bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Adenosine on Wavefront Propagation in Persistent Atrial Fibrillation: Insights From Global Noncontact Charge Density Mapping of the Left Atrium
Authors: Pope Michael T. B. , Kuklik Pawel , Briosa e Gala Andre , Leo Milena , Mahmoudi Michael , Paisey John , Betts Timothy R.
Published: May 2022

Background

Adenosine shortens action potential duration and refractoriness and provokes atrial fibrillation. This study aimed to evaluate the effect of adenosine on mechanisms of wavefront propagation during atrial fibrillation.

Methods and Results

The study included 22 patients undergoing catheter ablation for persistent atrial fibrillation. Left atrial mapping was performed using the AcQMap charge density system before and after administration of intravenous adenosine at 1 or more of 3 time points during the procedure (before pulmonary vein isolation, after pulmonary vein isolation, and after nonpulmonary vein isolation ablation). Wave‐front propagation patterns were evaluated allowing identification and quantification of localized rotational activation (LRA), localized irregular activation, and focal firing. Additional signal processing was performed to identify phase singularities and calculate global atrial fibrillation cycle length and dominant frequency. A total of 35 paired maps were analyzed. Adenosine shortened mean atrial fibrillation cycle length from 181.7±14.3 to 165.1±16.3, (mean difference 16.6 ms; 95% CI, 11.3–21.9,
P
<0.0005) and increased dominant frequency from 6.0±0.7 Hz to 6.6±0.8 Hz (95% CI, 0.4–0.9,
P
<0.0005). This was associated with a 50% increase in the number of LRA occurrences (16.1±7.6–24.2±8.1; mean difference 8.1, 95% CI, 4.1–12,
P
<0.0005) as well as a 20% increase in the number of phase singularities detected (30.1±7.8–36.6±9.3; mean difference 6.5; 95% CI, 2.6–10.0,
P
=0.002). The percentage of left atrial surface area with LRA increased with adenosine and 42 of 70 zones (60%) with highest density of LRA coincided with high density LRA zones at baseline with only 28% stable across multiple maps.

Conclusions

Adenosine accelerates atrial fibrillation and promotes rotational activation patterns with no impact on focal activation. There is little evidence that rotational activation seen with adenosine represents promising targets for ablation aimed at sites of stable arrhythmogenic sources in the left atrium.
Same‐Day Discharge After Transcatheter Aortic Valve Implantation: Insights from the Nationwide Readmission Database 2015 to 2019
Authors: Zahid Salman , Rai Devesh , Tanveer Ud Din Mian , Khan Muhammad Zia , Ullah Waqas , Usman Khan Muhammad , Thakkar Samarthkumar , Hussein Ahmed , Baibhav Bipul , Rao Mohan , Abtahian Farhad , Bhatt Deepak L. , Depta Jeremiah P.
Published: May 2022

Background

There is a paucity of data on the feasibility of same‐day discharge (SDD) following transcatheter aortic valve implantation (TAVI) at a national level.

Methods and Results

This study used data from the Nationwide Readmission Database from the fourth quarter of 2015 through 2019 and identified patients undergoing TAVI using the claim code 02RF3. A total of 158 591 weighted hospitalizations for TAVI were included in the analysis. Of the patients undergoing TAVI, 961 (0.6%) experienced SDD. Non‐SDDs included 65 814 (41.5%) patients who underwent TAVI who were discharged the next day, and 91 816 (57.9%) discharged on the second or third day. The 30‐day readmission rate for SDD after TAVI was similar to non‐SDD TAVI (9.8% versus 8.9%,
P
=0.31). The cumulative incidence of 30‐day readmissions for SDD was higher compared with next‐day discharge (log‐rank
P
=0.01) but comparable to second‐ or third‐day discharge (log‐rank
P
=0.66). At 30 days, no differences were observed in major or minor vascular complications, heart failure, or ischemic stroke for SDD compared with non‐SDD. Acute kidney injury, pacemaker implantation, and bleeding complications were lower with SDD. Predictors associated with SDD included age <85 years, male sex, and prior pacemaker placement, whereas left bundle‐branch block, right bundle‐branch block, second‐degree heart block, heart failure, prior percutaneous coronary intervention, and atrial fibrillation were negatively associated with SDD.

Conclusions

SDD following TAVI is associated with similar 30‐day readmission and complication rates compared with non‐SDD. Further prospective studies are needed to assess the safety and feasibility of SDD after TAVI.
Lipoprotein(a) and the Risk for Coronary Heart Disease and Ischemic Stroke Events Among Black and White Adults With Cardiovascular Disease
Authors: Colantonio Lisandro D. , Bittner Vera , Safford Monika M. , Marcovina Santica , Brown Todd M. , Jackson Elizabeth A. , Li Mei , López J. Antonio G. , Monda Keri L. , Plante Timothy B. , Kent Shia T. , Muntner Paul , Rosenson Robert S.
Published: May 2022

Background

It is unclear whether lipoprotein(a) is associated with coronary heart disease (CHD) and ischemic stroke events in White and Black adults with atherosclerotic cardiovascular disease (ASCVD).

