bluuebunny/crossref_metadata_2025 huggingface dataset:
Mass splitting in an 331-TC coupled scenario
Authors: Doff A.
Published: September 2020

The root of most of the technicolor (TC) problems lies in the way the ordinary fermions acquire their masses, where an ordinary fermion [Formula: see text] couples to a technifermion [Formula: see text] mediated by an extended technicolor (ETC) boson leading to fermion masses that vary with the ETC mass scale [Formula: see text] as [Formula: see text]. Recently, we discussed a new approach consisting of models where TC and QCD are coupled through a larger theory, in this case the solutions of these equations are modified compared to those of the isolated equations, and TC and QCD self-energies are of the irregular form, which allows us to build models where ETC boson masses can be pushed to very high energies. In this work we extend these results for 331-TC models, in particular considering a coupled system of Schwinger–Dyson equations, we show that all technifermions of the model exhibit the same asymptotic behavior for TC self-energies. As an application we discuss how the mass splitting of the order [Formula: see text](100) GeV could be generated between the second and third generation of fermions.
Increasing effective intensity of soft strong interactions
Authors: Troshin S. M. , Tyurin N. E.
Published: September 2020

We suggest definition of effective interaction intensity for soft hadron collisions and discuss its energy dependence in the preasymptotic region. Practical importance of this quantity consists in separation of rising interaction radius from effective interaction intensity increase both contributing to the total cross-section growth. It would be helpful for understanding the origin of this growth at the accelerator energies. The essential feature is that the effective interaction intensity is an experimentally measurable quantity.
Observational constraints of bulk viscous Friedmann–Robertson–Walker cosmology with hybrid expansion law
Authors: Debnath Partha Sarathi
Published: September 2020

In this work, we study bulk viscous Friedmann–Robertson–Walker cosmologies with hybrid expansion law. The bulk viscous theory of dissipative effects described by Eckart theory, truncated Israel–Stewart theory and full Israel–Stewart theory are implemented here. The hybrid expansion law model of scale factor is a general analytic type of evolution from which one can recover power-law and exponential expansion as a special cases. Hybrid expansion law model are applied to describe the present accelerating phase and early phases of evolution. We have determined the cosmological parameters such as Hubble parameter, deceleration parameter, jerk parameter, energy density, bulk viscous pressure and coefficient of bulk viscosity of the universe to construct physically acceptable cosmological model. We have considered both flat and closed space–time of Friedmann–Robertson–Walker cosmology to implement hybrid expansion law with dissipative effect. The variations of the coefficient of bulk viscosity with cosmic evolution are studied here in Eckart, truncated and full Israel–Stewart theory for flat and closed space–time to obtain physically acceptable hybrid expansion models driven by viscosity. We have also estimated observational constraints of the parameters of hybrid expansion law model by considering recent observational data set. We further reveal possible connections of our models with [Formula: see text] tension problem.
String backgrounds in string geometry
Authors: Honda Masaki , Sato Matsuo
Published: September 2020

String geometry theory is a candidate of the nonperturbative formulation of string theory. In order to determine the string vacuum, we need to clarify how string backgrounds are described in string geometry theory. In this paper, we show that the string backgrounds are embedded in configurations of the fields of a string geometry model. Especially, we show that the configurations satisfy the equations of motion of the string geometry model if and only if the embedded string backgrounds satisfy their equations of motion. This means that classical dynamics of the string backgrounds are described as a part of classical dynamics in string geometry theory. Furthermore, we define an energy of the configurations in the string geometry model because they do not depend on the string geometry time. A string background can be determined by minimizing the energy.
Thoughts on the naming of “COVID-19”
Authors: Gao Zhen , Lu Linwei , Bian Qin , Wu Jinfeng , Liu Feng , Le Jingjing , Wang Wenqian , Wang Shiyuan , Deng Xiaohong , Mohammadtursun Nabijan , Qin Jingjing , Zhu Xueyi , Dong Jingcheng
Published: September 2020

Based on the naming of diseases in the history and the nomenclature of diseases, especially that of novel human infectious diseases, in traditional Chinese medicine (TCM) and modern medicine, we put forward the following suggestions for the naming and severity classification of “coronavirus disease 2019 (COVID-19)”: (1) Patients with only nucleic acids positive or nucleic acid positive as well as some of the symptoms but without any evidence of pneumonia should be diagnosed more generally such as “Novel coronavirus respiratory infection (NCRI)” or “Novel coronavirus infection (NCI)”. (2) The manifestations concerning pneumonia can be used as the main basis for the classification of the severity of the disease. For instance, those with only nucleic acids positive or nucleic acid positive as well as mild symptoms are mild, those with nucleic acid positive as well as symptoms like fever and cough are moderate, those with nucleic acid positive as well as pneumonia are severe, those with severe symptoms as well as respiratory failure and multiple organ damage are critical. (3) Also, those with infections and clinical manifestations but no pneumonia can be called simple type, and those with pneumonia can be called pneumonia type. (4) Under the current background of integrative medicine, the naming of newly emerging infectious diseases by TCM should be changed from an ambiguous concept to a clearly defined one. It may define the disease according to the etiology, pathogenesis, clinical manifestation or prognosis of the disease, redefine the original concept in TCM and discard the excessively broad part, or carry out the common naming between TCM and modern medicine based on the specific pathogen. (5) According to the nomenclature of diseases in TCM plus that in modern medicine, the NCI may be named “Jihai (2019) — Pestilence” (Ji Hài (2019) — Yì Lì) in TCM.
When to Stop Reviewing in Technology-Assisted Reviews
Authors: Li Dan , Kanoulas Evangelos
Published: September 2020

