bluuebunny/crossref_metadata_2025 huggingface dataset:
Green-Synthesized Silver Nanoparticles Induced Apoptotic Cell Death in MCF-7 Breast Cancer Cells by Generating Reactive Oxygen Species and Activating Caspase 3 and 9 Enzyme Activities
Authors: Ullah Ikram , Khalil Ali Talha , Ali Muhammad , Iqbal Javed , Ali Waqar , Alarifi Saud , Shinwari Zabta Khan
Published: October 2020

Silver nanoparticles are among the most significant diagnostic and therapeutic agents in the field of nanomedicines. In the current study, the green chemistry approach was made to optimize a cost-effective synthesis protocol for silver nanoparticles from the aqueous extract of the important anticancer plant Fagonia indica. We investigated the anticancer potential and possible involvement of AgNPs in apoptosis. The biosynthesized AgNPs are stable (zeta potential, -16.3 mV) and spherical with a crystal size range from 10 to 60 nm. The MTT cell viability assay shows concentration-dependent inhibition of the growth of Michigan Cancer Foundation-7 (MCF-7) cells (IC50, 12.35 μg/mL). In addition, the fluorescent microscopic analysis shows activation of caspases 3 and 9 by AgNPs that cause morphological changes (AO/EB assay) in the cell membrane and cause nuclear condensation (DAPI assay) that eventually lead to apoptotic cell death (Annexin V/PI assay). It was also observed that AgNPs generate reactive oxygen species (ROS) that modulate oxidative stress in MCF-7 cells. This is the first study that reports the synthesis of a silver nanoparticle mediated by Fagonia indica extract and evaluation of the cellular and molecular mechanism of apoptosis.
Efficacy and Safety Profile of Montgomery T-Tube Implantation in Patients with Tracheal Stenosis
Authors: Wu Feng-Jie , Yao Yang-Wei , Chen En-Guo , Hu Hui-Hui , Jiang Jian-Ping , Yang Meng , Gu Yang-Yang , Cao Da-Kui , Zhu Ye-Li
Published: October 2020

Background. Tracheal stenosis is able to lead to airway obstruction. Objective. To evaluate the efficacy and safety profile of Montgomery T-tube implantation in patients with tracheal stenosis. Methods. Fifty-two patients with tracheal stenosis diagnosed between 2016 and 2019 were included in this retrospective cohort study. The patients were divided into observation group (n = 25 cases) and control group (n = 27). The therapeutic effect, arterial blood gas analysis, arterial oxygen partial pressure (PaO2), arterial carbon dioxide partial pressure (PaCO2), shortness of breath score, airway diameter change, dyspnea score, quality of life, and safety were compared between the two groups before and after treatment. Results. The therapeutic effect of the observation group gained better results than that of the control group (84.00% vs. 62.96%). One week after operation, the pH value, SaO2, PaCO2, shortness of breath score, airway diameter change, dyspnea score, life quality, and incidence of postoperative complications in the observation group exerted better results as compared to the control group. Conclusion. The implantation of Montgomery T-tube has effective function in terms of improving the symptoms of dyspnea and the life quality of patients with safety profile in patients harboring tracheal stenosis.
High-Order Approximation to Two-Level Systems with Quasiresonant Control
Authors: Wang Lin , Zu Jian
Published: October 2020

In this paper, we focus on high-order approximate solutions to two-level systems with quasi-resonant control. Firstly, we develop a high-order renormalization group (RG) method for Schrödinger equations. By this method, we get the high-order RG approximate solution in both resonance case and out of resonance case directly. Secondly, we introduce a time transformation to avoid the invalid expansion and get the high-order RG approximate solution in near resonance case. Finally, some numerical simulations are presented to illustrate the effectiveness of our RG method. We aim to provide a mathematically rigorous framework for mathematicians and physicists to analyze the high-order approximate solutions of quasi-resonant control problems.
Effectiveness of Conventional Swallowing Therapy in Acute Stroke Patients with Dysphagia
Authors: Jongprasitkul Hathaya , Kitisomprayoonkul Wasuwat
Published: October 2020

Background. Dysphagia is a common problem in acute stroke patient. Aspiration pneumonia increases in this group. Swallowing therapy is immediately conducted in a stable stroke patient. An effectiveness of our program has not been determined. Objective. To determine an effectiveness of conventional swallowing therapy in acute stroke patients with dysphagia. Methods. We retrospectively reviewed data from medical records of acute stroke patients with dysphagia who participated a swallowing therapy from January 2017 to June 2017. Fifty-seven acute stroke patients with dysphagia (26 males and 31 females) were participating in a conventional swallowing therapy (50 minutes a day for 3 days per week). A functional oral intake scale (FOIS) and swallow function scoring system (SFSS) were used to determine an effectiveness of the swallowing therapy. FOIS and SFSS scores before the first therapy session and after the last therapy session were compared using a paired t-test. Results. The mean age of the patient was 69.5±15.35 years. The period from stroke onset to the first swallowing therapy session was 7.5±6.69 days. The number of therapy was 5.6±2.83 sessions. Participants showed a significant improvement of the FOIS (mean score increased from 1.74 to 3.30 points, P=0.001) and SFSS (mean score increased from 2.51 to 3.68 points, P=0.001). Forty-two percent of patients with tube dependent change to total oral intake. Conclusion. Conventional swallowing therapy is an effective treatment in acute stroke with dysphagia.
TPPP3 Associated with Prognosis and Immune Infiltrates in Head and Neck Squamous Carcinoma
Authors: Yang Zheng , Li Xiaohong , Li Jingyu , Su Qisheng , Qiu Yuling , Zhang Zunni , Zhang Liqian , Mo Wuning
Published: October 2020

