bluuebunny/crossref_metadata_2025 huggingface dataset:
Evolving treatment landscape: 18 years of managing melanoma in a single patient
Authors: Biosse-Duplan Garance , Murphy Suzanne , Durrani Amer , Corrie Pippa
Published: November 2021

A 57-year-old woman diagnosed with primary melanoma was managed with a wide variety of treatments over 18 years. Given her long history of disease, the array of therapies she has received range from those no longer recommended to those recently approved. This case highlights the extraordinary rate at which both the medical and surgical melanoma treatment landscape has evolved, alongside how professional consensus has changed over the past two decades. It also demonstrates the innovation and collaboration required between the patient and the multidisciplinary team, as well as how external factors such as national guidelines, eligibility for clinical trials and drug funding in the National Health Service (NHS) alter a management plan, presenting yet another set of challenges when managing cancer patients in the modern era.
Inhaled and intranasal ciclesonide for the treatment of covid-19 in adult outpatients: CONTAIN phase II randomised controlled trial
Authors: Ezer Nicole , Belga Sara , Daneman Nick , Chan Adrienne , Smith Benjamin M , Daniels Shay-Anne , Moran Kristen , Besson Charlotte , Smyth Louisa Y , Bartlett Susan J , Benedetti Andrea , Martin James G , Lee Todd C , McDonald Emily G
Published: November 2021

Objective

To determine if inhaled and intranasal ciclesonide are superior to placebo at decreasing respiratory symptoms in adult outpatients with covid-19.

Design

Randomised, double blind, placebo controlled trial.

Setting

Three Canadian provinces (Quebec, Ontario, and British Columbia).

Participants

203 adults aged 18 years and older with polymerase chain reaction confirmed covid-19, presenting with fever, cough, or dyspnoea.

Intervention

Participants were randomised to receive either inhaled ciclesonide (600 μg twice daily) and intranasal ciclesonide (200 μg daily) or metered dose inhaler and nasal saline placebos for 14 days.

Main outcome measures

The primary outcome was symptom resolution at day 7. Analyses were conducted on the modified intention-to-treat population (participants who took at least one dose of study drug and completed one follow-up survey) and adjusted for stratified randomisation by sex.

Results

The modified intention-to-treat population included 203 participants: 105 were randomly assigned to ciclesonide (excluding two dropouts and one loss to follow-up) and 98 to placebo (excluding three dropouts and six losses to follow-up). The median age was 35 years (interquartile range 27-47 years) and 54% were women. The proportion of participants with resolution of symptoms by day 7 did not differ significantly between the intervention group (42/105, 40%) and control group (34/98, 35%); absolute adjusted risk difference 5.5% (95% confidence interval −7.8% to 18.8%). Results might be limited to the population studied, which mainly included younger adults without comorbidities. The trial was stopped early, therefore could have been underpowered.

Conclusion

Compared with placebo, the combination of inhaled and intranasal ciclesonide did not show a statistically significant increase in resolution of symptoms among healthier young adults with covid-19 presenting with prominent respiratory symptoms. As evidence is insufficient to determine the benefit of inhaled and intranasal corticosteroids in the treatment of covid-19, further research is needed.

Trial registration

ClinicalTrials.gov
NCT04435795
.
Zinc for the prevention or treatment of acute viral respiratory tract infections in adults: a rapid systematic review and meta-analysis of randomised controlled trials
Authors: Hunter Jennifer , Arentz Susan , Goldenberg Joshua , Yang Guoyan , Beardsley Jennifer , Myers Stephen P , Mertz Dominik , Leeder Stephen
Published: November 2021

Objective

To evaluate the benefits and risks of zinc formulations compared with controls for prevention or treatment of acute viral respiratory tract infections (RTIs) in adults.

Method

Seventeen English and Chinese databases were searched in April/May 2020 for randomised controlled trials (RCTs), and from April/May 2020 to August 2020 for SARS-CoV-2 RCTs. Cochrane rapid review methods were applied. Quality appraisals used the Risk of Bias 2.0 and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

Results

Twenty-eight RCTs with 5446 participants were identified. None were specific to SARS-CoV-2. Compared with placebo, oral or intranasal zinc prevented 5 RTIs per 100 person-months (95% CI 1 to 8, numbers needed to treat (NNT)=20, moderate-certainty/quality). Sublingual zinc did not prevent clinical colds following human rhinovirus inoculations (relative risk, RR 0.96, 95% CI 0.77 to 1.21, moderate-certainty/quality). On average, symptoms resolved 2 days earlier with sublingual or intranasal zinc compared with placebo (95% CI 0.61 to 3.50, very low-certainty/quality) and 19 more adults per 100 were likely to remain symptomatic on day 7 without zinc (95% CI 2 to 38, NNT=5, low-certainty/quality). There were clinically significant reductions in day 3 symptom severity scores (mean difference, MD −1.20 points, 95% CI −0.66 to −1.74, low-certainty/quality), but not average daily symptom severity scores (standardised MD −0.15, 95% CI −0.43 to 0.13, low-certainty/quality). Non-serious adverse events (AEs) (eg, nausea, mouth/nasal irritation) were higher (RR 1.41, 95% CI 1.17 to 1.69, NNHarm=7, moderate-certainty/quality). Compared with active controls, there were no differences in illness duration or AEs (low-certainty/quality). No serious AEs were reported in the 25 RCTs that monitored them (low-certainty/quality).