Technology-Assisted Reviews (TAR) aim to expedite document reviewing (e.g., medical articles or legal documents) by iteratively incorporating machine learning algorithms and human feedback on document relevance. Continuous Active Learning (CAL) algorithms have demonstrated superior performance compared to other methods in efficiently identifying relevant documents. One of the key challenges for CAL algorithms is deciding when to stop displaying documents to reviewers. Existing work either lacks transparency—it provides an ad-hoc stopping point, without indicating how many relevant documents are still not found, or lacks efficiency by paying an extra cost to estimate the total number of relevant documents in the collection prior to the actual review.

In this article, we handle the problem of deciding the stopping point of TAR under the continuous active learning framework by jointly training a ranking model to rank documents, and by conducting a “greedy” sampling to estimate the total number of relevant documents in the collection. We prove the unbiasedness of the proposed estimators under a with-replacement sampling design, while experimental results demonstrate that the proposed approach, similar to CAL, effectively retrieves relevant documents; but it also provides a transparent, accurate, and effective stopping point.
BoostMeUp
Authors: Costa Jean , Guimbretière François , Jung Malte F. , Khalid Choudhury Tanzeem
Published: September 2020

In recent years, there has been a surge of interest in mobile applications and devices for emotion regulation. Examples include biofeedback devices and mobile applications that help users manage their stress [1][2]. These technologies are often designed to help users reflect on their past or current emotions or prompt users to perform specific tasks (e.g., deep breathing exercises). Despite the utility of these solutions, users are often unable to use them while performing certain tasks, such as during a job interview or public speech, since the technologies often require users to shift their attention away.
VoltJockey
Authors: Qui Pengfei , Wang Dongsheng , Lyu Yongqiang , Qu Gang
Published: September 2020

Based on the concept of hardware separation, ARM introduced TrustZone to build a trusted execution environment for applications. It has been quite successful in defending against various software attacks and forcing attackers to explore vulnerabilities in interface designs and side channels. In this article, we propose an innovative software-controlled hardware fault-based attack, VoltJockey, on multi-core processors that adopt dynamic voltage and frequency scaling (DVFS) techniques for energy efficiency. We deliberately manipulate the processor voltage via DVFS to induce hardware faults into the victim cores, and therefore breaking TrustZone. The entire attack process is based on software without any involvement of hardware, which makes VoltJockey stealthy and hard to prevent.
PHLPPing the Script: Emerging Roles of PHLPP Phosphatases in Cell Signaling
Authors: Baffi Timothy R. , Cohen-Katsenelson Ksenya , Newton Alexandra C.
Published: September 2020

Whereas protein kinases have been successfully targeted for a variety of diseases, protein phosphatases remain an underutilized therapeutic target, in part because of incomplete characterization of their effects on signaling networks. The pleckstrin homology domain leucine-rich repeat protein phosphatase (PHLPP) is a relatively new player in the cell signaling field, and new roles in controlling the balance among cell survival, proliferation, and apoptosis are being increasingly identified. Originally characterized for its tumor-suppressive function in deactivating the prosurvival kinase Akt, PHLPP may have an opposing role in promoting survival, as recent evidence suggests. Additionally, identification of the transcription factor STAT1 as a substrate unveils a role for PHLPP as a critical mediator of transcriptional programs in cancer and the inflammatory response. This review summarizes the current knowledge of PHLPP as both a tumor suppressor and an oncogene and highlights emerging functions in regulating gene expression and the immune system. Understanding the context-dependent functions of PHLPP is essential for appropriate therapeutic intervention.
Communication—Identifying and Managing Reversible Capacity Losses that Falsify Cycle Ageing Tests of Lithium-Ion Cells
Authors: Burrell Robert , Zulke Alana , Keil Peter , Hoster Harry
Published: September 2020

We report on a cycle ageing study of commercial NCA/Gr+Si cells, in which reversible capacity fluctuations turn a central experimental finding upside down: an upper voltage limit of 4.1 V seems to cause faster degradation than going all the way to 4.2 V. The underlying effect is the reversible loss of lithium inventory into passive anode overhang areas. We demonstrate how the resulting artefact arises from a combination of slow transport processes and the related time periods spent in specific state-of-charge regions. We propose an alternative visualisation tool to identify and manage such artefacts, often neglected in typical ageing studies.
Assessment of Job Satisfaction Level and Its Associated Factors among Health Workers in Addis Ababa Health Centers: A Cross-Sectional Study
Authors: Aklilu Mesfin , Warku Waleleng , Tadele Wogayehu , Mulugeta Yimer , Usman Hussene , Alemu Amelework , Abdela Sintayehu , Hailemariam Alemnesh , Birhanu Endalkachew , La Torre Giuseppe
Published: September 2020

Health workers account for the largest share of public expenditures on health and play an important role in improving the quality of health services. There is concern that poor health worker performance limits the effectiveness of health systems strengthening efforts. A cross-sectional study was conducted from September to October 2016 in Addis Ababa health centers. Data were collected from 420 healthcare workers using a pretested and structured questionnaire by trained data collectors. EPI Info 7 was used for data entry, and analysis was done by SPSS version 20. Bivariate and multivariate logistic analyses were used to identify factors associated with the outcome variable and to control confounders.

