bluuebunny/crossref_metadata_2025 huggingface dataset:
Robustness evaluation for real traffic network from complex network perspective
Authors: Fan Lijun , Jiang Zhongyuan , Wang Qiang
Published: March 2021

Robustness is a critical characteristic of ubiquitous real networked systems which are often very vulnerable to the random failures or targeted attacks. In this work, we aim to evaluate the robustness of a traffic network which is constructed from real trajectory data. First, we divide a city into grids which are considered as nodes and a link is established if there is at least one taxi dispatch order from one grid to another. Second, we propose two categories of attack strategies: node attacks (e.g. random node failure, and degree, in-degree, out-degree, closeness, clustering coefficient, PageRank-based targeted attacks) and link attacks (e.g. random link failure and link weight, link degree, link betweenness-based targeted attacks). Third, we suppose all elements (i.e. node or link) are simultaneously or iteratively removed, and evaluate the network robustness by employing the relative size of the giant components, average clustering coefficient and average shortest path length. The results show that the degree-based targeted attacks are the most destructive among all attacks, and no matter node or link, the betweenness-based attack is the most effective method to be beneficial to the target index. Moreover, most methods with recalculations take priority over the ones without recalculations.
SVIR rumor spreading model considering individual vigilance awareness and emotion in social networks
Authors: Liqing Qiu , Shuqi Liu
Published: March 2021

Rumor, as a form of information, can be widely spread in a short time. A host of researchers focus on the spread of rumor, aiming to explore the rules of rumor spreading and put forward effective measures to help control the spread of rumor. In real life, when the individual is not interested in the rumor spread or feels that the rumor is not related to him, it is easy to trigger the individual’s vigilance awareness. On the contrary, if the rumor is more closely related to the individual’s life, the individual will usually be less alert and have great motivation to share it with friends. Based on the typical Susceptible–Infected–Recovered (SIR) model, a new vigilant state is added to describe the above phenomenon and a Susceptible–Vigilant–Infectious–Recovered (SVIR) rumor model is proposed. In addition, considering the fact that the infectious with high emotion may cause emotional resonance among individuals, this model adds a connection edge from the recovered to the infectious triggered by emotional infection. Based on the obtained dynamic equations, the steady state of the model is analyzed by utilizing basic reproduction number method and verified on the generated homogeneous network as well as Facebook network. Simulation results reveal that the improvement of individual vigilance awareness can reduce the influence of rumor. Although high emotional infectious can promote the spread of rumor, appealing them to clarify the fact for curbing rumor spreading is a forceful measure.
STABILITY ANALYSIS OF A MATHEMATICAL MODEL FOR CHRONIC MYELOID LEUKEMIA ERADICATION
Authors: BUNIMOVICH-MENDRAZITSKY SVETLANA , SHAIKHET LEONID
Published: March 2021

We analyze a mathematical model for the treatment of chronic myeloid leukemia (CML). The model is designed for complete recovery of CML patients after treatment. The model developed in the paper [Bunimovich-Mendrazitsky S, Kronik N, Vainstein V, Optimization of interferon-alpha and imatinib combination therapy for CML: A modeling approach, Adv Theory Simul 2(1):1800081, 2018] introduced a combined treatment of CML based on imatinib therapy and immunotherapy. Immunotherapy based on Interferon alpha-2a (IFN-[Formula: see text]) affects stem and mature cancer cell mortality, and leads to outcome improvements in the combined therapy. The qualitative character of our results shows that additional therapy for the complete cure of CML patients is required. This additional treatment is tumor infiltrating lymphocytes (TIL) along with a combination imatinib and IFN-[Formula: see text] treatment. The model examines the interaction between CML cancer cells and effector cells, using an ODE system. Stability analysis of the model defines conditions when imatinib treatment might lead to the eradication of CML with IFN-[Formula: see text] and TIL. Three equilibria are investigated for the proposed model. Stability conditions for equilibria are formulated in terms of the linear matrix inequalities (LMIs).
Investigations on Machining Performances and Tool Wear Surface Characterization During CNC Hard Turning of AISI 4140 Alloy Steel
Authors: Ghosh Shuvajit , Mandal Nirmal Kumar , Kar Tuhin
Published: March 2021

Researchers are always trying to explore, use resources so that the machining performances become more efficient, economically viable, and environment-friendly which are in general, conflicting in nature. In this investigation, surface finish, material removal rate, and tool wear are considered as responses, and cutting speed, feed, and depth of cut are considered as input factors for optimization of AISI 4140 alloy steel during CNC dry turning. In most of the previous researches, weights of the responses are considered arbitrarily. But, in this investigation, weighted ratio analysis is considered as an optimizing tool whose weights are determined by the Eigenvectors obtained from the principal component analysis of the experimental data. This weighted ratio analysis technique requires very few computations compared to others, and even it can be performed without a computer. Surface texture of the tool wear is measured using image processing of the wear surface. First, a metallurgical microscope captures an image of the sharp tool (unworn), and RGB values of the gray scale image are noted, which acts as a reference. After machining, RGB values of the wear surface from the gray scale image are noted. Comparing these two RGB values, the amount of flank wear of the tool is determined. It is observed that the error is within 10% and therefore it is accepted.
Influencing Factors of Logistical Operations Toward Economic Development and Environmental Regulations: Temporal and Spatial Evolution Mechanism
Authors: Dongfang Wang , Khan Syed Abdul Rehman , Arthur Tarasov , Jinfeng Li
Published: March 2021

