bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and validation of a novel nomogram to predict aneurysm rupture in patients with multiple intracranial aneurysms: a multicentre retrospective study
Authors: Feng Xin , Tong Xin , Peng Fei , Niu Hao , Qi Peng , Lu Jun , Zhao Yang , Jin Weitao , Wu Zhongxue , Zhao Yuanli , Liu Aihua , Wang Daming
Published: February 2021

Background and purpose

Approximately 15%–45% of patients with unruptured intracranial aneurysms have multiple intracranial aneurysms (MIAs). Determining which one is most likely to rupture is extremely important for treatment decision making for MIAs patients. This study aimed to develop and validate a nomogram to evaluate the per-aneurysm rupture risk of MIAs patients.

Methods

A total of 1671 IAs from 700 patients with MIAs were randomly dichotomised into derivation and validation sets. Multivariate logistic regression analysis was used to select predictors and construct a nomogram model for aneurysm rupture risk assessment in the derivation set. The discriminative accuracy, calibration performance and clinical usefulness of this nomogram were assessed. We also developed a multivariate model for a subgroup of 158 subarachnoid haemorrhage (SAH) patients and compared its performance with the nomogram model.

Results

Multivariate analyses identified seven variables that were significantly associated with IA rupture (history of SAH, alcohol consumption, female sex, aspect ratio >1.5, posterior circulation, irregular shape and bifurcation location). The clinical and morphological-based MIAs (CMB-MIAs) nomogram model showed good calibration and discrimination (derivation set: area under the curve (AUC)=0.740 validation set: AUC=0.772). Decision curve analysis demonstrated that the nomogram was clinically useful. Compared with the nomogram model, the AUC of multivariate model developed from SAH patients had lower value of 0.730.

Conclusions

This CMB-MIAs nomogram for MIAs rupture risk is the first to be developed and validated in a large multi-institutional cohort. This nomogram could be used in decision-making and risk stratification in MIAs patients.
Zero-Avoiding Transducers, Length Separable Relations, and the Rational Asymmetric Partition Problem
Authors: Konstantinidis Stavros , Mastnak Mitja , Šebej Juraj
Published: February 2021

We consider the problem of partitioning effectively a given irreflexive (and possibly symmetric) rational relation [Formula: see text] into two asymmetric rational relations. This problem is motivated by a recent method of embedding an [Formula: see text]-independent language into one that is maximal [Formula: see text]-independent, where the method requires to use an asymmetric partition of [Formula: see text]. We solve the problem when [Formula: see text] is length-separable, which means that the following two subsets of [Formula: see text] are rational: the subset of word pairs [Formula: see text] where [Formula: see text]; and the subset of word pairs [Formula: see text] where [Formula: see text]. This property is satisfied by all recognizable, all left synchronous, and all right synchronous relations. We leave it as an open problem when [Formula: see text] is not length-separable. We also define zero-avoiding transducers for length-separable relations, which makes our partitioning solution constructive.
Phase space analysis of the Umami Chaplygin model
Authors: Huang Qihong , Zhang Ruanjing , Chen Jun , Huang He , Tu Feiquan
Published: February 2021

In this paper, we analyze the universe evolution and phase space behavior of the Umami Chaplygin model, where the Umami Chaplygin fluid replaces both a dark energy and a dark and baryonic matter. We find the Umami Chaplygin model can be stable against perturbations under some conditions and can be used to explain the late-time cosmic acceleration. The results of phase space analysis show that there exists a late-time accelerated expansion attractor with [Formula: see text], which indicates the Umami Chaplygin fluid can behave as a cosmological constant. Moreover, the Umami Chaplygin model can describe the expansion history of the universe. The evolutionary trajectories of the statefinder diagnostic pairs and the finite time future singularities are also discussed.
On the gauge transformation for the rotation of the singular string in the Dirac monopole theory
Authors: Pan Xiao-Yin , Chen Yin , Li Yu-Qi , Kogan Aaron G. , Wu Juhao
Published: February 2021

In the Dirac theory of the quantum-mechanical interaction of a magnetic monopole and an electric charge, the vector potential is singular from the origin to infinity along a certain direction — the so-called Dirac string. Imposing the famous quantization condition, the singular string attached to the monopole can be rotated arbitrarily by a gauge transformation, and hence is not physically observable. By deriving its analytical expression and analyzing its properties, we show that the gauge function [Formula: see text] which rotates the string to another one is a smooth function everywhere in space, except their respective strings. On the strings, [Formula: see text] is a multi-valued function. Consequently, some misunderstandings in the literature are clarified.
The generalized Klein–Gordon oscillator with position-dependent mass in a particular Gödel-type space–time
Authors: Yang Yi , Long Zheng-Wen , Ran Qi-Kang , Chen Hao , Zhao Zi-Long , Long Chao-Yun
Published: February 2021

The relativistic quantum dynamics of the generalized Klein–Gordon (KG) oscillator having position-dependent mass in the Gödel-type space–time is investigated. We have presented the generalized KG oscillator in this space–time, and discussed the effect of Cornell potential and linear potential for our considered system. The modification from the parameters of position-dependent mass and characterizing the space–time for the energy spectrums are presented.
A General Framework to Detect Design Patterns by Combining Static and Dynamic Analysis Techniques
Authors: Liu Cong
Published: February 2021

