bluuebunny/crossref_metadata_2025 huggingface dataset:
The Secretome of Parental and Bone Metastatic Breast Cancer Elicits Distinct Effects in Human Osteoclast Activity after Activation of β2 Adrenergic Signaling
Authors: Conceição Francisco , Sousa Daniela M. , Tojal Sofia , Lourenço Catarina , Carvalho-Maia Carina , Estevão-Pereira Helena , Lobo João , Couto Marina , Rosenkilde Mette M. , Jerónimo Carmen , Lamghari Meriem
Published: March 2023

The sympathetic nervous system (SNS), particularly through the β2 adrenergic receptor (β2-AR), has been linked with breast cancer (BC) and the development of metastatic BC, specifically in the bone. Nevertheless, the potential clinical benefits of exploiting β2-AR antagonists as a treatment for BC and bone loss-associated symptoms remain controversial. In this work, we show that, when compared to control individuals, the epinephrine levels in a cohort of BC patients are augmented in both earlier and late stages of the disease. Furthermore, through a combination of proteomic profiling and functional in vitro studies with human osteoclasts and osteoblasts, we demonstrate that paracrine signaling from parental BC under β2-AR activation causes a robust decrease in human osteoclast differentiation and resorption activity, which is rescued in the presence of human osteoblasts. Conversely, metastatic bone tropic BC does not display this anti-osteoclastogenic effect. In conclusion, the observed changes in the proteomic profile of BC cells under β-AR activation that take place after metastatic dissemination, together with clinical data on epinephrine levels in BC patients, provided new insights on the sympathetic control of breast cancer and its implications on osteoclastic bone resorption.
Can Virtual Reality Cognitive Rehabilitation Improve Executive Functioning and Coping Strategies in Traumatic Brain Injury? A Pilot Study
Authors: De Luca Rosaria , Bonanno Mirjam , Marra Angela , Rifici Carmela , Pollicino Patrizia , Caminiti Angelo , Castorina Milva Veronica , Santamato Andrea , Quartarone Angelo , Calabrò Rocco Salvatore
Published: March 2023

Executive dysfunction is among the most common and disabling facets of cognitive impairment following traumatic brain injury (TBI), and may include deficits in reasoning, planning, mental flexibility, some aspects of attention and orientation, awareness and behavior. Rehabilitation programs based on cognitive-behavioral approaches to retrain planning and problem-solving and other executive deficits may improve such cognitive dysfunction. The purpose of this study is to investigate the effects of non-immersive virtual reality-based training to improve executive abilities and to reduce anxiety and depression symptoms in patients with TBI. Twenty patients with moderate to severe TBI were enrolled at our Neurorehabilitation Unit and divided to receive either the standard cognitive training or the virtual reality (VR) based cognitive training using the virtual reality rehabilitation system (VRRS-Evo). Each group received the same amount of rehabilitative training, including ROT (Reality Orientation Therapy) and Executive Training (ET), but using a different approach, i.e., a paper and pencil and an advanced approach. All patients were evaluated with a specific psychometric battery before (T0) and after the end (T1) of each program. Comparing pre- and post- treatment scores, in the VR-CT group, we found statistically significant differences in all administered outcome measures for cognitive and executive functioning, i.e., MoCA (p < 0.005), FAB (p < 0.005), TMT-A (p < 0.005), TMT-B (p < 0.005), TMT-BA (p < 0.001), and mood, i.e., HRS-D (p < 0.008). In the Conventional cognitive training (C-CT) group, we found a significant improvement only in MoCA (p < 0.03), FAB (p < 0.02) and in TMT-BA (p < 0.01). Coping strategies also improved, with better results in the VR-CT group. Our results suggest that VR rehabilitation, using the VRRS system, may be a valuable and motivational approach to improve visuo-executive abilities and coping strategies as well as mood in chronic TBI patients.
Visuo-Spatial Working Memory and Mathematical Skills in Children: A Network Analysis Study
Authors: Macchitella Luigi , Tosi Giorgia , Romano Daniele Luigi , Iaia Marika , Vizzi Francesca , Mammarella Irene C. , Angelelli Paola
Published: March 2023

Visuo-spatial working memory is one of the main domain-general cognitive mechanisms underlying mathematical abilities and their development in children. However, if visuo-spatial working memory involves different processes and components, then the term ‘mathematics’ refers to a broad concept that includes multiple domains and skills. The aim of this present study was to investigate the relationship between different visuo-spatial working memory components and several mathematical abilities in a sample of third- to fifth-grade Italian children. To assess the relationships between different visuo-spatial working memory components and different mathematical abilities, we relied on Network Analysis (NA). Results indicate that some but not all visuo-spatial working memory components are associated with some mathematical abilities.
Experimental and Analytical Investigation on Flexural Behavior of High-Strength Steel-Concrete Composite Beams
Authors: Du Hao , Yuan Shengnan , Yu Tianhong , Hu Xiamin
Published: March 2023

