bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the Association of HLA Genetic Risk Burden on Thalamic and Hippocampal Atrophy in Multiple Sclerosis Patients
Authors: Santoro Silvia , Clarelli Ferdinando , Preziosa Paolo , Storelli Loredana , Cannizzaro Miryam , Mascia Elisabetta , Esposito Federica , Rocca Maria Assunta , Filippi Massimo
Published: November 2022

Multiple sclerosis (MS) is a complex disease of the central nervous system for which human leukocyte antigen (HLA) alleles are major contributors to susceptibility. Several investigations have focused on the relationship between HLA and clinical parameters, while few studies have evaluated its correlation with brain magnetic resonance imaging (MRI) measures. We investigated the association between the HLA genetic burden (HLAGB), originating from the most updated HLA alleles associated with MS, and neuroimaging endophenotypes, with a specific focus on brain atrophy metrics. A monocentric Italian cohort of 334 MS patients with imputed HLA alleles and cross-sectional volumetric measures of white matter (WM), gray matter (GM), hippocampus, thalamus and T2-hyperintense lesions was investigated. Linear regression models with covariate adjustment were fitted for each metric. We detected no effect of HLAGB on WM and GM volumes. Interestingly, we found a marginal correlation between higher HLAGB and lower hippocampal volume (β = −0.142, p = 0.063) and a nominal association between higher HLAGB and lower thalamic volume (β = −0.299, p = 0.047). No association was found with T2 lesion volumes. The putative impact of higher HLAGB on hippocampus and thalamus suggests, if replicated in independent cohorts, a possible cumulative contribution of HLA risk loci on brain volumetric traits linked to clinical deficits in MS.
All That Is Solid Turns into Sand: Woman in the Dunes across Page and Screen
Authors: Zhao Xinyi
Published: November 2022

This paper attempts a close study of Abe Kobo’s novel Woman in the Dunes and its screen adaptation (dir. Teshigahara Hiroshi 1964). Engaging adaptation studies, media studies, and sound studies, this paper moves from the conventional focus on the linear transfer of text from a source to a result, to examine adaptation as a multilevel, multisensory, and multidirectional process of remediation. By mediating documentary cinema and avant-garde tradition, the filmic adaptation, as the paper argues, not only provokes and enhances its literary original, but also illuminates existentialist concerns that gained critical currency in the 1960s. The paper moves on to analyze Takemitsu Toru’s score in relation to Teshigahara’s surrealist imagery; in doing so, it elucidates the way the film gives the sand a form of human agency alluded to yet not fully realized in Abe’s novel. Scrutiny of Abe and Takemitsu’s early years in Japan-occupied Manchuria further connects Abe’s work to the issue of postcolonial identity while opening Woman in the Dunes to more interpretative possibilities as an I-Novel. Through mediating collective history and personal memory, adaptation opens a dialogic intersubjective horizon where questions of identity and affect intersect in the post-war media environment.
Experiences of Transgender Women with Speech Feminization Training: A Qualitative Study
Authors: Leyns Clara , Alighieri Cassandra , De Wilde Jana , Van Lierde Kristiane , T’Sjoen Guy , D’haeseleer Evelien
Published: November 2022

This study investigated the experiences of transgender women after following sessions for speech feminization using semi-structured face-to-face interviews. Transgender women who completed a clinical trial were invited for an interview and 12 accepted the invitation. Interviews were conducted using an interview guide and were recorded and transcribed verbatim. NVivo 12 was used for qualitative data analysis, applying an inductive thematic approach. Four main themes were identified: communication, therapy experiences, impact on mental health, and external factors associated with the outcomes. For most participants, fear of speaking in public decreased after the training and all participants mentioned improved vocal characteristics. Though, reactions ranged from needing more speech therapy to being satisfied with the results. Coping strategies during misgendering occasions differed a lot between participants. More emotive counseling during speech feminization sessions is necessary to help clients in managing possible negative emotions.
Training in Hypoxia at Alternating High Altitudes Is a Factor Favoring the Increase in Sports Performance
Authors: Dragos Ovidiu , Alexe Dan Iulian , Ursu Emil Vasile , Alexe Cristina Ioana , Voinea Nicoale Lucian , Haisan Petronela Lacramioara , Panaet Adelina Elena , Albina Andreea Mihaela , Monea Dan
Published: November 2022

