bluuebunny/crossref_metadata_2025 huggingface dataset:
Geriatric clinical screening tool for cervical spine injury after ground-level falls
Authors: Engelbart Jacklyn , Zhou Peige , Johnson Jenna , Lilienthal Michele , Zhou Yunshu , Ten-Eyck Patrick , Galet Colette , Skeete Dionne
Published: June 2021

Background

A consistent approach to cervical spine injury (CSI) clearance for patients 65 and older remains a challenge. Clinical clearance algorithms like the National Emergency X-Radiography Utilisation Study (NEXUS) criteria have variable accuracy and the Canadian C-spine rule excludes older patients. Routine CT of the cervical spine is performed to rule out CSI but at an increased cost and low yield. Herein, we aimed to identify predictive clinical variables to selectively screen older patients for CSI.

Methods

The University of Iowa’s trauma registry was interrogated to retrospectively identify all patients 65 years and older who presented with trauma from a ground-level fall from January 2012 to July 2017. The relationship between predictive variables (demographics, NEXUS criteria and distracting injuries) and presence of CSI was examined using the generalised linear modelling (GLM) framework. A training set was used to build the statistical models to identify clinical variables that can be used to predict CSI and a validation set was used to assess the reliability and consistency of the model coefficients estimated from the training set.

Results

Overall, 2312 patients ≥65 admitted for ground-level falls were identified; 253 (10.9%) patients had a CSI. Using the GLM framework, the best predictive model for CSI included midline tenderness, focal neurological deficit and signs of trauma to the head/face, with midline tenderness highly predictive of CSI (OR=22.961 (15.178–34.737); p<0.001). The negative predictive value (NPV) for this model was 95.1% (93.9%–96.3%). In the absence of midline tenderness, the best model included focal neurological deficit (OR=2.601 (1.340–5.049); p=0.005) and signs of trauma to the head/face (OR=3.024 (1.898–4.815); p<0.001). The NPV was 94.3% (93.1%–95.5%).

Conclusion

Midline tenderness, focal neurological deficit and signs of trauma to the head/face were significant in this older population. The absence of all three variables indicates lower likelihood of CSI for patients≥65. Future observational studies are warranted to prospectively validate this model.
Retinal imaging in Alzheimer’s disease
Authors: Cheung Carol Y , Mok Vincent , Foster Paul J , Trucco Emanuele , Chen Christopher , Wong Tien Yin
Published: June 2021

Identifying biomarkers of Alzheimer’s disease (AD) will accelerate the understanding of its pathophysiology, facilitate screening and risk stratification, and aid in developing new therapies. Developments in non-invasive retinal imaging technologies, including optical coherence tomography (OCT), OCT angiography and digital retinal photography, have provided a means to study neuronal and vascular structures in the retina in people with AD. Both qualitative and quantitative measurements from these retinal imaging technologies (eg, thinning of peripapillary retinal nerve fibre layer, inner retinal layer, and choroidal layer, reduced capillary density, abnormal vasodilatory response) have been shown to be associated with cognitive function impairment and risk of AD. The development of computer algorithms for respective retinal imaging methods has further enhanced the potential of retinal imaging as a viable tool for rapid, early detection and screening of AD. In this review, we present an update of current retinal imaging techniques and their potential applications in AD research. We also discuss the newer retinal imaging techniques and future directions in this expanding field.
Bioeconomic analysis accounting for environmental effects in data-poor fisheries: the northern Labrador Arctic char
Authors: Kourantidou Melina , Jin Di , Solow Andrew
Published: June 2021

Fisheries managers call for more nuanced understandings of complex interactions between exploitation and environmental variability, especially in data poor settings. We develop a bioeconomic model for the Arctic char (Salvelinus alpinus) out of Nain, northern Labrador, incorporating climate variability into growth. We derive parameters necessary for the bioeconomic analysis through optimization and identify optimal equilibrium conditions for the model with and without climate variability. Accounting for variability results in a slightly higher optimal harvest, fishing effort and stock. We find an optimal effort of 591 fishing weeks and harvest of 156 920 kg for 2014, suggesting that both were below optimal. We further find that increased temperature leads to higher optimal effort and net benefits at steady state. Despite numerous uncertainties, data and knowledge gaps limiting the accuracy of our estimates, this is the first effort to identify the equilibrium harvesting conditions for this currently uneconomic, yet socially and culturally important fishery. The methodology can be applicable to other data-deficient fisheries with similar challenges and unknowns, to advance the understanding of socially optimal harvesting and interactions with environmental variability.
Predictive Analytics for Smart Parking: A Deep Learning Approach in Forecasting of IoT Data
Authors: Piccialli Francesco , Giampaolo Fabio , Prezioso Edoardo , Crisci Danilo , Cuomo Salvatore
Published: June 2021

Nowadays, a sustainable and smart city focuses on energy efficiency and the reduction of polluting emissions through smart mobility projects and initiatives to “sensitize” infrastructure. Smart parking is one of the building blocks of intelligent mobility, innovative mobility that aims to be flexible, integrated, and sustainable and consequently integrated into a Smart City. By using the Internet of Things (IoT) sensors located in the parking areas or the underground car parks in combination with a mobile application, which indicates to citizens the free places in the different areas of the city and guides them toward the chosen parking, it is possible to reduce air pollution and fluidifying noise traffic. In this article, we present and discuss an innovative Deep Learning-based ensemble technique in forecasting the parking space occupancy to reduce the search time for parking and to optimize the flow of cars in particularly congested areas, with an overall positive impact on traffic in urban centres. A genetic algorithm has also been used to optimize predictors parameters. The main goal is to design an intelligent IoT-based service that can predict, in the next few hours, the parking spaces occupancy of a street. The proposed approach has been assessed on a real IoT dataset composed by over than 15M of collected sensor records. Obtained results demonstrate that our method outperforms both single predictors and the widely used strategy of the mean providing inherently robust predictions.
Spatio-temporal Bayesian Learning for Mobile Edge Computing Resource Planning in Smart Cities
Authors: Ale Laha , Zhang Ning , King Scott A. , Guardiola Jose
Published: June 2021

