bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic and Therapeutic Significance of Circulating Tumor Cell Phenotype Detection Based on Epithelial-Mesenchymal Transition Markers in Early and Midstage Colorectal Cancer First-Line Chemotherapy
Authors: Lu Guang , Lu Zhiwen , Li Caixia , Huang Xianping , Luo Qiang
Published: November 2021

Purpose. Epithelial-mesenchymal transition (EMT) is related to the process of metastasis and challenges the detection of circulating tumor cells (CTCs) based on epithelial cell adhesion molecules. Circulating tumor cells (CTCs) have been proven to be a prognostic indicator of colorectal cancer (CRC). Although there is evidence that CTC heterogeneity based on EMT markers is associated with disease progression, no standard recommendations have been established for clinical practice. This study is aimed at evaluating the prognostic significance of dynamic CTC detection based on EMT for early and midstage colorectal cancer patients. Methods. 101 patients with early to midterm CRC were admitted from January 2016 to September 2018. All patients underwent CRC radical surgery and standard chemotherapy. Patients in the postchemotherapy were able to epithelial mesenchymal transformed (EMT) CTC testing in peripheral blood using the CanPatrol™ system. Multiple CTC tests were performed according to patient’s own condition and different follow-up time points. Based on patient’s basic information and follow-up data, the Kaplan-Meier method was utilized to establish the progression-free survival model, and the log-rank test was utilized to compare the survival rates between the two groups. Result. Total CTC change of the patient is the best method to predict whether progression-free survival progresses in tumor patients (

Area
=
0.857

). The second detection of total number of CTCs (

P
<
0.01

) detected after chemotherapy, epithelial CTCs (

P
=
0.032

), the increased total number of CTCs (

P
<
0.01

), and the increased number of mesenchymal CTCs (

P
=
0.015

) are significantly related with patient’s poor progression-free survival. Conclusion. Analysis of the second CTC count and classification after follow-up are more related to the survival prognosis of the tumor. The joint analysis of CTC dynamic monitoring data is a good tool to judge patient’s survival prognosis.
Robust and Secure Zero-Watermarking Algorithm for Medical Images Based on Harris-SURF-DCT and Chaotic Map
Authors: Gong Cheng , Li Jingbing , Bhatti Uzair Aslam , Gong Ming , Ma Jixin , Huang Mengxing
Published: November 2021

To protect the patient information in medical images, this article proposes a robust watermarking algorithm for medical images based on Harris-SURF-DCT. First, the corners of the medical image are extracted using the Harris corner detection algorithm, and then, the previously extracted corners are described using the method of describing feature points in the SURF algorithm to generate the feature descriptor matrix. Then, the feature descriptor matrix is processed through the perceptual hash algorithm to obtain the feature vector of the medical image, which is a binary feature vector with a size of 32 bits. Secondly, to enhance the security of the watermark information, the logistic map algorithm is used to encrypt the watermark before embedding the watermark. Finally, with the help of cryptography knowledge, third party, and zero-watermarking technology, the algorithm can embed the watermark without modifying the medical image. When extracting the watermark, the algorithm can extract the watermark from the test image without the original image. In addition, the algorithm has strong robustness to conventional attacks and geometric attacks. Especially under geometric attacks, the algorithm performs better.
On the Analytical and Numerical Solutions of the One-Dimensional Nonlinear Schrodinger Equation
Authors: Farag Neveen G. A. , Eltanboly Ahmed H. , EL-Azab M. S. , Obayya S. S. A.
Published: November 2021

In this paper, four compelling numerical approaches, namely, the split-step Fourier transform (SSFT), Fourier pseudospectral method (FPSM), Crank-Nicolson method (CNM), and Hopscotch method (HSM), are exhaustively presented for solving the 1D nonlinear Schrodinger equation (NLSE). The significance of this equation is referred to its notable contribution in modeling wave propagation in a plethora of crucial real-life applications such as the fiber optics field. Although exact solutions can be obtained to solve this equation, these solutions are extremely insufficient because of their limitations to only a unique structure under some limited initial conditions. Therefore, seeking high-performance numerical techniques to manipulate this well-known equation is our fundamental purpose in this study. In this regard, extensive comparisons of the proposed numerical approaches, against the exact solution, are conducted to investigate the benefits of each of them along with their drawbacks, targeting a broad range of temporal and spatial values. Based on the obtained numerical simulations via MATLAB, we extrapolated that the SSFT invariably exhibits the topmost robust potentiality for solving this equation. However, the other suggested schemes are substantiated to be consistently accurate, but they might generate higher errors or even consume more processing time under certain conditions.
Echinacoside Upregulates Sirt1 to Suppress Endoplasmic Reticulum Stress and Inhibit Extracellular Matrix Degradation In Vitro and Ameliorates Osteoarthritis In Vivo
Authors: Lin Zhen , Teng Cheng , Ni Libin , Zhang Zhao , Lu Xinlei , Lou Junsheng , Wang Libo , Wang Yuxin , Chen Wenhao , Zhang Xiaolei , Lin Zhongke
Published: November 2021

