bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis and Design of the Accessory Structure under the Large Deformation of a Flexible Roof
Authors: Zhang Shi-chang , Xu Xiao-ming , Gao Feng , Huang Peng , Luo Bin , Shi Wei-zhou , Fang Qing
Published: September 2022

An increasing number of large‐span space structures use flexible roofs to achieve a light and splendid architectural effect. When a flexible structural system such as a cable net is applied in a large‐span stadium, the roof will deform significantly under the self‐weight and wind load. Accessory structures of the roof such as catwalks, radial drainage pipes, circular drainage channels, and radial cable trenches need to cooperate with the large deformation of the roof to prevent damage caused by the large deformation of the roof. To thoroughly unveil the analysis and design method of an accessory structure, this paper first carried out the wind tunnel test to determine the wind load of the structure. Then, the gust response factors of each roof area and the dynamic amplification coefficient of the accessory structure considering the roof vibration were determined. Next, circular and radial catwalks were designed based on static analysis. A sliding joint was set in the accessory structure to adapt to the large deformation of the roof. Finally, a time history analysis of the catwalk was carried out to obtain the maximum deformation value of the sliding joint for the safety of the structure. The results demonstrate that the maximum deformation is less than the value given by the design and meets the specification.
EGCG Enhances the Chemosensitivity of Colorectal Cancer to Irinotecan through GRP78-MediatedEndoplasmic Reticulum Stress
Authors: Wu Wenbing , Gou Hui , Xiang Bin , Geng Ruiman , Dong Jingying , Yang Xiaolong , Chen Dan , Dai Rongyang , Chen Lihong , Liu Ji
Published: September 2022

This study aimed to explore the role of GRP78-mediated endoplasmic reticulum stress (ERS) in the synergistic inhibition of colorectal cancer by epigallocatechin-3-gallate (EGCG) and irinotecan (IRI). Findings showed that EGCG alone or in combination with irinotecan can significantly promote intracellular GRP78 protein expression, reduce mitochondrial membrane potential and intracellular ROS in RKO and HCT 116 cells, and induce cell apoptosis. In addition, glucose regulatory protein 78 kDa (GRP78) is significantly over-expressed in both colorectal cancer (CRC) tumor specimens and mouse xenografts. The inhibition of GRP78 by small interfering RNA led to the decrease of the sensitivity of CRC cells to the drug combination, while the overexpression of it by plasmid significantly increased the apoptosis of cells after the drug combination. The experimental results in the mouse xenografts model showed that the combination of EGCG and irinotecan could inhibit the growth of subcutaneous tumors of HCT116 cells better than the two drugs alone. EGCG can induce GRP78-mediated endoplasmic reticulum stress and enhance the chemo-sensitivity of colorectal cancer cells when coadministered with irinotecan.
Was It an Adrenocortical Adenoma or an Adrenocortical Carcinoma? Limitation of the Weiss Scoring System in Determining the Malignant Potential of Adrenocortical Tumor: Report on Two Cases
Authors: Wong Cheuk-Lik , Fok Chun-Kit , Chan Yuk-Kit , Tam Vicki Ho-Kee , Fung Lai-Ming
Published: September 2022

Background. Adrenocortical carcinoma (ACC) is a rare endocrine malignancy. An accurate diagnosis of ACC is of paramount importance as it greatly impacts the management and prognosis of a patient. However, the differentiation between early stage, low-grade ACC and adrenocortical adenoma (ACA) may not always be straightforward. The recommended classification system, namely, the Weiss scoring system, is not without flaws. We herein report two cases of ACC which were initially diagnosed as ACA according to the Weiss scoring system but developed distant metastases in subsequent years. Case Presentation. Case 1: A 60-year-old Chinese woman presented with a recent onset of worsening of blood pressure control and clinical features of Cushing’s syndrome. Investigations confirmed ACTH-independent endogenous hypercortisolism, and a CT abdomen showed a 6 cm right adrenal mass. Twenty-four-hour urine steroid profiling revealed co-secretion of adrenal androgens and atypical steroid metabolites. Laparoscopic right adrenalectomy was performed, and pathology of the tumor was classified as an ACA by the Weiss scoring system. Four years later, the patient presented with an abrupt onset of severe hypercortisolism and was found to have a metastatic recurrence in the liver and peritoneum. The patient received a combination of mitotane, systemic chemotherapy, and palliative debulking surgery and succumbed 8.5 years after the initial presentation due to respiratory failure with extensive pulmonary metastases. Case 2: A 68-year-old Chinese woman presented with acute bilateral pulmonary embolism and was found to have a 3 cm left adrenal mass. Hormonal workup confirmed ACTH-independent endogenous hypercortisolism, and laparoscopic left adrenalectomy revealed an ACA according to the Weiss scoring system. Five years later, she presented with recurrent hypercortisolism due to hepatic and peritoneal metastases. The patient had progressive disease despite mitotane therapy and succumbed 7 years after initial presentation. Conclusions. Although the Weiss scoring system is recommended as the reference pathological classification system to diagnose adrenocortical carcinoma, there remain tumors of borderline malignant potential which may escape accurate classification. Various alternative classification systems and algorithms exist but none are proven to be perfect. Clinicians should recognize the potential limitation of these histological criteria and scoring systems and incorporate other clinical parameters, such as the pattern of hormonal secretion, urinary steroid profiling, and radiographic features, to improve the prognostication and surveillance strategy of these tumors.
Experimental Study on Warm Permafrost Dynamic Characteristics under Cyclic Loading in the Cold Region
Authors: Song Liwei , Liu Junfang , Jin Yan , Li Chi , Cai Songbao
Published: September 2022

