bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Study on Gemological and Mineralogical Characteristics and Coloration Mechanism of Four Color Types of Fluorite
Authors: Liu Yang , Guo Qingfeng , Liu Liangyu , Zhang Sixue , Li Qingling , Liao Libing
Published: January 2023

Fluorite has been attracting the attention of gemstone mineralogists because of its rich color and excellent fluorescence properties. This paper studied fluorite with three color types (blue, green, and white) and five blue-purple fluorites with an alexandrite effect. Through the study of their structure, composition, and spectral characteristics, the gemological and mineralogical characteristics and coloration mechanisms of different color types of fluorites are compared and analyzed. The results show that the color of fluorite is caused by multiple color centers. Blue fluorite is associated with Y3+-F− color center, while green fluorite is associated with a Y3+-Ce2+-F− color center and Sm2+ color center, and white fluorite contains vacancy color center. The color of white fluorite is a mixture of yellow tones produced in visible light and blue fluorescence under UV light. Blue-purple color is caused by the colloid calcium color center and 2F− color center, and its changing from blue-purple to red-purplish (alexandrite effect) are due to colloidal calcium nanoparticles caused by radioactive element Th.
Stretching and Compression of Double Dusty Plasma Vortex
Authors: Scurtu Adrian , Ticoș Dorina , Mitu Maria Luiza , Udrea Nicoleta , Ticoș Cătălin Mihai
Published: January 2023

The interest in complex plasmas is increasing due to the multiple applications they target (astrophysics, plasma fusion, industry, etc.). A crystal with two vortexes made of spherical microparticles that levitates in an rf plasma interacts with a gas jet. The crystal is displaced in the jet propagation direction due to the neutral pushing force, maintaining its vortex structure. The crystal shift also involves a change of its shape, especially at the level of the two vortexes. One vortex is stretched, and the other one is compressed. During the three phases of modification of the shape of the crystal, its length is approximately constant, about 12.5 mm, this being a consequence of the fact that electric forces and ion drag forces are preserved. The orderly structure of the crystal lasts until the particles begin to fall on the bottom electrode. The changing of the vorticity in the crystal regions can be attributed to the neutral push force.
Formation of LiNbO3 Nanocrystals Using the Solvothermal Method
Authors: Dravecz Gabriella , Kolonits Tamás , Péter László
Published: January 2023

The optimization of the parameters of the solvothermal synthesis of lithium niobate (LiNbO3, LN) nanocrystals from Nb2O5 and LiOH was performed. The effects of polyol media, reaction time and Li excess of the starting reagents were investigated. According to the X-ray diffraction phase analysis, Li3NbO4 and Nb2O5 were also detected besides the LN phase in many samples depending on the ratio of the starting components and the reaction time. The best yield and the most homogeneous LN phase was prepared by using diethylene glycol medium with a Li/Nb ratio of 1.5 and a 72 h reaction time. The size and the shape of the LN particles were characterized by scanning electron microscopy. The particle size distribution was narrow and under 100 nm for all cases.
Facile Adjustment of Exposed Crystal Facet of Hematite Derived-From Goethite to Enhance Cr (VI) Sorption
Authors: Li Yuxin , Lv Guocheng , Wu Limei , Li Zhaohui , Liao Libing
Published: January 2023

The (110) facets of hematite have excellent adsorption performance for chromium. We aim to obtain hematite with a large specific surface area and exposed (110) facets by using natural needle-like goethite as the precursor. The derived hematite shows a significant increment in the removal capacity of chromium by six times compared with goethite under the same experimental conditions. Structural model fitting of extended X-ray absorption fine structure (EXAFS) spectroscopy suggested that the interatomic distance of Cr-Fe was approximately 3.6 Å for the Cr (VI) coordinated hematite with exposed (110) facets, which was characteristic of the form of bidentate binuclear surface complex. Molecular dynamic simulations for the arrangement of Cr (VI) in (110) facets of goethite and hematite indicated the superiority of hematite adsorption for chromium. We optimized efficient and economic permeable reactive barrier (PRB) materials by crystal plane adjustment based on these experimental and theoretical results. It was found that the life span of the column even reached 610 PVs when the initial concentration of Cr (VI) was 20 mg/L, which indicates its potential application in the field of PRB medium material.
Study on Mechanism and Influencing Factors of Wheel Strengthening and Toughening of High-Speed and Heavy-Load Train
Authors: Jia Tuosheng , Shen Zhigang , Liu Cuirong , Zhao Xinglong , Zhang Xiaofeng
Published: January 2023

When maximum speed of 160 km/h is reached and the axle load reaches 25–30 tons, the train wheels need to have high strength and toughness. The main chemical elements affecting the strength and toughness of the wheel were determined by the mechanical features of the samples with different chemical compositions. Through analysis of the impact fracture of typical specimens, the difference of wheel toughness was mainly reflected in the dimple band, crack source, and cleavage pattern. By SEM analysis of fracture cracks, the critical size difference was found to exist between the grains during brittle fracture, where the intergranular fracture between grains of different sizes is mainly due to the different interfacial stresses between grains of different sizes.
A Deep Learning Workflow for Mass-Forming Intrahepatic Cholangiocarcinoma and Hepatocellular Carcinoma Classification Based on MRI
Authors: Liu Yangling , Wang Bin , Mo Xiao , Tang Kang , He Jianfeng , Hao Jingang
Published: January 2023

