bluuebunny/crossref_metadata_2025 huggingface dataset:
Numerical Study on the Impact Instability Characteristics Induced by Mine Earthquake and the Support Scheme of Roadway
Authors: Liu Guang-jian , Li Shan-lin , Mu Zong-long , Chen Wen , Song Lei-bo , Liu Jie , Xu Yu-dong
Published: September 2021

Rockburst of deep roadway was induced by the superposition of mine earthquake disturbance and high static stress exceeding the limit strength of coal‐rock mass. To study the roadway impact instability characteristics caused by mine earthquake disturbance and to propose an optimized support scheme, the discrete element model of the roadway structure was established based on the 1305 working face of the Zhaolou Coal Mine. The influence of mine earthquake amplitude and hypocenter location on the roadway was analyzed. The mesocrack evolution characteristics of the roadway were simulated and reproduced. Characteristics of stress field, crack field, displacement field, and energy field of the disturbed roadway with different support schemes were studied. The results showed that the greater the amplitude of the mine earthquake was, the severer the roadway impact failure was. The upper and left hypocenters had a significant influence on the roadway. The superposition of the high static stress and the dynamic stress due to the far‐field mine earthquake resulted in the impact instability of coal‐rock mass around the roadway, causing severe roof subsidence as well as rib and bottom heave. The evolution of tensile cracks caused the severe impact failure of roadway from a mesoscopic perspective. Using the flexible support to reinforce the roadway retarded the stress decline in roof and rib, improved the self‐stability, reduced the number of near‐field cracks, and decreased the displacement. Meanwhile, it allowed the roof and rib deformation, which was conducive to releasing elastic energy in surrounding rocks and reducing mine earthquake energy. The cracks and deformation in the floor were controlled by using the floor bolt. The optimal support scheme for a roadway to resist mine earthquake disturbance was proposed: “bolt‐cable‐mesh‐steel strip‐π‐beam + floor bolt.” The research results have a specific guiding significance for the support of the coal mine roadway.
Hierarchical Bayesian Spatio-Temporal Modeling for PM10 Prediction
Authors: Mahdi Esam , Alshamari Sana , Khashabi Maryam , Alkorbi Alya
Published: September 2021

Over the past few years, hierarchical Bayesian models have been extensively used for modeling the joint spatial and temporal dependence of big spatio-temporal data which commonly involves a large number of missing observations. This article represented, assessed, and compared some recently proposed Bayesian and non-Bayesian models for predicting the daily average particulate matter with a diameter of less than 10 (PM10) measured in Qatar during the years 2016–2019. The disaggregating technique with a Markov chain Monte Carlo method with Gibbs sampler are used to handle the missing data. Based on the obtained results, we conclude that the Gaussian predictive processes with autoregressive terms of the latent underlying space-time process model is the best, compared with the Bayesian Gaussian processes and non-Bayesian generalized additive models.
Intelligent Learning Algorithm for English Flipped Classroom Based on Recurrent Neural Network
Authors: Shan Qi
Published: September 2021

Reading and writing are the foundations of English learning as well as an important method of instruction. With the advancement of network technology and the onset of the information age, an increasing number of students have lost interest in traditional English reading and writing instruction in the classroom. Flipped classrooms have emerged as a result of this situation and have become the focus of research in one fell swoop. As a result, flipped classroom research at home and abroad has primarily focused on the theory and practical application of flipped classrooms, and flipped classroom application practice is primarily based on the overall classroom, with few separate discussions on the effects of flipped classroom students’ self‐learning. As a result, we developed a recurrent neural network‐based intelligent assisted learning algorithm for English flipped classrooms. There are two main characteristics of the model. First, it is a gated recurrent unit based on a variant structure of the recurrent neural network. The double‐gating mechanism fully considers the context and selects memory through weight assignment, and on this basis, it integrates the novel LeakyReLU function to improve the model’s training convergence efficiency. Second, by overcoming time‐consuming problems in the medium, the adoption of the connection sequence classification algorithm eliminates the need for prior alignment of speech and text data, resulting in a direct boost in model training speed. The experimental results show that in the English flipped classroom’s intelligent learning mode, students explore and discover knowledge independently, their enthusiasm and interest in learning are greatly increased, and the flipped classroom’s teaching effect is greatly improved.
The SWISS IOL Technique (Small-Width Incision Scleral Suture): A Mini-Invasive Technique
Authors: Kecik Mateusz , Pajic Bojan , Le Quoy Olivier , Thumann Gabriele , Massa Horace
Published: September 2021

Purpose. To evaluate the outcomes and safety of a minimally invasive technique for sutured IOL scleral fixation in case of compromised capsular and iris support. Materials and Methods. In this retrospective study, we explain our mini-invasive technique and assess the outcomes in terms of visual acuity, pre- or postoperative complications, and IOL position (Sensar AR40e, AMO) in a case series of three patients. Results. The expected best corrected visual acuity could be achieved after one month. Surgeries were uneventful with a stable eye. No postoperative complications occurred except for one patient who had a conjunctival disinsertion. Neither postoperative hypotony nor raised IOP was found. Additionally, no patient experienced corneal edema at one week control, IOL dislocation, vitreous hemorrhage, or new pupil’s irregularity. Conclusions. In conclusion, each scleral technique has its own advantages and its inherent postoperative complications. To date, there is no evidence of superiority of any single technique. By improving our scleral sutured lens techniques, we could improve peroperative ocular stability, potentially decrease postoperative complication rate, and offer a rapid recovery with a stable visual acuity within a month.
Mean Deviation Coupling Control for Multimotor System via Global Fast Terminal Sliding Mode Control
Authors: Zhu Changlin , Tu Qunzhang , Jiang Chengming , Pan Ming , Huang Hao , Tu Zhiwen
Published: September 2021

