bluuebunny/crossref_metadata_2025 huggingface dataset:
A Resilience‐Based Security Assessment Approach for CBTC Systems
Authors: Lu Ruiming , Dong Huiyu , Wang Hongwei , Cui Dongliang , Zhu Li , Wang Xi
Published: October 2021

With the rapid development of urban rail transit systems, large amounts of information technologies are applied to increase efficiency of train control systems, such as general computers, communication protocols, and operation systems. With the continuous exposure of information technology vulnerabilities, security risks are increasing, and information is easy to use by malicious attackers, which can bring huge property and economic losses. The communication‐based train control (CBTC) system is the most important subsystem of urban rail transit. The CBTC system ensures safe and efficient operation of trains, so the quantitative assessment of cyber security is quite necessary. In this paper, a resilience‐based assessment method is proposed to analyze the security level of CBTC systems based on indicators of both the cyber domain and the physical domain. The proposed method can demonstrate the robustness and recovery ability of CBTC systems under different security attacks. Based on the structural information entropy, the fusion of different indicators is achieved. Two typical attacking scenarios are analyzed, and the simulation results illustrate the effectiveness of the proposed assessment approach.
Values of Sinogram Affirmed Iterative Reconstruction Algorithm-Based Low-Dose Computed Tomography Imaging in Clinical Diagnosis of Cerebral Hemorrhage
Authors: Wang Yifei , Chen Ying , Fang Jincai , Song Yunnong , Shen Jianguo , Wang Jianchao
Published: October 2021

In this study, the sinogram affirmed iterative reconstruction (SAFIRE) technology combined with low-dose computed tomography (CT) scanning technology was applied to scan patients with cerebral hemorrhage to evaluate the application value of this combined technology in the diagnosis of patients with cerebral hemorrhage. 132 patients with cerebral hemorrhage admitted to the hospital were selected randomly as the research objects in this study. According to the patients’ wishes, all of them were rolled into an experimental group and a control group. Besides, patients who were willing to use low-dose CT imaging scanning technology based on the SAFIRE algorithm were classified into the experimental group, and those who received simple low-dose CT scans were classified into the control group. Subjective score, objective score (mean CT value), image noise (SD), signal-to-noise ratio (SNR), and contrast-noise ratio (CNR) were used to analyze and compare the two groups of detection methods. The results showed the following: (1) The average result of CT images was 4.05 ± 0.28 points for the control group and 4.43 ± 0.59 points for the experimental group. According to the classification, the excellent and good rates of the experimental group (89.9%) were markedly higher than the rates of the control group (65.8%), with a statistically obvious difference (

P

 < 0.05). (2) The standard deviation (SD), image signal-to-noise ratio (SNR), and contrast-noise ratio (CNR) results of gray matter, white matter, and cerebral hemorrhage lesions of patients from the experimental group were better than those of the control group, and the differences were statistically significant (

P

 < 0.05). In conclusion, the image quality of a low-dose CT scan reconstructed by the SAFIRE algorithm was superior to that of a simple low-dose CT scan. In other words, the image quality of CT images could be guaranteed by the SAFIRE technology under the condition of reducing radiation dose. It enabled patients with cerebral hemorrhage to carry out diagnostic examinations with guaranteed accuracy under the risk of low radiation and provided better imaging services for patients with cerebral hemorrhage.
Classification of Material Type from Optical Coherence Tomography Images Using Deep Learning
Authors: Sabuncu Metin , Ozdemir Hakan
Published: October 2021

Classification of material type is crucial in the recycling industry since good quality recycling depends on the successful sorting of various materials. In textiles, the most commonly used fiber material types are wool, cotton, and polyester. When recycling fabrics, it is critical to identify and sort various fiber types quickly and correctly. The standard method of determining fabric fiber material type is the burn test followed by a microscopic examination. This traditional method is destructive, tedious, and slow since it involves cutting, burning, and examining the yarn of the fabric. We demonstrate that the identification procedure can be done nondestructively using optical coherence tomography (OCT) and deep learning. The OCT image scans of fabrics that are composed of different fiber material types such as wool, cotton, and polyester are used to train a deep neural network. We present the results of the created deep learning models’ capability to classify fabric fiber material types. We conclude that fiber material types can be identified nondestructively with high precision and recall by OCT imaging and deep learning. Because classification of material type can be performed by OCT and deep learning, this novel technique can be employed in recycling plants in sorting wool, cotton, and polyester fabrics automatically.
Global Stability for Novel Complicated SIR Epidemic Models with the Nonlinear Recovery Rate and Transfer from Being Infectious to Being Susceptible to Analyze the Transmission of COVID-19
Authors: Alshammari Fehaid Salem , Akyildiz F. Talay
Published: October 2021

Epidemiological models play pivotal roles in predicting, anticipating, understanding, and controlling present and future epidemics. The dynamics of infectious diseases is complex, and therefore, researchers need to consider more complicated mathematical models. In this paper, we first describe the dynamics of a complex SIR epidemic model with nonstandard nonlinear incidence and recovery rates. In this model, we consider the rate at which individuals lose immunity. Rigorous mathematical results have been established from the point of view of stability and bifurcation. The basic reproduction number (

R

0

) is determined. We then apply LaSalle’s invariance principle and Lyapunov’s direct method to prove that the disease-free equilibrium is globally asymptotically stable when