Tubulin polymerization promoting protein family member 3 (TPPP3) is a kind of protein that can mediate the dynamics and stability of microtubules. However, the correlations of TPPP3 between prognosis and immune infiltrates in different tumors are still unclear. The analysis of TPPP3 expression was performed via Oncomine and Gene Expression Profiling Interactive Analysis (GEPIA) website. We also used GEPIA to assess the impact of TPPPT3 on clinical outcomes. The related pathways involved in TPPP3 were analyzed by gene‐set enrichment analysis (GSEA), and the correlation between TPPP3 and immune infiltration was studied by Tumor Immune Estimation Resource2.0 (TIMER 2.0). The TPPP3 expression was significantly reduced in head and neck squamous carcinoma (HNSC) compared to adjacent tissues. In addition, the low expression of TPPP3 in HNSC was significantly associated with prognosis. The pathways closely related to the low expression of TPPP3 are “Antigen Processing and Presentation,” “Primary Immunodeficiency,” and so on. The TPPP3 expression was negatively correlated with the level of CD8+ T cell, B cell, and myeloid dendritic cell infiltration in HNSC. The TPPP3 expression is closely related to multiple immunomarkers in CD8+ T cell and Myeloid dendritic cells. These data indicate that TPPP3 is associated with multiple cancers and involves multiple immune‐related pathways, and TPPP3 is associated with immune infiltration levels. Besides, the TPPP3 expression may help regulate tumor‐associated CD8 + T cells, DC cells in HNSC. We conclude TPPP3 can be considered as a biomarker for predicting head and neck squamous cell carcinoma prognosis and immune infiltration.
Impact of Dexmedetomidine on Tourniquet‐Induced Systemic Effects in Total Knee Arthroplasty under Spinal Anesthesia: a Prospective Randomized, Double‐Blinded Study
Authors: Lee Cheol , Lee Cheolhyeong , So Cheolhwan , Lee Jiheui , Choi Insung , Ma Xiao , Hwang Jihyo
Published: October 2020

Background. Clinical studies on the impact of dexmedetomidine on tourniquet‐induced systemic effects have been inconsistent. We investigated the impact of dexmedetomidine on tourniquet‐induced systemic effects in total knee arthroplasty. Methods. Eighty patients were randomly assigned to either control (CON) or dexmedetomidine (DEX) group. The DEX group received an intravenous loading dose of 0.5 μg/kg DEX over 10 minutes, followed by a continuous infusion of 0.5 μg/kg/h from 10 minutes before the start of surgery until completion. The CON group received the same calculated volume of normal saline. Pain outcomes and metabolic and coagulative changes after tourniquet application and after tourniquet release were investigated. Results. The frequency of fentanyl administration postoperatively, patient‐controlled analgesia (PCA) volume at 24 hours postoperatively, total PCA volume consumed in 48 hours postoperatively, and VAS score for pain at 24 and 48 hours postoperatively were significantly lower in the DEX group than in the CON group. Ten minutes after the tourniquet release, the DEX group showed significantly higher pH and lower lactate level than those in the CON group. Antithrombin III activity and body temperature 10 minutes after tourniquet release were significantly lower in the DEX group than in the CON group. Ca2+, K+, HCO3-, base excess, and PCO2 levels 10 minutes after tourniquet release were not significantly different between the two groups. Conclusion. We showed that DEX attenuated pain and hemodynamic, metabolic, and coagulative effects induced by the tourniquet. However, these metabolic and coagulative changes were within normal limits. Therefore, DEX could be used as an analgesic adjuvant, but should not be considered for routine use to prevent the systemic effects induced by tourniquet use.
Influence of Compaction Level on the Water‐Heat‐Vapor Characteristics of Unsaturated Coarse‐Grained Fillings Exposed to Freezing and Thawing
Authors: Zhang Yuzhi , Wen An , Zhao Weigang , Liang Xiaojie , Li Pei
Published: October 2020

Compaction level is an important control index to guarantee subgrade stability. Under freezing‐thawing cycles, water‐heat‐vapor characteristics due to different compaction levels of unsaturated coarse‐grained fillings of high‐speed railway (HSR) subgrade are key factors in understanding the mechanism of freezing‐thawing deformations. Experiments have been performed to study the characteristics of water‐heat‐vapor of coarse‐grained fillings with different compaction levels exposed to freezing and thawing. Fluorescein was used to trace the variations of liquid water in external moisture supply. Test results indicated that compaction level affected the water‐heat‐vapor characteristics of coarse‐grained fillings to some extent. The increase of compaction level increased frost penetration and freezing rate; however, initial water replenishment time delayed during freezing process; liquid water migration height and external liquid migration increased, but total moisture migration, the amount of vapor migration, and vapor of the soil sample moving up to the top pedestal simultaneously reduced. Repeated freezing‐thawing cycles improve the compaction of coarse‐grained fillings. Variation of the amount of moisture caused by the increase of compaction level may decrease the frost heaving of coarse‐grained fillings. Therefore, proper selection and uniformity of compaction level is of critical importance in HSR engineering.
Comparison of Mechanical Properties of Cement‐Stabilized Loess Produced Using Different Compaction Methods
Authors: Jiang Yingjun , Yuan Kejia , Li Qilong , Deng Changqing , Yi Yong , Zhang Yu , Xue Jinshun
Published: October 2020

