bluuebunny/crossref_metadata_2025 huggingface dataset:
Transition Metal Dissolution and Degradation in NMC811-Graphite Electrochemical Cells
Authors: Ruff Zachary , Xu Chao , Grey Clare P.
Published: May 2021

Nickel-rich lithium nickel-manganese-cobalt oxide cathodes, in particular Li(Ni0.8Mn0.1Co0.1)O2 (NMC811), are currently being commercialized as next generation cathode materials, due to their increased capacities compared to current materials. Unfortunately, the higher nickel content has been shown to accelerate cell degradation and a better understanding is needed to maximize cell lifetimes. NMC811/graphite cells were tested under stressed conditions (elevated temperature and cell voltages) to accelerate degradation focusing on transition metal (TM) dissolution from the cathode. Increasing the cell temperature, upper cut-off voltage (UCV) and number of cycles all accelerated capacity fade and diffraction studies showed that under stressed conditions, additional degradation mechanisms beyond lithium loss to the SEI are present. Significant TM dissolution and subsequent deposition on the graphite anode is seen, particularly at stressed conditions. The concentration of TMs in the electrolyte remained invariant with cycling conditions, presumably reflecting the limited solubility of these ions and emphasizing the role that TM deposition on the anode plays in continuing to drive dissolution. Significant deposits of metals from the cell casings and current collectors were also detected at all cycling conditions, indicating that corrosion and metal leaching can be as important as TM dissolution from the active material in some cell formats.
Etch Characteristics of Copper Thin Films in Inductively Coupled Plasma of Piperidine/Ethanol/Ar Gas Mixture
Authors: Lim Eun Taek , Lee Ji Soo , Park Sung Yong , Chung Chee Won
Published: May 2021

High density plasma reactive ion etching of copper thin films patterned with SiO2 masks was performed via piperidine/ethanol/Ar gas mixture. The etch characteristics of the copper thin films were examined as functions of the gas concentrations in piperidine/Ar and piperidine/ethanol/Ar mixtures. As the piperidine concentration increased, the etch rates of the copper films decreased whereas the etch selectivities of the copper films to SiO2 mask increased and the etch profiles improved. Optical emission spectroscopy studies showed that the major active species in the plasmas of piperidine/Ar and piperidine/ethanol/Ar were CH and CN, which were responsible for the good etch profiles. Further, X-ray photoelectron spectroscopy revealed the formation of CuCN, copper compounds, and polymer layers. Finally, dry etching of copper thin films was successfully accomplished with the optimized piperidine/ethanol/Ar gas mixture, thereby obtaining good etch profiles with high degrees of anisotropy.
Variability in vastus lateralis fiber type distribution, fiber size, and myonuclear content along and between the legs
Authors: Horwath Oscar , Envall Helena , Röja Julia , Emanuelsson Eric B. , Sanz Gema , Ekblom Björn , Apró William , Moberg Marcus
Published: May 2021

This study provides a comprehensive analysis of the variability of key human skeletal muscle fiber characteristics in multiple sites along and between the musculus vastus lateralis of healthy and active individuals. We found a notable but nonsystematic variability in fiber type and size, whereas myonuclear content was distinctively less variable, and the prevalence of type IIX fibers was random and very low. These data are important to consider when designing and interpreting studies including musculus vastus lateralis biopsies.
Dynamic airway function during exercise in COPD assessed via impulse oscillometry before and after inhaled bronchodilators
Authors: Tiller Nicholas B. , Cao Min , Lin Fang , Yuan Wei , Wang Chu-Yi , Abbasi Asghar , Calmelat Robert , Soriano April , Rossiter Harry B. , Casaburi Richard , Stringer William W. , Porszasz Janos
Published: May 2021

This study provides a novel, mechanistic insight into dynamic airway function during exercise in COPD, before and after inhaled bronchodilators. The use of impulse oscillometry (IOS) to evaluate airway function is unique among exercise studies. We show strong correlations among IOS variables, dynamic hyperinflation, and shape-changes in the spontaneous expiratory flow-volume curve. This approach may aid in clinical assessment of airway function during exercise.
One-year aerobic exercise altered cerebral vasomotor reactivity in mild cognitive impairment
Authors: Tomoto Tsubasa , Tarumi Takashi , Chen Jason N. , Hynan Linda S. , Cullum C. Munro , Zhang Rong
Published: May 2021

One-year moderate-to-vigorous intensity aerobic exercise training (AET) improved cardiorespiratory fitness (V̇o2peak), increased hypocapnic cerebral vasomotor reactivity (CVMR), whereas it decreased hypercapnic CVMR when compared with stretching and toning in patients with amnestic mild cognitive impairment (MCI). Furthermore, changes in hypercapnic CVMR with AET were correlated with improved memory and executive function. These findings indicate that AET has an impact on cerebrovascular function which may benefit cognitive performance in older adults who have high risk of Alzheimer’s disease.
Tumor burden negatively impacts protein turnover as a proteostatic process in noncancerous liver, heart, and muscle, but not brain
Authors: Brown Jacob L. , Lawrence Marcus M. , Borowik Agnieszka , Oliver Lauren , Peelor Fredrick F. , Van Remmen Holly , Miller Benjamin F.
Published: May 2021