Background. Osteoarthritis (OA) is a progressive illness that destroys cartilage. Oxidative stress is a major contributor of OA, while endoplasmic reticulum (ER) stress is the key cellular damage under oxidative stress in chondrocytes. Echinacoside (ECH) is the main extract and active substance of Cistanche, with potent antioxidative stress (OS) properties, and currently under clinical trials in China. However, its function in OA is yet to be determined. Purpose. We aimed to explore the specific role of ECH in the occurrence and development of OA and its underlying mechanism in vivo and in vitro. Methods. After the mice were anesthetized, the bilateral medial knee joint meniscus resection was performed to establish the DMM model. TBHP was used to induce oxidative stress to establish the OA model in chondrocytes in vitro. Western blot and RT‐PCR were used to evaluate the level of ER stress‐related biomarkers such as p‐PERK/PERK, GRP78, ATF4, p‐eIF2α/eIF2α, and CHOP and apoptosis‐related proteins such as BAX, Bcl‐2, and cleaved caspase‐3. Meanwhile, we used SO staining, immunofluorescence, and immunohistochemical staining to evaluate the pharmacological effects of ECH in mice in vivo. Results. We demonstrated the effectiveness of ECH in suppressing ER stress and restoring ECM metabolism in vitro. In particular, ECH was shown to suppress tert‐Butyl hydroperoxide‐ (TBHP‐) induced OS and subsequently lower the levels of p‐PERK/PERK, GRP78, ATF4, p‐eIF2α/eIF2α, and CHOP in vitro. Simultaneously, ECH reduced MMP13 and ADAMTS5 levels and promoted Aggrecan and Collagen II levels, suggesting ECM degradation suppression. Moreover, we showed that ECH mediates its cellular effects via upregulation of Sirt1. Lastly, we confirmed that ECH can protect against OA in mouse OA models. Conclusion. In summary, our findings indicate that ECH can inhibit ER stress and ECM degradation by upregulating Sirt1 in mouse chondrocytes treated with TBHP. It can also prevent OA development in vivo.
Temperature Control Technology for Construction of Jinsha River Bridge
Authors: Jin Hui-Wu , Wang Guo-An , Chen Zhan-Ming
Published: November 2021

The key problem of mass concrete temperature control is to effectively control the maximum temperature inside concrete, the temperature difference between inside and outside concrete, and the temperature difference between surface and environment. The size of the main tower cap of No. 3 Jinsha River Bridge is 37 m × 23.5 m × 5.5 m, and the cubic volume of concrete reaches 4782.3 m3, which is poured in two times. In order to ensure construction quality of mass concrete structure, prevent the large mass concrete temperature stress, through the numerical simulation of the temperature control and optimization scheme, by optimizing the mixture ratio design, reducing the temperature of concrete pouring into the mold, cooling water cycling, insulation keeping in good health and a series of measures to effectively achieve the control goal, and eliminating the temperature cracks. The measured data show that the maximum temperature inside concrete, the temperature difference between inside and outside, and the temperature difference between surface and environment are qualified, but the temperature difference control of cooling water inlet and outlet has hysteresis effect, and the temperature difference between inlet and outlet will be greater than 10°C, which should be noticed.
Structural and Functional Deficits in Patients with Poststroke Dementia: A Multimodal MRI Study
Authors: Cai Huaying , Zhao Zhiyong , Ni Linhui , Han Guocan , Hu Xingyue , Wu Dan , Ding Xianjun , Wang Jin
Published: November 2021

Although many neuroimaging studies have reported structural and functional abnormalities in the brains of patients with cognitive impairments following stroke, little is known about the pattern of such brain reorganization in poststroke dementia (PSD). The present study was aimed at investigating alterations in spontaneous brain activity and gray matter volume (GMV) in PSD patients. We collected T1-weighted and resting-state functional magnetic resonance imaging data from 20 PSD patients, 24 poststroke nondementia (PSND) patients, and 21 well-matched normal controls (NCs). We compared the differences among the groups in GMV and the fractional amplitude of low-frequency fluctuations (fALFF). Then, we evaluated the relationship between these brain measures and cognitive assessments and explored the possible distinguisher for PSD by receiver operating characteristic (ROC) curve analysis. PSD patients showed smaller GMV in the right superior temporal gyrus and lower fALFF values in the right inferior frontal gyrus than both PSND patients and NCs, but such differences were not observed between PSND patients and NCs. Moreover, GMV in the left medial prefrontal cortex showed a significant positive correlation with the Mini-Cog assessment in PSD patients, and GMV in the left CPL displayed the highest area under the ROC curve among all the features for classifying PSD versus PSND patients. Our findings suggest that PSD patients show dementia-specific structural and functional alteration patterns, which may help elucidate the pathophysiological mechanisms underlying PSD.
Quercetin Impact in Pancreatic Cancer: An Overview on Its Therapeutic Effects
Authors: Asgharian Parina , Tazehkand Abbas Pirpour , Soofiyani Saiedeh Razi , Hosseini Kamran , Martorell Miquel , Tarhriz Vahideh , Ahangari Hossein , Cruz-Martins Natália , Sharifi-Rad Javad , Almarhoon Zainab M. , Ydyrys Alibek , Nurzhanyat Ablaikhanova , Yessenbekova Arailym , Cho William C.
Published: November 2021