Design pattern detection can provide useful insights to support software comprehension. Accurate and complete detection of pattern instances are extremely important to enable software usability improvements. However, existing design pattern detection approaches and tools suffer from the following problems: incomplete description of design pattern instances, inaccurate behavioral constraint checking, and inability to support novel design patterns. This paper presents a general framework to detect design patterns while solving these issues by combining static and dynamic analysis techniques. The framework has been instantiated for typical behavioral and creational patterns, such as the observer pattern, state pattern, strategy pattern, and singleton pattern to demonstrate the applicability. Based on the open-source process mining toolkit ProM, we have developed an integrated tool that supports the whole detection process for these patterns. We applied and evaluated the framework using software execution data containing around 1,000,000 method calls generated from eight synthetic software systems and three open-source software systems. The evaluation results show that our approach can guarantee a higher precision and recall than existing approaches and can distinguish state and strategy patterns that are indistinguishable by the state-of-the-art.
Improved Entity Linking for Simple Question Answering Over Knowledge Graph
Authors: Chen Kai , Shen Guohua , Huang Zhiqiu , Wang Haijuan
Published: February 2021

Question Answering systems over Knowledge Graphs (KG) answer natural language questions using facts contained in a knowledge graph, and Simple Question Answering over Knowledge Graphs (KG-SimpleQA) means that the question can be answered by a single fact. Entity linking, which is a core component of KG-SimpleQA, detects the entities mentioned in questions, and links them to the actual entity in KG. However, traditional methods ignore some information of entities, especially entity types, which leads to the emergence of entity ambiguity problem. Besides, entity linking suffers from out-of-vocabulary (OOV) problem due to the limitation of pre-trained word embeddings. To address these problems, we encode questions in a novel way and encode the features contained in the entities in a multilevel way. To evaluate the enhancement of the whole KG-SimpleQA brought by our improved entity linking, we utilize a relatively simple approach for relation prediction. Besides, to reduce the impact of losing the feature during the encoding procedure, we utilize a ranking algorithm to re-rank (entity, relation) pairs. According to the experimental results, our method for entity linking achieves an accuracy of 81.8% that beats the state-of-the-art methods, and our improved entity linking brings a boost of 5.6% for the whole KG-SimpleQA.
Constructing Bug Knowledge Graph as a Service for Bug Search
Authors: Chen Ying
Published: February 2021

When encountering bug issues, developers tend to search the bug repository and commit repository for references. However, the links between bug reports and commits in version control systems are often missed, and the information in bug repository and commit repository can provide is simple. When developers search a bug issue, they can only get the information of bug reports or commits, which are loose and difficult for developers to refer. What’s more, many searching results are not accurate. To deal with these problems, this paper proposes an approach to deal with the bug and commit information with the topic model, and construct bug knowledge graph as a service to assist in bug search. In addition, as the amount of bug related information continuously increase, it is time-consuming to update the data. We can automatically update the bug knowledge graph with the LTM topic model (a lifelong topic model). Finally, the experiment with the bug reports from Bugzilla@Mozilla and the corresponding commits from Github was conducted. The experiment results show that our approach is effective and efficient to help developers search relevant bugs for reference by constructing the bug knowledge as a service.
Data-Driven Persona Retrospective Based on Persona Significance Index in B-to-B Software Development
Authors: Watanabe Yasuhiro , Washizaki Hironori , Fukazawa Yoshiaki , Honda Kiyoshi , Taga Masahiro , Matsuzaki Akira , Suzuki Takayoshi
Published: February 2021

Business-to-Business (B-to-B) software development companies develop services to satisfy their customers’ requirements. Developers should prioritize customer satisfaction because customers greatly influence agile software development. However, satisfying current customer’s requirements may not fulfill actual users or future customers’ requirements because customers’ requirements are not always derived from actual users. To reconcile these differences, developers should identify conflicts in their strategic plan. This plan should consider current commitments to end users and their intentions as well as employ a data-driven approach to adapt to rapid market changes. A persona models an end user representation in human-centered design. Although previous works have applied personas to software development and proposed data-driven software engineering frameworks with gap analysis between the effectiveness of commitments and expectations, the significance of developers’ commitment and quantitative decision-making are not considered. Developers often do not achieve their business goal due to conflicts. Hence, the target of commitments should be validated. To address these issues, we propose Data-Driven Persona Retrospective (DDR) to help developers plan future releases. DDR, which includes the Persona Significance Index (PerSI) to reflect developers’ commitments to end users’ personas, helps developers identify a gap between developers’ commitments to personas and expectations. In addition, DDR identifies release situations with conflicts based on PerSI. Specifically, we define four release cases, which include different situations and issues, and provide a method to determine the release case based on PerSI. Then we validate the release cases and their determinations through a case study involving a Japanese cloud application and discuss the effectiveness of DDR.
A Convex Cover for Closed Unit Curves has Area at Least 0.0975
Authors: Grechuk Bogdan , Som-am Sittichoke
Published: February 2021

We combine geometric methods with a numerical box search algorithm to show that the minimal area of a convex set in the plane which can cover every closed plane curve of unit length is at least [Formula: see text]. This improves the best previous lower bound of [Formula: see text]. In fact, we show that the minimal area of the convex hull of circle, equilateral triangle, and rectangle of perimeter [Formula: see text] is between [Formula: see text] and [Formula: see text].
SURFACE PHASE DIAGRAMS OF SEMI-INFINITE FERRIMAGNETIC SYSTEM
Authors: ZOUHAIR SAIDA , MONKADE MOHAMED , EL ANTARI ABDELMOUMEN , EL BOUZIANI MOHAMMED , HACHEM NABIL , MADANI MOHAMED
Published: February 2021

