bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility Study for Implementing a Suggested Road to Solve the Problem of Delay in the Road Network of Hilla City
Authors: Saadi Musllim Ali , Abdul Ameer Alwash Ali
Published: August 2024

Hilla city (the center of Babil Governorate) is subjected to extremely high traffic volume due to its geographical placement in the middle of the Middle Euphrates governorates, especially 60th Street. This high traffic volume will lead to traffic jams, delays, accidents and environmental pollution. Therefore, this paper suggested a ring road as a solution to the problem of internal congestion in the city. The project has contributed to reducing the travel time for vehicles using the (external-external) route, as the travel time is reduced by 68%. The total project cost was approximately 90.5 billion Iraqi dinars. The benefits of the project are calculated and it is found that the project will achieve profits after the eighth year of the project’s opening. The transactions that achieve the effectiveness of the project are also calculated, which are the net present value and the cost-benefit ratio. It was found that the project is economically feasible, as the two transactions were successful in the evaluation. An indicator is also devised that describes the effectiveness of the road to be built in advance, as it will provide subsequent studies with the ease of choosing the road according to coefficients (1-0). It has shown that the current project is effective and feasible because its index is between the numbers (1-0), where the ratio is 0.28.
Study the Causes and Effects of Frequent Failures of Roads Pavement in Iraq
Authors: Mohaisen Ali H. , Rashid Hatim A.
Published: August 2024

Road deterioration continues to be one of the community’s main challenges and problems. Despite many previous research efforts related to identifying the causes and types of distresses spread on roads, there is still a lack of research investigating administrative problems and the effects of frequent failures. This paper tackles this knowledge gap in the context of highway maintenance operations in Iraq. For this purpose, the authors used an integrated research method that deals with (1) the selection and analysis of previous local and international studies and (2) conducting a comprehensive questionnaire in the departments concerned with the maintenance process. The authors were consulted on all research steps by experts in the field. Through the analysis of previous studies and the results of the questionnaire, the results show that the deterioration in the roads is the result of several factors, the most important of which is the absence of preventive maintenance and the resort to emergency interventions in most municipalities, as well as the late maintenance time, the insufficient funds allocated for maintenance, and the inaccurate identification of the causes of distresses, which caused the failure of many operations maintenance. This deterioration also, directly and indirectly, affects safety, the economy, and the environment. Ultimately, the research shows the most important causes and effects of distortions frequently appearing on Iraqi roads. It is considered a reference for many departments and researchers to find solutions and avoid falling into the same problems.
Evaluating the traffic characteristics of the road network in Ramadi city using sustainable transportation indicators (Hazard Index)
Authors: khudier Rafal M. , Mahmood Thaer Sh , Awad Hamid A.
Published: August 2024

Annually, road accidents claim the lives of around 1.25 million individuals and leave a staggering 20 to 50 million people injured. The objective of this thesis is to create a hazard index for the primary highways in the metropolitan region of Al-Ramadi City, Iraq, covering the time span from 2018 to 2023. To achieve the main objective of this study, we will analyze how traffic characteristics, such as the logarithm of the average daily volume (Ln ADV), the daily volume of heavy vehicles (HVv), and the operation speed (OS), affect the frequency of accidents. We will use both fixed parameter model (FPM) and random parameter model (RPM) for this analysis. The model’s estimation outcomes indicate a positive correlation between LnADV and both the frequency and rate of all types of accidents. The models indicate that the parameter of LnADV is fixed for all models, indicating that this variable will not vary over all roadway segments. A 10% rise in LnADV results in a corresponding 65% increase in total accident frequencies, a 45% increase in slight damage accident frequencies, and a 70% increase in serious damage accident frequencies. There was a significant correlation between HVv (high vehicle volume) and the frequency of total, slight damage, and major damage accidents. The parameter estimates for HVv were found to be random parameters in the models for total, slight damage, and major damage accident frequencies. This indicates that the impact of Hvv on the rates of total, slight damage, and major damage accidents will differ according on the specific sections of the road. An increase of 10% in HVv results in a corresponding rise of 20% in total accident frequencies, 10% in slight damage accident frequencies, and 17% in serious damage accident frequencies. The examination of stochastic variables The model results indicate a positive correlation between the increase in OS and the increase in frequency of total, slight damage, and major damage accidents. A 10% increase in operating speed (OS) results in an 8% rise in the frequency of total accidents, a 6% increase in the frequency of slight damage accidents, and a 13% increase in the frequency of serious damage accidents.
SWOT Analysis for Kirkuk Irrigation Project
Authors: Salah Al-obaidi Riyam , Ridha Faris Mariwan
Published: August 2024

