bluuebunny/crossref_metadata_2025 huggingface dataset:
An Improved Adaptive Passive Coordinated Control for Generator Excitation and STATCOM
Authors: Du Chaofan , Zhang Lei , Tang Yuanhui , Zhu Jiahao , Wang Kaifeng
Published: August 2021

An improved adaptive backstepping passive coordinated control strategy is proposed to deal with the uncertainty of damping coefficient and mechanical power and external disturbance on the system stability. A nonlinear coordinated controller of generator excitation and STATCOM (static synchronous compensator) is designed to improve its adaptability. The adaptive estimation laws of damping coefficient and mechanical power are designed by using I&I (immersion and invariance) adaptive control to improve the adaptive ability of the controller. Based on the backstepping recursive method, the control law of STATCOM is designed and combines the passivity theory, thus acquiring the control law of generator excitation. In the backstepping design, the derivative of the virtual control input and external disturbance are considered to be uncertain, and the nonlinear damping algorithm is introduced to reduce the “calculation explosion.” Simulation results show that the designed controller improves the stability of the power system and shows strong adaptability and robustness.
Similarity Law between Centrifuge Scale Test and Prototype Underwater Explosion
Authors: Ma Shang , Chen Yeqing , Wang Zhenqing , Wang Jianhui , Lyu Linmei , Wei Wanli
Published: August 2021

Shock wave and bubble pulsation caused by underwater explosion destroy the hydraulic structure. However, the realization of the underwater explosion prototype test is restricted by many factors, such as the site environment. Furthermore, the repeatability of the test scheme is not strong. The centrifuge scale test provides a new way of studying the damage degree of the structure under the action of underwater explosion. The similarity relationship refers to the bridge between the scaled model and the prototype, which cannot achieve complete similarity in practice. The centrifuge‐scaled model test is performed by increasing the acceleration of a certain multiple. Meanwhile, the model reduces the corresponding ratio in the geometric layout to achieve the geometric similarity with the prototype test. Therefore, the applicability of the centrifuge scaling method in the study of the dynamic response of the structure in underwater explosion needs to be explored further. In this work, the underwater explosion scaling test numerical model for 1 g RDX (equivalent to 1.62 g TNT) charge under different centrifugal acceleration conditions is established, and the calculation results of underwater pressure and dynamic response of the steel plate are compared with the centrifuge test results. A prototype model is established to study the similarity relationship between the centrifuge scale test and the prototype model when the steel plate structure is in the stage of small deformation and linear elasticity. The application of the similarity ratio in the scale test of underwater explosion the centrifuge is discussed. The application of the centrifuge in the study of the failure response of the hydraulic structure in underwater explosion is expanded by establishing the model and comparing with the experimental results.
Dynamic Influence of Near‐Source Seismic Ground Motion on Underground Mine Working Stability Using Time‐Frequency Analysis
Authors: Lurka Adam , Mutke Grzegorz , Małkowski Piotr
Published: August 2021

Peak particle velocity parameter is very useful in assessing underground mine working stability. Its application is widespread and requires additional analysis of the dominant frequency of the seismic signal. In order to properly analyze the velocity amplitudes of strong ground motions generated from seismic sources, time‐frequency properties of near‐source seismic signals in underground mines should be quantified. Using numerical calculations, the continuous wavelet transform (CWT) of the recorded near‐source seismic signals in three perpendicular directions was obtained to characterize its time‐frequency properties. The properties of recorded strong ground motion velocity seismograms for two high energy seismic events and two blasts from two underground coal mines in Poland have been extracted with the use of continuous wavelet transform spectrograms showing the duration time of each frequency group. Assuming a constant peak particle velocity amplitude on the analyzed seismograms, the duration time of each frequency group starts to play a key role. The longer the duration time of the lower frequency group is on the CWT spectrogram, the more the damaging effect on underground mining excavations can be observed. Varying bandwidths of dominant frequencies in separate time intervals for the analyzed seismic signals have had significantly different influence on the potentially damaging effect on underground mining excavations.
Fiber‐Reinforced Magnesium Phosphate Cement‐Based Nanocomposites in the Field of Bridge Structure Repair and Strengthening
Authors: Yang Wenwei
Published: August 2021

Currently, fiber‐reinforced magnesium phosphate cement‐based nanocomposites are being used in various projects. The unique physical properties of this material allow it to bear the load together with the material in the inherent structure, and it will be better used in the field of bridge structure repair and reinforcement. The purpose of this article is to study the application of fiber‐reinforced magnesium phosphate cement‐based nanocomposites in the field of bridge structure repair and reinforcement. Through the use of finite element analysis software and various stress sensor materials, the mechanical properties of fiber‐reinforced magnesium phosphate cement‐based nanocomposites are used to analyze the mechanical properties of damaged bridges in our area after reinforcement treatment and establish a control group (using magnesium phosphate cement‐based nanocomposite materials) for comparative experiments. The reinforcement effect of the bridge repair structure under different ballast conditions is studied. Studies have shown that fiber‐reinforced magnesium phosphate cement‐based nanocomposites can provide excellent reinforcement for damaged bridge structures. Compared to the control group, the strength and stiffness of the repaired structure were significantly improved, the strength increased by 15.7%, and the stiffness increased by 12%. The carrying capacity has also been improved compared to the previous one, from the original 120 t to 150 t.
Coronary Embolism despite CHA₂DS₂-VASc Score of Zero: Should We Reconsider Anticoagulation?
Authors: Ahmed Ammar , Assaf Andrew , Shankar Aditi , Zughaib Marcel
Published: July 2021

