bluuebunny/crossref_metadata_2025 huggingface dataset:
Bilateral pterygoid abscesses in a patient with Lemierre’s syndrome
Authors: Someko Hidehiro , Shiojiri Toshiaki
Published: July 2023

Patients with Lemierre’s syndrome may have complications such as lung lesions, large joint arthritis and central nervous system involvement. However, complications involving a pterygoid abscess have scarcely been reported. Here, we report a case of bilateral Lemierre’s syndrome accompanied with an intracranial epidural abscess and bilateral pterygoid abscesses. A woman in her 70s presented to the emergency room with a decreased level of consciousness. Infection was suspected, andSlackia exiguaand species ofFusobacteriumwere identified in blood cultures, which suggested that the origin of infection was odontogenic, particularly as the patient had poor oral hygiene. Head and neck CT with contrast enhancement revealed bilateral internal jugular vein thrombophlebitis, septic pulmonary embolism, frontal epidural abscess and bilateral pterygoid abscesses. After antibiotic treatment and drainage, her condition improved. Pterygoid abscesses should be recognised as a rare complication of Lemierre’s syndrome, especially when the infection origin is odontogenic.
Distributional impact of infectious disease interventions in the Ethiopian Essential Health Service Package: a modelling study
Authors: Assebe Lelisa Fekadu , Norheim Ole
Published: July 2023

Objectives

Reducing inequalities in health and financial risk are key goals on the path toward universal health coverage, particularly in low-income and middle-income countries. The design of the health benefit package creates an opportunity to select interventions through established criteria. The aim of this study is to examine the health equity and financial protection impact of selected interventions, along with their costs, at the national level in Ethiopia.

Design

Distributional cost-effectiveness analysis.

Population

The eligible population for all selected interventions is assumed to be 10 million.

Data sources

Data on disease prevalence and population size were gathered from the Global Burden of Disease database, and average health benefits and program costs are sourced from the Ethiopian Essential Health Service Package (EHSP) database, national surveys and other publicly available sources.

Intervention

A total of 30 interventions were selected from the latest EHSP revision and analysed over a 1-year period.

Outcome measures

Health benefits, social welfare indices and financial protection metrics across income quintiles were reported.

Results

We found 23 interventions that improve population health and reduce health inequality and four interventions reduce both population health and health inequality. Additionally, three interventions improve population health while increasing health inequality. Overall, the EHSP interventions provide a 0.021 improvement in health-adjusted life expectancy (HALE) per person, with a positive distributional equity impact: 0.029 (26.9%) HALE gained in the poorest and 0.015 (14.0%) in the richest quintile. Similarly, a total of 1 79 475 cases of catastrophic health expenditure were averted, including 82 100 (46.0%) cases in the poorest and 17 900 (10.0%) in the richest quintile.

Conclusion

Increasing access to the EHSP improves health equity and financial protection. Improved access to selected EHSP interventions also has the potential to provide greater benefits to the poorest and thereby improve social welfare.
Plenteous specific analytical solutions for new extended deoxyribonucleic acid (DNA) model arising in mathematical biology
Authors: Abdou M. A. , Ouahid Loubna , Kumar Sachin
Published: July 2023

In this paper, the generalized Kudryashov (GK) approach and the sine-Gordon expansion approach are used for constructing new specific analytical solutions of the deoxyribonucleic acid model, which include the well-known bell-shaped soliton, kink, singular kink, periodic soliton, contracted bell-shaped soliton and anti-bell-shaped soliton. The efficacy of these strategies demonstrates their utility and efficiency in addressing a wide range of integer and fractional-order nonlinear evolution problems. The physical relevance of the demonstrated results has been proven using three-dimensional forms. It is interesting to mention that the solutions achieved here using the provided methods are extra-extensive and may be used to explain the internal interaction of the deoxyribonucleic acid model originating in mathematical biology. The suggested approach was utilized to get exact traveling wave solutions for fractional nonlinear partial differential equations appearing in nonlinear science.
Harmonic Estimation and Comparative Analysis of Ultra-High Speed Flip-Flop and Latch Topologies for Low Power and High Performance Future Generation Micro-/Nano Electronic Systems
Authors: Khan Muhammad Imran
Published: July 2023

This paper presents estimation and analysis of the higher order harmonics, power features, and real performance of flip-flop and master-slave latch topologies. This research article outlines the impact of transistor model quality and input signal selection on the estimate of higher order harmonic contents of switching waveform emitted by the digital integrated circuits. Highly integrated systems require accurate estimation of higher order harmonics to control noise. This work presents simulations of 12 kinds of flip-flop and latch topologies on different process technologies i.e., 28 nm, 45 nm, 65 nm, and 130 nm. It is implied that the steeper the spectrum roll-off, the fewer the contents of higher order harmonics. Results of 28 nm process design kit are improved compared to 45 nm, 65 nm, and 130 nm process design kits. Furthermore, the results of the comparison of representative flip-flop and latch topologies illustrate the advantage of the approach and the suitability for high performance and low power consumption.
Prisma : A Tierless Language for Enforcing Contract-client Protocols in Decentralized Applications
Authors: Richter David , Kretzler David , Weisenburger Pascal , Salvaneschi Guido , Faust Sebastian , Mezini Mira
Published: July 2023

Decentralized applications (dApps) consist of smart contracts that run on blockchains and clients that model collaborating parties. dApps are used to model financial and legal business functionality. Today, contracts and clients are written as separate programs—in different programming languages—communicating via send and receive operations. This makes distributed program flow awkward to express and reason about, increasing the potential for mismatches in the client-contract interface, which can be exploited by malicious clients, potentially leading to huge financial losses.