Conclusions

In adult populations unlikely to be zinc deficient, there was some evidence suggesting zinc might prevent RTIs symptoms and shorten duration. Non-serious AEs may limit tolerability for some. The comparative efficacy/effectiveness of different zinc formulations and doses were unclear. The GRADE-certainty/quality of the evidence was limited by a high risk of bias, small sample sizes and/or heterogeneity. Further research, including SARS-CoV-2 clinical trials is warranted.

PROSPERO registration number

CRD42020182044.
Effect of Pudilan Keyanning antibacterial mouthwash on dental plaque and gingival inflammation in patients during periodontal maintenance phase: study protocol for double-blind, randomised clinical trial
Authors: Liu Jianru , Huang Yan , Lou Xinzhe , Liu Bei , Liu Wenyi , An Na , Wu Rong , Ouyang Xiangying
Published: November 2021

Introduction

Plaque control plays a critical role in the prevention and treatment of periodontitis. Antibacterial mouthwash is one of the most important tools for plaque control. Pudilan, including extracts ofScutellaria baicalensisroot,Taraxacum mongolicum, Bunge corydalis herb andIsatis indigotica, was reported playing the role of anti-inflammatory and anti-bacterial. However, its effect on dental plaque and periodontal inflammation remains unknown. We aimed to assess the efficacy of Pudilan Keyanning antibacterial mouthwash which contains the active essence of Pudilan and 0.03%–0.06% cetylpyridinium chloride, as well as Pudilan active essence for plaque control and gingival anti-inflammation in patients during periodontal maintenance phase.

Methods and analysis

In this double-blind, randomised, placebo-controlled clinical trial, a total of 120 participants during periodontal maintenance phase will be enrolled. After supragingival scaling, they will be randomly assigned into three groups in a 1:1:1 ratio: the Pudilan Keyanning antibacterial mouthwash group, a chlorhexidine acetate mouthwash (0.12%) group or a placebo group with mouthwash containing the same components as the Pudilan Keyanning mouthwash except for Pudilan active ingredients. They will rinse with mouthwash, respectively, two times per day for 6 weeks. Clinical parameters (such as plaque index, bleeding index) and the level of volatile sulfide in the breath will be measured and analysed. The subgingival plaque will be collected and analysed microbiologically. Questionnaire feedback will be analysed.

Ethics and dissemination

The study protocol (V.4) was reviewed and approved by the Medical Ethical Committee of Peking University School and Hospital of Stomatology (Ethics Approval No. PKUSSIRB-201950153b). All participants signed a written consent form.

Trial registration number

ChiCTR2000041253.
MyPal ADULT study protocol: a randomised clinical trial of the MyPal ePRO-based early palliative care system in adult patients with haematological malignancies
Authors: Scarfò Lydia , Karamanidou Christina , Doubek Michael , Garani-Papadatos Tina , Didi Jana , Pontikoglou Charalampos , Ling Julie , Payne Cathy , Papadaki Helen Α , Rosenquist Richard , Stavroyianni Niki , Payne Sheila , Ghia Paolo , Natsiavas Pantelis , Maramis Christos , Stamatopoulos Kostas
Published: November 2021

Introduction

The systematic collection of electronic patient-reported outcome (ePRO) in the routine care of patients with chronic haematological malignancies such as chronic lymphocytic leukaemia (CLL) and myelodysplasia syndromes (MDS) can constitute a very ambitious but worthwhile challenge. MyPal is a Horizon 2020 Research & Innovation Action aiming to meet this challenge and foster palliative care for patients with CLL or MDS by leveraging ePRO systems to adapt to the personal needs of patients and caregiver(s).

Methods and analysis

In this interventional randomised trial, 300 patients with CLL or MDS will be recruited across Europe. Patients will be randomly allocated to early palliative care using the MyPal system (n=150) versus standard care including general palliative care if needed (n=150). Patients in the experimental arm will be given access to the MyPal digital health platform which consists of purposely designed software available on smartphones and/or tablets. The platform entails different functionalities including physical and psychoemotional symptom reporting via regular questionnaire completion, spontaneous self-reporting, motivational messages, medication management and a personalised search engine for health information. Data on patients’ activity (daily steps and sleep quality) will be automatically collected via wearable devices.

Ethics and dissemination

The integration of ePROs via mobile applications has raised ethical concerns regarding inclusion criteria, information provided to participants, free and voluntary consent, and respect for their autonomy. These have been carefully addressed by a multidisciplinary team. Data processing, dissemination and exploitation of the study findings will take place in full compliance with European Union data protection law. A participatory design was adopted in the development of the digital platform involving focus groups and discussions with patients to identify needs and preferences. The protocol was approved by the ethics committees of San Raffaele (8/2020), Thessaloniki ‘George Papanikolaou’ Hospital (849), Karolinska Institutet (20.10.2020), University General Hospital of Heraklion (07/15.4.2020) and University of Brno (01-120220/EK).

Trial registration number

NCT04370457.
Gender differences in faculty rank among academic physicians: a systematic review and meta-analysis
Authors: Li Ben , Jacob-Brassard Jean , Dossa Fahima , Salata Konrad , Kishibe Teruko , Greco Elisa , Baxter Nancy N , Al-Omran Mohammed
Published: November 2021

Objective

Many studies have analysed gender bias in academic medicine; however, no comprehensive synthesis of the literature has been performed. We conducted a pooled analysis of the difference in the proportion of men versus women with full professorship among academic physicians.