This research investigated the flexural behavior of high-strength steel (HSS)—concrete composite beams. The effect of concrete strength on the load-deflection behavior, flexural capacity, and ductility of HSS—concrete composite beams was investigated. Four full-scale HSS—concrete composite beam specimens were tested under static load. The test results demonstrate that the failure mode of HSS—concrete composite beams is flexural failure of the steel member and compression fracture of concrete at mid-span. The HSS—concrete composite beam exhibits good mechanical performance and deformation behavior. The ultimate bending strength and ductility of HSS—concrete composite beams were improved with the increased concrete strength. The theoretical results demonstrate that the simplified plastic method overestimates the ultimate bending strength of HSS—concrete composite beams. The main reason is that only a small part of the steel beam bottom shows plastic strengthening, which is not enough to make up for the strength loss caused by the steel near the neutral axis failure to yield and the relative interface slip. The nonlinear method based on material constitutive model could predict the load-bearing capacity accurately. After analyzing the ultimate bending capacity of 192 sample beams, the simplified plastic method was modified, and the theoretical method for ultimate bearing capacity of HSS—concrete composite beams was proposed.
Sensitization of Resistant Cells with a BET Bromodomain Inhibitor in a Cell Culture Model of Deep Intrinsic Resistance in Breast Cancer
Authors: Singh Balraj , Sarli Vanessa N. , Milligan Ryan D. , Kinne Hannah E. , Shamsnia Anna , Washburn Laura J. , Addanki Sridevi , Lucci Anthony
Published: March 2023

We treated highly metabolically adaptable (SUM149-MA) triple-negative inflammatory breast cancer cells and their control parental SUM149-Luc cell line with JQ1 for long periods to determine its efficacy at inhibiting therapy-resistant cells. After 20 days of treatment with 1–2 µM of JQ1, which killed majority of cells in the parental cell line, a large number of SUM149-MA cells survived, consistent with their pan-resistant nature. Interestingly, though, the JQ1 treatment sensitized resistant cancer cells in both the SUM149-MA and SUM149-Luc cell lines to subsequent treatment with doxorubicin and paclitaxel. To measure JQ1-mediated sensitization of resistant cancer cells, we first eradicated approximately 99% of relatively chemotherapy-sensitive cancer cells in culture dishes by long treatments with doxorubicin or paclitaxel, and then analyzed the remaining resistant cells for survival and growth into colonies. In addition, combination, rather than sequential, treatment with JQ1 and doxorubicin was also effective in overcoming resistance. Notably, Western blotting showed that JQ1-treated cancer cells had significantly lower levels of PD-L1 protein than did untreated cells, indicating that JQ1 treatment may reduce tumor-mediated immune suppression and improve the response to immunotherapy targeting PD-L1. Finally, JQ1 treatment with a low 62.5 nM dose sensitized another resistant cell line, FC-IBC02-MA, to treatment with doxorubicin and paclitaxel.
Immune Environment and Immunotherapy in Endometrial Carcinoma and Cervical Tumors
Authors: Lainé Alexandra , Gonzalez-Lopez Andrea M. , Hasan Uzma , Ohkuma Ryotaro , Ray-Coquard Isabelle
Published: March 2023

Endometrial cancer (EC) is the seventh most common tumor in women, and prognosis of recurrent and metastatic disease is poor. Cervical cancer (CC) represents the fifth most common gynecological cancer. While ECs are more common in developed countries, the incidence of CC has decreased due to the recent implementation of large screening and vaccination programs. Until very recently, patients with advanced or unresectable EC or CC had very limited treatment options and were receiving in first line setting platinum/taxane-based chemotherapy (CT). Significant progress in the treatment of gynecological cancers has occurred in the last few years, with the use of innovative targeted therapies and immunotherapy. However, targeting the immune system in patients with gynecological tumors remains challenging and is not always successful. In ovarian cancer, several immunotherapy treatment regimens have been investigated (as monotherapy and combination therapy in first and subsequent lines of treatment) and showed poor responses. Therefore, we specifically focused our review on EC and CC for their specific immune-related features and therapeutic results demonstrated with immunotherapy. We report recent and current immunotherapy-based clinical trials and provide a review of emerging data that are likely to impact immunotherapy development based on increased biomarkers’ identification to monitor response and overcome resistance.
Selective Axillary Dissection after Neoadjuvant Chemotherapy in Patients with Lymph-Node-Positive Breast Cancer (CLYP Study): The Radio-Guided Occult Lesion Localization Technique for Biopsy-Proven Metastatic Lymph Nodes
Authors: Rella Rossella , Conti Marco , Bufi Enida , Trombadori Charlotte Marguerite Lucille , Di Leone Alba , Terribile Daniela , Masetti Riccardo , Zagaria Luca , Mulè Antonino , Morciano Francesca , Franceschini Gianluca , Belli Paolo
Published: March 2023

(1) Background: To help to refine the accuracy of sentinel lymph node biopsy (SLNB) in breast cancer (BC) patients with biopsy-proven nodal disease prior to neoadjuvant chemotherapy (NACT), a method of marking the biopsy-proven positive LN at diagnosis to enable its removal during surgery was proposed. The aim of this study was to evaluate the accuracy of the Radio-Guided Occult Lesion Localization (ROLL) technique of biopsy-proven metastatic LN in nodal staging after NACT among node-positive BC patients. (2) Methods: Patients with invasive BC and biopsy-proven axillary metastases receiving NACT were enrolled. A clip marker was placed on the sampled LN (clipped lymph node, CLN) before NACT. Before surgery, the ROLL procedure (radioactive tracer injection into CLN under ultrasound guidance) was performed, and the CLN was surgically resected. The correspondence between the CLNs and SLNs was evaluated. The pathologic findings of the CLNs and SLN(s) were compared with remaining axillary nodes at ALND to determine false negative rates (FNRs). (3) Results: Seventy-two patients were analyzed. Surgery successfully identified the CLN in 70/72 procedures (97.2%). For 60/72 patients who underwent ALND, the FNRs dropped from 19.35% for SLNB to 3.13% for CLN biopsy. (4) Conclusions: The ROLL procedure got CLNs is accurate in axillary nodal staging after NACT in node-positive BC patients at diagnosis.
Specific Subtypes of Carcinoma-Associated Fibroblasts Are Correlated with Worse Survival in Resectable Pancreatic Ductal Adenocarcinoma
Authors: Knipper Karl , Damanakis Alexander I. , Zhao Yue , Bruns Christiane J. , Schmidt Thomas , Popp Felix C. , Quaas Alexander , Lyu Su Ir
Published: March 2023