Mechanical properties are important indexes to evaluate the improvement effect and engineering performance of cement‐stabilized loess (CSL). This paper presents a comparison of the mechanical properties of CSL compacted using hammer quasi‐static compaction method (QSCM) and vertical vibration compaction method (VVCM). The compaction properties, unconfined compressive strength (UCS), splitting strength (SPS), and resilient modulus (RM) of the laboratory‐compacted CSL using VVCM and QSCM are tested and compared. Furthermore, the effects of compaction method, cement content, compaction coefficient, and curing time of the CSL specimens are investigated. In addition, field measurements are carried out to validate the laboratory investigations. The results show that the laboratory‐compacted CSL using VVCM has a larger dry density and smaller optimum water content than that using QSCM. And the compaction method has a great influence on the mechanical strength of CSL. The UCS, SPS, and RM of the specimen produced using VVCM are averagely 1.17 times, 1.49 times, and 1.17 times that of CSL produced using QSCM, respectively, and the UCS, SPS, and RM of the specimens produced using these two methods increase linearly as the cement content and compaction coefficient increase, while the mechanical strength growth curve experiences three periods of increasing sharply, increasing slowly, and stabilizing with the curing time increased. Moreover, the results also show that the mechanical properties of laboratory‐compacted CSL using VVCM have a better correlation of 83.8% with the field core samples.
A Framework for Online Reverse Auction Based on Market Maker Learning with a Risk-Averse Buyer
Authors: Tayaran Hojat , Ghazanfari Mehdi
Published: October 2020

The online reverse auction is considered as a new e-commerce approach to purchasing and procuring goods and materials in the supply chain. With the rapid and ever-expanding development of information technology as well as the increasing usage of the Internet around the world, the use of an online reverse auction method to provide the required items by organizations has increased. Accordingly, in this paper, a new framework for the online reverse auction process is provided that takes both sides of the procurement process, namely, buyer and seller. The proposed process is a multiattribute semisealed multiround online reverse auction. The main feature of the proposed process is that an online market maker facilitates the seller’s bidding process by the estimation of the buyer’s scoring function. For this purpose, a multilayer perceptron neural network was used to estimate the scoring function. In this case, in addition to hiding the buyer’s scoring function, sellers can improve their bids using the estimated scoring function and a nonlinear multiobjective optimization model. The NSGA II algorithm has been used to solve the seller model. To evaluate the proposed model, the auction process is simulated by considering three scoring functions (additive, multiplicative, and risk-aversion) and two types of open and semisealed auctions. The simulation results show that the efficiency of the proposed model is not significantly different from the open auction, and in addition, unlike the open auction, the buyer information was not disclosed.
Phenolic Content and Antioxidant, Antihyperlipidemic, and Antidiabetogenic Effects of Opuntia dillenii Seed Oil
Authors: Bouhrim Mohamed , Daoudi Nour Elhouda , Ouassou Hayat , Benoutman Amina , Loukili El Hassania , Ziyyat Abderrahim , Mekhfi Hassane , Legssyer Abdelkhaleq , Aziz Mohammed , Bnouham Mohamed , Peluso Marco E. M.
Published: October 2020

Opuntia dillenii (Ker-Gawl.) Haw. is a medicinal plant that is widely used by the Moroccan population to treat many diseases, thanks to its richness in bioactive molecules. This study aims to evaluate the total phenolic content and antioxidant, antihyperlipidemic, and antidiabetogenic activities of O. dillenii seeds oil (ODSO), in vivo. The 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging assay and the Folin–Ciocalteu method were applied in this study to determine antioxidant activity and total phenolic content of ODSO, respectively. The antihyperlipidemic effect of the ODSO (2 ml/kg) was evaluated in the high-fat diet-fed albino mice, relying on lipid profile, blood glucose, and growth performance variations. Moreover, the preventive effect of ODSO was evaluated against alloxan monohydrate-induced diabetes in albino mice. ODSO had the highest total phenolic content (518.18 ± 14.36 mg EAC/kg) and DPPH scavenging activity (IC50 = 0.38 ± 0.08 mg/mL). Furthermore, ODSO showed a significant antidiabetogenic effect by reducing bodyweight loss, blood sugar level rise, and mortality rate caused by alloxan in albino mice. Then, ODSO has exhibited a significant antihyperlipidemic effect by improving the lipid profile disorder and glucose level rise in the blood, produced by the high-fat diet-fed albino mice. Results suggest that antidiabetogenic and antihyperlipidemic activities of ODSO correlate to the phenolic content and antioxidant activity of this oil. Hence, this plant could be a significant source of medically important critical compounds.
Double Retinal Tamponade for Treatment of Rhegmatogenous Retinal Detachment with Proliferative Vitreoretinopathy and Inferior Breaks
Authors: Farouk Abdelkader Mohamed , Abd-Elhamid Mehany Elwan Shaaban , Shawkat Abdelhalim Ahmed
Published: October 2020

Purpose. To evaluate the efficacy and safety of the simultaneous use of short-term perfluoro-n-octane (PFO) with perfluoropropane (C3F8) gas to achieve retinal reattachment in eyes with rhegmatogenous retinal detachment (RRD) with proliferative vitreoretinopathy (PVR) grade C and multiple retinal breaks including inferior breaks. Design. This is a prospective interventional case series study. Patients and Methods. The study was a prospective noncomparative interventional study. It included 30 eyes of 30 patients who had RRD with PVR grade C and multiple retinal breaks including inferior tears attending the vitreoretinal unit of Minia University Hospital, Egypt. The mean age was 50.2 ± 10.63 years; 18 patients were females and 12 were males. Combined phacoemulsification and 23 G pars plana vitrectomy (PPV) with double retinal tamponade by C3F8 and PFO were done, and PFO was removed in 10–14 days. The patients were followed up for one year. The primary outcome was to achieve successful retinal reattachment, and the secondary outcomes were visual improvement and occurrence of complications. Results. Successful retinal reattachment was obtained in 28 eyes out of 30 (93.3%), and 2 eyes (6.7%) had recurrent RD. Best-corrected distance visual acuity (BCDVA) in logMAR was significantly improved from baseline 1.74 ± 0.05 to 0.93 ± 0.04, 0.82 ± 0.05, 0.80 ± 0.07, and 0.73 ± 0.055 at follow-up visits 3, 6, and 9 months and one year, respectively (

