bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing video consultation and telephone consultation at the outpatient clinic of a tertiary referral centre: patient and provider benefits
Authors: Barsom Esther Z , van Dalen Anne Sophie H M , Blussé van Oud-Alblas Marjolein , Buskens Christianne J , van de Ven Anthony W H , Tanis Pieter J , Schijven Marlies P , Bemelman Willem A
Published: October 2020

Objectives

Telephone consultations are frequently used in the outpatient setting in order to avoid unnecessary travel and to reduce hospital visit-related costs for patients. However, they are limited by the absence of non-verbal communication in contrast to video consultation. Little is known considering the possible advantages of using video consultation in comparison to telephone consultation according to both patients and healthcare providers.

Methods

Patients with colorectal diseases were asked to choose between a telephone consultation or a video consultation for their next appointment at the outpatient clinic of a tertiary referral centre. Willingness to use video consultation, value of non-verbal communication, patient satisfaction, provider satisfaction and user friendliness of the video connection technology were measured using questionnaires.

Results

None of the included patients ever had a video consultation before with a healthcare provider. Nonetheless, 22/50 preferred a video consultation over a telephone consultation. Patients who preferred a video consultation underlined the benefits of providing visual feedback to both patients and healthcare providers. Moreover, healthcare providers felt they were better able to assess the patients’ healthcare condition.

Conclusion

For patients who value both verbal and non-verbal interaction and feel comfortable with the use of video consultation, video consultation is the preferred contact modality. Shared decision making should be used to choose the preferred interaction modality. For patients with low digital skills, support might be needed or video consultation may not be the preferred choice.
Discovering themes in medical records of patients with psychogenic non-epileptic seizures
Authors: Lay Joshua , Seneviratne Udaya , Fok Anthony , Roberts Helene , Phan Thanh
Published: October 2020

Introduction

Epileptic and psychogenic non-epileptic seizures (PNES) are common diagnostic problems encountered in hospital practice. This study explores the use of unsupervised machine learning in discovering themes in medical records of patients presenting with PNES. We hypothesised that themes generated by machine learning are comparable with the classification by human experts.

Methods

This is a retrospective analysis of the medical records in the emergency department of patients (age >18 years) with PNES who underwent inpatient video-electroencephalography monitoring from May 2009 to June 2014 and received a final diagnosis of PNES. Prior to machine learning of written text, we applied a standardised approach in natural language processing to create a document-term matrix (removal of numbers, stop-words and punctuations, transforming fonts to lower case). The words were separated into tokens and treated as if existing within a bag-of-words. A probability of each word existing within a topic (theme) was modelled on multivariate Dirichlet distribution (R Foundation, V.3.5.0). Next, we asked four experts to independently provide a clinical interpretation of the generated topics. When the majority of (≥3) experts agreed, it was regarded as highly congruent. Interactive data are available on the web at (https://gntem2.github.io/PNES/%23topic=1&lambda=0.6&term=).

Results

There were 39 patients (74.4% women, median age 35 years with range 20–82). A total of 121 documents were converted to text files for text mining. There were 15 generated topics with 12/15 topics rated as highly congruent. The main themes were about descriptors of seizures and medication use.

Conclusions

The findings from machine learning on PNES-related documentation provides evidence for the feasibility of applying machine-learning methodology to analyse large volumes of medical records. The topics generated by machine learning were congruent with interpretations by clinicians indicating this method can be used for screening of medical conditions among large volumes of medical records.
How does self-perceived nutrition competence change over time during medical training? A prospective longitudinal observational study of New Zealand medical students
Authors: Crowley Jennifer , Ball Lauren , Wall Clare
Published: October 2020

Objectives

Medical nutrition education aims to equip doctors with nutrition knowledge, skills, attitudes and confidence to counsel patients to improve their diet. This study aimed to describe changes in medical students’ self-perceived nutrition competence at three time points during medical training.

Design

Prospective longitudinal observational study.

Setting

The University of Auckland, School of Medicine.

Participants

Year 2 medical students (phase 1, preclinical) were surveyed in May 2016. Participants repeated the survey in February 2018 as Year 4 students and July 2019 (phase 2, clinical) as Year 5 students.

Primary outcome measure

Primary outcome measure was self-perceived nutrition competence measured using the validated NUTrition Competence (NUTCOMP) survey.

Results

In 2016, 102 of 279 eligible Year 2 medical students completed the survey (response rate (RR 36.7%)). In 2018, 89 Year 4 students repeated the survey (RR 87.3%) and 30 students as Year 5 students in 2019 (RR 29.41%). There was a significant increase in total NUTCOMP scores (knowledge, skills, confidence to counsel and attitude towards nutrition) between Year 2 and Year 4 (p=0.012). There was a significant increase in the confidence to counsel construct (mean difference 7.615, 95% CI 2.291 to 12.939, p=0.003) between Year 2 and Year 4. Constructs with lowest scores at all time points were nutrition knowledge and nutrition skills. There was clear desire for more nutrition education from all students: Year 2 (mean=3.8 out of 5 (1.1)), Year 4 (mean=3.9 out of 5 (0.9)), Year 5 (mean=3.8 out of 5 (0.8)).