With the rapid development of infrastructure construction, some places have to face the problem of highway foundation disease, especially for the highway built on warm permafrost in cold region. In order to analyze the influence of confining pressure and vehicle load to the warm permafrost, the dynamic triaxial tests were conducted on the frozen soil extracted from highway in Yakeshi City. While the load frequency is 6 Hz and the test temperature is −1.5°C, we changed the confining pressure and axial stress amplitude, respectively, and then gained the deviator stress‐strain curves. The test results show that the shape of deviator stress‐strain curve is related to the deviator stress amplitude. When σ3 = 25 kPa and |σ1−σ3|max = 75 kPa, the hysteretic loops approximately appear rectangular and the dynamic modulus increases with loading time increasing for the compression effect. The specimen did not fail when the test stopped, and its hysteretic loop is stable. When σ3 = 20 kPa and |σ1−σ3|max = 100 kPa, the hysteretic loops become smoother and appear oval. The test stopped while the axial strain reached 5% after loading 1279 times, and the dynamic modulus decreases with loading time increasing. When σ3 = 30 kPa and |σ1−σ3|max = 115 kPa, the test stopped just after the 154th loop, and the hysteretic loop area linearly decreased with increasing loading time. The research conclusions in this article have numerous reference values for the highway design, construction, and operation built on the warm permafrost.
Multiple Differential Distinguisher of SIMECK32/64 Based on Deep Learning
Authors: Wang Huijiao , Tian Jiapeng , Zhang Xin , Wei Yongzhuang , Jiang Hua
Published: September 2022

Currently, deep learning has provided an important means to solve problems in various fields. Intelligent computing will bring a new solution to the security analysis of lightweight block cipher as its analysis becomes more and more intelligent and automatic. In this study, the novel multiple differential distinguishers of round-reduced SIMECK32/64 based on deep learning are proposed. Two kinds of SIMECK32/64’s 6–11 rounds deep learning distinguishers are designed by using the neural network to simulate the case of the multiple input differences and multiple output differences in multiple differential cryptanalysis. The general models of the two distinguishers and the neural network structures are presented. The random multiple ciphertext pairs and the associated multiple ciphertext pairs are exploited as the input of the model. The generation method of the data set is given. The performance of the two proposed distinguishers is compared. The experimental results confirm that the proposed distinguishers have higher accuracy and rounds than the distinguisher with a single difference. The relationship between the quantity of multiple differences and the performance of the distinguishers is also verified. The differential distinguisher based on deep learning needs less time complexity and data complexity than the traditional distinguisher. The accuracy of filtering error ciphertext of our 8-round neural distinguisher is up to 96.10%.
A Study of Occupational Therapy Strategies and Psychological Regulation of Students’ Internet Addiction in the Mobile Social Media Environment
Authors: Zhang Xueqin
Published: September 2022

This paper provides an in-depth research analysis of occupational therapy strategies and psychological regulation of students’ Internet addiction in the existing mobile social media environment. Based on the definition of Internet use peer pressure, a preliminary scale with 2 dimensions of specific behavioral pressure and psychological cognitive pressure was developed. First, a professor of mental health education and a master’s degree student in mental health education were invited to rate the scale, while 47 junior high school students were selected to try the scale to ensure that the questions of the scale were clearly expressed. Secondly, 461 subjects were selected to take the initial test of the scale, and item tests and exploratory factor analysis were conducted to ensure that the structure of the scale was as expected and the scale was expressed to psychometric standards. Finally, 810 subjects were selected for the scale retest, and item analysis and validated factor analysis were conducted, and their results met the psychometric criteria. Student peer attachment significantly and positively predicted adolescent Internet addiction; Internet use peer pressure played an incomplete mediating role in the prediction of peer attachment to Internet addiction; loneliness played a moderating role in the pathway of peer attachment to Internet addiction, and loneliness also played a moderating role in the pathway of peer attachment to Internet use peer pressure. The attitude towards online games is entertainment to kill time, a tool to escape the pressure of study and to gain the fun of friends comparing with each other. The main online motivations of adolescents included individual and situational factors, and behaviors were characterized by pan-entertainment and gamification, mainly through mobile social networks to obtain external information and knowledge, maintain interpersonal relationships, and gain a sense of belonging; they were characterized by a fixation on time, space, and online content. The interaction of family members is more of a behavioral habit, and the communication habits and behavior patterns established in the family will influence the construction of children’s relationships with others, while parents’ head-down behavior will also influence children’s attention to various needs of an Internet-dependent behavior problem, which in turn affects children’s problem-solving and intimate relationships with family members.
Effects of Sports Functional Food on Physical Function of Athletes under Ultrasound Observation
Authors: Cheng Zhao , Lin Hong , Zhou Zhenmao
Published: September 2022

In order to improve the physical function of athletes under hypoxic training, the authors propose to observe the effect of functional food with active ingredients of polypeptide polyamines in deer antler on the physical function of athletes under ultrasound observation. According to the characteristics of physiological changes during hypoxic training, functional foods containing the active ingredients of polypeptide polyamines in deer antler were selected and given to athletes under simulated hypoxic training, observe the changes of red blood cells (RBC), hemoglobin (Hb), hematocrit (Hct), blood lactic acid, free radical metabolism and immune function of athletes, and musculoskeletal under ultrasound observation, discuss how to improve the physical function and athletic ability of athletes under hypoxic training. Experimental results show that athletes after 6 weeks of hypoxic training, red blood cells and hemoglobin were significantly increased, there was a significant difference compared to the control group (