In view of the shortcomings of the existing multimotor synchronous control strategy, a new method of mean deviation coupling control for multimotor system via global fast terminal sliding mode control is proposed. Firstly, the mathematical model of permanent magnet synchronous motor (PMSM) under a

d

-

q

reference frame is established. Next, based on the deviation coupling control, the deviation is calculated by the average speed, and the structure of the deviation coupling control strategy is optimized. The speed controller of the multimotor system is designed based on the global fast terminal sliding mode control (GFTSMC) algorithm to improve the synchronization accuracy of the system. In addition, a load torque Luenberger observer is designed to observe the load in real time. Then, the stability analysis of the controller is carried out by using the Lyapunov function. Finally, a four-motor experimental platform is built to verify the effectiveness of the proposed control strategy.
A Guttate Psoriasis That Tends to Spare Three Tattoos: A Macrophage Liaison
Authors: Spyridonos Panagiota , Zampeli Vasiliki , Rapti Sophia-Nefeli , Bassukas Ioannis D.
Published: September 2021

Induction of new psoriasis sites was reported in only a small amount of psoriasis patients undergoing tattooing, despite the intuitive belief that tattoo trauma might awaken the disease due to the isomorphic phenomenon of Koebner. In this case report, we discuss a patient who presented with a remarkable sparing of his three tattoo sites during a guttate psoriasis flare-up that was unrelated to tattooing. The spatial concordance of tattoo and psoriasis lesions was analyzed on clinical pictures of tattoo sites taken during the psoriasis episode. For the quantification of the spatial distribution of the psoriasis lesions, Voronoi diagrams were generated, and coefficients of variation and the two-sample t-test were employed to compare the distributions of Voronoi patch sizes in different settings. Compared to skin areas without tattoos, a tattoo introduced a higher variation in the sizes of the Voronoi patches centered around psoriasis lesions. Based on our findings, we would like to discuss the possible role of macrophages as the key cellular link in the complex pathophysiologic relationship between tattooing/tattoo and psoriasis. Taking into account the relationship of autophagy and psoriasis lesions, we propose the hypothesis that tattoos represent a “psoriasis-hostile” tissue environment pertained by a population of LAP active M2-polarized macrophages. Further clinical studies of the relationship of psoriasis lesions to the tattooed skin are needed and may provide important insights into the role of macrophages in the pathogenesis of psoriasis.
Prognostic Relevance of Pancreatic Adenocarcinoma Whole-Tumor Transcriptomic Subtypes and Components
Authors: Zhao Shulin , Nicolle Rémy , Augustin Jérémy , Svrcek Magali , de Mestier Louis , Le Corre Delphine , Pietrasz Daniel , Caliez Olivier , Cros Jérôme , Laurent-Puig Pierre , Bachet Jean-Baptiste
Published: September 2021

Purpose:

Our team previously defined six quantitative transcriptomic components, and a classification in five subtypes by association of these components. In this study, we compared the robustness of quantitative components and qualitative classifications from different transcriptomic profiling techniques, investigated their clinical relevance, and proposed a new prognostic model.

Experimental Design:

A total of 210 patients from a multicentric cohort and 149 patients from a monocentric cohort were included in this study. RNA microarray profiles were obtained from 165 patients of the multicentric cohort. RNA sequencing (RNA-seq) profiles were obtained from all the patients.

Results:

For the patients with both RNA microarray and RNA-seq profiles, the concordance in subtype assignment was partial with an 82.4% coherence rate. The correlation between the two technique projections of the six components ranged from 0.85 to 0.95, demonstrating an advantage of robustness. On the basis of the Akaike information criterion, the RNA components showed more prognostic value in univariate or multivariate models than the subtypes. Using the monocentric cohort for training, we developed a multivariate Cox regression model using all six components and clinicopathologic characteristics (node invasion and resection margins) on disease-free survival (DFS). This prognostic model was highly associated with DFS (P < 0.001). The evaluation of the model in the multicentric cohort showed significant association with DFS and overall survival (P < 0.001).

Conclusions:

We described the advantage of the prognostic value and robustness of the whole-tumor transcriptomic components than subtypes. We created and validated a new DFS-based multivariate Cox regression prognostic model, including six pancreatic adenocarcinoma transcriptomic component levels and pathologic characteristics.
Single-Cell Profiling Reveals Metabolic Reprogramming as a Resistance Mechanism inBRAF-Mutated Multiple Myeloma
Authors: Waldschmidt Johannes M. , Kloeber Jake A. , Anand Praveen , Frede Julia , Kokkalis Antonis , Dimitrova Valeriya , Potdar Sayalee , Nair Monica S. , Vijaykumar Tushara , Im Nam Gyu , Guillaumet-Adkins Amy , Chopra Nitish , Stuart Hannah , Budano Lillian , Sotudeh Noori , Guo Guangwu , Grassberger Clemens , Yee Andrew J. , Laubach Jacob P. , Richardson Paul G. , Anderson Kenneth C. , Raje Noopur S. , Knoechel Birgit , Lohr Jens G.
Published: September 2021

Purpose:

Although remarkably effective in some patients, precision medicine typically induces only transient responses despite initial absence of resistance-conferring mutations. Using BRAF-mutated myeloma as a model for resistance to precision medicine we investigated if BRAF-mutated cancer cells have the ability to ensure their survival by rapidly adapting to BRAF inhibitor treatment.

