bluuebunny/crossref_metadata_2025 huggingface dataset:
A College Music Teaching System Designed Based on Android Platform
Authors: Sun Sibing
Published: September 2021

Today’s rapid evolution in information and communication technologies affects all sectors, including education, and has a positive impact. As a result, teachers need to use technology effectively and keep up with innovation to meet the needs of the next generation. The college music educational system was always an important part of higher education in China, and the corresponding music curriculum system has gradually been established. This curriculum system has been instrumental in the systematization and standardization of China’s music industry, and it has produced a large number of outstanding musical talents for the country. The goal of this research is to discover advanced and dependable teaching methods. With the growing popularity of mobile intelligent terminal devices and the expanding application of the Android platform, using a mobile intelligent terminal for university courses’ learning has become a more powerful technical feature. Through the development of an intelligent learning application using the Android intelligent platform, students can practice exercises and evaluate themselves, allowing them to analyze their weak points based on their evaluation value, whether in class or after class, and then facilitate their learning. In this paper, I present my original perspectives and proposals on music education in colleges and universities, based on literature, analysis, and study, as well as my years of practical experience. To assure stability of the suggested framework, scalability, and sustainability, I have used the Model View Controller (MVC) architecture. This framework is based on the mobile client of Android that teaches and queries college music remotely and controls smart music. According to the experimental data, online music teaching has a greater learning effect on music skills and enhances traditional music performance by 25%. In terms of increasing interest in musical courses, this online college teaching information platform has the ability to raise 74% of students’ awareness.
Modelling the Latent Semantics of Diffusion Sources in Information Cascade Prediction
Authors: Huang Ningbo , Zhou Gang , Zhang Mengli , Zhang Meng , Yu Ze
Published: September 2021

Predicting the information spread tendency can help products recommendation and public opinion management. The existing information cascade prediction models are devoted to extract the chronological features from diffusion sequences but treat the diffusion sources as ordinary users. Diffusion source, the first user in the information cascade, can indicate the latent topic and diffusion pattern of an information item to mine user potential common interests, which facilitates information cascade prediction. In this paper, for modelling the abundant implicit semantics of diffusion sources in information cascade prediction, we propose a Diffusion Source latent Semantics‐Fused cascade prediction framework, named DSSF. Specifically, we firstly apply diffusion sources embedding to model the special role of the source users. To learn the latent interaction between users and diffusion sources, we proposed a co‐attention‐based fusion gate which fuses the diffusion sources’ latent semantics with user embedding. To address the challenge that the distribution of diffusion sources is long‐tailed, we develop an adversarial training framework to transfer the semantics knowledge from head to tail sources. Finally, we conduct experiments on real‐world datasets, and the results show that modelling the diffusion sources can significantly improve the prediction performance. Besides, this improvement is limited for the cascades from tail sources, and the adversarial framework can help.
Intelligent Optimization Algorithm‐Based Path Planning for a Mobile Robot
Authors: Song Qisong , Li Shaobo , Yang Jing , Bai Qiang , Hu Jianjun , Zhang Xingxing , Zhang Ansi
Published: September 2021

The purpose of mobile robot path planning is to produce the optimal safe path. However, mobile robots have poor real‐time obstacle avoidance in local path planning and longer paths in global path planning. In order to improve the accuracy of real‐time obstacle avoidance prediction of local path planning, shorten the path length of global path planning, reduce the path planning time, and then obtain a better safe path, we propose a real‐time obstacle avoidance decision model based on machine learning (ML) algorithms, an improved smooth rapidly exploring random tree (S‐RRT) algorithm, and an improved hybrid genetic algorithm‐ant colony optimization (HGA‐ACO). Firstly, in local path planning, the machine learning algorithms are used to train the datasets, the real‐time obstacle avoidance decision model is established, and cross validation is performed. Secondly, in global path planning, the greedy algorithm idea and B‐spline curve are introduced into the RRT algorithm, redundant nodes are removed, and the reverse iteration is performed to generate a smooth path. Then, in path planning, the fitness function and genetic operation method of genetic algorithm are optimized, the pheromone update strategy and deadlock elimination strategy of ant colony algorithm are optimized, and the genetic‐ant colony fusion strategy is used to fuse the two algorithms. Finally, the optimized path planning algorithm is used for simulation experiment. Comparative simulation experiments show that the random forest has the highest real‐time obstacle avoidance prediction accuracy in local path planning, and the S‐RRT algorithm can effectively shorten the total path length generated by the RRT algorithm in global path planning. The HGA‐ACO algorithm can reduce the iteration number reasonably, reduce the search time effectively, and obtain the optimal solution in path planning.
Towards Achieving Personal Privacy Protection and Data Security on Integrated E-Voting Model of Blockchain and Message Queue
Authors: Chaisawat Siriboon , Vorakulpipat Chalee
Published: September 2021