The Kirkuk Irrigation Project is significant importance as one of Iraq’s foremost irrigation projects. The project now in operation provides irrigation to expansive regions inside the Kirkuk Governorate. The project was initiated in 1975, but remains unfinished in certain sections. Currently, only two phases of the project have been completed: the first phase, spanning from the Dibs area to Taza and the second phase, located within the administrative borders of Daquq . However, the third and fourth phases are still incomplete. The research aims to assess the project and identify its strengths, weaknesses, opportunities, and threats. The SWOT analysis serves as a solid foundation for informing and guiding decisions pertaining to the advancement of irrigation projects. The data indicates a significant decrease in the quantities of water within the project, as the discharge of the Kirkuk irrigation project in 2023 is limited to daily needs only and reached 30 cubic meters per second. This is a very low number compared to the period at the beginning of the project construction. To counteract these Threats, however, opportunities abound, such as the implementation of contemporary irrigation techniques for watering, the cultivation of water-efficient crops, and the utilization of groundwater in agriculture, given that a staggering 291,480 wells have been drilled throughout the governorate.
Additive manufacturing to design a new material TiB2-reinforced SUS316L using TiB2-Fe composite powder
Authors: Otsuka R. , Kikuchi T. , Yamamoto T. , Katayama S.
Published: August 2024

The metal additive manufacturing (AM) process allows for the production of three-dimensional (3D) parts with unique geometries that could not be formed by conventional methods. However, our aim is to utilize the AM process to create never-before-seen new materials because we believe it holds potential not only for new processing but also for creating a new material. The TiB2-Fe composite powder developed as a new raw material of the AM process, which was used as an additive powder in additive manufactured (AMed) SUS316L for effectively improving the mechanical properties of AMed SUS316L. The TiB2-reinfoced SUS316L synthesized by a Powder Bed Fusion (PBF) method using the TiB2-Fe composite powder had an extremely high Vickers hardness and strength of about 400 HV and 1250 MPa, respectively, being close to twice those of AMed SUS316L.
Microstructure of additive manufactured materials for plasma-facing components of future fusion reactors
Authors: Wartacz D A H , Becker H , Antusch S , Ordás N , Gundlach C , Mishin O V , Pantleon W
Published: August 2024

Two metallic materials considered for the divertor in fusion reactors are manufactured by powder bed fusion through electron beam melting: tungsten as armor of plasma-facing components and an age-hardenable CuCrZr alloy as heat sink material for the divertor. Cuboids are additively manufactured from both materials, and cross sections containing the build direction are characterized by electron backscatter diffraction. A peculiar heterogeneity is observed in the microstructure of tungsten and traced to the scanning strategy. Large columnar grains along the building direction with slight outward inclination are seen on both sides of the cross section i.e. where grains are observed in viewing planes perpendicular to the printing direction. Grains appear only slightly elongated in the center; neither their entire length nor their inclination is detected when the plane of view contains the printing direction. Many incidental twin boundaries are identified in the CuCrZr alloy; their occurrence is rationalized by the presence of an almost perfect <110> fiber texture. Additionally, X-ray computed tomography confirmed the low porosity of the CuCrZr specimen.
Micro-macro relationship between microstructure and mechanical behavior of 316L stainless steel fabricated using L-PBF additive manufacturing
Authors: Ozdogan C , Yildiz R A , Tavares L , Malekan M
Published: August 2024

