bluuebunny/crossref_metadata_2025 huggingface dataset:
Chest radiograph-based artificial intelligence predictive model for mortality in community-acquired pneumonia
Authors: Quah Jessica , Liew Charlene Jin Yee , Zou Lin , Koh Xuan Han , Alsuwaigh Rayan , Narayan Venkataraman , Lu Tian Yi , Ngoh Clarence , Wang Zhiyu , Koh Juan Zhen , Ang Christine , Fu Zhiyan , Goh Han Leong
Published: August 2021

Background

Chest radiograph (CXR) is a basic diagnostic test in community-acquired pneumonia (CAP) with prognostic value. We developed a CXR-based artificial intelligence (AI) model (CAP AI predictive Engine: CAPE) and prospectively evaluated its discrimination for 30-day mortality.

Methods

Deep-learning model using convolutional neural network (CNN) was trained with a retrospective cohort of 2235 CXRs from 1966 unique adult patients admitted for CAP from 1 January 2019 to 31 December 2019. A single-centre prospective cohort between 11 May 2020 and 15 June 2020 was analysed for model performance. CAPE mortality risk score based on CNN analysis of the first CXR performed for CAP was used to determine the area under the receiver operating characteristic curve (AUC) for 30-day mortality.

Results

315 inpatient episodes for CAP occurred, with 30-day mortality of 19.4% (n=61/315). Non-survivors were older than survivors (mean (SD)age, 80.4 (10.3) vs 69.2 (18.7)); more likely to have dementia (n=27/61 vs n=58/254) and malignancies (n=16/61 vs n=18/254); demonstrate higher serum C reactive protein (mean (SD), 109 mg/L (98.6) vs 59.3 mg/L (69.7)) and serum procalcitonin (mean (SD), 11.3 (27.8) μg/L vs 1.4 (5.9) μg/L). The AUC for CAPE mortality risk score for 30-day mortality was 0.79 (95% CI 0.73 to 0.85, p<0.001); Pneumonia Severity Index (PSI) 0.80 (95% CI 0.74 to 0.86, p<0.001); Confusion of new onset, blood Urea nitrogen, Respiratory rate, Blood pressure, 65 (CURB-65) score 0.76 (95% CI 0.70 to 0.81, p<0.001), respectively. CAPE combined with CURB-65 model has an AUC of 0.83 (95% CI 0.77 to 0.88, p<0.001). The best performing model was CAPE incorporated with PSI, with an AUC of 0.84 (95% CI 0.79 to 0.89, p<0.001).

Conclusion

CXR-based CAPE mortality risk score was comparable to traditional pneumonia severity scores and improved its discrimination when combined.
Efficacy of a low FODMAP diet in irritable bowel syndrome: systematic review and network meta-analysis
Authors: Black Christopher J. , Staudacher Heidi M. , Ford Alexander C.
Published: August 2021

Objective

A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) is recommended for irritable bowel syndrome (IBS), if general lifestyle and dietary advice fails. However, although the impact of a low FODMAP diet on individual IBS symptoms has been examined in some randomised controlled trials (RCTs), there has been no recent systematic assessment, and individual trials have studied numerous alternative or control interventions, meaning the best comparator is unclear. We performed a network meta-analysis addressing these uncertainties.

Design

We searched the medical literature through to 2 April 2021 to identify RCTs of a low FODMAP diet in IBS. Efficacy was judged using dichotomous assessment of improvement in global IBS symptoms or improvement in individual IBS symptoms, including abdominal pain, abdominal bloating or distension, and bowel habit. Data were pooled using a random effects model, with efficacy reported as pooled relative risks (RRs) with 95% CIs, and interventions ranked according to their P-score.

Results

We identified 13 eligible RCTs (944 patients). Based on failure to achieve an improvement in global IBS symptoms, a low FODMAP diet ranked first vs habitual diet (RR of symptoms not improving=0.67; 95% CI 0.48 to 0.91, P-score=0.99), and was superior to all other interventions. Low FODMAP diet ranked first for abdominal pain severity, abdominal bloating or distension severity and bowel habit, although for the latter it was not superior to any other intervention. A low FODMAP diet was superior to British Dietetic Association (BDA)/National Institute for Health and Care Excellence (NICE) dietary advice for abdominal bloating or distension (RR=0.72; 95% CI 0.55 to 0.94). BDA/NICE dietary advice was not superior to any other intervention in any analysis.

Conclusion

In a network analysis, low FODMAP diet ranked first for all endpoints studied. However, most trials were based in secondary or tertiary care and did not study effects of FODMAP reintroduction and personalisation on symptoms.
Return on investment of Canadian tobacco control policies implemented between 2001 and 2016
Authors: Tarride Jean-Eric , Blackhouse Gord , Guindon G. Emmanuel , Chaiton Michael O , Planinac Lynn , Schwartz Robert
Published: August 2021

Objectives

To determine the return on investment (ROI) associated with tobacco control policies implemented between 2001 and 2016 in Canada.

Methods

Canadian expenditures on tobacco policies were collected from government sources. The economic benefits considered in our analyses (decrease in healthcare costs, productivity costs and monetised life years lost, as well as tax revenues) were based on the changes in smoking prevalence and attributable deaths derived from the SimSmoke simulation model for the period 2001–2016. The net economic benefit (monetised benefits minus expenditures) and ROI associated with these policies were determined from the government and societal perspectives. Sensitivity analyses were conducted to check the robustness of the result. Costs were expressed in 2019 Canadian dollars.