Objective: Precise classification of mass-forming intrahepatic cholangiocarcinoma (MF-ICC) and hepatocellular carcinoma (HCC) based on magnetic resonance imaging (MRI) is crucial for personalized treatment strategy. The purpose of the present study was to differentiate MF-ICC from HCC applying a novel deep-learning-based workflow with stronger feature extraction ability and fusion capability to improve the classification performance of deep learning on small datasets. Methods: To retain more effective lesion features, we propose a preprocessing method called semi-segmented preprocessing (Semi-SP) to select the region of interest (ROI). Then, the ROIs were sent to the strided feature fusion residual network (SFFNet) for training and classification. The SFFNet model is composed of three parts: the multilayer feature fusion module (MFF) was proposed to extract discriminative features of MF-ICC/HCC and integrate features of different levels; a new stationary residual block (SRB) was proposed to solve the problem of information loss and network instability during training; the attention mechanism convolutional block attention module (CBAM) was adopted in the middle layer of the network to extract the correlation of multi-spatial feature information, so as to filter the irrelevant feature information in pixels. Results: The SFFNet model achieved an overall accuracy of 92.26% and an AUC of 0.9680, with high sensitivity (86.21%) and specificity (94.70%) for MF-ICC. Conclusion: In this paper, we proposed a specifically designed Semi-SP method and SFFNet model to differentiate MF-ICC from HCC. This workflow achieves good MF-ICC/HCC classification performance due to stronger feature extraction and fusion capabilities, which provide complementary information for personalized treatment strategy.
Diversity, Ecological Characteristics and Identification of Some Problematic Phytopathogenic Fusarium in Soil: A Review
Authors: Nikitin Dmitry A. , Ivanova Ekaterina A. , Semenov Mikhail V. , Zhelezova Alena D. , Ksenofontova Natalya A. , Tkhakakhova Azida K. , Kholodov Vladimir A.
Published: January 2023

The genus Fusarium includes many pathogenic species causing a wide range of plant diseases that lead to high economic losses. In this review, we describe how the Fusarium taxonomy has changed with the development of microbiological methods. We specify the ecological traits of this genus and the methods of its identification in soils, particularly the detection of phytopathogenic representatives of Fusarium and the mycotoxins produced by them. The negative effects of soil-borne phytopathogenic Fusarium on agricultural plants and current methods for its control are discussed. Due to the high complexity and polymorphism of Fusarium species, integrated approaches for the risk assessment of Fusarium diseases are necessary.
Effects of Mustard Invasions on Soil Microbial Abundances and Fungal Assemblages in Southern California
Authors: Wakefield Zachary R. , Cavalcanti André R. O. , Driessen Lucía , Jaramillo Ana , Crane Edward J. , Richetta Giuliano , Meyer Wallace M.
Published: January 2023

Although mustards (family, Brassicaceae) are common across southern California, research has not focused on the effects of type-conversion of native California sage scrub (CSS) to areas dominated by invasive mustards. To better understand how mustard invasions, primarily the short-pod mustard, Hirschfeldia incana, impact soil microbial assemblages, we examined microbial abundance and assemblages from intact CSS and adjacent mustard-dominated soils at three sites. We also explored if germination rates for various plant species differed between CSS and mustard soils. We found that mustard invasions reduce soil microbial abundances by more than 50% and alter soil fungal assemblages. Fungal richness, diversity, and evenness did not differ between habitats, highlighting that these habitats harbor unique microbial assemblages. While mustard allelopathy is predicted to be the primary driver of these changes, mustard invasions also increased soil pH. Although functional consequences of these shifts are unknown, low mustard germination in CSS soils supports biological resistance to mustard invasion in CSS. Overall, our results demonstrate that mustard invasions, H. incana in particular, exert a strong selecting force on soil microbial assemblages, which can influence effective CSS restoration and preservation of ecosystem services.
EDLDR: An Ensemble Deep Learning Technique for Detection and Classification of Diabetic Retinopathy
Authors: Mondal Sambit S. , Mandal Nirupama , Singh Krishna Kant , Singh Akansha , Izonin Ivan
Published: January 2023

Diabetic retinopathy (DR) is an ophthalmological disease that causes damage in the blood vessels of the eye. DR causes clotting, lesions or haemorrhage in the light-sensitive region of the retina. Person suffering from DR face loss of vision due to the formation of exudates or lesions in the retina. The detection of DR is critical to the successful treatment of patients suffering from DR. The retinal fundus images may be used for the detection of abnormalities leading to DR. In this paper, an automated ensemble deep learning model is proposed for the detection and classification of DR. The ensembling of a deep learning model enables better predictions and achieves better performance than any single contributing model. Two deep learning models, namely modified DenseNet101 and ResNeXt, are ensembled for the detection of diabetic retinopathy. The ResNeXt model is an improvement over the existing ResNet models. The model includes a shortcut from the previous block to next block, stacking layers and adapting split–transform–merge strategy. The model has a cardinality parameter that specifies the number of transformations. The DenseNet model gives better feature use efficiency as the dense blocks perform concatenation. The ensembling of these two models is performed using normalization over the classes followed by maximum a posteriori over the class outputs to compute the final class label. The experiments are conducted on two datasets APTOS19 and DIARETDB1. The classifications are carried out for both two classes and five classes. The images are pre-processed using CLAHE method for histogram equalization. The dataset has a high-class imbalance and the images of the non-proliferative type are very low, therefore, GAN-based augmentation technique is used for data augmentation. The results obtained from the proposed method are compared with other existing methods. The comparison shows that the proposed method has higher accuracy, precision and recall for both two classes and five classes. The proposed method has an accuracy of 86.08 for five classes and 96.98% for two classes. The precision and recall for two classes are 0.97. For five classes also, the precision and recall are high, i.e., 0.76 and 0.82, respectively.
A Multi-Stage Approach to Breast Cancer Classification Using Histopathology Images
Authors: Bagchi Arnab , Pramanik Payel , Sarkar Ram
Published: January 2023