Compared to traditional production techniques, additive manufacturing (AM) of metallic components has several benefits, mainly little material waste and more design freedom. AM process based on laser powder bed fusion has many key process parameters including scanning speed, layer thickness, build direction, and printing power. Each one of these parameters influences microstructure, and hence macro-mechanical behavior of the manufactured part, as the part microstructure plays a critical role in determining the mechanical properties. This work aims to address a relationship between micro-structure and macro-mechanical behavior of AM fabricated parts made of 316L Stainless Steel. Both as-built and heat-treated samples are being used for experimental testing and microstructure characterizations. Arcan fixture is used to evaluate the macro-mechanical fracture behavior of the material under mode-I, mode-II, and mixed-mode conditions. Microstructure evaluations of the fracture surfaces are done using scanning electron microscopy and X-Ray diffraction techniques. Finally, a correlation between micro-scale characteristics and macro-mechanical behavior is obtained together with different AM process parameters.
Additive Manufacturing of 7xxx Aluminium Alloys by Laser Powder Bed Fusion
Authors: Zhang K , Wenner S , Marioara C D , Hovig E W , Du Q , Onsøien M , Marthinsen K
Published: August 2024

Additive manufacturing of high strength wrought grade aluminium alloys is of great industrial and academic interests, but still difficult in practice due to the tendency of crack formations in the microstructure. This work aimed at producing dense crack-free samples of AA7075-type aluminium alloys by the laser powder bed fusion (LPBF) technology, and to investigate the microstructure. It was found that LPBF of pure AA7075 powder gave micro-cracks for all tested 25 processing parameters which covered a wide range of laser power and speed. In order to avoid the cracks, different methods were tried including high preheating temperature, introducing nano-particles, and adding Si into the alloys. Introducing ZrH2 nano-particles into AA7075 by mechanical blending could successfully produce crack-free samples using LPBF. Adding 5% Si into the AA7075 powder by mechanical blending could also give crack-free samples with high relative density. It was also found that the as-built samples with preheating at 250°C had hardness as-low-as 70HV. Solutionizing at 480°C with water quenching followed by artificial aging at 120°C can bring the hardness to 140HV and 120HV, for the AA7075 variants with ZrH2 and with addition of Si, respectively. Detailed characterizations revealed clear influences of both preheating temperature and alloying on the microstructure. It is concluded that preheating temperature should be carefully selected for AM of high strength precipitation hardening Al alloys.
On the chemical composition, microstructure and mechanical properties of a Nitrogen-contaminated Ti-6Al-4V component built by Wire-Arc Additive Manufacturing
Authors: Hu D , Biswal R , Sahu V K , Fellowes J W , Zadehkabir A , Williams S W , Davis A E
Published: August 2024

Additive manufacturing (AM) using recycled Ti-6Al-4V (Ti64) feedstock material from wrought waste streams is a novel process that can reduce the overall energy cost and carbon (CO2) footprint when compared to primary-production routes. The potential contamination of recycled feedstock material (e.g. C, O, N and Fe) can affect the microstructure and mechanical properties of the component. In this work, a Ti64 test wall built using wire arc AM (WAAM) was studied, where the top half only was contaminated by N through the shielding gas during deposition. This allowed a direct comparison of Ti64 WAAM material with high and low N content, deposited under otherwise identical conditions, to replicate the worst-case scenario of N contamination from using recycled swarf. The hardness of the N-contaminated section was found to be 25% higher than the uncontaminated section of the wall, demonstrating the N solid solution strengthening in Ti64. The room temperature transformed microstructure was found to have a 25% coarser α-lath thickness, which was proposed to be an effect of the AM cyclical heating and increasing of the β-transus temperature due to a higher level of N. Additionally, the outer layer of the N-contaminated sample section was found to have a refined parent β grain structure.
Synthesis and characterization of the dealloyed hierarchical structure of AlSi10Mg-Cu alloys prepared using laser-powder bed fusion
Authors: Sun S , Zhang C F , Wang W Y , Godfrey A
Published: August 2024

