bluuebunny/crossref_metadata_2025 huggingface dataset:
Antibacterial Activity of Defatted and Nondefatted Methanolic Extracts of Aframomum melegueta K. Schum. against Multidrug-Resistant Bacteria of Clinical Importance
Authors: Olajuyigbe Olufunmiso Olusola , Adedayo Otunola , Coopoosamy Roger Murugas
Published: August 2020

The antibacterial activity of the extracts of Aframomum melegueta including n-hexane extract (NHE), nondefatted methanol extract (NDME), and defatted methanol extract (DME) was investigated in this study. The NHE exhibited no antibacterial activity. The DME showed higher antibacterial activity than the NDME against the different isolates. At the highest concentration of 10 mg/mL in agar diffusion, NDME produced inhibition zones ranging from 11 to 29 mm against the microorganisms while DME produced inhibition zones ranging from 20 to 40 mm with the concentration of 10 mg/mL against the microorganisms. 0.1 mg/mL of the DME produced inhibition zones ranging between 12 and 14 mm in Aeromonas hydrophila ATCC 35654 and Pseudomonas aeruginosa ATCC 15442, respectively, while none of the isolates were inhibited by the NDME at a concentration of 1 mg/mL or less. In the agar dilution assay, the MICs of the NDME and DME ranged between 0.31 and 10 mg/mL, but more isolates were inhibited at 0.31 mg/mL of DME than those in NDME. In macrobroth assay, the MICs of the NDME ranged between 0.15 and 5.0 mg/mL and the MBCs ranged between 0.63 and 5.0 mg/mL, and the MICs of the DME ranged between 0.08 and 5.0 mg/mL and the MBCs were between 0.31 and 5.0 mg/mL. This study indicated that DME was more active with higher antibacterial activity than the NDME of this plant, and extracting the fatty portion of plant materials prior susceptibility testing would allow plant extracts to be more effective as well as justifying the use of Aframomum melegueta in traditional medicine for the treatment of bacterial infections.
Rich Dynamics of a Brucellosis Model with Transport
Authors: Liang Juan , Zhao Zhirong , Li Can
Published: August 2020

Brucellosis is one of the major infectious diseases in China. In this study, we consider an SI model of animal brucellosis with transport. The basic reproduction number ℛ0 is obtained, and the stable state of the equilibria is analyzed. Numerical simulation shows that different initial values have a great influence on results of the model. In addition, the sensitivity analysis of ℛ0 with respect to different parameters is analyzed. The results reveal that the transport has dual effects. Specifically, transport can lead to increase in the number of infected animals; besides, transport can also reduce the number of infected animals in a certain range. The analysis shows that the number of infected animals can be controlled if animals are transported reasonably.
Predicting Pathologic Bone Lesions Using Scout Computed Tomography (CT) Imaging
Authors: Colello Michael J. , Pichiotino Erin R. , Tanner Stephanie L. , Porter Scott E. , Gurich Richard W.
Published: August 2020

The purpose of this study is to evaluate the benefit of reviewing scout CT images, obtained for routine oncologic surveillance, for the early identification of pathologic bony lesions. A retrospective review was conducted on patients who previously underwent surgical treatment by two orthopedic oncology surgeons at a tertiary care institution from 2009–2019 for pathologic lesions or fractures of the humerus or femur. Radiographic records were reviewed to identify patients in this cohort who had available scout views from CT imaging prior to official diagnosis of the bony lesion or fracture. CT scout images were assessed by two independent reviewers to identify any pathologic lesions, and radiographic reports were reviewed to identify if the lesions were noted by radiology at the time of the initial scan interpretation. One hundred and forty-four patients were identified, and thirty-nine had an available scout CT image prior to official diagnosis of the lesion. Twenty-five patients (64.1%) had lesions identified by authors on scout CT versus only 9 (23.1%) who had lesions that were documented in the initial CT radiologic report. There was a total of 29 lesions identified by the study authors on scout CT, and 19 (65.5%) were not reported in the initial radiographic interpretation with an average interval between observation by authors and official diagnosis of 202 days. Of the impending fractures, three patients (16.7%) went on to complete fracture prior to referral to orthopedics with an average interval between these missed lesions on scout CT and their presentation with fracture of 68 days. This study advocates for the careful review of all scout CT imaging as an essential part of the work up for metastatic disease and encourages all practitioners to utilize this screening tool for the identification of pathologic bony lesions which may help expedite early treatment to reduce patient morbidity.
Risk Mitigation and Construction Control for Effective Underwater Recovery of an EPB Shield: A Case Study of the First Metro Tunnel in Tel Aviv
Authors: Qi Weiqiang , Yang Zhiyong , Jiang Yusheng , Liu Zhiyong , Guo Yinxin , Yang Xing
Published: August 2020