Pancreatic cancer (PC) is a lethal malignancy cancer, and its mortality rates have been increasing worldwide. Diagnosis of this cancer is complicated, as it does not often present symptoms, and most patients present an irremediable tumor having a 5‐year survival rate after diagnosis. Regarding treatment, many concerns have also been raised, as most tumors are found at advanced stages. At present, anticancer compounds‐rich foods have been utilized to control PC. Among such bioactive molecules, flavonoid compounds have shown excellent anticancer abilities, such as quercetin, which has been used as an adjunctive or alternative drug to PC treatment by inhibitory or stimulatory biological mechanisms including autophagy, apoptosis, cell growth reduction or inhibition, EMT, oxidative stress, and enhancing sensitivity to chemotherapy agents. The recognition that this natural product has beneficial effects on cancer treatment has boosted the researchers’ interest towards more extensive studies to use herbal medicine for anticancer purposes. In addition, due to the expensive cost and high rate of side effects of anticancer drugs, attempts have been made to use quercetin but also other flavonoids for preventing and treating PC. Based on related studies, it has been found that the quercetin compound has significant effect on cancerous cell lines as well as animal models. Therefore, it can be used as a supplementary drug to treat a variety of cancers, particularly pancreatic cancer. This review is aimed at discussing the therapeutic effects of quercetin by targeting the molecular signaling pathway and identifying antigrowth, cell proliferation, antioxidative stress, EMT, induction of apoptotic, and autophagic features.
Development of a Pressure-Sensitive Conductive Rubber Sensor for Analyzing Meniscal Injury in Porcine Models
Authors: Sezaki Shunsuke , Otsuki Shuhei , Ikeda Kuniaki , Okuno Nobuhiro , Okamoto Yoshinori , Wakama Hitoshi , Okayoshi Tomohiro , Neo Masashi
Published: November 2021

The assessment of the distribution of contact pressure on the meniscus is important in the elucidation of kinematics, etiology of joint diseases, and establishment of treatment methods. Compared with sensors widely used in recent years, pressure-sensitive conductive rubber sensors are easy to mold, flexible, durable, and resistant to shearing forces. This study is aimed at developing a rubber sensor for meniscal research and evaluating the pressure distribution after meniscal injury using porcine models. After confirming the reliability of the rubber sensor, contact pressure was obtained from the rubber sensor using the medial meniscus and femur of the porcine knee. Three test conditions of intact meniscus, radial tear, and meniscectomy were prepared, and a compressive load of 100 N was applied. After confirming the high reliability of the rubber sensor, the intact meniscus had the most uniform pressure distribution map, while the pressure in the meniscectomy model was concentrated in the resection region. The high-pressure region was significantly smaller in the intact group than in the radial tear models after 80 and 100 N (

P
<
0.05

). The rubber sensor captured the pressure concentration specific to each examination group and was useful for evaluating the relationship between the pattern of meniscal injury and changes in the biomechanical condition of the knee.
Value of Magnetic Resonance Imaging Features in Diagnosis and Treatment of Breast Cancer under Intelligent Algorithms
Authors: Liu Shuang , Tang Min , Ruan Shuqin , Wei Feng , Lu Jiaxi
Published: November 2021

This study was to analyze the clinical application value of magnetic resonance imaging (MRI) image features based on intelligent algorithms in the diagnosis and treatment of breast cancer and to provide an effective reference assessment for breast cancer diagnosis. The MRI diagnosis model (ACO-MRI) based on the ant colony algorithm (ACO) was proposed, which was compared with the diagnosis methods based on support vector machine (SVM) and proximity (KNN) algorithm, and the proposed algorithm was applied to MRI images to diagnose breast cancer. The results showed that the accuracy, sensitivity, and specificity of the ACO-MRI model were greater than those of the KNN and SVM algorithm. Moreover, the specificity was statistically considerable compared with the two algorithms of KNN and SVM (

P
<
0.05

). By comparing 1/5 number of ants and the average gray path of the ACO-MRI model under 1/8 number of ants, it was found that the average gray path value of 1/8 number of ants was greatly higher than the average gray path value of 1/5 number of ants (

P
<
0.05

). The differences in the overall distribution of breast MRI imaging features among Luminal A, Luminal B, HER-2 overexpression, and TN were compared. There were considerable differences in the overall distribution of the three breast MRI imaging features of the boundaries, morphology, and enhancement methods among the four groups (

P
<
0.05

). In short, MRI image based on the intelligent algorithm ACO-MRI diagnosis model can effectively improve the diagnosis effect of breast cancer. Its image feature boundaries, morphology, and enhancement methods had good imaging features in the diagnosis of breast cancer.
A Review of the Structural Fire Performance Testing Methods for Beam‐to‐Column Connections
Authors: Radzi Noor Azim Mohd. , Hamid Roszilah , Mutalib Azrul A. , Amrul Kaish A. B. M.
Published: November 2021

The structural fire performance tests for beam‐to‐column connections are critical in determining their fire performance at high temperatures. The current standard fire testing methods provide the procedures for establishing the fire resistance of each construction element exposed to a standard fire. However, these methods cannot verify the fire behaviour of the connections between building elements. Researchers have performed numerous fire tests on beam‐to‐column connections despite the lack of structural fire performance testing methods. This paper presents a comprehensive literature review of the structural fire performance testing methods for beam‐to‐column connections. The major areas in this review are travelling fires, development of travelling fires on beam‐to‐column connections, fire testing considerations, fire testing criteria, recent fire testing, and loading applications. This paper identifies the key issues and challenges of the structural fire performance testing methods for beam‐to‐column connections. Finally, this paper provides recommendations and discusses the way forward for structural fire performance tests on beam‐to‐column connections.
Moderate and Severe Level of Food Insecurity Is Associated with High Calorie-Dense Food Consumption of Filipino Households
Authors: Angeles-Agdeppa Imelda , Toledo Marvin B. , Zamora Jezreel Ann T.
Published: November 2021