Conclusion

Medical students’ self-perceived nutrition competence in providing nutrition care increased modestly at three points throughout medical training. There remains opportunity for further supporting medical students to increase their competence in nutrition care, which could be achieved through mandatory and greater medical nutrition education.
Factors influencing use of essential surgical services in North-East India: a cross-sectional study of obstetric and gynaecological surgery
Authors: Ensor Tim , Virk Amrit , Aruparayil Noel
Published: October 2020

Introduction

There continues to be a large gap between need and actual use of surgery in low-resource settings. While policy frequently focuses on expanding the supply of services, demand-side factors are at least as important in determining under utilisation and over utilisation. The aim of this study is to understand how these factors influence the use of selected essential obstetric and gynaecological surgical procedures in the underserved and remote setting of North-East India.

Methods

The study combines and makes use of data from a variety of surveys and routine systems. Descriptive analysis of variations in caesarean section, hysterectomy and sterilisation and then multivariate logit analysis of demand-side and supply-side factors on access to these services is undertaken.

Results

Surgical rates vary substantially both across and within North-East India, correlated with service capacity and socioeconomic status. Travel times to surgical facilities are associated with rates of caesarean section and hysterectomy but not sterilisation where services are much more deconcentrated. Travel is less important for surgery in private facilities where capacity is much more dispersed but dominated by the non-poor. The presence of non-doctor medical staff is associated with lower levels of surgical activity.

Conclusion

In low resource, remote settings policy interventions to improve access to services must recognise that surgical rates in low-resource settings are heavily influenced by demand-side factors. As well as boosting services, mechanisms need to mitigate demand-side barriers particularly distance and influence practice to encourage surgical intervention only where clinically indicated.
Family medicine residency training in Ghana after 20 years: resident attitudes about their education
Authors: Toma Ghazwan , Essuman Akye , Fetters Michael D
Published: October 2020

Objective

In addition to assessing educational needs of family medicine trainees in Ghana, we sought to assess whether those entering the training programme aimed to pursue an academic career.

Design

A case study using an anonymous cross-sectional survey through collaboration between faculty members from the family medicine departments of Ghana and the University of Michigan.

Setting

The family medicine postgraduate trainees and the most recent graduates in the three training sites, Accra, Kumasi and Mampong, as well as modular residents in Ghana served as the targeted participants during data collection between October and November of 2018.

Participants

Second and third year family medicine residents, fellows (known as senior residents in Ghana) and recent graduates were invited to participate in this study. Thirty-five of 77 eligible subjects provided responses (46% response rate), but five records were eliminated due to incomplete data to yield a survey completion rate of 39% (30/77).

Result

Participants were mostly men (n=19), and the average age of respondents was 37 years old. The participants indicated the residency programmes needed more faculty 97% (n=29), supervision during outpatient care 87% (n=26) and lectures 83% (n=25). The main reason provided by respondents for entering residency programme in family medicine, which is currently not required for practising primary care in Ghana, was to obtain more education 93% (n=28). Participants who had completed the residency programme were much more likely to be interested in becoming faculty compared with those still in residency (p <0.001).

Conclusion

The research confirms the need for more faculty and the importance of investing in faculty development resources for ensuring a robust programme. These findings provide constructive feedback that could improve residency curricula of the local and regional family medicine training programmes and supports investing in trainees and new graduates as future faculty candidates.
Blood-based extracellular matrix biomarkers are correlated with clinical outcome after PD-1 inhibition in patients with metastatic melanoma
Authors: Hurkmans Daan P , Jensen Christina , Koolen Stijn L W , Aerts Joachim , Karsdal Morten Asser , Mathijssen Ron H J , Willumsen Nicholas
Published: October 2020

Background

Immune checkpoint inhibitors that target the programmed cell death protein 1 (PD-1) receptor induce a response in only a subgroup of patients with metastatic melanoma. Previous research suggests that transforming growth factor beta signaling and a collagen-rich peritumoral stroma (tumor fibrosis), may negatively interfere with the interaction between T cells and tumor cells and thereby contribute to resistance mechanisms by immune-exclusion, while increased tumor infiltration of M1-like macrophages enhances T cell activity. Hence, the current study aimed to assess the relationship between blood-based markers of collagen or vimentin turnover (reflecting M1 macrophage activity) and clinical outcome in patients with metastatic melanoma after PD-1 inhibition.

Methods

Patients with metastatic melanoma who were treated with anti-PD-1 monotherapy between May 2016 and March 2019 were included in a prospective observational study. N-terminal pro-peptide of type III collagen (PRO-C3) cross-linked N-terminal pro-peptides of type III collagen (PC3X), matrix metalloprotease (MMP)-degraded type III (C3M) and type IV collagen (C4M), granzyme B-degraded type IV collagen and citrullinated and MMP-degraded vimentin (VICM) were measured with immunoassays in serum before (n=107), and 6 weeks after the first administration of immunotherapy (n=94). The association between biomarker levels and overall survival (OS) or progression-free survival (PFS) was assessed.

Results

Multivariate Cox regression analysis identified high baseline PRO-C3 (Q4) and PC3X (Q4) as independent variables of worse PFS (PRO-C3: HR=1.81, 95% CI=1.06 to 3.10, p=0.030 and PC3X: HR=1.86, 95% CI=1.09 to 3.18, p=0.023). High baseline PRO-C3 was also independently related to worse OS (HR=2.08, 95% CI=1.06 to 4.09, p=0.035), whereas a high C3M/PRO-C3 ratio was related to improved OS (HR=0.42, 95% CI=0.20 to 0.90, p=0.025). An increase in VICM (p<0.0001; in 56% of the patients) was observed after 6 weeks of treatment, and an increase in VICM was independently associated with improved OS (HR=0.28, 95% CI=0.10 to 0.77, p=0.014).