We present data showing that simultaneously measuring protein synthesis and cell proliferation can help in the understanding of protein turnover as a proteostatic process in response to tumor burden. In some tissues, like hepatic, cardiac, and skeletal muscle, there was a decrease in the protein to DNA synthesis ratio indicating less proteostatic maintenance. In contrast, the brain maintained or even increased this protein to DNA synthesis ratio indicating more proteostatic maintenance.
Movement of the ribs in supine humans for small and large changes in lung volume
Authors: Luu Billy L. , McDonald Rhys J. , Bolsterlee Bart , Héroux Martin E. , Butler Jane E. , Hudson Anna L.
Published: May 2021

Rib movements over inspiratory capacity are comparable for healthy controls and participants with chronic obstructive pulmonary disease when normalized to the change in lung volume. The kinematics of the ribs during tidal breathing were described from four-dimensional computed tomography images. For large changes in lung volume with inspiratory capacity, pump-handle movements of the ribs are four times greater than bucket-handle movements, whereas at tidal volume, pump-handle movements are 20% smaller than bucket-handle movements.
Dynamic Behavior of Geosynthetic‐Reinforced Expansive Soil under Freeze‐Thaw Cycles
Authors: Yang Zhongnian , Liu Xuesen , Zhang Liang , Niu Fujun , Ling Xianzhang , Li Guoyu , Shi Wei
Published: May 2021

Expansive soil has a significant impact on the stability of many key construction projects in cold regions. To study the physical and mechanical properties of expanded soil under the condition of freeze‐thaw cycle, cryogenic cyclic triaxial tests were conducted on the dynamic and the displacement characteristics of geosynthetic‐reinforced expansive soil subjected to the freeze‐thaw cycles. Compared with the unreinforced expansive soil samples, the effects of freeze‐thaw cycles on the soil dynamics were discussed. The dynamic shear modulus (Gd) and damping ratio (λ) of the expansive soil samples are improved by reinforcement. Reinforced soil can inhibit the axial compression of the sample and restrain the frost heave deformation of the sample during the freezing process. Meanwhile, it can delay the structural damage effect caused by frost heave and reduce the rate of change of the Gd and the λ with the freeze‐thaw cycle. At the same time, reinforced soil can inhibit the axial expansion, reduce the rate of reduction of the Gd, stabilize it with a higher rate, and reduce the influence of the freeze‐thaw cycles on the λ of the expansive soil sample. Finally, the change of mechanical properties of expansive soil under the condition of reinforcement is obtained. The main conclusions of this paper can be used to reinforce the roadbed and foundation engineering of frozen soil in a cold region and provide support for the fiber reinforcement method of expansive soil.
The Unforeseen Diagnosis: Hyperparathyroidism-Jaw Tumour Syndrome Case Report and Review of the Literature
Authors: Barnett Maxim , Ahmed Farhan , Mihai Radu , Rattan Asha , Humayun Malik Asif
Published: May 2021

Hypercalcaemia and its systemic sequelae are a relatively common finding amongst patients in the field of endocrinology. Primary hyperparathyroidism, a frequent cause of hypercalcaemia, is often seen among middle-aged female patients, typically resulting from an underlying single-gland adenoma. Although patients may present with symptoms (nephrolithiasis, musculoskeletal discomfort, dehydration, or mood disturbance, to name a few), hypercalcaemia is rather frequently identified incidentally. In younger patients, a familial form of primary hyperparathyroidism must be considered, with a positive diagnosis mandating familial screening. Hyperparathyroidism-jaw tumour syndrome is one such autosomal dominant familial disorder, characterised by a mutation in the cell division cycle 73 (CDC73; also known as HRPT-2) tumour suppressor gene. This disorder is characterised by multiple pleiotropic phenomena, including recurrent primary hyperparathyroidism (and the effects of hypercalcaemia), neoplasms (such as uterine, renal, mandibular, and maxillary), and infertility. A patient not conforming to the classic candidacy for primary hyperparathyroidism requires consideration for a familial cause. Case Description. We present a rare diagnostic entity—hyperparathyroidism-jaw tumour (HPT-JT) syndrome—in a 36-year-old female with recurrent primary hyperparathyroidism, frequent nephrolithiasis, and infertility for 18 years prior to the diagnosis. We aim to promote awareness amongst medical professionals of this rare, but nonetheless essential differential diagnosis through a case report and review of the literature. Conclusion. Medical professionals must avoid diagnostic overshadowing and display a low threshold for genetic testing in younger patients with primary hyperparathyroidism. The importance of proper identification extends beyond the patient to their relatives and offspring.
GJA1 rs2071165 A > G Variant Increased Gastric Cancer Risk in Females of Northwest China: A Case-Control Study
Authors: Yuan Lijuan , Yang Ping , Wei Gang , Lu Jianguo , Yang Zhengyu , Yang Lin , Peng Shujia , He Xianli , Bao Guoqiang
Published: May 2021

