bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating the Comprehensive Performance of 5G Base Station: A Hybrid MCDM Model Based on Bayesian Best-Worst Method and DQ-GRA Technique
Authors: Liang Mingliang , Li Wenxuan , Ji Jie , Zhou Zhenxi , Zhao Yihang , Zhao Huiru , Guo Sen
Published: February 2022

In recent years, 5G technology has rapidly developed, which is widely used in medical, transportation, energy, and other fields. As the core equipment of the 5G network, 5G base stations provide wireless coverage and realize wireless signal transmission between wired communication networks and wireless terminals. However, as the scale of 5G base stations gradually increases, problems such as poor user experience and insufficient coverage area frequently occur. Hence, it is necessary to evaluate the comprehensive performance of 5G base stations, so as to clarify the problems existing in the construction of base stations. First, the performance evaluation index system is constructed from the perspectives of operational performance, financial performance, environmental impact, and social influence. Then, a novel hybrid multicriteria decision-making (MCDM) model based on the Bayesian best-worst method (BBWM) and difference-quotient gray relational analysis (DQ-GRA) technique is adopted. Finally, sixteen 5G base stations are taken as examples for analysis. The result shows that the signal coverage area and per capita input cost are the most important indicators greatly affecting the overall performance of the 5G base station. Compared with the two other MCDM models, the proposed hybrid MCDM model has good applicability and effectiveness for performance evaluation of 5G base stations.
Distinguishing Cardiac Amyloidosis and Hypertrophic Cardiomyopathy by Thickness and Myocardial Deformation of the Right Ventricle
Authors: Liu Hui , Bai Peng , Xu Hua-Yan , Li Zhen-Lin , Xia Chun-Chao , Zhou Xiao-Yue , Gong Liang-Geng , Guo Ying-Kun
Published: February 2022

Objectives. To compare right ventricular thickness (RVT) and deformation of cardiac amyloidosis (CA) and hypertrophic cardiomyopathy (HCM) patients. Methods. Sixty CA (mean age 58 ± 10 years; 33 males (55%)) and sixty HCM patients (mean age 55 ± 14 years; 27 males (45%)) were retrospectively enrolled. RVT, global radical peak strain (GRPS), global longitudinal peak strain (GLPS), and global circumferential peak stain (GCPS) were analyzed. To determine the cutoff values of the RVT and RV strain parameters for distinguishing CA from HCM, the areas under the receiver operating characteristic curve (AUCs) were analyzed. Results. RVT of CA patients was significantly thicker than that of HCM patients (7.8 ± 2.1 vs 5.9 ± 1.3,

p

 < 0.001). Moreover, significantly decreased RV-GRPS (12.1 ± 6.9 vs 23.5 ± 12.1,

p

 < 0.001), RV-GCPS (−3.4 ± 2.2 vs −5.6 ± 3.5,

p

 < 0.001), and RV-GLPS (−4.6 ± 2.3 vs −11.1 ± 4.9,

p

 < 0.001) were observed in CA patients compared with HCM patients. RVT and RV strain demonstrate comparable diagnostic accuracy in differentiating CA from HCM. In particular, RV-GLPS combined with RVT showed the best performance for discriminating CA from HCM (AUC = 0.92, 95% CI: 0.85 to 0.96,

p

 = 0.0001). Conclusions. Right ventricular myocardial thickness and deformation of CA patients was more severe than HCM patients. RV-GLPS combined with RVT presents an excellent diagnostic performance in distinguishing CA and HCM.
Sensitivity Analysis of Effective Parameters in Borehole Failure, Using Neural Network
Authors: Jolfaei Somaie , Lakirouhani Ali
Published: February 2022

After drilling a borehole in the ground and in a rocky environment, the materials around the borehole are crushed and separated in layers from the borehole wall; this causes the borehole cross section to lose its original circular shape, which redistributes stresses and further failure. This type of episodic failure, which occurs symmetrically and V‐shaped on both sides of the borehole and along the minor principal stress, is called breakout. The dimensions of breakout, i.e., its depth and width, are two important indicators that have recently been used in estimating in situ stresses; however, the dimensions of the breakout area depend on the in situ stresses and mechanical properties of the rock, which have not been well addressed so far. This paper presents a comprehensive investigation of breakout dimensions using finite element numerical analysis. The proposed numerical model is based on the equations governing the two‐dimensional breakout phenomenon under nonisotropic in situ stresses and plane strain condition. According to the results, increasing the failure function of the area around the breakout tip causes the breakout to expand, until the failure function is less than 1 for all points around the breakout tip, at which point the breakout expansion is stopped and breakout reaches stability. In the other part of the article, using 121 datasets obtained from numerical analysis, an artificial neural network is trained to predict breakout dimensions based on the input parameters of the problem. The main finding of this section is a model that shows that among the parameters affecting the borehole breakout, the internal friction angle of the rock has the greatest impact on the dimensions of the breakout.
A Method of Intrusion Detection Based on WOA‐XGBoost Algorithm
Authors: Song Yan , Li Haowei , Xu Panfeng , Liu Dan
Published: February 2022