Methods and Results

We conducted a case‐cohort analysis, including Black and White REGARDS (Reasons for Geographic and Racial Differences in Stroke) study participants ≥45 years of age with prevalent ASCVD (ie, CHD or stroke) at baseline between 2003 and 2007. Baseline lipoprotein(a) molar concentration was measured in participants with ASCVD who experienced a CHD event by December 2017 (n=1166) or an ischemic stroke by September 2019 (n=492) and in a random subcohort of participants with prevalent ASCVD (n=1948). The hazard ratio (HR) for CHD events per 1 SD (1.5 units) higher log‐transformed lipoprotein(a) was 1.26 (95% CI, 1.02–1.56) among Black participants and 1.16 (95% CI, 1.02–1.31) among White participants (
P
value comparing HRs, 0.485). The HR for CHD events per 1 SD higher log‐lipoprotein(a) within subgroups with hs‐CRP (high‐sensitivity C‐reactive protein) ≥2 and <2 mg/L was 1.31 (95% CI, 0.99–1.73) and 1.23 (95% CI, 0.85–1.80), respectively (
P
value comparing HRs, 0.836), among Black participants, and 1.07 (95% CI, 0.91–1.27) and 1.36 (95% CI, 1.10–1.70), respectively (
P
value comparing HRs, 0.088), among White participants. There was no evidence that the association between lipoprotein(a) and CHD events differed by statin use. There was no evidence of an association between lipoprotein(a) and ischemic stroke events among Black or White participants.

Conclusions

Higher lipoprotein(a) levels were associated with an increased risk for CHD events in Black and White adults with ASCVD.
Seasonality and Spatial Dependence of Mesoscale and Submesoscale Ocean Currents from Along-Track Satellite Altimetry
Authors: Lawrence Albion , Callies Jörn
Published: May 2022

Along-track wavenumber spectral densities of sea surface height (SSH) are estimated from Jason-2 altimetry data as a function of spatial location and calendar month to understand the seasonality of meso- and submesoscale balanced dynamics across the global ocean. Regions with significant mode-1 and mode-2 baroclinic tides are rejected, restricting the analysis to the extratropics. Where balanced motion dominates, the SSH spectral density is averaged over all pass segments in a region for each calendar month and is fit to a four-parameter model consisting of a flat plateau at low wavenumbers, a transition at wavenumber k0 to a red power law spectrum k−s, and a white spectrum at high wavenumbers that models the altimeter noise. The monthly time series of the model parameters are compared to the evolution of the mixed layer. The annual mode of the spectral slope s reaches a minimum after the mixed layer deepens, and the annual mode of the bandpassed kinetic energy in the ranges [2k0, 4k0] and [k0, 2k0] peak ∼2 and ∼4 months, respectively, after the maximum of the annual mode of the mixed layer depth. This analysis is consistent with an energization of the submesoscale by a winter mixed layer instability followed by an inverse cascade of kinetic energy to the mesoscale, in agreement with prior modeling studies and in situ measurements. These results are compared to prior modeling, in situ, and satellite investigations of specific regions and are broadly consistent with them within measurement uncertainties.

Significance Statement

This paper uses satellite observations to understand the source of ocean dynamics at the 1–100-km scales at which vertical motion becomes important and which are thus relevant for biology and for the exchange of heat and carbon with the atmosphere. The observations are consistent with a seasonal variation of dynamics at these scales, predicted by a specific theory of upper-ocean turbulence and confirmed by modeling studies and regional observations. We update prior satellite-based studies by excluding regions with competing effects, by our treatment of the noise, and by our characterization of the seasonality. This work provides a template for analyzing data from the upcoming Surface Water and Ocean Topography (SWOT) satellite.
In Situ Calibration of Underwater Glider Flight Model Using Acoustic Doppler Current Profilers
Authors: Tanaka T. , Hasegawa D. , Okunishi T. , Yasuda I. , Welch T. P.
Published: May 2022

The angle of attack (AOA) is the difference between the underwater glider’s path and pitch angle and is necessary to accurately estimate dead-reckoned position and depth-averaged velocity. The AOA is also important for any sensor measurements that are affected by the glider’s velocity through water, such as ocean turbulence measurement. A glider flight model is generally used to accurately estimate AOA and glider’s actual velocity based on the knowledge of lift and drag coefficients optimized for each glider. This paper examines the AOA of a Slocum glider using an acoustic Doppler current profiler (ADCP) to demonstrate a regression method to estimate these coefficients. Since the current shear was sufficiently small on average, it was reasonable to assume that the ADCP velocity at the nearest bin could capture the glider’s motion during flight and was used to calculate AOA. The lift and drag coefficients were optimized so the flight model estimated the observed pitch–AOA relationship derived from the ADCP and the glider’s pitch observations. The resultant coefficients also satisfied the vertical and horizontal constraints of glider motion and gave unbiased estimates of turbulence intensity derived from the flight model and ADCP. Our method was also applied to a SeaExplorer glider to derive the lift and drag coefficients for the first time. The observed pitch–AOA relationship was reasonably captured by the flight model with the resultant coefficients, suggesting that our method to estimate the lift and drag coefficient of underwater gliders can be applied to any type of underwater glider equipped with an ADCP.
A multi-objective grouping genetic algorithm for modular design
Authors: Tseng Hwai-En , Chang Chien-Cheng , Lee Shih-Chen , Li Tzu-Hui
Published: May 2022

Due to the increasingly variable market competition, product modular design is gaining in importance. This study attempts to seek a balance in three perspectives on product design: connection intensity, cost-effectiveness, and environmental protection. A multi-objective grouping genetic algorithm is adopted. Grouping genetic algorithms feature the flexible grouping and correcting mechanisms of crossover and mutation to meet the requirements of grouping, making it possible to establish a reasonable multi-objective measurement method after grouping and further offer suggestions to improve the modular design. In this study, the ceiling fan is used as an example to verify the proposed method for evaluation of the grouping method in the Matlab program. Results of the ceiling fan case verify that the proposed multi-objective algorithm is effective in modular design.
Measuring tourism demand nowcasting performance using a monotonicity test
Authors: Liu Han , Wang Yongjing , Song Haiyan , Liu Ying
Published: May 2022

