bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of Destructive Effects with Electron Bombardment in Slow-Wave
Structures
Authors: Tan Nongchao , Wu Ping , Hua Ye , Sun Jun , Cao Yibing , Zhang Guangshuai , Huang Wenhui , Huang Wenhua , Batani Katarzyna
Published: February 2022

Radio frequency (RF) breakdown can result in pulse shortening and
seriously degrade the stability and reliability of relativistic backward
wave oscillators (RBWOs). This paper discusses the energy range of electrons
causing breakdown traces in slow-wave structures (SWSs) through
particle-in-cell (PIC) simulation, numerical calculation, and experimental
verification. The PIC simulation and numerical calculation results reveal
that the energy of the majority of the field-induced electrons bombarding
the SWS surfaces after being accelerated is less than 120 keV. Furthermore,
the micro appearances of the breakdown traces in SWSs and the witness
targets bombarded directly by electrons of various energy levels have been
analyzed. Scanning electron microscope (SEM) shows that the breakdown traces
are featured with corrugated morphologies with a wide range and a shallow
depth. A mass of craters emerge in the vicinity of the corrugated
morphologies. These appearances are quite similar to destructive traces
impacted directly by low-energy electrons (around 160 keV). Thus, it is
confirmed that the breakdown traces result from the bombardment of
low-energy electrons. Therefore, the breakdown mechanism of field-emitted
electrons impacting on the structure surfaces in RBWOs has been further
improved.
The Magnitude of Salt Intake Behaviors and Its Predictors among Saqez Urban Population of Kurdistan District in Iran: A Cross-Sectional Study
Authors: Khoram Kolsom , Asghari-Jafarabadi Mohammad , Ebrahimi-Mamagani Mehrangiz , Shokrvash Behjat , Hariri-Akbari Maral
Published: February 2022

Background. Controlling and reducing salt intake are one of the solutions to overcome hypertension. This study aimed at determining the predictors related to salt control methods in Saqez urban population. Methods and Materials. In the present cross-sectional study, the sample population was randomly selected through cluster sampling. Data collection was performed using valid questionnaires, demographic, family economic status, knowledge, perception, intention, salt intake behaviors, and salt control methods, along with measuring body mass index (BMI) and hypertension levels. Descriptive, analytical statistical methods and multivariate logistic regression analysis were used to determine the predictors of desirable salt control methods. The variables of sex, age, family economic status, knowledge, perception, perceived social support, self-efficacy, and intention were analyzed as independent variables. Data analysis was performed using SPSS software version 24 at a significance level of 0.05. Results. Out of 766 participants, 73% were women, with mean (M) 32.83, standard deviation (SD) 9.52 years, and 77.2% were married. There were significant sex differences in employment (

P
=
0.01

) and economic status (

P
=
0.016

). The M (SD) of blood pressure (systolic/diastolic) was 110.65 (0.0212) (

P
=
0.441

). The salt intake control methods between men and women did not show significant differences (

P
=
0.368

). Among totally 88.5%, 87.7% men and 88.9% women followed desirable behaviors. The predictors that determine the adoption of salt control methods were sex (man) (OR = 0.71, 95% CI (0.38–1.29)), age (OR = 1.02, 95% CI = (0.99–1.05)), SES/FAS (medium, high level) (OR = 1.37, 95% CI = (0.754–2.47); OR = 0.46, 95% CI = (0.047–4.55)), blood pressure (OR = 1.33, 95% CI = (0.16–11.23)), knowledge (have) (OR = 1.01, 95% CI = (0.39–1.63)), intent to reduce salt (OR = 1.047, 95% CI = (1.03–1.06)), perceived salt reduction importance (OR = 1.02, 95% CI = (1.01–1.04)), perceived emotional support (health staff) (OR = 1.02, 95% CI = (1.01–1.04)), media (OR = 1.01, 95% CI = 0.99–1.02), perceived practical support (spouse) (OR = 1.02, 95% CI = 0.99–1.04)), and perceived self-efficacy (OR = 1.01, 95% CI = (0.99–1.03)). Conclusion. The support of health staff and spouse seems to be effective in controlling the salt intake behaviors of healthy individuals. In parallel with the development and change of people’s lifestyles, new approaches (legal and services) for salt control based on the support of media and social media were expected.
Epileptic Seizure Detection with Hybrid Time-Frequency EEG Input: A Deep Learning Approach
Authors: Pan Yayan , Zhou Xiaoyu , Dong Fanying , Wu Jianxiang , Xu Yongan , Zheng Shilian
Published: February 2022

The precise detection of epileptic seizure helps to prevent the serious consequences of seizures. As the electroencephalogram (EEG) reflects the brain activity of patients effectively, it has been widely used in epileptic seizure detection in the past decades. Recently, deep learning-based detection methods which automatically learn features from the EEG signals have attracted much attention. However, with deep learning-based detection methods, different input formats of EEG signals will lead to different detection performances. In this paper, we propose a deep learning-based epileptic seizure detection method with hybrid input formats of EEG signals, i.e., original EEG, Fourier transform of EEG, short-time Fourier transform of EEG, and wavelet transform of EEG. Convolutional neural networks (CNNs) are designed for extracting latent features from these inputs. A feature fusion mechanism is applied to integrate the learned features to generate a more stable syncretic feature for seizure detection. The experimental results show that our proposed hybrid method is effective to improve the seizure detection performance in few-shot scenarios.
Application and Development of Modern 3D Printing Technology in the Field of Orthopedics
Authors: Li Binglong , Zhang Meng , Lu Qunshan , Zhang Baoqing , Miao Zhuang , Li Lei , Zheng Tong , Liu Peilai
Published: February 2022

