bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of age-related macular degeneration on fracture risks among osteoporosis population: a nationwide population-based cohort study
Authors: Sun Chi Chin , Huang Ting-Shuo , Fu Tsai-Sheng , Lee Chia-Yi , Chen Bing-Yu , Chen Fang-Ping
Published: September 2020

Objectives

Visual impairment is an important risk factor for fracture in the elderly population. Age-related macular degeneration (AMD) is the leading cause of irreversible visual impairment in elderly people. This study was conducted to explore the relationship between AMD and incident fractures in patients with osteoporosis (OS).

Design

Retrospective analysis of Taiwan’s National Health Insurance Research Database (NHIRD).

Setting

A multicenter study conducted in Taiwan.

Participants and controls

The current study used the NHIRD in Taiwan between 1996 and 2011. A total of 13 584 and 54 336 patients with OS were enrolled in the AMD group and the non-AMD group, respectively.

Intervention

Patients with OS were included from the Taiwan’s NHIRD after exclusion, and each patient with AMD was matched for age, sex and comorbidities to four patients with non-AMD OS, who served as the control group. A Cox proportional hazard model was used for the multivariable analysis.

Primary outcome measures

Transitions for OS to spine fracture, OS to hip fracture, OS to humero-radio-ulnar fracture and OS to death.

Results

The risks of spine and hip fractures were significantly higher in the AMD group (HR=1.09, 95% CI=1.04 to 1.15, p<0.001; HR=1.18; 95% CI=1.08 to 1.30, p=0.001, respectively) than in the non-AMD group. The incidence of humero-radio-ulnar fracture between AMD and non-AMD individuals was similar (HR=0.98; 95% CI=0.90 to 1.06; p=0.599). However, the risk of death was higher in patients with OS with older age, male sex and all types of comorbidity (p<0.05), except for hyperthyroidism (p=0.200).

Conclusion

Patients with OS with AMD had a greater risk of spine and hip fractures than did patients without AMD.
Association between guidelines and medical practitioners’ perception of best management for patients attending with an apparently uncomplicated acute sore throat: a cross-sectional survey in five countries
Authors: Gunnarsson Ronny , Ebell Mark H , Wächtler Hannelore , Manchal Naveen , Reid Lynne , Malmberg Stefan , Hawkey Sean , Hay Alastair D , Hedin Katarina , Sundvall Pär-Daniel
Published: September 2020

Objective

To investigate the relationship between guidelines and the medical practitioners’ perception of optimal care for patients attending with an apparently uncomplicated acute sore throat in five countries (Australia, Germany, Sweden, UK and USA).

Design

International cross-sectional survey.

Setting

Primary healthcare (PHC).

Participants

Medical practitioners working in PHC.

Main outcome measures

ORs for: (A) perception of throat swabs as important, (B) perception of blood tests (C reactive protein, B-ESR and B-leucocytes) as important and (C) antibiotic prescriptions if no pathogenic bacteria isolated on throat swab.

Results

Guidelines differed significantly; those recommending throat swabs (Sweden and USA) were associated with practitioners perceiving them as important. The UK guideline was the only one actively discouraging the use of throat swabs. Hence, compared with the USA (reference), a throat swab showing no pathogenic bacteria increased the probability of antibiotic prescribing in the UK with OR 3.2 (95% CI 1.7 to 6.1) for adults, whereas it reduced the probability in Sweden for adults OR 0.35 (95% CI 0.13 to 0.96) and children 0.19 (95% CI 0.069 to 0.50).

Conclusions

The differences between practitioners’ perceptions of best management were associated with their guidelines. It remains unclear if guidelines influenced medical practitioners’ perception or if guidelines merely reflect the consensus of current practice. A larger effort should be made to reach an international consensus in high-income countries about the best management of patients attending for an uncomplicated acute sore throat.
Women and partners’ experiences of critical perinatal events: a qualitative study
Authors: Navne Laura Emdal , Høgh Stinne , Johansen Marianne , Svendsen Mette Nordahl , Sorensen Jette Led
Published: September 2020

Objective

The aim of this study was to explore women and partners’ experiences following critical perinatal events.

Design

This is a qualitative interview study. We conducted semistructured individual interviews with women and their partners in separate rooms. Interviews were analysed thematically and validated by a transdisciplinary group of anthropologists, obstetricians and a midwife.

Setting

Department of obstetrics at a tertiary referral university hospital in Denmark.

Participants

Women and partners who had experienced a critical perinatal event within the past 3–12 months.

Results

We conducted 17 interviews and identified three main themes: (1) ambivalence towards medicalisation, (2) the extended temporality of a critical birth and (3) postnatal loss of attention from healthcare professionals. Overall, participants expressed a high degree of trust in and quality of provided healthcare during the critical perinatal events. They experienced medicalisation (obstetric interventions) as a necessity, linking them to the safety of the child and their new role as responsible parents. However, some women experienced disempowerment when healthcare professionals overlooked their ability to stay actively involved during birth events. Postnatally, women and their partners experienced shortages of healthcare professional resources, absent healthcare and lack of attention.