R

0

<
1

. The model has a unique endemic equilibrium when

R

0

>
1

. A nonlinear Lyapunov function is used together with LaSalle’s invariance principle to show that the endemic equilibrium is globally asymptotically stable under some conditions. Further, for the case when

 

R

0

=
1

, we analyze the model and show a backward bifurcation under certain conditions. In the second part of this paper, we analyze a modified SIR model with a vaccination term, which must be a function of time. We show that the modified model agrees well with COVID-19 data in Saudi Arabia. We then investigate different future scenarios. Simulation results suggest that a two-pronged strategy is crucial to control the COVID-19 pandemic in Saudi Arabia.
User‐Level Membership Inference for Federated Learning in Wireless Network Environment
Authors: Zhao Yanchao , Chen Jiale , Zhang Jiale , Yang Zilu , Tu Huawei , Han Hao , Zhu Kun , Chen Bing
Published: October 2021

With the rise of privacy concerns in traditional centralized machine learning services, federated learning, which incorporates multiple participants to train a global model across their localized training data, has lately received significant attention in both industry and academia. Bringing federated learning into a wireless network scenario is a great move. The combination of them inspires tremendous power and spawns a number of promising applications. Recent researches reveal the inherent vulnerabilities of the various learning modes for the membership inference attacks that the adversary could infer whether a given data record belongs to the model’s training set. Although the state‐of‐the‐art techniques could successfully deduce the membership information from the centralized machine learning models, it is still challenging to infer the member data at a more confined level, the user level. It is exciting that the common wireless monitor technique in the wireless network environment just provides a good ground for fine‐grained membership inference. In this paper, we novelly propose and define a concept of user‐level inference attack in federated learning. Specifically, we first give a comprehensive analysis of active and targeted membership inference attacks in the context of federated learning. Then, by considering a more complicated scenario that the adversary can only passively observe the updating models from different iterations, we incorporate the generative adversarial networks into our method, which can enrich the training set for the final membership inference model. In the end, we comprehensively research and implement inferences launched by adversaries of different roles, which makes the attack scenario complete and realistic. The extensive experimental results demonstrate the effectiveness of our proposed attacking approach in the case of single label and multilabel.
A Mathematical Method to Adjust MLC Leaf End Position for Accurate Dose Calculation in Carbon Ion Beam Radiation Therapy Treatment Planning System
Authors: Zhang Yan-Shan , Ye Yan-Cheng , Wu Jia-Ming
Published: October 2021

Introduction. We present a mathematical method to adjust the leaf end position for dose calculation correction in the carbon ion radiation therapy treatment planning system. Methods and Materials. A straggling range algorism of 400 MeV/n carbon ion beam in nine different multileaf collimator (MLC) materials was conducted to calculate the dose 50% point to derive the offset corrections in the carbon ion treatment planning system (ciPlan). The visualized light field edge position in the treatment planning system is denoted as Xtang.p, and MLC position (Xmlc.p) is defined as the source to leaf end midpoint projection on axis for monitor unit calculation. The virtual source position of energy at 400 MeV/n and straggling range in MLC at different field sizes were used to calculate the dose 50% position on axis. On‐axis MLC offset (correction) could then be obtained from the position corresponding to 50% of the central axis dose minus the Xmlc.p. Results. The exact MLC position in the carbon ion treatment planning system can be used as an offset to do the correction. The offset correction of pure tungsten is the smallest among the others due to its shortest straggling range of carbon ion beam in MLC. The positions of 50% dose of all MLC materials are always located in between Xtang.p and Xmlc.p under the largest field of 12 cm by 12 cm. Conclusions. MLC offset should be adjusted carefully at different field sizes in the treatment planning systems especially of its small penumbra characteristic in the carbon ion beam. It is necessary to find out the dose 50% position for adjusting MLC leaf edge on‐axis location in the treatment planning system to reduce dose calculation error.
Cyclophotocoagulation under Microscopy Combined with Phacoemulsification for Primary Angle-Closure Glaucoma
Authors: Xiang Xiaoli , Chen Haiying , Li Jian , Xiao Pan , Zhu Wei , Miao Ling , Huang Zhengru
Published: October 2021

The purpose of this study was to evaluate the safety and efficacy of cyclophotocoagulation under microscopy combined with phacoemulsification in patients with primary chronic angle-closure glaucoma. We retrospectively reviewed the results of cyclophotocoagulation under microscopic direct vision combined with phacoemulsification in 35 eyes (35 patients) with primary chronic angle-closure glaucoma and coexisting visually significant cataracts, treated between January 2017 and April 2020 at the glaucoma unit of the affiliated Changshu Hospital of Xuzhou Medical University. All patients were followed up for at least 12 months postoperatively. The preoperative to postoperative changes in best-corrected visual acuity (BCVA), intraocular pressure (IOP), number of antiglaucoma medications, and surgery-associated complications were recorded. The BCVA improved from 1.15 ± 0.91 logMAR preoperatively to 0.86 ± 0.82 logMAR at the final postoperative examination (Z = −3.62,

P
<
0.0001

). The mean IOP was 36.63 ± 13.50 mmHg preoperatively and 15.14 ± 3.19 mmHg at the final examination (Z = −5.16,

P
<
0.0001

). The number of antiglaucoma drugs was significantly reduced from 2.23 ± 0.55 preoperatively to 0.54 ± 0.86 at the final postoperative examination (Z = −5.26,