The three-dimensional semi-infinite mixed spin-1/2 and spin-3/2 ferrimagnetic Ising system with crystal field is investigated using the mean-field approximation and the Monte Carlo simulation. According to the ratio [Formula: see text] of bulk and surface exchange interactions and the ratio [Formula: see text] of bulk and surface crystal fields, we have classified four qualitative types of phase diagrams characterized by the presence or absence of ordinary, extraordinary, surface and special phase transitions. The critical behavior of the surface and bulk magnetizations has also been highlighted in the vicinity of these different transitions. At low temperatures, two critical end-points appear in the bulk and on the surface in the ordered region limiting two successive first-order phase transitions. Furthermore, we have made a comparison with other works on similar models in pure or mixed versions.
THE DYNAMICS OF PRICE–VOLUME INFORMATION TRANSFER IN THE CRYPTOCURRENCY MARKETS
Authors: ZHENG JINGLAN , NIE CHUN-XIAO
Published: February 2021

This study examines the information flow between prices and transaction volumes in the cryptocurrency market, where transfer entropy is used for measurement. We selected four cryptocurrencies (Bitcoin, Ethereum, Litecoin and XRP) with large market values, and Bitcoin and BCH (Bitcoin Cash) for hard fork analysis; a hard fork is when a single cryptocurrency splits in two. By examining the real price data, we show that the long-term time series includes too much noise obscuring the local information flow; thus, a dynamic calculation is needed. The long-term and short-term sliding transfer entropy (TE) values and the corresponding [Formula: see text]-values, based on daily data, indicate that there is a dynamic information flow. The dominant direction of which is [Formula: see text]. In addition, the example based on minute Bitcoin data also shows a dynamic flow of information between price and transaction volume. The price–volume dynamics of multiple time scales helps to analyze the price mechanism in the cryptocurrency market.
REGIONS AND INNOVATION: A NEW TALE OF THREE ECONOMIC REGIONS IN CHINA
Authors: LI MEGAN YUAN , MAKINO SHIGE , MURPHREE MICHAEL , JIANG CHUNYAN
Published: February 2021

Learning is a key component of firm upgrading in emerging economies, and China is no exception to this. Studies have identified, among others, two critical mechanisms that facilitate learning: (1) connections with supportive local governments that enhance access to resources or publicly funded knowledge and (2) connections to co-located foreign multinational enterprises (MNEs) that enhance access to advanced knowledge and capabilities. However, previous studies on the effects of these connections on learning and innovation have had contradictory results. In this study, we develop a model of firm innovation capabilities based on regional differences in firms’ dependence on government and MNEs. Using a sample of 715 indigenous firms from the three historically dominant economic regions in China, we find that the effects of government and MNE ties on local firms’ learning and innovation performance vary depending on the historically dominant dependency patterns in the region.
A CONFIGURATIONAL PERSPECTIVE ON BoP INNOVATION CAPABILITY
Authors: VON JANDA SERGEJ , KUESTER SABINE , SCHUHMACHER MONIKA C.
Published: February 2021

Marketing capabilities are a major driver of competitive advantage across different business contexts. One of these capabilities is the ability to sense consumer needs and to develop innovations to meet these needs, referred to as innovation capability. Innovation holds the potential to improve the living conditions of resource-constrained consumers at the bottom of the world’s economic pyramid (BoP) in emerging markets. Surprisingly, research has failed to develop a comprehensive understanding of how firms can innovate successfully in BoP markets. Applying a configurational perspective, this study explores the organisational configurations that characterise firms that successfully develop innovations for the BoP market. Analysing data from an online survey with senior-level managers ([Formula: see text] = 245) in 10 emerging markets, the authors offer important insights for firms seeking to develop innovations for BoP consumers in terms of the specific organisational configurations that lead to BoP innovation success.
Novel Preparation of Bi/BiVO4 Catalyst Supported by Alkali-Modified Diatomite and its Visible Light-Driven Degradation Performance
Authors: Liu Mingwei , Jiang Linhua , Shen Mingxia , Guo Mingzhi , Zhu Pengfei , Jin Weizhun
Published: February 2021

