bluuebunny/crossref_metadata_2025 huggingface dataset:
On the Impact of Programming Languages on Code Quality
Authors: Berger Emery D. , Hollenbeck Celeste , Maj Petr , Vitek Olga , Vitek Jan
Published: October 2019

In a 2014 article, Ray, Posnett, Devanbu, and Filkov claimed to have uncovered a statistically significant association between 11 programming languages and software defects in 729 projects hosted on GitHub. Specifically, their work answered four research questions relating to software defects and programming languages. With data and code provided by the authors, the present article first attempts to conduct an experimental repetition of the original study. The repetition is only partially successful, due to missing code and issues with the classification of languages. The second part of this work focuses on their main claim, the association between bugs and languages, and performs a complete, independent reanalysis of the data and of the statistical modeling steps undertaken by Ray et al. in 2014. This reanalysis uncovers a number of serious flaws that reduce the number of languages with an association with defects down from 11 to only 4. Moreover, the practical effect size is exceedingly small. These results thus undermine the conclusions of the original study. Correcting the record is important, as many subsequent works have cited the 2014 article and have asserted, without evidence, a causal link between the choice of programming language for a given task and the number of software defects. Causation is not supported by the data at hand; and, in our opinion, even after fixing the methodological flaws we uncovered, too many unaccounted sources of bias remain to hope for a meaningful comparison of bug rates across languages.
A Neural Network Prefetcher for Arbitrary Memory Access Patterns
Authors: Peled Leeor , Weiser Uri , Etsion Yoav
Published: October 2019

Memory prefetchers are designed to identify and prefetch specific access patterns, including
spatiotemporal
locality (e.g., strides, streams), recurring patterns (e.g., varying strides, temporal correlation), and specific irregular patterns (e.g., pointer chasing, index dereferencing). However, existing prefetchers can only target premeditated patterns and relations they were designed to handle and are unable to capture access patterns in which they do not specialize. In this article, we propose a context-based neural network (NN) prefetcher that dynamically adapts to arbitrary memory access patterns. Leveraging recent advances in machine learning, the proposed NN prefetcher correlates program and machine contextual information with memory accesses patterns, using online-training to identify and dynamically adapt to unique access patterns exhibited by the code. By targeting
semantic locality
in this manner, the prefetcher can discern the useful context attributes and learn to predict previously undetected access patterns, even within noisy memory access streams. We further present an architectural implementation of our NN prefetcher, explore its power, energy, and area limitations, and propose several optimizations. We evaluate the neural network prefetcher over SPEC2006, Graph500, and several microbenchmarks and show that the prefetcher can deliver an average speedup of 21.3% for SPEC2006 (up to 2.3×) and up to 4.4× on kernels over a baseline of PC-based stride prefetcher and 30% for SPEC2006 over a baseline with no prefetching.
A Resource-Efficient Embedded Iris Recognition System Using Fully Convolutional Networks
Authors: Tann Hokchhay , Zhao Heng , Reda Sherief
Published: October 2019

Applications of fully convolutional networks (FCN) in iris segmentation have shown promising advances. For mobile and embedded systems, a significant challenge is that the proposed FCN architectures are extremely computationally demanding. In this article, we propose a resource-efficient, end-to-end iris recognition flow, which consists of FCN-based segmentation and a contour fitting module, followed by Daugman normalization and encoding. To attain accurate and efficient FCN models, we propose a three-step SW/HW co-design methodology consisting of FCN architectural exploration, precision quantization, and hardware acceleration. In our exploration, we propose multiple FCN models, and in comparison to previous works, our best-performing model requires 50× fewer floating-point operations per inference while achieving a new state-of-the-art segmentation accuracy. Next, we select the most efficient set of models and further reduce their computational complexity through weights and activations quantization using an 8-bit dynamic fixed-point format. Each model is then incorporated into an end-to-end flow for true recognition performance evaluation. A few of our end-to-end pipelines outperform the previous state of the art on two datasets evaluated. Finally, we propose a novel dynamic fixed-point accelerator and fully demonstrate the SW/HW co-design realization of our flow on an embedded FPGA platform. In comparison with the embedded CPU, our hardware acceleration achieves up to 8.3× speedup for the overall pipeline while using less than 15% of the available FPGA resources. We also provide comparisons between the FPGA system and an embedded GPU showing different benefits and drawbacks for the two platforms.
Optimization of Threshold Logic Networks with Node Merging and Wire Replacement
Authors: Chen Yung-Chih , Zheng Li-Cheng , Wong Fu-Lian
Published: October 2019

In this article, we present an optimization method for threshold logic networks (TLNs) based on observability don’t-care-based node merging. To reduce gate count in a TLN, it iteratively merges two gates that are functionally equivalent or whose differences are never observed at the primary outputs. Furthermore, it is able to identify redundant wires and replace wires for removing more gates. Basically, the proposed method is primarily adapted from an ATPG-based node-merging approach which works for conventional Boolean logic networks. To extend the approach for TLNs, we develop a method for computing mandatory assignments of a stuck-at fault test on a threshold gate and a method for conducting logic implication in a TLN. Additionally, to achieve a better optimization quality, we integrate the proposed method with other optimization methods. The experimental results show that the overall optimization method can save an average of approximately 4.7% threshold gates for a set of TLNs which are generated by using the latest TLN synthesis method. The experimental results also demonstrate the efficiency of the optimization method.
Characterization of Flowing Aqueous Solid Dispersions of Electroactive Lithium-Ion Battery Materials
Authors: Koenig Gary
Published: October 2019