Experimental Design:

Full-length single-cell RNA (scRNA) sequencing (scRNA-seq) was conducted on 3 patients with BRAF-mutated myeloma and 1 healthy donor. We sequenced 1,495 cells before, after 1 week, and at clinical relapse to BRAF/MEK inhibitor treatment. We developed an in vitro model of dabrafenib resistance using genetically homogeneous single-cell clones from two cell lines with established BRAF mutations (U266, DP6). Transcriptional and epigenetic adaptation in resistant cells were defined by RNA-seq and H3K27ac chromatin immunoprecipitation sequencing (ChIP-seq). Mitochondrial metabolism was characterized by metabolic flux analysis.

Results:

Profiling by scRNA-seq revealed rapid cellular state changes in response to BRAF/MEK inhibition in patients with myeloma and cell lines. Transcriptional adaptation preceded detectable outgrowth of genetically discernible drug-resistant clones and was associated with widespread enhancer remodeling. As a dominant vulnerability, dependency on oxidative phosphorylation (OxPhos) was induced. In treated individuals, OxPhos was activated at the time of relapse and showed inverse correlation to MAPK activation. Metabolic flux analysis confirmed OxPhos as a preferential energetic resource of drug-persistent myeloma cells.

Conclusions:

This study demonstrates that cancer cells have the ability to rapidly adapt to precision treatments through transcriptional state changes, epigenetic adaptation, and metabolic rewiring, thus facilitating the development of refractory disease while simultaneously exposing novel vulnerabilities.
Disease- and Therapy-Specific Impact on Humoral Immune Responses to COVID-19 Vaccination in Hematologic Malignancies
Authors: Chung David J. , Shah Gunjan L. , Devlin Sean M. , Ramanathan Lakshmi V. , Doddi Sital , Pessin Melissa S. , Hoover Elizabeth , Marcello LeeAnn T. , Young Jennifer C. , Boutemine Sawsan R. , Serrano Edith , Sharan Saumya , Momotaj Saddia , Margetich Lauren , Bravo Christina D. , Papanicolaou Genovefa A. , Kamboj Mini , Mato Anthony R. , Roeker Lindsey E. , Hultcrantz Malin , Mailankody Sham , Lesokhin Alexander M. , Vardhana Santosha A. , Knorr David A.
Published: September 2021

Coronavirus disease-19 (COVID-19) vaccine response data for patients with hematologic malignancy, who carry high risk for severe COVID-19 illness, are incomplete. In a study of 551 hematologic malignancy patients with leukemia, lymphoma, and multiple myeloma, anti–SARS-CoV-2 spike IgG titers and neutralizing activity were measured at 1 and 3 months from initial vaccination. Compared with healthy controls, patients with hematologic malignancy had attenuated antibody titers at 1 and 3 months. Furthermore, patients with hematologic malignancy had markedly diminished neutralizing capacity of 26.3% at 1 month and 43.6% at 3 months, despite positive seroconversion rates of 51.5% and 68.9% at the respective time points. Healthy controls had 93.2% and 100% neutralizing capacity at 1 and 3 months, respectively. Patients with leukemia, lymphoma, and multiple myeloma on observation had uniformly blunted responses. Treatment with Bruton tyrosine kinase inhibitors, venetoclax, phosphoinositide 3-kinase inhibitors, anti-CD19/CD20–directed therapies, and anti-CD38/B-cell maturation antigen–directed therapies substantially hindered responses, but single-agent immunomodulatory agents did not.

Significance:

Patients with hematologic malignancy have compromised COVID-19 vaccine responses at baseline that are further suppressed by active therapy, with many patients having insufficient neutralizing capacity despite positive antibody titers. Refining vaccine response parameters is critical to guiding clinical care, including the indication for booster vaccines, for this vulnerable population.

See related article by Tamari et al., p. 577.

This article is highlighted in the In This Issue feature, p. 549
Brain Tumor Presenting with Parkinsonism
Authors: Saleh Christian , Akhalbedashvili Nino , Hund-Georgiadis Margret
Published: September 2021

Movement disorders caused by brain tumors are rare. The diagnosis of idiopathic Parkinson’s disease (PD) is based foremost on clinical findings. However, not performing imaging already within the initial diagnostic workup in patients presenting with symptoms of PD can delay or miss a serious diagnosis and consequently proper treatment. We describe and discuss a 59-year-old female patient who presented for several months of increasing tremor in her left hand, which was caused by a large meningioma located in the right frontal area, pressing on the right frontal lobe and nucleus lenticularis.
No-Touch Versus Conventional Vein Harvesting Techniques at 12 Months After Coronary Artery Bypass Grafting Surgery: Multicenter Randomized, Controlled Trial
Authors: Tian Meice , Wang Xianqiang , Sun Hansong , Feng Wei , Song Yunhu , Lu Feng , Wang Liqing , Wang Yang , Xu Bo , Wang Huaibin , Liu Su , Liu Zhigang , Chen Yu , Miao Qi , Su Pixiong , Yang Yan , Guo Shaoxian , Lu Bin , Sun Zhiqiang , Liu Kaiyang , Zhang Changwei , Wu Yue , Xu Haitao , Zhao Wei , Han Chao , Zhou Xingtong , Wang Enshi , Huo Xiaoning , Hu Shengshou
Published: September 2021

Background:

Vein graft occlusion is deemed a major challenge in coronary artery bypass grafting. Previous studies implied that the no-touch technique for vein graft harvesting could reduce occlusion rate compared with the conventional approach; however, evidence on the clinical benefit and generalizability of the no-touch technique is scare.