Conclusions

Blood-based biomarkers reflecting excessive type III collagen turnover were associated with worse OS and PFS after PD-1 inhibition in metastatic melanoma. Moreover, an increase in VICM levels after 6 weeks of treatment was associated with improved OS. These findings suggest that type III collagen and vimentin turnover contribute to resistance/response mechanisms of PD-1 inhibitors and hold promise of assessing extracellular matrix-derived and stroma-derived components to predict immunotherapy response.
Implementation of computer simulation to assess flow diversion treatment outcomes: systematic review and meta-analysis
Authors: Zhang Mingzi , Tupin Simon , Anzai Hitomi , Kohata Yutaro , Shojima Masaaki , Suzuki Kosuke , Okamoto Yoshihiro , Tanaka Katsuhiro , Yagi Takanobu , Fujimura Soichiro , Ohta Makoto
Published: October 2020

Introduction

Despite a decade of research into virtual stent deployment and the post-stenting aneurysmal hemodynamics, the hemodynamic factors which correlate with successful treatment remain inconclusive. We aimed to examine the differences in various post-treatment hemodynamic parameters between successfully and unsuccessfully treated cases, and to quantify the additional flow diversion achievable through stent compaction or insertion of a second stent.

Methods

A systematic review and meta-analysis were performed on eligible studies published from 2000 to 2019. We first classified cases according to treatment success (aneurysm occlusion) and then calculated the pooled standardized mean differences (SMD) of each available parameter to examine their association with clinical outcomes. Any additional flow diversion arising from the two common strategies for improving the stent wire density was quantified by pooling the results of such studies.

Results

We found that differences in the aneurysmal inflow rate (SMD −6.05, 95% CI −10.87 to −1.23, p=0.01) and energy loss (SMD −5.28, 95% CI −7.09 to −3.46, p<0.001) between the successfully and unsuccessfully treated groups were indicative of statistical significance, in contrast to wall shear stress (p=0.37), intra-aneurysmal average velocity (p=0.09), vortex core-line length (p=0.46), and shear rate (p=0.09). Compacting a single stent could achieve additional flow diversion comparable to that by dual-stent implantation.

Conclusions

Inflow rate and energy loss have shown promise as identifiers to discriminate between successful and unsuccessful treatment, pending future research into their diagnostic performance to establish optimal cut-off values.
Cyclic thermomechanical response of fine-grained soil−concrete interface for energy piles applications
Authors: Ravera Elena , Sutman Melis , Laloui Lyesse
Published: October 2020

Understanding the behaviour of soil−structure interfaces is critical for addressing the analysis and design of energy geostructures. In this study, the interface failure mechanism of energy piles (where a shear band is detached from the surrounding soil that behaves under oedometric conditions) is experimentally analysed in the laboratory for saturated conditions. The choice of material (clayey soil and concrete), temperature range, and stress level is based on conditions that are likely to be encountered in practice. Specifically, cyclic thermal tests under constant vertical effective stress in oedometric conditions as well as constant normal stiffness (CNS) interface direct shear tests (in which samples have been subjected to thermal cycles between 10 and 40 °C) are presented. From a practical perspective, the results show very low volumetric strain variations and negligible effects on shear strength. The volumetric aspects do not appear to have significant impact on the shear resistance of the interfaces against cyclic thermal loads. Fundamental insight on the effects of thermal cycles on the concrete−soil interface behaviour that are relevant to energy piles are presented. In addition, the proposed interpretation procedure provides a basis for the standardization of thermomechanical testing in geotechnical engineering.
Constraints on scalar–tensor theory of gravity by solar system tests
Authors: González P. A. , Olivares Marco , Papantonopoulos Eleftherios , Vásquez Yerko
Published: October 2020

We study the motion of particles in the background of a scalar–tensor theory of gravity in which the scalar field is kinetically coupled to the Einstein tensor. We constrain the value of the derivative parameter z through solar system tests. By considering the perihelion precession we obtain the constraint $$\sqrt{z}/m_{\mathrm{p}} > 2.6\times 10^{12}$$

z

/

m
p

>
2.6
×

10
12

 m, the gravitational redshift $$\frac{\sqrt{z}}{m_{\mathrm{p}}}>2.7\times 10^{\,10}$$

z

m
p

>
2.7
×

10

10

 m, the deflection of light $$\sqrt{z}/m_{\mathrm{p}} > 1.6 \times 10^{11}$$

z

/

m
p

>
1.6
×

10
11

 m, and the gravitational time delay $$\sqrt{z}/m_{\mathrm{p}} > 7.9 \times 10^{12}$$

z

/

m
p

>
7.9
×

10
12

 m; thereby, our results show that it is possible to constrain the value of the z parameter in agreement with the observational tests that have been considered.
Further evidence for the non-existence of a unified hoop conjecture
Authors: Hod Shahar
Published: October 2020

The hoop conjecture, introduced by Thorne almost five decades ago, asserts that black holes are characterized by the mass-to-circumference relation $$4\pi {\mathcal {M}}/{\mathcal {C}}\ge 1$$

