bluuebunny/crossref_metadata_2025 huggingface dataset:
Computational modeling of choice-induced preference change: A Reinforcement-Learning-based approach
Authors: Zhu Jianhong , Hashimoto Junya , Katahira Kentaro , Hirakawa Makoto , Nakao Takashi
Published: January 2021

The value learning process has been investigated using decision-making tasks with a correct answer specified by the external environment (externally guided decision-making, EDM). In EDM, people are required to adjust their choices based on feedback, and the learning process is generally explained by the reinforcement learning (RL) model. In addition to EDM, value is learned through internally guided decision-making (IDM), in which no correct answer defined by external circumstances is available, such as preference judgment. In IDM, it has been believed that the value of the chosen item is increased and that of the rejected item is decreased (choice-induced preference change; CIPC). An RL-based model called the choice-based learning (CBL) model had been proposed to describe CIPC, in which the values of chosen and/or rejected items are updated as if own choice were the correct answer. However, the validity of the CBL model has not been confirmed by fitting the model to IDM behavioral data. The present study aims to examine the CBL model in IDM. We conducted simulations, a preference judgment task for novel contour shapes, and applied computational model analyses to the behavioral data. The results showed that the CBL model with both the chosen and rejected value’s updated were a good fit for the IDM behavioral data compared to the other candidate models. Although previous studies using subjective preference ratings had repeatedly reported changes only in one of the values of either the chosen or rejected items, we demonstrated for the first time both items’ value changes were based solely on IDM choice behavioral data with computational model analyses.
Mortality and other outcomes of patients with coronavirus disease pneumonia admitted to the emergency department: A prospective observational Brazilian study
Authors: Brandão Neto Rodrigo A. , Marchini Julio F. , Marino Lucas O. , Alencar Julio C. G. , Lazar Neto Felippe , Ribeiro Sabrina , Salvetti Fernando V. , Rahhal Hassan , Gomez Gomez Luz Marina , Bueno Caue G. , Faria Carine C. , da Cunha Victor P. , Padrão Eduardo , Velasco Irineu T. , de Souza Heraldo Possolo ,   Emergencia USP Covid group
Published: January 2021

Background

The first cases of coronavirus disease (COVID-19) in Brazil were diagnosed in February 2020. Our Emergency Department (ED) was designated as a COVID-19 exclusive service. We report our first 500 confirmed COVID-19 pneumonia patients.

Methods

From 14 March to 16 May 2020, we enrolled all patients admitted to our ED that had a diagnosis of COVID-19 pneumonia. Infection was confirmed via nasopharyngeal swabs or tracheal aspirate PCR. The outcomes included hospital discharge, invasive mechanical ventilation, and in-hospital death, among others.

Results

From 2219 patients received in the ED, we included 506 with confirmed COVID-19 pneumonia. We found that 333 patients were discharged home (65.9%), 153 died (30.2%), and 20 (3.9%) remained in the hospital. A total of 300 patients (59.3%) required ICU admission, and 227 (44.9%) needed invasive ventilation. The multivariate analysis found age, number of comorbidities, extension of ground glass opacities on chest CT and troponin with a direct relationship with all-cause mortality, whereas dysgeusia, use of angiotensin converting enzyme inhibitor or angiotensin-ii receptor blocker and number of lymphocytes with an inverse relationship with all-cause mortality

Conclusions

This was a sample of severe patients with COVID-19, with 59.2% admitted to the ICU and 41.5% requiring mechanical ventilator support. We were able to ascertain the outcome in majority (96%) of patients. While the overall mortality was 30.2%, mortality for intubated patients was 55.9%. Multivariate analysis agreed with data found in other studies although the use of angiotensin converting enzyme inhibitor or angiotensin-ii receptor blocker as a protective factor could be promising but would need further studies.

Trial registration

The study was registered in the Brazilian registry of clinical trials:RBR-5d4dj5.
(TIMP2) x (IGFBP7) as early renal biomarker for the prediction of acute kidney injury in aortic surgery (TIGER). A single center observational study
Authors: Waskowski Jan , Pfortmueller Carmen A. , Schenk Noelle , Buehlmann Roman , Schmidli Juerg , Erdoes Gabor , Schefold Joerg C.
Published: January 2021

Objective

Postoperative acute kidney injury (po-AKI) is frequently observed after major vascular surgery and impacts on mortality rates. Early identification of po-AKI patients using the novel urinary biomarkers insulin-like growth factor-binding-protein 7 (IGFBP7) and tissue inhibitor of metalloproteinases-2 (TIMP-2) might help in early identification of individuals at risk of AKI and enable timely introduction of preventative or therapeutic interventions with the aim of reducing the incidence of po-AKI. We investigated whether biomarker-based monitoring would allow for early detection of po-AKI in patients undergoing abdominal aortic interventions.

Methods

In an investigator-initiated prospective single-center observational study in a tertiary care academic center, adult patients with emergency/ elective abdominal aortic repair were included. Patients were tested for concentrations of urinary (TIMP-2) x (IGFBP7) at baseline, after surgical interventions (PO), and in the mornings of the first postoperative day (POD1). The primary endpoint was a difference in urinary (TIMP-2) x (IGFBP7) levels at POD1 in patients with/ without po-AKI (all KDIGO stages, po-AKI until seven days after surgery). Secondary endpoints included sensitivity/ specificity analyses of previously proposed cut-off levels and clinical outcome measures (e.g. need for renal replacement therapy).

