Number Of Contractions Research Articles

Association between coronary inflammation measured by FAT attenuation index and CT features of atheromatous plaque vulnerability

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): This research has been funded by the research grant Intel-FAT, proposal registration code PN-III-P4-ID-PCE-2020-2861, contract number PCE 206/2021, Project funded by the European Union and the Government of Romania through the Ministry of European Funds, and the Doctoral School of the “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Romania. Background Coronary computed tomography angiography (CCTA) is a rapidly evolving tool for the assessment of coronary artery disease (CAD), being able to characterise not only the degree of coronary artery stenosis but also the presence and severity of coronary plaque vulnerability. Fat attenuation index (FAI) is a recently developed marker of coronary inflammation, based on the gradient of CT density at the level of pericoronary fat. Purpose The aim of our study is to investigate the correlation between (1) coronary inflammation as assessed by FAI score, and (2) vulnerability degree of atheromatous coronary plaques, as assesses by presence and severity of CT features of vulnerability at the level of coronary plaques. Methods A total of 54 patients who underwent 128-slice CCTA for chest pain, and having at least one vulnerable coronary plaque, were enrolled in the study. Vulnerable plaques were defined as plaques showing at least one of the following on CT scan: low attenuation plaque, napkin-ring sign, spotty calcifications, or positive remodeling. In total, 114 vulnerable plaques were identified and analyzed using the advanced via Syngo.via Frontier software. FAI score was determined using the FAI technology patented by Caristo. Results The FAI score of coronary inflamamtion was significantly correlated with the total plaque volume at the level of left anterior descendent artery (LAD) (p = 0,01), respectively with the calcified plaque volume at the level of the circumflex artery (p = 0,02). Receiver operating characteristic (ROC) analysis for the correlation between the FAI score and the presence of the Napkin Ring Sign (NRS) showed a significant correlation for plaques located on LAD (AUC 0,729; 95%CI 0,585 – 0,845; p = 0,01), and lefty circumflex artery (AUC 0,745; 95%CI 0,601–0,859; p = 0,032), but not for the right coronary artery (AUC 0,636; 95%CI 0,487–0,767; p = 0,25). Furthermore, the ROC analysis identified a good correlation between the FAI score and the presence of spotty calcification or positive coronary remodeling (AUC 0,777, p = 0,0004, respectively AUC 0,717, p = 0,0081). Conclusion Coronary inflammation measured by FAT attenuation index is significantly correlated with the presence of CT vulnerability features in the coronary tree.

Increased risk of coronary plaque vulnerabilization following COVID-19 infection, identified by elevated FAI index of pericoronary inflammation at coronary CT

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): This research has been funded by the research grant Intel-FAT, proposal registration code PN-III-P4-ID-PCE-2020-2861, contract number PCE 206/2021, Project funded by the European Union and the Government of Romania through the Ministry of European Funds, and the Doctoral School of the “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Romania. Background Inflammation plays an essential role in all stages of atherosclerosis, with stable plaques characterized by chronic inflammation and vulnerable or ruptured plaques exhibiting "active" inflammation. COVID infection may significantly increase systemic inflammation, but the role of SARS COV-2 infection on local plaque vulnerability is still not elucidated. Mapping the PCAT - FAI on routine CCTA can detect coronary artery inflammation non-invasively by measuring changes in the composition of pericoronary fat. Purpose The aim of this study was to assess the impact of COVID-19 infection on CAD in patients who underwent CCTA examinations for chest pain in the early stages after infection, using the new AI - powered CaRi-Heart® solution. Methods In our study, we included 158 patients (mean age was 61.63 ± 10.14 years) with chest pain and low to intermediate clinical likelihood of CAD, who underwent 128-slice CCTA for assessment of coronary anatomy, atherosclerosis, and determination of FAI – Score. The study population was divided into two main groups: Group 1 (n = 75) – patients who had a COVID-19 infection a few months prior to their CCTA examination, and Group 2 (n = 83) – patients adjusted for age and gender, who did not have a COVID-19 infection. Results The FAI - Score was consistently higher in the non COVID-19 group: LAD (11.61 ± 7.60 vs. 9.32 ± 6.00, p = 0.05), LCX (12.43 ± 6.65 vs. 10.48 ± 6.24, p = 0.05), RCA (15.40 ± 11.36 vs. 14.54 ± 12.17, p = ns), the average FAI - Score (12.81 ± 8.28 vs. 10.47 ± 7.19, p = 0.001). For the FAI-Score Centile, the overall pattern shifts significantly, as the values for all three coronary arteries are higher for the subjects in the COVID-19 positive group, as follows: LAD (0.66 ± 0.29 vs. 0.58 ± 0.28, p = 0.05), LCX (0.79 ± 0.16 vs. 0.68 ± 0.26, p = 0.03), RCA (0.83 ± 0.20 vs. 0.68 ± 0.29, p = 0.05). In both cases, the CaRi Heart® Risk (p < 0.0001) and the Duke Score (p < 0.0001) had significantly higher values for the patients in the COVID-negative group. Conclusion Lesions with higher pericoronary FAI - Score Centile values were more commonly found in patients who had previously been infected with COVID-19. The higher levels of inflammation in the pericoronary adipose tissue suggests that COVID-19 infection is linked to an increased risk of coronary plaque destabilization.