The growing number of e-voting applications indicates the need in resolving issues that exist in the traditional election model. By integrating with blockchain technology, we could extend the model’s capabilities by presenting transparency in logic execution and integrity in data storage. Despite these advantages, blockchain brings in new challenges regarding system performance and data privacy. Due to distributed nature of blockchain, any new updating request needs to be reflected in all network’s peers before proceeding to the subsequence requests. This process produces delay and possibility in request rejection due to update conflict. In addition, data removal is no longer feasible since each record is protected by immutable hashed link. To overcome these limitations, the integration model of blockchain and message queue is proposed in this paper. The design addresses security concerns in data exchanging patterns, voter anonymization, and proof of system actor’s legitimacy. Performance tests are conducted on system prototypes which were deployed on two different settings. The result shows that the system can perform well in production environment, and introduction of message queue handling scheme can cope with blockchain’s errors in unexpected scenarios.
Effect of Health Education Combined with Dietary Guidance on Nutritional Indicator, Immune Level, and Quality of Life of Patients with Pulmonary Tuberculosis
Authors: Hu Baojuan , Ren Guoxia , Zhao Lin
Published: September 2021

Objective. To investigate the effects of health education combined with dietary guidance on nutritional indicators, immune level, and quality of life of patients with pulmonary tuberculosis. Method. A total of 123 patients with pulmonary tuberculosis who were hospitalized to our hospital between October 2019 and October 2020 were chosen for the study and were separated into 60 control cases and 63 observation cases based on the ward they were assigned to. Patients in the two groups were compared in terms of nutritional risk, nutritional indicator levels in serum, immunological function, treatment compliance, sputum culture conversion rate, and quality of life. Result. With the prolongation of patients’ illness, the total NRS 2002 score gradually increased in both groups and the total NRS 2002 score of patients in the control group was higher than that of patients in the observation group at the same time point after discharge. The difference between the total NRS 2002 score of patients in both groups was significant at 3 and 6 months after discharge. After the intervention, the Hb, ALB, CD4+, and CD4+/CD8+ levels of patients in both groups were higher than those at the time of admission, and the CD8+ levels were lower than those at the time of admission. At 6 months after discharge, the Hb, ALB, CD4+, and CD4+/CD8+ levels of patients in the observation group were significantly higher than those in the control group, and the CD8+ levels were significantly lower than those in the control group. The treatment compliance rate of patients in the observation group (96.83%) was significantly higher than that of the control group (75%), and the negative sputum culture transfer rate (85.71%) was significantly higher than that in the control group (60%). The overall quality of life scores of patients in the observation group was significantly higher than that in the control group. Conclusion. Health education combined with dietary guidance for patients with pulmonary tuberculosis can deepen patients’ understanding of disease and nutritional knowledge, improve treatment compliance, improve their nutritional status, enhance their immune function, accelerate sputum bacterial conversion, enhance treatment effect, and improve their quality of life.
[Retracted] FastQR: Fast Pose Estimation of Objects Based on Multiple QR Codes and Monocular Vision in Mobile Embedded Devices
Authors: Yan Yuheng , Liang Yiqiu , Zhou Zihan , Jiang Bin , Xiao Jian
Published: September 2021

In recent years, the pose estimation of objects has become a research hotspot. This technique can effectively estimate the pose changes of objects in space and is widely used in many mobile devices, such as AR/VR. At present, mainstream technologies can achieve high‐precision pose estimation, but the problem of that of multiple irregular objects in mobile and embedded devices under limited resource conditions is still challenging. In this paper, we propose a FastQR algorithm that can estimate the pose of multiple irregular objects on Renesas by utilizing homography method to solve the transformation matrix of a single QR code and then establish the spatial constraint relationship between multiple QR codes to estimate the posture of irregular objects. Our algorithm obtained a competitive result in simulation and verification on the RZ/A2M development board of Renesas. Moreover, the verification results show that our method can estimate the spatial pose of the multiobject accurately and robustly in distributed embedded devices. The average frame rate calculated on the RZ/A2M can reach 28 fps, which is at least 37 times faster than that of other pose estimation methods.
Constitutive Model and Deformation Characteristics of a Throat Insert Made of the C/C Composite
Authors: Tian Weiping , Wang Chunguang
Published: September 2021

Axial braided C/C composite materials are widely applied in the throat insert of solid rocket motors. It is the key for the development and design of solid rocket motors to characterize accurately the macromechanical properties of the materials. The Jones-Nelson model is employed to characterize the constitutive relation of the axial braided C/C composite material in this paper. The Jones-Nelson model is expanded and modified to characterize the C/C composite under complex load conditions. The typical external load tests were carried out to verify the accuracy. On this basis, the deformation features of the axial braided C/C composite throat insert are investigated during the working process of motors, and the strain of the throat insert during the working process is obtained by FEM. The strain and temperature in the outer surface of the throat insert are measured in the ground test of motors and are compared with the numerical results by FEM to verify the accuracy of the model. The results show that the result calculated based on the modified Jones-Nelson model by FEM is in a good agreement with the test result. It shows that the modified Jones-Nelson model can better describe the constitutive relation of C/C composite materials, and it can be promoted to the engineering application of the throat insert of solid rocket motors.
Secure Multi-Keyword Search and Access Control over Electronic Health Records in Wireless Body Area Networks
Authors: Ding Yong , Xu Hui , Wang Yujue , Yuan Fang , Liang Hai
Published: September 2021