Tourism demand nowcasting is generally carried out using econometric models that incorporate either macroeconomic variables or search query data as explanatory variables. Nowcasting model accuracy is normally evaluated by traditional loss functions. This study proposes a novel statistical method, the monotonicity test, to assess whether the nowcasting errors obtained from the ordinary least squares, generalised dynamic factor model and generalised dynamic factor model combined with mixed data sampling model are monotonically decreasing when new data on explanatory variables become available, based on the mixed frequency data between 1 January 2011 and 31 December 2019. The results of the empirical analysis show that nowcasts generated results based on two data sources combined are superior to that based on a single data source. Compared with traditional loss functions, the monotonicity test leads to a more objective and convincing nowcasting model performance. This study is the first attempt to evaluate tourism demand nowcasting performance using a monotonicity test.
The effects of constructive journalism techniques on mood, comprehension, and trust
Authors: van Antwerpen Natasha , Searston Rachel A. , Turnbull Deborah , Hermans Liesbeth , Kovacevic Petra
Published: May 2022

The role of news media in the perpetuation of misinformation has faced increasing scrutiny. Concerns have been raised about news media’s negative influence on mental health, increasing news avoidance, and decreasing trust in news. Constructive journalism is proposed to increase engagement with and trust in news media, reduce the mental health impact of news consumption, and provide a more accurate view of the world. However, constructive journalism studies primarily investigate the inclusion of solutions and positive emotions in news stories, to the exclusion of other techniques. Additionally, few studies have investigated constructive journalism’s effects on trust and comprehension. We used a randomised-controlled repeated-measures experimental design to investigate the effects of a comprehensive set of constructive journalism techniques on mood, comprehension, and trust among 238 Australian participants. Participants who read constructive articles reported higher positive emotion, and lower negative emotion, compared to participants who read the same articles without constructive features. However, participants in the constructive condition demonstrated worse comprehension than participants in the control, an effect partially mediated by negative emotion but not effort. No significant differences in trust in journalism as an institution or in article content were present between groups. However, when accounting for interest, constructive journalism demonstrated a significant negative effect on trust in the information, though positive where it increased mood. Further research is needed to calibrate techniques which balance the positive effects of constructive journalism with its ability to convey information.
Paper 24: The Natural Course of Recovery for Health-Related Quality of Life Following Hip Arthroscopy for Femoroacetabular Impingement Syndrome
Authors: Malloy Phil , Alter Thomas , Chahla Jorge , Nho Shane , Clapp Ian , Bodendorfer Blake
Published: May 2022

Objectives:

To determine if subgroups of patients exist based on the recovery trajectory of health-related quality of life following hip arthroscopy for femoroacetabular impingement syndrome (FAIS), and to determine clinical data predictors for these subgroups of patients.

Methods:

A clinical hip data repository was queried for patients who underwent primary hip arthroscopy for the treatment of FAIS between January 2012 and May 2018. Patients who completed pre-operative, 1-year, and 2-year International Hip Outcome Tool-12 (iHOT-12) were included in the study. Latent class growth analysis (LCGA) and growth mixture models (GMM) were used to identify subgroups of patients based on trajectories of recovery for iHOT-12 utilizing 3 clinical time points (pre-operative [within 1 week of surgery], one-year postoperative, and two-year postoperative). LCGA and GMM models using 1 – 6 classes were assessed for best model fit according to AIC, BIC, bootstrapped likelihood ratio test, and log-likelihood ratios. Following the final model selection, a multivariable multinomial logistic regression on the final model was performed with the largest class as the reference group to determine clinical predictors of subgroup membership.

Results:

A total of 443 patients with an average age of 34.25 ± 12.65 and BMI of 25.02 ± 5.11met inclusion criteria. The 3-class GMM was the best fit model, and the resulting subgroups were named based on trajectories of iHOT-12 scores: early progressors, late regressors, and late progressors (Figure 1A). The early progressors comprised 70.0% of the study group and had substantial early improvement between preoperative and 1-year follow-up with further improved 2-year outcomes (Figure 1B). The late regressors comprised 22.3% of the study sample and demonstrated improvement between preoperative and 1-year follow-up with decreasing function between 1-year and 2-years postoperatively (Figure 1C). The late progressors represented the smallest group at 7.7% and only demonstrated improved outcomes after 1-year postoperatively (Figure 1D). Predictors of the late regressor membership were worker’s compensation status, psychiatric history, preoperative chronic pain, and lower preoperative iHOT-12 scores. Patients in the late progressor subgroup were less likely to participate in physical hobbies/exercise.

Conclusions:

Using growth mixture models, three natural courses of health-related quality of life recovery following hip arthroscopy for the treatment of FAIS were identified: early progressors, late regressors, and late progressors. Worker’s compensation status, psychiatric history, preoperative chronic pain, and lower preoperative iHOT-12 scores were predictive of less than favorable trajectories of recovery. [Figure: see text]
Gallbladder microbiota composition is associated with pancreaticobiliary and gallbladder cancer prognosis
Authors: Kirishima Mari , Yokoyama Seiya , Matsuo Kei , Hamada Taiji , Shimokawa Michiko , Akahane Toshiaki , Sugimoto Tomoyuki , Tsurumaru Hirohito , Ishibashi Matsujiro , Mataki Yuko , Ootsuka Takao , Nomoto Mitsuharu , Hayashi Chihiro , Horiguchi Akihiko , Higashi Michiyo , Tanimoto Akihide
Published: May 2022

Background

The microbial population of the intestinal tract and its relationship to specific diseases has been extensively studied during the past decade. However, reports characterizing the bile microbiota are rare. This study aims to investigate the microbiota composition in patients with pancreaticobiliary cancers and benign diseases by 16S rRNA gene amplicon sequencing and to evaluate its potential value as a biomarker for the cancer of the bile duct, pancreas, and gallbladder.