Results

93 patients (n = 71 open surgery) were included. Po-AKI was observed in 33% (31/93) of patients. Urinary (TIMP-2) x (IGFBP7) levels at POD1 did not differ between patients with/ without AKI (median 0.39, interquartile range [IQR] 0.13–1.05 and median 0.23, IQR 0.14–0.53, p = .11, respectively) and PO (median 0.2, IQR 0.08–0.42, 0.18, IQR 0.09–0.46; p = .79). Higher median (TIMP-2) x (IGFBP7) levels were noted in KDIGO stage 3 pAKI patients at POD1 (3.75, IQR 1.97–6.92; p = .003). Previously proposed cutoff levels (0.3, 2) showed moderate sensitivity/ specificity (0.58/0.58 and 0.16/0.98, respectively).

Conclusion

In a prospective monocentric observational study in patients after abdominal aortic repair, early assessment of urinary (TIMP-2) x (IGFBP7) did not appear to have adequate sensitivity/ specificity to identify patients that later developed postoperative AKI.

Clinicaltrials.gov

NCT03469765, registered March 19, 2018.
The complex interplay of climate, TBEV vector dynamics and TBEV infection rates in ticks—Monitoring a natural TBEV focus in Germany, 2009–2018
Authors: Borde Johannes P. , Kaier Klaus , Hehn Philip , Matzarakis Andreas , Frey Stefan , Bestehorn Malena , Dobler Gerhard , Chitimia-Dobler Lidia
Published: January 2021

Background

Tick-borne encephalitis (TBE) is the most important tick-borne viral disease in Eurasia and causes disease in humans and in a number of animals, among them dogs and horses. There is still no good correlation between tick numbers, weather conditions and human cases. There is the hypothesis that co-feeding due to simultaneous occurrence of larvae and nymphs may be a factor for the increased transmission of the virus in nature and for human disease. Based on long-term data from a natural TBEV focus, phylogenetic results and meteorological data we sought to challenge this hypothesis.

Methods

Ticks from an identified TBE natural focus were sampled monthly from 04/2009 to 12/2018. Ticks were identified and pooled. Pools were tested by RT-qPCR. Positive pools were confirmed by virus isolation and/or sequencing of additional genes (E gene, NS2 gene). Temperature data such as the decadal (10-day) mean daily maximum air temperature (DMDMAT) were obtained from a nearby weather station and statistical correlations between tick occurrence and minimal infection rates (MIR) were calculated.

Results

In the study period from 04/2009 to 12/2018 a total of 15,530 ticks (2,226 females, 2,268 males, 11,036 nymphs) were collected. The overall MIR in nymphs over the whole period was 77/15,530 (0.49%), ranging from 0.09% (2009) to 1.36% (2015). The overall MIR of female ticks was 0.76% (17/2,226 ticks), range 0.14% (2013) to 3.59% (2016). The overall MIR of males was 0.57% (13/2,268 ticks), range from 0.26% (2009) to 0.97% (2015). The number of nymphs was statistically associated with a later start of spring/vegetation period, indicated by the onset of forsythia flowering.

Conclusion

There was no particular correlation between DMDMAT dynamics in spring and/or autumn and the MIR of nymphs or adult ticks detected. However, there was a positive correlation between the number of nymphs and the number of reported human TBE cases in the following months, but not in the following year. The hypothesis of the importance of co-feeding of larvae and nymphs for the maintenance of transmission cycle of TBEV in nature is not supported by our findings.
Transcriptional profiling of pediatric cholestatic livers identifies three distinct macrophage populations
Authors: Taylor Sarah A. , Chen Shang-Yang , Gadhvi Gaurav , Feng Liang , Gromer Kyle D. , Abdala-Valencia Hiam , Nam Kiwon , Dominguez Salina T. , Montgomery Anna B. , Reyfman Paul A. , Ostilla Lorena , Wechsler Joshua B. , Cuda Carla M. , Green Richard M. , Perlman Harris , Winter Deborah R.
Published: January 2021

Background & aims

Limited understanding of the role for specific macrophage subsets in the pathogenesis of cholestatic liver injury is a barrier to advancing medical therapy. Macrophages have previously been implicated in both the mal-adaptive and protective responses in obstructive cholestasis. Recently two macrophage subsets were identified in non-diseased human liver; however, no studies to date fully define the heterogeneous macrophage subsets during the pathogenesis of cholestasis. Here, we aim to further characterize the transcriptional profile of macrophages in pediatric cholestatic liver disease.

Methods

We isolated live hepatic immune cells from patients with biliary atresia (BA), Alagille syndrome (ALGS), and non-cholestatic pediatric liver by fluorescence activated cell sorting. Through single-cell RNA sequencing analysis and immunofluorescence, we characterized cholestatic macrophages. We next compared the transcriptional profile of pediatric cholestatic and non-cholestatic macrophage populations to previously published data on normal adult hepatic macrophages.

Results

We identified 3 distinct macrophage populations across cholestatic liver samples and annotated them as lipid-associated macrophages, monocyte-like macrophages, and adaptive macrophages based on their transcriptional profile. Immunofluorescence of liver tissue using markers for each subset confirmed their presence across BA (n = 6) and ALGS (n = 6) patients. Cholestatic macrophages demonstrated reduced expression of immune regulatory genes as compared to normal hepatic macrophages and were distinct from macrophage populations defined in either healthy adult or pediatric non-cholestatic liver.