Design

Systematic review and meta-analysis.

Data sources

MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Education Resources Information Center and PsycINFO were searched from inception to 3 July 2020.

Study selection

All original studies reporting faculty rank stratified by gender worldwide were included.

Data extraction and synthesis

Study screening, data extraction and quality assessment were performed by two independent reviewers, with a third author resolving discrepancies. Meta-analysis was conducted using random-effects models.

Results

Our search yielded 5897 articles. 218 studies were included with 991 207 academic physician data points. Men were 2.77 times more likely to be full professors (182 271/643 790 men vs 30 349/251 501 women, OR 2.77, 95% CI 2.57 to 2.98). Although men practised for longer (median 18 vs 12 years, p<0.00002), the gender gap remained after pooling seven studies that adjusted for factors including time in practice, specialty, publications, h-index, additional PhD and institution (adjusted OR 1.83, 95% CI 1.04 to 3.20). Meta-regression by data collection year demonstrated improvement over time (p=0.0011); however, subgroup analysis showed that gender disparities remain significant in the 2010–2020 decade (OR 2.63, 95% CI 2.48 to 2.80). The gender gap was present across all specialties and both within and outside of North America. Men published more papers (mean difference 17.2, 95% CI 14.7 to 19.7), earned higher salaries (mean difference $33 256, 95% CI $25 969 to $40 542) and were more likely to be departmental chairs (OR 2.61, 95% CI 2.19 to 3.12).

Conclusions

Gender inequity in academic medicine exists across all specialties, geographical regions and multiple measures of success, including academic rank, publications, salary and leadership. Men are more likely than women to be full professors after controlling for experience, academic productivity and specialty. Although there has been some improvement over time, the gender disparity in faculty rank persists.

PROSPERO registration number

CRD42020197414.
Preterm birth among Pacific Islander women and related perinatal outcomes: a scoping review protocol
Authors: Wu Bohao , Arslanian Kendall J , Nyhan Kate , Taylor Sarah , Shabanova Veronika , Muasau-Howard Bethel , Hawley Nicola L
Published: November 2021

Introduction

Infants born alive <37 weeks are classified as premature. The global estimate of preterm birth in 2014 was 10.6%, and it is the leading cause of death of children under the age of 5 years. Preterm birth disproportionately affects women of minority populations, yet knowledge about the incidence and associated outcomes among Pacific Islanders is limited. The objectives of this scoping review are to identify studies that describe risk factors, maternal-child health outcomes and existing interventions to prevent preterm birth among Pacific Islanders, and to summarise the barriers and facilitators to decrease the burden.

Methods and analysis

We will follow the Joanna Briggs Institute Manual for Evidence Synthesis for scoping reviews and the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) to conduct this scoping review. The Covidence web application will be used for data management and consensus review. We will search on MEDLINE ALL (Ovid), EMBASE (Ovid), Web of Science Core Collection (as licensed at Yale), the Cochrane Library, CINAHL (EBSCOhost) and two non-indexed regional journals (Pacific Journal of Reproductive HealthandPacific Health Dialog). Title-abstract and full-text screening of eligible studies will be performed by two authors, and data will be extracted by the first author. Outcomes extracted will be presented using evidence mapping.

Ethics and dissemination

Findings will drive suggestions for new data collection needed to fill knowledge gaps and improve future study designs to decrease the burden of preterm birth among Pacific Islanders. There are no ethical concerns. This protocol will be disseminated in related peer-reviewed journals.
Impact of disease-modifying therapies on MRI and neurocognitive outcomes in relapsing–remitting multiple sclerosis: a protocol for a systematic review and network meta-analysis
Authors: Lees Samuel , Dicker Mathew , Ku Jie En , Chaganti Varun , Mew-Sum Matthew , Wang Nick , Smith Angela , Oldmeadow Christopher , Goon Wooi Lynn , Bevan Marc , Lang Danielle , Hinwood Madeleine
Published: November 2021

Introduction

Disease-modifying therapies (DMTs) are the mainstay of treatment for relapsing–remitting multiple sclerosis (RRMS). There is established evidence that DMTs are effective at reducing relapse rate and disease progression in RRMS, but there has been less consideration to the synthesis of MRI and neurocognitive outcomes, which play an increasingly important role in treatment decisions. The aim of this systematic review and network meta-analysis is to examine the relative efficacy, acceptability and tolerability of DMTs for RRMS, using MRI and neurocognitive outcomes.

Methods and analysis

We will search electronic databases, including MEDLINE, Embase and the Cochrane Central Register of Controlled Trials, with no date restrictions. We will also search the websites of international regulatory bodies for pharmaceuticals and international trial registries. We will include parallel group randomised controlled trials of DMTs including interferon beta-1a intramuscular, interferon beta-1a subcutaneous, interferon beta-1b, peginterferon beta-1a, glatiramer acetate, natalizumab, ocrelizumab, alemtuzumab, dimethyl fumarate, teriflunomide, fingolimod, cladribine, ozanimod, mitoxantrone and rituximab, either head-to-head or against placebo in adults with RRMS. Primary outcomes include efficacy (MRI outcomes including new T1/hypointense lesions and T2/hyperintense lesions) and acceptability (all-cause dropouts). Secondary outcomes include gadolinium-enhancing lesions, cerebral atrophy and tolerability (dropouts due to adverse events). Neurocognitive measures across three domains including processing speed, working memory and verbal learning will be included as exploratory outcomes. Data will be analysed using a random-effects pairwise meta-analysis and a Bayesian hierarchical random effects network meta-analysis to evaluate the efficacy, acceptability and tolerability of the included DMTs. Subgroup and sensitivity analyses will be conducted to assess the robustness of the findings. The review will be reported using the Preferred Reporting Items for Systematic Reviews incorporating Network Meta-Analyses statement.