P
<
0.0001

). The absolute value of the mean defect and retinal nerve fiber layer thickness at the last follow-up postoperatively were significantly reduced compared to preoperative values (Z = −3.35,

P
=
0.001

; Z = −4.56,

P
<
0.001

, respectively). One patient experienced an explosive suprachoroidal hemorrhage during the operation. The sclera was incised at the corresponding site of the intraoperative hemorrhage. The operation was continued once there was no active bleeding, and the outcome was satisfactory. None of the patients required additional surgery to treat complications. Thus, cyclophotocoagulation under microscopic direct vision combined with phacoemulsification can be performed safely for the management of primary angle-closure glaucoma.
Prediction and Evaluation of Coal Mine Coal Bump Based on Improved Deep Neural Network
Authors: Gong Shuang , Tan Yi , Wang Wen
Published: October 2021

Coal bump prediction is one of the key problems in deep coal mining engineering. To predict coal bump disaster accurately and reliably, we propose a depth neural network (DNN) prediction model based on the dropout method and improved Adam algorithm. The coal bump accident examples were counted in order to analyze the influencing factors, characteristics, and causes of this type of accidents. Finally, four indexes of maximum tangential stress of surrounding rock, uniaxial compressive strength of rock, uniaxial tensile strength of rock, and elastic energy of rock are selected to form the prediction index system of coal bump. Based on the research results of rock burst, 305 groups of rock burst engineering case data are collected as the sample data of coal bump prediction, and then, the prediction model based on a dropout and improved Adam-based deep neural network (DA-DNN) is established by using deep learning technology. The DA-DNN model avoids the problem of determining the index weight, is completely data-driven, reduces the influence of human factors, and can realize the learning of complex and subtle deep relationships in incomplete, imprecise, and noisy limited data sets. A coal mine in Shanxi Province is used to predict coal bump with the improved depth learning method. The prediction results verify the effectiveness and correctness of the DA-DNN coal bump prediction model. Finally, it is proved that the model can effectively provide a scientific basis for coal bump prediction of similar projects.
A Variant of sNASP Exacerbates Lymphocyte Subset Disorder and Nephritis in a Spontaneous Lupus Model Sle1.Yaa Mouse
Authors: Zhang Jianye , Du Xiaoping , Wang Hui , Bao Yatao , Lian Meng , Xu Zhiwei , Ju Jiyu
Published: October 2021

A variant of somatic nuclear autoantigenic sperm protein (sNASP) was identified from the murine lupus susceptibility locus Sle2c1 by whole exome sequencing (WES). Previous studies have shown that mutant sNASP could synergize with the Faslpr mutation in exacerbating autoimmunity and aggravating end-organ inflammation. In the current study, the sNASP mutation was introduced into Sle1.Yaa mice to detect whether it has a synergistic effect with Sle1 or Yaa loci. As expected, compared with Sle1.Yaa mice, Sle1.Yaa.ΔsNASP mice showed enlarged lymph nodes, aggravated renal inflammation, and shortened survival time. The proportions of CD3+ T cells, activated CD19+CD86+ B cells, Th1 cells in the spleen and lymph nodes, and Th17 cells in lymph nodes in Sle1.Yaa.ΔsNASP mice were increased compared to those in Sle1.Yaa mice. The levels of IFN-γ and TNF-α in the serum of Sle1.Yaa.ΔsNASP mice were higher than those of Sle1.Yaa mice. The above results show that mutant sNASP can interact with different lupus susceptibility genes and promote the disease process of systemic lupus erythematosus.
Computation of Vertex-Based Topological Descriptors of Organometallic Monolayers of

TM

3

C

12

S

12
Authors: Alrowaili Dalal , Ashraf Faraha , Ali Rifaqat , Shoukat Arsalan , Shaheen Aqila , Azeem Mehran , Siddique Imran
Published: October 2021

Topological descriptors are mathematical values related to chemical structures which are associated with different physicochemical properties. The use of topological descriptors has a great contribution in the field of quantitative structure-property relationship (QSPR) and quantitative structure-activity relationship (QSAR) modeling. These are mathematical relationships between different molecular properties or biological activity and some other physicochemical or structural properties. In this article, we calculate few vertex degree-based topological indices/descriptors of the organometallic monolayer structure. At present, the numerical programming of the biological structure with topological descriptors is increasing in consequence in invigorating science, bioinformatics, and pharmaceutics.
Risk of Liver Cirrhosis in HBV/HCV-Infected Individuals with First-Degree Relatives Who Have Liver Cancer: Development and Validation of a Simple Model
Authors: Liu Yin , Guo Lan-Wei , Xu Hui-Fang , Kang Rui-Hua , Zheng Li-Yang , Zhang Lu-Yao , Chen Qiong , Sun Xi-Bin , Zhang Shao-Kai , Qiao You-Lin
Published: October 2021