Gastric cancer (GC) is one of the most common malignancies, and its incidence rates vary widely between men and women. Previous studies have suggested that connexin 43 (Cx43, encoded by gap junction protein alpha 1 (GJA1)) and secretory carrier membrane protein 1 (SCAMP1) are key functional proteins in tumors. Herein, the association between GJA1 and SCAMP1 polymorphisms and GC susceptibility and prognosis was evaluated. A total of three single-nucleotide polymorphisms among 681GC patients and 756 controls were tested using the Agena MassARRAY RS1000 system, including GJA1 rs2071165, SCAMP1 rs4530741, and SCAMP1 rs6874309. The strength of the association with GC risk was assessed by the odds ratios (ORs) and 95% confidence intervals (CIs) generated from the logistic regression model. Kaplan–Meier curve, long-rank tests, and a multivariate Cox proportional hazard model were used for prognosis analysis. The expression of GJA1 was assessed by immunohistochemistry. The GJA1 rs2071165 AA/AG genotype significantly increased the risk of GC in the female Chinese population (OR = 1.55, 95% CI = 1.03–2.32,

p
=
0.034

). Furthermore, the risk effect of GJA1 rs2071165 was more evident in the subgroups of female patients with GC, stratified by age, clinical stage, tumor size, and recurrence/metastasis. However, no obvious differences in Cx43 expression in GC tissues were observed between males and females. Furthermore, no significant association between SCAMP1 rs4530741 and rs6874309 polymorphisms and GC risk or prognosis was observed. In conclusion, this study suggests for the first time that the GJA1 rs2071165 polymorphism is associated with increased GC risk in females, revealing a potential new clinical marker for assessing GC risk in females.
Interpreting the Molecular Mechanisms of Yinchenhao Decoction on Hepatocellular Carcinoma through Absorbed Components Based on Network Pharmacology
Authors: Sun Jijia , Han Tao , Yang Tao , Chen Yunhui , Huang Jihan
Published: May 2021

To investigate the mechanisms through which Yinchenhao decoction (YCHD) inhibits hepatocellular carcinoma (HCC), we analyzed YCHD ingredients absorbed into the bloodstream by using network pharmacology. We conducted a weighted gene coexpression network analysis on gene expression data collected from the Gene Expression Omnibus and The Cancer Genome Atlas databases to derive an HCC gene set; moreover, we used four online prediction system databases to predict the potential targets of YCHD ingredients absorbed into the bloodstream. We discovered that YCHD directly interfered with 17 HCC‐related disease targets. Subsequent gene ontology enrichment analyses of these 17 disease targets revealed that YCHD exhibited effects through 17 biological processes, 7 molecular functions, and 9 cellular components. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses indicated 14 pathways through which YCHD inhibits HCC. We observed similar trends in how the 17 small molecules interfered with the key target set. We surmised that YCHD inhibits HCC by regulating inflammatory and metabolic pathways. Network pharmacological analysis of YCHD ingredients absorbed into the bloodstream may provide new insights and serve as a new method for discovering the molecular mechanisms through which YCHD inhibits HCC.
Mulberroside A from Cortex Mori Enhanced Gut Integrity in Diabetes
Authors: Xu Yinyan , Guo Hengli , Zhao Tingting , Fu Jing , Xu Youhua
Published: May 2021

Background. Diabetic endotoxemia has been recognized as one of the hallmarks of type 2 diabetes mellitus (T2DM). Recent findings suggest that gut leak plays a pivotal role in diabetic endotoxemia. Cortex Mori (CM) has been widely applied in China to ameliorate development of T2DM, but its effect on endotoxemia is unknown. Methods. The study was constructed with two parts: (1) in vivo study of CM on diabetic endotoxemia in db/db mice. Eight C57BL/6 mice were set as normal control; (2) in vitro study of mulberroside A (MBA) from CM on diabetic endotoxemia. Potential mechanism of MBA on ameliorating diabetic endotoxemia was also explored. Results. The present study found that CM water extract decreased levels of blood glucose, ameliorated liver and renal damage in db/db mice, and ameliorated diabetic endotoxemia (

p
<
0.01

). We also found that the water extract enhanced gut integrity and decreased gut inflammatory protein ICAM-1 expression in db/db mice as detected by H&E staining and immunohistochemistry methods. In the in vitro study, MBA decreased levels of MDA and ROS induced by LPS (

p
<
0.01

) and enhanced the integrity of gut epithelial barrier (

p
<
0.01

). Conclusions. We found that Cortex Mori and its active component mulberroside A could ameliorate diabetic endotoxemia by preserving gut integrity.
Synergetic Action of Forskolin and Mevastatin Induce Normalization of Lipids Profile in Dyslipidemic Rats through Adenosine Monophosphate Kinase Upregulation
Authors: Abdelazim Aaser M. , Ismail Tamer Ahmed , Abumaghaid Mosleh M. , Saadaldin Islam M.
Published: May 2021

In the present study, we examined the synergetic effect of forskolin and mevastatin administration on lipid profile and lipid metabolism in omental adipose tissue in dyslipidemic rats. The study was conducted on forty male albino rats. The rats were randomly classified into four main groups of ten animals in each group as follows: group A, served as control nontreated; group B, rats that received Triton WR 1339 (500 mg/kg); group C, rats that received Triton WR 1339 with forskolin (100% FSK extract 0.5 mg/kg/day) for four weeks; and group D, dyslipidemic rats received both mevastatin and forskolin. At the end of the experimental period, blood and omental adipose tissue samples were collected, preserved, and used for biochemical determination of lipid profile and mRNA expression profile of adenylate cyclase (AC), hormone‐sensitive lipase, respectively (HSL), and adenosine monophosphate‐activated protein kinase (AMPK). The results showed a significant decline in the serum concentration of total cholesterol, LDL‐cholesterol, and triglycerides, although there was a significant increase in serum levels of HDL‐cholesterol and glycerol in rats received forskolin alone or with mevastatin when compared with control and dyslipidemic groups. The mRNA expression levels of AC, HSL, and AMPK were significantly increased in omental adipose tissue of rats received forskolin when compared with other groups. In conclusion, forskolin acts synergistically with mevastatin to lower lipid profile and improve lipid metabolism in dyslipidemic rats through upregulation of AMPK expression.
Research on Landslide Warning Model Establishment and Disaster Space‐Time Evolution Analysis
Authors: Wang Zhen
Published: May 2021

