bluuebunny/crossref_metadata_2025 huggingface dataset:
Multi-Endpoint Toxicity Tests and Effect-Targeting Risk Assessment of Surface Water and Pollution Sources in a Typical Rural Area in the Yellow River Basin, China
Authors: Li Fangxu , Tan Jisui , Yang Qian , He Miao , Yu Ruozhen , Liu Chun , Zhou Xiaohong
Published: November 2022

Multi-endpoint toxicity tests were used to evaluate the acute toxicity, estrogenic activity, neurotoxicity, genotoxicity, and ecological risks of surface water and sewage from possible pollution sources in rural areas of the Yellow River (China). Toxicity testing results showed that the luminescence inhibition rates of acute toxicity ranged from not detected (ND) to 38%, the 17β-estradiol equivalent (E2-EQ) values of estrogenic activity ranged from 4.8 to 131.0 ng·L−1, neurotoxicity was not detected, and the protein effect level index (PELI) values of genotoxicity ranged from 1 to 6.06. Neither acute toxicity nor genotoxicity were detected in the tributaries of the Yellow River (River 2) flowing through the investigated rural area. The distribution of high estrogenic activity sites was relatively scattered, but mainly located in the tributaries of River 2. Industrial, domestic, and livestock and poultry breeding sewage were all possible sources of toxicity, and the contribution of livestock and poultry to environmental estrogens in the surface water was significant. Furthermore, the potential effect-targeting risks of toxic substances in the surface water for aquatic organisms were assessed using the risk quotient method, by considering the toxic equivalent concentration. The results indicated that the risk of estrogenic activity was the main ecological risk in the surface water of this rural area. Except for the reservoir site, the other sampling sites showed a moderate to high estrogenic activity risk, especially in the tributaries of River 2.
Climate Change-Related Hazards and Livestock Industry Performance in (Peri-)Urban Areas: A Case of the City of Masvingo, Zimbabwe
Authors: Chari Felix , Ngcamu Bethuel
Published: November 2022

In an effort to improve their quality of life and battle poverty, many urban residents are turning to agriculture as an alternative source of income, employment, and food security. However, climate-related hazards such as heatwaves, floods, and droughts have had an effect on urban agriculture. The purpose of this study was to determine how climate change-related hazards affected the urban livestock industry in Masvingo City. These researchers administered a structured questionnaire on urban livestock farmers, the results of which were triangulated with in-depth interviews with livestock stakeholders. The results show that the urban livestock industry is significantly impacted by climate-related hazards. Farmers lose livestock to diseases, poor pastures, and extreme weather conditions. Furthermore, the hazards badly affect the storage and distribution of livestock products, the labour supply and productivity, and the profitability of livestock enterprises. This study contributes to the body of knowledge on the urban livestock industry and climate change-related hazards. The results are significant to policy makers and livestock stakeholders to understand climate change effects on the urban livestock sector so as to formulate mitigation, adaptation, and coping strategies against any adverse effects. This paper is a foundation for future studies and these researchers suggest that future studies be on location-specific adaptation strategies.
Laser Polishing and Annealing Injection Mold Using Dual-Beam Laser System
Authors: Xu Xiaomei , Chen Xu , Zhou Yongquan , Li Yi , Liu Mingjun
Published: November 2022

One of the challenges regarding the application of laser polishing in injection mold manufacturing is to eliminate the tensile residual stress on a polished cavity surface without the extra expenses of an annealing vacuum furnace. This study aims to develop a fast laser annealing method using a dual-beam laser system by which a mold cavity can be laser-polished and then laser-annealed. Fourteen mold steel specimens were laser-polished by a dual-beam laser, resulting in a roughness reduction from the initial state, Sa 1.11 μm, to Sa 0.16 μm, a smoother surface finish. A numerical simulation of laser annealing using the current CW laser was implemented to optimize the laser annealing parameters to guide the experiment of CW laser annealing. XRD measurement results showed that the tensile residual stress dropped from an initial 638 MPa to 10 MPa in an annealing cycle time of 40 min at 750 °C; therefore, fatigue cracks or stress corrosion cracks (SCC) on the mold cavity will no longer occur. Confocal microscopy, X-ray diffraction, and scanning electron microscopy were used to obtain the microstructure and phase composition of the microstructures, demonstrate that laser polishing and laser annealing by a dual-beam laser is a fast and effortless technique which can be effectively employed in injection mold manufacturing.
Numerical Simulation of Reinforced Concrete Piers after Seawater Freeze–Thaw Cycles
Authors: Teng Fei , Zhang Yueying , Yan Weidong , Wang Xiaolei , Li Yanfeng
Published: November 2022

The reinforced concrete (RC) piers of offshore bridges inevitably experience seawater freeze–thaw cycles due to the periodic movement of tides in cold climates. The damage caused by seawater freeze–thaw cycles will reduce the durability and mechanical properties of concrete, and then affect the seismic performance of RC piers. The method of seismic performance analysis on RC piers by numerical simulation is gradually emerging because the process of the conventional experiment is relatively complicated, and the heterogeneity and degradation of concrete after seawater freeze–thaw cycles should be considered. In this study, the method of meso-element equivalent and layered modeling was used to simulate a low cyclic loading test on an RC pier after seawater freeze–thaw cycles with ABAQUS software. The numerical simulation results were compared with the experimental results; the deviation value of peak load was not more than 6%, and the deviation value of peak displacement was not more than 10%. The result of the numerical simulation matched well with the experimental results, and the influence of different parameters was analyzed through the practical method of numerical simulation. It can be determined that the peak load decreased by 11%, while the peak displacement increased by 40% after 125 seawater freeze–thaw cycles. In the same 125 freeze–thaw cycles, the peak load increased by 15% and 27% while the axial compression ratio and the longitudinal reinforcement diameter increased. As the stirrup spacing of specimens decreased, the peak load remained unchanged, but the ductility coefficient of the specimens increased by 20%.
Effect of Oxygen Content on the Properties of Sputtered TaOx Electrolyte Film in All-Solid-State Electrochromic Devices
Authors: Li Jiuyong , Liu Weiming , Wei Youxiu , Yan Yue
Published: November 2022