Training above 1800 m causes increases in hemoglobin, erythropoietin and VO2max values in the bodies of athletes. The purpose of this study is to prove that living at an altitude of 1850 m and training at 2200 m (LHTH+) is more effective than living and training at 2000 m (LHTH). Ten endurance athletes (age 21.2 ± 1.5 years, body mass 55.8 ± 4.3 kg, height 169 ± 6 cm, performance 3000 m 8:35 ± 0:30 min) performed three training sessions of 30 days, in three different situations: [1] living and training at 2000 m altitude (LHTH), [2] living at 1850 m and training at 2200 m (LHTH+), and [3] living and training at 300 m (LLTL). The differences in erythropoietin (EPO), hemoglobin (Hb) concentration, and VO2max values were compared before and at the end of each training session. Data analysis indicated that LHTH training caused an increase in EPO values (by 1.0 ± 0.8 mU/mL, p = 0.002 < 0.05.); Hb (by 1.1 ± 0.3 g/dL, p < 0.001); VO2max (by 0.9 ± 0.23 mL/kg/min, p < 0.001). LHTH+ training caused an increase in EPO values (by 1.9 ± 0.5 mU/ML, p < 0.001); Hb (by 1.4 ± 0.5 g/dL, p < 0.001); VO2max (by 1.7 ± 0.3 mL/kg/min, p < 0.001). At the LLTL training, EPO values do not have a significant increase (p = 0.678 > 0.050; 1 ± 0.1 mU/mL, 0.1 ± 0.9%.), Hb (0.1 ± 0.0 g/dL, 0.3 ± 0.3%), VO2max (0.1 ± 0.1, 0.2 ± 0.2%, p = 0.013 < 0.05). Living and training at altitudes of 2000 m (LHTH) and living at 1850 m training at 2200 m (LHTH+) resulted in significant improvements in EPO, Hb, and VO2max that exceeded the changes in these parameters, following traditional training at 300 m (LLTL). LHTH+ training has significantly greater changes than LHTH training, favorable to increasing sports performance. The results of this study can serve as guidelines for athletic trainers in their future work, in the complete structure of multi-year planning and programming, and thus improve the process of development and performance training.
Multipath Routing in Wireless Body Area Sensor Network for Healthcare Monitoring
Authors: Akbar Shuja , Mehdi Muhammad Mohsin , Jamal M. Hasan , Raza Imran , Hussain Syed Asad , Breñosa Jose , Espinosa Julio César Martínez , Pascual Barrera Alina Eugenia , Ashraf Imran
Published: November 2022

Mobility and low energy consumption are considered the main requirements for wireless body area sensor networks (WBASN) used in healthcare monitoring systems (HMS). In HMS, battery-powered sensor nodes with limited energy are used to obtain vital statistics about the body. Hence, energy-efficient schemes are desired to maintain long-term and steady connectivity of the sensor nodes. A sheer amount of energy is consumed in activities such as idle listening, excessive transmission and reception of control messages, packet collisions and retransmission of packets, and poor path selection, that may lead to more energy consumption. A combination of adaptive scheduling with an energy-efficient protocol can help select an appropriate path at a suitable time to minimize the control overhead, energy consumption, packet collision, and excessive idle listening. This paper proposes a region-based energy-efficient multipath routing (REMR) approach that divides the entire sensor network into clusters with preferably multiple candidates to represent each cluster. The cluster representatives (CRs) route packets through various clusters. For routing, the energy requirement of each route is considered, and the path with minimum energy requirements is selected. Similarly, end-to-end delay, higher throughput, and packet-delivery ratio are considered for packet routing.
Safety Evaluation of Remdesivir for COVID-19 Patients with eGFR < 30 mL/min without Renal Replacement Therapy in a Japanese Single-Center Study
Authors: Umemura Takumi , Mutoh Yoshikazu , Mizuno Takahito , Hagihara Mao , Kato Hideo , Yamada Tetsuya , Ikeda Yoshiaki , Mikamo Hiroshige , Ichihara Toshihiko
Published: November 2022

There are limited reports on the safety of remdesivir for patients with severe kidney disease. We investigated the safety of remdesivir administration for COVID-19 patients with estimated glomerular filtration rate (eGFR) <30 mL/min. This single-center retrospective study was conducted between March 2020 and April 2022 at Tosei General Hospital, Japan. Propensity score matching was performed between patients with eGFR ≤ 30 mL/min and eGFR >30 mL/min with remdesivir administration. The primary outcome was 30-day mortality after the first administration. Adverse events, including development of acute kidney injury (AKI), liver function disorder, anemia, and thrombocytopenia 48 h after the end of remdesivir administration, were evaluated. After propensity score matching, 23 patients were selected from each group. There were no differences in the 30-day mortality (risk ratio [RR] 1.00; 95% confidence interval [CI] 0.18–5.56). Development of AKI and liver function disorder was not statistically different between the two groups (RR 1.05; 95% CI 0.96–1.14 and RR 0.48; 95% CI 0.04–5.66, respectively). There was no trend toward a significant increase in adverse events in the eGFR < 30 mL/min group and severe renal dysfunction had little effect on the safety of remdesivir treatment.
Building Block Extraction from Historical Maps Using Deep Object Attention Networks
Authors: Zhao Yao , Wang Guangxia , Yang Jian , Zhang Lantian , Qi Xiaofei
Published: November 2022

The geographical feature extraction of historical maps is an important foundation for realizing the transition from human map reading to machine map reading. The current methods for building block extraction from historical maps have many problems, such as low accuracy and poor scalability. Moreover, the high cost of annotating historical maps further limits its applications. In this study, a method for extracting building blocks from historical maps is proposed based on the deep object attention network. Based on the OCRNet framework, multiple attention mechanisms were used to improve the ability of the network to extract the contextual information of the target. Moreover, through the optimization of the feature extraction network structure, the impact of the down-sampling process on local information and boundary contours was reduced, in order to improve the network’s ability to capture boundary information. Subsequently, the transfer learning method was used to jointly train the network model on both remote sensing datasets and few-shot historical map datasets to further improve the feature learning ability of the network, which overcomes the constraints of small sample sizes. The experimental results show that the proposed method can effectively improve the extraction accuracy of building blocks from historical maps.
Characterizing Repellencies of Methyl Benzoate and Its Analogs against the Common Bed Bug, Cimex lectularius
Authors: Strickland Jaime , Larson Nicholas R. , Feldlaufer Mark , Zhang Aijun
Published: November 2022