Food insecurity is often deeply rooted in poverty. Hence, accessibility and the quality of foods consumed may affect the dietary pattern. The study aims to assess the relationship between food insecurity and dietary consumption. This investigation analyzed the data from the 2015 Updating of Nutritional Nutrition Survey. The Household Food Insecurity Access Scale (HFIAS) was used to determine household food security status and the prevalence of food insecurity. Food weighing, food inventory, and food recall were the methods used to collect food consumption data of sampled households. The study revealed poor nutrient quality and a greater likelihood of inadequacy of nutrients among moderate and severe food insecure households. Mild, moderate, and severe levels of food insecurity were found to affect 12%, 32%, and 22% of the population, respectively. The test showed that both moderate and severe food insecure families have significantly lower mean consumption of meat, milk, and fats and oils in contrast to food secure households. In comparison with food secure households, moderate and severe food insecure households consume higher amounts of cereals and cereal products, rice, and vegetables. Moderate and severe food insecure households have higher consumption of total carbohydrates but have significantly lower average intake of vitamin A, riboflavin, niacin, and total fat related to food stable households. Moreover, the results of the multiple logistic regression revealed that food insecure households have a higher likelihood to be deficient in energy, protein, calcium, vitamin A, thiamin, riboflavin, niacin, and vitamin C intakes, but except for iron (

p

value <0.05). Indeed, household food insecurity was associated with the higher consumption of calorie-dense food among Filipino households. This explains a lower nutrient quality and a higher likelihood of inadequacy of nutrients among moderate and severe food insecure households.
Molecular Mechanism of Gas Anesthetics on the Invasion, Metastasis, and Chemosensitivity of Osteosarcoma Cells
Authors: Zhao Qian , Yan Jianyong , Li Wen , Yang Ye , You Lu , Qin Chenguang
Published: November 2021

Background. Osteosarcoma is one of the most prominent bone cancers which has a predominant occurrence in children and adolescents. This study is focused on determining the effects of treatment of gas anesthetics on invasion, metastasis, and chemosensitivity in the progression of osteosarcoma cells. Material and Methods. The biological effects of the common gas anesthetics—desflurane, isoflurane, and sevoflurane—on osteosarcoma cells were studied and compared. The biological assays were performed for analysis of cell migration and proliferation. Results. Isoflurane and sevoflurane have shown significant inhibition in the osteosarcoma cells at clinically relevant concentrations. Desflurane has shown less potent action on cell migration and inhibition. All three gas anesthetics have shown inhibition in cell proliferation. The effective antiproliferative action was at a clinically significant dose. At low millimolar concentrations, cell apoptosis was moderately affected. Drug combination analysis with chemotherapeutic drugs showed relevant inhibition in cell migration. All three agents showed significant augmentation of chemotherapeutic drugs in suppression and inhibition of inducing apoptosis. The antimigration action is likely to affect the PI3K/AKT pathway and IGF-1. Conclusion. The study demonstrates the proposed mechanisms of gas anesthetics and their differential effects on osteosarcoma cells and their survival, migration, growth, and chemosensitivity.
Transient Pressure Behavior of Complex Fracture Networks in Unconventional Reservoirs
Authors: Feifei Gou , Chuanxi Liu , Zongxiao Ren , Zhan Qu , Sukai Wang , Xuejie Qin , Wenchao Fang , Ping Wang , Xinzhu Wang
Published: November 2021

Unconventional resources have been successfully exploited with technological advancements in horizontal-drilling and multistage hydraulic-fracturing, especially in North America. Due to preexisting natural fractures and the presence of stress isotropy, several complex fracture networks can be generated during fracturing operations in unconventional reservoirs. Using the DVS method, a semianalytical model was created to analyze the transient pressure behavior of a complex fracture network in which hydraulic and natural fractures interconnect with inclined angles. In this model, the complex fracture network can be divided into a proper number of segments. With this approach, we are able to focus on a detailed description of the network properties, such as the complex geometry and varying conductivity of the fracture. The accuracy of the new model was demonstrated by ECLIPSE. Using this method, we defined six flow patterns: linear flow, fracture interference flow, transitional flow, biradial flow, pseudoradial flow, and boundary response flow. A sensitivity analysis was conducted to analyze each of these flow regimes. This work provides a useful tool for reservoir engineers for fracture designing as well as estimating the performance of a complex fracture network.
The Numerical Analysis for Parametric Resonance of Multicable System considering Interaction between Adjacent Beam Portions
Authors: Chen Kefan , He Shuanhai , Song Yifan , Wu Linming , Wang Kang , Zhang Hanhao
Published: November 2021

The investigation aims to propose a refined model to analyze the parametric resonance under multicable systems such as cable‐stayed bridges. Considering the interaction between the adjacent beam portions, the shear difference is applied to modify the vibration equations derived from the multi‐degree‐of‐freedom stiffness method. Furthermore, the difference method is adopted to make the equations more accessible for numerical analysis. The comparison results indicate that the refined model exhibits the key character of parametric resonance and also further verified the simulation methods. The consequences show that the cable will resonate at the fundamental frequency under the support excitation. In particular, when resonance occurs, most of the energy in the subsystem is transferred to the cable, resulting in the resonance amplitude of the beam portion being weakened to some certain extent. Moreover, the global resonance will have a sufficient excitation on the local resonance only when the resonance condition is satisfied.
Bioinformatic Analysis of Immune Significance of RYR2 Mutation in Breast Cancer
Authors: Xu Zhiquan , Xiang Ling , Wang Rong , Xiong Yongfu , Zhou He , Gu Haitao , Wang Jijian , Peng Linglong
Published: November 2021