As important methods to avoid landslide disasters, velocity monitoring and early warning are significant research topics in slope engineering at the present stage. This paper combines the randomness of velocity data in evolution process of landslide disasters, using Markov chain theory with no aftereffect to describe the randomness process, and introduces it into landslide warning. The research collects velocity monitoring data before landslide occurrence and applies average standard deviation method which can reflect statistical characteristics of the classification data to carry out state division of the velocity data. Then, it proposes landslide warning criteria and establishes landslide warning model based on dynamic prediction of future velocity status by Markov chain theory. Meanwhile, it puts forward the evaluation standard of landslide warning model from the aspects of timeliness, anti‐interference, and credibility. At the same time, it takes typical open‐pit mine landslide disaster as the engineering background and gradually optimizes and evaluates the landslide warning model from the above three evaluation standards. The results show that the landslide warning model can realize the landslide early warning of multiple monitoring points; it has good effects in both time warning and regional warning. On the other hand, the landslide warning model has high accuracy in timeliness, anti‐jamming, and credibility, and it can reveal space‐time evolution law of landslide occurrence, so this research has important theoretical significance and engineering promotion value.
[Retracted] Optimization of the Rapid Design System for Arts and Crafts Based on Big Data and 3D Technology
Authors: Zhou Haihan
Published: May 2021

In this paper, to solve the problem of slow design of arts and crafts and to improve design efficiency and aesthetics, the existing big data and 3D technology are used to conduct an in‐depth analysis of the optimization of the rapid design system of arts and crafts machine salt baking. In the system requirement analysis, the functional modules of this system are identified as nine functional modules such as design terminology management system and external information import function according to the actual usage requirements. In the system design, the overall structure design, database design, and functional module design of the system are comprehensively elaborated, and the key issues such as 3D display and home layout generation algorithm based on reinforcement learning are analyzed and designed. In the implementation part of the system, the overall construction of the system and the composition of functional modules are introduced in detail and the main functional modules of the system are presented with interface diagrams. In the system implementation part, the overall system construction and functional module composition are introduced in detail, the main functional modules of the system are shown with interface diagrams, codes, and algorithms, and the specific implementation process of 3D display and soft layout algorithms are also explained in detail. The process of Surface Mount Technology (SMT) big data processing and analysis is designed, and the design of SMT production line data collection scheme and real‐time data processing architecture is completed. Based on the characteristics of SMT production line data, the K‐means algorithm is used to detect data outliers and verify the accuracy of the method; also, the Spark‐based association rule printing parameter recommendation model is designed, and the efficiency of the Apriori algorithm is significantly improved by parallelization.
Chemical Constituents and Coagulation Activity of Amygdalus persica L. Flowers
Authors: Zhang Juanjuan , Yin Zhenhua , Chen Lin , Yang Baocheng , Zhang Wei , Kang Wenyi
Published: May 2021

Amygdalus persica L., belongs to Rosaceae family, and its flowers are used as medicine and food. n-Butanol extract of A. persica flowers were isolated and purified with various column chromatographies, and the fourteen compounds, chlorogenic acid butyl ester (1), rutin (2), protocatechuic acid (3), caffeic acid (4), 5-O-coumarroylquinic acid methyl ester (5), kaempferol-3-O-neohesperidoside (6), quercetin-3-O-β-D-glucoside (7), 3,5-dicaffeoylquinic acid (8), quercetin-3-O-α-L-rhamnoside (9), 5-O-coumaroylquinic acid (10), kaempferol-3-O-α-L-rhamnoside (11), kaempferol-3-O-β-D-galactoside (12), D-glucitol (13), and multiflorin A (14), were identified by spectroscopic data and physical data. All the compounds except compound 2 were identified from A. persica flowers for the first time. The compounds were investigated for their coagulation activity by activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), and bibrinogen (FIB) in vitro. The results of coagulation activity showed that rutin (2), caffeic acid (4), kaempferol-3-O-neohesperidoside (6), kaempferol-3-O-α-L-rhamnoside (11), and kaempferol-3-O-β-D-galactoside (12) exhibited significant procoagulant activity, while chlorogenic acid butyl ester (1) possessed anticoagulant activity in vitro.
Design of an Intelligent Virtual Classroom Platform for Ideological and Political Education Based on the Mobile Terminal APP Mode of the Internet of Things
Authors: Zhang Xilin , Gao Xiaohan , Yi Honglian , Li Zhe
Published: May 2021

This article uses a software architecture model that combines two architectures, based on the traditional Android environment. Through comparative research on network technology today, Java technology has been selected as a tool for developing network education systems for future research and maintenance upgrades. The underlying network education technology relies on APP to enable education between teachers and students. This technology can not only give play to the advantages of computers in network data transmission, but also embody a new teaching model with teachers and students as the main body. It can solve various practical problems in teacher and student education and educate teachers and students by simulating the actual educational environment of the classroom and educational process using a variety of practical education management strategies. The experimental results prove that with the help of this virtual classroom platform for ideological and political education, it can provide students with more ideological and political learning resources, increase students' interest and time in learning, and promote the diversification of ideological and political learning methods. The quality of teaching is more conducive to the learning of knowledge points for students. At the same time, the system is operating in good condition. Switching between different interfaces is maintained at about 0.1 seconds. The system performance is also perfect. The overall analysis function is basically designed. It is a better learning platform.
Modeling of Badminton Intelligent Teaching System Based on Neural Network
Authors: Wang Ping
Published: May 2021