P
≤
0.001

). There were no serious ocular complications recorded. Conclusions. The results of this study indicated that primary vitrectomy with simultaneous use of both C3F8 and short-term PFO as retinal tamponades was effective and safe in the management of complex cases of RRD with PVR grade C and inferior breaks. This trial is registered with NCT04168255.
Anatomical and Visual Outcomes after LASIK Performed in Myopic Eyes with the WaveLight® Refractive Suite (Alcon® Laboratories Inc., USA)
Authors: Salah-Mabed Imene , Moran Sarah , Perez Emmanuelle , Debellemanière Guillaume , Gatinel Damien
Published: October 2020

Purpose. To evaluate changes in corneal anatomy and quality of vision following LASIK refractive surgery for mild to high myopia using the WaveLight® Refractive Suite (Alcon® Laboratories Inc., USA).Setting. Rothschild Foundation, Paris, France.Design. Prospective interventional case series.Methods. We examined 60 myopic eyes (average SE −4.5 D, from −9.3 to −0.75 D) of 30 patients from 21.3 to 38.7 years old. Pachymetry, keratometry,Qfactor, corneal aberrations, visual acuity (VA), contrast sensitivity, dry eye assessment, and quality of vision were measured preoperatively, one day (D1), and 1, 3, and 6 months postoperatively.Results. 6 months postoperatively, keratometry became flatter, and theQfactor became more oblate (from −0.18 ± 0.08 to +0.19 ± 0.06). Pachymetry decreased by 117.9 ± 62.2 µm at D1 and increased by 37.87 ± 32.6 µm between D1 and M6. Refraction was emmetropic at D1 and remained stable thereafter. Six months after surgery, VA was slightly but nonsignificantly improved (<0.05 log MAR), whereas contrast sensitivity remained unchanged. Quality of vision was not affected by surgery and was more related to dry eye symptoms than to corneal HOAs (r2 = 0.49;p<0.001vs.r2 = 0.03;p<0.001).Conclusions. LASIK surgery for moderate to high myopia, performed with the WaveLight® Refractive Suite, showed good postoperative outcomes, with demonstrated safety, predictability, efficiency, and stability. This is probably due to well-controlled spherical aberration and the use of large optical zones. Besides, we can assume that the patients’ quality of vision depends more on the postoperative dry eye disease generated by the laser than on the induced HOAs.
The Unexpected Diagnosis of Hepatic Tuberculosis in an Immunocompetent Patient
Authors: Garmpis Nikolaos , Damaskos Christos , Garmpi Anna , Liakea Aliki , Mantas Dimitrios
Published: October 2020

Background/Aim. Tuberculosis (TB) is a chronic infectious disease which affects millions. The most affected system is the respiratory. Thus, hepatic TB (HTB) without involvement of other organs is not common. Its clinical manifestations are not specific, and both imaging and histopathological findings are necessary for the diagnosis. The differential diagnosis includes primary and metastatic liver malignancies. Our aim is to describe the rare entity of HTB via a case presentation. Patient and Methods. We report a case of a 50-year-old female with abdominal pain, weight loss, fever, and anorexia. All imaging methods described a liver lesion. She underwent right lobe hepatectomy, and the histological evaluation demonstrated granuloma with central caseous necrosis. Results. Seven months postoperatively, the patient remains fit and healthy. Conclusion. HTB is a rare entity with no specific symptoms, signs, and no laboratory nor imaging findings. It can be managed effectively if diagnosed in time or lead to death if left untreated.
Changes in the Nrf2/Keap1 Ratio and PON1 Concentration in Plasma of Patients Undergoing the Left Main Coronary Artery Stenting
Authors: Kasprzak Magdalena P. , Olasińska-Wiśniewska Anna , Gryszczyńska Bogna , Budzyń Magdalena , Lesiak Maciej , Trojnarska Olga , Iskra Maria
Published: October 2020

Nuclear factor erythroid 2-related factor2 (Nrf2), together with its inhibitor Kelch-like ECH-associated protein 1 (Keap1), is a crucial regulator of cellular redox response. Nrf2 binds to the antioxidant response element (ARE) present in the DNA sequence of a broad group of antioxidant compounds, including paraoxonase (PON1), inducing their transcription. This study was to answer the question of the effect of temporary ischemia/oxidative stress resulting from the left main stenting via percutaneous coronary intervention (LMPCI) performed in the patients included in this study on the cellular redox balance, which is guarded by the Nrf2/Keap1 interaction. We expected a reflection of the redox imbalance due to reactive oxygen species (ROS) in the change in PON1 concentration observed in the following stages of the study, as well as in total antioxidant capacity (TAC) levels. Our results showed the mobilization of cellular Nrf2/Keap1 team right after the procedure (pre-LMPCI median: 2.532, range: 0.07-11.88; post-LMPCI median: 3.735, range: 0.1545-16.18; 24 h-LMPCI median: 5.596, range: 0.02-49.18), which suggest being the result of oxidative stress that accompanies percutaneous coronary intervention (PCI). The course of Keap1 and Nrf2 concentrations at all stages of the experiment appeared to show that Keap1 shadowed the Nrf2 to switch off its activity after Nrf2 induced the mobilization of the antioxidant response. We observed an increase in PON1 concentration (pre-LMPCI median: 179.3, range: 49.76-6120; post-LMPCI median: 215.7, range: 3.80-2771) and a decrease in the TAC level immediately after PCI (pre-LMPC:

1.008
±
0.27
I

, post-LMPCI:

0.8030
±
0.27

). This study design allowed for the first time to analyze the chronology of mechanisms and the relationship between selected parameters reflecting the redox state in patients’ plasma. We may conclude that ischemia induced by the PCI was the source of imbalance in the Nrf2/Keap1 ratio via oxidative stress, and this leads to an increase in PON1 concentration first and, in the next step, the TAC mobilization.
Iatrogenic Severe Splenic Injury after Colonoscopy
Authors: Enofe Ikponmwosa , Burch Jacob , Yam Julie , Rai Manoj
Published: October 2020

Colonoscopy is a low-risk procedure performed for screening and diagnostic purposes. About 15 million colonoscopies were carried out in the United States in 2012 with this number projected to increase. Injury to the spleen as a complication of colonoscopy is still a rather rare occurrence. We report a case of significant splenic injury, American Association of Surgery for Trauma (AAST) grade III with hemoperitoneum, in a patient following diagnostic colonoscopy, managed conservatively without the need for invasive or salvage surgical procedure.
Tianxia120: A Multimodal Medical Data Collection Bioinformatic System for Proactive Health Management in Internet of Medical Things
Authors: Jiao Zihan , Xiao Yindong , Jin Yanmei , Chen Xinyu , Huang Xiwei
Published: October 2020

A digital medical health system named Tianxia120 that can provide patients and hospitals with “one-step service” is proposed in this paper. Evolving from the techniques of Internet of Medical Things (IoMT), medical dig data, and medical Artificial Intelligence, the system can systematically promote the change of service status between doctors and patients from “passive mode” to “proactive mode” and realize online service that is similar to offline medical treatment scenarios. The system consists of a patient terminal and a doctor terminal. They can perform online inquiry (through graphic, voice, telephone, video, etc.), electronic prescription, multiparameter self-diagnosis, cold chain logistics, medicine distribution, etc. The system can provide rich medical health information, medical tools browsing, and health care big data aggregation processing functions. Compared with the traditional medical system, this system has the characteristics of full function, rich data, and high security. It is expected to be applied to hospital applications and medical research to promote the construction and innovation of clinical medical disciplines.
Vehicle Detection Based on Multifeature Extraction and Recognition Adopting RBF Neural Network on ADAS System
Authors: Chen Xuewen , Chen Huaqing , Xu Huan
Published: October 2020

A region of interest (ROI) that may contain vehicles is extracted based on the composite features on vehicle’s bottom shadow and taillights by setting a gray threshold on vehicle shadow region and a series of constraints on taillights. In order to identify the existence of target vehicle in front of Advanced Driver Assistance System (ADAS) for the extracted ROI, a neural network recognizer of the Radial Basis Function (RBF) is found by extracting a series of parameters on the vehicle’s edge and region features. Using a large amount of collected images, the ROI that may contain vehicles is verified to be effective by extracting composite features of the shadow at the bottom of vehicle and taillights. Based on the positive and negative sample base of vehicles, the neural network recognizer is trained and learned, which can quickly realize network convergence. Furthermore, the vehicle can be effectively identified in the region of interest using the trained network. Test results show that the vehicle detection method based on multifeature extraction and recognition method based on RBF network have stable performance and high recognition accuracy.
Real-Time Incident Detection and Capacity Estimation Using Loop Detector Data
Authors: Rizvi Syed Muzammil Abbas , Ahmed Afzal , Shen Yongjun
Published: October 2020

Given the fact that the existing literature lacks the real-time estimation of road capacity and incident location using data from inductance loop detectors, a data-driven framework is proposed in this study for real-time incident detection, as well as road capacity and incident location estimation. The proposed algorithm for incident detection is developed based on the variation in traffic flow parameters acquired from inductance loop detectors. Threshold values of speed and occupancy are determined for incident detection based on the PeMS database. The detection of the incident is followed by the real-time road capacity and incident location estimation using a Cell Transmission Model (CTM) based approach. The data of several incidents were downloaded from PeMS and used for the development of the proposed framework presented in this study. Results show that the developed framework detects the incident and estimates the reduced capacity accurately. The location of the incident is estimated with an overall accuracy of 92.5%. The performance of the proposed framework can be further improved by incorporating the effect of the on-ramps, off-ramps, and high-occupancy lanes, as well as by modeling each lane separately.
Safety of Autonomous Vehicles
Authors: Wang Jun , Zhang Li , Huang Yanjun , Zhao Jian , Bella Francesco
Published: October 2020