Background. Currently, immunotherapy is widely used for breast cancer (BC) patients, and tumor mutation burden (TMB) is regarded as a valuable independent predictor of response to immunotherapy. However, specific gene mutations and their relationship with TMB and tumor‐infiltrating immune cells in BC are not fully understood. Methods. Comprehensive bioinformatic analyses were performed using data from The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) datasets. Survival curves were analyzed via Kaplan‐Meier analysis. Univariate and multivariate Cox regression analyses were used for prognosis analysis. Gene set enrichment analysis (GSEA) was performed to explore regulatory mechanisms and functions. The CIBERSORT algorithm was used to calculate the tumor‐infiltrating immune cell fractions. Results. We analyzed somatic mutation data of BC from TCGA and ICGC datasets and found that 19 frequently mutated genes were reported in both cohorts, namely, SPTA1, TTN, MUC17, MAP3K1, CDH1, FAT3, SYNE1, FLG, HMCN1, RYR2 (ryanodine receptor 2), GATA3, MUC4, PIK3CA, KMT2C, TP53, PTEN, ZFHX4, MUC16, and USH2A. Among them, we observed that RYR2 mutation was significantly associated with higher TMB and better clinical prognosis. Moreover, GSEA revealed that RYR2 mutation‐enriched signaling pathways were related to immune‐associated pathways. Furthermore, based on the CIBERSORT algorithm, we found that RYR2 mutation enhanced the antitumor immune response by enriching CD8+ T cells, activated memory CD4+ T cells, and M1 macrophages. Conclusion. RYR2 is frequently mutated in BC, and its mutation is related to increased TMB and promotes antitumor immunity; thus, RYR2 may serve as a valuable biomarker to predict the immune response.
The Promise for Reducing Healthcare Cost with Predictive Model: An Analysis with Quantized Evaluation Metric on Readmission
Authors: Teo Kareen , Yong Ching Wai , Muhamad Farina , Mohafez Hamidreza , Hasikin Khairunnisa , Xia Kaijian , Qian Pengjiang , Dhanalakshmi Samiappan , Priya Utama Nugraha , Lai Khin Wee
Published: November 2021

Quality of care data has gained transparency captured through various measurements and reporting. Readmission measure is especially related to unfavorable patient outcomes that directly bends the curve of healthcare cost. Under the Hospital Readmission Reduction Program, payments to hospitals were reduced for those with excessive 30-day rehospitalization rates. These penalties have intensified efforts from hospital stakeholders to implement strategies to reduce readmission rates. One of the key strategies is the deployment of predictive analytics stratified by patient population. The recent research in readmission model is focused on making its prediction more accurate. As cost-saving improvements through artificial intelligent-based health solutions are expected, the broad economic impact of such digital tool remains unknown. Meanwhile, reducing readmission rate is associated with increased operating expenses due to targeted interventions. The increase in operating margin can surpass native readmission cost. In this paper, we propose a quantized evaluation metric to provide a methodological mean in assessing whether a predictive model represents cost-effective way of delivering healthcare. Herein, we evaluate the impact machine learning has had on transitional care and readmission with proposed metric. The final model was estimated to produce net healthcare savings at over $1 million given a 50% rate of successfully preventing a readmission.
RPA and Artificial Intelligence in Budget Management Based on Multiperspective Recognition Based on Network Communication Integration
Authors: Luo Haiying , Luo Haichang
Published: November 2021

Nowadays, RPA robots are increasingly used in daily office tasks such as finance and human resources. They play an increasingly important role in realizing office automation, which can improve work efficiency and reduce labor costs. In order to improve the efficiency of budget management and save human resources, this paper conducts related research based on the multiview recognition technology of network communication integration, combined with RPA in artificial intelligence technology. In the method part, this article introduces the mode of network communication integration and the principles that should be followed, as well as the related processes of RPA. In the algorithm, this paper introduces an integrated algorithm based on ELM. In the experimental part, this article predicts the performance of each model, compares identification functions with different signal‐to‐voice signals, and compares timing functions on different signal‐to‐voice signals, periodic transmission mode indicators, recognition rates of different kernel functions, and comparison of average recognition rates and multiview recognition rate comprehensive analysis of these multiple aspects. Under the same conditions, the recognition rate of some angles is lower than other angles; 0 degrees, 18 degrees, 126 degrees, and 180 degrees are slightly lower than other angles, which will affect the average recognition rate of the entire recognition. But for multiview gait features, considering the influence of each angle on the recognition rate, the characteristics of each angle are merged together, so that the recognition rate is significantly higher than the average recognition rate of 11 angles. It can be seen that multiview recognition based on network communication integration does have obvious effects on RPA and artificial intelligence in budget management and can improve the efficiency of budget management. The multiperspective recognition technology designed in this study can realize modernization and digitization in budget management.
Exploring Coupling Relationship between Urban Connection and High‐quality Development Using the Case of Lanzhou‐Xining Urban Agglomeration
Authors: Yin Junfeng , Liu Haimeng , Shi Peiji , Zhang Weiping
Published: November 2021