A smart city improves operational efficiency and comfort of living by harnessing techniques such as the Internet of Things (IoT) to collect and process data for decision-making. To better support smart cities, data collected by IoT should be stored and processed appropriately. However, IoT devices are often task-specialized and resource-constrained, and thus, they heavily rely on online resources in terms of computing and storage to accomplish various tasks. Moreover, these cloud-based solutions often centralize the resources and are far away from the end IoTs and cannot respond to users in time due to network congestion when massive numbers of tasks offload through the core network. Therefore, by decentralizing resources spatially close to IoT devices, mobile edge computing (MEC) can reduce latency and improve service quality for a smart city, where service requests can be fulfilled in proximity. As the service demands exhibit spatial-temporal features, deploying MEC servers at optimal locations and allocating MEC resources play an essential role in efficiently meeting service requirements in a smart city. In this regard, it is essential to learn the distribution of resource demands in time and space. In this work, we first propose a spatio-temporal Bayesian hierarchical learning approach to learn and predict the distribution of MEC resource demand over space and time to facilitate MEC deployment and resource management. Second, the proposed model is trained and tested on real-world data, and the results demonstrate that the proposed method can achieve very high accuracy. Third, we demonstrate an application of the proposed method by simulating task offloading. Finally, the simulated results show that resources allocated based upon our models’ predictions are exploited more efficiently than the resources are equally divided into all servers in unobserved areas.
Isolation and characterization of muscle stem cells, fibro-adipogenic progenitors, and macrophages from human skeletal muscle biopsies
Authors: Jensen Jonas B. , Møller Andreas B. , Just Jesper , Mose Maike , de Paoli Frank V. , Billeskov Tine B. , Fred Rikard G. , Pers Tune H. , Pedersen Steen B. , Petersen Klaus K. , Bjerre Mette , Farup Jean , Jessen Niels
Published: June 2021

Animal models clearly illustrate that the maintenance of skeletal muscle mass depends on the function and interaction of a heterogeneous population of resident and infiltrating mononuclear cells. Several lines of evidence suggest that mononuclear cells also play a role in muscle wasting in humans, and targeting these cells may open new treatment options for intervention or prevention in sarcopenia. Methodological and ethical constraints have perturbed exploration of the cellular characteristics and function of mononuclear cells in human skeletal muscle. Thus, investigations of cellular phenotypes often depend on immunohistochemical analysis of small tissue samples obtained by needle biopsies, which do not match the deep phenotyping of mononuclear cells obtained from animal models. Here, we have developed a protocol for fluorescence-activated cell sorting (FACS), based on single-cell RNA-sequencing data, for quantifying and characterizing mononuclear cell populations in human skeletal muscle. Muscle stem cells, fibro-adipogenic progenitors, and two subsets of macrophages (CD11c+/–) are present in needle biopsies in comparable quantities per milligram tissue to open surgical biopsies. We find that direct cell isolation is preferable due to a substantial shift in transcriptome when using preculture before the FACS procedure. Finally, in vitro validation of the cellular phenotype of muscle stem cells, fibro-adipogenic progenitors, and macrophages confirms population-specific traits. This study demonstrates that mononuclear cell populations can be quantified and subsequently analyzed from needle biopsy material and opens the perspective for future clinical studies of cellular mechanisms in muscle wasting.
A temporal Ca2+ desensitization of myosin light chain kinase in phasic smooth muscles induced by CaMKKβ/PP2A pathways
Authors: Kitazawa Toshio , Matsui Toshiyasu , Katsuki Shuichi , Goto Akira , Akagi Kai , Hatano Naoya , Tokumitsu Hiroshi , Takeya Kosuke , Eto Masumi
Published: June 2021

Cell signaling pathways regulating myosin regulatory light chain (LC20) phosphorylation contribute to determining contractile responses in smooth muscles. Following excitation and contraction, phasic smooth muscles, such as the digestive tract and urinary bladder, undergo relaxation due to a decline of cellular Ca2+ concentration and decreased Ca2+ sensitivity of LC20 phosphorylation, named Ca2+ desensitization. Here, we determined the mechanisms underlying the temporal Ca2+ desensitization of LC20 phosphorylation in phasic smooth muscles using permeabilized strips of the mouse ileum and urinary bladder. Upon stimulation with pCa6.0 at 20°C, contraction and LC20 phosphorylation peaked within 30 s and then declined to about 50% of the peak force at 2 min after stimulation. During the relaxation phase after the contraction, LC20 kinase [myosin light chain kinase (MLCK)] was inactivated, but no fluctuation in LC20 phosphatase activity occurred, suggesting that MLCK inactivation is a cause of the Ca2+-induced Ca2+ desensitization of LC20 phosphorylation. MLCK inactivation was associated with phosphorylation at the calmodulin-binding domain of the kinase. Treatment with STO-609 and TIM-063 antagonists for Ca2+/calmodulin (CaM)-dependent protein kinase kinase-β (CaMKKβ) attenuated both the phasic response of the contraction and MLCK phosphorylation, whereas neither CaM kinase II, AMP-activated protein kinase, nor p21-activated kinase induced MLCK inactivation in phasic smooth muscles. Conversely, protein phosphatase 2A inhibition amplified the phasic response. Signaling pathways through CaMKKβ and protein phosphatase 2A may contribute to regulating the phasic response of smooth muscle contraction.
Insulinoma-derived pseudo-islets for diabetes research
Authors: Hart Nathaniel J. , Weber Craig , Price Nicholas , Banuelos Alma , Schultz Madison , Huey Barry , Harnois Emily , Gibson Cyonna , Steyn Leah V. , Papas Klearchos K. , Lynch Ronald M.
Published: June 2021