The manufacture of diatomite-supported composite catalyst with enhanced photocatalytic activity is of great interest for wastewater treatment. In this study, the pretreated diatomite (PD) with 5[Formula: see text]wt.% NaOH solution possessed better pore structure and large specific surface area. A facile hydrothermal-photoreduction method was adopted to prepare Bi/BiVO4/PD composite. The chemical composition, microstructure morphology and pore structure of samples were investigated by means of XRF, XRD, SEM, TEM, EDS, XPS and BET methods. The results showed that the metallic Bi was uniformly deposited on the BiVO4. After loaded on PD, both surface area and total pore volume had a significant increase. In addition, UV-vis diffuse reflectance spectra presented that the absorption capacity of Bi/BiVO4/PD-25% composite in the visible light range was remarkably high due to the surface plasmon resonance (SPR) caused by metallic Bi. From photoluminescence (PL) spectra and transient photocurrents, the heterojunction formed between Bi/BiVO4 and PD helped promoting the separation and migration of photo-generated carriers, which in turn led to higher photocatalytic activity. Compared with Bi/BiVO4, Bi/BiVO4/PD loaded with 25[Formula: see text]wt.% PD showed highest decolorization rate for rhodamine B (RhB), malachite green (MG), methylene blue (MB), methyl orange (MO) and lemon yellow (LY) under visible light irradiation. According to trapping experiments on free radicals, the active species that played a decisive role in RhB degradation were h[Formula: see text] and [Formula: see text]. Findings from this study suggest that Bi/BiVO4/PD-25% composite holds great promise for dye degradation and wastewater treatment.
Structural and dielectric properties of sol–gel processed Ce-doped BaTi0.97Y0.03O3 ceramics
Authors: Nfissi Aziz , Ababou Yahya , Belhajji Mounir , Sayouri Salaheddine , Lamcharfi Taj-dine
Published: February 2021

Structural and dielectric properties of Ce-doped [Formula: see text][Formula: see text]O3 powders, with the chemical formulation (Ba[Formula: see text][Formula: see text](Ti([Formula: see text]- [Formula: see text]O3 such as [Formula: see text] = 0%, 1%, 3%, 5%, 7% and 9%, produced by the sol–gel method, have been investigated. X-ray diffraction analysis showed that Ce[Formula: see text] ions incorporated Ba sites until [Formula: see text]= 7% indicating that this concentration represents a solubility limit of Ce[Formula: see text] ions in [Formula: see text][Formula: see text]O3 matrix. Scanning electron microscopy (SEM) analysis showed a decrease in grain size down to the same concentration of 7%. Raman spectroscopy analysis showed the appearance of [Formula: see text] mode, which we attributed to the effect of incorporation of Ce[Formula: see text] and Y[Formula: see text] in BaTiO3 matrix. Dielectric measurements revealed that doping with cerium lowers the temperature of permittivity maximum at the ferroelectric-to-paraelectric transition (FPT) of the [Formula: see text][Formula: see text]O3 sample, and reaches a value that should be below [Formula: see text]C for [Formula: see text]= 9%. Moreover, the phenomenon of dielectric resonance was observed on all Ce-doped samples, which was not the case with other dopants as reported in the literature.
SIMPLE BAYESIAN FORECAST COMBINATION
Authors: FRANSES PHILIP HANS
Published: February 2021

In this paper, it is proposed to combine the forecasts using a simple Bayesian forecast combination algorithm. The algorithm is applied to forecasts from three non-nested diffusion models for S shaped processes like virus diffusion. An illustration to daily data on first-wave cumulative Covid-19 cases in the Netherlands shows the ease of use of the algorithm and the accuracy of the newly combined forecasts.
PREDICTING CASES AND DEATHS IN EUROPE FROM COVID-19 TESTS AND COUNTRY POPULATIONS
Authors: ALLEN DAVID E. , MCALEER MICHAEL
Published: February 2021

The paper presents a critical analysis of the European spread of the SARS-CoV-2 virus that causes the COVID-19 disease across 48 European countries and territories, including the Monaco and Andorra principalities and Vatican City. Simple cross-sectional regressions, using country populations, are able to predict quite accurately both the total number of cases and deaths, which cast doubt on measures aimed at controlling the disease via lockdowns. This throws into sharp contrast the relative effectiveness of the attempts to risk manage the spread of the virus by ‘flattening the curve’ of the speed of transmission, and the efficacy of lockdowns in terms of the spread of the disease and death rates. The algorithmic techniques, results and analysis presented in the paper should prove useful to the medical and health professions, science advisers and risk management and decision making of healthcare by state, regional and national governments in all countries in Europe.
Parkinson’s Disease Diagnostics Based on the Analysis of Digital Sentence Writing Test
Authors: Netšunajev Aleksei , Nõmm Sven , Toomela Aaro , Medijainen Kadri , Taba Pille
Published: February 2021

Analysis of the sentence writing test is conducted in this paper to support diagnostics of the Parkinsons disease. Drawing and writing tests digitization has become a trend where synergy of machine learning techniques on the one side and knowledge base of the neurology and psychiatry on the other side leading sophisticated result in computer aided diagnostics. Such rapid progress has a drawback. In many cases, decisions made by machine learning algorithm are difficult to explain in a language human practitioner familiar with. The method proposed in this paper employs unsupervised learning techniques to segment the sentence into the individual characters. Then, feature engineering process is applied to describe writing of each letter using a set of kinematic and pressure parameters. Following feature selection process applicability of different machine learning classifiers is evaluated. To guarantee that achieved results may be interpreted by human, two major guidelines are established. The first one is to keep dimensionality of the feature set low. The second one is clear physical meaning of the features describing the writing process. Features describing amount and smoothness of the motion observed during the writing alongside with letter size are considered. Resulting algorithm does not take into account any semantic information or language particularities and therefore may be easily adopted to any language based on Latin or Cyrillic alphabets.
Follow Ecological Laws and Improve Ecological Governance Capacity and Level
Authors: PAN Jiahua
Published: February 2021