Conclusions

We are the first to perform single-cell RNA sequencing on human pediatric cholestatic liver and identified three macrophage subsets with distinct transcriptional signatures from healthy liver macrophages. Further analyses will identify similarities and differences in these macrophage sub-populations across etiologies of cholestatic liver disease. Taken together, these findings may allow for future development of targeted therapeutic strategies to reprogram macrophages to an immune regulatory phenotype and reduce cholestatic liver injury.
Validating International Classification of Disease 10th Revision algorithms for identifying influenza and respiratory syncytial virus hospitalizations
Authors: Hamilton Mackenzie A. , Calzavara Andrew , Emerson Scott D. , Djebli Mohamed , Sundaram Maria E. , Chan Adrienne K. , Kustra Rafal , Baral Stefan D. , Mishra Sharmistha , Kwong Jeffrey C.
Published: January 2021

Objective

Routinely collected health administrative data can be used to efficiently assess disease burden in large populations, but it is important to evaluate the validity of these data. The objective of this study was to develop and validate International Classification of Disease 10th revision (ICD -10) algorithms that identify laboratory-confirmed influenza or laboratory-confirmed respiratory syncytial virus (RSV) hospitalizations using population-based health administrative data from Ontario, Canada.

Study design and setting

Influenza and RSV laboratory data from the 2014–15, 2015–16, 2016–17 and 2017–18 respiratory virus seasons were obtained from the Ontario Laboratories Information System (OLIS) and were linked to hospital discharge abstract data to generate influenza and RSV reference cohorts. These reference cohorts were used to assess the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the ICD-10 algorithms. To minimize misclassification in future studies, we prioritized specificity and PPV in selecting top-performing algorithms.

Results

83,638 and 61,117 hospitalized patients were included in the influenza and RSV reference cohorts, respectively. The best influenza algorithm had a sensitivity of 73% (95% CI 72% to 74%), specificity of 99% (95% CI 99% to 99%), PPV of 94% (95% CI 94% to 95%), and NPV of 94% (95% CI 94% to 95%). The best RSV algorithm had a sensitivity of 69% (95% CI 68% to 70%), specificity of 99% (95% CI 99% to 99%), PPV of 91% (95% CI 90% to 91%) and NPV of 97% (95% CI 97% to 97%).

Conclusion

We identified two highly specific algorithms that best ascertain patients hospitalized with influenza or RSV. These algorithms may be applied to hospitalized patients if data on laboratory tests are not available, and will thereby improve the power of future epidemiologic studies of influenza, RSV, and potentially other severe acute respiratory infections.
Variation in hospital admission in febrile children evaluated at the Emergency Department (ED) in Europe: PERFORM, a multicentre prospective observational study
Authors: Borensztajn Dorine M. , Hagedoorn Nienke N. , Rivero Calle Irene , Maconochie Ian K. , von Both Ulrich , Carrol Enitan D. , Dewez Juan Emmanuel , Emonts Marieke , van der Flier Michiel , de Groot Ronald , Herberg Jethro , Kohlmaier Benno , Lim Emma , Martinon-Torres Federico , Nieboer Daan , Nijman Ruud G. , Pokorn Marko , Strle Franc , Tsolia Maria , Vermont Clementien , Yeung Shunmay , Zavadska Dace , Zenz Werner , Levin Michael , Moll Henriette A. ,   on behalf of PERFORM consortium: Personalised Risk assessment in febrile children to optimise Real-life Management across the European Union
Published: January 2021

Objectives

Hospitalisation is frequently used as a marker of disease severity in observational Emergency Department (ED) studies. The comparison of ED admission rates is complex in potentially being influenced by the characteristics of the region, ED, physician and patient. We aimed to study variation in ED admission rates of febrile children, to assess whether variation could be explained by disease severity and to identify patient groups with large variation, in order to use this to reduce unnecessary health care utilization that is often due to practice variation.

Design

MOFICHE (Management and Outcome of Fever in children in Europe, part of the PERFORM study, www.perform2020.org), is a prospective cohort study using routinely collected data on febrile children regarding patient characteristics (age, referral, vital signs and clinical alarming signs), diagnostic tests, therapy, diagnosis and hospital admission.

Setting and participants

Data were collected on febrile children aged 0–18 years presenting to 12 European EDs (2017–2018).

Main outcome measures

We compared admission rates between EDs by using standardised admission rates after adjusting for patient characteristics and initiated tests at the ED, where standardised rates >1 demonstrate higher admission rates than expected and rates <1 indicate lower rates than expected based on the ED patient population.

Results

We included 38,120 children. Of those, 9.695 (25.4%) were admitted to a general ward (range EDs 5.1–54.5%). Adjusted standardised admission rates ranged between 0.6 and 1.5. The largest variation was seen in short admission rates (0.1–5.0), PICU admission rates (0.2–2.2), upper respiratory tract infections (0.4–1.7) and fever without focus (0.5–2.7). Variation was small in sepsis/meningitis (0.9–1.1).

Conclusions

Large variation exists in admission rates of febrile children evaluated at European EDs, however, this variation is largely reduced after correcting for patient characteristics and therefore overall admission rates seem to adequately reflect disease severity or a potential for a severe disease course. However, for certain patient groups variation remains high even after adjusting for patient characteristics.
A scientometric overview of CORD-19
Authors: Colavizza Giovanni , Costas Rodrigo , Traag Vincent A. , van Eck Nees Jan , van Leeuwen Thed , Waltman Ludo
Published: January 2021

As the COVID-19 pandemic unfolds, researchers from all disciplines are coming together and contributing their expertise. CORD-19, a dataset of COVID-19 and coronavirus publications, has been made available alongside calls to help mine the information it contains and to create tools to search it more effectively. We analyse the delineation of the publications included in CORD-19 from a scientometric perspective. Based on a comparison to the Web of Science database, we find that CORD-19 provides an almost complete coverage of research on COVID-19 and coronaviruses. CORD-19 contains not only research that deals directly with COVID-19 and coronaviruses, but also research on viruses in general. Publications from CORD-19 focus mostly on a few well-defined research areas, in particular: coronaviruses (primarily SARS-CoV, MERS-CoV and SARS-CoV-2); public health and viral epidemics; molecular biology of viruses; influenza and other families of viruses; immunology and antivirals; clinical medicine. CORD-19 publications that appeared in 2020, especially editorials and letters, are disproportionately popular on social media. While we fully endorse the CORD-19 initiative, it is important to be aware that CORD-19 extends beyond research on COVID-19 and coronaviruses.
Content comparison and person-centeredness of standards for quality improvement in cardiovascular health care
Authors: Algurén Beatrix , Jernberg Tomas , Vasko Peter , Selb Melissa , Coenen Michaela
Published: January 2021

Background

Quality standards are important for improving health care by providing compelling evidence for best practice. High quality person-centered health care requires information on patients' experience of disease and of functioning in daily life.