In this article, we present
Prisma
, a language for tierless decentralized applications, where the contract and its clients are defined in one unit and pairs of send and receive actions that “belong together” are encapsulated into a single direct-style operation, which is executed differently by sending and receiving parties. This enables expressing distributed program flow via standard control flow and renders mismatching communication impossible. We prove formally that our compiler preserves program behavior in presence of an attacker controlling the client code. We systematically compare
Prisma
with mainstream and advanced programming models for dApps and provide empirical evidence for its expressiveness and performance.
Regular Composite Resource Partitioning and Reconfiguration in Open Systems
Authors: Chen Wei-Ju , Wu Peng , Huang Pei-Chi , Mok Aloysius K. , Han Song
Published: July 2023

We consider the problem of resource provisioning for real-time cyber-physical applications in an open system environment where there does not exist a global resource scheduler that has complete knowledge of the real-time performance requirements of each individual application that shares the resources with the other applications. Regularity-based Resource Partition (RRP) model is an effective strategy to hierarchically partition and assign various resource slices among such applications. However, previous work on RRP model only discusses uniform resource environment, where resources are implicitly assumed to be synchronized and clocked at the same frequency. The challenge is that a task utilizing multiple resources may experience unexpected delays in non-uniform environments, where resources are clocked at different frequencies. This paper extends the RRP model to non-uniform multi-resource open system environments to tackle this problem. It first introduces a novel composite resource partition abstraction and then proposes algorithms to construct and reconfigure the composite resource partitions. Specifically, the
Acyclic Regular Composite Resource Partition Scheduling (ARCRP-S)
algorithm constructs regular composite resource partitions and the
Acyclic Regular Composite Resource Partition Dynamic Reconfiguration (ARCRP-DR)
algorithm reconfigures the composite resource partitions in the run time upon requests of partition configuration changes. Our experimental results show that compared with state-of-the-art methods, ARCRP-S can prevent unexpected resource supply shortfall and improve the schedulability up to 50%. On the other hand, ARCRP-DR can guarantee the resource supply during the reconfiguration with moderate computational overhead.
A Survey of Malware Analysis Using Community Detection Algorithms
Authors: Amira Abdelouahab , Derhab Abdelouahid , Karbab Elmouatez Billah , Nouali Omar
Published: July 2023

In recent years, we have witnessed an overwhelming and fast proliferation of different types of malware targeting organizations and individuals, which considerably increased the time required to detect malware. The malware developers make this issue worse by spreading many variants of the same malware [
13
]. To deal with this issue, graph theory techniques, and particularly community detection algorithms, can be leveraged to achieve bulk detection of malware families and variants to identify malicious communities instead of focusing on the detection of an individual instance of malware, which could significantly reduce the detection time. In this article, we review the state-of-the-art malware analysis solutions that employ community detection algorithms and provide a taxonomy that classifies the solutions with respect to five facets: analysis task, community detection approach, target platform, analysis type, and source of features. We present the solutions with respect to the analysis task, which covers malware detection, malware classification, cyber-threat infrastructure detection, and feature selection. The findings of this survey indicate that there is still room for contributions to further improve the state of the art and address research gaps. Finally, we discuss the advantages and the limitations of the solutions, identify open issues, and provide future research directions.
Medium-chain fatty acid oxidation is independent of l-carnitine in liver and kidney but not in heart and skeletal muscle
Authors: Pereyra Andrea S. , McLaughlin Kelsey L. , Buddo Katherine A. , Ellis Jessica M.
Published: July 2023

This work demonstrates that the traditional concept of mitochondrial medium-chain fatty acid oxidation as unregulated and independent of carnitine applies only to liver metabolism, and to kidney to a lesser extent, but not the heart or skeletal muscle. Thus, the benefits of dietary medium-chain fatty acids are set by liver metabolic activity and peripheral tissues are unlikely to receive direct benefits from medium-chain fatty acid metabolism, but rather metabolic byproducts of liver’s medium-chain oxidative metabolism.
Identifying Risk Factors for Aspiration in Patients Hospitalized with Community-Acquired Pneumonia
Authors: Zhao Tianming , Zhang Yi , Wang Kun , Yu Huan , Lin Lianjun , Qin Xueying , Wu Tao , Chen Dafang , Wu Yiqun , Hu Yonghua
Published: July 2023