P
<
0.05

or

P
<
0.01

). After 6 weeks of hypoxic training, hemoglobin increased by 10.1%, a 5.6 percentage point increase compared to the control group. Conclusion. The antler peptides used by the authors can enhance the effect of hypoxic training.
The Modality Density of Pragmatic Apology in L2
Authors: Li Dongyan , Liu Chunbo
Published: September 2022

In this study, multimodal interaction analysis is used to analyze the apology act of two Chinese EFL learners and two Bangladeshi EFL learners in face-to-face interaction through task-role-playing via the multimodal software Elan. The radar figures are also drawn to show the similarities and differences of the modal density of six different modal resources: gesture, head movement, gaze, facial expression, posture, and utterances. It is found that the intensity of the gaze modality used by the four participants is higher with the gaze modality and utterance modality occupying the central position in the sequence of the apology act. Chinese learners of English and Bangladeshi learners of English achieve the highest values as regards the intensity of each mode in explanatory strategy and repair strategy, respectively. It indicates that they attach importance to different apology strategies. Chinese EFL learners, by contrast, have low modal complexity, suggesting that they do not engage in complex actions, but still use verbal and nonverbal modes together to build the ongoing meaning of conversations. As is indicated, pragmatic competence is the ability of language users to communicate properly in social interaction. And, communication needs different modes to coordinate, produce resultant force and play a role. Meanwhile, the application of multi-modal analysis to the speech act of apology is a new paradigm to re-examine the classic study of pragmatic competence, in which the construction and negotiation of utterance meaning can be revealed, to a greater extent, more clearly and completely.
GPC1 Is Associated with Poor Prognosis and Treg Infiltration in Colon Adenocarcinoma
Authors: Liu Ying , Ren Hui , Yang Mu-qing , Li Ji-yu
Published: September 2022

Glypican-1 (GPC1) is a glycosylated protein recognized as a promising biomarker for cancer. Nonetheless, there have been few systematic studies on GPC1 in colon adenocarcinoma (COAD). We conducted bioinformatic analysis based on The Cancer Genome Atlas (TCGA) and used clinical samples to verify that GPC1 is overexpressed in colon adenocarcinoma. Kaplan-Meier analysis showed that higher GPC1 expression was associated with poor overall survival (OS). The Cox regression model further showed that GPC1 expression is an independent negative prognostic factor for COAD. Gene set enrichment analysis demonstrated that multiple oncogenic signaling pathways were differentially enriched in GPC1 high- versus low-expressing COAD tumors, including DNA methylation, G2/M damage checkpoint, and telomere dysfunction. We observed a positive correlation between GPC1 expression and immune cell infiltration, such as regulatory T cells (Tregs), macrophages, and mast cells, and immunohistochemistry of 50 COAD tissues revealed that GPC1 expression was positively associated with Treg enrichment. Our results provide a promising candidate gene to predict the prognosis of COAD and new insights into tumor immunity. Further research is required to validate these results.
Fixed Point Results for

α
,

⊥

F

-Contractions in Orthogonal
F
-Metric Spaces with Applications
Authors: Ahmad Jamshaid , Al-Rawashdeh Ahmed Saleh , Al-Mazrooei Abdullah Eqal
Published: September 2022

The main objective of this article is to introduce the notion of

α
,

⊥

F

-contraction in the setting of orthogonal

F

-metric space and present some new fixed point results in such newly introduced space. We also furnish an example to manifest the originality of the obtained results. As application of our foremost result, we look into the solution of a nonlinear fractional differential equation.
Synthesis and Food Applications of Resistant Starch‐Based Nanoparticles
Authors: Islam Fakhar , Noman Muhammad , Afzaal Muhammad , Saeed Farhan , Ahmad Shabana , Zubair Muhammad Waqas , Zahra Syeda Mahvish , Hussain Muzzamal , Ateeq Huda , Awuchi Chinaza Godswill
Published: September 2022

Starch is recognized biopolymer because it is abundant in nature. Dietary starches are major energy source for various human civilizations, and it is obvious that they may also contribute to health in very particular ways. Resistant starch has got a lot of interest because of its possible health advantages (similar to soluble fibre) as well as its functional qualities. Resistant starch improves blood cholesterol levels, microbial flora, gastrointestinal tract function, the glycemic index, and helps with diabetes management. Aside from the significant health advantages of starch, there is an additional benefit that it has a smaller effect on food sensory characteristics than usual sources of fibre, such as grains, bran, or fruits. Moreover, when boiled, many starches form weak‐bodied and unpleasant gels, which are influenced negatively by temperature, humidity, and storage duration. The present review article highlights resistant starch as a functional food, starch extraction method, preparation of starch nanoparticles, and nano‐ and microencapsulation of probiotics in detail.
Research on the Creation of Chinese National Cultural Identity Symbols Based on Visual Images
Authors: Yang LianShuQing , Li Jiahui
Published: September 2022