The interconnection of traffic infrastructure and the logistics industry’s efficient operation is a basis for the reconstruction of industrial spatial structure and economic optimization of the urban cluster. In this paper, the Undesirable-SBM DEA model was used to calculate the logistics eco-efficiency (LEE) of the five coastal urban clusters for 2009–2017, and the panel fixed-effect Tobit model was used to analyze the LEE evolution mechanism. Findings show that the overall score for LEE in China’s five coastal urban clusters is in a downward trend, and the gap in LEE between the cities is increasing. The temporal and spatial distribution of the LEE score has evolved from the pyramid structure of “the number of high-efficiency cities is the largest, followed by medium-efficiency in-between, and the least being low-efficiency cities” to the inverted triangle structure of “the number of low-efficiency cities is the largest, followed by medium-efficiency in-between, and the least being high-efficiency cities”. The evolution of the spatial distribution of LEE in various urban clusters shows heterogeneous characteristics. The cities with middle- and high-investment volumes of logistics resources are mainly the core and sub-core cities, but most of them have low LEE scores. The employee excess rate is the main reason for the loss of LEE. Energy prices and government intervention significantly and negatively affect LEE, while environmental regulations positively and significantly affect the excess of capital stock and employees. The impact of influencing factors, such as economic development and environmental regulations, on LEE and input excesses is different among the five coastal urban clusters.
Multi-Objective Optimization of Mn-Doped Tio2 Content for Wettability, Printability and Intermetallic Layer of Sac305 Pb-Free Solder Paste on a Cu Substrate
Authors: Kanlayasiri K. , Ariga T.
Published: March 2021

Effects of Mn-doped TiO2 nanoparticles on the wettability, printability and thickness of intermetallic layer of SAC30 on a Cu substrate were studied in this paper. Concentration of Mn-doped TiO2 nanoparticles was varied from 0.05 wt.% to 1[Formula: see text]wt.%. The wettability was evaluated in terms of contact angle of solder on the copper substrate and the printability was measured from the volume ratio of printed solder on the copper substrate to volume of stencil opening. The experimental results showed that 0.10[Formula: see text]wt.% Mn-doped TiO2 led to the lowest contact angle while the printability was decreased with the increase of the added nanoparticles and the thinnest intermetallic layer was found at 0.50[Formula: see text]wt.% Mn-doped TiO2 nanoparticles. Mn-doped TiO2 concentration was then optimized using a desirability function to find optimal values for the three responses. It was found that 0.07[Formula: see text]wt.% was the optimal concentration for the three metrics — wettability, printability and thickness of the intermetallic layer.
Using Hybrid Artificial Neural Network and Particle Swarm Optimization Algorithm for Modeling and Optimization of Welding Process
Authors: Tafarroj Mohammad Mahdi , Moghaddam Masoud Azadi , Dalir Hamid , Kolahan Farhad
Published: March 2021

This study addresses a hybrid procedure used for modeling and optimization of gas tungsten arc (GTA) welding process of AL5052 alloy. There are different process input parameters among which welding current ([Formula: see text], frequency ([Formula: see text], welding speed ([Formula: see text], and gap ([Formula: see text] are the most important ones considered in GTA welding process. Furthermore, heat affected zone (HAZ) is considered as the most important quality measure of the process. To gather the required data for the modeling and optimization purpose, design of experiments (DOE) approach has been used. Image processing technique is used to take accurate measurements of HAZ values. In order to determine the relationship between process input variables and output measures, artificial neural networks (ANNs) have been used. Then, the trained ANNs have been used to find the optimal value of the outputs using particle swarm optimization (PSO) algorithm. Experiments have been done to verify the optimal levels of the input parameters. Verification results demonstrate that the proposed ANN-PSO procedure is quite efficient in modeling and optimization (with about 4% error) of GTA welding process.
Smart Manufacturing Plant Implementation Using Industrial IoT
Authors: Sowmya N. , Rani Alex John Sahaya , Sathiyanarayanan S.
Published: March 2021

Industry 4.0 initiatives include the concept of smart manufacturing with the help of sensors and intelligent systems. Smart manufacturing optimizes the internal process and decision making with no/minor intervention from humans. Nevertheless, the adoption of IIoT in industry setting remains a challenge and very minimal work has been in progress. This work is aimed to showcase adoption of IIoT in the Slip Control System/Anti-Lock Braking System. It optimizes the monitoring and decision making of various processes with the help of intelligent systems and IoT in the perspective of Industrial IoT 4.0. It mainly focuses on the various conditions and parameters such as line breakdown notifications, pressure levels, etc. They are monitored through the cloud platform and an alert system is developed in the cloud to warn the user regarding the pressure level. The instant alert of line breakdown notifications reduces the downtime of the plant, improves production and monitoring of the pressure system in the plant and safety check of the plant is in place at any instant.
Sheet-Metal Feature Recognition Using STEP: Database for Product Development
Authors: Gupta Ravi Kumar , Salem Hossam , Hussein Hussein M. A. , Salunkhe Sachin , Ramadan Aya A. A.
Published: March 2021

Sheet-metal parts are widely used in many engineering fields have different shapes and applications. It consists of small shapes, considered as basic building blocks which are called features. These features are combined to form a part. A sheet-metal part must go through many stages before considering it as the final product. Each stage has its own preferences of considering features set for the study and usages which requires suppression of not-considered features. These suppressed features may be considered in other stages. Sheet-metal features are the bridge to the die design CAD world. Therefore, features recognition from a sheet-metal part model and then smartly suppressing and inserting a feature in the model for product development applications are considered. Features extraction from a part model that is stored in STEP format is presented. Features in a sheet-metal part model are defined as the number, type, and connectivity of geometric entities in the part model. A sheet-metal features database is developed for the process of features recognition, suppression, and insertion in order to be utilized for the product development applications. The developed algorithm for feature recognition and database development is presented along with industrial use case examples.
meso-Carbazole substituted palladium porphyrins: Efficient catalysts for visible light induced oxidation of aldehydes
Authors: Janaagal Anu , Pandey Vijayalakshmi , Sabharwal Sudhir , Gupta Iti
Published: March 2021