Bed bug infestations are on the rise globally, and remediation efforts are becoming more expensive and difficult to achieve due to rising insecticide resistance in the pest populations. This study evaluates Cimex lectularius behavior in the presence of attractive elements—aggregation pheromone or food source (human blood)—and the reported botanical repellent methyl benzoate (MB), several MB analogs, as well as the well-known insect repellent, N,N-diethyl-meta-toluamide (DEET). Utilizing EthoVision, a video tracking system, we now report that MB and several of its analogs exhibit strong spatial repellency against C. lectularius, with methyl 2-methoxybenzoate (M2MOB) and methyl 3-methoxybenzoate (M3MOB) exhibiting the strongest repellent effects. Further, our data showed that MB, M2MOB, M3MOB, and DEET exhibit repellency against a pyrethroid resistant strain of C. lectularius.
Exercise-Associated Hyponatremia in Marathon Runners
Authors: Klingert Mark , Nikolaidis Pantelis T. , Weiss Katja , Thuany Mabliny , Chlíbková Daniela , Knechtle Beat
Published: November 2022

Exercise-associated hyponatremia (EAH) was first described as water intoxication by Noakes et al. in 1985 and has become an important topic linked to several pathological conditions. However, despite progressive research, neurological disorders and even deaths due to hyponatremic encephalopathy continue to occur. Therefore, and due to the growing popularity of exercise-associated hyponatremia, this topic is of great importance for marathon runners and all professionals involved in runners’ training (e.g., coaches, medical staff, nutritionists, and trainers). The present narrative review sought to evaluate the prevalence of EAH among marathon runners and to identify associated etiological and risk factors. Furthermore, the aim was to derive preventive and therapeutic action plans for marathon runners based on current evidence. The search was conducted on PubMed, Scopus and Google Scholar using a predefined search algorithm by aggregating multiple terms (marathon run; exercise; sport; EAH; electrolyte disorder; fluid balance; dehydration; sodium concentration; hyponatremia). By this criterion, 135 articles were considered for the present study. Our results revealed that a complex interaction of different factors could cause EAH, which can be differentiated into event-related (high temperatures) and person-related (female sex) risk factors. There is variation in the reported prevalence of EAH, and two major studies indicated an incidence ranging from 7 to 15% for symptomatic and asymptomatic EAH. Athletes and coaches must be aware of EAH and its related problems and take appropriate measures for both training and competition. Coaches need to educate their athletes about the early symptoms of EAH to intervene at the earliest possible stage. In addition, individual hydration strategies need to be developed for the daily training routine, ideally in regard to sweat rate and salt losses via sweat. Future studies need to investigate the correlation between the risk factors of EAH and specific subgroups of marathon runners.
Traumatic Proximal Femoral Fractures during COVID-19 Pandemic in the US: An ACS NSQIP® Analysis
Authors: Jawad Muhammad Umar , Delman Connor M. , Campbell Sean T. , Fitzpatrick Ellen P. , Soles Gillian L. S. , Lee Mark A. , Randall R. Lor , Thorpe Steven W.
Published: November 2022

In order to determine the impact of COVID-19 on the treatment and outcomes in patients with proximal femoral fracture’s (PFF), we analyzed a national US sample. This is a retrospective review of American College of Surgery’s (ACS) National Surgical Quality Improvement Program (NSQIP) for patients with proximal femoral fractures. A total of 26,830 and 26,300 patients sustaining PFF and undergoing surgical treatment were sampled during 2019 and 2020, respectively. On multivariable logistic regression, patients were less likely to have ‘presence of non-healing wound’ (p < 0.001), functional status ‘independent’ (p = 0.012), undergo surgical procedures of ‘hemiarthroplasty’(p = 0.002) and ‘ORIF IT, Peritroch, Subtroch with plates and screws’ (p < 0.001) and to be ‘alive at 30-days post-op’ (p = 0.001) in 2020 as compared to 2019. Patients were more likely to have a case status ‘emergent’, ‘loss of ≥10% body weight’, discharge destination of ‘home’ (p < 0.001 for each) or ‘leaving against medical advice’ (p = 0.026), postoperative ‘acute renal failure (ARF)’ (p = 0.011), ‘myocardial infarction (MI)’ (p = 0.006), ‘pulmonary embolism (PE)’ (p = 0.047), and ‘deep venous thrombosis (DVT)’ (p = 0.049) in 2020 as compared to 2019. Patients sustaining PFF and undergoing surgical treatment during pandemic year 2020 differed significantly in preoperative characteristics and 30-day postoperative complications when compared to patients from the previous year.
Pregnancy Outcomes in Double Stimulation versus Two Consecutive Mild Stimulations for IVF in Poor Ovarian Responders
Authors: Li Jingzhe , Lyu Shiqing , Lyu Shijian , Gao Minzhi
Published: November 2022