P

values less than 0.05 were considered statistically significant. The overall job satisfaction level accounts for 53.8% with 95% CI of (48.9%, 59.0%). Marital status and professional qualification were the potent predictors of job satisfaction. Respondents who never married were 1.65 times more likely to be satisfied in their job than those married or divorced (AOR: 1.65 (95% CI: 1.02, 2.66)). Laboratory professionals and nursing professionals were 2.74 and 1.97 times more likely to be satisfied in their job compared to health officers (AOR: 2.47 (95% CI: 1.14, 6.59) and AOR: 1.97 (95% CI: 1.12, 3.48), respectively). More than half of the healthcare workers in the study area were satisfied in their job. Marital status and healthcare workers’ profession type were predictors of job satisfaction. Research studies indicate that there is a positive relationship between performance and job satisfaction. Accordingly, the present study aimed at determining the level of job satisfaction of health workers and its associated factors in the health centers of Addis Ababa, Ethiopia.
Dietary Addition of Antioxidant Complex Packs and Functional Amino Acids Can Improve the Digestion, Absorption, and Immunity of Huanjiang Minipigs
Authors: Cui Zhijuan , Tan Bie , Liao Simeng , Qi Ming , Wang Xianze , Zha Andong , Kong Xiangfeng , Chen Yuguang , Liao Peng
Published: September 2020

To study the effect of functional amino acids and the antioxidant function compound package on Huanjiang minipigs and to lay a foundation for the formulation of green and efficient feed for Huanjiang minipigs, we added functional amino acids and the antioxidant function compound package to piglet feed for 28 days. After feeding, we detected the growth performance, biochemical indexes, inflammatory indexes, and intestinal disaccharidase of piglets. It was found that functional amino acids and the antioxidant compound package had certain effects on the growth performance and biochemical indexes of piglets and could reduce the level of IL‐6 and increase the level of LZM and SIgA of piglets, and the levels of lactase and maltase in the intestine also increased significantly. The results showed that the compound package of functional amino acids and antioxidation could improve the growth performance and immunity of piglets and promote the digestion and absorption of nutrients in piglets.
Evaluation of Multimodal Transport in China Based on Hesitation Fuzzy Multiattribute Decision-Making
Authors: Han Bing , Wan Min , Zhou Yu , Su Yi
Published: September 2020

Intermodal transportation, as an efficient form of transport organization, is a key technology and means for the logistics industry to balance transport costs and efficiency. How to deeply analyze the key factors constraining the level of development of multimodal transportation in China, building multimodal transportation development evaluation index system and evaluation model, evaluating comprehensively the multimodal transportation development level in China, and putting forward targeted countermeasures is of great practical significance. Based on the hesitant fuzzy multiattribute decision-making method, this paper analyzes the key factors influencing the level of multimodal transportation development from the perspective of sea-rail intermodal transport and further uses the interval number discretization and likelihood deviation maximization multiattribute decision-making method to construct a mixed-data index evaluation model, which is combined with data from 11 provinces (cities) in China. The study shows that there is a big gap among different provinces (cities) in China concerning the level of multimodal transportation development. Besides, the volume of intermodal container transportation and railway mileage are the core factors affecting the level of multimodal transportation development, and the results of the evaluation model can objectively reflect the level of multimodal transportation development and problems in each province (city). The research results further enrich the theoretical system of intermodal transportation development and provide a reference for the relevant management departments in formulating intermodal transportation plans and policies by putting forward pertinent suggestions in the field of management. In the future, the research direction should include the ecological environment, economic benefits, and other indicators into the evaluation system, expand the research scope of the modes of combined transportation such as public rail transport and public air transport, and improve the applicable scope of the evaluation model and the evaluation capability of specific scenarios.
Identification of ATP8B1 as a Tumor Suppressor Gene for Colorectal Cancer and Its Involvement in Phospholipid Homeostasis
Authors: Deng Li , Niu Geng-Ming , Ren Jun , Ke Chong-Wei
Published: September 2020

Homeostasis of membrane phospholipids plays an important role in cell oncogenesis and cancer progression. The flippase ATPase class I type 8b member 1 (ATP8B1), one of the P4‐ATPases, translocates specific phospholipids from the exoplasmic to the cytoplasmic leaflet of membranes. ATP8B1 is critical for maintaining the epithelium membrane stability and polarity. However, the prognostic values of ATP8B1 in colorectal cancer (CRC) patients remain unclear. We analyzed transcriptomics, genomics, and clinical data of CRC samples from The Cancer Genome Atlas (TCGA). ATP8B1 was the only potential biomarker of phospholipid transporters in CRC. Its prognostic value was also validated with the data from the Gene Expression Omnibus (GEO). Compared to the normal group, the expression of ATP8B1 was downregulated in the tumor group and the CRC cell lines, which declined with disease progression. The lower expression level of ATP8B1 was also significantly associated with worse survival outcomes in both the discovery samples (359 patients) and the validation samples (566 patients). In multivariate analyses, low ATP8B1 levels predicted unfavorable OS (adjusted HR 1.512, 95% CI: 1.069‐2.137; P = 0.019) and were associated with poor progress‐free interval (PFI) (adjusted HR: 1.62, 95% CI: 1.207‐2.174; P = 0.001). The pathway analysis results showed that the underexpression of ATP8B1 was negatively associated with phospholipid transport, phospholipid metabolic process, and cell‐cell adherent junction and positively associated with the epithelial‐mesenchymal transition in CRC. Our analysis suggests that ATP8B1 is a potential cancer suppressor in CRC patients and may offer new strategies for CRC therapy.
Elevated Circulating Fetuin-B Levels Are Associated with Insulin Resistance and Reduced by GLP-1RA in Newly Diagnosed PCOS Women
Authors: Mokou Mani , Yang Shan , Zhan Bin , Geng Shan , Li Kejia , Yang Mengliu , Yang Gangyi , Deng Wuquan , Liu Hua , Liu Dongfang , Zhu Zhiming , Li Ling , Caruso Calogero
Published: September 2020