Correlations between coronary calcium score, FAI index of epicardial fat inflammation and regional distribution of pericoronary inflammation - insights from the IntelFAT study

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): This research has been funded by the research grant Intel-FAT, proposal registration code PN-III-P4-ID-PCE-2020-2861, contract number PCE 206/2021, Project funded by the European Union and the Government of Romania through the Ministry of European Funds, and the Doctoral School of the “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Romania. Introduction Coronary calcium score (CCS) is a well-established coronary CT angiography (CCTA) feature associated with the future risk of cardiovascular events. At the same time, coronary inflammation, which can be measured by the recently developed FAI technology at the level of epicardial fat using CCTA, has been proved to be associated with increased plaque-associated risk. However, the correlation between these 2 CT features, both associated with cardiovascular risk, has not been established so far. The aim of the study was to assess the correlation between CCS, as a measure of coronary calcification, and FAI index of coronary inflammation, as a measure of associated inflammation in the coronary tree. Methods In total, 169 patients who underwent CCTA were enrolled in the study and divided into two groups according to their calculated CCS: group 1: 54 patients with CCS < 130, and group 2: 115 patients with CCS > 130. In all patients, FAI index of coronary inflammation and associated FAI score centiles were calculated for each coronary artery. The global CT-derived cardiovascular risk was calculated according to both Duke score and CariHeart score, a risk score derived from the FAI index of coronary inflammation and CT phenotype of the coronary plaques. Results Patients with high CCS had a higher FAI score (mean FAI score 12.37 +/- 8.33 in group 2 vs 11.65 +/- 7.84 in group 1, p = 0.7). The presence of a high CCS was not significantly associated with the CT-derived Duke score of lesion severity (3.02 +/- 1.38 in group 2 vs 3.09 +/- 1.29 in group 1, p = ns), however the CaRI Heart Risk was significantly higher in the group with high Calcium score (22.88 +/- 19.05 vs 15.95 +/- 11.87, p = 0.0004). At the same time, mapping of inflammation scores along the coronary tree identified that in the group with high CCS, lesions located in the right coronary artery (RCA) had a significantly higher score of inflammation than those in the left coronary artery (Mean FAI score 17.95 +/- 14.56 for RCA versus 11.47 +/- 7.03 for LCA, p = 0.002), while this difference was not significant in patients with lower CCS (p>0.05). Conclusions A high level of coronary calcification, as expressed by a high CCS, is associated with an increased level of inflammation at the level of pericoronary fat. At the same time, patients with high CCS present regional differences in distribution of coronary inflammation, showing increased inflammatory reactions especially at the level of the right coronary circulation. This suggests the potential role of geometric and hemorheologic alterations in the complex process of plaque progression.

Motor unit firing rates in young and very old adult males during an isokinetic fatiguing task and short-term recovery in the anconeus muscle.