Conclusions

Women and their partners’ experiences of critical perinatal events begin long before and end long after the actual moment of childbirth, challenging conventional ideas about the birth as being the pivotal event in making families. In future healthcare planning, it is important to to align expectations and guide parental involvement in birth events and to acknowledge the postnatal period as equally crucial.
Comprehensive Cervical Cancer Prevention in Tanzania (CONCEPT) study: Cohort profile
Authors: Mchome Bariki , Swai Patricia , Wu Chunsen , Katanga Johnson , Kahesa Crispin , Manongi Rachel , Mwaiselage Julius D , Kjaer Susanne , Rasch Vibeke , Linde Ditte Søndergaard
Published: September 2020

Purpose

Cervical cancer is a major cause of death among women in Eastern Africa, and the distribution of human papillomavirus (HPV) according to HIV status is inadequately characterised in this region. In order to guide future cervical cancer preventive strategies that involve HPV testing, the Comprehensive Cervical Cancer Prevention in Tanzania (CONCEPT) study was established in 2015. The CONCEPT cohort aims to investigate the natural history of HPV and determine acquisition and persistence patterns of high-risk (HR) HPV among HIV-positive and HIV-negative women. Further, the influence of lifestyle and sexual/reproductive factors will be investigated. The main objective of this article is to describe how the CONCEPT cohort was established.

Participants

Women aged 25–60 years were enrolled from cervical cancer screening clinics in Dar-es-Salaam and Moshi, Tanzania. Data were collected at baseline, at 14 months (first follow-up) and at 28 months (second follow-up). Biological samples included two cervical swabs for careHPV DNA testing, cytology, Hybrid Capture 2, genotyping and blood samples for HIV. Visual inspection with acetic acid was performed, and sociodemographic, lifestyle and sexual/reproductive characteristics were collected through a standardised questionnaire.

Findings to date

4043 women were included in the cohort from August 2015 to May 2017. At baseline, 696 (17.1%) women were HR HPV positive, and among these, 31.6% were HIV positive; 139 women (3.4%) had high-grade squamous intraepithelial lesions. 3074 women (81%) attended the first follow-up. The majority attended after receiving a phone call reminder (35%) or from home via self-samples (41%). At first follow-up, 438 (14.4%) were HR HPV positive and 30.4% of these were HIV positive.

Future plans

A second follow-up is underway (17 December 2018–October 2020). We plan to integrate our data with a previous cross-sectional HPV study from Tanzania to increase the power of our findings. Researchers interested in collaborating are welcomed, either by extracting data or jointly requesting further investigation from the cohort.
Avelumab for advanced Merkel cell carcinoma in the Netherlands: a real-world cohort
Authors: Levy Sonja , Aarts Maureen J B , Eskens Ferry A L M , Keymeulen Kristien B M I , Been Lukas B , Grünhagen Dirk , van Akkooi Alexander , Jalving Mathilde , Tesselaar Margot E T
Published: September 2020

Background

Merkel cell carcinoma (MCC) is associated with high recurrence rates and poor survival when metastatic disease is present. The immune checkpoint inhibitor avelumab has shown high response rates (RRs) and durable responses in patients with advanced MCC (aMCC) in clinical trials. To date, only results from clinical trials, patients treated in an expanded access program and very small numbers of patients have been reported. In this study, detailed real-world efficacy and toxicity data of avelumab in patients with aMCC are reported.

Methods

Patients with aMCC treated in four dedicated referral centers in the Netherlands were analyzed from February 2017 until December 2019. Patients were included if they had received at least one administration of avelumab, regardless of previous lines of therapy. Patient data were collected retrospectively from patient records. Primary endpoints were response rate (RR) and duration of response (DOR). Secondary endpoints were progression-free survival (PFS), overall survival (OS), and toxicity.

Results

Fifty-four patients received avelumab. Eight (15%) patients had locally advanced disease (laMCC). In 40 (74%) patients, avelumab was first-line treatment, these included all patients with laMCC. The median follow-up was 8.9 (range 0.5–35.9) months. RR was 57% (n=31) with 24% (n=13) of patients achieving a complete response. The median DOR was 8.4 (range 1.3–22.1) months and 23 (43%) patients had an ongoing response at the end of the study. The median PFS was 8.6 (95% CI 1.6–15.5) months, and the median OS was 25.8 (95% CI 9.1–42.4) months. Six (11%) patients experienced grade 3 toxicity. No grade 4–5 toxicity was seen.

Conclusions

In this real-world cohort, clinical efficacy and toxicity outcomes in clinical practice were in line with results from clinical trials and showed relatively high RRs and durable responses in patients with aMCC.
Tales of treatment and new perspectives for global health research on antimicrobial resistance
Authors: Haenssgen Marco J , Charoenboon Nutcha , Thavethanutthanawin Patthanan , Wibunjak Kanokporn
Published: September 2020

Global health champions modernism and biomedical knowledge but tends to neglect knowledge, beliefs and identities of rural communities in low-income and middle-income countries. The topic of antimicrobial resistance represents these common challenges, wherein the growing emphasis on public engagement offers a yet underdeveloped opportunity to generate perspectives and forms of knowledge that are not typically incorporated into research and policy. The medical humanities as an interdisciplinary approach to illness and health behaviour play a central role in cultivating this potential—in particular, through the field’s emphasis on phenomenological and intersubjective approaches to knowledge generation and its interest in dialogue between medicine, the humanities and the broader public.

