bluuebunny/crossref_metadata_2025 huggingface dataset:
Indication-specific tumor evolution and its impact on neoantigen targeting and biomarkers for individualized cancer immunotherapies
Authors: Lo Amy A , Wallace Andrew , Oreper Daniel , Lounsbury Nicolas , Havnar Charles , Pechuan-Jorge Ximo , Wu Thomas D , Bourgon Richard , Jones Ryan , Krogh Katrina , Yang Guang-Yu , Zill Oliver A
Published: October 2021

Background

Individualized neoantigen-specific immunotherapy (iNeST) requires robustly expressed clonal neoantigens for efficacy, but tumor mutational heterogeneity, loss of neoantigen expression, and variable tissue sampling present challenges. It is assumed that clonal neoantigens are preferred targets for immunotherapy, but the distributions of clonal neoantigens are not well characterized across cancer types.

Methods

We combined multiregion sequencing (MR-seq) analysis of five untreated, synchronously sampled metastatic solid tumors with re-analysis of published MR-seq data from 103 patients in order to characterize their globally clonal neoantigen content and factors that would impact neoantigen targeting.

Results

Branching evolution in colorectal cancer and renal cell carcinoma led to fewer clonal neoantigens and to clade-specific neoantigens (those shared across a subset of tumor regions but not fully clonal), with the latter not being readily distinguishable in single tumor samples. In colorectal, renal, and bladder cancer, most tumors had few globally clonal neoantigens. Prioritizing mutations with higher purity-adjusted and ploidy-adjusted variant allele frequency enriched for globally clonal neoantigens (those found in all tumor regions), whereas estimated cancer cell fraction derived from clustering-based tools, surprisingly, did not. Neoantigen quality was associated with loss of neoantigen expression in the bladder cancer case, and HLA-allele loss was observed in the renal and non-small cell lung cancer cases.

Conclusions

We show that tumor type, multilesion sampling, neoantigen expression, and HLA allele retention are important factors for iNeST targeting and patient selection, and may also be important factors to consider in the development of biomarker strategies.
Improving the Selection of Candidates for Royal Marine Recruit Training by the use of a Combination of Performance Tests
Authors: Allsopp A. J. , Shariff A.
Published: October 2021

Candidates who wish to undertake Royal Marine recruit training, a physically strenuous course which now extends 32 weeks, must first of all successfully complete a Personal Qualities Assessment (PQA) and four psychomotor tests (Naval Recruiting Tests or RTs) before attending a three-day selection course at the Commando Training Centre, Lympstone, where their Physical capabilities are tested to the full. The effectiveness of theses procedures was untested until the Institute of Naval Medicine conducted a retrospective study during 1999-2000 from which the present study is taken.

Data from 1232 recruits were examined to explore the relationship between the outcome of Commando training (pass or fail) with these various selection measures. Estimated aerobic power, time to complete the assault course and age were associated with outcome, as were PQA, RTs 1, 3, 4 and total RT score. A regression equation comprising aerobic fitness, assault course time, RT4 and age gave the best overall prediction of outcome (64%). It is suggested that this mathematical approach provides a scientifically valid and objective assessment tool for future selection strategies.
The Pathophysiology of Exertional Heatstroke
Authors: Smith J. E.
Published: October 2021

Exertional heat illness remains a major cause of morbidity and occasional mortality within the Armed Forces. This review explores the normal responses to heat, known causes of exertional heatstroke, and suggests possible answers to the question of why one member of a military unit collapses with heat stroke, while matched controls at his side remain unaffected.
An Observational Study on Diagnoses of 3,233 Gulf Veterans (Op Granby 1990-91) who attended the Ministry of Defence’s Medical Assessment Programme 1993-2004
Authors: Bale A. J. , Lee H. A.
Published: October 2021

Background

This is the result of an observational study on 3,233 Gulf veterans who have attended our medical assessment programme. We wanted to determine as a result of in-depth interviews, full medical examination and appropriate investigations, whether there was any unique Gulf war related medical condition.

Methods

Over a period of 10 years, 3,233 veterans have been assessed. All diagnoses have been made according to ICD-10 classifications. All psychiatric diagnoses have been confirmed by consultant psychiatrists.

Findings

75% of veterans were well. Of the 25% unwell, 83% of ill health was accounted for by a psychiatric disorder. 3% of veterans had organic conditions which could be linked to Gulf deployment. The most common of these were respiratory disorders, followed by digestive disorders, injuries and skin disorders. Only 11 of these cases could be linked to the use of medical countermeasures. A further, 51 cases (41 respiratory disorders, 6 infections, 2 skin disorders and 2 eye conditions) could be linked to environmental conditions.

Interpretation

All veterans seen with health problems could be identified as per ICD-10 classification of disease. We did not find any medically unexplained conditions. We found no evidence of a unique ‘Gulf War Syndrome’.
Look at the whole X-ray, not just the bones
Authors: Warwick S. , Smith J. E. , Higginson I.
Published: October 2021

A case is presented where an incidental finding on a trauma radiograph led to early diagnosis of a potentially life-threatening tumour, highlighting the need to be vigilant when interpreting X-rays.
Postoperative Vigilance in Patients with Total Intravenous Anaesthesia with Ketamine/Propofol
Authors: Felfernig Michael , Andel Dorothea , Weintraud Marion , Connor Daniel , Andel Harald , Blaicher Alex M.
Published: October 2021

Ketamine is a strong acting analgesic drug, used mainly in trauma and emergency medicine settings, as well as for minor procedures. Its pharmacological properties make it a useful drug for military anaesthesia. Ketamine acts by blocking activation of the spinal and supraspinal NMDA-type glutamate and opioid receptors. It produces dissociative anaesthesia, which means that patients might remain conscious, though insensitive to pain and amnesic (anterograde), Dysphoria and hallucinations are the main side effects in the early recovery period. We studied the incidence of post operative nausea and vomiting, vigilance disturbances and haemodynamic instability during combined ketamine and propofol anaesthesia.