The A3B and A2B2 type porphyrins having [Formula: see text]-butylcarbazole and [Formula: see text]-cyanophenyl groups are synthesized and characterized. Their palladium complexes have also been prepared and utilized as catalysts for the photo-oxidation reactions of aromatic aldehydes in good yields. Pd(II)porphyrins displayed decent phosphorescence at [Formula: see text]670 nm and were able to generate singlet oxygen upon light irradiation. The calculated singlet oxygen quantum yields for Pd(II)porphyrins were between 57% and 73%. The photo-catalytic application of Pd(II)porphyrins for aerobic oxidation of aromatic aldehydes is demonstrated.
Visible-light-driven peroxymonosulfate activation by porous sulfur-doped g-C3N4 for the removal of organic contaminant
Authors: Yang Dan , Zhao Lei , Feng Xueting , Ma Lili , Ding Hanming
Published: March 2021

As a potential nonmetal activator of peroxymonosulfate (PMS), [Formula: see text]-C3N4 becomes a hot material owing to its superior chemical and physical properties. Nevertheless, pristine [Formula: see text]-C3N4 is unsatisfactory for PMS activation because of its limited photo-generated charge separation and low specific surface area. Herein, a porous sulfur-doped [Formula: see text]-C3N4 (S-doped [Formula: see text]-C3N[Formula: see text] has been prepared through a one-step calcination route without a template. The in-situ doping of sulfur element and the formation of porous morphology have been confirmed via various characterization methods. The catalytic activity of porous S-doped [Formula: see text]-C3N4 is approximately 6.2-fold higher than that of the pristine [Formula: see text]-C3N4 on rhodamine B (RhB) decomposition in aid of the photo-assisted PMS activation. The superior catalytic activity and high stability of the porous S-doped [Formula: see text]-C3N4 catalyst in a wide pH range are attributed to its higher specific surface area, enriched active sites, efficient photo-induced charge separation, and increased visible-light utilization. Meantime, a synergistic effect between the PMS activation process and the photocatalytic process is conducive to produce abundant radicals for the RhB degradation. This study offers new insight into further developing highly efficient nonmetal heterogeneous catalysts for wastewater treatment.
Outer complete fair domination in graphs
Authors: Swaminathan V. , Sundareswaran R. , Lalkshmanaraj D. , Muthusubramanian L.
Published: March 2021

Graphs considered here are simple, finite and undirected. A graph is denoted by [Formula: see text] and its vertex set by [Formula: see text] and edge set by [Formula: see text]. Kulli and Janakiram introduced the concept of the strong non-split domination number of a graph [The strong non-split domination number of a graph, Int. J. Manag. Syst. 19 (2003) 2]. The concept of fair domination was introduced by Yaro Caro et al. in [Fair domination in graphs, Discrete Math. 312 (2012) 2905–2914]. This paper is an outcome of the combination of these two concepts.
Review—Ti3C2Tx MXene: An Emerging Two-Dimensional Layered Material in Water Treatment
Authors: Wang Yijin , Niu Bingqiang , Zhang Xingmao , Lei Yimin , Zhong Peng , Ma Xiaohua
Published: March 2021

Since its discovery in 2011, the Ti3C2Tx MXene has attracted more and more attentions in diverse fields such as photocatalysis, energy storage, and electromagnetic shielding interference etc., due to its unique layered structure, high specific surface area, high conductivity, catalytic activity and easy functionalization. In recent years, attributed to its excellent light-to-heat conversion property, good selective adsorption and effective reduction feature for heavy metal ions, the Ti3C2Tx MXene has appealed new attentions in water treatment. This review mainly summarizes the latest research progresses on Ti3C2Tx MXene in water treatment. Firstly, the synthesis methods in recent years, characterizations and surface modifications of Ti3C2Tx MXene are briefly summarized. Then the application progresses and mechanisms of Ti3C2Tx MXene in solar desalination, removal of heavy metal ions, organic dyes, radionuclides and bacteria are introduced. Finally, the main challenges and prospects of Ti3C2Tx MXene based nanomaterials are proposed. This review provides a reference for further research on water treatment, and might promote the practical application of nanomaterials in water treatment from the laboratory research.
A mathematical model of the rat kidney. III. Ammonia transport
Authors: Weinstein Alan M.
Published: March 2021

This is the first mathematical model to estimate solute concentrations within the kidney cortex. The model predicts cortical ammonia to be several fold greater than in the systemic circulation. This higher concentration drives ammonia secretion in proximal and distal tubules. The model reveals a gap in our understanding of how ammonia generated within the cortex is channeled efficiently into the final urine
Transcriptomic signatures of exacerbated progression in leptospirosis subclinical chronic kidney disease with secondary nephrotoxic injury
Authors: Chou Li-Fang , Chen Ting-Wen , Yang Huang-Yu , Tian Ya-Chung , Chang Ming-Yang , Hung Cheng-Chieh , Hsu Shen-Hsing , Tsai Chung-Ying , Ko Yi-Ching , Yang Chih-Wei
Published: March 2021