Shield recovery in water‐rich sand strata is a challenging issue in the field of shield tunnel engineering, especially when the end of the shaft cannot be reinforced by jet grouting or freezing or when the shield cannot be supported with a steel sleeve. Therefore, it is important to develop an effective recovery approach and adopt suitable techniques to control the risks. In this study, a new method based on filling the receiving shaft with water is proposed for the underwater recovery of an earth pressure balance (EPB) shield with zero end reinforcement from a metro tunnel in Tel Aviv, Israel. Several additional techniques are used to ensure safe recovery of the shield, including the design of a concrete cradle, drilling of pressure relief holes, control of excavation parameters, screw conveyor sealing, portal sealing, tail sealing, and grouting. Furthermore, according to the actual situation on site, filling the shaft with water to 1 m above the water level in the strata can prevent the fine sand from percolating into the shaft. Before the cutterhead approaches the underground diaphragm wall, the driving attitude should be strictly controlled, and the edge hob should be inspected for wear. The necessary thrust of shield tunneling in the underground diaphragm wall and shaft is calculated theoretically. In order to ensure the deformation control of the underground diaphragm wall and the smooth tunneling of the shield, the thrust of the shield excavating the underground diaphragm wall will not be larger than 12 000 kN, and the penetration degree will be limited to 3 mm/r. Qualitative observations and measurements of surface subsidence in the metro tunnel indicate that these risk mitigation techniques are effective and suitable for the underwater recovery of EPB shields in water‐rich sand strata.
Daily Usage of Proton Pump Inhibitors May Reduce the Severity of Critical Upper Gastrointestinal Bleeding in Elderly Patients
Authors: Matsuda Hidetaka , Nosaka Takuto , Akazawa Yu , Saito Yasushi , Ozaki Yoshihiko , Takahashi Kazuto , Naito Tatsushi , Ofuji Kazuya , Ohtani Masahiro , Hiramatsu Katsushi , Nakamoto Yasunari
Published: August 2020

Introduction. We retrospectively examined the relationship between daily proton pump inhibitor (PPI) use and severity of upper gastrointestinal bleeding (UGIB), mainly in the elderly. Methods. We included 97 patients with nonvariceal UGIB diagnosed at our hospital from January 2012 to October 2017. Bleeding severity was assessed using the shock index (SI) and estimated bleeding volume; 49 patients met the criterion for the mild group and 48 for the moderate/severe group. The effect of PPI use on bleeding severity was compared between the groups. The relationships of PPI use and dose with the clinical symptoms of UGIB were also analyzed. Results. Among the 97 patients, 17 (17.5%) habitually used PPIs. The rate of habitual PPI use was significantly higher in the mild group, indicating as an independent factor contributing to a reduction in the severity of UGIB in a multiple logistic regression analysis (30.6% vs. 4.2%; OR 10.147; 95% CI 2.174–47.358, P<0.01). When analyzing data for a subgroup of patients older than 75 years, we found the protective PPI effect to be even higher in the mild UGIB group than in the moderate/severe group (37.0% vs. 5.6%; OR 10.000; 95% CI 1.150–86.951, P<0.05). Conversely, we found no association between PPI prescription and UGIB symptoms in patients younger than 75 years. The mean estimated bleeding volume and SI in the 17 habitual PPI users were both significantly less than those among the 80 nonhabitual users, respectively (P<0.05). The proportion of patients with mild UGIB was similar between the low- and high-dose PPI users. Conclusions. Particularly in elderly patients with nonvariceal UGIB, habitual PPI use can alleviate the clinical symptoms of UGIB by suppressing the volume of bleeding, regardless of the adapted dose of PPIs.
Bifurcation and Chaos of a Discrete-Time Population Model
Authors: Feng Guo , Xinghao Song
Published: August 2020

A Leslie population model for two generations is investigated by qualitative analysis and numerical simulation. For the different parameters a and b in the model, the dynamics of the system are studied, respectively. It shows many complex dynamic behavior, including several types of bifurcations leading to chaos, such as period-doubling bifurcations and Neimark–Sacker bifurcations. With the change of parameters, attractor crises and chaotic bands with periodic windows appear. The largest Lyapunov exponents are numerically computed and can verify the rationality of the theoretical analysis.
Prevalence and Factors Associated with Intestinal Parasitic Infections among Pregnant Women in West Gojjam Zone, Northwest Ethiopia
Authors: Hailu Tadesse , Abera Bayeh , Mulu Wondemagegn , Kassa Simachew , Genanew Ashenafi , Amor Arancha
Published: August 2020

Background. Intestinal parasitic infections are the major causes of morbidity and mortality in sub-Saharan countries. The disease burden of these parasites is significantly high among pregnant women in developing countries like Ethiopia. Poor living conditions, sanitation, and hygiene are believed to be the contributing factors. The aim of this study was to determine the magnitude of intestinal parasitic infection and factors associated with pregnant women. Methods. A cross-sectional study was conducted from February 2017 to June 2017. A structured questionnaire was used to obtain the sociodemographic and other explanatory variables via face-to-face interviews. Stool samples were collected and examined using formol ether concentration technique. The magnitude of parasitic infection was calculated using descriptive statistics. The association between intestinal parasitic infection and determinant factors was assessed by logistic regression. The differences were considered to be statistically significant if the p value was less than 0.05. Results. From a total of 743 pregnant women, the overall prevalence of intestinal parasitosis was 277 (37.3%). The prevalence of hookworm 138 (18.6%) was the leading cause of intestinal parasitosis followed by E. histolytica/dispar 113 (15.2%). Dwelling in rural area (AOR: 2.9 (95% CI: 1.85-4.85)), being a farmer (AOR: 1.91 (95% CI: 1.20-3.03)), eating raw vegetables (AOR: 1.45, 95% CI:0.09-0.24), lack of proper use of latrine (AOR: 2.89 (95%1.18-7.08)), poor environmental sanitation (AOR: 0.19 (95%: CI:0.08-0.47)), habit of soil eating (AOR: 0.42 (95% CI: 0.25-0.72)), having irrigation practice (AOR: 0.47 (95% CI: 0.29-0.77)), and lack of health education (AOR: 0.32 (95% CI: 0.13-0.77)) were significantly associated with intestinal parasitic infections. Conclusions. Intestinal parasitic infection is a major problem among pregnant women in the study area. High parasitic infection is associated with poor hygienic and sanitation practices. Therefore, awareness creation through health education should be given to pregnancy on intestinal parasitic infection and associated factors.
Limiting Privacy Breaches in Average-Distance Query
Authors: Xia Huihua , Xiong Yan , Huang Wenchao , Meng Zhaoyi , Miao Fuyou
Published: August 2020