3D printing, also known as additive manufacturing, is a technology that uses a variety of adhesive materials such as powdered metal or plastic to construct objects based on digital models. Recently, 3D printing technology has been combined with digital medicine, materials science, cytology, and other multidisciplinary fields, especially in the field of orthopedic built‐in objects. The development of advanced 3D printing materials continues to meet the needs of clinical precision medicine and customize the most suitable prosthesis for everyone to improve service life and satisfaction. This article introduces the development of 3D printing technology and different types of materials. We also discuss the shortcomings of 3D printing technology and the current challenges, including the poor bionics of 3D printing products, lack of ideal bioinks, product safety, and lack of market supervision. We also prospect the future development trends of 3D printing.
The Use of Trichostatin A during Pluripotent Stem Cell Generation Does Not Affect MHC Expression Level
Authors: Farahi Sara , Hosseini Sara , Ghanbarian Hossein , Hashemi Seyed Mahmoud , Salehi Mohammad , Hosseini Samaneh
Published: February 2022

Pluripotent stem cells (PSCs) are considered as a potent tool for use in regenerative medicine. Highly efficient generation of PSCs through chromatin modulators such as trichostatin A (TSA) might change their MHC molecule expression profile. The efficiency of PSC generation and their immunogenicity is major obstacles for clinical use. Hence, we aim to investigate whether the use of TSA during PSC generation affects MHC expression level. Three PSC lines were generated by iPSCs, NT-ESCs, and IVF-ESCs’ reprogramming methods from B6D2F1 mouse embryonic fibroblast cells. Established PSC lines were characterized by alkaline phosphatase assay (ALP) and immunocytochemistry. Their chromosome fidelity was checked by karyotyping. The expression level of pluripotent genes (oct4, nanog, sox2, klf4), HDACs (hdac1, hdac2, and hdac3), and immune-related genes (including Qa-1, Qa-2, H2kb, H2kd, H2db, H2db, CIITA, H2-IE-βb, H2-IE-βd) in iPSC and ESC lines were assessed by real-time PCR analysis. The presence of MHC molecules on the surface of pluripotent stem cells was also checked by flow cytometry technique. Significant increase of pluripotency markers, oct4, nanog, sox2, and klf4, was observed in 100 nM TSA-treated samples. 100 nM TSA induced significant upregulation of H2db in generated iPSCs. H2-IE-βd was remarkably downregulated in 50 and 100 nM TSA-treated iPSC lines. The expression level of other immune-related genes was not greatly affected by TSA in iPSC and NT-ESC lines. It is concluded that the use of short-term and low concentration of TSA during reprogramming in PSC generation procedure significantly increases PSC generation efficiency, but do not affect the MHC expression in established cell lines, which is in the benefit of cell transplantation in regenerative medicine.
[Retracted] Chlorella protothecoides Algae Oil and Its Mixes with Lower and Higher Alcohols and Al2O3 Metal Nanoadditives for Reduction of Pollution in a CI Engine
Authors: Vaidya Gayatri , Patil Pravin P. , SENER Arif Senol , Ramnath Navale Sainath , Singh Bharat , Surakasi Raviteja , Sripathi Srujana , Atiso Tsegaye Alemayehu
Published: February 2022

Numerous Algae oils with low and medium viscosity were investigated as fuel for CI engines. However, high viscous algae oil has not been explored in detail as a replacement for diesel in CI engines due to operational problems and poor performance characteristics. Esterification of neat algae oil to obtain its biodiesel is a complex process. The biodiesel obtained also has viscosity nearly five times more than diesel viscosity. Hence, research efforts on CI engines using algae oil methyl ester are lacking, particularly in combustion characteristics. This work focuses on utilizing algae oil as a fuel in CI engines. Algae oil has more affinity for alcohols due to a higher percentage of ricinoleic acid which aids in forming a homogeneous mixture. Alcohols with better fuel properties improve the combustion capability of algae oils with low and medium viscosity. However, not much research has been carried out in alcohols with very high viscous algae oil. Hence, in this work, higher and lower‐order alcohols were blended with algae oil in their neat form and their biodiesel with Al2O3 nanoadditives for performance improvement.
Noninferior Red Cell Concentrate Quality after Repeated Air Rescue Mission Transport for Prehospital Transfusion
Authors: Boecker Clemens , Sitzmann Nicole , Halblaub Miranda Jose Luis , Suhr Hajo , Wiedemann Philipp , Bieback Karen , Rudolph Marcus , Klüter Harald
Published: February 2022

Background: Transfusion of red cell concentrates (RCCs) is an integral therapy after severe hemorrhage or trauma. Prehospital transfusion offers an immediate intervention in emergency cases. Air ambulance-based prehospital transfusion, already used in different countries, is currently established in Germany. Limited information is available for regulatory-compliant transport logistics of RCCs and their quality after repeated air rescue missions. Thus, the aim of this study was (i) to validate regulatory-compliant logistics and (ii) to assess product quality, analyzing biochemical parameters and RBC morphology. Study Design and Methods: Due to regulatory requirements, we adapted a rotation system of 1 day transport, 1 day quarantine storage and 1 day storage over the entire RCC shelf life. RCCs transported on air rescue missions (flight group) were compared against a control group, treated identically except for helicopter transport. RCCs were visually inspected, and their temperature was documented throughout the entire rotation cycles. RCCs at the end of shelf life (end point samples) were assessed for levels of hemoglobin, hematocrit, free hemoglobin, hemolysis, mean corpuscular volume, potassium and pH. In addition, morphological changes were assessed using flow morphometry. Results: In total 81 RCCs were assessed in the flight group and 50 in the control group. Within the flight group, 30 RCCs were transfused. RCCs were dispatched on average 11 times (7–13 times). The average flight time was 18.3 h (6.6–28.8 h). The rotation system ensured adherence to regulatory guidelines, especially compliance to storage conditions of +2 to +6°C of intermediate storage. Biochemical and morphological quality parameters did not exhibit any changes upon repeated air rescue missions. A correlation with respect to the flight time was not observed either. Discussion: The quality of RCCs after repeated air rescue missions is noninferior to control samples regarding biochemical and morphological parameters. The product quality is within German regulations for up to 42 days of storage. The logistics and maintenance of the thermal conditions are safe and feasible. Thus, a rotation system of RCCs offers a regulatory-compliant option to supply air rescue missions with RCCs to allow life-saving prehospital transfusions at the incident scene.
Belly Dancer’s Dyskinesia: 3 Cases of a Rare Entity
Authors: Rathmann Kristina , Hambach Jens , Meleshchenko Nataliia , Rohkamm Reinhard , Kermer Pawel
Published: February 2022