To compare pregnancy outcomes between double stimulation (DouStim) and two consecutive mild stimulations in poor ovarian responders, this study retrospectively analyzed 281 patients diagnosed as having poor ovarian response (POR) who underwent oocytes retrieval for in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) from January 2018 to December 2020. They were divided into two groups: the DouStim group (n = 89) and the two consecutive mild stimulations group (n = 192). The results illustrated that there were no significant differences in the number of oocytes and 2PNs between the two groups. The number of frozen embryos [1 (0, 2) versus 1(0, 2)] was significantly lower and the proportion of patients without frozen embryos (39.3% versus 26.0%) was significantly higher in the DouStim group than in the two consecutive mild stimulations group (p < 0.05). There were no significant differences in the clinical pregnancy rate (CPR) and the cumulative live birth rate (CLBR) between the two groups (p > 0.05). The intra-subgroup comparison showed that in young POR patients under 35 years old, there were no significant differences in clinical indicators and pregnancy outcomes (p > 0.05). In elderly POR patients aged 35 years and above, the number of frozen embryos [1 (0, 1.5) versus 1 (0.25, 2)] (p < 0.01) was significantly lower in the DouStim group than in the two consecutive mild stimulations group, but the pregnancy outcomes were not significantly different (p > 0.05). In conclusion, the DouStim protocol is inferior to the two consecutive mild stimulations protocol in terms of the number of frozen embryos, which mainly occurs in elderly patients, but there is no difference in pregnancy outcomes between the two protocols.
Maxillomandibular Advancement and Upper Airway Stimulation for Treatment of Obstructive Sleep Apnea: A Systematic Review
Authors: Zhou Ning , Ho Jean-Pierre T. F. , Spijker René , Aarab Ghizlane , de Vries Nico , Ravesloot Madeline J. L. , de Lange Jan
Published: November 2022

This systematic review aimed to comparatively evaluate the efficacy and safety of maxillomandibular advancement (MMA) and upper airway stimulation (UAS) in obstructive sleep apnea (OSA) treatment. A MEDLINE and Embase database search of articles on MMA and/or UAS for OSA was conducted. Twenty-one MMA studies and nine UAS studies were included. All the MMA studies demonstrated a reduction in apnea hypopnea index (AHI) postoperatively, and success rates ranged from 41.1% to 100%. Ten MMA studies reported pre- and postoperative Epworth sleepiness scale (ESS), and all but one study demonstrated a reduction in ESS. In the UAS studies, all but one demonstrated a reduction in AHI, and success rates ranged from 26.7% to 77.8%. In the eight UAS studies reporting pre- and postoperative ESS, an ESS reduction was demonstrated. No studies reported any deaths related to MMA or UAS. The most common postoperative complications after MMA and UAS were facial paresthesia in the mandibular area and discomfort due to electrical stimulation, respectively. This systematic review suggests that both MMA and UAS are effective and generally safe therapies for OSA. However, due to the limitations of the included studies, there is no evidence yet to directly compare these two procedures in OSA treatment.
Molecular Basis and Rationale for the Use of Targeted Agents and Immunotherapy in Sinonasal Cancers
Authors: Esposito Andrea , Stucchi Erika , Baronchelli Maria , Di Mauro Pierluigi , Ferrari Marco , Lorini Luigi , Gurizzan Cristina , London Nyall Robert Jr , Hermsen Mario , Lechner Matt , Bossi Paolo
Published: November 2022

Despite the progress of surgery, radiotherapy, and neoadjuvant chemotherapy, the prognosis for advanced sinonasal cancers (SNCs) remains poor. In the era of precision medicine, more research has been conducted on the molecular pathways and recurrent mutations of SNCs, with the aim of understanding carcinogenesis, helping with diagnosis, identifying prognostic factors, and finding potentially targetable mutations. In the treatment of SNC, immunotherapy is rarely used, and no targeted therapies have been approved, partly because these tumors are usually excluded from major clinical trials. Data on the efficacy of targeted agents and immune checkpoint inhibitors are scarce. Despite those issues, a tumor-agnostic treatment approach based on targeted drugs against a detected genetic mutation is growing in several settings and cancer subtypes, and could also be proposed for SNCs. Our work aims to provide an overview of the main molecular pathways altered in the different epithelial subtypes of sinonasal and skull base tumors, focusing on the possible actionable mutations for which potential target therapies are already approved in other cancer types.
Validation of the Trifecta Scoring Metric in Vacuum-Assisted Mini-Percutaneous Nephrolithotomy: A Single-Center Experience
Authors: Pozzi Efrem , Malfatto Matteo , Turetti Matteo , Silvani Carlo , Jannello Letizia Maria Ippolita , Garbagnati Susanna , Galbiati Gilda , Zanetti Stefano Paolo , Longo Fabrizio , De Lorenzis Elisa , Albo Giancarlo , Salonia Andrea , Montanari Emanuele , Boeri Luca
Published: November 2022