Methods:

From April 2017 to June 2019, we randomly assigned 2655 patients undergoing coronary artery bypass grafting at 7 hospitals in a 1:1 ratio to receive no-touch technique or conventional approach for vein harvesting. The primary outcome was vein graft occlusion on computed tomography angiography at 3 months and the secondary outcomes included 12-month vein graft occlusion, recurrence of angina, and major adverse cardiac and cerebrovascular events. The generalized estimate equation model was used to account for the cluster effect of grafts from the same patient.

Results:

During the follow-up, 2533 (96.0%) participants received computed tomography angiography at 3 months after coronary artery bypass grafting and 2434 (92.2%) received it at 12 months. The no-touch group had significantly lower rates of vein graft occlusion than the conventional group both at 3 months (2.8% versus 4.8%; odds ratio, 0.57 [95% CI, 0.41–0.80];
P
<0.001) and 12 months (3.7% versus 6.5%; odds ratio, 0.56 [95% CI, 0.41–0.76];
P
<0.001). Recurrence of angina was also less common in the no-touch group at 12 months (2.3% versus 4.1%; odds ratio, 0.55 [95% CI, 0.35–0.85];
P
<0.01). Rates of major adverse cardiac and cerebrovascular events were of no significant difference between the 2 groups. The no-touch technique was associated with higher rates of leg wound surgical interventions at 3-month follow-up (10.3% versus 4.3%; odds ratio, 2.55 [95% CI, 1.85–3.52];
P
<0.001).

Conclusions:

Compared with the conventional vein harvesting approach in coronary artery bypass grafting, the no-touch technique significantly reduced the risk of vein graft occlusion and improved patient prognosis.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03126409.
LVS‐HARMED Risk Score for Incident Heart Failure in Patients With Atrial Fibrillation Who Present to the Emergency Department: Data from a World‐Wide Registry
Authors: Johnson Linda S. B. , Oldgren Jonas , Barrett Tyler W. , McNaughton Candace D. , Wong Jorge A. , McIntyre William F. , Freeman Clifford L. , Murphy Laura , Engström Gunnar , Ezekowitz Michael , Connolly Stuart J. , Xu Lizhen , Nakamya Juliet , Conen David , Bangdiwala Shrikant I. , Yusuf Salim , Healey Jeff S.
Published: September 2021

Background

Heart failure (HF) is a common complication to atrial fibrillation (AF), leading to rehospitalization and death. Early identification of patients with AF at risk for HF might improve outcomes. We aimed to derive a score to predict 1‐year risk of new‐onset HF after an emergency department (ED) visit with AF.

Methods and Results

The RE‐LY AF (Randomized Evaluation of Long‐Term Anticoagulant Therapy) registry enrolled patients with AF presenting to an ED in 47 countries, and followed them for a year. The end point was HF hospitalization and/or HF death. Among 15 400 ED patients, 9765 had no prior HF (mean age, 64.9±14.9 years). Within 1 year, new‐onset HF developed in 6.8% of patients, of whom 21% died of HF. Independent predictors of HF included left ventricular hypertrophy (odds ratio [OR], 1.47; 95% CI, 1.19–1.82), valvular heart disease (OR, 1.55; 95% CI, 1.18–2.04), smoking (OR, 1.42; 95% CI, 1.12–1.78), height (OR, 0.93; 95% CI, 0.90–0.95 per 3 cm), age (OR, 1.11; 95% CI, 1.07–1.15 per 5 years), rheumatic heart disease (OR, 1.77, 95% CI, 1.24–2.51), prior myocardial infarction (OR, 1.85; 95% CI, 1.45–2.36), remaining in AF at ED discharge (OR, 1.86; 95% CI, 1.46–2.36), and diabetes (OR, 1.33; 95% CI, 1.09–1.64). A continuous risk prediction score (LVS‐HARMED [left ventricular, valvular heart disease, smoking or other tobacco use, height, age, rheumatic heart disease, myocardial infarction, emergency department discharge rhythm, and diabetes]) had good discrimination (C statistic, 0.735; 95% CI, 0.716–0.755). Validation was conducted internally using bootstrapping (optimism‐corrected C statistic, 0.705) and externally (C statistic, 0.699). The 1‐year incidence of HF hospitalization and/or HF death across quartile groups of the score was 1.1%, 4.5%, 6.9%, and 14.4%, respectively. LVS‐HARMED also predicted incident stroke (C statistic, 0.753; 95% CI, 0.728–0.778).

Conclusions

The LVS‐HARMED score predicts new‐onset HF after an ED visit for AF. Preventative strategies should be considered in patients with high LVS‐HARMED HF risk.
Coronary Artery Bypass Graft Surgery in Patients With Acute Coronary Syndromes After Primary Percutaneous Coronary Intervention: A Current Report From the North‐Rhine Westphalia Surgical Myocardial Infarction Registry
Authors: Thielmann Matthias , Wendt Daniel , Slottosch Ingo , Welp Henryk , Schiller Wolfgang , Tsagakis Konstantinos , Schmack Bastian , Weymann Alexander , Martens Sven , Neuhäuser Markus , Wahlers Thorsten , Choi Yeong‐Hoon , Ruhparwar Arjang , Liakopoulos Oliver‐J.
Published: September 2021

Background

Coronary artery bypass grafting has remained an important treatment option for acute coronary syndromes, particularly in patients (1) with ongoing ischemia and large areas of jeopardized myocardium, if percutaneous coronary intervention (PCI) cannot be performed; (2) following successful PCI of the culprit lesion with further indication for coronary artery bypass grafting; and (3) where PCI is incomplete, not sufficient, or failed.