Objective

To analyze and compare the content of five Swedish National Quality Registries (NQRs) and two standard sets of the International Consortium of Health Outcomes Measurement (ICHOM) related to cardiovascular diseases.

Materials and methods

An analysis of 2588 variables (= data items) of five NQRs—the Swedish Registry of Congenital Heart Disease, Swedish Cardiac Arrest Registry, Swedish Catheter Ablation Registry, Swedish Heart Failure Registry, SWEDEHEART (including four sub-registries) and two ICHOM standard sets–the Heart Failure Standard Set and the Coronary Artery Disease Standard Set. According to the name and definition of each variable, the variables were mapped to Donabedian’s quality criteria, whereby identifying whether they capture health care processes or structures or patients’ health outcomes. Health outcomes were further analyzed whether they were clinician- or patient-reported and whether they capture patients’ physiological functions, anatomical structures or activities and participation.

Results

In total, 606 variables addressed process quality criteria (31%), 58 structure quality criteria (3%) and 760 outcome quality criteria (38%). Of the outcomes reported, 85% were reported by clinicians and 15% by patients. Outcome variables addressed mainly ‘Body functions’ (n = 392, 55%) or diseases (n = 209, 29%). Two percent of all documented data captured patients’ lived experience of disease and their daily activities and participation (n = 51, 3% of all variables).

Conclusions

Quality standards in the cardiovascular field focus predominately on processes (e.g. treatment) and on body functions-related outcomes. Less attention is given to patients’ lived experience of disease and their daily activities and participation. The results can serve as a starting-point for harmonizing data and developing a common person-centered quality indicator set.
Acute high folic acid treatment in SH-SY5Y cells with and without MTHFR function leads to gene expression changes in epigenetic modifying enzymes, changes in epigenetic marks, and changes in dendritic spine densities
Authors: Clark Daniel F. , Schmelz Rachael , Rogers Nicole , Smith Nuri E. , Shorter Kimberly R.
Published: January 2021

Epigenetics are known to be involved in various disorders, including neurobiological disorders like autism. Dietary factors such as folic acid can affect epigenetic marks using methylenetetrahydrofolate reductase (MTHFR) to metabolize folic acid to a one-carbon methyl group. As MTHFR mutations are frequent, it is curious as to whether excess folic acid, with or without functioning MTHFR, could affect gene expression, epigenetics, and neuromorphology. Here, we investigated gene expression and activity of epigenetic modifying enzymes, genome-wide DNA methylation, histone 3 modifications, and dendritic spine densities in SH-SY5Y cells with or without a knockdown of MTHFR and with or without an excess of folic acid. We found alterations to gene expression of epigenetic modifying enzymes, including those associated with disorders like autism. Grouping the epigenetic modifying enzymes by function indicated that gene expression was widely affected for genes that code for enzymes affecting DNA methylation, histone acetylation, histone methylation, histone phosphorylation, and histone ubiquitination when excess folic acid treatment occurred with or without the knockdown of MTHFR. MTHFR was significantly reduced upon excess folic acid treatment whether MTHFR was knocked-down or not. Further, methyl-CpG binding protein 2 expression was significantly decreased with excess folic acid treatment with and without proper MTHFR expression. Global DNA methylation decreased due to the knockdown alone while global hydroxymethylated DNA increased due to the knockdown alone. TET2 expression significantly increased with the MTHFR knockdown alone. Excess folic acid alone induced a decrease in TET3 expression. Excess folic acid induced an increase in dendritic spines without the MTHFR knockdown, but folic acid induced a decrease in dendritic spines when MTHFR was knocked-down. The knockdown alone also increased the dendritic spines significantly. Histone 3 acetylation at lysine 18 was significantly increased when excess folic acid was applied to cells with the MTHFR knockdown, as was histone 3 phosphorylation at serine 10. Broadly, our results indicate that excess folic acid, even with functioning MTHFR, could have detrimental effects on cells.
A multi-mechanism approach reduces length of stay in the ICU for severe COVID-19 patients
Authors: Valerio Pascua Fernando , Diaz Oscar , Medina Rina , Contreras Brian , Mistroff Jeff , Espinosa Daniel , Sekhon Anupamjeet , Paz Handal Diego , Pineda Estela , Vargas Pineda Miguel , Pineda Hector , Diaz Maribel , Lewis Anita S. , Hesse Heike , Castro Lainez Miriams T. , Stevens Mark L. , Sierra- Hoffman Miguel , Ontai Sidney C. , VanBuren Vincent
Published: January 2021

Purpose

COVID-19 pandemic has multifaceted presentations with rising evidence of immune-mediated mechanisms underplay. We sought to explore the outcomes of severe COVID-19 patients treated with a multi-mechanism approach (MMA) in addition to standard-of-care (SC) versus patients who only received SC treatment.

Materials and methods

Data were collected retrospectively for patients admitted to the intensive care unit (ICU). This observational cohort study was performed at five institutions, 3 in the United States and 2 in Honduras. Patients were stratified for MMA vs. SC treatment during ICU stay. MMA treatment consists of widely available medications started immediately upon hospitalization. These interventions target immunomodulation, anticoagulation, viral suppression, and oxygenation. Primary outcomes included in-hospital mortality and length of stay (LOS) for the index hospitalization and were measured using logistic regression.

