bluuebunny/crossref_metadata_2025 huggingface dataset:
A New Mitigation Measure to Counter Thermal Instability of Air‐Cooled Embankment in Sandy Permafrost Zones of Tibet Plateau
Authors: Liu Minghao , Luo Jing , Zhang Liang , Ju Xin
Published: April 2021

A crushed‐rock revetment (CRR) with high permeability that can be paved on embankment slopes is widely used to cool and protect the subgrade permafrost. In this study, a traditional CRR over warm permafrost was selected to investigate its cooling characteristics based on the ground temperature observed from 2003 to 2014. A new mitigation structure (NMS) was designed to improve the cooling capacity of the CRR and to counter the pore‐filling of the rock layer. Numerical simulations were conducted to evaluate the cooling performance and reinforcing capacity of the NMS based on a developed heat and mass transfer model. The results indicate that the traditional CRR can improve the symmetry of the permafrost subgrade and decrease the ground temperature of shallow permafrost. However, the CRR cannot generate strong enough cooling to influence the deep (below 10 m depth) and warm permafrost with a mean annual ground temperature above −1.0°C. The wind‐blown sand can further weaken the cooling of the CRR and cause significant permafrost warming and thawing beneath the slopes, posing a severe threat to the long‐term safe operation of the embankment. The proposed NMS can produce a significantly superior cooling performance to the CRR. If the CRR is reinforced by the new structure, it can not only effectively cool the underlying warm permafrost but also elevate the permafrost table. The new structure can also protect the rock layer on the slopes from sand‐filling. The NMS can be used as an effective method for roadbed design or maintenance over warm permafrost.
Multiauthority Traceable Ring Signature Scheme for Smart Grid Based on Blockchain
Authors: Tang Fei , Pang Junjie , Cheng Kefei , Gong Qianhong
Published: April 2021

As the next‐generation power grid system, the smart grid can realize the balance of supply and demand and help in communication security and privacy protection. However, real‐time power consumption data collection might expose the users’ privacy information, such as their living habits and economic conditions. In addition, during the process of data transmission, it may lead to data inconsistency between the user side and the storage side. Blockchain provides tamper‐resistant and traceable characteristics for solving these problems, and ring signature schemes provide an anonymous authentication mechanism. Therefore, in this work, we consider the applications of ring signature scheme in smart grid based on blockchain. We introduce the notion of multi‐authority traceable ring signature (MA‐TRS) scheme for distributed setting. In our scheme, there is an auditing node that can distinguish the identity of the real signer from the ring without any secret information. Last but not least, we prove that the proposed scheme is unforgeable, anonymous, and traceable.
Industrial Internet of Things for Mobile Phone Shell Intelligent Detection in Smart Cities
Authors: Zheng Tianyi , Peng Bao , Zhou Guofu
Published: April 2021

Industrial Internet of Things is the core field of smart city. And intelligent detection is an important application field of industrial Internet of Things. Demand of the industrial is particularly urgent. In particular, the defect detection of mobile phone shells (MPS) has always been a common problem for famous mobile phone companies. A compression‐free defect detection method (CFDDM) for MPS based on machine vision is proposed in this paper. Firstly, affine transformation is utilized to solve the angle deviation of MPS in different images. Then, edge detection, binarization, and open operation are combined to highlight the edge region based on the results of angle adjustment. It is convenient for region of interest (ROI) extraction and clipping. Finally, the method of gray histogram contrasting is utilized for defect detection according to the results of ROI clipping. And the detection results are obtained. In this paper, MPS data set is utilized for many tests. The results show that the proposed method can effectively detect whether there are defects in MPS data set without image compression. The recognition accuracy is 100%. The recognition time of a single image is about 4.56 s, which is better than other defect detection methods.
Experimental Study on the Fine Iron Ore Tailing Containing Gypsum as Backfill Material
Authors: Deng Daiqiang , Cao Guodong , Zhang Youxuan
Published: April 2021

The strength of the filling body is largely affected by the properties of the binder, mineral composition, fineness, and slurry concentration of tailing. In this paper, the rheological test was conducted to determine the slurry concentration of iron ore tailing containing gypsum. Then, the samples made from slurry and three binders, Portland cement, filling plant binder, and Huazhong binder, were tested, respectively. The effects of curing time, binder‐tailing ratio by mass (b/t), and slurry concentration on compression strength were investigated. The sample made from Huazhong binder and iron ore tailing presented the largest compression strength.
From the Perspective of Jurisprudence View the Application of Urban Image Monitoring Technology and the Application and Improvement of the Information Collection System in This Field
Authors: An Zheming , Jiang Zhiyong
Published: April 2021