No patient suffered from postoperative nausea and vomiting. No haemodynamic instabilily could be observed in any of the patients. Tie interesting point is that though there were no unpleasant emergence phenomenons, no patient reached the preoperative state of vigilance within two hours after extubation.

These results indicate that for plastic/dermatological surgical procedures, patients undergoing ketamine/propofol anaesthesia do not require excessive haemodynamic monitoring, but do need prolonged personal observation in the spostoperative period.
Unexplained early neurological deterioration after endovascular treatment for acute large vessel occlusion: incidence, predictors, and clinical impact: Data from ANGEL-ACT registry
Authors: Sun Dapeng , Tong Xu , Huo Xiaochuan , Jia Baixue , Raynald  , Wang Anxin , Ma Gaoting , Ma Ning , Gao Feng , Mo Dapeng , Song Ligang , Sun Xuan , Liu Lian , Deng Yiming , Li Xiaoqing , Wang Bo , Luo Gang , Wang Yongjun , Miao Zhongrong
Published: September 2021

Background

Early neurological deterioration (END) may occur in some patients with acute large vessel occlusion (LVO) undergoing endovascular treatment (EVT). Despite several clear causes of END, such as symptomatic intracranial hemorrhage, failure of recanalization, and intraprocedure complications, a particular END, termed unexplained END (ENDunexplained), exists. We aimed to investigate the incidence, independent predictors, and clinical impact of ENDunexplainedafter EVT in patients with acute LVO.

Methods

Subjects were selected from the ANGEL-ACT registry. ENDunexplainedwas defined as ≥4-point increase in the National Institutes of Health Stroke Scale (NIHSS) score between baseline and 24 hours after EVT, without the causes listed above. Logistic regression analyses were performed to determine the independent predictors of ENDunexplained, as well as the association between ENDunexplainedand 90-day outcomes assessed by modified Rankin Scale (mRS) score.

Results

Among the 1557 enrolled patients, the incidence of ENDunexplainedwas 4.3% (67/1557). Admission NIHSS ≤8 (OR=6.88, 95% CI 3.86 to 12.26, p<0.001), general anesthesia (OR=3.15, 95% CI 1.81 to 5.48, p<0.001), admission neutrophil to lymphocyte ratio >5 (OR=2.82, 95% CI 1.61 to 4.94, p<0.001), and number of EVT attempts >3 (OR=2.11, 95% CI 1.14 to 3.89, p=0.018) were associated independently with a high risk of ENDunexplained. Furthermore, patients with ENDunexplainedwere associated with a shift toward worse 90-day outcomes (mRS 5 vs 3, common OR=5.24, 95% CI 3.22 to 8.52, p<0.001).

Conclusions

ENDunexplainedassociated with poor 90day outcomes occurred in 4.3% of patients with acute LVO undergoing EVT. Several independent predictors of ENDunexplainedwere identified in this study, which should be considered in daily practice to improve acute LVO management.

Clinical trial Registration

http://wwwclinicaltrialsgovNCT03370939.
A quantum strategy to compute the jet quenching parameter $$\hat{q}$$
Authors: Barata João , Salgado Carlos A.
Published: October 2021

Jet quenching, the modification of the properties of a QCD jet when the parton cascade takes place inside a medium, is an intrinsically quantum process, where color coherence effects play an essential role. Despite a very significant progress in the last years, the simulation of a full quantum medium induced cascade remains inaccessible to classical Monte Carlo parton showers. In this situation, alternative formulations are worth being tried and the fast developments in quantum computing provide a very promising direction. The goal of this paper is to introduce a strategy to quantum simulate single particle momentum broadening, the simplest building block of jet quenching. Momentum broadening is the modification of the quark or gluon transverse momentum due interactions with the underlying medium, modeled as a QCD background field. At the lowest order in $$\alpha _s$$

α
s

that we consider here, momentum broadening does not involve parton splittings and particle number is conserved, greatly simplifying the quantum algorithmic implementation. This quantity is, however, very relevant for the phenomenology of RHIC, LHC or the future EIC.
A Hybrid Max–Min Ant System by Levy Flight and Opposition-Based Learning
Authors: Zhang Zhaojun , Xu Zhaoxiong , Luan Shengyang , Li Xuanyu
Published: September 2021

The max–min ant system (MMAS) is a modified ant colony optimization (ACO) algorithm. Its convergence speed is effectively improved by setting the upper and lower bounds of the pheromone and updating it in the optimal path. However, MMAS still has drawbacks, such as long search time and local extremums. In this paper, the hybrid max–min ant system (HMMAS) is proposed to deal with the shortcomings of MMAS. Employing Levy flight strategy, HMMAS can dynamically adjust the parameters to increase the diversity of solutions and expand the search range. Besides, HMMAS uses the OBL strategy to generate opposite solutions in the early stage. In this way, the convergence is accelerated. When HMMAS falls into a local extremum, the path reorganization strategy is utilized. With its help, HMMAS can redistribute the pheromone in each path and achieve global optimum. To verify the effectiveness, HMMAS is first compared with the three conventional ACO algorithms of AS, ACS, and MMAS in 20 sets of experiments. The results indicate that the average results of HMMAS in the 19 sets of TSP instances are better than the other three algorithms, and the standard deviation in the 14 sets of calculation instances is the smallest. Then, HMMAS is compared with some state-of-the-art algorithms, and the results show that HMMAS is better than other comparison algorithms, either by the minimum or the average value.
Multiple rings in the shadow of extremely compact objects
Authors: Wang Jingkai
Published: October 2021