With the development of information technology, computer networks have become a part of people’s lives and work. However, computer viruses and malicious network attacks make network security face huge challenges, and more accurate detection of attacks has become the focus of attention to current computer fields. This paper proposes an intrusion detection model, which is mainly based on the XGBoost (Extreme Gradient Boosting), and uses the WOA (Whale Optimization Algorithm) to find the best parameters for it. The collected network data are first preprocessed by the PCA (Principal Component Analysis) dimensionality reduction method, and then, the preprocessed data are imported into the WOA‐XGBoost algorithm so that the overall model has better intrusion detection capabilities for data after training. The experimental results are applied to the well‐known KDD CUP 99 data in the computer network field, and compared with the accuracy of the results obtained by parameter adjustment in the traditional way, it shows that the intrusion detection model under this method has better accuracy.
Dynamic Multicompartment Refrigerated Vehicle Routing Problem with Multigraph Based on Real-Time Traffic Information
Authors: Hou Deng-Kai , Fan Hou-Ming , Lv Ying-Chun , Ren Xiao-Xue
Published: February 2022

Aiming at the dynamic multicompartment refrigerated vehicle routing problem with multigraph based on real-time traffic information, this study, based on the idea of preoptimization followed by real-time adjustment, establishes a two-stage mathematical model with minimizing delivery cost. In the preoptimization phase, this study, based on historical traffic information, designed a hybrid chaotic genetic algorithm with variable neighborhood search (HCGAVNS) to obtain the initial delivery scheme. In the real-time adjustment phase, the order in which customers are served remains the same and a path selection strategy is proposed to solve the problem according to the real-time traffic information of different paths. The validity of the model and the algorithm are verified through the analysis of instances. The research results can enrich the related research on cold chain vehicle routing problem and provide a theoretical basis for logistics companies to optimize their delivery scheme.
Downlink Cofrequency Interference Analysis of Vehicles and UAV Network in Ka Band
Authors: Wang Maolin , Zhang YuXin , Wang Zhi
Published: February 2022

With the rapid development of radio and computer technologies, the application scenarios of UAV carrying computer flight control systems are becoming more and more abundant. UAV can form a collaborative network with ground IoV (Internet of Vehicle) to improve the link quality of vehicle signals in some environments with poor network connectivity. For UAV and ground vehicles that are far apart, satellites can assist in the transmission of data between them. UAVs are allowed to be included in the satellite communication network in the Ka band in the 2015 World Radiocommunication Conference. In order to avoid the interference with existing communication services in the Ka band, it is necessary to limit the flying height of the UAV. This article will study the frequency compatibility between UAV and Internet of Vehicles in the same-frequency band. First, model the propagation environment of the UAV transmitting signal is modeled and the path loss of it is calculated, including the basic transmission loss in free space of the signal and the atmospheric propagation loss when the signal passes through the atmosphere. Then the radiation pattern of the receiving antenna is modeled, which is a 4 × 2 antenna array in this article, and the total antenna gain is obtained by adding the element gain and the array gain. Finally, the interference between UAV and Internet of Vehicles is simulated, calculating the interference and noise ratio of UAV to the Internet of Vehicles under different pointing angles between the interference and the interfered antenna and different elevation angles from UAV to the GSO satellite. Finally, the safe separation distance to protect the Internet of Vehicles from interference is got.
Influence of Dietary Berberine on Liver Immune Response and Intestinal Health of Black Sea Bream (Acanthopagrus schlegelii) Fed with Normal and High-Lipid Diets
Authors: Wang Lei , Sagada Gladstone , Xu Bingying , Zhang Jinzhi , Shao Qingjun
Published: February 2022

This study designed the normal diet (Con), high-lipid diet (HL), and 50 mg/kg berberine supplemented Con and HL diets (named as ConB and HLB, respectively). Fingerling black sea bream (Acanthopagrus schlegelii) (initial weight

1.47
±
0.03

 g) were fed these four diets for 8 weeks, and the liver immune response and intestinal health were evaluated. Fish fed the HL diet had the lowest serum glutathione peroxidase and catalase activities, while berberine supplementation significantly improved serum catalase activity (

P
<
0.05

). The expressions of tumor necrosis factor-alpha (tnfα), nuclear factor-kappa b (nf-κb), and interleukin 1 beta (il-1β) were significantly increased by the HL diet, whereas berberine supplementation significantly downregulated these proinflammation cytokine expressions (

P
<
0.05

). Berberine supplementation in normal and high-lipid diets significantly promoted hepatic anti-inflammation cytokines interleukin-10 (il-10) and transforming growth factor beta-1 (tgfβ-1) expressions (

P
<
0.05

). The intestinal expressions of tnfα, nf-κb, and tgfβ-1 were not significantly influenced by different treatments, while Cu/Zn-superoxide dismutase (Cu/Zn-sod) expression was significantly upregulated in the ConB group compared with the Con group. High-lipid diet reduced intestinal villus length. the thickness of muscularis mucosa, mucosal folds, and diversity and richness of intestinal microbiota but increased numbers of goblet cells and width of lamina propria. Berberine supplementation in high-lipid diet alleviated these pathological changes and rebalanced intestinal microbiota composition. At the genus level, fish fed the HL diet had significantly lower abundances of some probiotics such as Lactobacillus and Hydrogenophaga than that of the HLB group (

P
<
0.05

). In conclusion, berberine supplementation in high-lipid diet reduced liver inflammation, improved the antioxidative status of fish, and alleviated intestinal damage and intestinal microbiota alteration of black sea bream.
Effects of Electroacupuncture at Different Acupoints on Functional Dyspepsia Rats
Authors: Li Yue-Jie , Yang Na-Na , Huang Jin , Lin Lu-Lu , Qi Ling-Yu , Ma Si-Ming , Hu Cheng-Xin , Wang Yu , Yang Jing-Wen , Liu Cun-Zhi
Published: February 2022