Understanding motor unit (MU) properties with muscle fatigue in adult aging is limited to isometric tasks. The purpose was to investigate the effect of an isokinetic fatiguing task on MU firing rates between two adult age groups of males. Single MUs were recorded by intramuscular electrodes in the anconeus muscle of eight young (19-33 yr) and 11 very old adults (78-93 yr). Fatigue was induced by repeated isokinetic maximal voluntary contractions at 25% of maximum velocity (Vmax), until elbow extension power decreased by 35%. At baseline, the very old had lower maximal power (135 vs. 214 W, P = 0.002) and slower maximal velocity (177 vs. 196°/s, P < 0.001) compared with young. Despite a similar number of contractions (average 39 young and 44 very old) to task failure (P = 0.33), the older males were less fatigable as time under tension was ∼25% longer (P = 0.04). Maximum firing rates from ∼20 single MUs per age group were tracked continuously throughout the task and during 10 min of recovery. Similar rates were recorded (24.7 and 23.6 Hz, P = 0.18) at baseline 25% Vmax, and during the task (23.3 and 28.7% decrease, P = 0.21) between young and very old, respectively. Power and MU rates were recovered similarly by 2 min of rest in both groups (all P > 0.15). Despite differences in baseline capability, very old males in this relatively slow isokinetic task were more fatigue resistant, but the fatigue-related reduction and recovery in MU rates were similar between groups. Therefore, fatigue in this task between age groups is not differentially affected by alterations in firing rates.NEW & NOTEWORTHY Maximal motor unit firing rates were recorded during an isokinetic fatiguing protocol and short-term recovery in young and very old adult males. Prior studies were limited to isometric fatiguing tasks. Despite the old being ∼37% weaker and less fatigable, anconeus rates during elbow extension declined with fatigue and recovered similarly to young males. Therefore, it is unlikely that greater fatigue resistance of very old males during isokinetic contractions is related to differences in motor unit rates.

Multivalued neutrosophic fractals and Hutchinson-Barnsley operator in neutrosophic metric space

In this article, we introduce the concept of multivalued fractals in neutrosophic metric spaces using an iterated multifunction system made up of a finite number of neutrosophic B-contractions and neutrosophic Edelstein contractions. Further, we show that multivalued fractals exist and are unique in both complete neutrosophic metric spaces and compact neutrosophic metric spaces and investigate the Collage theorem in order to study multivalued neutrosophic fractals in neutrosophic metric spaces. Also, we establish the neutrosophic contraction characteristics of the Hutchinson-Barnsley operator on the neutrosophic hyperspace and Hausdorff neutrosophic metric spaces.

ОСОБЕННОСТИ РАЗВИТИЯ ГОСУДАРСТВЕННО-ЧАСТНОГО ПАРТНЁРСТВА В РОССИЙСКОЙ ФЕДЕРАЦИИ

There is an insufficient amount of investment in domestic infrastructure facilities. The first place in the number of contracts was given to the sphere of municipal infrastructure. The implementation of projects related to the de-velopment of transport infrastructure is usu-ally postponed. Factors such as the econom-ic crisis, the COVID-19 pandemic and changes in legislation influenced the decline in the indicators of concession agreements.

Morphokinetic changes and apoptotic cell death in vitrified and non-vitrified in vitro-produced ovine embryos.

This article addresses morphokinetic changes and the extent of apoptosis in vitrified and non-vitrified in vitro-derived ovine blastocysts. Cumulus-oocyte complexes were collected after ovarian scarification obtain after slaughter and in vitro maturation was performed in TCM 199 medium supplemented with Earle's Salt, 10 % of FBS, and 5µg/mL of LH/FSH at 38°C for 24h. After maturation, the oocytes were co-incubated with thawed ram semen (IVF) for 19h.Embryo development was monitored with the aid of the Primo Vision Time-Lapse (TL) system. Twenty-five out of thirty-one ovine blastocysts that were vitrified using the Cryotop system at the early blastulation stage of development subsequently re-expanded. Both the vitrified (n=25) and non-vitrified (control group: n=28) blastocysts were examined for detection of apoptosis (TUNEL assay) and total blastomere counts at the time they attained the expanded blastocyst stage. Blastocyst formation occurred earlier in non-vitrified than in vitrified ovine embryos (147:49±20:23 compared with 156:46±19:24; hours:minutes post-insemination; mean ± SD; P<0.05). The average number of blastocyst collapses was greater (2.45±1.64 compared with 1.45±1.64), but the number of weak contractions was less for vitrified than non-vitrified ovine blastocysts (P<0.05). The mean number of blastomeres was greater (131.8±38.6 compared with 91.5±18.3; P<0.05) while the number of TUNEL-positive cells (4.4±1.6 compared with 6.3±2.3) and apoptotic index (3.4±1.2 % compared with 6.9±2.6 %) were less (P<0.05) in non-vitrified compared with vitrified blastocysts. Vitrification of ovine embryos was associated with a delayed blastocyst formation, greater numbers of apoptotic cells, significant reduction in the number of blastomeres, and higher/lower incidence of blastocyst collapse/weak contractions.