Breast cancer is one of the deadliest diseases worldwide among women. Early diagnosis and proper treatment can save many lives. Breast image analysis is a popular method for detecting breast cancer. Computer-aided diagnosis of breast images helps radiologists do the task more efficiently and appropriately. Histopathological image analysis is an important diagnostic method for breast cancer, which is basically microscopic imaging of breast tissue. In this work, we developed a deep learning-based method to classify breast cancer using histopathological images. We propose a patch-classification model to classify the image patches, where we divide the images into patches and pre-process these patches with stain normalization, regularization, and augmentation methods. We use machine-learning-based classifiers and ensembling methods to classify the image patches into four categories: normal, benign, in situ, and invasive. Next, we use the patch information from this model to classify the images into two classes (cancerous and non-cancerous) and four other classes (normal, benign, in situ, and invasive). We introduce a model to utilize the 2-class classification probabilities and classify the images into a 4-class classification. The proposed method yields promising results and achieves a classification accuracy of 97.50% for 4-class image classification and 98.6% for 2-class image classification on the ICIAR BACH dataset.
The Role of miRNAs in the Prognosis of Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis
Authors: Santana Talita Araújo B. da S. , de Oliveira Passamai Larissa , de Miranda Felipe Silva , Borin Thaiz Ferraz , Borges Grasiely Faccin , Luiz Wilson Barros , Campos Luciene Cristina Gastalho
Published: January 2023

Breast cancer is one of the most common malignancies among women around the world. The basal or triple-negative subtype (TNBC) is a heterogeneous group of tumors, characterized by its aggressive and metastatic nature, with low survival and worse prognosis. Research on genetic biomarkers, such as microRNAs (miRs) in TNBC, demonstrate their relevance in the prognosis of the disease. Therefore, the objective of this research was to verify the role of miRs in the prognosis of TNBC. A search was carried out in the PubMed (MEDLINE), Web of Science, and Scopus databases, with articles in the English language from 2010 to 2022. Only articles that analyzed the role of miRNAs in the prognosis of TNBC and that met the criteria of the MOOSE method were included. For the preparation and planning of this systematic review, a PRISMA checklist and the MOOSE method were used. The Newcastle–Ottawa Scale was used to analyze the quality of the included studies. The excluded criteria considered were: (1) studies that presented duplication in the databases; (2) reviews of the literature, clinical case reports, meta-analyses, conference abstracts, letters to the editor, theses, dissertations, and book chapters; (3) studies that stratified only women diagnosed with other subtypes of breast cancer subtypes; (4) experiments without a control or comparison group. After the bibliographic survey of the 2.274 articles found, 43 articles met the inclusion criteria, totaling 5421 patients with TNBC analyzed for this review. Six miRs (miR-155, miR-21, miR-27a/b/, miR-374a/b, miR-30a/c/e, and miR-301a) were included in the meta-analysis. A low expression of miR-155 was associated with reduced overall survival (OS) (HR: 0.68, 95% CI: 0.58–0.81). A high expression of miR-21 was a predictor of OS reduction (HR: 2.56; 95% CI: 1.49–4.40). In addition, high levels of miR-27a/b and miR-301a/b were associated with lower OS, while the decreased expression levels of miR-30 and miR-374a/b were associated with worse relapse-free survival (RFS) and shorter disease-free survival (DFS), respectively. The present study revealed that miRs play essential roles in the development of metastases, in addition to acting as suppressors of the disease, thus improving the prognosis of TNBC. However, the clinical application of these findings has not yet been investigated.
Clinical Applications of Quantitative Perfusion Imaging with a C-Arm Flat-Panel Detector—A Systematic Review
Authors: Zaid Al-Kaylani Abdallah H. A. , Schuurmann Richte C. L. , Maathuis Wouter D. , Slart Riemer H. J. A. , De Vries Jean-Paul P. M. , Bokkers Reinoud P. H.
Published: January 2023

C-arm systems with digital flat-panel detectors are used in interventional radiology and hybrid operating rooms for visualizing and performing interventions on three-dimensional structures. Advances in C-arm technology have enabled intraoperative quantitative perfusion imaging with these scanners. This systematic review provides an overview of flat-panel detector C-arm techniques for quantifying perfusion, their clinical applications, and their validation. A systematic search was performed for articles published between January 2000 and October 2022 in which a flat-panel detector C-arm technique for quantifying perfusion was compared with a reference technique. Nine articles were retrieved describing two techniques: two-dimensional perfusion angiography (n = 5) and dual-phase cone beam computed tomography perfusion (n = 4). A quality assessment revealed no concerns about the applicability of the studies. The risk of bias was relatively high for the index and reference tests. Both techniques demonstrated potential for clinical application; however, weak-to-moderate correlations were reported between them and the reference techniques. In conclusion, both techniques could add new possibilities to treatment planning and follow-up; however, the available literature is relatively scarce and heterogeneous. Larger-scale randomized prospective studies focusing on clinical outcomes and standardization are required for the full understanding and clinical implementation of these techniques.
The Feasibility of Interventional Pulmonology Methods for Detecting the T790M Mutation after the First or Second-Generation EGFR-TKI Resistance of Non-Small Cell Lung Cancer
Authors: Cheng Wen-Chien , Shen Yi-Cheng , Chen Chieh-Lung , Liao Wei-Chih , Chen Hung-Jen , Hsia Te-Chun , Chen Chia-Hung , Tu Chih-Yen
Published: January 2023