Although, acupoint specificity is regarded as the core of scientific issues in electroacupuncture (EA), the difference of EA on treating functional dyspepsia (FD) at different acupoints is unclear. Therefore, this study aims to investigate the different therapeutic effects of EA at lower extremity or abdominal acupoints on the mucosal integrity and lower-inflammatory response in FD. The intragastric administration of iodoacetamide (IA) was performed in 48 rats to establish the FD model. These rats were randomly divided into the control group, the model group and the six EA groups receiving stimulation at the lower extremity (ST36, ST37, and ST39) or abdominal acupoints (ST25, CV4, and CV12) separately. The open-field test (OFT) was measured after 8 weeks of IA, and gastric emptying was evaluated after 10 days of the EA treatment. The local inflammation markers of CD45, eosinophil major basic protein (EMBP), and the tight junction proteins ZO1 and Claudin3 were assessed by immunofluorescence in all groups. Western blot analysis showed that the EMBP and Occludin1 levels in the duodenal. EA at lower extremity acupoint ST36 could improve the gastric emptying. EA at lower extremity acupoints reduced the immunoreactivity of EMBP, but the CD45 was reregulated by the ST37 and ST39 acupoints. The lower extremity acupoints also ameliorated FD-tight junction protein in the expression of Claudin3 and ZO1. However, only the ST36 suppressed the expression of EMBP and recovered the expression of Occludin1. Similarly, the effect of EA at abdominal acupoints was not obvious either in facilitating gastric motility or in improving inflammatory and mucosal injury. EA at lower extremity and abdominal acupoints with the same stimulation parameters had different therapeutic effects in gastric emptying, intestinal mucosal integrity, and inflammation response, thus proving the specificity of acupoints.
Chinese Stock Market’s Reaction to COVID‐19 in the Short and Long Run
Authors: Wang Hongxia , Yu Zongzheng
Published: February 2022

We study the impact of COVID‐19 on Chinese stock market which can be seen as a complex system. We use the event study method to evaluate its performance change in terms of the return rate, turnover rate, etc. We show that the abnormal return of stock market was significantly negative after the outbreak of COVID‐19 and did not turn positive until May 2020. Moreover, the five‐factor model is used to estimate the ordinary returns of different industries and show that abnormal returns for medical and food industries were significantly positive, while energy and public utility industries had significantly negative abnormal returns which persisted for a long time. COVID‐19 had lag effects on clothes industry, finance industry, transportation industry, and IT industry. We also find that energy and finance industries had negative abnormal turnover rates during the sample period, while other industries, such as healthcare and telecommunications service industries, had positive abnormal turnover rates.
Follow‐Up of High‐Grade Glial Tumor; Differentiation of Posttreatment Enhancement and Tumoral Enhancement by DCE‐MR Perfusion
Authors: Dündar Tolga Turan , Cetinkaya Ezra , Yurtsever İsmail , Uysal Ömer , Aralaşmak Ayşe
Published: February 2022

Purpose. To search for the utility of DCE‐MRP to differentiate between posttreatment enhancement (PT) and tumoral enhancement (TM) in high‐grade glial tumors. Materials and Methods. Thirty‐four patients with glioma (11 grade 3; 23 grade 4) were enrolled. Enhancement in the vicinity of the resection cavity demonstrated by DCE‐MRP was taken into consideration. Based on the follow‐up scans, reoperation or biopsy results, the enhancement type was categorized as PT or TM. Measurements were performed at the enhancing area near the resection cavity (ERC), nearby (NNA) and contralateral nonenhancing areas (CLNA). Perfusion parameters of the ERC were also subtracted from NNA and CLNA. Intragroup comparison (paired sample t‐test) and intergroup comparison (Student's t‐test) were made. Results. There were 7 PTs and 27 TMs. In the PT, the subtracted values of Ve and IAUC from the CLNA and NNA and the subtracted value of Kep from NNA were statistically different. In TM, all metrics were significantly different comparing the CLNA and NNA. Comparing PT with TM, Ktrans, IAUC, Kep, and subtracted values of Ktrans and IAUC from both NNA and CLNA were significantly different. Conclusions. In PT, only Ktrans values did not reveal any difference comparing NNA and CLNA. To differentiate PT from TM, Ktrans, Kep, IAUC, and subtracted values of Ktrans and IAUC from NNA and CLNA can be used. These findings are in concordance with literature.
Urban Landscape Design Based on Data Fusion and Computer Virtual Reality Technology
Authors: Zhang Xiaoning , Fan Wen , Guo Xiaohong
Published: February 2022