As times go by, social management faces new challenges. This article examines the application of urban image surveillance technology and the methods of information collection and processing from a legal perspective, and explains the necessity of creating image surveillance. This article introduces the application of the system to the construction of legal systems in countries where urban image surveillance has been applied earlier and with more advanced legal systems at home and abroad, from the construction of the image surveillance legal system, the protection of personal privacy rights, and the protection of communication data. Explain the legislative principles to be followed in the legislative process, and put forward the principles of human rights and freedom, the principle of public interest, the principle of rule of law, and the principle of information security. Finally, I put forward a point of view on how to formulate a legal and fair legal system. It is clear that in the field of legislation, it is necessary to seek constitutional support, use civil law to regulate, use personal information protection law to regulate, and use urban image monitoring system legislation to manage. This paper proposes a “peer-to-peer tree” architecture of a two-tier distributed indexing service system based on service types. Its joining and leaving algorithms create and maintain the framework, cascading organizations related to service interests into a tree structure. Learning the neighbor search algorithm can slowly evolve the peer layer composed of many cascaded trees into an overlay network with small-world characteristics, thereby ensuring a higher search efficiency. Research shows that through functional testing and performance testing, it is found that when the number of supernodes is 200, the success rate is the highest.
Research on Risk Identification System Based on Random Forest Algorithm‐High‐Order Moment Model
Authors: Liu Li-Jun , Shen Wei-Kang , Zhu Jia-Ming
Published: April 2021

With the continuous development of the stock market, designing a reasonable risk identification tool will help to solve the irrational problem of investors. This paper first selects the stocks with the most valuable investment value in the future through the random forest algorithm in the nine‐factor model and then analyzes them by using the higher‐order moment model to find that different investors’ preferences will make the weight of the portfolio change accordingly, which will eventually make the optimal return and risk set of the composition of the portfolio change. The risk identification system designed in this paper can provide an effective risk identification tool for investors and help them make rational judgments.
Blow-Up of Certain Solutions to Nonlinear Wave Equations in the Kirchhoff-Type Equation with Variable Exponents and Positive Initial Energy
Authors: Alkhalifa Loay , Dridi Hanni , Zennir Khaled
Published: April 2021

This paper is concerned with the blow-up of certain solutions with positive initial energy to the following quasilinear wave equation:

u

t
t

−
M

N
u

t

Δ

p

·

u
+
g

u

t

=
f

u

. This work generalizes the blow-up result of solutions with negative initial energy.
Roof Stability of Rectangle Coal Roadway: In Light of Calculation of Compressive Bar Stability
Authors: Shou-Long Ma , Linsheng Gao , Yue Yang , Rui Peng , Qifeng Zhao
Published: April 2021

The roadway roof is a key factor to the roadway stability. The analysis of roof stability is mainly based on numerical calculation and on‐site observation, while the basic theory of the bearing mechanism is relatively weak. We have founded a critical pressure calculation model, on the theory of compressive bar, for the rectangle coal roadway stability. The model has been tested and verified on accuracy and feasibility while applied on a roadway case. The critical pressure for roof stability and roof bending moment and deflection under combined axial and lateral load was deduced using the theory of compressive bar stability. The numerical calculation verified the feasibility of numerical modeling of stability of compressive bar using FLAC3D, and the influence of the background ambient horizontal stress and the parameters of the contact surface to the roof stability were further studied. The result turns out that some factors lead to a higher instability tendency, including higher horizontal stress, higher cohesion force, and larger internal friction angle on the coal‐rock interface and lower cohesion force and smaller friction angle on the rock‐rock interface. The results contribute to bearing mechanisms of roadway roof stability, ground pressure and strata control theory and application, and design of bolting support.
Shock in the Setting of Diamond-Blackfan Anemia Relapse
Authors: Haddaden Metri , Husami Samir , Alom Modar , Pang Yifan , Imam Zaid , Keena Daniel
Published: April 2021

Adult intensivists have increasing exposure to individuals with congenital diseases surviving into adulthood. Solid knowledge bases and early recognition of the possible sequelae of congenital disorders are crucial in caring for these patients. We present a challenging case of shock and relapse of Diamond-Blackfan anemia in a 42-year-old man lost to follow-up for 18 years and highlighted the importance of healthcare transitions into adulthood and the challenges faced by health care systems to develop new strategies successfully transitioning complex pediatric patients to adult care.
Effect of Prophylactic Vaccination with the Membrane-Bound Acid Phosphatase Gene of Leishmania mexicana in the Murine Model of Localized Cutaneous Leishmaniasis
Authors: Burgos-Reyes María Angélica , Baylón-Pacheco Lidia , Espíritu-Gordillo Patricia , Galindo-Gómez Silvia , Tsutsumi Víctor , Rosales-Encina José Luis
Published: April 2021

Leishmaniasis is a disease caused by an intracellular protozoan parasite of the genus Leishmania. Current treatments for leishmaniasis are long, toxic, and expensive and are not available in some endemic regions. Attempts to develop an effective vaccine are feasible, but no vaccine is in active clinical use. In this study, the LmxMBA gene of Leishmania mexicana was selected as a possible vaccine candidate using the reverse vaccinology approach, and the prophylactic effect generated by DNA vaccination with this gene in a murine model of cutaneous leishmaniasis was evaluated. The results showed that prophylactic vaccination with pVAX1::LmxMBA significantly reduced the size of the lesion and the parasitic load on the footpad, compared to the control groups. At a histological level, a smaller number of parasites were evident in the dermis, as well as the absence of connective tissue damage. Mice immunized with plasmid pVAX1::LmxMBA induced immunity characterized by an increase in theIgG2a/IgG1>1ratio and a higher rate of lymphocyte proliferation. In this study, immunization with the plasmid promoted an improvement in the macroscopic and microscopic clinical manifestations of the experimental infection by L. mexicana, with a T helper 1 response characterized by anIgG2a/IgG1>1ratio and high lymphoproliferative response. These findings support immunization with the plasmid pVAX1::LmxMBA as a preventive strategy against cutaneous infection of L. mexicana.
Offensive, Defensive, and Generic Advertising Strategies in a Dynamic Oligopolistic Market
Authors: Jafari Mostafa , Mohammadpour omran Mohammad , Jahani Ehsan
Published: April 2021