While there are many material characterization techniques that are employed for the quality control processes of lithium-ion battery active material powders, eventually the materials must be validated electrochemically in battery cells. This requires making the cells including slurry mixing, slurry coating and drying, electrode calendering and pairing, and final cell assembly. Fabricating cells requires significant equipment and material expense and, in some cases, significant time. Additionally, the cells must be electrochemically tested which depending on the protocol can take multiple days. A technique that provides insights into the electrochemical properties of battery materials without cell fabrication and electrochemical evaluation could improve battery active material powder quality control and potentially reduce the time and cost involved in material validation. Our lab has been working on a technique where dispersions of battery active materials are evaluated electrochemically during collisions with current collectors. The technique has been referred to as dispersed particle resistance (DPR), and in previous studies we have shown that DPR measurements provide an indicator of the rate capability of lithium-ion battery active materials. DPR has a significant advantage with regards to timescale for material evaluation because the method takes only a few minutes and has the option of high throughput analysis due to a flow-through configuration. We have also adapted the technique to characterization of the particles in aqueous dispersions, and in this presentation we will demonstrate that the technique is effective with aqueous dispersions of cathode materials, including water-sensitive layered metal oxides with high nickel content such as LiNi0.8Co0.1Mn0.1O2.
Ectopic Cushing’s Syndrome Unveiling a Metastatic Parotid Carcinoma
Authors: Castro Oliveira Sofia , Neves João Sérgio , Souteiro Pedro , Belo Sandra , Oliveira Ana Isabel , Moreira Helena , Mergulhão Gomes Paulo , Coelho Lígia , Sarmento Cristina , Fonseca Elsa , Neves Celestino , Freitas Paula , Carvalho Davide
Published: October 2019

Introduction. Adrenocorticotropic hormone (ACTH) ectopic production is a rare cause of Cushing syndrome (CS). The most commonly associated tumours are small-cell lung carcinoma along with bronchial and thymic carcinoids. To date, only 5 cases have been published in the literature featuring ectopic ACTH secretion from metastatic acinic cell carcinoma (ACC) of the parotid gland. We hereby describe a very uncommon case of ectopic CS (ECS) unveiling a metastatic parotid ACC. Case Presentation. A 46-year-old man with hypertension and dyslipidemia diagnosed 4-months before, as well as new-onset diabetes mellitus unveiled 1-month earlier, was referred to emergency department for hypokalemia. Hormonal study and dynamic biochemical tests performed indicated ECS. Imaging and cytological findings pointed toward a likely primary right parotid malignancy with liver metastases. Somatostatin receptor scintigraphy has shown an increased uptake in the parotid gland and mild expression in liver metastasis. The patient underwent right parotidectomy, and histopathologic examination confirmed ACC. Meanwhile, hypercortisolism was managed with metyrapone, ketoconazole, and lanreotide. Despite chemotherapy onset, a rapid disease progression and clinical course deterioration was observed. Conclusion. The present report highlights a rare ECS, exposing a metastatic parotid ACC, with an aggressive and challenging clinical course, representing the first case whose diagnosis of ECS came prior to ACC.
Severe Hypocalcemia and Resulting Seizure Caused by Vitamin D Deficiency in an Older Patient Receiving Phenytoin: Eldecalcitol and Maxacalcitol Ointment as Potential Therapeutic Options for Hypocalcemia
Authors: Aihara Seishi , Yamada Shunsuke , Kondo Mika , Oka Hideaki , Kamimura Taro , Harada Atsumi , Nakano Toshiaki , Tsuruya Kazuhiko , Kitazono Takanari
Published: October 2019

An 82-year-old man treated with phenytoin for the prevention of symptomatic epilepsy was hospitalized to treat consciousness disturbance, seizure, and hypocalcemia (serum calcium: 4.6 mg/dL). Serum 25-hydroxyvitamin D level was very low (5.4 ng/mL), whereas serum calcitriol level was normal (27 pg/mL) and serum intact parathyroid hormone level was increased (369 pg/mL). He was finally diagnosed with vitamin D deficiency associated with low sunlight exposure and long-term phenytoin use for symptomatic epilepsy: phenytoin is shown to accelerate catabolism of 25-hydroxyvitamin D. Combination treatment with eldecalcitol and maxacalcitol ointments successfully normalized corrected serum calcium level: both eldecalcitol and maxacalcitol are vitamin D receptor activators used for osteoporosis and psoriasis, respectively. Our case illustrates the importance of periodic serum calcium level monitoring in patients receiving anti-epileptic drugs and the usefulness of eldecalcitol and maxacalcitol ointment as a therapeutic option for hypocalcemia, especially in countries where native vitamin D and 25-hydroxyvitamin D are not available.
Combined Inositol Hexakisphosphate and Inositol Supplement Consumption Improves Serum Alpha-Amylase Activity and Hematological Parameters in Streptozotocin-Induced Type 2 Diabetic Rats
Authors: Foster Shadae R. , Dilworth Lowell L. , Sparks Jean , Alexander-Lindo Ruby L. , Omoruyi Felix O.
Published: October 2019