Tantalum oxide (TaOx) thin films are one of the commonly used solid electrolytes in inorganic all-solid-state electrochromic devices (ECDs). The chemical composition and microstructure of TaOx films have a crucial influence on its electron blocking and ion transport properties in all-solid-state ECDs. In this work, various oxygen flux was used to deposit the TaOx films with different compositions and microstructures by pulsed direct current (p-DC) reactive magnetron sputtering. The structural properties, morphologies, chemical compositions, optical properties, electron blocking, and ionic conductive properties of the TaOx films were systematically investigated. The results show that in a certain range, the higher the oxygen flux, the stronger the ion transport ability of TaOx and the lower the electronic conductivity, which could be attributed to the loose structure and smaller number of oxygen vacancies of the films, respectively. Moreover, an all-solid-state ECD with the multilayer structure of glass/ITO/WO3/Li/TaOx/NiO/ITO was also fabricated by the magnetron sputtering method. The device exhibited excellent comprehensive electrochromic properties including high optical modulation, large coloring efficiency, fast response (especially bleaching process), and good cycle stability.
Meta-Heuristic Optimization Algorithm-Based Hierarchical Intrusion Detection System
Authors: ElDahshan Kamal A. , AlHabshy AbdAllah A. , Hameed Bashar I.
Published: November 2022

Numerous network cyberattacks have been launched due to inherent weaknesses. Network intrusion detection is a crucial foundation of the cybersecurity field. Intrusion detection systems (IDSs) are a type of machine learning (ML) software proposed for making decisions without explicit programming and with little human intervention. Although ML-based IDS advancements have surpassed earlier methods, they still struggle to identify attack types with high detection rates (DR) and low false alarm rates (FAR). This paper proposes a meta-heuristic optimization algorithm-based hierarchical IDS to identify several types of attack and to secure the computing environment. The proposed approach comprises three stages: The first stage includes data preprocessing, feature selection, and the splitting of the dataset into multiple binary balanced datasets. In the second stage, two novel meta-heuristic optimization algorithms are introduced to optimize the hyperparameters of the extreme learning machine during the construction of multiple binary models to detect different attack types. These are combined in the last stage using an aggregated anomaly detection engine in a hierarchical structure on account of the model’s accuracy. We propose a software machine learning IDS that enables multi-class classification. It achieved scores of 98.93, 99.63, 99.19, 99.78, and 0.01, with 0.51 for average accuracy, DR, and FAR in the UNSW-NB15 and CICIDS2017 datasets, respectively.
Reliability of SnPbSb/Cu Solder Joint in the High-Temperature Application
Authors: Xu Jiachen , Fu Yucan , Zhou Xiaoxiao , Zhang Junqian , Xue Songbai
Published: November 2022

With the continuous miniaturization and increase in functionality of the electronic devices used in the aerospace and national defense industries, the requirements for reliability of the solder joints in these devices keep increasing. In this study, a SnPbSb solder with excellent wettability was used as the research object, and the effects of high-temperature aging at 150 °C on the microstructure and mechanical properties of SnPbSb/Cu solder joints were investigated according to the relevant industry standards. It was found that high-temperature aging does not change the eutectic structure of the SnPbSb solder, but it does significantly coarsen the Sn-rich phase and the Pb-rich phase in the solder. In addition, the interfacial intermetallic compound (IMC) layer in the SnPbSb/Cu solder joint changes from a Cu6Sn5 single layer to a Cu6Sn5/Cu3Sn double layer after the aging, and the thickness of the IMC layer increases greatly. High-temperature aging significantly deteriorates the mechanical properties of the solder joints. After aging at 150 °C for 1000 h, the shear strength of the SnPbSb/Cu solder joints decreased by 45.39%, while the ductile fracture mode did not change.
Internal Jugular Vein Tumor Thrombus: A Tricky Question for the Thyroid Surgeon
Authors: Morvan Jean-Baptiste , Boudin Laurys , Metivier Denis , Delarbre David , Bouquillon Edouard , Thariat Juliette , Pascaud Damien , Marcy Pierre-Yves
Published: November 2022

Internal jugular vein tumor thrombus is an extremely rare condition in thyroid carcinoma, but it does exist. Correlated with greater aggressiveness with a higher incidence of distant metastases at diagnosis and a higher recurrence rate, this important prognostic element should be systematically investigated by ultrasound operators in all patients presenting with thyroid carcinoma. The patient’s follow-up must be careful. This can be a trap that surgeons must look for in their preoperative checklist. We report the case of a 58-year-old woman with an IJV thrombus associated with multiple bone metastases. She underwent successful surgical treatment, and postoperative pathology showed a poorly differentiated follicular carcinoma of the thyroid and a tumor thrombus in the internal jugular vein.
Cost-Effectiveness Analysis of Sequential Treatment Strategies for Advanced Melanoma in Real Life in France
Authors: Kandel Marguerite , Bardet Aurélie , Dalle Stéphane , Allayous Clara , Mortier Laurent , Guillot Bernard , Dutriaux Caroline , Leccia Marie-Thérèse , Dalac Sophie , Montaudie Henri , Saiag Philippe , Legoupil Delphine , Brunet-Possenti Florence , Arnault Jean-Philippe , Quatrebarbes Julie De , Beylot-Barry Marie , Maubec Eve , Lesimple Thierry , Aubin François , Grob Jean-Jacques , Granel-Brocard Florence , Stoebner Pierre-Emmanuel , Dupuy Alain , Dreno Brigitte , Michiels Stefan , Lebbe Céleste , Borget Isabelle
Published: November 2022