Results

We enrolled patients who were diagnosed with cancer, cystic lesions, and inflammation of the pancreaticobiliary tract. The study cohort comprised 244 patients. We extracted microbiome-derived DNA from the bile juice in surgically resected gallbladders. The microbiome composition was not significantly different according to lesion position and cancer type in terms of alpha and beta diversity. We found a significant difference in the relative abundance of Campylobacter, Citrobacter, Leptotrichia, Enterobacter, Hungatella, Mycolicibacterium, Phyllobacterium and Sphingomonas between patients without and with lymph node metastasis.

Conclusions

There was a significant association between the relative abundance of certain microbes and overall survival prognosis. These microbes showed association with good prognosis in cholangiocarcinoma, but with poor prognosis in pancreatic adenocarcinoma, and vice versa. Our findings suggest that pancreaticobiliary tract cancer patients have an altered microbiome composition, which might be a biomarker for distinguishing malignancy.
Determinants of implementing pet robots in nursing homes for dementia care
Authors: Koh Wei Qi , Toomey Elaine , Flynn Aisling , Casey Dympna
Published: May 2022

Background

Pet robots have been employed as viable substitutes to pet therapy in nursing homes. Despite their potential to enhance the psychosocial health of residents with dementia, there is a lack of studies that have investigated determinants of implementing pet robots in real-world practice. This study aims to explore the determinants of implementing pet robots for dementia care in nursing homes, from the perspectives of healthcare professionals and organisational leaders.

Methods

A descriptive qualitative study, conceptualised and guided using the Consolidated Framework of Implementation Research (CFIR), was conducted. We conducted semi-structured interviews with healthcare professionals and organisational leaders from nursing homes. Data was transcribed and analysed using Framework Analysis, based on the CFIR as an a priori framework.

Results

A total of 22 participants from eight nursing homes were included. Determinants were mapped to constructs from all five CFIR domains. Determinants relating to the characteristics of pet robots include their design, realisticness and interactivity, affordability, cleanability, perceived evidence strength and comparative advantages to live pets. Determinants relating to external influences (outer setting) include national regulatory guidelines, funding and networks with other organisations. With regards to characteristics of nursing homes (inner setting), determinants include the relevance of pet robots in relation to the needs of residents with dementia, alignment with care processes, infection control mandates and their relative priority. In the domain ‘characteristics of individuals’, determinants were associated with individuals’ beliefs on the role of technology, desires to enhance residents’ quality of life, and differential attitudes on the use of robots. Finally, in the domain ‘implementation process’, assessments and care planning were identified as determinants.

Conclusions

Overall, while sentiments around determinants within CFIR domains of pet robots’ characteristics, outer setting and implementation process were similar, participants’ opinions on the determinants within the ‘inner setting’ and ‘characteristics of individuals’ were more varied. This could be due to different organisational structures, disciplinary differences and personal experiences of using pet robots. Many determinants in different domains were interrelated. Findings provide a springboard for identifying and designing implementation strategies to guide the translation of pet robots from research into real-world practice.
Long-term effect of chronic hepatitis B on mortality in HIV-infected persons in a differential HBV transmission setting
Authors: Umutesi Justine , Nsanzimana Sabin , Yingkai Liu Carol , Vanella Patrizio , Ott Jördis J. , Krause Gérard
Published: May 2022

Background

There remain gaps in quantifying mortality risk among individuals co-infected with chronic hepatitis B (HBV) and human immunodeficiency virus (HIV) in sub-Saharan African contexts. Among a cohort of HIV-positive individuals in Rwanda, we estimate the difference in time-to mortality between HBV-positive (HIV/HBV co-infected) and HBV-negative (HIV mono-infected) individuals.

Methods

Using a dataset of HIV-infected adults screened for hepatitis B surface antigen (HBsAg) from January to June 2016 in Rwanda, we performed time-to-event analysis from the date of HBsAg results until death or end of study (31 December 2019). We used the Kaplan–Meier method to estimate probability of survival over time and Cox proportional hazard models to adjust for other factors associated with mortality.

Results

Of 21,105 available entries, 18,459 (87.5%) met the inclusion criteria. Mean age was 42.3 years (SD = 11.4) and 394 (2.1%) died during follow-up (mortality rate = 45.7 per 100,000 person-months, 95% confidence interval (CI) 41.4–50.4) Mortality rate ratio for co-infection was 1.7, 95% CI 1.1–2.6, however, Cox regression analysis did not show any association with mortality between compared groups. The adjusted analysis of covariates stratified by co-infection status showed that males, residing outside of the capital Kigali, drinking alcohol, WHO-HIV-clinical stage 3 and 4 were associated with increased mortality in this HIV cohort.

Conclusions

HBV infection does not significantly influence mortality among HIV-infected individuals in Rwanda. The current cohort is likely to have survived a period of high-risk exposure to HBV and HIV mortality and limited health care until their diagnosis.
Deep transfer learning to quantify pleural effusion severity in chest X-rays
Authors: Huang Tao , Yang Rui , Shen Longbin , Feng Aozi , Li Li , He Ningxia , Li Shuna , Huang Liying , Lyu Jun
Published: May 2022

Purpose

The detection of pleural effusion in chest radiography is crucial for doctors to make timely treatment decisions for patients with chronic obstructive pulmonary disease. We used the MIMIC-CXR database to develop a deep learning model to quantify pleural effusion severity in chest radiographs.