Methods and Results

We aimed to analyze coronary artery bypass grafting outcome following prior PCI in acute coronary syndromes from the North‐Rhine‐Westphalia surgical myocardial infarction registry comprising 2616 patients. Primary end points were in‐hospital all‐cause mortality and major adverse cardio‐cerebral event. Patients were 68±11 years of age, had 3‐vessel and left main‐stem disease in 80.4% and 45.3%, presenting a logistic EuroSCORE of 15.1% in unstable angina, 20.3% in non–ST‐segment–elevation myocardial infarction, and 23.5% in ST‐segment–elevation myocardial infarction. A history of PCI was present in 36.2% and PCI was performed within 24 hours before surgery in 5.2% in unstable angina, 5.9% in non–ST‐segment–elevation myocardial infarction, and 16.1% in ST‐segment–elevation myocardial infarction. PCI failed in 5.3% in unstable angina, 6.8% in non–ST‐segment–elevation myocardial infarction and 17.2% in ST‐segment–elevation myocardial infarction, and 28.8% of patients presented with cardiogenic shock. In‐hospital mortality without PCI was 7.4%, but increased to 8.7% with prior PCI >24 hours, 14.5% with prior PCI <24 hours, and 14.1% with failed PCI (
P
<0.003). The in‐hospital major adverse cardio‐cerebral event rate was 16.4% without PCI, but 17.4% with prior PCI >24 hours, 25.6% with prior PCI <24 hours, and 41.3% with failed PCI (
P
=0.014). Multivariable logistic regression analysis showed prior PCI (
P
=0.039), as well as failed PCI (
P
=0.001) to be predictors for in‐hospital all‐cause mortality and major adverse cardio‐cerebral event.

Conclusions

In the current PCI era, immediately prior or failed PCI before coronary artery bypass grafting in acute coronary syndromes is associated with high perioperative risk, cardiogenic shock, and increased morbidity and mortality.
Claims‐Based Score for the Prediction of Bleeding in a Contemporary Cohort of Patients Receiving Oral Anticoagulation for Venous Thromboembolism
Authors: Alonso Alvaro , Norby Faye L. , MacLehose Richard F. , Zakai Neil A. , Walker Rob F. , Adam Terrence J. , Lutsey Pamela L.
Published: September 2021

Background

Current scores for bleeding risk assessment in patients with venous thromboembolism (VTE) undergoing oral anticoagulation have limited predictive capacity. We developed and internally validated a bleeding prediction model using healthcare claims data.

Methods and Results

We selected patients with incident VTE initiating oral anticoagulation in the 2011 to 2017 MarketScan databases. Hospitalized bleeding events were identified using validated algorithms in the 180 days after VTE diagnosis. We evaluated demographic factors, comorbidities, and medication use before oral anticoagulation initiation as potential predictors of bleeding using stepwise selection of variables in Cox models run on 1000 bootstrap samples of the patient population. Variables included in >60% of all models were selected for the final analysis. We internally validated the model using bootstrapping and correcting for optimism. We included 165 434 patients with VTE and initiating oral anticoagulation, of whom 2294 had a bleeding event. After undergoing the variable selection process, the final model included 20 terms (15 main effects and 5 interactions). The c‐statistic for the final model was 0.68 (95% CI, 0.67–0.69). The internally validated c‐statistic corrected for optimism was 0.68 (95% CI, 0.67–0.69). For comparison, the c‐statistic of the Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile International Normalized Ratio, Elderly (>65 Years), Drugs/Alcohol Concomitantly (HAS‐BLED) score in this population was 0.62 (95% CI, 0.61–0.63).

Conclusions

We have developed a novel model for bleeding prediction in VTE using large healthcare claims databases. Performance of the model was moderately good, highlighting the urgent need to identify better predictors of bleeding to inform treatment decisions.
Systolic Blood Pressure and Outcome in Patients Admitted With Acute Heart Failure: An Analysis of Individual Patient Data From 4 Randomized Clinical Trials
Authors: Grand Johannes , Miger Kristina , Sajadieh Ahmad , Køber Lars , Torp‐Pedersen Christian , Ertl Georg , López‐Sendón José , Pietro Maggioni Aldo , Teerlink John R. , Sato Naoki , Gimpelewicz Claudio , Metra Marco , Holbro Thomas , Nielsen Olav W.
Published: September 2021

BACKGROUND

In acute heart failure (AHF), systolic blood pressure (SBP) is an important clinical variable. This study assessed the association between SBP and short‐term and long‐term outcomes in a large cohort of patients with AHF.

METHODS AND RESULTS

This is an analysis of 4 randomized controlled trials investigating serelaxin versus placebo in patients admitted with AHF and SBPs from 125 to 180 mm Hg. Outcomes were 180‐day all‐cause mortality and a composite end point of all‐cause mortality, worsening heart failure, or hospital readmission for heart failure the first 14 days. Left ventricular ejection fraction (LVEF) was examined as LVEF<40% and LVEF≥40%. Multivariable Cox regression models were adjusted for known confounders of outcomes in AHF. A total of 10 533 patients with a mean age of 73 (±12) years and a mean SBP of 145 (±7) mm Hg were included. LVEF was assessed in 9863 patients (93%); 4737 patients (45%) had LVEF<40%. Increasing SBP was inversely associated with 180‐day mortality (adjusted hazard ratio [HR
adjusted
], 0.93; 95% CI, 0.89–0.98;
P
=0.008 per 10 mm Hg increase) and with the composite end point (HR
adjusted
, 0.90; 95% CI, 0.85–0.94;
P
<0.001 per 10 mm Hg increase). A significant interaction with LVEF was observed, revealing that SBP was not associated with mortality in patients with LVEF≥40% (HR
adjusted
, 0.98; 95% CI, 0.91–1.04; per 10 mm Hg increase), but was strongly associated with increased mortality in LVEF<40% (HR
adjusted
, 0.84; 95% CI, 0.77–0.92; per 10 mm Hg increase).