Wireless body area network (WBAN) consists of a number of sensors that are worn on patients to collect dynamic e-health records (EHRs) and mobile devices that aggregate EHRs. These EHRs are encrypted at mobile devices and then uploaded to the public cloud for storage and user access. To share encrypted EHRs with users effectively, help users retrieve EHRs accurately, and ensure EHRs confidentiality, a secure multi‐keyword search and access control (SMKS-AC) scheme is proposed, which implements encrypted EHRs access control under the ciphertext-policy attribute-based encryption (CP-ABE). SMKS-AC provides multi‐keyword search for accurate EHRs retrieval, supports the validation of decrypted EHRs, and traces and revokes the identity of users who leak private key. Security analysis shows that SMKS-AC is secure against chosen keyword and chosen plaintext attacks. Through theoretical analysis and experimental verification, the proposed SMKS-AC scheme requires less storage resources and computational costs on mobile devices than existing schemes.
A Data Collection Strategy for Heterogeneous Wireless Sensor Networks Based on Energy Efficiency and Collaborative Optimization
Authors: Cao Li , Yue Yinggao , Zhang Yong
Published: September 2021

In the clustering routing protocol, prolonging the lifetime of the sensor network depends to a large extent on the rationality of the cluster head node selection. The selection of cluster heads for heterogeneous wireless sensor networks (HWSNs) does not consider the remaining energy of the current nodes and the distribution of nodes, which leads to an imbalance of network energy consumption. A strategy for selecting cluster heads of HWSNs based on the improved sparrow search algorithm‐ (ISSA‐) optimized self‐organizing maps (SOM) is proposed. In the stage of cluster head selection, the proposed algorithm establishes a competitive neural network model at the base station and takes the nodes of the competing cluster heads as the input vector. Each input vector includes three elements: the remaining energy of the node, the distance from the node to the base station, and the number of neighbor nodes of the node. The best cluster head is selected through the adaptive learning of the improved competitive neural network. When selecting the cluster head node, comprehensively consider the remaining energy, the distance, and the number of times the node becomes a cluster head and optimize the cluster head node selection strategy to extend the network life cycle. Simulation experiments show that the new algorithm can reduce the energy consumption of the network more effectively than the basic competitive neural network and other algorithms, balance the energy consumption of the network, and further prolong the lifetime of the sensor network.
Sweet Syndrome, Not so Sweet during an Ulcerative Colitis Flare Especially When You Cannot Eat
Authors: Stead Courtney , Hakimian Shahrad , Luffman Christina , Elaba Zendee , Orlowski Gregory , Marya Neil
Published: September 2021

Sweet syndrome is a rare skin condition characterized by painful papules, nodules, or plaques with dense neutrophilic infiltrate in the upper dermis. It has been observed as idiopathic (classical), malignancy-associated, and drug-induced. The pathogenesis is not completely understood, but it is thought to involve hypersensitivity reactions to specific triggers. In some cases the etiology is unclear or may be multifactorial. We present a case of Sweet syndrome secondary to ulcerative colitis flare versus adalimumab re-induction.
Relationship between CRP Albumin Ratio and the Mortality in Critically Ill Patients with AKI: A Retrospective Observational Study
Authors: Wang Jiajia , Zhao Kai , Mao Xuehui , Zhang Yabin , Shao Jing , Fan Weihua , Wang Yong
Published: September 2021

Background. AKI is known to be associated with inflammation and nutritional status. The novel inflammatory prognostic score CAR (CRP/albumin ratio), which combines inflammation and nutritional status, was hypothesized to be associated with mortality in critically ill AKI patients in this study. Methods. The included cases were patients admitted to the ICU of Shandong Provincial Hospital from January 2016 to November 2018 and diagnosed with AKI within 48 hours of ICU admission. From the electronic case database of Shandong Provincial Hospital, we extracted the baseline demographic information, vital signs, routine laboratory parameters, complications, and other data. The above records are measured within 48 hours of admission to ICU. The clinical endpoint was the total cause mortality rate in hospital and 2 years. We constructed two multivariate regression models to determine the statistically significant correlation between CAR and mortality and conducted subgroup analysis to determine the mortality among different subgroups. Results. A total of 580 patients were included in this study. In multivariate regression analysis, higher CAR was associated with an increase in hospital and two‐year all‐cause mortality in critically ill patients with AKI after adjusting gender, age, respiratory frequency, temperature, and other confounding factors (tertile 3 versus tertile 1: OR, 95% CI: 2.97, 1.70‐5.17; 3.03, 1.68‐5.47, respectively; P < 0.001). Subgroup analysis showed that the CAR level in each subgroup increases with hospital mortality in critically ill patients with AKI. Conclusion. The increase of CAR in critically ill patients with AKI was associated with an increased risk of all‐cause death.
Sox2 Is an Oncogenic Driver of Small-Cell Lung Cancer and Promotes the Classic Neuroendocrine Subtype
Authors: Voigt Ellen , Wallenburg Madeline , Wollenzien Hannah , Thompson Ethan , Kumar Kirtana , Feiner Joshua , McNally Moira , Friesen Hunter , Mukherjee Malini , Afeworki Yohannes , Kareta Michael S.
Published: September 2021

Although many cancer prognoses have improved in the past 50 years due to advancements in treatments, there has been little improvement in therapies for small-cell lung cancer (SCLC). One promising avenue to improve treatment for SCLC is to understand its underlying genetic alterations that drive its formation, growth, and cellular heterogeneity. RB1 loss is one key driver of SCLC, and RB1 loss has been associated with an increase in pluripotency factors such as SOX2. SOX2 is highly expressed and amplified in SCLC and has been associated with SCLC growth. Using a genetically engineered mouse model, we have shown that Sox2 is required for efficient SCLC formation. Furthermore, genome-scale binding assays have indicated that SOX2 can regulate key SCLC pathways such as NEUROD1 and MYC. These data suggest that SOX2 can be associated with the switch of SCLC from an ASCL1 subtype to a NEUROD1 subtype. Understanding this genetic switch is key to understanding such processes as SCLC progression, cellular heterogeneity, and treatment resistance.