4
π
M
/
C
≥
1

, whereas horizonless compact objects are characterized by the opposite inequality $$4\pi {\mathcal {M}}/{\mathcal {C}}<1$$

4
π
M
/
C
<
1

(here $${\mathcal {C}}$$
C
is the circumference of the smallest ring that can engulf the self-gravitating compact object in all azimuthal directions). It has recently been proved that a necessary condition for the validity of this conjecture in horizonless spacetimes of spatially regular charged compact objects is that the mass $${\mathcal {M}}$$
M
be interpreted as the mass contained within the engulfing sphere (and not as the asymptotically measured total ADM mass). In the present paper we raise the following physically intriguing question: is it possible to formulate a unified version of the hoop conjecture which is valid for both black holes and horizonless compact objects? In order to address this important question, we analyze the behavior of the mass-to-circumference ratio of Kerr–Newman black holes. We explicitly prove that if the mass $${\mathcal {M}}$$
M
in the hoop relation is interpreted as the quasilocal Einstein–Landau–Lifshitz–Papapetrou and Weinberg mass contained within the black-hole horizon, then these charged and spinning black holes are characterized by the sub-critical mass-to-circumference ratio $$4\pi {\mathcal {M}}/{\mathcal {C}}<1$$

4
π
M
/
C
<
1

. Our results provide evidence for the non-existence of a unified version of the hoop conjecture which is valid for both black-hole spacetimes and spatially regular horizonless compact objects.
Segre invariant and a stratification of the moduli space of coherent systems
Authors: Roa-Leguizamón L.
Published: October 2020

The aim of this paper is to generalize the [Formula: see text]-Segre invariant for vector bundles to coherent systems. Let [Formula: see text] be a non-singular irreducible complex projective curve of genus [Formula: see text] and [Formula: see text] be the moduli space of [Formula: see text]-stable coherent systems of type [Formula: see text] on [Formula: see text]. For any pair of integers [Formula: see text] with [Formula: see text], [Formula: see text] we define the [Formula: see text]-Segre invariant, and prove that it defines a lower semicontinuous function on the families of coherent systems. Thus, the [Formula: see text]-Segre invariant induces a stratification of the moduli space [Formula: see text] into locally closed subvarieties [Formula: see text] according to the value [Formula: see text] of the function. We determine an above bound for the [Formula: see text]-Segre invariant and compute a bound for the dimension of the different strata [Formula: see text]. Moreover, we give some conditions under which the different strata are nonempty. To prove the above results, we introduce the notion of coherent systems of subtype [Formula: see text].
Jensen–Shannon Divergence Based on Horizontal Visibility Graph for Complex Time Series
Authors: Yin Yi , Wang Wenjing , Li Qiang , Ren Zunsong , Shang Pengjian
Published: October 2020

In this paper, we propose Jensen–Shannon divergence (JSD) based on horizontal visibility graph (HVG) to measure the time series irreversibility for both stationary and non-stationary series efficiently. Numerical simulations are first conducted to show the validity of the proposed method and then empirical applications to the financial time series and traffic time series are investigated. It can be found that JSD shows better robustness than Kullback–Leibler divergence (KLD) on quantifying time series irreversibility and correctly distinguishes the different type of simulated series. For the empirical analysis, JSD based on HVG is able to detect the significant time irreversibility of stock indices and reveal the relationship between different stock indices. JSD results show the time irreversibility of speed time series for different detectors and present better accuracy and robustness than KLD. The hierarchical clustering based on their behavior of time irreversibility obtained by JSD classifies the detectors into four groups.
On macroscopic dimension of non-spin 4-manifolds
Authors: Daher Michelle , Dranishnikov Alexander
Published: October 2020

We prove that for 4-manifolds [Formula: see text] with residually finite fundamental group and non-spin universal covering [Formula: see text], the inequality [Formula: see text] implies the inequality [Formula: see text]. This allows us to complete the proof of Gromov’s Conjecture for 4-manifolds with abelian fundamental group.
Braid group and leveling of a knot
Authors: Cho Sangbum , Koda Yuya , Seo Arim
Published: October 2020

Any knot [Formula: see text] in genus-1 1-bridge position can be moved by isotopy to lie in a union of [Formula: see text] parallel tori tubed by [Formula: see text] tubes so that [Formula: see text] intersects each tube in two spanning arcs, which we call a leveling of the position. The minimal [Formula: see text] for which this is possible is an invariant of the position, called the level number. In this work, we describe the leveling by the braid group on two points in the torus, which yields a numerical invariant of the position, called the (1, 1)-length. We show that the (1, 1)-length equals the level number. We then find braid descriptions for (1,1)-positions of all 2-bridge knots providing upper bounds for their level numbers and also show that the (-2, 3, 7)-pretzel knot has level number two.
Reason-checking fake news
Authors: Visser Jacky , Lawrence John , Reed Chris
Published: October 2020

Using argument technology to strengthen critical literacy skills for assessing media reports.
Depth-bounded Graph Partitioning Algorithm and Dual Clocking Method for Realization of Superconducting SFQ Circuits
Authors: Pasandi Ghasem , Pedram Massoud
Published: October 2020