With the popularity of neural networks and the maturity of network technology, fully functional intelligent terminals have become indispensable devices for people’s lives, research, and entertainment. However, in the badminton teaching of people’s daily exercise, the old traditional teaching mode is still used, which cannot achieve good teaching effects. In order to study the best of badminton teaching, this article is based on the previous research, by introducing neural network, using literature data method, questionnaire survey method, interview method, experimental method, and other research methods to conduct research. The intelligent learning of the network is connected, experiments are designed to be applied, and then, data analysis is conducted. The research results show that with the use of smartphone mobile learning teaching methods, the experimental group students’ technical movements, theoretical knowledge, learning interest, and learning enthusiasm are about 20% higher than those of the control group, and the badminton intelligent teaching system based on neural network is better than the control group’s traditional teaching methods. The satisfaction of the students in the experimental group was also higher than that of the students in the control group. Based on what network, the satisfaction of badminton teaching can reach more than 90%. This student recognizes and accepts the teaching methods of intelligent teaching.
High Neutrophil‐to‐Lymphocyte Ratio and Platelet‐to‐Lymphocyte Ratio Are Associated with Poor Survival in Patients with Hemodialysis
Authors: Zhang Jialing , Lu Xiangxue , Wang Shixiang , Li Han
Published: May 2021

Background. The neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) are markers for systemic inflammation condition. Although NLR has emerged as a risk factor for poor survival in end‐stage renal disease (ESRD) patients, the relationship between PLR and mortality is still unknown. We aimed to explore the interaction of NLR and PLR in predicting mortality in hemodialysis (HD) patients. Method. We enrolled 360 HD patients for a 71‐month follow‐up. The endpoint was all‐cause and cardiovascular (CV) mortality. Pearson correlation analysis was conducted to evaluate the relationship between factors and NLR or PLR. Kaplan‐Meier curves and Cox proportional analysis were used to assess the prognostic value of NLR and PLR. Results. NLR was positively correlated with neutrophil and negatively correlated with lymphocyte, hemoglobin, and serum albumin. PLR was positively correlated with neutrophil and platelet and negatively correlated with lymphocyte and hemoglobin. In multivariate Cox regression, a higher NLR level was independently associated with all‐cause mortality (OR 2.011, 95% CI 1.082‐3.74, p = 0.027), while a higher PLR level might predict CV mortality (OR 2.768, 95% CI 1.147‐6.677, p = 0.023) in HD patients. Conclusion. NLR and PLR are cheap and reliable biomarkers for all‐cause and CV mortality to predict survival in HD patients.
Steady Wind Load on External Surface and Its Effect on Wind‐Induced Response for a 200 m High Natural‐Draught Cooling Tower
Authors: Zou Yunfeng , Xue Fanrong , He Xuhui , Cai Chenzhi , Li Shouke
Published: May 2021

Wind tunnel tests were carried out to measure the wind pressure of a 200 m high natural‐draught cooling tower. An analysis of the distribution characteristics of external pressure was then conducted to determine the pressure coefficients Cp(θ, z) in a given wind profile. Finally, the effect on the response of the shell and the buckling safety of the shell, applying the simplified height‐constant pressure coefficient Cp(θ) and the realistic pressure Cp(θ, z), was determined. Taking the wind load specified in the code as an example, the influence of the distribution of external pressure on the wind‐induced response was further analyzed. The results indicate that the pressure distribution varies with not only the height z but also the circumferential angle θ, and the wind load of both ends of the tower is significantly greater than that of its middle. Moreover, the wind‐induced static responses of the tower under the action of the realistic pressure distribution Cp(θ, z) and the simplified approach Cp(θ) are basically consistent, because the wind load distribution is more important than its magnitude for the wind‐induced response of cooling tower, and the wind‐induced response of the cooling tower is dominated by the local shell deformation.
Sex-Based Dimorphism of Anticancer Immune Response and Molecular Mechanisms of Immune Evasion
Authors: Conforti Fabio , Pala Laura , Pagan Eleonora , Bagnardi Vincenzo , De Pas Tommaso , Queirolo Paola , Pennacchioli Elisabetta , Catania Chiara , Cocorocchio Emilia , Ferrucci Pier Francesco , Saponara Maristella , Orsolini Gianmarco , Zagami Paola , Nicoló Eleonora , De Marinis Filippo , Tortora Giampaolo , Bria Emilio , Minucci Saverio , Joffe Hadine , Veronesi Paolo , Wargo Jennifer , Rosenthal Rachel , Swanton Charles , Mantovani Alberto , Gelber Richard D. , Viale Giuseppe , Goldhirsch Aron , Giaccone Giuseppe
Published: May 2021

Purpose:

We previously demonstrated that sex influences response to immune checkpoint inhibitors. In this article, we investigate sex-based differences in the molecular mechanisms of anticancer immune response and immune evasion in patients with NSCLC.