Cultural symbol generation has always been a challenging task to achieve symbols that can represent national culture and promote people’s identification with Chinese culture. In this paper, we combine generative adversarial network (GAN) to propose a symbolic generation model of Chinese national cultural identity based on visual images. First, combining pattern search regular terms with generator cross-loss functions based on GAN generative adversarial networks to improve the pattern collapse phenomenon of generative adversarial networks. Second, the normal convolutional layer of the generator in the network structure is replaced with a deep-space separable convolution to improve the real-time performance of the model by reducing the model parameters. Through extensive testing on real datasets, the results show that the model in this paper can generate higher performance ethnic culture symbols while maintaining better temporal performance, which has some practical application value.
Metal Cellulose Nanocomposites in Decorative Animation Character Modeling
Authors: Zhang Lili
Published: September 2022

With the development of economy, people’s research on nanomaterials has become more and more, and nanomaterials can be applied in many fields, such as medicine and building materials. The animation character modeling is very important in the cartoon, and the decoration of the animation character modeling can help improve people’s interest in watching cartoons and improve the quality of cartoons. This paper aims to study the role of metal cellulose nanocomposites in the modeling of decorative animation characters. In this paper, the principles and basic concepts of metal cellulose nanocomposites are presented, as well as the analysis of their properties. The experimental results in this paper show that the adsorption of copper in cellulose nanocomposites reaches 256.28 mg/g, the adsorption of chromium is 40.73 mg/g, and the adsorption of cadmium is 47.20 mg/g. The adsorption of other materials to copper is only 80.44 mg/g, the adsorption of chromium (VI) is only 1.116 mg/g, and the adsorption of cadmium is only 9.487 mg/g. It can be seen that the adsorption capacity of cellulose nanocomposites is much higher than that of other materials, so the adsorption properties of cellulose nanocomposites are very strong and can be applied in many fields.
Four-Channel Vibrating Testbed Design for Full Vehicle Durability Simulation
Authors: Du Huiqi , Xu Shiqing
Published: September 2022

The four-channel vibrating testbed for full vehicle durability simulation is indispensable for testing vehicle performance. This paper combines theoretical analysis with experimental verification, and the four-channel vibrating simulation testbed is designed. The hardware system consists of three parts: hydraulic mechanical components, sensors, and closed-loop control system, and the software system consists of platform configuration system, platform management system, and basic test system. Based on the design of the hardware system and software system, the emphasis is put on signal processing. Based on the least squares principle, the undetermined coefficients of trend items are determined, the trend items are transformed into the arithmetic mean of signal data, and the models that eliminate constant trend items are established to eliminate the trend items. In order to reflect the fatigue process of parts more truly, the anomaly points were identified and eliminated based on the two-parameter rain-flow counting method. By representing the transfer function in the frequency domain, the measured signal is changed quickly by Fourier, and the uniqueness of the transfer function is ensured by establishing an invariant system. Finally, test verification was performed on the designed testbed with the white powder noise taken as the driving signal. The test results agree well with field testing results. The design of the testbed can meet the requirements of engineering application, and its design method and signal processing method are reasonable, which has certain theoretical research significance and engineering application value.
HDAC5 Loss Enhances Phospholipid-Derived Arachidonic Acid Generation and Confers Sensitivity to cPLA2 Inhibition in Pancreatic Cancer
Authors: Pan Penglin , Qin Gengdu , Wang Bo , Yu Haixin , Chen Jie , Liu Jiaying , Bing Kaijian , Shen Jian , Ren Dianyun , Zhao Yuhan , Xia Wentao , Li Hui , Wu Heshui , Zhou Yingke
Published: September 2022

HDAC5 is a class IIa histone deacetylase member that is downregulated in multiple solid tumors, including pancreatic cancer, and loss of HDAC5 is associated with unfavorable prognosis. In this study, assessment of The Cancer Genome Atlas pancreatic adenocarcinoma dataset revealed that expression of HDAC5 correlates negatively with arachidonic acid (AA) metabolism, which has been implicated in inflammatory responses and cancer progression. Nontargeted metabolomics analysis revealed that HDAC5 knockdown resulted in a significant increase in AA and its downstream metabolites, such as eicosanoids and prostaglandins. HDAC5 negatively regulated the expression of the gene encoding calcium-dependent phospholipase A2 (cPLA2), the key enzyme in the production of AA from phospholipids. Mechanistically, HDAC5 repressed cPLA2 expression via deacetylation of GATA1. HDAC5 knockdown in cancer cells enhanced sensitivity to genetic or pharmacologic inhibition of cPLA2 in vitro and in vivo. Fatty acid supplementation in the diet reversed the sensitivity of HDAC5-deficient tumors to cPLA2 inhibition. These data indicate that HDAC5 loss in pancreatic cancer results in the hyperacetylation of GATA1, enabling the upregulation of cPLA2, which contributes to overproduction of AA. Dietary management plus cPLA2-targeted therapy could serve as a viable strategy for treating HDAC5-deficient pancreatic cancer patients.

Significance:

The HDAC5-GATA1-cPLA2-AA signaling axis regulates sensitivity to fat restriction plus cPLA2 inhibition in pancreatic ductal adenocarcinoma, proposing dietary management as a feasible strategy for treating a subset of patients with pancreatic cancer.
Gene Therapy for Inherited Retinal Disease: Long-Term Durability of Effect
Authors: Leroy Bart P. , Fischer M. Dominik , Flannery John G. , MacLaren Robert E. , Dalkara Deniz , Scholl Hendrik P.N. , Chung Daniel C. , Spera Claudio , Viriato Daniel , Banhazi Judit
Published: September 2022