Superconducting Single Flux Quantum (SFQ) logic with switching delay of
1ps
and switching energy of 10
−19
J
is a potential emerging candidate for replacing Complementary Metal Oxide Semiconductor (CMOS) to achieve very high speed and ultra energy efficiency. Conventional SFQ circuits need Full Path Balancing (FPB), which tends to require insertion of many path balancing buffers (D-Flip-Flops). FPB method increases total power consumption as well as total area of the chip. This article presents a novel scheme for realization of superconducting SFQ circuits by introducing a new depth-bounded graph partitioning algorithm in combination with a dual clocking method (slow and fast clock pulses) that minimizes the aforesaid path balancing overheads. Experimental results show that the proposed solution reduces total number of path balancing buffers and total static power consumption by an average of 2.68× and 60%, respectively, when compared to the best of other methods for realizing SFQ circuits. However, our scheme degrades the peak throughput; therefore, it is especially valuable when the actual throughput of the SFQ circuit is much lower than the peak theoretical throughput. This is typically the case due to high-level data dependencies of the application that feeds data into an SFQ circuit.
Seeking artificial common sense
Authors: Monroe Don
Published: October 2020

The long-standing goal of providing artificial intelligence some measure of common sense remains elusive.
Terahertz networks move closer to reality
Authors: Greengard Samuel
Published: October 2020

The desire for faster, higher-frequency wireless networking is a constant. Terahertz technology could deliver large gains.
Tackling the challenges of CS education
Authors: Hoffmann Leah
Published: October 2020

Chris Stephenson on the complex challenges that continue to plague the computer science education community.
Development of ADHD: Etiology, Heterogeneity, and Early Life Course
Authors: Nigg Joel T. , Sibley Margaret H. , Thapar Anita , Karalunas Sarah L.
Published: October 2020

Attention-deficit/hyperactivity disorder (ADHD) represents a powerful entry point for developmental approaches to psychopathology due to its substantial role in early emergence of major life problems. One key issue concerns the role of early environmental risks in etiology and maintenance in the context of genetic liability. Here, psychosocial aspects of development need more attention. A second key issue is that phenotypic heterogeneity requires better resolution if actionable causal mechanisms are to be effectively identified. Here, the interplay of cognition and emotion in the context of a temperament lens is one helpful way forward. A third key issue is the poorly understood yet somewhat striking bifurcation of developmental course in adolescence, when a subgroup seems to have largely benign outcomes, while a larger group continues on a problematic path. A final integrative question concerns the most effective conceptualization of the disorder in relation to broader dysregulation. Key scientific priorities are noted.
The effect of cold exposure with shivering on glucose tolerance in healthy men
Authors: Sellers Adam Jake , Pallubinsky Hannah , Rense Pascal , Bijnens Wouter , van de Weijer Tineke , Moonen-Kornips Esther , Schrauwen Patrick , van Marken Lichtenbelt Wouter D.
Published: October 2020

This is the first study to examine the effect of cold-induced shivering on subsequent glucose tolerance determined under thermoneutral conditions. Plasma glucose and insulin concentrations increased during the oral glucose tolerance test post shivering. Additionally, insulin sensitivity indices suggest insulin resistance following cold exposure. These results provide evidence for an acute post-shivering response, whereby glucose metabolism has deteriorated, contrary to the results from earlier studies on cold acclimation.
On Analytical Solution of a Plasma Flow over a Moving Plate under the Effect of an Applied Magnetic Field
Authors: Wahid Taha Zakaraia Abdel , Morad Adel M.
Published: October 2020

Our objective of this investigation is to mainly focus on the behavior of a plasma gas that is bounded by a moving rigid flat plate; its motion is damping with time. The effects of an external magnetic field on the electrons collected with each other, with positive ions, and with neutral atoms in the plasma fluid are studied. The BGK type of the Boltzmann kinetic equation is used to study the gas dynamics various regimes with Maxwellian velocity distribution functions. An analytical solution of the model equations for the unsteady flow was given using the moment and the traveling wave methods. The manner of the mean velocity of plasmas is illustrated, which is compatible with the variation of the shear stress, viscosity coefficient, and the initial and boundary conditions. Besides, the thermodynamic prediction is investigated by applying irreversible thermodynamic principles and extended Gibbs formula. Finally, qualitative agreements with previous related papers were demonstrated using 3-dimensional graphics for calculating the variables. The significance of this study is due to its vast applications in numerous fields such as in physics, engineering, commercial, and industrial applications.
Clinicopathologic Characteristics and Long-Term Outcome of Gastric Cancer Patients with Family History: Seven-Year Follow-Up Study for Korean Health Check-Up Subjects
Authors: Lee Jooyoung , Chung Su Jin , Choi Ji Min , Han Yoo Min , Kim Joo Sung
Published: October 2020

Background/Aims. Family history (FHx) has been reported to be a risk factor for gastric cancer (GC). However, the long-term prognosis of GC with FHx remains controversial. We aimed to investigate the clinicopathologic characteristics and long-term outcomes of GC according to the presence or absence of GC FHx. Methods. This study was conducted on asymptomatic healthy individuals who underwent upper gastrointestinal endoscopy for the purpose of GC screening. Patients who were diagnosed with GC between October 2003 and December 2013 at Seoul National University Hospital Healthcare System Gangnam Center were identified. Demographic and clinicopathologic characteristics were compared between the groups with and without FHx of GC. Overall survival (OS) and recurrence-free survival (RFS) were assessed as primary outcomes. Results. There were no significant differences in tumor characteristics according to FHx of GC. However, preexisting adenoma was more frequent in patients with FHx than in those without FHx (14.5% vs. 6.3%,