Nanoporous structures with high surface area can be obtained by 3D printing of lattice structures and subsequent dealloying, with potential applications in the field of catalysis and batteries. Here we prepared a AlSi10Mg-Cu (38wt%) alloy by laser-powder bed fusion of mixed powders. A metastable structure was obtained after 3D printing, with significant differences in solidification structures in different regions. The solidification structure is inherited after dealloying, in which dendrites form submicron ligaments, and nanoscale ligaments are formed inside the dendrites. Dealloying of a 3D-printed lattice structure allows the preparation of hierarchical nanoporous copper with only limited crack formation.
Effects of cold-bonded artificial aggregate properties on the behaviour of concrete
Authors: Bekkeri Gopal Bharamappa , Shetty Kiran K , Nayak Gopinatha
Published: August 2024

The study investigates the use of artificial aggregates (AAs), specifically manufactured from ground granulated blast furnace slag (GGBFS) and ordinary Portland cement (OPC), to mitigate environmental harm caused by illegal quarrying due to the scarcity of natural aggregates (NAs). A cold-bonded pelletization technique was employed to produce five types of AAs with varying proportions of GGBFS & OPC as 82.5:17.5, 85:15, 87.5:12.5, 90:10, 95:5. The AAs with maximum OPC content exhibited a density of 1298 kg m−3, water absorption of 4.8%, and crushing and impact values of 28.6% and 26.3%, respectively. The impact of these AAs on concrete properties was assessed, revealing that AAs facilitated the production of workable concrete with low-density ranges between 1700–2337 kg m−3. Despite a decrease in concrete strength with higher AAs content, structural requirements were met, demonstrating AAs’ potential to effectively substitute natural coarse aggregates (NCAs). The concrete microstructure confirmed the formation of a strong interfacial transition zone (ITZ) and strength-developing cement-hydrated products. This research underscores the scientific contribution of AAs to address aggregate scarcity sustainably and recommends its application in structural elements by experimental validation.
Syntheses, characterization, luminescent and magnetic properties of polymer bifunctional fibers containing terbium complexes and Fe3O4 nanoparticles
Authors: Liu Lina , Wang Kexin , An Xiuyun , Wang Yujun , Shan Feng , Liu Jia , Tang Chunjuan , Su Jianfeng , Qin Ruifei
Published: August 2024

The combination of electrospun nanofibers and nanoparticles is opening up potential in the field of bifunctional materials. Herein, polystyrene (PS, Mw ≈ 260, 000), polyvinyl pyrrolidone (PVP, Mw ≈1, 300, 000), and poly(methyl methacrylate) (PMMA, Mw ≈ 350, 000) bifunctional fibers containing Tb(acac)3phen complexes (acac: acetylacetone, phen: 1,10-phenanthroline) and Fe3O4 nanoparticles (NPs) were synthesized by single-fluid electrospinning method. The structure of bifunctional microfibers was characterized by x-ray diffraction (XRD), scanning electron microscope (SEM), transmission electron microscope (TEM), energy spectrum (EDAX) and infrared spectrum (IR). The average diameters of PS, PVP and PMMA bifunctional fibers are 1.65, 0.313 and 0.571 μm, respectively. The TEM images indicated that Fe3O4 NPs were successfully incorporated into bifunctional fibers. No absorption peaks of terbium complexes and Fe3O4 NPs can be seen in the IR spectra of bifunctional fibers. The luminescent and magnetic properties of bifunctional fibers were also investigated. Due to the change of ligands environment, the main excitation peaks blue shifted about 5–8 nm in the bifunctional fibers. Bifunctional fibers exhibited characteristic emission of Tb3+ ions. The polymers have no effect on the fluorescence lifetimes of terbium complexes. All bifunctional fibers were soft ferromagnetic. In addition, mechanical performances of these nanofibers were also studied. The maximum stress, strain corresponding to the maximum stress and elastic modulus of sample PVP-Fe-Tb is the largest, which indicates that the tensile performance of sample PVP-Fe-Tb is the best.
STAR-FDTD: space-time modulated acousto-optic guidestar in disordered media
Authors: Raju Michael , Jayet Baptiste , Andersson-Engels Stefan
Published: August 2024