Purpose: The pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancer entities. Effective therapy options are still lacking. The tumor microenvironment possibly bears further treatment possibilities. This study aimed to describe the expression patterns of four established carcinoma-associated fibroblast (CAFs) markers and their correlation in PDAC tissue samples. Methods: This project included 321 patients with PDAC who underwent surgery with a curative intent in one of the PANCALYZE study centers. Immunohistochemical stainings for FAP, PDGFR, periostin, and SMA were performed. The expression patterns of each marker were divided into low- and high-expressing CAFs and correlated with patients’ survival. Results: Tumors showing SMAhigh-, PeriostinhighSMAhigh-, or PeriostinhighSMAlowPDGFRlowFAPhigh-positive CAFs demonstrated significantly worse survival. Additionally, a high expression of SMA in PDAC tissue samples was shown to be an independent risk factor for worse survival. Conclusion: This project identified three subgroups of PDAC with different expression patterns of CAF markers which showed significantly worse survival. This could be the base for the further characterization of the fibroblast subgroups in PDAC and contribute to the development of new targeted therapy options against CAFs.
Determination of the Cancer Genome Atlas (TCGA) Endometrial Cancer Molecular Subtypes Using the Variant Interpretation and Clinical Decision Support Software MH Guide
Authors: Mustea Alexander , Ralser Damian J. , Egger Eva , Ziehm Ulrike , Vivas Sonia , Brock Stephan , Jackson David , Condic Mateja , Meisel Christian , Otten Lucia , Laib Anna , Cordova Miguel Cubas , Hartmann Rahel , Stein Martin A. , Koensgen Dominique , Stope Matthias B.
Published: March 2023

Background: The Cancer Genome Atlas (TCGA) network (United States National Cancer Institute) identified four molecular endometrial cancer (EC) subtypes using an extensive multi-method approach. The aim of this study was to determine the four TCGA EC molecular subtypes using a single-method whole-exome sequencing (WES)-based approach provided by MH Guide (Molecular Health, Heidelberg, Germany). Methods: WES and clinical data of n = 232 EC patients were obtained from TCGA. The four TCGA EC molecular subtypes designated as (i) Mutated Polymerase ε (POLE), (ii) Microsatellite Instability (MSI), (iii) Copy Number (CN) low and, (iv) CN-high were determined using the MH Guide software. The prognostic value of the subtypes determined by MH Guide were compared with the TCGA classification. Results: Analysis of WES data using the MH Guide software led to the precise identification of the four EC molecular subtypes analogous to the TCGA classification. Both approaches displayed high concordance in terms of prognostic significance. Conclusions: The multi-method-based TCGA EC molecular subtypes can reliably be reproduced by the single-method-based MH Guide approach. The easy-to-implement single-method MH Guide approach represents a promising diagnostic tool.
Loss-of-Function Variants in DRD1 in Infantile Parkinsonism-Dystonia
Authors: Reid Kimberley M. , Steel Dora , Nair Sanjana , Bhate Sanjay , Biassoni Lorenzo , Sudhakar Sniya , Heys Michelle , Burke Elizabeth , Kamsteeg Erik-Jan ,   Genomics England Research Consortium, Hameed Biju , Zech Michael , Mencacci Niccolo E. , Barwick Katy , Topf Maya , Kurian Manju A.
Published: March 2023

The human dopaminergic system is vital for a broad range of neurological processes, including the control of voluntary movement. Here we report a proband presenting with clinical features of dopamine deficiency: severe infantile parkinsonism-dystonia, characterised by frequent oculogyric crises, dysautonomia and global neurodevelopmental impairment. CSF neurotransmitter analysis was unexpectedly normal. Triome whole-genome sequencing revealed a homozygous variant (c.110C>A, (p.T37K)) in DRD1, encoding the most abundant dopamine receptor (D1) in the central nervous system, most highly expressed in the striatum. This variant was absent from gnomAD, with a CADD score of 27.5. Using an in vitro heterologous expression system, we determined that DRD1-T37K results in loss of protein function. Structure-function modelling studies predicted reduced substrate binding, which was confirmed in vitro. Exposure of mutant protein to the selective D1 agonist Chloro APB resulted in significantly reduced cyclic AMP levels. Numerous D1 agonists failed to rescue the cellular defect, reflected clinically in the patient, who had no benefit from dopaminergic therapy. Our study identifies DRD1 as a new disease-associated gene, suggesting a crucial role for the D1 receptor in motor control.
Atherogenic Index of Plasma (AIP) and Its Association with Fatty Liver in Obese Adolescents
Authors: Dağ Hüseyin , İncirkuş Fatih , Dikker Okan
Published: March 2023

