bluuebunny/crossref_metadata_2025 huggingface dataset:
The Potential of circRNA as a Novel Diagnostic Biomarker in Cervical Cancer
Authors: Chen Shuying , Yang Xiaoyi , Yu Chengxuan , Zhou Wenhan , Xia Qiuyi , Liu Ying , Chen Qiudan , Chen Xiaotong , Lv Yuan , Lin Yong
Published: April 2021

Cervical cancer is the fourth most common cancer among females worldwide. In spite of advances in detection and treatment, it is still one of the most dangerous gynecological malignancies in the world, especially in developing countries, and seriously threatens human health. Circular RNA (circRNA) is a special new type of endogenous noncoding RNA discovered recently. They form a covalently closed continuous loop and are specifically expressed in the eukaryotic transcriptome. With further understanding of circular RNA, a large number of studies have determined the key regulatory role of circRNA in a variety of diseases, especially cancer (including cervical cancer, liver cancer, and lung cancer). In addition, it has also been found that the abnormal expression of circRNA is related to its pathological characteristics in cervical cancer tissue, which can be used as a potential indicator for early screening and diagnosis of cervical cancer, targeted therapy, and prognosis prediction. This article summarizes the recent research achievements of circRNAs in cervical cancer. We briefly described the abnormal expression of circRNA in cervical cancer and discussed the involvement of circRNA in the occurrence process of cervical cancer by regulating cell proliferation, migration, invasion, and apoptosis. We believe that circRNA has potential value as a biomarker in the diagnosis and prognosis of cervical cancer.
The Galerkin Method for Fourth-Order Equation of the Moore–Gibson–Thompson Type with Integral Condition
Authors: Mesloub Ahlem , Zaraï Abderrahmane , Mesloub Fatiha , Cherif Bahri-Belkacem , Abdalla Mohamed
Published: April 2021

In this manuscript, we consider the fourth order of the Moore–Gibson–Thompson equation by using Galerkin’s method to prove the solvability of the given nonlocal problem.
Second‐Order Delay Differential Equations to Deal the Experimentation of Internet of Industrial Things via Haar Wavelet Approach
Authors: Xuan Yongtao , Amin Rohul , Zaman Fakhar , Khan Zohaib , Ullah Imad , Nazir Shah
Published: April 2021

In this article, an efficient numerical approach for the solution of second‐order delay differential equations to deal with the experimentation of the Internet of Industrial Things (IIoT) is presented. With the help of the Haar wavelet technique, the considered problem is transformed into a system of algebraic equations which is then solved for the required results by using Gauss elimination algorithm. Some numerical examples for convergence of the proposed technique are taken from the literature. Maximum absolute and root mean square errors are calculated for various collocation points. The results show that the Haar wavelet method is an effective method for solving delay differential equations of second order. The convergence rate is also measured for various collocation points, which is almost equal to 2.
Collaborative Filtering Recommendation Algorithm for MOOC Resources Based on Deep Learning
Authors: Wu Lili
Published: April 2021

In view of the poor recommendation performance of traditional resource collaborative filtering recommendation algorithms, this article proposes a collaborative filtering recommendation model based on deep learning for art and MOOC resources. This model first uses embedding vectors based on the context of metapaths for learning. Embedding vectors based on the context of metapaths aggregate different metapath information and different MOOCs may have different preferences for different metapaths. Secondly, to capture this preference drift, the model introduces an attention mechanism, which can improve the interpretability of the recommendation results. Then, by introducing the Laplacian matrix into the prior distribution of the hidden factor feature matrix, the relational network information is effectively integrated into the model. Finally, compared with the traditional model using the scoring matrix, the model in this article using text word vectors effectively alleviates the impact of data sparsity and greatly improves the accuracy of prediction. After analyzing the experimental results, compared with other algorithms, the resource collaborative filtering recommendation model proposed in this article has achieved better recommendation results, with good stability and scalability.
Some Methods about Finding the Exact Solutions of Nonlinear Modified BBM Equation
Authors: Niu Fan , Qi Jianming , Zhou Zhiyong
Published: April 2021

Finding exact solutions of nonlinear equations plays an important role in nonlinear science, especially in engineering and mathematical physics. In this paper, we employed the complex method to get eight exact solutions of the modified BBM equation for the first time, including two elliptic function solutions, two simply periodic solutions, and four rational function solutions. We used the exp

−
ϕ

z

-expansion methods to get fourteen forms of solutions of the modified BBM equation. We also used the sine-cosine method to obtain eight styles’ exact solutions of the modified BBM equation. Only the complex method can obtain elliptic function solutions. We believe that the complex method presented in this paper can be more effectively applied to seek solutions of other nonlinear evolution equations.
Prevalence and Risk Factors of Gestational Diabetes Mellitus among Women Attending Antenatal Care in Hadiya Zone Public Hospitals, Southern Nation Nationality People Region
Authors: Larebo Yilma Markos , Ermolo Niggussie Abebe
Published: April 2021