Querying average distances is useful for real-world applications such as business decision and medical diagnosis, as it can help a decision maker to better understand the users’ data in a database. However, privacy has been an increasing concern. People are now suffering serious privacy leakage from various kinds of sources, especially service providers who provide insufficient protection on user’s private data. In this paper, we discover a new type of attack in an average-distance query (AVGD query) with noisy results. The attack is general that it can be used to reveal private data of different dimensions. We theoretically analyze how different factors affect the accuracy of the attack and propose the privacy-preserving mechanism based on the analysis. We experiment on two real-life datasets to show the feasibility and severity of the attack. The results show that the severity of the attack is mainly influenced by the factors including the noise magnitude, the number of queries, and the number of users in each query. Also, we validate the correctness of our theoretical analysis by comparing with the experimental results and confirm the effectiveness of the privacy-preserving mechanism.
Chinese Sign Language Recognition Based on DTW-Distance-Mapping Features
Authors: Cheng Juan , Wei Fulin , Liu Yu , Li Chang , Chen Qiang , Chen Xun
Published: August 2020

Sign language is an important communication tool between the deaf and the external world. As the number of the Chinese deaf accounts for 15% of the world, it is highly urgent to develop a Chinese sign language recognition (CSLR) system. Recently, a novel phonology- and radical-coded CSL, taking advantages of a limited and constant number of coded gestures, has been preliminarily verified to be feasible for practical CSLR systems. The keynote of this version of CSL is that the same coded gesture performed in different orientations has different meanings. In this paper, we mainly propose a novel two-stage feature representation method to effectively characterize the CSL gestures. First, an orientation-sensitive feature is extracted regarding the distances between the palm center and the key points of the hand contour. Second, the extracted features are transformed by a dynamic time warping- (DTW-) based feature mapping approach for better representation. Experimental results demonstrate the effectiveness of the proposed feature extraction and mapping approaches. The averaged classification accuracy of all the 39 types of CSL gestures acquired from 11 subjects exceeds 93% for all the adopted classifiers, achieving significant improvement compared to the scheme without DTW-distance-mapping.
Seismic Damage Rapid Assessment of Road Networks considering Individual Road Damage State and Reliability of Road Networks in Emergency Conditions
Authors: Liu Jinlong , Jia Hanxi , Lin Junqi , Hu Heng
Published: August 2020

Road networks are one of the vital components of a transportation system that influence the traffic capacity and disaster losses after the earthquakes. The road network reliability is crucial for the postearthquake emergency decision‐making. In this study, a method is proposed to assess the seismic damage of road networks considering individual road damage state and reliability of road networks in emergency conditions. First, we assess the importance of the factors that affect seismic road damage using the AdaBoost algorithm. In addition, artificial neural networks are used to evaluate the damage state of an individual road based on the factors that are selected with higher importance. Then, the improved estimation for the reliability of road networks is adopted to assess the damage of road networks. Last, the method is demonstrated using the road networks in Karamay, China.
The Impact of Lipoprotein Apheresis on Oxidative Stress Biomarkers and High-Density Lipoprotein Subfractions
Authors: Mickiewicz Agnieszka , Kreft Ewelina , Kuchta Agnieszka , Wieczorek Ewa , Marlęga Joanna , Ćwiklińska Agnieszka , Paprzycka Milena , Gruchała Marcin , Fijałkowski Marcin , Jankowski Maciej
Published: August 2020

Lipoprotein apheresis (LA) treatment results in a substantial reduction of low-density lipoprotein- (LDL-) cholesterol and lipoprotein(a) concentrations, which consequently decreases the rate of cardiovascular events. The additional benefit of LA may be associated with its impact on the composition and quality of high-density lipoprotein (HDL) particles, inflammation, and oxidative stress condition. To verify the effects of LA procedure, the current study is aimed at analyzing the effect of a single apheresis procedure with direct hemadsorption (DALI) and cascade filtration (MONET) on oxidative stress markers and HDL-related parameters. The study included eleven patients with familial hypercholesterolemia and hyperlipoproteinemia(a) treated with regular LA (DALI or MONET). We investigated the pre- and postapheresis concentration of the lipid-related oxidative stress markers 8-isoPGF2, oxLDL, TBARS, and PON-1. We also tracked potential changes in the main HDL apolipoproteins (ApoA-I, ApoA-II) and cholesterol contained in HDL subfractions. A single session of LA with DALI or MONET techniques resulted in a similar reduction of lipid-related oxidative stress markers. Concentrations of 8-isoPGF2 and TBARS were reduced by ~60% and ~30%, respectively. LA resulted in a 67% decrease in oxLDL levels along with a ~19% reduction in the oxLDL/ApoB ratio. Concentrations of HDL cholesterol, ApoA-I, ApoA-II, and PON-1 activity were also reduced by LA sessions, with more noticeable effects seen in the MONET technique. The quantitative proportions between HDL2 and HDL3 cholesterol did not change significantly by both methods. In conclusion, LA treatment with MONET or DALI system has a small nonselective effect on lowering HDL particles without any changes in the protein composition of these particles. Significant reduction in the level of oxidative stress parameters and less oxidation of LDL particles may provide an additional benefit of LA therapy.
O impacto do PRONAF sobre a sustentabilidade agrícola de agricultores familiares na microrregião do vale do médio Curu, no estado do Ceará
Authors: Bittencourt Passos Ana Tereza , Saeed Khan Ahmad
Published: August 2020