Segmented sensor blockchain based on state and block compression

In the sensor blockchain network, sensors need to collect data continuously and upload it to the blockchain network for verification of data integrity. The deployment of smart contracts on the chain can be used to authenticate data visitors. Historical data is valuable for data visitors, but it is useless for sensor nodes that can continue to link data only with current information. With the passage of time, the data of the sensor blockchain network will continue to grow. A node data storage mode that can adapt to the continuous expansion of the blockchain scale is needed, which can encourage nodes to join the network to participate in consensus and jointly maintain the security of the blockchain data. This paper provides a segmented storage solution based on state and block compression for sensor device nodes with limited storage capacity. After experimental verification, this scheme can significantly reduce the storage cost. It allows nodes to use blockchain for a long time in sensor blockchain networks with large transaction volumes and a large number of smart contracts and allows new nodes to be deployed faster.

Unequal capitalization of rural credit in brazilian states and regions

The research sought to evaluate how the resources are appropriated and how the number of contracts of the National Program for Strengthening Family Agriculture (Pronaf) were distributed in the Brazilian regions and states between the years 2000 and 2018. To reach the research objectives, which also sought to evaluate the homogeneity/heterogeneity of the appropriation of Pronaf resources in Brazilian regions and states, data from the Central Bank of Brazil were used. The values were updated for the year 2018. The rural credit appropriation index (ICAR) was constructed, which is the weighted average of the relative annual values of the Pronaf credit modalities: funding and investment for crop and animal production. The weights used for the weighting were generated using factor analysis. The results of the research showed that the appropriation of Pronaf's resources was quite unequal in the evaluated period, being the richest regions and states the ones that captured the highest average values of the credit modalities taken in aggregated way.

Walking the 'design-build-test-learn' cycle: flux analysis and genetic engineering reveal the pliability of plant central metabolism.

This article is a Commentary on Morley et al. (2023), 239: 1834–1851.

Severity of obstructive sleep apnea is associated with the presence of frequent premature ventricular contractions

Abstract Funding Acknowledgements Type of funding sources: None. Background Obstructive Sleep Apnea (OSA) is a highly prevalent disorder in developed countries. It is well known that OSA is strongly associated with Atrial Fibrillation (AFib) and sinus pauses, but its impact on ventricular arrhythmias is less clear. Purpose The aim of this study was to evaluate the presence of rhythm disorders in 24h Holter in patients with OSA and their association with different grades of OSA severity. Methods We performed a retrospective single-center cohort study. The study included patients who underwent both a level 3 polysomnography and a 24h Holter test at our hospital center between 1 January 2015 and 31 December 2019 (n=464). We excluded patients without OSA, patients with OSA under current treatment with CPAP/APAP and those who only had 24h Holter test after starting CPAP/APAP. Patients were divided into 3 groups according to the OSA severity in the sleep study test: mild, moderate and severe. The Holter was analyzed for the presence of AFib, number of premature atrial contractions (PACs), presence of runs of PACs, number of premature ventricular contractions (PVCs), presence of non-sustained ventricular tachycardia (NSVT) and the presence of conduction disorders. Premature contractions were considered frequent when greater than 30 per hour. These results were compared in the three groups. Results This cohort included 233 patients: 89 classified into mild, 74 into moderate and 70 into severe OSA form. The baseline characteristics of patients are depicted in table 1. The overall median age was 67 (57-73) years and was similar between the groups. Male gender was more prevalent in the overall sample and statistically more prevalent in the severe OSA group (56.2% in mild vs 75.7% in severe OSA, p=0.08). Regarding cardiovascular risk factors, there was no difference between the groups except for obesity, with higher body mass indexes translating into more OSA severity (p=0.049). Results are shown in table 2. We observed that OSA severity and AFib are associated. AFib was more prevalent in the moderate and severe forms of OSA (13.5% in moderate and 18.6% in severe OSA vs. 6.7% in mild OSA; p=0.041). The prevalence of atrioventricular block and the prevalence of intraventricular block were higher in the moderate group of OSA (p=0.048; p=0.007). There was no association between OSA severity and the burden and complexity of PACs. On the contrary, we found a higher percentage of frequent PVCs in more severe forms of OSA (20.3 and 21.4% in moderate and severe group, p=0.031). Conclusion In the present study the severity of OSA was associated with a higher prevalence of AFIb and conductions disorders as expected. However, it was also associated with higher prevalence of frequent premature ventricular contractions but not with atrial premature contractions. Further studies are needed to confirm these findings and to study the benefit of level 3 polysomnography testing in patients with frequent PVCs.