In today’s highly competitive business environment, advertisement plays an influential role in attracting customers and increasing market share. Companies adopt different advertising strategies in a competitive market, such as offensive, defensive, and generic, to keep and increase their market share. Researchers have generally modeled this problem using a dynamic differential game. All previous research studies have focused on finding these strategies in a duopoly market. Also, to simultaneously determine the optimal equilibrium strategy for these three strategies, the model is designed as a symmetric game due to the ease of solving. In contrast with the previous researches, the purpose of this paper is to present and solve an asymmetric game model to determine the optimal offensive, defensive, and generic advertising strategies in an oligopoly market. The proposed model’s objective is to obtain the maximum equilibrium profit for each company at any moment regarding the market share of each company and those of competitors. A numerical solution method based on the Pontryagin’s maximum principle is developed to solve the model. Then, the proposed model is solved for a triopoly market. Also, the sensitivity of the results to changes in model parameters has been investigated. The obtained results denote that in markets with more than two players under the asymmetric game, the proposed model can prescribe the optimal type of offensive, defensive, and generic advertising strategies.
Classification and Prediction of Bee Honey Indirect Adulteration Using Physiochemical Properties Coupled with K-Means Clustering and Simulated Annealing-Artificial Neural Networks (SA-ANNs)
Authors: Al-Mahasneh Majdi , Al-U’datt Muhammad , Rababah Taha , Al-Widyan Mohamad , Abu Kaeed Aseel , Al-Mahasneh Ahmad Jobran , Abu-Khalaf Nawaf
Published: April 2021

The higher demand and limited availability of honey led to different forms of honey adulteration. Honey adulteration is either direct by addition of various syrups to natural honey or indirect by feeding honey bees with sugar syrups. Therefore, a need has emerged for reliable and cost-effective quality control methods to detect honey adulteration in order to ensure both safety and quality of honey. In this study, honey is adulterated by feeding honey bees with various proportions of sucrose syrup (0 to 100%). Various physiochemical properties of the adulterated honey are studied including sugar profile, pH, acidity, moisture, and color. The results showed that increasing sucrose syrup in the feed resulted in a decrease in glucose and fructose contents significantly, from 33.4 to 29.1% and 45.2 to 35.9%, respectively. Sucrose content, however, increased significantly from 0.19 to 1.8%. The pH value increased significantly from 3.04 to 4.63 with increase in sucrose feed. Acidity decreased slightly but nonsignificantly with increase in sucrose feed and varied between 7.0 and 4.00 meq/kg for 0% and 100% sucrose, respectively. Honey’s lightness (L value) also increased significantly from 59.3 to 68.84 as sucrose feed increased. Other color parameters were not significantly changed by sucrose feed. K-means clustering is used to classify the level of honey adulteration by using the above physiological properties. The classification results showed that both glucose content and total sugar content provided 100% accurate classification while pH values provided the worst results with 52% classification accuracy. To further predict the percent honey adulteration, simulated annealing coupled with artificial neural networks (SA-ANNs) was used with sugar profile as an input. RBF-ANN was found to provide the best prediction results with SSE = 0.073, RE = 0.021, and overall R2 = 0.992. It is concluded that honey sugar profile can provide an accurate and reliable tool for detecting indirect honey adulteration by sucrose solution.
The Combination of Shear Wave Elastography and Platelet Counts Can Effectively Predict High‐Risk Varices in Patients with Hepatitis B‐Related Cirrhosis
Authors: Xie Xiaoyu , Feng Yuemin , Lyu Zhuozhen , Wang Le , Yang Yao , Bai Yuping , Liu Chenxi , Wu Hao , Ren Wanhua , Zhu Qiang
Published: April 2021

