between the sham and 2K1C groups. In addition, the cGMP mimetic 8-Br-cGMP (protein kinase G agonist) induced similar relaxation in both groups. Furthermore, there were no differences in BAY 41-2272-stimulated and BAY 60-2770-stimulated cGMP generation between the groups. These findings suggest that the balance between NO-sensitive and NO-insensitive forms of sGC is maintained during renovascular hypertension. Therefore, sGC might not be responsible for the reduced NO bioavailability observed during renovascular hypertension.
Underdosed Direct Oral Anticoagulants in Atrial Fibrillation Patients Reduce Stroke Severity and Improve Outcome
Authors: Naganuma Masaki , Inatomi Yuichiro , Yonehara Toshiro , Nakajima Makoto , Ueda Mitsuharu
Published: December 2021

Background and Purpose: Anticoagulant drugs, including vitamin K antagonist (VKA) and direct oral anticoagulants (DOACs), can reduce stroke severity and are associated with good functional outcomes. Some patients are prescribed lower-than-recommended doses of DOACs; whether these have similar effects has not been clarified. Methods: We retrospectively evaluated 1,139 consecutive ischemic stroke and transient ischemic attack patients with atrial fibrillation. Patients were divided into 5 groups according to their preceding anticoagulant drug therapies: no anticoagulant therapy (ACn), undercontrolling VKA doses (VKAuc), recommended, controlling VKA doses (VKArec), prescribed underdoses of DOAC (DOACud), and recommended doses of DOAC (DOACrec). We investigated the associations between these anticoagulant drug therapies and patients’ initial stroke severity and 3-month outcomes. Results: Median National Institutes of Health Stroke Scale scores at admission were as follows: ACn: 16, VKAuc: 15, VKArec: 9, DOACud: 5, and DOACrec: 7. When the ACn group was used as a reference, regression analysis showed that VKArec (odds ratio [OR] 1.49, 95% confidence interval [CI] 1.01–2.21), DOACud (OR 2.84, 95% CI: 1.47–5.66), and DOACrec (OR 1.83, 95% CI: 1.23–2.74) were associated with milder stroke severity, while VKAuc was not. Median 3-month modified Rankin Scale scores were 2 in the DOACud and DOACrec groups and 4 in all other groups. After adjusting for confounding factors, DOACud (OR 3.14, 95% CI: 1.50–6.57) and DOACrec (OR 1.67, 95% CI: 1.05–2.64) were associated with good 3-month outcomes while VKAuc and VKArec were not. Conclusions: In patients with atrial fibrillation, recommended doses and underdoses of DOACs reduced stroke severity on admission and were associated with good 3-month outcomes.