Involuntary, undulating, or circular movements of abdominal wall muscles are a rare condition descriptively termed belly dancer syndrome or belly dancer’s dyskinesia. Differential diagnoses range from cerebral, spinal, peripheral, hormonal/drug-induced effects to local or even unknown/idiopathic and functional/psychogenic causes. Thorough diagnostic work-up is mandatory and therapeutic options depend on etiology and include surgical approaches and symptomatic treatment. We present 3 cases of belly dancer’s dyskinesia, in which differential diagnostic work-up did not uncover known etiologies for this movement disorder. Strikingly, 2 patients manifested vitamin B12 deficiency while 1 case showed values close to the lower limit of normal. While relevance of vitamin B12 levels remains elusive, all patients improved substantially following a combined therapeutic approach of clonazepam treatment and vitamin B12 supplementation.
Use of Intraoperative Multidimensional Fluoroscopy to Assess Femoral Neck Reduction Quality in a Patient with Displaced Femoral Neck Fracture: A Case Report
Authors: You Daniel Z. , Abbott Annalise G. , Boyd Steven K. , Duffy Paul
Published: February 2022

We present a case of displaced femoral neck fracture (FNF) in a patient treated with closed reduction and surgical fixation. An anatomic reduction was confirmed using intraoperative multidimensional fluoroscopy following reduction and surgical fixation. At the 1-year follow-up, the patient had returned to all activities and there were no signs of avascular necrosis. The quality of FNF reduction is an important modifiable treatment variable to reduce the risk of post-operative complications. Intraoperative multidimensional fluoroscopy enables the surgeon to utilize closed reduction techniques, limiting the risk of damage to vascular structures, while allowing for critical assessment of FNF reduction.
Endocannabinoid Receptor Expression in Early Zebrafish Development
Authors: Son Hae-Won , Ali Declan William
Published: February 2022

The endocannabinoid system (ECS) is widely studied due to its interactions with cannabis and its role in modulating physiological responses. While most research has focused on the effects of cannabis on adult ECSs, recent studies have begun to investigate the role of the ECS in developing organisms. However, little is known about the spatial or temporal expression of these receptors during early development. This study combines reverse transcriptase-polymerase chain reaction (RT-PCR) with in situ hybridizations to compile a timeline of the developmental expression of six key cannabinoid receptors; cb1, cb2, trpv1, trpa1a, trpa1b, and gpr55 in zebrafish embryos, starting from as early as 6-h postfertilization (hpf) until 3 days pf (dpf). This time frame is roughly equivalent to 2–10 weeks in human embryonic development. All six genes were confirmed to be expressed within this time range and share similarities with human and rodent expression. Cb1 expression was first detected between 12 and 24 hpf in the retina and CNS, and its expression increased thereafter and was more evident in the olfactory bulb, tegmentum, hypothalamus, and gut. Cb2 expression was relatively high at the 6 and 24 hpf timepoints, as determined by RT-PCR but was undetectable at other times. Trpv1 was first detected at 1 dpf in the trigeminal (Tg) ganglia, Rohon-Beard neurons, and lateral line, and its expression increased in the first 3 dpf. Expression of trpa1a was first detected as late as 3 dpf in vagal (V) neurons, whereas trpa1b was first detected at 1 dpf associated with Tg, glossopharyngeal, and V ganglia. Expression of gpr55 was diffuse and widespread throughout the brain and head region but was undetectable elsewhere in the embryo. Thus, receptor expression was found to be enriched in the central nervous system and within sensory neurons. This work aims to serve as a foundation for further investigation on the role of cannabinoid and cannabinoid-interacting receptors in early embryonic development.
Sex Differences in Right Ventricular Systolic Function and All-Cause Mortality in Tricuspid Regurgitation
Authors: Saeed Sahrai , Smith Jenna , Grigoryan Karine , Freitas Dario , Bleie Øyvind , Chambers John B. , Rajani Ronak
Published: February 2022