Coronary embolism (CE) is a rare but important cause of acute coronary syndrome. The most common source of emboli is considered to be infective endocarditis and atrial fibrillation. Various studies have estimated the prevalence of coronary embolism; however, diagnosis is challenging. Often, it is difficult to differentiate. Nonetheless, this is an important step as treating the underlying cause of an embolism is essential to limit recurrence. However, while this condition may have fatal consequences, due to its uncommon occurrence, there is no consensus on diagnosis and management. We present a case of a 53-year-old obese male, with a history of paroxysmal atrial fibrillation not on anticoagulation due to a low CHA2DS2-VASc score, who presented with chest pain associated with lightheadedness. ECG on admission revealed coarse atrial fibrillation, and troponin was gradually elevating on serial lab workup. Coronary angiography revealed a distal left anterior descending artery occlusion with apical wall akinesis without any evidence of atherosclerotic coronary artery disease. A presumptive diagnosis of coronary embolism secondary to paroxysmal atrial fibrillation was made, and the patient was started on anticoagulation despite a low CHA2DS2-VASc score. This case not only highlights coronary embolism but also illustrates that a low CHA2DS2-VASc score does not mean there is no risk of emboli. For such patients, it is important to take clinical reasoning into account along with the CHA2DS2-VASc score to determine the benefit of anticoagulation.
Incentive Mechanism Design for Distributed Autonomous Organizations Based on the Mutual Insurance Scenario
Authors: Pan Yiguang , Deng Xiaomei
Published: August 2021

The rise of blockchain has led to discussions on new governance models and the cooperation of multiple participants. Due to the cognitive defects of the blockchain protocol in terms of intelligent contracts and decentralized autonomous organizations (DAOs), it is often unclear as to how to make decisions about the evolution of blockchain applications. Many autonomous organizations, with the support of network technologies such as blockchain, blindly absorb members and expand the scale of the capital pool, while ignoring the cost advantage of traditional autonomous organizations based on social relations and mutual supervision to fight information asymmetry. In this context, this study analyzes the evolutionary trend of autonomous organizations and their members’ strategies under different policy environments. To this end, under the digital economy background, based on game theory, the evolutionary dynamics method, and the form of the mutual insurance organization, this study constructs an evolutionary dynamics model of distributed autonomous organizations. The results show that blind expansion without review aggravates the overall risk pool’s moral hazard, in the context of mutual insurance. Organizational strategies, such as risk pool splits, can effectively improve the risk pool’s operating performance and establish a benign competition elimination mechanism. Driven by cooperation efficiency and split supervision based on homogeneous clustering, the comprehensive application of the market elimination mechanism can effectively combat moral hazards, restrain the adverse effects of member flow, expand the living space of small‐ and medium‐sized insurance organizations, curb the emergence of a large‐scale monopoly risk pool, and improve market vitality. These conclusions and suggestions also apply to autonomous organizations based on social relations and mutual supervision. The results offer specific decision‐making guidance and suggestions for the government, insurance companies, and risk management.
Panax ginseng C. A. Meyer Phenolic Acid Extract Alleviates Ultraviolet B-Irradiation-Induced Photoaging in a Hairless Mouse Skin Photodamage Model
Authors: Li Zhenzhuo , Jiang Rui , Liu Jianzeng , Xu Xiaohao , Sun Liwei , Zhao Daqing
Published: August 2021

Here, we evaluated the in vivo skin-protective effects of topical applications of Panax ginseng C. A. Meyer extract (PG2) and its phenolic acid- (PA-) based components against UVB-induced skin photoaging. PG2 or PA applied to skin of hairless mice after UVB-irradiation alleviated UVB-induced effects observed in untreated skin, such as increased transepidermal water loss (TEWL), increased epidermal thickness, and decreased stratum corneum water content without affecting body weight. Moreover, PG2 and PA treatments countered reduced mRNA-level expression of genes encoding filaggrin (FLG), transglutaminase-1 (TGM1), and hyaluronan synthases (HAS1, HAS2, and HAS3) caused by UVB exposure and reduced UVB-induced collagen fiber degradation by inhibiting the expression of matrix metalloproteinase genes encoding MMP-1, MMP-2, and MMP-9. Meanwhile, topical treatments reduced cyclooxygenase-2 (COX-2) mRNA-level expression in photodamaged skin, leading to the inhibition of interleukin-1β (IL-1β) and interleukin-6 (IL-6) mRNA-level expression. Thus, ginseng phenolic acid-based preparations have potential value as topical treatments to protect skin against UVB-induced photoaging.
Study on the Effect of Deep Eutectic Solvent Liquid Phase Microextraction on Quality Standard, Antitussive, and Expectorant of Sangbaipi Decoction
Authors: Li Lijing , Wang Yuejie , Liu Fangxin , Xu Yang , Bao Huiwei
Published: August 2021