Results

The total of provincial and federal expenditures associated with the implementation of tobacco control policies in Canada from 2001 through 2016 was estimated at $2.4 billion. Total economic benefits from these policies during that time were calculated at $49.2 billion from the government perspective and at $54.2 billion from the societal perspective. The corresponding ROIs were $19.8 and $21.9 for every dollar invested. Sensitivity analyses yielded ROI values ranging from $16.3 to $28.3 for every dollar invested depending on the analyses and perspective.

Conclusions

This analysis has found that the costs to implement the Canadian tobacco policies between 2001 and 2016 were far outweighed by the monetised value associated with the benefits of these policies, making a powerful case for the investment in tobacco control policies.
Global fits of third family hypercharge models to neutral current B-anomalies and electroweak precision observables
Authors: Allanach B. C. , Camargo-Molina J. Eliel , Davighi Joe
Published: August 2021

While it is known that third family hypercharge models can explain the neutral currentB-anomalies, it was hitherto unclear whether the$$Z-Z^\prime $$Z-Z′mixing predicted by such models could simultaneously fit electroweak precision observables. Here, we perform global fits of several third family hypercharge models to a combination of electroweak data and those data pertinent to the neutral currentB-anomalies. While the Standard Model is in tension with this combined data set with ap-value of .0007, simple versions of the models (fitting two additional parameters each) provide much improved fits. The original Third Family Hypercharge Model, for example, has ap-value of$${.065}$$.065, with$$\sqrt{\Delta \chi ^2}=6.5\sigma $$Δχ2=6.5σ.
Magnetic nonsingular black holes in lovelock gravity coupled to exponential electrodynamics
Authors: Ali Askar
Published: August 2021

The model of exponential electromagnetic field is coupled to Lovelock gravitational field in [Formula: see text]-dimensional spacetime geometry. In this context, new class of magnetically charged nonsingular or regular Lovelock black holes has been introduced. The asymptotic behavior of resulting metric function in the vicinity of [Formula: see text] is studied. The obtained asymptotic expressions in both even and odd critical dimensions show the finiteness and regularity of the solution at [Formula: see text]. The thermodynamic quantities such as Hawking temperature and specific heat capacity at constant magnetic charge corresponding to the nonsingular black hole are computed. The tunneling probability associated with Hawking radiations from these black holes is calculated as well.
DISCRETE-TIME OPTIMAL EXECUTION UNDER A GENERALIZED PRICE IMPACT MODEL WITH MARKOVIAN EXOGENOUS ORDERS
Authors: FUKASAWA MASAAKI , OHNISHI MASAMITSU , SHIMOSHIMIZU MAKOTO
Published: August 2021

This paper examines a discrete-time optimal execution problem with generalized price impact. Our main objective is to investigate the effect of price impact caused by aggregate random trade orders posed by small traders on the optimal execution strategy when orders of the small traders have a Markovian dependence. Our problem is formulated as a Markov decision process with state variables which include the last small traders’ aggregate orders. Over a finite horizon, a large trader with Constant Absolute Risk Aversion (CARA) von Neumann–Morgenstern (vN-M) utility function maximizes the expected utility from the final wealth. By applying the backward induction method of dynamic programming, we characterize the optimal execution strategy and optimal value function and conclude that the optimal execution strategy is a time-dependent affine function of three state variables. Moreover, numerical analysis prevails that the optimal execution strategy admits a “statistical arbitrage” via a round-trip trading, although our model considers a linear permanent price impact. The result differs from the previous prevailing one that a linear permanent price impact model precludes any price manipulation or arbitrage. Thus, considering a price impact caused by small traders’ orders with a Markovian dependence is significant.
Deflection angle for charged wormhole in f(R,T) gravity
Authors: Godani Nisha , Samanta Gauranga C.
Published: August 2021

This paper is focused on the study of charged wormholes which are combinations of Morris–Thorne wormhole and Reissner–Nordström spacetime. Gravitational lensing is an important tool which has been adopted to detect various objects like wormholes using the notion of deflection angle. In this work, we have evaluated deflection angle with and without using the strong field limit coefficients and compared the results. Further, exact charged wormhole solutions are obtained in [Formula: see text] gravity and the nature of the energy conditions is examined.
A global review of Carboniferous marine and non-marine bivalve biostratigraphy
Authors: Amler Michael R. W. , Silantiev Vladimir V.
Published: August 2021

This review summarizes research on the biostratigraphic application of Carboniferous marine and non-marine bivalves worldwide, with a focus on the southern margin of Laurussia and the Palaeotethys. Preliminary and established biostratigraphic zonations based on marine and non-marine bivalves are compiled and, if possible, correlated. Bivalve taxa of potential biostratigraphic significance are discussed, and possible limitations of bivalve zonations are outlined. Although marine and non-marine bivalves have not received primary attention for biostratigraphic purposes, a wealth of as yet unused data exists practically worldwide that can assist and complement the more favoured brachiopod, foraminiferid, ammonoid and conodont biozonations.
Plant Communication
Authors: Karban Richard
Published: August 2021

Communication occurs when a sender emits a cue perceived by a receiver that changes the receiver's behavior. Plants perceive information regarding light, water, other nutrients, touch, herbivores, pathogens, mycorrhizae, and nitrogen-fixing bacteria. Plants also emit cues perceived by other plants, beneficial microbes, herbivores, enemies of herbivores, pollinators, and seed dispersers. Individuals responding to light cues experienced increased fitness. Evidence for benefits of responding to cues involving herbivores and pathogens is more limited. The benefits of emitting cues are also less clear, particularly for plant–plant communication. Reliance on multiple or dosage-dependent cues can reduce inappropriate responses, and plants often remember past cues. Plants have multiple needs and prioritize conflicting cues such that the risk of abiotic stress is treated as greater than that of shading, which is in turn treated as greater than that of consumption. Plants can distinguish self from nonself and kin from strangers. They can identify the species of competitor or consumer and respond appropriately. Cues involving mutualists often contain highly specific information.
The Biology of Chernobyl
Authors: Mousseau Timothy A.
Published: August 2021