Identification of high-risk population among hepatitis B virus (HBV)/hepatitis C virus (HCV)-infected individuals with first-degree relatives (FDR) who have liver cancer is important to implement precise intervention. A cross-sectional study was conducted under the framework of a population-based Cancer Screening Program in Urban China (CanSPUC), aimed to develop and validate a simple noninvasive model that could assess and stratify cirrhosis risk, in HBV/HCV-infected individuals with FDRs who have liver cancer. People who participated in liver cancer screening in Henan province were enrolled. Using the data set consisting of participants admitted from October 1, 2013, to December 31, 2016, a 24-point scale risk score model was developed through logistic regression, based on educational background, dietary habit, smoking index, cooking oil fume exposure, history of severe trauma, HBV/HCV infection status, history of diabetes, history of hyperlipidemia, and parent history of liver cancer. The model showed excellent discrimination with area under the receiver operator characteristic curve (AUROC) of 0.875 [95% confidence interval (CI), 0.853–0.896] and fair calibration with a Hosmer–Lemeshow test P = 0.106. The prevalence rates in the medium- and high-risk groups were 2.87 (95% CI, 1.94–4.25) and 47.57 (95% CI, 31.59–71.63) times of low-risk group, respectively. After internal validation, bias-corrected AUROC was 0.874 (95% CI, 0.873–0.875). In the external validation data set consisting of participants admitted from January 1, 2017, to October 31, 2018, the model had achieved similar discrimination, calibration, and risk stratification ability. In conclusion, the risk score model we developed can be a practical tool for the screening and prevention of liver cirrhosis among HBV/HCV-infected individuals with FDRs who have liver cancer.

Prevention Relevance:

We created a simple and noninvasive cirrhosis risk model for individuals infected by HBV/HCV who have FDRs with liver cancer. This model is useful not only for the prognosis of HBV/HCV infection, but also for the prevention of hepatocellular carcinoma.
Dietary Pterostilbene for MTA1-Targeted Interception in High-Risk Premalignant Prostate Cancer
Authors: Hemani Rutu , Patel Ishani , Inamdar Ninad , Campanelli Gisella , Donovan Virginia , Kumar Avinash , Levenson Anait S.
Published: October 2021

Prostate cancer remains one of the most prevalent cancers in aging men. Active surveillance subpopulation of patients with prostate cancer includes men with varying cancer risk categories of precancerous disease due to prostatic intraepithelial neoplasia (PIN) heterogeneity. Identifying molecular alterations associated with PIN can provide preventable measures through finding novel pharmacologic targets for cancer interception. Targeted nutritional interception may prove to be the most appropriate chemoprevention for intermediate- and high-risk active surveillance patients. Here, we have generated two prostate-specific transgenic mouse models, one overexpressing MTA1 (R26MTA1) and the other overexpressing MTA1 on the background of Pten heterozygosity (R26MTA1; Pten+/f), in which we examined the potential chemopreventive efficacy of dietary pterostilbene. We show that MTA1 promotes neoplastic transformation of prostate epithelial cells by activating cell proliferation and survival, leading to PIN development. Moreover, MTA1 cooperates with PTEN deficiency to accelerate PIN development by increasing cell proliferation and MTA1-associated signaling. Further, we show that mice fed with a pterostilbene-supplemented diet exhibited more favorable histopathology with decreased severity and number of PIN foci accompanied by reduced proliferation, angiogenesis, and inflammation concomitant to reduction in MTA1 and MTA1-associated CyclinD1, Notch2, and oncogenic miR-34a and miR-22 levels.

Prevention Relevance:

Developing novel interceptive strategies for prostate cancer chemoprevention is a paramount goal in clinical oncology. We offer preclinical evidence for the potential of pterostilbene as a promising natural agent for MTA1-targeted interceptive strategy in future cancer prevention trials towards protecting select patients with prostate cancer under active surveillance from developing cancer.
The Urgent Need for Expanded Cancer Screening
Authors: DuBois Raymond N.
Published: October 2021

On October 20, 2021, I had the privilege of testifying before the House Energy and Commerce Committee, Subcommittee on Health Hearing on Enhancing Public Health: Legislation to Protect Children and Families. This commentary is based on the written testimony I provided to the Subcommittee on issues related to cancer screening and early detection. It highlights the research progress, updated guidelines, and new challenges in this field, emphasizing the importance of screening asymptomatic, at-risk population to detect precancerous lesions or cancer at an early stage.
A Pilot Study on Clinical Scores, Immune Cell Modulation, and Microbiota Composition in Allergic Patients with Rhinitis and Asthma Treated with a Probiotic Preparation
Authors: Torre Enza , Sola Daniele , Caramaschi Alice , Mignone Flavio , Bona Elisa , Fallarini Silvia
Published: October 2021

Background: Specific drugs and/or immunotherapies are widely used to treat allergies, but drug-induced adverse effects recently led to explore new additional strategies. We studied whether a probiotic preparation (iPROB®; Anallergo SpA, Florence, Italy) is effective in allergic patients and the mechanisms underlying clinical outcomes. Methods: Eligible patients (n = 28), all suffering from allergic rhinitis with/without bronchial asthma, were consecutively recruited at the Allergology Medical Unit (Novara, Italy) and treated with this probiotic. From each patient, we collected blood and stool samples at the baseline, after 60 days of probiotic supplementation, and after 60 days from probiotic discontinuation. In each blood sample, the percentage of hematopoietic stem cells, eosinophils, and basophils was measured by FACS. To analyze stool microbiota composition, genomic DNA was extracted, bacterial 16S DNA libraries sequenced by Illumina platform (Miseq), and raw sequences processed. Generated data were statistically analyzed. Results: Probiotic-treated patients showed a significant decrease in Average Rhinitis Total Symptom Score (d = −10.5714), and Visual Analog Scale (d = −2.00) clinical indices, as well as important improvements in quality of life. In whole blood, a significant reduction in the percentage of activated eosinophils and basophils was determined, and this effect persisted after specific cell stimulation. Consistently, the serum levels of IL-4 and IL-5 decreased after probiotic treatment, suggesting a reduction in the Th2 cytokine profile. In addition, microbiome genomic analysis (n = 6) showed an increase in microbiome biodiversity, which positively correlates with clinical and cellular data. Conclusion: Present study suggests that iPROB® preparation has clinical/biological properties to be a valid add-on supplementation in allergic patients with asthma and rhinitis.
A Peculiar Case of Large and “Unresectable” Primary Localized Cutaneous Nodular Amyloidosis of the Ankle
Authors: Stanizzi Antonio , Torresetti Matteo , Barbisan Francesca , Peltristo Benedetta , Zavalloni Yasmine , Di Benedetto Giovanni
Published: October 2021