This study evaluated the effect of combined inositol hexakisphosphate (IP6) and inositol supplement on organ weight, intestinal ATPase activities, complete blood count, and serum analytes in streptozotocin (STZ)-induced type 2 diabetic rats. High-fat diet and a single intraperitoneal injection of streptozotocin (35 mg/kg body weight) were used to induce type 2 diabetes mellitus in Sprague–Dawley rats. The diabetic groups were then treated with either combined IP6 and inositol supplement or glibenclamide for four weeks. Organ weights, intestinal ATPase activities, complete blood count, serum α-amylase, total protein, albumin, and globulin content were determined. Pancreatic weight was significantly reduced while relative kidney and liver weights were elevated in the group treated with combined IP6 and inositol supplement compared to the nondiabetic control. Serum α-amylase activity for the glibenclamide and combination treated groups was significantly improved compared to that of the untreated diabetic group. Red cell distribution width percentage was significantly lower in the combination treated group compared to that in the untreated diabetic group, while intestinal ATPase activities were unaffected by the treatment regime. Combined IP6 and inositol supplement consumption may protect people with diabetes from increased risk of cardiovascular diseases due to the supplement's ability to maintain red cell distribution width percentage towards the normal control group.
Hydrodynamics of Compound Droplet Flowing in the Curved Minichannel
Authors: Sun Meimei , Zhao Miao , Gao Wei
Published: October 2019

Based on the volume of fluid (VOF) method, a theoretical model of compound droplet deformation in curved minichannel is developed. The effects of curved angle, continuous phase, radius ratio between the inner and integral droplets, and viscosity of the middle phase are examined to reveal the underlying mechanism of compound droplet deformation. The results indicate that the deformation process of the compound droplets in the curved minichannel can be divided into three stages, namely, the initial stage, the turning stage, and the adjustment stage. Both large curved angle and high capillary number of the continuous phase result in the large shear force and high eccentricity of the compound droplet. However, as the radius ratio increases, the influence of the inner droplet on the deformation of the compound droplet transits from enhancing to suppressing.
Serum-Free Culture System for Spontaneous Human Mesenchymal Stem Cell Spheroid Formation
Authors: Dong Guoyi , Wang Shengpeng , Ge Yuping , Deng Qiuting , Cao Qi , Wang Quanlei , Shang Zhouchun , OuYang Wenjie , Li Jing , Liu Chao , Tang Jie , Zhao Weihua , Gu Ying
Published: October 2019

Human mesenchymal stem cells (hMSCs) are widely used in clinical research because of their multipotential, immunomodulatory, and reparative properties. Previous studies determined that hMSC spheroids from a three-dimensional (3D) culture possess higher therapeutic efficacy than conventional hMSCs from a monolayer (2D) culture. To date, various 3D culture methods have been developed to form hMSC spheroids but most of them used culture medium containing fetal bovine serum (FBS), which is not suitable for further clinical use. Here, we demonstrate that dissociated single MSCs seeded in induced pluripotent stem medium (MiPS) adhere loosely to the dish and spontaneously migrate to form spheroids during day 3 to day 6. Through component deletion screening and complementation experiments, the knockout serum replacement (KSR) was identified as necessary and sufficient for hMSC spheroid formation. Transcriptome analysis showed that the overall expression profiles were highly similar between 2D culture with FBS and KSR-derived spheroids. Interestingly, genes related to inflammatory response, immune response, and angiogenesis were upregulated in spheroids at day 6 and qPCR results further validated the increased expression level of related genes, including STC1, CCL7, HGF, IL24, and TGFB3. When spheroids were replated in normal FBS medium, cells formed a typical spindle-shaped morphology and FACS results showed that the recovered cells retained MSC-specific surface markers, such as CD73, CD90, and CD105. In summary, we developed a practical and convenient method to generate hMSC spheroids for clinical research and therapy.
Preparation of Ag-Coated SiO2@TiO2 Core-Shell Nanocomposites and Their Photocatalytic Applications towards Phenol and Methylene Blue Degradation
Authors: Fu Ning , Ren Xue-chang , Wan Jian-xin
Published: October 2019

Ag-coated SiO2@TiO2 (Ag-SiO2@TiO2) core-shell nanocomposites were synthesized by a two-step method, which combined hydrothermal process and photodeposition. The morphology, structure, composition, and optical properties of the Ag-coated SiO2@TiO2 nanocomposites were extensively characterized by field-emission scanning microscopy (FE-SEM), transmission electron microscopy (TEM), energy-dispersive X-ray spectroscopy (EDS), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), and Fourier-transform infrared spectra (FT-IR spectra). The anatase TiO2 nanoparticles (5-10 nm) with high surface area were loaded on SiO2 spheres (200-300 nm) in the form of SiO2@TiO2 core-shell nanoparticle with a porous shell of controlled thickness (10–30 nm). Ag nanoparticles of different mass concentrations were photodeposited on SiO2@TiO2 core-shell structure with particle sizes of about 10-20 nm. The results showed that Ag nanoparticles increased the photocatalytic activity of SiO2@TiO2 core-shell nanoparticle improved the degradation of phenol and methylene blue under UV irradiation. The experimental results showed that Ag nanoparticles with mass concentrations of 6% had the highest photocatalytic activity on SiO2@TiO2 core-shell nanoparticles.
Evaluation of the Effect Derived from Silybin with Vitamin D and Vitamin E Administration on Clinical, Metabolic, Endothelial Dysfunction, Oxidative Stress Parameters, and Serological Worsening Markers in Nonalcoholic Fatty Liver Disease Patients
Authors: Federico Alessandro , Dallio Marcello , Masarone Mario , Gravina Antonietta Gerarda , Di Sarno Rosa , Tuccillo Concetta , Cossiga Valentina , Lama Stefania , Stiuso Paola , Morisco Filomena , Persico Marcello , Loguercio Carmelina
Published: October 2019