The rapid urbanization development has brought huge opportunities for the development of architectural landscape design, and naturally there will be various huge challenges accordingly. What this kind of development speed presents to people is the rapid emergence of new urban areas, endless new construction projects, and so on. This paper conducts research on urban landscape design based on data fusion and computer virtual reality technology. The purpose is to use the dual guidance of data fusion technology and virtual reality technology to demonstrate the feasibility of creating a more planned urban landscape design. This article uses SketchUp software for modeling and uses a digital camera for continuous digital photography. Firstly, multiple digital landscape images are merged into a complete panoramic image. Then, the simplified model is imported into the virtual reality platform to adjust the material and scene lighting of the model, and the plan is checked in the virtual reality platform, and the model and volume of the model are analyzed and compared. Finally, design an auxiliary program and export it together with the effect image. The research results show that when the virtual landscape reaches 400, the frame rate can be kept above 30. It can be seen that the efficiency of this algorithm is higher than that of the original algorithm. When the scene thread and the rendering thread are parallel, the frame floats up and down in 9, and the time spent on the frame is reduced by about 40%. The conclusion is that the accuracy of the landscape planning system based on virtual reality technology is higher than that of the traditional algorithm, and the degree of scene simulation is more realistic. It has contributed to the construction and application of landscape systems. The application of data fusion technology and virtual reality technology in urban landscape design can achieve considerable results in terms of modeling ability, design ability, innovation ability, and expression ability, and the design ability has reached a score of 8.82.
Design and Analysis of a Novel Quasi-Zero Stiffness Isolator under Variable Loads
Authors: Xie Yingjiang , Niu Fu , Sun Jinggong , Meng Lingshuai
Published: February 2022

The designed load of most quasi-zero stiffness (QZS) isolators is constant. The isolation performance will drop sharply once the load changes. A novel QZS isolator that can adapt to variable loads is proposed in this paper to improve the range of application of the isolator. The isolator is designed by paralleling the electromagnetic spring (ES), which provides negative stiffness, and the pneumatic spring (PS), which provides positive stiffness. The positive and negative stiffness can be adjusted by changing the pressure and coil current, which provides the possibility for the isolator to adapt to variable loads. This paper derived the conditions for the isolation system to obtain QZS characteristics, proposed the dynamic model of the isolation system, derived and verified the analytical expressions of the amplitude-frequency response and force transmissibility (FT), and discussed the change of FT and displacement transmissibility(DT) under different loads. Theoretical analysis shows that changing the pressure and coil current in the same proportion can maintain the superior low-frequency isolation performance when the load changes, thanks to the preservation of the QZS characteristics of the system after adjusting the pressure and coil current. Finally, the simulation results fg and isolation frequency band over the linear isolation system and PS isolation system. Furthermore, the proposed isolator can be adjusted online.
Effect of Different Predrying Treatments on Physicochemical Quality and Drying Kinetics of Twin Layer Solar Tunnel Dried Tomato (Lycopersicon esculentum L.) Slices
Authors: Tilahun Dufera Lelise , Hofacker Werner , Esper Albert , Hensel Oliver
Published: February 2022

In tomato drying, degradation in final quality may occur based on the drying method used and predrying preparation. Hence, this research was conducted to evaluate the effect of different predrying treatments on physicochemical quality and drying kinetics of twin-layer-solar-tunnel-dried tomato slices. During the experimental work, tomato slices of var. Galilea were used. As predrying treatments, 0.5% calcium chloride (CaCl2), 0.5% ascorbic acid (C6H8O6), 0.5% citric acid (C6H8O7), and 0.5% sodium chloride (NaCl) were used. The tomato samples were sliced to 5 mm thickness, socked in the pretreatments for ten minutes, and dried in a twin layer solar tunnel dryer under the weather conditions of Jimma, Ethiopia. Untreated samples were used as control. The moisture losses from the samples were monitored by weighing samples at 2 h interval from each treatment. SAS statistical software version 9.2 was used for analyzing data on the physicochemical quality of tomato slices in CRD with three replications. From the experimental result, it was observed that dried tomato slices pretreated with 0.5% ascorbic acid gave the best retention of vitamin C and total phenolic content with a high sugar/acid ratio. Better retention of lycopene and fast drying were observed in dried tomato slices pretreated with 0.5% sodium chloride, and pretreating tomatoes with 0.5% citric acid resulted in better color values than the other treatments. Compared to the control, pretreating significantly preserved the overall quality of dried tomato slices and increased the moisture removal rate in the twin layer solar tunnel dryer.
Preliminary Assessment of Trace Metal Pollution and Their Bioaccumulation in Mollusks Inhabiting the Intertidal Sediments of the Atlantic Coast of Accra, Ghana
Authors: Blankson Emmanuel R. , Addison Thyra F. , Oduro Daniel , Ewool Juliet , Gbogbo Francis
Published: February 2022

The present study investigated the trace metal levels in sediments, enrichment in sediments, and its bioaccumulation in mollusks collected from the intertidal sediments of the coast of Accra, Ghana, which is influenced by anthropogenic activities. The metals (Fe, Mn, Cu, Cr, and Zn) were analyzed in sediments. The metals (Mn, Cu, Cr, and Zn) were analyzed in the soft tissue of the mollusks collected from the different coastal areas. The results indicate that although Accra is the capital city and the coast receives tons of anthropogenic wastes, trace metal levels were low and there was no enrichment for the metals analyzed except Cu which showed minor to moderate enrichment in the coastal sediments. There was bioaccumulation of the trace metals in the soft tissue of the mollusks, and the results suggest that the mollusks studied, the gastropods (Agaronia razetoi) and the bivalves (Tivela tripla), can be used for biomonitoring.
Changes of Functional, Morphological, and Inflammatory Reactions in Spontaneous Peripheral Nerve Reinnervation after Thermal Injury
Authors: Yu Xing , Liu Chang , Ji Caihong , Lenahan Cameron , Fang Yuanjian , Wang Yong , Shao Anwen
Published: February 2022