The Event Horizon Telescope’s image of the M87 black hole provides an exciting opportunity to study black hole physics. Since a black hole’s event horizon absorbs all electromagnetic waves, it is difficult to actively probe the horizon’s existence. However, with the help of a family of extremely compact, horizon-less objects, named “gravastars”, whose external spacetimes are nearly identical to those of black holes, one can test the absence of event horizons: absences of additional features that arise due to the existence of the gravastar, or its surface, can be used as quantitative evidence for black holes. We apply Gralla et al. approach of studying black hole images to study the images of two types of gravastars: transparent ones and reflective ones. In both cases, the transmission of rays through gravastars, or their reflections on their surfaces, leads to more rings in their images. For simple emission models, where the redshifted emissivity of the disk is peaked at a particular radius [Formula: see text], the position of a series of rings can be related in a simple manner to light ray propagation: a ring shows up around impact parameter [Formula: see text] whenever rays incident from infinity at [Formula: see text] intersects the disk at [Formula: see text]. We show that additional rings will appear in the images of transparent and reflective gravastars. In particular, one of the additional rings for the reflective gravastar is due to the prompt reflection of light on the gravastar surface, and appears to be well separated from the others. This can be an intuitive feature, which may be reliably used to constrain the reflectivity of the black hole’s horizon.
APPLICATION OF FRACTAL NEURAL NETWORK IN NETWORK SECURITY SITUATION AWARENESS
Authors: DING CAICHANG , CHEN YIQIN , ALGARNI ABDULLAH M. , ZHANG GUOJUN , PENG HONGHUI
Published: September 2021

The purposes are to accurately perceive the network security situations and predict the development trend and effectively defend against network attacks during the operation of the Internet. The Long Short-Term Memory (LSTM) network is adopted as the subject of the network security situation awareness and prediction model. Moreover, it is optimized by the Genetic Algorithm (GA) to improve its global search capability. Then, a Fractal Neural Network (FNN) is constructed in combination with fractal theory, which is utilized in network security situation awareness to avoid the exploding or vanishing gradient problems. The KDD CUP 99 standard dataset is applied to verify the performance of the proposed GA-LSTM FNN; results demonstrate that its accuracy of network security situation awareness can reach 90.22%. The experimental results confirm that using the fractal difference function as the activation function can deliver the gradient variation in a balanced and stable manner. Besides, it can improve the feasibility and effectiveness of the neural network structure for network security situation awareness and prediction. The FNN studied is of practical significance for assessing the current network security situation and predicting its evolution trend, providing a reference for protecting the operation of the Internet from network attacks.
SYNTHESIS AND CHARACTERIZATION OF DIAMOND FILMS ADDED CO2 AND Ar UNDER CH4/H2 ATMOSPHERE
Authors: JIAN XIAOGANG , HU JIBO
Published: October 2021

Diamond coating was widely used in various fields because of its high performance. The study was used to describe the performance analysis of coatings prepared by CH4/H2, CH4/H2/CO2, CH4/H2/Ar, CH4/H2/CO2/Ar and analyze it by scanning electron microscopy (SEM), Raman spectrum, X-ray diffraction (XRD) and tribological experiments. The results showed that the addition of CO2 and Ar was beneficial for the preparation of coatings with smaller grain size and the friction performance was reduced, but the coating quality of nanodiamond coatings was better.
RESEARCH AND REVIEW OF CLAY AND GLASS FIBER REINFORCED POLYESTER NANOCOMPOSITE MATERIALS USING OPTIMIZATION TECHNIQUES
Authors: PRABHU P. , KUMAR M. SIVA , IQBAL S. MOHAMED , BALAJI A. , KARTHIKEYAN B.
Published: October 2021

Drilling process plays a vital role in the development of polymer clay nanocomposites. The effects of various parameters, such as tool, feed rate and speed to generate the impact on tangential force, thrust force and delamination factor acting on the material in production are studied during drilling operations in the aerospace and automotive industries. The input variable settings to adjust the speed and feed rate to show the outcomes of tangential force, thrust force and delamination factor of the material according to the consumption of the parts in the next stage of manufacturing are calculated by efficient feed rate optimization. A series of tests are performed by changing tools such as High speed steel (HSS), end mill (HEM), High speed steel (HSS), twist drill (HTD) and carbide twist drill (CTD) on various materials to evaluate the influence on the feed rate and speed. Based on the experimental analysis, mathematical modeling is implemented to study the properties of glass fiber reinforced polyester nanocomposite (GFRPNC; 3[Formula: see text]wt.%). Using the desirability approach, the optimum operating conditions of the selected process variables are considered to minimize delamination. A full factorial experiment design is adopted using the two fundamental concepts of replication and randomization of experimental design to research the relationship between the variables. Based on the analysis of variance (ANOVA), the process model is formulated using the [Formula: see text] statistical kit. It is inferred that the delamination factor is minimal for all tools (CTD, HTD and HEM) at 0.1[Formula: see text]mm/rev feed rate and speed at 852[Formula: see text]rpm.
Potential leakage paths at the dams constructed on karst terrains in Iran
Authors: Mozafari Morteza , Raeisi Ezzat
Published: September 2021