Background. Aspiration pneumonia (AP) is difficult to diagnose and has poor outcomes. This case-control study aimed to explore the risk factors and delineate the antibiotic usage for AP. Methods. Inpatients diagnosed with community-acquired pneumonia (CAP) from 2013 to 2017, enrolled in the urban employee basic medical insurance program in Beijing, were included and classified into the AP (N = 2,885) and non-AP (N = 53,825) groups. Risk factors were identified by logistic regression. Results. Older age (compared to 18–64 years, OR for 65–79 years: 4.3, 95% CI: 3.8–4.9; OR for >80 years: 6.3, 95% CI: 5.6–7.2), male (OR: 1.4, 95% CI: 1.3–1.5), cerebrovascular disease (OR: 3.1, 95% CI: 2.8–3.5), dementia (OR: 2.0, 95% CI: 1.8–2.1), vomiting (OR: 1.4, 95% CI: 1.2–1.7), Parkinson’s disease (OR: 2.1, 95% CI: 1.8–2.4), and epilepsy (OR: 3.2, 95% CI: 2.8–3.7) were associated with an increased risk of AP. 92.8% of the AP patients received antibiotic therapy. Among them, patients treated with broad-spectrum antibiotics, antibiotics for injection, and combined antibiotics accounted for 93.3%, 97.9%, and 81.7%, respectively. Conclusions. Older age, male, and several comorbidities were independent risk factors for AP, and combined antibiotics treatments are common, which merits attention in accurate detection of AP in a high-risk population.
Mathematical Modelling with the Exact Solution of Three Different Bioheat Conduction Models of a Skin Tissue Shocked by Thermoelectrical Effect
Authors: Al-Lehaibi Eman A. N.
Published: July 2023

This research deals with the temperature increment and responsiveness of skin tissue to a continuous flow of surface heat induced by a constant-voltage electrical current. The exact analytical solution for the dual-phase-lag (DPL) of bioheat transfer has been obtained. It is used to confine the variables to a limited domain to solve the governing equations. The transition temperature reactions have been measured and investigated. The figures provide a comparison of the Pennes, Tzou models, and Vernotte–Cattaneo models. The numerical results demonstrate the values of the voltage, resistance, electric shock time, and dual-phase-lag time parameters which have significant influences on the distributions of the dynamic and conductive temperature rise through the skin tissue.
The Validity and Reliability of Automatic Tooth Segmentation Generated Using Artificial Intelligence
Authors: Al-Ubaydi Ammar Sh. , Al-Groosh Dheaa
Published: July 2023

This study aimed at evaluating the precision of the segmented tooth model (STM) that was produced by the artificial intelligence (AI) program (CephX®) with an intraoral scan (IOS) and insignia outcomes. Methods. 10 patients with Cl I malocclusion (mild-to-moderate crowding) who underwent nonextraction orthodontic therapy with the Insignia™ system had IOS and CBCT scans taken before treatment. AI was used to produce a total of 280 STMs; each tooth will be measured from three aspects (apexo-occlusal, mesiodistal, and labiolingual) for DICOM and STL formats. Also, root volume measurements for each tooth generated by using the CephX® software and Insignia™ system were compared. The software used for these measurements was the OnDemand3D program used for the multiplanar reconstruction for DICOM format and Geomagic® Control X™ used for STL format. Statistics. An intraclass correlation (ICC) analysis was used to check the agreement between the volume measurement of the segmented teeth generated by using the CephX® and Insignia™ system. Also, it was used to check the agreement between the STL (IOS), STL (CephX®), and DICOM tooth models. In addition, it was used to determine the intraexaminer repeatability by remeasuring five randomly selected individuals two weeks after the initial measurement. After confirmation of the data normality using the Shapiro–Wilk test, the right and left tooth models and the differences between the DICOM, CephX® (STL), and IOS (STL) tooth models were compared using a paired t-test. The STL (IOS), STL (CephX®), and DICOM tooth models were compared utilizing the ANOVA test.

p
<
0.05

was set as the statistical significance level. Result. Overall data showed good agreement with ICC. The measurements of the various tooth types on the right and left sides did not differ significantly. Also, there was no significant difference between the three groups. Conclusions. The automatic AI approach (CephX®) may be advised in the clinical practice for patients with mild crowding and no teeth restorations due to its speed and effectiveness.
Do Primary Healthcare Facilities in More Remote Areas Provide More Medical Services? Spatial Evidence from Rural Western China
Authors: Shen Chi , Lai Sha , Deng Qiwei , Dong Wanyue , Cao Dan , Zhao Dantong , Zhao Yaxin , Zhou Zhongliang , Chen Xi
Published: July 2023

Primary healthcare institutions (PHIs) in China have experienced a sizable decline in medical services in recent years. Despite the large regional disparities in China, there is a lack of evidence on the differential patterns of medical services offered by PHIs, especially from a spatial perspective. This study examines whether residents in more remote areas use more medical services offered by township healthcare centers (THCs), a main type of PHIs. Linking medical visits to 923 THCs in a western Chinese province in 2020 with the driving time and geographic coordinates from the Gaode map, a leading map navigation provider in China, we applied a multilevel linear model and a geographically weighted regression to examine spatial heterogeneity in medical service utilization. We showed that a one-hour increase in the shortest driving time between THCs and the local county hospitals was associated with an average 6% increase in THCs outpatient visits and a 0.6% increase in THCs inpatient visits. Our findings suggest that THCs located in more remote areas provided more medical services, especially outpatient services. This study may improve our understanding of the spatial disparity in medical services provision for THCs in western China. We suggest that more attention should be paid to enhance the quality of THCs in remote areas, which deserve a higher priority in the process of improving the quality of primary healthcare. Health policymaking in developing regions such as western China should take geographic factors into account.
Clinical Characterization of Data-Driven Diabetes Clusters of Pediatric Type 2 Diabetes
Authors: Abbasi Mahsan , Tosur Mustafa , Astudillo Marcela , Refaey Ahmad , Sabharwal Ashutosh , Redondo Maria J.
Published: July 2023