CONCLUSIONS

Elevated SBP is associated with favorable short‐term and long‐term outcomes in patients with AHF. In our predefined subgroup analysis, we found that baseline SBP was not associated with mortality in LVEF≥40%, but was strongly associated with mortality in patients with LVEF<40%.
Can Community Crime Monitoring Reduce Student Absenteeism?
Authors: Komisarow Sarah , Gonzalez Robert
Published: September 2021

In this paper we study the impact on student absenteeism of a large, school-based community crime monitoring program that employed local community members to monitor and report crime on designated city blocks during times when students traveled to and from school. We find that the program resulted in a 0.58 percentage point (8.5 percent) reduction in the elementary school-level absence rate in the years following initial implementation. We discuss and explore potential channels to explain this and believe our results are most consistent with improved neighborhood conditions in the form of reduced crime as an underlying mechanism.
YU-FENG GU, MORIGENGAOWA, RI-HONG JIANG, BAO-DONG LIU & YUE-HONG YAN (2021) Sphaeropteris guangxiensis Y. F. Gu & Y. H. Yan (Cyatheaceae), a new species of tree fern from Southern China. Phytotaxa 518 (1): 69–74.
Authors: GU YU-FENG , GAOWA MORIGEN , JIANG RI-HONG , LIU BAO-DONG , YAN YUE-HONG
Published: September 2021

N/A
Clarification of some morphological characters in Artemisia anomala (Asteraceae, Anthemideae), with reduction of var. tomentella and var. acuminatissima to the synonymy of the species
Authors: GUO XIN-QIANG , WANG LONG , YANG QIN-ER
Published: September 2021

Based on observations on herbarium specimens (including type material) and living plants in the wild, we demonstrate that Artemisia anomala (Asteraceae, Anthemideae), a distinctive Chinese species yet morphologically imperfectly understood since its description, is variable with respect to its leaf indumentum and shape within and between populations. The leaves are ovate, ovate-lanceolate, elliptic-lanceolate, or lanceolate, and adaxially sparsely pubescent or glabrous, abaxially tomentose to sparsely pubescent, or rarely glabrescent. Morphologically, the two currently recognized varieties of A. anomala, var. tomentella and var. acuminatissima, fall within the variation range of the species in leaf indumentum and shape, and thus are synonymized herein. Lectotypification is proposed for A. anomala.
An overview on the valid publication of Aristolochia fangchi and the status of Isotrema fangchi (Aristolochiaceae)
Authors: LIAO SHUAI , ZHU XIN-XIN , LI HONG-QING
Published: September 2021

N/A
Dynamics of widespread extreme precipitation events and the associated large-scale environment using AMeDAS and JRA-55 data
Authors: Shibuya Ryosuke , Takayabu Yukari , Kamahori Hirotaka
Published: September 2021

This study examines disastrous historical precipitation cases that generate extreme precipitation simultaneously over a wide area in Japan (as in July 2018), defined as widespread extreme precipitation events. A statistically significant large-scale environment conducive for widespread extreme precipitation events over western Japan is investigated based on composite analysis. During a widespread precipitation event, a zonally elongated positive anomaly of the column-integrated water vapor extends from East China to western Japan. In the lower troposphere, a dipole of a geopotential height anomaly exists with positive and negative values at the east and west of the precipitation area, respectively. It is found that the negative geopotential anomaly is enhanced over East China at two days before the event and moves toward the precipitating area mainly due to the PV production term by diabatic heating, in analogy of a diabatic Rossby wave. The temporal evolution of the dynamical forced vertical velocity is well in phase with that the PV production term, inferring the importance of the coupling between the dynamical forced motion and diabatic heating. This result provides a physical understanding of the reason why both the background moisture and the baroclinicity are essential in the composited atmospheric fields and another view to the importance of the feedback parameter between the dynamical motion and diabatic heating.
Learning from the COVID-19 Pandemic: When Public Health and Tornado Threats Converge
Authors: Croskery Craig D. , Sherman-Morris Kathleen , Brown Michael E.
Published: September 2021

The coronavirus disease 2019 (COVID-19) pandemic resulted in unprecedented challenges that dramatically affected the way of life in the United States and globally in 2020. The pandemic also made the process of protecting individuals from tornadoes more challenging, especially when their personal residence lacks suitable shelter, particularly for residents of mobile homes. The necessity of having to shelter with other families – either in a public shelter or at another residence – in order to protect themselves from a tornado threat conflicted with the advice of public health officials who recommended avoiding public places and limiting contact with the public to minimize the spread of COVID-19. There was also a perception that protecting against one threat could amplify the other threat. A survey was undertaken with the public to determine the general viewpoint to see if that was indeed the case.