The islets of Langerhans of the pancreas are the primary endocrine organ responsible for regulating whole body glucose homeostasis. The use of isolated primary islets for research development and training requires organ resection, careful digestion, and isolation of the islets from nonendocrine tissue. This process is time consuming, expensive, and requires substantial expertise. For these reasons, we sought to develop a more rapidly obtainable and consistent model system with characteristic islet morphology and function that could be employed to train personnel and better inform experiments prior to using isolated rodent and human islets. Immortalized β cell lines reflect several aspects of primary β cells, but cell propagation in monolayer cell culture limits their usefulness in several areas of research, which depend on islet morphology and/or functional assessment. In this manuscript, we describe the propagation and characterization of insulinoma pseudo-islets (IPIs) from a rat insulinoma cell line INS832/3. IPIs were generated with an average diameter of 200 μm, consistent with general islet morphology. The rates of oxygen consumption and mitochondrial oxidation-reduction changes in response to glucose and metabolic modulators were similar to isolated rat islets. In addition, the dynamic insulin secretory patterns of IPIs were similar to primary rat islets. Thus, INS832/3-derived IPIs provide a valuable and convenient model for accelerating islet and diabetes research.
Diagnosis of Chronic Kidney Disease Using Effective Classification Algorithms and Recursive Feature Elimination Techniques
Authors: Senan Ebrahime Mohammed , Al-Adhaileh Mosleh Hmoud , Alsaade Fawaz Waselallah , Aldhyani Theyazn H. H. , Alqarni Ahmed Abdullah , Alsharif Nizar , Uddin M. Irfan , Alahmadi Ahmed H. , Jadhav Mukti E , Alzahrani Mohammed Y.
Published: June 2021

Chronic kidney disease (CKD) is among the top 20 causes of death worldwide and affects approximately 10% of the world adult population. CKD is a disorder that disrupts normal kidney function. Due to the increasing number of people with CKD, effective prediction measures for the early diagnosis of CKD are required. The novelty of this study lies in developing the diagnosis system to detect chronic kidney diseases. This study assists experts in exploring preventive measures for CKD through early diagnosis using machine learning techniques. This study focused on evaluating a dataset collected from 400 patients containing 24 features. The mean and mode statistical analysis methods were used to replace the missing numerical and the nominal values. To choose the most important features, Recursive Feature Elimination (RFE) was applied. Four classification algorithms applied in this study were support vector machine (SVM), k-nearest neighbors (KNN), decision tree, and random forest. All the classification algorithms achieved promising performance. The random forest algorithm outperformed all other applied algorithms, reaching an accuracy, precision, recall, and F1-score of 100% for all measures. CKD is a serious life-threatening disease, with high rates of morbidity and mortality. Therefore, artificial intelligence techniques are of great importance in the early detection of CKD. These techniques are supportive of experts and doctors in early diagnosis to avoid developing kidney failure.
YOLO-Highway: An Improved Highway Center Marking Detection Model for Unmanned Aerial Vehicle Autonomous Flight
Authors: Zhao Zhiwei , Han Jianfeng , Song Lili
Published: June 2021

Automatic visual navigation flight of an unmanned aerial vehicle (UAV) plays an important role in the highway maintenance field. Automatic highway center marking detection is the most important part of the visual navigation flight of a UAV. In this study, the UAV-viewed highway data are collected from the UAV perspective. This paper proposes a model named the YOLO-Highway that uses an improved form of the You Only Look Once (YOLO) model to enhance the real-time detection of highway marking problems. The proposed model is mainly designed by optimizing the network structure and the loss function of the original YOLOv3 model. The proposed model is verified by the experiments using the highway center marking dataset, and the results show that the average precision (AP) of the trained model is 82.79%, and the frames per second (FPS) is 25.71 f/s. In comparison with the original YOLOv3 model, the detection accuracy of the proposed model is improved by 7.05%, and its speed is improved by 5.29 f/s. Moreover, the proposed model had stronger environmental adaptability and better detection precision and speed than the original model in complex highway scenarios. The experimental results show that the proposed YOLO-Highway model can accurately detect the highway center markings in real-time and has high robustness to changes in different environmental conditions. Therefore, the YOLO-Highway model can meet the real-time requirements of the highway center marking detection.
Benign Metastasizing Leiomyoma of the Uterus with Pulmonary and Bone Metastases
Authors: Padhi Parikshit , Topalovski Margarita
Published: June 2021