O estudo tem por objetivo avaliar o impacto do PRONAF sobre a sustentabilidade agrícola de agricultores familiares por meio do propensity score matching. Os dados são oriundos de pesquisa direta com beneficiários e não beneficiários. Os resultados com pareamento demonstram que os beneficiários apresentam sustentabilidade agrícola superior aos não beneficiários. O PRONAF, entretanto, traz impactos positivos para as gestões econômica e social da propriedade, bem como para a receita agrícola anual, embora tenha se mostrado ineficaz para incentivar a adoção de práticas agrícolas sustentáveis, comprometendo a gestão ambiental da propriedade e a sustentabilidade agrícola em longo prazo.
Role of Extracellular Vesicles in Pulmonary Arterial Hypertension
Authors: Khandagale Avinash , Åberg Mikael , Wikström Gerhard , Bergström Lind Sara , Shevchenko Ganna , Björklund Erik , Siegbahn Agneta , Christersson Christina
Published: August 2020

Objective:

Extracellular vesicles (EVs) have the potential to act as intercellular communicators. The aims were to characterize circulating EVs in patients with pulmonary arterial hypertension (PAH) and to explore whether these EVs contribute to endothelial activation and angiogenesis.

Approach and Results:

Patients with PAH (n=70) and healthy controls (HC; n=20) were included in this cross-sectional study. EVs were characterized and human pulmonary endothelial cells (hPAECs) were incubated with purified EVs. Endothelial cell activity and proangiogenic markers were analyzed. Tube formation analysis was performed for hPAECs, and the involvement of PSGL-1 (P-selectin glycoprotein ligand 1) was evaluated. The numbers of CD62P
+
, CD144
+
, and CD235a EVs were higher in blood from PAH compared with HC. Thirteen proteins were differently expressed in PAH and HC EVs, where complement fragment C1q was the most significantly elevated protein (
P
=0.0009) in PAH EVs. Upon EVs-internalization in hPAECs, more PAH compared with HC EVs evaded lysosomes (
P
<0.01). As oppose to HC, PAH EVs stimulated hPAEC activation and induced transcription and translation of VEGF-A (vascular endothelial growth factor A;
P
<0.05) and FGF (fibroblast growth factor;
P
<0.005) which were released in the cell supernatant. These proangiogenic proteins were higher in patient with PAH plasma compered with HC. PAH EVs induced a complex network of angiotubes in vitro, which was abolished by inhibitory PSGL-1antibody. Anti-PSGL-1 also inhibited EV-induced endothelial cell activation and PAH EV dependent increase of VEGF-A.

Conclusions:

Patients with PAH have higher levels of EVs harboring increased amounts of angiogenic proteins, which induce activation of hPAECs and in vitro angiogenesis. These effects were partly because of platelet-derived EVs evasion of lysosomes upon internalization within hPAEC and through possible involvement of P-selectin-PSGL-1 pathway.
Poly(ADP-Ribose) Polymerase Activity and Coronary Artery Disease in Type 2 Diabetes Mellitus
Authors: Cui Ning-hua , Yang Jun-mei , Liu Xia’nan , Wang Xue-bin
Published: August 2020

Objective:

Experimental evidence suggests a close link between PARP (poly[ADP-ribose] polymerase) activation and diabetic endothelial dysfunction. Here, we tested whether PARP activity in circulating leukocytes was associated with coronary artery disease (CAD) among patients with type 2 diabetes mellitus (T2DM).

Approach and Results:

We performed observational and bidirectional Mendelian randomization studies of 3149 Chinese individuals with T2DM who underwent coronary angiography, with leukocyte PARP activity, 16 tag single-nucleotide polymorphisms in
PARP1
and
PARP2
, and 17 CAD risk single-nucleotide polymorphisms analyzed. Of 3149 participants, 1180 who further received percutaneous coronary intervention were prospectively followed for 1 year to track major adverse cardiovascular and cerebrovascular events. Overall, greater PARP activity was cross-sectionally associated with an odds ratio of 1.23 for obstructive CAD, and prospectively with a hazard ratio of 1.34 for 1-year major adverse cardiovascular and cerebrovascular events after percutaneous coronary intervention (both
P
<0.001). Using a genetic score of 5 screened single-nucleotide polymorphisms in
PARP1
and
PARP2
as the instrumental variable, genetically predicted elevation in PARP activity showed a causal association with obstructive CAD (odds ratio=1.35,
P
<0.001). In contrast, the genetic risk of CAD had no significant effect on PARP activity. Ex vivo and in vitro cultures of human monocytes showed that rs747657, as the lead single-nucleotide polymorphism strongly associated with PARP activity, caused the differential binding of transcription factor GATA2 (GATA-binding protein 2) to an intronic regulatory region in
PARP1
, thus modulating
PARP1
expression and PARP activity.

Conclusions:

Greater PARP activity may have causal roles in the development of obstructive CAD among patients with diabetes mellitus.
Representation of Women Authors in International Heart Failure Guidelines and Contemporary Clinical Trials
Authors: Reza Nosheen , Tahhan Ayman Samman , Mahmud Nadim , DeFilippis Ersilia M. , Alrohaibani Alaaeddin , Vaduganathan Muthiah , Greene Stephen J. , Ho Annie Hang , Fonarow Gregg C. , Butler Javed , O’Connor Christopher , Fiuzat Mona , Vardeny Orly , Piña Ileana L. , Lindenfeld JoAnn , Jessup Mariell
Published: August 2020

Background:

Gender disparities in authorship of heart failure (HF) guideline citations and clinical trials have not been examined.