Ethics and dissemination

This protocol does not require ethics approval. Results will be disseminated in a peer-reviewed academic journal.

PROSPERO registration number

CRD42021239630.
Predicting patient-level new-onset atrial fibrillation from population-based nationwide electronic health records: protocol of FIND-AF for developing a precision medicine prediction model using artificial intelligence
Authors: Nadarajah Ramesh , Wu Jianhua , Frangi Alejandro F , Hogg David , Cowan Campbell , Gale Chris
Published: November 2021

Introduction

Atrial fibrillation (AF) is a major cardiovascular health problem: it is common, chronic and incurs substantial healthcare expenditure because of stroke. Oral anticoagulation reduces the risk of thromboembolic stroke in those at higher risk; but for a number of patients, stroke is the first manifestation of undetected AF. There is a rationale for the early diagnosis of AF, before the first complication occurs, but population-based screening is not recommended. Previous prediction models have been limited by their data sources and methodologies. An accurate model that uses existing routinely collected data is needed to inform clinicians of patient-level risk of AF, inform national screening policy and highlight predictors that may be amenable to primary prevention.

Methods and analysis

We will investigate the application of a range of deep learning techniques, including an adapted convolutional neural network, recurrent neural network and Transformer, on routinely collected primary care data to create a personalised model predicting the risk of new-onset AF over a range of time periods. The Clinical Practice Research Datalink (CPRD)-GOLD dataset will be used for derivation, and the CPRD-AURUM dataset will be used for external geographical validation. Both comprise a sizeable representative population and are linked at patient-level to secondary care databases. The performance of the deep learning models will be compared against classic machine learning and traditional statistical predictive modelling methods. We will only use risk factors accessible in primary care and endow the model with the ability to update risk prediction as it is presented with new data, to make the model more useful in clinical practice.

Ethics and dissemination

Permissions for CPRD-GOLD and CPRD-AURUM datasets were obtained from CPRD (ref no: 19_076). The CPRD ethical approval committee approved the study. The results will be submitted as a research paper for publication to a peer-reviewed journal and presented at peer-reviewed conferences.

Trial registration details

A systematic review to incorporate within the overall project was registered on PROSPERO (registration number CRD42021245093). The study was registered on ClinicalTrials.gov (NCT04657900).
Mechanical thrombectomy versus intravenous alteplase alone in acute isolated posterior cerebral artery occlusion: a systematic review
Authors: Monteiro Andre , Khan Slah , Waqas Muhammad , Dossani Rimal H , Ruggiero Nicco , Siddiqi Nehaal M , Baig Ammad A , Rai Hamid H , Cappuzzo Justin M , Levy Elad I , Siddiqui Adnan H
Published: November 2021

Background

Acute isolated posterior cerebral artery occlusions (aPCAOs) were excluded or under-represented in major randomized trials of mechanical thrombectomy (MT). The benefit of MT in comparison to intravenous tissue plasminogen activator (alteplase; IV-tPA) alone in these patients remains controversial and uncertain.

Methods

We performed a systematic search of PubMed, MEDLINE, and EMBASE databases for articles comparing MT with or without bridging IV-tPA and IV-tPA alone for aPCAO using keywords (‘posterior cerebral artery’, ‘thrombolysis’ and ‘thrombectomy’) with Boolean operators. Extracted data from patients reported in the studies were pooled into groups (MT vs IV-tPA alone) for comparison. Estimated rates for favorable outcome (modified Rankin scale score 0–2), symptomatic intracranial hemorrhage (sICH), and mortality were extracted.

Results

Seven articles (201 MT patients, 64 IV-tPA) were included, all retrospective. There was no statistically significant difference between pooled groups in median age, median presentation National Institutes of Health Stroke Scale (NIHSS) score, PCAO segment, and median time from symptom onset to puncture or needle. The recanalization rate was significantly higher in the MT group than the IV-tPA group (85.6% vs 53.1%, p<0.00001). Odds ratios for favorable outcome (OR 1.5, 95% CI 0.8 to 2.5), sICH (OR 1.1, 95% CI 0.2 to 5.5), and mortality (OR 1.4, 95% CI 0.5 to 3.6) did not significantly favor any modality.