The recent approval of voretigene neparvovec (Luxturna®) for patients with biallelic RPE65 mutation-associated inherited retinal dystrophy with viable retinal cells represents an important step in the development of ocular gene therapies. Herein, we review studies investigating the episomal persistence of different recombinant adeno-associated virus (rAAV) vector genomes and the preclinical and clinical evidence of long-term effects of different RPE65 gene replacement therapies. A targeted review of articles published between 1974 and January 2021 in Medline®, Embase®, and other databases was conducted, followed by a descriptive longitudinal analysis of the clinical trial outcomes of voretigene neparvovec. Following an initial screening, 14 publications examining the episomal persistence of different rAAV genomes and 71 publications evaluating gene therapies in animal models were included. Viral genomes were found to persist for at least 22 months (longest study follow-up) as transcriptionally active episomes. Treatment effects lasting almost a decade were reported in canine disease models, with more pronounced effects the earlier the intervention. The clinical trial outcomes of voretigene neparvovec are consistent with preclinical findings and reveal sustained results for up to 7.5 years for the full-field light sensitivity threshold test and 5 years for the multi-luminance mobility test in the Phase I and Phase III trials, respectively. In conclusion, the therapeutic effect of voretigene neparvovec lasts for at least a decade in animal models and 7.5 years in human subjects. Since retinal cells can retain functionality over their lifetime after transduction, these effects may be expected to last even longer in patients with a sufficient number of outer retinal cells at the time of intervention.
Decision-Making among Experts in Advanced Hodgkin Lymphoma
Authors: Hitz Felicitas , Lang Noémie , Mey Ulrich , Mingrone Walter , Moccia Alden , Taverna Christian , Novak Urban , Stenner Frank , Schmidt Adrian , Mamot Christoph , Fischer Natalie , Putora Paul M.
Published: September 2022

Introduction: In the treatment of advanced Hodgkin lymphoma (aHL), based on guidelines a multitude of treatment options are available. The availability of PET-guided decision-making and new therapeutic agents increase the complexity of the decision-making process. Methods: Thirteen experts of Swiss university and cantonal hospitals in Switzerland were asked to describe their institutional decision-making practice in aHL. Variables influencing the decision-making process were identified, standardized, and converted into decision trees for analysis of consent and discrepancies. The algorithms of all participating experts were analyzed with the objective consensus methodology. Results: Four decision criteria (age, fertility preservation, fitness, and interim PET) and 12 unique treatment regimens were identified. Consensus for the treatment of aHL for young and fit, as well as for older patients without comorbidity, was found. Large heterogeneity was identified with use of a variety of different regimens for unfit patients with aHL and for young female patients with a desire of fertility preservation. Conclusions: Four major decision criteria were identified allowing the representation of expert’s approach to first-line treatment of aHL. Among Swiss experts, consensus for a PET-guided curative treatment of aHL was identified. The use of a multitude of treatment regimens was observed for older and comorbid (unfit) aHL patients, highlighting the need for clinical trials and recommendations for this group of patients.
Ten-Year Survival of Breast Cancer in Iran: A National Study (Retrospective Cohort Study)
Authors: Akbari Mohammad Esmaeil , Akbari Atieh , Khayamzadeh Maryam , Salmanian Reza , Akbari Mohammad
Published: September 2022

Purpose: This study aimed to estimate the 5- and 10-year survival rates of breast cancer in Iran. Methods: This retrospective cohort study was performed in 2019 on breast cancer patients registered in the national cancer registry system of Iran during 2007–2014. The patients were contacted to collect their information and status (alive or dead). Age and pathological type of tumor were categorized into five groups, and the place of residence was divided into 13 regions. The Kaplan-Meier method and the Cox proportional hazards model were used for data analysis. Results: A total of 87,902 patients were diagnosed with breast cancer during the study, 22,307 of whom were followed-up. The 5- and 10-year survival rates of the patients were 80% and 69%, respectively. The mean age of the patients was 50.68 ± 12.76 years (median age, 49 years). About 2.3% of the patients were male. The 5- and 10-year survival rates were 69% and 50% in men, respectively. The highest survival rate was reported in the age group of 40–49 years, and the lowest rate was found in the age group of ≥70 years. Of all pathological types, 88% were found in the invasive ductal carcinoma group; the highest survival rate was reported in the noninvasive carcinoma group. The highest survival rate was reported in the Tehran region and the lowest in the Hamedan region. Based on the results, the Cox proportional hazards model, sex, age group, and pathological type were statistically significant differences. Conclusion: This nationwide study performed on breast cancer patients indicated an improvement in the overall survival rate of these patients over the past years (the 5-year survival rate increased from 71% in 2011 to 80% in the present study), which might be attributed to advances in cancer management.
Recurrence of Primary Acquired Melanosis and Conjunctival Intraepithelial Neoplasia
Authors: Svedberg Karin
Published: September 2022

Introduction: The aim of this study was to investigate the frequency of recurrences, time to recurrence, and which patients had a recurrence after treatment of conjunctival intraepithelial neoplasia (CIN), carcinoma in situ, and primary acquired melanosis (PAM) with atypia. Methods: A retrospective chart review of all patients included in the follow-up program after completion of treatment for CIN or PAM with atypia on October 18, 2021, at the Department of Ophthalmology, Sahlgrenska University Hospital, was conducted. Results: There were five recurrences (5/31, 17%) in the group with CIN or carcinoma in situ: two for patients with CIN grade II and three for individuals with carcinoma in situ. Time to diagnosis of recurrence ranged from 6 to 288 months. No recurrence was diagnosed for the 26 patients followed after treatment for PAM with atypia. Conclusion: With the strategy of radical treatment for CIN and PAM with atypia, whenever possible, subsequent follow-up can probably be ceased after 10 years if the patient is not immunocompromised. For completely excised PAM with atypia grade I, there is most likely no need for further clinical controls.
Structural and Functional Analysis of Multiple Subretinal Fluid Blebs after Successful Surgery for Rhegmatogenous Retinal Detachment
Authors: Kong Kangjie , Xu Sisi , Wang Yingchao , Ding Xinyi , Li Gang , Wang Ling , Ni Yingqin
Published: September 2022