Environmental disasters offer the unique opportunity for landscape-scale ecological and evolutionary studies that are not possible in the laboratory or small experimental plots. The nuclear accident at Chernobyl (1986) allows for rigorous analyses of radiation effects on individuals and populations at an ecosystem scale. Here, the current state of knowledge related to populations within the Chernobyl region of Ukraine and Belarus following the largest civil nuclear accident in history is reviewed. There is now a significant literature that provides contrasting and occasionally conflicting views of the state of animals and how they are affected by this mutagenic stressor. Studies of genetic and physiological effects have largely suggested significant injuries to individuals inhabiting the more radioactive areas of the Chernobyl region. Most population censuses for most species suggest that abundances are reduced in the more radioactive areas.
The Bacterial Hsp90 Chaperone: Cellular Functions and Mechanism of Action
Authors: Wickner Sue , Nguyen Thu-Lan Lily , Genest Olivier
Published: August 2021

Heat shock protein 90 (Hsp90) is a molecular chaperone that folds and remodels proteins, thereby regulating the activity of numerous substrate proteins. Hsp90 is widely conserved across species and is essential in all eukaryotes and in some bacteria under stress conditions. To facilitate protein remodeling, bacterial Hsp90 collaborates with the Hsp70 molecular chaperone and its cochaperones. In contrast, the mechanism of protein remodeling performed by eukaryotic Hsp90 is more complex, involving more than 20 Hsp90 cochaperones in addition to Hsp70 and its cochaperones. In this review, we focus on recent progress toward understanding the basic mechanisms of bacterial Hsp90-mediated protein remodeling and the collaboration between Hsp90 and Hsp70. We describe the universally conserved structure and conformational dynamics of these chaperones and their interactions with one another and with client proteins. The physiological roles of Hsp90 in Escherichia coli and other bacteria are also discussed. We anticipate that the information gained from exploring the mechanism of the bacterial chaperone system will provide a framework for understanding the more complex eukaryotic Hsp90 system.
A Zero-Dimensional Model for Electrochemical Behavior and Capacity Retention in Organic Flow Cells
Authors: Modak Sanat , Kwabi David G.
Published: August 2021

Comprehensively understanding the behavior of redox-active compounds in organic flow cells is essential to developing low-cost and long service life flow batteries. We develop and validate a zero-dimensional model of the electrochemical performance of an organic flow cell. The model simulates voltage losses from Faradaic charge transfer, Ohmic resistance, and mass transfer, along with the influence of spatial variations in the electrolyte’s state-of-charge between the cell and electrolyte reservoir, on the cell’s cycling behavior. The model’s predictions agree with constant current and constant voltage cycling data for a symmetric ferro-/ferricyanide cell across a wide range of current densities and electrolyte flow rates. We determine the model’s voltage loss parameters from electrochemical impedance spectroscopy and voltammetry measurements acquired prior to cycling, rather than fitted a posteriori. In operando measurements of the electrolyte’s state-of-charge demonstrate that the finite time for electrolyte flow between its reservoir and the electrochemical cell may significantly affect voltage-current behavior. By modelling active reactant decay, we demonstrate how capacity fade measured in a cell depends on the cycling protocol and reactant decay mechanism. This work shows that zero-dimensional electrochemical modeling helps in elucidating capacity fade mechanisms and optimizing the performance of chemistries under consideration for practical organic flow batteries.
Application of Pet-CT Fusion Deep Learning Imaging in Precise Radiotherapy of Thyroid Cancer
Authors: Lin Qiuyu , Qi Qianle , Hou Sen , Chen Zhen , Jiang Nan , Zhang Lan , Lin Chenghe
Published: August 2021

This article explores the value of wall F-FDG PET/Cr imaging in the diagnosis of thyroid cancer, studies its ability to distinguish benign and malignant thyroid lesions, and seeks ways to improve the accuracy of diagnosis. The normal control group selected 40 patients who came to our center for physical examination. In the normal control group, the average value of the standard uptake value of both sides of the thyroid was used as the SUV of the thyroid gland and the highest SUV value of the patient's lesion (SUV max) represented the SUV of the lesion. After injection of imaging agent 18F-FD1G, routine imaging was performed at 1h, time-lapse imaging was performed at 2.5 h, and the changes with conventional imaging were compared to infer the benign and malignant lesions. We used SPSS software to carry out statistical analysis, respectively, carrying out analysis of variance, paired t-test, independent sample t-test, and linear correlation analysis. In the thyroid cancer group, 87.5% of the delayed imaging SUV was higher than the conventional imaging SUV, while 83.33% of the benign disease group had a lower SUV than the conventional imaging SUV. 18F-FDG PET/CT imaging has higher sensitivity and specificity for the diagnosis of recurrence or metastasis in patients with Tg positive. However, it has lower sensitivity and specificity for the diagnosis of 131I-Dx-WBS negative DTC and 18F-FDG PET/CT. The specificity increases with the increase of serum Tg level. The above results confirm that 18F-FDG PET/CT imaging is of great significance for the diagnosis of recurrence or metastasis in patients; with PET/CT imaging, the results changed 16.13% of the Tg-positive and 131I-Dx-WBS negative DTC patients' later treatment decision. The decision-making and curative effect evaluation have certain value.
miRNA‐27a Transcription Activated by c‐Fos Regulates Myocardial Ischemia‐Reperfusion Injury by Targeting ATAD3a
Authors: Bao Yandong , Qiao Ying , Yu Hang , Zhang Zeying , Yang Huimin , Xin Xin , Chen Yuqiong , Guo Yuxuan , Wu Nan , Jia Dalin
Published: August 2021