In recent decades, the use of energy-based devices has substantially increased the incidence of iatrogenic thermal injury to nerves (cauterization, etc.). While recovery of the nerve after thermal injury is important, the changes in neural structure, function, and peripheral inflammatory reactions postinjury remain unclear. This study is aimed at demonstrating the changes mentioned above during the acute, subacute, and chronic stages of nerve reinnervation after thermal injury. Spontaneous reinnervation was evaluated, including the neural structures, nerve conduction abilities, and muscle regeneration. These effects vary depending on the severity of thermal injury (slight, moderate, and severe). Peripheral inflammatory reactions, as impediments to reinnervation, were found in significant numbers 3 days after thermal injury, exhibiting high expression of IL-1β and TNF-α, but low expression of IL-10. Our findings reveal the pathogenesis of peripheral nerve reinnervation after thermal injury, which will assist in selecting appropriate treatments in further research.
Inhibition of LSD1 Attenuates Oral Cancer Development and Promotes Therapeutic Efficacy of Immune Checkpoint Blockade and YAP/TAZ Inhibition
Authors: Alhousami Thabet , Diny Michael , Ali Faiza , Shin Jennifer , Kumar Gaurav , Kumar Vikas , Campbell Joshua D. , Noonan Vikki , Hanna Glenn J. , Denis Gerald V. , Monti Stefano , Kukuruzinska Maria A. , Varelas Xaralabos , Bais Manish V.
Published: February 2022

Lysine-specific demethylase 1 (LSD1) is a histone demethylase that contributes to the etiology of oral squamous cell carcinoma (OSCC) in part by promoting cancer stem cell phenotypes. The molecular signals regulated by LSD1, or acting with LSD1, are poorly understood, particularly in the development of OSSC. In this study, we show that conditional deletion of the Lsd1 gene or pharmacologic inhibition of LSD1 in the tongue epithelium leads to reduced development of OSCC following exposure to the tobacco carcinogen 4NQO. LSD1 inhibition attenuated proliferation and clonogenic survival and showed an additive effect when combined with the YAP inhibitor Verteporfin. Interestingly, LSD1 inhibition upregulated the expression of PD-L1, leading to immune checkpoint inhibitor therapy responses.

Implications:

Collectively, our studies reveal a critical role for LSD1 in OSCC development and identification of tumor growth targeting strategies that can be combined with LSD1 inhibition for improved therapeutic application.
Navigating Critical Challenges Associated with Immunopeptidomics-Based Detection of Proteasomal Spliced Peptide Candidates
Authors: Lichti Cheryl F. , Vigneron Nathalie , Clauser Karl R. , Van den Eynde Benoit J. , Bassani-Sternberg Michal
Published: February 2022

Within the tumor immunology community, the topic of proteasomal spliced peptides (PSP) has generated a great deal of controversy. In the earliest reports, careful biological validation led to the conclusion that proteasome-catalyzed peptide splicing was a rare event. To date, six PSPs have been validated biologically. However, the advent of algorithms to identify candidate PSPs in mass spectrometry data challenged this notion, with several studies concluding that the frequency of spliced peptides binding to MHC class I was quite high. Since this time, much debate has centered around the methodologies used in these studies. Several reanalyses of data from these studies have led to questions about the validity of the conclusions. Furthermore, the biological and technical validation that should be necessary for verifying PSP assignments was often lacking. It has been suggested therefore that the research community should unite around a common set of standards for validating candidate PSPs. In this review, we propose and highlight the necessary steps for validation of proteasomal splicing at both the mass spectrometry and biological levels. We hope that these guidelines will serve as a foundation for critical assessment of results from proteasomal splicing studies.
The Value of Dyspnea and Spirometry in Detecting Relapse of Benign Tracheal Stenosis
Authors: Kossyvaki Vasiliki , Anagnostopoulos Nektarios , Kaltsakas Georgios , Emmanouil Philip , Alsaid Abir , Touman Abdelfattah , Tzavara Chara , Koulouris Nikolaos , Stratakos Grigoris
Published: February 2022

Background: Benign tracheal stenosis may relapse after management. Objectives: This study aimed to assess the value of dyspnea and spirometry in detecting relapse of benign tracheal stenosis. Methods: Patients with benign tracheal stenosis were evaluated post-management, at regular follow-up and emergency visits, with the Medical Research Council (MRC) dyspnea scale, spirometry, and flexible bronchoscopy. Patient visits were categorized and compared, in terms of change in clinical and functional parameters, in 2 groups: visits with relapse (case group) and visits with no relapse (control group). The ability of the MRC dyspnea scale and spirometry to predict relapse was evaluated. Results: Thirty-five patients with benign tracheal stenosis were included. Mean follow-up duration was 3.2 years (standard deviation = 3.3). Spirometry data were analyzed from 43 relapse visits (23 patients) versus 90 nonrelapse visits. The MRC dyspnea score and most spirometric indices were associated with relapse. In the receiver operating characteristic analysis, forced expiratory volume in 1 s, forced expiratory flow when 25% of forced vital capacity has been expired, peak expiratory flow (PEF), and total peak flow were superior to the MRC dyspnea score in predicting relapse. Among spirometric indices, >10.8% of PEF reduction has been very sensitive and specific. Conclusions: This study supports the role of dyspnea and spirometry in monitoring benign tracheal stenosis, with spirometry predicting relapse even in clinically stable patients. PEF being a very sensitive index has the additional advantage of being assessed by peak flow meter and could potentially be used for remote monitoring.
Macrohistory of Moyamoya Disease Analyzed Using Artificial Intelligence
Authors: Kuribara Tomoyoshi , Akiyama Yukinori , Mikami Takeshi , Komatsu Katsuya , Kimura Yusuke , Takahashi Yasuhiro , Sakashita Kyoya , Chiba Ryohei , Mikuni Nobuhiro
Published: February 2022