Nine drugs have been marketed for 10 years for the treatment of advanced melanoma (AM). With half of patients reaching a second line, the optimal sequence of treatments remains unclear. To inform policy-makers about their efficiency, we performed a cost-effectiveness analysis of sequential strategies in clinical practice in France, for BRAF-mutated and wild-type patients. A multistate model was developed to describe treatment sequences, associated costs, and health outcomes over 10 years. Sequences, clinical outcomes, utility scores, and economic data were extracted from the prospective Melbase cohort, collecting individual data in 1518 patients since 2013, from their AM diagnosis until their death. To adjust the differences in patients’ characteristics among sequences, weighting by inverse probability was used. In the BRAF-mutated population, the MONO-targeted therapies (TT)-anti-PD1 sequence was the less expensive, whereas the anti-PD1-BI-TT sequence had an incremental cost-effectiveness ratio (ICER) of 180,441 EUR/QALY. Regarding the BRAF wild-type population, the three sequences constituted the cost-effective frontier, with ICERs ranging from 116 to 806,000 EUR/QALY. For BRAF-mutated patients, the sequence anti-PD1-BI-TT appeared to be the most efficient one in BRAF-mutated AM patients until 2018. Regarding the BRAF wild-type population until 2018, the sequence starting with IPI+NIVO appeared inefficient compared to anti-PD1, considering the extra cost for the QALY gained.
Concomitant Bladder Tumor Is a Risk Factor for Bladder Recurrence but Not Upper Tract
Authors: Liu Kang , Zhao Hongda , Alvarez-Maestro Mario , Gravas Stavros , Van Renterghem Koen , Zeng Guohua , Ng Chi-Fai , Laguna Pilar , Teoh Jeremy Yuen-Chun , De La Rosette Jean
Published: November 2022

Objective: To evaluate the clinical outcomes of UTUC patients with or without concurrent bladder tumor. Design, Setting, and Participants: The Clinical Research Office of the Endourology Society-Urothelial Carcinomas of the Upper Tract (CROES-UTUC) Registry included 1134 UTUC patients with or without concurrent bladder tumor treated between 2014 and 2019. Results: In 218 (19.2%) cases, concurrent bladder tumor was present, while in 916 (80.8%) patients, no bladder cancer was found. In the multivariable Cox regression analysis, concomitant bladder tumor (hazard ratio (HR) 1.562, 95% confidence interval (CI) 0.954–2.560, p = 0.076) indicated a trend associated with recurrence-free survival for UTUC. Further data dissection confirmed that concomitant bladder tumor is a risk factor of bladder recurrence (HR 1.874, 95% CI 1.104–3.183, p = 0.020) but not UTUC recurrence (HR 0.876, 95% CI 0.292–2.625, p = 0.812). Kidney-sparing surgery (KSS) (HR 3.940, 95% CI 1.352–11.486, p = 0.012), pathological T staging ≥ pT2 (HR 2.840, 95% 1.039–7.763, p = 0.042) were significantly associated with UTUC recurrence. KSS does not affect bladder recurrence (HR 0.619, 95% CI 0.242–1.580, p = 0.315). A limitation is the retrospective nature of the present study analysis. Conclusions: The presence of concomitant bladder tumor does not increase risk of UTUC recurrence, but it results in an increased risk of bladder recurrence. KSS does not affect bladder recurrence and can still be considered in patients with concomitant bladder tumor.
Intraoperative Assessment of High-Risk Thyroid Nodules Based on Electrical Impedance Measurements: A Feasibility Study
Authors: Beheshti Firoozabadi Jalil , Mahdavi Reihane , Shamsi Khosro , Ataee Hossein , Shafiee Abdollah , Ebrahiminik Hojat , Chegini Hossein , Hoseinpour Parisa , Moradi Afshin , Yousefpour Narges , Aghaei Faeze , Fardoost Ali , Ghelichli Alireza , Mokhtari Dowlatabad Hadi , Hajighasemi Farzane , Sami Nafiseh , Rouhollah Miri Seyed , Akbari Mohammad , Abdolahad Mohammad
Published: November 2022

Precise diagnosis of thyroid nodules is challenging due to non-diagnostic/inconclusive results and uncertainties about the malignancy of follicular neoplasms (FNs), even in frozen-section pathology. Therefore, surgical management, especially in Bethesda III and IV categories, may be complicated, and sometimes a second surgery may be required. The Thyroid Nodule Impedance Measurement System (TN-IMS) consists of a metallic patch attached to submental skin and a G20 I.V. cannula inserted into the targeted nodules. Two impedance-based parameters named Z1kHz and impedance phase slope (IPS) in 100 kHz to 500 kHz of the thyroid nodules are recorded and compared with their histopathological results as the gold standard. TN-IMS was intra-surgically applied to 103 human thyroid nodules and normal thyroid tissues. A remarkable consistency between defined co-ranges of Z1kHz/IPS and the histopathological status of specimens was achieved (p < 0.001). Based on these measurements, it was concluded that intraoperative bioelectrical impedance scanning of thyroid nodules would be a helpful complementary approach to detecting high-risk excision-required thyroid nodules.
Endoscopic Ultrasound Guided Fine Needle Aspiration versus Endoscopic Ultrasound Guided Fine Needle Biopsy for Pancreatic Cancer Diagnosis: A Systematic Review and Meta-Analysis
Authors: Hassan Galab M. , Laporte Louise , Paquin Sarto C. , Menard Charles , Sahai Anand V. , Mâsse Benoît , Trottier Helen
Published: November 2022