Benign metastasizing leiomyoma (BML) is a rare spindle cell neoplasm seen in middle-aged women who have a history of leiomyoma of the uterus. The most common sites of metastases are the lungs; however, other sites of spread have been documented. These tumors by definition have no malignant features on histology and tend to be estrogen and progesterone positive. We present a middle-aged woman who was incidentally found to have multiple pulmonary nodules and a mass on her sternum after she was involved in a motor vehicle accident. She had a history of uterine leiomyoma and had undergone a hysterectomy ten years prior to the accident. Biopsies were performed of the lung nodules and sternum mass and compared to her hysterectomy specimen, and they were identical, and hence, she was diagnosed with BML. Due to the growing tumor of her sternum, she was started on tamoxifen with stability of her tumors. These tumors, since they are benign, tend to have an indolent course. However, in the instances that treatment is warranted, options include surgery or antiestrogen therapy. We will be discussing the pathogenesis, histological findings, and treatment options of this rare condition. Our case is unique because BML in general do not tend to spread to multiple organs and tend to be limited to one site of disease.
Massive Hematochezia from a Large Bleeding Duodenal Diverticulum
Authors: Esteban Marcus Juan , Sureen Amit , Herlihy Daniel , Elhanafi Sherif , Zuckerman Marc J.
Published: June 2021

Background. Duodenal diverticula are a rare cause of gastrointestinal (GI) bleeding despite being a common finding in the GI tract. We present a case of a patient who had massive hematochezia due to a complex duodenal diverticulum. Case Presentation. A 74-year-old Hispanic female presented initially with generalized weakness. During admission, the patient had an episode of a large amount of hematochezia and had to be transferred to the intensive care unit (ICU). Upper endoscopy was done using a forward-viewing endoscope which revealed a bleeding complex duodenal diverticulum. Successful hemostasis was achieved through epinephrine injection followed by placement of hemostatic clips. Conclusion. Although rare, gastroenterologists need to be aware of duodenal diverticulum as a possible cause of gastrointestinal bleed. It could be life-threatening, and thus, prompt diagnosis and management is necessary.
Orbital Solitary Fibrous Tumor: Four Case Reports—Clinical and Histopathological Features
Authors: Navarro-Perea Carmen , Calleja-García Cristina , Bengoa-González Álvaro , Garrido María-C. , Mencía-Gutiérrez Enrique , Pérez-Trigo Silvia
Published: June 2021

Purpose. To retrospectively describe the clinical characteristics, management, and outcomes of four cases of orbital solitary fibrous tumor (SFT). In one patient, we present an ultrasonic aspirator system for tumor removal. Methods. Four patients with orbital SFT were selected: one patient with orbital SFT, another patient with frontal and ethmoidal SFT and orbital affectation with high rates of recurrence, the third patient with frontal lobe SFT and orbital invasion with multiple recurrences, and the fourth case with a history of craniopharyngioma surgery and SFT located on the orbital apex. Results. All cases showed proptosis, eye movement restriction, and, in three cases, visual acuity alteration. Different treatments were applied: in three cases, excision was performed, one of them with an ultrasonic aspirator system, and in the remaining case, an exenteration was done (in two cases, radiosurgery treatment was also applied). The immunohistochemical study revealed SFT, similar to hemangiopericytomas (HPCs). No recurrence has been observed after surgical treatment. Conclusion. The SFT is a spectrum of different tumors with similar histopathological characteristics. The use of immunohistochemical markers is very helpful in the diagnosis. The main problem of orbital involvement is the risk of damaging important structures adjacent to the tumor during the surgical removal. The ultrasonic aspirator system allows elimination of the tumor without damaging other orbital structures.
Designing Online Psychological Consultation Expert System Using Human-Computer Interaction
Authors: Sha Yutian , Feng Tianxin , Xiong Xue , Yang Ting
Published: June 2021

Traditional online psychological consultation expert system has low efficiency. It is because of limited human-computer interaction and lack of intelligence. As a result, an expert system for psychological consultation is needed. Therefore, in this paper, we design an online psychological consultation expert system based on human-computer interaction. Using human-computer interaction technology, the basic principles of the system’s design are formulated. The design is used to build a psychological consultation expert system framework suitable for numerous applications. Human-computer interaction knowledge is imported into the system to determine the consultation process based on fuzzy set. To complete the online psychological consultation preset, the adjustment of human-computer interaction accuracy is determined. Moreover, a psychological state of the user in human-computer interaction is achieved using the expression of psychological counseling results. Comparing the simulated psychological consultation process, the results show that the design system is 30% more efficient than the traditional consultation system. The consulting success rate is more than 20%. The comprehensive consultation time is shortened, and its effectiveness is proved.
Research of Robust Trajectory Tracking Control and Attenuated Chattering: Application on Quadrotor
Authors: Zhou Guangli , Yao Yongming , Liu Huiying , Bai Xupeng , Liu Jianbo
Published: June 2021

In this paper, we presented a strategy for accurate trajectory tracking control of a quadrotor with unknown disturbances. To guarantee that the tracking errors of all system state variables converge to zero in finite time and eliminate the chattering phenomenon caused by the switching control action, a control strategy that combines linear prediction model of disturbances and fuzzy sliding mode control (SMC) based on logical framework with side conditions (LFSC) was designed. LFSC was applied for both position and attitude tracking of the quadrotor. Firstly, a linear prediction method was devised to minimize the effects of external disturbances. Secondly, a new fuzzy law was implemented to eliminate the chattering phenomenon. In addition, the stabilities of position and attitude were demonstrated by using Lyapunov theory, respectively. Simulation results and comprehensive comparisons demonstrated the superior performance and robustness of the proposed LFSC scheme in the case of external disturbances.
Dynamic Air Target Threat Assessment Based on Interval-Valued Intuitionistic Fuzzy Sets, Game Theory, and Evidential Reasoning Methodology
Authors: Zhao Ruojing , Yang Fengbao , Ji Linna , Bai Yongqiang
Published: June 2021