Background: The atherogenic index of plasma (AIP) is the base-10 logarithmic conversion of the triglyceride to high-density lipoprotein cholesterol ratio [AIP = log10 (triglyceride/HDL cholesterol)]. Some studies have found a link between low serum vitamin D levels, AIP, and fatty liver. This study was conducted to evaluate the relationship between AIP levels, fatty liver, and vitamin D levels in obese adolescents aged 10–17 years. Methods: This study included 136 adolescents, including 83 obese and 53 healthy controls, in the age range of 10–17 years. Thirty-nine of the obese adolescents had fatty livers. Those with ultrasonography grades 2 or 3 of fat were in the fatty liver group. The AIP value was calculated as the logarithmic conversion of the ratio (triglyceride/HDL cholesterol) at the base of 10. Vitamin D and other laboratory tests were analyzed biochemically. Statistical evaluations were made with the SPSS program. Results: The AIP, body mass index (BMI), homeostatic model assessment for insulin resistance (HOMA-IR), and insulin averages of obese adolescents with fatty liver were significantly higher than those of obese adolescents without fatty liver and the healthy control group (p < 0.05). Again, the mean AIP of obese patients without fatty liver was pointedly higher than that of the healthy control group (p < 0.05). There was a positive, moderate relationship between AIP and BMI, AIP and HOMA-IR, and AIP and insulin levels (p < 0.05), whereas there was a negative, moderate (37.3%) relationship between AIP and vitamin D (p = 0.019). Conclusion: AIP levels were higher in obese adolescents, and this increase was higher in obese adolescents with fatty liver in this study. Moreover, we detected a negative correlation between AIP and vitamin D levels and a positive correlation with BMI, insulin resistance, and insulin levels. Based on our data, we concluded that AIP can be a useful predictor of fatty liver in obese adolescents.
Linear and Nonlinear Optical Properties of PVA:SA Blend Reinforced by TiO2 Nanoparticles Prepared by Flower Extract of Aloe Vera for Optoelectronic Applications
Authors: Khalil Rania , Kelany Nermeen A. , Ibrahim Manar A. , Al-Senani Ghadah M. , Mostafa Ayman M.
Published: March 2023

In this study, a polyvinyl alcohol–sodium alginate blend, PVA:SA 3:1 (w:w), was doped with different contents of TiO2 nanoparticles (NPs) prepared by aloe vera leaf extract to form the investigated nanocomposites. The nonlinear parameters of third-order susceptibility (χ(3)) and refractive index (n2) were detected by using UV-Vis spectroscopy and Z-scan techniques. Some different optical parameters were also determined, including the refractive index (n), optical dielectric parameters, volume and surface energy loss functions, and some others. The best solar skin protection factor (SSPF) was investigated by 5 wt.% of TiO2 NPs doped in PVA:SA 3:1, which was about 84.6% compared to the corresponding value of the host blend (41%). The studied nanocomposites were examined for their utility in the optical limiting of CUT-OFF laser filters utilizing a continuous He-Ne laser working at 632.2 nm. As a result, our finding demonstrated that TiO2 NPs doped in the host blend of PVA:SA positively influences a laser light blocking for the investigated laser source. Using the estimated gap energies values, different models were used to deduce theoretical values of the linear refractive index (n). The presence of Ti peaks in the EDX spectrum confirmed the doping of TiO2 NPs in the nanocomposites. SEM showed that the TiO2 NPs are homogeneously dispersed through the host blend with some agglomerates. XRD spectra showed that the values of the lattice strain εstr. detected at 2ϴ = 19.78° are 0.058, 0.055, and 0.060, corresponding to 1, 3, and 5 wt.% of TiO2 NPs doped in the PVA:SA blend.
Microstructural Evolution and Deterioration of Shear Properties of Sn3.0Ag0.5Cu/Cu Solder Joints after Long-Term Storage at Cryogenic Temperatures
Authors: Guo Xiaotong , Zuo Xinlang , He Hao , Xiao Hui , Liu Jiahao , Tian Ruyu , Liu Yufeng
Published: March 2023

In deep space exploration the exploration equipment will inevitably experience the harsh environment of cryogenic temperature. Solder joints belong to the most vulnerable parts of electronic equipment, and the harsh environment of extreme cryogenic temperature will seriously threaten the reliability of solder joints. In this paper, Sn3.0Ag0.5Cu/Cu solder joints were prepared and stored at cryogenic temperatures (−50 °C, −100 °C, and −196 °C) for up to 960 h, whilst studying the microstructural evolution and deterioration of shear properties. The results showed that the influence of cryogenic temperature on microstructure deterioration was greater than that of storage time. With the decrease of storage temperature and the extension of storage time, the Ag3Sn intermetallic compounds (IMCs) were uniformly dispersed in the β-Sn matrix; the size decreased and the number increased. After being stored at −196 °C for 960 h, some microcracks appeared at the interface of the solder joints. Meanwhile, the shear force of the solder joints was reduced by 19.02%, and the fracture mode changed from ductile fracture to ductile–brittle mixed fracture. Therefore, it is of great scientific significance to reveal the microstructural evolution and deterioration of shear properties of the solder joints under long-term storage at cryogenic temperatures.
Longer Survival and Preserved Liver Function after Proton Beam Therapy for Patients with Unresectable Hepatocellular Carcinoma
Authors: Nosaka Takuto , Matsuda Hidetaka , Sugata Ryotaro , Akazawa Yu , Takahashi Kazuto , Naito Tatsushi , Ohtani Masahiro , Kinoshita Kazuyuki , Tsujikawa Tetsuya , Sato Yoshitaka , Maeda Yoshikazu , Tamamura Hiroyasu , Nakamoto Yasunari
Published: March 2023