Introduction. In low‐ and middle‐income countries, gestational diabetes mellitus is increasing globally; it is also a double burden of illness for both mothers and children. While gestational diabetes mellitus is recognized in Ethiopia, according to recent diagnostic criteria, information regarding it remains scarce. Objective. To assess the prevalence of gestational diabetes mellitus and associated factors among women attending antenatal care in Hadiya Zone public Hospitals, Southern Ethiopia. Methods. An institution‐based cross‐sectional research on a total of 470 pregnant mothers was conducted in the Hadiya Region from August 2019 to December 2020. Finally, via the systematic random sampling process, the study subjects were chosen. A two‐hour oral glucose tolerance test of 75 g was used to conduct the universal one‐step screening and diagnostic technique. Bivariate and multivariate analyses were used to identify factors associated with gestational diabetes mellitus. Results. Gestational diabetes mellitus prevalence was 26.2% (95% CI, 21.8, 30.5). Urban residents (AOR: 2.181; 95% CI: 1.274, 3.733), primary education (AOR:2.286; 95% CI: 1.396, 3.745), without previous history of abortion (AOR: 0.097; 95% CI: 0.048, 0.196), with history of late gestational age in weeks (29‐32) (AOR: 0.393; 95% CI: 0.213, 0.723), with no history of coffee drinking (AOR: 2.704; 95% CI: 1.044, 7.006), and adequate dietary diversity (AOR: 2.740; 95% CI: 1.585, 4.739) were significantly associated with gestational diabetes mellitus. Conclusion. In Hadiya Zone public Hospitals, the prevalence of gestational diabetes mellitus among women attending antenatal treatment was higher compared to other studies conducted. The urban residents, primary schooling, no prior history of abortion, late gestational age, no history of coffee drinking, and sufficient dietary diversity were significantly linked with gestational diabetes mellitus. To enhance maternal and child health, reinforcing screening, treatment, and prevention strategies for gestational diabetes mellitus is essential.
Identification of Inflammatory Genes, Pathways, and Immune Cells in Necrotizing Enterocolitis of Preterm Infant by Bioinformatics Approaches
Authors: Zhang Lili , Sun Lizhen , Wu Mingli , Huang Jie
Published: April 2021

Background. Necrotizing enterocolitis (NEC) is one of the most serious gastrointestinal disease‐causing high morbidity and mortality in premature infants. However, the underlying mechanism of the pathogenesis of NEC is still not fully understood. Methods. RNA sequencing of intestinal specimens from 9 NEC and 5 controls was employed to quantify the gene expression levels. RNA sequencing was employed to quantify the gene expression levels. DESeq2 tool was used to identify the differentially expressed genes. The biological function, pathways, transcription factors, and immune cells dysregulated in NEC were characterized by gene set enrichment analysis. Results. In the present study, we analyzed RNA sequencing data of NECs and controls and revealed that immune‐related pathways were highly activated, while some cellular responses to external stimuli‐related pathways were inactivated in NEC. Moreover, B cells, macrophages M1, and plasma cells were identified as the major cell types involved in NEC. Furthermore, we also found that inflammation‐related transcription factor genes, such as STAT1, STAT2, and IRF2, were significantly activated in NEC, further suggesting that these TFs might play critical roles in NEC pathogenesis. In addition, NEC samples exhibited heterogeneity to some extent. Interestingly, two subgroups in the NEC samples were identified by hierarchical clustering analysis. Notably, B cells, T cells, Th1, and Tregs involved in adaptive immune were predicted to highly infiltrate into subgroup I, while subgroup II was significantly infiltrated by neutrophils. The heterogeneity of immune cells in NEC indicated that both innate and adaptive immunes might induce NEC‐related inflammatory response. Conclusions. In summary, we systematically analyzed inflammation‐related genes, signaling pathways, and immune cells to characterize the NEC pathogenesis and samples, which greatly improved our understanding of the roles of inflammatory responses in NEC.
Study of Groove Parameters on the Hydrodynamic Behavior of Spiral-Grooved Thrust Bearing with Gas Lubricant
Authors: Xia Xianfei , Chen Yu , Wang Xiuying , Sun Yu
Published: April 2021

The gas-lubricated thrust bearing is widely used in agriculture mechanical systems, and the groove shape plays an important role on the hydrodynamic behavior of spiral-grooved thrust bearing (SGTB). Although the groove shape may change smaller, it is clear that the hydrodynamic response is very sensitive to the groove parameters. This paper proposes a computational method for the analysis of SGTB with gas lubricant, considering the effects of groove parameters. With the compressibility taken into account, the evaluation of lubrication performance for SGTB is obtained by the CFD technology. Also, the simulation results are compared with the published data, which indicates that the presented model of SGTB is able to obtain more realistic results of hydrodynamic characteristics of SGTB. Moreover, the mapping relationship between groove parameter and hydrodynamic behavior of SGTB is represented.
Pricing of American Carbon Emission Derivatives and Numerical Method under the Mixed Fractional Brownian Motion
Authors: Wang Yuling , Wang Jing
Published: April 2021

This paper studies the pricing of American carbon emission derivatives and its numerical method under the mixed fractional Brownian motion. To capture the long memory properties such as self-similarity and long-range dependence in the price process, we proposed a model based on a fractional Black–Scholes, which is more in line with the actual characteristics of the option market. We have outlined a power penalty approach using parabolic variation inequality and linear complementarity (LCP) which arises from mixed fractional Brownian motion. In addition, we introduced a nonuniform grid-based modification of the fitted finite volume method for numerical solution. Numerically, we show the impact of Hurst exponent on the pricing and analyze the convergence rates of the proposed penalty method. In conclusion, since mfBm is a well-developed mathematical model of strongly correlated stochastic processes, this model will be an efficient model for pricing carbon financial derivative.
Extensive Mycobacterium abscessus Pneumonia in an Immunocompetent Infant with No Underlying Lung Pathology
Authors: Alramadhan Morouge M. , Murphy James R. , Chang Michael L.
Published: April 2021