The SD was extracted with a new green eutectic solvent, and the extraction method of TCM decoction was developed. In the quantitative analysis by HPLC, choline chloride phenol was selected as the eutectic solvent, THF was used as the extractant, and investigation of DES type, DES molar ratio, DES-to-THF ratio, vortex time, and material-to-liquid ratio was carried out. The experimental results showed that the optimal extraction method was as follows: the molar ratio of DES was 1 : 3, and the material-liquid ratio was 5 : 1200 (mL/μL). The volume ratio of DES to THF was 1200 : 800 (μL), the vortex time was 3 min, and the extraction was repeated two times. The eutectic solvent liquid phase microextraction method was adopted to optimize the extraction method of SD and reduce the complicated processing, long time, and low efficiency of traditional methods. At the same time, in the mouse ammonia water inducing cough and phenol red excretion and expectorant experiments, SD high- and medium-dose groups have a significant inhibitory effect on the frequency of antitussive in mice and both can increase the excretion of phenol red to varying degrees, indicating that SD has good cough-relieving and expectorant effect. The present study suggests a scientific basis and basis for the clinical research and quality standard formulation of SD.
Mitochondria as Playmakers of CAR T-cell Fate and Longevity
Authors: Rostamian Hosein , Khakpoor-Koosheh Mohammad , Fallah-Mehrjardi Keyvan , Mirzaei Hamid R. , Brown Christine E.
Published: August 2021

The development of chimeric antigen receptor (CAR) T-cell therapy has led to a paradigm shift in cancer treatment. However, patients often do not benefit from CAR T-cell therapy due to poor persistence of the adoptively transferred cells. Development of strategies based on the generation and maintenance of long-lasting memory T cells may expand the therapeutic effects of CAR T cells. Mitochondrial metabolic pathways play crucial roles in regulating the fate, function, and longevity of T cells. Here, we discuss how reprogramming of mitochondrial metabolic pathways influences function, persistence, and determination of CAR T-cell fate toward a memory phenotype. Moreover, we explore how mitochondrial activity determines persistence and the clinical outcome of CAR T-cell therapy. In addition, we review some strategies for manipulating CAR T-cell mitochondria to improve the survival of CAR T cells.
Multigene Combined Detection by RT-qPCR Using Cytological Specimens
Authors: Ma Yang , Zhao Jingxia , Du Yun , Wang Rui , Ji Xiaokun , Wu Juan , Guo Xiao , Liu Ying , Zhang Yan
Published: August 2021

Objective: The aim of the study was to investigate the mutation status of multiple driver genes by RT-qPCR and their significance in advanced lung adenocarcinoma using cytological specimens. Materials and Methods: 155 cytological specimens that had been diagnosed with lung adenocarcinoma in the Fourth Hospital of Hebei Medical University were selected from April to November 2019. The cytological specimens included serous cavity effusion and fine-needle aspiration biopsies. Among cytological specimens, 108 cases were processed by using the cell block method (CBM), and 47 cases were processed by the disposable membrane cell collector method (MCM) before DNA/RNA extraction. Ten drive genes of EGFR, ALK, ROS1, BRAF, KRAS, NRAS, HER2, RET, PIK3CA, and MET were combined detected at one step by the amplification refractory mutation system and ABI 7500 RT-qPCR. Results: The purity of RNA (p = 0.005) and DNA (p = 0.001) extracted by using the MCM was both significantly higher than that extracted by using the CBM. Forty-seven cases of fresh cell specimens processed by the MCM all succeeded in multigene detections, while of 108 specimens processed by the CBM, 6 cases failed in multigene detections. Among 149 specimens, single-gene mutation rates of EGFR, ALK, ROS1, RET, HER2, MET, KRAS, NRAS, BRAF, and PIK3CA mutations were 57.71%, 6.04%, 3.36%, 2.68%, 2.01%, 2.01%, 1.34%, 0.67%, 0% and 0% respectively, and 6 cases including 2 coexistence mutations. We found that mutation status was correlated with gender (p = 0.047), but not correlated with age (p = 0.141) and smoking status (p = 0.083). We found that the EGFR mutation status was correlated with gender (p = 0.003), age (p = 0.015) and smoking habits (p = 0.007), and ALK mutation status was correlated with age (p = 0.002). Conclusion: Compared with the CBM, the MCM can improve the efficiency of DNA/RNA extraction and PCR amplification by removing impurities and enriching tumor cells. And we speculate that the successful detection rate of fresh cytological specimens was higher than that of paraffin-embedded specimens. EGFR, ALK, and ROS1 mutations were the main driver mutations in patients with advanced lung adenocarcinoma. We speculate that EGFR and ALK are more prone to concomitant mutations, respectively. Targeted therapies for patients with coexisting mutations need further study.
Bariatric Surgery-Associated Myelopathy
Authors: Asakly Sewar , Magen-Rimon Ramit , Ighbariya Ahmad , Marjih-Shallufi Miriam , Ben-Porat Tair , Ravid Sarit , Eran Ayelet , Gepstein Vardit , Hanna Suhair , Weiss Ram
Published: August 2021

Bariatric surgery is gaining acceptance as an efficient treatment modality for adults and adolescents with morbid obesity. The early postbariatric period has the potential to induce an immunomodulatory imbalance due to the development or worsening of nutritional deficiencies, changes in hormonal balance (specifically after sleeve gastrectomy), and a shift in the proinflammatory cytokine profile along with a major change in the gut microbiome and permeability. These changes may induce encephalomyelitic T cell activity, change neural barrier permeability, and induce gut dysbioisis, favoring a proinflammatory metabolic profile. Such changes, in genetically prone individuals or those with additional risk factors, may lead to the development of myelopathy, particularly MS. Key Message: Postbariatric myelopathy is rare but should be considered in bariatric patients with relevant complaints in the postoperative period.
Hemoperfusion with CytoSorb to Manage Multiorgan Dysfunction in the Spectrum of Hemophagocytic Lymphohistiocytosis Syndrome in Critically Ill Children
Authors: Bottari Gabriella , Murciano Manuel , Merli Pietro , Bracaglia Claudia , Guzzo Isabella , Stoppa Francesca , Pardeo Manuela , Nunziata Joseph , Bufalo Francesca del , Genuini Leonardo , De Benedetti Fabrizio , Locatelli Franco , Cecchetti Corrado
Published: August 2021