Background. Baveno VI criteria, based on liver stiffness (LS) measured by transient elastography and platelet counts (PLT), have been proposed to avoid unnecessary endoscopy screening for high‐risk varices (HRVs). However, the cut‐off value of LS measured by 2D‐SWE and PLT to predict HRVs in compensated hepatitis B‐related cirrhotic patients remains unknown. Aims. To prospectively analyze the cut‐off of the combination of LS measured by 2D‐SWE and PLT in predicting HRVs and the influence of antiviral therapies in its efficacy. Methods. Serum parameters, LS, and endoscopy results were obtained from 160 compensated hepatitis B‐related cirrhotic patients. The accuracy of the combined algorithm was assessed in the whole cohort and subgroups with or without consecutive antiviral therapies in the past 6 months. Results. In the whole cohort, the optimal cut‐off value of LS for HRVs was 14.5 kPa. Patients with a LS value < 14.5 kPa with a PLT value > 110 × 109/L can be excluded from HRVs (NPV = 0.99, endoscopy saved rates = 0.68). Conversely, a LS value of ≥14.5 kPa and a PLT value of ≤110 × 109/L indicated HRVs, with accurate rates of 82.35%, and 10.63% of patients can avoid additional endoscopy screening. Moreover, antiviral therapy had no significant effect on the accuracy and rates saved from further endoscopy screening, when comparing patients with or without antiviral therapies (all p values > 0.05). Conclusions. The combination of LS (14.5 kPa) measured by 2D‐SWE and PLT (110 × 109/L) can predict HRVs accurately in compensated hepatitis B‐related cirrhotic patients without significant interference of antiviral therapy histories.
Attention-Guided Digital Adversarial Patches on Visual Detection
Authors: Lang Dapeng , Chen Deyun , Shi Ran , He Yongjun
Published: April 2021

Deep learning has been widely used in the field of image classification and image recognition and achieved positive practical results. However, in recent years, a number of studies have found that the accuracy of deep learning model based on classification greatly drops when making only subtle changes to the original examples, thus realizing the attack on the deep learning model. The main methods are as follows: adjust the pixels of attack examples invisible to human eyes and induce deep learning model to make the wrong classification; by adding an adversarial patch on the detection target, guide and deceive the classification model to make it misclassification. Therefore, these methods have strong randomness and are of very limited use in practical application. Different from the previous perturbation to traffic signs, our paper proposes a method that is able to successfully hide and misclassify vehicles in complex contexts. This method takes into account the complex real scenarios and can perturb with the pictures taken by a camera and mobile phone so that the detector based on deep learning model cannot detect the vehicle or misclassification. In order to improve the robustness, the position and size of the adversarial patch are adjusted according to different detection models by introducing the attachment mechanism. Through the test of different detectors, the patch generated in the single target detection algorithm can also attack other detectors and do well in transferability. Based on the experimental part of this paper, the proposed algorithm is able to significantly lower the accuracy of the detector. Affected by the real world, such as distance, light, angles, resolution, etc., the false classification of the target is realized by reducing the confidence level and background of the target, which greatly perturbs the detection results of the target detector. In COCO Dataset 2017, it reveals that the success rate of this algorithm reaches 88.7%.
Two-Stage Joint Model for Multivariate Longitudinal and Multistate Processes, with Application to Renal Transplantation Data
Authors: Alafchi Behnaz , Mahjub Hossein , Tapak Leili , Roshanaei Ghodratollah , Amirzargar Mohammad Ali
Published: April 2021

In longitudinal studies, clinicians usually collect longitudinal biomarkers’ measurements over time until an event such as recovery, disease relapse, or death occurs. Joint modeling approaches are increasingly used to study the association between one longitudinal and one survival outcome. However, in practice, a patient may experience multiple disease progression events successively. So instead of modeling of a single event, progression of the disease as a multistate process should be modeled. On the other hand, in such studies, multivariate longitudinal outcomes may be collected and their association with the survival process is of interest. In the present study, we applied a joint model of various longitudinal biomarkers and transitions between different health statuses in patients who underwent renal transplantation. The full joint likelihood approaches are faced with the complexities in computation of the likelihood. So, here, we have proposed two-stage modeling of multivariate longitudinal outcomes and multistate conditions to avoid these complexities. The proposed model showed reliable results compared to the joint model in case of joint modeling of univariate longitudinal biomarker and the multistate process.
Application of Laparoscopy in Comprehensive Staging Operation of Ovarian Cancer Based on Electronic Medical Blockchain Technology
Authors: Zhang Limei , Li Xinrui , Ning Yao , Cai Yufei
Published: April 2021

Ovarian cancer has always entangled most women. Studies have shown that the prevalence of ovarian cancer ranks third in female reproductive malignancies, and the mortality rate has always been the highest. The reason is mainly because the diagnosis and treatment of preovarian cancer has always been a big problem. However, the emergence of laparoscopy can well solve this problem, especially laparoscopy assisted by blockchain technology, which plays a huge role in the overall staging of ovarian cancer. This article proposes the application research of laparoscopy in the comprehensive staging of ovarian cancer based on electronic medical blockchain technology. First of all, this article uses the literature method to study the clinical characteristics and surgical classification of ovarian cancer, as well as the application status of blockchain technology and laparoscopic technology. Secondly, it designed an application experiment based on electronic medical blockchain technology to assist laparoscopy in the comprehensive staging of ovarian cancer and analyzed the comparison of the laparoscopic group and the control group in the comprehensive staging of ovarian cancer. The results of the study showed that the amount of bleeding in the laparoscopic group was 103.5 ml, while the amount of bleeding in the control group was 141.1 ml; the proportion of tertiary pain in the laparoscopic group was 11.37%, and the proportion of tertiary pain in the control group was 31.82%. From this, it can be seen that, in the comprehensive staging operation for ovarian cancer, the laparoscopic group has less intraoperative blood loss than the control group and lower pain, and the treatment effect is better.
Integrated Train Rescheduling and Rerouting during Multidisturbances under a Quasi-Moving Block System
Authors: Xu Peijuan , Zhang Dawei , Guo Jingwei , Liu Dan , Peng Hui
Published: April 2021