Nowadays, the nonalcoholic fatty liver disease represents the main chronic liver disease in the Western countries, and the correct medical therapy remains a big question for the scientific community. The aim of our study was to evaluate the effect derived from the administration for six months of silybin with vitamin D and vitamin E (RealSIL 100D®) on metabolic markers, oxidative stress, endothelial dysfunction, and worsening of disease markers in nonalcoholic fatty liver disease patients. We enrolled 90 consecutive patients with histological diagnosis of nonalcoholic fatty liver disease and 60 patients with diagnosis of reflux disease (not in therapy) as healthy controls. The nonalcoholic fatty liver disease patients were randomized into two groups: treated (60 patients) and not treated (30 patients). We performed a nutritional assessment and evaluated clinical parameters, routine home tests, the homeostatic model assessment of insulin resistance, NAFLD fibrosis score and fibrosis-4, transient elastography and controlled attenuation parameter, thiobarbituric acid reactive substances, tumor necrosis factor α, transforming growth factor β, interleukin-18 and interleukin-22, matrix metalloproteinase 2, epidermal growth factor receptor, insulin growth factor-II, cluster of differentiation-44, high mobility group box-1, and Endocan. Compared to the healthy controls, the nonalcoholic fatty liver disease patients had statistically significant differences for almost all parameters evaluated at baseline (p<0.05). Six months after the baseline, the proportion of nonalcoholic fatty liver disease patients treated that underwent a statistically significant improvement in metabolic markers, oxidative stress, endothelial dysfunction, and worsening of disease was greater than not treated nonalcoholic fatty liver disease patients (p<0.05). Even more relevant results were obtained for the same parameters by analyzing patients with a concomitant diagnosis of metabolic syndrome (p<0.001). The benefit that derives from the use of RealSIL 100D could derive from the action on more systems able to advance the pathology above all in that subset of patients suffering from concomitant metabolic syndrome.
Stearoyl CoA Desaturase Regulates Ferroptosis in Ovarian Cancer Offering New Therapeutic Perspectives
Authors: Carbone Michele , Melino Gerry
Published: October 2019

Better therapies are urgently needed for ovarian cancer, which is associated with an overall median survival of less than 5 years from diagnosis. In this issue of Cancer Research, Tesfay and colleagues show that stearoyl CoA desaturase (SCD1) is expressed at high levels in different isotypes of ovarian cancer and that SCD1 protects ovarian cancer cells from cell death. Pharmaceutical inhibition of SCD1 induces apoptosis and ferroptosis in vitro and in vivo. Combination therapies of SCD1 inhibitors and ferroptosis inducers significantly decrease ovarian tumor masses in mice. This novel therapy may prove useful to treat women with ovarian cancer.

See related article by Tesfay et al., p. 5355
Long-Term Outcomes after Endoscopic Submucosal Dissection for Ulcerative Colitis-Associated Dysplasia
Authors: Matsumoto Kenta , Oka Shiro , Tanaka Shinji , Tanaka Hidenori , Boda Kazuki , Yamashita Ken , Sumimoto Kyoku , Ninomiya Yuki , Arihiro Koji , Shimamoto Fumio , Chayama Kazuaki
Published: October 2019

Introduction: The Surveillance for Colorectal Endoscopic Neoplasia Detection and Management in Inflammatory Bowel Disease Patients: International Consensus Recommendations guidelines recommend surveillance colonoscopy instead of colectomy after the complete removal of “endoscopically resectable” dysplastic lesions in ulcerative colitis (UC). There are no studies on long-term outcomes of endoscopic submucosal dissection (ESD) for UC-associated neoplasia (UCAN). We aimed to evaluate the clinical outcomes of ESD for UC-associated dysplasia (UCAD) during long-term follow-up. Methods: We retrospectively enrolled 17 consecutive UC patients with 22 UCADs, who underwent initial ESD or total proctocolectomy at the Hiroshima University Hospital. The clinicopathological features of the patients and neoplasias and clinical outcomes of ESD were evaluated and compared with those of total proctocolectomy. Results: UCAD in the ESD and total proctocolectomy groups was mostly noted on the left side of the colon, and most lesions were superficial macroscopic lesions. In the ESD group, en bloc resection and histological complete resection rates were 83 and 67%, respectively. One patient died of malignant melanoma; however, none of the patients died of UC-associated carcinoma in both groups. Metachronous neoplasias developed in 5 of the 7 patients in the ESD group. Among the 5 patients with metachronous UCAN, 4 finally underwent total proctocolectomy and 1 underwent additional ESD. Conclusions: ESD for UCAD is a useful method for total excisional biopsy. UC patients with UCAD resected by ESD have a high risk of developing metachronous UCAN during the follow-up period.
The Alliance-Outcome Relation in Internet-Based Interventions for Psychological Disorders: A Correlational Meta-Analysis
Authors: Probst Greta Helene , Berger Thomas , Flückiger Christoph
Published: October 2019

Background: The alliance between therapists and patients is one of the most investigated factors of psychotherapy and a robust predictor of treatment outcome in face-to-face interventions. The implementation of internet-based interventions for psychological disorders has become more and more relevant over the past years, particularly in European countries. Regarding the relevance of the alliance for therapy outcome in internet-based interventions, mixed results are reported. The present correlative meta-analysis systematically summarizes the relation between alliance and therapy outcome in internet-based interventions for psychological disorders. Methods: Based on a systematic search, we detected 18 internet-based studies with 23 independent samples (1,177 participants). Results: The omnibus revealed a moderate effect of r = 0.252, p < 0.001, 95% CI [0.19, 0.31]. The analyses of the subscales indicated that the task component (r = 0.28) was slightly more predictive than the bond component (rbond = 0.16; QM(3) = 26.85, p < 0.001). None of the investigated moderators indicated significance. Discussion: This meta-analysis underlines the assumption that the alliance is a robust facilitative factor across mental health treatments.
Contribuição aos estudos da evolução da escarpa entre as bacias hidrográficas dos rios Doce e Paraíba do Sul, na Serra da Mantiqueira-MG-Brasil
Authors: Marent Breno Ribeiro , Valadão Roberto Célio
Published: October 2019