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening condition characterized by a state of hyperinflammation. Blood purification techniques can blunt the inflammatory process with a rapidly relevant nonselective effect on the cytokine storm, thus potentially translating into survival benefit for these patients. In this cohort, we evaluated the impact of hemoadsorption with CytoSorb combined with continuous kidney replacement therapy used as adjunctive therapy in 6 critically ill children with multiple organ dysfunction due to HLH. In our series, we found a reduction in inflammatory biomarkers in patients with HLH secondary to infection. Ferritin, one of the most important bedside biomarkers of HLH, showed a reduction in most of the treated patients. The same results were found measuring interleukin-6 and interleukin-10. The same patients showed hemodynamic stabilization measured by the Vasopressor-Inotropic-Score, and reduction in the organ disease score measured with the Pediatric Logistic Organ Dysfunction score. In our cohort, mortality was less than expected based on the Pediatric Index of Mortality 3 score at pediatric intensive care unit admission. Our study shows that hemoperfusion could be a valuable therapeutic option in HLH: stronger scientific evidence is needed to confirm our preliminary experience.
Carbohydrate Antigen 19-9 Is an Invasive Malignancy Preoperative Prognostic Factor for Intraductal Papillary Mucinous Neoplasms
Authors: Suzuki Shuji , Shimoda Mitsugi , Shimazaki Jiro , Oshiro Yukio , Nishda Kiyotaka , Orimoto Naoki , Nagakawa Yuichi , Tsuchida Akihiko
Published: August 2021

Introduction: This study aimed to determine the preoperative clinicophysiological and postoperative clinicopathological predictors of malignancy in patients with intraductal papillary mucinous neoplasm (IPMN). Methods: This was a retrospective observational study. We included 121 patients (73 men and 48 women; mean age: 68.7 years) who had undergone pancreatic resection for IPMN between 2007 and 2018. These patients were grouped into invasive carcinoma (IPMN-INV, N = 21) and low/high-grade IPMN (IPMN-LG/HG, N = 100) groups. Univariate and multivariate analyses of clinicophysiological parameters were carried out. These parameters were also compared between the IPMN-INV/HG (N = 53) and IPMN-LG (N = 68) groups. Survival analyses according to macroscopic type and IPMN subtypes were performed. Results: On univariate analysis, age (p = 0.038), carbohydrate antigen (CA) 19-9 (p < 0.001), IPMN macroscopic type (p = 0.001), IPMN subtype (p < 0.001), pancreatic duct diameter (p < 0.001), and mural nodule (p = 0.042), between IPMN-INV and IPMN-LG/HG were found to be significant prognostic factors of malignancy. CA 19-9 was found to be an independent prognostic factor of IPMN malignancy on multivariate analysis (p = 0.035). The 1-, 3-, and 5-year overall survival (OS) rates of the IPMN-INV and IPMN-LG/HG groups were 94.4/100%, 94.4/100%, and 67.2/100%, respectively. The OS rate in the IPMN-LG/HG group was significantly higher than that in the IPMN-INV group (p < 0.001). On univariate analysis, platelet (p = 0.043), CA 19-9 (p = 0.039), prognostic nutritional index (p = 0.034), platelet/lymphocyte ratio (p = 0.01), IPMN macroscopic type (p < 0.001), IPMN subtype (p < 0.001), pancreatic duct diameter (p = 0.036), and mural nodule (p = 0.032) between IPMN-INV/HG and IPMN-LG were found to be significant prognostic factors of malignancy. On multivariate analysis, CA 19-9 was found to be an independent prognostic factor (p = 0.042) between IPMN-INV/HG and IPMN-LG of malignancy. The 1-, 3-, and 5-year OS rates of the IPMN-INV/HG and IPMN-LG groups were 97.9/100%, 97.9/100%, and 82.6/100%, respectively. The OS rate was significantly higher in the IPMN-LG group than in the IPMN-INV/HG group (p = 0.03). No significant differences in survival were observed in patients with macroscopic tumors (p= 0.544). Conclusion: CA 19-9 is an independent invasive malignancy predictor of IPMN.
YAP1 Overexpression Is Associated with Kidney Dysfunction in Lupus Nephritis
Authors: Xie Ying , Ruan Yuanyuan , Zou Huimei , Wang Yixin , Wu Xin , Li Xiaoying , Lai Jiao , Shi Mingjun , Xiao Ying , Wang Yuanyuan , Zhou Yuxia , Guo Bing , Zhang Fan
Published: August 2021