Leptospira-infected mice followed by secondary nephrotoxic injury exacerbated immune/inflammatory responses and renal fibrosis. Comparison with the murine model revealed candidates involved in the progression of renal fibrosis in chronic kidney disease (CKD). Comparative transcriptome study suggests that secondary nephrotoxic injury in Leptospira-infected mice recapitulates the gene expression signatures found in CKD patients. This study indicates that secondary nephrotoxic injury may exacerbate CKD in chronic Leptospira infection implicating in the progression of CKD of unknown etiology.
Xinmailong Attenuates Doxorubicin‐Induced Lysosomal Dysfunction and Oxidative Stress in H9c2 Cells via HO‐1
Authors: Jiang Yu , Liu Yanjuan , Xiao Wen , Zhang Dandan , Liu Xiehong , Xiao Huiqiong , You Sanli , Yuan Lili
Published: March 2021

The clinical use of doxorubicin (DOX) is limited by its cardiotoxicity, which is closely associated with oxidative stress. Xinmailong (XML) is a bioactive peptide extracted from American cockroaches, which has been mainly applied to treat chronic heart failure in China. Our previous study showed that XML attenuates DOX‐induced oxidative stress. However, the mechanism of XML in DOX‐induced cardiotoxicity remains unclear. Heme oxygenase‐1 (HO‐1), an enzyme that is ubiquitously expressed in all cell types, has been found to take antioxidant effects in many cardiovascular diseases, and its expression is protectively upregulated under DOX treatment. Lysosome and autophagy are closely involved in oxidative stress as well. It is still unknown whether XML could attenuate doxorubicin‐induced lysosomal dysfunction and oxidative stress in H9c2 cells via HO‐1. Thus, this study was aimed at investigating the involvement of HO‐1‐mediated lysosomal function and autophagy flux in DOX‐induced oxidative stress and cardiotoxicity in H9c2 cells. Our results showed that XML treatment markedly increased cell proliferation and SOD activity, improved lysosomal function, and ameliorated autophagy flux block in DOX‐treated H9c2 cells. Furthermore, XML significantly increased HO‐1 expression following DOX treatment. Importantly, HO‐1‐specific inhibitor (Znpp) or HO‐1 siRNA could significantly attenuate the protective effects of XML against DOX‐induced cell injury, oxidative stress, lysosomal dysfunction, and autophagy flux block. These results suggest that XML protects against DOX‐induced cardiotoxicity through HO‐1‐mediated recovery of lysosomal function and autophagy flux and decreases oxidative stress, providing a novel mechanism responsible for the protection of XML against DOX‐induced cardiomyopathy.
A Spatiotemporal Change Detection Analysis of Coastline Data in Qingdao, East China
Authors: Yasir Muhammad , Hui Sheng , Hongxia Zheng , Hossain Md Sakaouth , Fan Hong , Zhang Li , Jixiang Zhao
Published: March 2021

This study focuses on the coastal features, environments, and dynamics to accurately describe and regularly monitor the Qingdao shoreline in eastern China. It collects categorical ETM+ and OLI data from 2000, 2010, and 2019 on the mainland coastline and explores the characteristics and spatiotemporal differences across the past 19 years by using remote sensing and geographic information system (GIS) technologies. The results show that the length of the Qingdao coastline has increased continuously over the last two decades, for a total increase of 18.14 km. There are different natural and artificial coastlines that have undergone major changes. The human-induced deterioration of coastlines has gradually and substantially risen from 53.63% in 2000 to 68.40% in 2019, while the length of the natural coastlines has decreased dramatically. Jiaozhou Bay focuses on areas with significantly changing coastlines, and major changes have occurred in the west and east of the Qingdao coast. The coastline has largely expanded seaward because of the comprehensive impact of natural and anthropogenic factors. The leading factor in coastal evolution is coastal engineering constructions. In addition, the top three other construction activities are the restoration of the aquaculture pond, salt field, and harbor edifices. The driving force that triggered the shift in the coastline reveals significant temporal heterogeneity.
Phytochemistry and Biological Activities of Poria
Authors: Lu Jie , Tian Jing , Zhou Li , Meng Lijun , Chen Sitan , Ma Changyang , Wang Jinmei , Liu Zhenhua , Li Changqin , Kang Wenyi
Published: March 2021

Poria is a common Traditional Chinese Medicine in clinic. In recent years, the chemical and pharmacological studies of Poria have made great progress, triterpenes and polysaccharides have been isolated, and various types of compounds containing lipids, octanoic acids, fatty acids, and trace elements have been found. In this paper, we reviewed the literature, summarized the main compound types, and reviewed in detail their pharmacological effects in antitumor, immunomodulatory, effects on kidney, hepatoprotective activity, effects on blood sugar, antioxidant effects, anti-inflammatory effects, effects on the gut, antidepressant, and so on, and also categorized the compounds with the same or similar pharmacological effects to provide a reference for the in-depth study of the material basis of the pharmacological effect, quality standards, and pharmacological activity of Poria.
Assessment of the Accelerated Shelf Life of Human Milk Dehydrated by Aspersion and Treated by UV, High Pressures, and Pasteurization
Authors: Aguilar Uscanga B. R. , Solís Pacheco J. R. , Ragazzo-Sánchez J. A. , Cavazos Garduño A. , Muro Valdéz J. C. , Rodríguez Arreola A. , Serrano Niño J. C.
Published: March 2021

Human milk banks pasteurize and freeze the milk in order to conserve it, but thawing and prolonged storage cause loss of nutritional components. The aim of this work was to evaluate the effect of pasteurization, high hydrostatic pressures, UV radiation, and spray drying in human milk packed and stored at 25 to 40°C by a period of 14 weeks, using an accelerated shelf life method with Arrhenius model. Effectiveness of packaging, microbiological viability, and deterioration of carbohydrates, lipids, and proteins was evaluated. The results showed that proteins and carbohydrates in powdered human milk with different treatments did not show significant changes during storage at 25 to 40°C and without the growth of microorganisms. However, 33.3% deterioration of lipid oxidation was observed up at 40°C. We predict with the applied model that, at 18°C, the human milk powder will be preserved for approximately one year without significant changes in its composition.
The Pattern of Microorganisms and Drug Susceptibility in Pediatric Oncologic Patients with Febrile Neutropenia
Authors: Jungrungrueng Thanyathorn , Anugulruengkitt Suvaporn , Lauhasurayotin Supanun , Chiengthong Kanhatai , Poparn Hansamon , Sosothikul Darintr , Techavichit Piti
Published: March 2021