p
=
0.035

). The proportion of patients with microsatellite instability (MSI) was also higher in groups with FHx of GC (43.2% vs. 13.2%,

p
=
0.006

). Helicobacter pylori infection rates of patients with FHx of GC tended to be higher although not significant (70.5% vs. 61.3%,

p
=
0.188

). However, OS and RFS at 5 years of the GC patients with FHx were not significantly different from those of patients without FHx. Conclusion. Preexisting adenoma and GC with MSI are more common in patients with FHx of GC than in those without. There were no significant differences in the survival rate according to FHx.
Evaluating the Relationship of GDF-15 with Clinical Characteristics, Cardinal Features, and Survival in Multiple Myeloma
Authors: Banaszkiewicz Małgorzata , Małyszko Jolanta , Batko Krzysztof , Koc-Żórawska Ewa , Żórawski Marcin , Dumnicka Paulina , Jurczyszyn Artur , Woziwodzka Karolina , Tisończyk Joanna , Krzanowski Marcin , Małyszko Jacek , Waszczuk-Gajda Anna , Drożdż Ryszard , Kuźniewski Marek , Krzanowska Katarzyna
Published: October 2020

Growth differentiation factor 15 (GDF-15), a member of the transforming growth factor-β superfamily, participates in processes associated with myeloma development and its end-organ complications. It plays a significant role in both physiological and abnormal erythropoiesis and regulates iron homeostasis through modulation of hepcidin. It is abnormally secreted in marrow stromal cells of patients with multiple myeloma (MM), which may reflect the tumor microenvironment. We analyzed the associations of serum GDF-15 with clinical characteristics of 73 MM patients (including asymptomatic MM) and the laboratory indices of renal function, anemia, and inflammation. Baseline serum GDF-15 was studied as the predictor of two-year survival. We defined five clinically relevant subgroups of patients (symptomatic MM only, patients with and without remission, patients on chemotherapy, and without treatment). Increased GDF-15 concentrations were associated with more advanced MM stage, anemia, renal impairment (lower glomerular filtration and higher markers of tubular injury), and inflammation. Most of the results were confirmed in the subgroup analysis. Serum cystatin C and urine neutrophil gelatinase-associated lipocalin were associated with GDF-15 independently of other variables. In the studied MM patients, GDF-15 did not significantly predict survival (

p
=
0.06

). Our results suggest that serum GDF-15 reflects myeloma burden and shares a relationship with several markers of prognostic significance, as well as major manifestations.
Some Existence Results for High Order Fractional Impulsive Differential Equation on Infinite Interval
Authors: Hao Zhaocai , Wang Tian
Published: October 2020

In this paper, we consider the high order impulsive differential equation on infinite interval

D

0
+

α

u

t

+
f

t
,
u

t

,

J

0
+

β

u

t

,

D

0
+

α
−
1

u

t

=
0
,
 
t
∈

0
,
∞

∖

t

k

k
=
1

m

△
u

t

k

=

I

k

u

t

k

,
 
t
=

t

k

,
k
=
1
,
…
,
m

u

0

=

u

′

0

=
⋯
=

u

n
−
2

0

=
0
,

D

0
+

α
−
1

u

∞

=

u

0

By applying Schauder fixed points and Altman fixed points, we obtain some new results on the existence of solutions. The nonlinear term of the equation contains fractional integral operator

J

β

u

t

and lower order derivative operator

D

0
+

α
−
1

u

t

. An example is presented to illustrate our results.
High-Capacity Reversible Data Hiding in Encrypted Images by Information Preprocessing
Authors: Li Xi-Yan , Zhou Xia-Bing , Zhou Qing-Lei , Han Shi-Jing , Liu Zheng
Published: October 2020

With the development of cloud computing, high-capacity reversible data hiding in an encrypted image (RDHEI) has attracted increasing attention. The main idea of RDHEI is that an image owner encrypts a cover image, and then a data hider embeds secret information in the encrypted image. With the information hiding key, a receiver can extract the embedded data from the hidden image; with the encryption key, the receiver reconstructs the original image. In this paper, we can embed data in the form of random bits or scanned documents. The proposed method takes full advantage of the spatial correlation in the original images to vacate the room for embedding information before image encryption. By jointly using Sudoku and Arnold chaos encryption, the encrypted images retain the vacated room. Before the data hiding phase, the secret information is preprocessed by a halftone, quadtree, and S-BOX transformation. The experimental results prove that the proposed method not only realizes high-capacity reversible data hiding in encrypted images but also reconstructs the original image completely.
Fast Path Planning for On-Water Automatic Rescue Intelligent Robot Based on Constant Thrust Artificial Fluid Method
Authors: Qi Yongqiang , Ke Yi
Published: October 2020

In this paper, fast path planning of on-water automatic rescue intelligent robot is studied based on the constant thrust artificial fluid method. First, a three-dimensional environment model is established, and then the kinematics equation of the robot is given. The constant thrust artificial fluid method based on the isochronous interpolation method is proposed, and a novel algorithm of constant thrust fitting is researched through the impulse compensation. The effect of obstacles on original fluid field is quantified by the perturbation matrix, and the streamlines can be regarded as the planned path. Simulation results demonstrate the effectiveness of this method by comparing with A-star algorithm and ant colony algorithm. It is proved that the planned path can avoid all obstacles smoothly and swiftly and reach the destination eventually.
The Role of Situation Criticality in Affecting the Effect of Cognitive Load on Drivers’ Brake responses: A Driving Simulator Based Study
Authors: Xue Qingwan , Yan Xuedong , Zhao Yi , Zhang Yuting
Published: October 2020