Background. Pediatric Type 2 diabetes (T2D) is highly heterogeneous. Previous reports on adult-onset diabetes demonstrated the existence of diabetes clusters. Therefore, we set out to identify unique diabetes subgroups with distinct characteristics among youth with T2D using commonly available demographic, clinical, and biochemical data. Methods. We performed data-driven cluster analysis (K-prototypes clustering) to characterize diabetes subtypes in pediatrics using a dataset with 722 children and adolescents with autoantibody-negative T2D. The six variables included in our analysis were sex, race/ethnicity, age, BMI Z-score and hemoglobin A1c at the time of diagnosis, and non-HDL cholesterol within first year of diagnosis. Results. We identified five distinct clusters of pediatric T2D, with different features, treatment regimens and risk of diabetes complications: Cluster 1 was characterized by higher A1c; Cluster 2, by higher non-HDL; Cluster 3, by lower age at diagnosis and lower A1c; Cluster 4, by lower BMI and higher A1c; and Cluster 5, by lower A1c and higher age. Youth in Cluster 1 had the highest rate of diabetic ketoacidosis (DKA) (

p
=
0.0001

) and were most prescribed metformin (

p
=
0.06

). Those in Cluster 2 were most prone to polycystic ovarian syndrome (

p
=
0.001

). Younger individuals with lowest family history of diabetes were least frequently diagnosed with diabetic ketoacidosis (

p
=
0.001

) and microalbuminuria (

p
=
0.06

). Low-BMI individuals with higher A1c had the lowest prevalence of acanthosis nigricans (

p
=
0.0003

) and hypertension (

p
=
0.03

). Conclusions. Utilizing clinical measures gathered at the time of diabetes diagnosis can be used to identify subgroups of pediatric T2D with prognostic value. Consequently, this advancement contributes to the progression and wider implementation of precision medicine in diabetes management.
Reinforcement Learning to Harmonize Performance of Shuffled Frog Leading Algorithm: A Solution for Optimized Photovoltaic Cells
Authors: Weng Xuemeng , Heidari Ali Asghar , Chen Huiling
Published: July 2023

Accurate determination of photovoltaic (PV) parameters holds immense significance for ensuring the reliability of solar system operations, uninterrupted power supply for load consumption, and efficient control and management of energy sources. I-V curves transform parameter extraction into a nonlinear optimization problem supported by the I-V data points in the PV model to characterize the PV model macroscopically. Therefore, this paper proposes a novel parameter extraction model using the

Q

-learning-based multistrategy improved shuffled frog leading algorithm (CRNSFLA). During the evaluation process of the proposed algorithm, the colony predation algorithm (CPA) is utilized to expand the search range of the worst individual, which is no longer confined to the line segment range between the current and best values. In the later stage of evaluation, the optimal individual serves as the starting point and is applied to the Nelder-Mead simplex (NMS) for forming a simplex to mine higher-quality solutions. Besides, the simplest reinforcement

Q

-learning allows for a reasonable switch between these two mechanisms. A reasonable balance between exploration and exploitation trends is ensured while making full use of the advantages of both according to the reward and punishment mechanisms. The comprehensive test results under various optimization functions, different PV models, and environmental conditions demonstrate that the proposed algorithm is more advantageous than existing algorithms for parameter extraction problems. Specifically, CRNSFLA had RMSEs of 9.8602E-04, 9.8248E-04, and 9.8248E-04 in the single-diode model (SDM), double-diode model (DDM), and three-diode model (TDM), respectively. Moreover, compared with the original shuffled frog leading algorithm, the CRNSFLA showed significant improvements in 62% of the optimization functions. Therefore, CRNSFLA can be considered an effective tool for solar cell parameter extractions.
Radar Echo Maps Prediction Using an Improved MIM with Self‐Attention Memory Module
Authors: Zhou Wei , Qu Zhongwei , Qu Lianen , Wang Xupeng , Shi Yilin , Zhang De , Hui Zhenlin
Published: July 2023