The eco-civilization system constitutes an important part of the system of socialism with Chinese characteristics. In order to achieve harmonious coexistence between man and nature, it is required to not only uphold and improve the eco-civilization system, but also give full play to the advantages of China’s socialist system and governance system to ensure that the eco-civilization system is effectively implemented; meanwhile, it is important to apply ecological laws in a scientific manner to continuously develop and improve the system of socialism with Chinese characteristics. Ecological laws function as the scientific basis for the building of ecological systems and ecological governance. Nature-based Solutions (NbS) demand the guarantee of ecological system and improvement of ecological governance capacity. While adhering to and perfecting the eco-civilization system, it is also needed to continuously advance the modernization of ecological governance capacity.
The Welfare Effects of Carbon Tax on Chinese Households: A Study Based on the 2013 Chip Survey Data
Authors: LI Xuehui , LI Zhi , WANG Zhengxin
Published: February 2021

Based on the micro-data from the 2013 Chinese Household Income Project (CHIP) Survey, the authors use a Quadratic Almost Ideal Demand System (QUAIDS) model to simulate and measure the impacts on the welfare of urban and rural households with different incomes after a carbon tax at 50[Formula: see text]RMB/ton was levied in China. The results show that the collection of carbon tax will increase households’ consumer spending to varying degrees. In urban areas, the carbon tax exerts the greatest impact on low-income households, followed by high-income households; while in rural areas, it has the most significant effects on high-income households and the least on low-income households. On the whole, carbon tax’s impact on urban households is greater than that on rural households. To a certain extent, it can help the household income inequality change for the better and narrow the urban–rural income gap. Since the carbon tax does not act on the distribution of Chinese household income in a simply regressive or progressive way, the authors believe that China should implement supporting policies such as tax subsidies or tax refund as supplements to carbon taxation in an effort to establish a mechanism for cyclic utilization of carbon tax revenue.
A Review of the Research on the Indicator Evaluation of the New Development Philosophy
Authors: ZHANG Zhuoqun , ZHANG Tao , SONG Mengdi , LIU Kuanbin
Published: February 2021

The philosophy of innovative, coordinated, green, open and inclusive development, collectively referred to as the new development philosophy, is an important component of Xi Jinping Thought on Socialist Economy with Chinese Characteristics for a New Era. It plays a vital role in China’s efforts to resolve problems in economic development and cultivate new advantages. Based on a keen understanding of the new development philosophy, we review the literature on the evaluation of a single indicator of the five dimensions of philosophy and that on a comprehensive evaluation of all the indicators of philosophy. The results show varied depths of research in single-indicator evaluation, and a lack of systematic study on comprehensive evaluation. We propose a multi-tier (macro–micro)-indicator evaluation system of new development philosophy, and recommend to establish a smart evaluation platform by integrating big data with traditional data, which will serve as a foundation and provide reference for the development of a scientific, well-conceived indicator evaluation system of new development philosophy that can guide the practice.
Visual Analysis of Biomarkers Reveals Differences in Lipid Profiles and Liver Enzymes before and after Gastric Sleeve and Bypass
Authors: van Berckel Marijn Marthe Georgine , van Loon Saskia L.M. , Boer Arjen-Kars , Scharnhorst Volkher , Nienhuijs Simon W.
Published: February 2021

Introduction: Bariatric surgery results in both intentional and unintentional metabolic changes. In a high-volume bariatric center, extensive laboratory panels are used to monitor these changes pre- and postoperatively. Consecutive measurements of relevant biochemical markers allow exploration of the health state of bariatric patients and comparison of different patient groups. Objective: The objective of this study is to compare biomarker distributions over time between 2 common bariatric procedures, i.e., sleeve gastrectomy (SG) and gastric bypass (RYGB), using visual analytics. Methods: Both pre- and postsurgical (6, 12, and 24 months) data of all patients who underwent primary bariatric surgery were collected retrospectively. The distribution and evolution of different biochemical markers were compared before and after surgery using asymmetric beanplots in order to evaluate the effect of primary SG and RYGB. A beanplot is an alternative to the boxplot that allows an easy and thorough visual comparison of univariate data. Results: In total, 1,237 patients (659 SG and 578 RYGB) were included. The sleeve and bypass groups were comparable in terms of age and the prevalence of comorbidities. The mean presurgical BMI and the percentage of males were higher in the sleeve group. The effect of surgery on lowering of glycated hemoglobin was similar for both surgery types. After RYGB surgery, the decrease in the cholesterol concentration was larger than after SG. The enzymatic activity of aspartate aminotransferase, alanine aminotransferase, and alkaline phosphate in sleeve patients was higher presurgically but lower postsurgically compared to bypass values. Conclusions: Beanplots allow intuitive visualization of population distributions. Analysis of this large population-based data set using beanplots suggests comparable efficacies of both types of surgery in reducing diabetes. RYGB surgery reduced dyslipidemia more effectively than SG. The trend toward a larger decrease in liver enzyme activities following SG is a subject for further investigation.
MicroRNA Expression Profiles in the Subcutaneous Adipose Tissues of Morbidly Obese Chinese Women
Authors: Wang Linjie , Shang Chen , Pan Hui , Yang Hongbo , Zhu Huijuan , Gong Fengying
Published: February 2021