We developed a 2D Finite-difference time-domain (FDTD) method for modeling a space-time modulated guidestar targeting wavefront shaping applications in disordered media. Space-time modulation in general (a particular example being the acousto-optic effect) is used here as a guidestar for the transverse confinement of light around the tagged region surrounded by disorder. Together with the guidestar, the iterative optical phase conjugation (IOPC) method is used to overcome the diffusion of light due to multiple scattering. A phase sensitive lock-in detection technique is utilized to estimate the steady-state amplitude and phase of the modulated wavefronts emerging from the guidestar region continuously operating in the Raman-Nath regime. As the IOPC scheme naturally converges to the maximally transmitting eigenchannel profile, one could use the position of the guidestar within the disorder to channelize the maximal transmission through the tagged region. The associated code developed in MATLAB® is provided as an open source (The MIT License) package. The code package is referred by the acronym STAR-FDTD where STAR stands for Space-Time modulated Acousto-optic guidestaR.
Assessing the environmental justice implications of decarbonizing the US electric grid: estimating changes in asthma exacerbation by race and income
Authors: Mehdi Qasim , Vasilakos Petros
Published: August 2024

This paper examines how air quality improvements due to the 100% decarbonization of the US power sector in 2040 can reduce asthma exacerbation among children disaggregated by poverty status, race, and geography. Using spatial datasets that differentiate asthma prevalence by income, race, and state, we find that children living in households with income below the poverty line receive a disproportionate share of the benefits. To obtain these results, we employ several different federally administered datasets: American Community Survey, Behavioral Risk Factor Surveillance System (BRFSS), and Poverty Thresholds as provided by the US Census. We find that Black children and poor children, on average, have higher reductions in exposure to PM2.5. Nationally, close to 235 372 asthma exacerbation cases will be averted in 2040 under the decarbonization policy compared with Business-as-Usual. States with significant gains in asthma cases averted per 100 000 are Indiana, Kentucky, Ohio, Missouri, Pennsylvania, Texas, and Wisconsin. Furthermore, since the asthma portion of the BRFSS is not conducted in South Carolina, Colorado, Arkansas, and South Dakota, these states were omitted from the analysis. Across all states with significant gains, children living below the poverty line have larger health benefits than children above the poverty line. Households with child poverty have 50% larger reductions in asthma exacerbations than households without childhood poverty. Black children below the poverty line experience 33% higher health gains compared to Black children per 100 000 above the poverty line, 50% higher health gains compared to White children below the poverty line, and 159% higher than White children above the poverty line. We also provide general methodological insights for quantifying the environmental justice impacts of regulatory policies. We demonstrate why using race and poverty status-based prevalence rates is critical for understanding the distribution of health improvements and evaluating whether policies contribute to environmental justice goals.
Breaking the Fourth Wall and (Meta)Fictional Reference
Authors: Semeijn Merel
Published: August 2024

I investigate statements in fiction that ‘break the fourth wall’ (i.e. statements through which a fictional character somehow acknowledges the fictionality of their world) and suggest that they are a mirror image of ‘parafictional statements’—that is, reports on what is true in some fiction. I explore two possible analyses, according to which statements that break the fourth wall are either a type of fictional statement, or are a type of metafictional statement, and propose a synthesis of these two analyses. I discuss how the proposed analysis relates to different interpretative strategies for dealing with inconsistency in fiction and discuss several potential counterexamples to the proposed analysis.
Nonprofit Poetry: Lewis MacAdams and the Art of Environmental Bureaucracy
Authors: Earhart Nick
Published: August 2024