Introduction: Sex differences have been poorly studied in patients with right-sided heart valve disease. The principal aim of the current study was to explore the impact of sex differences on right ventricular (RV) hemodynamics and all-cause mortality in patients with moderate or severe tricuspid regurgitation (TR). Methods: This is a retrospective study of 209 patients with significant TR. All patients were clinically profiled at baseline and underwent a transthoracic echocardiogram. The cohort was followed up for clinical events for a median duration of 80 months (mean ± SD 69.4 ± 33.4 months). Results: There were 117 women with a mean (± SD) age of 72.6 ± 13 years and 92 men with a mean (± SD) age of 70.8 ± 15.8 years. There were no sex differences between the individual measures of RV systolic function (tricuspid annular plane systolic excursion [TAPSE], systolic pulmonary artery pressure, and RV S’), but overall RV systolic dysfunction (TAPSE <16 mm and/or RV S’ <10 cm/s) and left ventricular ejection fraction <50% were more common in men. Mean (± SD) RV wall tension (RV WT) was 3,170 ± 1,220 mm Hg × mm in women and 3,817 ± 1,499 mm Hg × mm in men (p = 0.002). There was no difference in all-cause mortality between women and men (Log-Rank p = 0.528). Age and increased RV WT were independent predictors of all-cause mortality both in women (hazard ratio [HR] 2.61) and men (HR 3.01). Conclusions: In this cohort of patients with significant TR, women more frequently had preserved RV systolic function than men. There was no sex-difference in all-cause mortality. An increased RV WT and higher age were independent predictors of all-cause mortality in both women and men.
In vitro Effect of Occlusal Loading on Cervical Wall Lesion Development in a Class II Composite Restoration
Authors: Hollanders Audrey C.C. , Ruben Jan L. , Kuper Nicolien K. , Huysmans Marie-Charlotte D.N.J.M.
Published: February 2022

The aim of this study was to determine the effect of simulated occlusal loading on wall lesion development in cervical gaps of class II composite restorations in vitro. Sixty-four extracted human molars received standardized (4.0 × 4.2 × 3.0 mm) box preparations. The teeth were randomly assigned to one of two restoration groups: restoration with a normal or a low E-modulus composite material (CLEARFIL AP-X: E-modulus 16.8 GPa or CLEARFIL MAJESTY ES Flow: E-modulus 6.6 GPa). A metal matrix was placed at the bottom of the box for each restoration, creating a cervical gap of about 100 μm wide. Samples were exposed to simulated caries lesion development in a lactic acid solution (pH 4.8) for 8 weeks in a Rub&Roll device. Half of the samples were subjected to 90 N cyclic loading. After demineralization, the teeth were sectioned. Wall lesion development was measured using microradiography (transversal wavelength-independent microradiography) in two different locations (location 1: 1,000 μm and location 2: 1,600 μm from the gap entrance) and recorded in lesion depth (LD) (μm) and mineral loss (μm × vol%). Linear regression modeling was used to estimate the effect of loading and material on wall lesion development. Mean wall LD in location 1 across all groups was 150.83 μm with a standard deviation (SD) of 61.83 μm. In location 2, mean overall wall LD was 102.98 μm with an SD of 64.92 μm. Linear regression showed no significant effect of either loading or material on wall lesion development. Occlusal loading had no significant effect on secondary caries lesion development in composite class II restoration in this in vitro study.
Trophoblast Cell Surface Antigen 2 (Trop2) in Chromophobe Renal Cell Carcinoma
Authors: Mikuteit Marie , Steffens Sandra , Zschäbitz Stefanie , Autenrieth Michael , Weichert Wilko , Hartmann Arndt , Erlmeier Franziska
Published: February 2022

Background: Overexpression of tumor-associated calcium signal transducer 2 (Trop2) is found in many tumor entities. The prognostic value of Trop2 in renal cell renal carcinoma (RCC), especially in nonclear cell RCC, is still unclear. Aim: The aim of this study was to evaluate the prognostic impact of Trop2 expression in a large cohort of patients with chromophobe (ch)RCC. Materials and Methods: Patients who underwent renal surgery due to chRCC were retrospectively evaluated. Tumor specimens were analyzed for Trop2 expression by immunohistochemistry. Results: Eighty-one chRCC patients were eligible for analysis, of these 24 (29.6%) patients were positive for Trop2. No significant associations were found for Trop2 expression and clinical attributes in patients with chRCC. The Kaplan-Meier analysis revealed no differences in 5-year overall survival for Trop2− compared to Trop2+ (89.6% vs. 100.0%; p = 0.288). Conclusion: In chRCC, Trop2 expression is not associated with survival and other parameters of aggressiveness. Due to the rare incidence of chRCC, further studies with larger cohorts are warranted.
The Role of C-Reactive Protein as a Prognostic Biomarker in Patients with Early Breast Cancer Treated with Neoadjuvant Chemotherapy
Authors: Edimiris-Herrmann Alexandra , Kolberg-Liedtke Cornelia , Bittner Ann-Kathrin , Hoffmann Oliver , Wetzig Sarah , Shaheen Mohamed , Stephanou Miltiades , Kolberg Hans-Christian
Published: February 2022