The development of third-generation epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) targeting T790M-mutant non-small cell lung cancer (NSCLC) has raised the importance of re-biopsy after EGFR-TKI failure. This study aimed to investigate the feasibility of interventional pulmonology (IP) procedures as re-biopsy methods for identifying the T790M mutation in EGFR-TKI-resistant patients. One hundred and thirty-nine NSCLC patients who underwent IP procedures for re-biopsy as their initial investigation after EGFR-TKI treatment failure were enrolled in this study between January 2020 and August 2022. All patients underwent a first re-biopsy with IP methods, with a diagnostic yield of 81.2% and T790M mutation detection rate of 36%. Thirty patients underwent a second re-biopsy; IP methods were used for 17 (56.6%) patients and non-IP methods for 13 (43.4%) patients; the T790M mutation detection rate was 36.4%. Only six patients underwent a third re-biopsy; no T790M mutation was noted. The T790M mutation detection rate did not differ between IP and non-IP methods (33.6 % vs. 37.5%, p = 0.762). In 11 cases (7.5%), a re-biopsy revealed histologic transformation from lung adenocarcinoma. IP procedures, as first-line re-biopsy methods for NSCLC, are feasible and provide sufficient tissue for identification of the resistance mechanism and target gene T790M mutation.
An Efficient Deep Learning Method for Detection of COVID-19 Infection Using Chest X-ray Images
Authors: Nayak Soumya Ranjan , Nayak Deepak Ranjan , Sinha Utkarsh , Arora Vaibhav , Pachori Ram Bilas
Published: January 2023

The research community has recently shown significant interest in designing automated systems to detect coronavirus disease 2019 (COVID-19) using deep learning approaches and chest radiography images. However, state-of-the-art deep learning techniques, especially convolutional neural networks (CNNs), demand more learnable parameters and memory. Therefore, they may not be suitable for real-time diagnosis. Thus, the design of a lightweight CNN model for fast and accurate COVID-19 detection is an urgent need. In this paper, a lightweight CNN model called LW-CORONet is proposed that comprises a sequence of convolution, rectified linear unit (ReLU), and pooling layers followed by two fully connected layers. The proposed model facilitates extracting meaningful features from the chest X-ray (CXR) images with only five learnable layers. The proposed model is evaluated using two larger CXR datasets (Dataset-1: 2250 images and Dataset-2: 15,999 images) and the classification accuracy obtained are 98.67% and 99.00% on Dataset-1 and 95.67% and 96.25% on Dataset-2 for multi-class and binary classification cases, respectively. The results are compared with four contemporary pre-trained CNN models as well as state-of-the-art models. The effect of several hyperparameters: different optimization techniques, batch size, and learning rate have also been investigated. The proposed model demands fewer parameters and requires less memory space. Hence, it is effective for COVID-19 detection and can be utilized as a supplementary tool to assist radiologists in their diagnosis.
Biomechanical Rupture Risk Assessment in Management of Patients with Abdominal Aortic Aneurysm in COVID-19 Pandemic
Authors: Kubicek Lubos , Vitasek Radek , Schwarz David , Staffa Robert , Strakos Petr , Polzer Stanislav
Published: January 2023

Background: The acute phase of the COVID-19 pandemic requires a redefinition of healthcare system to increase the number of available intensive care units for COVID-19 patients. This leads to the postponement of elective surgeries including the treatment of abdominal aortic aneurysm (AAA). The probabilistic rupture risk index (PRRI) recently showed its advantage over the diameter criterion in AAA rupture risk assessment. Its major improvement is in increased specificity and yet has the same sensitivity as the maximal diameter criterion. The objective of this study was to test the clinical applicability of the PRRI method in a quasi-prospective patient cohort study. Methods: Nineteen patients (fourteen males, five females) with intact AAA who were postponed due to COVID-19 pandemic were included in this study. The PRRI was calculated at the baseline via finite element method models. If a case was diagnosed as high risk (PRRI > 3%), the patient was offered priority in AAA intervention. Cases were followed until 10 September 2021 and a number of false positive and false negative cases were recorded. Results: Each case was assessed within 3 days. Priority in intervention was offered to two patients with high PRRI. There were four false positive cases and no false negative cases classified by PRRI. In three cases, the follow-up was very short to reach any conclusion. Conclusions: Integrating PRRI into clinical workflow is possible. Longitudinal validation of PRRI did not fail and may significantly decrease the false positive rate in AAA treatment.
miR-146a, miR-221, and miR-155 are Involved in Inflammatory Immune Response in Severe COVID-19 Patients
Authors: Gaytán-Pacheco Noemí , Ibáñez-Salazar Alejandro , Herrera-Van Oostdam Ana Sofía , Oropeza-Valdez Juan José , Magaña-Aquino Martín , Adrián López Jesús , Monárrez-Espino Joel , López-Hernández Yamilé
Published: January 2023