Pulmonary infection due to Mycobacterium abscessus occurs in patients with cystic fibrosis, but rarely in immunocompetent children without underlying lung pathology. Treatment is complicated by frequent resistance to many antibiotics. We present a case report of a 4-month-old female infant with 2 months of cough, difficulty feeding, and failure to thrive, with extensive culture-confirmed M. abscessus pulmonary infection without identified immunodeficiency or underlying lung pathology following multidisciplinary evaluation. We describe our complete evaluation including immunodeficiency evaluation incorporating whole-exome sequencing, describe our antibiotic selection and treatment duration given complicated susceptibility pattern of the M. abscessus isolate, and review literature for nontuberculous mycobacterial pulmonary disease in immunocompetent children. A complete multidisciplinary evaluation for underlying lung disease and primary and acquired immunodeficiency should be undertaken in pediatric patients with M. abscessus pneumonia. Confirming macrolide susceptibility through erm(41) gene evaluation is clinically important for isolates with complicated susceptibility pattern.
ROS‐Triggered Autophagy Is Involved in PFOS‐Induced Apoptosis of Human Embryo Liver L‐02 Cells
Authors: Zeng Huai-cai , Zhu Bi-qi , Wang You-quan , He Qing-zhi
Published: April 2021

The liver is the primary target organ for perfluorooctane sulphonate (PFOS), a recently discovered persistent organic pollutant. However, the mechanisms mediating hepatotoxicity remain unclear. Herein, we explored the relationship between reactive oxygen species (ROS) and autophagy and apoptosis induced by PFOS in L‐02 cells, which are incubated with different concentrations of PFOS (0, 50, 100, 150, 200, or 250 μmol/L) for 24 or 48 hrs at 37°C. The results indicated that PFOS exposure decreased cell activities, enhanced ROS levels in a concentration‐dependent manner, decreased mitochondrial membrane potential (MMP), and induced autophagy and apoptosis. Compared with the control, 200 μmol/L PFOS increased ROS levels; enhanced the expression of Bax, cleaved‐caspase‐3, and LC3‐II; induced autophagy; decreased MMP; and lowered Bcl‐2, p62, and Bcl‐2/Bax ratio. The antioxidant N‐acetyl cysteine (NAC) protected MMP against PFOS‐induced changes and diminished apoptosis and autophagy. Compared with 200 μmol/L PFOS treatment, NAC pretreatment reversed the increase in ROS, Bax, and cleaved‐caspase‐3 protein caused by PFOS, lowered the apoptosis rate increased by PFOS, and increased the levels of MMP and Bcl‐2/Bax ratio decreased by PFOS. The autophagy inhibitor 3‐methyladenine and chloroquine decreased apoptosis and cleaved‐caspase‐3 protein level and increased the Bcl‐2/Bax ratio. In summary, our results suggest that ROS‐triggered autophagy is involved in PFOS‐induced apoptosis in L‐02 cells.
Detection of Fatigue Microcrack Using Eddy Current Pulsed Thermography
Authors: Zhang Xiang , Peng Jianping , Du Luquan , Bai Jie , Feng Lingfan , Guo Jianqiang , Gao Xiaorong
Published: April 2021

Microcracks are a common metallic defect, resulting in degradation of material properties. In this paper, specimens with different fatigue microcracks were detected by eddy current pulsed thermography (ECPT). Signal processing algorithms were investigated to improve the detectability and sensitivity; principal component analysis (PCA) and Tucker decomposition were used to compare the performance of microcrack detection. It was found that both algorithms were highly adaptable. A thermal quotient was used to assess the temperature variation trend. Furthermore, the potential correspondence between crack closure and temperature change was investigated.
The Herd Behavior on Peer-To-Peer Online Lending Markets: Evidence from China
Authors: Liu Rong , Chen Ningning , Li Yuelei
Published: April 2021

Based on the transaction data and related borrowers’ characteristics of Renrendai.com, this study conducts an empirical study on the influencing factors of the investor’s herd behavior and rationality of herd behavior on a Chinese online lending platform. We mainly find that investors’ herd behavior exists significantly on Renrendai.com; there is an “inverted U-shaped” relationship between the number of bids and the herd behavior of investors. When the number of bids exceeds a certain amount, the time required for the order to obtain another bid will be prolonged, and the investors’ herd behavior will be slowed down; herd behavior on Renrendai.com in Chinese market is a partly rational pursuit, but irrational in general.
Breakpoints for the Classification of Anti‐Candida Compounds in Antifungal Screening
Authors: Alves Danielle da Nóbrega , Ferreira Alana Rodrigues , Duarte Allana Brunna Sucupira , Melo Ana Karoline Vieira , de Sousa Damião Pergentino , Castro Ricardo Dias de
Published: April 2021