Introduction: One of the most effective diagnostic tools for pancreatic cancer is endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) or biopsy (EUS-FNB). Several randomized clinical trials have compared different EUS tissue sampling needles for the diagnosis of pancreatic cancer. Objective: To compare the diagnostic accuracy of EUS-guided FNA as EUS-FNB needles for the diagnosis of pancreatic cancer using a systematic review and meta-analysis. Method: A literature review with a meta-analysis was performed according to the PRISMA guide. The databases of PubMed, Cochrane and Google Scholar were used, including studies published between 2011–2021 comparing the diagnostic yield (diagnostic accuracy or probability of positivity, sensitivity, specificity, predictive value) of EUS-FNA and EUS-FNB for the diagnosis of pancreatic cancer. The primary outcome was diagnostic accuracy. Random effect models allowed estimation of the pooled odds ratio with a confidence interval (CI) of 95%. Results: Nine randomized control trials were selected out of 5802 articles identified. Among these, five studies found no statistically significant difference between the EUS-FNA and EUS-FNB, whereas the other four did. The meta-analysis found EUS-FNB accuracy superior to EUS-FNA for the diagnosis of pancreatic cancer with a pooled odds ratio of 1.87 (IC 95%: 1.33–2.63). Conclusion: As compared to EUS-FNA, EUS-FNB seems to improve diagnostic accuracy when applied to suspicious pancreatic lesions.
AID-U-Net: An Innovative Deep Convolutional Architecture for Semantic Segmentation of Biomedical Images
Authors: Tashk Ashkan , Herp Jürgen , Bjørsum-Meyer Thomas , Koulaouzidis Anastasios , Nadimi Esmaeil S.
Published: November 2022

Semantic segmentation of biomedical images found its niche in screening and diagnostic applications. Recent methods based on deep learning convolutional neural networks have been very effective, since they are readily adaptive to biomedical applications and outperform other competitive segmentation methods. Inspired by the U-Net, we designed a deep learning network with an innovative architecture, hereafter referred to as AID-U-Net. Our network consists of direct contracting and expansive paths, as well as a distinguishing feature of containing sub-contracting and sub-expansive paths. The implementation results on seven totally different databases of medical images demonstrated that our proposed network outperforms the state-of-the-art solutions with no specific pre-trained backbones for both 2D and 3D biomedical image segmentation tasks. Furthermore, we showed that AID-U-Net dramatically reduces time inference and computational complexity in terms of the number of learnable parameters. The results further show that the proposed AID-U-Net can segment different medical objects, achieving an improved 2D F1-score and 3D mean BF-score of 3.82% and 2.99%, respectively.
PVR—A Prognostic Biomarker Correlated with Immune Cell Infiltration in Hepatocellular Carcinoma
Authors: Liu Wen-Feng , Quan Bing , Li Miao , Zhang Feng , Hu Ke-Shu , Yin Xin
Published: November 2022

The poliovirus receptor (PVR) is a member of the immunoglobulin superfamily (Ig SF) and is essential for the promotion of cancer cell proliferation and invasion. However, the correlation between PVR expression and prognosis as well as immune infiltration in hepatocellular carcinoma (HCC) remains unclear. The expression level of PVR was quantified using the Tumor and Tumor Immunity Evaluation Resource (TIMER) and Sangerbox. The Gene Expression Omnibus (GEO) database was used to validate the PVR expression. The receiver operating characteristic (ROC) curve was used to evaluate the feasibility of using PVR as a differentiating factor according to the area under curve (AUC) score. A PVR binding protein network was built using the STRING tool. An enrichment analysis using the R package clusterProfiler was used to explore the potential function of PVR. Immune infiltration analysis was calculated with ESTIMATE algorithms. We also assessed the correlation between PVR expression and immune infiltration by the single-sample Gene Set Enrichment Analysis (ssGSEA) method from the R package GSVA and TIMER database. The results showed that PVR was commonly overexpressed in multiple types of tumors including HCC. The data of GSE64041 confirmed the same result. The ROC curve suggested that PVR could be a potential diagnostic biomarker. Additionally, high mRNA expression of PVR in HCC was significantly correlated with poor overall survival (OS) and relapse free survival (RFS). Results also indicated correlations between PVR mRNA expression with the level of infiltration immune cells including B cells, CD8+ T cells, cytotoxic cells, DCs, CD56dim NK cells, pDCs, and Th2 cells. Furthermore, the PVR level was significantly correlated with immune markers for immunosuppressive cells in HCC. In conclusion, PVR might be an important regulator of tumor immune cell infiltration and a valuable prognostic biomarker in HCC. However, additional work is needed to fully elucidate the underlying mechanisms.
Venous Thromboembolism in Cancer Patients Undergoing Chemotherapy: A Systematic Review and Meta-Analysis
Authors: Sun Ming-Yee , Bhaskar Sonu M. M.
Published: November 2022