Objective: The goal of the present study was to determine the expression of yes-associated protein 1 (YAP1) in renal tissues of mice with lupus nephritis (LN) and elucidate its role in the progression of renal fibrosis. Methods: C57BL/6 mice and MRL/lpr mice were selected for experimental comparison. Mouse kidney tissues were removed and sectioned for hematoxylin and eosin staining, Masson’s trichome staining, Sirius staining, and immunohistochemistry. The mRNA and protein levels of YAP1 in mouse kidney tissues were detected, and the correlation between YAP1 and fibronectin (FN) mRNA levels was analyzed. Mouse renal epithelial cells were used for in vitro experiments. After transfection and stimulation, the cells were divided into 4 groups, namely the C57BL/6 serum group (group 1), the MRL/lpr serum group (group 2), the MRL/lpr serum + siRNA-negative control group (group 3), and the MRL/lpr serum + siRNA-YAP1 group (group 4). Epithelial-mesenchymal transition (EMT) markers in each group were detected by Western blotting and immunofluorescence staining. Serum creatinine, blood urea nitrogen, and urinary protein levels were detected and assessed for their correlation with YAP1 mRNA levels by Spearman’s analysis. Results: Compared to C57BL/6 mice, MRL/lpr mice exhibited obvious changes in fibrosis in renal tissues. In addition, YAP1 expression was significantly higher in the renal tissues of MRL/lpr mice than in those of C57BL/6 mice, and YAP1 mRNA levels were positively correlated with those of FN. YAP1 silencing in lupus serum-stimulated cells could effectively relieve serum-induced EMT. Finally, we observed that YAP1 mRNA levels in mouse kidney tissue were significantly and positively correlated with the degree of renal function injury. Conclusion: YAP1 expression in the kidney tissues of LN mice was higher than that observed in normal mice, indicating that YAP1 may play an important role in the occurrence and development of LN.
Investigation of the Physical Properties and Clinical Application of Embosphere Microspheres
Authors: Hu Yinbao , Zhao Zhangping , Li Songwei , Xu Xingming , Xie Ying , Yan Dong , Zou Youjian , Liu Hui
Published: August 2021

Background: The aim of this study was to understand physical characteristics of Embosphere microspheres for the clinical use of microsphere chemotherapy embolization of liver cancer. Methods: The morphology of Embosphere microspheres in different states, including static, oscillating, and in a magnetic field was observed with the naked eye. Ninety-five patients diagnosed with primary hepatocellular carcinoma (HCC) were separated into 3 groups based on the types of embolic material as follows: 32 cases of sole microspheres, 34 cases of iodinated oil (17 cases with additional application of gelatin sponge particle), and 29 cases of iodinated oil + Embosphere microspheres. Results: The diameter of the microspheres ranged from 100 to 300 μm, with a sedimentation rate υ = 0.0375 cm/s in physiological saline. The diameter of microspheres ranged from 300 to 500 μm, with a sedimentation rate υ = 0.1875 cm/s. The swelling rate of microspheres was 90%. Microspheres showed nondirectional movement in a 1.5- or 3.0-T magnetic field during magnetic resonance imaging. A volumetric ratio of 1:1.4–1:1.5 between microspheres and contrast agent resulted in optimal suspension properties. Microspheres appeared circular with a smooth surface upon water adsorption. Microsphere embolism was observable in blood vessels of pathological sections. The surface of microspheres can adsorb 5-fluorouracil and arsenic trioxide. There are statistically significant differences in local-regional tumor control conditions among patients treated with sole microspheres, iodinated oil, and iodinated oil + microspheres during transarterial chemoembolization. Conclusions: Embosphere microspheres can be used to embolize patients with rupture and hemorrhage of HCC. Embosphere microsphere embolization is superior to iodinated oil and iodinated oil + microsphere for HCC.
Scalp Psoriasis and Biologic Agents: A Review
Authors: Papadimitriou Ilias , Bakirtzi Katerina , Katoulis Alexander , Ioannides Dimitrios
Published: August 2021

Scalp-localized psoriasis is common among patients affected with plaque psoriasis, rendering its treatment exceedingly difficult. Furthermore, the symptoms caused by the disease like scaling, erythema, and pruritus, among others, pose a major psychological impact and a significant regression in the quality of life of the affected patients. Biologics have proved their efficacy in assuaging the symptoms, in terms of Psoriasis Area and Severity Index (PASI) reduction, and offering optimum quality of life, by decreasing the Dermatology Life Quality Index (DLQI) in the patients suffering from plaque psoriasis. Herein, we sought to evaluate the efficacy of biologics and small molecules in controlling the symptoms and their ability to offer long-term maintenance in the disease activity.
Clinical Effects of Early and Short-Term Tolvaptan Administration in Patients Hospitalized for Acute Decompensated Heart Failure
Authors: Tanaka Nobukiyo , Dan Kazuhiro , Maeda Takuya , Ishihara Hiroki , Teramura Masanori , Ichihashi Kei , Takahashi Yuya , Tsuzura Daichi , Shinoda Akira , Fujii Masato , Okada Hisashi , Teramoto Tomohiko
Published: August 2021

Introduction: Previous trials showed that tolvaptan improves acute heart failure (HF). However, the optimal timing for administering tolvaptan to achieve the best outcome remains unclear. Therefore, the current study investigated the relationship between the timing of tolvaptan treatment initiation and clinical outcomes in patients with acute decompensated HF. Methods: We prospectively evaluated 201 patients with acute decompensated HF, randomly divided into 2 groups based on the timing of tolvaptan initiation. The early group was administered tolvaptan approximately 1 week after day 1 or 2 (n = 104), whereas the late group was administered the same drug 1 week after the early group (n = 97). Results: All-cause mortality, cardiovascular death, and hospitalization during the follow-up period were comparable between both groups. The early group had shorter durations of oxygenation, carperitide infusion, and hospitalization than the late group (p = 0.013, 0.003, 0.006, respectively). The early group demonstrated a significantly faster decrease in pleural effusion than the late group (p = 0.001). The 2 groups had comparable maximum and minimum serum sodium and potassium levels and minimum estimated glomerular filtration rates during hospitalization. The early group spent significantly less money on all diuretics administered over the first 2 weeks and on tolvaptan and carperitide administered during the hospitalization period than the late group (p < 0.001). Conclusions: Early and short-term administration of tolvaptan was feasible, contributed to a more rapid improvement in patients with acute decompensated HF, and reduced health-care costs.
Ankyrin-G Heterozygous Knockout Mice Display Increased Sensitivity to Social Defeat Stress
Authors: Cordner Zachary A. , Khambadkone Seva G. , Zhu Shanshan , Bai Justin , Forti R. Rasadokht , Goodman Ethan , Tamashiro Kellie L.K. , Ross Christopher A.
Published: August 2021