Nodular cutaneous amyloidosis represents the rarest variant of primary localized cutaneous amyloidosis. The proposed management ranges from topical or systemic agents to surgical treatment. Complete surgical excision is advisable due to its potential progression to systemic amyloidosis due to dermis and subcutaneous tissue infiltration. However, in particular locations, the risk of functional complications is high, so an alternative treatment option should be considered. We report a case of a large primary nodular cutaneous amyloidosis of the leg involving the joint capsule which was successfully treated by incomplete surgical removal, without recurrences at 7-year follow-up.
FPI: Mejorar la sobrevida mediante la evaluación y el tratamiento de los trastornos respiratorios del dormir
Authors: Romero-López Zaira
Published: October 2021

Background: It is not well-known if diagnosing and treating sleep breathing disorders among individuals with idiopathic pulmonary fibrosis (IPF) improves health outcomes. We evaluated the association between receipt of laboratory-based polysomnography (which is the first step in the diagnosis and treatment of sleep breathing disorders in Ontario, Canada) and respiratory-related hospitalization and all-cause mortality among individuals with IPF. Methods: We used a retrospective, population-based, cohort study design, analyzing health administrative data from Ontario, Canada, from 2007 to 2019. Individuals with IPF were identified using an algorithm based on health administrative codes previously developed by IPF experts. Propensity score matching was used to account for potential differences in 41 relevant covariates between individuals that underwent polysomnography (exposed) and individuals that did not undergo polysomnography (controls), in order minimize potential confounding. Respiratory-related hospitalization and all-cause mortality were evaluated up to 12 months after the index date. Results: Out of 5044 individuals with IPF identified, 201 (4.0%) received polysomnography, and 189 (94.0%) were matched to an equal number of controls. Compared to controls, exposed individuals had significantly reduced rates of respiratory-related hospitalization (hazard ratio [HR] 0.43, 95% confidence interval [CI] 0.24–0.75), p = 0.003) and all-cause mortality (HR 0.49, 95% CI 0.30–0.80), p = 0.004). Significantly reduced rate of respiratory-related hospitalization (but not all-cause mortality) was also observed among those with > = 1 respiratory-related hospitalization (HR 0.38, 95% CI 0.15–0.99) and systemic corticosteroid receipt (HR 0.37, 95% CI 0.19–0.94) in the year prior to the index date, which reflect sicker subgroups of persons. Conclusions: Undergoing polysomnography was associated with significantly improved clinically-important health outcomes among individuals with IPF, highlighting the potential importance of incorporating this testing in IPF disease management.
A Risk-Prediction Nomogram for Neutropenia or Febrile Neutropenia after Etoposide-Based Chemotherapy in Cancer Patients: A Retrospective Cohort Study
Authors: Zhu Yu , Guo Daihong , Kong Xianghao , Liu Siyuan , Yu Chengxuan
Published: October 2021

Introduction: This study was conducted to develop and validate a nomogram for predicting the risk of neutropenia or febrile neutropenia (FN) in tumor patients in the first cycle of etoposide-based chemotherapy. Methods: This retrospective cohort study used an information system to monitor patients with non-Hodgkin’s lymphoma or solid tumors receiving an etoposide regimen in the first chemotherapy cycle in our hospital from 2009 to 2020. Binary logistic regression analysis was used to identify the influencing factors of patients with neutropenia or FN. Those factors were then used to develop a nomogram. Results: A total of 1,554 patients were divided into the development group (n = 1,072) and validation group (n = 482). Variables used to predict neutropenia or FN were Karnofsky performance status (odds ratio [OR] = 0.85, 95% confidence interval [CI] = 0.81–0.89, p < 0.01), metastatic sites ≥3 (OR = 6.33, 95% CI = 2.66–15.11, p < 0.01), comorbidity of heart disease (OR = 4.88, 95% CI = 1.74–13.67, p < 0.01), recent surgery (OR = 7.96, 95% CI = 1.96–32.36, p < 0.01), administration of alkylating agents (OR = 4.50, 95% CI = 1.10–18.48, p < 0.01), total bilirubin ≥25 μmol/L (OR = 11.42, 95% CI = 4.00–32.61, p < 0.01), and lymphocyte count <0.7 × 109/L (OR = 4.22, 95% CI = 2.00–9.75, p < 0.01). Conclusion: This model can aid the early identification and screening of the potential risk of neutropenia or FN in the first cycle of treatment for patients using etoposide-based chemotherapy.
Neurosarcoidosis Presenting as Young-Onset Chronic Headache: A Case Report
Authors: Ray Barun Kumar , Thakur Rahul Kumar , Shah Anish Kumar , Adhikari Biplov , Mandal Dipesh Kumar , Pandey Ranjit
Published: October 2021