Objective: Venous thromboembolism (VTE) is a life-threatening complication that may exacerbate cancer prognosis. Whilst some studies indicate an increased risk of VTE in cancer patients undergoing chemotherapy, the prevalence estimates on the pooled prevalence of VTE in cancer patients undergoing chemotherapy are not known. This study aims to calculate the pooled prevalence of VTE in chemotherapy-treated cancer patients. Methods: Studies on VTE occurrence in cancer patients undergoing chemotherapy were retrieved after database search. The terms used included “cancer”, “chemotherapy”, and “venous thromboembolism”. A random-effects meta-analysis was conducted to obtain a pooled estimate of VTE prevalence in cancer patients undergoing chemotherapy. Results: A total of 102 eligible studies involving 30,671 patients (1773 with VTE, 28,898 without) were included in the meta-analysis. The pooled estimate of VTE prevalence was found to be 6%, ranging from 6% to 7% (ES 6%; 95% CI 6–7%; z = 18.53; p < 0.001). Conclusions: The estimated pooled prevalence rate of VTEs was 6% in cancer patients undergoing CRT, which was higher than the overall crude prevalence rate (5.78%). Comprehensive cancer care should consider stratified VTE risk assessment based on cancer phenotype, given that certain phenotypes of cancer such as bladder, gastric and ovarian posing particularly high risks of VTE.
Role of Biomarkers in Periprosthetic Joint Infections
Authors: Akcaalan Serhat , Ozaslan Halil Ibrahim , Caglar Ceyhun , Şimşek Mehmet Emin , Citak Mustafa , Akkaya Mustafa
Published: November 2022

Periprosthetic joint infection (PJI) is one of the most serious complications after joint arthroplasty. The incidence rate of PJI after total joint replacement is 1–3%. Although there are different guidelines and diagnostic criteria used to diagnose PJI, diagnosing PJI is a highly difficult process for orthopedists. The current Musculoskeletal Infection Society (MSIS) criteria are widely used for the diagnosis of PJI. These criteria include results from blood/synovial fluid tests, physical examination, and histological and microbiological analyses of intra-operative samples. However, there is currently no blood or synovial test that can definitively diagnose PJI. To make a more effective diagnosis of PJI, a large number of studies have explored and continue to investigate biomarkers. This review aims to provide general information about serum and synovial markers used for the diagnosis of PJI that may be used to create a database to guide researchers in new studies.
Quantitative Susceptibility Mapping: Translating an Investigative Research Tool into High Volume Clinical Diagnostic Imaging
Authors: Borzage Matthew , Doyle Eamon , Liu Chia-Shang , Nelson Marvin , Blüml Stefan , Wood John , Tamrazi Benita
Published: November 2022

Quantitative susceptibility mapping (QSM) is an MRI-based technique for iron quantification of targeted tissue. QSM provides information relevant to clinicians in a broad range of diagnostic contexts, including sickle cell disease, inflammatory/demyelinating processes, and neoplasms. However, major MRI vendors do not offer QSM post-processing in a form ready for general use. This work describes a vendor-agnostic approach for scaling QSM analysis from a research technique to a routine diagnostic test. We provide the details needed to seamlessly integrate hardware, software, and clinical systems to provide QSM processing for a busy clinical radiology workflow. This approach can be generalized to other advanced MRI acquisitions and analyses with proven diagnostic utility, yet without crucial MR vendor support.
ECMO in Cardiogenic Shock: Time Course of Blood Biomarkers and Associated Mortality
Authors: Rajsic Sasa , Breitkopf Robert , Oezpeker Ulvi , Treml Benedikt
Published: November 2022

Background: Veno-arterial extracorporeal membrane oxygenation (va-ECMO) is a temporary life support for severe cardiogenic shock, gaining time for organ recovery, permanent assistance, or transplantation. In this work, we aimed to investigate the trends of blood biomarkers over the period of ECMO support and their role in patient outcome. Methods: This retrospective study comprised patients receiving va-ECMO support over the period of 14 years at a tertiary university center. Results: Of 435 patients, 62% (268/435) survived to discharge, and the most frequent adverse event was hemorrhage (46%), followed by thrombosis (25%). Deceased patients had increased blood levels of C-reactive protein, procalcitonin, and white blood cells during the whole observation period, with higher peaks compared with survivors. The multivariable model identified hemorrhage (HR 1.73, p = 0.005) and higher levels of procalcitonin (HR 1.01, p = 0.001) as independent risk factors for death. Conclusions: In our population of critically ill patients receiving va-ECMO support, deceased patients had increased inflammatory biomarkers during the whole observation period. Patients having higher values of procalcitonin and experiencing bleeding events showed an increased risk for mortality. Further studies focusing on inflammation in ECMO patients, clarifying its role in patient outcome and potential therapeutic interventions, are warranted.
Pulsed Radiofrequency Ablation for Orchialgia—A Literature Review
Authors: Alzahrani Meshari A. , Safar Omar , Almurayyi Muath , Alahmadi Abdulaziz , Alahmadi Abdulrahman M. , Aljohani Muhannad , Almhmd Abdalah E. , Almujel Khaled Nasser , Alyousef Bader , Bashraheel Hussam , Badriq Feras , Almujaydil Abdulaziz
Published: November 2022