Background. Previous studies have suggested that Fetuin-B seems to be a secreted adipokine related to metabolic diseases. However, the results have been inconsistent. Here, our objective is to investigate the changes in circulating Fetuin-B levels in women with polycystic ovary syndrome (PCOS) and analyze the association of Fetuin-B and insulin resistance (IR). Methods. The current study is comprised of a cross-sectional study and a series of interventional studies. Oral glucose tolerance test (OGTT) and euglycemic-hyperinsulinemic clamp (EHC) were engaged to assess glucose tolerance and insulin sensitivity. Serum Fetuin-B levels were determined by ELISA. Results. Serum Fetuin-B and TNF-α levels were markedly increased in women with PCOS compared to healthy women. Circulating Fetuin-B was positively associated with body mass index, waist-to-hip ratio, the percentage of body fat (FAT%), systolic blood pressure, triglyceride, low-density lipoprotein cholesterol, fasting blood glucose, 2 h blood glucose after glucose overload, fasting insulin, 2 h insulin after glucose overload, HOMA-insulin resistance index (HOMA-IR), the area under the curve for insulin (AUCi), AUCg, and TNF-α, while negatively associated with

M

value and follicular stimulating hormone (FSH). During the EHC, Fetuin-B levels were found to be significantly increased in PCOS women. After a glucose challenge, serum Fetuin-B levels in healthy women were significantly increased. Lipid infusion reduced serum Fetuin-B levels in 30 healthy subjects. After six months of glucagon-like peptide-1 receptor agonist (GLP-1RA) intervention, serum Fetuin-B concentrations in PCOS women markedly decreased following ameliorated IR. Conclusion. Our results indicate that Fetuin-B may be a biomarker of IR in individuals with PCOS. This trial is registered with ChiCTR-IIR-16007901.
Alterations of the Bile Microbiome in Recurrent Common Bile Duct Stone
Authors: Ye Cheng , Zhou Wence , Zhang Hui , Miao Long , Lv Gen
Published: September 2020

Objective. Common bile duct stone (CBDS) recurrence is associated with bile microbial structure. This study explored the structure of bile microbiome in patients with recurrent CBDS, and its relationship with the recurrence of CBDS. Methods. Patients with recurrent CBDS (recurrence group) and controls without CBDS (control group) requiring endoscopic retrograde cholangiopancreatography (ERCP) were prospectively included. The control group was noncholelithiasis patients, mainly including benign and malignant biliary stenosis. Bile samples were collected, and bile microbiome structure was analyzed by the 16S rRNA encoding gene (V3–V4). Results. A total of 27 patients in the recurrence group and 19 patients in the control group were included. The diversity of bile microbiome in the recurrence group was significantly lower than that in the control group (Shannon index: 2.285 vs. 5.612, P = 0.001). In terms of bile microbial distribution, patients with recurrent CBDS had significantly higher Proteobacteria (86.72% vs. 64.92%, P = 0.037), while Bacteroidetes (3.16% vs. 8.53%, P = 0.001) and Actinobacteria (0.29% vs. 6.74%, P = 0.001) are significantly lower compared with the control group at the phylum level. At the genus level, the recurrence group was mainly the Escherichia, and there was a variety of more evenly distributed microbiome in the control group, with significant differences between the two groups. Conclusion. The diversity of bile microbiome in patients with recurrent CBDS is lower. Patients with recurrent CBDS may have bile microbial imbalance, which may be related to the repeated formation of CBDS.
Solving Interval Quadratic Programming Problems by Using the Numerical Method and Swarm Algorithms
Authors: Elsisy M. A. , Hammad D. A. , El-Shorbagy M. A.
Published: September 2020

In this paper, we present a new approach which is based on using numerical solutions and swarm algorithms (SAs) to solve the interval quadratic programming problem (IQPP). We use numerical solutions for SA to improve its performance. Our approach replaced all intervals in IQPP by additional variables. This new form is called the modified quadratic programming problem (MQPP). The Karush–Kuhn–Tucker (KKT) conditions for MQPP are obtained and solved by the numerical method to get solutions. These solutions are functions in the additional variables. Also, they provide the boundaries of the basic variables which are used as a start point for SAs. Chaotic particle swarm optimization (CPSO) and chaotic firefly algorithm (CFA) are presented. In addition, we use the solution of dual MQPP to improve the behavior and as a stopping criterion for SAs. Finally, the comparison and relations between numerical solutions and SAs are shown in some well-known examples.
On Performance of Full-Duplex Decode-and-Forward Relay Systems with an Optimal Power Setting under the Impact of Hardware Impairments
Authors: Nguyen Ba Cao , Tran Xuan Nam , Nguyen Thi Thu Hang , Tran Dinh Tan , Darsena Donatella
Published: September 2020