Sarcoidosis causes granulomatous inflammation in multiple organ systems. Lungs are the most commonly affected organs. In 50% of the cases with lung involvement, other organs are also involved. The central nervous system is one of the rarer organ systems involved – comprising 5–15% of all the cases. Neurological involvement, when present, can affect virtually every part of the central and peripheral nervous system. We present an interesting case of a 30-year-old nonalcoholic, nonsmoker man who presented with a chronic headache of 6 years. He had a recent swaying of the body for 6 months and mild forgetfulness for 4 months. The patient had 2 episodes of facial nerve palsy in the past – which had responded to the treatment of Bell’s palsy; however, the patient had some residual findings on presentation. While CSF findings suggested meningeal tuberculosis, the radiological evidence and biopsy confirmed the diagnosis of neurosarcoidosis. On follow-up after 6 weeks of steroid therapy, the patient displayed a marked improvement in headache, cognitive function, and a good response on imaging studies. Our case emphasizes that neurosarcoidosis should be considered in the differential diagnosis of chronic headaches and recurrent facial nerve palsy despite being very rare.
Asthma: Führt die Anwendung einer App zur Therapiekontrolle zu besserer Adhärenz?
Authors: Haidl Peter
Published: October 2021

Background: Poor medication adherence is a major challenge in asthma and objective assessment of inhaler adherence is needed. InspirerMundi app aims to monitor inhaler adherence while turning it into a positive experience through gamification and social support. Objective: We assessed the medium-term feasibility of the InspirerMundi app to monitor inhaler adherence in real-world patients with persistent asthma (treated with daily inhaled medication). In addition, we attempted to identify the characteristics of the patients related to higher app use. Methods: Two real-world multicenter observational studies, with one initial face-to-face visit and a 4-month telephone interview, were conducted in 29 secondary care centers from Portugal. During an initial face-to-face visit, patients were invited to use the app daily to register their asthma medication intakes. A scheduled intake was considered taken when patients took a photo of the medication (inhaler, blister, or others) using the image-based medication detection tool. Medication adherence was calculated as the number of doses taken as a percentage of the number scheduled. Interacting with the app ≥30 days was used as the cut-off for higher app use. Results: A total of 114 patients {median 20 [percentile 25 to percentile 75 (P25–P75) 16–36] years, 62% adults} were invited, 107 (94%) installed the app and 83 (73%) completed the 4-month interview. Patients interacted with the app for a median of 18 [3–45] days, translated on a median use rate of 15 [3–38]%. Median inhaler adherence assessed through the app was 34 [4–73]% when considering all scheduled inhalations for the study period. Inhaler adherence assessed was not significantly correlated with self-reported estimates. Median adherence for oral and other medication was 41 [6–83]% and 43 [3–73]%, respectively. Patients with higher app use were slightly older (p = 0.012), more frequently taking medication for other health conditions (p = 0.040), and more frequently prescribed long-acting muscarinic antagonists (LAMA, p = 0.024). After 4 months, Control of Allergic Rhinitis and Asthma Test (CARAT) scores improved (p < 0.001), but no differences between patients interacting with the app for 30 days or less were seen. Conclusions: The InspirerMundi app was feasible to monitor inhaler adherence in patients with persistent asthma. The persistent use of this mHealth technology varies widely. A better understanding of characteristics related to higher app use is still needed before effectiveness studies are undertaken.
Altered Cardiac Energetics and Mitochondrial Dysfunction in Hypertrophic Cardiomyopathy
Authors: Ranjbarvaziri Sara , Kooiker Kristina B. , Ellenberger Mathew , Fajardo Giovanni , Zhao Mingming , Vander Roest Alison Schroer , Woldeyes Rahel A. , Koyano Tiffany T. , Fong Robyn , Ma Ning , Tian Lei , Traber Gavin M. , Chan Frandics , Perrino John , Reddy Sushma , Chiu Wah , Wu Joseph C. , Woo Joseph Y. , Ruppel Kathleen M. , Spudich James A. , Snyder Michael P. , Contrepois Kévin , Bernstein Daniel
Published: October 2021

Background:

Hypertrophic cardiomyopathy (HCM) is a complex disease partly explained by the effects of individual gene variants on sarcomeric protein biomechanics. At the cellular level, HCM mutations most commonly enhance force production, leading to higher energy demands. Despite significant advances in elucidating sarcomeric structure–function relationships, there is still much to be learned about the mechanisms that link altered cardiac energetics to HCM phenotypes. In this work, we test the hypothesis that changes in cardiac energetics represent a common pathophysiologic pathway in HCM.

Methods:

We performed a comprehensive multiomics profile of the molecular (transcripts, metabolites, and complex lipids), ultrastructural, and functional components of HCM energetics using myocardial samples from 27 HCM patients and 13 normal controls (donor hearts).