Analysis of an acute effect of air pollution on cardiovascular mortality in Eastern Poland (EP-PARTICLES study)

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Science Center. Background According to WHO reports, cardiovascular diseases (CVD) are responsible for almost 18 million deaths worldwide annually. The harmful effect of air pollution on human health in highly polluted regions is well documented. However, Eastern Poland is a region with so-called "Polish smog" – air pollution causing exceptionally adverse cardiovascular effects. Purpose The aim of our study was to assess whether "Polish smog" has an impact on mortality due to CVD,. Methods All-cause deaths from 5 main cities in Eastern Poland in 2016-2020 were analyzed. Mortality data was obtained from Central Statistical Office, while air pollution concentrations (PM2.5, PM10, and NO2) were attained from Voivodeship Inspectorate for Environmental Protection. The analysis with almost 6 million person-years of follow-up with a time-stratified case-crossover design was performed. Results are reported as odds ratio (OR) and 95% Confidence Intervals (95%CI) associated with an increase of 10 μg/m3 in a daily concentration of air pollutants. The study was financed from the funds of the National Science Center granted under the contract number UMO-2021/41/B/NZ7/03716. Results We recorded 87990 all-cause deaths, including 34907, 9688, and 3776 deaths due to CVD, acute coronary syndromes (ACS), and ischemic stroke (IS) respectively. A 10 μg/m3 increase in all analyzed air pollutants was associated with an increase in mortality due to CVD on the day of exposure (PM2.5 OR 1.034, 95%CI 1.027-1.041, p&amp;lt;0.001; PM10 OR 1.033, 95% CI 1.027-1.039, p&amp;lt;0.001; NO2 OR=1.083, 95%CI 1.073-1.094, p&amp;lt;0.001) [Figure 1]. Moreover, a similar effect was also noted on LAG 1 and LAG 2 (LAG 1: PM2.5 OR 1.028, 95%CI 1.021-1.036, p&amp;lt;0.001; PM10 OR 1.025, 95% CI 1.02-1.031, p&amp;lt;0.001; NO2 OR=1.082, 95%CI 1.069-1.094, p&amp;lt;0.001 and LAG 2: PM2.5 OR 1.024, 95%CI 1.017-1.032, p&amp;lt;0.001; PM10 OR 1.023, 95% CI 1.017-1.029, p&amp;lt;0.001; NO2 OR=1.075, 95%CI 1.063-1.087, p&amp;lt;0.001). An increase in PM level caused increased mortality due to ACS on LAG 0 [(PM2.5 OR=1.029, 95%CI 1.011-1.047, p=0.002; PM10 OR=1.015, 95%CI 1-1.029, p=0.049)] [Figure 2]. On LAG 1 we recorded an increase in both IS- (PM2.5 OR=1.03, 95%CI 1.001-1.058, p=0.04) and ACS-related mortality (PM2.5 OR=1.028, 95%CI 1.01-1.047, p=0.003; PM10 OR=1.026, 95%CI 1.011-1.041, p=0.001; NO2 OR=1.036, 95%CI 1.003-1.07, p=0.04). These effects were the most noticeable in women (ACS: PM2.5 OR=1.032, 95%CI 1.006-1.058, p=0.01; PM10 OR=1.028, 95%CI 1.008-1.05, p=0.01) and in older adults (ACS: PM2.5 OR=1.03, 95%CI 1.01-1.05, p=0.003; PM10 OR=1.027, 95% CI 1.011-1.043, p&amp;lt;0.001 and IS: PM2.5 OR=1.037, 95%CI 1.007-1.069, p=0.01; PM10 OR=1.025, 95%CI 1.001-1.05, p=0.04). Conclusions "Polish smog" has a significant impact on CVD-related mortality. The negative influence of PMs was observed on mortality due to ACS and IS, whereas NO2 affected only ACS-related mortality. The most vulnerable subgroups to air pollution were women and people over 65 years old.

Analytical Study of (Ag-Graphene)/Blood Hybrid Nanofluid Influenced by (Platelets-Cylindrical)nanoparticles and Joule Heating via VIM.