Implications:

Understanding the molecular mechanisms of SCLC initiation and development are key to opening new potential therapeutic options for this devastating disease.
MYC Hyperactivates Wnt Signaling in APC/CTNNB1-Mutated Colorectal Cancer Cells through miR-92a–Dependent Repression of DKK3
Authors: Sehgal Priyanka , Lanauze Claudia , Wang Xin , Hayer Katharina E. , Torres-Diz Manuel , Leu N. Adrian , Sela Yogev , Stanger Ben Z. , Lengner Christopher J. , Thomas-Tikhonenko Andrei
Published: September 2021

Activation of Wnt signaling is among the earliest events in colon cancer development. It is achieved either via activating mutations in the CTNNB1 gene encoding β-catenin, the key transcription factor in the Wnt pathway, or most commonly by inactivating mutations affecting APC, a major β-catenin binding partner and negative regulator. However, our analysis of recent Pan Cancer Atlas data revealed that CTNNB1 mutations significantly co-occur with those affecting Wnt receptor complex components (e.g., Frizzled and LRP6), underscoring the importance of additional regulatory events even in the presence of common APC/CTNNB1 mutations. In our effort to identify non-mutational hyperactivating events, we determined that KRAS-transformed murine colonocytes overexpressing direct β-catenin target MYC show significant upregulation of the Wnt signaling pathway and reduced expression of Dickkopf 3 (DKK3), a reported ligand for Wnt co-receptors. We demonstrate that MYC suppresses DKK3 transcription through one of miR-17-92 cluster miRNAs, miR-92a. We further examined the role of DKK3 by overexpression and knockdown and discovered that DKK3 suppresses Wnt signaling in Apc-null murine colonic organoids and human colon cancer cells despite the presence of downstream activating mutations in the Wnt pathway. Conversely, MYC overexpression in the same cell lines resulted in hyperactive Wnt signaling, acquisition of epithelial-to-mesenchymal transition markers, and enhanced migration/invasion in vitro and metastasis in a syngeneic orthotopic mouse colon cancer model.

Implications:

Our results suggest that the MYC→miR-92a-|DKK3 axis hyperactivates Wnt signaling, forming a feed-forward oncogenic loop.
Initial Presentation of Granulomatosis with Polyangiitis as Progressive Skull Base Osteomyelitis
Authors: Qureshi Hannan A. , Bandhlish Anshu , DeConde Robert P. , Humphreys Ian M. , Abuzeid Waleed M. , Jafari Aria
Published: September 2021

A healthy man in his 30s presented with a 2-week history of severe bitemporal pain and pressure. He was initially treated for presumed acute rhinosinusitis, but his symptoms continued to worsen and underwent endoscopic sinus surgery at an outside community facility. He developed left abducens nerve palsy postoperatively, and magnetic resonance imaging (MRI) demonstrated evidence of extensive skull base osteomyelitis. He was initiated on intravenous (IV) broad-spectrum antibiotics but was subsequently found to have prostatic and submandibular sterile fluid collections. The patient subsequently developed new right abducens and left vagal nerve palsies and underwent revision endoscopic sinus surgery. Pathology revealed extensive inflammation, necrotizing granulomas, and evidence of small and medium vessel vasculitis. Extensive laboratory workup was negative, except for anti-PR-3 antibody positivity. Given the characteristic findings on pathology and laboratory findings, the patient was diagnosed with granulomatosis with polyangiitis (GPA). High-dose glucocorticoid therapy as well as rituximab infusion were promptly initiated. He had marked improvement in his symptoms and resolution of his right CN VI palsy but left-sided CN VI and CN X palsies persisted. This patient presented without the typical rhinologic manifestations of GPA, and rather presented with progressive sinusitis, skull base osteomyelitis with associated cranial neuropathies, and aseptic systemic abscesses. Prompt diagnosis of GPA is particularly important in those with otorhinolaryngological manifestations, as early initial immunosuppressive therapy has been linked to lower relapse and mortality rates. Vigilance and early differentiation between GPA and other forms of sinusitis is of critical importance, particularly when symptoms are refractory to standard rhinosinusitis therapies.
Phenotypic Differences of CD103+ Tissue-Resident Memory T Cells Associated with Various Cancers
Authors: Park Hye Seon , Jeon Yeonjin , Lee Hyun , Lee Heejae , Kim Young-Ae , Park In Ah , Bang Won Seon , Lee Miseon , Cho Young Jin , Kim Jihyeong , Gong Gyungyub , Lee Hee Jin
Published: September 2021

