bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex-related differences in profiles of muscle oxygen saturation of different muscles in trained cyclists during graded cycling exercise
Authors: Sendra-Pérez Carlos , Priego-Quesada Jose I. , Salvador-Palmer Rosario , Murias Juan M. , Encarnacion-Martinez Alberto
Published: September 2023

This study investigated the profiles of muscle oxygen saturation (SmO2) during incremental exercise in females and males. Females presented higher overall SmO2 than males during moderate and heavy intensity domain exercise in all muscles including muscles that are not mainly involved in pedaling (triceps brachii), from those that are stabilizers (medial gastrocnemius, tibialis anterior, and biceps femoris), to those that are related to power output production (vastus lateralis).
Multiscale structure and function of the aortic valve apparatus
Authors: El-Nashar Hussam , Sabry Malak , Tseng Yuan-Tsan , Francis Nadine , Latif Najma , Parker Kim H. , Moore James E. , Yacoub Magdi H.
Published: September 2023

Whereas studying the aortic valve in isolation has facilitated the development of life-saving procedures and technologies, the dynamic interplay of the aortic valve and its surrounding structures is vital to preserving their function across the wide range of conditions encountered in an active lifestyle. Our view is that these structures should be viewed as an integrated functional unit, here referred to as the aortic valve apparatus (AVA). The coupling of the aortic valve and root, left ventricular outflow tract, and blood circulation is crucial for AVA’s functions: unidirectional flow out of the left ventricle, coronary perfusion, reservoir function, and support of left ventricular function. In this review, we explore the multiscale biological and physical phenomena that underlie the simultaneous fulfillment of these functions. A brief overview of the tools used to investigate the AVA, such as medical imaging modalities, experimental methods, and computational modeling, specifically fluid-structure interaction (FSI) simulations, is included. Some pathologies affecting the AVA are explored, and insights are provided on treatments and interventions that aim to maintain quality of life. The concepts explained in this article support the idea of AVA being an integrated functional unit and help identify unanswered research questions. Incorporating phenomena through the molecular, micro, meso, and whole tissue scales is crucial for understanding the sophisticated normal functions and diseases of the AVA.
Modeling the Effect of the Platoon Size of CAVs on Mixed Traffic Flow: A Cellular Automaton Method
Authors: Jiang Yangsheng , Yi Zhiyuan , Xiao Guosheng , Li Hongwu , Yao Zhihong
Published: September 2023

This study proposes a cellular automaton model incorporating the platoon size of connected automated vehicles (CAVs) to examine their impact on mixed traffic flow. First, vehicles are classified into three modes, human-driven vehicles (HDVs), adaptive cruise control (ACC), and cooperative adaptive cruise control (CACC), by considering the characteristics of the car-following behavior. Second, the CACC is further subdivided into interplatoon and intraplatoon car-following modes due to the limitations of the platoon size of CAVs. Then, cellular automaton rules are developed for each of these four modes. Finally, numerical simulation experiments are conducted to analyze the influence of the penetration rate and platoon size of CAVs on mixed traffic flow. The results demonstrate that (1) the simulation results closely align with the theoretically derived outcomes, with an error rate of only 0.46% at a penetration rate of 100%; (2) when the penetration rate of CAVs reaches 100%, increasing the platoon size further enhances the traffic capacity; and (3) the optimal platoon size is determined to be seven CAVs under moderate traffic density.
Vitamin D Concentration Changes after Bariatric Surgery
Authors: Mayana Alves Baad Vanessa , Chaves Pereira de Holanda Narriane , Fonseca Nogueira Alves Juliana , Bandeira Francisco , Célia Oliveira dos Santos Ana , Alves Marcelino da Silva Amanda , Cinthia Ferro Cavalcante Taisy
Published: September 2023

Introduction. Bariatric surgery causes physiological and anatomical changes in the gastrointestinal tract that interfere with intestinal absorption and, consequently, with the nutritional status, especially about vitamin D. The aim of the study was to evaluate the vitamin D levels and body composition of these patients in the Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) types of surgery. Methods. The retrospective cohort study included a population of 120 patients aged between 18 and 65 years, with class II or III obesity, undergoing bariatric surgery procedures (VSG or RYGB-type). Data were collected on the degree of obesity, age, average time since surgery, and gender. The individuals underwent a complete physical examination, measuring blood pressure, weight, height, waist, and neck circumference. In addition to calculating the percentage of loss of body weight and assessing body fat, the food frequency and physical activity of these patients were evaluated. Blood was collected, and the insulin variables, hydroxyvitamin D (25OHD), were analyzed. Results. There was a significant difference between groups only for PTH, total BMD, and insulin variables. A significant intragroup difference was found in the variables’ body mass index (BMI) and vitamin D for the vertical sleeve gastrectomy group and BMI for the RYGB group. Conclusion. The analysis between the groups of procedures, similarity in body composition and postsurgical vitamin D levels, with significant differences only for PTH, BMD, and insulin variables, demonstrates that both procedures are effective in reducing fat mass.
Assessing the Relationship between Climate Variables and Hemorrhagic Fever with Renal Syndrome Transmission in Eastern China: A Multi-Cities Time Series Study
Authors: Wang Yao , Duan Qing , Pang Bo , Tian Xueying , Ma Jing , Ma Wei , Kou Zengqiang , Wen Hongling
Published: September 2023