COVID-19 infection triggered a global public health crisis during the 2020–2022 period, and it is still evolving. This highly transmissible respiratory disease can cause mild symptoms up to severe pneumonia with potentially fatal respiratory failure. In this cross-sectional study, 41 PCR-positive patients for SARS-CoV-2 and 42 healthy controls were recruited during the first wave of the pandemic in Mexico. The plasmatic expression of five circulating miRNAs involved in inflammatory and pathological host immune responses was assessed using RT-qPCR (Reverse Transcription quantitative Polymerase Chain Reaction). Compared with controls, a significant upregulation of miR-146a, miR-155, and miR-221 was observed; miR-146a had a positive correlation with absolute neutrophil count and levels of brain natriuretic propeptide (proBNP), and miR-221 had a positive correlation with ferritin and a negative correlation with total cholesterol. We found here that CDKN1B gen is a shared target of miR-146a, miR-221-3p, and miR-155-5p, paving the way for therapeutic interventions in severe COVID-19 patients. The ROC curve built with adjusted variables (miR-146a, miR-221-3p, miR-155-5p, age, and male sex) to differentiate individuals with severe COVID-19 showed an AUC of 0.95. The dysregulation of circulating miRNAs provides new insights into the underlying immunological mechanisms, and their possible use as biomarkers to discriminate against patients with severe COVID-19. Functional analysis showed that most enriched pathways were significantly associated with processes related to cell proliferation and immune responses (innate and adaptive). Twelve of the predicted gene targets have been validated in plasma/serum, reflecting their potential use as predictive prognosis biomarkers.
Transcatheter Arterial Embolization for Alleviating Chronic Musculoskeletal Pain and Improving Physical Function: A Narrative Review
Authors: Wang Bow , Liang Keng-Wei , Chen Chia-Hui , Wang Chien-Kuo
Published: January 2023

Chronic musculoskeletal pain imposes immense suffering and diminishes the quality of life for millions of patients worldwide; the pain persists despite the use of standard conservative treatments. Increases in our understanding of the pathophysiological mechanisms underlying musculoskeletal disorders indicate the involvement of inappropriate angiogenesis. Accordingly, the resulting neovessels are the target of emerging treatments for chronic musculoskeletal pain, including transarterial embolization. The use of this noninvasive procedure to treat pain refractory to standard therapy in a variety of musculoskeletal conditions is the focus of numerous recent investigations. Here, we describe the pathophysiological indications for the use of transarterial embolization and summarize the findings of studies investigating its use in a variety of histopathological conditions and anatomical sites.
Assessment of Enhancement Kinetics Improves the Specificity of Abbreviated Breast MRI: Performance in an Enriched Cohort
Authors: Kim Haejung , Ko Eun , Kim Ka , Kim Myoung , Choi Ji , Ko Eun , Han Boo-Kyung
Published: January 2023

Objective: To investigate the added value of kinetic information for breast lesion evaluation on abbreviated breast MRI (AB-MRI). Methods: This retrospective study analyzed 207 breast lesions with Breast Imaging Reporting and Data System categories 3, 4, or 5 on AB-MRI in 198 consecutive patients who had breast MRI for screening after breast cancer surgery between January 2017 and December 2019. All lesions were pathologically confirmed or stable on follow-up images for 2 years or more. Kinetic information of the lesions regarding the degree and rate of enhancement on the first post-contrast-enhanced image and the enhancement curve type from two post-contrast-enhanced images were analyzed on a commercially available computer-assisted diagnosis system. The diagnostic performances of AB-MRI with morphological analysis alone and with the addition of kinetic information were compared using the McNemar test. Results: Of 207 lesions, 59 (28.5%) were malignant and 148 (71.5%) were benign. The addition of an enhancement degree of ≥90% to the morphological analysis significantly increased the specificity of AB-MRI (29.7% vs. 52.7%, p < 0.001) without significantly reducing the sensitivity (94.9% vs. 89.8%, p = 0.083) compared to morphological analysis alone. Unnecessary biopsy could have been avoided in 34 benign lesions, although three malignant lesions could have been missed. For detecting invasive cancer, adding an enhancement degree ≥107% to the morphological analysis significantly increased the specificity (26.5% vs. 57.6%, p < 0.001) without significantly decreasing the sensitivity (94.6% vs. 86.5%, p = 0.083). Conclusion: Adding the degree of enhancement on the first post-contrast-enhanced image to the morphological analysis resulted in higher AB-MRI specificity without compromising its sensitivity.
Cardiac Magnetic Resonance in Hypertensive Heart Disease: Time for a New Chapter
Authors: Zdravkovic Marija , Klasnja Slobodan , Popovic Maja , Djuran Predrag , Mrda Davor , Ivankovic Tatjana , Manojlovic Andrea , Koracevic Goran , Lovic Dragan , Popadic Viseslav
Published: January 2023

Hypertension is one of the most important cardiovascular risk factors, associated with significant morbidity and mortality. Chronic high blood pressure leads to various structural and functional changes in the myocardium. Different sophisticated imaging methods are developed to properly estimate the severity of the disease and to prevent possible complications. Cardiac magnetic resonance can provide a comprehensive assessment of patients with hypertensive heart disease, including accurate and reproducible measurement of left and right ventricle volumes and function, tissue characterization, and scar quantification. It is important in the proper evaluation of different left ventricle hypertrophy patterns to estimate the presence and severity of myocardial fibrosis, as well as to give more information about the benefits of different therapeutic modalities. Hypertensive heart disease often manifests as a subclinical condition, giving exceptional value to cardiac magnetic resonance as an imaging modality capable to detect subtle changes. In this article, we are giving a comprehensive review of all the possibilities of cardiac magnetic resonance in patients with hypertensive heart disease.
Ischiofemoral Impingement Syndrome: Clinical and Imaging/Guidance Issues with Special Focus on Ultrasonography
Authors: Wu Wei-Ting , Chang Ke-Vin , Mezian Kamal , Naňka Ondřej , Ricci Vincenzo , Chang Hsiang-Chi , Wang Bow , Hung Chen-Yu , Özçakar Levent
Published: January 2023