Applications: Flow-through permeable media have a wide range of applications in biomedical engineering, geophysical fluid dynamics, and recovery and refinement of underground reservoirs and large-scale chemical applications such as filters, catalysts, and adsorbents. Therefore, this study on a nanoliquid in a permeable channel is conducted under physical constraints. Purpose and Methodology: The key purpose of this research is to introduce a new biohybrid nanofluid model (BHNFM) with (Ag-G)hybridnanoparticles with additional significant physical effects of quadratic radiation, resistive heating, and magnetic field. The flow configuration is set between the expanding/contracting channels, which has broad applications, especially in biomedical engineering. The modified BHNFM was achieved after the implementation of the bitransformative scheme, and then to obtain physical results of the model, the variational iteration method was applied. Core Findings: Based on a thorough observation of the presented results, it is determined that the biohybrid nanofluid (BHNF) is more effective than mono-nano BHNFs in controlling fluid movement. The desired fluid movement for practical purposes can be achieved by varying the wall contraction number (α1 = -0.5, -1.0, -1.5, -2.0) and with stronger magnetic effects (M = 1.0,9.0,17.0,25.0). Furthermore, increasing the number of pores on the surface of the wall causes the BHNF particles to move very slowly. The temperature of the BHNF is affected by the quadratic radiation (Rd), heating source (Q1), and temperature ratio number (θr), and this is a dependable approach to acquire a significant amount of heat. The findings of the current study can aid in a better understanding of parametric predictions in order to produce exceptional heat transfer in BHNFs and suitable parametric ranges to control fluid flow inside the working area. The model results would also be useful for individuals working in the fields of blood dynamics and biomedical engineering.

The Validity of the Cyber Notary in Supporting Govermment Indonesia in the Field of International Trade

Along with the very rapid development of information and electronic technology where electronic media is widely used as a reliable platform for carrying out various activities including communicating and carrying out various kinds of work from business transactions to implementing duties and positions, also the use of the use of electronic signatures (electromic signatures) or digital signatures (digital signatures) on authentic deeds, the concept of cyber notary has been around for quite a long time but an ideal meeting point and harmonization have not been found regarding implementing comprehensive regulations for its implementation. The authors are interested in examining how the relationship and role of Notaries in Indonesia are implemented when digital signatures are implemented in a number of agreements or contracts in the context of international trade. This writing was written using normative research methods by collecting primary, secondary, tertiary or non-legal legal materials which collected and analysed through the steps of description, systematization and explanation. The conclusion that can be drawn from this writing is that the development and regulation of cyber notaries in Indonesian positive law can be seen from the new authority for Notaries to certify transactions carried out electronically, and the concept of cyber notary in supporting Indonesia in the field of international trade based on UNCITRAL, can be done with 3 (three) approaches in regulating electronic signature authentication procedures. To make the notary's authority in the concept of cyber notary effective, legal protection and legal certainty are needed for the perpetrators of the transaction.

SEBOTOK WHARF CONSTRUCTION RISK MANAGEMENT ANALYSIS SUMBAWA WEST NUSA TENGGARA

Abstract: The construction of the Sebotok Pier in Sebotok Village, Labuhan Badas Subdistrict, was carried out for the 2017 Fiscal Year, with Contract Number 027/34/PPK-DISHUB/VIII/2017 dated 21 August 2017 with an implementation period of 125 calendar days (from 21 August to 23 December 2017) and maintenance period of 180 calendar days. Contract Addendum Number 027/63.1/PPK-DISHUB/XII/2017, December 11 2017 (August 21 to January 12 2018). The work was 100% complete and a Provisional Hand Over (PHO) was carried out on January 23 2018. Based on information that there was damage to the Causeway (collapse of the talud masonry wall) in March 2019 and repairs had been carried out in the same month. The Construction Experts Team aims to provide technical justification related to the Sebotok Wharf Construction work, Labuhan Badas District. Referring to the Decree of the Inspector of Sumbawa Regency Number 732.a.Year 2019 concerning the Appointment and Determination of the Amount of Honorarium for the Team of Construction Experts in the Investigation Audit of the Causeway Work for the Sebotok Wharf Development, Sumbawa Regency for the 2017 Fiscal Year addressed to the Team of Construction Experts. The Construction Expert Team conducts field data collection; measuring the dimensions of the causeway construction, checking the physical condition of the causeway building, taking material samples and laboratory tests, interviewing (village officials, community leaders, several people who were directly involved as workers in the implementation of the causeway construction) and documentation. From the results of the analysis it can be concluded that masonry construction in causeway work with dimensions of width (B) 0.40 m, and height (H) 2.16 m a stability safety score of &lt;1.5 is obtained so that the construction is declared UNSAFE. Keywords: Justification, Wharf, Construction Services

Artificial intelligence guided HRCT assessment predicts the severity of COVID-19 pneumonia based on clinical parameters