In this paper, we analyze the performance of in-band full-duplex (IBFD) relay systems that use the decode-and-forward (DF) protocol at the relay under the impact of imperfect self-interference cancellation and hardware impairments. Three practical relay scenarios are considered in our analysis: (i) there is no direct link from the source to the destination; (ii) there is a direct link, but the signal from the source is considered interference; and (iii) there is a direct link, and the signal from the source is cooperatively combined with that from the relaying path. Specifically, we derive exact and asymptotic expressions for the outage probability (OP) of the IBFD system. Based on the OP, the exact expression for symbol error probability (SEP) is also derived. Moreover, in order to cope with the effect of imperfect self-interference cancellation (SIC) due to the full-duplex mode, we propose optimal and suboptimal power calculation methods for the relay to minimize the OP and SEP. A performance evaluation shows that the IBFD relay system is significantly affected by both imperfect SIC and hardware impairments. However, the optimal power values can help to improve the system performance, significantly.
Simulation and Analysis of the Complex Dynamic Behavior of Supply Chain Inventory System from Different Decision Perspectives
Authors: Zhang Zusheng , Wang Xu , Yang Shanshan , Wu Yingbo , Du Jianhui , Aguirre-Hernández Baltazar
Published: September 2020

Based on the local decision perspective and the global decision perspective, considering the limitation of supply capacity and prohibiting returns, the system dynamics method is used to establish a nonlinear supply chain system model. We use the Z-transform theory to transform the dynamic transfer equation into a block diagram, build a supply chain system simulation model, and use it to conduct simulation experiments. The Wolf reconstruction method is used to calculate the largest Lyapunov exponent (LLE) value of each node or combined system to judge the stability of the system. Based on different decision-making perspectives, under different combinations of safety stock factors and demand scenarios, the adjustment coefficients’ decision-making schemes that keep each node in a stable state are obtained. Then, we comparatively analyze the inventory changes of each node and combined system in a stable state under different decision-making schemes.
Synthesis of Amino Acid Schiff Base Nickel (II) Complexes as Potential Anticancer Drugs In Vitro
Authors: Li Yang , Dong Jianfang , Zhao Peiran , Hu Ping , Yang Dawei , Gao Lei , Li Lianzhi , Pettinari Claudio
Published: September 2020

Three hexacoordinated octahedral nickel (II) complexes, [Ni (Trp-sal) (phen) (CH3OH)] (1), [Ni (Trp-o-van) (phen) (CH3OH)]•2CH3OH (2), and [Ni (Trp-naph) (phen) (CH3OH)] (3) (where Trp-sal = Schiff base derived from tryptophan and salicylaldehyde, Trp-o-van = Schiff base derived from tryptophan and o-vanillin, Trp-naph = Schiff base derived from tryptophan and 2-hydroxy-1-naphthaldehyde, phen = 1, 10-phenanthroline), have been synthesized and characterized as potential anticancer agents. Details of structural study of these complexes using single-crystal X-ray crystallography showed that distorted octahedral environment around nickel (II) ion has been satisfied by three nitrogen atoms and three oxygen atoms. All these complexes displayed moderate cytotoxicity toward esophageal cancer cell line Eca-109 with the IC50 values of 23.95 ± 2.54 μM for 1, 18.14 ± 2.39 μM for 2, and 21.89 ± 3.19 μM for 3. Antitumor mechanism studies showed that complex 2 can increase the autophagy, reactive oxygen species (ROS) levels, and decrease the mitochondrial membrane potential remarkably in a dose-dependent manner in the Eca-109 cells. Complex 2 can cause cell cycle arrest in the G2/M phase. Additionally, complex 2 can regulate the Bcl-2 family and autophagy-related proteins.
Text Messaging-Based Medical Diagnosis Using Natural Language Processing and Fuzzy Logic
Authors: Omoregbe Nicholas A. I. , Ndaman Israel O. , Misra Sanjay , Abayomi-Alli Olusola O. , Damaševičius Robertas
Published: September 2020

The use of natural language processing (NLP) methods and their application to developing conversational systems for health diagnosis increases patients’ access to medical knowledge. In this study, a chatbot service was developed for the Covenant University Doctor (CUDoctor) telehealth system based on fuzzy logic rules and fuzzy inference. The service focuses on assessing the symptoms of tropical diseases in Nigeria. Telegram Bot Application Programming Interface (API) was used to create the interconnection between the chatbot and the system, while Twilio API was used for interconnectivity between the system and a short messaging service (SMS) subscriber. The service uses the knowledge base consisting of known facts on diseases and symptoms acquired from medical ontologies. A fuzzy support vector machine (SVM) is used to effectively predict the disease based on the symptoms inputted. The inputs of the users are recognized by NLP and are forwarded to the CUDoctor for decision support. Finally, a notification message displaying the end of the diagnosis process is sent to the user. The result is a medical diagnosis system which provides a personalized diagnosis utilizing self-input from users to effectively diagnose diseases. The usability of the developed system was evaluated using the system usability scale (SUS), yielding a mean SUS score of 80.4, which indicates the overall positive evaluation.
Endocarditis Complicated by Severe Aortic Insufficiency in a Patient with COVID-19: Diagnostic and Management Implications
Authors: Sanders David J. , Sutter Joanne S. , Tatooles Antone , Suboc Tisha M. , Rao Anupama K.
Published: September 2020