Background: Scoring metrics to assess and compare outcomes of percutaneous nephrolithotomy (PCNL) are needed. We aim to evaluate prevalence and predictors of trifecta in a cohort of patients treated with vacuum-assisted mini-percutaneous nephrolithotomy (vmPCNL) for kidney stones. Methods: Data from 287 participants who underwent vmPCNL were analysed. Patients’ and stones’ characteristics as well as operative data were collected. Stone-free was defined as no residual stones. The modified Clavien classification was used to score postoperative complications. Trifecta was defined as stone-free status without complications after a single session and no auxiliary procedures. Descriptive statistics and logistic regression models tested the association between predictors and trifecta outcome. Results: After vmPCNL, 219 (76.3%) patients were stone-free, and 81 (28.2%) had postoperative complications (any Clavien). Of 287, 170 (59.2%) patients achieved trifecta criteria. Patients who achieved trifecta status had smaller stone volume (p < 0.001), a higher rate of single stones (p < 0.001), shorter operative time (p < 0.01), and a higher rate of single percutaneous tract (p < 0.01) than −trifecta patients. Trifecta status decreased with the number of calyces involved, being 77.1%, 18.8%, and 4.1% in patients with 1, 2, or 3 calyces with stones, respectively (p < 0.001). Multivariable logistic regression analysis showed that stone volume (OR 1.1, p = 0.02) and multiple calyces being involved (OR 2.8 and OR 4.3 for two- and three-calyceal groups, respectively, all p < 0.01) were independent unfavourable risk factors for trifecta after accounting for age, BMI, gender, operative time, and number of access tracts. Conclusions: Trifecta status was achieved in 6 out of 10 patients after vmPCNL. Stone distribution in multiple calyceal groups and stone volume were independent unfavourable risk factors for trifecta.
Identification of Functional Cortical Plasticity in Children with Cerebral Palsy Associated to Robotic-Assisted Gait Training: An fNIRS Study
Authors: Perpetuini David , Russo Emanuele Francesco , Cardone Daniela , Palmieri Roberta , Filippini Chiara , Tritto Michele , Pellicano Federica , De Santis Grazia Pia , Calabrò Rocco Salvatore , Merla Arcangelo , Filoni Serena
Published: November 2022

Cerebral palsy (CP) is a non-progressive neurologic condition that causes gait limitations, spasticity, and impaired balance and coordination. Robotic-assisted gait training (RAGT) has become a common rehabilitation tool employed to improve the gait pattern of people with neurological impairments. However, few studies have demonstrated the effectiveness of RAGT in children with CP and its neurological effects through portable neuroimaging techniques, such as functional near-infrared spectroscopy (fNIRS). The aim of the study is to evaluate the neurophysiological processes elicited by RAGT in children with CP through fNIRS, which was acquired during three sessions in one month. The repeated measure ANOVA was applied to the β-values delivered by the General Linear Model (GLM) analysis used for fNIRS data analysis, showing significant differences in the activation of both prefrontal cortex (F (1.652, 6.606) = 7.638; p = 0.022), and sensorimotor cortex (F (1.294, 5.175) = 11.92; p = 0.014) during the different RAGT sessions. In addition, a cross-validated Machine Learning (ML) framework was implemented to estimate the gross motor function measure (GMFM-88) from the GLM β-values, obtaining an estimation with a correlation coefficient r = 0.78. This approach can be used to tailor clinical treatment to each child, improving the effectiveness of rehabilitation for children with CP.
Possibility of Neoadjuvant Treatment for Radiologically Judged Resectable Pancreatic Cancer
Authors: Okabayashi Takehiro , Sui Kenta , Tabuchi Motoyasu , Murokawa Takahiro , Sakamoto Shinichi , Iwata Jun , Morita Sojiro , Okamoto Nobuto , Iiyama Tatsuo , Shimada Yasuhiro , Fujiwara Toshiyoshi
Published: November 2022

Survival remains poor even after resection of pancreatic cancer and the postoperative recurrence rate is extremely high. Thus, neoadjuvant treatment may improve outcomes for resectable pancreatic cancer (RPC). This study evaluated the efficacy of neoadjuvant therapy for radiologically judged RPC. A prospectively maintained institutional database was reviewed to identify patients who underwent potentially curative resection of radiologically judged RPC. Patient characteristics and intermediate-term outcomes were compared between groups that received neoadjuvant treatment or upfront surgery (UFS). We identified 353 eligible patients, including 55 patients who received neoadjuvant chemoradiotherapy (CRT group), 53 patients who received neoadjuvant gemcitabine plus nab-paclitaxel (GnP group), and 245 patients who underwent UFS (UFS group). The cumulative rates of pancreatic cancer recurrence at 2 years after pancreatic surgery were 49.5% in the UFS, 48.1% in the CRT group, and 52.7% in the GnP group. The recurrence rate tended to be improved after neoadjuvant treatment, although the difference was not significant at this follow-up point. While the clinical TNM classifications were noticeably different from the final pathological findings, the clinical and pathological TNM classifications were more similar in the groups that underwent neoadjuvant treatment. Neoadjuvant treatment can help identify good surgical candidates and avoid unnecessary laparotomy. Our results also suggest that neoadjuvant therapy might help improve the preoperative diagnostic accuracy for patients with RPC.
Combination of Interleukin-6, C-Reactive Protein and Procalcitonin Values as Predictive Index of Sepsis in Course of Fever Episode in Adult Haematological Patients: Observational and Statistical Study
Authors: Carcò Daniela , Castorina Paolo , Guardo Paola , Iachelli Valeria , Pace Tecla , Scirè Paola , Stanco Rosaria , Markovic Uros , Milone Giulio Antonio , Galbo Federica , Moschetti Gaetano , Martorana Emanuele
Published: November 2022