Objective. The study aimed to describe the pattern of causative microorganisms, drug susceptibility, risk factors of antibiotic-resistant bacterial infection, and clinical impact of these organisms on pediatric oncology patients with febrile neutropenia. Methods. A retrospective descriptive study of oncologic patients aged less than 15 years who were diagnosed with febrile neutropenia in King Chulalongkorn Memorial Hospital was conducted between January 2013 to December 2017. Characteristics and clinical outcomes of febrile neutropenia episodes, causative pathogens, and their antibiotic susceptibilities were recorded. Result. This study included 267 patients with 563 febrile neutropenia episodes. The median (range) age was 5.1 years (1 month–15 years). The most common underlying disease was acute lymphoblastic leukemia (42.7%). Of 563 febrile episodes, there were 192 (34.1%) with microbiologically documented infection. Among these 192 episodes of microbiologically documented infection, there were 214 causative pathogens: 154 bacteria (72%), 32 viruses (15%), 27 fungus (12.6%), and 1 Mycobacterium tuberculosis (0.4%). Gram-negative bacteria (48.6%) accounted for most of the causative pathogens. Twenty-three percent of them were multidrug resistant, and 18% were carbapenem resistant. Among Gram-positive bacterial infection which accounted for 23.4% of all specimens, the proportion of MRSA was 20%. The 2-week mortality rate was 3.7%. Drug-resistant Gram-negative bacterial infection caused significant adverse events and mortality compared to nonresistant bacterial infection (p<0.05). Conclusion. There is high rate of drug-resistant organism infection in pediatric oncology patients in a tertiary-care center in Thailand. Infection with drug-resistant Gram-negative bacterial infection was associated with significant morbidity and mortality. Continuous surveillance for the pattern of drug-resistant infections is crucial.
Evaluation of Hematocrit in Adults with Dengue by a Laboratory Information System
Authors: Sahassananda Duangjai , Thanachartwet Vipa , Chonsawat Putza , Wongphan Benjamaporn , Chamnanchanunt Supat , Surabotsophon Manoon , Desakorn Varunee
Published: March 2021

The implementation of a laboratory information system (LIS) at the Hospital for Tropical Diseases in Thailand provides valuable medical resources, particularly for dengue. Hematocrit (Hct), which is often derived from hemoglobin (Hgb), is important in the diagnosis and management of dengue. This study aimed to evaluate the Hct value obtained from the LIS automated analyzer. We prospectively enrolled 163 hospitalized adults with dengue, for whom 1,141 real-time complete blood count (CBC) results were obtained via a hematology analyzer and updated in the LIS database. The median (interquartile range (IQR)) duration of analytic turnaround times (TATs) was 40.0 (30.0–53.0) minutes. Linear regression analysis indicated a significant relationship between Hgb and Hct with a coefficient of determination (Pearson’s R2) of 0.92 at red blood cell distribution width (RDW) ≤18, but Pearson’s R2 decreased to 0.78 at RDW >18. The Hct calculated from the three-fold conversion method and from the analyzer had a Pearson’s R2 of 0.92. At Hgb <12 g/dl and ≥16 g/dl, a greater difference between the two Hct values was observed, with median (IQR) differences of −0.8% (−1.9%–0.2%) and 0.8% (−0.1%–1.7%), respectively (

P

value <0.05). In conclusion, the Hgb and Hct of patients with dengue were highly correlated at RDW ≤18. The Hct calculated from the three-fold conversion method and from the analyzer had an excellent relationship, except when the Hgb was <12 g/dl or ≥16 g/dl. Apart from routine CBC evaluation, the LIS could help for accurate data collection in clinical research and development.
Musculoskeletal Corticosteroid Injection during COVID-19 Pandemic in Sabah: Is It Safe?
Authors: Azwan Aziz Mohamad , Abu Hanifah Redzal , Mohd Nahar Azmi Mohamed
Published: March 2021

Musculoskeletal corticosteroid injection is commonly used as an adjunct to help patients in pain management. In this current COVID-19 pandemic, many clinicians would differ from this treatment as steroid is considered an immunosuppressive drug and could risk the patient of developing severe adverse effects if contracting COVID-19. This is a retrospective study based in Sabah, Malaysia, examining the prevalence of COVID-19 infection following musculoskeletal corticosteroid injection from 1 December 2019 until 30 June 2020 in the sports medicine clinic and the orthopedic clinic. Patients who received musculoskeletal corticosteroid injection were called by telephone and asked about visits to the emergency department or government health clinic for influenza-like illness symptoms or severe acute respiratory infection that would require screening of COVID-19. Thirty-five patients who responded to the call were included, with mean ages of 47.9 years ± 15.1. 52% were male respondents, while 48% were female. 25% of them were diabetics, and 2.9% of them had a history of lymphoproliferative disorders. The mean pain score before injection was 6.74 ± 1.03 and after injection pain was 2.27 ± 1.63. In this study, there were 11.4% (n = 4) with minor complications of steroid injection, that is, skin discoloration. Nonetheless, there were no severe complications due to corticosteroids reported. There were no reported cases of COVID-19 among the respondents following corticosteroid injection. Musculoskeletal pain would affect a person’s well-being and activities; thus, its management requires that careful consideration with risk-benefit analysis be made before administering musculoskeletal corticosteroid injection during COVID-19 pandemic.
PKM2 Aggravates Cerebral Ischemia Reperfusion-Induced Neuroinflammation via TLR4/MyD88/TRAF6 Signaling Pathway
Authors: Zhang Baocheng , Shen Jie , Zhong Zhiyue , Zhang Lin
Published: March 2021