Conclusions

We found no significant differences in odds of favorable outcome, sICH, and mortality in MT and IV-tPA in comparable aPCAO patients, despite superior MT recanalization rates. Equipoise remains regarding the optimal treatment modality for these patients.
TGF-β1-containing exosomes from cardiac microvascular endothelial cells mediate cardiac fibroblast activation under high glucose conditions
Authors: Zhang Yan , Zhu Zhengru , Wang Tingting , Dong Yuan , Fan Yanhong , Sun Dongdong
Published: November 2021

Cardiac fibroblast (CF)-mediated extracellular matrix (ECM) remodeling is the key pathological basis for the occurrence and development of diabetic cardiomyopathy (DCM); its specific regulatory mechanisms have been widely studied but remain unclear. Exosomes are a type of stable signal transmission medium, and exosome-mediated cell-cell interactions play an important role in DCM. Endothelial cells form an important barrier between circulation and cardiomyocytes, in addition to being an important endocrine organ of the heart and an initial target for hyperglycemia, a key aspect in the development of DCM. We previously showed that exosomes derived from cardiac microvascular endothelial cells (CMECs) under high glucose conditions can be taken up by cardiomyocytes and regulate autophagy, apoptosis, and glucose metabolism. Consequently, in the present study, we focused on how exosomes mediate the interaction between CMECs and CFs. Surprisingly, exosomes derived from CMECs under high glucose were rich in TGF-β1 mRNA, which significantly promoted the activation of CFs. Additionally, exosomes derived from CMECs under high glucose conditions aggravated perivascular and interstitial fibrosis in mice treated with streptozotocin. Herein, we demonstrated for the first time the capacity of exosomes, released by CMECs under high glucose, to mediate fibroblast activation through TGF-β1 mRNA, which may be potentially beneficial in the development of exosome-targeted therapies to control DCM.
Strong cosmic censorship in near-extremal Kerr-Sen-de Sitter spacetime
Authors: Zhang Ming , Jiang Jie
Published: November 2021

In this work, we first calculate equations of motion for particles in the Kerr-Sen-de Sitter black hole spacetime. Then, in the eikonal regime, we analytically obtain the quasi-normal resonant modes of massless neutral scalar field perturbation and find its imaginary part to be characterized by the surface gravity of a near-extremal Kerr-Sen-de Sitter black hole with the Cauchy horizon approaching the event horizon. We further show that the Penrose strong cosmic censorship conjecture is thus respected in this spacetime with dilaton scalar field and axion pseudoscalar field.
Prospects on searches for baryonic Dark Matter produced in $${\varvec{b}}$$-hadron decays at LHCb
Authors: Brea Rodríguez Alexandre , Chobanova Veronika , Cid Vidal Xabier , López Soliño Saúl , Martínez Santos Diego , Mombächer Titus , Prouvé Claire , Rodríguez Fernández Emilio Xosé , Vázquez Sierra Carlos
Published: November 2021

A model that can simultaneously explain Dark Matter relic density and the apparent matter anti-matter imbalance of the universe has been recently proposed. The model requires b-hadron branching fractions to Dark Matter at the per mille level. The b-hadrons decay to a dark sector baryon, $$\psi _{\mathrm{DS}}$$

ψ
DS

, which has a mass in the region $$940 ~\mathrm{MeV}/c^2\le m_{\psi _{\mathrm{DS}}}\le 4430~\mathrm{MeV}/c^2$$

940

MeV
/

c
2

≤

m

ψ
DS

≤
4430

MeV
/

c
2

. In this paper, we discuss the sensitivity of the LHCb experiment to search for this dark baryon, covering different types of topology and giving prospects for Runs 3 and 4 of the LHC, as well as for the proposed Upgrade II. We show that the LHCb experiment can cover the entire mass range of the hypothetical dark baryon.
A Multimodal Deep Framework for Derogatory Social Media Post Identification of a Recognized Person
Authors: Bhowmick Rajat Subhra , Ganguli Isha , Paul Jayanta , Sil Jaya
Published: November 2021

In today’s era of digitization, social media platforms play a significant role in networking and influencing the perception of the general population. Social network sites have recently been used to carry out harmful attacks against individuals, including political and theological figures, intellectuals, sports and movie stars, and other prominent dignitaries, which may or may not be intentional. However, the exchange of such information across the general population inevitably contributes to social-economic, socio-political turmoil, and even physical violence in society. By classifying the derogatory content of a social media post, this research work helps to eradicate and discourage the upsetting propagation of such hate campaigns. Social networking posts today often include the picture of Memes along with textual remarks and comments, which throw new challenges and opportunities to the research community while identifying the attacks. This article proposes a multimodal deep learning framework by utilizing ensembles of computer vision and natural language processing techniques to train an encapsulated transformer network for handling the classification problem. The proposed framework utilizes the fine-tuned state-of-the-art deep learning-based models (e.g., BERT, Electra) for multilingual text analysis along with face recognition and the optical character recognition model for Meme picture comprehension. For the study, a new Facebook meme-post dataset is created with recorded baseline results. The subject of the created dataset and context of the work is more geared toward multilingual Indian society. The findings demonstrate the efficacy of the proposed method in the identification of social media meme posts featuring derogatory content about a famous/recognized individual.
Double-Shift: A Low-Power DNN Weights Storage and Access Framework based on Approximate Decomposition and Quantization
Authors: Han Ming , Wang Ye , Dong Jian , Qu Gang
Published: November 2021