Introduction. The absence of a standardized classification scheme for the antifungal potency of compounds screened against Candida species may hinder the study of new drugs. This systematic review proposes a scheme of interpretative breakpoints for the minimum inhibitory concentration (MIC) of bioactive compounds against Candida species in in vitro tests. Materials and Methods. A literature search was conducted in the PubMed, Scopus, Web of Science, Lilacs, and SciFinder databases for the period from January 2015 to April 2020. The following inclusion criterion was used: organic compounds tested by the microdilution technique according to the Clinical and Laboratory Standards Institute protocol against reference strains of the genus Candida. A total of 545 articles were retrieved after removing duplicates. Of these, 106 articles were selected after applying the exclusion criteria and were evaluated according to the number of synthesized molecules and their chemical classes, the type of strain (reference or clinical) used in the antifungal test, the Candida species, and the MIC (in μg/mL) used. Results. The analysis was performed based on the median, quartiles (25% and 75%), maximum, and minimum values of four groups: all strains, ATCC strains, C. albicans strains, and C. albicans ATCC strains. The following breakpoints were proposed to define the categories: MIC < 3.515 μg/mL (very strong bioactivity); 3.516‐25 μg/mL (strong bioactivity); 26‐100 μg/mL (moderate bioactivity); 101‐500 μg/mL (weak bioactivity); 500‐2000 μg/mL (very weak bioactivity); and >2000 μg/mL (no bioactivity). Conclusions. A classification scheme of the antifungal potency of compounds against Candida species is proposed that can be used to identify the antifungal potential of new drug candidates.
3D Printing in Construction: Current Status, Implementation Hindrances, and Development Agenda
Authors: Ning Xin , Liu Tong , Wu Chunlin , Wang Chao
Published: April 2021

3D printing (3DP) is regarded as an innovation that contributes to automation in civil engineering and offers benefits in design, greenness, and efficiency. It is necessary to objectively analyze the current status and challenges associated with 3DP and identify future research directions to properly understand its construction applications. Previous research has focused more on the technical dimension of 3DP; however, the nontechnical dimension of the technology may hinder its implementation and thus must be paid particular attention to. This study presents a systematic review of the existing literature from both technical and nontechnical dimensions by combining quantitative and qualitative studies. The quantitative study was conducted using scientometric methods. The qualitative study analyzed information, including the technical research status and nontechnical challenges and trends. Two aspects of technical research status are presented, including materials and processes. In addition, nontechnical challenges and trends from the economic, environmental, social, and legislative aspects are proposed. This study provides a comprehensive agenda to advance 3DP in construction and proposes research interests, challenges, and future topics. It is intended to help construction practitioners systematically master existing processes and materials and assess the application degree and necessity of 3DP.
The Net in a Fuzzy Soft Topological Space and Its Applications
Authors: Gao Rui , Wu Jianrong
Published: April 2021

In this paper, the fuzzy soft net is explored to study the properties of a fuzzy soft topological space. Some important results about the closure, separation, and compactness are obtained. It is demonstrated that the net is a powerful tool for studying fuzzy soft topological spaces.
Technoeconomic Performance Analysis of Solar Tracking Methods for Roof-Type Solar Power Plants and Electric Vehicle Charging Stations
Authors: Boyekin Tahsin , Kıyak İsmail
Published: April 2021

In building integrated photovoltaic (BIPV) solar energy projects, cost effectiveness, durability, and long-term reliability are among the criteria that should be taken into consideration as well as the gain in electricity generation efficiency. Also, in a study, it is stated that a dual-axis solar tracking system occupies approximately 100% more space than a single-axis system and 160% more than a fixed-angle system. It has been observed that most of the studies that are mounted on the building and include a tracking system are small-scale experimental studies. The aim of this article is to present a systematic analysis with a low investment cost, a low operating cost, and high reliability, in a real application especially for roof applications in buildings. Three buildings in the same location and with the same roof area were selected. Photovoltaic power plants with 23.68 kW power were installed; these panels had three types: fixed-angle, manually controlled, and single-axis solar tracking systems. The energy generation system is connected to the network with a double-sided meter, and there is a double-sided energy flow. The energy produced is used to meet the energy needs of the vehicle charging station and common areas of the buildings. Although the single-axis tracking system is 27.85% more efficient than other energy generation methods, the manually adjusted method has proven to have the shortest amortization time. The study also presents shading, which is a serious problem in large-scale roof projects, and the area covered by the module per unit watt produced.
Wasserstein Metric-Based Location Spoofing Attack Detection in WiFi Positioning Systems
Authors: Tian Yinghua , Zheng Nae , Chen Xiang , Gao Liuyang
Published: April 2021

WiFi positioning systems (WPS) have been introduced as parts of 5G location services (LCS) to provide fast positioning results of user devices in urban areas. However, they are prominently threatened by location spoofing attacks. To end this, we present a Wasserstein metric-based attack detection scheme to counter the location spoofing attacks in the WPS. The Wasserstein metric is used to measure the similarity of each two hotspots by their signal’s frequency offset distribution features. Then, we apply the clustering method to find the fake hotspots which are generated by the same device. When applied with WPS, the proposed method can prevent location spoofing by filtering out the fake hotspots set by attackers. We set up experimental tests by commercial WiFi devices, which show that our method can detect fake devices with 99% accuracy. Finally, the real-world test shows our method can effectively secure the positioning results against location spoofing attacks.
Research on the Influence of Wheel Polygonization on Axle Stress
Authors: Zhang Fubing , Wang Qunsheng , Zhang Zhengqiao , Zhu Bin , Yang Zhenhuan
Published: April 2021