Introduction: Obesity is a main global health issue and an outstanding cause of morbidity and mortality. Exploring miRNA profiling may help further studies on obesity. Methods: Three morbidly obese and 5 normal-weight Chinese women were enrolled in the microarray testing group. Abdominal subcutaneous adipose tissue (SAT) samples were excised. Total RNAs including miRNAs were extracted. Affymetrix GeneChip miRNA 4.0 Array was used to compare the expression profiles of miRNAs between the 2 groups. Two algorithms, miRanda and TargetScan, were used to predict target messenger RNAs (mRNAs). Bioinformatics analysis was then done based on the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) databases. The sample sizes were further expanded to 8 morbidly obese and 9 normal-weight subjects, and quantitative real-time PCR (qRT-PCR) was utilized to verify the expression of differential miRNAs and target genes. Results: As per the microarray assay, 58 miRNAs were differentially expressed in the SAT from the morbidly obese and normal-weight groups (Fold >4, p < 0.01, FDR <0.05); 54 of these were downregulated and 4 were upregulated in morbidly obese subjects. A total of 1,333 target genes were jointly predicted by miRanda and TargetScan. Further bioinformatics analysis showed that the differential miRNAs were involved in 269 significant biological functions and 89 significant signaling pathways. The validation experiment by qRT-PCR showed that the expression levels of miRNA-143-5p, miRNA-143-3p, miRNA-145-5p, and let-7a-5p were downregulated in morbidly obese subjects, consistent with the microarray detection. High-mobility group A2 (HMGA2), a target gene of the downregulated miRNA let-7a-5p, was first found to be upregulated 3.19-fold in the SAT of morbidly obese Chinese women when compared to normal-weight controls. Conclusions: MiRNA downregulation is a hallmark of intact SAT in a morbidly obese state. Transcription (DNA-dependent), small-molecule metabolic processes, the MAPK signaling pathway, and cancer-related pathways may play important roles in the occurrence and development of obesity. For the first time, we proved that HMGA2, a target gene of let-7a-5p, is upregulated in the SAT of morbidly obese Chinese women.
Allergy-Related Symptoms Are Poorly Predicted by IgE and Skin Prick Testing in Early Life
Authors: Mustonen Neea , Siljander Heli , Niemelä Onni , Ilonen Jorma , Haahtela Tari , Knip Mikael ,   the DIABIMMUNE Study Group
Published: February 2021

Introduction: In childhood, the so-called allergic march involves progression from IgE sensitization to allergy-related symptoms. Both IgE sensitization and relevant clinical symptoms are required for the diagnosis of allergy, but concordance between test results and clinical symptoms varies greatly, creating challenges for the diagnostics and for the prediction of outcomes. We assessed the prevalence of IgE sensitization and allergy symptoms, concordance between 2 IgE sensitization testing methods, and predictive value of these tests in relation to clinical symptoms in young Finnish children. Methods: The current study included 2 series of children: a birth cohort, in which the participants were followed prospectively from birth up to 3 years, and a young children cohort observed from 3 to 5 years of age. They were regularly monitored for sensitization by measuring serum allergen-specific IgEs (sIgEs) and performing skin prick tests (SPTs). The emergence of atopic dermatitis, wheezing, and symptoms associated with food allergies was recorded. Results: Over the first 5 years of life, the prevalence of sIgE sensitization was 46%, while it was 36% for positive SPTs. Disease prevalence was 26% for atopic dermatitis, 25% for wheezing, and 19% for symptoms associated with food allergies. Concordance between sIgE and SPT results was good for aeroallergens, but poor for dietary allergens. The association between clinical symptoms and sensitization was stronger at 5 years than at 3 years of age. The proportion of children with concordant combinations of allergy symptoms and sensitization markers in contrast to those with discordant combinations increased from 3 to 5 years. Conclusion: In early childhood, testing for IgE sensitization predicts allergy-related symptoms in an age-dependent manner, but not particularly well. Tests predict symptoms caused by aeroallergens clearly better than those caused by dietary allergens. The clinical relevance of sensitization testing in early life is therefore limited in the prediction of true allergy.
The Diagnostic Yield of Prenatal Genetic Technologies in Congenital Heart Disease: A Prospective Cohort Study
Authors: Mone Fionnuala , Stott Bethany K. , Hamilton Susan , Seale Anna N. , Quinlan-Jones Elizabeth , Allen Stephanie , Hurles Matthew E. , McMullan Dominic J. , Maher Eamonn R. , Kilby Mark D.
Published: February 2021

Introduction: The objective was to evaluate: (i) the proportion of prenatally diagnosed congenital heart disease (CHD) associated with an abnormal quantitative fluorescence-PCR (QF-PCR), chromosome microarray (CMA), and exome sequencing (ES) result; and (ii) the diagnostic yield of these technologies based on CHD category and presence of extra-cardiac anomalies (ECAs). Methods: This prospective cohort study was set across 12 UK foetal medicine centres. All cases underwent QF-PCR, CMA, and ES, and the diagnostic yield in n = 147 cases of prenatally diagnosed CHD was assessed. Results: In 34.7% (n = 51/147), a genetic diagnosis was obtained. Using a stepwise testing strategy, the diagnostic yield for QF-PCR, CMA, and ES was 15.6% (n = 23/147), 13.7% (n = 17/124), and 10.2% (n = 11/107), respectively. Abnormal QF-PCR/shunt (septal) defects 31.4% (n = 11/35), p = 0.046, and abnormal CMA/conotruncal anomalies 22.7% (n = 10/44), p = 0.04, had significant associations. Monogenic variants were commonest in complex CHD 36.4% (n = 4/11). Multisystem CHD had a greater diagnostic yield overall compared to isolated OR 2.41 (95% CI, 1.1–5.1), particularly in association with brain and gastrointestinal tract anomalies. The proportion of variants of uncertain significance was 4.7% (n = 5/107) with ES, with none in the CMA group. Conclusion: In the era of prenatal ES, there remains an important role for QF-PCR and CMA. Identification of monogenic pathologic variants further allows delineation of prognosis in CHD.
Cyanosis and Clipping: Noninfectious Aneurysm in a Patient with 22q11.2 Deletion Syndrome
Authors: Sudhir Bhanu Jayanand , Honavalli Murali Sanjay , Gohil Jaypalsinh , Poyuran Rajalakshmi , Sethuraman Manikantan , Harihara Venkat Easwer
Published: February 2021