BackgroundThe purpose of the study was to compare the results of AI (artificial intelligence) analysis of the extent of pulmonary lesions on HRCT (high resolution computed tomography) images in COVID-19 pneumonia, with clinical data including laboratory markers of inflammation, to verify whether AI HRCT assessment can predict the clinical severity of COVID-19 pneumonia.MethodsThe analyzed group consisted of 388 patients with COVID-19 pneumonia, with automatically analyzed HRCT parameters of volume: AIV (absolute inflammation), AGV (absolute ground glass), ACV (absolute consolidation), PIV (percentage inflammation), PGV (percentage ground glass), PCV (percentage consolidation). Clinical data included: age, sex, admission parameters: respiratory rate, oxygen saturation, CRP (C-reactive protein), IL6 (interleukin 6), IG - immature granulocytes, WBC (white blood count), neutrophil count, lymphocyte count, serum ferritin, LDH (lactate dehydrogenase), NIH (National Institute of Health) severity score; parameters of clinical course: in-hospital death, transfer to the ICU (intensive care unit), length of hospital stay.ResultsThe highest correlation coefficients were found for PGV, PIV, with LDH (respectively 0.65, 0.64); PIV, PGV, with oxygen saturation (respectively − 0.53, -0.52); AIV, AGV, with CRP (respectively 0.48, 0.46); AGV, AIV, with ferritin (respectively 0.46, 0.45). Patients with critical pneumonia had significantly lower oxygen saturation, and higher levels of immune-inflammatory biomarkers on admission. The radiological parameters of lung involvement proved to be strong predictors of transfer to the ICU (in particular, PGV ≥ cut-off point 29% with Odds Ratio (OR): 7.53) and in-hospital death (in particular: AIV ≥ cut-off point 831 cm3 with OR: 4.31).ConclusionsAutomatic analysis of HRCT images by AI may be a valuable method for predicting the severity of COVID-19 pneumonia. The radiological parameters of lung involvement correlate with laboratory markers of inflammation, and are strong predictors of transfer to the ICU and in-hospital death from COVID-19.Trial registrationNational Center for Research and Development CRACoV-HHS project, contract number SZPITALE-JEDNOIMIENNE/18/2020.

A Comparative Study to Investigate the Effects of Bisoprolol in Patients with Chronic Heart Failure and Hypertension When Switched from Tablets to Transdermal Patches.

Oral beta-blockers are effective for heart failure and hypertension. Here, we conducted a prospective study to investigate the efficacy of the beta-blocker bisoprolol in patients switching from the oral tablet to the transdermal patch. We studied 50 outpatients receiving oral bisoprolol for chronic heart failure and hypertension. After patients switched treatments, we measured heart rate (HR) over 24 h by Holter echocardiography as the primary endpoint. Secondary endpoints were (1) HR at 00:00, 06:00, 12:00, and 18:00, (2) the total number of premature atrial contractions (PACs) over 24 h and the incidence rate per time segment, and the total number of premature ventricular contractions (PVCs) over 24 h and the incidence rate per time segment, (3) blood pressure, (4) atrial natriuretic peptide and B-type natriuretic peptide, and (5) echocardiography. Minimum, maximum, mean, and total HR over 24 h was not significantly different between the two groups. Mean and maximum HR at 06:00, total PACs, total PVCs, and PVCs at 00:00 to 05:59 and 06:00 to 11:59 were significantly lower in the patch group. Compared with oral bisoprolol, the bisoprolol transdermal patch lowers HR at 06:00 and inhibits the onset of PVCs during sleep and in the morning.

Adjuvant skewing of host immune response to vaccination and subsequent infection with influenza virus