Autonomous vehicle (AV) is regarded as the ultimate solution to future automotive engineering; however, safety still remains the key challenge for the development and commercialization of the AVs. Therefore, a comprehensive understanding of the development status of AVs and reported accidents is becoming urgent. In this article, the levels of automation are reviewed according to the role of the automated system in the autonomous driving process, which will affect the frequency of the disengagements and accidents when driving in autonomous modes. Additionally, the public on-road AV accident reports are statistically analyzed. The results show that over 3.7 million miles have been tested for AVs by various manufacturers from 2014 to 2018. The AVs are frequently taken over by drivers if they deem necessary, and the disengagement frequency varies significantly from 2 × 10−4 to 3 disengagements per mile for different manufacturers. In addition, 128 accidents in 2014–2018 are studied, and about 63% of the total accidents are caused in autonomous mode. A small fraction of the total accidents (∼6%) is directly related to the AVs, while 94% of the accidents are passively initiated by the other parties, including pedestrians, cyclists, motorcycles, and conventional vehicles. These safety risks identified during on-road testing, represented by disengagements and actual accidents, indicate that the passive accidents which are caused by other road users are the majority. The capability of AVs to alert and avoid safety risks caused by the other parties and to make safe decisions to prevent possible fatal accidents would significantly improve the safety of AVs. Practical applications. This literature review summarizes the safety-related issues for AVs by theoretical analysis of the AV systems and statistical investigation of the disengagement and accident reports for on-road testing, and the findings will help inform future research efforts for AV developments.
A Predictive Model for Tumor Invasion of the Inferior Vena Cava Wall Using Multimodal Imaging in Patients with Renal Cell Carcinoma and Inferior Vena Cava Tumor Thrombus
Authors: Liu Zhuo , Li Liwei , Hong Peng , Zhu Guodong , Tang Shiying , Zhao Xun , Zhang Qiming , Wang Guoliang , He Wei , Zhang Hua , Xue Heng , Cui Ligang , Ge Huiyu , Jiang Jie , Zhang Shudong , Cao Fangting , Yan Jing , Ma Fengrong , Liu Cheng , Ma Lulin , Wang Shumin
Published: October 2020

Purpose. Developed a preoperative prediction model based on multimodality imaging to evaluate the probability of inferior vena cava (IVC) vascular wall invasion due to tumor infiltration. Materials and Methods. We retrospectively analyzed the clinical data of 110 patients with renal cell carcinoma (RCC) with level I‐IV tumor thrombus who underwent radical nephrectomy and IVC thrombectomy between January 2014 and April 2019. The patients were categorized into two groups: 86 patients were used to establish the imaging model, and the data validation was conducted in 24 patients. We measured the imaging parameters and used logistic regression to evaluate the uni‐ and multivariable associations of the clinical and radiographic features of IVC resection and established an image prediction model to assess the probability of IVC vascular wall invasion. Results. In all of the patients, 46.5% (40/86) had IVC vascular wall invasion. The residual IVC blood flow (OR 0.170 [0.047‐0.611]; P = 0.007), maximum coronal IVC diameter in mm (OR 1.203 [1.065‐1.360]; P = 0.003), and presence of bland thrombus (OR 3.216 [0.870‐11.887]; P = 0.080) were independent risk factors of IVC vascular wall invasion. We predicted vascular wall invasion if the probability was >42% as calculated by: {Ln [Pre/(1 − pre)] = 0.185 × maximum cornal IVC diameter + 1.168 × bland thrombus–1.770 × residual IVC blood flow–5.857}. To predict IVC vascular wall invasion, a rate of 76/86 (88.4%) was consistent with the actual treatment, and in the validation patients, 21/26 (80.8%) was consistent with the actual treatment. Conclusions. Our model of multimodal imaging associated with IVC vascular wall invasion may be used for preoperative evaluation and prediction of the probability of partial or segmental IVC resection.
Lack of PPARβ/δ‐Inactivated SGK‐1 Is Implicated in Liver Carcinogenesis
Authors: Shen Bo , Li Aimin , Wan Yu-Jui Yvonne , Shen Guijia , Zhu Jinshui , Nie Yuqiang
Published: October 2020

Objective. The present study examined the role of PPARβ/δ in hepatocellular carcinoma (HCC). Methods. The effect of PPARβ/δ on HCC development was analyzed using PPARβ/δ‐overexpressed liver cancer cells and PPARβ/δ‐knockout mouse models. Results. PPARβ/δ(-/-) mice were susceptible to diethylnitrosamine‐ (DEN‐) induced HCC (87.5% vs. 37.5%, p < 0.05). In addition, PPARβ/δ‐overexpressed HepG2 cells had reduced proliferation, migration, and invasion capabilities accompanied by increased apoptosis and cell cycle arrest at the G0/G1 phase. Moreover, differential gene expression profiling uncovered that the levels of serine/threonine‐protein kinase (SGK‐1) mRNA and its encoded protein were reduced in PPARβ/δ‐overexpressed HepG2 cells. Consistently, elevated SGK‐1 levels were found in PPARβ/δ(-/-) mouse livers as well as PPARβ/δ‐knockdown human SMMC‐7721 HCC cells. Chromatin immunoprecipitation (ChIP) assays followed by real‐time quantitative polymerase chain reaction (qPCR) assays further revealed the binding of PPARβ/δ to the SGK‐1 regulatory region in HepG2 cells. Conclusions. Due to the known tumor‐promoting effect of SGK1, the present data suggest that PPARβ/δ‐deactivated SGK1 is a novel pathway for inhibiting liver carcinogenesis.
CD19-specific CAR T Cells that Express a PD-1/CD28 Chimeric Switch-Receptor are Effective in Patients with PD-L1–positive B-Cell Lymphoma
Authors: Liu Hui , Lei Wen , Zhang Chaoting , Yang Chunmei , Wei Juying , Guo Qunyi , Guo Xiaojun , Chen Zhilu , Lu Ying , Young Ken H. , Lu Zheming , Qian Wenbin
Published: October 2020

Purpose:

CD19-specific chimeric antigen receptor (CAR) T-cell therapy is effective against refractory or relapsed (R/R) B-cell lymphoma, but the efficacy is hindered by the existence of PD-1/PD-L1 pathway.

Patients and Methods:

Here, we generated a novel anti-CD19 CAR-expressing PD-1/CD28 chimeric switch-receptor (CD19-PD-1/CD28-CAR). We then conducted a phase Ib study to evaluate safety and efficacy of CD19-PD-1/CD28-CAR T cells in the treatment of PD-L1+ B-cell lymphoma.