A dramatic increase in talking on the phone whilst driving has been seen over the past decades, which posed a significant safety threat on the whole society consequently. Studies on the topic regarding the effect of phone conversations on drivers’ driving performances have never come to a cease, especially on the studies of drivers’ brake response times. However, few studies focus on the relationship between situation criticality and the effect of cognitive load on drivers’ brake responses. To better understand it, a driving simulator experiment with two braking scenarios corresponding to two levels of situation criticality was conducted in this study. Participants were asked to follow a lead vehicle as they normally did and answer arithmetic problems (simple and complex) in three phone modes (baseline, hands-free, and handheld) in the meantime. Drivers’ brake response times to the lead vehicle under five conditions were collected and fitted in accumulator models, in which visual looming and brake lights onset were included as the sensory cues. Results demonstrated that the previously proposed mechanistically explicit simulation model was able to predict drivers’ brake response times on different levels of cognitive load and the increased effect of cognitive load on drivers’ brake response times in less critical situations was demonstrated in this paper as well.
A Hybrid Approach Integrating Multiple ICEEMDANs, WOA, and RVFL Networks for Economic and Financial Time Series Forecasting
Authors: Wu Jiang , Zhou Tengfei , Li Taiyong
Published: October 2020

The fluctuations of economic and financial time series are influenced by various kinds of factors and usually demonstrate strong nonstationary and high complexity. Therefore, accurately forecasting economic and financial time series is always a challenging research topic. In this study, a novel multidecomposition and self-optimizing hybrid approach integrating multiple improved complete ensemble empirical mode decompositions with adaptive noise (ICEEMDANs), whale optimization algorithm (WOA), and random vector functional link (RVFL) neural networks, namely, MICEEMDAN-WOA-RVFL, is developed to predict economic and financial time series. First, we employ ICEEMDAN with random parameters to separate the original time series into a group of comparatively simple subseries multiple times. Second, we construct RVFL networks to individually forecast each subseries. Considering the complex parameter settings of RVFL networks, we utilize WOA to search the optimal parameters for RVFL networks simultaneously. Then, we aggregate the prediction results of individual decomposed subseries as the prediction results of each decomposition, respectively, and finally integrate these prediction results of all the decompositions as the final ensemble prediction results. The proposed MICEEMDAN-WOA-RVFL remarkably outperforms the compared single and ensemble benchmark models in terms of forecasting accuracy and stability, as demonstrated by the experiments conducted using various economic and financial time series, including West Texas Intermediate (WTI) crude oil prices, US dollar/Euro foreign exchange rate (USD/EUR), US industrial production (IP), and Shanghai stock exchange composite index (SSEC).
Knockdown of YAP/TAZ Inhibits the Migration and Invasion of Fibroblast Synovial Cells in Rheumatoid Arthritis by Regulating Autophagy
Authors: Zhou Wei , Shen Qin , Wang Hui , Yang Jie , Zhang Chen , Deng Zijing , Wu Keyan , Zhou Yang , Zeng Jing , Zhang Yu , Shen Weigan
Published: October 2020

The purpose of this study was to investigate the effect of knockdown of the yes-associated protein (YAP) and transcriptional coactivator with PDZ-binding motif (TAZ) on the migration and invasion of the rheumatoid arthritis fibroblast-like synoviocytes (RA-FLS) and to preliminarily elucidate the mechanisms between YAP/TAZ and autophagy in the migration and invasion of RA-FLS. RA-FLS stable knockdown of YAP or TAZ was successfully established by using lentiviral-mediated gene knockdown techniques. Wound healing assay and Transwell assay were used to evaluate the effect of knockdown of YAP or TAZ on the migration and invasion of RA-FLS. Reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) and western blotting assays were performed to examine the expression of indicated genes. The results showed that YAP and TAZ were upregulated in RA-FLS, and knockdown of YAP or TAZ inhibited the migration and invasion, reduced the expression of N-cadherin and Vimentin, and increased the accumulation of E-cadherin and β-catenin in RA-FLS. Our results also demonstrated that knockdown of YAP or TAZ promoted autophagy which increased the accumulation of LC3B-II and ULK1 and decreased the amount of SQSTM1/p62 in RA-FLS. Furthermore, our data displayed that inhibition of autophagy either with 3-MA or CQ can partially reverse the decrease of migration and invasion induced by YAP and TAZ knockdown in RA-FLS. Our experiments preliminarily revealed that YAP/TAZ and autophagy play important roles in the migration and invasion of RA-FLS, which might provide novel targets for the treatment of RA.
Phenotypic Differences in Juvenile Polyposis Syndrome With or Without a Disease-causing SMAD4/BMPR1A Variant
Authors: MacFarland Suzanne P. , Ebrahimzadeh Jessica E. , Zelley Kristin , Begum Lubna , Bass Lee M. , Brand Randall E. , Dudley Beth , Fishman Douglas S. , Ganzak Amanda , Karloski Eve , Latham Alicia , Llor Xavier , Plon Sharon , Riordan Mary K. , Scollon Sarah R. , Stadler Zsofia K. , Syngal Sapna , Ukaegbu Chinedu , Weiss Jennifer M. , Yurgelun Matthew B. , Brodeur Garrett M. , Mamula Petar , Katona Bryson W.
Published: October 2020