The ANK3 locus has been repeatedly found to confer an increased risk for bipolar disorder. ANK3 codes for Ankyrin-G (Ank-G), a scaffold protein concentrated at axon initial segments, nodes of Ranvier, and dendritic spines, where it organizes voltage-gated sodium and potassium channels and cytoskeletal proteins. Mice with homozygous conditional knockout of Ank-G in the adult forebrain display hyperactivity and reduced anxiety-like behaviors, responsive to mood stabilizers. Their behavior switches to a depression-like phenotype when exposed to chronic social defeat stress (SDS), and then spontaneously reverts to baseline hyperactivity. Ank-G heterozygous conditional knockouts (Ank-G Het cKO) have not previously been characterized. Here, we describe the behavior of Ank-G Het cKO mice compared to littermate controls in the open field, elevated plus maze, and forced swim test, under both unstressed and stressed conditions. We found that Ank-G Het cKO is not significantly different from controls at baseline or after chronic SDS. The chronic stress-induced “depression-like” behavioral phenotype is persistent for at least 28 days and is responsive to fluoxetine. Strikingly, Ank-G Het cKO mice display increased sensitivity to a short duration SDS, which does not affect controls. The heterozygous Ank-G genetic model may provide novel insights into the role of Ank-G in the pathophysiology of stress sensitivity and “depression-like” phenotypes and could be useful for studying Ank-G-related gene-environment interactions.
Aquecimentos para banda de música: estado da arte
Authors: Serpa Frances Alexandre , Cordeiro Raimundo Nonato , Holanda Francisco José Costa
Published: August 2021

Este artigo é um recorte da revisão de literatura de uma de pesquisa de mestrado em andamento, tendo como proposta apresentar uma revisão de literatura relativa aos aquecimentos para banda de música. O recorte aqui exposto compreende o levantamento do estado da arte sobre o tema no âmbito brasileiro no tocante a pesquisas bibliográficas, publicações em revistas e congressos e também na literatura americana, onde o tema é bastante abordado em livros, congressos, artigos e cujo uso faz parte da abordagem sistêmica utilizada no ensino musical com bandas naquele país. Com base no estado da arte, e levando em conta a escassez da temática na produção científica nacional no âmbito do conhecimento, a pesquisa proporciona uma ampla visão sobre a importância, relevância e uma compreensão mais completa do tema aqui apresentado.
O Choro no interior de São Paulo: a evolução e importância do Choro Avareense (1951-1990)
Authors: Orru Caio Vinícius Zévola
Published: August 2021

Este trabalho tem por objetivo buscar as origens do Choro em Avaré, cidade localizada no interior do Estado de São Paulo. Situamos nosso recorte entre os anos de 1951-1990, pois compreendemos esse período como basilar para o desenvolvimento do Choro Avareense. Iniciaremos com uma breve contextualização do Choro em São Paulo, para chegarmos até o nosso recorte, o surgimento e a evolução da cultura “chorística” em Avaré. Assim, poderemos compreender como o Choro se interioriza; sendo isso, um reflexo da pressão das bases econômicas sobre a superestrutura. O Choro produzido em Avaré e seus músicos têm grande importância e relevância para a evolução do gênero musical, a exemplo do citadino Jamil Caram, que foi um chorão de estirpe nacional. Desta maneira, perscrutaremos desde o primeiro chorão da cidade até a mais concreta realização do Choro avareense, o Clube do Choro de Avaré.
Aperfeiçoamento e Capacitação em Performance Musical: estratégias de trabalho na pandemia
Authors: Domingues Ravi Shankar Viana , Noda Luciana
Published: August 2021

O presente trabalho apresenta as estratégias adotadas pela classe de oboé da Universidade Federal da Paraíba (UFPB) durante a pandemia. Essas atividades fazem parte do Projeto de Capacitação e Aperfeiçoamento em Performance Musical, criado em 2018. O projeto tem como objetivo fomentar atividades que contribuam para o desenvolvimento integral da performance de instrumentistas e cantores brasileiros. Nas duas primeiras edições do projeto foram realizadas mais de 50 ações cujo foco principal foram os aspectos psicofísicos da performance através de workshops sobre Yoga, Tai-Chi Chuan, Meditação e Psicologia da Performance, além de recitais  em diferentes espaços da cidade de João Pessoa. Em 2020, devido às restrições de isolamento social impostas pela pandemia de COVID-19, todas as atividades do projeto foram adaptadas ao formato remoto, com o intuito de mantermos "atividades de resistência" que pudessem contribuir para a motivação e desenvolvimento dos estudantes de música no Brasil. Apesar de todas as adversidades, o projeto foi expandido e contou com a colaboração de músicos de diversas instituições musicais brasileiras e internacionais e a participação de pessoas de todo o mundo.
Placebo-Controlled Efficacy of Percutaneous Coronary Intervention for Focal and Diffuse Patterns of Stable Coronary Artery Disease
Authors: Rajkumar Christopher A. , Shun-Shin Matthew , Seligman Henry , Ahmad Yousif , Warisawa Takayuki , Cook Christopher M. , Howard James P. , Ganesananthan Sashiananthan , Amarin Laura , Khan Caitlin , Ahmed Ayesha , Nowbar Alexandra , Foley Michael , Assomull Ravi , Keenan Niall G. , Sehmi Joban , Keeble Thomas R. , Davies John R. , Tang Kare H. , Gerber Robert , Cole Graham , O’Kane Peter , Sharp Andrew S.P. , Khamis Ramzi , Kanaganayagam Gajen , Petraco Ricardo , Ruparelia Neil , Malik Iqbal S. , Nijjer Sukhjinder , Sen Sayan , Francis Darrel P. , Al-Lamee Rasha
Published: August 2021