Background: C-reactive protein (CRP) is an acute phase reactant influenced by inflammation and tissue damage. Elevated CRP levels have been associated with poor outcome of various cancers including breast cancer. However, evidence regarding a potential impact of CRP levels on outcome of neoadjuvant chemotherapy (NACT) in patients with early breast cancer (EBC) is insufficient. Methods: Patients who had received NACT for EBC and had available data regarding CRP levels before therapy, pathologic complete remission (pCR), and follow-up were included. The association between CRP at baseline and outcome parameters was analyzed. Results: 152 women were included in this analysis; median follow-up was 5.8 years. No association between CRP at baseline and pCR rates could be detected. 6.6% of the patients developed a local recurrence, 10.5% developed a distant recurrence, and 5.2% died from breast cancer. A negative correlation (Spearman-Rho) between CRP at baseline and overall survival (OS) (correlation coefficient (CC) −0.255; p = 0.45), disease-free survival (DFS) (CC −0.348; p = 0.075), local recurrence-free survival (LRFS) (CC −0.245; p = 0.327), and distant DFS (DDFS) (CC −0.422; p = 0.057) was not statistically significant, although especially in DFS and DDFS a strong trend was detected. The probability of death from breast cancer was 2% if the CRP was <0.08 mg/dL and 40% if the CRP was >2.08 mg/dL; this association was highly statistically significant (χ2; p < 0.001). These results were independent from age, estrogen and progesterone receptor status, HER2 status, nodal status, and grading. The hazard ratio for OS was 5.75 (p = 0.004) for CRP <0.08 mg/dL versus CRP >2.08 mg/dL. Discussion/Conclusion: CRP at baseline is not predictive for pCR in EBC after NACT in our patient dataset. However, an association of parameters of long-term prognosis with CRP could be demonstrated. Although the correlations of higher CRP levels at baseline and shorter OS, DFS, LRFS, and DDFS were not significant, a strong trend could be detected that was reproduced in the analysis of different groups of CRP levels and the probability of breast cancer mortality. Higher CRP levels are indicating a worse prognosis in EBC after NACT in this retrospective analysis. These results justify further investigation of CRP not as a predictive parameter for pCR but as a biomarker of long-term prognosis in EBC in prospective trials and may lead to therapeutic approaches with the aim of lowering CRP levels.
Brain Cancer Cell-Derived Matrices and Effects on Astrocyte Migration
Authors: Louisthelmy Rebecca , Burke Brycen M. , Cornelison R. Chase
Published: February 2022

Cell-derived matrices are useful tools for studying the extracellular matrix (ECM) of different cell types and testing the effects on cell migration or wound repair. These matrices typically are generated using extended culture with ascorbic acid to boost ECM production. Applying this technique to cancer cell cultures could advance the study of cancer ECM and its effects on recruitment and training of the tumor microenvironment, but ascorbic acid is potently cytotoxic to cancer cells. Macromolecular crowding (MMC) agents can also be added to increase matrix deposition based on the excluded volume principle. We report the use of MMC alone as an effective strategy to generate brain cancer cell-derived matrices for downstream analyses and cell migration studies. We cultured the mouse glioblastoma cell line GL261 for 1 week in the presence of three previously reported MMC agents (carrageenan, Ficoll 70/400, and hyaluronic acid). We measured the resulting deposition of collagens and sulfated glycosaminoglycans using quantitative assays, as well as other matrix components by immunostaining. Both carrageenan and Ficoll promoted significantly more accumulation of total collagen content, sulfated glycosaminoglycan content, and fibronectin staining. Only Ficoll, however, also demonstrated a significant increase in collagen I staining. The results were more variable in 3D spheroid culture. We focused on Ficoll MMC matrices, which were isolated using the small molecule Raptinal to induce cancer cell apoptosis and matrix decellularization. The cancer cell-derived matrix promoted significantly faster migration of human astrocytes in a scratch wound assay, which may be explained by focal adhesion morphology and an increase in cellular metabolic activity. Ultimately, these data show MMC culture is a useful technique to generate cancer cell-derived matrices and study the effects on stromal cell migration related to wound repair.
Breast Augmentation with Autologous Fat Grafting Immediately after Removal of Polyacrylamide Hydrogel and Fibrotic Capsule in 162 Patients
Authors: Gao Qiuni , Zhai Peiming , Qi Jun , Yang Zhenyu , Hu Yuling , Yuan Xihang , Liu Chengsheng , Qi Zuoliang
Published: February 2022

Objective: In this study, we investigated the feasibility and efficacy of immediate breast augmentation with autologous fat grafting after removal of polyacrylamide hydrogel (PAAG) and fibrotic capsule. Methods: A retrospective study was conducted on 162 female patients who underwent removal of breast filler PAAG and the fibrotic capsule which produced after injection of PAAG via areola omega-shaped incision. Then autologous fat grafting was immediately performed evenly and radially around the areola via the same incision into different layers (subcutaneous, submammary tissue, pectoralis major intramuscular, and inferior pectoralis major space) except the empty cavity. The cavity left by removal of PAAG and fibrous capsule was closed with negative pressure drainage tube and slight external pressure. Results: All patients recovered well without severe complications. The average score of postoperative satisfaction with physical well-being: chest was 99.83 (total score: 100) compared with the average satisfaction score of 71.69 (total score: 100) preoperatively by means of BREAST-Q™ evaluation (p < 0.01). All patients were satisfied with their postoperative breast shape. Conclusions: Removing as much as possible is critical for patients who underwent the PAAG injection. Our experience in immediate breast augmentation with autologous fat grafting after removal of PAAG and fibrotic capsule proved useful and effective to maintain the balance between removing the PAAG as much as possible and retaining soft tissue to reshape breasts. Level of Evidence: IV.
Optimizing Outcomes After Out-of-Hospital Cardiac Arrest With Innovative Approaches to Public-Access Defibrillation: A Scientific Statement From the International Liaison Committee on Resuscitation
Authors: Brooks Steven C. , Clegg Gareth R. , Bray Janet , Deakin Charles D. , Perkins Gavin D. , Ringh Mattias , Smith Christopher M. , Link Mark S. , Merchant Raina M. , Pezo-Morales Jaime , Parr Michael , Morrison Laurie J. , Wang Tzong-Luen , Koster Rudolph W. , Ong Marcus E.H. ,   on behalf of the International Liaison Committee on Resuscitation
Published: February 2022