A 38-year-old man presented with cough, shortness of breath, and fatigue. He was diagnosed with Coronavirus Disease-2019 (COVID-19) as well as Enterococcus faecalis bacteremia. Imaging revealed a subaortic membrane with aortic valve endocarditis and severe aortic insufficiency. He had successful aortic valve replacement with a mechanical prosthesis and subaortic membrane resection. This case highlights some of the diagnostic and therapeutic challenges presented by COVID-19 pandemic.
Application of the Time Step Optimization Method in Seismic Liquefaction Analysis and Its Evaluation Method for Computational Efficiency Improvement
Authors: Li Qi , Li Bin , Sun Shaorui , Yang Nan , Rizzo Fabio
Published: September 2020

In order to solve the time step setting problem in seismic liquefaction numerical analysis, the time step optimization method was introduced into seismic liquefaction numerical analysis platform, and the seismic response of earth dam was analyzed. The results show that the time step optimization method can effectively solve the time step setting problem. In addition, in order to evaluate the computational efficiency improvement of the optimized seismic response, a new method was proposed, and an example with analytical solution was selected to verify it. And the proposed method was used to evaluate the calculation efficiency of the optimized seismic response. The results show that the computing efficiency is greatly improved after the seismic liquefaction numerical analysis program is optimized by the time step optimization method.
Metastatic Merkel Cell Carcinoma Masquerading as Multiple Immune-Related Adverse Events
Authors: Saqlain Farees , Shalhout Sophia Z. , Emerick Kevin S. , Neilan Tomas G. , Sharova Tatyana , Miller David Michael
Published: September 2020

Merkel cell carcinoma is a rare cutaneous neuroendocrine carcinoma with a high rate of regional and distant metastasis and mortality. Here, we report a novel case of Merkel cell carcinoma which presented as a primary lesion to the left cheek with regional lymph node involvement and was treated with pembrolizumab and radiation. Widely metastatic disease eventually revealed on autopsy clinically mimicked immune-related organ insult leading to management with immunosuppressants. The patient also had a biopsy-confirmed immune-related cutaneous adverse event during admission. The case highlights a rare circumstance in which disease progression masqueraded as multiple immune-related end-organ adverse events. Contribution of on-target anti-PD-1 toxicity remains a possibility.
Investigation of an Underwater Vectored Thruster Based on 3RPS Parallel Manipulator
Authors: Liu Tao , Hu Yuli , Xu Hui , El Ghami Mohamed
Published: September 2020

Autonomous underwater vehicles (AUVs) are important and useful tool platforms in exploring and utilizing ocean resource. However, the effect of control surfaces would decrease even invalid complete in this condition, and it is very hard for conventional AUVs to perform detailed missions at a low forward speed. Therefore, solving this problem of AUVs becomes particularly important to increase the application scope of AUVs. In this paper, we present a design scheme for the vectored thruster AUV based on 3RPS parallel manipulator, which is a kind of parallel manipulator and has advantages of compact structure and reliable performance. To study the performance and characteristics of the proposed thrust-vectoring mechanism, a series of works about corresponding kinematic and dynamic analysis have been performed through the theoretical analysis and numerical simulation. In the part of kinematics, the inverse, forward kinematics, and workspace analysis of the thrust-vectoring mechanism is presented, and the numerical simulations are accomplished to prove the feasibility and effectiveness of this design in AUVs. In order to further verify feasibility of the thrust-vectoring mechanism, based on the considerations of various affecting factors, a dynamic model of the designed thrust-vectoring mechanism is established according to theoretical analysis, and the driving forces of the linear actuator are presented through a series of numerical simulations. In addition, a control scheme based on PID algorithm is proposed for the designed vectored thruster with considering various affecting factors and the application environment. Meanwhile, the control scheme is also established and verified in MATLAB Simscape Mutibody. A series of numerical simulations of the thrust-vectoring mechanism prove the feasibility of the vectored thruster. According to equipping the designed vectored thruster, the AUVs can overcome the limit of weakening the control ability at zero or low forward speeds, and this improvement also expands the application of it, which has been scaled greatly.
Persistent Poverty and Cancer Mortality Rates: An Analysis of County-Level Poverty Designations
Authors: Moss Jennifer L. , Pinto Casey N. , Srinivasan Shobha , Cronin Kathleen A. , Croyle Robert T.
Published: September 2020

Background:

Cancer mortality is higher in counties with high levels of (current) poverty, but less is known about associations with persistent poverty. Persistent poverty counties (with ≥20% of residents in poverty since 1980) face social, structural, and behavioral challenges that may make their residents more vulnerable to cancer.

Methods:

We calculated 2007 to 2011 county-level, age-adjusted, and overall and type-specific cancer mortality rates (deaths/100,000 people/year) by persistent poverty classifications, which we contrasted with mortality in counties experiencing current poverty (≥20% of residents in poverty according to 2007–2011 American Community Survey). We used two-sample t tests and multivariate linear regression to assess mortality by persistent poverty, and compared mortality rates across current and persistent poverty levels.

Results:

Overall cancer mortality was 179.3 [standard error (SE) = 0.55] deaths/100,000 people/year in nonpersistent poverty counties and 201.3 (SE = 1.80) in persistent poverty counties (12.3% higher, P < 0.0001). In multivariate analysis, cancer mortality was higher in persistent poverty versus nonpersistent poverty counties for overall cancer mortality as well as for several type-specific mortality rates: lung and bronchus, colorectal, stomach, and liver and intrahepatic bile duct (all P < 0.05). Among counties experiencing current poverty, those counties that were also experiencing persistent poverty had elevated mortality rates for all cancer types as well as lung and bronchus, colorectal, breast, stomach, and liver and intrahepatic bile duct (all P < 0.05).