Experimental Design:

We analyzed (i) transcriptome data of 2,575 early-stage NSCLCs from seven different datasets; (ii) 327 tumor samples extensively characterized at the molecular level from the TRACERx lung study; (iii) two independent cohorts of 329 and 391 patients, respectively, with advanced NSCLC treated with anti–PD-1/anti–PD-L1 drugs.

Results:

As compared with men, the tumor microenvironment (TME) of women was significantly enriched for a number of innate and adaptive immune cell types, including specific T-cell subpopulations. NSCLCs of men and women exploited different mechanisms of immune evasion. The TME of females was characterized by significantly greater T-cell dysfunction status, higher expression of inhibitory immune checkpoint molecules, and higher abundance of immune-suppressive cells, including cancer-associated fibroblasts, MDSCs, and regulatory T cells. In contrast, the TME of males was significantly enriched for a T-cell–excluded phenotype. We reported data supporting impaired neoantigens presentation to immune system in tumors of men, as molecular mechanism explaining the findings observed. Finally, in line with our results, we showed significant sex-based differences in the association between TMB and outcome of patients with advanced NSCLC treated with anti–PD-1/PD-L1 drugs.

Conclusions:

We demonstrated meaningful sex-based differences of anticancer immune response and immune evasion mechanisms, that may be exploited to improve immunotherapy efficacy for both women and men.
Standardized Uptake Value Illuminates Tumor Inflammation and Treatment Response
Authors: Williamson Casey W. , Zamarin Dmitriy , Mayadev Jyoti
Published: May 2021

Maximum standardized uptake value (SUVmax) on PET imaging is prognostic in cervical cancer. It was recently demonstrated that low pretreatment SUVmax is associated with superior prognosis and is correlated with decreased inflammatory signaling and myeloid-derived cell infiltration into the tumor microenvironment, potentially identifying susceptibility to targeted therapies.

See related article by Floberg et al., p. 4245
Exosomal CD47 Plays an Essential Role in Immune Evasion in Ovarian Cancer
Authors: Shimizu Aasa , Sawada Kenjiro , Kobayashi Masaki , Yamamoto Misa , Yagi Taro , Kinose Yasuto , Kodama Michiko , Hashimoto Kae , Kimura Tadashi
Published: May 2021

Ovarian cancer is largely diagnosed at advanced stages upon detection of multiple peritoneal dissemination, resulting in poor outcomes. CD47 is overexpressed in tumors, facilitates tumor immune evasion, and is located on exosomes. We aimed to investigate the role of exosomal CD47 in ovarian cancer progression. Prognostic significance of CD47 expression in ovarian cancer was examined using a public database including 1,435 patients and validated with 26 patients at our institution. CD47 expression was associated with poor progression-free survival and inversely correlated with macrophage infiltration in ovarian cancer tissues. Exosomes were collected from ovarian cancer cell lines, and CD47 expression on exosomes was confirmed via flow cytometry. Inhibition of exosome secretion with GW4869 and exosome uptake with 5-(N-ethyl-N-isopropyl)-amiloride inhibited the surface CD47 expression on ovarian cancer cells and promoted phagocytosis by macrophages. RAB27A (a key regulator of exosome release) knockdown inhibited exosome secretion and led to CD47 downregulation in ovarian cancer cells. In a xenograft mouse model, suppression of the release of tumor-derived exosomes by GW4869 or RAB27A knockdown suppressed tumor progression and enhanced M1 macrophage phagocytosis in cancer tissues. Collectively, CD47 expression was correlated with poor prognoses in patients with ovarian cancer, suggesting the importance of immune evasion. CD47 was expressed on exosomes and the inhibition of exosome secretion and/or uptake enhanced cancer cell phagocytosis by macrophages, and thus, suppressed peritoneal dissemination. This suggests the potential of a novel immune checkpoint therapeutic agent that focuses on exosomes.

Implications:

Mechanistic insight from the current study suggests that exosomal CD47 may be an advantageous therapeutic target in ovarian cancer.
Femoral Shaft Fracture Occurring as a Result of Physical Manipulation: A Case Report
Authors: Ayoubi Rami A. , Aouad Dany K. , Darwish Mohammad M. , Lati Georgio G. , Saade Jamal , Nehme Alexandre H.
Published: May 2021

Treatments including physical manipulation maneuvers have been widely used for the management of various pain complaints. These maneuvers, although generally considered safe, can be associated with serious complications. We report the case of a 37-years-old previously healthy male patient, who presented to our emergency department (ED) for severe right thigh pain and inability to bear weight that developed during a chiropractic session. Imaging done at the ED showed a displaced distal femoral shaft fracture. The majority of the complications of manipulation maneuvers can be as simple as sprains, however, can be drastic or life-threatening in certain cases causing cerebrovascular accidents or major orthopedic fractures. Such complications are rare and definitely underreported. A femoral shaft fracture occurring as a result of physical manipulation has not been previously reported in the literature. We report a distal femoral shaft fracture that was induced by forceful chiropractic manipulation. It is the first to be reported in the literature. This complication should be noted, reported, and the necessary precautions are taken to avoid such major adverse events.
Visual Impact of Early Hydroxychloroquine-Related Retinal Structural Changes in Patients with Systemic Lupus Erythematosus
Authors: Sallam Moataz A. , Beltagi Arwa S. , Abdellatif Mai A. , Awadalla Magdy A.
Published: May 2021