Methods:

We identified authors of publications referenced in Class I Recommendations in United States (n=173) and European (n=100) HF guidelines and of publications of all HF trials with >400 participants (n=118) published between 2001 and 2016. Authors’ genders were determined, and changes in authorship patterns over time were evaluated with linear regression and nonparametric testing.

Results:

The median proportion of women authors per publication was 20% (interquartile range [IQR], 8%–33%) in United States guidelines, 14% (IQR, 2%–20%) in European guidelines, and 11% (IQR, 4%–20%) in HF trials. The proportion of women authors increased modestly over time in United States and European guidelines’ references (β=0.005 and 0.003, respectively, from 1986 to 2016;
P
<0.001) but not in HF trials (12.5% [IQR, 0%–20%] in 2001–2004 to 8.9% [IQR, 0%–20%] in 2013–2016;
P
>0.50). Overall proportions of women as first or last authors in HF trials (16%) did not change significantly over time (
P
=0.60). North American HF trials had the highest likelihood of having a woman as first or senior author (24%). HF trials with a woman first or senior author were associated with a higher proportion of enrolled female participants (39% versus 26%,
P
=0.01).

Conclusions:

In HF practice guidelines and trials, few women are authors of pivotal publications. Higher number of women authors is associated with higher enrollment of women in HF trials. Barriers to authorship and representation of women in HF guidelines and HF trial leadership need to be addressed.
Lower Rates of Heart Failure and All-Cause Hospitalizations During Pulmonary Artery Pressure-Guided Therapy for Ambulatory Heart Failure
Authors: Shavelle David M. , Desai Akshay S. , Abraham William T. , Bourge Robert C. , Raval Nirav , Rathman Lisa D. , Heywood J. Thomas , Jermyn Rita A. , Pelzel Jamie , Jonsson Orvar T. , Costanzo Maria Rosa , Henderson John D. , Brett Marie-Elena , Adamson Philip B. , Stevenson Lynne W. ,   for the CardioMEMS Post-Approval Study Investigators
Published: August 2020

Background:

Ambulatory hemodynamic monitoring with an implantable pulmonary artery (PA) sensor is approved for patients with New York Heart Association Class III heart failure (HF) and a prior HF hospitalization (HFH) within 12 months. The objective of this study was to assess the efficacy and safety of PA pressure-guided therapy in routine clinical practice with special focus on subgroups defined by sex, race, and ejection fraction.

Methods:

This multi-center, prospective, open-label, observational, single-arm trial of 1200 patients across 104 centers within the United States with New York Heart Association class III HF and a prior HFH within 12 months evaluated patients undergoing PA pressure sensor implantation between September 1, 2014, and October 11, 2017. The primary efficacy outcome was the difference between rates of adjudicated HFH 1 year after compared with the 1 year before sensor implantation. Safety end points were freedom from device- or system-related complications at 2 years and freedom from pressure sensor failure at 2 years.

Results:

Mean age for the population was 69 years, 37.7% were women, 17.2% were non-White, and 46.8% had preserved ejection fraction. During the year after sensor implantation, the mean rate of daily pressure transmission was 76±24% and PA pressures declined significantly. The rate of HFH was significantly lower at 1 year compared with the year before implantation (0.54 versus 1.25 events/patient-years, hazard ratio 0.43 [95% CI, 0.39–0.47],
P
<0.0001). The rate of all-cause hospitalization was also lower following sensor implantation (1.67 versus 2.28 events/patient-years, hazard ratio 0.73 [95% CI, 0.68–0.78],
P
<0.0001). Results were consistent across subgroups defined by ejection fraction, sex, race, cause of cardiomyopathy, presence/absence of implantable cardiac defibrillator or cardiac resynchronization therapy and ejection fraction. Freedom from device- or system-related complications was 99.6%, and freedom from pressure sensor failure was 99.9% at 1 year.

Conclusions:

In routine clinical practice as in clinical trials, PA pressure-guided therapy for HF was associated with lower PA pressures, lower rates of HFH and all-cause hospitalization, and low rates of adverse events across a broad range of patients with symptomatic HF and prior HFH.

Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02279888.
Percutaneous Interventions for Secondary Mitral Regurgitation
Authors: Ali Mahboob , Shreenivas Satya S. , Pratt David N. , Lynch Donald R. , Kereiakes Dean J.
Published: August 2020

Mitral regurgitation is frequently associated with ventricular dysfunction and carries a high mortality. Guideline-directed medical therapy, surgical mitral valve repair or replacement, and, in the setting of advanced heart failure, heart transplant and left ventricular assist devices have been the mainstay of treatment. However, rapid advancement in the field has resulted in approval of edge-to-edge mitral valve repair with the MitraClip, and there are several novel catheter-based percutaneous options in clinical trials. Percutaneous options, while promising, must be deployed in patients who are most likely to benefit, and thus, understanding the pathophysiology of specific subgroups of patients with functional mitral regurgitation (eg, disproportionate versus proportionate mitral regurgitation) is key to the success of new devices. We review the pathophysiology, percutaneous therapeutic treatment options, and ongoing clinical trials for functional mitral regurgitation.
One-Year Echocardiographic, Functional, and Quality of Life Outcomes After Ultrasound-Facilitated Catheter-Based Fibrinolysis for Pulmonary Embolism
Authors: Piazza Gregory , Sterling Keith M. , Tapson Victor F. , Ouriel Kenneth , Sharp Andrew S.P. , Liu Ping-Yu , Goldhaber Samuel Z. ,   for the Optimum Duration and Dose of r-tPA with the Acoustic Pulse Thrombolysis Procedure for Intermediate-Risk Pulmonary Embolism (OPTALYSE-PE) Investigators
Published: August 2020

Background:

Accelerated tPA (tissue-type plasminogen activator) dosing regimens for ultrasound-facilitated, catheter-directed fibrinolysis improve short-term computed tomographic-measured right ventricular (RV)-to-left ventricular diameter ratio in massive and submassive pulmonary embolism. The impact on RV remodeling, functional status, and quality of life over the long-term remains unclear.