Out-of-hospital cardiac arrest is a global public health issue experienced by ≈3.8 million people annually. Only 8% to 12% survive to hospital discharge. Early defibrillation of shockable rhythms is associated with improved survival, but ensuring timely access to defibrillators has been a significant challenge. To date, the development of public-access defibrillation programs, involving the deployment of automated external defibrillators into the public space, has been the main strategy to address this challenge. Public-access defibrillator programs have been associated with improved outcomes for out-of-hospital cardiac arrest; however, the devices are used in <3% of episodes of out-of-hospital cardiac arrest. This scientific statement was commissioned by the International Liaison Committee on Resuscitation with 3 objectives: (1) identify known barriers to public-access defibrillator use and early defibrillation, (2) discuss established and novel strategies to address those barriers, and (3) identify high-priority knowledge gaps for future research to address. The writing group undertook systematic searches of the literature to inform this statement. Innovative strategies were identified that relate to enhanced public outreach, behavior change approaches, optimization of static public-access defibrillator deployment and housing, evolved automated external defibrillator technology and functionality, improved integration of public-access defibrillation with existing emergency dispatch protocols, and exploration of novel automated external defibrillator delivery vectors. We provide evidence- and consensus-based policy suggestions to enhance public-access defibrillation and guidance for future research in this area.
Relationship Between Myocardial Perfusion Imaging Abnormalities on Positron Emission Tomography and Anginal Symptoms, Functional Status, and Quality of Life
Authors: Patel Krishna K. , Patel Femina S. , Bateman Timothy M. , Kennedy Kevin F. , Peri-Okonny Poghni A. , McGhie A. Iain , Sperry Brett W. , Shaw Leslee , Di Carli Marcelo , Thompson Randall C. , Saeed Ibrahim M. , Jones Philip G. , Spertus John A.
Published: February 2022

Background:

Myocardial perfusion imaging (MPI) identifies abnormalities that occur early in the ischemic cascade leading to angina. Our aim was to study the association between ischemic measures on positron emission tomography MPI and patients’ health status; their symptoms, function, and quality of life.

Methods:

Health status was collected using the Seattle Angina Questionnaire (SAQ-7, 0–100, higher=better) and Rose Dyspnea Score (RDS) on 1515 outpatients with known or suspected coronary artery disease presenting for clinically indicated pharmacological
82
Rb positron emission tomography MPI from July 2018 to July 2019. Adjusted multivariable ordinal regression models were used to assess the association between MPI findings of ischemia and the SAQ physical limitation, angina frequency, quality of life, summary score, and the RDS.

Results:

The mean SAQ and RDS scores of the cohort (mean age 71.7 years, 55% male, 37.6% prior myocardial infarction or revascularization) were 73.8±28.6 (physical limitation), 87.4±21.7 (angina frequency), 79.0±26.1 (quality of life), 81.3±19.0 (summary score), and 2±2 (RDS). No perfusion, flow or function abnormalities were significantly associated with SAQ angina frequency scores. Low left ventricular ejection fraction reserve (≤0%), low global and regional myocardial blood flow reserve (<2) were independently associated with worse SAQ Physical Limitation score, SAQ summary score, and RDS (30% to 57% greater odds; all
P
≤0.01), but reversible perfusion defects were not.

Conclusions:

Impaired augmentation of left ventricular ejection fraction and myocardial blood flow with stress is associated with significant angina-associated functional limitation, health status, and dyspnea in patients who underwent positron emission tomography MPI, but not the frequency of their angina. Future studies should evaluate whether therapies that improve stress-induced abnormalities in systolic function and myocardial flow may improve patients’ health status.
Coronary Access After Transcatheter Aortic Valve Replacement With Commissural Alignment: The ALIGN-ACCESS Study
Authors: Tarantini Giuseppe , Nai Fovino Luca , Scotti Andrea , Massussi Mauro , Cardaioli Francesco , Rodinò Giulio , Benedetti Alice , Boiago Mauro , Matsuda Yuji , Continisio Saverio , Montonati Carolina , Cacciavillani Luisa , Pavei Andrea , Masiero Giulia , Napodano Massimo , Fraccaro Chiara , Fabris Tommaso , Iliceto Sabino
Published: February 2022

Background:

Coronary access (CA) after transcatheter aortic valve replacement (TAVR) with supra-annular transcatheter heart valves (THV) can be challenging. Specific Evolut R/Pro and Acurate Neo THVs orientations are associated with reduced neo-commissure overlap with coronary ostia, while SAPIEN 3 THV cannot be oriented. With the ALIGN-ACCESS study (TAVR With Commissural Alignment Followed by Coronary Access), we investigated the impact of commissural alignment on the feasibility of CA after TAVR.

Methods:

We performed coronary angiography after TAVR with intra-annular SAPIEN 3, supra-annular Evolut R/Pro, and Acurate Neo THVs in 206 patients. Evolut THVs were implanted aiming for commissure alignment. Alignment of Acurate Neo was retrospectively assessed in 36, intentionally attempted in 26 cases. The primary end point was the rate of unfeasible and nonselective CA after TAVR.

Results:

Thirty-eight percent of patients received SAPIEN 3, 31.1% Evolut Pro/R, 30.1% Acurate Neo THV. Final valve orientation was favorable to commissural alignment in 85.9% of Evolut and 69.4% of Acurate Neo cases (with intentional alignment successful in 88.5%). Selective CA was higher for SAPIEN 3 than for aligned and misaligned supra-annular THVs (95% versus 71% versus 46%,
P
<0.001). Cannulation of at least one coronary was unfeasible with 11% misaligned supra-annular, 3% aligned supra-annular, and 0% SAPIEN 3 THVs. Independent predictors of unfeasible/nonselective CA were implantation of a misaligned supra-annular THV (odds ratio, 4.59 [95% CI, 1.81–11.61];
P
<0.01), sinus of Valsalva height (odds ratio, 0.83 [95% CI, 0.7–0.98];
P
=0.03), and THV–sinus of Valsalva relation (odds ratio, 1.06 [95% CI, 1.02–1.1];
P
<0.01).