To study the influence of wheel polygonization on the dynamic stress of the wheel axle, a vehicle‐track rigid‐flexible coupling dynamic model was established. In the model, the wheelset, axle box, and track system were modelled as flexible bodies to consider the influence of elastic vibration. At the same time, the dynamic stress on key positions of the axle under the wheel polygonization excitation was measured on the high‐frequency vibration test rig. The accuracy of the model was verified by comparison with the test results. The wheel axle stress under the excitation of the wheel polygonization with different orders, wave depths, and running speed was calculated. The results show that the wheel polygonization can increase the amplitude of the axle dynamic stress, and the larger the wave depth of the wheel polygonization, the larger the stress amplitude. When the wheel polygonization frequency is close to the frequency of the wheelset elastic vibration mode, the wheelset first‐order bending and second‐order bending modes have a great influence on the axle stress. The resonance vibration of the wheelset elastic modal can cause the dynamic stress on key positions of the axle increase sharply.
The Role of Angiotensin Antagonism in Coronary Plaque Regression: Insights from the Glagovian Model
Authors: Alkatiri Abdul H. , Firman Doni , Alkatiri Amir A. , Suryajaya Paskalis I. , Sudharsono Albert
Published: April 2021

The benefit of antagonizing the effect of the renin angiotensin aldosterone system (RAAS), notably by the use of angiotensin-converting enzyme inhibitor (ACEi) and angiotensin II type 1 receptor blocker (ARB) for coronary artery disease (CAD), has been demonstrated in multiple studies, which may be attributed to their ability to inhibit the deleterious effect of RAAS to the cardiovascular system. It is well known that angiotensin II (Ang II) plays a vital role in atheromatous plaque formation and progression through multiple pathways, including inflammatory and arterial remodeling aspects. Significant coronary atheromatous plaque regression has been previously demonstrated in various studies using statin agents. Similar results have been reported in different studies using angiotensin inhibitor agents, notably ARB agents. Analysis from various trials utilizing ARB showed a significant plaque regression using olmesartan and telmisartan as evaluated by IVUS studies. In contrary, the use of ACEi did not demonstrated significant plaque regression, which may be attributed to the heavy plaque calcification in respective studies. On this review, we aim to present the basic mechanism on the role of RAAS in plaque modulation and its arterial remodeling aspect, which is then integrated with the clinical evidence based on the available intravascular ultrasonography (IVUS) studies on coronary arteries.
Self-Assembly Iron Oxide Nanoclusters for Photothermal-Mediated Synergistic Chemo/Chemodynamic Therapy
Authors: Li Xiang , Wang Zhen , Ma Mian , Chen Zhouqing , Tang Xiang-long , Wang Zhong
Published: April 2021

Background and Purpose. Although chemodynamic therapy (CDT) is promising for cancer treatment, its clinical application is still limited because of unresolved issues. In this study, an efficient CDT agent for synergistic chemo/CDT therapy mediated by the photothermal effect was developed by an iron oxide self-assembly method. Methods. Superparamagnetic iron oxide nanoclusters (SPIOCs) were located within the core, which resulted in high photothermal conversion and outstanding generation of reactive oxygen species (ROS). The shell consisted of a human serum albumin- (HSA-) paclitaxel (PTX) layer, which extended the blood circulation time and ensured the effectiveness of the chemotherapy. Arg-Gly-Asp peptides (RGD) were linked to the naked cysteine moieties in HSA to promote the specific targeting of human glioma U87 cells by αvβ3 integrins. Continuous near-infrared light irradiation triggered and promoted the synergistic chemo/CDT therapy through the photothermal effect. Results. Our SPIOCs@HSA-RGD nanoplatform showed well biocompatibility and could target glioma specifically. Photothermal conversion and ROS burst were detected after continuous 808 nm light irradiation, and a significant antitumor effect was achieved. Conclusion. Experimental in vitro and in vivo evaluations showed that our photothermal-mediated chemo/CDT therapy could efficiently inhibit tumor growth and is therefore promising for cancer therapy.
Diagnostic Value of Optical Coherence Tomography Angiography for Choroidal Neovascularization in Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis
Authors: Chen Chang-Xi , Liu Mei-Ling , Cao Kai , Yusufu Mayinuer , Wang Jin-Da
Published: April 2021

Objective: This study aims to evaluate the diagnostic value of optical coherence tomography angiography (OCTA) in detecting the choroidal neovascularization (CNV) in age-related macular degeneration (AMD). Methods: A systematic review and meta-analysis was performed by searching Pubmed, Science Direct, Embase, and Web of Science. The pooled sensitivity and specificity with 95% confidence intervals (CIs), area under the summary receiver operator characteristic curve (sROC), and the total accurate classification rate were used to evaluate OCTA’s diagnostic value of CNV in AMD patients. Results: Seven studies involving 517 eyes were included in the analysis. The mean age of subjects in each study ranged from 58.5 years to 81.7 years. Fluorescein angiography was applied as the gold standard in 5 studies. There were 350 eyes diagnosed with CNV, OCTA detected 301 eyes correctly, while among the 167 eyes without CNV, OCTA identified 150 correctly. The total accurate classification rate was 87.23%. The Spearman’s rank correlation coefficient was 0.5, indicating that there was no significant threshold effect in the current study (S = 8, p = 0.103). The pooled sensitivity and pooled specificity were 0.89 (95% CI: 0.82, 0.94) and 0.96 (95% CI: 0.85, 1.00), respectively. The area under sROC was up to 0.911. Conclusion: The specificity of OCTA for the detection of CNV in AMD patients is extremely high; however, the sensitivity still needs to be improved. In general, the meta-analysis revealed that OCTA had a high diagnostic value for the detection of CNV in AMD patients.
Histopathology of Hydrolyzed MIRAgel Scleral Buckles
Authors: Wolkow Natalie , Jakobiec Frederick A.
Published: April 2021