Based on socioeconomic statistical data, transport data, and network big data, the urban connection index (UCI) was constructed in terms of industry, transportation, information, and innovation, and the high‐quality development index (HDI) was established from five aspects: innovation, coordination, green development, openness, and sharing. Taking Lanzhou‐Xining urban agglomeration as a case, the urban connection intensity and high‐quality development level were measured to analyze the relationship between them. From 2012 to 2018, the UCI and HDI of each city showed different degrees of growth. Note that there exist significant regional differences, with Lanzhou and Xining having the largest difference. The biggest gap among cities lies in the innovative connection intensity. Moreover, urban external connections are closely related to high‐quality development, especially innovation and green development. For every 1% increase in industrial and transport connection, the HDI will increase by 0.317% and 0.159%, respectively. This study provides a methodological reference for measuring urban connectivity and provides decision support for high‐quality development in China and other countries.
Immunosuppressive Therapy in Primary Membranous Nephropathy with Compromised Renal Function
Authors: Ramachandran Raja , Prabakaran Rudreshwar , Priya Gnana , Nayak Saurabh , Kumar Pankaj , Kumar Ashwani , Kumar Vinod , Agrawal Neha , Rathi Manish , Kohli Harbir Singh , Nada Ritambhra
Published: November 2021

Introduction: Renal dysfunction at presentation is uncommon in primary membranous nephropathy (PMN). The data on the outcome of PMN patients with renal dysfunction at outset are scarce. The objective of the current study was to report the clinical outcomes of PMN patients with renal dysfunction. Material and Methods: This prospective longitudinal observational study included PMN patients (both incident and treatment resistant) with an estimated glomerular filtration rate of <60 mL/min/1.73 m2. Immunosuppressive treatment was as per the unit’s protocol. Patients were evaluated for proteinuria, creatinine, and serum albumin at monthly intervals for 6 months, then quarterly for a year, and then biannually. Both serum and tissue anti-PLA2R were performed at baseline. Outcome: Percentage of patients achieving clinical remission. Results: Sixty-four adults met study criteria and were analysed. The median (IQR) age of the patients was 48 (40, 56) years. PMN was PLA2R related in 52 (81.3%) patients. Twenty-eight (43.8%) and 30 (46.9%) patients were in remission at 12 months and at the end of the study [median (IQR) follow up: 24 months (12, 35)], respectively. Eight (12.5%) had progressed to end-stage renal disease at the last follow-up. Median (IQR) baseline anti-PLA2R titre was 150.1 RU/mL (38.5, 308). Nineteen (61.3%) and 18 (58.1%) patients with >90% reduction in anti-PLA2R titres at 12 months were in clinical remission at 12 months and at the end of the follow-up, respectively. Both cyclical cyclophosphamide/steroids (cCYC/GC) and rituximab were equally effective in inducing remission, but rituximab had a favourable adverse event profile compared to cCYC/GC. Conclusion: To conclude, both cCYC/GC and rituximab are equally effective in inducing remission of nephrotic state with compromised renal function due to PMN. Immunosuppression induces remission in up to 50% PMN patients with CKD-stage 3–4.
Severity Assessment of Complex and Repeated Intracranial Surgery in Rats
Authors: Riedesel Ann-Kristin , Helgers Simeon O.A. , Abdulbaki Arif , Hatipoglu Majernik Gökce , Alam Mesbah , Krauss Joachim K. , Schwabe Kerstin
Published: November 2021

Introduction: Evidence-based grading of the impact of intracranial surgery on rat’s well-being is important for ethical and legal reasons. We assessed the severity of complex and repeated intracranial surgery in a 6-hydroxydopamine (6-OHDA) Parkinson’s rat model with subsequent intracranial electrode implantation and in an intracranial tumor model with subsequent resection. Methods: Stereotactic surgery was performed in adult male rats with the same general anesthesia and perioperative pain management. In Parkinson’s model, Sprague Dawley rats received unilateral injection of 6-OHDA (n = 11) or vehicle (n = 7) into the medial forebrain bundle as first operation (1st OP). After four weeks, neural electrodes were implanted in all rats as second operation (2nd OP). For tumor formation, BDIX/UlmHanZtm rats (n = 8) received frontocortical injection of BT4Ca cells as 1st OP, followed by tumor resection as 2nd OP after one week. Multiple measures severity assessment was done two days before and four days after surgery in all rats, comprising clinical scoring, body weight, and detailed behavioral screening. To include a condition with a known burden, rats with intracranial tumors were additionally assessed up to a predefined humane endpoint that has previously been classified as “moderate”. Results: After the 1st OP, only 6-OHDA injection resulted in transient elevated clinical scores, a mild long-lasting weight reduction, and motor disturbances. After the second surgery, body weight was transiently reduced in all groups. All other parameters showed variable results. Principal component analysis showed a separation from the preoperative state driven by motor-related parameters after 6-OHDA injection, while separation after electrode implantation and more clearly after tumor resection was driven by pain-related parameters, although not reaching the level of the humane endpoint of our tumor model. Conclusion: Overall, cranial surgery of different complexity only transiently and rather mildly affects rat’s well-being. Multiple measures assessment allows the differentiation of model-related motor disturbances in Parkinson’s model from potentially pain-related conditions after tumor resection and electrode implantation.
Coronary Endothelium‐Dependent Vasomotor Function After Drug‐Eluting Stent and Bioresorbable Scaffold Implantation
Authors: Gomez‐Lara Josep , Oyarzabal Loreto , Ortega‐Paz Luis , Brugaletta Salvatore , Romaguera Rafael , Salvatella Neus , Roura Gerard , Rivero Fernando , Fuentes Lara , Alfonso Fernando , Otaegui Imanol , Vandeloo Bert , Vaquerizo Beatriz , Sabate Manel , Comin‐Colet Josep , Gomez‐Hospital Joan‐Antoni
Published: November 2021