Noninfectious cerebral aneurysms are rare in patients with congenital cyanotic heart disease. We present a patient with DiGeorge/velocardiofacial syndrome with a complex congenital cyanotic heart disease with a ruptured anterior communicating artery aneurysm. The 10-year-old child was managed by surgical clipping of the aneurysm. Surgical challenges included prominent veins in the Sylvian fissure, difficulty in differentiating arterial and venous bleed, and anesthetic risks. The patient recovered without any neurological deficits. This is the first report of a patient with 22q11.2 deletion syndrome, with a noninfectious cerebral aneurysm.
A Rare Case of Pneumomediastinum after Eustachian Tube Dilation
Authors: Long Sallie , Obayemi Adetokunbo , Rameau Anaïs
Published: February 2021

Eustachian tube dilation (ETD) is a relatively new intervention for the treatment of eustachian tube dysfunction. Though it previously had no assigned billing code, the American Medical Association recently accepted a new Category I Current Procedural Terminology code application for ETD to be effective in January 2021. Reported complications are uncommon and usually minor. Herein, we present a rare case of massive pneumomediastinum following this procedure. Such major complications are critical to report as ETD becomes a more commonly practiced procedure.
Giant Arachnoid Cyst Associated with an Orbital Meningocele: A Case Report and Cystoperitoneal Shunt Management
Authors: Khoulali Mohamed , Oulali Noureddine , Raouzi Nabil , Moufid Fayçal
Published: February 2021

Introduction: Intracranial arachnoid cysts (ACs) are space-occupying lesions that typically remain stable in size and clinically silent over time. Case Report: We describe an unusual pediatric case of enlarged AC impressive by its compressive phenomena. An 11-month-old girl presented with remarkable macrocephaly associated with a cystic orbital tumor. CT scan and MRI studies revealed a large intracranial ACs extending in the orbit with an orbital meningocele (OM). The intracranial cyst did communicate with the orbital one into a bony defect in the right inner region of the orbital roof and represses the globe outward. A cystoperitoneal shunting procedure was performed to remove the mass effect as soon as possible and facilitate normal development. Discussion/Conclusion: Cysts in infants younger than 1 year of age are remarkably different from those in older children and adults in terms of cyst localization and enlargement. Classically described complications result from compression of adjacent structures and include focal neurologic involvement, headaches and seizures and developmental deficits, or macrocephaly in younger children. There are few cases of ACs with ophthalmic manifestations reported in the literature. The paucity of literature prompted us to analyze the case. To the best of our knowledge, an AC accompanying OM has not been reported. The pathogenesis and management of the case will be discussed.
Smad3-Targeted Therapy Protects against Cisplatin-Induced AKI by Attenuating Programmed Cell Death and Inflammation via a NOX4-Dependent Mechanism
Authors: Yang Qin , Gao Li , Hu Xiao-wei , Wang Jia-nan , Zhang Yao , Dong Yu-hang , Lan Hui Yao , Meng Xiao-ming
Published: February 2021

Background: Transforming growth factor-β (TGF-β)/Smad signaling is the central mediator in renal fibrosis, yet its functional role in acute kidney injury (AKI) is not fully understood. Recent evidence showed that TGF-β/Smad3 may be involved in the pathogenesis of AKI, but its functional role and mechanism of action in cisplatin-induced AKI are unclear. Objectives: Demonstrating that Smad3 may play certain roles in cisplatin nephropathy due to its potential effect on programmed cell death and inflammation. Methods: Here, we established a cisplatin-induced AKI mouse model with Smad3 knockout mice and created stable in vitro models with Smad3 knockdown tubular epithelial cells. In addition, we tested the potential of Smad3-targeted therapy using 2 in vivo protocols – lentivirus-mediated Smad3 silencing in vivo and use of naringenin, a monomer used in traditional Chinese medicine and a natural inhibitor of Smad3. Results: Disruption of Smad3 attenuated cisplatin-induced kidney injury, inflammation, and NADPH oxidase 4-dependent oxidative stress. We found that Smad3-targeted therapy protected against loss of renal function and alleviated apoptosis, RIPK-mediated necroptosis, renal inflammation, and oxidative stress in cisplatin nephropathy. Conclusions: These findings show that Smad3 promotes cisplatin-induced AKI and Smad3-targeted therapy protects against this pathological process. These findings have substantial clinical relevance, as they suggest a therapeutic target for AKI.
Measurement of the Concentration of Citrate in Human Biofluids in Patients Undergoing Continuous Renal Replacement Therapy Using Regional Citrate Anticoagulation: Application of a Two-Step Enzymatic Assay
Authors: Anstey Chris M. , Russell Fraser D.
Published: February 2021