No estado de Minas Gerais, a Serra da Mantiqueira constituí escarpa que separa bacias hidrográficas em distintos degraus topográficos, sendo a do rio Doce em nível superior e Paraíba do Sul em inferior. Na área da escarpa, vales suspensos são o registro mais marcante da evolução dessas bacias que ocorrem através de capturas fluviais. O presente trabalho investigou a evolução recente desse escarpamento com base em elementos geomorfológicos e dados geocronológicos secundários. Os resultados demonstraram que a escarpa evolui por capturas fluviais através de downwearing e backwearing. Esses se propagam a remontante na zona do knickpoint ao longo do canal principal e tributários. Considera-se também a importância da atuação dos processos de vertente. Esses processos levam a ampliação lateral do vale e o consequente entulhamento do canal principal decorrentes do aumento de gradiente e amplitude durante o ajuste do vale fluvial com o novo nível de base.
Myocardial Energetics in Heart Failure With Preserved Ejection Fraction
Authors: AbouEzzeddine Omar F. , Kemp Bradley J. , Borlaug Barry A. , Mullan Brian P. , Behfar Atta , Pislaru Sorin V. , Fudim Marat , Redfield Margaret M. , Chareonthaitawee Panithaya
Published: October 2019

Background:

The role of coronary microvascular disease and its impact on functional and energetic reserve in heart failure with preserved ejection fraction (HFpEF) remains unclear. We hypothesized that in response to submaximal pharmacologic stress (dobutamine), patients with HFpEF have impairment in left ventricular (LV) myocardial mechanical (external work [EW]), energetic (myocardial O
2
consumption [MVO
2
]), and myocardial blood flow (MBF) reserve. We further assessed whether coupling of MBF to EW is impaired in HFpEF and associated with compensatory increases or pathological decreases in myocardial O
2
extraction. Lastly, we assessed whether coupling of MVO
2
to EW (mechanical efficiency) was impaired in HFpEF.

Methods and Results:

In prospectively enrolled patients with HFpEF (n=19) and age/sex-matched healthy controls (n=19), we performed
11
C-acetate positron emission tomography assessing MVO
2
and MBF at rest and during dobutamine infusion. EW was calculated as stroke volume (echo)×end-systolic pressure×heart rate. At rest, compared with controls, patients with HFpEF had higher LV EW, MVO
2
, and MBF. With dobutamine, LV EW, MVO
2
, and MBF increased in both HFpEF and controls; however, the magnitude of increases was significantly smaller in HFpEF. In both groups, MBF increased in relation to EW, but in HFpEF, the slope of the relationship was significantly smaller than in controls. Myocardial O
2
extraction was increased in HFpEF. Mechanical efficiency was similar in HFpEF and controls. In a post hoc analysis, HFpEF patients with LV hypertrophy (n=10) had significant reductions in LV mechanical efficiency relative to controls.

Conclusions:

In HFpEF during submaximal dobutamine stress, there is myocardial mechanical-, energetic- and flow-reserve dysfunction with impaired coupling of blood flow to demand and slight increases in myocardial O
2
extraction. These findings provide evidence that coronary microvascular dysfunction is present in HFpEF, limits O
2
supply relative to demand, and is associated with reserve dysfunction.
Atrial Fibrillation Burden Signature and Near-Term Prediction of Stroke
Authors: Han Lichy , Askari Mariam , Altman Russ B. , Schmitt Susan K. , Fan Jun , Bentley Jason P. , Narayan Sanjiv M. , Turakhia Mintu P.
Published: October 2019

Background:

Atrial fibrillation (AF) increases the risk of stroke 5-fold and there is rising interest to determine if AF severity or burden can further risk stratify these patients, particularly for near-term events. Using continuous remote monitoring data from cardiac implantable electronic devices, we sought to evaluate if machine learned signatures of AF burden could provide prognostic information on near-term risk of stroke when compared to conventional risk scores.

Methods and Results:

We retrospectively identified Veterans Health Administration serviced patients with cardiac implantable electronic device remote monitoring data and at least one day of device-registered AF. The first 30 days of remote monitoring in nonstroke controls were compared against the past 30 days of remote monitoring before stroke in cases. We trained 3 types of models on our data: (1) convolutional neural networks, (2) random forest, and (3) L1 regularized logistic regression (LASSO). We calculated the CHA
2
DS
2
-VASc score for each patient and compared its performance against machine learned indices based on AF burden in separate test cohorts. Finally, we investigated the effect of combining our AF burden models with CHA
2
DS
2
-VASc. We identified 3114 nonstroke controls and 71 stroke cases, with no significant differences in baseline characteristics. Random forest performed the best in the test data set (area under the curve [AUC]=0.662) and convolutional neural network in the validation dataset (AUC=0.702), whereas CHA
2
DS
2
-VASc had an AUC of 0.5 or less in both data sets. Combining CHA
2
DS
2
-VASc with random forest and convolutional neural network yielded a validation AUC of 0.696 and test AUC of 0.634, yielding the highest average AUC on nontraining data.