Methods

The Medical Information Mart for Intensive Care Chest X-ray (MIMIC-CXR) dataset was divided into patients ‘with’ or ‘without’ chronic obstructive pulmonary disease (COPD). The label of pleural effusion severity was obtained from the extracted COPD radiology reports and classified into four categories: no effusion, small effusion, moderate effusion, and large effusion. A total of 200 datasets were randomly sampled to manually check each item and determine whether the tags are correct. A professional doctor re-tagged these items as a verification cohort without knowing their previous tags. The learning models include eight common network structures including Resnet, DenseNet, and GoogleNET. Three data processing methods (no sampling, downsampling, and upsampling) and two loss algorithms (focal loss and cross-entropy loss) were used for unbalanced data. The Neural Network Intelligence tool was applied to train the model. Receiver operating characteristic curves, Area under the curve, and confusion matrix were employed to evaluate the model results. Grad-CAM was used for model interpretation.

Results

Among the 8533 patients, 15,620 chest X-rays with clearly marked pleural effusion severity were obtained (no effusion, 5685; small effusion, 4877; moderate effusion, 3657; and large effusion, 1401). The error rate of the manual check label was 6.5%, and the error rate of the doctor’s relabeling was 11.0%. The highest accuracy rate of the optimized model was 73.07. The micro-average AUCs of the testing and validation cohorts was 0.89 and 0.90, respectively, and their macro-average AUCs were 0.86 and 0.89, respectively. The AUC of the distinguishing results of each class and the other three classes were 0.95 and 0.94, 0.76 and 0.83, 0.85 and 0.83, and 0.87 and 0.93.

Conclusion

The deep transfer learning model can grade the severity of pleural effusion.
Enhancement of the International prognostic index with β2-microglobulin, platelet count and red blood cell distribution width: a new prognostic model for diffuse large B-cell lymphoma in the rituximab era
Authors: Chen Haizhu , Zhong Qiaofeng , Zhou Yu , Qin Yan , Yang Jianliang , Liu Peng , He Xiaohui , Zhou Shengyu , Zhang Changgong , Gui Lin , Yang Sheng , Zhou Liqiang , Shi Yuankai
Published: May 2022

Background

This study aimed to propose a new user-friendly, cost effective and robust risk model to facilitate risk stratification for diffuse large B-cell lymphoma (DLBCL) treated with frontline R-CHOP regimens.

Methods

Data on 998 patients with de novo DLBCL diagnosed between Jan 1st, 2005 and Dec 31st, 2018 at our center, who received frontline R-CHOP or R-CHOP-like regimens, were retrospectively collected. Patients were randomly divided into the training cohort (n = 701) and the validation cohort (n = 297). A new prognostic model for overall survival (OS) was built based on the training cohort. The performance of the new model was compared with International prognostic index (IPI), revised IPI (R-IPI) and National Comprehensive Cancer Network (NCCN)-IPI (NCCN-IPI). The new model was validated in the validation cohort.

Results

The multivariate analysis of the training cohort showed that the IPI, β2-microglobulin, platelet count and red blood cell distribution width were independent factors for OS, which were incorporated into the new prognostic model. Patients were stratified into low risk, low-intermediate risk, high-intermediate risk, high risk and very high risk groups, with distinct survival outcomes. The new model achieved good C-indexes for 5-year OS prediction of 0.750 (95%CI 0.719–0.781) and 0.733 (95%CI 0.682–0.784) in the training and validation cohorts, respectively, and displayed well-fitted calibration curves. The C-index and the time-dependent ROC analysis demonstrated better performance of the new model than the IPI, R-IPI and NCCN-IPI in both training and validation cohorts. The integrated Brier score for predicting 5-year OS of the new model was lower than that of the IPI, R-IPI and NCCN-IPI in both cohorts, and decision curve analysis also showed a higher net benefit, indicating the superiority of the new model over the conventional models.

Conclusion

The new prognostic model might be a useful predictive tool for DLBCL treated with R-CHOP regimens. Further external validation is warranted.
Prevalence and risk factors of functional gastrointestinal disorders in Vietnamese infants and young children
Authors: Chia Loo Wee , Nguyen Thi Viet Ha , Phan Van Nha , Luu Thi Thao Nguyen , Nguyen Gia Khanh , Tan Serene Yaling , Rajindrajith Shaman , Benninga Marc Alexander
Published: May 2022

Background

Functional gastrointestinal disorders (FGIDs) are common early in life. The prevalence of FGIDs varies among countries but is unknown in Vietnam. The aim of this study is to assess the prevalence of FGIDs in healthy Vietnamese infants and young children.

Methods

This was a cross-sectional, observational study involving healthy infants and young children between 0 – 48 months old in Hanoi, Vietnam. A representative total of 1511 subjects completed the validated questionnaire on paediatric FGIDs. Rome IV criteria were used to define FGIDs.

Results

For Vietnamese infants (0–6 months) and young children (7–48 months), the prevalence of having at least one FGID was 10.0% and only 0.6% was having more than one FGID. Infantile regurgitation (9.3%) was the most prevalent FGID among infants 0—6 months of age while all other FGIDs had a low prevalence between 0—2.5%. For young children between 7 – 48 months old, functional constipation was the most common disorder at the rate of 5.6%. Association analysis revealed that the risk of infant regurgitation was significantly lower among infants with exclusively breastfeeding at 2 – 3 months and 3 – 4 months, formula initiation at 0 – 1 months, and higher paternal education level. The prevalence of functional constipation was significantly higher in male subjects, children in families with annual household income between 273,000,000 – 546,999,999 VND (or estimate around 11,800 – 23,800 USD), families with one child only, and formula feeding initiation at 1 – 2 months.