Background: Proton beam therapy (PBT) has been recently reported to achieve excellent tumor control with minimal toxicity in patients with unresectable hepatocellular carcinoma (HCC). Radiofrequency ablation (RFA) combined with transcatheter arterial chemoembolization (TACE) was investigated for larger HCC. This study was designed to evaluate the therapeutic effect of PBT on unresectable HCC in comparison with TACE combined with RFA. Methods: We retrospectively analyzed 70 patients with HCC which was difficult to control by surgical resection or RFA monotherapy, 24 patients treated with PBT and 46 patients with TACE plus RFA. The therapeutic effects were assessed as local progression-free survival (PFS) and overall survival (OS). Results: The local PFS was more than 65% in 60 months for PBT and TACE plus RFA. The patients treated with PBT showed 82% OS at 60 months post-treatment. In contrast, those treated with TACE plus RFA showed 28% OS. When comparing the changes of ALBI scores in patients with different severities of chronic liver disease, the scores of PBT-treated patients were maintained at the baseline; however, those of TACE plus RFA-treated patients worsened after the treatments. Conclusions: The results indicated that PBT may show better benefits than TACE plus RFA therapy in terms of OS in patients with unresectable HCC by sparing the non-tumor liver tissues.
Deep-Learning-Enabled Computer-Aided Diagnosis in the Classification of Pancreatic Cystic Lesions on Confocal Laser Endomicroscopy
Authors: Lee Tsung-Chun , Angelina Clara Lavita , Kongkam Pradermchai , Wang Hsiu-Po , Rerknimitr Rungsun , Han Ming-Lun , Chang Hsuan-Ting
Published: March 2023

Accurate classification of pancreatic cystic lesions (PCLs) is important to facilitate proper treatment and to improve patient outcomes. We utilized the convolutional neural network (CNN) of VGG19 to develop a computer-aided diagnosis (CAD) system in the classification of subtypes of PCLs in endoscopic ultrasound-guided needle-based confocal laser endomicroscopy (nCLE). From a retrospectively collected 22,424 nCLE video frames (50 videos) as the training/validation set and 11,047 nCLE video frames (18 videos) as the test set, we developed and compared the diagnostic performance of three CNNs with distinct methods of designating the region of interest. The diagnostic accuracy for subtypes of PCLs by CNNs with manual, maximal rectangular, and U-Net algorithm-designated ROIs was 100%, 38.9%, and 66.7% on a per-video basis and 88.99%, 73.94%, and 76.12% on a per-frame basis, respectively. Our per-frame analysis suggested differential levels of diagnostic accuracy among the five subtypes of PCLs, where non-mucinous PCLs (serous cystic neoplasm: 93.11%, cystic neuroendocrine tumor: 84.31%, and pseudocyst: 98%) had higher diagnostic accuracy than mucinous PCLs (intraductal papillary mucinous neoplasm: 84.43% and mucinous cystic neoplasm: 86.1%). Our CNN demonstrated superior specificity compared to the state-of-the-art for the classification of mucinous PCLs (IPMN and MCN), with high specificity (94.3% and 92.8%, respectively) but low sensitivity (46% and 45.2%, respectively). This suggests the complimentary role of CNN-enabled CAD systems, especially for clinically suspected mucinous PCLs.
An Overview of Clinical Manifestations of Dermatological Disorders in Intensive Care Units: What Should Intensivists Be Aware of?
Authors: Al Bshabshe Ali , Mousa Wesam F. , Nor El-Dein Nashwa
Published: March 2023

Acute skin failure is rarely the primary diagnosis that necessitates admission to an intensive care unit. Dermatological manifestations in critically ill patients, on the other hand, are relatively common and can be used to make a key diagnosis of an adverse drug reaction or an underlying systemic illness, or they may be caused by factors related to a prolonged stay or invasive procedures. In intensive care units, their classification is based on the aetiopathogenesis of the cutaneous lesion and, in the meantime, distinguishes critical patients. When evaluating dermatological manifestations, several factors must be considered: onset, morphology, distribution, and associated symptoms and signs. This review depicts dermatological signs in critical patients in order to lay out better recognition.
Diagnostic Accuracy of 128-Slice Single-Source CT for the Detection of Dislocated Bucket Handle Meniscal Tears in the Setting of an Acute Knee Trauma—Correlation with MRI and Arthroscopy
Authors: Gohla Georg , Kraus Mareen Sarah , Peyker Isabell , Springer Fabian , Keller Gabriel
Published: March 2023

(1) Background: Meniscal tears are amongst the most common knee injuries. Dislocated bucket handle meniscal tears in particular should receive early intervention. The purpose of this study was to evaluate the diagnostic performance of CT in detecting dislocated bucket handle meniscal tears compared with the gold-standard MRI and arthroscopy. (2) Methods: Retrospectively, 96 consecutive patients underwent clinically indicated CT of the knee for suspected acute traumatic knee injuries (standard study protocol, 120 kV, 90 mAs). Inclusion criteria were the absence of an acute fracture on CT and a timely MRI (<6 months). Corresponding arthroscopy was assessed. Two experienced musculoskeletal radiologists analyzed the images for dislocated bucket handle meniscal tears, associated signs thereof (double posterior cruciate ligament sign, double delta sign, disproportional posterior horn sign), and subjective diagnostic confidence on a 5-point-Likert scale (1 = ‘non-diagnostic image quality’, 5 = ‘very confident’). (3) Results: Dislocated bucket handle meniscal tears were detected on CT by standard three-plane bone kernel reconstructions with a sensitivity of 90.7% and a specificity of 99.3% by transferring the knowledge of established MRI signs. The additional use of soft-tissue kernel reconstructions in three planes increased the sensitivity by 4.0% to 94.7%, specificity to 100%, inter-rater agreement to 1.0, and the diagnostic confidence of both readers improved to a median 4/5 (‘confident’) in both readers. (4) Conclusions: Trauma CT scan of the knee with three-plane soft-tissue reconstructions delivers the potential for the detection of dislocated bucket handle meniscal tears with very high diagnostic accuracy.
Single-Site Experience with an Automated Artificial Intelligence Application for Left Ventricular Ejection Fraction Measurement in Echocardiography
Authors: Sveric Krunoslav Michael , Botan Roxana , Dindane Zouhir , Winkler Anna , Nowack Thomas , Heitmann Christoph , Schleußner Leonhard , Linke Axel
Published: March 2023