Results:

We found that CD19-PD-1/CD28-CAR T cells had superior T-cell proliferation, cytokine production, and sequentially capability of killing PD-L1+ B-cell lymphoma cells in vitro and in vivo relative to the prototype, CD19-CAR T cells. Among 17 adult patients with R/R lymphoma who received the CAR T therapy, 10 patients had objective response (58.8%), including seven patients with complete remission (41.2%). At a median follow-up 15 months, median overall survival for all patients was not reached. Remarkably, no severe neurologic toxicity or cytokine release syndrome was observed.

Conclusions:

This first-in-human study demonstrates the tolerability, safety, and encouraging efficacy of CD19-PD-1/CD28-CART in PD-L1+ large B-cell lymphoma.
Effect of Germline Mutations in Homologous Recombination Repair Genes on Overall Survival of Patients with Pancreatic Adenocarcinoma
Authors: Yadav Siddhartha , Kasi Pashtoon M. , Bamlet William R. , Ho Thanh P. , Polley Eric C. , Hu Chunling , Hart Steven N. , Rabe Kari G. , Boddicker Nicholas J. , Gnanaolivu Rohan D. , Lee Kun Y. , Lindstrom Tricia H. , Petersen Gloria M. , Couch Fergus J. , McWilliams Robert R.
Published: October 2020

Purpose:

To compare the clinical characteristics and overall survival (OS) of germline mutation carriers in homologous recombination repair (HRR) genes and noncarriers with pancreatic ductal adenocarcinoma (PDAC).

Experimental Design:

Germline DNA from 3,078 patients with PDAC enrolled in a prospective registry at Mayo Clinic between 2000 and 2017 was analyzed for mutations in 37 cancer predisposition genes. Characteristics and OS of patients with mutations in eight genes (ATM, BARD1, BRCA1, BRCA2, BRIP1, PALB2, RAD51C, and RAD51D) involved in HRR were compared with patients testing negative for mutations in all 37 genes.

Results:

The 175 HRR mutation carriers and 2,730 noncarriers in the study had a median duration of follow-up of 9.9 years. HRR mutation carriers were younger (median age at diagnosis: 63 vs. 66 years, P < 0.001) and more likely to have metastatic disease at diagnosis (46% vs. 36%, P = 0.004). In a multivariable model adjusting for sex, age at diagnosis, and tumor staging, patients with germline HRR mutations had a significantly longer OS compared with noncarriers [HR, 0.83; 95% confidence interval (CI), 0.70–0.97; P = 0.02]. Further gene-level analysis demonstrated that germline ATM mutation carriers had longer OS compared with patients without germline mutations in any of the 37 genes (HR, 0.72; 95% CI, 0.55–0.94; P = 0.01).

Conclusions:

This study demonstrates that germline mutation carrier status in PDAC is associated with longer OS compared with noncarriers. Further research into tumor biology and response to platinum-based chemotherapy in germline mutation carriers with PDAC are needed to better understand the association with longer OS.
Effect of Different Toothbrushing Routines on Interproximal Fluoride Concentration
Authors: Ishizuka Yoichi , Lehrkinder Anna , Nordström Anna , Lingström Peter
Published: October 2020

This study aimed to evaluate the effect of different toothbrushing routines and different kinds of toothpaste on the interproximal fluoride concentration after toothbrushing and its clinical relevance to the recommendations given to patients regarding the process of toothbrushing. Eight adults participated a total of 8 times in order to test different toothbrushing routines with different amounts of toothpaste (1 or 2 cm), durations (1 or 2 min) and amounts of water after toothbrushing (10 or 20 mL). An additional 8 adults participated 6 times in total to test different forms of toothpaste administration (paste, gel and foam) with different amounts of water after toothbrushing (no rinsing or 10 mL). Interdental saliva samples were collected from proximal sites 25/26 and 46/45 using small paper points, before and up to 60 min after toothbrushing. The fluoride concentration was measured by an ion-specific electrode. The area under the curve, saliva fluoride concentration versus time, was calculated. Differences between the groups were tested by ANOVA with Tukey’s multiple comparisons test. An increase in fluoride concentration of 47.2% was observed when the amount of toothpaste increased from 1 to 2 cm (p < 0.01), 26.8% when increasing the duration from 1 to 2 min (p < 0.01) and 41.2% when reducing the amount of water rinsing from 20 to 10 mL (p < 0.01). The paste and gel resulted in higher fluoride concentration (p < 0.01) compared with foam. These findings suggest that the amount of toothpaste, the duration and the amount of water have a significant effect on fluoride concentration after toothbrushing. Furthermore, despite the lower amount of fluoride, the gel gives almost the same fluoride concentration after toothbrushing as the toothpaste. The results confirm the importance of giving clear advice to patients regarding the process of toothbrushing.
Heterogeneity of Effect of Net Ultrafiltration Rate among Critically Ill Adults Receiving Continuous Renal Replacement Therapy
Authors: Serpa Neto Ary , Naorungroj Thummaporn , Murugan Raghavan , Kellum John A. , Gallagher Martin , Bellomo Rinaldo
Published: October 2020