Objectives: Cerebral ischemia-reperfusion (I/R) injury is the leading cause of ischemic stroke. Pyruvate Kinase isozymes M2 (PKM2), as a critical glycolytic enzyme during glycolysis, is involved in neuronal apoptosis in rats with hypoxic-ischemic encephalopathy. This study focused on functional investigation and potential molecular mechanism toward PKM2 in cerebral I/R injury. Methods: Cerebral I/R injury model was established by middle cerebral artery occlusion (MCAO) in vivo or oxygen-glucose deprivation and reoxygenation (OGD/R) in vitro. qRT-PCR and Western blot were used to detect the expression of PKM2 in I/R injury models. The effects of PKM2 on I/R injury were determined via triphenyl tetrazolium chloride staining and evaluation of neurological deficits. Cell Counting Kit-8 was employed to detect cell viability, and ELISA was conducted to detect pro-inflammatory cytokines. The underlying mechanism involved in regulation of PKM2 on I/R injury was investigated via ELISA and Western blot. Results: PKM2 was upregulated after cerebral I/R injury. Knockdown of PKM2 alleviated MCAO-induced infarction and neurological dysfunction. Moreover, PKM2 knockdown also alleviated OGD/R-induced neuronal cell injury and inflammatory response. Mechanistically, PKM2 knockdown-induced neuroprotection was accompanied by inhibition of high-mobility group box 1 (HMGB1), reflected by inactivation of TLR4/MyD88 (myeloid differentiation factor 88)/TRAF6 (TNF receptor-associated factor 6) signaling pathway. Conclusions: Knockdown of PKM2 attenuated cerebral I/R injury through HMGB1-mediated TLR4/MyD88/TRAF6 expression change, providing a potential target for cerebral I/R injury treatment.
Long Noncoding RNA PRNCR1 Reduces Renal Epithelial Cell Apoptosis in Cisplatin-Induced AKI by Regulating miR-182-5p/EZH1
Authors: Li Jing , Fan Xing , Wang Qian , Gong Youlan , Guo Li
Published: March 2021

Background/Aims: This study was designed to examine the role of long noncoding RNA PRNCR1 in cisplatin-induced acute kidney injury (AKI) in vitro and in vivo. Methods: The expression levels of PRNCR1 and miR-182-5p in cisplatin-induced AKI mice were examined. HK-2 cells were treated with cisplatin to induce cell damage. Then, the effects of PRNCR1 and miR-182-5p on cisplatin-stimulated HK-2 cell viability and apoptosis were detected by the CCK-8 and annexin V-FITC/PI method. Target genes of PRNCR1 and miR-182-5p were analyzed by bioinformatics analysis and luciferase. Results: The expression level of PRNCR1 was significantly reduced in cisplatin-induced AKI mice. In addition, overexpression of PRNCR1 attenuated the damage of cisplatin to HK-2. The expression level of miR-182-5p was significantly raised in cisplatin-induced AKI mice. MiR-182-5p was negatively regulated by PRNCR1 and leaded to an upregulation of EZH1 expression. Overexpression of PRNCR1 attenuated cisplatin-induced apoptosis by downregulating the miR-182-5p/EZH1 axis. Conclusion: LncPRNCR1 reduced the apoptosis of renal epithelial cells induced by cisplatin by modulating miR-182-5p/EZH1.
Total and Sn-2 Fatty Acid Proﬁle in Human Colostrum and Mature Breast Milk of Women Living in Inland and Coastal Areas of China
Authors: Ni Mengmei , Wang Yingyao , Wu Rui , Zhang Lishi , Xu Xuebing , Yang Yuexin , Chen Jinyao
Published: March 2021

Introduction: Although lipid is the major energy source and exerts beneficial effects on infant growth, research on the composition of fatty acid (FA) at the sn-2 position of human milk (HM) in China and abroad is limited. Objectives: This study aimed to investigate the FA positional distribution in colostrum and mature HM of women living in the inland and coastal areas of China and explore the potential influences of geographical region and lactation stage on the FA profile of Chinese women. Methods: Colostrum milk (n = 61) and mature milk (n = 56) samples were obtained longitudinally from healthy lactating women in Guangzhou and Chengdu, China. Gas chromatography was used to determine the total and sn-2 FA composition. Results: Significant diﬀerences were observed in the FA profile of HM between diﬀerent regions and lactation stages, with differences in polyunsaturated FA levels being the most pronounced. Nearly 70% of sn-2 FAs were saturated FAs, of which C16:0 accounted for approximately 75%. C8:0, C10:0, C18:0, C20:0, C22:0, and all of the unsaturated FAs were mainly located at the sn-1 and sn-3 positions, while C14:0, C15:0, and C16:0 were mainly at the sn-2 position. The proportion of C12:0 and C17:0 at sn-2 was approximately equivalent to that at the sn-1, 3 positions. Conclusions: The results indicate the variability in the FA profile of HM between regions and lactation stages. The contents of polyunsaturated FAs and sn-2 FAs, especially palmitic acid, should be paid more attention when optimizing infant formula.
Distinguishing Choroidal Nevi from Melanomas Using the MOLES Algorithm: Evaluation in an Ocular Nevus Clinic
Authors: Al Harby Lamis , Sagoo Mandeep S. , O’Day Roderick , Hay Gordon , Arora Amit K. , Keane Pearse A. , Cohen Victoria M.-L. , Damato Bertil
Published: March 2021