Background/Aims: The presence and clinical importance of tissue-resident memory T (TRM) cells have been recently described in association with various cancer types. However, the frequency and the traditional naïve–effector–memory phenotypic characteristics of TRM cells are largely unknown. Methods: We analyzed single-cell populations of colorectal cancer (CC, n = 18), stomach cancer (SC, n = 13), renal cell carcinoma (RCC, n = 19), and breast cancer (BC, n = 16) by dissociation of tumor tissue with collagenase/hyaluronidase. We investigated populations of naïve, effector, and memory T and TRM cells by flow cytometry. Results: Among CD8− cells, CC was associated with a significantly higher proportion of CD103+ T cells than other tumor types (p < 0.001). Among CD8+ cells, CC and SC were associated with higher CD103+ T-cell proportions than RCC and BC (p < 0.001). Significantly more CD8+ than CD8− cells expressed CD103 (p < 0.001). In association with SC, RCC, and BC, CD8+ T cells had a similar T-cell phenotype composition pattern: fewer effector T cells and more memory-type T cells among CD103+ cells compared with CD103− cells (p < 0.05). Tumors with higher proportion of CD103+ cells had no specific clinicopathologic characteristics than those with lower proportion of CD103+ cells. Conclusion: TRM cell abundance and phenotypes varied among CC, SC, RCC, and BC. Further studies regarding the functional differences of TRM associated with various tumors are warranted.
Pneumologische Rehabilitation bei ILD: Unmittelbar effektive Verbesserung der Lebensqualität, aber wie sieht es langfristig aus?
Authors: Faccioli Desiree , Spielmanns Marc
Published: September 2021

Background and aim: Benefits of pulmonary rehabilitation in Interstitial Lung Diseases (ILD) have been reported. The aim of this large multicenter study was to identify the success predictors of pulmonary rehabilitation in a real-life setting. Methods: Data of 240 in-patients (110 idiopathic pulmonary fibrosis (IPF), 106 ILD other than IPF and 24 undetermined ILD) undergoing pulmonary rehabilitation in a 10-year period were retrospectively evaluated. Six minute walking distance (6MWT), body weight-walking distance product tests, dyspnoea and arterial blood gases were assessed at admission and discharge. Differences in post rehabilitation changes in outcome measures as function of baseline characteristics were evaluated. Results:After rehabilitation, patients showed improvements in all outcome measures (p < 0.05), regardless of the underlying diagnosis or disease severity. Patients needing oxygen therapy at rest showed reduced benefits. Baseline 6MWD inversely correlated with its changes at discharge. Non-significant greater benefits after rehabilitation were found in IPF patients under antifibrotic therapy. In a subset of 50 patients assessed on average 10.3 ± 3.5 months after discharge, the benefits in 6MWD were not maintained (312.9 ± 139.4, 369.7 ± 122.5 and 310.8 ± 139.6 m at admission, discharge and follow up respectively: p < 0.0001). Conclusion: Pulmonary rehabilitation may improve dyspnoea, exercise capacity and fatigue in patients with ILD of different aethiologies and level of severity. The long-term effects need to be established.
Serum Biomarker Status with a Distinctive Pattern in Prognosis of Gastroenteropancreatic Neuroendocrine Carcinoma
Authors: Zhang Jianwei , Cao Yanshuo , Zhang Panpan , Zhang Xiaotian , Li Jian , Zhou Jun , Wang Xicheng , Peng Zhi , Sun Yu , Li Jie , Shen Lin , Lu Ming
Published: September 2021

Objective: Gastroenteropancreatic neuroendocrine carcinoma (GEPNEC) is a major research focus, but the application of biomarkers to guide its prognostication and management is unsatisfying. Clinical values of conventional serum biomarkers, neuron-specific enolase (NSE), carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA199) warrant scrutiny. Methods: Patients diagnosed with GEPNEC with baseline NSE, CEA, and CA199 levels provided in Peking University Cancer Hospital were retrospectively studied. Relationships between biomarkers and prognosis were investigated by the χ2 test, Kaplan-Meier analysis, and univariate and multivariate Cox regression analyses. Results: A total of 640 GEPNEC patients were enrolled. NSE, CEA, and CA199 were elevated in 59.5%, 28.5%, and 21.3% of the population, respectively. Higher NSE had worse median overall survival (OS) (17.0 months vs. not reached, hazard ratio = 2.77 [2.06, 3.73], p < 0.001), and so did patients with higher CEA and CA199. Multivariable analysis confirmed that NSE and CA199 correlated with OS independently. Baseline NSE level and NSE remission predicted OS and the response of patients with first-line etoposide plus cisplatin (EP) treatment. Furthermore, we combined NSE/CEA/CA199 to segregate GEPNEC into novel subgroups, namely, adenocarcinoma-like NEC (ALN), neuroendocrine-like NEC (NLN), and triple-normal NEC (TNN). The groups shared distinctive clinicopathologic features and prognosis (21.0 months vs. 17.1 months vs. not reached, p < 0.001). The EP regimen remained the priority treatment option in NLN/TNN, while ALN was predisposed to “adenocarcinoma-like chemotherapy.” Conclusions: Elevation of NSE, CEA, or CA199 was common and independently indicates poor prognosis in GEPNEC patients. Serum biomarker-based subtypes suggest meaningful clinical implications and appropriate therapeutic approaches, illuminating promising ways to characterize the prognosis of GEPNEC.
Transient Receptor Potential Melastatin 2 Thermosensitive Neurons in the Preoptic Area Involved in Menopausal Hot Flashes in Ovariectomized Mice
Authors: Yang Qiyue , Sun Yanrong , Wang Wenjuan , Jia Jing , Bai Wenpei , Wang Ke , Wang Ziyue , Luo Xiaofeng , Wang Hong , Qin Lihua
Published: September 2021