Introduction: This retrospective study investigated the clinical characteristics of multiple subretinal fluid blebs (MSFBs) after successful surgery for rhegmatogenous retinal detachment (RRD) and explored the association between MSFB with best-corrected visual acuity (BCVA) and metamorphopsia. Methods: The study comprised 206 patients after successful surgery for RRD, with 58 and 148 eyes undergoing, respectively, scleral buckling (SB), and pars plana vitrectomy (PPV). The clinical characteristics of MSFBs were analyzed by optical coherence tomography (OCT). The choroidal vessels in some cases were evaluated with OCT angiography. M-charts were used to determine the metamorphopsia. Results: MSFBs occurred in 17 (29.3%) and 8 (5.4%) eyes given SB and PPV, respectively. MSFBs appeared 5.6 ± 5.5 weeks after surgery and required 34.9 ± 13.8 weeks to disappear. Disrupted external limiting membrane and ellipsoid zone could still be seen in 83.3% and 66.7% of the patients 12 months after surgery; these rates were significantly higher than those of patients without MSFBs (p = 0.047, 0.022, respectively). Twelve months post-surgery, BCVA and metamorphopsia scores of the patients with MSFBs were statistically comparable to those of the controls. Conclusions: MSFBs occur more commonly after SB than PPV. MSFBs may delay the recovery of the outer retina structure but do not affect postoperative BCVA and metamorphopsia.
Avaliação do paciente com diminuição da acuidade visual
Authors: Furtado João Marcello , Oliveira Italo Pena de
Published: September 2022

A queixa de diminuição da acuidade visual é muito frequente nos diversos cenários de atendimento médico. É importante, portanto, que o médico generalista esteja apto a realizar uma avaliação qualificada na apresentação inicial do paciente, de modo a identificar doenças prontamente tratáveis e diferenciá-las daquelas que devem ser encaminhadas ao especialista. Este artigo aborda, em detalhes, a avaliação do paciente com queixa de baixa acuidade visual.
Senilidade ocular
Authors: Melchior Bruna , Barroso Leticia , Bastos Thaís Marino de Azeredo , Oliveira Italo Pena de , Jorge Rodrigo , Paula Jayter Silva
Published: September 2022

O processo de envelhecimento do olho está associado ao desenvolvimento de diversas condições patológicas que resultam em perda visual. Este artigo aborda três doenças que figuram entre as principais causas de cegueira na população mundial: catarata, glaucoma e degeneração macular relacionada à idade.
Estratégias e desafios em prevenção à cegueira e deficiência visual
Authors: Oliveira Italo Pena de , Amaral Marina Diedrich Moreira do , Costa Luisa Canesin Dourado Figueiredo , Marcusso Barbara Maria Guedes , Furtado João Marcello
Published: September 2022

Deficiência visual e cegueira estão associados a importante comprometimento sócio econômico e de qualidade de vida. Apesar dos avanços nas estratégias de detecção e tratamento de diversos distúrbios oftalmológicos, o número absoluto de cegos e deficientes visuais aumentou globalmente nas últimas décadas, e com a projeção de aumento e envelhecimento populacional, a demanda por serviços de tratamento e reabilitação visual aumentarão ainda mais. No presente estudo, apresentaremos as principais causas de cegueira e deficiência visual no Brasil e no mundo, além das dificuldades encontradas na abordagem do problema a nível de saúde pública e possíveis estratégias de ação.
Impact of Socioeconomic Status on Mortality and Readmission in Patients With Heart Failure With Reduced Ejection Fraction: The ARIC Study
Authors: Mathews Lena , Ding Ning , Mok Yejin , Shin Jung‐Im , Crews Deidra C. , Rosamond Wayne D. , Newton Anna‐Kucharska , Chang Patricia P. , Ndumele Chiadi E. , Coresh Josef , Matsushita Kunihiro
Published: September 2022

Background

Low socioeconomic status (SES) is associated with a higher risk of heart failure (HF). The contribution of individual and neighborhood SES to the prognosis and quality of care for HF with reduced ejection fraction is not clear yet has important implications.

Methods and Results

We examined 728 participants of the
ARIC
(Atherosclerosis Risk in Communities) study (mean age, 78.2 years; 34% Black participants; 46% women) hospitalized with HF with reduced ejection fraction (ejection fraction <50%) between 2005 and 2018. We assessed associations between education, income, and area deprivation index with mortality and HF readmission using multivariable Cox models. We also evaluated the use of guideline‐directed medical therapy (optimal: ≥3 of ß‐blockers, mineralocorticoid receptor antagonist, angiotensin‐converting enzyme inhibitors, or angiotensin receptor blockers; acceptable: at least 2) at discharge. During a median follow‐up of 3.2 years, 58.7% were readmitted with HF, and 74.0% died. Low income was associated with higher mortality (hazard ratio [HR], 1.52 [95% CI, 1.14–2.04]) and readmission (HR, 1.45 [95% CI, 1.04–2.03]). Similarly, low education was associated with mortality (HR, 1.27 [95% CI, 1.01–1.59]) and readmission (HR, 1.62 [95% CI, 1.24–2.12]). The highest versus lowest area deprivation index quartile was associated with readmission (HR, 1.69 [95% CI, 1.11–2.58]) but not necessarily with mortality. The prevalence of optimal guideline‐directed medical therapy and acceptable guideline‐directed medical therapy was 5.5% and 54.4%, respectively, but did not significantly differ by SES.