Hemorrhagic fever with renal syndrome (HFRS) is a climate-sensitive infectious disease. The effect of climatic drivers might predict and prevent HFRS, and understanding their relationship is urgently needed in the face of climate change. This study aimed to investigate the effect of meteorological factors on HFRS incidence. The random forest regression model, generalized additive model, and distributed lag nonlinear model (DLNM) were constructed to predict the importance, nonlinear trend and interaction effect, and exposure-lag effect of meteorological factors on HFRS incidence based on the data obtained in Shandong Province, China, 2013–2022. The most crucial meteorological factor was the weekly mean temperature. Interaction results showed that relative humidity affected HFRS incidence only under high or low-temperature conditions, and the effect of relative humidity with high and low pressure was the opposite. Using the median value as the reference, DLNM indicated that extremely low temperature had significant associations with HFRS at a lag of 3–5 weeks. Under extremely high temperatures, relative risks (RRs) became significantly high from a lag of 11 weeks, with the lowest value of 1.07 (95% CI: 1.00–1.13). RRs increased and then decreased with increasing mean temperature at lag 4 and 8 weeks, whereas at lag 12 and 16 weeks, the RRs gradually increased as the mean temperature climbed. This study demonstrates the complex relationship between meteorological factors and HFRS incidence. Our findings provide implications for the development of weather-based HFRS early warning systems.
Alterations in the “Gut–Liver Axis” on Rats with Immunological Hepatic Fibrosis
Authors: Qi Zhaoyao , Qi Xinxin , Xu Yuanhui , Sun Hongguang , Li Dengfeng , Liu Jincun , Cong Meili , Liu Tao
Published: September 2023

There remains a lack of standard models that have all the characteristics of human diseases. Especially in immunological hepatic fibrosis, the bovine serum albumin (BSA)-induced liver fibrosis models have the same developmental mechanisms as human liver fibrosis models, but have received little attention. We standardized a BSA-induced liver fibrosis model in rats and thoroughly assessed its pathological characteristics. We also used 16S sequencing to assess homeostasis of the intestinal microflora of rats with BSA-induced liver fibrosis and detected various differential metabolites in the serum of these rats using ultrahigh-performance liquid chromatography–tandem mass spectrometry (UHPLC-MS/MS). We observed stable and unambiguous histological changes in liver tissue morphology and remarkably high concentrations of inflammatory markers in the serum of BSA-induced liver fibrosis rats. In keeping with the fact that BSA induction can cause gut microbiota disorders in rats. UHPLC-MS/MS analysis of rat serum samples in positive-ion mode and negative-ion mode revealed 17 and 25 differential metabolites, respectively. Network analysis revealed that phenylalanine or tyrosine metabolites (e.g., PAGln) were the predominant metabolites in the sera of BSA-induced liver fibrosis rats. Taken together, our results suggest that disorders of amino acid metabolism caused by the gut microbiota may play an important role in the progression of immunological hepatic fibrosis.
Evaluation of Mean Platelet Volume in Children with Hypertension
Authors: Yildiz Ismail , Kizilca Ozgur
Published: September 2023

Background. Childhood hypertension, a disease with increasing prevalence, can lead to severe health problems. With the increased pressure on the vascular endothelium in hypertension, lesions in the endothelium result in endothelial activation and a process of inflammation, which causes platelet activation and in the bone marrow the release of platelet precursor cells into the peripheral blood stream. During inflammation, changes in the number and size of platelets are observed. With the release of platelet precursors into the peripheral blood stream due to platelet activation, an increase in mean platelet volume (MPV) is also seen. Aim. Our aim in this study is the evaluation of MPV changes in the hemogram of children suffering from hypertension, a condition causing severe cardiovascular problems. Material and Methods. This research is a descriptive retrospective cross-sectional study. It consists of a patient group diagnosed with hypertension and a control group of children presenting for routine check-ups with no diagnosed hypertension. Demographic characteristics, arterial pressure values, and hemogram parameters have been evaluated. Results. A total of 90 cases were enrolled in the study, including a patient group of 45 cases with hypertension (19 females, 26 males) and a control group of 45 cases (27 females, 18 males). The median age was 15 years in the hypertension group and 13 years in the control group. In the hypertension cases, the thickness of the carotis intima media was statistically significantly greater than in the control group (

p

 < 0.001). Echocardiographic findings (IVSd, LVDd, LVPWd, IVSs, LVDs, LVPWs, and LV mass) were significantly higher in the hypertension group compared to the control group (

p

 < 0.001). A statistically significant difference in platelet count and MPV values between the groups was not found (

p

 = 0.151,

p

 = 0.405, respectively). Conclusion. While MPV is hypothesized to be higher in hypertensive individuals, there was no statistically significant difference between the hypertensive and non-hypertensive groups in this study.
Influence of Different Extraction Methods on the Changes in Bioactive Compound Composition and Antioxidant Properties of Solid-State Fermented Coffee Husk Extracts
Authors: Jiamjariyatam Rossaporn , Phucharoenrak Pakkapong , Samosorn Siritron , Dolsophon Kulvadee , Lorliam Wanlapa , Krajangsang Sukhumaporn , Tantayotai Prapakorn
Published: September 2023