The results found that it was possible to attenuate both threats provided that careful planning and actions were undertaken. Understanding how emergency managers should react and plan for such dual threats is important to minimize the spread of COVID-19 while also maintaining the safety of the public. As there was no precedence for tornado protection scenarios amidst a pandemic, both short-term and long-term recommendations were suggested which may also be useful in future pandemic situations.
Ambivalent Strategies: Student-Migrant-Workers’ Efforts at Challenging Administrative Bordering
Authors: Maury Olivia
Published: September 2021

Migrants’ struggles against borders have been examined extensively among refugees and undocumented migrants, whereas the everyday struggles in contexts of administrative bordering have remained insufficiently examined within the framework of so-called highly skilled migration. Drawing on in-depth interviews (N=34) with migrants holding a student residence permit in Finland, this article addresses the means of challenging administrative borders in a constrained situation produced by the border regime. I argue that student-migrant-workers employ pragmatic strategies by making use of the legal framework to secure their right to residence. However, the efforts at circumventing the constraints of the border regime often become re-inscribed within the framework of capitalist production, displaying the ambivalence of migrant practices. This article contributes to the scarce sociological literature on the struggles around administrative borders and the vague scholarly inquiry into student-migrants' efforts at challenging migration control.
Investigation of the nonlinear phenomena of a Langevin ultrasonic transducer caused by high applied voltage
Authors: Zhang Shibo , Li Yang , Li Sisi , Wu Yongbo , Zeng Jiang
Published: September 2021

In the field of power ultrasound, Langevin ultrasonic transducers (LUTs) usually operate at a large displacements output power by applying high voltages. However, empirically, a LUT exhibits nonlinearities such as amplitude jumping and peak hysteresis for high voltages in actual operations. The nonlinearities would reduce the efficiency and output accuracy of an LUT. In this research, the burst-mode method was used to measure the longitudinal vibration velocity of the LUT, which gradually decreased with time after the excitation voltage was turned off. The equivalent mechanical losses and equivalent spring constants were determined using the velocity attenuation rate and resonant frequency and they were found to be the linear functions of velocity, helping to develop a novel nonlinear model. This model contained two quadratic nonlinear terms based on the linear model. Furthermore, the developed nonlinear model was analyzed using the Lagrangian method as well as the multiscale method, which confirmed that the model was effective in describing the nonlinear behavior. It was also found that the frequency-amplitude curve bent when the nonlinear term was taken into account, which resembled the nonlinear phenomenon tested experimentally. From a physical point of view, this bending was meaningful because it led to the formation of multi-valued response regions with jumping phenomena. Additionally, according to the obtained results, the maximum value of the system response was independent of the degree of nonlinearity of the system.
Anisotropic constitutive model coupled with damage for Sn-rich solder: Application to SnAgCuSb solder under tensile conditions
Authors: Zhang Zhao , Liu Sheng , Ma Kun , Chen Zhiwen , Qian Zhengfang , Lee Ning-Cheng
Published: September 2021

With the rapid development of microelectronics and nanoelectronics, Moore law has significantly slowed down and More than Moore based system in packaging (SiP) is expected to be more and more important, at least for next one to two decades. Mechanical behaviors of interconnect materials such as solders are critical for yield in processes and reliability in testing and operation. Based on the framework of crystal plastic theory and continuum damage mechanics, an anisotropic constitutive model coupled with damage was developed to describe the deformation behaviors of Sn-rich solder. In the proposed model, the inelastic shear rate function was presented by hyperbolic sinusoidal form and power law form. For the damage evolution law, the total shear strain was chosen as the damage function variable. The proposed model was implemented into the general finite element software ABAQUS by forward Euler integration procedure. Some simulation examples were performed to verify the proposed model by comparing the simulation results with the experiments at uniaxial tensile conditions with SnAgCuSb solder chosen as the Sn-rich solder. The tensile stress-strain curves of the simulation results agreed well with the experiments at small strain under different temperatures and strain rates. The simulated stress-rupture stages showed reasonable accuracy with the experiments under four representative tensile conditions. Different tensile stress-strain curves of single grains with orientation of (0-0-0)°, (0-45-0)°, and (0-90-0)° were obtained under the same loading conditions, with an inverse relationship between the tensile strength and elongation. This relationship was in accordance with a referable literature. All these results indicate that the proposed model can describe the deformation behaviors of SnAgCuSb solder well under the tensile conditions in consideration of the mechanical anisotropy and the damage evolution.
Malconenoside A, a New Phenolic Glycoside from Bupleurum malconense
Authors: Yan Jie , Luo Qin , Long Fei , Zhao Mei-Lian
Published: September 2021

A new phenolic glycoside, 7-(4- O- β-D-glucopyranosyl, 3-methoxyphenyl)-6,8-dihydrofuro[3′,4′:7,8]naphtho[1,2-d][1,3]dioxol-10(7H)-one, named malconenoside A (1), was isolated from Bupleurum malconense Shan et Y. Li . The structure, including absolute configurations, was assigned by using spectroscopic methods and ECD calculation. Biological activities of compound 1 towards human cancer cells (HepG2, BGC-823, and A549) were evaluated. The most sensitive two cell lines were HepG2 and BGC823, in which the IC50 values of compound 1 were 8.70 and 16.94 μM, respectively.
The microenvironment of DLBCL is characterized by noncanonical macrophages recruited by tumor-derived CCL5
Authors: Manfroi Benoît , De Grandis Maria , Moreaux Jérôme , Tabruyn Sébastien , Mayol Jean-François , Quintero Mélanie , Righini Christian , Sturm Nathalie , Aurrand-Lions Michel , Huard Bertrand
Published: September 2021