Introduction: Moyamoya disease is characterized by progressive stenotic changes in the terminal segment of the internal carotid artery and the development of abnormal vascular networks called moyamoya vessels. The objective of this review was to provide a holistic view of the epidemiology, etiology, clinical findings, treatment, and pathogenesis of moyamoya disease. A literature search was performed in PubMed using the term “moyamoya disease,” for articles published until 2021. Results: Artificial intelligence (AI) clustering was used to classify the articles into 5 clusters: (1) pathophysiology (23.5%); (2) clinical background (37.3%); (3) imaging (13.2%); (4) treatment (17.3%); and (5) genetics (8.7%). Many articles in the “clinical background” cluster were published from the 1970s. However, in the “treatment” and “genetics” clusters, the articles were published from the 2010s through 2021. In 2011, it was confirmed that a gene called Ringin protein 213 (RNF213) is a susceptibility gene for moyamoya disease. Since then, tremendous progress in genomic, transcriptomic, and epigenetic profiling (e.g., methylation profiling) has resulted in new concepts for classifying moyamoya disease. Our literature survey revealed that the pathogenesis involves aberrations of multiple signaling pathways through genetic mutations and altered gene expression. Conclusion: We analyzed the content vectors in abstracts using AI, and reviewed the pathophysiology, clinical background, radiological features, treatments, and genetic peculiarity of moyamoya disease.
Comparative Analysis of Postoperative Complications after Cytoreductive Surgery and HIPEC in Gastric Cancer
Authors: Merboth Felix , Garcia Sebastian , v. Renesse Janusz , Distler Marius , Welsch Thilo , Weitz Jürgen , Stange Daniel E.
Published: February 2022

Introduction: Patients with advanced gastric cancer (AGC) frequently show peritoneal carcinomatosis (PC). PC reduces life expectancy and quality of life. Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to improve overall survival. Nevertheless, it has been reported that CRS and HIPEC are accompanied by an increase in postoperative complications. The purpose of this study was to investigate the complications associated with CRS and HIPEC and overall and disease-free survival. Methods: Patients with AGC and PC, who received complete CRS and HIPEC, were included in the HIPEC group (n = 15). Patients with AGC but without PC, who received resection of the primary tumor alone, constituted the control group (n = 43). Results: Patients enrolled in the HIPEC group presented with a median PCI of 7. In comparison with the control group, no differences were found in patient characteristics, risk factors, pathological findings, and operative procedures. Twenty-five percentage of the patients in both groups suffered from serious postoperative complications (CDC ≥3a). Surgical and medical complications, rate of reoperation, and mortality did not differ. Also, the recurrence pattern, median survival, and 1- and 2-year survival rates showed no differences. Conclusion: CRS and HIPEC do not lead to an increased postoperative morbidity and mortality in AGC with PC. Albeit the poorer prognosis of patients with PC, survival of both groups was comparable.
Therapeutic Leukapheresis: Experience of a Single Oncologic Centre
Authors: Rosales Maria , Roncon Susana , Mariz Mário , Ferreira Ana Maia , Faria Filomena , Santos Luisa
Published: February 2022

Introduction: Leukostasis refers to clinical symptoms caused by hyperleukocytosis seen in some haematological diseases such as leukaemia. Cytoreduction can be achieved by therapeutic leukapheresis. The aim of this study was to retrospectively analyse the procedures performed in our Centre and to evaluate their efficacy and safety. Methods: This was a retrospective study of all the therapeutic leukapheresis procedures carried out in our Centre between January 1998 and December 2020. The sample collection was obtained through the review of the clinical files of the respective patients. Statistical analysis was performed using the software R v.4.0.1. A total of 54 therapeutic leukapheresis procedures were performed in 31 patients in our Centre. Results: After these procedures clinical improvement was observed in 16 patients and we verify that there was a significant difference in survival between the group that improved and the group that maintained the same clinical condition or worsened. The lack of immediate clinical improvement was a sign of a poor prognosis. Laboratory efficacy occurred in 16 patients who had a reduction in white blood cell count, with a 39.1% reduction after 24 h, and did not succeed in 15 patients, who had no reduction. However, in this case there is no significant difference in survival between the two groups. There was some complication in 53.9% of the procedures, with hypocalcaemia being the most frequent, which was observed in 22 procedures. Only 4 patients experienced serious side effects but these adverse reactions cannot be attributed to the procedures carried out. The overall survival rate 6 months after this treatment was 51.6%. Conclusion: Despite the reduced number of patients, we conclude that therapeutic leukapheresis is a safe and effective option that may still have a therapeutic role in some cases.
Commentary on the Continued Investigational Status of DBS for Psychiatric Indications
Authors: Coffey Robert J. , Caroff Stanley N.
Published: February 2022