We present a case study of public engagement that incorporates three medical humanities methods: participatory co-production, photographic storytelling and dialogue between researchers and the public. Situated in the context of northern Thailand, we explore subcases on co-production workshops with villagers, tales of treatment shared by traditional healers and dialogue surrounding artistic display in an international photo exhibition. Our starting assumption for the case study analysis was that co-produced local inputs can (and should) broaden the understanding of the sociocultural context of antimicrobial resistance.

Our case study illustrates the potential of medical humanities methods in public engagement to foreground cultural knowledge, personal experience and ‘lay’ sensemaking surrounding health systems and healing (including medicine use). Among others, the engagement activities enabled us to formulate and test locally grounded hypotheses, gain new insights into the social configuration of treatment seeking and reflect on the relationship between traditional healing and modern medicine in the context of antimicrobial resistance. We conclude that medical-humanities-informed forms of public engagement should become a standard component of global health research, but they require extensive evaluation to assess benefits and risks comprehensively.
Noreen Dale Lewis
Authors: Turner Sally ,   with contributions from Arlene Coulson, Gibbs Christine , McNeill Ewan
Published: September 2020

Despite being a naturally shy and private person, Noreen was also strong‐willed and independent. She made strong bonds with people, her pets and places, and she loved to travel.
Digestibility of amino acids in pigs fed distillers dried grains with solubles derived from corn, sorghum, and triticale
Authors: Park Chan Sol , Ragland Darryl , Adeola Olayiwola
Published: September 2020

An experiment was conducted to determine the standardized ileal digestibility (SID) of amino acids (AA) in distillers dried grains with solubles derived from corn (C-DDGS), sorghum (S-DDGS), and triticale (T-DDGS) fed to growing pigs. A total of 16 barrows [initial body weight (BW) = 23.1 ± 2.03 kg] surgically fitted with T-cannulas at the distal ileum were divided into four groups based on BW and assigned to a quadruplicated 4 × 2 incomplete Latin square design with four dietary treatments and two experimental periods. Three diets containing C-DDGS, S-DDGS, or T-DDGS, as well as a nitrogen-free diet, were fed in each experimental period consisting of 5 d of adaptation and 2 d of ileal digesta collection. Pigs fed S-DDGS had less (P < 0.05) SID of histidine, isoleucine, leucine, and methionine compared with those fed T-DDGS, which were less (P < 0.05) than the values observed for pigs fed C-DDGS. The SID of arginine, phenylalanine, threonine, and valine in C-DDGS were greater (P < 0.05) than in S-DDGS but were not different from those in T-DDGS. The SID of lysine in C-DDGS was greater (P < 0.05) than in S-DDGS and T-DDGS. In conclusion, AA in S-DDGS were less digestible than those in C-DDGS and T-DDGS.
LOCAL INSTITUTIONAL ENVIRONMENT AND STOCK PRICE CRASH RISK: EVIDENCE FROM CHINA
Authors: TANG XIAOJIAN , TSUI STEPHANIE , LO KUANG-TA
Published: September 2020

Based on province-level data on China’s local institutional environment from 2008 to 2014, we explore the relationship between the local institutional environment and stock price crash risk. We find that a stronger local institutional environment curbs stock price crash risk. Furthermore, we explore the relationship between local institutional environment and stock price crash risk for state-owned versus privately owned enterprises. We find that a stronger local institutional environment is more likely to curb stock price crash risk in state-owned enterprises than in privately owned enterprises. Our results are robust to additional tests. These findings suggest that it is necessary to accelerate the progress of local marketization in China to ensure the development of the stock market and a strong economy.
Hidden non-locality and self-superrenormalization of quantum gravity
Authors: Addazi Andrea
Published: September 2020

We show that the formation/evaporation of Black Holes (BH) unitarizes quantum gravity at all the orders of the perturbation theory. Non-perturbative quantum effects save the scattering amplitudes from any polynomial divergences. Such a phenomena is intimately related to the dynamical emergence of an effective non-locality as well as emergent modifications of the Heisenberg’s uncertainty principle. The BH production delocalizes quantum gravity vertices and propagators as a consequence of its holographically stored entropy. In this sense, quantum gravity is a superrenormalizable theory, although non-locality is hidden in its action.
INTEGRATION OF TAGUCHI ANALYSIS WITH PHANTOM AND INNOVATIVE GAUGES: OPTIMIZATION OF THE CT SCAN PROTOCOL FOR PERIPHERAL ARTERIAL OCCLUSIVE DISEASE (PAOD) SYNDROME
Authors: LEE TSUNG-MIN , LIN CHIEN-CHUNG , PENG BING-RU , PAN LUNG-FA , PAN LUNG-KWANG
Published: September 2020