Results

Of 86 patients admitted, 65 (76%) who had severe COVID-19 were included in the study; 30 (46%) patients were in SC group, compared with 35 (54%) patients treated with MMA group. Twelve (40%) patients in the SC group died, compared with 5 (14%) in the MMA group (p-value = 0.01, Chi squared test). After adjustment for gender, age, treatment group, Q-SOFA score, the MMA group had a mean length of stay 8.15 days, when compared with SC group with 13.55 days. ICU length of stay was reduced by a mean of 5.4 days (adjusted for a mean age of 54 years, p-value 0.03) and up to 9 days (unadjusted for mean age), with no significant reduction in overall adjusted mortality rate, where the strongest predictor of mortality was the use of mechanical ventilation.

Conclusion

The finding that MMA decreases the average ICU length of stay by 5.4 days and up to 9 days in older patients suggests that implementation of this treatment protocol could allow a healthcare system to manage 60% more COVID-19 patients with the same number of ICU beds.
Quantitative analysis of dynamic computed tomography angiography for the detection of endoleaks after abdominal aorta aneurysm endovascular repair: A feasibility study
Authors: Apfaltrer Georg , Lavra Francesco , Schoepf U. Joseph , Scarabello Marco , Yamada Ricardo , van Assen Marly , Varga-Szemes Akos , Jacobs Brian E. , Bauer Maximilian J. , Greenberg William T. , Guimaraes Marcelo , Saba Luca , De Cecco Carlo N.
Published: January 2021

Objectives

To assess the feasibility of quantitative analysis of dynamic computed tomography angiography (dCTA) for the detection of endoleaks in patients who underwent endovascular repair of abdominal aortic aneurysms (EVAR).

Material and methods

Twenty patients scheduled for contrast-enhanced CT angiography (CTA) of the abdominal aorta post-EVAR were prospectively enrolled. All patients received a standard triphasic CTA protocol, followed by an additional dCTA. The dCTA acquisition enabled reconstruction of color-coded maps depicting blood perfusion and a dCTA dataset of the aneurysm sac. Observers assessed the dCTA and dynamic CT perfusion (dCTP) images for the detection of endoleaks, establishing diagnostic confidence based on a modified 5-point Likert scale. An index was calculated for the ratio between the endoleak and aneurysm sac using blood flow for dCTP and Hounsfield units (HU) for dCTA. The Wilcoxon test compared the endoleak index and the diagnostic confidence of the observers.

Results

In total, 19 patients (18 males, median age 74 years [70.5–75.7]) were included for analysis. Nine endoleaks were detected in 7 patients using triphasic CTA as the reference standard. There was complete agreement for endoleak detection between the two techniques on a per-patient basis. Both dCTA and dCTP identified an additional endoleak in one patient. The diagnostic confidence using dCTP for detection of endoleaks was not significantly superior to dCTA (5.0 [5–5] vs. 4.5 [4–5], respectively; p = 0.11); however, dCTP demonstrated superior diagnostic confidence for endoleak exclusion compared to dCTA (1.0 [1–1] vs 1.5 [1.5–1.5], respectively; p <0.01). Moreover, the dCTP endoleak index was significantly higher than the dCTA index (18.5 [10.8–20.5] vs. 3.5 [5–2.7], respectively; p = 0.02).

Conclusions

Quantitative analysis of dCTP imaging can aid in the detection of endoleaks and demonstrates a higher endoleak detection rate than triphasic CTA, as well as a strong correlation with visual assessment of dCTA images.
Clinicopathological characteristics and outcomes of gastrointestinal stromal tumors with high progranulin expression
Authors: Do In-Gu , Jung Kyung Uk , Koo Dong-Hoe , Lee Yun-Gyoo , Oh Sukjoong , Kim Kyungeun , Kim Dong-Hoon , Sohn Jin Hee , Son Byung Ho , Lee Sung Ryol , Shin Jun Ho , Kim Hyung Ook , Kim Hungdai , Chun Ho-Kyung , Serrero Ginette , Yoo Chang Hak
Published: January 2021

Background & aims

Progranulin (PGRN) is known to promote tumorigenesis and proliferation of several types of cancer cells. However, little is known about the clinicopathological features of patients with gastrointestinal stromal tumors (GISTs) with regard to PGRN expression.

Methods

A retrospective analysis was performed on patients with GISTs who underwent curative surgical resection between 2007 and 2017. PGRN expression was evaluated by immunohistochemical (IHC) analysis and semi-quantitatively categorized (no expression, 0; weak, 1+; moderate, 2+; strong, 3+). Tumors with a staining intensity of 2+ or 3+ were considered high PGRN expression.

Results

Fifty-four patients were analyzed; 31 patients (57%) were male. The median age at surgery was 60 years (range, 33–79), and the most common primary site was the stomach (67%). Thirty-five patients (65%) had spindle histology; 42 patients (78%) were separated as a high-risk group according to the modified National Institutes of Health (NIH) classification. High PGRN-expressing tumors were observed in 27 patients (50%), had more epithelioid/mixed histology (68% vs. 32%; p = 0.046), and KIT exon 11 mutations (76% vs. 24%; p = 0.037). Patients with high PGRN-expressing tumors had a worse recurrence-free survival (RFS) (36% of 5-year RFS) compared to those with low PGRN-expressing tumors (96%; p<0.001). Multivariate analysis showed that high PGRN expression and old age (>60 years) were independent prognostic factors for poor RFS.