It is known that it is critical for train rescheduling problem to address some uncertain disturbances to keep the normal condition of railway traffic. This paper is keen on a mathematical model to reschedule high-speed trains controlled by the quasi-moving blocking signalling system impacted by multidisturbances (i.e., primary delay, speed limitation, and siding line blockage). To be specific, a mixed-integer linear programming is formulated based on an improved alternative graph theory, by the means of rerouting, reordering, retiming, and train control. In order to adjust the train speed and find the best routes for trains, the set of alternative arcs and alternative arrival/departure paths are considered in the constraints, respectively. Due to this complex NP-hard problem, a two-step algorithm with three scheduling rules based on a commercial optimizer is applied to solve the problem efficiently in a real-word case, and the efficiency, validity, and feasibility of this method are demonstrated by a series of experimental tests. Finally, the graphical timetables rescheduled are analysed in terms of free conflicts of the solution. Consequently, the proposed mathematical model enriches the existing theory about train rescheduling, and it can also assist train dispatchers to figure out disturbances efficiently.
Color Stability and Surface Properties of PMMA/ZrO2 Nanocomposite Denture Base Material after Using Denture Cleanser
Authors: Gad Mohammed M. , Abualsaud Reem , Fouda Shaimaa M. , Rahoma Ahmed , Al-Thobity Ahmad M. , Khan Soban Q. , Akhtar Sultan , Al-Abidi Khalid S. , Ali Mohamed S. , Al-Harbi Fahad A.
Published: April 2021

Statement of Problem. Novel polymethyl methacrylate (PMMA) containing zirconium dioxide nanoparticles (nano-ZrO2) was suggested as a denture base material but there is a lack of information regarding denture cleanser effects. Objectives. This study aimed to evaluate denture cleanser effects on color stability, surface roughness, and hardness of PMMA denture base resin reinforced with nano-ZrO2. Materials and Methods. A total of 420 specimens were fabricated of unreinforced and nano-ZrO2 reinforced acrylic resin at 2.5% and 5%, resulting in 3 main groups. These groups were further subdivided (n = 10) according to immersion solution (distilled water, Corega, sodium hypochlorite, and Renew) and immersion duration. Surface roughness, hardness, and color were measured at baseline (2 days-T0) in distilled water and then after 180 and 365 days of immersion (T1 & T2) in water or denture cleansing solutions. Data was collected and analyzed using two-way ANOVA followed by Bonferroni post hoc test (α = 0.05). Results. Surface roughness increased significantly after denture cleanser immersion of unmodified and nano-ZrO2-modified PMMA materials while hardness decreased (P<0.001). The denture cleansers significantly affected the color of both PMMA denture bases (P<0.001). The immersion time in denture cleansers significantly affected all tested properties (P<0.001). Within denture cleansers, NaOCl showed the highest adverse effects (P<0.05) while Renew showed the least adverse effects. Conclusion. Denture cleansers can significantly result in color change and alter the surface roughness and hardness of denture base resin even with ZrO2 nanoparticles addition. Therefore, they should be carefully used.
Biomarkers and Their Possible Functions in the Intestinal Microenvironment of Chagasic Megacolon: An Overview of the (Neuro)inflammatory Process
Authors: do Carmo Neto José Rodrigues , Braga Yarlla Loyane Lira , da Costa Arthur Wilson Florêncio , Lucio Fernanda Hélia , do Nascimento Thais Cardoso , dos Reis Marlene Antônia , Celes Mara Rubia Nunes , de Oliveira Flávia Aparecida , Machado Juliana Reis , da Silva Marcos Vinícius
Published: April 2021

The association between inflammatory processes and intestinal neuronal destruction during the progression of Chagasic megacolon is well established. However, many other components play essential roles, both in the long-term progression and control of the clinical status of patients infected with Trypanosoma cruzi. Components such as neuronal subpopulations, enteric glial cells, mast cells and their proteases, and homeostasis-related proteins from several organic systems (serotonin and galectins) are differentially involved in the progression of Chagasic megacolon. This review is aimed at revealing the characteristics of the intestinal microenvironment found in Chagasic megacolon by using different types of already used biomarkers. Information regarding these components may provide new therapeutic alternatives and improve the understanding of the association between T. cruzi infection and immune, endocrine, and neurological system changes.
Choroidal Vascular Changes in Acute Idiopathic Maculopathy as Demonstrated by Multimodal Imaging including Optical Coherence Tomography Angiography
Authors: Khundkar Tahsin , Hasan Syed R. , Breazzano Mark P. , Mei Constance , Johnson Brandon B.
Published: April 2021