Ischiofemoral impingement syndrome is a neglected cause of posterior hip pain which is derived from narrowing of the space between the lateral aspect of the ischium and the medial aspect of the lesser trochanter. Its diagnosis is challenging and requires the combination of physical tests and imaging studies. In the present narrative review, we found that femoral anteversion predisposes patients to the narrowing of the ischiofemoral space and subsequent quadratus femoris muscle injury. Magnetic resonance imaging serves as the gold-standard diagnostic tool, which facilities the quantification of the ischiofemoral distance and the recognition of edema/fat infiltration/tearing of the quadratus femoris muscle. Ultrasound is useful for scrutinizing the integrity of deep gluteal muscles, and its capability to measure the ischiofemoral space is comparable to that of magnetic resonance. Various injection regimens can be applied to treat ischiofemoral impingement syndrome under ultrasound guidance and they appear to be safe and effective. Finally, more randomized controlled trials are needed to build solid bases of evidence on ultrasound-guided interventions in the management of ischiofemoral impingement syndrome.
Cervicovaginal-Microbiome Analysis by 16S Sequencing and Real-Time PCR in Patients from Novosibirsk (Russia) with Cervical Lesions and Several Years after Cancer Treatment
Authors: Ivanov Mikhail K. , Brenner Evgeny V. , Hodkevich Anastasia A. , Dzyubenko Victoria V. , Krasilnikov Sergey E. , Mansurova Alphiya S. , Vakhturova Irina E. , Agletdinov Eduard F. , Shumeikina Anastasia O. , Chernyshova Alyona L. , Titov Sergei E.
Published: January 2023

Disturbed cervicovaginal-microbiome (CVM) structure promotes human papillomavirus (HPV) persistence and reflects risks of cervical lesions and cancer onset and recurrence. Therefore, microbiomic biomarkers may be useful for cervical disease screening and patient management. Here, by 16S rRNA gene sequencing and commercial PCR-based diagnostic kits, we profiled CVM in cytological preparations from 140 HPV-tested women (from Novosibirsk, Russia) with normal cytological findings, cervical lesions, or cancer and from 101 women who had recently received different cancer therapies. An increase in lesion severity was accompanied by higher HPV prevalence and elevated CVM biodiversity. Post-treatment CVM was found to be enriched with well-known microbial biomarkers of dysbiosis, just as in cervical disease. Nonetheless, concentrations of some skin-borne and environmental species (which gradually increased with increasing lesion severity)—especially Cutibacterium spp., Achromobacter spp., and Ralstonia pickettii—was low in post-treatment patients and depended on treatment types. Frequency of Lactobacillus iners dominance was high in all groups and depended on treatment types in post-treatment patients. Microbiome analysis via PCR-based kits revealed statistically significant differences among all groups of patients. Thus, microbiome profiling may help to find diagnostic and prognostic markers for management of cervical lesions; quantitative PCR-based kits may be suitable for these purposes.
Increased Epicardial Adipose Tissue (EAT), Left Coronary Artery Plaque Morphology, and Valvular Atherosclerosis as Risks Factors for Sudden Cardiac Death from a Forensic Perspective
Authors: Hogea Timur , Suciu Bogdan Andrei , Ivănescu Adrian Dumitru , Carașca Cosmin , Chinezu Laura , Arbănași Emil Marian , Russu Eliza , Kaller Réka , Arbănași Eliza Mihaela , Mureșan Adrian Vasile , Radu Corina Carmen
Published: January 2023

Background: In sudden cardiac deaths (SCD), visceral adipose tissue has begun to manifest interest as a standalone cardiovascular risk factor. Studies have shown that epicardial adipose tissue can be seen as a viable marker of coronary atherosclerosis. This study aimed to evaluate, from a forensic perspective, the correlation between body mass index (BMI), heart weight, coronary and valvular atherosclerosis, left ventricular morphology, and the thickness of the epicardial adipose tissue (EAT) in sudden cardiac deaths, establishing an increased thickness of EAT as a novel risk factor. Methods: This is a retrospective case–control descriptive study that included 80 deaths that were autopsied, 40 sudden cardiac deaths, and 40 control cases who hanged themselves and had unknown pathologies prior to their death. In all the autopsies performed, the thickness of the epicardial adipose tissue was measured in two regions of the left coronary artery, and the left ventricular morphology, macro/microscopically quantified coronary and valvular atherosclerosis, and weight of the heart were evaluated. Results: This study revealed a higher age in the SCD group (58.82 ± 9.67 vs. 53.4 ± 13.00; p = 0.03), as well as a higher incidence in females (p = 0.03). In terms of heart and coronary artery characteristics, there were higher values of BMI (p = 0.0009), heart weight (p < 0.0001), EAT of the left circumflex artery (LCx) (p < 0.0001), and EAT of the left anterior descending artery (LAD) (p < 0.0001). In the multivariate analysis, a high baseline value of BMI (OR: 4.05; p = 0.004), heart weight (OR: 5.47; p < 0.001), EAT LCx (OR: 23.72; p < 0.001), and EAT LAD (OR: 21.07; p < 0.001) were strong independent predictors of SCD. Moreover, age over 55 years (OR: 2.53; p = 0.045), type Vb plaque (OR: 17.19; p < 0.001), mild valvular atherosclerosis (OR: 4.88; p = 0.002), and moderate left ventricle dilatation (OR: 16.71; p = 0.008) all act as predictors of SCD. Conclusions: The data of this research revealed that higher baseline values of BMI, heart weight, EAT LCx, and EAT LAD highly predict SCD. Furthermore, age above 55 years, type Vb plaque, mild valvular atherosclerosis, and left ventricle dilatation were all risk factors for SCD.
Comparison of Safety of RADial comPRESSion Devices: A Multi-Center Trial of Patent Hemostasis following Percutaneous Coronary Intervention from Conventional Radial Access (RAD-PRESS Trial)
Authors: Nemeth Balazs T. , Hizoh Istvan , Nowotta Fanni , Ruzsa Zoltan , Szuk Tibor , Kulyassa Peter , Fulop Gabor A. , Szablics Fanni E. , Becker David , Merkely Bela , Edes Istvan F.
Published: January 2023