Methods:

To study 1-year changes in RV remodeling, functional status, and quality of life, we assessed patients with acute submassive pulmonary embolism randomly assigned to 1 of 4 tPA dosing regimens for ultrasound-facilitated, catheter-directed fibrinolysis in the OPTALYSE-PE trial (Optimum Duration and Dose of r-tPA With the Acoustic Pulse Thrombolysis Procedure for Intermediate-Risk Pulmonary Embolism; 8 mg/2 hours, 8 mg/4 hours, 12 mg/6 hours, and 24 mg/6 hours). Echocardiographic assessment included RV-to-left ventricular diameter ratio within 4 hours of treatment end, and at 48 hours, 30 days, 90 days, and 1 year. Functional status was assessed by 6-minute walk test at 30 days, 90 days, and 1 year and PROMIS-PF-6b scores at 30 days, 90 days, 180 days, 270 days, and 1 year. Quality of life was evaluated by PEmb-QOL scores at 30 days, 90 days, 180 days, 270 days, and 1 year.

Results:

Mean RV-to-left ventricular diameter ratio decreased from baseline to 4 hours and further at 48 hours and 30 days, with reductions maintained at 90 days and 1 year in all groups. Mean 6-minute walk distance, PROMIS-PF-6b, and PEmb-QOL scores improved over the course of 1 year in all groups.

Conclusions:

Accelerated lower-dose tPA regimens for ultrasound-facilitated, catheter-directed fibrinolysis resulted in sustained recovery of RV-to-left ventricular diameter ratio and tricuspid annular plane systolic excursion and improvements in functional status and quality of life over 1 year.

Registration:

URL:
https://www.ClinicalTrials.gov
. Unique Identifier: NCT02396758.
Derivation and External Validation of a High‐Sensitivity Cardiac Troponin–Based Proteomic Model to Predict the Presence of Obstructive Coronary Artery Disease
Authors: McCarthy Cian P. , Neumann Johannes T. , Michelhaugh Sam A. , Ibrahim Nasrien E. , Gaggin Hanna K. , Sörensen Nils A. , Schäefer Sarina , Zeller Tanja , Magaret Craig A. , Barnes Grady , Rhyne Rhonda F. , Westermann Dirk , Januzzi James L.
Published: August 2020

Background

Current noninvasive modalities to diagnose coronary artery disease (CAD) have several limitations. We sought to derive and externally validate a hs‐cTn (high‐sensitivity cardiac troponin)–based proteomic model to diagnose obstructive coronary artery disease.

Methods and Results

In a derivation cohort of 636 patients referred for coronary angiography, predictors of ≥70% coronary stenosis were identified from 6 clinical variables and 109 biomarkers. The final model was first internally validated on a separate cohort (n=275) and then externally validated on a cohort of 241 patients presenting to the ED with suspected acute myocardial infarction where ≥50% coronary stenosis was considered significant. The resulting model consisted of 3 clinical variables (male sex, age, and previous percutaneous coronary intervention) and 3 biomarkers (hs‐cTnI [high‐sensitivity cardiac troponin I], adiponectin, and kidney injury molecule‐1). In the internal validation cohort, the model yielded an area under the receiver operating characteristic curve of 0.85 for coronary stenosis ≥70% (
P
<0.001). At the optimal cutoff, we observed 80% sensitivity, 71% specificity, a positive predictive value of 83%, and negative predictive value of 66% for ≥70% stenosis. Partitioning the score result into 5 levels resulted in a positive predictive value of 97% and a negative predictive value of 89% at the highest and lowest levels, respectively. In the external validation cohort, the score performed similarly well. Notably, in patients who had myocardial infarction neither ruled in nor ruled out via hs‐cTnI testing (“indeterminate zone,” n=65), the score had an area under the receiver operating characteristic curve of 0.88 (
P
<0.001).

Conclusions

A model including hs‐cTnI can predict the presence of obstructive coronary artery disease with high accuracy including in those with indeterminate hs‐cTnI concentrations.
Risk of Distal Embolization From tPA (Tissue-Type Plasminogen Activator) Administration Prior to Endovascular Stroke Treatment
Authors: Flint Alexander C. , Avins Andrew L. , Eaton Abigail , Uong Stephen , Cullen Sean P. , Hsu Daniel P. , Edwards Nancy J. , Reddy Prasad A. , Klingman Jeffrey G. , Rao Vivek A. , Chan Sheila L. , Hartman Jonathan , Zrelak Patricia A. , Nguyen-Huynh Mai N.
Published: August 2020

Background and Purpose:

In large artery occlusion stroke, both intravenous (IV) tPA (tissue-type plasminogen activator) and endovascular stroke treatment (EST) are standard-of-care. It is unknown how often tPA causes distal embolization, in which a procedurally accessible large artery occlusion is converted to a more distal and potentially inaccessible occlusion.

Methods:

We analyzed data from a decentralized stroke telemedicine program in an integrated healthcare delivery system covering 21 hospitals, with 2 high-volume EST centers. We captured all cases sent for EST and examined the relationship between IV tPA administration and the rate of distal embolization, the rate of target recanalization (modified Treatment in Cerebral Infarction scale 2b/3), clinical improvement before EST, and short-term and long-term clinical outcomes.