Introduction: The goal of this study was to histopathologically evaluate the appearance of degrading MIRAgel scleral buckles so that they can be reliably distinguished by ophthalmic pathologists from other foreign materials. Methods: Retrospective chart review and histopathologic study with special stains, including Alcian blue, periodic acid-Schiff, Masson’s trichrome, and Perls’ Prussian blue for iron, of 4 cases between 2017 and 2019. Results: Hydrolyzed MIRAgel scleral buckles from 4 patients had a consistent histopathologic appearance. They had a honeycomb structure with the walls of the lattice ranging from distinct to poorly defined. The walls of the lattice were positive for Alcian blue, while the contents of each cell contained periodic acid-Schiff-positive material. Other special stains were not as valuable in highlighting the material. Discussion: Although the capsules of MIRAgel scleral buckles have been well studied, the material itself has not been. While clinical history and radiographic appearance are often diagnostic of a hydrolyzed MIRAgel scleral buckle, there are instances of preoperative ambiguity where histopathologic confirmation can be useful. Conclusions: MIRAgel scleral buckles have a distinct histopathologic appearance that can be readily distinguished from that of other foreign materials.
Long-Term Effectiveness of Fingolimod for Multiple Sclerosis in a Real-World Clinical Setting
Authors: Uzunköprü Cihat , Beckmann Yesim , Türe Sabiha
Published: April 2021

Introduction: The primary aim of the present study was to evaluate the long-term efficacy of fingolimod in patients with multiple sclerosis (MS); secondary aims were to describe the safety of fingolimod with the evaluation of treatment satisfaction and impact on the quality of life in real life. Methods: We collected clinical, demographical, neuroradiological, and treatment data, including pre- and posttreatment status health-related quality of life from 286 MS patients consecutively treated with fingolimod. Clinical assessment was based on the Expanded Disability Status Scale (EDSS), and quality of life assessment was performed with MS-related quality of life inventory (MSQOLI). The data were recorded at baseline and every 6 months for 2 years. Results: One hundred and fourteen males and 172 females were enrolled. The annualized relapse rate and EDSS showed a statistically significant reduction during the observation period (p < 0.001). The patients also demonstrated substantial improvements in magnetic resonance imaging (MRI) outcomes (p < 0.001). Health-related quality of life scores improved significantly between baseline and 24-month visit (p < 0.001). No serious adverse events occurred. Conclusion: In our cohort, fingolimod treatment was associated with reduced relapse, MRI activity, and improved EDSS and MSQOLI scores. Additionally, fingolimod has been able to maintain its effectiveness over a considerable long period of treatment.
The Efficacy of Etoposide-Based Therapy in Adult Secondary Hemophagocytic Lymphohistiocytosis
Authors: Naymagon Leonard , Tremblay Douglas , Mascarenhas John
Published: April 2021

Data supporting the use of etoposide-based therapy in hemophagocytic lymphohistiocytosis (HLH) arise largely from pediatric studies. There is a lack of comparable data among adult patients with secondary HLH. We conducted a retrospective study to assess the impact of etoposide-based therapy on outcomes in adult secondary HLH. The primary outcome was overall survival. The log-rank test was used to compare Kaplan-Meier distributions of time-to-event outcomes. Multivariable Cox proportional hazards modeling was used to estimate adjusted hazard ratios (HRs) with 95% confidence intervals (CIs). Ninety adults with secondary HLH seen between January 1, 2009, and January 6, 2020, were included. Forty-two patients (47%) received etoposide-based therapy, while 48 (53%) received treatment only for their inciting proinflammatory condition. Thirty-three patients in the etoposide group (72%) and 32 in the no-etoposide group (67%) died during follow-up. Median survival in the etoposide and no-etoposide groups was 1.04 and 1.39 months, respectively. There was no significant difference in survival between the etoposide and no-etoposide groups (log-rank p = 0.4146). On multivariable analysis, there was no association between treatment with etoposide and survival (HR for death with etoposide = 1.067, 95% CI: 0.633–1.799, p = 0.8084). Use of etoposide-based therapy was not associated with improvement in outcomes in this large cohort of adult secondary HLH patients.
Prognostic Factors for Pediatric Acute Encephalopathy Associated with Severe Brain Edema
Authors: Tamura Goichiro , Inagaki Takayuki
Published: April 2021