Tissue invasion by tumor cells induces a host inflammatory response that variably impacts tumorigenesis. This has been well documented for tumor-associated macrophages (TAMs) that could play a pro/M2- or an anti/M1-tumoral function. TAMs frequently infiltrate diffuse large B-cell lymphoma (DLBCL), an aggressive neoplasm arising from germinal center–experienced B cells. However, the pathway leading to the presence of TAMs in DLBCL remains unknown, and their impact is unclear. Here, we show that some DLBCL tumor cells expressed the chemokine CCL5, enabling the differential recruitment of blood monocytes through their expression of CCR1 and CCR5. CCL5 expression by DLBCL was not related to molecular subtypes, and healthy tonsillar B cells did not produce this chemokine, implying a posttransformation event. A single-cell analysis revealed that most DLBCL TAMs had a noncanonical gene signature with the concomitant expression of M1 and M2 genes. The presence of noncanonical TAMs may explain the lack of impact of macrophages on DLBCL development reported in some survival studies.
Gata2 +9.5 enhancer regulates adult hematopoietic stem cell self-renewal and T-cell development
Authors: You Xiaona , Zhou Yun , Chang Yuan-I , Kong Guangyao , Ranheim Erik A. , Johnson Kirby D. , Soukup Alexandra A. , Bresnick Emery H. , Zhang Jing
Published: September 2021

Mammalian GATA2 gene encodes a dual zinc finger transcription factor, which is essential for hematopoietic stem cell (HSC) generation in the aorta, gonad, mesonephros (AGM) region, HSC self-renewal, and specification of progenitor cell fates. Previously, we demonstrated that Gata2 expression in AGM is controlled by its intronic +9.5 enhancer. Gata2 +9.5 deficiency removes the E-box motif and the GATA site and depletes fetal liver HSCs. However, whether this enhancer has an essential role in regulating adult hematopoiesis has not been established. Here, we evaluate Gata2 +9.5 enhancer function in adult hematopoiesis. +9.5+/− bone marrow cells displayed reduced T cell reconstitution in a competitive transplant assay. Donor-derived analysis demonstrated a previously unrecognized function of the +9.5 enhancer in T cell development at the lymphoid-primed multipotent progenitor stage. Moreover, +9.5+/− adult HSCs displayed increased apoptosis and reduced long-term self-renewal capability in comparison with wild-type (WT) HSCs. These phenotypes were more moderate than those of Gata2+/− HSCs. Consistent with the phenotypic characterization, Gata2 expression in +9.5+/− LSKs was moderately higher than that in Gata2+/− LSKs, but lower than that in WT LSKs. Our data suggest that +9.5 deficiency compromises, without completely abrogating, Gata2 expression in adult HSCs.
Impact of dexmedetomidine supplemented analgesia on delirium in patients recovering from orthopedic surgery: A randomized controlled trial
Authors: Hong Hong , Zhang Da-Zhi , Li Mo , Wang Geng , Zhu Sai-Nan , Zhang Yue , Wang Dong-Xin , Sessler Daniel I.
Published: September 2021

Background

Dexmedetomidine promotes normal sleep architecture; the drug also improves analgesia. We therefore tested the hypothesis that supplementing intravenous analgesia with dexmedetomidine reduces delirium in older patients recovering from orthopedic surgery.

Methods

In this double-blinded randomized controlled trial, we enrolled 712 older (aged 65–90 years) patients scheduled for major orthopedic surgery. Postoperative analgesia was provided by patient-controlled intravenous sufentanil, supplemented by randomly assigned dexmedetomidine (1.25 μg/mL) or placebo, for up to three days. The primary outcome was the incidence of delirium assessed twice daily with the Confusion Assessment Method. Among secondary outcomes, pain severity was assessed twice daily and sleep quality once daily, each with an 11-point scale where 0 = no pain/the best possible sleep and 10 = the worst pain/the worst possible sleep.

Results

The incidence of postoperative delirium was 7.3% (26 of 354) with placebo and 4.8% (17 of 356) with dexmedetomidine; relative risk 0.65, 95% CI 0.36 to 1.18; P = 0.151. Dexmedetomidine reduced pain both at rest (median difference -1 to 0 points, P ≤ 0.001) and with movement (-1 points, P < 0.001) throughout the first 5 postoperative days; it also improved subjective sleep quality during the first 3 postoperative days: day one median difference -1 point (95% CI -1 to 0), P = 0.007; day two 0 point (-1 to 0), P = 0.010; and day three 0 point (-1 to 0), P = 0.003. The incidence of adverse events was similar in each group.

Conclusions

Supplementing sufentanil intravenous analgesia with low-dose dexmedetomidine did not significantly reduce delirium, but improved analgesia and sleep quality without provoking adverse events.

Trial registration

www.chictr.org.cn: ChiCTR1800017182 (Date of registration: July 17, 2018); ClinicalTrials.gov:NCT03629262 (Date of registration: August 14, 2018).
Structural equation modeling for identification of patient safety antecedents in primary care
Authors: Kosiek Katarzyna , Staniec Iwona , Godycki-Cwirko Maciej , Depta Adam , Kowalczyk Anna
Published: September 2021

Background

Patient safety is defined as an activity that minimizes and removes possible errors and injuries to patients. A number of factors have been found to influence patient safety management, including the facilities available in the practice, communication and collaboration, education regarding patient safety and generic conditions. This study tested a theoretical model of patient safety interventions based on safety antecedents.

Methods

Medical professionals were surveyed using a questionnaire developed by Gaal et al. The results were analyzed with SPSS 20 and AMOS. A hypothetical model of direct and indirect effects on patient safety in a primary care environment was created and analyzed using structural equation modeling (SEM).

Results

SEM proved to be an effective tool to analyse safety in primary care. The facilities in the practice appear to have no significant influence on patient safety management in the case of female respondents, those below mean age, those who are not GPs (general practitioner) and respondents not working in counselling centres.

Conclusions

The integrated safety model described in the study can improve patient safety management.