Introduction: Menopausal hot flashes are related to hypothalamic preoptic area (POA) dysfunction. Thermosensitive transient receptor potential channels (ThermoTRPs) are involved in temperature sensing and regulation of thermosensitive neurons (TSNs) in the POA. Whether ThermoTRP-TSNs in the POA, particularly the non-noxious thermoreceptor, transient receptor potential melastatin 2 (TRPM2), are involved in the occurrence of hot flashes is still unclear. Methods: Twenty wild-type and 50 Trpm2-Cre adult female mice were randomly divided into sham (SHAM) and ovariectomy (OVX) groups. In the POA, ERα, ERβ, GPR30, TRPA1, TRPM8, TRPM2, and TRPV1 expression was detected by Western blot or/and quantitative real-time polymerase chain reaction and the number of TSNs expressing TRPM2 (TRPM2-TSNs) by immunofluorescence. Before and after TRPM2-TSN activation/inhibition, back (BST) and tail skin temperature (TST) and the proportion of glutamatergic and GABAergic neurons among TRPM2-TSNs were recorded. Results: Compared with SHAM, the expression of ERα, ERβ, TRPM2, and TRPM8 in the POA of the OVX group decreased, with a significantly larger change range for TRPM2 than TRPM8. In addition, the number of TRPM2-TSNs showing TRPA1, TRPM8, and TRPV1 expression in the OVX group decreased, and the proportion of glutamatergic and GABAergic neurons in TRPM2-TSNs decreased and increased, respectively. Meanwhile, BST and TST increased. After activating or inhibiting TRPM2-TSNs, the proportions of glutamatergic and GABAergic neurons in TRPM2-TSNs changed, along with the BST and TST. Conclusion: In menopause, the abnormal quantity and function of TRPM2-TSNs in the POA is key for the development of hot flashes, characterized by an imbalance in heat dissipation and production due to the corresponding imbalance in glutamatergic and GABAergic neurons.
Dietary Neu5Ac Intervention Protects Against Atherosclerosis Associated With Human-Like Neu5Gc Loss—Brief Report
Authors: Kawanishi Kunio , Coker Joanna K. , Grunddal Kaare V. , Dhar Chirag , Hsiao Jason , Zengler Karsten , Varki Nissi , Varki Ajit , Gordts Philip L.S.M.
Published: September 2021

Objective:

Species-specific pseudogenization of the
CMAH
gene during human evolution eliminated common mammalian sialic acid
N
-glycolylneuraminic acid (Neu5Gc) biosynthesis from its precursor
N
-acetylneuraminic acid (Neu5Ac). With metabolic nonhuman Neu5Gc incorporation into endothelia from red meat, the major dietary source, anti-Neu5Gc antibodies appeared. Human-like
Ldlr
−/−
Cmah
−/−
mice on a high-fat diet supplemented with a Neu5Gc-enriched mucin, to mimic human red meat consumption, suffered increased atherosclerosis if human-like anti-Neu5Gc antibodies were elicited.

Approach and Results:

We now ask whether interventional Neu5Ac feeding attenuates metabolically incorporated Neu5Gc-mediated inflammatory acceleration of atherogenesis in this
Cmah
−/−
Ldlr
−/−
model system. Switching to a Neu5Gc-free high-fat diet or adding a 5-fold excess of Collocalia mucoid-derived Neu5Ac in high-fat diet protects against accelerated atherosclerosis. Switching completely from a Neu5Gc-rich to a Neu5Ac-rich diet further reduces severity. Remarkably, feeding Neu5Ac-enriched high-fat diet alone has a substantial intrinsic protective effect against atherosclerosis in
Ldlr
−/−
mice even in the absence of dietary Neu5Gc but only in the human-like
Cmah
-null background.

Conclusions:

Interventional Neu5Ac feeding can mitigate or prevent the red meat/Neu5Gc-mediated increased risk for atherosclerosis, and has an intrinsic protective effect, even in the absence of Neu5Gc feeding. These findings suggest that similar interventions should be tried in humans and that Neu5Ac-enriched diets alone should also be investigated further.

Graphic Abstract:

A graphic abstract is available for this article.
Yellow Wine Polyphenolic Compound Protects Against Doxorubicin-Induced Cardiotoxicity by Modulating the Composition and Metabolic Function of the Gut Microbiota
Authors: Lin Hui , Meng Liping , Sun Zhenzhu , Sun Shiming , Huang Xingxiao , Lin Na , Zhang Jie , Lu Wenqiang , Yang Qi , Chi Jufang , Guo Hangyuan
Published: September 2021

Background:

Dietary polyphenols help to prevent cardiovascular diseases, and interactions between polyphenols and gut microbiota are known to exist. In this study, we speculated that gut microbiota-mediated metabolite regulation might contribute to the anticardiotoxic effects of yellow wine polyphenolic compound (YWPC) in doxorubicin (DOX)-treated rats.

Methods:

16S-rDNA sequencing was performed to analyze the effects of YWPC on the gut microbiota in DOX-treated rats (n=6). Antibiotics were used to investigate the contribution of the altered microbiome to the role of YWPC (n=6). Plasma metabolomics were also analyzed by untargeted gas chromatography-mass spectrometry systems.