Haematological patients represent a vulnerable population to opportunistic infections, mainly due to the disease itself and chemotherapy-induced neutropenia. The level of immune suppression strongly increases the importance of timely antibiotic treatment in order to prevent sepsis-related mortality. During the initial fever episode, serum biomarkers are usually used to estimate the probability of blood stream infection prior to the results of microbial diagnosis. A new serum biomarker combination study on a febrile haematological population, including C-reactive protein (CRP), interleukin-6 (IL−6) and procalcitonin (PCT), is proposed in order to improve their predictive accuracy. In our prospective study, CRP, IL−6 and PCT were evaluated in 34 immunosuppressed haematological patients immediately after the onset of 51 fever episodes, either during the course of standard chemotherapy or high-dose chemotherapy and autologous stem cell transplant. The fever episodes were divided into documented infections and fever alone. Receiver operating characteristic analysis (ROC) was performed for each biomarker and a combination of all three biomarkers (multiROC) to define a new predictive index. Significant differences were evidenced between the two groups (documented infection and no infection) for both PCT and IL−6 (p = 0.03 and p = 0.035, respectively), but none for CRP (p = 0.1). The composite parameter is more reliable than any single biomarker alone, with an area under the curve (AUC) of 79% and with high sensitivity and specificity. IL−6 gave the closest response compared to the composite index. Composite parameters of serum biomarkers could be used for an early diagnosis of infection at fever onset in haematological patients.
Pupillometry as a Window into Young Children’s Sustained Attention
Authors: Benitez Viridiana L. , Robison Matthew K.
Published: November 2022

Sustained attention is critical to cognition, social competence, and academic success. Importantly, sustained attention undergoes significant development over the early childhood period. Yet, how sustained attention fluctuates over time on task has not been clearly outlined, particularly in young children. In this study, we provide a first test of whether the pupillary response can be used as an indicator of moment-to-moment sustained attention over time on task in young children. Children aged 5 to 7 years (N = 41) completed a psychomotor vigilance task, where they were asked to press a button as fast as possible at the onset of a target stimulus. We measured reaction times over the course of the task, pupil size prior to target onset (baseline pupil size), and pupil size in response to target onset (task-evoked pupil size). The results showed a stereotypical vigilance decrement in children’s response times: as time on task increased, reaction times increased. Critically, children’s task-evoked pupil size decreased over time on task, while no such change was present in baseline pupil size. These results suggest that young children’s waning sustained attention may be linked to a decrease in alertness while overall arousal is maintained. We discuss the importance of leveraging pupillometry to understand the mechanisms of sustained attention over individuals and development.
Reduction of Sulphur in Marine Residual Fuels by Deasphalting to Produce VLSFO
Authors: Sultanbekov Radel , Denisov Kirill , Zhurkevich Aleksei , Islamov Shamil
Published: November 2022

This paper presents the results of the controlled sedimentation process for deasphalting, caused by targeted formation of the fuel dispersed system components incompatibility (proportion of the paraffins with normal structure increase) experimental investigations. The main purpose was to decrease the contained amount of sulphur in sedentary marine fuel and procure VLSFO. Developed and given account of the laboratorial method of instituting the sediment which modifies standard TSP and allows to control the deasphalting with the take-off of sediment and deasphaltisate for future analysis. In this case, 5 components of marine fuels, their basic physical and chemical properties, and chemical group composition were used as an object of study. Based on the data obtained and via use of worked out software package, 6 compositions of marine fuels were specified. Furthermore, they were then produced and their quality attributes were defined. The results show that the deasphalting caused by the components targeted incompatibility is accompanied by the desulphurization. Sulphur concentration took place in the sediment where its content was 4.5 times higher than in composite fuel. At the same time, sediment content fell from 0.9% to 1.02% by weight according to the fuel composition. The sulphur content in the resulting deasphaltisate declined by approximately 15% in relation to original fuel mix, moreover, other quality indicators improved. In order to find out whether the usage of sediment obtained is possible, its composition and structure were assessed. The results of the interpretation showed, that sediments were inclined to bitumens, which allows them to be mixed with sediments as a way to cut process waste. Targeted deasphalting makes it possible for the expenses on reducing sulphur containment in marine residual fuels to be decreased, which expands the opportunities of fuels application according to ISO 8217:2017.
Typhoon-Resistant Performance Assessment of Coastal Rural Residential Keel Brick Walls Reinforced with High Ductility Concrete
Authors: Li Qiang , Zhang Jun , Wang Rui , Liu Jing , Li Ping
Published: November 2022