One major challenge in deploying
Deep Neural Network (DNN)
in resource-constrained applications, such as edge nodes, mobile embedded systems, and IoT devices, is its high energy cost. The emerging approximate computing methodology can effectively reduce the energy consumption during the computing process in DNN. However, a recent study shows that the weight storage and access operations can dominate DNN's energy consumption due to the fact that the huge size of DNN weights must be stored in the high-energy-cost DRAM. In this paper, we propose Double-Shift, a low-power DNN weight storage and access framework, to solve this problem. Enabled by approximate decomposition and quantization, Double-Shift can reduce the data size of the weights effectively. By designing a novel weight storage allocation strategy, Double-Shift can boost the energy efficiency by trading the energy consuming weight storage and access operations for low-energy-cost computations. Our experimental results show that Double-Shift can reduce DNN weights to 3.96%–6.38% of the original size and achieve an energy saving of 86.47%–93.62%, while introducing a DNN classification error within 2%.
MeF-RAM: A New Non-Volatile Cache Memory Based on Magneto-Electric FET
Authors: Angizi Shaahin , Khoshavi Navid , Marshall Andrew , Dowben Peter , Fan Deliang
Published: November 2021

Magneto-Electric FET
(
MEFET
) is a recently developed post-CMOS FET, which offers intriguing characteristics for high-speed and low-power design in both logic and memory applications. In this article, we present
MeF-RAM
, a non-volatile cache memory design based on
2-Transistor-1-MEFET
(
2T1M
) memory bit-cell with separate read and write paths. We show that with proper co-design across MEFET device, memory cell circuit, and array architecture, MeF-RAM is a promising candidate for fast
non-volatile memory
(
NVM
). To evaluate its cache performance in the memory system, we, for the first time, build a device-to-architecture cross-layer evaluation framework to quantitatively analyze and benchmark the MeF-RAM design with other memory technologies, including both volatile memory (i.e., SRAM, eDRAM) and other popular non-volatile emerging memory (i.e., ReRAM, STT-MRAM, and SOT-MRAM). The experiment results for the PARSEC benchmark suite indicate that, as an L2 cache memory, MeF-RAM reduces
Energy Area Latency
(
EAT
) product on average by ~98% and ~70% compared with typical 6T-SRAM and 2T1R SOT-MRAM counterparts, respectively.
Vine Copula Based Modeling
Authors: Czado Claudia , Nagler Thomas
Published: November 2021

With the availability of massive multivariate data comes a need to develop flexible multivariate distribution classes. The copula approach allows marginal models to be constructed for each variable separately and joined with a dependence structure characterized by a copula. The class of multivariate copulas was limited for a long time to elliptical (including the Gaussian and t-copula) and Archimedean families (such as Clayton and Gumbel copulas). Both classes are rather restrictive with regard to symmetry and tail dependence properties. The class of vine copulas overcomes these limitations by building a multivariate model using only bivariate building blocks. This gives rise to highly flexible models that still allow for computationally tractable estimation and model selection procedures. These features made vine copula models quite popular among applied researchers in numerous areas of science. This article reviews the basic ideas underlying these models, presents estimation and model selection approaches, and discusses current developments and future directions.
Fabrication of an Ionomer-Free Electrode Containing Vertically Aligned One-Dimensional Nanostructures for Alkaline Membrane Fuel Cells
Authors: Kim Sungjun , Choi Jiwoo , Sung Yung-Eun , Choi Mansoo , Jang Segeun
Published: November 2021

An ionomer-free electrode containing vertically aligned one-dimensional nanostructures was designed and fabricated for anion exchange membrane fuel cells (AEMFCs) by hydrothermal and vapor deposition processes. The silver-coated zinc oxide (ZnO) nanorod arrays (diameter = ca. 100 nm) were directly aligned with the gas diffusion layer (GDL), and these one-dimensional structures of the electrode enhanced the mass transport of the reactants to the catalytic surface via its short diffusion pathway and ionomer-free nature. Applied as a cathode, the membrane electrode assembly (MEA) containing the vertically aligned gas diffusion electrode showed about 80% increased maximum power density than that of MEA containing a conventional electrode, which consisted of randomly dispersed carbon-supported nanoparticle catalysts and an ionomer. Moreover, the durability test revealed that the prepared ionomer-free catalyst layer was a more stable electrode than the conventional one. Also, water consumption and oxygen transport characteristics of AEMFC with the ionomer-free electrode at the cathode were intensively investigated by varying the electrode thickness and compositions.
Unmanned Driving Infringement Judgment Based on Wireless Sensor Network Data Mining
Authors: Yang Menglu
Published: November 2021

Based on the wireless sensor network unmanned driving infringement identification system, this paper focuses on the application of data mining technology and state machine technology and designs and implements a set of practical and effective. Self‐driving cars can reduce the frequency of traffic accidents, alleviate urban traffic congestion, improve people’s travel efficiency, and lower the threshold of driving and other social values. The data processing program and a number of algorithms are given, and a complete set of data processing procedures and algorithms are proposed, including the collection of raw sensor data, the preprocessing of the collected data, and the feature extraction of the processed data. In the experiment, the unmanned driving infringement monitoring network was first designed to conduct real‐time monitoring of unmanned driving infringements during transportation and application. Aiming at the characteristics of unmanned driving infringements, a monitoring network platform was designed for remote control and large‐scale monitoring. Secondly, according to the characteristics of the unmanned driving infringement monitoring sensor network, the unmanned driving infringement node monitoring terminal is designed. The monitoring terminal part mainly designs the sensor module, the wireless communication module, the display warning module power module, and the data mining processing module. The sensor modules, respectively, include temperature, humidity, and concentration sensors, and the communication mode in the communication module mainly adopts Wi‐Fi. At the same time, the research is based on wireless sensor network, combined with data mining technology, puts forward a sensory data display system model based on data mining technology, and conducts an in‐depth analysis of the sensory data display system model, including the logical level of the system, system architecture, and functional modules. Finally, it focuses on the specific application of data mining technology in environmental information analysis and prediction, uses JAVA programming and realizes a data analysis and display system based on wireless sensor network, and verifies the accuracy of the data mining algorithm. The experimental results analyze the application of data mining technology in the driverless infringement determination system and use a large number of unmanned driving infringements to analyze the determination rules, so as to realize the interaction between active people and driverless cars.
Beekeeping Production System, Challenges, and Opportunities in Selected Districts of South Wollo Zone, Amhara, Ethiopia
Authors: Bihonegn Addisu , Begna Desalegn
Published: November 2021