Objective: The aim of this study was to determine the sensitivity and specificity of the MOLES scoring system in differentiating choroidal melanomas from nevi according to Mushroom shape, Orange pigment, Large tumor size, Enlarging tumor, and Subretinal fluid (SRF). Methods: Color photographs, fundus-autofluorescence images, and optical coherence tomography of 222 melanocytic choroidal tumors were reviewed. Each MOLES feature was retrospectively scored between 0 and 2 and tumors categorized as “common nevus,” “low-risk nevus,” “high-risk nevus,” and “probable melanoma” according to the total score. MOLES scores were compared with the experts’ diagnosis of melanoma. Results: The MOLES scoring system indicated melanoma in all 81 tumors diagnosed as such by ocular oncologists (100% sensitivity) and nevus in 135 of 141 tumors given this diagnosis by these experts (95.7% specificity). Of the 6 tumors with discordant diagnoses, 4 had basal diameters exceeding 6 mm, all with SRF and/or orange pigment, and 2 small tumors showed either significant SRF with traces of orange pigment, or vice versa. Conclusions: The MOLES system for diagnosing melanocytic choroidal tumors compares well with expert diagnosis but needs to be evaluated when deployed by ophthalmologists and community optometrists in a wide variety of working environments.
Implementing Medical Chatbots: An Application on Hidradenitis Suppurativa
Authors: Walss Manuel , Anzengruber Florian , Arafa Ahmed , Djamei Vahid , Navarini Alexander A.
Published: March 2021

Background: The use of digital health resources is growing quickly as they are easily accessible and permit self-evaluation. Yet, research on consumer health informatics platforms is insufficient. Chatbots, interactive conversational platforms based on artificial intelligence, can facilitate access to specific information. Hidradenitis suppurativa (HS) is burdensome and has a high threshold for consultation. Objectives: We aimed to identify the most important principles for the assembly of medical chatbots through the analysis of usage data. Methods: The HS Chatbot1 is a question-and-answer platform in the style of a chatbot. Usage data were collected over the course of a year. 254 responses were statistically analysed. Results: 239 users were alleged patients. 82.9% were looking for a tentative diagnosis. The users were on average 32.49 (±11.33) years old and predominantly female (70.2%). The average number of clicks per visit on the website was 14.69 (±8.83). Conclusions: A medical chatbot has to be customised to the specific subject whilst general principles have to be considered. High-quality information has to be available in just a few clicks. People concerned about HS are looking for a diagnosis online and often have not seen a doctor previously. Guidance towards appropriate care should be provided.
The Role of Immune-Related Adverse Events in Prognosis and Efficacy Prediction for Patients with Non-Small Cell Lung Cancer Treated with Immunotherapy: A Retrospective Clinical Analysis
Authors: Sonehara Kei , Tateishi Kazunari , Araki Taisuke , Komatsu Masamichi , Yamamoto Hiroshi , Koizumi Tomonobu , Hanaoka Masayuki
Published: March 2021

Purpose: The development of immune-related adverse events (irAEs) in patients undergoing immunotherapy has been reported to be a favorable prognostic factor in several studies. We aimed to examine the correlation between irAEs and prognosis in patients with non-small cell lung cancer (NSCLC) and further reveal the patient characteristics associated with response to immunotherapy among treatment responders who developed irAEs. Methods: We retrospectively enrolled 80 patients with NSCLC who received immunotherapy at Shinshu University Hospital between February 2016 and February 2020. Progression-free survival (PFS) and overall survival (OS) were compared between patients with and those without irAEs. We examined the prognostic factors associated with PFS and OS using univariate and multivariate Cox proportional-hazards models. We further analyzed the patients who developed irAEs by classifying them into responders and non-responders. Results: Twenty-five patients developed irAEs. The median PFS and OS of the patients with irAEs were significantly longer than those of the patients without irAEs (6.8 vs. 1.9 months, p < 0.001, and 37.8 vs. 8.1 months, p < 0.001, respectively). Multivariate analysis associated with PFS and OS indicated that the development of irAEs was an independent favorable prognostic factor. Among the patients developing irAEs, the responder group had a significantly higher incidence of multiple irAEs than the non-responder group (41.7 vs. 0.0%, p = 0.009). Conclusion: Our findings revealed that the development of irAEs was associated with clinical benefits in NSCLC patients who received immunotherapy. In particular, patients with multiple irAEs might have good prognoses.
An Evaluation of the Relationship between Retinal Nerve Fiber Thickness, Cochlear Nerve Thickness, the Level of Tinnitus, and Hearing Loss in Unilateral Tinnitus Patients
Authors: Avcu Mustafa , Metin Mehmet , Kılıç Raşit , Alpaslan Muhammed
Published: March 2021