MicroRNA‐27a (miR‐27a) has been implicated in myocardial ischemia‐reperfusion injury (MIRI), but the underlying mechanism is not well understood. This study is aimed at determining the role of miR‐27a in MIRI and at investigating upstream molecules that regulate miR‐27a expression and its downstream target genes. miR‐27a expression was significantly upregulated in myocardia exposed to ischemia/reperfusion (I/R) and cardiomyocytes exposed to hypoxia/reoxygenation (H/R). c‐Fos could regulate miR‐27a expression by binding to its promoter region. Moreover, overexpression of miR‐27a led to a decrease in cell viability, an increase in LDH and CK‐MB secretion, and an increase in apoptosis rates. In contrast, suppression of miR‐27a expression resulted in the opposite effects. ATPase family AAA‐domain‐containing protein 3A (ATAD3a) was identified as a target of miR‐27a. miR‐27a regulated the translocation of apoptosis‐inducing factor (AIF) from the mitochondria to the nucleus and H/R‐induced apoptosis via the regulation of ATAD3a. It was found that inhibiting miR‐27a in vivo by injecting a miR‐27a sponge could ameliorate MIRI in an isolated rat heart model. In conclusion, our study demonstrated that c‐Fos functions as an upstream regulator of miR‐27a and that miR‐27a regulates the translocation of AIF from the mitochondria to the nucleus by targeting ATAD3a, thereby contributing to MIRI. These findings provide new insight into the role of the c‐Fos/miR‐27a/ATAD3a axis in MIRI.
Tissue Renin‐Angiotensin System (tRAS) Induce Intervertebral Disc Degeneration by Activating Oxidative Stress and Inflammatory Reaction
Authors: Sun Kaiqiang , Sun Xiaofei , Sun Jingchuan , Jiang Yan , Lin Feng , Kong Fanqi , Li Fudong , Zhu Jian , Huan Le , Zheng Bing , Wang Yuan , Zou Weiguo , Gao Lu , Xu Ximing , Shi Jiangang
Published: August 2021

Lumbar intervertebral disc degeneration (IDD) has been the major contributor to low back pain (LBP). IDD is an chronic inflammation process, with the activation of plentiful inflammation‐related cytokines and ECM degradation‐related enzymes. In the past few years, hypertension has been reported to correlate with LBP. In addition, the local tissue renin‐angiotensin system (tRAS) has been identified in multiple tissues, including the spinal cord, skin, kidney, heart, and bone. Recently, tRAS has also been established in both bovine and human intervertebral disc tissues, especially in the degenerated disc tissue. However, the exact of tRAS and IDD remains unknown. In this present study, proteomic analysis, molecular biology analysis, and animal model were all used. Firstly, we revealed that tRAS was excessively activated in the human degenerated intervertebral disc tissue via proteomic analysis and molecular biology analysis. Then, in vitro experiment suggested that Ang II could decrease the cell viability of human NP cells and promote NP cell apoptosis, senescence, oxidative stress, and NLRP3 activation in human NP cells. In addition, Ang II could also trigger degeneration and fibrosis phenotype in human NP cells. Finally, the animal model demonstrated that the local activated ACE/Ang II axis in the NP tissue could accelerate IDD in aging spontaneously hypertensive rats (SHR). Collectively, the degenerated intervertebral disc tissue showed excessively activated tRAS, and local activated tRAS could induce NP cell senescence, apoptosis, oxidative stress, and inflammatory reaction to promote IDD. These biological effects of Ang II on human NP cells may provide novel insight into further treatment of IDD.
Research on Balance Control of Freestyle Skiing Aerial Skills Based on Ant Colony Algorithm
Authors: Jun Wang , Song Wenli , Li Zhipeng
Published: August 2021

Aiming at solving the problem of poor performance of airborne freestyle skiing balance, this paper presents the research of airborne freestyle skiing balance control based on ant colony algorithm. On the basis of defining the trajectory division of the airborne balance of freestyle skiing and the track of the center of gravity of the human body, a sensor is used to collect the data of the airborne balance of freestyle skiing, and the moving average, denoising, and normalizing processes are done. The training label of the ant colony algorithm is made by the analog signal matrix, the implementation foreground of the key posture frame of freestyle skiing is extracted, the disturbed area in the key posture frame is removed by the clustering algorithm, and the key posture area of freestyle skiing is obtained. The incremental clustering of the data of the key posture area of freestyle skiing is conducted, the incremental posture data mining model of freestyle skiing is established, the mining parameters are input into the mining model, and the incremental data mining is realized by the ant colony algorithm to complete the research on the control of the airborne balance of freestyle skiing. The results show that the proposed method has good reliability, good convergence, and strong response ability.
Relationship between Admission Electrolyte Level and Short-term Prognosis of Patients with Acute ST-segment Elevation Myocardial Infarction after Percutaneous Coronary Intervention
Authors: Ren Yaping , Yue Zhijie , Li Xuewen
Published: August 2021