Conclusions:

Cancer mortality was higher in persistent poverty counties than other counties, including those experiencing current poverty.

Impact:

Etiologic research and interventions, including policies, are needed to address multilevel determinants of cancer disparities in persistent poverty counties.
Tumor Cell–Derived TGFβ1 Attenuates Antitumor Immune Activity of T Cells via Regulation of PD-1 mRNA
Authors: Wu Pengfei , Geng Bo , Chen Qun , Zhao Enyang , Liu Jiang , Sun Chen , Zha Caijun , Shao Yong , You Bosen , Zhang Wenfu , Li Lulu , Meng Xiangqi , Cai Jinquan , Li Xuedong
Published: September 2020

Dysfunction in T-cell antitumor activity contributes to the tumorigenesis, progression, and poor outcome of clear cell renal cell carcinoma (ccRCC), with this dysfunction resulting from high expression of programmed cell death-1 (PD-1) in T cells. However, the molecular mechanisms maintaining high PD-1 expression in T cells have not been fully investigated in ccRCC. Here, we describe a mechanism underlying the regulation of PD-1 at the mRNA level and demonstrated its impact on T-cell dysfunction. Transcriptomic analysis identified a correlation between TGFβ1 and PD-1 mRNA levels in ccRCC samples. The mechanism underlying the regulation of PD-1 mRNA was then investigated in vitro and in vivo using syngeneic tumor models. We also observed that TGFβ1 had prognostic significance in patients with ccRCC, and its expression was associated with PD-1 mRNA expression. CcRCC-derived TGFβ1 activated P38 and induced the phosphorylation of Ser10 on H3, which recruited p65 to increase SRSF3 and SRSF5 expression in T cells. As a result, the half-life of PD-1 mRNA in T cells was prolonged. SRSF3 coordinated with NXF1 to induce PD-1 mRNA extranuclear transport in T cells. We then demonstrated that TGFβ1 could induce SRSF3 expression to restrict the antitumor activity of T cells, which influenced immunotherapy outcomes in ccRCC mouse models. Our findings highlight that tumor-derived TGFβ1 mediates immune evasion and has potential as a prognostic biomarker and therapeutic target in ccRCC.

See related Spotlight on p. 1464
Serum Prealbumin and Echocardiography Parameters Predict Mortality in Peritoneal Dialysis Patients
Authors: Ye Min , Li Jianbo , Liu Yanqiu , He Wei , Lin Hong , Fan Rui , Li Cuiling , Li Wei , Zhang Jingwei , Huang Huiling , Yao Fengjuan
Published: September 2020

Aim: Protein-energy malnutrition and cardiovascular (CV) disease predisposes patients with end-stage renal disease (ESRD) on dialysis to a high risk of early death, but the prognostic value of prealbumin (PAB) and echocardiographic indices in ESRD patients treated with maintenance peritoneal dialysis (PD) remains unclear. Methods: A total of 211 PD patients (mean age 49.2 ± 15.4 years, 51.7% male) were prospectively studied. PAB and echocardiography parameters were recorded at baseline. Follow-up (mean ± SD: 33.7 ± 17.3 months) was conducted based on hospital records, clinic visits, and telephone reviews, to record death events and their causes. Results: In the Cox proportional hazards model, PAB and the echocardiographic parameters listed below were found to be optimal predictors of all-cause mortality: PAB (p = 0.003), aortic root diameter (ARD) (p = 0.004), interventricular septum end-diastolic thickness (IVSd) (p = 0.046), and left ventricular end-diastolic diameter index (LVEDDI) (p = 0.029). Of the above-mentioned factors, PAB (p = 0.018), ARD (p = 0.031), and IVSd (p = 0.037) were independent predictors of CV mortality in PD patients. Of note, malnutrition, degradation of the aorta, and myocardial hypertrophy are also known death risk factors in the general population. The all-cause mortality and CV death rate significantly increased as the number of risk factors increased, reaching values as high as 40 and 22% in patients who had all of the risk factors, i.e., abnormal PAB, ARD, and IVSd (p < 0.001 and p = 0.011). Conclusion: In PD patients, low serum PAB and abnormal echocardiographic parameters together were significantly associated with all-cause mortality and CV death, independently of other risk factors. These risk factors for death in PD are similar to those in the general population. Noticeably, the combination of echocardiographic parameters and PAB could provide additional predictive value for mortality in PD patients. In light of these findings, more studies in an optimal model containing PAB and echocardiographic parameters for the prediction of outcomes in ESRD are required.
A Prospective Single-Blind Randomized Trial of Ramipril, Eplerenone and Their Combination in Type 2 Diabetic Nephropathy
Authors: El Mokadem Mostafa , Abd El Hady Yasser , Aziz Ashraf
Published: September 2020