Poet Lewis MacAdams is widely regarded as a founder of the movement to restore the Los Angeles River, a 51-mile concrete drainage channel that once served as the region’s primary water source. His nonprofit organization Friends of the Los Angeles River (FoLAR) began as a one-off performance art piece in 1985. Scholars in urban planning and geography have addressed FoLAR as a case study for grassroots environmentalism, but little attention has been paid to the interplay between poetry and politics in MacAdams’s work. Given that MacAdams described FoLAR as a “forty-year artwork to bring the Los Angeles River back to life,” it is worth entertaining the quixotic premise that a nonprofit could double as a conceptual artwork or performance poem. If we consider his literary efforts in conversation with his activism, the premise seems less far-fetched. In this essay, I trace MacAdams’s path from the New York School to the poets’ enclave of Bolinas, California, in the 1970s to the concrete banks of the Los Angeles River. I argue that he devised political-poetic strategies to intervene in planning bureaucracies and that FoLAR should be understood as a durational utopian experiment, pursuing transformative possibilities from within dispiriting everyday conditions.
Consuming Consumption
Authors: Marsh Nicky
Published: August 2024

This essay reviews four recent works examining the cultural politics of consumption. It explores the methodological and theoretical distinctions and commonalities between three works which share an historical focus. It notes the different emphases suggested by historians, sociologists, and literary critics but emphasises their shared concern with understanding the complex agency of consumption as it is can be found specifically in cultural representations. The essay also notes the persistence of the theoretical divide between these historical studies, which identify consumption as a site of ambivalent possibility and even resistance, and contemporary accounts that regard it as a site of commodification and expropriation of the self.
Soymilk yogurt fermented using Pediococcus pentosaceus TOKAI 759 m improves mice gut microbiota and reduces pro-inflammatory cytokine production
Authors: Nakashima Yuki , Onuki Kotone , Hibi Tomoyuki , Ohno Rei-Ichi , Sugawa Hikari , Tominaga Yuki , Yasuda Shin , Kinoshita Hideki
Published: August 2024

This study aimed to determine the anti-inflammatory activities and bioactive compounds of soymilk yogurt prepared using Lactiplantibacillus plantarum TOKAI 17 or Pediococcus pentosaceus TOKAI 759 m. Mice were divided into five groups: normal diet (ND), soymilk, soymilk yogurt using L. plantarum TOKAI 17 (SY 17) or P. pentosaceus TOKAI 759 m (SY 759 m), and 0.5 × 109 cells of each starter strain (BC 17 or BC759m). In the SY 759 m group, the serum pro-inflammatory cytokine levels and the cytotoxicity of natural killer cells were attenuated compared to the ND group. In the cecum microbiota, the abundances of butyrate-producing bacteria increased in the SY 759 m and BC 17 groups. Furthermore, SY 759 m metabolites contained high levels of aglycone isoflavone, adenine and showed a significant decrease in CCL-2 and interleukin-6 production in lipopolysaccharide-induced macrophage. In conclusion, soymilk yogurt produced using P. pentosaceus TOKAI 759 m modulates the gut microbiota and can potentially prevent pro-inflammatory cytokine production.
Relationship between dominance hierarchy steepness and rank-relatedness of benefits in primates
Authors: Huang Pengzhen , Arlet Malgorzata E , Balasubramaniam Krishna N , Beisner Brianne A , Bliss-Moreau Eliza , Brent Lauren J N , Duboscq Julie , García-Nisa Iván , Kaburu Stefano S K , Kendal Rachel , Konečná Martina , Marty Pascal R , McCowan Brenda , Micheletta Jérôme , Ostner Julia , Schülke Oliver , Schino Gabriele , Majolo Bonaventura
Published: August 2024