The CT scan protocol optimization for peripheral arterial occlusive disease (PAOD) syndrome was performed by organizing seven CT factors [kVp, mAs, pitch, field of view (FOV) (mm), time of rotation (s), slice thickness (mm), and matrix size] into Taguchi unique [Formula: see text] orthogonal array. The minimum detectable difference (MDD) in the optimizing process was quantified by adopting a customized line group gauge. Besides, three qualified experts in radiology examined by the double-blind criterion the gauge scanned images and ranked them, yielding the optimal setting of CT scan protocols. The latter setting for PAOD included the kVp of 100, mAs of 240, pitch of 0.513, FOV of 320[Formula: see text]mm, rotation time of 0.75[Formula: see text]s, slice thickness of 4.0, and matrix size of [Formula: see text]. The ANOVA and revised Student’s [Formula: see text]-test verified the smallest MDD as 1.43[Formula: see text]mm at a 0.45-mm gauge depth. The ranking process, which makes it possible to magnify and emphasize the imaging correlation among groups, was found to be preferable to grading in the optimization process. The comparative analysis of various MDDs obtained from different medical facilities and literary sources was performed, which revealed that the cardiac X-ray provided the finest spatial resolution according to the quantified MDD. Meanwhile, the CT scan protocol for PAOD adopted in this study had finer MDD than that for the abdomen due to comparatively low kVp or/and mAs.
QUANTIFICATION OF MASS AND CENTER-OF-MASS OF HEALTHY AND AMPUTATED SEGMENTS AS WELL AS FULL-BODY CENTER-OF-MASS OF AMPUTEES
Authors: XU QINGHUA , WANG XIANGDONG , LIU JINGXIN , SHAN GONGBING
Published: September 2020

Quantification of segment-inertial uniqueness can provide a relevant foundation for motion analysis, biomechanical modeling and human motor skill optimization of both normal and amputated athletes. It is known that previous studies focused on quantifying Body Segment Inertial Parameters (BSIP) of non-amputated people in order to establish regression equations for calculating BSIPs. Until now, no anthropometrical study existed on quantifying BSIPs such as mass and center of mass (COM) of both non-amputated segment (NAS) and partially-amputated segment (PAS) of amputees. This study aims to fill the gap. A quantification method derived from Damavandi approach was applied to determine the mass and COM of PAS as well as full-body COM. For validating the reliability of this method, the calculated values were compared to the values measured by balance board test. Further, two anthropometrical approaches (i.e. Zheng and Zatsiorsky) for normal subjects were tested for their validity to estimatfe the mass and COM of NASs of amputees. The results reveal that Damavandi approach can also be used for reliable quantifying of mass and COM of PAS and Zatsiorsky’s approach is more reliable to quantify NAS masses and full-body COM of amputees, therefore, Damavandi approach and Zatsiorsky’s regression model are more suitable for motion analysis, biomechanical modeling and motor skill optimization of amputees.
On the co-movement of crude, gold prices and stock index in the Indian market
Authors: Sen Abhibasu , Choudhury Karabi Dutta
Published: September 2020

The nonlinear relationship in the joint time-frequency domain has been studied for the Indian National Stock Exchange (NSE) with the international Gold price and WTI Crude Price being converted from Dollar to Indian National Rupee based on that week’s closing exchange rate. Though a good correlation was obtained during some period, but as a whole no such cointegration relation can be found out. Using the Discrete Wavelet Analysis, the data was decomposed and the presence of Granger Causal relations was tested. Unfortunately, no significant relationships are being found. We then studied the Wavelet Coherence of the two pairs, namely NSE-Nifty & Gold and NSE-Nifty & Crude. For different frequencies, the coherence between the pairs have been studied. At lower frequencies, some relatively good coherence have been found.

In this paper, we report for the first time the co-movements between Crude Oil, Gold and Indian Stock Market Index using Wavelet Analysis (both Discrete and Continuous), a technique which is most sophisticated and recent in market analysis. Thus, for long-term traders they can include gold and/or crude in their portfolio along with NSE-Nifty index in order to decrease the risk (volatility) of the portfolio for the Indian Market. But for short-term traders, it will not be effective, not to include all the three in their portfolio.
Dynamic Upsampling of Smoke through Dictionary-based Learning
Authors: Bai Kai , Li Wei , Desbrun Mathieu , Liu Xiaopei
Published: September 2020

Simulating turbulent smoke flows with fine details is computationally intensive. For iterative editing or simply faster generation, efficiently upsampling a low-resolution numerical simulation is an attractive alternative. We propose a novel learning approach to the dynamic upsampling of smoke flows based on a training set of flows at coarse and fine resolutions. Our multiscale neural network turns an input coarse animation into a sparse linear combination of small velocity patches present in a precomputed over-complete dictionary. These sparse coefficients are then used to generate a high-resolution smoke animation sequence by blending the fine counterparts of the coarse patches. Our network is initially trained from a sequence of example simulations to both construct the dictionary of corresponding coarse and fine patches and allow for the fast evaluation of a sparse patch encoding of any coarse input. The resulting network provides an accurate upsampling when the coarse input simulation is well approximated by patches present in the training set (e.g., for re-simulation), or simply visually plausible upsampling when input and training sets differ significantly. We show a variety of examples to ascertain the strengths and limitations of our approach and offer comparisons to existing approaches to demonstrate its quality and effectiveness.
Early and Ultraearly Administration of Tranexamic Acid in Traumatic Brain Injury: Our 8-Year-Long Clinical Experience
Authors: Acar Nurdan , Canakci Mustafa Emin , Bilge Ugur
Published: September 2020