Although radial access is the current gold standard for the implementation of percutaneous coronary interventions (PCI), post-procedural radial compression devices are seldom compared with each other in terms of safety or efficacy. Our group aimed to compare a cost effective and potentially green method to dedicated radial compression devices, with respect to access site complications combined in a device oriented complex endpoint (DOCE), freedom from which served as our primary endpoint. Patients undergoing PCI were randomized to receive either the cost effective or a dedicated device, either of which were removed using patent hemostasis. Twenty-four hours after the procedure, radial artery ultrasonography was performed to evaluate the access site. The primary endpoint was assessed using a non-inferiority framework with a non-inferiority margin of five percentage points, which was considered as the least clinically meaningful difference. The cost-effective technique and the dedicated devices were associated with a comparably low rate of complications (freedom from DOCE: 83.3% vs. 70.8%, absolute risk difference: 12.5%, one-sided 95% confidence interval (CI): 1.11%). Composition of the DOCE (i.e., no complication, hematoma, pseudoaneurysm, and radial artery occlusion) and compression time were also assessed in superiority tests as secondary endpoints. Both the cost-effective technique and the dedicated devices were associated with comparably low rates of complications: p = 0.1289. All radial compression devices performed similarly when considering the time to complete removal of the respective device (120.0 (inter-quartile range: 100.0–142.5) for the vial vs. 120.0 (inter-quartile range: 110.0–180) for the dedicated device arm, with a median difference of [95% CI]: 7.0 [−23.11 to 2.00] min, p = 0.2816). In conclusion, our cost-effective method was found to be non-inferior to the dedicated devices with respect to safety, therefore it is a safe alternative to dedicated radial compression devices, as well as seeming to be similarly effective.
Immunological Aspects of Von Hippel-Lindau Disease: A Focus on Neuro-Oncology and Myasthenia Gravis
Authors: Norata Davide , Peri Marta , Giammalva Giuseppe Roberto , Lupica Antonino , Paolini Federica , Incorvaia Lorena , Badalamenti Giuseppe , Gristina Valerio , Galvano Antonio , Russo Antonio , Iacopino Domenico Gerardo , Silvestrini Mauro , Bazan Viviana , Brighina Filippo , Di Stefano Vincenzo
Published: January 2023

Von Hippel-Lindau (VHL) disease is an autosomal dominant condition that predisposes affected individuals to a variety of malignant and benign neoplasms. The pathogenetic turning point of this illness is the accumulation of hypoxia-inducible factor (HIF)-1α, a transcription factor of several genes involved in oncogenesis, angiogenesis, tissue regeneration, metabolic regulation, hematopoiesis, and inflammatory responses. From an oncological perspective, increased awareness of the molecular pathways underlying this disease is bringing us closer to the development of specific and targeted therapies. Meanwhile, on the surgical side, improved understanding can help to better identify the patients to be treated and the surgical timing. Overall, pathogenesis research is crucial for developing patient-tailored therapies. One of the actual key topics of interest is the link between the VHL/HIF axis and inflammation. The present study aims to outline the fundamental mechanisms that link VHL disease and immune disorders, as well as to explore the details of the overlap between VHL disease and myasthenia gravis (MG) pathogenetic pathways. As a result, MG becomes a paradigm for autoimmune disorders that might be related with VHL disease.
Subtypes of the Completely Reversed Flow Waveform in Vertebral Artery Can Help to Differentiate Subclavian Artery Occlusion from Severe Stenosis
Authors: Chen Shun-Ping , Zhong Zhen , Tu Dong-Pei
Published: January 2023