In order to reduce the uncertainty of target threat assessment results and improve exact target assessment in the complicated and changeable air combat environment, a novel method based on the combination of interval-valued intuitionistic fuzzy sets (IVIFSs), game theory, and evidential reasoning methodology is proposed in this paper. First, the imprecise and fuzzy information of battlefield air target is expressed by IVIFS. Second, the optimal index weight is determined by the interval intuitionistic fuzzy entropy and game theory. And the time series weight is calculated by the inverse Poisson distribution method. Then, the target evaluation information at different times is dynamically fused through an evidential reasoning algorithm. Finally, the accuracy function is applied to obtain the threat ranking of all the targets. A case of the threat assessment of air targets is provided to demonstrate the implementation process of the method proposed in this paper. Simulation experiments show that in a rapidly evolving combat environment, this algorithm can effectively reduce the uncertainty of target threat assessment results. It provides us with a useful way for target threat assessment based on interval-valued intuitionistic fuzzy sets, game theory, and evidential reasoning methodology.
Identification of a Seven-lncRNA-mRNA Signature for Recurrence and Prognostic Prediction in Relapsed Acute Lymphoblastic Leukemia Based on WGCNA and LASSO Analyses
Authors: Qi Haiyan , Chi Long , Wang Xiaogang , Jin Xing , Wang Wensong , Lan Jianping
Published: June 2021

Abnormal expressions of long noncoding RNAs (lncRNAs) and protein-encoding messenger RNAs (mRNAs) are important for the development of childhood acute lymphoblastic leukemia (ALL). This study developed an lncRNA-mRNA integrated classifier for the prediction of recurrence and prognosis in relapsed childhood ALL by using several transcriptome data. Weighted gene coexpression network analysis revealed that green, turquoise, yellow, and brown modules were preserved across the TARGET, GSE60926, GSE28460, and GSE17703 datasets, and they were associated with clinical relapse and death status. A total of 184 genes in these four modules were differentially expressed between recurrence and nonrecurrence samples. Least absolute shrinkage and selection operator analysis showed that seven genes constructed a prognostic signature (including one lncRNA: LINC00652 and six mRNAs: INSL3, NIPAL2, REN, RIMS2, RPRM, and SNAP91). Kaplan-Meier curve analysis observed that patients in the high-risk group had a significantly shorter overall survival than those of the low-risk group. Receiver operating characteristic curve analysis demonstrated that this signature had high accuracy in predicting the 5-year overall survival and recurrence outcomes, respectively. LINC00652 may function by coexpressing with the above prognostic genes (INSL3, SNAP91, and REN) and lipid metabolism-related genes (MIA2, APOA1). Accordingly, this lncRNA-mRNA-based classifier may be clinically useful to predict the recurrence and prognosis for childhood ALL. These genes represent new targets to explain the mechanisms for ALL.
Applications of the Atmospheric Transport and Diffusion of LES Modeling to the Spread and Dissipation of COVID-19 Aerosol Particles inside and outside the Japan National Stadium (Tokyo Olympic Stadium)
Authors: Uchida Takanori , Araya Ryo
Published: June 2021

In this paper, we use an analysis function for gas diffusion known as the Research Institute for Applied Mechanics, Kyushu University, Computational Prediction of Airflow over Complex Terrain (RIAM-COMPACT), which was developed for complex terrain, in Airflow Analyst software, and apply it to the spread and dissipation of a fluid layer (assuming the fluid layer contains COVID-19 particles). First, to verify the prediction accuracy of the gas diffusion using RIAM-COMPACT, comparisons with past wind tunnel test results conducted on simple and complex terrains are presented under neutral atmospheric stability. The results of the numerical simulations carried out in this study show good agreement with the wind tunnel experiments for both simple and complex terrains. Next, a model of the Japan National Stadium (Tokyo Olympic Stadium) was constructed using 3D detailed topographic Advanced World 3D Map (AW3D) data generated by combining high-resolution satellite images. We tried to reproduce the hypothetical spread and dissipation of the fluid layer (assuming the fluid layer contains COVID-19 particles) inside and outside of the Japan National Stadium using Airflow Analyst implemented with the RIAM-COMPACT analysis function for gas diffusion. We paid special attention to the effect of wind ventilation driven by natural wind. The numerical results under various scenarios show that ventilation driven by natural wind is very effective for the Japan National Stadium.
Performance Optimization in UAV‐Assisted Wireless Powered mmWave Networks for Emergency Communications
Authors: Gui Jinsong , Jin Nansen , Deng Xiaoheng
Published: June 2021

In this paper, we explore how a rotary‐wing unmanned aerial vehicle (UAV) acts as an aerial millimeter wave (mmWave) base station to provide recharging service and radio access service in a postdisaster area with unknown user distribution. The addressed optimization problem is to find out the optimal path starting and ending at the same recharging point to cover a wider area under limited battery capacity, and it can be transformed to an extended multiarmed bandit (MAB) problem. We propose the two improved path planning algorithms to solve this optimization problem, which can improve the ability to explore the unknown user distribution. Simulation results show that, in terms of the total number of served user equipment (UE), the number of visited grids, the amount of data, the average throughput, and the battery capacity utilization level, one of our algorithms is superior to its corresponding comparison algorithm, while our other algorithm is superior to its corresponding comparison algorithm in terms of the number of visited grids.
Integrated Optimization Strategy for Sustainable Shared Designated Driver Ferry Vehicle Scheduling
Authors: Wang Siqi , Yin Jingbo , Khan Rafi Ullah
Published: June 2021