Introduction. The most important result of head trauma, which can develop with a blunt or penetrating mechanism, is traumatic brain injury. Tranexamic acid (TXA) can be used safely in multiple trauma. Recent studies showed that TXA can be useful in management of intracerebral hemorrhage, especially in reducing the amount of bleeding. The TXA given in the first 3 hours has been shown to reduce mortality. The aim of our study was to evaluate the effectiveness of tranexamic acid used in patients with traumatic brain injury. Method. Patients with trauma in the emergency room between January 2012 and January 2020 were screened in this retrospective study. The inclusion criteria were being over the age of 18 years, tranexamic acid administration in the emergency department, and traumatic brain injury on brain computerized tomography (CT) and control CT imaging after 6 hours. Results. The number of study patients was 51. The median score of GCS was 12.00 (8.00–15.00). Subdural hemorrhage and subarachnoid hemorrhage were the most common findings on brain CT scans. In the group TXA treatment for less than 1 hour, the arrival MAP was low and the pulse was high (p=0.022 and p=0.030, respectively). All the patients were admitted with multiple trauma. None of the 51 patients had thrombotic complications and died due to head injury. Conclusion. TXA appears to be a safe drug with few side effects in the short term in head injuries. According to our experience, it comes to mind earlier in multiple trauma, especially in head trauma with pelvic trauma.
A Method for Parameters Estimation in a Dynamical Model of Ebola Virus Transmission in Sierra Leone
Authors: Li Li , Du Li-Xia , Yan Ziheng , Zhang Jie , Wu Yong-Ping
Published: September 2020

Ebola is an infectious virus that causes Ebola hemorrhagic fever in primates and humans, which was first found in 1976. The Ebola virus outbreak in West Africa in 2014 was the largest ever. A lot of researchers use mathematical models to analyze the characteristics of infectious diseases. However, many parameters in the model cannot be estimated completely. To ease the difficulty, we proposed an approach to estimate the parameter based on genetic algorithm (GA). GA uses the natural selection method of the fittest to find the optimal solution of the model. The least residual squares sum is used as fitness function to measure the performance of GA in parameter estimation. Moreover, we used a dynamical model and the real data of Ebola in Sierra Leone to verify the validity of GA. The experimental results indicate that the GA has strong competitiveness compared with the classical method, and it is a feasible method for estimating the parameters of infectious disease models.
Enhanced Immunotherapy with LHRH-R Targeted Lytic Peptide in Ovarian Cancer
Authors: Kim Mark Seungwook , Ma Shaolin , Chelariu-Raicu Anca , Leuschner Carola , Alila Hector W. , Lee Sanghoon , Coleman Robert L. , Sood Anil K.
Published: September 2020

Here, we examined the role of EP-100 [luteinizing hormone-releasing hormone (LHRH) ligand joined to a lytic peptide], improving the efficacy of immune checkpoint blockade. LHRH-R–positive murine ovarian cancer cells (ID8, IG10, IF5, and 2C12) were sensitive to EP-100 and were specifically killed at low micromolar levels through LHRH-R. EP-100 increased PD-L1 levels on murine ovarian cancer cells. In vivo syngeneic mouse models (ID8 and IG10) demonstrated that single-agent EP-100 reduced tumor volume, tumor weight, and ascites volume. The greatest reductions in tumor and ascites volume were observed with the combination of EP-100 with an anti–PD-L1 antibody. Immune profiling analysis showed that the population of CD8+ T cells, natural killer cells, dendritic cells, and macrophages were significantly increased in tumor and ascitic fluid samples treated with anti–PD-L1, EP-100, and the combination. However, monocytic myeloid suppressor cells, B cells, and regulatory T cells were decreased in tumors treated with anti–PD-L1, EP-100, or the combination. In vitro cytokine arrays revealed that EP-100 induced IL1α, IL33, CCL20, VEGF, and Low-density lipoprotein receptor (LDLR) secretion. Of these, we validated increasing IL33 levels following EP-100 treatment in vitro and in vivo; we determined the specific biological role of CD8+ T-cell activation with IL33 gene silencing using siRNA and Cas9-CRISPR approaches. In addition, we found that CD8+ T cells expressed very low level of LHRH-R and were not affected by EP-100. Taken together, EP-100 treatment had a substantial antitumor efficacy, particularly in combination with an anti–PD-L1 antibody. These results warrant further clinical development of this combination.
CH7233163 Overcomes Osimertinib-Resistant EGFR-Del19/T790M/C797S Mutation
Authors: Kashima Kenji , Kawauchi Hiroki , Tanimura Hiromi , Tachibana Yukako , Chiba Takashi , Torizawa Takuya , Sakamoto Hiroshi
Published: September 2020