Conclusions

High PGRN-expressing GISTs showed more epithelioid/mixed histology and KIT exon 11 mutations. PGRN overexpression was significantly associated with poor RFS in patients with GISTs who underwent curative resection.
Brain folding shapes the branching pattern of the middle cerebral artery
Authors: Shalom Diego E. , Trevisan Marcos A. , Mallela Arka , Nuñez Maximiliano , Goldschmidt Ezequiel
Published: January 2021

The folds of the brain offer a particular challenge for the subarachnoid vascular grid. The primitive blood vessels that occupy this space, when the brain is flat, have to adapt to an everchanging geometry while constructing an efficient network. Surprisingly, the result is a non-redundant arterial system easily challenged by acute occlusions. Here, we generalize the optimal network building principles of a flat surface growing into a folded configuration and generate an ideal middle cerebral artery (MCA) configuration that can be directly compared with the normal brain anatomy. We then describe how the Sylvian fissure (the fold in which the MCA is buried) is formed during development and use our findings to account for the differences between the ideal and the actual shaping pattern of the MCA. Our results reveal that folding dynamics condition the development of arterial anastomosis yielding a network without loops and poor response to acute occlusions.
Neuromarkers and neurological outcome in out-of-hospital cardiac arrest patients treated with therapeutic hypothermia–experience from the HAnnover COoling REgistry (HACORE)
Authors: Akin Muharrem , Garcheva Vera , Sieweke Jan-Thorben , Adel John , Flierl Ulrike , Bauersachs Johann , Schäfer Andreas
Published: January 2021

Background

Neuron-specific enolase (NSE) and S-100b have been used to assess neurological damage following out-of-hospital cardiac arrest (OHCA). Cut-offs were derived from small normothermic cohorts. Whether similar cut-offs apply to patients treated with hypothermia remained undetermined.

Methods

We investigated 251 patients with OHCA treated with hypothermia but without routine prognostication. Neuromarkers were determined at day 3, neurological outcome was assessed after hospital discharge by cerebral performance category (CPC).

Results

Good neurological outcome (CPC≤2) was achieved in 41%. Elevated neuromarkers, older age and absence of ST-segment elevation after ROSC were associated with increased mortality. Poor neurological outcome in survivors was additionally associated with history of cerebrovascular events, sepsis and higher admission lactate. Mean NSE was 33μg/l [16–94] vs. 119μg/l [25–406]; p<0.001, for survivors vs. non-survivors, and 21μg/l [16–29] vs. 40μg/l [23–98], p<0.001 for good vs. poor neurological outcome. S-100b was 0.127μg/l [0.063–0.360] vs. 0.772μg/l [0.121–2.710], p<0.001 and 0.086μg/l [0.061–0.122] vs. 0.138μg/l [0.090–0.271], p = 0.009, respectively. For mortality, thresholds of 36μg/l for NSE and 0.128μg/l for S-100b could be determined; for poor neurological outcome 33μg/l (NSE) and 0.123μg/l (S-100b), respectively. Positive predictive value for NSE was 81% (74–88) and 79% (71–85) for S-100b.

Conclusions

Thresholds for NSE and S-100b predicting mortality and poor neurological outcome are similar in OHCA patients receiving therapeutic hypothermia as in those reported before the era of hypothermia. However, both biomarkers do not have enough specificity to predict mortality or poor neurological outcome on their own and should only be additively used in clinical decision making.
Comparison of multidirectional jump performance and lower limb passive range of motion profile between soccer and basketball young players
Authors: Domínguez-Díez Marta , Castillo Daniel , Raya-González Javier , Sánchez-Díaz Silvia , Soto-Célix María , Rendo-Urteaga Tara , Lago-Rodríguez Ángel
Published: January 2021

This study was performed aimed at comparing multidirectional bilateral and unilateral jump performance and passive range of motion (ROM) of lower limbs between soccer and basketball young players and evaluating associations between inter-limb ROM asymmetry and bilateral jump performance. A total of 67 young male athletes participated in this study, who were classified as soccer (n = 40; 15.55 ± 1.5 y; 1.76 ± 0.12 m; 58.15 ± 10.82 kg; 19.84 ± 2.98 kg·m2) and basketball (n = 27; 15.7 ± 1.66 y; 1.76 ± 0.12 m; 62.33 ± 16.57 kg; 19.84 ± 2.98 kg·m2) players. Participants were asked to perform bilateral and unilateral multidirectional jumps, and passive ROM of hip (flexion, extension and abduction), knee (flexion) and ankle (dorsiflexion) joints was also assessed. Significant between-group differences were observed for hip extension with flexed knee ROM in dominant (soccer: 142.43 ± 7.74°; basketball: 148.63 ± 8.10°) and non-dominant (soccer: 144.38 ± 8.36°; basketball: 148.63 ± 6.45°) legs; hip flexion with flexed knee ROM in dominant (soccer: 13.26 ± 4.71°; basketball: 9.96 ± 3.42°) and non-dominant (soccer: 12.86 ± 4.55°; basketball: 9.70 ± 3.62°) legs; and for the ratio of hip abduction (soccer: 1.02 ± 0.08; basketball: 0.97 ± 0.11). However, no significant between-group differences were observed for bilateral and unilateral jump capacity, or for inter-limb asymmetries (dominant vs. non-dominant leg). Finally, no associations were observed between ROM ratio (dominant vs. non-dominant leg) and bilateral jump performance. These findings lead to the suggestion that differences on passive ROM values in young male athletes may be sport-specific. Additionally, there seems to be need for the implementation of training strategies specifically aimed at improving bilateral or unilateral jump ability, or at diminishing inter limb passive ROM differences in order to improve multidirectional jump performance for neither soccer nor basketball youth male players.
Inhibitory Potential Of Black Seed (Nigella Sativa L.) Bioactive Compounds Towards Main Protease Of SARS-CoV-2 : In Silico Study
Authors: Ferdian Pamungkas Rizki , Elfirta Rizki Rabeca , Emilia Qori , Ikhwani Azra Zahrah Nadhirah
Published: January 2021