Left ventricular ejection fraction (LVEF) is a key parameter in evaluating left ventricular (LV) function using echocardiography (Echo), but its manual measurement by the modified biplane Simpson (MBS) method is time consuming and operator dependent. We investigated the feasibility of a server-based, commercially available and ready-to use-artificial intelligence (AI) application based on convolutional neural network methods that integrate fully automatic view selection and measurement of LVEF from an entire Echo exam into a single workflow. We prospectively enrolled 1083 consecutive patients who had been referred to Echo for diagnostic or therapeutic purposes. LVEF was measured independently using MBS and AI. Test–retest variability was assessed in 40 patients. The reliability, repeatability, and time efficiency of LVEF measurements were compared between the two methods. Overall, 889 Echos were analyzed by cardiologists with the MBS method and by the AI. Over the study period of 10 weeks, the feasibility of both automatic view classification and seamlessly measured LVEF rose to 81% without user involvement. LVEF, LV end-diastolic and end-systolic volumes correlated strongly between MBS and AI (R = 0.87, 0.89 and 0.93, p < 0.001 for all) with a mean bias of +4.5% EF, −12 mL and −11 mL, respectively, due to impaired image quality and the extent of LV function. Repeatability and reliability of LVEF measurement (n = 40, test–retest) by AI was excellent compared to MBS (coefficient of variation: 3.2% vs. 5.9%), although the median analysis time of the AI was longer than that of the operator-dependent MBS method (258 s vs. 171 s). This AI has succeeded in identifying apical LV views and measuring EF in one workflow with comparable results to the MBS method and shows excellent reproducibility. It offers realistic perspectives for fully automated AI-based measurement of LVEF in routine clinical settings.
Scaling Up Q-Learning via Exploiting State–Action Equivalence
Authors: Lyu Yunlian , Côme Aymeric , Zhang Yijie , Talebi Mohammad Sadegh
Published: March 2023

Recent success stories in reinforcement learning have demonstrated that leveraging structural properties of the underlying environment is key in devising viable methods capable of solving complex tasks. We study off-policy learning in discounted reinforcement learning, where some equivalence relation in the environment exists. We introduce a new model-free algorithm, called QL-ES (Q-learning with equivalence structure), which is a variant of (asynchronous) Q-learning tailored to exploit the equivalence structure in the MDP. We report a non-asymptotic PAC-type sample complexity bound for QL-ES, thereby establishing its sample efficiency. This bound also allows us to quantify the superiority of QL-ES over Q-learning analytically, which shows that the theoretical gain in some domains can be massive. We report extensive numerical experiments demonstrating that QL-ES converges significantly faster than (structure-oblivious) Q-learning empirically. They imply that the empirical performance gain obtained by exploiting the equivalence structure could be massive, even in simple domains. To the best of our knowledge, QL-ES is the first provably efficient model-free algorithm to exploit the equivalence structure in finite MDPs.
Dynamic Load Balancing in Stream Processing Pipelines Containing Stream-Static Joins
Authors: Marić Josip , Pripužić Krešimir , Antonić Martina , Škvorc Dejan
Published: March 2023

Data stream processing systems are used to continuously run mission-critical applications for real-time monitoring and alerting. These systems require high throughput and low latency to process incoming data streams in real time. However, changes in the distribution of incoming data streams over time can cause partition skew, which is defined as an unequal distribution of data partitions among workers, resulting in sub-optimal processing due to an unbalanced load. This paper presents the first solution designed specifically to address partition skew in the context of joining streaming and static data. Our solution uses state-of-the-art principles to monitor processing load, detect load imbalance, and dynamically redistribute partitions, to achieve optimal load balance. To accomplish this, our solution leverages the collocation of streaming and static data, while considering the processing load of the join and the subsequent stream processing operations. Finally, we present the results of an experimental evaluation, in which we compared the throughput and latency of four stream processing pipelines containing such a join. The results show that our solution achieved significantly higher throughput and lower latency than the competing approaches.
A TDMA-Based Access Protocol for Dense Networks with Moving Nodes for IoT Applications
Authors: Kantelis Konstantinos F. , Beletsioti Georgia A. , Valkanis Anastasios , Nicopolitidis Petros , Papadimitriou Georgios I.
Published: March 2023

Low-power wide-area (LPWA) technologies have gained popularity in accordance with the explosive growth of the Internet of Things (IoT). Among others, LoRa is considered as the leading standard that can meet the needs of modern wireless networking, mainly offering energy efficiency and broad coverage as well as a massive amount of device support. In addition to the ALOHA protocol, which is the default channel access mechanism used by the standard, a number of alternatives have been proposed in the literature in an effort to ameliorate the overall network performance. Furthermore, with moving nodes gaining ground more and more in the IoT realm and the research being at a relatively premature stage, it is imperative to create innovative algorithms that support highly dense networks with fast moving nodes. Motivated by these reasons, this work proposes a novel medium access protocol that takes advantage of the increased capabilities of modern wake up radio (WuR) technology in order to achieve low latency and mitigate the risk of lost packets in IoT networks with moving nodes based on the LoRa technology. A number of simulation scenarios have been devised and the findings suggest that the proposed protocol achieves the set goals and improves existing solutions.
Performance Study on an Electrocaloric Heat Pump Based on Ga-Based Liquid Metal
Authors: Song Panpan , Zhu Yawei , An Zhongyan , Wei Mingshan , Sun Xiaoxia , Zhang Yangjun
Published: March 2023