Osimertinib is the only EGFR-tyrosine kinase inhibitor (TKI) capable of overcoming EGFR-T790M–mutated NSCLC, but osimertinib-resistant EGFR triple mutations (Del19/T790M/C797S or L858R/T790M/C797S) have been reported. Although allosteric EGFR TKIs (e.g., EAI-045) that potentially overcome L858R/T790M/C797S have been identified, there are no effective inhibitors against Del19/T790M/C797S. In this study, we identified CH7233163 as having the potential to overcome EGFR-Del19/T790M/C797S. CH7233163 showed potent antitumor activities against tumor with EGFR-Del19/T790M/C797S in vitro and in vivo. In addition to EGFR-Del19/T790M/C797S, the characterization assays showed that CH7233163 more selectively inhibits various types of EGFR mutants (e.g., L858R/T790M/C797S, L858R/T790M, Del19/T790M, Del19, and L858R) over wild type. Furthermore, crystal structure analysis suggested that CH7233163 is a noncovalent ATP-competitive inhibitor for EGFR-Del19/T790M/C797S that utilizes multiple interactions with the EGFR's αC-helix-in conformation to achieve potent inhibitory activity and mutant selectivity. Therefore, we conclude that CH7233163 is a potentially effective therapy for osimertinib-resistant patients, especially in cases of EGFR-Del19/T790M/C797S.
A Rare Case of Neglected Rupture of Right Axillary Artery Pseudoaneurysm Mimicking a Soft Tissue Tumor
Authors: Setiawati Rosy , Varidha Vivid Umi , Guglielmi Giuseppe , Del Grande Filippo
Published: September 2020

Traumatic lesions of the axillary artery itself are limited to 2.9–9% of major arterial injuries. Pseudoaneurysms represent a pulsating encapsulated hematoma in communication with the lumen of a ruptured vessel. Traumatic pseudoaneurysm of the axillary artery is a rare sequela of injury to the shoulder region. We describe a case of posttraumatic pseudoaneurysm involving the axillary artery, which was initially misdiagnosed as an aggressive soft tissue tumor. The man presented 10 years after an injury from a fall from a tree with a slowly growing mass in the right upper limb region and reduced range of movement. This is a neglected case with a history of traditional massage. The patient presented a pathologic fracture of the right proximal humerus and dislocation of the glenohumeral joint. At the beginning, it was suggested to be a primary soft tissue tumor, but after several examinations, including comparable X-ray, ultrasound, and histopathology, the results did not support a soft tissue tumor. Magnetic resonance imaging and computed tomography angiography (CTA) finally confirmed the finding of a pseudoaneurysm of the right axillary artery associated with a huge hematoma with different age of the bleeding product and granulation tissue. This case demonstrates the necessity of early diagnosis of axillary artery pseudoaneurysm to prevent complications after a history of trauma. CTA is a useful modality to evaluate vascular injury and provides valuable information.
Omental Cyst – Rare Cause of Abdominal Pain in a 7-Year-Old Child: A Case Report
Authors: Sayeed Maimuna , Benzamin Md , Akter Sharmin , Mazumder Md. Wahiduzzaman , Karim A.S.M. Bazlul , Dey Bishnu Pada
Published: September 2020

Introduction: Abdominal pain is a common complaint in children. In most cases it may be functional. Among all organic causes, an abdominal cyst of omental or mesenteric origin is an uncommon etiology. Case Presentation: A 7-year-old girl presented with a short history of abdominal pain for 1 month associated with gradual abdominal distention. Physical examination revealed a large oval palpable firm, non-tender mass extending almost the whole abdomen. Imaging studies were suggestive of an intra-abdominal cyst, and the diagnosis was confirmed after exploratory laparotomy. The patient was managed surgically by enucleation of the cyst. Conclusion: Omental cysts are a rare benign condition, but should be considered as a diagnostic hypothesis in children with abdominal pain with or without a mass. It is difficult to diagnose an omental/mesenteric cyst clinically. A proper imaging study can guide the diagnosis. After confirming the diagnosis, the main treatment would be surgical excision.
Plasma Transfusion Practice in Adult Surgical Patients: Systematic Review of the Literature
Authors: Adam Elisabeth Hannah , Fischer Dania
Published: September 2020

Background: Plasma transfusions are most commonly used therapeutically for bleeding or prophylactically in non-bleeding patients prior to invasive procedures or surgery. Although plasma transfusions generally seem to decline, plasma usage for indications that lack evidence of efficacy prevail. Summary: There is wide international, interinstitutional, and interindividual variance regarding the compliance with guidelines based on published references, supported by appropriate testing. There is furthermore a profound lack of evidence from randomized controlled trials comparing the effect of plasma transfusion with that of other therapeutic interventions for most indications, including massive bleeding. The expected benefit of a plasma transfusion needs to be balanced carefully against the associated risk of adverse events. In light of the heterogeneous nature of bleeding conditions and their rapid evolvement over time, fibrinogen and factor concentrate therapy, directed at specific phases of coagulation identified by alternative laboratory assays, may offer advantages over conventional blood product ratio-driven resuscitation. However, their outcome benefit has not been demonstrated in well-powered prospective trials. This systematic review will detail the current evidence base for plasma transfusion in adult surgical patients.
Development of algorithm for identification of maligant growth in cancer using artificial neural network
Authors: Pandian R. , Kumar D.N.S. Ravi , Kumar R. Raja
Published: September 2020