COVID-19, caused by SARS-CoV-2, has become a massive worldwide concern of the 21st century. One potential strategy to block the biochemical pathway of SARS-CoV-2 was by inhibiting the main protease (Mpro), which is a key enzyme on viral replication. Black seed (Nigella sativa L.) has a long history for its use as a traditional medicine. Therefore, we hypothesised that the black seed contains numerous active compounds that could potentially confer inhibitory activity against SARS-CoV-2 viral Mpro. In this study, 24 active compounds from black seed were tested. Compounds were screened using Lipinski's Rules and admetSAR, then docked to viral Mpro 7BQY by AutoDockTools-1.5.6 and AutoDock Vina using a site directed docking approach resulting in affinity energy (∆G) and binding data. We found that the most potential active compound of N. sativa is 3-[(4-Methylphenyl)sulfanyl]-1,3-diphenyl-1-propanone, since its affinity energy was -7.6 kCal.mol-1. Its similarity to N3 inhibitor based on Ligplot analysis and DS were 86.7% and 76.19%, respectively, and the occupancy on binding site based on Ligplot analysis and DS were 90.91% and 81.82%, respectively. These findings can be used as a starting point for further investigation using in vitro and in vivo studies.
TÜRK SİGORTACILIK SEKTÖRÜNDE ETKİNLİK VE ETKİNLİĞİ BELİRLEYEN FAKTÖRLERİN TESADÜFİ ETKİ PANEL TOBİT MODELİ İLE TAHMİNİ
Authors: GENÇER ÇELİK Gülşah , ÖNGEL Volkan
Published: January 2021

Çalışmada, Türk sigortacılık sektöründe hayat dışı sigortacılık alanında faaliyet gösteren 30 sigortacılık şirketinin etkinlik düzeyleri veri zarflama analizi yöntemiyle hesaplanmış ve daha sonra bu etkinlik düzeylerinin belirleyenleri tesadüfi etki Panel Tobit modeli yardımıyla tahmin edilmiştir. Etkinliğin belirleyenlerine ilişkin Panel Tobit modelinden elde edilen bulgulara göre, borsada listelenen sigortacılık şirketlerinin listelenmeyen şirketlere göre daha az etkin oldukları, likidite ve finansal riskle etkinlik arasında negatif yönde, karlılıkla etkinlik arasında pozitif yönlü bir ilişkinin olduğu, sigortacılık şirketlerinin ölçeklerinin yetersiz olduğu, ölçeklerini arttırarak bu şirketlerin etkinliklerini artırabilecekleri, sektörde yüksek hasar-prim oranına sahip şirketlerin daha az etkin oldukları sonucuna ulaşılmıştır.
Critical Care Nurses’ Experiences of End-of-Life Care: A Qualitative Study
Authors: Utami Reni Sulung , Pujianto Ahmat , Setyawan Dody , Naviati Elsa , Rochana Nana
Published: January 2021

Background: Patients admitted to the intensive care unit (ICU) may face terminal illness situations, which may lead to death. In this case, the role of critical care nurses shifts from life-sustaining to end-of-life care (EOLC). Nurses’ involvement in EOLC varies between countries, even in one country due to differences in religion, culture, organization, laws, cases and patient quality. In Indonesia, research on EOLC in ICU has not been carried out.Purpose: This study aimed to explore the experiences of critical care nurses in providing EOLC.Methods: A qualitative study with a phenomenological approach was conducted. Ten critical care nurses having the experiences of caring for dying patients were recruited through a purposive sampling technique for in-depth interviews. Manual content analysis was used to identify themes.Results: The results of the study found five themes, including the challenge of communication with the family, support for the family, support for the patient, discussion and decision making, and nurses’ emotions. Conclusion: Most of EOLC provided by critical care nurses was focused on the family. They had some challenges in communication and decision making. Nurses need to get training and education about how to care for patients towards the end of life.
Technical and Economic Analysis of Ship Launching with Slipway and Airbag KM. Sabuk Nusantara 72 in PT. Janata Marina Indah Shipyard Semarang
Authors: Sugeng Sunarso , Ridwan Mohammad , Suharto Suharto , Khristyson Samuel Febriary
Published: January 2021

In a ship planning can not be separated from the planning of the ship launching process. A ship can glide perfectly if it has a high enough planning time and costs. The launch process itself is divided into several ways. The choice of this method needs to be considered because it relates to the budget and preparations made. The method used is the calculation according to the numerical approach assisted by computational software. In the first calculation it is planned with the slipway launch, and then the next one is planned with the airbags that have been implemented previously. The purpose of this study is to provide analysis results as a consideration in implementing the slipway and airbag ship launching method on KM ships. Belt Nusantara 72 measuring 2000 DWT. In steps 5 to 6, both the slipway and the airbags experience a stern lift condition with a value (yVd) of 1396.97 ton.  Based on the economic analysis of the hours of people using airbags, there is a decrease in working hours by 44% when compared to the launch using a slipway. This also happened to work productivity where it was 84% more time effective. When viewed from an investment point of view, the use of slipways is actually more economical than airbag, the difference is 43% more economical using slipways. Both types of launch can be applied by looking at the economical side and the ability of each shipyard in carrying out the launching process and seeing the main size of the ship to be launched.
Un-/hörbar und un-/sichtbar: Rassismuskritische Überlegungen zur universitären Lehramts(aus)bildung und den Möglichkeiten zur Anerkennung vielfältiger Perspektiven
Authors: Kasatschenko Tatjana , Zitzelsberger Olga
Published: January 2021