Objective. The objective of this study is to analyze the relationship between the electrolyte level of patients with acute ST-segment elevation myocardial infarction (STEMI) and short-term prognosis after percutaneous coronary intervention (PCI). Methods. The clinical data of 142 patients with acute STEMI who underwent PCI in our hospital from September 2018 to September 2019 were retrospectively analyzed. According to the level of serum sodium, potassium, and chloride in patients admitted to the hospital, they were divided into the normal electrolyte group (n = 78), the mild decline group (n = 46), and the severe decline group (n = 16). Univariate and logistic regression multivariate analysis of the relationship between patient electrolyte levels and general clinical data is performed. Statistical analysis of patients’ adverse events within 90 days was performed. The Kaplan–Meier survival curve analyzed the relationship between the survival period and electrolyte levels in patients with acute STEMI without major acute cardiovascular events (MACE) within 90 days. Results. The levels of creatine kinase-MB (CK-MB), cardiac troponin I (cTnI), myocardial infarction area, and Gensini score in patients with mild decline were significantly higher than those in the normal group, left ventricle ejection fractions (LVEF) value was significantly lower than the normal group, and patients with severe decline were significantly higher in creatine kinase (CK) level than the normal group (

P
<
0.05

). The levels of CK-MB, CK, cTnI, and myocardial infarction area of the patients in the severe decline group were significantly higher than those in the mild decline group, and the LVEF values were significantly lower than those in the mild decline group (

P
<
0.05

). The levels of CK-MB, CK, cTnI, the area of myocardial infarction, and Gensini score in patients with acute STEMI have an independent effect on their electrolyte levels. The patients in the mild decline group and severe decline group had significantly higher rates of cardiogenic shock, heart failure, ventricular aneurysm formation, ventricular septal perforation, or death within 90 days after PCI. The median without MACE survival time of patients with mildly and severely reduced electrolyte levels was significantly lower than that of patients with normal electrolyte levels. Conclusion. Patients with acute STEMI are prone to electrolyte disturbances, and their CK-MB, CK, and cTnI levels; myocardial infarction area; and Gensini score have independent effects on electrolyte levels. Patients with electrolyte disturbances are prone to poor prognosis after PCI, and their survival period without MACE at 90 days is significantly lower than that of normal patients.
Breaching Subjects’ Thoughts Privacy: A Study with Visual Stimuli and Brain-Computer Interfaces
Authors: Quiles Pérez Mario , Martínez Beltrán Enrique Tomás , López Bernal Sergio , Huertas Celdrán Alberto , Martínez Pérez Gregorio
Published: August 2021

Brain-computer interfaces (BCIs) started being used in clinical scenarios, reaching nowadays new fields such as entertainment or learning. Using BCIs, neuronal activity can be monitored for various purposes, with the study of the central nervous system response to certain stimuli being one of them, being the case of evoked potentials. However, due to the sensitivity of these data, the transmissions must be protected, with blockchain being an interesting approach to ensure the integrity of the data. This work focuses on the visual sense, and its relationship with the P300 evoked potential, where several open challenges related to the privacy of subjects’ information and thoughts appear when using BCI. The first and most important challenge is whether it would be possible to extract sensitive information from evoked potentials. This aspect becomes even more challenging and dangerous if the stimuli are generated when the subject is not aware or conscious that they have occurred. There is an important gap in this regard in the literature, with only one work existing dealing with subliminal stimuli and BCI and having an unclear methodology and experiment setup. As a contribution of this paper, a series of experiments, five in total, have been created to study the impact of visual stimuli on the brain tangibly. These experiments have been applied to a heterogeneous group of ten subjects. The experiments show familiar visual stimuli and gradually reduce the sampling time of known images, from supraliminal to subliminal. The study showed that supraliminal visual stimuli produced P300 potentials about 50% of the time on average across all subjects. Reducing the sample time between images degraded the attack, while the impact of subliminal stimuli was not confirmed. Additionally, younger subjects generally presented a shorter response latency. This work corroborates that subjects’ sensitive data can be extracted using visual stimuli and P300.
Mask-Related Glasses Fogging: A Predisposing Mechanism of Falls during the COVID-19 Pandemic
Authors: Dankert John F. , Virk Mandeep S.
Published: August 2021

Fogging is a relatively infrequent, yet annoying, issue encountered by individuals who wear glasses. With the arrival of COVID-19, glasses fogging is more common due to the ubiquitous use of face masks. Individuals are stuck wrestling between leaving their mask off or trying to navigate their day-to-day lives with fogged glasses and risk falling. We report a case of an olecranon fracture sustained due to reduced visibility secondary to mask-related fogging during the COVID-19 pandemic. The recommendations included here will provide health care providers with the necessary information to educate patients regarding prevention of mask-related glass fogging.
Mild Hypothermia Therapy Lowers the Inflammatory Level and Apoptosis Rate of Myocardial Cells of Rats with Myocardial Ischemia-Reperfusion Injury via the NLRP3 Inflammasome Pathway
Authors: Gao Renjun , Zhao Hongye , Wang Xianyan , Tang Bo , Cai Yu , Zhang Xinrui , Zong Hao , Li Yitong , Wang Yanli
Published: August 2021