Conclusions:

This proof-of-concept study found that machine learning and ensemble methods that incorporate daily AF burden signature provided incremental prognostic value for risk stratification beyond CHA
2
DS
2
-VASc for near-term risk of stroke.
TÜRKİYE’NİN AVRUPA BİRLİĞİ ÜLKELERİ İLE DIŞ TİCARETİNİN YAPISAL ANALİZİ: ARTAN REKABET Mİ YOKSA YOĞUNLAŞMA MI?
Authors: SOYYİĞİT Semanur , DOĞAN Seyhun
Published: October 2019

Uluslararası ticaretin boyutlarının oldukça
genişlediği günümüz dünyasında, ülkelerin sadece dış ticaret hacimlerinde artış
sağlamaları sürdürülebilir bir büyümeye ulaşmalarında yeterli olmamaktadır.
Ülkeler arasında karşılıklı bağımlılığın giderek artması, bir ülkede yaşanan
şokun diğer ülkelere sirayet etmesi sonucunu doğurmaktadır. Bu bakımdan,
ülkelerin dış ticaret hacimlerini arttırmalarına paralel olarak ihracat
pazarlarını ve ihraç ettikleri ürünleri çeşitlendirmeleri önem kazanmıştır.
Böylelikle, ticaret ortağı ülkelerde yaşanması olası şoklar yoluyla oluşacak
riskler de azaltılmış olacaktır.

Bu çalışmada; Türkiye’nin Avrupa Birliği
ülkeleri ile gerçekleştirdiği dış ticaretteki yoğunlaşma incelenmiştir. Gümrük
Birliği sürecinde Türkiye’nin Avrupa Birliği pazarındaki ürün ve ülke
çeşitliliğinin Yoğunlaşma Oranı (CR), Herfindahl-Hirschman İndeksi (HHI) ve
Gini-Hirschman İndeksi (GHI) ile analiz edildiği çalışmanın sonucunda; ihracat
açısından gerek ülke gerek ürün çeşitliliğinin sağlandığı görülmüştür. Ayrıca,
ithalattaki çeşitlenmenin sınırlı kaldığı ve ihracatın nitelik açısından
geliştiği bulgusuna ulaşılmıştır.
In Vitro and In Vivo Bioactivity of Tricalcium Phosphate and Fluoroapatite Nanoparticles for Medical Implants
Authors: Algarni H. , Alshahrani Ibrahim , Ibrahim Essam H. , Eid Refaat A. , Kilany Mona , Ghramh Hamed A. , Reben M. , Yousef El Sayed
Published: October 2019

A novel 40P2O5–20Na2O–10Ca(OH)2–20CaCl2–6.0ZnO–2.0BaF2–2.0TiO2 (BGBaFTi) bioglasses is prepared. The reaction of the glasses in SBF solution is characterized by XRD and SEM
indicated that the carbonate hydroxyapatite has formed rapidly on the glasses. BGBaFTi bioglasses was tested for its antimicrobial activity, anti-proliferative/cytotoxicity against normal and activated splenic cells in vitro and in vivo. This results showed that BGBaFTi has antimicrobial
activities against Gram negative and positive bacteria as well as fungi. We found that the antimicrobial activity of nanoparticles of BGBaFTI is high than the normal powder of it. Moreover BGBaFTi (powder and nanoparticle) with cytotoxic effect on normal splenic cells was investigated. The
products of activated splenic cells did not cause any changes in the structure of BGBaFTi. It did not cause any acute cytotoxicity or lysis to RBCs which was not affected by lytic products of immune cells. The bioactivity and biocompatibility of the present glasses use it a good potential
candidate in the field of tissue engineering.
Preparation and Targeted Regulation of Microbial Induced Mineralized Products
Authors: Yi Haihe , Zhan Qiwei , Qian Chunxiang
Published: October 2019

Microbial induced mineralization is an effective method to prepare green cementitious materials, which has the characteristics of ecological and environmental protection. In this study, preparation and targeting regulation of mineralized products by Bacillus lysine induced was
investigated. Law of growth and reproduction was studied via change curves of concentration and pH value of culture solution in the culture process. Four periods, included retardation phase, logarithmic phase, stable phase and decline phase, were verified. The pH value of culture solution
was on the rise throughout the culture process, which increased from 7 to 8.1. Characteristics of enzyme production were explored by the deposition of mineralized products in different systems, and the way of extracellular production enzyme was determined. The composition and microstructure
of mineralized products were analyzed by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and X-ray spectroscopy (EDS). The mineralized products were characterized as calcite, and mineralized products in the culture solution had higher
crystallinity. Finally, targeting regulation of temperature on mineralized products was conducted. At the low temperature, mineralization efficiency was higher, and the structure of mineralized products was more favorable.
The Study of Security and Separation: An Unexpected Forerunner of Attachment Theory?
Authors: Stroebe Margaret
Published: October 2019

John Bowlby’s attachment theory has made a lasting contribution to scientific understanding of the nature and the impact of close interpersonal bonds, tracing their influence from early childhood through adulthood and into bereavement. The experience of separation and loss featured powerfully in Bowlby’s account of the causes of mental health difficulties. He acknowledged many sources for his ideas. However, one potential intellectual force, namely, that of the eminent philosopher Bertrand Russell, is missing. The association between Bowlby and Russell is highlighted in this essay to illustrate how a monumental theory may emerge from ideas already around during a particular historical period. Scientific and personal features of their lives are explored to shed light on possible influence. Commonalities between their propositions about attachment are described as well as pertinent biographical details. Questions whether Bowlby was aware of Russell’s writing on this topic and reasons why Russell’s ideas were not acknowledged are considered.
Money, power, and inequality within marriage among Palestinian families in Israel
Authors: Meler Tal
Published: October 2019