Pulsed radiofrequency, short bursts of radiofrequency energy, has been used by pain practitioners as a non- or minimally neurodestructive technique, an alternative to radiofrequency heat lesions. The clinical advantages and mechanisms of this treatment remain unclear. To review the current clinical implication of the pulsed radiofrequency technique for male patients with chronic scrotal pain. We systematically searched the English literature available at the EMBASE, MEDLINE/PubMed, Google Scholar, and Cochrane Library from inception to 22 November 2022. Only reports on a pulsed radiofrequency application on male patients with chronic scrotal pain were included. The final analysis yielded six reports on the clinical use of pulsed radiofrequency applications in male patients with chronic scrotal pain: six full publications, three case reports, one case series, one prospective uncontrolled pilot study, and one prospective randomized, controlled clinical trial. The accumulation of these data shows that using pulsed radiofrequency generates an increasing interest in pain physicians, radiologists, and urologists for managing chronic scrotal pain. No side effects related to the pulsed radiofrequency technique were reported to date. Further research on the clinical and biological effects is justified. Large sample sizes and randomized clinical trials are warranted.
Dual-Energy Computed Tomography Collagen Density Mapping of the Cranio-Cervical Ligaments—A Retrospective Feasibility Study
Authors: Wittig Thomas Matthias , Ziegeler Katharina , Kreutzinger Virginie , Golchev Milen , Ponsel Simon , Diekhoff Torsten , Ulas Sevtap Tugce
Published: November 2022

The objectives of this study were to investigate the mean collagen content of the atlanto-axial joint (AAJ) ligaments in a cohort without inflammatory disease and to analyze clinical confounders such as age, sex, and presence of ligamentous calcifications. A total of 153 patients who underwent dual-energy computed tomography (DECT) due to various reasons (e.g., suspected cancer or infection) were included in this retrospective study. Reconstruction of collagen density maps from the DECT dataset was performed. Region of interest (ROI) analysis was performed to assess densities in the following regions: ligamentum transversum atlantis (LTA), ligamenta alaria, fasciculi longitudinales, ligamentum nuchae, and retro-odontoid soft tissue (RDS). Osteoarthritis (OA) and the presence of calcifications were assessed by two experienced readers blinded to clinical data. Subgroup comparisons were performed using unpaired t-tests. The correlation of collagen density and clinical factors was investigated using Pearson’s correlation coefficient. Mean LTA collagen density was 141.7 (SD 35.7). Ligamentous calcifications were rare (14.4 %). OA of the AAJ was common (91.5 %). LTA collagen density was not associated with age (Pearson’s r of 0.109; p = 0.180) and was not significantly higher in patients with OA (p = 0.070). No correlations between RDS thickness, collagen density or calcifications were found. Our results show collagen density mapping of the cranio-cervical joint ligaments to be feasible; collagen densities are not significantly associated with age, sex, AAJ degeneration, or asymptomatic ligamentous calcification.
The Utility of Arterial Spin Labeling MRI in Medial Temporal Lobe as a Vascular Biomarker in Alzheimer’s Disease Spectrum: A Systematic Review and Meta-Analysis
Authors: Kapasouri Efthymia Maria , Ioannidis Diomidis C. , Cameron Donnie , Vassiliou Vassilios S. , Hornberger Michael
Published: November 2022

We sought to systematically review and meta-analy the role of cerebral blood flow (CBF) in the medial temporal lobe (MTL) using arterial spin labeling magnetic resonance imaging (ASL-MRI) and compare this in patients with Alzheimer’s disease (AD), individuals with mild cognitive impairment (MCI), and cognitively normal adults (CN). The prevalence of AD is increasing and leading to high healthcare costs. A potential biomarker that can identify people at risk of developing AD, whilst cognition is normal or only mildly affected, will enable risk-stratification and potential therapeutic interventions in the future. All studies investigated the role of CBF in the MTL and compared this among AD, MCI, and CN participants. A total of 26 studies were included in the systematic review and 11 in the meta-analysis. Three separate meta-analyses were conducted. Four studies compared CBF in the hippocampus of AD compared with the CN group and showed that AD participants had 2.8 mL/min/100 g lower perfusion compared with the CN group. Eight studies compared perfusion in the hippocampus of MCI vs. CN group, which showed no difference. Three studies compared perfusion in the MTL of MCI vs. CN participants and showed no statistically significant differences. CBF measured via ASL-MRI showed impairment in AD compared with the CN group in subregions of the MTL. CBF difference was significant in hippocampus between the AD and CN groups. However, MCI and CN group showed no significant difference in subregions of MTL.
Associations of the Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio with Osteoporosis: A Meta-Analysis
Authors: Liu Yu-Cheng , Yang Tzu-I , Huang Shu-Wei , Kuo Yi-Jie , Chen Yu-Pin
Published: November 2022

Osteoporosis is characterized by low bone mass and increased bone fragility. Numerous studies have suggested that inflammation contributes to its pathogenesis. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are simple, noninvasive biomarkers that can reflect the inflammation status on human body. However, evidence on their associations with osteoporosis remains scant. The PubMed, Embase, and Cochrane Library databases were searched for relevant studies from their inception to April 2022. Observational studies providing complete NLR or PLR data in both the osteoporosis and normal bone mineral density (BMD) groups were included. Studies involving individuals at risk of secondary osteoporosis or restricted to a certain disease population were excluded. The main outcome was the associations of NLR and PLR with osteoporosis. Between-group differences were measured using mean differences (MDs) and 95% confidence intervals (CIs). In our analysis, both NLR and PLR were significantly higher in the osteoporosis group (MD = 0.494, 95% CI: 0.339–0.649, p < 0.0001; MD = 23.33, 95% CI: 4.809–41.850, p = 0.014, respectively) than in the normal BMD group. NLR was significantly higher in postmenopausal women with osteoporosis (MD = 0.432, 95% CI: 0.309–0.544, p < 0.0001). Our findings suggest the associations of NLR and PLR with osteoporosis. NLR and PLR constitute potential targets in osteoporosis screening.
Clinical and Imaging Characteristics of Non-Neoplastic Spinal Lesions: A Comparative Study with Intramedullary Tumors
Authors: Kajikawa Keita , Nagoshi Narihito , Tsuji Osahiko , Suzuki Satoshi , Ozaki Masahiro , Takahashi Yohei , Yagi Mitsuru , Matsumoto Morio , Nakamura Masaya , Watanabe Kota
Published: November 2022