A radar echo sequence which includes N frames plays a crucial role in monitoring precipitation clouds and serves as the foundation for accurate precipitation forecasting. To predict future frames, spatiotemporal models are used to leverage historical radar echo sequences. The spatiotemporal information combining both temporal and spatial information is derived from radar echo sequence. The spatiotemporal information reveals the changing trend of intensity in the echo region over time. Dynamic variation information extracted in radar echo maps mainly consists of nonstationary information and spatiotemporal information. However, the changing trends at different locations within the precipitation cloud are different, so the significance of the spatiotemporal information should be different. The current precipitation forecasting model, Memory In Memory (MIM), has the capability to store the nonstationary information derived from radar echo maps. However, the MIM falls short in discerning the significance of the spatiotemporal information extracted from these maps. To address this limitation, we propose a novel model, SAMM‐MIM (self‐attention memory module‐MIM), which regulates the generation of hidden states and spatiotemporal memory states using a SAMM. The proposed SAMM uses the self‐attention mechanism and a series of gate mechanisms to concentrate on significant spatiotemporal information, learn changing trends in the echo region, and output predictive information. The predictive information which is stored in hidden states contains predictions of the changing trends of dynamic variation information. Experimental evaluation on a dataset of radar data from Qingdao, China, demonstrates that SAMM‐MIM achieves superior prediction performance compared with other spatiotemporal sequence models, as indicated by improved scores on mean squared error, critical success index, and missing alarm rate metrics.
The Combination of Serum Total IgE and Blood Eosinophil Levels as a Predictor of Response to Phototherapy Treatment in Patients with Atopic Dermatitis
Authors: Barzilai Aviv , Drousiotis Theodoulos , Dalal Adam , Pavlotsky Felix , Shemer Avner , Baum Sharon
Published: July 2023

Atopic dermatitis (AD) is the most common chronic inflammatory skin disease affecting approximately 25% of all people worldwide at some point during their lifetime. Although total serum immunoglobulin E (IgE) and blood eosinophil levels are not elevated in all patients with AD, they have been shown associated with AD severity. This study aimed to investigate whether IgE and blood eosinophil levels correlate with the response to phototherapy treatment, which is a second‐line treatment for moderate‐to‐severe AD, and therefore could be considered a readily available and reliable biomarker that could guide patient management. Eighty‐two patients with AD who received phototherapy at the Sheba Medical Center were retrospectively evaluated for the following: demographic characteristics, serum IgE levels, blood eosinophils count, hospitalization duration, response to phototherapy, and requirement for systemic treatment. Response to phototherapy treatment was assessed by comparing the pre‐ and post‐treatment Investigator’s Global Assessment score for each patient in relation to the aforementioned factors. The total IgE and eosinophil levels were found to be significantly higher in patients who did not respond to phototherapy (p = 0.018 and p = 0.002, accordingly). Serum values of 1780 IU/mL for IgE and 225.0 cells/μL for eosinophils showed maximum sensitivity and specificity as predictive values for treatment response. In conclusion, this study found that high total serum IgE levels and eosinophilia were correlated with a low response to phototherapy. These results suggest that escalating treatment is recommended for patients presenting these clinical features.
The Impact of COVID-19 on Parental Perception of Oral Health-Related Quality of Life of Children: A Comparison of a Sample from Saudi Arabia and Kuwait
Authors: AlHayyan Wasmiya A. , AlSaffan Abdulrahman D. , Alenezi Maram I. , Almutairi Bashaer K. , Alammari Lena F. , Pani Sharat Chandra
Published: July 2023

Background and Aim. The COVID-19 pandemic has impacted access to dental care for children over the world. This study aimed to assess the impact of the COVID-19 pandemic on parentally reported oral health-related quality of life (OHRQoL) in Riyadh, Saudi Arabia and Kuwait City, Kuwait. Materials and Methods. OHRQoL was measured using a a validated Arabic version of the Child Oral Health Impact Profile (COHIP). Parents of children aged between 5 and 9 years were administered questionnaire during the COVID-19 pandemic. The responses were compared across the different domains of the questionnaire between the two countries using the Mann–Whitney U test. Differences were also tested between the parents of males and females separately in each city. The correlation of the COHIP scores with the age of the child was done using the Spearman’s rho. Results. No significant differences in overall COHIP scores were found between the parents in Riyadh and Kuwait City (

p
>
0.05

). There were significant gender differences observed across domains in Kuwait (

p
=
0.030

) but not in Riyadh (

p
=
0.295

). There was also a significant negative correlation between the different COHIP domains in Kuwait but not Riyadh. Conclusion. There is a greater gender difference and age correlation of OHRQoL among the population studied in Kuwait City when compared to those in Riyadh.
Data from Clinical and Genomic Characteristics of Patients with HR+, HER2- Metastatic Breast Cancer Following Progression on a CDK4 and 6 Inhibitor
Authors: Rao Xi , Chen Yongmei , Beyrer Julie , Nash Smyth Emily , Morato Guimaraes Claudia , Litchfield Lacey M. , Bowman Lee , Lawrence Garreth W. , Aggarwal Amit , Andre Fabrice
Published: July 2023