A key factor in promoting egalitarian gender relations is financial independence for women. Palestinian women citizens of Israel (PWCI) serve as a case study for gender relations in a patriarchal society. The financial identity of these women develops alongside general institutional discrimination, dual judicial systems (civil and religious), civil status, and cultural norms. However, factors affecting family budget allocation and financial autonomy of women in this society are not well understood. The present qualitative study used in-depth, semi-structured interviews to analyze patterns of financial allocation in the family system. The findings reveal that the financial independence of most PWCI is limited, although the spectrum ranges from partially autonomous financial management to economic violence. Most couples keep separate accounts, where the wife receives an allowance from her husband, and the wife’s relative financial autonomy is determined by the magnitude of this allowance. Under such conditions, gender relations and power relations are unequal. Most PWCI are unemployed or working in low-paid jobs, and consequently, their contribution to the family budget is considered negligible. However, this meager contribution enables women to participate in financial decision-making, from which they are often excluded by their husband. Furthermore, the ability of women to save money is limited as well, and some must do so in a clandestine manner. The findings shed light on economic autonomy of women, and will allow policy makers to establish criteria for determining when normative economic behavior becomes violent, to promote legislation ensuring equal rights for women.
Probation reform, the RAR and the forgotten ingredient of supervision
Authors: Robinson Gwen , Dominey Jane
Published: October 2019

Considering the current review of probation services in England and Wales, this comment piece acknowledges the disappearance of supervision as a cornerstone of effective rehabilitation and the emergence of Rehabilitative Activity Requirements (RARs) replacing supervision. The authors raise concerns about the effectiveness of RARs and at this juncture argue the importance of retaining supervision within the responsibilities of National Probation Service case managers and safeguarding against it becoming an intervention that is delivered by external providers.
Psychometric evaluation of the shortened version of the Functional Difficulties Questionnaire to assess thoracic physical function
Authors: Katijjahbe Mohd Ali , Denehy Linda , Granger Catherine L , Royse Alistair , Royse Colin , Logie Sarah , Sturgess Tamica , Md Ali Nur Ayub , McManus Margaret , Clarke-Errey Sandy , El-Ansary Doa
Published: October 2019

Objective:

The aim of this study was to investigate the psychometric properties of the shortened version of the Functional Difficulties Questionnaire (FDQ).

Design:

This is a multisite observational study.

Setting:

The study was conducted in four tertiary care hospitals in Australia.

Subjects:

A total of 225 participants, following cardiac surgery, were involved in the study.

Intervention:

Participants completed the original 13-item FDQ and other measures of physical function, pain and health-related quality of life.

Method:

Item reduction was utilized to develop the shortened version. Reliability was evaluated using intraclass correlation coefficients (ICCs), the smallest detectable change and Bland–Altman plots. The validity and responsiveness were evaluated using correlation. Anchor and distribution-based calculation was used to calculate the minimal clinical important difference (MCID).

Results:

Item reduction resulted in the creation of a 10-item shortened version of the questionnaire (FDQ-s). Within the cohort of cardiac surgery patient, the mean (SD) for the FDQ-s was 38.7 (19.61) at baseline; 15.5 (14.01) at four weeks and 7.9 (12.01) at three months. Validity: excellent internal consistency (Cronbach’s α > 0.90) and fair-to-excellent construct validity (>0.4). Reliability: internal consistency was excellent (Cronbach’s α > 0.8). The FDQ-s had excellent test–retest reliability (ICC = 0.89–0.92). Strong responsiveness overtime was demonstrated with large effect sizes (Cohen’s d > 1.0). The MCID of the FDQ-s was calculated between 4 and 10 out of 100 (in cm).

Conclusion:

The FDQ-s demonstrated robust psychometric properties as a measurement tool of physical function of the thoracic region following cardiac surgery.
Diffusional kurtosis imaging of kidneys in patients with hyperuricemia: initial study
Authors: Cheng Zhong-Yuan , Feng You-Zhen , Liu Xiao-Ling , Ye Yao-Jiang , Hu Jun-Jiao , Cai Xiang-Ran
Published: October 2019

Background

At present, there remains a lack of a reliable indicator for monitoring renal function in patients with hyperuricemia.

Purpose

This study aimed to evaluate the feasibility of diffusion kurtosis imaging in the assessment of renal function in patients with hyperuricemia.

Material and Methods

A total of 75 male participants, including 25 with asymptomatic hyperuricemia, 25 with gouty arthritis, and 25 age-matched male healthy controls, were enrolled in this study. Diffusion kurtosis imaging data were acquired to derive axial (Ka), radial (Kr), and mean kurtosis (MK), fractional anisotropy, axial (Da), radial (Dr), and mean diffusivity (MD) for comparisons among the three groups. They were also correlated with estimated glomerular filtration rate (eGFR).

Results

The MK values of the renal cortex and medulla and Kr value of the renal medulla in patients with asymptomatic hyperuricemia and gouty arthritis significantly increased compared with those in the controls ( P < 0.05). Patients with gouty arthritis showed significant higher cortical and medullary Ka values compared with the other two groups ( P < 0.05). The cortical Kr values of the asymptomatic hyperuricemia and gouty arthritis patients were significantly higher than that of the controls ( P < 0.05). The medullary fractional anisotropy value showed a significant difference between the control and gouty arthritis groups ( P < 0.05). No correlation was found between any diffusion kurtosis imaging parameters and eGFR value.