Purpose: The aim of the study was to assess the early retinal structural changes due to hydroxychloroquine (HCQ) use and its impact on visual acuity (VA) of patients with systemic lupus erythematosus (SLE). Patients and Methods: The study was conducted as a case-control study that included 60 eyes of 30 SLE patients treated with HCQ compared with 50 eyes of 25 healthy individuals. Patients were kept on 200 or 400 mg as daily maintenance dose. SLE patients were subgrouped into patients with normal VA and patients with decreased VA. All participants were assessed by the optical coherence tomography (OCT), and early structural abnormalities were recorded. The main outcomes and measures were best-corrected VA, drug exposure time, central macular thickness (CMT), inner segment-outer segment (IS-OS) junction disruption, ganglion cell complex † (GCC†, ganglion cell layer + inner plexiform layer), ganglion cell complex †† (GCC††, nerve fiber layer + GCC†), and peripapillary retinal nerve fiber layer. The characteristics of HCQ retinal toxicity were correlated to VA. Results: All OCT parameters were found to be significantly lower (p < 0.001) in HCQ patients with decreased VA than in controls. Patients receiving a daily dose of 400 mg had lower (p < 0.05) parameters than those receiving 200 mg. Patients with IS-OS disruption had lower CMT, GCC †, and GCC †† than those without (p < 0.05). VA was significantly correlated (p < 0.05) with CMT and drug exposure time. Conclusions: The HCQ use caused OCT changes that precede clinically visible retinopathy and might be associated with slight VA reduction. Screening with OCT of patients receiving HCQ is essential to detect early vision loss.
Jaundice as a Diagnostic and Therapeutic Problem: A General Practitioner’s Approach
Authors: Pavlovic Markovic Aleksandra , Stojkovic Lalosevic Milica , Mijac Dragana Danilo , Milovanovic Tamara , Dragasevic Sanja , Sokic Milutinovic Aleksandra , Krstic Miodrag N.
Published: May 2021

Background: Jaundice is a common clinical finding in clinical practice of hepatologists and general practitioners. It occurs when serum bilirubin levels exceed 3 mg/dL. Summary: In this review, we summarize the pathophysiological mechanism of jaundice, clinical approach to the patient with jaundice, and laboratory and imaging techniques. Clinical presentation of jaundice manifests through yellow skin and sclera coloration. Evaluation of every patient includes detailed medical history and examination. In the laboratory, evaluation of enzymes of hepatic inflammation as well as cholestatic enzymes with serum bilirubin must be included. Additional laboratory analysis and imaging modalities are needed in order to differentiate jaundice etiology. Moreover, imaging is available and needed in further evaluation, and treatment is dependent on the underlying cause. Key Messages: In this review, we will outline the pathophysiological mechanism of jaundice, clinical approach to the patient with jaundice, and diagnostic and treatment approach to these patients.
Importância das orientações em saúde para o desenvolvimento infantil e o aleitamento materno no primeiro ano de vida
Authors: Guedes-Granzotti Raphaela Barroso , Silva Kelly da , César Carla Patrícia Hernandez Alves Ribeiro , Dornelas Rodrigo , Souza Larissa Santos , Jesus Larissa Santos de , Oliveira Taisa Ribeiro de Souza , Domenis Danielle Ramos
Published: May 2021

Objetivo: determinar o efeito das orientações em saúde para o desenvolvimento infantil e aleitamento materno no primeiro ano de vida. Método: estudo longitudinal (n=45 crianças), sendo 31 pertencentes ao grupo não exposto e 14 ao exposto, sendo este último acompanhado com visitas domiciliares mensais do nascimento ao 12º mês de vida, recebendo informações sobre saúde materno-infantil. Foi utilizado o Teste de Triagem Denver II para acompanhamento do desenvolvimento neuropsicomotor e um questionário para avaliação das variáveis do estudo. Resultados: 64,3% do grupo exposto e 45,2% do não exposto foram amamentados até o primeiro ano de vida, sem diferenças significantes. Quanto à transição alimentar, a única relevância estatística foi a introdução de alimentos sólidos, ocorrendo em período adequado para o exposto e antecipado para o não exposto. Houve introdução precoce de líquidos e pastosos para ambos os grupos. Quanto ao desenvolvimento neuropsicomotor, houve maior número de sujeitos além do esperado para a idade e tendência de melhor coordenação motora fina no grupo exposto (sem diferenças estatísticas). Conclusão: as orientações evidenciaram que intervenções em saúde na primeira infância, mesmo para grupos que não são de risco, proporcionam oportunidades para um desenvolvimento pleno.
Processamento sensorial e oportunidades para o desenvolvimento de bebês
Authors: Britto Luana Borges , Santos Camila Boarini dos , Garros Danielle dos Santos Cutrim , Rocha Aila Narene Dahwache Criado
Published: May 2021