Behavioral disorders exact a tragic toll on patients, families, and society. Consequently, the search for better treatments is a public health priority. Recent research promises to lead to advances in psychiatric treatment that may include implantation of deep brain stimulation (DBS) devices. In this commentary, the authors discuss how promising results from initial pilot studies of DBS in treatment-resistant depression (TRD) were not validated in 2 randomized, controlled, multicenter trials. Reliance on pilot data may have contributed to the selection of primary efficacy endpoints that were not achieved, and to the underestimation of adverse events and device-related complications. Published data on the population prevalence of affective disorders also may have led sponsors to overestimate the number of patients with TRD who were candidates for DBS therapy. Consequently, a more complete discussion of certain aspects of the depression trials may allow a realistic appraisal of the clinical and ethical situation of DBS therapy for TRD in a US regulatory context. A US regulatory perspective also may clarify the clinical research and reimbursement consequences of the Humanitarian Device Exemption (HDE) approval status of DBS for obsessive-compulsive disorder (OCD). Retrospective analyses akin to failure modes and effects analysis in engineering may clarify unexpected results in the DBS depression trials. Recent research suggests that subject selection in future trials may be augmented by advanced neuroimaging methods. For the present, the noncommercial research status of DBS to treat depression and the HDE status for OCD appear likely to remain in place.
Remote Ischemic Conditioning: A Potential Treatment for Chronic Cerebral Hypoperfusion
Authors: Ma Xiao , Ji Chenhua
Published: February 2022

Background: Chronic cerebral hypoperfusion (CCH) is a clinical syndrome, which is characterized by significantly decreased cerebral blood flow (CBF). CCH is a common consequence of cerebrovascular and cardiovascular diseases and the elderly. CCH results in a series of pathological damages, increasing cell death, autophagy dysfunction, amyloid β (Aβ) peptide accumulation, blood-brain barrier (BBB) disruption, and endothelial damage, which are found in CCH models. In addition, CCH is a prominent risk factor of cognitive impairment, such as vascular dementia, and CCH contributes to the occurrence and development of Alzheimer’s disease. Therefore, the treatment of patients with CCH is of great value. It has been confirmed that remote ischemic conditioning (RIC) is a safe, promising treatment for acute and chronic cerebrovascular diseases. RIC significantly increases CBF in both CCH models and patients, inhibits neuronal apoptosis, reduces Aβ deposition, protects BBB integrity and endothelial function, alleviates neuroinflammation, improves cognitive impairment, and exerts neuroprotection. Summary: With the development of animal models, the pathophysiological mechanisms of CCH and RIC are increasingly revealed. Key Messages: We discuss the mechanisms related to hypoperfusion in the brain and explore the potential treatment of RIC for CCH to promote its transformation and application in humans.
Quantitative Analysis of Immune-Reactive Cells among Leukocytes Is Useful for the Diagnosis of Drug Eruptions Caused by Bexarotene
Authors: Chiba Hiromu , Kambayashi Yumi , Ohuchi Kentaro , Amagai Ryo , Tamabuchi Erika , Hashimoto Akira , Fujimura Taku
Published: February 2022

Bexarotene is a third-generation retinoid X receptor-selective retinoid that has been approved for use in the treatment of cutaneous T-cell lymphomas (CTCLs). Since the objective response rate of bexarotene is relatively high, with no racial differences, bexarotene can be administered to patients with phototherapy-resistant early CTCL as one of the first-line therapies in real-world clinical practice. Although various adverse events caused by bexarotene have been reported, there have been no reports of drug eruptions caused by bexarotene. One of the possible reasons is that it is difficult to distinguish a drug eruption from recurrence of CTCL, histologically. In this report, drug eruptions in 2 patients with CTCL treated with bexarotene diagnosed by quantitative analysis of immunohistochemical staining by digital microscopy are described.
Effects of L-Carnitine Treatment on Kidney Mitochondria and Macrophages in Mice with Diabetic Nephropathy
Authors: Ito Seigo , Nakashima Masahiro , Ishikiriyama Takuya , Nakashima Hiroyuki , Yamagata Akira , Imakiire Toshihiko , Kinoshita Manabu , Seki Shuhji , Kumagai Hiroo , Oshima Naoki
Published: February 2022

Introduction: In diabetic nephropathy (DN), mitochondrial dysfunction and leakage of mitochondrial DNA (mtDNA) are caused by the downregulation of superoxide dismutase 2 (SOD2). mtDNA induces the activation of Toll-like receptor (TLR) 9, which is present in macrophages (Mφs), and triggers their activation. Methods: We orally administered L-carnitine, which exerts protective effects on the mitochondria, to obesity-induced DN (db/db) mice for 8 weeks. We then investigated the effects of L-carnitine on kidney mitochondrial reactive oxygen species (mtROS) production, circulating mtDNA content, and kidney CD11bhigh/CD11blow Mφ functions. Results: In db/db mice, mtROS production increased in proximal tubular cells and kidney CD11blow Mφs; both Mφ types showed enhanced TLR9 expression. L-Carnitine treatment suppressed mtROS production in both proximal tubular cells and CD11blow Mφs (p < 0.01), with improved SOD2 expression in the kidney (p < 0.01), decreased circulating mtDNA content, and reduced albuminuria. Moreover, it suppressed Mφ infiltration into kidneys and reduced TLR9 expression in Mφs (p < 0.01), thereby lowering tumor necrosis factor-α production in CD11bhigh Mφs (p < 0.05) and ROS production by CD11blow Mφs (p < 0.01). Collectively, these changes alleviated DN symptoms. Conclusion: The positive effects of L-carnitine on DN suggest its potential as a novel therapeutic agent against obesity-linked DN.
Incidence, Clinical Presentation, and Management of Myocarditis following mRNA-Based Covid-19 Vaccines: A Brief Report
Authors: Saeed Sahrai , Käsk Lauri , Rajani Ronak , Larsen Terje H.
Published: February 2022