The focus of this study is on optimizing the schedule adjustment scheme of shared designated driver ferry vehicles to obtain a sustainable and energy-efficient system to pick up and drop off designated drivers to serve drunk customers. A two-stage matching model for driver and customer supply and demand matching and driver ferry vehicle dispatching is designed in order to optimize the total distance travelled and minimize the generalized deviation costs. A maximum residual time adjustment algorithm is designed to reduce the logarithm of new interference demand, and a tabu search algorithm is used to solve the schedule adjustment scheme for ferry vehicles. The validity of the model and the algorithm is verified by a multiperiod example constructed in the Solomon test question bank. The result of numerical experiments shows that the proposed model and algorithm can solve the disruption adjustment scheduling strategy of shared designated driver ferry vehicles. The integrated optimization strategy can effectively improve the utilization rate and the operation efficiency of the shared driver ferry vehicles to reduce operation cost and energy consumption.
Exploring the Mechanism of Berberine Intervention in Ulcerative Colitis from the Perspective of Inflammation and Immunity Based on Systemic Pharmacology
Authors: Jiang Yan , Zhao Li , Chen Qing , Zhou Lihong
Published: June 2021

Background. Ulcerative colitis (UC) is a chronic nonspecific inflammatory disease of the colon and rectum. Recent studies found that berberine had effects on inflammatory diseases and immune diseases. Methods. The PharmMapper database was used to predict the berberine potential target and GeneCards database and OMIM database were utilized to collect UC genes. The Cytoscape software was used to construct and analyze the networks and DAVID was utilized to perform enrichment analysis. Then, animal experiments were performed to validate the prediction results. The experimental rats were randomly divided into normal group (control group), model group, and berberine group. The general condition, body weight, gross morphology of colon tissue, and colonic mucosal damage index (CMDI) score were observed. The pathological changes of colon tissue were observed by H&E staining. The levels of serum interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and IL-4 were detected by ELISA. The expressions of IL-1β, TNF-α, and IL-4 protein in colon tissue were detected by immunohistochemistry. Results. A total of 211 Berberine’s potential targets and 210 UC genes were obtained. The enrichment analysis showed that berberine may regulate inflammation, inflammatory cytokines, and their mediated inflammation signal pathways such as inflammatory bowel disease (IBD), rheumatoid arthritis, cytokine-cytokine receptor interaction, TNF, T cell receptor, Toll-like receptor, and JAK/STAT signaling pathway. Compared with the model group, the body mass of rats in the berberine group was significantly increased (

P

 < 0.05); the general morphology and pathological changes of colon tissue were significantly improved; CMDI score, serum and colon tissue IL-1β, TNF-α content, and protein expression were decreased significantly (

P

 < 0.05); and IL-4 content and protein expression increased significantly (

P

 < 0.05). Conclusion. Berberine can interfere with UC through related biological processes and signal pathways related to inflammation and immunity. In-depth exploration of the mechanism of berberine in the treatment of UC will provide a basis for clinical application.
Group A Streptococcal Toxic Shock Syndrome after a Routine Gynecological Procedure
Authors: Ameda Kei , Yamada Yoko , Uehara Yuriko , Ohno Tamami , Hoya Mari , Oda Hiroko , Mishima Misako
Published: June 2021

Streptococcal toxic shock syndrome (STSS) is a life-threatening illness mainly caused by invasive group A Streptococcus (GAS) infection. Herein, we report a case of a postmenopausal woman who developed STSS from an ascending vaginal GAS infection after cytocervical sampling. The patient complained of vaginal discharge, for which she underwent gynecological examination with vaginal sampling. The following day, there was onset of diarrhea and vomiting. After 7 days, she was admitted to our hospital with septic shock. Necrotizing enterocolitis was suspected and surgical intervention was performed; however, the patient was diagnosed with primary peritonitis and antibiotics were initiated. On day 2, GAS was suspected by blood cultures, and antibiotics were changed in consideration of STSS. On day 4, GAS was confirmed in blood, ascitic fluid, and vaginal swab specimens, and STSS caused by an ascending vaginal GAS infection was diagnosed. This case report indicates that STSS could occur following cytocervical sampling for vaginal discharge. If a woman has unexplained septic shock, especially with gastroenteritis symptoms, STSS should be considered as a differential diagnosis.
An Effective Heuristic for Multidepot Low-Carbon Vehicle Routing Problem
Authors: Liu LiLing , Lai LiFang
Published: June 2021

Low-carbon economy has been a hot research topic in recent years. This paper firstly considers the vehicle load weight, the key factors affecting the fuel consumption, to establish the fuel consumption model, and then constructs the vehicle routing planning model in the last mile delivery with multiple depots within time windows. In order to solve this problem, we improve the classical fruit fly algorithm which is easy to fall into the local optimum, and the improved fruit fly optimization algorithm is designed and integrated with genetic algorithm. Computational results show that our solution approach is capable of solving instances with up to 48 customers and 4 different depots. The effectiveness and efficiency of the model and multigroup fruit fly algorithm are verified through case study.
Diabetes Risk Reduction Diet and Survival after Breast Cancer Diagnosis
Authors: Wang Tengteng , Farvid Maryam S. , Kang Jae H. , Holmes Michelle D. , Rosner Bernard A. , Tamimi Rulla M. , Willett Walter C. , Eliassen A. Heather
Published: June 2021