Purpose. To present a case of acute idiopathic maculopathy (AIM) and illustrate primary choroidal perfusion defect using multimodal imaging. Case Description. We report a case of a 24-year-old man with a paracentral scotoma of the right eye and recent flu-like illness. The patient was found to have a unilateral ovoid-shaped, placoid lesion just inferior to the fovea. Multimodal imaging confirmed findings most consistent with a diagnosis of acute idiopathic maculopathy (AIM). Serologic studies confirmed a strongly positive immunoglobulin G (IgG) titer for coxsackievirus A. Spectral-domain optical coherence tomography angiography (SD-OCTA) showed bilateral areas of vascular reduction at the level of the choriocapillaris and choroid, sparing the retinal circulation. Conclusions and Importance. The changes in outer retina and retinal pigment epithelium, classically described in AIM, are likely secondary to choroidal hypoperfusion.
Research of Thermal Effect of Cable‐Stayed Bridge with a Separated Side‐Box Steel‐Concrete Composite Girder under Solar Radiation
Authors: Zhang Han-hao , Wang Pei-zhi , He Shuanhai , Li Yuan , Chen Ke-fan , Sun Nan-nan
Published: April 2021

At present, there are few studies on the thermal effect of solar radiation on a separated double‐sided box steel‐concrete composite girder cable‐stayed bridge. In this paper, the beam element and mixed element models are combined with the theory of transient heat transfer analysis and meteorology; this approach is adopted to carry out a thermodynamic analysis of a related bridge project. The calculation results of the thermal field and structural thermodynamic analysis of bridge sections show that, in terms of a separated double‐sided box steel‐concrete composite girder cable‐stayed bridge, the thermal field distributions of the main girder and the pylons are extremely complex under conditions of solar radiation. Therefore, the real thermal field cannot be accurately described as a one‐dimensional temperature gradient. The traditional beam element model cannot accurately simulate the temperature effect, and it will underestimate its thermal effect. The calculated temperature stress values of the mixed element model are quite different from those of the of beam element model. The mixed element model can precisely reflect the local thermal effect of each component in this system under solar radiation. Compared with the calculation results of the beam element model, the maximum temperature stress of the bridge deck in each section of the main girder is generally 20% larger; the maximum temperature stress levels of the steel‐beam top and bottom plates are 14.7 MPa and 15.9 MPa larger, respectively. The maximum shear stress of the steel‐concrete interface is 0.2 MPa larger. The research results of the temperature effect calculated by the mixed element have an important guiding significance for the design and maintenance of bridges.
Clustering Trend Changes of Lung Cancer Incidence in Europe via the Growth Mixture Model during 1990–2016
Authors: Bahabin Boroujeni Mohammad , Mehrabani Kamran , Raeisi Shahraki Hadi
Published: April 2021

Background. Lung cancer accounts for half of all deaths from cancer in Europe and has the highest incidence in Southern Europe. The current study aimed to cluster trend changes of lung cancer incidence in Europe via the growth mixture model. Methods. The dataset included incidence rates of female and male lung cancer per 100,000 for 42 European countries during 1990–2016 compiled from the Gapminder database. The growth mixture model was implemented to recognize different longitudinal patterns and estimate the linear trend of each pattern in Mplus 7.4 software. Results. The observed overall trend of incidence for female and male lung cancer was raising and falling, respectively, and Iceland was the only country with higher incidence of female versus male lung cancer in 2016. The growth mixture model suggests 3 main patterns for the trend of lung cancer incidence both for males and females. In male lung cancer, a sharp decreasing pattern was detected for 6 countries including Belarus, Estonia, Russia, Slovenia, Ukraine, and the United Kingdom; also, a moderately decreasing pattern was observed among the other countries. In female lung cancer, a moderate increasing trend was observed for 8 countries including the United Kingdom, Denmark, Hungary, Iceland, Ireland, Montenegro, Netherlands, and Norway; the other patterns were categorized into two clusters with slow increasing trends. Conclusion. Given the raising patterns in the incidence of lung cancer among European females, especially in the United Kingdom, Denmark, Hungary, Iceland, Ireland, Montenegro, Netherlands, and Norway, urgent effective measures are recommended to be taken.
Kidney Disease-Specific Quality of Life among Patients on Hemodialysis
Authors: Al Salmi Issa , Kamble Pramod , Lazarus Eilean Rathinasamy , D’Souza Melba Sheila , Al Maimani Yaqoob , Hannawi Suad
Published: April 2021

Introduction. Quality of life (QoL) of hemodialysis patients can be examined in two aspects: kidney-specific quality of life and general quality of life. Objective. To determine the QoL among patients undergoing hemodialysis, to assess patients’ QoL on hemodialysis, and to determine the factors associated with QoL among hemodialysis patients in Oman. Method. A cross-sectional study was carried out with 205 patients to measure the QoL across various demographic and clinical variables in Oman. The Arabic version of the KDQOL-SFtool was used to collect data from patients undergoing hemodialysis to give QoL quantitative measures. Results. The physical-QoL was 45.7 (95% CI, 44.3, 47.0), which is less than half that of a healthy human. The emotional-QoL is 53.33 (95% CI, 51.1, 55.5), slightly more than half in a healthy human-QoL. The difference between physical and emotional-QoL scores is −7.66 (95% CI, −10.3, -5.1), showing that physical QoL is significantly less than emotional-QoL. The overall general QoL score was 49.5 (95% CI, 47.8, 51.2), half the QoL score of a healthy human. Younger patients are also more likely to experience emotional problems compared with older patients. Patients with 5–8 mg/l levels of serum creatinine have lower emotional wellbeing. People on low incomes experienced social difficulties, while the maximum burden was found in physical activities and minimum social function. Conclusion. Both physical (45.7) and emotional (53.3) QoL scores in dialysis patients are nearly half those of an average human. Hence, there is a poor QoL among dialysis patients like other studies, and therefore, further improvement of renal rehabilitation in dialysis patients is warranted to improve patients’ QoL.
The Recursive Properties of the Error Term of the Fourth Power Mean of the Generalized Cubic Gauss Sums
Authors: Jin Zhang , Jiafan Zhang
Published: April 2021