Background: Recent surveillance studies following nationwide mass vaccination are investigating rare complications such as myocarditis, pericarditis, and thromboembolic events related to mRNA-based Covid-19 vaccines. Summary: In the current report, we present an overview of the incidence, clinical presentation and management of post-mRNA vaccine myocarditis, and pericarditis in view of the currently available data. Our main focus is directed toward myocarditis. Key Messages: Myocarditis following mRNA-based Covid-19 vaccines is rare, more frequently affects younger men <30 years and is usually of mild severity with spontaneous recovery. The overall benefit of mRNA vaccines in terms of protecting from severe Covid-19 infection and associated cardiovascular complications outweighs the risk of postvaccination myocarditis. Currently, there are no dedicated guidelines for patients with postvaccination myocarditis or pericarditis in terms of the frequency of follow-up including clinical assessment, repeated echocardiography, and cardiac resonance imaging. However, follow-up studies in terms of long-term consequences are underway.
130 years of evidence: risk of suicide among doctors and medical students
Authors: Muzzolon Sandra Regina , Muzzolon Mariana , Lima Mônica Nunes
Published: February 2022

Objective: To evaluate the incidence of risk of Mental Disorders (MD), Suicide and Quality of Life in medical students. Methods: This is a prospective cross-sectional study conducted at a Public Higher Education Institution of Medicine in Southern Brazil. Evaluation of 775 students who responded in person to Adult Self Repport (ASR) and WHOQOL-100, with individual return of results, orientation and mandatory referral for those with “Borderline” and “Clinical” scores and optional for those with “Normal” score. Results: The incidence of MD risk was 54.3% and suicide risk was 10.6%. Internalizing Problems were observed in 34.7% of cases and Externalizing Problems in 12.6%. Among the most frequent syndromes, Anxiety/Depression, Isolation and Attention were highlighted. “Poor” or “Moderate” Overall Quality of Life was observed in about 30%, associated with adaptive functioning and the presence of DSM-Oriented or ASR problems at “Clinical” level (p <0.001). The main variables for suicide risk were Anxiety/Depression Problems, Internalizing Problems, Thought Problems, and Antisocial Personality (p <0.001). “Clinical” Score for two or more Syndromes or Total Problems was selected as an independent variable for the risk of suicide, while the Spirituality and Psychological domains were appointed as protective (p <0.001). Conclusions: There was a high incidence of MD associated with poor quality of life and increased risk of suicide among medical students.
A democratização da informação, no contexto da pandemia por COVID-19: diálogos necessários entre educação em saúde e comunicação
Authors: Lima Eloisa Helena de , Gonçalves Ana Luiza Godinho , Martins Anna Luiza Rodrigues Perigo , Barroso André Chabot , Oliveira Elisa Bastos Martins de , Almeida Vinícius Augusto Reis , Santos Gláucio Antônio
Published: February 2022

Introdução: O projeto de extensão “Viva Mais” produz programas de rádio para educação em saúde. Em 2020, seus conteúdos abordaram a pandemia de COVID-19. Objetivos: Demonstrar a importância da educomunicação em saúde, por meio do que foi experimentado pelo “Viva Mais”. Metodologia: A equipe se reuniu via Google Meet, para debater cada episódio. Foram feitas pesquisas, gravações e entrevistas com especialistas. Em seguida, os episódios eram formatados, com subsequente veiculação em plataformas de streaming e mídias sociais. Relato de Experiência e Resultados: Relata-se a nova rotina de produção da equipe, diferenciando as realidades pré e pós isolamento físico, os desafios em manter cada episódio atualizado e os resultados do projeto, com mais de 500 visualizações dos podcasts. Conclusão: É preciso trazer informações fidedignas ao alcance da população, a fim de encorajá-la a consumir informações reais e a não compartilhar mensagens falsas. É este o papel social do “Viva Mais”.
Mycobacterium avium pelvic abscess with vaginocutaneous fistula after transobturatory sling surgery
Authors: Teles Filho Ricardo Vieira , Abe Guilherme de Matos , Azevêdo Lucas Henrique Souza de , Daldat Gabriela
Published: February 2022

This study presents a rare case of abscess associated with vaginocutaneous fistula due to atypical mycobacterial infection after sling surgery, which was successfully treated. Abscesses and fistulas are rare postoperative complications in treatment of stress urinary incontinence by transobturatory sling surgery, due to its high rate of positive outcomes in the treatment of urinary incontinence in women. These complications are considered to be related to the composition of the mesh and bacterial infection. We report a case of a 50-year-old patient who developed, in the 7th postoperative year of perineoplasty with sling placement, pelvic abscess and cutaneous fistula in the left thigh. Microbiological examination of the lesion revealed infection by Mycobacterium avium. Antibiotic therapy plus abscess drainage surgery and surgical correction of the fistulous pathway were the treatment of choice. During the surgery, a vaginal opening of the cutaneous fistula was evidenced, originating from the sling mesh, which was removed and later proved to be colonized by M. avium. The patient became asymptomatic after 1 year of postoperative follow-up.