Juvenile polyposis syndrome (JPS) is a clinically diagnosed hamartomatous polyposis syndrome that increases the risk of gastrointestinal cancer. Approximately 40%–50% of JPS is caused by a germline disease-causing variant (DCV) in the SMAD4 or BMPR1A genes. The aim of this study was to characterize the phenotype of DCV-negative JPS and compare it with DCV-positive JPS. Herein, we analyzed a cohort of 145 individuals with JPS from nine institutions, including both pediatric and adult centers. Data analyzed included age at diagnosis, family history, cancer history, need for colectomy/gastrectomy, and polyp number and location. Compared with DCV-positive JPS, DCV-negative JPS was associated with younger age at diagnosis (P < 0.001), lower likelihood of having a family history of JPS (P < 0.001), and a lower risk of colectomy (P = 0.032). None of the DCV-negative individuals had gastric or duodenal polyps, and polyp burden decreased after the first decade compared with DCV-positive JPS. Subgroup analysis between SMAD4 and BMPR1A carriers showed that SMAD4 carriers were more likely to have a family history of JPS and required gastrectomy. Taken together, these data provide the largest phenotypic characterization of individuals with DCV-negative JPS to date, showing that this group has distinct differences compared with JPS due to a SMAD4 or BMPR1A variant. Better understanding of phenotype and cancer risk associated with JPS both with and without a DCV may ultimately allow for individualized management of polyposis and cancer risk.

Prevention Relevance: Juvenile Polyposis Syndrome (JPS) is a gastrointestinal cancer predisposition syndrome requiring lifelong surveillance, however there is limited data comparing individuals with and without a germline disease-causing variant in SMAD4 or BMPR1A. Herein we show that individuals with JPS without an underlying disease-causing variant have distinct phenotypic differences including lack of upper gastrointestinal polyps and lower rates of a family history of JPS, suggesting that a different approach to management may be appropriate in this population.
Pharmacologic Inhibition of FGFR Modulates the Metastatic Immune Microenvironment and Promotes Response to Immune Checkpoint Blockade
Authors: Akhand Saeed S. , Liu Zian , Purdy Stephen C. , Abdullah Ammara , Lin Hang , Cresswell Gregory M. , Ratliff Timothy L. , Wendt Michael
Published: October 2020

The effectiveness of immunotherapy as a treatment for metastatic breast cancer is limited due to low numbers of infiltrating lymphocytes in metastatic lesions. Herein, we demonstrated that adjuvant therapy using FIIN4, a covalent inhibitor of fibroblast growth factor receptor (FGFR), dramatically delayed the growth of pulmonary metastases in syngeneic models of metastatic breast cancer. In addition, we demonstrated in a syngeneic model of systemic tumor dormancy that targeting of FGFR enhanced the immunogenicity of the pulmonary tumor microenvironment through increased infiltration of CD8+ lymphocytes and reduced presence of myeloid suppressor cells. Similar impacts on immune cell infiltration were observed upon genetic depletion of FGFR1 in tumor cells, which suggested a direct influence of FGFR signaling on lymphocyte trafficking. Suppression of CD8+ lymphocyte infiltration was consistent with FGFR-mediated inhibition of the T-cell chemoattractant CXCL16. Initial attempts to concomitantly administer FIIN4 with immune checkpoint blockade failed due to inhibition of immune-mediated tumor cell killing via blockade of T-cell receptor signaling by FIIN4. However, this was overcome by using a sequential dosing protocol that consisted of FIIN4 treatment followed by anti–PD-L1. These data illustrate the complexities of combining kinase inhibitors with immunotherapy and provide support for further assessment of FGFR targeting as an approach to enhance antitumor immunity and improve immunotherapy response rates in patients with metastatic breast cancer.
Management of Chemotherapy-Induced Nausea and Vomiting with Trastuzumab Deruxtecan: A Case Series
Authors: Stankowicz Matthew , Mauro Lauren , Harnden Kathleen , Pennisi Angela
Published: October 2020

Introduction: Trastuzumab deruxtecan is a monoclonal antibody linked to a chemotherapy moiety that was recently approved by the Food and Drug Administration (FDA) for the treatment of metastatic human epidermal growth factor receptor 2 (HER2) positive breast cancers. There are labeled black box warnings for interstitial lung disease (ILD)/pneumonitis and embryo-fetal toxicity. Additionally, chemotherapy-induced nausea and vomiting (CINV) was reported to be as high as 78% (∼8% grade 3 or higher) in phase I and II clinical trials. Clinical trial and package insert recommendations for the management of CINV are not available, making real-world management difficult. Case Presentation: We reviewed the first 10 patients who received trastuzumab deruxtecan at our hospital-based community cancer center to determine if CINV management was adequate. We found a rate of 28.9% CINV (all grade 1 and 2) despite treatment as a moderate emetic potential regimen. Interventions by the treatment team to manage trastuzumab deruxtecan as a high-risk emetic regimen resulted in reduced CINV and ongoing treatment for all patients. Discussion and Conclusion: This review indicates that management of CINV for patients receiving trastuzumab deruxtecan should follow recommendations for regimens with a high-risk emetic potential.