O objetivo foi caracterizar o processamento sensorial e as oportunidades ambientais de bebês. A pesquisa foi submetida à avaliação para o Comitê de Ética, tendo parecer favorável. A coleta de dados foi realizada durante visitas domiciliares e participaram da pesquisa 21 bebês e seus responsáveis. Foi utilizado o Perfil Sensorial 2 do Bebê e da Criança Pequena para avaliar o processamento sensorial e o Affordances in the home environment for motor development para avaliar as oportunidades ambientais. Após a análise dos instrumentos, os dados foram compilados no programa Microsoft Excel© e posteriormente foi realizada a análise descritiva. Os resultados evidenciaram que, mesmo avaliando bebês sem diagnóstico que interferisse no desenvolvimento infantil, em alguns casos, apresentaram alterações no processamento sensorial. Em relação às oportunidades ambientais, foram encontradas residências com a classificação “fraca” e “muito fraca”. Foi concluído que há a necessidade do monitoramento do desenvolvimento de bebês pela Atenção Primária em Saúde, mesmo sem o indicativo de atraso no desenvolviment.
Ten-Year All-Cause Death According to Completeness of Revascularization in Patients With Three-Vessel Disease or Left Main Coronary Artery Disease: Insights From the SYNTAX Extended Survival Study
Authors: Takahashi Kuniaki , Serruys Patrick W. , Gao Chao , Ono Masafumi , Wang Rutao , Thuijs Daniel J.F.M. , Mack Michael J. , Curzen Nick , Mohr Friedrich-Wilhelm , Davierwala Piroze , Milojevic Milan , Wykrzykowska Joanna J. , de Winter Robbert J. , Sharif Faisal , Onuma Yoshinobu , Head Stuart J. , Kappetein Arie Pieter , Morice Marie-Claude , Holmes David R. ,   on behalf of the SYNTAX Extended Survival Study Investigators
Published: May 2021

Background:

Ten-year all-cause death according to incomplete (IR) versus complete revascularization (CR) has not been fully investigated in patients with 3-vessel disease and left main coronary artery disease undergoing percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG).

Methods:

The SYNTAX Extended Survival study (Synergy Between PCI With TAXUS and Cardiac Surgery: SYNTAX Extended Survival [SYNTAXES]) evaluated vital status up to 10 years in patients who were originally enrolled in the SYNTAX trial. In the present substudy, outcomes of the CABG CR group were compared with the CABG IR, PCI CR, and PCI IR groups. In addition, in the PCI cohort, the residual SYNTAX score (rSS) was used to quantify the extent of IR and to assess its association with fatal late outcome. The rSS of 0 suggests CR, whereas a rSS>0 identifies the degree of IR.

Results:

IR was more frequently observed in patients with PCI versus CABG (56.6% versus 36.8%) and more common in those with 3-vessel disease than left main coronary artery disease in both the PCI arm (58.5% versus 53.8%) and the CABG arm (42.8% versus 27.5%). Patients undergoing PCI with CR had no significant difference in 10-year all-cause death compared with those undergoing CABG (22.2% for PCI with CR versus 24.3% for CABG with IR versus 23.8% for CABG with CR). In contrast, those with PCI and IR had a significantly higher risk of all-cause death at 10 years compared with CABG and CR (33.5% versus 23.7%; adjusted hazard ratio, 1.48 [95% CI, 1.15–1.91]). When patients with PCI were stratified according to the rSS, those with a rSS≤8 had no significant difference in all-cause death at 10 years as the other terciles (22.2% for rSS=0 versus 23.9% for rSS>0–4 versus 28.9% for rSS>4–8), whereas a rSS>8 had a significantly higher risk of 10-year all-cause death than those undergoing PCI with CR (50.1% versus 22.2%; adjusted hazard ratio, 3.40 [95% CI, 2.13–5.43]).

Conclusions:

IR is common after PCI, and the degree of incompleteness was associated with 10-year mortality. If it is unlikely that complete (or nearly complete; rSS<8) revascularization can be achieved with PCI in patients with 3-vessel disease, CABG should be considered.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT00114972. URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03417050.
Development and Evaluation of a Novel Mouse Model of Asphyxial Cardiac Arrest Revealed Severely Impaired Lymphopoiesis After Resuscitation
Authors: Wang Wei , Li Ran , Miao Wanying , Evans Cody , Lu Liping , Lyu Jingjun , Li Xuan , Warner David S. , Zhong Xiaoping , Hoffmann Ulrike , Sheng Huaxin , Yang Wei
Published: May 2021

Background

Animal disease models represent the cornerstone in basic cardiac arrest (CA) research. However, current experimental models of CA and resuscitation in mice are limited. In this study, we aimed to develop a mouse model of asphyxial CA followed by cardiopulmonary resuscitation (CPR), and to characterize the immune response after asphyxial CA/CPR.

Methods and Results

CA was induced in mice by switching from an O
2
/N
2
mixture to 100% N
2
gas for mechanical ventilation under anesthesia. Real‐time measurements of blood pressure, brain tissue oxygen, cerebral blood flow, and ECG confirmed asphyxia and ensuing CA. After a defined CA period, mice were resuscitated with intravenous epinephrine administration and chest compression. We subjected young adult and aged mice to this model, and found that after CA/CPR, mice from both groups exhibited significant neurologic deficits compared with sham mice. Analysis of post‐CA brain confirmed neuroinflammation. Detailed characterization of the post‐CA immune response in the peripheral organs of both young adult and aged mice revealed that at the subacute phase following asphyxial CA/CPR, the immune system was markedly suppressed as manifested by drastic atrophy of the spleen and thymus, and profound lymphopenia. Finally, our data showed that post‐CA systemic lymphopenia was accompanied with impaired T and B lymphopoiesis in the thymus and bone marrow, respectively.

Conclusions

In this study, we established a novel validated asphyxial CA model in mice. Using this new model, we further demonstrated that asphyxial CA/CPR markedly affects both the nervous and immune systems, and notably impairs lymphopoiesis of T and B cells.