Results:

YWPC ameliorated DOX-mediated cardiotoxicity, as evidenced by increased cardiac and mitochondrial function and reduced levels of inflammation and myocardial apoptosis (
P
<0.05 for all). The low abundance of
Escherichia
–
Shigella
,
Dubosiella
, and
Allobaculum
, along with enrichment of
Muribaculaceae_unclassified
,
Ralstonia
, and
Rikenellaceae_RC9_gut_group
in the gut, suggested that YWPC ameliorated DOX-induced microbial dysbiosis. YWPC also influenced the levels of metabolites altered by DOX, resulting in lower arachidonic acid and linoleic acid metabolism and higher tryptophan metabolite levels (
P
<0.05 for all). Correlational studies indicated that YWPC alleviated DOX-induced inflammation and mitochondrial dysfunction by modulating the gut microbial community and its associated metabolites. Antibiotic treatment exacerbated cardiotoxicity in DOX-treated rats, and its effect on the gut microbiota partly abolished the anticardiotoxic effects of YWPC, suggesting that the microbiota is required for the cardioprotective role of YWPC.

Conclusions:

YWPC protected against DOX-induced cardiotoxicity in a gut microbiota–dependent manner. This supports the use of dietary polyphenols as a therapeutic approach for the treatment of cardiovascular diseases via microbiota regulation.
Clinical Heart Failure Among Patients With and Without Severe Mental Illness and the Association With Long-Term Outcomes
Authors: Polcwiartek Christoffer , Loewenstein Daniel , Friedman Daniel J. , Johansson Karin G. , Graff Claus , Sørensen Peter L. , Nielsen René E. , Kragholm Kristian , Torp-Pedersen Christian , Søgaard Peter , Jensen Svend E. , Jackson Kevin P. , Atwater Brett D.
Published: September 2021

Background:

Patients with severe mental illness (SMI) including schizophrenia, bipolar disorder, and severe depression have earlier onset of cardiovascular risk factors, predisposing to worse future heart failure (HF) compared with the general population. We investigated associations between the presence/absence of SMI and long-term HF outcomes.

Methods:

We identified patients with HF with and without SMI in the Duke University Health System from 2002 to 2017. Using multivariable Cox regression, we examined the primary outcome of all-cause mortality. Secondary outcomes included rates of implantable cardioverter defibrillator use, cardiac resynchronization therapy, left ventricular assist device implantation, and heart transplantation.

Results:

We included 20 906 patients with HF (SMI, n=898; non-SMI, n=20 008). Patients with SMI presented clinically 7 years earlier than those without SMI. We observed an interaction between SMI and sex on all-cause mortality (
P
=0.002). Excess mortality was observed among men with SMI compared with men without SMI (hazard ratio, 1.36 [95% CI, 1.17–1.59]). No association was observed among women with and without SMI (hazard ratio, 0.97 [95% CI, 0.84–1.12]). Rates of implantable cardioverter defibrillator use, cardiac resynchronization therapy, left ventricular assist device implantation, and heart transplantation were similar between patients with and without SMI (6.1% versus 7.9%,
P
=0.095). Patients with SMI receiving these procedures for HF experienced poorer prognosis than those without SMI (hazard ratio, 2.12 [95% CI, 1.08–4.15]).

Conclusions:

SMI was associated with adverse HF outcome among men and not women. Despite equal access to procedures for HF between patients with and without SMI, those with SMI experienced excess postprocedural mortality. Our data highlight concurrent sex- and mental health-related disparities in HF prognosis, suggesting that patients with SMI, especially men, merit closer follow-up.
Synopsis of the Brazilian genus Symphyllophyton (Gentianaceae) with four new species
Authors: GUIMARÃES ELSIE FRANKLIN , ALVES RUY JOSÉ VÁLKA , SANTOS EDUARDO RIBEIRO DOS , SILVA NÍLBER GONÇALVES DA
Published: September 2021

Symphyllophyton (Gentianaceae) is characterized by autotrophic herbs, with tetramerous flowers didynamous stamens, filaments attached to the distal portion of the corolla tube and connate-perfoliate or free leaves. The finding of a new population in the Brazilian State of Goiás inspired a detailed and unprecedented study of the genus, which lead to the discovery of four new species in different States and to the repositioning of Schultesia sucreana within the genus, thus elevating the known number of species from two to seven. A lectotype is designated for the genus. Descriptions, illustrations, and an identification key are provided along with notes on ecology and conservation.
Designing an AfCFTA-Driven Continent-Wide Competition Policy Around the Regional Economic Communities
Authors: Okadia Fiona , Wa-Kyendo Emmanuel , Njeru Melody , Jattani Darmi , Kemboi Leo
Published: September 2021

Implementation of the African Continental Free Trade Area (AfCFTA) Agreement will lead to liberalization of trade in Africa, thus expanding the market for African products and services. Expansion of markets necessitates development of a regulatory framework that will promote healthy competition among businesses and protect consumers’ welfare. The Agreement recognizes this fact and has set out the Competition Protocol among the key enablers of its success. Since the regional economic communities (RECs) are the building blocks of the continental wide free trade area, the analysis of their regional competition regime is paramount for providing insight that will guide the development of the Competition Protocol. This article responds to this need by analyzing Africa’s four largest RECs and providing policy proposals on how the continental competition policy should be fashioned. Specifically, this article looks at the RECs’ institutional structure, principles, and carries out a legal, economic, and political analysis on the same. It examines how these laws relate to the three elements (abuse of dominance, anticompetitive mergers, and acquisitions) of competition policy and the challenges that they pose in achieving AfCFTA’s goal. It also looks into the challenges that affect trade and fair competition in the region. Finally, it offers proposals on the competition framework that bridge the gap between the AfCFTA Agreement objectives and the African economic, political, and legal realities.
Quick on the Draw: American Negativity Bias and Costly Signals in International Relations
Authors: Kim Seok Joon
Published: September 2021