Objective. To explore the protective effects and mechanism of mild hypothermia treatment in the treatment of myocardial ischemia-reperfusion injury. Material and Methods. A total of 20 Sprague-Dawley (SD) rats were assigned to 4 groups: the blank control group, sham operation group, ischemia reperfusion group, and mild hypothermia therapy group (each

n
=
5

). Some indexes were detected. In addition, myocardial cell models of oxygen-glucose deprivation/reoxygenation injury (OGD) were established. The expression of mRNA IL-6 and TNF-α and the key enzyme levels of apoptosis (cleaved-Caspase-3) and the NLRP3 inflammasome/p53 signaling pathway in the models were determined. Results. The expression of serum IL-6 and TNF-α in the mild hypothermia therapy group was significantly lower than that in the ischemia reperfusion group. The mild hypothermia therapy group also showed a significantly lower TUNEL cell count and NLRP3 and p53 phosphorylation levels than the ischemia reperfusion group (all

p
<
0.05

). The in vitro mild

hypothermia
+
OGD

group also showed significantly lower mRNA expression of IL-6 and TNF-α and levels of cleaved Caspase-3, NLRP3, and phosphorylated p53 protein than the OGD group (all

p
<
0.05

). Conclusion. In conclusion, mild hypothermia therapy can inhibit the apoptosis and myocardial inflammation of cells induced by MI/R injury in rats and inhibiting the activity of the NLRP3 inflammasome pathway and p53 signaling pathway may be the mechanism.
Management of Neurofibromatosis of the Nipple-Areolar Complex
Authors: Aljindan Fahad , Aljehani Lamiaa , Alsharif Bayan , Mortada Hatan
Published: August 2021

Neurofibromatosis type 1 is an autosomal dominant disease having an incidence of 1 in 3000 individuals. It primarily involves the peripheral nervous system and usually presents with many neurofibromas. On rare occasions, NF1 can affect the breast and manifests as nipple-areolar complex extranipple (pseudopolythelia) like neurofibromas which can be disfiguring and sometimes cause pain and therefore need to be addressed surgically. We present a case of a 31-year-old female, who had multiple pedunculated neurofibromas around the nipple on both breasts for 3 years. These lesions were associated with mild pain and were increasing in size. Surgical excision was done while preserving the nipples bilaterally. NF1 primarily involves the peripheral nervous system and usually presents with a large number of neurofibromas. Several case series of patients with NF1 have been reported, but there are only a few published reports on neurofibromas of the nipple-areolar complexes. These lesions can be painful and cause cosmetic deformity. In our case, these lesions were approached by circumferentially excising the redundant nipple-areolar skin containing the neurofibromas, while isolating the nipple on a central ductal and vascular pedicle. In conclusion, the redundant nipple-areolar skin containing the neurofibromas can simply be approached by circumferential excision while preserving the nipple. This technique is simple, easy to perform, while it allows duct preservation and preserves cosmesis.
Trophoblasts Modulate the Ca2+ Oscillation and Contraction of Myometrial Smooth Muscle Cells by Small Extracellular Vesicle‐ (sEV‐) Mediated Exporting of miR‐25‐3p during Premature Labor
Authors: Wang Lin , Zhang Wenzhu , Zou Ning , Zhang Lijuan
Published: August 2021

The placenta could transmit information to the maternal circulation via the secretion of small extracellular vesicles (sEVs), but little is known about whether and how these sEVs participate in premature labor (PTL). We speculate that miRNA plays an important role in sEV‐mediated fetal‐maternal information transmission. The present study was aimed at investigating whether the placenta can regulate the contraction of the maternal myometrium via sEV‐mediated transmit of miR‐25‐3p during PTL. The expression of miR‐25‐3p and its targets Cav3.2 and SERCA2a in clinical samples, cells, and animal specimens was detected. The role of miR‐25‐3p was observed in the LPS‐induced preterm labor mouse model. The sEVs from HTR‐8/SVneo cells were characterized by transmission electron microscopy and nanoparticle tracking analysis. The Ca2+ oscillation in HMSMs was analyzed by an intracellular Ca2+ change tracking assay on a confocal microscope. The contraction of HMSMs was detected by a collagen matrix contraction assay. We found that miR‐25‐3p can directly bind to the 3 ′UTR of Cav3.2 and SERCA2a. The miR‐25‐3p level was decreased, and the expression of its targets Cav3.2 and SERCA2a was increased in the placenta and myometrium tissues of PTL patients. Forced upregulation of miR‐25‐3p reduced the oxidative stress and inflammation responses and the incidence of PTL in LPS‐treated mice. The expression of miR‐25‐3p was not changed in LPS‐stimulated human myometrial smooth muscle cells (HMSMs) but was strongly reduced in the trophoblast cell and its sEVs. Additionally, the trophoblast cell line HTR‐8/SVneo could transmit miR‐25‐3p into HMSMs via sEVs. The sEVs derived from LPS‐stimulated trophoblasts upregulated the expression of Cav3.2 and SERCA2a and triggered Ca2+ oscillation as well as the contraction of HMSMs; these effects were partially reversed by the overexpression of miR‐25‐3p in the trophoblasts. Further, the upregulation of miR‐25‐3p induced changes of Ca2+ oscillation and contraction of HMSMs mediated by sEVs which were also abrogated by the knockdown of miR‐25‐3p in HMSMs. The results demonstrated that miR‐25‐3p plays a crucial role in PTL via Cav3.2‐ and SERCA2a‐mediated Ca2+ oscillation and contraction of HMSMs. PTL seems to be related to the decreased exosomal miR‐25‐3p content transmitted by the trophoblasts under inflammatory conditions.
Antiaging Effects of Vicatia thibetica de Boiss Root Extract on Caenorhabditis elegans and Doxorubicin‐Induced Premature Aging in Adult Mice
Authors: Liu Wenwen , Guan Yunhui , Qiao Sicong , Wang Jiqun , Bao Keting , Mao Zhifan , Liao Liang , Moskalev Alexey , Jiang Bei , Zhu Jin , Xia Conglong , Li Jian , Hu Zelan
Published: August 2021