In brewing coffee, a huge amount of food waste is generated; that waste, coffee husks in particular, should be comprehensively exploited. They offer a rich source of bioactive compounds such as caffeine, chlorogenic acid, and trigonelline. The aim of this study was to investigate the effects of extraction methods on the bioactive compounds and antioxidant activity of such waste. Coffee husks in this study were fermented with S. cerevisiae based on a solid-state fermentation technique. The study method included ethanolic or water extraction with varied controllable factors, i.e., temperature (60, 100°C) and extraction technique. Bioactive contents were investigated with the Folin–Ciocalteu assay and 1H-NMR spectroscopy. The antioxidant activity was investigated with DPPH and FRAP assays. Results show that yields were the highest in the extract of fermented coffee husks at 100°C. The highest levels of bioactive contents (total trigonelline content at 3.59% and antioxidant activity at 23.35% (DPPH) and 25.9% (FRAP)) were found in the ethanolic extract of fermented coffee husks at 60°C. The bioactive content and bioactivity, including antioxidant activity, depended on different raw materials, preparation methods, and extraction conditions. This study illustrates the potential for using food waste such as coffee husks as a sustainable source of bioactive compounds or bioactive extracts.
Privacy‐Preserving Image Retrieval Based on Disordered Local Histograms and Vision Transformer in Cloud Computing
Authors: Wang Zhangdong , Qin Jiaohua , Xiang Xuyu , Tan Yun
Published: September 2023

Frequent data breaches in the cloud environment have seriously affected cloud subscribers and providers. Privacy‐preserving image retrieval methods can improve the security of cloud image retrieval; however, existing methods have limited accuracy on dynamically updated image databases and mobile lightweight devices. In this study, we propose a privacy‐preserving image retrieval method based on disordered local histograms and vision transformer in cloud computing, by designing a multiple encryption method and transformer‐based feature model to better mine the local feature value of encrypted images. Specifically, the user performs different value substitution, position substitution, and color substitution on the subblocks of the image to protect the image information. The cloud server extracts the unordered local histogram from the encrypted image and generates retrievable features using transformer. Experiments show that compared with similar CNN schemes, the retrieval accuracy of this method is improved by 8.5%, and the retrieval efficiency is improved by 54.8%.
Cancer Incidence and Mortality Estimates in Arab Countries in 2018: A GLOBOCAN Data Analysis
Authors: Al-Muftah Mariam , Al-Ejeh Fares
Published: September 2023

Background:

Arab countries are projecting increase in cancer incidence and mortality; however, there are limited studies that compare the epidemiology of cancer in Arab countries compared with other parts of the world.

Methods:

We used the 2018 Global Cancer Observatory data to compare the age-standardized incidence and mortality estimates in Arab-speaking countries to the rest of the world.

Results:

Rates for incidence and mortality for all cancers in Arab countries were lower than the world's rates but the incidence rates of non-Hodgkin and Hodgkin lymphoma, bladder, breast, and liver cancers were higher. Arab countries generally had higher mortality-to-incidence ratio than the world's ratio. Incidence rates, even in age-specific groups, varied between subregions of Arab countries (the Levant, Arabian Gulf, and Arab African subregions), and Iraq and Egypt, suggesting some common and unique environmental factors and possible ethnic or genetic heritages.

Conclusions:

There are essential scopes for improvements in Arab countries including better treatments to reduce the high mortality-to-incidence ratio, and supporting vaccination programs and antiviral treatments that would prevent the prevalent viral infection–related cancers. The high incidence of several cancers in younger Arabs suggests genetic factors and underlines the importance of genetic epidemiology studies.

Impact:

This study is an essential reference to evaluate and monitor the progress of national cancer initiatives in Arab countries for surveillance and prevention programs and improving clinical management. The study also provides a comprehensive snapshot of cancers in a unique region that could shed light on the interplay of environmental, lifestyle, and genetic risk factors.
Data from Inferred Immune-Cell Activity Is an Independent Predictor of HER2-Negative Breast Cancer Prognosis and Response to Paclitaxel-Based Therapy in the GeparSepto Trial
Authors: Fasching Peter A. , Szeto Christopher , Denkert Carsten , Benz Stephen , Weber Karsten , Spilman Patricia , Budczies Jan , Schneeweiss Andreas , Stickeler Elmar , Schmatloch Sabine , Jackisch Christian , Karn Thomas , Sinn Hans Peter , Warm Mathias , van Mackelenbergh Marion , Rabizadeh Shahrooz , Schem Christian , Heinmöller Ernst , Mueller Volkmar , Marmé Frederik , Soon-Shiong Patrick , Nekljudova Valentina , Untch Michael , Loibl Sibylle
Published: September 2023

AbstractPurpose:
Tumor microenvironment (TME) immune markers have been correlated with both response to neoadjuvant therapy and prognosis in patients with breast cancer. Here, immune-cell activity of breast cancer tumors was inferred by expression-based analysis to determine if it is prognostic and/or predictive of response to neoadjuvant paclitaxel-based therapy in the GeparSepto (G7) trial (NCT01583426).
Experimental Design:
Pre-study biopsies from 279 patients with HER2-negative breast cancer in the G7 trial underwent RNA-seq-based profiling of 104 immune-cell-specific genes to assess inferred Immune Cell Activity (iICA) of 23 immune-cell types. Hierarchical clustering was used to classify tumors as iICA “hot,” “warm,” or “cold” by comparison of iICA in the G7 cohort relative to that of 1,467 samples from a tumor database established by Nantomics LLC. Correlations between iICA cluster, pathology-assessed tumor-infiltrating lymphocytes (TIL), and hormone receptor (HR) status for pathologic complete response (pCR), disease-free survival (DFS), and overall survival (OS) were determined.
Results:
iICA cluster correlated with TIL levels. The highest pCR rates were observed in hot cluster tumors, and those with relatively higher TILs. Greater inferred activity of several T-cell types was significantly associated with pCR and survival. DFS and OS were prolonged in patients with hot or warm cluster tumors, the latter particularly for HR negative tumors, even if TILs were relatively low.
Conclusions:
Overall, TIL level better predicted pCR, but iICA cluster better predicted survival. Differences in associations between TILs, cluster, pCR, and survival were observed for HR-positive tumors versus HR-negative tumors, suggesting expanded study of the implication of these findings is warranted.
Figure S6 from miR-146a Exerts Differential Effects on Melanoma Growth and Metastatization
Authors: Raimo Monica , Orso Francesca , Grassi Elena , Cimino Daniela , Penna Elisa , De Pittà Cristiano , Stadler Michael B. , Primo Luca , Calautti Enzo , Quaglino Pietro , Provero Paolo , Taverna Daniela
Published: September 2023