Background

Early generation drug‐eluting stents (DESs) showed a high grade of coronary endothelial dysfunction that was attributed to lack of stent reendothelialization. Endothelium‐dependent vasomotor response of current DESs and bioresorbable scaffolds (BRSs) remains unknown. This study sought to assess the device‐related endothelial function of current devices and to correlate neointima healing with endothelial function.

Methods and Results

A total of 206 patients from 4 randomized trials treated with the durable‐polymer everolimus‐eluting Xience (n=44), bioresorbable‐polymer sirolimus‐eluting Orsiro (n=35), polymer‐free biolimus‐eluting Biofreedom (n=24), bioactive endothelial‐progenitor cell‐capturing sirolimus‐eluting Combo DES (n=25), polymer‐based everolimus‐eluting Absorb (n=44), and Mg‐based sirolimus‐eluting Magmaris BRS (n=34) underwent endothelium‐dependent vasomotor tests and optical coherence tomography imaging, as per protocol, at follow‐up. Crude vasomotor responses of distal segments to low‐dose acetylcholine (10
−6
 mol/L) were different between groups: bioresorbablepolymer DEShad the worst (−8.4%±12.6%) and durable‐polymer DES had the most physiologic (−0.4%±11.8%;
P
=0.014). High‐dose acetylcholine (10
−4
 mol/L) showed similar responses between groups (ranging from −10.8%±11.6% to −18.1%±15.4%;
P
=0.229). Device healing was different between devices. Uncovered struts ranged from 6.3%±7.1% (bioresorbable‐polymer DES) to 2.5%±4.5% (bioactive DES;
P
=0.056). In multivariate models, endothelium‐dependent vasomotor response was associated with age, bioresorbable‐polymer DES, and angiographic lumen loss, but not with strut coverage nor plaque type. Endothelial dysfunction (defined as ≥4% vasoconstriction) was observed in 46.6% of patients with low‐dose and 68.9% with high‐dose acetylcholine, without differences between groups.

Conclusions

At follow‐up, endothelial dysfunction was frequently observed in distal segments treated with current stents without remarkable differences between devices. Although neointima healing was different between devices, poor healing was not associated with endothelial dysfunction.
Incidence of Infective Endocarditis Among Patients With Tetralogy of Fallot
Authors: Havers‐Borgersen Eva , Butt Jawad H. , Smerup Morten , Gislason Gunnar H. , Torp‐Pedersen Christian , Gröning Mathis , Schmidt Michael Rahbek , Søndergaard Lars , Køber Lars , Fosbøl Emil L.
Published: November 2021

Background

Patients with tetralogy of Fallot (ToF) are considered at high risk of infective endocarditis (IE) as a result of altered hemodynamics and multiple invasive procedures, including pulmonary valve replacement (PVR). Data on the long‐term risk of IE are sparse.

Methods and Results

In this observational cohort study, all patients with ToF born from 1977 to 2018 were identified using Danish nationwide registries and followed from date of birth until occurrence of first‐time IE, emigration, death, or end of study (December 31, 2018). The comparative risk of IE among patients with ToF versus age‐ and sex‐matched controls from the background population was assessed. Because of rules on anonymity, exact numbers cannot be reported if the number of patients is <4. A total of 1164 patients with ToF were identified and matched with 4656 controls. Among patients with ToF, 851 (73.1%) underwent early surgical intracardiac repair and 276 (23.7%) underwent PVR during follow‐up. During a median follow‐up of 20.3 years, 41 (3.5%) patients with ToF (comprising 24 [8.7%] with PVR and 17 [1.9%] without PVR) and <4 (<0.8%) controls were admitted with IE. The incidence rates of IE per 10 000 person‐years were 22.4 (95% CI, 16.5–30.4) and 0.1 (95% CI, 0.01–0.7) among patients and controls, respectively. Moreover, PVR was associated with a further increased incidence of IE among patients with ToF (incidence rates per 10 000 person‐years with and without PVR were 46.7 [95% CI, 25.1–86.6] and 2.8 [95% CI 2.0–4.0], respectively).

Conclusions

Patients with ToF are associated with a substantially higher incidence of IE than the background population. In particular, PVR was associated with an increased incidence of IE. With an increasing life expectancy of these patients, intensified awareness, preventive measures, and surveillance of this patient group are decisive.
Lack of Association Between Neurohormonal Blockade and Survival in Transthyretin Cardiac Amyloidosis
Authors: Cheng Richard K. , Vasbinder Alexi , Levy Wayne C. , Goyal Parag , Griffin Jan M. , Leedy Douglas J. , Maurer Mathew S.
Published: November 2021

Background

Despite the belief that heart failure therapies are not effective in transthyretin cardiac amyloidosis, data are limited. We tested the association of neurohormonal blockade use with survival.