Water leakage has been reported from several dams constructed on karst terrains in Iran. In this study the main reasons for dam leakage were identified by studying 10 examples: the Lar, Kowsar, Seymareh, Tangab and Shah-Ghasem dams with considerable leakage, and the Karun I, Karun III, Karun IV, Salman Farsi and Marun dams with negligible leakage. The potential leakage passage (PLP) is defined as those parts of a karst aquifer that transfer reservoir water downstream. The most important control on leakage is in the narrowest part of the PLP, the ‘bottleneck’, which depends mainly on the geological setting. At the dams with negligible leakage, sealing of the PLPs was found to be technologically and economically feasible by connecting all the edges of the grout curtain to the natural impermeable barriers. In the cases of dams with considerable leakage, wider PLPs were not completely sealed and the installed grout curtain did not fully connect to the impermeable rock. To reduce the risk of leakage and inform effective design of grout curtains, the characteristics of the PLP should be determined during the initial stage of dam studies, and geological and hydrogeological information should be incorporated in the ground model. This study highlights the significant risk of engineering project failures that can occur if hydrogeological conditions are not properly assessed, understood and managed early in development of dam location, design and construction.
Structural and geochemical ore-forming processes in deformed gold deposits: towards a multiscale and multimethod approach
Authors: Perret Julien , André-Mayer Anne-Sylvie , Eglinger Aurélien , Feneyrol Julien , Voinot Alexandre , Morlot Christophe , Barou Fabrice , Teitler Yoram , Seira Diego , Bosc Rémi
Published: October 2021

Integrating structural control on mineralization and geochemical ore-forming processes is crucial when studying deformed ore deposits. Yet structural and geochemical data are rarely acquired at the same scale: structural control on mineralization is typically investigated from the district to the deposit and macroscopic scales whereas geochemical ore processes are described at the microscopic scale. The deciphering of a deformation–mineralization history valid at every scale thus remains challenging. This study proposes a multiscale approach that enables the reconciliation of structural and geochemical information collected at every scale, applied to the example of the Galat Sufar South gold deposit, Nubian shield, NE Sudan. It gathers field and laboratory information by coupling a classical petrological–structural study with high-resolution X-ray computed tomography, electron back-scattered diffraction and laser ablation inductively coupled plasma mass spectrometry on mineralized sulfide mineral assemblages. This approach demonstrates that there is a linear control on mineralization expressed from the district to microscopic scales at the Galat Sufar South gold deposit. We highlight the relationships between Atmur–Delgo suturing tectonics, microdeformation of sulfide minerals, syn-pyrite recrystallization metal remobilization, gold liberation and ore upgrading. Our contribution therefore represents another step forward in a holistic field-to-laboratory approach for the study of any other sulfide-bearing, structurally controlled ore deposit type.
Fractional Integral Inequalities via Atangana-Baleanu Operators for Convex and Concave Functions
Authors: Akdemir Ahmet Ocak , Karaoğlan Ali , Ragusa Maria Alessandra , Set Erhan
Published: October 2021

Recently, many fractional integral operators were introduced by different mathematicians. One of these fractional operators, Atangana-Baleanu fractional integral operator, was defined by Atangana and Baleanu (Atangana and Baleanu, 2016). In this study, firstly, a new identity by using Atangana-Baleanu fractional integral operators is proved. Then, new fractional integral inequalities have been obtained for convex and concave functions with the help of this identity and some certain integral inequalities.
Beam Selection Assisted UAV‐BS Deployment and Trajectory for Beamspace mmWave Systems
Authors: Zuo Xingxuan , Zhang Jiankang , Chen Sheng , Mu Xiaomin
Published: October 2021

Exploiting unmanned aerial vehicles (UAVs) as base stations (UAV‐BS) can enhance capacity, coverage, and energy efficiency of wireless communication networks. To fully realize this potential, millimeter wave (mmWave) technology can be exploited with UAV‐BS to form mmWave UAV‐BS. The major difficulty of mmWave UAV‐BS, however, lies in the limited energy of UAV‐BS and the multiuser interference (MUI). Beam division multiple access with orthogonal beams can be employed to alleviate the MUI. Since each user has dominant beams around the line of sight direction, beam selection can reduce the power consumption of radio frequency chain. In this paper, we formulate the problem of maximizing the sum rate of all users by optimizing the beam selection for beamspace and UAV‐BS deployment in the mmWave UAV‐BS system. This nonconvex problem is solved in two steps. First, we propose a signal‐to‐interference plus noise ratio‐based greedy beam selection scheme to ensure that all the ground users in the given area can be served by the UAV‐BS, where a zero forcing precoding scheme is used to eliminate the MUI. Then, we utilize the continuous genetic algorithm to find the optimal UAV‐BS deployment and beam pattern to maximize the sum rate of all users. Moreover, considering the mobility of the UAV‐BS, the UAV‐BS trajectory and beam selection for beamspace are optimized in the mmWave UAV‐BS system. The simulation results demonstrate the effectiveness of the proposed design for the mmWave UAV‐BS system.
Magnetic Resonance Imaging Features under Deep Learning Algorithms in Evaluated Cerebral Protection of Craniotomy Evacuation of Hematoma under Propofol Anesthesia
Authors: Xin Deqian , An Zhongzhe , Ding Juan , Li Zhi , Qiao Leyan
Published: October 2021