Type II diabetes is associated with poor breast cancer prognosis. To study the association between a diabetes risk reduction diet (DRRD) and survival following breast cancer, we followed 8,482 women with breast cancer from two large cohort studies. Information on diet and other factors was repeatedly measured in validated questionnaires every two to four years. The DRRD includes 9 components: higher intakes of cereal fiber, coffee, nuts, whole fruits and polyunsaturated/saturated fat ratio; and lower glycemic index, trans fat, sugar-sweetened beverages, and red meat. Cumulative average DRRD score was calculated using repeated measures of postdiagnostic diet. Deaths were assessed by family members or via National Death Index. Multivariable-adjusted HRs and 95% confidence intervals (CI) were estimated using Cox proportional hazards models. During a median of 14 years of follow-up since diagnosis, 2,600 deaths occurred among participants, 1,042 of which were due to breast cancer. Women with higher postdiagnostic DRRD score had a 20% lower risk of breast cancer–specific mortality (top vs. bottom quintile HR = 0.80; 95% CI = 0.65–0.97; Ptrend = 0.02) and 34% lower risk of all-cause mortality (HR = 0.66; 95% CI = 0.58–0.76; Ptrend < 0.0001). Compared with women who consistently had lower score (≤median) before and after diagnosis, those whose score improved from low to high had a lower risk of breast cancer–specific mortality (HR = 0.77; 95% CI = 0.62–0.95) and overall mortality (HR = 0.85; 95% CI = 0.74–0.97). These findings demonstrate that greater adherence to DRRD was associated with better survival, suggesting postdiagnosis dietary modification consistent with type II diabetes prevention may be important for breast cancer survivors.

Significance:

This study suggests that greater adherence to the diabetes risk reduction diet after diagnosis associates with improved survival outcomes among a large number of breast cancer survivors.
Characteristics and Outcomes of Lung Cancers Detected on Low-Dose Lung Cancer Screening CT
Authors: Zhang Eric W. , Shepard Jo-Anne O. , Kuo Anderson , Chintanapakdee Wariya , Keane Florence , Gainor Justin F. , Mino-Kenudson Mari , Lanuti Michael , Lennes Inga T. , Digumarthy Subba R.
Published: June 2021

Background:

Lung cancer screening (LCS) with low-dose CT (LDCT) was implemented in the United States following the National Lung Screening Trial (NLST). The real-world benefits of implementing LCS are yet to be determined with outcome-oriented data. The study objective is to investigate the characteristics and outcomes of screening-detected lung cancers.

Methods:

This single-institution retrospective study included LCS patients between June 2014 and December 2019. Patient demographics, number of screening rounds, imaging features, clinical workup, disease extent, histopathology, treatment, complications, and mortality outcomes of screening-detected lung cancers were extracted and compared with NLST data.

Results:

LCS LDCTs (7,480) were performed on 4,176 patients. The cancer detection rate was 3.8%, higher than reported by NLST (2.4%, P < 0.0001), and cancers were most often found in patients ≥65 years (62%), older than those in NLST (41%, P < 0.0001). The patients' ethnicity was similar to NLST, P = 0.87. Most LCS-detected cancers were early stage I tumors (71% vs. 54% in NLST, P < 0.0001). Two thirds of cancers were detected in the first round of screening (67.1%) and were multifocal lung cancers in 15%. As in NLST, the complication rate after invasive workup or surgery was low (24% vs. 28% in NLST, P = 0.32). Over a median follow-up of 3.3 years, the mortality rate was 0.45%, lower than NLST (1.33%, P < 0.0001).

Conclusions:

LCS implementation achieved a higher cancer detection rate, detection of early-stage cancers, and more multifocal lung cancers compared with the NLST, with low complications and mortality.

Impact:

The real-world implementation of LCS has been successful for detection of lung cancer with favorable outcomes.
Pharmacodynamic Biomarkers Predictive of Survival Benefit with Lenvatinib in Unresectable Hepatocellular Carcinoma: From the Phase III REFLECT Study
Authors: Finn Richard S. , Kudo Masatoshi , Cheng Ann-Lii , Wyrwicz Lucjan , Ngan Roger K.C. , Blanc Jean-Frederic , Baron Ari D. , Vogel Arndt , Ikeda Masafumi , Piscaglia Fabio , Han Kwang-Hyub , Qin Shukui , Minoshima Yukinori , Kanekiyo Michio , Ren Min , Dairiki Ryo , Tamai Toshiyuki , Dutcus Corina E. , Ikezawa Hiroki , Funahashi Yasuhiro , Evans Thomas R. Jeffry
Published: June 2021

Purpose:

In REFLECT, lenvatinib demonstrated an effect on overall survival (OS) by confirmation of noninferiority to sorafenib in unresectable hepatocellular carcinoma. This analysis assessed correlations between serum or tissue biomarkers and efficacy outcomes from REFLECT.

Experimental Design:

Serum biomarkers (VEGF, ANG2, FGF19, FGF21, and FGF23) were measured by ELISA. Gene expression in tumor tissues was measured by the nCounter PanCancer Pathways Panel. Pharmacodynamic changes in serum biomarker levels from baseline, and associations of clinical outcomes with baseline biomarker levels, were evaluated.