Results:

Distal embolization before EST was quite common (63/314 [20.1%]) and occurred more often after IV tPA before EST (57/229 [24.9%]) than among those not receiving IV tPA (6/85 [7.1%];
P
<0.001). Distal embolization was associated with an inability to attempt EST: after distal embolization, 26/63 (41.3%) could not have attempted EST because of the new clot location, while in cases without distal embolization, only 8/249 (3.2%) were unable to have attempted EST (
P
<0.001). Among patients who received IV tPA, 13/242 (5.4%) had sufficient symptom improvement that a catheter angiogram was not performed; 6/342 (2.5%) had improvement to within 2 points of their baseline NIHSS. At catheter angiogram, 2/229 (0.9%) of patients who had received tPA had complete recanalization without distal embolization. Both IV tPA and EST recanalization were associated with improved long-term outcome.

Conclusions:

IV tPA administration before EST for large artery occlusion is associated with distal embolization, which in turn may reduce the chance that EST can be attempted and recanalization achieved. At the same time, some IV tPA-treated patients show symptomatic improvement and complete recanalization. Because IV tPA is associated with both distal embolization and improved long-term clinical outcome, there is a need for prospective clinical trials testing the net benefit or harm of IV tPA before EST.
Plaque Distribution Correlates With Morphology of Lenticulostriate Arteries in Single Subcortical Infarctions
Authors: Jiang Shuai , Yan Yuying , Yang Tang , Zhu Qiange , Wang Changyi , Bai Xueling , Hao Zilong , Zhang Shihong , Yang Qi , Fan Zhaoyang , Sun Jiayu , Wu Bo
Published: August 2020

Background and Purpose:

We aimed to use novel whole-brain vessel-wall magnetic resonance imaging (WB-VWI) to investigate the association between plaque distribution of middle cerebral artery (MCA) and morphological changes of the lenticulostriate arteries (LSAs) in single subcortical infarctions.

Methods:

Forty single subcortical infarction patients with no relevant MCA disease on magnetic resonance angiography were prospectively enrolled. Plaque location in the MCA was dichotomized as proximal (located adjacent to the LSA origin) or distal (located distal to the LSA origin) on whole-brain vessel-wall magnetic resonance imaging. The MCAs with proximal plaques were divided into the symptomatic and asymptomatic side, and asymptomatic side MCAs without proximal plaques were the control group. The morphological characteristics of the LSAs and features of proximal plaques were analyzed.

Results:

A total of 71 MCAs in 40 patients were analyzed (31 on the symptomatic side, 22 on the asymptomatic side, and 18 in the control group). Superior-wall plaques of MCAs were observed more frequently on the symptomatic side than the asymptomatic side (45.2% versus 9.1%,
P
=0.005). The wall area index, plaque burden, and remodeling index did not differ significantly between the symptomatic and asymptomatic side. The number of LSA branches was smaller (
P
=0.011) in the symptomatic side (5.48±1.88) compared with the control group (6.83±1.92). The symptomatic side exhibited shorter average length of the LSAs (23.23±3.44 versus 25.75±3.76 mm,
P
=0.025) and shorter average distance of the LSAs (16.47±3.11 versus 21.53±4.76 mm,
P
<0.001) compared with the asymptomatic side.

Conclusions:

Superiorly distributed MCA plaques at the LSA origin are closely associated with morphological changes of the LSA in symptomatic MCAs, suggesting that the distribution, rather than the inherent features of plaques, determines the occurrence of single subcortical infarctions. Our findings provide insight into the etiologic mechanism of branch atheromatous disease in single subcortical infarctions.
Hyperxiphia hirashimai, comb. n. (Hymenoptera, Xiphydriidae) from southern Japan: remarkable sexual dimorphism revealed by DNA barcodes and new distribution records
Authors: SHINOHARA AKIHIKO , YAMASAKO JUNSUKE
Published: August 2020

Based on a study of the type material, Genaxiphia hirashimai Okutani, 1965, a southern Japanese xiphydriid showing remarkable sexual dimorphism, is newly combined with the genus Hyperxiphia Maa, 1949. The previously unknown female is described, and the male is redescribed with additional material. The sexes are associated by examination of specimens of both sexes that apparently emerged from the same piece of branch and by a molecular analysis using mitochondrial COI sequences. Hyperxiphia hirashimai, originally described from Amami-oshima Island, is newly recorded from Miyake-jima Island, southwestern Shikoku, southern Kyushu, Yakushima, Kuroshima and Okinawa-jima Islands.
Systematic Differences in Bucket Sea Surface Temperatures Caused by Misclassification of Engine Room Intake Measurements
Authors: Chan Duo , Huybers Peter
Published: August 2020

Differences in sea surface temperature (SST) biases among groups of bucket measurements in the International Comprehensive Ocean–Atmosphere Dataset, version 3.0 (ICOADS3.0), were recently identified that introduce offsets of as much as 1°C and have first-order implications for regional temperature trends. In this study, the origin of these groupwise offsets is explored through covariation between offsets and diurnal cycle amplitudes. Examination of an extended bucket model leads to expectations for offsets and amplitudes to covary in either sign, whereas misclassified engine room intake (ERI) temperatures invariably lead to negative covariance on account of ERI measurements being warmer and having a smaller diurnal amplitude. An analysis of ICOADS3.0 SST measurements that are inferred to come from buckets indicates that offsets after the 1930s primarily result from the misclassification of ERI measurements in points of five lines of evidence. 1) Prior to when ERI measurements become available in the 1930s, offset–amplitude covariance is weak and generally positive, whereas covariance is stronger and generally negative subsequently. 2) The introduction of ERI measurements in the 1930s is accompanied by a wider range of offsets and diurnal amplitudes across groups, with 3) approximately 20% of estimated diurnal amplitudes being significantly smaller than buoy and drifter observations. 4) Regressions of offsets versus amplitudes intersect independently determined end-member values of ERI measurements. 5) Offset-amplitude slopes become less negative across all regions and seasons between 1960 and 1980, when ERI temperatures were independently determined to become less warmly biased. These results highlight the importance of accurately determining measurement procedures for bias corrections and reducing uncertainty in historical SST estimates.
Thinking With Time: Reflections on Migration and Diaspora Studies Through Sri Lankan Tamil Marriage Migration
Authors: Maunaguru Sidharthan
Published: August 2020