The study was conducted in Tehulederie, Kalu, and Dessie Zuria districts of South Wollo Zone, Amhara, Ethiopia, to assess the current beekeeping production system with available opportunities and challenges facing the beekeeping subsector. The districts were purposively selected based on potential and accessibility and then stratified into lowland, midland, and highland. In total, 135 beekeepers, of which 126 were males and 9 were females, were interviewed using a pretested semistructured questionnaire. The result revealed that beekeeping is actively practiced by the community regardless of age and sex. Three beekeeping production systems, that is, traditional, transitional, and movable frame hive, have been identified, accounting for 80%, 4%, and 16%, respectively. More than 80% of total bee colonies are managed being placed in the backyard. Besides, the study indicated that about 79% of the beekeepers keep bees primarily for income generation and home consumption. According to this study, the average bee colony holding size is 5.13 per a beekeeper. Also, this study identified that the swarm catching method is the major source of bee colony accounting for more than 45% to start beekeeping and 76% to increase existing colony number. Bee colony decline, absconding and swarming, honeybee pests and predators, and lack of training and extension were identified as major beekeeping challenges in the study areas. This study identified the beekeeping production system, opportunities, and challenges of the study areas and has significantly contributed to our knowledge and identified lack of extension and training as intervention areas. Therefore, practical beekeeping training and extension should get primary emphasis to combat the existing challenges.
Mufangji Decoction and Its Active Ingredient Patchouli Alcohol Inhibit Tumor Growth through Regulating Akt/mTOR-Mediated Autophagy in Nonsmall-Cell Lung Cancer
Authors: Yang Liu , Chen Hongyu , Li Ruixiao , Li Haoze , Rui Xing , Zhou Lihong , Liu Ningning , Ji Qing , Li Qi
Published: November 2021

Background. Nonsmall-cell lung cancer (NSCLC) is the main type of lung cancer, whose morbidity and mortality rank first among malignant tumors. More than 70% of NSCLC patients are diagnosed at locally advanced or advanced stage, missing the best operation period. Chemotherapy and targeted therapy are important means for the treatment of advanced NSCLC, but various side effects seriously affect the curative effect and the life quality of NSCLC patients. Our previous clinical practice has shown that Mufangji Decoction, a classic traditional Chinese medicine, has a significant curative effect in the treatment of NSCLC, but the specific mechanism is not clear. This study intends to explore the potential mechanism of Mufangji Decoction and its active ingredient patchouli alcohol against NSCLC and to provide a scientific basis for the prevention and treatment of NSCLC by traditional Chinese medicine. Methods. The in vivo and in vitro experiments were performed to evaluate the antitumor effects and investigate the underlying mechanism of Mufangji Decoction and its active ingredient patchouli alcohol. Network pharmacology was applied to analyze the effective ingredients and potential targets or signaling pathways of Mufangji Decoction. Results. Our current study shows that Mufangji Decoction can effectively inhibit the growth of subcutaneous transplantation of NSCLC. The following network pharmacological analysis and in vivo experiment suggest that patchouli alcohol is one of the main active ingredients of Mufangji Decoction and exerts antitumor effects. Further mechanism investigation reveals that the antitumor effect of patchouli alcohol is related to the induction of Akt/mTOR signaling pathway-mediated autophagy in NSCLC cells. Conclusion. Mufangji Decoction and its active ingredient patchouli alcohol might exert their antitumor effects in NSCLC partly through regulating Akt/mTOR-mediated autophagy, providing the evidence that traditional Chinese medicine might be a key approach for NSCLC treatment via targeting the Akt/mTOR signal axis.
Multistrengthening Module-Based Salient Object Detection
Authors: Zhao Qian , Wang Haifeng , Dang Junpeng , Li Songlin , Chang Rong , Fang Yanbin , Zhang Zhi , Peng Jie , Yang Yang
Published: November 2021

Object detection is a classical research problem in computer vision, and it is widely used in the automatic monitoring field of various production safety. However, current object detection techniques often suffer low detection accuracy when an image has a complex background. To solve this problem, this paper proposes a double U-shaped multireinforced unit structure network (DUMRN). The proposed network consists of a detection module (DM), a reinforced module (RM), and a salient loss function (SLF). Extensive experiments on five public datasets and a practical application dataset are conducted and compared against nine state-of-the-art methods. The experiment results show the superiority of our method over the state of the art.
Association between Biomarkers of Oxidative Stress and Inflammation with Cardiac Necrosis and Heart Failure in Non‐ST Segment Elevation Myocardial Infarction Patients and Various Degrees of Kidney Function
Authors: Roumeliotis Stefanos , Veljkovic Andrej , Georgianos Panagiotis I. , Lazarevic Gordana , Perisic Zoran , Hadzi-Djokic Jovan , Liakopoulos Vassilios , Kocic Gordana
Published: November 2021