States signal their intentions to domestic and foreign audiences but are not always believed. Why do people believe some state signals but not others? Using a survey experiment on a representative sample of the US public, this study finds that individuals have a negativity bias when assessing the credibility of state signals. They take other states’ aggressive actions as evidence of deep hostility but are skeptical of the credibility of conciliatory gestures. The experimental result shows that the mobilization of a small proportion of an army is perceived credible enough as an aggressive action, while the removal of even a large proportion is not perceived as conciliatory. The psychological mechanism found here is a strong foundation for theorizing about how individuals process information embedded in state signals and can improve our understanding of signaling.
What’s Fair in International Politics? Equity, Equality, and Foreign Policy Attitudes
Authors: Powers Kathleen E. , Kertzer Joshua D. , Brooks Deborah J. , Brooks Stephen G.
Published: September 2021

How do concerns about fairness shape foreign policy preferences? In this article, we show that fairness has two faces—one concerning equity, the other concerning equality—and that taking both into account can shed light on the structure of important foreign policy debates. Fielding an original survey on a national sample of Americans, we show that different types of Americans think about fairness in different ways, and that these fairness concerns shape foreign policy preferences: individuals who emphasize equity are far more sensitive to concerns about burden sharing, are far less likely to support US involvement abroad when other countries aren’t paying their fair share, and often support systematically different foreign policies than individuals who emphasize equality. As long as IR scholars focus only on the equality dimension of fairness, we miss much about how fairness concerns matter in world politics.
Problems in managing a co-morbid patient with no previous medical records undergoing alternative therapy
Authors: Baptist Joanna , Shetty Premalatha , Singh Rica , Achappa Basavaprabhu
Published: September 2021

Individuals with intellectual disability are often uncooperative for complete dental evaluation and treatment. Many of these patients fall within autistic spectrum disease. These patients are also said to be associated with other medically relevant disorders such as seizures, and metabolic and hormonal dysfunction. Undertaking treatment of such patients under general anaesthesia will require complete medical evaluation. As many of the antiepileptic drugs interact with anaesthetic agents, a sound knowledge of drugs taken by the patient is necessary. However, when the patient is under alternative therapy, this problem becomes multi-fold. This paper will discuss the basic, but real problems with the gap of understanding between allopathic and alternative therapy, the importance of reviewing the patients’, previous medical records, and its medico-legal consequences. It will also raise the issue of delays in management with increased cost and time of hospitalisation in such patients.
Turkish Muslim Physicians' and Nurses' Views About the Do Not Resuscitate Order: A Cross-Sectional Two Center Study
Authors: Çuvalci Burcu , Akbal Yağmur , Hintistan Sevilay
Published: September 2021

This study aims to determine Turkish Muslim physicians’ and nurses’ views about the Do Not Resuscitate order and the factors influencing these views. This was a cross-sectional, descriptive study. The sample consisted of 327 health workers including 77 physicians and 250 nurses employed in internal and surgical clinics, intensive care units and emergency services of two different university hospitals located in the northeast of Turkey. 90.9% of Muslim Turkish physicians and 74.4% of nurses request the Do Not Resuscitate order to be legally implemented. The factors predicting 40.0% of Muslim Turkish physicians and nurses requesting the legal implementation of the Do Not Resuscitate order were determined as working at institution 1; requesting implemented before emergencies occur, in emergencies and in both cases; considering informing the patient and their surrogates about as a patient's right; and requesting to be a surrogate for one relatives.
Remembering John Polkinghorne: a vision of one world, and one culture
Authors: C. B. McLeish Tom
Published: September 2021

A personal recollection of gratitude reports on the way that the writings of John Polkinghorne inspired and guided the author’s own thinking in science and theology since meeting him as a graduate student. Themes of both agreement and disagreement are selected from the many to be found in Polkinghorne’s corpus. Closer attention is paid to two of his books, Science and Christian Belief and Faith, Science and Understanding. A running theme is the creative tension of a ‘bottom-up thinker’, one of whose salient and influential arguments was that of ‘top-down causation’. Although there is disagreement over Polkinghorne’s exegesis of divine character in Job, thinking the argument through did bear fruit.
Living in communion: visible unity and the Porvoo Common Statement
Authors: Tjørhom Ola
Published: September 2021

Living in communion is no mere organizational measure; it means sharing in a common life that is anchored in love, solidarity and mutual accountability. In the classic vision of the ecumenical movement, this is expressed through the goal of a visible and structured unity. The Porvoo Common Statement, in providing the basis for fellowship between Anglican and Lutheran Churches in Europe, is comparable to this goal. However, on the occasion of the twenty-fifth anniversary of the signing of the text, it should be asked if today’s Porvoo communion lives up to the aspirations in the Porvoo statement.
Difficult text: John 14.6 – is Jesus the only way?
Authors: Wallis Ian
Published: September 2021

Few verses have defined Christian identity and informed attitudes to other religions more than John 14.6. But who is the ‘I’ in ‘I am the way and the truth and the life’? After exploring antecedents and considering indicators within the Gospel itself, this article concludes that the Evangelist not only distinguishes between Jesus of Nazareth and the divine Logos, but also identifies the divine Logos incarnated in Jesus as the subject of this and other ‘I am’ sayings within John.