Objectives: To investigate the value of subtypes of completely reversed flow (CRF) waveform in vertebral artery (VA) on Doppler ultrasound in differentiation occlusion from severe stenosis of the ipsilateral proximal subclavian artery (SA). Methods: A total of 357 patients with CRF in the VA on Doppler US were reviewed retrospectively. Among them, 49 patients (mean age, 68.2 ± 7.8 years) confirmed by digital subtraction angiography (DSA) were included. According to the status of diastolic flow, the CRF was divided into continuous CRF (CCRF, n = 27) and intermittent CRF (ICRF, n = 22). The correlation of subtypes of CRF waveform and VA parameters with the severity of SA stenosis was evaluated. The severity of SA stenosis was determined by DSA. Results: Of those 49 patients, SA occlusion was observed in 33 patients (67%, occlusion group) and severe stenosis in 16 patients (33%, stenosis group). The subtypes of CRF waveforms showed a significant between-group difference (p = 0.005). CCRF exhibited an accuracy of 85.2% (23/27) in diagnosing SA occlusion. The diameter of the target VA with ICRF showed a significant between-group difference (p = 0.041). The target VA diameter ≥ 3.8 mm in ICRF achieved an accuracy of 81.8% (18/22), and its combination with CCRF achieved an accuracy of 83.7% (41/49) in the differentiation of SA occlusion from severe stenosis. Conclusions: Subtypes of CRF in VA can help to differentiate SA occlusion from severe stenosis. CCRF has higher accuracy in diagnosing SA occlusion. The CCRF waveform plus VA diameter in ICRF is more accurate for differentiating SA occlusion from severe stenosis.
An AI-Powered Clinical Decision Support System to Predict Flares in Rheumatoid Arthritis: A Pilot Study
Authors: Labinsky Hannah , Ukalovic Dubravka , Hartmann Fabian , Runft Vanessa , Wichmann André , Jakubcik Jan , Gambel Kira , Otani Katharina , Morf Harriet , Taubmann Jule , Fagni Filippo , Kleyer Arnd , Simon David , Schett Georg , Reichert Matthias , Knitza Johannes
Published: January 2023

Treat-to-target (T2T) is a main therapeutic strategy in rheumatology; however, patients and rheumatologists currently have little support in making the best treatment decision. Clinical decision support systems (CDSSs) could offer this support. The aim of this study was to investigate the accuracy, effectiveness, usability, and acceptance of such a CDSS—Rheuma Care Manager (RCM)—including an artificial intelligence (AI)-powered flare risk prediction tool to support the management of rheumatoid arthritis (RA). Longitudinal clinical routine data of RA patients were used to develop and test the RCM. Based on ten real-world patient vignettes, five physicians were asked to assess patients’ flare risk, provide a treatment decision, and assess their decision confidence without and with access to the RCM for predicting flare risk. RCM usability and acceptance were assessed using the system usability scale (SUS) and net promoter score (NPS). The flare prediction tool reached a sensitivity of 72%, a specificity of 76%, and an AUROC of 0.80. Perceived flare risk and treatment decisions varied largely between physicians. Having access to the flare risk prediction feature numerically increased decision confidence (3.5/5 to 3.7/5), reduced deviations between physicians and the prediction tool (20% to 12% for half dosage flare prediction), and resulted in more treatment reductions (42% to 50% vs. 20%). RCM usability (SUS) was rated as good (82/100) and was well accepted (mean NPS score 7/10). CDSS usage could support physicians by decreasing assessment deviations and increasing treatment decision confidence.
Radiomics in Oncology III
Authors: Zerunian Marta , Laghi Andrea , Caruso Damiano
Published: January 2023

In recent years, radiomics has been among the most impactful topics in the research field of quantitative imaging [...]
Haemostasis and Inflammatory Parameters as Potential Diagnostic Biomarkers for VTE in Trauma-Immobilized Patients
Authors: Ramli Noor Nabila , Iberahim Salfarina , Mohd Noor Noor Haslina , Zulkafli Zefarina , Tengku Md Shihabuddin Tengku Muzaffar , Din Mohd Hadizie , Mohamed Saat Muhamad Aizat , Samsudin Ahmad Hadif Zaidin
Published: January 2023

Venous thromboembolism (VTE), which encompasses deep venous thrombosis (DVT) and pulmonary embolism (PE), is a major public health concern due to its high incidences of morbidity and mortality. Patients who have experienced trauma with prolonged immobilization are at an increased risk of developing VTE. Plasma D-dimer levels have been known to be elevated in trauma patients, and they were closely correlated with the number of fractures. In other words, plasma D-dimer levels cannot be used as the only indicator of VTE in trauma cases. Given the limitations, further study is needed to explore other potential biomarkers for diagnosing VTE. To date, various established and novel VTE biomarkers have been studied in terms of their potential for predicting VTE, diagnostic performance, and improving clinical therapy for VTE. Therefore, this review aims to provide information regarding classic and essential haemostasis (including prothrombin time (PT), activated partial thromboplastin time (aPTT), D-dimer, fibrinogen, thrombin generation, protein C, protein S, antithrombin, tissue factor pathway inhibitor, and platelet count) and inflammatory biomarkers (C-reactive protein, erythrocyte sedimentation rate, and soluble P-selectin) as potential diagnostic biomarkers that can predict the risk of VTE development among trauma patients with prolonged immobilization. Thus, further advancement in risk stratification using these biomarkers would allow for a better diagnosis of patients with VTE, especially in areas with limited resources.
Analyzing Brand Awareness Strategies on Social Media in the Luxury Market: The Case of Italian Fashion on Instagram
Authors: Brambilla Marco , Badrizadeh Hoda , Malek Mohammadi Narges , Javadian Sabet Alireza
Published: January 2023

The rapid proliferation of social media has been redefining every facet of the old marketing and customer engagement tactics, not only for low-end and mass-market products but also for luxury brands. In this context, brands are dealing with the challenge of maintaining a balance between using mass marketing strategies concurrent with accentuating the exclusivity of their offerings. Social media can be considered beneficial if brands employ it to reach the right audience and use the right platform and incorporating the right content. In this work, we propose a sector-specific, integrated, and holistic investigation of the social media strategies of luxury brands together with the impact they generate in terms of the engagement level of the users as an indicator of their success. We provide empirical validation of the methods used in the Italian market of the luxury fashion sector, providing a qualitative and quantitative analysis of the content shared on social media, considering the type, timing, and modality of the sharing. We evaluate consumer-brand engagement in different contexts, including important live events in the field.