Conclusions

The prevalence of FGIDs in Vietnamese infants and young children is relatively low compared to the published literature using Rome IV diagnostic criteria. Infantile regurgitation was the most common FGID in Vietnamese infants while functional constipation was most prevalent among Vietnamese young children.

Trial registration

Netherlands Trial Registry Identifier: NL7286/NTR7495.
The effect of talus osteochondral defects of different area size on ankle joint stability: a finite element analysis
Authors: Li Jia , Wang Yezhou , Wei Yu , Kong Dan , Lin Yuan , Wang Duanyang , Cheng Shi , Yin Pengbin , Wei Min
Published: May 2022

Background

Osteochondral lesion of the talus (OLT) is one of the most common ankle injuries, which will lead to biomechanical changes in the ankle joint and ultimately affect ankle function. Finite element analysis (FEA) is used to clarify the effect of talus osteochondral defects on the stability of the ankle joint at different depths. However, no research has been conducted on talus osteochondral defect areas that require prompt intervention. In this research, FEA was used to simulate the effect of the area size of talus osteochondral defect on the stress and stability of the ankle joint under a specific depth defect.

Methods

Different area sizes (normal, 2 mm* 2 mm, 4 mm* 4 mm, 6 mm* 6 mm, 8 mm* 8 mm, 10 mm* 10 mm, and 12 mm* 12 mm) of the three-dimensional finite element model of osteochondral defects were established. The model was used to simulate and calculate joint stress and displacement of the articular surface of the distal tibia and the proximal talus when the ankle joint was in the heel-strike, midstance, and push-off phases.

Results

When OLT occurred, the contact pressure of the articular surface, the equivalent stress of the proximal talus, the tibial cartilage, and the talus cartilage did not change significantly with an increase in the size of the osteochondral defect area when the heel-strike phase was below 6 mm * 6 mm. Gradual increases started at 6 mm * 6 mm in the midstance and push-off phases. Maximum changes were reached when the defect area size was 12 mm * 12 mm. The same patterns were observed in the talus displacement.

Conclusions

The effect of the defect area of the ankle talus cartilage on the ankle biomechanics is evident in the midstance and push-off phases. When the size of the defect reaches 6 mm * 6 mm, the most apparent change in the stability of the ankle joint occurs, and the effect does not increase linearly with the increase in the size of the defect.
System dynamic modelling of healthcare associated influenza -a tool for infection control
Authors: Sansone Martina , Holmstrom Paul , Hallberg Stefan , Nordén Rickard , Andersson Lars-Magnus , Westin Johan
Published: May 2022

Background

The transmission dynamics of influenza virus within healthcare settings are not fully understood. Capturing the interplay between host, viral and environmental factors is difficult using conventional research methods. Instead, system dynamic modelling may be used to illustrate the complex scenarios including non-linear relationships and multiple interactions which occur within hospitals during a seasonal influenza epidemic. We developed such a model intended as a support for health-care providers in identifying potentially effective control strategies to prevent influenza transmission.

Methods

By using computer simulation software, we constructed a system dynamic model to illustrate transmission dynamics within a large acute-care hospital. We used local real-world clinical and epidemiological data collected during the season 2016/17, as well as data from the national surveillance programs and relevant publications to form the basic structure of the model. Multiple stepwise simulations were performed to identify the relative effectiveness of various control strategies and to produce estimates of the accumulated number of healthcare-associated influenza cases per season.

Results

Scenarios regarding the number of patients exposed for influenza virus by shared room and the extent of antiviral prophylaxis and treatment were investigated in relation to estimations of influenza vaccine coverage, vaccine effectiveness and inflow of patients with influenza. In total, 680 simulations were performed, of which each one resulted in an estimated number per season. The most effective preventive measure identified by our model was administration of antiviral prophylaxis to exposed patients followed by reducing the number of patients receiving care in shared rooms.

Conclusions

This study presents an system dynamic model that can be used to capture the complex dynamics of in-hospital transmission of viral infections and identify potentially effective interventions to prevent healthcare-associated influenza infections. Our simulations identified antiviral prophylaxis as the most effective way to control in-hospital influenza transmission.
Development and validation of a prediction model for tuberculous pleural effusion: a large cohort study and external validation
Authors: Liu Yanqing , Liang Zhigang , Yuan Songbo , Wang Shanshan , Guo Fei , Peng Weidong , Yang Jing , Wu Aihua
Published: May 2022

Background

Distinguishing tuberculous pleural effusion (TPE) from non-tuberculosis (TB) benign pleural effusion (BPE) remains to be a challenge in clinical practice. The aim of the present study was to develop and validate a novel nomogram for diagnosing TPE.

Methods

In this retrospective analysis, a total of 909 consecutive patients with TPE and non-TB BPE from Ningbo First Hospital were divided into the training set and the internal validation set at a ratio of 7:3, respectively. The clinical and laboratory features were collected and analyzed by logistic regression analysis. A diagnostic model incorporating selected variables was developed and was externally validated in a cohort of 110 patients from another hospital.

Results

Six variables including age, effusion lymphocyte, effusion adenosine deaminase (ADA), effusion lactatedehy drogenase (LDH), effusion LDH/effusion ADA, and serum white blood cell (WBC) were identified as valuable parameters used for developing a nomogram. The nomogram showed a good diagnostic performance in the training set. A novel scoring system was then established based on the nomogram to distinguish TPE from non-TB BPE. The scoring system showed good diagnostic performance in the training set [area under the curve (AUC) (95% confidence interval (CI)), 0.937 (0.917–0.957); sensitivity, 89.0%, and specificity, 89.5%], the internal validation set [AUC (95%CI), 0.934 (0.902–0.966); sensitivity, 88.7%, and specificity, 90.3%], and the external validation set [(AUC (95%CI), 0.941 (0.891–0.991); sensitivity, 93.6%, and specificity, 87.5%)], respectively.