The features of non-neoplastic lesions are often similar to those of intramedullary tumors, and a differential diagnosis is challenging to obtain in some cases. A surgical biopsy, which is performed on highly invasive tumors, should be avoided in cases of non-neoplastic lesions. Therefore, an accurate diagnosis is important prior to treatment. We evaluated 43 patients suspected of having spinal cord tumors and, finally, were diagnosed with non-neoplastic intramedullary lesions via magnetic resonance imaging. The patients commonly presented with myelitis. The patients with non-neoplastic neurological diseases had a significantly shorter symptom duration than those with intramedullary astrocytomas. The proportion of patients with non-neoplastic neurological diseases who presented with lesions at the cervical spinal level and focal lesions on axial imaging but without a spinal cord enlargement was significantly higher than that of patients with intramedullary astrocytomas. The current study aimed to distinguish spinal cord tumors from non-neoplastic intramedullary lesions based on their distinct features.
Blood Transfusion, All-Cause Mortality and Hospitalization Period in COVID-19 Patients: Machine Learning Analysis of National Health Insurance Claims Data
Authors: Lee Byung-Hyun , Lee Kwang-Sig , Kim Hae-In , Jung Jae-Seung , Shin Hyeon-Ju , Park Jong-Hoon , Hong Soon-Cheol , Ahn Ki Hoon
Published: November 2022

This study presents the most comprehensive machine-learning analysis for the predictors of blood transfusion, all-cause mortality, and hospitalization period in COVID-19 patients. Data came from Korea National Health Insurance claims data with 7943 COVID-19 patients diagnosed during November 2019–May 2020. The dependent variables were all-cause mortality and the hospitalization period, and their 28 independent variables were considered. Random forest variable importance (GINI) was introduced for identifying the main factors of the dependent variables and evaluating their associations with these predictors, including blood transfusion. Based on the results of this study, blood transfusion had a positive association with all-cause mortality. The proportions of red blood cell, platelet, fresh frozen plasma, and cryoprecipitate transfusions were significantly higher in those with death than in those without death (p-values < 0.01). Likewise, the top ten factors of all-cause mortality based on random forest variable importance were the Charlson Comorbidity Index (53.54), age (45.68), socioeconomic status (45.65), red blood cell transfusion (27.08), dementia (19.27), antiplatelet (16.81), gender (14.60), diabetes mellitus (13.00), liver disease (11.19) and platelet transfusion (10.11). The top ten predictors of the hospitalization period were the Charlson Comorbidity Index, socioeconomic status, dementia, age, gender, hemiplegia, antiplatelet, diabetes mellitus, liver disease, and cardiovascular disease. In conclusion, comorbidity, red blood cell transfusion, and platelet transfusion were the major factors of all-cause mortality based on machine learning analysis. The effective management of these predictors is needed in COVID-19 patients.
An Automatic Segmentation Method for Lung Tumor Based on Improved Region Growing Algorithm
Authors: Wang Monan , Li Donghui
Published: November 2022

In medical image processing, accurate segmentation of lung tumors is very important. Computer-aided accurate segmentation can effectively assist doctors in surgery planning and treatment decisions. Although the accurate segmentation results of lung tumors can provide a reliable basis for clinical treatment, the key to obtaining accurate segmentation results is how to improve the segmentation performance of the algorithm. We propose an automatic segmentation method for lung tumors based on an improved region growing algorithm, which uses the prior information on lung tumors to achieve an automatic selection of the initial seed point. The proposed method includes a seed point expansion mechanism and an automatic threshold update mechanism and takes the combination of multiple segmentation results as the final segmentation result. In the lung image database consortium (LIDC-IDRI) dataset, we designed 10 experiments to test the proposed method and compare it with 4 popular segmentation methods. The experimental results show that the average dice coefficient obtained by the proposed method is 0.936 ± 0.027, and the average Jaccard distance is 0.114 ± 0.049. The average dice coefficient obtained by the proposed method is 0.107, 0.053, 0.040, and 0.156, higher than that of the other four methods, respectively. This study proves that the proposed method can automatically segment lung tumors in CT slices and has suitable segmentation performance.
Flat Inferior Vena Cava on Computed Tomography for Predicting Shock and Mortality in Trauma: A Meta-Analysis
Authors: Kim Do Wan , Yoo Hee Seon , Kang Wu Seong
Published: November 2022

Hypovolemia may be underestimated due to compensatory mechanisms. In this systematic review and meta-analysis, we investigated the diagnostic accuracy of a flat inferior vena cava (IVC) on computed tomography (CT) for predicting the development of shock and mortality in trauma patients. Relevant studies were obtained by searching PubMed, EMBASE, and Cochrane databases (articles up to 16 September 2022). The number of 2-by-2 contingency tables for the index test were collected. We adopted the Bayesian bivariate random-effects meta-analysis model. Twelve studies comprising a total of 1706 patients were included. The flat IVC on CT showed 0.46 pooled sensitivity (95% credible interval [CrI] 0.32–0.63), 0.87 pooled specificity (95% CrI 0.78–0.94), and 0.78 pooled AUC (95% CrI 0.58–0.93) for the development of shock. The flat IVC for mortality showed 0.48 pooled sensitivity (95% CrI 0.21–0.94), 0.70 pooled specificity (95% CrI 0.47–0.88), and 0.60 pooled AUC (95% CrI 0.26–0.89). Regarding the development of shock, flat IVC provided acceptable accuracy with high specificity. Regarding in-hospital mortality, the flat IVC showed poor accuracy. However, these results should be interpreted with caution due to the high risk of bias and substantial heterogeneity in some included studies.
Expression of the Hippo Pathway Core Components in Endometrial Cancer and Its Association with Clinicopathologic Features
Authors: Yang Juseok , Song Dae Hyun , Kim Cho Hee , Kim Min Hye , Jo Hyen Chul , Kim Hyoeun , Park Ji Eun , Baek Jong Chul
Published: November 2022