This study aimed to explore the value of magnetic resonance imaging (MRI) features based on deep learning super-resolution algorithms in evaluating the value of propofol anesthesia for brain protection of patients undergoing craniotomy evacuation of the hematoma. An optimized super-resolution algorithm was obtained through the multiscale network reconstruction model based on the traditional algorithm. A total of 100 patients undergoing craniotomy evacuation of hematoma were recruited and rolled into sevoflurane control group and propofol experimental group. Both were evaluated using diffusion tensor imaging (DTI) images based on deep learning super-resolution algorithms. The results showed that the fractional anisotropic image (FA) value of the hind limb corticospinal tract of the affected side of the internal capsule of the experimental group after the operation was 0.67 ± 0.28. The National Institute of Health Stroke Scale (NIHSS) score was 6.14 ± 3.29. The oxygen saturation in jugular venous (SjvO2) at T4 and T5 was 61.93 ± 6.58% and 59.38 ± 6.2%, respectively, and cerebral oxygen uptake rate (CO2ER) was 31.12 ± 6.07% and 35.83 ± 7.91%, respectively. The difference in jugular venous oxygen (Da-jvO2) at T3, T4, and T5 was 63.28 ± 10.15 mL/dL, 64.89 ± 13.11 mL/dL, and 66.03 ± 11.78 mL/dL, respectively. The neuron-specific enolase (NSE) and central-nerve-specific protein (S100β) levels at T5 were 53.85 ± 12.31 ng/mL and 7.49 ± 3.16 ng/mL, respectively. In terms of the number of postoperative complications, the patients in the experimental group were better than the control group under sevoflurane anesthesia, and the differences were substantial (

P

 < 0.05). In conclusion, MRI images based on deep learning super-resolution algorithm have great clinical value in evaluating the degree of brain injury in patients anesthetized with propofol and the protective effect of propofol on brain nerves.
Molecular Analysis of Prognosis and Immune Pathways of Pancreatic Cancer Based on TNF Family Members
Authors: Zhu Zemin , Tang Caixi , Xu Tao , Zhao Zhijian
Published: October 2021

Background. Tumor necrosis factor (TNF) family members play a vital role in anticancer therapy. This study aimed to screen the critical markers for the prognostic analysis of pancreatic adenocarcinoma (PAAD) by analyzing the clustering patterns of TNF family members in PAAD. Methods. In this study, the NMF clustering method was adopted to cluster samples from The Cancer Genome Atlas (TCGA) to acquire the clustering pattern of the TNF family in PAAD. Differential gene analysis was performed according to TNF family gene clusters. The support vector machine (SVM) method was conducted for further gene screening, and the risk score model of the screened genes was constructed by Lasso. The single sample gene set enrichment analysis (ssGSEA) method was adopted for immunoenrichment analysis and tumor immune cycle analysis. Genes associated with risk scores were analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Results. We clustered PAAD into two groups based on TNF family genes. Nineteen TNF family genes were significantly associated with the clinical characteristics of PAAD patients. The risk score formula was composed of RHOD, UBE2C, KLHDC7b, MSLN, ADAM8, NME3, GNG2, and MCOLN3. GSE57495 and GSE62452 datasets verified that patients in the high-risk group had a worse prognosis than those in the low-risk group. The risk score-related genes analyzed by GO and KEGG were mainly involved in the modulation of chemical synaptic transmission and synaptic vesicle cycle pathway. There were significant differences in the expression of 15 immune cells between the high-risk group and the low-risk group. The risk score was positively correlated with HCK, interferon, MHC-I, and STAT1. The expression of genes relevant to chemokine, immunostimulator, MHC, and receptor was strongly associated with the risk score. Conclusion. The risk score model based on the TNF family can predict the prognosis and immune status of PAAD patients. Further research is needed to verify the clinical prognostic value of risk scores.
Prediction of Europium Retention in Perovskite: Potential Candidates for an Engineering Barrier in the Disposal of Radioactive Waste
Authors: Ortiz-Oliveros Huemantzin B. , Flores Espinosa Rosa Ma. , Ávila-Pérez Pedro , Cruz-Gonzalez Daniel , Ouerfelli Noureddine
Published: October 2021

Perovskites, such as tausonite, are crystalline metal oxides with excellent optical and photocatalytic properties and have also been used successfully in the retention of metals, simulating the isotopes of uranium and plutonium. In this work, different pseudo-order and thermodynamic models were studied to achieve the prediction of the sorption of Eu3+ (chemical analogous for actinides) in tausonite. The effects of gamma irradiation and temperature on the structural characteristics of the material were determined, as an additional step in the evaluation of material as an engineering barrier in the disposal of radioactive waste. The results obtained show that the tausonite is resistant to the gamma irradiation and thermal energy. Likewise, it was possible to determine that europium sorption occurs through an exothermic and spontaneous reaction, as well as through the formation of surface complexes, where Eu3+ ions bind to sites on the tausonite by dipole-dipole interaction. Furthermore, it was shown that the sorption mechanism is influenced by diffusive phenomena, which participate in the formation of surface complexes. Additionally, a new sorption model with respect to pH was proposed, which allowed determining the physical parameter π. The evidence obtained suggests that π is a physical parameter that relates pH to an optimal value and could explain the equilibrium between the surface complexes that tausonite forms with europium. Likewise, the evidence suggests that 50 kg of tausonite would have the capacity to retain at least 26.59 g of alpha-emitting radionuclides, equivalent to a waste package (900 kg) with a maximum activity of 4000 Bq/g.
Dynamic Bus Scheduling of Multiple Routes Based on Joint Optimization of Departure Time and Speed
Authors: Liu Yingxin , Luo Xinggang , Cheng Shengping , Yu Yang , Tang Jiafu
Published: October 2021