miR-146a affects cell movement in vitro.
Figure S15 from miR-146a Exerts Differential Effects on Melanoma Growth and Metastatization
Authors: Raimo Monica , Orso Francesca , Grassi Elena , Cimino Daniela , Penna Elisa , De Pittà Cristiano , Stadler Michael B. , Primo Luca , Calautti Enzo , Quaglino Pietro , Provero Paolo , Taverna Daniela
Published: September 2023

miR-146a-dependent activation of the NOTCH/Akt affects cell growth, but not cell movement.
Figure S10 from miR-146a Exerts Differential Effects on Melanoma Growth and Metastatization
Authors: Raimo Monica , Orso Francesca , Grassi Elena , Cimino Daniela , Penna Elisa , De Pittà Cristiano , Stadler Michael B. , Primo Luca , Calautti Enzo , Quaglino Pietro , Provero Paolo , Taverna Daniela
Published: September 2023

miR-146a affects LFNG, ROCK1, ITGAV and NUMB expression in melanoma cells.
Figure S1 from miR-146a Exerts Differential Effects on Melanoma Growth and Metastatization
Authors: Raimo Monica , Orso Francesca , Grassi Elena , Cimino Daniela , Penna Elisa , De Pittà Cristiano , Stadler Michael B. , Primo Luca , Calautti Enzo , Quaglino Pietro , Provero Paolo , Taverna Daniela
Published: September 2023

miR-146a is highly expressed in human melanoma aggressive cells.
Etomidate Depresses Spontaneous Complex Spikes Activity of Cerebellar Purkinje Cells via Cannabinoid 1 Receptor in vivo in Mice
Authors: Pan Wen , Chu Chun-Ping , Qiu De-Lai
Published: September 2023

Introduction: Complex spikes (CSs) activity of cerebellar Purkinje cells plays critical roles in motor coordination and motor learning by transferring information to cerebellar cortex, which is an accessible and useful model for neurophysiological investigation. Etomidate is an ultrashort-acting nonbarbiturate intravenous anesthetic, which inhibits the spontaneous activity of cerebellar Purkinje cells through activation of GABAA and glycine receptors in vivo in mice. However, the effect of etomidate on the spontaneous CSs activity of cerebellar Purkinje cells in living mouse is not clear. Methods: We here investigated the effects of etomidate on spontaneous CSs activity of cerebellar Purkinje cell in urethane-anesthetized mice by electrophysiology recording technique and pharmacological methods. Results: Our results showed that cerebellar surface perfusion of etomidate significantly depressed the activity of spontaneous CSs, which exhibited decreases in the number of spikelets and the area under curve (AUC) of the CSs. The etomidate-produced inhibition of CSs activity was persisted in the presence of GABAA and glycine receptors antagonists. However, application of cannabinoid 1 (CB1) receptor antagonist, AM-251, completely blocked the etomidate-induced inhibition of CSs. Furthermore, application of the CB1 receptor agonist, WIN55212-2, induced a decrease of CSs. Moreover, in the presence of a specific protein kinase A (PKA) inhibitor, KT5720, etomidate failed to produce decreases in the spikelets number and the AUC of the spontaneous CSs. Conclusion: These results indicate that cerebellar surface application of etomidate facilitates CB1 receptor activity resulting in a depression of spontaneous CSs activity of Purkinje cells via PKA signaling pathway in mouse cerebellar cortex. Our present results suggest that the etomidate administration may impair the function of cerebellar cortical neuronal circuitry by inhibition of the climbing fiber – Purkinje cells synaptic transmission through activation of CB1 receptors in vivo in mice.
A Systems Nephrology Approach to Diabetic Kidney Disease Research and Practice
Authors: Martin William P. , Docherty Neil G.
Published: September 2023