Introduction: Angiotensin-converting enzyme inhibitors (ACEI) combined with mineralocorticoid receptor antagonists were found to have a beneficial effect on patients with chronic kidney disease. Objective: The aim of our clinical trial was to compare the antialbuminuric effect of ramipril monotherapy, eplerenone monotherapy and eplerenone/ramipril combination therapy in patients with stage 1 hypertension and type 2 diabetes mellitus. Methods: In a single-blind, randomized clinical trial, 75 hypertensive patients (stage 1 hypertension) with type 2 diabetes mellitus and microalbuminuria were randomized in a 1:1:1 ratio to 1 of 3 groups: ramipril 10 mg monotherapy (25 patients), eplerenone 50 mg monotherapy (25 patients) and combination therapy of eplerenone/ramipril 50/10 mg (25 patients) through a randomized clinical trial. Blood pressure, urinary albumin/creatinine ratio (UACR), serum creatinine, estimated glomerular filtration rate (eGFR) and serum K level were measured before randomization and after 24 weeks. Results: Ramipril and eplerenone monotherapy showed a significant lowering of UACR compared with baseline levels (p ≤ 0.0001). The eplerenone/ramipril combination group showed a more significant reduction of UACR compared with the ramipril and eplerenone monotherapy groups (p = 0.0001). There was a more significant lowering of systolic blood pressure in the combination group (p < 0.0001). A nonsignificant change of serum potassium level, serum creatinine and eGFR was found among the 3 groups. Conclusion: Addition of eplerenone to ACEI shows an added antialbuminuric effect without significant change of the serum K level compared with eplerenone or ACEI.
The Effect of a Persian Medicine Massage (Dalk and Ghamz) on Neck Pain and Disability in Nonspecific Chronic Neck Pain
Authors: Mohammadi-Kenari Hoorieh , Khoramizadeh Mansour , Forogh Bijan , Hashem-Dabaghian Fataneh
Published: September 2020

Background: This study was conducted to investigate the effect of Dalk and Ghamz on pain and disability in patients with nonspecific chronic neck pain. Patients and Methods: This study was conducted on 37 patients with nonspecific chronic neck pain. Dalk and Ghamz massage were performed once a week for four sessions and the neck pain was evaluated by visual analog scale (VAS). In addition, the neck disability index (NDI) was used to assess the disability related to neck disorder. Data were analyzed with the SPSS software. Results: Among 37 patients, 85.5% were female and 13.5% were male. A significant decrease in VAS score was observed during the study (F = 57.77, p < 0.001). The NDI score decreased from 27.27 ± 5.83 to 19.08 ± 7.71 (p < 0.001). Conclusion: Dalk and Ghamz massage in patients with nonspecific neck pain could reduce pain and disability.
Against Scientism: Corrupted Science and the Fight for Medicine’s Soul
Authors: Milgrom Lionel R.
Published: September 2020

This article maintains that via the current form of evidence-based medicine, scientism (a pseudo-religious belief in science that is itself not scientific) has been allowed to encroach into medicine. By setting out the philosophical limits of what it is science can do, the effects of this encroachment are discussed in terms of upsetting the balance between the necessarily conflicting art AND science of medicine. In this context, one effect of the Covid-19 pandemic might be to act as a timely reminder – as if it was needed – of the importance of the Hippocratic Oath, which is and always has been the soul of medicine.
Predictive Value of FMO3 Variants on Plasma Disposition and Adverse Reactions of Oral Voriconazole in Febrile Neutropenia
Authors: Wang Xiaokang , Zhao Jingjing , Wen Ting , Liao Xueyi , Luo Bin
Published: September 2020

Background and Objectives: With the increasing number of patients with febrile neutropenia (FN), voriconazole (VRC) has been widely used in hospitals for first-line treatment of FN. The study was designed for evaluating the influence of FMO3 mutation on the plasma disposition and adverse reactions of VRC in FN. Materials and Methods: A single-center observational study was conducted in the inpatient ward for 4 years. The genotypes of FMO3 and cytochrome P450 (CYP) 2C19 were detected by PCR-restriction fragment length polymorphism. Patients with neutropenia were screened according to the CYP2C19 metabolic phenotype and other inclusion criteria. Five days after empirical administration of VRC, blood concentrations of VRC and nitrogen oxides in patients’ blood were determined by liquid chromatography-electrospray tandem mass spectrometry (LC-ESI MS/MS). Serum parameters and clinical adverse reaction symptoms in the medical records were collected and statistically analyzed. Results: A total of 165 patients with neutropenia with the intermediate metabolic phenotype of CYP2C19 were screened. At the initial stage of oral VRC treatment, patients with the FMO3 E308G genotype had a poorer plasma disposal ability to VRC than those with the wide type of FMO3 (WT) genotype (p = 0.0005). Moreover, patients with the FMO3 E308G genotype were more likely to have adverse drug reactions and abnormal serum parameters after receiving VRC treatment. For example, the serum potassium level in the FMO3 E308G genotype group was significantly lower than that in the WT group (p = 0.028), the abnormal level of total bilirubin in the FMO3 E308G genotype group was significantly higher than that in the WT group (p = 0.049), and the aspartate aminotransferase level in the E308G group was significantly higher than that in the WT group (p = 0.05). The incidence of atopic dermatitis and visual impairment in the FMO3 E308G genotype group was 67 and 75%, respectively, and the incidences of peripheral neuroedema, headache, and diarrhea were 57, 50, and 60%, respectively, which were significantly different from those in the WT group. Conclusion: FMO3 E308G reduces the activity of the FMO3 enzyme by decreasing the metabolic ability of VRC, which increases the plasma concentration of VRC and may also lead to adverse reactions in patients with FN.