The precise identification and characterization of small pulmonary nodules at low-dose CT is a necessary requirement for the completion of valuable lung cancer screening. It is compulsory to develop some automated tool, in order to detect pulmonary nodules at low dose ct at the beginning stage itself. The numerous algorithms had been proposed earlier by many researchers in the past, but, the accuracy of prediction is always a challenging task. In this work, an artificial neural network based methodology is proposed to find the irregular growth of lung tissues. Higher probability of detection is taken as a goal to get an automated tool, with great accuracy. The finest feature sets derived from Haralick Gray level co occurrence Matrix and used as the dimension reduction way for feeding neural network. In this work, a binary Binary classifier neural network has been proposed to identify the normal images out of all the images. The capability of the proposed neural network has been quantitatively computed using confusion matrix and found in terms of classification accuracy.
Hiding text in speech signal using K-means, LSB techniques and chaotic maps
Authors: Abduljaleel Iman Qays , Khaleel Amal Hameed
Published: September 2020

In this paper, a new technique that hides a secret text inside a speech signal without any apparent noise is presented. The technique for encoding the secret text is through first scrambling the text using Chaotic Map, then encoding the scraped text using the Zaslavsky map, and finally hiding the text by breaking the speech signal into blocks and using only half of each block with the LSB, K-means algorithms. The measures (SNR, PSNR, Correlation, SSIM, and MSE) are used on various speech files (“.WAV”), and various secret texts. We observed that the suggested technique offers high security (SNR, PSNR, Correlation, and SSIM) of an encrypted text with low error (MSE). This indicates that the noise level in the speech signal is very low and the speech purity is high, so the suggested method is effective for embedding encrypted text into speech files.
Cyber DoS attack based security simulator for VANET
Authors: Yasir Muntadher Naeem , Croock Muayad Sadik
Published: September 2020

At the late years, researches focused on the cyber Denial of Service (DoS) attacks in the Vehicle Ad hoc Networks (VANETS). This is due to high importance of ensuring the save receiving of information in terms of Vehicle to Vehicle (V2V), Vehicle to Infrastructure (V2I) and Vehicle to Road Side Unit (V2R). In this paper, a cyber-security system is proposed to detect and block the DoS attacks in VANET. In addition, a simulator for VENAT based on lightweight authentication and key exchange is presented to simulate the network performance and attacks. The proposed system consists of three phases: registration, authentication as well as communications and DoS attack detection. These phases improve the system ability to detect the attacks in efficient way. Each phase working is based in a proposed related algorithm under the guidance of lightweight protocol. In order to test the proposed system, a prototype is considered includes six cars and we adopt police cars due to high importance of exchanged information. Different case studies have been considered to evaluate the proposed system and the obtained results show a high efficiency of performance in terms of information exchange and attack detection.
Design and implementation a network mobile application for plants shopping center using QR code
Authors: Nasir Saja , Al-Qaraawi Salih , Croock Muayad
Published: September 2020

During the revolution of developing mobile phone applications, they can be used in different fields like business, health, transportation, communications and tourism, and other uses. This paper presents QR based information management system for plants shopping centers. This system includes two main sides: mobile and server. The proposed application is used as a substitute for the human guide that each visitor needs in the plants shopping center. The complete information can be provided on any seedling displayed in the shop depending on the QR code technology. Each branch of the same enterprise includes sub-server that is linked to the main server using a private computer network. The server side contains information of all plants and all branches for such enterprise in the form of text and image in different languages. The proposed application facilitates the movement of the customer inside the place, the ease in preparing bills electronically that helps the visitor to save the time of queue to preparing the bill and paying. The proposed system is tested over different case studies to prove the efficiency in terms of information and selling management.
Design and optimization of cost-effective coldproof portable enclosures for polar environment
Authors: Parsi Behzad , Zhang Lihong
Published: September 2020

Based on the International Electrotechnical Commission standards,

the electronic devices in the industrial class (e.g., integrated circuits or batteries) can only operate at the ambient temperature between -40°C and 85°C. For the human-involved regions in Alaska, Northern Canada, and Antarctica, extreme cold condition as low as -55°C might affect sensing electronic devices utilized in the scientific or industrial applications. In this paper, we propose a design and optimization methodology for the self-heating portable enclosures, which can warm up the inner space from -55°C for encasing the low-cost industrial-class electronic devices instead of expensive military-class ones to work reliably within their allowed operating temperature limit. Among the other options, ceramic thermal resistors are selected as the heating elements inside the enclosure. The placement of the thermal resistors is studied with the aid of thermal modelling for the single heating device by using the curve fitting technique to achieve uniform temperature distribution within the enclosure. To maintain the inner temperature above -40°C but with the least power consumption from the thermal resistors, we have developed a control system based on the fuzzy logic controller. For validation, we have utilized COMSOL Multiphysics software and then one prototyped enclosure along with the fuzzy control system. Our experimental measurement exhibits its efficacy compared to the other design options.
Improving the delivered power quality from WECS to the grid based on PMSG control model
Authors: Hussien Shimaa A. , Deab M. A. , Hosny N. S.
Published: September 2020