Background: Diagnosis and staging of diabetic kidney disease (DKD) via the serial assessment of routine laboratory indices lacks the granularity required to resolve the heterogeneous disease mechanisms driving progression in the individual patient. A systems nephrology approach may help resolve mechanisms underlying this clinically apparent heterogeneity, paving a way for targeted treatment of DKD. Summary: Given the limited access to kidney tissue in routine clinical care of patients with DKD, data derived from renal tissue in preclinical model systems, including animal and in vitro models, can play a central role in the development of a targeted systems-based approach to DKD. Multi-centre prospective cohort studies, including the Kidney Precision Medicine Project (KPMP) and the European Nephrectomy Biobank (ENBiBA) project, will improve access to human diabetic kidney tissue for research purposes. Integration of diverse data domains from such initiatives including clinical phenotypic data, renal and retinal imaging biomarkers, histopathological and ultrastructural data, and an array of molecular omics (transcriptomics, proteomics, etc.) alongside multi-dimensional data from preclinical modelling offers exciting opportunities to unravel individual-level mechanisms underlying progressive DKD. The application of machine and deep learning approaches may particularly enhance insights derived from imaging and histopathological/ultrastructural data domains. Key Messages: Integration of data from multiple model systems (in vitro, animal models, and patients) and from diverse domains (clinical phenotypic, imaging, histopathological/ultrastructural, and molecular omics) offers potential to create a precision medicine approach to DKD care wherein the right treatments are offered to the right patients at the right time.
Neglected Vitamin K Deficiency Causing Coagulation Dysfunction in an Older Patient with Pneumonia: A Case Report
Authors: Wu Qiaoping , Wang Lufeng , Zhao Rongqing
Published: September 2023

Background: The development of coagulation disorders can be dangerous and fatal in the older people, especially those with multiple medical conditions. Vitamin K-dependent coagulation disorders are easily overlooked when anticoagulant drugs are not used and the patient shows no signs of bleeding. Case presentation: We report a case of a 71-year-old male suffering from pulmonary infection with severe coagulation disorder without bleeding symptoms. He also had a history of Parkinson’s disease, Alzheimer’s disease and cardiac insufficiency. Coagulation tests were normal at the time of admission, prothrombin time (PT) is 13.9 (normal, 9.5–13.1) seconds and the activated partial thromboplastin time (APTT) is 30.2 (normal, 25.1–36.5) seconds. But it turn­ed severely abnormal after 20 days (PT: 136.1 s, APTT: 54.8 s). However, no anticoagulants such as warfarin was used and no bleeding symptoms were observed. Subsequent mixing studies with normal plasma showed a decrease in prothrombin times. Vitamin K deficiency was thought to be the cause of coagulation disorders considering long-term antibiotic therapy, especially cephalosporins, inadequate diet and abnormal liver function. After supplementation with 20 mg of vitamin K, coagulation dysfunction was rescued the next day and serious consequences were effectively prevented.
Costs of Weaning Failure: A Prospective, Multicentre, Controlled, Non-Randomised, Interventional Study on Economic Implications for the German Health Care System
Authors: Michels Julia D. , Trudzinski Franziska C. , Bornitz Florian , Ewert Ralf , Müller Michael , Trinkmann Frederik , Schellenberg Mavi , Windisch Wolfram , Herth Felix J.F.
Published: September 2023

Background: Intensive care patients with respiratory failure often need invasive mechanical ventilation (IMV). With increasing population age and multimorbidity, the number of patients who cannot be weaned from IMV rises as well. Up to 85% of these patients have no access to a certified weaning centre. Their medical care is associated with impaired quality of life and high costs for the German health care system. Objectives: This study examined the weaning outcome of patients in certified weaning centres after a primarily unsuccessful weaning attempt in order to calculate saving expenses compared to patients on long-term IMV in an outpatient setting. Methods: In this multicentre, controlled, non-randomised, interventional, prospective study, 61 patients (16 from out-of-hospital long-term IMV, 49 from other hospitals) were referred to a certified weaning centre for a second weaning phase. The incurred costs after 1 year of the latter were compared to insurance claim data of patients who were discharged from an acute hospital stay to receive IMV in an outpatient setting. Results: In the intervention group, 50 patients (82%) could be completely weaned or partially weaned using non-invasive ventilation, thus not needing IMV any longer. The costs per patient for weaning and out-of-hospital care in the intervention group were EUR 114,877.08, and the costs in the comparison cohort were EUR 234,442.62. Conclusions: Early transfer to a certified weaning centre can increase weaning success and reduce total costs by approximately EUR 120,000 per patient in the first year. Given the existing structural prerequisites in Germany, every patient should have access to a weaning centre before being transferred to long-term IMV, from a medical and health economical point of view.
Malnutrition, Low Muscle Mass and Sarcopenia May be Underestimated in Certain Populations with Cancer. The Case For: “One Size, Does Not Fit All… Patient’s Diversity”
Authors: Hug Adele , Couto Irving Susana
Published: September 2023