Most of the migration studies or diaspora studies predominantly focus on migration patterns, human movements and their circulation over space. Recently a shift occurred focusing on nonhumans and immobility to analyze migration and diaspora. In this article by taking one of the features of Sri Lankan Tamil transnational marriage between Sri Lankan Tamils from Sri Lanka and Sri Lankan diaspora, I argue the importance of time and temporality to rethink about migration and diaspora studies. I show how different temporalities of things and humans that get (dis)entangled at different places and different points in the marriage migration process allow us to shift our lens slightly in future studies on migration and diaspora.
Preinjury Antiplatelet Use Does Not Increase the Risk of Progression of Small Intracranial Hemorrhage
Authors: Billings Joshua D. , Khan Abid D. , McVicker John H. , Schroeppel Thomas J.
Published: August 2020

Background

The modified brain injury guidelines (mBIG) provide an algorithm for surgeons to manage some mild traumatic brain injury (TBI) with intracranial hemorrhage (ICH) without neurosurgical consultation or repeat imaging. Currently, antiplatelet use among patients with any ICH classifies a patient at the highest level, mBIG 3. This study assesses the risk of clinical progression among patients taking antiplatelet medications with mild TBI with ICH.

Methods

A retrospective analysis of patients with traumatic ICH over a 5-year period was conducted. Demographics, injury severity, and outcome data were collected for each patient. Patients taking antiplatelet agents were reclassified as if they were not taking these medications. Patients who would have met criteria for a lower classification (mBIG 1 or 2) without antiplatelet agents were designated mBIG 3 Antiplatelet and compared with all other mBIG 1 and 2 patients.

Results

736 patients met the inclusion criteria. 158 patients were taking antiplatelet medications and 53 were reclassified as mBIG 3 Antiplatelet. When comparing mBIG 3 Antiplatelet to the 226 patients originally classified as mBIG 1 and 2, mBIG 3 Antiplatelet patients were more likely to undergo repeat head computed tomography (98.1% vs 76.6%; P < .001) and neurosurgical consultation (94.2% vs 76.5%; P < .001) but had no significant differences in outcomes. No mBIG 3 Antiplatelet patients had a worsening examination or needed operative intervention.

Discussion

This data suggests that antiplatelet medication use should not automatically classify a patient as mBIG 3. Adoption of this strategy would better utilize resources and avoid unnecessary costs without sacrificing care.
Modeling Crime Density with Population Dynamics in Space and Time: An Application of Assault in Gangnam, South Korea
Authors: Jung Yeondae , Chun Yongwan , Kim Kamyoung
Published: August 2020

The current study explores populational and environmental factors associated with violent crime. Specifically, it compares ambient and residential populations with regard to their association with assault density at a fine spatial and temporal unit in a city with socio-economic control variables. The results show that the ambient population are consistently associated with the level of assaults throughout the four time periods in a day, while residential population does not contribute much to explaining its variation. In addition, we also find that the percentage of single-member households and the distance to the nearest subway station are constantly associated with assault density, while the proportion of non-residential use and the land price are partially associated.
Colorism and the Poetics of Resistance Among Black Youth: An Application of the Colorist-Historical Trauma Framework
Authors: Crutchfield Jandel , Hall J. Camille , Ortega-Williams Anna , Webb Sarah L.
Published: August 2020

The colorist-historical trauma framework offers scholars, practitioners, and educators a new lens with which to more effectively combat racial disparities in society through the understanding of the intergenerational transmission of colorism in the historical trauma response of African Americans. This article applies the colorist-historical trauma framework to the colorism poems of young African Americans who demonstrate that poetry, as a device of healing, can be a useful mechanism of passing on more than the challenges associated with colorism, but also the art of resistance. The results of this thematic analysis produced three emerging concepts about the poetics of 16 young African Americans and have implications for mental health practitioners, educators, and scholars that uplift the healing process of poetry.
Effects of cutting temperature and process optimization in drilling of GFRP composites
Authors: Erturk A Tamer , Vatansever Fahri , Yarar Eser , Guven E Asım , Sinmazcelik Tamer
Published: August 2020

The present work deals with temperature effects and parametric optimization in the drilling of continuous glass fiber reinforced epoxy composite. Drilling ability was examined operating a drilling system with different drill bits, feed rate, and spindle speed parameters. The investigation was performed by changing the tool and composite interface. Drilling experiments were carried out under the dry condition. Thrust force and drilling temperatures were measured using dynamometer and thermal camera. Peel-up and push-out delamination were evaluated using an image analyzing tool. Results show that the tribo-mechanical behavior of the drilling operation is affected at different levels by tool coating. This behavior is related to the intrinsic friction properties of coating nature. Response surface methodology was used in the evaluation of experiment results. The feed rate of 0.13 mm/rev, spindle speed of 2425 rpm and HSS-TiN drill bit are found as an optimum drilling parameters and drill type.