Renewable energy has become one of the most energy resources nowadays, especially, wind energy. It is important to implement more analysis and develop new control algorithms due to the rapid changes in the wind generators size and the power electronics development in wind energy applications. This paper proposes a grid-connected wind energy conversion system (WECS) control scheme using permanent magnet synchronous generator (PMSG). The model works to improve the delivered power quality and maximize its value. The system contained one controller on the grid side converter (GSC) and two simulation packages used to simulate this model, which were PSIM software package for simulating power circuit and power electronics converters, and MATLAB software package for simulating the controller on Simulink. It employed a meta-heuristic technique to fulfil this target effectively. Mine-blast algorithm (MBA) and harmony search optimization technique (HSO) were applied to the proposed method to get the best controller coefficient to ensure maximum power to the grid and minimize the overshoot and the steady state error for the different control signals. The comparison between the results of the MBA and the HSO showed that the MBA gave better results with the proposed system.
Text documents clustering using modified multi-verse optimizer
Authors: Abasi Ammar Kamal , Khader Ahamad Tajudin , Al-Betar Mohammed Azmi , Naim Syibrah , Awadallah Mohammed A. , Alomari Osama Ahmad
Published: September 2020

In this study, a multi-verse optimizer (MVO) is utilised for the text document clus- tering (TDC) problem. TDC is treated as a discrete optimization problem, and an objective function based on the Euclidean distance is applied as similarity measure. TDC is tackled by the division of the documents into clusters; documents belonging to the same cluster are similar, whereas those belonging to different clusters are dissimilar. MVO, which is a recent metaheuristic optimization algorithm established for continuous optimization problems, can intelligently navigate different areas in the search space and search deeply in each area using a particular learning mechanism. The proposed algorithm is called MVOTDC, and it adopts the convergence behaviour of MVO operators to deal with discrete, rather than continuous, optimization problems.

For evaluating MVOTDC, a comprehensive comparative study is conducted on six text document datasets with various numbers of documents and clusters. The quality of the ﬁnal results is assessed using precision, recall, F-measure, entropy accuracy, and purity measures. Experimental results reveal that the proposed method performs competitively in comparison with state-of-the-art algorithms. Statistical analysis is also conducted and shows that MVOTDC can produce signiﬁcant results in comparison with three well-established methods.
Improving the initial values of VFactor suitable for balanced modulus
Authors: Somsuk Kritsanapong
Published: September 2020

The aim of this study is to estimate the new initial values of VFactor. In general, this algorithm is one of the members in a group of special proposed integer factorization algorithm. It has very high performance whenever the result of the difference between two prime factors of the modulus is a little, it is also called as balanced modulus. In fact, if this situation is occurred, RSA which is a type of public key cryptosystem will be broken easily. In addition, the main process of VFactor is to increase and decrease two odd integers in order to compute the multiplication until the targets are found. However, the initial values are far from the targets especially that the large value of the difference between two prime factors that is not suitable for VFactor. Therefore, the new initial values which are closer to the targets than the traditional values are proposed to decrease loops of the computation. In experimental results, it is shown that the loops can be decreased about 26% for the example of 256 bits-length of modulus that is from the small result of the difference between prime factors.
Optimizing RPL performance based on the selection of best route between child and root node using E-MHOF method
Authors: Zarzoor Ahmed R.
Published: September 2020

IETF has proposed the routing protocol for low power and lossy networks (RPL) for IOT as view as light weight routing protocol. In RPL, the objective function (OF) is used to select the best route between child and root node. Several researches have been conducted in order to, enhance OF according to number parameters such as number of hops, remaining energy and expected number of transmissions (ETX), without a consideration to other challenges such as congestion node problem and latency. So, to overcome these challenges a new technique called “Enhance-Minimum Rank with Hysteresis Objective Function (MHOF)” is proposed in this paper, to select the ideal path between the child and root node. The technique is consisted of three layers: parent selection layer in which parent is selected based on three parameters (ETX, RSSI and nodes’ residual energy), path selection layer in which the best route is chosen according to the minimum of (average ETX value) and maximum of (average remaining energy value) of all nodes in the selected route. The last layer is child node minimization, which utilized to solve the congestion node energy problem by using two parameters (RSSI reference and threshold value). The proposed method has been implemented and evaluated by using Cooja simulator software. The simulation results have shown that selected path with E-MHOF is increased the network lifetime and reduced latency in comparison with MHOF.
Modified hotelling’s T2 control charts using modified mahalanobis distance
Authors: Haddad Firas
Published: September 2020

This paper proposed new adjusted Hotelling’s T^2 control chart for individual observations. For this objective, bootstrap method for producing the individual observations were employed. To do so, both arithmetic mean vector and the covariance matrix in the traditional Hotelling’s T^2 chart were substituted by the trimmed mean vector and the covariance matrix of the robust scale estimators〖 Q〗_n, respectively which, in turn, its performance is carried out by simulated. In fact, the calculation of false alarms and the probability of detection outlier is used for determining the validity of this modified chart. The findings revealed a considerable significance in its performance.
Design of a model reference adaptive PID control algorithm for a tank system
Authors: Mfoumboulou Yohan Darcy
Published: September 2020

This paper describes the design of an adaptive controller based on model reference adaptive PID control (MRAPIDC) to stabilize a two-tank process when large variations of parameters and external disturbances affect the closed-loop system. To achieve that, an innovative structure of the adaptive PID controller is defined, an additional PI is designed to make sure that the reference model produces stable output signals and three adaptive gains are included to guarantee stability and robustness of the closed-loop system. Then, the performance of the model reference adaptive PID controller on the behaviour of the closed-loop system is compared to a PI controller designed on MATLAB when both closed-loop systems are under various conditions. The results demonstrate that the MRAPIDC performs significantly better than the conventional PI controller.