In animal social groups, the extent to which individuals consistently win agonistic interactions and their ability to monopolize resources represent 2 core aspects of their competitive regime. However, whether these two aspects are closely correlated within groups has rarely been studied. Here, we tested the hypothesis that hierarchy steepness, which is generally used to represent power differentials between group members, predicts the variation in the distribution of fitness-related benefits (i.e. fecundity, infant survival, mating success, and feeding success) in relation to individual dominance ranks. We tested this hypothesis in primate groups using comparative phylogenetic meta-analytical techniques. Specifically, we reviewed published and unpublished studies to extract data on individual dominance ranks, their access to fitness-related benefits, and hierarchy steepness. We collected and included in our analysis a total of 153 data points, representing 27 species (including 2 chimpanzee sub-species). From these, we used 4 common methods to measure individual dominance ranks and hierarchy steepness, i.e. Dij-based normalized David’s scores, randomized Elo-ratings, and David’s scores and Elo-ratings estimated in Bayesian frameworks. We found that hierarchy steepness had no effect on the strength of the relationship between dominance rank and access to fitness-related benefits. Our results suggest that hierarchy steepness does not reflect between-group variation in the extent to which individual dominance affects the acquisition of fitness-related benefits in primates. Although the ability to win agonistic encounters is essential, we speculate that other behavioral strategies adopted by individuals may play crucial roles in resource acquisition in animal competitive regimes.
Laparoscopic versus open right hepatectomy for colorectal liver metastases after portal vein embolization: international multicentre study
Authors: Bozkurt Emre , Sijberden Jasper P , Langella Serena , Cipriani Federica , Collado-Roura Francesc , Morrison-Jones Victoria , Görgec Burak , Zozaya Gabriel , Lanari Jacopo , Aghayan Davit , De Meyere Celine , Fuks David , Zimmiti Giuseppe , Ielpo Benedetto , Efanov Mikhail , Sutcliffe Robert P , Russolillo Nadia , Gomez-Artacho Miquel , Ratti Francesca , D’Hondt Mathieu , Edwin Bjørn , Cillo Umberto , Rotellar Fernando , Besselink Marc G , Primrose John N , Lopez-Ben Santi , Aldrighetti Luca A , Ferrero Alessandro , Abu Hilal Mohammad
Published: August 2024

Background

Laparoscopic liver surgery is increasingly used for more challenging procedures. The aim of this study was to assess the feasibility and oncological safety of laparoscopic right hepatectomy for colorectal liver metastases after portal vein embolization.

Methods

This was an international retrospective multicentre study of patients with colorectal liver metastases who underwent open or laparoscopic right and extended right hepatectomy after portal vein embolization between 2004 and 2020. The perioperative and oncological outcomes for patients who underwent laparoscopic and open approaches were compared using propensity score matching.

Results

Of 338 patients, 84 patients underwent a laparoscopic procedure and 254 patients underwent an open procedure. Patients in the laparoscopic group less often underwent extended right hepatectomy (18% versus 34.6% (P = 0.004)), procedures in the setting of a two-stage hepatectomy (42% versus 65% (P < 0.001)), and major concurrent procedures (4% versus 16.1% (P = 0.003)). After propensity score matching, 78 patients remained in each group. The laparoscopic approach was associated with longer operating and Pringle times (330 versus 258.5 min (P < 0.001) and 65 versus 30 min (P = 0.001) respectively) and a shorter length of stay (7 versus 8 days (P = 0.011)). The R0 resection rate was not different (71% for the laparoscopic approach versus 60% for the open approach (P = 0.230)). The median disease-free survival was 12 (95% c.i. 10 to 20) months for the laparoscopic approach versus 20 (95% c.i. 13 to 31) months for the open approach (P = 0.145). The median overall survival was 28 (95% c.i. 22 to 48) months for the laparoscopic approach versus 42 (95% c.i. 35 to 52) months for the open approach (P = 0.614).

Conclusion

The advantages of a laparoscopic over an open approach for (extended) right hepatectomy for colorectal liver metastases after portal vein embolization are limited.
Connectivity defines the distinctive anatomy and function of the hand-knob area
Authors: Beyh Ahmad , Howells Henrietta , Giampiccolo Davide , Cancemi Daniele , De Santiago Requejo Francisco , Citro Salvatore , Keeble Hannah , Lavrador José Pedro , Bhangoo Ranjeev , Ashkan Keyoumars , Dell’Acqua Flavio , Catani Marco , Vergani Francesco
Published: August 2024