Conclusions

The study developed and validated a novel scoring system based on a nomogram originated from six clinical parameters. The novel scoring system showed a good diagnostic performance in distinguishing TPE from non-TB BPE and can be conveniently used in clinical settings.
The functional evolution of termite gut microbiota
Authors: Arora Jigyasa , Kinjo Yukihiro , Šobotník Jan , Buček Aleš , Clitheroe Crystal , Stiblik Petr , Roisin Yves , Žifčáková Lucia , Park Yung Chul , Kim Ki Yoon , Sillam-Dussès David , Hervé Vincent , Lo Nathan , Tokuda Gaku , Brune Andreas , Bourguignon Thomas
Published: May 2022

Background

Termites primarily feed on lignocellulose or soil in association with specific gut microbes. The functioning of the termite gut microbiota is partly understood in a handful of wood-feeding pest species but remains largely unknown in other taxa. We intend to fill this gap and provide a global understanding of the functional evolution of termite gut microbiota.

Results

We sequenced the gut metagenomes of 145 samples representative of the termite diversity. We show that the prokaryotic fraction of the gut microbiota of all termites possesses similar genes for carbohydrate and nitrogen metabolisms, in proportions varying with termite phylogenetic position and diet. The presence of a conserved set of gut prokaryotic genes implies that essential nutritional functions were present in the ancestor of modern termites. Furthermore, the abundance of these genes largely correlated with the host phylogeny. Finally, we found that the adaptation to a diet of soil by some termite lineages was accompanied by a change in the stoichiometry of genes involved in important nutritional functions rather than by the acquisition of new genes and pathways.

Conclusions

Our results reveal that the composition and function of termite gut prokaryotic communities have been remarkably conserved since termites first appeared ~ 150 million years ago. Therefore, the “world’s smallest bioreactor” has been operating as a multipartite symbiosis composed of termites, archaea, bacteria, and cellulolytic flagellates since its inception.
The feasibility of patient-reported outcomes, physical function, and mobilization in the care pathway for head and neck cancer surgical patients
Authors: Daun Julia T. , Twomey Rosie , Capozzi Lauren C. , Crump Trafford , Francis George J. , Matthews T. Wayne , Chandarana Shamir , Hart Robert D. , Schrag Christiaan , Matthews Jennifer , McKenzie C. David , Lau Harold , Dort Joseph C. , Culos-Reed S. Nicole
Published: May 2022

Background

Head and neck cancer (HNC) patients are an understudied population whose treatment often includes surgery, causing a wide range of side effects. Exercise prehabilitation is a promising tool to optimize patient outcomes and may confer additional benefits as a prehabilitation tool. The primary objective of this study was to assess the feasibility of measuring patient-reported outcomes (PROs), physical function, and in-hospital mobilization across the HNC surgical timeline in advance of a future prehabilitation trial. The secondary objective was to examine potential changes in these outcomes across the surgical timeline.

Methods

HNC patients scheduled to undergo oncologic resection with free-flap reconstruction completed assessments of PROs and physical function at three timepoints across the surgical timeline (baseline, in-hospital, and postsurgical/outpatient). Mobilization was measured during the in-hospital period. The feasibility of recruitment and measurement completion was tracked, as were changes in both PROs and physical function.

Results

Of 48 eligible patients, 16 enrolled (recruitment rate of 33%). The baseline and in-hospital PROs were completed by 88% of participants, while the outpatient assessments were completed by 81% of participants. The baseline and in-hospital assessment of physical function were completed by 56% of participants, and 38% completed the outpatient assessment. Measuring in-hospital mobilization was completed for 63% of participants.

Conclusion

Measuring PROs and in-hospital mobilization is feasible across the surgical timeline in HNC; however, the in-person assessment of physical function prior to surgery was not feasible. A multidisciplinary collaboration between exercise specialists and clinicians supported the development of new clinical workflows in HNC surgical care that will aid in the implementation of a future prehabilitation trial for this patient population.
Development of a MnCO3-based Electrocatalyst for Water Oxidation from Rhodochrosite Ore
Authors: Sakai Arisu , Harada Kazuki , Tsunekawa Shun , Tamura Yoshiaki , Ito Masaya , Hatada Keisuke , Ina Toshiaki , Ohara Takumi , Wang Ke-Hsuan , Kawai Takeshi , Yoshida Masaaki
Published: May 2022

An electrocatalyst based on a manganese carbonate mineral and intended to promote the water oxidation reaction was obtained by simply ball milling rhodochrosite ore. This material was found to catalyze the water oxidation reaction in a stable manner. Mn K-edge and O K-edge X-ray absorption fine structure (XAFS) analyses combined with theoretical simulations showed that the catalyst was composed of MnCO3 with slight distortions of the surface structure. Operando UV-vis absorption spectroscopy and linear combination fitting of XAFS spectra established that a portion of the MnCO3 surface was oxidized to MnO2. The MnO2 generated on the surface of this material likely provided active sites for the water oxidation reaction.
Rheology and fracture of dynamic polymeric networks
Authors: Πυρομάλη Χριστίνα
Published: May 2022