Background: Low muscle mass (MM) is a common component of cancer-related malnutrition and sarcopenia, conditions that are all independently associated with an increased risk of mortality. This study aimed to (1) compare the prevalence of low MM, malnutrition, and sarcopenia and their association with survival in adults with cancer from the UK Biobank and (2) explore the influence of different allometric scaling (height [m2] or body mass index [BMI]) on low MM estimates. Methods: Participants in the UK Biobank with a cancer diagnosis within 2 years of the baseline assessment were identified. Low MM was estimated by appendicular lean soft tissue (ALST) from bioelectrical impedance analysis derived fat-free mass. Malnutrition was determined using the Global Leadership in Malnutrition criteria. Sarcopenia was defined using the European Working Group on Sarcopenia in Older People criteria (version 2). All-cause mortality was determined from linked national mortality records. Cox-proportional hazards models were fitted to estimate the effect of low MM, malnutrition, and sarcopenia on all-cause mortality. Results: In total, 4122 adults with cancer (59.8 ± 7.1 years; 49.2% male) were included. Prevalence of low MM (8.0% vs. 1.7%), malnutrition (11.2% vs. 6.2%), and sarcopenia (1.4% vs. 0.2%) was higher when MM was adjusted using ALST/BMI compared with ALST/height2, respectively. Low MM using ALST/BMI identified more cases in participants with obesity (low MM 56.3% vs. 0%; malnutrition 50% vs. 18.5%; sarcopenia 50% vs. 0%). During a median 11.2 (interquartile range: 10.2, 12.0) years of follow up, 901 (21.7%) of the 4122 participants died, and of these, 744 (82.6%) deaths were cancer-specific All conditions were associated with a higher hazard of mortality using either method of MM adjustment: low MM (ALST/height2: HR 1.9 [95% CI 1.3, 2.8], P = 0.001; ALST/BMI: HR 1.3 [95% CI 1.1, 1.7], P = 0.005; malnutrition (ALST/height2: HR 2.5 [95% CI 1.1, 1.7], P = 0.005; ALST/BMI: HR 1.3 [95% CI 1.1, 1.7], P = 0.005; sarcopenia (ALST/height2: HR 2.9 [95% CI 1.3, 6.5], P = 0.013; ALST/BMI: HR 1.6 [95% CI 1.0, 2.4], P = 0.037).
The Guiding Significance of Ocular Biometry in Evaluating the Refractive Status of Preschool Children
Authors: Zhang Ya , Su Ming , Liang Lingling , Shi Bingjie , Gong Dongmei , Wu Yidan , Zhang Junying , Wang Ming
Published: September 2023

Introductions: This study aimed to analyze the correlation between refractive status and ocular biological parameters in preschool-age children (3–6 years old), establish a regression curve, guide the clinical judgment of children’s refractive status, and improve the accuracy of refractive screening for this age group. Methods: A total of 508 children, aged 3–6 years, were admitted to the hospital, exhibiting symptoms of ametropia and a need for dilation optometry. Among these, 326 children were included in the statistics group, having been examined between August 2021 and October 2022, and 182 children were included in the validation group, having been examined between November 2022 and March 2023. Using IOL Master700, ocular biometry parameters were measured for all participants, including axial length (AL), keratometry readings (K1 and K2), anterior chamber depth (ACD), lens thickness (LT), and central corneal thickness (CCT). One percent atropine sulfate eye gel was administered, and then the spherical equivalent (SE) was calculated by Bennett’s formula. The correlation between SE and other ocular biometrics was analyzed, followed by the establishment of an SE prediction equation. The SE prediction equation was used to calculate the spherical equivalent (SE#) using ocular biometry data from the validation group, and the consistency between SE and SE# was evaluated. Results: SE showed a negative correlation with AL/CR (r = −0.936), AL (r = −0.811), ACD (r = −0.500), age (r = −0.396), and Km (r = −0.213) (p < 0.001), and positive correlation with LT (r = 0.301), LP (r = 0.176) (p < 0.001). A multiple linear regression equation was established for SE using the stepwise selection method, SE = 49.232 – 23.583 × AL/CR + 1.703 × ACD + 0.589 × Km − 0.609 × LP + 1.103 × LT (R2 = 0.997). Based on the regression equation, the predicted SE# highly correlated with SE after cycloplegia in the validation group (r = 0.998, p < 0.001). Conclusion: The main ocular biological factors of ocular diopter in children aged 3–6 years are AL/CR, ACD, Km, LP, and LT, which are jointly influenced by multiple factors. Ocular biometry is a reliable predictor of real refraction among children aged 3–6.
Do People with Type 2 Diabetes Mellitus Have a Higher Risk of Sarcopenia?
Authors: Hill Alyson
Published: September 2023

Introduction: Recent studies suggested that sarcopenia may be a significant comorbidity of diabetes mellitus (DM). Nonetheless, studies with nationally representative data are scarce, and the changing trend of sarcopenia prevalence over time is largely unknown. Therefore, we aimed to estimate and compare the prevalence of sarcopenia in diabetic and nondiabetic US older population, and to explore the potential predictors of sarcopenia as well as the trend of sarcopenia prevalent in the past decades. Methods: Data were retrieved from the National Health and Nutrition Examination Survey (NHANES). Sarcopenia and DM were defined according to corresponding diagnosis criteria. Weighted prevalence was calculated and compared between diabetic and nondiabetic participants. The differences among age and ethnicity groups were explored. Results: A total of 6,381 US adults (>50 years) were involved. The overall prevalence of sarcopenia was 17.8% for US elders, and the prevalence was higher (27.9% vs. 15.7%) in those with diabetes ones than those without. Stepwise regression revealed that sarcopenia was significantly associated with DM (adjusted odds ratio = 1.37, 95% CI: 1.08-1.22; p < 0.05) after controlling for potential confounders including gender, age, ethnicity, educational level, BMI, and muscle strengthening activity. A slight fluctuation but overall increasing trend of sarcopenia prevalence was observed among diabetic elders, while no obvious changing trend was observed in their counterparts in recent decades.
Cardiovascular Imaging in Contemporary Cardio-Oncology: A Scientific Statement From the American Heart Association
Authors: Addison Daniel , Neilan Tomas G. , Barac Ana , Scherrer-Crosbie Marielle , Okwuosa Tochi M. , Plana Juan C. , Reding Kerryn W. , Taqueti Viviany R. , Yang Eric H. , Zaha Vlad G. ,   on behalf of the American Heart Association Council on Cardiovascular Radiology and Intervention; Cardio-Oncology Committee of the Council on Clinical Cardiology and Council on Genomic and Precision Medicine; and Council on Cardiovascular and Stroke Nursing
Published: September 2023