Conclusions:

Commissural alignment improves the rate of selective CA after TAVR with supra-annular THVs. Nevertheless, aligned supra-annular THVs carry higher risk of unfeasible/nonselective CA than SAPIEN 3. Patients with a misaligned supra-annular THV, low sinus of Valsalva, and higher THV–sinus of Valsalva relation are at highest risk of impaired CA after TAVR.
Association of Different Definitions of Intradialytic Hypertension With Long-Term Mortality in Hemodialysis
Authors: Singh Anika T. , Waikar Sushrut S. , Mc Causland Finnian R.
Published: February 2022

Background:

Hypertension is common in hemodialysis patients. A subset of patients experience systolic blood pressure increases from prehemodialysis to posthemodialysis (intradialytic hypertension), which are associated with adverse outcomes. However, little consensus exists on an evidence-based definition.

Methods:

In 3198 hemodialysis patients, Cox models were fit to examine the association of various definitions of intradialytic hypertension (≥30% of baseline sessions with an increase in prehemodialysis to posthemodialysis systolic blood pressure of (1) ≥0 mm Hg [Hyper0]; (2) ≥10 mm Hg [Hyper10], or (3) ≥20 mm Hg increase [Hyper20]) with all-cause mortality. Effect modification was assessed using interaction terms according to prespecified variables.

Results:

At baseline, mean age was 62±15 years, 57% were male, and 14% of patients were Black. During the baseline period, 47% of individuals met the Hyper0 definition and experienced 32% (hazard ratio, 1.32 [95% CI, 1.05–1.66]) higher adjusted risk of death, compared with no systolic blood pressure increase. Hyper10 was present in 21.2% and associated with 18% higher adjusted risk of death (hazard ratio, 1.18 [95% CI, 0.94–1.48]). Hyper20 was present in 6.8% and associated with 3% higher adjusted risk of death (hazard ratio 1.03 [95% CI, 0.74–1.44]). Effect modification by age and peripheral vascular disease was observed (
P
interaction=0.04 for age and 0.02 for peripheral vascular disease), with higher associated risk of death for those aged 45 to 70 years and those without peripheral vascular disease.

Conclusions:

Individuals with any systolic blood pressure increase from prehemodialysis to posthemodialysis had the highest adjusted risk of mortality, compared with other threshold-based definitions.
Early Life Trauma Is Associated With Increased Microvolt T‐Wave Alternans During Mental Stress Challenge: A Substudy of Mental Stress Ischemia: Prognosis and Genetic Influences
Authors: Shah Amit J. , Weeks Virginia , Lampert Rachel , Bremner J. Douglas , Kutner Michael , Raggi Paolo , Sun Yan V. , Lewis Tené T. , Levantsevych Oleksiy , Kim Ye Ji , Hammadah Muhammad , Alkhoder Ayman , Wittbrodt Matthew , Pearce Brad D. , Ward Laura , Sheps David , Quyyumi Arshed A. , Vaccarino Viola
Published: February 2022

Background

Early life trauma has been associated with increased cardiovascular risk, but the arrhythmic implications are unclear. We hypothesized that in patients with coronary artery disease, early life trauma predicts increased arrhythmic risk during mental stress, measured by elevated microvolt T‐wave alternans (TWA), a measure of repolarization heterogeneity and sudden cardiac death risk.

Methods and Results

In a cohort with stable coronary artery disease (NCT04123197), we examined early life trauma with the Early Trauma Inventory Self Report‐Short Form. Participants underwent a laboratory‐based mental stress speech task with Holter monitoring, as well as a structured psychiatric interview. We measured TWA during rest, mental stress, and recovery with ambulatory electrocardiographic monitoring. We adjusted for sociodemographic factors, cardiac history, psychiatric comorbidity, and hemodynamic stress reactivity with multivariable linear regression models. We examined 320 participants with noise‐ and arrhythmia‐free ECGs. The mean (SD) age was 63.8 (8.7) years, 27% were women, and 27% reported significant childhood trauma (Early Trauma Inventory Self Report‐Short Form ≥10). High childhood trauma was associated with a multivariable‐adjusted 17% increase in TWA (
P
=0.04) during stress, and each unit increase in the Early Trauma Inventory Self Report‐Short Form total score was associated with a 1.7% higher stress TWA (
P
=0.02). The largest effect sizes were found with the emotional trauma subtype.

Conclusions

In a cohort with stable coronary artery disease, early life trauma, and in particular emotional trauma, is associated with increased TWA, a marker of increased arrhythmic risk, during mental stress. This association suggests that early trauma exposures may affect long‐term sudden cardiac death risk during emotional triggers, although more studies are warranted.
Uncovering Topics of Public Cultural Activities: Evidence from
China
Authors: Zeng Zixin , Hua Bolin
Published: February 2022

In this study, we uncover the topics of Chinese public cultural activities in 2020 with a two-step short text clustering (self-taught neural networks and graph-based clustering) and topic modeling approach. The dataset we use for this research is collected from 108 websites of libraries and cultural centers, containing over 17,000 articles. With the novel framework we propose, we derive 3 clusters and 8 topics from 21 provincial-level regions in China. By plotting the topic distribution of each cluster, we are able to shows unique tendencies of local cultural institutes, that is, free lessons and lectures on art and culture, entertainment and service for socially vulnerable groups, and the preservation of intangible cultural heritage respectively. The findings of our study provide decision-making support for cultural institutes, thus promoting public cultural service from a data-driven perspective.
Population densities and home range of the vulnerable Pyrenean brook newt in its core aquatic habitat
Authors: Dalibard Manon , Buisson Laëtitia , Besnard Aurélien , Riberon Alexandre , Laffaille Pascal
Published: February 2022