The aim of this study was to explore the possible association between markers of inflammation and oxidative stress (OS) and markers of cardiac function and necrosis in 100 NSTEMI (non‐ST‐elevation myocardial infarction) patients with various degrees of kidney dysfunction. At admission, ejection fraction (EF), brain natriuretic peptide (BNP), troponin (TnI), creatinine phosphokinase (CPK), alanine transaminase (ALT), aspartate transaminase (AST), high‐sensitive C‐reactive protein (hs‐CRP), interleukins 6 and 10 (IL‐6, IL10), myeloperoxidase (MPO), transforming growth factor beta (TGF‐β1), glomerular filtration rate (GFR), and albuminuria were assessed. Study participants were divided into 2 subgroups based on the median level of EF. Compared to the high, patients in the low EF group had higher GFR, BNP, CPK, hs‐CRP, IL‐10, IL‐6, and MPO values and lower albuminuria levels. The levels of EF decreased in parallel with the progression of CKD, whereas the levels of BNP, IL‐6, and TGF‐β were significantly higher in late stages of CKD. Spearman’s rho correlation analysis showed that EF was inversely correlated with MPO (r = −0.20, p = 0.05) BNP (r = −0.30, p = 0.002), hs‐CRP (r = −0.38, p < 0.0001), IL‐10 (r = −0.30, p = 0.003), and IL‐6 (r = −0.24, p = 0.02) and positively with GFR (r = 0.27, p = 0.008). TnI was correlated with CPK (r = 0.44, p < 0.0001), CPK‐MB (r = 0.31, p = 0.002), ALT (r = 0.50, p < 0.0001), AST (r = 0.29, p = 0.004), IL‐10 (r = 0.22, p = 0.03), and MPO (r = −0.28, p = 0.006). In multivariate regression analysis, only BNP (β = −0.011, p = 0.004), hs‐CRP (β = −0.11, p = 0.001), and GFR (β = 0.12, p = 0.0029) were independent determinants of EF. Similarly, MPO (β = −1.69, p = 0.02), IL‐10 (β = 0.15, p = 0.006), and AST (β = 0.04, p = 0.001) were the 3 major determinants of TnI. Based on these associations, we built a predictive model including markers of inflammation and OS (MPO, IL‐10, and hs‐CRP) to identify patients with the most severe cardiac injury (combined EF below median and troponin above median values). Receiver‐operator characteristic (ROC) analysis showed that the area under the ROC curve of this model to detect patients with low EF and high TnI was 0.67 (p = 0.015, 95%confidence interval = 0.53‐0.81).
Designing an Agile Closed-Loop Supply Chain with Environmental Aspects Using a Novel Multiobjective Metaheuristic Algorithm
Authors: Kai Liu , Kordestanizadeh Ramina Malekalipour
Published: November 2021

Success in supply chain implementation depends on the way of dealing with market changes and customer needs. Agility is a concept that has been introduced in recent years to improve the supply chain. On the other hand, paying attention to environmental problems is another issue, and chains are trying to increase their popularity by focusing on this issue. Considering the importance of this issue, designing a multiobjective closed-loop supply chain network has been discussed in this research. The main contribution of this research is the integration of green and agility concepts in supply chain design. In this regard, a mathematical model is presented with economic, environmental, and agility objectives. First, the mathematical model is solved using the Epsilon constraint method, and then, the multiobjective weed algorithm is proposed to solve the model. The results of comparisons between the two methods show that the multiobjective weed algorithm has performed well in terms of various metrics of NPS, SNS, and Max Spread. In terms of the solving time, the average solving time of this algorithm was about 0.1% of the solving time of the Epsilon constraint method. Moreover, all cases show the superiority of the multiobjective weed algorithm over the Epsilon constraint method in solving the proposed mathematical model.
Insight into the Adaptability of Dominant Plant Indigofera amblyantha Craib for Ecological Restoration of Rock Slopes in Stone Coal Mine
Authors: Peng Lu , Mao Qiming , Cao Lin-Ying , Sun Hailong , Xie Xiande , Luo Shuang
Published: November 2021

The eco-restoration was a very effective measure to solve the problem of environmental pollution caused by the exposed mine surface in the stone coal mine site. In this study, the dominant plant, Indigofera amblyantha Craib, was well adapted to the eco-restoration in stone coal mining area. The changes of nutrient elements, pH, heavy metals in substrate material, the biological concentration/transfer factor, and the distribution and diversity of bacteria and fungi in rhizosphere soil were investigated. The results show that the plant communities help slow down the loss of nutrient elements and the increase of the concentrations of heavy metals in the eco-restoration process. The Indigofera amblyantha Craib had the advantaged ability to enrich and transfer Cd, Cu, Mn, and its diversity index of microbial communities in rhizosphere soils was higher than that of other quadrats. These excellent properties found in this work help reveal the insight into the adaptability of Indigofera amblyantha Craib in the eco-restoration of stone coal mines. It is valuable to evaluate Indigofera amblyantha Craib for eco-restoration engineering of stone coal mine and extend the application in heavy metal contaminated sites.