The roots of Vicatia thibetica de Boiss are a kind of Chinese herb with homology of medicine and food. This is the first report showing the property of the extract of Vicatia thibetica de Boiss roots (HLB01) to extend the lifespan as well as promote the healthy parameters in Caenorhabditis elegans (C. elegans). For doxorubicin‐ (Doxo‐) induced premature aging in adult mice, HLB01 counteracted the senescence‐associated biomarkers, including P21 and γH2AX. Interestingly, HLB01 promoted the expression of collagen in C. elegans and mammalian cell systemically, which might be one of the essential factors to exert the antiaging effects. In addition, HLB01 was also found as a scavenger of free radicals, thereby performing the antioxidant ability. Lifespan extension by HLB01 was also dependent on DAF‐16 and HSF‐1 via oxidative stress resistance and heat stress resistance. Taken together, overall data suggested that HLB01 could extend the lifespan and healthspan of C. elegans and resist Doxo‐induced senescence in mice via promoting the expression of collagen, antioxidant potential, and stress resistance.
Comparison of Extracorporeal Shock Wave Therapy versus Manual Lymphatic Drainage on Cellulite after Liposuction: A Randomized Clinical Trial
Authors: Allam Nesma M. , Elshorbagy Radwa T. , Eid Marwa M. , Abdelbasset Walid Kamal , Elkholi Safaa Mostafa , Eladl Hadaya Mosaad
Published: August 2021

Introduction. Cellulite is associated with variations in the skin appearance with cottage cheese, mattress-like, or orange peel. The most common areas for these lesions are the posterior or upper thighs and buttocks and mainly affect females after puberty. The objective of the study was to determine whether extracorporeal shock wave therapy (ESWT) or manual lymphatic drainage (MLD) is more effective for the reduction of the grade of cellulite after liposuction. Methods. This study is a single-blinded randomized controlled clinical trial. Thirty females with grade 3 cellulite were randomly distributed into two groups equal in number (n = 15), group A was equipped to ESWT and group B was equipped to MLD. The cellulite grading scale was used to assess cellulite grade, and the skinfold caliper was used to assess the thickness of subcutaneous fat. The assessment was carried out before and four weeks after starting the treatment. Both groups received topical retinol twice daily for four weeks; in addition, group A received ESWT, while group B received MLD, two times/week for 4 weeks. Results. The mean values of the skinfold caliper in group A decreased by 24.4% and in group B by 15.38% with a significant difference between the two groups

p
<
0.001

. Also, the mean values of the cellulite grading scale decreased significantly after treatment in group A compared with the mean values of group B

p
<
0.001

. Conclusions. There was more reduction in the grade of cellulite and thickness of subcutaneous fat in the ESWT group than the MLD group after liposuction.
Experimental and Numerical Analysis Study on Loess‐Lime Structures Used for Lateral Antiseepage in Deep Collapsible Ground Embankment
Authors: Zhang Zhengrui , Matlan Siti Jahara , Zhang Lili , Wang Hao
Published: August 2021

The focus of this study was to investigate the effect of loess soil treated with lime on the lateral‐seepage response. Three groups of box experiments were carried out to study the lateral‐seepage effect under different types of loess‐lime structures. Automated testing systems were designed to perform experiments and collect data. Additionally, numerical analysis of lateral‐seepage impact and embankment settlement was performed. Finally, moisture content and settlement were monitored to quantify lateral‐seepage effect results under corresponding loess‐lime treatment. Results showed that loess‐lime compaction piles and diaphragm wall structures could effectively prevent lateral seepage, and the latter was better. The simulated results are similar to the measured values of the box experiment, which indicates the accuracy of the simulation analysis and further supports the experimental results of this study.
Reproducibility, Temporal Variability, and Concordance of Serum and Fecal Bile Acids and Short Chain Fatty Acids in a Population-Based Study
Authors: Farhat Zeinab , Sampson Joshua N. , Hildesheim Allan , Safaeian Mahboobeh , Porras Carolina , Cortés Bernal , Herrero Rolando , Romero Byron , Vogtmann Emily , Sinha Rashmi , Loftfield Erikka
Published: August 2021

Background:

Bile acid (BA) and short chain fatty acid (SCFA) production is affected by diet and microbial metabolism. These metabolites may play important roles in human carcinogenesis.

Methods:

We used a fully quantitative targeted LC-MS/MS system to measure serum and fecal BA and SCFA concentrations in 136 Costa Rican adults at study baseline and 6-months. We randomly selected 50 participants and measured their baseline samples in duplicate. Our objective was to evaluate: Technical reproducibility; 6-month temporal variability; and concordance between sample type collected from the same individual at approximately the same time.

Results:

Technical reproducibility was excellent, with intraclass correlation coefficients (ICC) ≥0.83 for all BAs except serum tauroursodeoxycholic acid (ICC = 0.72) and fecal glycolithocholic acid (ICC = 0.66) and ICCs ≥0.81 for all SCFAs except serum 2-methylbutyric acid (ICC = 0.56) and serum isobutyric acid (ICC = 0.64). Temporal variability ICCs were generally low, but several BAs (i.e., deoxycholic, glycoursodeoxycholic, lithocholic, taurocholic, and tauroursodeoxycholic acid) and SCFAs (i.e., 2-methylbutyric, butyric, propionic, and valeric acid) had 6-month ICCs ≥0.44. The highest degree of concordance was observed for secondary and tertiary BAs.

Conclusions:

Serum and fecal BAs and SCFAs were reproducibly measured. However, 6-month ICCs were generally low, indicating that serial biospecimen collections would increase statistical power in etiologic studies. The low concordance for most serum and fecal metabolites suggests that consideration should be paid to treating these as proxies.