Background: The Hippo signaling pathway has a key role in tumorigenesis. This study aimed to evaluate the relationship between the expression of core components of the Hippo signaling pathway and its association with clinicopathological features in endometrial cancer. Materials and Methods: We retrospectively collected endometrioid endometrial cancer specimens from 60 patients between January 2002 and December 2009 at Gyeongsang National University Hospital. Relevant clinicopathological data were obtained through electronic medical records of patients. The expression patterns of six core components (YAP, p-YAP, LATS1/2, MST1/2, KIBRA, and Merlin) were identified by immunohistochemistry on tissue microarray sections. Results: The positive expression ratio was 75.0% for YAP, 73.3% for p-YAP, 26.7% for MST1/2, 16.7% for KIBRA, 15.0% for Merlin, and 15.0% for LATS1/2. YAP expression was negatively correlated with MST 1/2 kinases (p = 0.045) and positively correlated with p-YAP (p = 0.012). Merlin, and MST 1/2 kinases (p = 0.043) showed a positive correlation. A subgroup of patients aged below 60 years (p = 0.004) and with myometrial invasion depth of less than 1/2 (p = 0.041) showed a positive association with YAP expression. p-YAP expression was negatively associated with a subset of patients with primary tumour size ≥4 cm (p = 0.03). Logistic regression analysis showed a significant association between age and YAP expression. The odds ratio of p-YAP expression was significantly lower in the group with tumour size ≥4 cm. Conclusion: Two prognostic factors, age and tumour size, were significantly associated with the expression of YAP and p-YAP in endometrial cancer. Further research should focus on their expression as a marker for prediction of clinicopathological implications in endometrial cancer.
Skin Lesion Detection Using Hand-Crafted and DL-Based Features Fusion and LSTM
Authors: Mahum Rabbia , Aladhadh Suliman
Published: November 2022

The abnormal growth of cells in the skin causes two types of tumor: benign and malignant. Various methods, such as imaging and biopsies, are used by oncologists to assess the presence of skin cancer, but these are time-consuming and require extra human effort. However, some automated methods have been developed by researchers based on hand-crafted feature extraction from skin images. Nevertheless, these methods may fail to detect skin cancers at an early stage if they are tested on unseen data. Therefore, in this study, a novel and robust skin cancer detection model was proposed based on features fusion. First, our proposed model pre-processed the images using a GF filter to remove the noise. Second, the features were manually extracted by employing local binary patterns (LBP), and Inception V3 for automatic feature extraction. Aside from this, an Adam optimizer was utilized for the adjustments of learning rate. In the end, LSTM network was utilized on fused features for the classification of skin cancer into malignant and benign. Our proposed system employs the benefits of both ML- and DL-based algorithms. We utilized the skin lesion DermIS dataset, which is available on the Kaggle website and consists of 1000 images, out of which 500 belong to the benign class and 500 to the malignant class. The proposed methodology attained 99.4% accuracy, 98.7% precision, 98.66% recall, and a 98% F-score. We compared the performance of our features fusion-based method with existing segmentation-based and DL-based techniques. Additionally, we cross-validated the performance of our proposed model using 1000 images from International Skin Image Collection (ISIC), attaining 98.4% detection accuracy. The results show that our method provides significant results compared to existing techniques and outperforms them.
Morpho-Functional Macular Assessment in a Case of Facioscapulohumeral Muscular Dystrophy: Photoreceptor Degeneration as Possible Cause for Reduced Visual Acuity over Three Years of Follow-Up
Authors: Parravano Mariacristina , Costanzo Eliana , Barbano Lucilla , Viggiano Pasquale , De Geronimo Daniele , Antonelli Giulio , Parisi Vincenzo , Varano Monica , Ziccardi Lucia
Published: November 2022

Background: Autosomal-dominant facioscapulohumeral muscular dystrophy (FSHD) is a muscular dystrophy with associated retinal abnormalities such as retinal vessel tortuosity, focal retinal pigment epithelium defect and large telangiectasia vessels. Methods: Case report of an FSHD 16-year-old female referred for blurred vision in both eyes (20/40), evening fever and shoulder muscle weakness over the past month preceding assessment. A multimodal assessment including visual acuity (VA), microperimetry (MP), multifocal electroretinogram (mfERG), optical coherence tomography (OCT), fluorescein angiography (FA) and fundus autofluorescence (FAF) was performed. Results: OCT showed pseudocyst macular abnormalities and disruption of the photoreceptor layer with no signs of macular ischemia/exudation. Macular function showed foveal impairment recorded by mfERG and MP as a reduction of the response amplitude density and retinal sensitivity, respectively. No medical treatment was prescribed. After three years, patient’s VA slightly improved to 20/32. OCT showed resolution of bilateral pseudocyst macular changes and persistence of photoreceptor disruption. By contrast, mfERG recordings remained abnormal for impaired foveal function and microperimetry mean sensitivity was reduced as well. Conclusions: This multimodal assessment showed persistent VA impairment at three years follow-up associated to abnormal foveal function and reduced retinal sensitivity, with spontaneous resolution of morphological macular changes, suggesting a retinal neurodegenerative process on the basis of the disease.