Results:

Integrated omics analysis revealed alterations in a wide array of biochemical pathways with major dysregulation in fatty acid metabolism, reduction of acylcarnitines, and accumulation of free fatty acids. HCM hearts showed evidence of global energetic decompensation manifested by a decrease in high energy phosphate metabolites (ATP, ADP, and phosphocreatine) and a reduction in mitochondrial genes involved in creatine kinase and ATP synthesis. Accompanying these metabolic derangements, electron microscopy showed an increased fraction of severely damaged mitochondria with reduced cristae density, coinciding with reduced citrate synthase activity and mitochondrial oxidative respiration. These mitochondrial abnormalities were associated with elevated reactive oxygen species and reduced antioxidant defenses. However, despite significant mitochondrial injury, HCM hearts failed to upregulate mitophagic clearance.

Conclusions:

Overall, our findings suggest that perturbed metabolic signaling and mitochondrial dysfunction are common pathogenic mechanisms in patients with HCM. These results highlight potential new drug targets for attenuation of the clinical disease through improving metabolic function and reducing mitochondrial injury.
Foraging and scavenging behaviour of the prairie rattlesnake (Crotalus viridis): no evidence that envenomation cues facilitate kleptoparasitism of struck prey
Authors: Teshera Mark S. , Clark Rulon W. , Wagler Amy E. , Greenbaum Eli
Published: October 2021

Most viperids are ambush predators that primarily use venom to subdue prey, employing a strike-release-trail hunting strategy whereby snakes follow the unique scent of envenomated prey to locate carcasses they have bitten and released. In addition to killing prey, rattlesnakes (like most carnivores) will also opportunistically scavenge carrion. This scavenging strategy likely includes the occasional consumption of carcasses killed by other snakes (i.e., kleptoparasitism). In areas with high densities of other pitvipers, utilizing the unique scent of animals envenomated by other snakes might be a viable alternative foraging strategy. We evaluated this possibility experimentally using a series of captive behavioural trials on prairie rattlesnakes (Crotalus viridis) to determine whether conspecific or heterospecific (C. scutulatus, C. ornatus) envenomation cues might increase the likelihood of kleptoparasitism. Rattlesnakes did not prefer envenomated prey over nonenvenomated prey, nor did they prefer venom cues of one species over another. Although they did frequently scavenge carcasses, in the absence of striking, snakes generally located carcasses using random searching movements instead of scent trails. Additionally, the amount of time rattlesnakes spent investigating carcass trails did not differ significantly among treatments, suggesting that striking, and the resultant formation of a chemical search image of prey, is more crucial to trailing behaviour than venom cues. Moreover, a high degree of behavioural variation among individuals was observed, suggesting that scavenging and kleptoparasitism in rattlesnakes is more complex than previously realized, and making generalizations about these behaviours is challenging.
The Vacuity of Structurelessness: Situating Agency and Structure in Exploitative and Alienated Social Relations
Authors: Lafrance Xavier
Published: October 2021

Replying to Samuel Knafo and Benno Teschke, this article shows how Political Marxism offers powerful conceptual tools to understand modes of production that structure historical processes as fundamentally constituted by exploitative social and political relations. I explain how structure, or rules of reproduction, should be understood as alienated social relations, which are inherent to all class societies. Understanding structure this way leaves ample space for – and makes inevitable – the consideration of agency.
On ‘The Problem with Brenner’: The Paradox of Agency and the Heresy of Reification
Authors: Žmolek Michael Andrew
Published: October 2021

Knafo and Teschke’s surprisingly polemical critique of Brenner’s work is derived from earlier work which applies the same critique arising out of the agency/structure debate in International Relations theory. Casting Brenner’s work as increasingly structuralist over time and therefore increasingly prone to reify social relations, thereby suppressing or downplaying the role of agency, Knafo and Teschke ask their readers to take such claims at face value, offering no close textual reading of Brenner’s work. Focusing almost entirely on method rather than on substance and by framing their critique within the confines of the unending debate over structure and agency, Knafo and Teschke’s claim that Brenner’s work consistently reifies social relations – presuming but not demonstrating that this is his intent – obscures and fails to engage substantively with his powerful historical contributions, or to offer alternative definitions or historical theories.
First evidence of hunting of a Crested Indian Porcupine by an avian predator: The Eurasian Eagle Owl
Authors: Hadad Ezra , Shochat Eyal
Published: October 2021

Encounters between birds of prey and porcupines are rarely documented, and so far only in North America. At least 39% of such encounters lead to death of the attacker. We present first evidence for similar encounters between The Eurasian Eagle Owl and the Indian Crested Porcupine, suggesting that young porcupines may occasionally serve as potential prey for the owl.
Re-descriptions of eight chigger mite species (Acariformes: Trombiculidae) of the Leptotrombidium generic complex from Vietnam
Authors: STEKOLNIKOV ALEXANDR A. , ANTONOVSKAIA ANASTASIA A.
Published: October 2021

Six mite species of the genus Leptotrombidium Nagayo, Miyagawa, Mitamura and Imamura, 1916 and one species from each of the genera Lorillatum Nadchatram, 1963 and Trombiculindus Radford, 1948, incompletely described by Schluger et al. (1960b, 1963) from rodents and tree shrews in North Vietnam, are re-described based on type series. Lectotypes and paralectotypes have been designated for all redescribed species. Two new synonyms have been established: Leptotrombidium magnum (Schluger, 1960) (= Leptotrombidium dooleyi Nadchatram, 1970, syn. nov.; = Leptotrombidium submagnum Wang, Li and Shi, 1988, syn. nov.).
Description of the larva of Argia cuprea (Hagen, 1861) with notes on its phylogenetic affinities (Odonata: Coenagrionidae)
Authors: NOVELO-GUTIÉRREZ RODOLFO , GÓMEZ-ANAYA JOSÉ ANTONIO
Published: October 2021