Accurate estimations of population size and space-use are critical issues, for assessing population trends and extinction risk. In this study, we applied spatially explicit capture-recapture (SECR) modelling customized for linear habitats to a three-year Capture-Mark-Recapture (CMR) monitoring of three populations of stream-dwelling Pyrenean brook newt (Calotriton asper), an endemic species of the Pyrenean mountain range. Our aim was to explore (1) spatial and temporal variation in population densities, home range size and individual detection probability during breeding season between populations and years, and (2) the influence of water temperature and flow on activity of newts. Estimates of population density range from 3044 to 4641 individuals/km of stream across the three years of the study. Linear home range along the stream was estimated to be 13.31 m from the home range centre on average over the three years. All detection probability estimates were similar, both between years and between sites, with a mean probability of 0.09, except in Fougax in 2020 where detection probability was 0.03. Activity of the Pyrenean brook newt was influenced by water temperature and flow, but these factors acted at different time scales. Overall, population densities are locally high in both populations but home range of the Pyrenean brook newt during breeding season is very small indicating a strong site attachment. The importance of water temperature and flow on activity emphasizes the sensitivity of the species to these factors that are forecasted to change in coming decades.
Farmers against Fascism: How India’s Farmers’ Protests Cultivated Alternatives to Neoliberal Hindu Nationalist Dystopia
Authors: Narasimhaiah Sarang
Published: February 2022

In this article I analyze the mass mobilizations mounted by Indian farmers against three pro-corporate agricultural bills passed by the far-right government of Prime Minister Narendra Modi. I argue that the discourse of civil protest is insufficient to understand these mobilizations. On the contrary, they embody the principles of mutual aid, direct action, and intersectional and international solidarity, pointing to the possibility of collective life beyond the limits imposed by neoliberal Hindu nationalism. At the same time the emancipatory possibilities offered by these practices are qualified by persistent social divisions and the hegemony of nonviolence, alongside pressing circumstantial factors.
Legal Informatics Tools for Evidence-Based Policy Creation in Parliaments
Authors: Fitsilis Fotios , Koryzis Dimitris , Schefbeck Günther
Published: February 2022

Decision-making is a fundamental human process, central to the design and promulgation of effective legislation, as well as to the crafting of robust public policy. Supported by advances in legal informatics tools and services, in particular those that facilitate the extraction of meaningful information and metadata from legal documents, parliaments today are able to develop and test data-driven strategies and policies in a manner that places them on equal footing with the executive within the policy creation process. The article critically analyses the range of application and the efficiency of sophisticated decision support tools and services. Key actor-centric parameters are discussed within the context of a parliamentary production environment. While the role of main stakeholders is elucidated upon, the article assesses changing organizational and operational culture in parliaments in regards to the possible application of decision-making processes and addresses directions but also challenges for future research.
Allium elaounii: a new species of A. sect. Pseudoscorodon (Amaryllidaceae, Allioideae, Allieae) from Kroumirian mountains, Tunisia
Authors: EL MOKNI RIDHA
Published: February 2022

A new species of Allium, A. elaounii sp. nov. seemingly endemic to Kroumirian mountains (Northwestern of Tunisia) is described and illustrated. The new species is morphologically similar to A. rouyi group and A. valdecallosum, from which it differs mainly by characters of stem, bulb, leaves, inflorescence, and seeds. Distribution in Tunisia, notes of its preferred habitat, phenology, and the IUCN status of conservation are also provided. A diagnostic key to species of the A. sect. Pseudoscorodon occurring in North Africa is also presented.
A new species of Psydrax (Rubiaceae: Vanguerieae) from Tamil Nadu, India
Authors: LINCY JOSEPH , SOOSAIRAJ SEBASTIN , DHIVYA RAJAPPA , ARULANANDAM JOHN PETER
Published: February 2022

Psydrax cudalorensis sp.nov. is described and illustrated from Tamil Nadu, India based on morphological and molecular evidence. Although morphologically P. cudalorensis appears to be similar to P. dicoccos, it is different from P. dicoccos in various aspects such as presence of pubescent stem, leaf, peduncle, pedicel, calyx, corolla, fruit and apiculate anther. ITS, rbcL and matK based phylogenetic analysis and SEM study of leaf surface also help to distinguish both the species.
The Impact of Job and Insurance Loss on Prescription Drug use: A Panel Data Approach to Quantifying the Health Consequences of Unemployment During the Covid-19 Pandemic
Authors: Nguyen Amanda , Guttentag Alexandra , Li Diane , Meijgaard Jeroen van
Published: February 2022

Due to the nature of health insurance in the United States, health care utilization is often tied to economic conditions, at both the individual and aggregate levels. This article examines how loss of employment may reduce medication adherence through the subsequent loss of insurance and income. At the individual level, the loss of employer-sponsored insurance is shown to be associated with lower prescription drug use and higher out-of-pocket expenditures. The rapid increase in unemployment during the COVID-19 pandemic provides a natural experiment to estimate the causal relationship between unemployment and prescription drug use at the aggregate level. In total, the growth in unemployment during the pandemic resulted in a 2.6% reduction in medication adherence and 57.5 million fewer prescriptions filled in 2020, with prescriptions declining for many chronic conditions. Unemployment-related reductions in prescription fills and medication adherence were highest in states without expanded Medicaid eligibility, further underscoring the importance of social safety nets such as Medicaid during times of economic hardship.