The keel brick wall belongs to the rural residential exterior wall unique to the southeast coastal region of China. The wooden keel inside the wall and the external tie members can improve the stability of the whole wall. However, due to the age of construction, the wooden keel inside the existing residential keel brick walls has basically rotted and lost the tie with the external members, which seriously reduces the stability of the whole wall. Moreover, the collapse of keel brick walls caused by typhoons has become more and more frequent in recent years, seriously endangering the lives and properties of residents. Therefore, it is necessary to carry out reinforcement and repair for the existing residential buildings with keel brick walls. In this paper, the keel brick walls of rural houses in Ningbo area were taken as the research object, a framework for evaluating the performance of keel brick walls against typhoons was established, tests on the lateral force resistance of keel brick walls reinforced with high ductility concrete and mortar were carried out. With the help of typhoon full-track simulation and wind field simulation technology, the 600-year near-surface typhoon wind speeds affecting Ningbo area were obtained. A joint probability distribution model of multi-directional extreme wind speed was constructed using t-Copula function to determine the mixed wind climate of Ningbo area. The extreme wind loads that keel brick walls can withstand under four types of reinforcement were finally given. The results show that the high ductility concrete reinforcement has great advantages over mortar reinforcement and avoids brittle damage of the masonry structure. The keel brick walls reinforced with single-sided mortar can withstand wind loads of a 3-year return period, the keel brick walls reinforced with single-sided high ductile concrete can withstand extreme wind loads of a 110-year return period, while the keel brick walls reinforced with double-sided mortar as well as double-sided high ductile concrete can withstand extreme wind loads of well over a 110-year return period.
Long Range Optical Distance Sensors for Liquid Metal Free Surface Detection
Authors: Brenneis Björn
Published: November 2022

For the demonstration of fusion power plant technology, DEMO dedicated materials are necessary to cope with the harsh environment of high energy neutrons. For this purpose, the international neutron irradiation facility for fusion materials IFMIF/DEMO Oriented Neutron Source (DONES) is planned to be built in Granda, Spain. In the DONES facility, a deuteron beam hitting the lithium target produces a high energy neutron flux. Due to the high-power density, the windowless target is a free surface liquid lithium flow in a duct with a concave backplate. In order to keep the heat released by the beam within the liquid lithium and to avoid its intrusion in the backplate, a stable configuration of the free surface flow with a setpoint layer thickness of 25 ± 1 mm is crucial. In particular, stable wave structures, so called wakes, which occur from accumulated impurities at the nozzle edge, can cause a critical local decrease in the layer thickness of more than 1 mm. Therefore, it is necessary to better understand the nature of these wakes and to be able to monitor the surface profile to shut down the beam in case of a critical thickness loss, but to avoid unintended shutdowns. In the context of this work, currently available optical sensors were tested on their capability of detecting a specular liquid metal surface at measurement distances of several meters. After an initial selection, two optical sensors were further considered. Experiments with the liquid metal alloy GaInSn and simulations with the software Blender of the selected optical sensors for their capability of measuring distances of liquid metal were conducted. The results showed a significant dependency of the measurement results on the waviness of the liquid metal surface. Nevertheless, it was possible to resolve the wavy liquid metal surface with a sufficient resolution to detect critical wake structures.
Risk and Influence Factors of Fall in Immobilization Period after Arthroscopic Interventions
Authors: Rüther Johannes , Boban Luka , Paus Christoph , Loose Kim , Willauschus Maximilian , Bail Hermann Josef , Millrose Michael
Published: November 2022

Knee injuries are one of the most common injuries. Falls during the immobilization period can deteriorate the postoperative outcome. The risk factors causing falls after initial injury and the question of whether a rigid orthosis serves as a protective factor remain unclear. The primary aim of the study was to record the fall rate in the first six weeks after arthroscopic intervention. The secondary aim was to assess the influences of risk factors and protective factors on these fall ratios. Different scores were examined and compared in the groups ‘fall event’ and ‘no fall’. Data from 51 patients (39 males, 12 females) with a mean age of 31.2 years (19–57 years) were collected. A total of 20 patients suffered at least one fall event within the observation period. A total of 18 of 23 fall events happened within the first three weeks postoperatively. The Extra Short Musculoskeletal Function Assessment Questionnaire (XSMFA) showed a significant difference between the groups (p = 0.02). People with multiple injuries to the knee joint were more likely to suffer fall events. Conclusively, patients with limited knee functions appeared to fall more frequently within the first three weeks postoperatively. Therefore, appropriate measures should be taken to protect the postoperative outcome. Physical therapy and patient behavioural training should be practiced perioperatively in patients at risk.
Ethical Conundrums in the Application of Artificial Intelligence (AI) in Healthcare—A Scoping Review of Reviews
Authors: Prakash Sreenidhi , Balaji Jyotsna Needamangalam , Joshi Ashish , Surapaneni Krishna Mohan
Published: November 2022

Background: With the availability of extensive health data, artificial intelligence has an inordinate capability to expedite medical explorations and revamp healthcare.Artificial intelligence is set to reform the practice of medicine soon. Despite the mammoth advantages of artificial intelligence in the medical field, there exists inconsistency in the ethical and legal framework for the application of AI in healthcare. Although research has been conducted by various medical disciplines investigating the ethical implications of artificial intelligence in the healthcare setting, the literature lacks a holistic approach. Objective: The purpose of this review is to ascertain the ethical concerns of AI applications in healthcare, to identify the knowledge gaps and provide recommendations for an ethical and legal framework. Methodology: Electronic databases Pub Med and Google Scholar were extensively searched based on the search strategy pertaining to the purpose of this review. Further screening of the included articles was done on the grounds of the inclusion and exclusion criteria. Results: The search yielded a total of 1238 articles, out of which 16 articles were identified to be eligible for this review. The selection was strictly based on the inclusion and exclusion criteria mentioned in the manuscript. Conclusion: Artificial intelligence (AI) is an exceedingly puissant technology, with the prospect of advancing medical practice in the years to come. Nevertheless, AI brings with it a colossally abundant number of ethical and legal problems associated with its application in healthcare. There are manifold stakeholders in the legal and ethical issues revolving around AI and medicine. Thus, a multifaceted approach involving policymakers, developers, healthcare providers and patients is crucial to arrive at a feasible solution for mitigating the legal and ethical problems pertaining to AI in healthcare.
Blossom: Cluster-Based Routing for Preserving Privacy in Opportunistic Networks
Authors: Kluss Benedikt , Rashidibajgan Samaneh , Hupperich Thomas
Published: November 2022