In this paper, we use the analytic methods and the properties of the classical Gauss sums to study the properties of the error term of the fourth power mean of the generalized cubic Gauss sums and give two recurrence formulae for it.
Anlotinib in Locally Advanced or Metastatic Medullary Thyroid Carcinoma: A Randomized, Double-Blind Phase IIB Trial
Authors: Li Dapeng , Chi Yihebali , Chen Xiaohong , Ge Minghua , Zhang Yuan , Guo Zhuming , Wang Jun , Chen Jie , Zhang Jiewu , Cheng Ying , Li Zhendong , Liu Hui , Qin Jianwu , Zhu Jingqiang , Cheng Ruochuan , Xu Zhengang , Zheng Xiangqian , Tang Pingzhang , Gao Ming
Published: April 2021

Purpose:

Medullary thyroid cancer (MTC) accounts for about 2% of all thyroid cancer, but has a relatively poor prognosis compared with differentiated thyroid cancer. Anlotinib is a novel multitarget tyrosine kinase inhibitor targeting VEGFR, PDGFR, FGFR, and c-Kit. This multicenter, randomized, double-blind, placebo-controlled phase IIB study (ALTER 01031 and NCT02586350) was conducted to investigate the efficacy and safety of anlotinib in MTC.

Patients and Methods:

Patients with histopathologically confirmed, unresectable locally advanced or metastatic MTC were enrolled and randomly assigned in a 2:1 ratio to receive anlotinib (12 mg once daily from day 1 to 14 every 3 weeks) or placebo. Patients in placebo group were allowed to receive open-label anlotinib after disease progression. The primary endpoint was progression-free survival (PFS); secondary endpoints included objective response rate (ORR), disease control rate (DCR), and overall survival (OS).

Results:

Ninety-one patients were enrolled. At data cutoff date, the median PFS was significantly prolonged in the anlotinib group than in the placebo group (20.7 months vs. 11.1 months, P = 0.029; HR, 0.53; 95% confidence interval, 0.30–0.95). The ORR of anlotinib treatment was 48.4%. The incidence of treatment-related adverse events (TRAE) was 100% and 89.7% in the anlotinib and placebo groups, respectively. The most common TRAEs of all grades in the anlotinib group were palmar–plantar erythrodysesthesia syndrome (62.9%), proteinuria (61.3%), and hypertriglyceridemia (48.4%).

Conclusions:

Anlotinib demonstrates its efficacy and safety in this phase IIB trial for the treatment of MTC and may become a new choice for this rare disease, especially for Chinese patients.
Anti-CLL1 Chimeric Antigen Receptor T-Cell Therapy in Children with Relapsed/Refractory Acute Myeloid Leukemia
Authors: Zhang Hui , Wang Pengfei , Li Zhuoyan , He Yingyi , Gan Wenting , Jiang Hua
Published: April 2021

Purpose:

The survival rate of children with refractory/relapsed acute myeloid leukemia (R/R-AML) by salvage chemotherapy is minimal. Treatment with chimeric antigen receptor T cells (CAR T) has emerged as a novel therapy to improve malignancies treatment. C-type lectin-like molecule 1 (CLL1) is highly expressed on AML stem cells, blast cells, and monocytes, but not on normal hematopoietic stem cells, indicating the therapeutic potential of anti-CLL1 CAR T in AML treatment. This study aimed to test the safety and efficacy of CAR T-cell therapy in R/R-AML.

Patients and Methods:

Four pediatric patients with R/R-AML were enrolled in the ongoing phase I/II anti-CLL1 CAR T-cell therapy trial. The CAR design was based on an apoptosis-inducing gene, FKBP-caspase 9, to establish a safer CAR (4SCAR) application. Anti-CLL1 CAR was transduced into peripheral blood mononuclear cells of the patients via lentivector 4SCAR, followed by infusion into the recipients after lymphodepletion chemotherapy. Cytokine release syndrome, immune effector cell–associated neurotoxicity syndrome, and other adverse events were documented. Treatment response was evaluated by morphology and flow cytometry–based minimal residual disease assays.

Results:

Three patients with R/R-AML achieved complete remission and minimal residual disease negativity, while the other patient remained alive for 5 months. All these patients experienced low-grade and manageable adverse events.