Advances in cancer therapeutics have led to dramatic improvements in survival, now inclusive of nearly 20 million patients and rising. However, cardiovascular toxicities associated with specific cancer therapeutics adversely affect the outcomes of patients with cancer. Advances in cardiovascular imaging have solidified the critical role for robust methods for detecting, monitoring, and prognosticating cardiac risk among patients with cancer. However, decentralized evaluations have led to a lack of consensus on the optimal uses of imaging in contemporary cancer treatment (eg, immunotherapy, targeted, or biological therapy) settings. Similarly, available isolated preclinical and clinical studies have provided incomplete insights into the effectiveness of multiple modalities for cardiovascular imaging in cancer care. The aims of this scientific statement are to define the current state of evidence for cardiovascular imaging in the cancer treatment and survivorship settings and to propose novel methodological approaches to inform the optimal application of cardiovascular imaging in future clinical trials and registries. We also propose an evidence-based integrated approach to the use of cardiovascular imaging in routine clinical settings. This scientific statement summarizes and clarifies available evidence while providing guidance on the optimal uses of multimodality cardiovascular imaging in the era of emerging anticancer therapies.
Combined Treatment of Human Induced Pluripotent Stem Cell–Derived Cardiomyocytes and Endothelial Cells Regenerate the Infarcted Heart in Mice and Non-Human Primates
Authors: Cheng Yu-Che , Hsieh Marvin L. , Lin Chen-Ju , Chang Cindy M.C. , Huang Ching-Ying , Puntney Riley , Wu Moy Amy , Ting Chien-Yu , Herr Chan Darien Zhing , Nicholson Martin W. , Lin Po-Ju , Chen Hung-Chih , Kim Gina C. , Zhang Jianhua , Coonen Jennifer , Basu Puja , Simmons Heather A. , Liu Yen-Wen , Hacker Timothy A. , Kamp Timothy J. , Hsieh Patrick C.H.
Published: September 2023

BACKGROUND:

Remuscularization of the mammalian heart can be achieved after cell transplantation of human induced pluripotent stem cell (hiPSC)–derived cardiomyocytes (CMs). However, several hurdles remain before implementation into clinical practice. Poor survival of the implanted cells is related to insufficient vascularization, and the potential for fatal arrhythmogenesis is associated with the fetal cell–like nature of immature CMs.

METHODS:

We generated 3 lines of hiPSC-derived endothelial cells (ECs) and hiPSC-CMs from 3 independent donors and tested hiPSC–CM sarcomeric length, gap junction protein, and calcium-handling ability in coculture with ECs. Next, we examined the therapeutic effect of the cotransplantation of hiPSC-ECs and hiPSC-CMs in nonobese diabetic-severe combined immunodeficiency (NOD-SCID) mice undergoing myocardial infarction (n≥4). Cardiac function was assessed by echocardiography, whereas arrhythmic events were recorded using 3-lead ECGs. We further used healthy non-human primates (n=4) with cell injection to study the cell engraftment, maturation, and integration of transplanted hiPSC-CMs, alone or along with hiPSC-ECs, by histological analysis. Last, we tested the cell therapy in ischemic reperfusion injury in non-human primates (n=4, 3, and 4 for EC+CM, CM, and control, respectively). Cardiac function was evaluated by echocardiography and cardiac MRI, whereas arrhythmic events were monitored by telemetric ECG recorders. Cell engraftment, angiogenesis, and host–graft integration of human grafts were also investigated.

RESULTS:

We demonstrated that human iPSC-ECs promote the maturity and function of hiPSC-CMs in vitro and in vivo. When cocultured with ECs, CMs showed more mature phenotypes in cellular structure and function. In the mouse model, cotransplantation augmented the EC-accompanied vascularization in the grafts, promoted the maturity of CMs at the infarct area, and improved cardiac function after myocardial infarction. Furthermore, in non-human primates, transplantation of ECs and CMs significantly enhanced graft size and vasculature and improved cardiac function after ischemic reperfusion.

CONCLUSIONS:

These results demonstrate the synergistic effect of combining iPSC-derived ECs and CMs for therapy in the postmyocardial infarction heart, enabling a promising strategy toward clinical translation.
Existing Nongated CT Coronary Calcium Predicts Operative Risk in Patients Undergoing Noncardiac Surgeries (ENCORES)
Authors: Choi Daniel Y. , Hayes Dena , Maidman Samuel D. , Dhaduk Nehal , Jacobs Jill E. , Shmukler Anna , Berger Jeffrey S. , Cuff Germaine , Rehe David , Lee Mitchell , Donnino Robert , Smilowitz Nathaniel R.
Published: September 2023

BACKGROUND:

Preoperative cardiovascular risk stratification before noncardiac surgery is a common clinical challenge. Coronary artery calcium scores from ECG-gated chest computed tomography (CT) imaging are associated with perioperative events. At the time of preoperative evaluation, many patients will not have had ECG-gated CT imaging, but will have had nongated chest CT studies performed for a variety of noncardiac indications. We evaluated relationships between coronary calcium severity estimated from previous nongated chest CT imaging and perioperative major clinical events (MCE) after noncardiac surgery.