Background: In this study, optic coherence tomography (OCT) examination was performed to check whether there was any interaction between ophthalmic axonal structures in unilateral tinnitus patients, and the relationship between optic nerve thickness and cochlear nerve thickness was evaluated. Objective: The aim of the study was to evaluate the relatioship between hearing loss, tinnitus, and nerve thicknesses. Study Design: Prospective study. Setting: Tertiary referral university hospital. Patients: The study included 88 patients with unilateral tinnitus, for which no organic cause could be found in physical examination, psychiatric evaluation, or with imaging methods. Study groups were formed of the tinnitus side and control groups were formed of the healthy side as follows: Group 1 (Non-tinnitus side normal hearing values – n = 30), Group 2 (non-tinnitus side minimal hearing loss – n = 27), Group 3 (non-tinnitus side moderate hearing loss – n = 31), Group 4 (tinnitus side normal hearing values – n = 25), Group 5 (tinnitus side minimal hearing loss – n = 25), and Group 6 (tinnitus side moderate hearing loss – n = 38). Intervention: Retinal nerve fiber layer (RNFL) thickness was evaluated with OCT, and the cochlear nerve cross-sectional area was evaluated with MRI. Main Outcome Measures: RNFL measurements were taken with OCT from the subfoveal area (RNFL-SF) and 1.5 mm temporal to the fovea (RNFL-T µm) and nasal (RNFL-N µm) sectors. On MRI, 3 measurements were taken along the nerve from the cerebellopontine angle as far as the internal auditory canal, and the mean value of these 3 measurements was calculated. Results: When the groups were evaluated in respect of cochlear nerve thickness, a significant difference was seen between Group 1 and both the groups with hearing loss and the tinnitus groups. In the subgroup analysis, a statistically significant difference was determined between Group 1 and Groups 3, 4, 5, and 6 (p = 0.013, p = 0.003, p < 0.001, and p < 0.001, respectively). When the groups were evaluated in respect of the RNFL-SF (µm), RNFL-T (µm), and RNFL-N (µm) values, the differences were determined to be statistically significant (p < 0.001 for all). In the correlation analysis, a negative correlation was determined between hearing loss and cochlear nerve diameter (r: −0.184, p = 0.014), and RNFL-N (r: −0.272, p < 0.001) and between tinnitus and cochlear nerve diameter (r: −0.536, p < 0.001), and RNFL-T (r: −0.222, p < 0.009). Conclusion: The study results clearly showed a relationship between cochlear nerve fiber thickness and hearing loss and the severity of tinnitus in cases with unilateral tinnitus and that there could be neurodegenerative factors in the disease etiology. A similar relationship seen with the RNFL supports the study hypothesis.
Burden of Treatment-Induced Peripheral Neuropathy in Patients with Multiple Myeloma in Sweden
Authors: Nahi Hareth , Walinder Göran , Patel Vishal , Qu Ying , Levine Aaron , Majer Istvan , Kutikova Lucie , Hellqvist Franck Eva , Svensson Maria K. , Hansson Markus
Published: March 2021

Introduction: Treatment-induced peripheral neuropathy (TIPN) is a complication of multiple myeloma (MM) treatment. Objective: This real-world, retrospective study used electronic medical record (EMR) data from 3 Swedish clinics to assess the occurrence and economic burden of TIPN in patients with MM. Methods: Eligible patients had an MM diagnosis in the Swedish Cancer Registry between 2006 and 2015 and initiated treatment during that period. Follow-up was until last EMR visit, death, or study end (April 2017). The current analyses included patients receiving bortezomib, lenalidomide, carfilzomib, or thalidomide at any treatment line. To discern healthcare resource utilization (HCRU) and costs associated with TIPN from other causes, patients with TIPN were matched with those without on baseline characteristics, treatment, and line of therapy. All analyses were descriptive. Results: Overall, 457 patients were included; 102 (22%) experienced TIPN. Patients experiencing TIPN during first-line treatment mostly received bortezomib-based regimens (n = 48/57 [84%]); those with TIPN during second- and third/fourth-line treatment mostly received lenalidomide/thalidomide-based regimens (19/31 [61%], 8/14 [57%], respectively). Patients with TIPN had higher HCRU/costs than those without TIPN (mean differences in hospital outpatient visits: 5.2, p = 0.0031; total costs per patient-year: EUR 17,183, p = 0.0007). Conclusions: Effective MM treatments associated with a reduced incidence of TIPN could result in decreased healthcare expenditure.
Real-World Experience of Endoscopic Submucosal Dissection for Ulcerative Colitis-Associated Neoplasia
Authors: Matsui Akira , Hoteya Shu , Hayasaka Junnosuke , Yamashita Satoshi , Ochiai Yorinari , Suzuki Yugo , Fukuma Yumiko , Okamura Takayuki , Mitsunaga Yutaka , Tanaka Masami , Nomura Kousuke , Dan Nobuhiro , Odagiri Hiroyuki , Kikuchi Daisuke
Published: March 2021

Introduction: Patients with ulcerative colitis (UC) have an increased risk of colorectal cancer. Some studies have recently investigated endoscopic resection of UC-associated neoplasia (UCAN), but the indications for endoscopic resection of UCAN remain controversial. This study sought to clarify the problems encountered in endoscopic submucosal dissection (ESD) for UCAN. Methods: Seventeen lesions in 12 patients with UCAN (UCAN group) and 913 epithelial lesions in 824 control patients without UC (non-UC group) were evaluated. Both groups underwent ESD between January 2010 and December 2017 at Toranomon Hospital, Tokyo, Japan. Treatment outcomes of the 2 groups were compared retrospectively. Results: Univariate analysis showed that the mean tumor size was significantly smaller in the UCAN group than in the non-UC group (25.1 ± 26.7 mm vs. 31.9 ± 19.0; p = 0.0023); however, the R0 resection rate was significantly lower in the UCAN group (70.6 vs. 92.9%; p = 0.001). Multivariate analysis showed a significantly lower negative horizontal margin rate in the UCAN group (odds ratio 11.3, 95% confidence interval 3.588–34.525; p = 0.000). Discussion/Conclusion: ESD for UCAN is associated with a low-negative horizontal margin rate. When performing ESD for UCAN, it is important to evaluate the accuracy of the UCAN demarcation line, especially for flat lesions, using white-light imaging and chromoendoscopy as well as other modalities, including biopsy of surrounding tissues.