Abstract
Purpose: We explored the clinical and genomic characteristics of hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer (MBC) after progression on cyclin-dependent kinase 4 and 6 inhibitors (CDK4 & 6i) +/- endocrine therapy (ET) to understand potential resistance mechanisms that may aid in identifying treatment options. Experimental Design: US patients with HR+, HER2- MBC had tumor biopsies collected from metastatic site during routine care following progression on a CDK4 & 6i +/- ET (CohortPost) or prior to initiating CDK4 & 6i treatment (CohortPre) and analyzed using a targeted mutation panel and RNA-seq. Clinical and genomic characteristics were described. Results: The mean age at MBC diagnosis was 59 years in CohortPre (n=133) and 56 years in CohortPost (n=223); 14% and 45% of patients had prior chemotherapy/ET and 35% and 26% had de novo stage IV MBC, respectively. The most common biopsy site was liver (CohortPre, 23%; CohortPost, 56%). CohortPost had significantly higher tumor mutational burden (TMB), (median 3.16 vs 1.67 Mut/Mb, P<0.0001), ESR1 alteration frequency (mutations: 37% vs 10%, FDR<0.0001; fusions: 9% vs 2%, P=0.0176), and higher copy number amplification of genes on chr12q15, including MDM2, FRS2, and YEATS4 versus CohortPre patients. Additionally, CDK4 copy number gain on chr12q13 was significantly higher in CohortPost vs. CohortPre (27% vs. 11%, P=0.0005). Conclusions: Distinct mechanisms potentially associated with resistance to CDK4 & 6i +/- ET, including alterations in ESR1 and amplification of chr12q15 and CDK4 copy number gain, were identified.
Progress in the Understanding of Estrogen Receptor Alpha Signaling in Triple-Negative Breast Cancer: Reactivation of Silenced ER-α and Signaling through ER-α36
Authors: Al-Kabariti Aya Y. , Abbas Manal A.
Published: July 2023

Triple-negative breast cancer (TNBC) is an aggressive tumor that accounts for approximately 15% of total breast cancer cases. It is characterized by poor prognosis and high rate of recurrence compared to other types of breast cancer. TNBC has a limited range of treatment options that include chemotherapy, surgery, and radiation due to the absence of estrogen receptor alpha (ER-α) rendering hormonal therapy ineffective. However, possible targets for improving the clinical outcomes in TNBC exist, such as targeting estrogen signaling through membranous ER-α36 and reactivating silenced ER-α. It has been shown that epigenetic drugs such as DNA methyltransferase and histone deacetylase inhibitors can restore the expression of ER-α. This reactivation of ER-α, presents a potential strategy to re-sensitize TNBC to hormonal therapy. Also, this review provides up-to-date information related to the direct involvement of miRNA in regulating the translation of ER-α mRNA. Specific epi-miRNAs can regulate ER-α expression indirectly by post-transcriptional targeting of mRNAs of enzymes that are involved in DNA methylation and histone deacetylation. Furthermore, ER-α36, an alternative splice variant of ER-α66, is highly expressed in ER-negative breast tumors and activates MAPK/ERK pathway, promoting cell proliferation, escaping apoptosis, and enhancing metastasis. In the future, these recent advances may be helpful for researchers working in the field to obtain novel treatment options for TNBC, utilizing epigenetic drugs and epi-miRNAs that regulate ER-α expression. Also, there is some evidence to suggest that drugs that decrease the expression of ER-α36 may be effective in treating TNBC.
Preliminary Analysis of Simple Novelty Search
Authors: Wiegand R. Paul
Published: July 2023

Novelty search is a powerful tool for finding diverse sets of objects in complicated spaces. Recent experiments on simplified versions of novelty search introduce the idea that novelty search happens at the level of the archive space, rather than individual points. The sparseness measure and archive update criterion create a process that is driven by a two measures: (1) spread out to cover the space while trying to remain as efficiently packed as possible, and (2) metrics inspired by k nearest neighbor theory.

In this paper, we generalize previous simplifications of novelty search to include traditional population (μ,λ) dynamics for generating new search points, where the population and the archive are updated separately. We provide some theoretical guidance regarding balancing mutation and sparseness criteria and introduce the concept of saturation as a way of talking about fully covered spaces. We show empirically that claims that novelty search is inherently objectiveless are incorrect. We leverage the understanding of novelty search as an optimizer of archive coverage, suggest several ways to improve the search, and demonstrate one simple improvement—generating some new points directly from the archive rather than the parent population.
Sociocultural Factors and Offending Among a Nationally Representative Sample of U.S. Hispanic Men and Women: A Sex-Specific Analysis
Authors: Centelles Vanessa , Powers Ráchael A.
Published: July 2023

There is limited research on how sociocultural factors may relate to offending for adult Hispanic persons by gender. Using a nationally representative sample of U.S. Hispanic men and women, we used sex-specific models to examine the relationships of sociocultural factors (i.e., discrimination, acculturation, and ethnic identity) with offending and their respective moderating effects. Acculturation and discrimination were positively associated with violent and non-violent offending among men and women, with the effects largely invariant. Ethnic identity was only salient for women and non-violent offending. Acculturation contextualized discrimination for men at higher levels of non-violent offending, albeit no other interactions were notably significant. These are situated using discourse surrounding Hispanic gender norms and symmetry, and the importance of future research.
Parameter Adaptive Research of Automatic Train Control Algorithm Based on Sliding Mode PID
Authors: Wang Ziwei , Ou Dongxiu
Published: July 2023