Introduction: In continuous renal replacement therapy (CRRT)-treated patients, a net ultrafiltration (NUF) rate >1.75 mL/kg/h has been associated with increased mortality. However, there may be heterogeneity of effect of NUF rate on mortality, according to patient characteristics. Methods: To investigate the presence and impact of heterogeneity of effect, we performed a secondary analysis of the “Randomized Evaluation of Normal versus Augmented Level of Renal Replacement Therapy” (RENAL) trial. Exposure was NUF rate (weight-adjusted fluid volume removed per hour) stratified into tertiles (<1.01 mL/kg/h; 1.01–1.75 mL/kg/h; or >1.75 mL/kg/h). Primary outcome was 90-day mortality. Patients were clustered according to baseline characteristics. Heterogeneity of effect was assessed according to clusters and baseline edema and related to the additional impact of baseline cardiovascular Sequential Organ Failure Assessment (SOFA) score. We excluded patients with missing values for baseline weight and/or treatment duration. Results: We identified 2 clusters. The largest (cluster 1; n = 941) included more severely ill patients, with more sepsis, more edema, and more vasopressor therapy (all p < 0.001). Compared to the middle tertile, the probability of harm was greater with the high tertile of NUF rate in patients in cluster 1 and in patients with baseline edema (probability of harm, cluster 1: 99.9%; edema: 99.1%). Moreover, higher baseline cardiovascular SOFA score also increased mortality risk with both high and low compared to middle NUF rates in cluster 1 patients and in patients with edema. Conclusions: In CRRT patients, both high and low NUF rates may be harmful, especially in those with edema, sepsis, and greater illness severity. Cardiovascular SOFA scores modulate this association. Additional studies are needed to test these hypotheses, and targeted trials of NUF rates based on risk stratification appear justified. Trial Registration: ClinicalTrials.gov identifier: NCT00221013.
Pharmacoepidemiology of Furosemide in the Neonatal Intensive Care Unit
Authors: Thompson Elizabeth J. , Benjamin Daniel K. , Greenberg Rachel G. , Kumar Karan R. , Zimmerman Kanecia O. , Laughon Matthew , Clark Reese H. , Smith P. Brian , Hornik Christoph P.
Published: October 2020

Background: Furosemide is commonly used off-label in the neonatal intensive care unit (NICU), but current dosing practices vary widely. Objectives: To describe dosing practices including route, dose, and duration of exposure to furosemide in a large number of community and tertiary NICUs across North America. Method: Using the Pediatrix Medical Group Clinical Data Warehouse, we identified infants who received ≥1 dose of furosemide between 1997 and 2016. We excluded infants with incomplete dosing data. We calculated average daily furosemide dose, cumulative dose, total days of exposure, and maximum daily dose. We compared dosing between infants born at <32 weeks gestational age (GA) and ≥32 weeks GA. Results: A total of 18,572 infants had complete dosing data. The median (interquartile value) postnatal age at first exposure was 11 days (4, 26), the median maximum daily dose was 1.0 mg/kg (0.97, 1.6), the median average daily dose was 1.0 mg/kg (0.88, 1.1), and the median cumulative dose was 2.0 mg/kg (1.0, 4.5). The median total duration of exposure was 2 days (1, 4). A total of 177 (1%) infants received ≥4 mg/kg/day of furosemide. Infants born <32 weeks GA were an older age at initial furosemide exposure compared to those born ≥32 weeks GA: 19 versus 4 days, p < 0.001. Conclusions: Most infants received short courses of furosemide within the labeled dosing parameters. Further studies are needed to assess the safety and efficacy of furosemide in the NICU.
Malignant Arrhythmias in Patients With COVID-19
Authors: Turagam Mohit K. , Musikantow Daniel , Goldman Martin E. , Bassily-Marcus Adel , Chu Edward , Shivamurthy Poojita , Lampert Joshua , Kawamura Iwanari , Bokhari Mahmoud , Whang William , Bier Benjamin Aaron , Malick Waqas , Hashemi Helen , Miller Marc A. , Choudry Subbarao , Pumill Christopher , Ruiz-Maya Tania , Hadley Michael , Giustino Gennaro , Koruth Jacob S. , Langan Noelle , Sofi Aamir , Dukkipati Srinivas R. , Halperin Jonathan L. , Fuster Valentin , Kohli-Seth Roopa , Reddy Vivek Y.
Published: October 2020

Background:

Patients with coronavirus disease 2019 (COVID-19) who develop cardiac injury are reported to experience higher rates of malignant cardiac arrhythmias. However, little is known about these arrhythmias—their frequency, the underlying mechanisms, and their impact on mortality.

Methods:

We extracted data from a registry (NCT04358029) regarding consecutive inpatients with confirmed COVID-19 who were receiving continuous telemetric ECG monitoring and had a definitive disposition of hospital discharge or death. Between patients who died versus discharged, we compared a primary composite end point of cardiac arrest from ventricular tachycardia/fibrillation or bradyarrhythmias such as atrioventricular block.

Results:

Among 800 patients with COVID-19 at Mount Sinai Hospital with definitive dispositions, 140 patients had telemetric monitoring, and either died (52) or were discharged (88). The median (interquartile range) age was 61 years (48–74); 73% men; and ethnicity was White in 34%. Comorbidities included hypertension in 61%, coronary artery disease in 25%, ventricular arrhythmia history in 1.4%, and no significant comorbidities in 16%. Compared with discharged patients, those who died had elevated peak troponin I levels (0.27 versus 0.02 ng/mL) and more primary end point events (17% versus 4%,
P
=0.01)—a difference driven by tachyarrhythmias. Fatal tachyarrhythmias invariably occurred in the presence of severe metabolic imbalance, while atrioventricular block was largely an independent primary event.

Conclusions:

Hospitalized patients with COVID-19 who die experience malignant cardiac arrhythmias more often than those surviving to discharge. However, these events represent a minority of cardiovascular deaths, and ventricular tachyarrhythmias are mainly associated with severe metabolic derangement.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT04358029.