Dynamic bus scheduling is a rational solution to the urban traffic congestion problem. Most previous studies have considered a single bus line, and research on multiple bus lines remains limited. Departure schedules have been typically planned by making separate decisions regarding departure times. In this study, a joint optimization model of the bus departure time and speed scheduling is constructed for multiple routes, and a coevolutionary algorithm (CEA) is developed with the objective function of minimizing the total waiting time of passengers. Six bus lines are selected in Shenyang, with several transfer stations between them, as a typical case. Experiments are then conducted for high-, medium-, and low-intensity case of smooth, increasing and decreasing passenger flow. The results indicate that combining the scheduling departure time and speed produces better performances than when using only scheduling departure time. The total passengers waiting time of the genetic algorithm (GA) group was reduced by approximately 25%–30% when compared to the fixed speed group. The total passengers waiting time of the CEA group can be reduced by approximately 17%–24% when compared to that in the GA group, which also holds true for a multisegment convex passenger flow. The feasibility and efficiency of the constructed algorithm were demonstrated experimentally.
Kounis Syndrome Secondary to Medicine-Induced Hypersensitivity
Authors: Karunathilake Parackrama , Ralapanawa Udaya , Jayalath Thilak , Abeyagunawardena Shamali
Published: October 2021

Introduction. Kounis syndrome is the concurrence of an acute coronary syndrome (ACS) caused by coronary vasospasms, acute myocardial infarctions, or stent thromboses in case of allergic or hypersensitivity reactions. Kounis syndrome is mediated by mast cells that interact with macrophages and T-lymphocytes, causing degranulation and inflammation with cytokine release. It is a life-threatening condition that has many trigger factors and is most commonly caused by medicines. Case Presentation. A 71-year-old male was admitted with a fever of five days’ duration associated with cellulitis, for which he had been treated with clindamycin and flucloxacillin before admission. He was a diagnosed patient with hypertension and dyslipidemia five years ago. After taking the antibiotics, he had developed generalized itching followed by urticaria suggesting an allergic reaction. Therefore, he was admitted to the hospital. After admission, he developed an ischaemic-type chest pain associated with autonomic symptoms and shortness of breath. An immediate ECG was taken that showed ST-segment depressions in the chest leads V4–V6, confirmed by a repeat ECG. Troponin I was 8 ng/mL. Acute management of ACS was started, and prednisolone 10 mg daily dose was given. After complete recovery, the patient was discharged with aspirin, clopidogrel, atorvastatin, metoprolol, losartan, isosorbide mononitrate, and nicorandil. Prednisolone 10 mg daily dose was given for five days after discharge. Conclusion. In immediate hypersensitivity, with persistent cardiovascular instability, Kounis syndrome should be considered, and an electrocardiogram and other appropriate assessments and treatments should be initiated. Prompt management of the allergic reaction and the ACS is vital for a better outcome of Kounis syndrome.
Long-Term Clinically Significant Posterior Capsular Opacification Development Pattern in Eyes Implanted with an Aspheric Monofocal Intraocular Lens with a Square Optic Edge
Authors: Placeres Dabán Javier , Elvira Juan Carlos , Azrak César , Rial Lucía , Piñero David P. , Belda José I.
Published: October 2021

Purpose. To analyse the posterior capsular opacification (PCO) development pattern in the long term in eyes implanted with a monofocal intraocular lens (IOL) with a square edge all around the optic. Methods. Longitudinal retrospective study is data analyzed from a total of 7059 eyes from 4764 patients (mean age: 75.8 years) undergoing cataract surgery with implantation of an aspheric monofocal IOL (Bi-Flex HL 677AB/677P, Medicontur, Budapest, Hungary). These data were retrospectively collected using the electronic medical record of the hospitals involved. Nd : YAG capsulotomy rates were calculated per year during a follow-up of more than 10 years. The Kaplan–Meier analysis was used to establish the transparent capsule survival rate. Results. The Nd : YAG capsulotomy rate increased from 1.1% at 1 year postoperatively to 17.2% at 5 years after surgery. No significant differences were found between eyes with and without capsulotomy in terms of age

p
=
0.202

, gender

p
=
0.061

, type of anaesthesia used

p
=
0.128

, and presence of conditions such as hard cataract

p
=
0.111

or pseudoexfoliation

p
=
0.137

. IOL power was significantly lower in those eyes of patients requiring Nd : YAG capsulotomy during the follow-up

p
<
0.001

. Significantly more eyes implanted with the preloaded model of the IOL required capsulotomy

p
<
0.001

. Mean survival time and rate were 9.38 years and 85.9%, respectively. Conclusions. Most eyes undergoing cataract with implantation of the Bi-Flex IOL do not develop a clinically significant PCO requiring Nd : YAG capsulotomy in the long term. IOL material and design may be the main factors accounting for this finding.
Salvaging the Digit in Invasive Subungual Malignancies Using a Triple Technique under Awake Local Anesthesia
Authors: Al Samer Abdel , Abou Chaar Mohamad K. , Alkhatib Ala’a Aldeen , Al-Qawasmi Muhamad , Barham Mohammad , Yaser Sameer , Salah Samer , Suleiman Abed Al Raheem , Asha Wafa
Published: October 2021