Opportunistic networks are an enabler technology for typologies without centralized infrastructure. Portable devices, such as wearable and embedded mobile systems, send relay messages to the communication range devices. One of the most critical challenges is to find the optimal route in these networks while at the same time preserving privacy for the participants of the network. Addressing this challenge, we presented a novel routing algorithm based on device clusters, reducing the overall message load and increasing network performance. At the same time, possibly identifying information of network nodes is eliminated by cloaking to meet privacy requirements. We evaluated our routing algorithm in terms of efficiency and privacy in opportunistic networks of traditional and structured cities, i.e., Venice and San Francisco by comparing our approach against the PRoPHET, First Contact, and Epidemic routing algorithms. In the San Francisco and Venice scenarios, Blossom improves messages delivery probability and outperforms PRoPHET, First Contact, and Epidemic by 46%, 100%, and 160% and by 67%, 78%, and 204%, respectively. In addition, the dropped messages probability in Blossom decreased 83% compared to PRoPHET and Epidemic in San Francisco and 91% compared to PRoPHET and Epidemic in Venice. Due to the small number of messages generated, the network overhead in this algorithm is close to zero. The network overhead can be significantly reduced by clustering while maintaining a reliable message delivery.
Assessing Climate Change Exposure for the Adaptation of Conservation Management: The Importance of Scale in Mountain Landscapes
Authors: Gómez-Vadillo Mónica , Mingarro Mario , Ursul Guim , Wilson Robert J.
Published: November 2022

Vulnerability of mountain ecosystems to climate change depends on the capacity of topographic variation to provide heterogeneous microclimates and rates of climatic change. Accurate methods are therefore needed to assess climate at spatial resolutions relevant to ecological responses and environmental management. Here, we evaluate a mechanistic microclimate model (30 m resolution; Microclima) and mesoclimate data (1 km; CHELSA) against in situ temperatures, finding that both capture (whilst somewhat underestimating) variation well in observed ground-level maxima along a mountain ridge in 2011-13. We apply the models to estimate ecological exposure to recent temperature changes for four mountain areas of the Iberian Peninsula, based on analogous and non-analogous monthly maxima in 1980–1989 versus 2010–2019. The microclimate model revealed fine-resolution exposure to non-analogous conditions that were concealed in mesoclimate data, although whether exposure was greater at the micro- or mesoscale (and hence the types of organisms or management decisions affected) depended on the topographic context of each mountain range. Habitat type influenced microclimatic exposure, and hence may provide opportunities for conservation adaptation. These results suggest that mechanistic models are potentially useful tools to assess exposure to climate change at spatial resolutions that permit understanding and management of biodiversity responses in mountain ecosystems.
IG1, a Mansonone F Analog, Exhibits Antibacterial Activity against Staphylococcus aureus by Potentially Impairing Cell Wall Synthesis and DNA Replication
Authors: Chen Xin , Lin Yueqiao , Gao Qianqian , Huang Shiliang , Zhang Zihua , Li Nan , Zong Xin , Guo Xuemin
Published: November 2022

Infection caused by Staphylococcus aureus, especially methicillin-resistant S. aureus (MRSA), is very common in communities and hospitals, which poses a great challenge to human health. Therefore, increasing attention has been paid to finding effective antimicrobial agents. Mansonone F is a natural compound which has an oxaphenalene skeleton and anti-S. aureus activity, but its sources are limited and its synthesis is difficult. Thus, IG1, a C9-substituent mansonone F analog, was assessed for its activity against Staphylococcus aureus and its mechanism of action was investigated. Antimicrobial susceptibility assays showed that IG1 has strong antibacterial activity against S. aureus, including MRSA, with minimum inhibitory concentrations (MICs) ranging from 0.5 to 2 μg/mL, which were very close to those of vancomycin, and these changed little, even with an increase in the amount of the inoculum. To further explore the antibacterial properties of IG1, time–kill experiments were conducted. Compared with vancomycin and moxifloxacin, treatment with different concentrations of IG1 reduced the viability of organisms in a very similar manner and the reduction was not significant, which indicated that IG1 is a potentially strong anti-S. aureus agent. Finally, the antibacterial mechanism was analyzed, with flow cytometric analysis revealing that IG1 treatment resulted in a time-dependent decrease in the DNA content of S. aureus. Transmission electron microscopy (TEM) analysis showed that very few dividing cells could be found and the cell wall was damaged in the field of IG1-treated cells. These results indicate that IG1 is a potential new antibacterial agent against S. aureus, including MRSA.