Results:

Four hundred and seven patients were included in the serum analysis set (lenvatinib n = 279, sorafenib n = 128); 58 patients were included in the gene-expression analysis set (lenvatinib n = 34, sorafenib n = 24). Both treatments were associated with increases in VEGF; only lenvatinib was associated with increases in FGF19 and FGF23 at all time points. Lenvatinib-treated responders had greater increases in FGF19 and FGF23 versus nonresponders at cycle 4, day 1 (FGF19: 55.2% vs. 18.3%, P = 0.014; FGF23: 48.4% vs. 16.4%, P = 0.0022, respectively). Higher baseline VEGF, ANG2, and FGF21 correlated with shorter OS in both treatment groups. OS was longer for lenvatinib than sorafenib [median, 10.9 vs. 6.8 months, respectively; HR, 0.53; 95% confidence interval (CI), 0.33–0.85; P-interaction = 0.0397] with higher baseline FGF21. In tumor tissue biomarker analysis, VEGF/FGF-enriched groups showed improved OS with lenvatinib versus the intermediate VEGF/FGF group (HR, 0.39; 95% CI, 0.16–0.91; P = 0.0253).

Conclusions:

Higher baseline levels of VEGF, FGF21, and ANG2 may be prognostic for shorter OS. Higher baseline FGF21 may be predictive for longer OS with lenvatinib compared with sorafenib, but this needs confirmation.
Clinical Features of de novo Pure 16q21q24.1 Chromosome Duplication
Authors: Carvalho Daniel R. , Moretto Ana Luisa L. , Schneider Marcia , Formigli Lia M.
Published: June 2021

Pure partial duplications of the long arm of chromosome 16 are rare and few cases are described with delineation by chromosomal microarray. Data about clinical abnormalities of pure partial 16q duplications are incomplete because many individuals die during the perinatal period. We describe the clinical features of a 47-month-old Brazilian girl with 16q21q24.1 duplication. To the best of our knowledge, she is the first person with this specific chromosome segment duplication, and we compare her phenotype with the only reported individual alive with intermediate–distal pure 16q duplication.
The Prognostic Value of Sex-Determining Region Y-Box 2 and CD8+ Tumor-Infiltrating Lymphocytes in Limited-Stage Small-Cell Lung Cancer
Authors: Lee Jinsoo , Jung Yoon Yang , Lee Jung Hoon , Hong Mineui , Hwang Hye-Won , Hong Soon Auck , Hong Sook-Hee
Published: June 2021

Background: Sex-determining region Y-box 2 (SOX2) is a transcriptional factor that drives embryonic stem cells to neuroendocrine cells in lung development and is highly expressed in small-cell lung cancer (SCLC). However, the prognostic role of SOX2 and its relationship with tumor-infiltrating lymphocytes (TILs) has not been determined in SCLC. Herein, we assessed the expression of SOX2 and CD8+ TILs to obtain insights into the prognostic role of SOX2 and CD8+ TILs in limited-stage (LS)-SCLC. Methods: A total of 75 patients with LS-SCLC was enrolled. The SOX2 expression and CD8+ TILs were evaluated by immunohistochemistry. Results: High SOX2 and CD8+ TIL levels were identified in 52 (69.3%) and 40 (53.3%) patients, respectively. High SOX2 expression was correlated with increased density of CD8+ TILs (p = 0.041). Unlike SOX2, high CD8+ TIL numbers were associated with significantly longer progression-free survival (PFS; 13.9 vs. 8.0 months, p = 0.014). Patients with both high SOX2 expression and CD8+ TIL numbers (n = 29, 38.7%) had significantly longer PFS and overall survival (OS) compared to those from the other groups (median PFS 19.3 vs. 8.4 months; p = 0.002 and median OS 35.7 vs. 17.4 months; p = 0.004, respectively). Multivariate Cox regression analysis showed that the combination of high SOX2 expression and CD8+ TIL levels was an independent good prognostic factor for OS (HR = 0.471, 95% CI, 0.250–0.887, p = 0.02) and PFS (HR = 0.447, 95% CI, 0.250–0.801, p = 0.007) in SCLC. Conclusions: Evaluation of the combination of SOX2 and CD8+ TIL levels may be of a prognostic value in LS-SCLC.
Estratégias antropológicas incipientes para uma etnografia digital: uma discussão a partir de narrativas midiáticas sobre violências sexuais, de gênero, e trotes numa Faculdade de Medicina
Authors: Piva Felipe Paes
Published: June 2021

Este artigo tem como base a pesquisa desenvolvida entre 2017 e 2018 com o propósito de entender como os atuais processos de disputa política em torno da significação de categorias de violências sexuais, de gênero e trotes têm sido apropriados e representados pela mídia hegemônica brasileira. Para isso, foi analisada a construção da narrativa midiática desses casos nas faculdades paulistas, principalmente na Faculdade de Medicina, que foram alvo de uma Comissão Parlamentar de Inquérito na Assembleia Legislativa do Estado de São Paulo, em 2014. A repercussão midiática desses casos promoveu a nomeação pública de certas práticas como estupro, abuso e violência sexuais, práticas que, pouco tempo antes não eram necessariamente significadas desta forma. Buscou-se discutir não apenas os resultados obtidos, mas também estratégias possíveis para utilização do digital como campo de pesquisa antropológica e a construção de um arquivo digital como base de dados.