Introduction. Amputation for subungual malignancy (SUM) was thought to be the gold standard in preventing recurrence and metastasis. The rationale behind this aggressive treatment was never based on scientific evidence. Even though multiple recent studies supported more conservative management by illustrating successful results of the digit salvage technique, especially for “in situ” SUM, this salvage approach is not well supported for the more aggressive type of the “invasive” SUM; herein, we salvaged two cases of “invasive” SUM. Case Presentation. We present two cases of invasive SUM without radiographic evidence of intraosseous involvement, where we avoided digit amputation for both invasive subungual squamous cell carcinoma of the thumb and invasive subungual melanoma of the ring finger. Both were salvaged by using a triple technique under awake local anesthesia which included (I) radical excision of the nail bed unit including both eponychium and periosteum, (II) dorsal cortical bone shaving using a high-speed burr for the distal phalanx, and (III) flap coverage. Brunelli flap was used for the thumb in the first case, and V-Y plasty combined with proximal nail fold advancement flap was used for the ring finger in the second case. There was no evidence of local or distant recurrence, with a good functional outcome after 2.5 years in the first case and 2 years in the second. Conclusion. Ensuring complete resection with negative margins while preserving the functionality of the affected digit is considered to be the optimal challenge in treating “invasive” subungual malignancies. These two case reports contribute by reporting a successful digit salvage. The safety of this procedure could be confirmed by larger series and longer follow-up periods.
Edge Server Placement for Service Offloading in Internet of Things
Authors: Ma Rong
Published: October 2021

With the rapid development of the Internet of Things, a large number of smart devices are being connected to the Internet while the data generated by these devices have put unprecedented pressure on existing network bandwidth and service operations. Edge computing, as a new paradigm, places servers at the edge of the network, effectively relieving bandwidth pressure and reducing delay caused by long-distance transmission. However, considering the high cost of deploying edge servers, as well as the waste of resources caused by the placement of idle servers or the degradation of service quality caused by resource conflicts, the placement strategy of edge servers has become a research hot spot. To solve this problem, an edge server placement method orienting service offloading in IoT called EPMOSO is proposed. In this method, Genetic Algorithm and Particle Swarm Optimization are combined to obtain a set of edge server placements strategies, and Simple Additive Weighting Method is utilized to determine the most balanced edge server placement, which is measured by minimum delay and energy consumption while achieving the load balance of edge servers. Multiple experiments are carried out, and results show that EPMOSO fulfills the multiobjective optimization with an acceptable convergence speed.
Green Biosynthesis, Antioxidant, Antibacterial, and Anticancer Activities of Silver Nanoparticles of Luffa acutangula Leaf Extract
Authors: Nallappan Devi , Fauzi Agustine Nengsih , Krishna Balam Satheesh , Kumar Basivi Praveen , Reddy Avula Vijaya Kumar , Syed Tasqeeruddin , Reddy Cirandur Suresh , Yaacob Nik Soriani , Rao Pasupuleti Visweswara
Published: September 2021

Studies on green biosynthesis of newly engineered nanoparticles for their prominent medicinal applications are being the torch‐bearing concerns of the state‐of‐the‐art research strategies. In this concern, we have engineered the biosynthesized Luffa acutangula silver nanoparticles of flavonoid O‐glycosides in the anisotropic form isolated from aqueous leave extracts of Luffa acutangula, a popular traditional and ayurvedic plant in south‐east Asian countries. These were structurally confirmed by Ultraviolet‐visible (UV‐Vis), Fourier transform infrared spectroscopy accessed with attenuated total reflection (FTIR‐ATR) spectral analyses followed by the scanning electron microscopic (SEM) and the X‐ray diffraction (XRD) crystallographic studies and found them with the face‐centered cubic (fcc) structure. Medicinally, we have explored their significant antioxidant (DPPH and ABTS assays), antibacterial (disc diffusion assay on E. coli, S. aureus, B. subtilis, S. fecilis, and S. boydii), and anticancer (MTT assay on MCF‐7, MDA‐MB‐231, U87, and DBTRG cell lines) potentialities which augmented the present investigation. The molecular docking analysis of title compounds against 3NM8 (DPPH) and 1DNU (ABTS) proteins for antioxidant activity; 5FGK (Gram‐Positive Bacteria) and 1AB4 (Gram‐Negative Bacteria) proteins for antibacterial activity; and 4GBD (MCF‐7), 5FI2 (MDA‐MB‐231), 1D5R (U87), and 5TIJ (DBTRG) proteins for anticancer activity has affirmed the promising ligand‐protein binding interactions among the hydroxy groups of the title compounds and aspartic acid of the concerned enzymatic proteins. The binding energy varying from ‐9.1645 to ‐7.7955 for Cosmosioside (1, Apigenin‐7‐glucoside) and from ‐9.2690 to ‐7.8306 for Cynaroside (2, Luteolin‐7‐glucoside) implies the isolated compounds as potential bioactive compounds. In addition, the performed studies like QSAR, ADMET, bioactivity properties, drug scores, and toxicity risks confirmed them as potential drug candidates and aspartic acid receptor antagonists. This research auxiliary augmented the existing array of phytological nanomedicines with new drug candidates that are credible with multiple bioactivities.
Analysis of Influencing Factors of Acute Medication Poisoning in Adults in Emergency Department of Our Hospital from 2016 to 2019 and Observation of Curative Effect of Optimizing Emergency Procedures
Authors: Bian Wen , Zhu Na , Han Dong , Gu Fang , Hu Yiqian
Published: September 2021