Background:

Physiological assessment with pressure wire pullback can characterize coronary artery disease (CAD) with a focal or diffuse pattern. However, the clinical relevance of this distinction is unknown. We use data from the ORBITA trial (Objective Randomised Blinded Investigation With Optimal Medical Therapy of Angioplasty in Stable Angina) to test if the pattern of CAD predicts the placebo-controlled efficacy of percutaneous coronary intervention (PCI) on stress echocardiography ischemia and symptom end points.

Methods:

One hundred sixty-four patients in ORBITA underwent blinded instantaneous wave-free ratio (iFR) pullback assessment before randomization. Focal disease was defined as a ≥0.03 iFR unit drop within 15 mm, rather than over a longer distance. Analyses were performed using regression modeling.

Results:

In the PCI arm (n=85), 48 were focal and 37 were diffuse. In the placebo arm (n=79), 35 were focal and 44 were diffuse. Focal stenoses were associated with significantly lower fractional flow reserve (FFR) and iFR values than diffusely diseased vessels (mean FFR and iFR, focal 0.60±0.15 and 0.65±0.24, diffuse 0.78±0.10 and 0.88±0.08, respectively,
P
<0.0001). With adjustment for this difference, PCI for focal stenoses resulted in significantly greater reduction in stress echo ischemia than PCI for diffuse disease (
P
<0.05). The effect of PCI on between-arm pre-randomization adjusted exercise time was 9.32 seconds (95% CI, −17.1 to 35.7 seconds;
P
=0.487). When stratified for pattern of disease, there was no detectable difference between focal and diffuse CAD (
P
interaction=0.700). PCI improved Seattle Angina Questionnaire angina frequency score and freedom from angina more than placebo (
P
=0.034;
P
=0.0035). However, there was no evidence of interaction between the physiological pattern of CAD and these effects (
P
interaction=0.436;
P
interaction=0.908).

Conclusions:

PCI achieved significantly greater reduction of stress echocardiography ischemia in focal compared with diffuse CAD. However, for symptom end points, no such difference was observed.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique Identifier: NCT02062593.
External Validations of Cardiovascular Clinical Prediction Models: A Large-Scale Review of the Literature
Authors: Wessler Benjamin S. , Nelson Jason , Park Jinny G. , McGinnes Hannah , Gulati Gaurav , Brazil Riley , Van Calster Ben , van Klaveren David , Venema Esmee , Steyerberg Ewout , Paulus Jessica K. , Kent David M.
Published: August 2021

Background:

There are many clinical prediction models (CPMs) available to inform treatment decisions for patients with cardiovascular disease. However, the extent to which they have been externally tested, and how well they generally perform has not been broadly evaluated.

Methods:

A SCOPUS citation search was run on March 22, 2017 to identify external validations of cardiovascular CPMs in the Tufts Predictive Analytics and Comparative Effectiveness CPM Registry. We assessed the extent of external validation, performance heterogeneity across databases, and explored factors associated with model performance, including a global assessment of the clinical relatedness between the derivation and validation data.

Results:

We identified 2030 external validations of 1382 CPMs. Eight hundred seven (58%) of the CPMs in the Registry have never been externally validated. On average, there were 1.5 validations per CPM (range, 0–94). The median external validation area under the receiver operating characteristic curve was 0.73 (25th–75th percentile [interquartile range (IQR)], 0.66–0.79), representing a median percent decrease in discrimination of −11.1% (IQR, −32.4% to +2.7%) compared with performance on derivation data. 81% (n=1333) of validations reporting area under the receiver operating characteristic curve showed discrimination below that reported in the derivation dataset. 53% (n=983) of the validations report some measure of CPM calibration. For CPMs evaluated more than once, there was typically a large range of performance. Of 1702 validations classified by relatedness, the percent change in discrimination was −3.7% (IQR, −13.2 to 3.1) for closely related validations (n=123), −9.0 (IQR, −27.6 to 3.9) for related validations (n=862), and −17.2% (IQR, −42.3 to 0) for distantly related validations (n=717;
P
<0.001).