Der folgende Beitrag skizziert ein rassismuskritisches Bildungsprojekt zur Sensibilisierung (angehender) Pädagog*innen
und Lehrkräfte an der Institution Hochschule und die damit verbundenen theoretischen und vorausgehenden Überlegungen. Der partizipativen Projektstruktur gehen Fragen nach der Un- Hörbarkeit und Un-/Sichtbarkeit vielfältiger und oftmals marginalisierter gesellschaftlicher Positionierungen voraus. Erste Erfahrungen in Hinblick auf die Möglichkeiten, aber auch Herausforderungen geben auf mehreren Ebenen Einblicke in das erste Jahr eines Projekts im Feld pädagogischer Professionalisierung.
Efecto de un suplemento alimenticio a base de insumos naturales y componentes bioactivos de siete raíces sobre el comportamiento sexual en ratas
Authors: Zamudio Malpartida Karin , Ortega Romero Elizabeth C. , Guerra Brizuela Gustavo A. , Arroyo Acevedo Jorge L. , Condorhuamán Figueroa Martin
Published: January 2021

El presente estudio tuvo como objetivo determinar el efecto de un suplemento alimenticio a base de insumos naturales y componentes bioactivos de especies vegetales sobre el comportamiento sexual. Es una investigación experimental, prospectiva y longitudinal. Para el ensayo se utilizó 150 ratas albinas: 75 hembras y 75 machos de raza Holtzmann de 12 semanas de edad, con un peso promedio de 200 a 250 g. (machos) y de 150 – 200 g. (hembras). Se evaluaron dos productos: Uno que contenía el extracto de las raíces de siete especies vegetales a dosis de 200 y 400mg/kg y Dos que contenía el producto uno más harina de castaña y Sacha inchi a dosis de 830mg/kg. El ensayo se realizó por 10 semanas y las evaluaciones se ejecutaron a la octava, novena y décima semanas (días 1, 7 y 14 respectivamente). Asimismo, se realizó la evaluación de los parámetros bioquímicos, hematológicos, testosterona y antígeno prostático-específico (PSA). Los productos Uno a dosis de 400mg/kg y Dos a dosis de 830mg/kg presentaron efecto significativo sobre el comportamiento sexual comparados con los grupos control y el estándar (sildenafilo 5mg/kg). No se presentaron cambios a nivel bioquímico ni hematológico. Se concluye que los productos ensayados presentaron efecto sobre el comportamiento sexual aumentando la líbido en las ratas machos, sin efectos secundarios sobre los parámetros bioquímicos y hematológicos.
Habitar en movimiento
Authors: Evans Morales Franco
Published: January 2021

El artículo parte por comprender la ciudad como elemento de la vida urbana a través del espacio público y la movilidad urbana. Para ello se realiza una reflexión sobre lo producido en torno al espacio público desde el urbanismo, rescatando abordajes desde lo jurídico, la ciudadanía, el conflicto, así como sus dimensiones en lo físico-territorial, económico, político y cultural; por otro lado, se aborda a la movilidad urbana como una práctica social de viaje que conjuga necesidades y capacidades de satisfacerlos, diferenciándola del sistema de transporte. Se concluye que el espacio público como categoría analítica está en tensión constante ya que comparte lógicas de integración, conflicto, así como la difusa barrera frente a nuevas formas de concebir lo público y privado, mientras que la movilidad urbana no solo es un medio técnico de desplazamiento como el transporte, sino que prioriza las necesidades de movilidad de las personas, sus experiencias de viaje, condiciones en que se realiza, así como facilidades y dificultades sentidas.
Producción más limpia como estrategia ambiental preventiva en el proceso de elaboración de pasta de cacao. Un caso en la Amazonia Ecuatoriana
Authors: Molina-Cedeño Carla Stephany , Pillco-Herrera Briyidt Maryeli , Salazar-Muñoz Edison Fabricio , Coronel-Espinoza Billy Daniel , Sarduy-Pereira Liliana Bárbara , Diéguez-Santana Karel
Published: January 2021

Cocoa is one of the most important crops in Ecuador, destined for export to be used in making chocolate in other countries. The objective of this work was to analyze the environmental performance and the potentialities of applying cleaner production mechanisms (CP) in the Association of producers of fine aroma cocoa "Tsatsayaku". The CP tools used were the initial environmental review, ecomaps, and process analysis. The results show that mucilage and cocoa husk generation are the main environmental problems of the process. Two improvement options were proposed and evaluated to control and reduce process contamination. The analysis shows a B / C ratio of 1.38 and the Net Present Value is $ 36,001.37 with an Internal Rate of Return of 249.29%. Finally, the application of practices and technologies framed in CP systems can optimize the use of raw materials and reduce the solid and liquid contaminants generated.
Incidencia de las políticas empresariales medioambientales en la gestión de residuos sólidos en el sector construcción, Lima 2018
Authors: Mendiola Lázaro de Ortecho Alberto
Published: January 2021

Un problema de las grandes ciudades y por lo tanto de Lima, es la afectación de su medio ambiente debido a los residuos sólidos generados por las actividades constructivas. El presente estudio busca demostrar que se puede hacer una buena gestión integral de los residuos sólidos a través de la aplicación de políticas empresariales medioambientales efectivas con reglas y normas y no simple declaraciones de buena intensión. El instrumento de medición es un cuestionario plasmado en una encuesta a 86 profesionales del sector construcción en la ciudad de Lima y de cuyos resultados se han elaborado dos tipos de análisis; uno estadístico que demostró la correlación positiva considerable (incidencia) entre las dos variables y otro con aportes de los entrevistados para una buena gestión integral de los residuos sólidos en las obras.