Background and Objective: Acute encephalopathy is a life-threatening brain dysfunction in children, often associated with a preceding infection and diffuse noninflammatory brain edema. At present, the role of decompressive craniectomy (DC) over the swollen area of the brain is unclear. The risk factors for predicting clinical deterioration also need clarification. Methods: A retrospective study of pediatric patients admitted between 2015 and 2019 with acute cerebral encephalopathy was carried out. Patients were classified according to: (1) the preceding pathogens, (2) the syndromic classification, and (3) the extent of brain edema. The syndromic classification is a relatively new classification of acute encephalopathy proposed in 2016 and divides patients into 3 groups: those with systemic inflammatory reactions or “cytokine storms” (group 1), those with status epilepticus but no cytokine storm (group 2), and others (group 3). Glasgow Outcome Scale (GOS) scores of 1–3 were defined as unfavorable, while a GOS score of 4 or 5 was defined as a favorable outcome in this study. DC was performed for select patients with life-threatening signs of brainstem compression. Results: Nineteen patients (mean age: 23.3 months) were included in the study, 8 (42.1%) of whom had an unfavorable outcome. There was no significant correlation between the types of pathogens and outcome. Unfavorable outcomes were observed in significantly more patients in group 1 (87.5%) than group 2 (14.3%) and group 3 (0%). There was a significant association between diffuse brain edema and unfavorable outcomes (72.7%). Neurosurgical DC was performed in 2 patients to alleviate life-threatening brainstem compression: one with a cytokine storm and diffuse bilateral brain edema, and the other with prolonged status epilepticus causing diffuse right-sided brain edema. The GOS score was 3 and 4, respectively. Conclusion: The risk factors for clinical deterioration in pediatric acute encephalopathy were evaluated based on a variety of classifications, including the new syndromic classification. Laboratory features of cytokine storms and radiological evidence of diffuse brain edema were associated with unfavorable outcomes. The role of surgical decompression is still controversial and should be assessed on a case-by-case basis.
JNK Signaling Pathway Mediates Fluoride-Induced Upregulation of CK1α during Enamel Formation
Authors: Yang Zhongrui , Shi Guanghui , Guo Jing , Zhou Yanyan , Jia Jie
Published: April 2021

Fluorosis is a defect in the enamel mineral content caused by excessive fluoride intake during amelogenesis; the interaction of various factors in the development and progression of fluorosis has not been defined. Casein kinase 1α (CK1α) is constitutively active in cells and is involved in diverse cellular processes; however, its expression in fluorosis has not been measured. This study aimed to investigate the effects of fluoride on CK1α expression and to assess the regulation of molecular signaling involving fluoride and CK1α during enamel development. Kunming mice were randomly divided into the control and F groups with induced clinical features of fluorosis. The F group mice, including mothers and newborns, were treated with 50 ppm fluoridated water. Immunohistochemical staining of the sections of the embryonic mandible regions was performed at the bell stage. Protein expression and signaling pathways in a mouse-derived ameloblast-like cell line (LS8) exposed to fluoride or a Jun N-terminal kinase (JNK) inhibitor were compared to those in control cells without exposure. CK1α and proteins of the JNK signaling pathways were assayed by quantitative real-time PCR and Western blotting. Mice of the F group developed dental fluorosis. Scanning electron microscopy showed a significant reduction in the degree of mineralization in the F group mice, which manifested as thin, loosely arranged, and disorganized enamel rods. Additional analysis revealed that the expression of CK1α in the F group was significantly elevated compared with that in the control group; LS8 cells responded to fluoride by upregulation of CK1α expression through the JNK pathway. Our findings identified the potential effects of CK1α on fluorosis using a mouse model and revealed that a high fluoride level increases the expression of CK1α and that JNK can be a key regulatory factor in CK1α expression.
Reduction in Hospitalizations for Respiratory Diseases during the First COVID-19 Wave in Greece
Authors: Kyriakopoulos Christos , Gogali Athena , Exarchos Konstantinos , Potonos Dimitrios , Tatsis Konstantinos , Apollonatou Vasiliki , Loukides Stelios , Papiris Spyros , Sigala Ioanna , Katsaounou Paraskevi , Aggelidis Maximos , Fouka Evangelika , Porpodis Konstantinos , Kontakiotis Theodoros , Sampsonas Fotis , Karampitsakos Theodoros , Tzouvelekis Argyris , Bibaki Eleni , Karagiannis Konstantinos , Antoniou Katerina , Tzanakis Nikolaos , Dimeas Ilias , Daniil Zoe , Gourgoulianis Konstantinos , Kouratzi Maria , Steiropoulos Paschalis , Antonakis Emmanouil , Papanikolaou Ilias C. , Ntritsos Georgios , Kostikas Konstantinos
Published: April 2021