Objective. This study analyzed the influencing factors of acute medication poisoning in adults in the emergency department of our hospital from January 2016 to December 2019 and observed the curative effect of optimizing emergency procedures on adult acute medication poisoning. Our results showed that, among all acute drug poisoning patients, the most common poisoning drug was sleeping pills (24.22%), followed by painkillers (20.31%) and antipsychotics (16.41%). Education level, drug category, drug source, drug dosage, unknown drug composition, and medication side effect were all influencing factors of acute drug poisoning. High school education level or below, self-purchasing medicine, medication overdose, unknown drug composition, and medication side effect were the risk factors of acute medication poisoning. In addition, after the nursing management of optimizing emergency procedures for this type of patients, the rescue time, observation time, and hospital stay of the patients had been shortened, the incidence of complications was low, the rescue success rate was high, and the clinical application effect was good.
Traditional Chinese Mind and Body Exercises for Neck Pain: A Meta-Analysis of Randomized Controlled Trials
Authors: Xie Yu-Hua , Liao Man-Xia , Wang Mao-Yuan , Fernando W. C. Hewith A. , Gu Yue-Ming , Wang Xue-Qiang , Liao Lin-Rong
Published: October 2021

Background. Neck pain is common and can have a significant impact on patients’ physical functionality, mobility, and quality of life (QOL). In clinical practice, traditional Chinese mind and body exercise (TCMBE) is a combination of different types of exercise based on traditional Chinese medicine, including qigong, tai chi, the 12-words-for-life-nurturing exercise, and so on, and many studies have found that it is safe and effective at helping patients with neck pain. Objective. The aim of this study was to investigate the effectiveness of TCMBE on pain intensity, functional mobility, and QOL in individuals with neck pain. Methods. The PubMed, MEDLINE, PEDro, and Embase databases were systematically searched for relevant studies. Randomized controlled trials reporting the effects of TCMBE on pain intensity, functional mobility, and QOL in individuals with neck pain were included. Screening, data extraction, and literature quality assessments were performed independently by two reviewers. RevMan5.4 software was used for data analysis. Results. Six studies with 716 participants met the inclusion criteria. Compared with the control groups, TCMBE had no therapeutic advantage in improving pain intensity (visual analogue scale: mean difference (MD) = 1.8, 95% confidence interval (CI): −7.70 to 11.46, and

P

 = 0.70); functional mobility (neck disability index: MD = 0.15, 95% CI: −6.37 to 6.66, and

P

 = 0.96; neck pain and disability scale: MD = 1.31, 95% CI: −4.10 to 6.71, and

P

 = 0.64); or 36-item short-form health survey (SF-36) scores for physical function (MD = 5.58, 95% CI: −8.03 to 19.18, and

P

 = 0.42), general health (MD = 1.87, 95% CI: −4.99 to 8.72, and

P

 = 0.59), body pain (MD = 2.26, 95% CI: −3.80 to 8.32, and

P

 = 0.46), vitality (MD = 6.24, 95% CI: −1.49 to 13.98, and

P

 = 0.11), social function (MD = 8.06, 95% CI: −4.85 to 20.98, and

P

 = 0.22), role physical (MD = –1.46, 95% CI: −8.54 to 5.62, and

P

 = 0.69), or role emotional (MD = 6.5, 95% CI: −3.45 to 16.45, and

P

 = 0.2). However, TCMBE was less effective at improving mental health results based on the SF-36 survey (MD = 3.37, 95% CI: 0.5 to 6.24, and

P

 = 0.02). Conclusions. Based on the meta-analysis, there is insufficient evidence to support the clinical use of TCMBE in improving pain intensity and enhancing functional mobility and QOL in individuals with neck pain.
Indications and Surgical Techniques for Repeat Corneal Transplantation in Eastern China: A Twelve-Year Study
Authors: Wan Xichen , Yao Wang , Zhao Songjiao , Xu Jianjiang , Le Qihua
Published: October 2021

Purpose. To analyze the indications and surgical procedures for repeat keratoplasty in eastern China from 2008 to 2019. Methods. This retrospective descriptive study included 418 eyes of 411 patients who underwent no less than 2 keratoplasties at the Eye, Ear, Nose and Throat Hospital of Fudan University from 2008 to 2019. Medical charts were reviewed. The primary indications for repeat keratoplasty, the reasons for regrafting, and the surgical techniques used in the treatment were collected and analyzed. Results. Among 418 eyes, 337 eyes (80.6%) had one repeat keratoplasty, and 81 eyes (19.4%) had multiple repeat keratoplasties (≥2 repeat keratoplasties). The median interval between the initial keratoplasty and the first repeat keratoplasty was 25 months, and that between two keratoplasties after the first repeat keratoplasty was 27.5 months. Infectious keratitis was the leading primary indication for single repeat keratoplasty (80 cases, 23.7%) and multiple repeat keratoplasties (19 cases, 23.5%). The second most common primary indication was bullous keratopathy for single repeat keratoplasty (49 eyes, 14.5%) and chemical injury for multiple repeat keratoplasties (14 eyes, 17.3%). The main reason for regrafting was allograft rejection (262 cases, 49.3%), followed by endothelial dysfunction (92 cases, 17.3%), and for vision improvement after tectonic keratoplasty (60 cases, 11.3%). Penetrating keratoplasty (PKP) was the major technique used in repeat keratoplasty (447 cases, 84.2%). However, Descemet stripping endothelial keratoplasty was more frequently used than PKP (72.4% vs. 27.6%,

P
<
0.001

) in the treatment of failed endothelial keratoplasty. Conclusion. Infectious keratitis was still the leading cause of repeat keratoplasty in eastern China. Although PKP remains the major technique of repeat keratoplasty, the application of customized lamellar keratoplasty has greatly expanded in the last decade. Cautious selection of indications, surgical techniques, and timing for surgery is crucial for a good prognosis after repeat keratoplasty.