Conclusion

Diffusion kurtosis imaging is feasible in the assessment of the early changes of renal cortex and medulla in patients with hyperuricemia.
Orbital Rosai–Dorfman disease: a case report and literature review
Authors: Su Xin , Zhang Liqing
Published: October 2019

We report a case of orbital Rosai–Dorfman disease in a 45-year-old man who presented with exophthalmos as the first symptom for 6 months. He did not have any itching, photophobia, tears, headache, dizziness, nausea, vomiting, or other symptoms of discomfort. A soft tissue mass was found in the left orbital by a magnetic resonance imaging scan, and we were able to diagnose lymphoma before the operation. Rosai–Dorfman disease was finally diagnosed by surgical biopsy. The patient received radiotherapy. At a 1-year follow-up, there was no sign of a residual tumor. Rosai–Dorfman disease is easily misdiagnosed and accurate diagnosis of this condition is important for choosing the best treatment plan.
Survival of carbapenem-resistant Acinetobacter baumannii bacteremia: colistin monotherapy versus colistin plus meropenem
Authors: Park So Yeon , Si Hye Jin , Eom Joong Sik , Lee Jin Seo
Published: October 2019

Objective

The aim of this study was to compare clinical outcomes between patients with carbapenem-resistant Acinetobacter baumannii (CRAB) bacteremia treated with colistin monotherapy and those treated with colistin plus meropenem.

Methods

We retrospectively evaluated data from 71 patients with CRAB bacteremia treated from November 2006 to February 2018. Predictors of 14-day mortality were determined through logistic regression analysis.

Results

Our study cohort included 40 bacteremia patients (44.6 %) treated with colistin monotherapy and 31 (55.4 %) treated with colistin plus meropenem. Overall 14-day mortality tended to be higher with monotherapy rather than combination therapy (47.5% vs 25.8%). The latter also showed a tendency for higher clinical success rate compared with monotherapy (61.3% vs 40.0%). Logistic regression analysis showed that Pitt bacteremia score, pneumonia, and combination therapy were significantly associated with mortality. In patients with higher Pitt bacteremia score (≥4), mortality was significantly higher with monotherapy compared with combination therapy (66.7% vs 27.8%). In patients with lower Pitt bacteremia score (≤3), mortality was similar between the two treatment groups (26.3% vs 23.1%).

Conclusion

Treatment with colistin plus meropenem improves survival in critically-ill patients with CRAB.
The p48_HPC antithrombogenic flow diverter: initial human experience using single antiplatelet therapy
Authors: Bhogal Pervinder , Bleise Carlos , Chudyk Jorge , Lylyk Ivan , Perez Nicolas , Henkes Hans , Lylyk Pedro
Published: October 2019

Objective

The p48 is a low-profile, intermediate-porosity flow diverter. phenox GmbH-trademarked hydrophilic polymer coating (pHPC) is a hydrophilic coating that has been shown in vitro to reduce the thrombogenicity of nitinol device surfaces. We performed the present study to determine whether the p48_HPC can be implanted using prasugrel alone.

Methods

We retrospectively identified all patients who were treated with the p48_HPC from January 2017 to December 2018 (n = 5) and underwent single antiplatelet therapy (SAPT) with prasugrel. P2Y12 inhibition was confirmed by the VerifyNow assay. The occurrence of thromboembolic and haemorrhagic complications was recorded alongside the occlusion rates of the treated aneurysms.

Results

All patients achieved adequate occlusion (Raymond–Roy Occlusion Classification I or II) during the follow-up period. No thromboembolic complications occurred. One patient developed a contained haematoma within the Sylvian fissure from the treated aneurysm 2 weeks postoperatively without clinical sequelae.

Conclusions

In this small series, no thromboembolic complications occurred in patients treated with the surface modified p48_HPC flow diverter and SAPT. Further studies with longer follow-up periods and larger cohorts should be performed.
Comparative Prognostic Accuracy of Risk Prediction Models for Cardiogenic Shock
Authors: Miller Robert J. H. , Southern Danielle , Wilton Stephen B. , James Matthew T. , Har Bryan , Schnell Greg , van Diepen Sean , Grant Andrew D. M.
Published: October 2019

Objectives:

Despite advances in medical therapy, reperfusion, and mechanical support, cardiogenic shock remains associated with excess morbidity and mortality. Accurate risk stratification may improve patient management. We compared the accuracy of established risk scores for cardiogenic shock.

Methods:

Patients admitted to tertiary care center cardiac care units in the province of Alberta in 2015 were assessed for cardiogenic shock. The Acute Physiology and Chronic Health Evaluation-II (APACHE-II), CardShock, intra-aortic balloon pump (IABP) Shock II, and sepsis-related organ failure assessment (SOFA) risk scores were compared. Receiver operating characteristic curves were used to assess discrimination of in-hospital mortality and compared using DeLong’s method. Calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test.

Results:

The study included 3021 patients, among whom 510 (16.9%) had cardiogenic shock. Patients with cardiogenic shock had longer median hospital stays (median 11.0 vs 4.1 days, P < .001) and were more likely to die (29.0% vs 2.5%, P < .001). All risk scores were adequately calibrated for predicting hospital morality except for the APACHE-II score (Hosmer-Lemeshow P < .001). Discrimination of in-hospital mortality with the APACHE-II (area under the curve [AUC]: 0.72, 95% confidence interval [CI]: 0.66-0.76) and IABP-Shock II (AUC: 0.73, 95% CI: 0.68-0.77) scores were similar, while the CardShock (AUC: 0.76, 95% CI: 0.72-0.81) and SOFA (AUC: 0.76, 95%CI: 0.72-0.81) scores had better discrimination for predicting in-hospital mortality.

Conclusions:

In a real-world population of patients with cardiogenic shock, existing risk scores had modest prognostic accuracy, with no clear superior score. Further investigation is required to improve the discriminative abilities of existing models or establish novel methods.