Conclusions

Among patients hospitalized with HF with reduced ejection fraction, low SES was independently associated with mortality and HF readmission. A targeted secondary prevention approach that focuses intensive efforts on patients with low SES will be necessary to improve outcomes of those with HF with reduced ejection fraction.
To Modify or Not to Modify: Allele‐Specific Effects of 3'UTR‐
KCNQ1
Single Nucleotide Polymorphisms on Clinical Phenotype in a Long QT 1 Founder Population Segregating a Dominant‐Negative Mutation
Authors: Winbo Annika , Diamant Ulla‐Britt , Persson Johan , Jensen Steen M. , Rydberg Annika
Published: September 2022

Background

There are conflicting reports with regard to the allele‐specific gene suppression effects of single nucleotide polymorphisms (SNPs) in the 3'untranslated region (3'UTR) of the
KCNQ1
gene in long QT syndrome type 1 (LQT1) populations. Here we assess the allele‐specific effects of 3 previously published 3'UTR‐
KCNQ1
's SNPs in a LQT1 founder population segregating a dominant‐negative mutation.

Methods and Results

Bidirectional sequencing of the
KCNQ1
'
s
3'UTR was performed in the p.Y111C founder population (n=232, 147 genotype positive), with a minor allele frequency of 0.1 for SNP1 (rs2519184) and 0.6 for linked SNP2 (rs8234) and SNP3 (rs107980). Allelic phase was assessed in trios aided by haplotype data, revealing a high prevalence of derived SNP2/3
in cis
with p.Y111C (89%). Allele‐specific association analyses, corrected using a relatedness matrix, were performed between 3'UTR‐
KCNQ1
SNP genotypes and clinical phenotypes. SNP1
in trans
was associated with a significantly higher proportion of symptomatic phenotype compared with no derived SNP1 allele
in trans
(58% versus 32%, corrected
P
=0.027). SNP2/3
in cis
was associated with a significantly lower proportion of symptomatic phenotype compared with no derived SNP2/3 allele
in cis
(32% versus 69%, corrected
P
=0.010).

Conclusions

Allele‐specific modifying effects on symptomatic phenotype of 3'UTR‐
KCNQ1
SNPs rs2519184, rs8234, and rs107980 were seen in a LQT1 founder population segregating a dominant‐negative mutation. The high prevalence of suppressive 3'UTR‐
KCNQ1
SNPs segregating with the founder mutation could contribute to the previously documented low incidence of cardiac events in heterozygous carriers of the p.Y111C
KCNQ1
mutation.
Patients With Larger Left Atrial Appendage Orifice Presented Worse Prognosis Contributed by Acute Heart Failure After Left Atrial Appendage Closure
Authors: Ren Zhongyuan , Zheng Yixing , Zhang Jingying , Yang Haotian , Wu Jiayu , Li Hailing , Guo Rong , Meng Weilun , Zhang Jun , Sun Hui , Xu Yawei , Zhao Dongdong
Published: September 2022

Background

Left atrial appendage (LAA) closure (LAAC) could prevent stroke in patients with atrial fibrillation. However, LAAC may impair the compliance of the left atrium and result in poor prognosis. This study aimed to comparatively evaluate the prognosis of LAAC among patients with different sizes of LAA orifice.

Methods and Results

Three hundred two consecutive patients who underwent successful LAAC were included and divided into 4 groups based on LAA orifice size that was measured using transesophageal echocardiography. Clinical outcomes including thromboembolic events, major cardiocerebrovascular adverse events, and acute heart failure (AHF) were compared among 4 quartile groups and between propensity‐score matched groups of large and small LAAs. Through follow‐up of 39.6±8.4 months, survival of thromboembolic events was similar. Survival of major cardiocerebrovascular adverse events was significantly lower in the group with the largest LAA orifice (log‐rank
P
<0.001), including a higher incidence of AHF with New York Heart Association class III to IV (21.4%, log‐rank
P
=0.009). A large LAA orifice (by cutoff) could predict major cardiocerebrovascular adverse events (hazard ratio, 3.749 [95% CI, 2.074–6.779]) in most patients, except for subgroups of those aged <65 years, with paroxysmal atrial fibrillation, and/or with failed rhythm/rate control. Further compared with a propensity‐score matched small‐LAA group, the large‐LAA orifice group still presented worse survival of AHF with New York Heart Association class III to IV (log‐rank
P
=0.010).

Conclusions

Patients with a larger LAA orifice presented a worse prognosis after LAAC, including a higher incidence of AHF. A large LAA orifice could predict a post‐LAAC AHF event in most patients, except for young patients, patients with paroxysmal atrial fibrillation, and/or with failed rhythm/rate control.

Registration

URL:
clinicaltrials.gov
; Unique identifier: NCT04185142.
Intact Fibroblast Growth Factor 23 Regulates Chronic Kidney Disease–Induced Myocardial Fibrosis by Activating the Sonic Hedgehog Signaling Pathway
Authors: Li Lanlan , Gan Hua
Published: September 2022

Background

Clinically, myocardial fibrosis is one of the most common complications caused by chronic kidney disease (CKD). However, the potential mechanisms of CKD‐induced myocardial fibrosis have not been clarified.