Introduction: During the first COVID-19 wave, a considerable decline in hospital admissions was observed worldwide. Aim: This retrospective cohort study aimed to assess if there were any changes in the number of patients hospitalized for respiratory diseases in Greece during the first CO­VID-19 wave. Methods: In the present study, we evaluated respiratory disease hospitalization rates across 9 tertiary hospitals in Greece during the study period (March–April 2020) and the corresponding period of the 2 previous years (2018–2019) that served as the control periods. Demographic data and discharge diagnosis were documented for every patient. Results: Of the 1,307 patients who were hospitalized during the study period, 444 (35.5%) were males with a mean (±SD) age of 66.1 ± 16.6 years. There was a 47 and 46% reduction in all-cause respiratory morbidity compared to the corresponding periods of 2018 and 2019, respectively. The mean incidence rate for respiratory diseases during the study period was 21.4 admissions per day, and this rate was significantly lower than the rate during the same period in 2018 (40.8 admissions per day; incidence rate ratio [IRR], 0.525; 95% confidence interval [CI], 0.491–0.562; p < 0.001) or the rate during 2019 (39.9 admissions per day; IRR, 0.537; 95% CI, 0.502–0.574; p < 0.001). The greatest reductions (%) in the number of daily admissions in 2020 were observed for sleep apnoea (87% vs. 2018 and 84% vs. 2019) followed by admissions for asthma (76% vs. 2018 and 79% vs. 2019) and chronic obstructive pulmonary disease (60% vs. 2018 and 51% vs. 2019), while the lowest reductions were detected in hospitalizations for pulmonary embolism (6% vs. 2018 and 23% vs. 2019) followed by tuberculosis (25% vs. both 2018 and 2019). Discussion/Conclusion: The significant reduction in respiratory admissions in 2020 raises the reasonable question of whether some patients may have avoided seeking medical attention during the COVID-19 pandemic and suggests an urgent need for transformation of healthcare systems during the pandemic to offer appropriate management of respiratory diseases other than COVID-19.
Age Predicts Older Adults’ Driving Self-Regulation but Not Dangerous Driving Behaviors after Controlling for Executive Function
Authors: Bernstein John P.K. , Mattek Nora , Dorociak Katherine E. , Beattie Zachary T. , Kaye Jeffrey A. , Ferguson John E. , Hughes Adriana M.
Published: April 2021

Objectives: The aim of the study was to examine the unique contributions of age to objectively measure driving frequency and dangerous driving behaviors in healthy older adults after adjusting for executive function (EF). Method: A total of 28 community-dwelling older adults (mean age = 82.0 years, standard deviation [SD] = 7.5) without dementia who were in good physical health and enrolled in a longitudinal aging study completed several EF and clinical self-report measures at baseline. Participants subsequently had a sensor installed in their vehicle for a mean of 208 (SD = 38, range = 127–257) days. Results: Participants drove for an average of 54 min per day. Mixed-effects models indicated that after controlling for EF, older age was associated with less time driving per day, decreased number of trips, and less nighttime driving. Age was not associated with hard brakes or hard accelerations. Discussion: After accounting for EF, greater age is associated with higher driving self-regulation but not dangerous driving behaviors in healthy older adults. Future studies should recruit larger samples and collect sensor-measured driving data over a more extended time frame to better determine how and why these self-regulation changes take place.
The Relationship between Serum Ferritin Levels and 5-Year All-Cause Mortality in Hemodialysis Patients
Authors: Erdem Emre , Karatas Ahmet , Ecder Tevfik
Published: April 2021

Introduction: The effect of high serum ferritin levels on long-term mortality in hemodialysis patients is unknown. The relationship between serum ferritin levels and 5-year all-cause mortality in hemodialysis patients was investigated in this study. Methods: A total of 173 prevalent hemodialysis patients were included in this study. The patients were followed for up to 5 years and divided into 3 groups according to time-averaged serum ferritin levels (group 1: serum ferritin <800 ng/mL, group 2: serum ferritin 800–1,500 ng/mL, and group 3: serum ferritin >1,500 ng/mL). Along with the serum ferritin levels, other clinical and laboratory variables that may affect mortality were also included in the Cox proportional-hazards regression analysis. Results: Eighty-one (47%) patients died during the 5-year follow-up period. The median follow-up time was 38 (17.5–60) months. The 5-year survival rates of groups 1, 2, and 3 were 44, 64, and 27%, respectively. In group 3, the survival was lower than in groups 1 and 2 (log-rank test, p = 0.002). In group 1, the mortality was significantly lower than in group 3 (HR [95% CI]: 0.16 [0.05–0.49]; p = 0.001). In group 2, the mortality was also lower than in group 3 (HR [95% CI]: 0.32 [0.12–0.88]; p = 0.026). No significant difference in mortality between groups 1 and 2 was found (HR [95% CI]: 0.49 [0.23–1.04]; p = 0.063). Conclusion: Time-averaged serum ferritin levels >1,500 ng/mL in hemodialysis patients are associated with an increased 5-year all-cause mortality risk.
Effect of Photobiomodulation Therapy following Direct Pulp Capping on Postoperative Sensitivity by Thermal Stimulus: A Retrospective Study
Authors: Günaydın Adem , Çakıcı Elif Bahar
Published: April 2021

Objective: The aim of this study was to investigate the effect of photobiomodulation therapy (PBMT) on postoperative pain provoked by thermal stimulation in direct pulp capping (DPC). Subjects and Methods: A retrospective study was performed using the records of patients who received DPC using mineral trioxide aggregate. Teeth irradiated with a laser were assigned as the PBMT group, and nonirradiated teeth were considered as the control group. Before treatment and 6 h, 1 day, and 7 days after treatment, tooth sensitivity to a cold stimulus was recorded using a visual analog scale. Results: From a total of 123 documented DPC procedures, only 72 directly capped permanent teeth met the inclusion criteria. Age, gender, and tooth location were comparable between the groups. A statistically significant difference was found in sensitivity to cold stimulus between groups on day 7 (p = 0.007), but no difference was found at the preoperative, 6 h, and day 1 time points (p = 0.055, p = 0.132, and p = 0.100, respectively). In the intragroup evaluation, a significantly greater decrease in sensitivity to cold stimulus was detected in the PBMT group than that in the control group, although both groups showed a reduction in discomfort throughout the follow-up period (p = 0.000). Conclusion: PBMT is an effective method for enhancing patient comfort by reducing thermal sensitivity following DPC procedures.