Conclusions:

On the basis of our single-institution experience, autologous anti-CLL1 CAR T-cell therapy has the potential to be a safe and efficient alternative treatment for children with R/R-AML, and therefore requires further investigation.
Exercise Training Improves Tumor Control by Increasing CD8+ T-cell Infiltration via CXCR3 Signaling and Sensitizes Breast Cancer to Immune Checkpoint Blockade
Authors: Gomes-Santos Igor L. , Amoozgar Zohreh , Kumar Ashwin S. , Ho William W. , Roh Kangsan , Talele Nilesh P. , Curtis Hannah , Kawaguchi Kosuke , Jain Rakesh K. , Fukumura Dai
Published: April 2021

The mechanisms behind the antitumor effects of exercise training (ExTr) are not fully understood. Using mouse models of established breast cancer, we examined here the causal role of CD8+ T cells in the benefit acquired from ExTr in tumor control, as well as the ability of ExTr to improve immunotherapy responses. We implanted E0771, EMT6, MMTV-PyMT, and MCa-M3C breast cancer cells orthotopically in wild-type or Cxcr3−/− female mice and initiated intensity-controlled ExTr sessions when tumors reached approximately 100 mm3. We characterized the tumor microenvironment (TME) using flow cytometry, transcriptome analysis, proteome array, ELISA, and immunohistochemistry. We used antibodies against CD8+ T cells for cell depletion. Treatment with immune checkpoint blockade (ICB) consisted of anti–PD-1 alone or in combination with anti–CTLA-4. ExTr delayed tumor growth and induced vessel normalization, demonstrated by increased pericyte coverage and perfusion and by decreased hypoxia. ExTr boosted CD8+ T-cell infiltration, with enhanced effector function. CD8+ T-cell depletion prevented the antitumor effect of ExTr. The recruitment of CD8+ T cells and the antitumor effects of ExTr were abrogated in Cxcr3−/− mice, supporting the causal role of the CXCL9/CXCL11–CXCR3 pathway. ExTr also sensitized ICB-refractory breast cancers to treatment. Our results indicate that ExTr can normalize the tumor vasculature, reprogram the immune TME, and enhance the antitumor activity mediated by CD8+ T cells via CXCR3, boosting ICB responses. Our findings and mechanistic insights provide a rationale for the clinical translation of ExTr to improve immunotherapy of breast cancer.
Chemotherapy Induces Tumor-Associated Macrophages that Aid Adaptive Immune Responses in Ovarian Cancer
Authors: Heath Owen , Berlato Chiara , Maniati Eleni , Lakhani Anissa , Pegrum Colin , Kotantaki Panoraia , Elorbany Samar , Böhm Steffen , Barry Simon T. , Annibaldi Alessandro , Barton Desmond P. , Balkwill Frances R.
Published: April 2021

Neoadjuvant chemotherapy (NACT) may stimulate anticancer adaptive immune responses in high-grade serous ovarian cancer (HGSOC), but little is known about effects on innate immunity. Using omental biopsies from HGSOC, and omental tumors from orthotopic mouse HGSOC models that replicate the human tumor microenvironment, we studied the impact of platinum-based NACT on tumor-associated macrophages (TAM). We found that chemotherapy reduces markers associated with alternative macrophage activation while increasing expression of proinflammatory pathways, with evidence of inflammasome activation. Further evidence of a shift in TAM functions came from macrophage depletion via CSF1R inhibitors (CSF1Ri) in the mouse models. Although macrophage depletion in established disease had no impact on tumor weight or survival, CSF1Ri treatment after chemotherapy significantly decreased disease-free and overall survival. This decrease in survival was accompanied by significant inhibition of adaptive immune response pathways in the tumors. We conclude that chemotherapy skews the TAM population in HSGOC toward an antitumor phenotype that may aid adaptive immune responses, and therapies that enhance or sustain this during remission may delay relapse.
Technical Considerations in Awake Craniotomy with Cortical and Subcortical Motor Mapping in Preadolescents: Pushing the Envelope
Authors: Ratha Vishwaraj , Sampath Nishanth , Subramaniam Sudhakar , Kumar V.R. Roopesh
Published: April 2021

Introduction: Unlike adult gliomas, the utility of combined application of awake anesthesia and intraoperative neurophysiological monitoring (IONM) for maximal safe resection in eloquent region gliomas (ERG) has not been established for pediatric population while it remains unexplored in preadolescents (below 11 years old). Case Presentation: We report 2 cases of awake craniotomy with IONM in an 8 and 9 year old for safe maximal resection of ERG. In both the cases, repeated preoperative visits of the operating room was performed to familiarize and educate the children about intraoperative communication, comfortable positioning, and neurological assessment. Under conscious sedation protocol, cortical and subcortical mapping, and electrocorticography, gross total resection was achieved. In both the cases, there were no postoperative neurodeficits or perioperative complications. Conclusion: Our 2 cases illustrate the first instance of successful use of awake IONM for maximal safe resection of ERG in preadolescent age-group. We believe, with proper preoperative planning and careful titration of anesthetics, it is safe and feasible. The blanket notion that preadolescent age-group should be excluded from awake mapping needs to be challenged, rather curated on a case basis.