A solid-state heat pump using the electrocaloric effect (ECE) provides a new idea for the future development of heat pumps. However, most of the electrocaloric (EC) heat pumps presented in the literature are low in efficiency and use at least one moving part, which significantly reduces the reliability of the heat pump and adds to its complexities. In this context, combining the positive and negative ECEs, we proposed a plate-laminar non-mobile EC heat pump adopting Gallium-based liquid metal as an intermediate medium to guarantee highly efficient heat transfer. Numerical simulation in COMSOL Multiphysics has been performed to investigate the correlation between different operating parameters and the performance of the EC heat pump. Changing the temperature span only, a COP of 8.13 and a UVHP of 746.1 W·dm−3 were obtained at a temperature span of 7 K. It was also found that the UVHP increased by 28.45% and COP increased by 25.46% after adding one layer of EC material. The electric-induced quantity of heat and cooling capacity was found to significantly affect the heating performance. The biggest heating power of 7132.7 W·dm−3 was obtained under 200 MV·m−1, and the biggest COP of 14.84 was obtained under 150 MV·m−1 at a cyclic period of 8 s. This study provides a highly efficient, non-mobile EC heat pump that employs fluid-thermal conjugated heat transfer, and exploration of the parameters makes the optimization of the heat pump possible by fine-tuning the operation parameters.
An EV Charging Guidance Strategy Based on the Hierarchical Comprehensive Evaluation Method
Authors: Zhang Cong , Gao Qun , Peng Ke , Jiang Yan
Published: March 2023

With the increasing number of electric vehicles (EVs), the randomness of the charging load will have an increasing impact on the distribution network (DN) and road network. Different guidance strategies lead to different network-related capabilities of fast charging stations (FCSs). In this paper, a hierarchical and comprehensive evaluation method is proposed for the network-related capability of FCSs. Based on the comprehensive evaluation method, a charging guidance strategy is proposed to improve the network-related capability of FCSs. Finally, the network connection capability of FCSs under four strategies is comprehensively evaluated to verify the effectiveness of the proposed method.
iMAGINE—Visions, Missions, and Steps for Successfully Delivering the Nuclear System of the 21st Century
Authors: Merk Bruno , Litskevich Dzianis , Detkina Anna , Noori-kalkhoran Omid , Jain Lakshay , Derrer-Merk Elfriede , Aflyatunova Daliya , Cartland-Glover Greg
Published: March 2023

Nuclear technologies have the potential to play a major role in the transition to a global net-zero society. Their primary advantage is the capability to deliver controllable 24/7 energy on demand. However, as a prerequisite for successful worldwide application, significant innovation will be required to create the nuclear systems of the 21st century, the need of the hour. The pros (low harmful emissions, high reliability, low operational expenses, and high energy density) and cons (environmental damage, fuel waste disposal concerns, limited uranium reserves, and long construction time-frame) of nuclear are discussed and analysed at different levels—the societal and public recognition and concerns (accidents, weapons, mining, and waste) as well as the scientific/engineering and economic level—to assure a demand-driven development. Based on the analysis of the different challenges, a vision for the nuclear system of the 21st century is synthesised consisting of three pillars—unlimited nuclear energy, zero waste nuclear, and accident-free nuclear. These three combined visions are then transformed into dedicated and verifiable missions that are discussed, in detail, regarding challenges and opportunities. In the following, a stepwise approach to the development of such a highly innovative nuclear system is described. Essential steps to assure active risk reduction and the delivery of quick progress are derived as answers to the critique on the currently observed extensive construction time and cost overruns on new nuclear plants. The 4-step process consisting of basic studies, experimental zero power reactor, small-scale demonstrator, and industrial demonstrator is described. The four steps, including sub-steps, deliver the pathway to a successful implementation of such a ground-breaking new nuclear system. The potential sub-steps are discussed with the view not only of the scientific development challenges but also as an approach to reduce the regulatory challenges of a novel nuclear technology.
Analysis of Cantilever Triple-Layer Piezoelectric Harvester (CTLPH): Non-Resonance Applications
Authors: Ghodsi Mojtaba , Mohammadzaheri Morteza , Soltani Payam
Published: March 2023

In this research, a design guideline for a kinetic energy converter using a cantilever triple-layer piezoelectric harvester (CTLPH) for low-frequency applications is presented. By combining the constitutive and internal energy equations, the analytical equations for harvested voltage and power were developed. It was also found that frequency of motion, applied tip force, piezoelectric coefficients, geometrical dimensions, and mechanical properties of layers play significant roles in the performance of the harvester. Having characterised the voltage regulator module, LTC3588, the dependency of output voltage on both the storage and output capacitors of the LTC3588 was investigated. An experimental measurement using the optical method was carried out to determine the applied tip force. Furthermore, the performance of the CTLPH in low frequencies (<3.3 Hz) for various resistive loads was investigated. It was found that both excitation frequency and external resistance load are effective on the maximum generated power. The developed CTLPH shows the optimum power of 17.31 μW at the external resistance of 20 kΩ, which is highly appropriate for micropower devices with at least 3.2 Hz of kinetic vibration in their environment.
Difference in Response of Caragana intermedia Photosynthesis to Soil Water Content in Different Afforestation Years and Related Threshold Effects in Alpine Sandy Lands
Authors: Gao Ya , Jia Zhiqing , Wu Rina , He Lingxianzi , Liu Tao , Li Qingxue , Dai Jie , Zhang Jiapeng , Wang Long
Published: March 2023