Impact:

Our findings will inform the design and interpretation of future human studies on associations of BAs, SCFAs, and potentially other microbial metabolites, with disease risk.
MONARCH 2: Subgroup Analysis of Patients Receiving Abemaciclib Plus Fulvestrant as First-Line and Second-Line Therapy for HR+, HER2−-Advanced Breast Cancer
Authors: Neven Patrick , Johnston Stephen R.D. , Toi Masakazu , Sohn Joohyuk , Inoue Kenichi , Pivot Xavier , Burdaeva Olga , Okera Meena , Masuda Norikazu , Kaufman Peter A. , Koh Han , Grischke Eva-Maria , Conte PierFranco , Lu Yi , Haddad Nadine , Hurt Karla C. , Llombart-Cussac Antonio , Sledge George W.
Published: August 2021

Purpose:

In MONARCH 2, abemaciclib plus fulvestrant significantly prolonged progression-free survival (PFS) and overall survival (OS) versus placebo plus fulvestrant in patients with hormone receptor positive (HR+), HER2− advanced breast cancer. This exploratory analysis assessed the efficacy of abemaciclib plus fulvestrant across subgroups of patients receiving study therapy as first- or second-line treatment for metastatic disease.

Patients and Methods:

Improvements were estimated using Cox models, and a test of interactions of subgroups with treatment was performed.

Results:

The benefit in PFS [first-line, HR, 0.57; 95% confidence interval (CI), 0.45–0.73; second-line, HR, 0.48; 95% CI, 0.36–0.64] and OS (first-line, HR, 0.85; 95% CI, 0.64–1.14; second-line, HR, 0.66; 95% CI, 0.46–0.94) was observed across both subgroups, consistent with the intent-to-treat (ITT) population. In first-line patients (abemaciclib arm, n = 265; placebo arm, n = 133), the numerically largest effect on PFS and OS was observed in patients with primary resistance to endocrine therapy (ET; PFS, HR, 0.40; 95% CI, 0.26–0.63; OS, HR, 0.58; 95% CI, 0.35–0.97) and visceral disease (PFS, HR, 0.54; 95% CI, 0.39–0.73; OS, HR, 0.82; 95% CI, 0.58–1.20). In second-line patients (abemaciclib arm, n = 170; placebo arm, n = 86), a numerical benefit in PFS and OS was observed across primary and secondary ET resistance, with numerically more pronounced effects observed in patients with visceral disease (PFS, HR, 0.39; 95% CI, 0.27–0.57; OS, HR, 0.51; 95% CI, 0.33–0.81). Prolongation of time to second disease progression, time to chemotherapy, and chemotherapy-free survival was observed in both subgroups.

Conclusions:

Consistent with the ITT population, a benefit in PFS and OS was observed across the first- and second-line subgroups in MONARCH 2.
Early Use of High-Dose Glucocorticoid for the Management of irAE Is Associated with Poorer Survival in Patients with Advanced Melanoma Treated with Anti–PD-1 Monotherapy
Authors: Bai Xue , Hu Jiani , Betof Warner Allison , Quach Henry T. , Cann Christopher G. , Zhang Michael Z. , Si Lu , Tang Bixia , Cui Chuanliang , Yang Xiaoling , Wei Xiaoting , Pallan Lalit , Harvey Catriona , Manos Michael P. , Ouyang Olivia , Kim Michelle S. , Kasumova Gyulnara , Cohen Justine V. , Lawrence Donald P. , Freedman Christine , Fadden Riley M. , Rubin Krista M. , Sharova Tatyana , Frederick Dennie T. , Flaherty Keith T. , Rahma Osama E. , Long Georgina V. , Menzies Alexander M. , Guo Jun , Shoushtari Alexander N. , Johnson Douglas B. , Sullivan Ryan J. , Boland Genevieve M.
Published: August 2021

Purpose:

Programmed cell death receptor-1 (PD-1) inhibitors are frontline therapy in advanced melanoma. Severe immune-related adverse effects (irAEs) often require immunosuppressive treatment with glucocorticoids (GCCs), but GCC use and its correlation with patient survival outcomes during anti–PD-1 monotherapy remains unclear.

Experimental Design:

In this multicenter retrospective analysis, patients treated with anti–PD-1 monotherapy between 2009 and 2019 and detailed GCC use, data were identified from five independent cohorts, with median follow-up time of 206 weeks. IrAEs were tracked from the initiation of anti–PD-1 until disease progression, initiation of a new therapy, or last follow-up. Correlations between irAEs, GCC use, and survival outcomes were analyzed.

Results:

Of the entire cohort of 947 patients, 509 (54%) developed irAEs. In the MGH cohort [irAE(+) n = 90], early-onset irAE (within 8 weeks of anti–PD-1 initiation) with high-dose GCC use (≥60-mg prednisone equivalent once a day) was independently associated with poorer post-irAE PFS/OS (progression-free survival/overall survival) [post-irAE PFS: HR, 5.37; 95% confidence interval (CI), 2.10–13.70; P < 0.001; post-irAE OS: HR, 5.95; 95% CI, 2.20–16.09; P < 0.001] compared with irAEs without early high-dose GCC use. These findings were validated in the combined validation cohort [irAE(+) n = 419, post-irAE PFS: HR, 1.69; 95% CI, 1.04–2.76; P = 0.04; post-irAE OS: HR, 1.97; 95% CI, 1.15–3.39; P = 0.01]. Similar findings were also observed in the 26-week landmark analysis for post–irAE-PFS but not for post–irAE-OS. A sensitivity analysis using accumulated GCC exposure as the measurement achieved similar results.

Conclusions:

Early high-dose GCC use was associated with poorer PFS and OS after irAE onset. Judicious use of GCC early during anti–PD-1 monotherapy should be considered. Further prospective randomized control clinical trials designed to explore alternative irAE management options are warranted.