In existing urban rail systems, most trains are operated by automatic control, which places high demands on the control effectiveness of automatic train operation (ATO). In this study, a train operation model considering the response delay is firstly constructed. Subsequently, by analyzing and comparing the existing mainstream research methods, neural network and sliding mode control techniques were selected and incorporated into the speed control of the train. Among them, the dynamic sliding mode technique, is used to optimize the PID control effect of ATO. Single neuron and back propagation (BP) neural network algorithms are applied to the selection of PID control parameters. The study selects the difference between the actual speed of the control train and the target speed as the control objective. Through continuous optimization and iteration of the control parameters, the control accuracy of the train operation was improved. Finally, this study validates and simulates different model control methods using the actual operation data of urban rail transit. The results show that the sliding mode PID control model optimized with BP neural network performs better in terms of error distribution, average error value, and control effect variance under different simulation scenarios, showing good tracking ability and robustness. The related research results are expected to be applied to the initial selection of rail vehicle control parameters, dynamic adaptive operation control, and other fields, providing practical help to rail operators and rail signaling companies.
Violence Victimization, Homelessness, and Severe Mental Illness Among People Who Use Opioids in Three U.S. Cities
Authors: Hong Chenglin , Hoskin Jordan , Berteau Lorree K. , Schamel Jay T. , Wu Elizabeth S. C. , King Adrian R. , Randall Laura A. ,   The HBOU Study Team, Holloway Ian W. , Frew Paula M.
Published: July 2023

This study examined the associations between violence victimization, homelessness, and severe mental illness (SMI) among people who use opioids (PWUOs) in three U.S. cities. We analyzed data from a cross-sectional survey conducted from May 2019 to February 2020 across three study sites: Los Angeles, CA; Las Vegas, NV; and Atlanta, GA. We used multivariable regressions to examine how multiple victimizations and housing situation are associated with SMI. Based on K-6 scale, nearly half (44.2%) were screened positive for SMI. Meanwhile, 69.7% of the participants reported experiencing some kind of violence in their lifetime, and more than half (51.9%) reported experiencing recent violence (in the past 6 months). The most common form of lifetime violence was emotional (59.5%), followed by physical and intimate partner violence (IPV) (56.1 and 34.9%, respectively), and 34.9% of all participants reported experiencing multiple forms of victimization in the past 6 months. Participants who reported homelessness were more likely to report having experienced recent violence victimization ( p < .001). In multivariable models, experiencing recent victimization was significantly associated with SMI (adjusted odds ratio (AOR) = 1.85, 95% confidence interval [CI] [1.46, 2.38]), as was homelessness (AOR = 1.57, 95% CI [1.15, 2.14]), after adjusting for study covariates. Among those with moderate and SMI ( n = 927), only 22% were currently receiving mental health services, and those who reported having experienced any forms of violence in the past 6 months were more likely to utilize mental health services than those who had not experienced any recent violence victimization (25 vs. 17.9%, p < .05). To improve mental health and wellness among this high priority population, mental health facilities and syringe service programs may consider screening for experiences of violence and using trauma-informed mental health approaches. Harm reduction interventions must be responsive to the diverse individual and structural-level needs of PWUOs, especially those experiencing homelessness and housing insecurity. Holistic strategies and services are needed to meet the social and structural needs of this population.
Serpentine motion of a trimaran robot
Authors: Dosaev Marat , Golovanov Sergey , Klimina Liubov , Selyutskiy Yury
Published: July 2023

An aquatic robot is proposed that moves due to the motion of an internal flywheel. The body of the robot represents a trimaran that consists of a capsule and three floats rigidly attached to it. The floats are submerged into the water and ensure that the capsule is afloat. The horizontal cross-section of each float has the shape of an airfoil. The body moves in a horizontal plane. The rotation axis of the internal flywheel is vertical. The control system makes the flywheel to oscillate, which results in oscillations of the robot body together with the floats. It is known that, when an airfoil oscillates in pitch in fluid, a thrust force is produced. As a result, the center of mass of the body moves along a serpentine trajectory. The goal of the study is to describe the effect of geometrical parameters of the robot and coefficients of the control law on the average speed of propulsion. A quasi-steady model is used to describe the hydrodynamic forces acting upon the trimaran. In order to take into account non-steady effects, added masses are considered. This approach allows for describing the robot dynamics with the ODE system. Numerical simulation of the system behavior is performed. Attracting periodic solutions are found using the relaxation method. Parametric analysis of such solutions is performed. A laboratory model is manufactured, and a series of experiments is performed. It is shown theoretically and experimentally that the speed of propulsion of the robot depends non-monotonically on the control frequency.
An accurate and efficient implicit thermal network method for the steady-state temperature field
Authors: Zhan Ziquan , Fang Bin , Wan Shaoke , Bai Yu , Hong Jun , Li Xiaohu
Published: July 2023