METHODS:

We retrospectively identified consecutive adults age ≥45 years who underwent in-hospital, major noncardiac surgery from 2016 to 2020 at a large academic health system composed of 4 acute care centers. All patients had nongated (contrast or noncontrast) chest CT imaging performed within 1 year before surgery. Coronary calcium in each vessel was retrospectively graded from absent to severe using a 0 to 3 scale (absent, mild, moderate, severe) by physicians blinded to clinical data. The estimated coronary calcium burden (ECCB) was computed as the sum of scores for each coronary artery (0 to 9 scale). A Revised Cardiac Risk Index was calculated for each patient. Perioperative MCE was defined as all-cause death or myocardial infarction within 30 days of surgery.

RESULTS:

A total of 2554 patients (median age, 68 years; 49.7% women; median Revised Cardiac Risk Index, 1) were included. The median time interval from nongated chest CT imaging to noncardiac surgery was 15 days (interquartile range, 3–106 days). The median ECCB was 1 (interquartile range, 0–3). Perioperative MCE occurred in 136 (5.2%) patients. Higher ECCB values were associated with stepwise increases in perioperative MCE (0: 2.9%, 1–2: 3.7%, 3–5: 8.0%; 6–9: 12.6%,
P
<0.001). Addition of ECCB to a model with the Revised Cardiac Risk Index improved the C-statistic for MCE (from 0.675 to 0.712,
P
=0.018), with a net reclassification improvement of 0.428 (95% CI, 0.254–0.601,
P
<0.0001). An ECCB ≥3 was associated with 2-fold higher adjusted odds of MCE versus an ECCB <3 (adjusted odds ratio, 2.11 [95% CI, 1.42–3.12]).

CONCLUSIONS:

Prevalence and severity of coronary calcium obtained from existing nongated chest CT imaging improve preoperative clinical risk stratification before noncardiac surgery.
Nursing and Institutional Responsibilities for In-Hospital Stroke
Authors: Snavely Josh , Thompson Hilaire J.
Published: September 2023

In-hospital stroke events occur less often than stroke outside of a health care facility; yet, the need for timely evaluation and treatment is the same regardless of geographic location. During hospitalization, nurses are generally the first to recognize possible symptoms of stroke and activate emergency protocols. Such actions in response to changes in patient condition are critical to optimal patient outcomes. A recent scientific statement from the American Heart Association notes that patients with in-hospital stroke are likely to experience delayed recognition of symptoms, less likely to receive intravenous thrombolysis therapy, and have worse outcomes compared with community-occurring stroke. The aim of this article is to expand upon that scientific statement to assist nurses and acute care hospitals in the United States and elsewhere with similar health care systems to create evidence-based, nurse-driven protocols for in-hospital stroke recognition and management.
Family income is not significantly associated with T1w/T2w ratio in the Human Connectome Project in Development
Authors: Weissman David G. , Baum Graham L. , Sanders Ashley , Rosen Maya L. , Barch Deanna M. , McLaughlin Katie A. , Somerville Leah H.
Published: September 2023

Growing evidence indicates that brain development varies as a function of family socioeconomic status (SES). Numerous studies have demonstrated that children from low-SES backgrounds have thinner cortex than children from higher-SES backgrounds. A recent study in a large developmental sample found widespread associations between lower SES and greater cortical T1w/T2w ratio—thought to be an indirect proxy for cortical myelin. We evaluated the association of family income with cortical T1w/T2w ratio as a function of age in the Human Connectome Project in Development sample of 989 youth aged 8-21 years. We observed no associations between family income and T1w/T2w ratio that were significant after corrections for multiple comparisons at the region, network, or whole-brain level. Region of practical equivalence (ROPE) analyses were also consistent with the absence of an association between family income and T1w/T2w ratio. We discuss potential methodological sources of inconsistency between this and the previous study examining the same question. While the question of whether family income may influence cortical myelin development remains, these null results may indicate that the association between SES and cortical myelin development may not be as strong as with other aspects of brain structure.
Structure of virtual communication in the interrelation with personal characteristics of users
Authors: Gordeeva Alla V. , Kononenko Inna A.
Published: September 2023

Background. Having turned from a simple technology into information and communication environment, virtualization affects all spheres of human life. To date, the expansion of its influence proceeds in two main interpenetrating directions: increasing the impact of virtuality on the real world and the virtualization of reality itself. Under the influence of network communication, the consciousness of the individual changes. A new networked way of thinking and existence is being formed. With sufficiently versatile studies of cybercommunication, there is no collective image of the category of virtual communication that would describe its structure for better and more effective interaction of users on the Internet. Objective. The aim of the study is to determine the structure of ideas about virtual communication and to identify the relationship of individual ideas with the personal characteristics of social network users. Methods. The material was obtained during a survey (23.09.2020–15.12.2021), which asked the subjects to bring as many free associations to the phrase «Virtual communication is ...» as possible. R.B. Kettell's 16-factor personality questionnaire (Form A) was used to diagnose personality traits. Sample. The sample consisted of 183 people aged 18–75 years (average age 38.7 years). Results. The main attributes of the concept of «virtual communication» among users of social networks were identified. They included such attributes as «affective» with a division into «positive emotions» and «negative emotions», «motivational», «cognitive», «objectness», «subjectness», «alternative to reality», «self-realization», «space and time», and «perception». The interrelation of individual representations of the components of virtual communication with the personal characteristics of respondents is noted. Conclusion. According to the results of the study, eleven categories have been identified, with the help of which the concept of "virtual communication" is described by network users. The features of the received categories in different age groups are analyzed. A five-factor model of cybercommunication was obtained, which included emotional-affective, perceptual, subjectivity, motivational, and cognitive-temporal factors. The connection of the selected categories of cybercommunication with the personal characteristics of users of social networks is revealed and described.