The larva of Argia cuprea (Hagen, 1861) is described and figured. It falls into the group of Argia larvae with prominent ligula and one palpal seta, but it differs from its closest relatives by a combination of features such as male gonapophyses reaching posterior ventral margin of S10; dorsal and ventral margin of paraproct with long, abundant, white, delicate setae on distal 0.40; tip of paraproct 20% its total length; lateral surface of paraproct with abundant spiniform setae restricted to the triangular, yellowish-brown, slightly sclerotized area along the inflated area. It appears closely related to A. oenea Hagen in Selys, 1865 and A. orichalcea Hagen in Selys, 1865 larvae.
Evaluation of the utilization of extracorporeal toxin removal in lithium poisoning patients in Hong Kong
Authors: Chow Shuk Hang , Chan Chi Keung
Published: October 2021

Background:

Extracorporeal toxin removal is used for enhanced elimination in severe lithium poisoning. The Extracorporeal TReatments In Poisoning workgroup provides recommendations on the use of extracorporeal toxin removal in poisoning.

Objectives:

Our aim was to identify the pattern for using extracorporeal toxin removal in managing lithium poisoning in Hong Kong and compare the outcomes in extracorporeal toxin removal‐treated patients and non‐extracorporeal toxin removal‐treated patients if indicated for treatment as defined by The Extracorporeal TReatments In Poisoning criteria.

Methods:

Lithium poisoning presented between year 2009 and 2019 in Hong Kong Poison Information Centre (HKPIC) database was categorized into extracorporeal toxin removal‐treated group and non‐extracorporeal toxin removal‐treated group. Comparative analyses were performed.

Results:

Among 112 lithium‐poisoned patients, 21% were treated with extracorporeal toxin removal. Larger proportion of patients had fulfilled at least one Extracorporeal TReatments In Poisoning criteria for extracorporeal toxin removal in the extracorporeal toxin removal‐treated group (87% vs 18%, p < 0.005). The extracorporeal toxin removal‐treat group patients were more commonly presented with impaired consciousness, seizure and dysrhythmia (p < 0.05). They also got higher admission (3.62 mmol/L vs 2.18 mmol/L, p < 0.05) and peak (4.15 mmol/L vs 2.28 mmol/L, p < 0.05) serum lithium concentrations, as well as a significantly higher serum creatinine concentration upon presentation (263.74 µmol/L vs 98.66 µmol/L, p < 0.05). Extracorporeal toxin removal‐treat group patients more frequently had a severe poisoning outcome (91.3% vs 9%, p < 0.05) and developed complications (69.6% vs 13.5%, p < 0.05). Logistic regression identified seizure, peak serum lithium concentration, and serum creatinine concentration upon presentation as risk factors for severe poisoning outcome. In subgroup analysis on patients with at least one indication for extracorporeal toxin removal as defined by Extracorporeal TReatments In Poisoning criteria, the proportion of severe poisoning remained higher in the extracorporeal toxin removal‐treated group (90% vs 43.7%, p < 0.05). Complication rate was not significantly different between the two groups.

Conclusion:

Clinically severe lithium poisoning patients were treated with extracorporeal toxin removal in Hong Kong. Extracorporeal TReatments In Poisoning criteria can serve as a reference in considering extracorporeal toxin removal treatment for lithium poisoning patients. Nevertheless, Extracorporeal TReatments In Poisoning criteria recommend more extracorporeal toxin removal treatment than it was actually done. Lithium poisoning patients with positive Extracorporeal TReatments In Poisoning criteria have been managed without extracorporeal toxin removal. No statistically significant adverse outcome was observed in these cases.
Do institutions matter for tourism spending?
Authors: Nguyen Canh Phuc
Published: October 2021

Institutional frameworks are important for individuals’ attitudes and behaviours, and thus they are important for travel decisions. This study endeavours to examine the influence of various formal and informal institutional factors on tourism spending for a global sample of 120 countries from 2002 to 2019. Applying the two-step system generalised method of moments estimate, the results are robust and consistent. First, informal institutions, that is, colonial history, socialist history, origin of the legal system, religion and language, are important explanatory factors for differences in tourism spending between countries. Second, improvements in formal institutions appear to increase domestic tourism spending while they decrease outbound tourism spending. The results have important policy implications.

JEL code: E02, Z30, Z32.
Humoral and cellular responses after COVID-19 vaccination in anti-CD20-treated lymphoma patients
Authors: Liebers Nora , Speer Claudius , Benning Louise , Bruch Peter-Martin , Kraemer Isabelle , Meissner Julia , Schnitzler Paul , Kräusslich Hans-Georg , Dreger Peter , Mueller-Tidow Carsten , Poschke Isabel , Dietrich Sascha
Published: October 2021

Three reports address the protection of the vulnerable population of patients with hematologic malignancies in the face of the ongoing COVID pandemic. The reports suggest that some patients who fail to mount a B-cell response to vaccine may nevertheless have protective T cell responses. As a group, these reports suggest that patients should continue to be immunized with additional doses to attempt to improve immune response but that they need to maintain the precautions recommended for the unvaccinated.