Background: Continuous renal replacement therapy (CRRT) with regional citrate anticoagulation (RCA) is now commonly used to treat acute kidney injury in critically ill patients. The concentration of citrate is not routinely measured, with citrate accumulation and/or toxicity primarily assessed using surrogate measures. Objectives: The aim of this study was to measure the concentration of citrate in plasma and ultrafiltrate in patients receiving CRRT with RCA using a modified commercial enzymatic assay. Methods: After meeting inclusion criteria, blood was sampled from 20 patients before, during, and after episodes of filtration. Using spectrophotometry, samples were tested for citrate concentration. Demographic and other clinical and biochemical data were also collected. Throughout, a 15 mmol/L solution of trisodium citrate was used as the prefilter anticoagulant. Results were analysed using STATA (v15.0) and presented as mean (SD), median (IQR), or simple proportion. Comparisons were made using either the Student t test or the Wilcoxon rank-sum test. Correlation was assessed using Pearson’s r. Results: Twenty patients (17 males) were enrolled in the study. Mean (SD) age was 63.7 years (9.9). Median (IQR) ICU length of stay was 281 h (199, 422) with 85% undergoing intermittent positive pressure ventilation. Median APACHE 3 score was 95 (87, 117) with an overall 30% mortality rate. Median filtration time was 85 h (46, 149). No difference was found between pre- and post-filtration plasma citrate concentrations (79 µmol/L [50] vs. 71 µmol/L [42], p = 0.65). Mean citrate concentration during filtration was 508 µmol/L (221) with a maximum of 1,070 µmol/L. This was significantly higher than the pre/post levels (p < 0.001). Conclusions: Plasma concentrations of citrate rose significantly during episodes of CRRT using RCA returning back to normal after cessation of treatment.
Survival Analysis of Geriatric Patients with Low Digestive Hemorrhage Attending an Emergency Department
Authors: Fernandez-Suárez Ana , Yuguero Torres Oriol
Published: February 2021

Background: The increase in life expectancy and low mortality have doubled the number of individuals older than 65 in the last 30 years. Methods: We conducted a retrospective study of 101 patients older than 80 years of age treated by low digestive hemorrhage (LDH) in an emergency department during 2018. Sociodemographic variables were evaluated, as well as comorbidity and survival at 18 months. Survival was assessed by a Kaplan-Meier test. Results: 52.5% of the subjects were women. The average comorbidity of the sample was 1.97. The survival rate per year was 60%. The finding on colonoscopy shows no association with mortality. However, those patients on anticoagulant/antiplatelet therapy have a higher survival rate. Conclusion: Survival per year is high, so urgent colonoscopy for an LDH should be performed after evaluating the patient’s stability and functional status in a scheduled and outpatient manner.
Hemochromatosis and Xeroderma Pigmentosum: Two (Un)Suspicious Neighbors
Authors: Monte Filipa , Garrido Mónica , Pereira Guedes Tiago , Reis Joel , Porto Graça , Pedroto Isabel
Published: February 2021

A 51-year-old woman, clinically diagnosed with Xeroderma pigmentosum (XP), showed abnormalities in liver enzymes, high ferritin and transferrin saturation levels, with ultrasonographic features of chronic liver disease, in addition to skin hyperpigmentation. Genetic testing confirmed the clinical hypothesis of hereditary hemochromatosis (HH). Due to the known proximity of HFE (6p22.2) and POLH (6p21.1) genes, accountable for HH and the XP-V variant, respectively, a genetic test was offered and a rare variant of the POLH gene was identified. We report the first confirmed case, to our knowledge, of a patient diagnosed both with XP and HH, in whom two mutated neighbor genes – POLH and HFE – were identified, possibly the result of genetic linkage.
Protective Effect of a Bispecific Fc-Fusion Protein on the Barrier of Human Retinal Pigment Epithelial Cells
Authors: Wang Jing , Wang Yishen , Yu Dechao , Liu Qiuhui , Lin Shaofen , Tian Rong , Li Jia , Luo Yan
Published: February 2021

Introduction: The aim of the study was to evaluate the protective effects of IBI302, a bispecific Fc-fusion protein that theoretically can bind vascular endothelial growth factor (VEGF), complement C3b, and C4b in the barrier of the cultured human retinal pigment epithelial (hRPE) cells. Methods: Primary hRPE cells were isolated and cultured to monolayer barrier. hRPE monolayers were divided into the PBS control group, VEGF-Trap group, complement receptor 1 (CR1) group, and IBI302 group. Identification of hRPE cells, barrier function, inflammation factors, and immune response products was tested by immunofluorescent staining, transepithelial resistance (TER), and ELISA. Results: IBI302 treatment significantly improved the TER of the barrier of hRPE cells after complement-activated oxidative stress compared with the PBS control group, VEGF-Trap group, and CR1 group. The maximum effect of IBI302 on protecting hRPE cell viability was observed at the concentration of 1 μg/mL. The elevated expression of VEGF, chemokine (C-C Motif) ligand 2, C3a, C5a, and membrane attack complex was reduced by IBI302. Conclusion: IBI302 could protect the barrier function of hRPE cells. IBI302 might be a potentially effective drug for the RPE barrier-associated ocular diseases.