Methods and Results

A total of 309 consecutive patients with transthyretin cardiac amyloidosis were identified. Medication inventory was obtained at baseline and subsequent visits. Exposure included a neurohormonal blockade class (β‐blocker [βB], angiotensin‐converting enzyme inhibitor/angiotensin receptor blocker, and mineralocorticoid antagonist) at baseline and subsequent visits. βB was modeled as baseline use, time‐varying use, and in an inverse probability treatment weighted model. Primary outcome was all‐cause mortality analyzed with adjusted Cox proportional hazards models. Continuing compared with stopping βB during follow‐up was tested. Mean age was 73.2 years, 84.1% were men, and 17.2% had atrial fibrillation/flutter at baseline. At the time of study entry, 49.8% were on βBs, 35.0% were on angiotensin‐converting enzyme inhibitors/angiotensin receptor blockers, and 23.9% were on mineralocorticoid antagonists. For the total cohort, there was a trend toward harm in the unadjusted model for baseline βB use, but this was neutral after adjustment. When βB use was analyzed as a time‐varying exposure, there was no association with mortality. βB discontinuation was associated with decreased mortality for the total cohort. Findings were consistent in inverse probability treatment weighted models. For angiotensin‐converting enzyme inhibitor/angiotensin receptor blocker or mineralocorticoid antagonist use, there was no association with mortality after adjustment for the total cohort.

Conclusions

There was no association of neurohormonal blockade use with survival in transthyretin cardiac amyloidosis. For the total cohort, deprescribing βB may be associated with improved survival. Additional studies are needed to confirm these findings.
Enhanced Thrombotic Responses Are Associated With Striatin Deficiency and Aldosterone
Authors: Gromotowicz‐Poplawska Anna , Flaumenhaft Robert , Gholami Shadi K. , Merrill‐Skoloff Glenn , Chabielska Ewa , Williams Gordon H. , Romero Jose R.
Published: November 2021

Background

In addition to its role on blood pressure, aldosterone (ALDO) also affects the hemostatic system leading to increased experimental thrombosis. Striatin is an intermediate in the rapid, nongenomic actions of ALDO. Striatin heterozygote knockout (
Strn

+/‐

) mice have salt sensitivity of blood pressure and mildly chronically increased ALDO levels. In addition, in humans, striatin polymorphic gene variants are associated with increased salt sensitivity of blood pressure. Thus, we hypothesized that striatin deficiency would be associated with an increased prothrombotic response.

Methods and Results

Strn
+/ ‐

mice and wild‐type littermates were maintained on a liberal sodium diet (1.6%). We measured in vivo thrombus formation following laser‐induced injury in cremaster arterioles using intravital microscopy. Mice were randomized to intravenous administration of ALDO or its vehicle. Acutely, ALDO increased thrombotic responses in wild‐type mice (
P
<0.01) versus controls within minutes as determined by increased platelet accumulation and fibrin deposition at the site of laser injury. We then compared thrombus formation without ALDO administration in

Strn
+/‐

and wild‐type mice.

Strn
+/‐

mice showed highly significant increases in laser‐induced thrombosis (
P
<0.001), as shown by increased platelet accumulation and fibrin deposition. Interestingly, the response in the

Strn
+/‐

mice basally was far greater than the wild‐type mice with ALDO administration, and ALDO administration produced no additional effect on thrombus responses in

Strn
+/‐

mice.

Conclusions

These results demonstrate a novel protective role of striatin in experimental thrombosis. Such a protective effect may be reduced in human striatin risk allele carriers, given the similar salt sensitivity of blood pressure in these individuals and

Strn
+/‐

mice.
Nursing’s Role in Successful Stroke Care Transitions Across the Continuum: From Acute Care Into the Community
Authors: Camicia Michelle , Lutz Barbara , Summers Debbie , Klassman Lynn , Vaughn Stephanie
Published: November 2021

Facilitating successful care transitions across settings is a key nursing competency. Although we have achieved improvements in acute stroke care, similar advances in stroke care transitions in the postacute and return to community phases have lagged far behind. In the current delivery system, care transitions are often ineffective and inefficient resulting in unmet needs and high rates of unnecessary complications and avoidable hospital readmissions. Nurses must use evidence-based approaches to prepare stroke survivors and their family caregivers for postdischarge self-management, rehabilitation, and recovery. The purpose of this article is to provide evidence on the important nursing roles in stroke care and transition management across the care continuum, discuss cross-setting issues in stroke care, and provide recommendations to leverage nursing’s impact in optimizing outcomes for stroke survivors and their family unit across the continuum. To optimize nursing’s influence in facilitating safe, effective, and efficient care transitions for stroke survivors and their family caregivers across the continuum we have the following recommendations (1) establish a system of coordinated and seamless comprehensive stroke care across the continuum and into the community; (2) implement a stroke nurse liaison role that provides consultant case management for the episode of care across all settings/services for improved consistency, communication and follow-up care; (3) implement a validated caregiver assessment tool to systematically assess gaps in caregiver preparedness and develop a tailored caregiver/family care plan that can be implemented to improve caregiver preparedness; (4) use evidence-based teaching and communication methods to optimize stroke survivor/caregiver learning; and (5) use technology to advance stroke nursing care. Nurses must leverage their substantial influence over the health care delivery system to achieve these improvements in stroke care delivery to improve the health and lives of stroke survivors and their families.