Conclusions:

Many published cardiovascular CPMs have never been externally validated, and for those that have, apparent performance during development is often overly optimistic. A single external validation appears insufficient to broadly understand the performance heterogeneity across different settings.
Revisiting the Tropical Atlantic Influence on El Niño–Southern Oscillation
Authors: Richter Ingo , Tokinaga Hiroki , Kosaka Yu , Doi Takeshi , Kataoka Takahito
Published: August 2021

The influence of the tropical Atlantic on El Niño–Southern Oscillation (ENSO) is examined using sensitivity experiments with the SINTEX-F general circulation model with prescribed sea surface temperature (SST) distributions based on observations for the period 1982–2018. In the control experiment (CTRL) observed SSTs are prescribed over the global oceans; in the sensitivity experiment observed SSTs are prescribed in the tropical Atlantic only, while in other regions the climatological annual cycle is prescribed. A composite analysis of the model output suggests that cold SST events in the northern tropical Atlantic during boreal spring are associated with near-surface wind changes over the equatorial and subtropical Pacific that are conducive to the development of El Niño, consistent with previous studies. The amplitude of these changes, however, is at most 20% of those observed during typical El Niño events. Likewise, warm events in the equatorial Atlantic produce only about 10% of the wind changes seen in the western equatorial Pacific during the developing phase of typical La Niña events. Similar results are obtained from a partial regression analysis performed on an ensemble of atmosphere-only simulations from phase 6 of the Atmospheric Model Intercomparison Project (AMIP) although the equatorial Atlantic influence is stronger in AMIP. Further analysis of the AMIP models indicates that model biases do not have a major impact on the Atlantic-to-Pacific influence. Overall, the results suggest that the tropical Atlantic has a rather weak influence on ENSO development and mostly acts to modulate ongoing events rather than initiate them.
Machine Learning-Assisted Sampling of Surfance-Enhanced Raman Scattering (SERS) Substrates Improve Data Collection Efficiency
Authors: Rojalin Tatu , Antonio Dexter , Kulkarni Ambarish , Carney Randy P.
Published: August 2021

Surface-enhanced Raman scattering (SERS) is a powerful technique for sensitive label-free analysis of chemical and biological samples. While much recent work has established sophisticated automation routines using machine learning and related artificial intelligence methods, these efforts have largely focused on downstream processing (e.g., classification tasks) of previously collected data. While fully automated analysis pipelines are desirable, current progress is limited by cumbersome and manually intensive sample preparation and data collection steps. Specifically, a typical lab-scale SERS experiment requires the user to evaluate the quality and reliability of the measurement (i.e., the spectra) as the data are being collected. This need for expert user-intuition is a major bottleneck that limits applicability of SERS-based diagnostics for point-of-care clinical applications, where trained spectroscopists are likely unavailable. While application-agnostic numerical approaches (e.g., signal-to-noise thresholding) are useful, there is an urgent need to develop algorithms that leverage expert user intuition and domain knowledge to simplify and accelerate data collection steps. To address this challenge, in this work, we introduce a machine learning-assisted method at the acquisition stage. We tested six common algorithms to measure best performance in the context of spectral quality judgment. For adoption into future automation platforms, we developed an open-source python package tailored for rapid expert user annotation to train machine learning algorithms. We expect that this new approach to use machine learning to assist in data acquisition can serve as a useful building block for point-of-care SERS diagnostic platforms.
Polytomous Testlet Response Models for Technology-Enhanced Innovative Items: Implications on Model Fit and Trait Inference
Authors: Kang Hyeon-Ah , Han Suhwa , Kim Doyoung , Kao Shu-Chuan
Published: August 2021

The development of technology-enhanced innovative items calls for practical models that can describe polytomous testlet items. In this study, we evaluate four measurement models that can characterize polytomous items administered in testlets: (a) generalized partial credit model (GPCM), (b) testlet-as-a-polytomous-item model (TPIM), (c) random-effect testlet model (RTM), and (d) fixed-effect testlet model (FTM). Using data from GPCM, FTM, and RTM, we examine performance of the scoring models in multiple aspects: relative model fit, absolute item fit, significance of testlet effects, parameter recovery, and classification accuracy. The empirical analysis suggests that relative performance of the models varies substantially depending on the testlet-effect type, effect size, and trait estimator. When testlets had no or fixed effects, GPCM and FTM led to most desirable measurement outcomes. When testlets had random interaction effects, RTM demonstrated best model fit and yet showed substantially different performance in the trait recovery depending on the estimator. In particular, the advantage of RTM as a scoring model was discernable only when there existed strong random effects and the trait levels were estimated with Bayes priors. In other settings, the simpler models (i.e., GPCM, FTM) performed better or comparably. The study also revealed that polytomous scoring of testlet items has limited prospect as a functional scoring method. Based on the outcomes of the empirical evaluation, we provide practical guidelines for choosing a measurement model for polytomous innovative items that are administered in testlets.
Relational dimensions, motivation and knowledge-sharing in healthcare: a perspective from relational models theory
Authors: Monazam Tabrizi Negar
Published: August 2021

This study investigates the relational dimensions that shape clinicians' intentionality and motivation for knowledge-sharing. Qualitative data was collected from 40 clinicians in two hospitals, and relational models theory was used to investigate the impact of different relational models (communal-sharing, authority-ranking, equality-matching and market-pricing) on clinicians' intentionality and motivation to engage in knowledge and learning. While communal-sharing and expert-based authority–ranking relationships predominantly encourage intra-professional knowledge-sharing, equality-matching encourages inter-professional knowledge-sharing. This implies that while the idea is to work together to improve public service quality, each actor has their own interests and is motivated to share knowledge for different collective and/or personal reasons/agendas. In the public sector, formal authority-ranking and market-pricing are the main driving forces of coordination of actions and knowledge flow, through the medium of money and trade. Despite this, power games and a lack of support from those in positions of authority and ignorance of potential conflicts of interest, as well as extrinsic motivators, hamper knowledge-sharing, all of which threaten patient safety.

Points for practitioners

In pursuit of public service improvement, a focus on fostering an organizational culture that promotes collective behaviour, especially among those in authority, is crucial, given that their lack of support retards knowledge-sharing. For effective knowledge-sharing, both intrinsic and extrinsic motivators are equally important depending on the relational model.