This study was carried out to clarify the response of photosynthesis physiology of Caragana intermedia, an excellent tree species for wind protection and sand fixation, to soil water content (SWC) and to determine the relevant threshold ranges in the sandy lands of Qinghai-Tibet Plateau. In this study, based on the three-year forest experiment from 2017a to 2019a, C. intermedia in different afforestation years (2013a, 2011a, 2008a, 2006a, 2001a and 1986a) were selected for experimental analysis, the response process of leaf photosynthesis of C. intermedia to SWC changes was studied, and the physiological mechanism and growth suitability of C. intermedia to adapt to an alpine desert environment were clarified. The results showed that SWC played a critical role in the photosynthesis of C. intermedia in the sandy lands of Qinghai-Tibet Plateau. Afforestation years are negatively correlated with Pn, gs and Tr, but positively correlated with WUE; the longer the afforestation years, the higher demand for soil moisture. Regarding the relative roles of SWC and photosynthetic parameters, we demonstrated that this showed a significant square relationship (p < 0.001), while stomatal closure induced by the photosynthesis decline was important under dryness stress. The no-productivity and no-efficiency water (NPNEW) for the photosynthesis physiology of trees in different afforestation years were 3.31–3.64%; 3.33–4.06%; 3.08–3.63%; 3.36–3.85%; 1.45–4.02% and 3.39–5.50%, and the highest productivity with the highest availability of water (HPHAW) were 6.65–7.19%; 6.74–7.36%; 7.36–7.91%; 6.10–7.51%; 6.57–8.19% and 6.52–8.35%. Plantations in different afforestation years could survive safely in the sandy lands of Qinghai-Tibet Plateau. However, the productivity of trees decreased with the increase length of afforestation years; thus, we should pay attention to their growth status and make timely management adjustments in the future. These results provide important information for theoretical support for the diagnosis of ecological adaptability and field water management of C. intermedia in the sandy lands of Qinghai-Tibet Plateau and provide a reference for the adaptability evaluation and water–carbon cycle simulation of plantations in the sandy lands of Qinghai-Tibet Plateau against the background of global climate change.
Transglutaminase Cross-Linked and Lysozyme-Incorporated Antimicrobial Tilapia Collagen Edible Films: Development and Characterization
Authors: Hou Bing-Yi , Wang Be-Jen , Weng Yih-Ming
Published: March 2023

To improve the mechanical properties and confer antimicrobial activity, transglutaminase (TGase) was used as a cross-linking agent and lysozyme (LYS) was incorporated as an antimicrobial agent to prepare novel active tilapia collagen (TC) films. While the difference in visual appearance was not obvious, the LYS incorporation increased the opacity of TC films. The water vapor permeability of all TGase cross-linked TC films was significantly (p < 0.05) lower than that of the control film (prepared without TGase and LYS). In addition, while the tensile strength and Young’s modulus of all TGase cross-linked TC films were significantly (p < 0.05) higher than those of the control film, elongation at break of all TGase cross-linked TC films was significantly (p < 0.05) lower than that of the control film. LYS incorporated TC films showed antimicrobial activity against E. coli, Staphylococcus aureus, Enterococcus faecium, Bacillus subtilis and Pseudomonas fluorescens. Collectively, TC films with improved physiochemical properties and antimicrobial activity have a good potential to serve as active food packaging materials.
Genomic Characterization and Genetic Profiles of Salmonella Gallinarum Strains Isolated from Layers with Fowl Typhoid in Colombia
Authors: Chacón Ruy D. , Ramírez Manuel , Rodríguez-Cueva Carmen L. , Sánchez Christian , Quispe-Rojas Wilma Ursula , Astolfi-Ferreira Claudete S. , Piantino Ferreira Antonio J.
Published: March 2023

Salmonella Gallinarum (SG) is the causative agent of fowl typhoid (FT), a disease that is harmful to the poultry industry. Despite sanitation and prophylactic measures, this pathogen is associated with frequent disease outbreaks in developing countries, causing high morbidity and mortality. We characterized the complete genome sequence of Colombian SG strains and then performed a comparative genome analysis with other SG strains found in different regions worldwide. Eight field strains of SG plus a 9R-derived vaccine were subjected to whole-genome sequencing (WGS) and bioinformatics analysis, and the results were used for subsequent molecular typing; virulome, resistome, and mobilome characterization; and a comparative genome study. We identified 26 chromosome-located resistance genes that mostly encode efflux pumps, and point mutations were found in gyrase genes (gyrA and gyrB), with the gyrB mutation S464T frequently found in the Colombian strains. Moreover, we detected 135 virulence genes, mainly in 15 different Salmonella pathogenicity islands (SPIs). We generated an SPI profile for SG, including C63PI, CS54, ssaD, SPI-1, SPI-2, SPI-3, SPI-4, SPI-5, SPI-6, SPI-9, SPI-10, SPI-11, SPI-12, SPI-13, and SPI-14. Regarding mobile genetic elements, we found the plasmids Col(pHAD28) and IncFII(S) in most of the strains and 13 different prophage sequences, indicating a frequently obtained profile that included the complete phage Gifsy_2 and incomplete phage sequences resembling Escher_500465_2, Shigel_SfIV, Entero_mEp237, and Salmon_SJ46. This study presents, for the first time, the genomic content of Colombian SG strains and a profile of the genetic elements frequently found in SG, which can be further studied to clarify the pathogenicity and evolutionary characteristics of this serotype.