Στην παρούσα διατριβή ερευνούμε πειραματικά τις γραμμικές δυναμικές ιδιότητες και την μή-γραμμική διατμητική απόκριση μακρομοριακών δικτύων με απώτερο σκοπό την κατανόηση των συνθηκών ενδυνάμωσης, διαρροής και ροή συνεπεία ενός συνδυασμού τοπολογικών περιορισμών και ελκτικών αλληλεπιδράσεων, ώστε τελικά να προκύψουν κριτήρια σχεδιασμού για υλικά με βελτιωμένες ιδιότητες. Τόσο σε καθιερωμένα όσο και σε καινοτόμα πρότυπα συστήματα, πραγματοποιήσαμε πειράματα γραμμικής διάτμησης, μή-γραμμικής ρεολογίας σταθερής διάτμησης, ερπυσμού και μοντελοποίησης με τον αλγόριθμο χρονικής προσπέλασης που βασίζεται στο μοντέλο ενδοσωλήνιας κίνησης, με σκοπό την κατανόηση της επίδρασης της αρχιτεκτονικής, της τοπολογίας, των φυσικών και χημικών σταυροσυνδέσεων στην απόκριση των δικτύων. Η παρούσα διατριβή χωρίζεται σε τρία κυρίως μέρη. Το πρώτο μέρος συζητά το μηχανισμό χαλάρωσης των απλών τοπολογικά περιορισμένων διαπλεκόμενων ομοπολυμερών με έμφαση στην χαλάρωση των διατμητικών τάσεων μετά την παύση της ροής σταθερής διάτμησης. Το δεύτερο και το τρίτο μέρος επικεντρώνονται στην ανάπτυξη πολλαπλά αποκρίσιμων πολυμερικών πλεγμάτων με τουλάχιστον δύο διαφορετικές δυναμικές κλίμακες. Συγκεκριμένα, το δεύτερο μέρος διερευνά το ρόλο της μακρομοριακής αρχιτεκτονικής και του πλήθους των φυσικών δεσμών στις ρεολογικές ιδιότητες των υπερμοριακών δικτύων με δεσμούς από μεταλλικά σύμπλοκα. Το τελευταίο μέρος εστιάζει στην επίδραση της εσωτερικής μικροδομής, του μεγέθους και του κλάσματος όγκου μονομοριακών νανοσωματιδίων στα φαινόμενα ενδυνάμωσης πολυμερικών δικτύων.
Μελέτη ηλεκτρικών ιδιοτήτων χημικά τροποποιημένων νανοδομών άνθρακα και των υβριδίων τους
Authors: Κουτσιούκης Απόστολος
Published: May 2022

Η εμφάνιση των εύκαμπτων ηλεκτρονικών την περασμένη δεκαετία είχε ως αποτέλεσμα την αντικατάσταση της συμβατικής τεχνολογίας παραγωγής ηλεκτρονικών από τα αγώγιμα μελάνια σε συνδυασμό με κοινές μεθόδους εκτύπωσης. Τα νανοϋλικά του άνθρακα όπως το γραφένιο και οι νανοσωλήνες άνθρακα είναι οι κατάλληλοι υποψήφιοι για την παραγωγή αγώγιμων μελανιών και τη χρήση τους σε κοινές μεθόδους εκτύπωσης λόγω της ηλεκτρικής αγωγιμότητάς που παρουσιάζουν. Προς αυτή τη κατεύθυνση, τα νανοϋλικά του άνθρακα έχουν προταθεί για την αντικατάσταση μεταλλικών αγωγών και του οξειδίου του ινδίου (φθοριούχου) κασσιτέρου. Ωστόσο, τα νανοϋλικά άνθρακα δεν διασπείρονται σε οργανικούς διαλύτες ή το νερό. Για το λόγο αυτό, η χημική τροποποίηση τους (ομοιοπολικά / μη ομοιοπολικά ) με συγκεκριμένες λειτουργικές ομάδες, επιφανειοδραστικές ουσίες ή πολυμερή είναι το πιο ουσιαστικό βήμα για τη διασπορά τους σε οργανικούς διαλύτες ή ακόμα και στο νερό. Η χημική τροποποίηση των νανοϋλικών του άνθρακα έχει ως αποτέλεσμα τον σχηματισμό ποικιλίας οργανικών παραγώγων, υβριδίων και νανοσυνθέτων για πληθώρα εφαρμογών. Η παρούσα διδακτορική διατριβή αξιολογεί τον συνδυασμό του γραφενίου με χημικά τροποποιημένους νανοσωλήνες άνθρακα με τη μορφή υβριδίου με στόχο τη διασπορά στο νερό αλλά και την ενίσχυση της αγωγιμότητας. Οι δυνάμεις Van der Waals που αναπτύσσονται μεταξύ των υδρόφοβων γραφενικών επιφανειών και των κατά τόπους υδρόφοβων νανοσωλήνων σταθεροποιούν το υβρίδιο σε πολικούς διαλύτες αλλά ακόμη πιο σημαντικά στο νερό. H ηλεκτρική αγωγιμότητα των επιμέρους υλικών έχει σαν αποτέλεσμα την επαυξημένη αγωγιμότητα και του τελικού υβριδίου. Τα προϊόντα ενδιάμεσα και τελικά χαρακτηρίστηκαν με διάφορες πειραματικές τεχνικές (XRD, FTIR, ATR, Raman, UV-Vis, XPS, SEM, AFM, HRTEM) ενώ οι περισσότερες ηλεκτρικές μετρήσεις έγιναν με τη μέθοδο μέτρησης ηλεκτρικής αντίστασης 4 σημείων. Τέλος, τα υδρόφιλα υβρίδια γραφενίου/νανοσωλήνων που προκύπτουν χρησιμοποιούνται σε συνδυασμό με τις απαραίτητες ρητίνες, για τη παρασκευή αγώγιμων μελανιών σε τεχνικές εκτύπωσης, όπως η βαθυτυπία, η φλεξογραφία και η μεταξοτυπία, όπου η εκτυπωτική και η ηλεκτρική τους απόδοση μελετώνται πριν και μετά τη διαδικασία εκτύπωσης.