Methods and Results

In our in vivo study, a rat model of CKD with 5/6 nephrectomy was established. The CKD model was treated with the glioma 1 (Gli‐1) inhibitor GANT‐61, and myocardial fibrosis and serum intact fibroblast growth factor 23 levels were assessed 16 weeks after nephrectomy. Finally, we found that Gli‐1 and Smoothened in the Sonic Hedgehog (Shh) signaling pathway were activated and that collagen‐1 and collagen‐3, which constitute the fibrotic index, were expressed in CKD myocardial tissue. After administering the Gli‐1 inhibitor GANT‐61, the degree of myocardial fibrosis was reduced, and Gli‐1 expression was also inhibited. We also measured blood pressure, cardiac biomarkers, and other indicators in rats and performed hematoxylin‐eosin staining of myocardial tissue. Furthermore, in vitro studies showed that intact fibroblast growth factor 23 promoted cardiac fibroblast proliferation and transdifferentiation into myofibroblasts by activating the Shh signaling pathway, thereby promoting cardiac fibrosis, as manifested by increased expression of the Shh, Patch 1, and Gli‐1 mRNAs and Shh, Smoothened, and Gli‐1 proteins in the Shh signaling pathway. The protein and mRNA levels of other fibrosis indicators, such as α‐smooth muscle actin, which are also markers of transdifferentiation, collagen‐1, and collagen‐3, were increased.

Conclusions

On the basis of these results, intact fibroblast growth factor 23 promotes CKD‐induced myocardial fibrosis by activating the Shh signaling pathway.
Enriching the American Heart Association COVID‐19 Cardiovascular Disease Registry Through Linkage With External Data Sources: Rationale and Design
Authors: Oseran Andrew S. , Sun Tianyu , Wadhera Rishi K. , Dahabreh Issa J. , de Lemos James A. , Das Sandeep R. , Rutan Christine , Asnani Aarti H. , Yeh Robert W. , Kazi Dhruv S.
Published: September 2022

Background

The AHA Registry (American Heart Association COVID‐19 Cardiovascular Disease Registry) captures detailed information on hospitalized patients with COVID‐19. The registry, however, does not capture information on social determinants of health or long‐term outcomes. Here we describe the linkage of the AHA Registry with external data sources, including fee‐for‐service (FFS) Medicare claims, to fill these gaps and assess the representativeness of linked registry patients to the broader Medicare FFS population hospitalized with COVID‐19.

Methods and Results

We linked AHA Registry records of adults ≥65 years from March 2020 to September 2021 with Medicare FFS claims using a deterministic linkage algorithm and with the American Hospital Association Annual Survey, Rural Urban Commuting Area codes, and the Social Vulnerability Index using hospital and geographic identifiers. We compared linked individuals with unlinked FFS beneficiaries hospitalized with COVID‐19 to assess the representativeness of the AHA Registry. A total of 10 010 (47.0%) records in the AHA Registry were successfully linked to FFS Medicare claims. Linked and unlinked FFS beneficiaries were similar with respect to mean age (78.1 versus 77.9, absolute standardized difference [ASD] 0.03); female sex (48.3% versus 50.2%, ASD 0.04); Black race (15.1% versus 12.0%, ASD 0.09); dual‐eligibility status (26.1% versus 23.2%, ASD 0.07); and comorbidity burden. Linked patients were more likely to live in the northeastern United States (35.7% versus 18.2%, ASD 0.40) and urban/metropolitan areas (83.9% versus 76.8%, ASD 0.18). There were also differences in hospital‐level characteristics between cohorts. However, in‐hospital outcomes were similar (mortality, 23.3% versus 20.1%, ASD 0.08; home discharge, 45.5% versus 50.7%, ASD 0.10; skilled nursing facility discharge, 24.4% versus 22.2%, ASD 0.05).

Conclusions

Linkage of the AHA Registry with external data sources such as Medicare FFS claims creates a unique and generalizable resource to evaluate long‐term health outcomes after COVID‐19 hospitalization.
Working Remotely During the COVID-19 Pandemic: Work-Related Psychosocial Factors, Work Satisfaction, and Job Performance Among Russian Employees
Authors: Toscano Ferdinando , Bigliardi Eleonora , Polevaya Marina V. , Kamneva Elena V. , Zappalà Salvatore
Published: September 2022

Background. The spread of COVID-19 has forced organizations to quickly offer remote work arrangements to employees. Objective. The study focuses on remote work during the first wave of the pandemic and describes how Russian employees experienced remote work. The research has three main objectives: (1) to investigate the influence of gender and age on employees’ perceptions of remote work; (2) to investigate the relationship between remote work and psychosocial variables, such as remote work stress, remote work engagement, and family–work conflict; (3) to examine whether and how much such psychosocial factors are related to remote work satisfaction and job performance. These objectives were the basis for developing six hypotheses. Design. A cross-sectional study involved 313 Russian employees. Data were collected using an online survey distributed in April and May 2020. The hypotheses were tested using ANOVA, correlations, and multiple linear regression analyses. Results. Women experienced more stress and more engagement when working remotely; older employees perceived remote work as a less positive experience; opinions about remote work and remote work engagement were positively related to remote work satisfaction; leader–member exchange (LMX) was a significant predictor of job performance. Conclusion. During the lockdown, remote work was perceived as a positive experience. We discuss some practical implications for organizations and managers.