To calculate the temperature value accurately and efficiently, an implicit thermal network method (TNM) is developed in this study. The main idea of the method is the conversion of such time-varying observed variables as the thermal resistance and the heat source into latent variables to build the implicit thermal equilibrium equation. In the implicit TNM, the steady-state temperature is taken as an independent variable, then parameters related to the steady-state temperature can be expressed as the function of the independent variable. On this basis, implicit thermal equilibrium equations can be constructed. Finally, the steady-state temperature field can be obtained by Newton’s method in optimization. To validate the performance and effectiveness of the implicit TNM, case studies and the sensitivity analysis of algorithms are conducted. The result reveals that the implicit TNM outperforms conventional TNMs, the steady-state TNM and the transient TNM, in computation accuracy, computing time and allocated memory.
Financial Implications for Families of Newborns Admitted in a Tertiary Care Neonatal Unit in Northern India
Authors: Gautam Arun , Singh Anita , Verma Akanksha , Naranje Kirti M , Gupta Girish
Published: July 2023

Background

Admission of a newborn to neonatal intensive care unit is very stressful for family and poses significant financial burden.

Aim

To estimate the cost of neonatal care in a tertiary care level institution in northern India.

Methods

This prospective observational study was conducted over a period of 4 months at a 30-bedded level III neonatal unit in a tertiary care institute in north India. Data was collected from a self-written diaries by parents of all neonates admitted in the unit. The cost analysis included direct hospital cost and additional expenditure by families during entire hospital stay.

Results

A total of 135 newborns (86 males) were enrolled in this study. 60 babies required Neonatal intensive care unit (NICU) admission. The median total expenditure incurred in study cohort was US$172 (IQR 83.5–546.3); median duration of hospital stay was 7 (IQR 5–16) days. The total expenditure per day for babies with Neonatal intensive care unit stay was US$32.7 (IQR 23.5–48). The direct hospital charges amounted to approximately 3/4th of total expenditure, while rest 1/4th was additional cost incurred upon family.

Conclusion

The cost of care of a sick newborn in public sector hospital of India is substantial. Additional expenditure apart from direct cost of treatment contributes significantly to the financial burden.
A Delphi Study to Generate, Clarify, and Prioritize Professional Recommendations on Age of Majority-Related Practice in Special Education
Authors: Walters Charles B. , Plotner Anthony J.
Published: July 2023

A confluence of research and current events in the United States has brought guardianship for people with disabilities into focus in recent years. In the process, the field of special education has been confronted with an unpleasant reality. In their action or inaction, special education professionals may play a role in parents of students with disabilities pursuing undue and overbroad guardianship. The purpose of this study was to work with researchers and practitioners supporting alternatives to guardianship to gather their foremost recommendations for the field of special education on addressing the use of undue guardianship. To this end, the researchers conducted a three-round Delphi study with these established professionals to solicit, rate, and revise their ratings of related recommendations toward achieving consensus. The 30 top recommendations they offered have been collected here and discussed in terms of their relevance for policy, practice, and research in the field.
Metastatic Neuroendocrine Neoplasms to the Pancreas: Two Unusual Cases and a Review of the Literature
Authors: DelBaugh Regina M. , Kerr Darcy A. , Dominguez-Konicki Lillian , Beard Jonathan A. , Gordon Stuart R. , Adler Jeffrey M. , Liu Xiaoying
Published: July 2023

Neuroendocrine tumor metastases to the pancreas are rare, and they share substantial overlap with the significantly more common primary pancreatic neuroendocrine neoplasms, representing a potential diagnostic pitfall. Elucidating whether a neuroendocrine tumor within the pancreas is a primary neoplasm versus a metastasis has significant prognostic and treatment implications. Correlation with clinical history and imaging as well as incorporating an appropriate immunohistochemical panel are essential to establish the correct diagnosis. Herein, we present 2 rare neuroendocrine tumors that metastasized to the pancreas: a medullary thyroid carcinoma and an atypical carcinoid tumor of lung origin. We also provide a brief review of the literature.
Renal Neuroendocrine Tumor: A Case Report with Evaluation of Grading Criteria and Relationship with Carbonic Anhydrase 9 Immunoreactivity
Authors: Monroe Hunter L. , Patadji Santiago Stell , Williams H. James , El Naili Reima
Published: July 2023

Neuroendocrine tumors (NETs) are only exceptionally primary to the kidney. At present, scant information is known regarding the behavior and prognosis of renal NETs, especially according to the assessment of grading parameters used for NETs originating from other more commonplace sites such as the pancreas and lungs. There are only rare reports of grade assessment in renal NETs, with most of these reports relying upon now antiquated World Health Organization gastroenteropancreatic and lung/thymus criteria. As an additional prognostic factor, positive CA9 staining in NETs may correlate with elevated grade, stage and risk of metastasis while serving as a potential target of chemotherapy and immunotherapy and indicator of Von Hippel–Lindau Syndrome. Rarer still are descriptions of renal NETs presenting with renal cell carcinoma in the ipsilateral or contralateral kidney. Thus, we present a patient with a primary renal NET of the right kidney with regional lymphovascular invasion and distant metastasis with an emphasis on grading criteria concordant with the World Health Organization 2022 gastroenteropancreatic and lung/thymus systems. In addition, we discuss unusual staining for CA9 in the patient's tumor and a concomitant left kidney clear cell renal cell carcinoma that may act as a clinicopathologic mimic of Von Hippel–Lindau Syndrome.