Abstract Despite being a vaccine-preventable disease, seasonal influenza is responsible for thousands of hospitalizations and deaths yearly. Currently licensed quadrivalent inactivated influenza virus vaccines (QIV) aim to induce neutralizing antibodies but are poor inducers of T-cell responses, which could be potentially overcome with adjuvants. We evaluated adjuvant skewing of host-immune responses after vaccination and its persistence after infection. Hereto, we compared two squalene-based adjuvants (AddaVax, and AddaS03) and IMDQ-PC, a lymph node-draining TLR7/8 agonist. All adjuvants resulted in enhanced antibody titers and protection against challenge with H1N1 influenza virus. Lung cytokine/chemokine profiling at 5 days post-infection showed that AddaVax results in higher levels of type 2 immunity-stimulating cytokines IL-4, -5, and -13 in the lungs, which is also reflected by a higher IgG1:IgG2a ratio. Meanwhile, IMDQ-PC showed higher serological IgG2a titers after vaccination and higher levels of IFNγ in the lungs after challenge. To investigate the role of the myeloid compartment in adjuvant skewing of host responses, we examined adjuvant-mediated skewing of bone-derived macrophages in-vitro using Arginase I and iNOS as M2 or M1 markers, respectively. We also pre-licensed macrophages with IL-4 and IFNγ to evaluate adjuvant-intrinsic skewing effects. Licensing was required to induce M1 or M2 phenotypes by squalene-based adjuvants, whereas IMDQ-PC skewed towards M1 phenotype irrespective of licensing. Correlating with the observed type I immune host response, IMDQ-PC induced iNOS more robustly with IFNγ than the other adjuvants. And, AddaS03 induced the highest levels of Arginase I in the IL-4 group. This study was also partly funded by CRIPT (Center for Research on Inuenza Pathogenesis and Transmission), a NIH NIAID funded Center of Excellence for Influenza Research and Response (CEIRR, contract number 75N93021C00014), by the NIAID funded SEM-CIVIC consortium to improve inuenza vaccines (contract number 75N93019C00051), to AG-S. By NIH/NIAID HHSN272201400008C (L.C.), and NIH/NIAID R21AI151229 and R01AI160706 (M.S.). B.G.D.G. acknowledges funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation program (grant N 817938).

A novel method for studying intercellular networks: quantifying cellular cooperativity and inferring the extracellular signals driving it

Abstract Objective: Develop an integrated experimental-computational approach to determine the functional role played by different cell subsets and extracellular communication signals in shaping the behavior of intercellular networks. Methods: We present a microwell-based experimental system, that allows isolating and culturing small groups (up to a few dozens) of cells over extended periods of time, while monitoring their interactions and states using fluorescence microscopy. In parallel, we present a computational framework that uses the data generated by this system for estimating the degree of intercellular cooperativity associated with observed behaviors of the interacting cells, and for inferring the contribution of measured extracellular signals in shaping these behaviors. Results: We used our approach to study the differentiation of mouse Th17 cells. We show that this process requires a relatively large number (&amp;gt; 10) of intermediate intercellular communication steps, in which information processing is carried out by a relatively small percentage (10–20%) of the interacting cells. We correctly predict a correlation between the time in which communication signals are expressed during differentiation, and the degree of intercellular cooperativity associated with their production. Furthermore, we show that we can accurately predict cell-level behaviors. In addition, we correctly identify previously-known effects of cytokines on cell survival, and further predict novel relations, which we validate experimentally. Conclusions: We present a new and general approach for the study of collective cellular behaviors, identifying the key cell subsets and extracellular communication signals driving them. This work was supported in part by National Human Genome Research Institute Centers of Excellence in Genomics Science P50 HG006193 (N.H.), by National Institutes of Health Grants P01 AI045757 and DP3 DK09768101 (J.C.L.) and by the U. S. Army Research Office through the Institute for Soldier Nanotechnologies, under contract number W911NF-13-D-0001 (J.C.L.). This work was also supported in part by the Koch Institute Support (core) Grant P30-CA14051 from the National Cancer Institute. J.C.L. is a Camille Dreyfus Teacher-Scholar.

Development of a 40+ color full spectrum flow cytometry panel for in-depth immunophenotyping of chief cell subsets in non-human primate peripheral blood mononuclear cells

Abstract Leveraging full-spectrum technology, we designed and optimized a 40+ color flow cytometry panel for the analysis of non-human primate peripheral blood mononuclear cells (PBMCs). Non-human primate models of disease allow for the closest approximation of human outcomes to vaccination, disease, and treatment due to similarities in physiological host responses, which increase predictive accuracy. This first panel of its kind achieves comprehensive profiling of immune subpopulations by the inclusion of surface, intracellular, and cytokine markers representative of differentiation, activation, functionality, and proliferation to deeply interrogate the immune response to infectious disease and vaccination. The optimized panel is additionally appropriate for the discovery of new immune phenotypes important for protection against pathogens. After initial optimization for use with cynomolgus macaque (Macaca fascicularis) and rhesus macaque (Macaca mulatta) PBMCs, the panel was further adapted for use with African green monkey (Chlorocebus aethiops) PBMCs to allow for cross-comparison between three frequently implemented non-human primate models of infectious disease. This study was supported by the US Army Medical Research Acquisition Activity contract number W81XWH1910027 to TWG and Department of Health and Human Services, National Institutes of Health grant number UC7AI094660 for BSL-4 operations support of the Galveston National Laboratory.