Control of the hand muscles during fine digit movements requires a high level of sensorimotor integration, which relies on a complex network of cortical and subcortical hubs. The components of this network have been extensively studied in human and non-human primates, but discrepancies in the findings obtained from different mapping approaches are difficult to interpret. In this study, we defined the cortical and connectional components of the hand motor network in the same cohort of 20 healthy adults and 3 neurosurgical patients. We used multimodal structural magnetic resonance imaging (including T1-weighted imaging and diffusion tractography), as well as functional magnetic resonance imaging and navigated transcranial magnetic stimulation (nTMS). The motor map obtained from nTMS compared favourably with the one obtained from functional magnetic resonance imaging, both of which overlapped well within the ‘hand-knob’ region of the precentral gyrus and in an adjacent region of the postcentral gyrus. nTMS stimulation of the precentral and postcentral gyri led to motor-evoked potentials in the hand muscles in all participants, with more responses recorded from precentral stimulations. We also observed that precentral stimulations tended to produce motor-evoked potentials with shorter latencies and higher amplitudes than postcentral stimulations. Tractography showed that the region of maximum overlap between terminations of precentral–postcentral U-shaped association fibres and somatosensory projection tracts colocalizes with the functional motor maps. The relationships between the functional maps, and between them and the tract terminations, were replicated in the patient cohort. Three main conclusions can be drawn from our study. First, the hand-knob region is a reliable anatomical landmark for the functional localization of fine digit movements. Second, its distinctive shape is determined by the convergence of highly myelinated long projection fibres and short U-fibres. Third, the unique role of the hand-knob area is explained by its direct action on the spinal motoneurons and the access to high-order somatosensory information for the online control of fine movements. This network is more developed in the hand region compared to other body parts of the homunculus motor strip, and it may represent an important target for enhancing motor learning during early development.
ADRA2A promotes the classical/progenitor subtype and reduces disease aggressiveness of pancreatic cancer
Authors: Moreno Paloma , Ohara Yuuki , Craig Amanda J , Liu Huaitian , Yang Shouhui , Dorsey Tiffany H , Zhang Lin , Panigrahi Gatikrushna , Cawley Helen , Azizian Azadeh , Gaedcke Jochen , Ghadimi Michael , Hanna Nader , Hussain S Perwez
Published: August 2024

Pancreatic ductal adenocarcinoma (PDAC) manifests diverse molecular subtypes, including the classical/progenitor and basal-like/squamous subtypes, with the latter known for its aggressiveness. We employed integrative transcriptome and metabolome analyses to identify potential genes contributing to the molecular subtype differentiation and its metabolic features. Our comprehensive analysis revealed that adrenoceptor alpha 2A (ADRA2A) was downregulated in the basal-like/squamous subtype, suggesting its potential role as a candidate suppressor of this subtype. Reduced ADRA2A expression was significantly associated with a high frequency of lymph node metastasis, higher pathological grade, advanced disease stage, and decreased survival among PDAC patients. In vitro experiments demonstrated that ADRA2A transgene expression and ADRA2A agonist inhibited PDAC cell invasion. Additionally, ADRA2A-high condition downregulated the basal-like/squamous gene expression signature, while upregulating the classical/progenitor gene expression signature in our PDAC patient cohort and PDAC cell lines. Metabolome analysis conducted on the PDAC cohort and cell lines revealed that elevated ADRA2A levels were associated with suppressed amino acid and carnitine/acylcarnitine metabolism, which are characteristic metabolic profiles of the classical/progenitor subtype. Collectively, our findings suggest that heightened ADRA2A expression induces transcriptome and metabolome characteristics indicative of classical/progenitor subtype with decreased disease aggressiveness in PDAC patients. These observations introduce ADRA2A as a candidate for diagnostic and therapeutic targeting in PDAC.
Characterizing the use of full- and split-thickness skin grafts among dermatologists: an international survey
Authors: Lim Puo Nen , Salence Brogan Kelly , Hunt William Thomas Nicholas
Published: August 2024

Background

The use of full-thickness and split-thickness skin grafts (FTSG/STSG) among dermatologists has not been well characterized.

Objectives

To characterize the utilization of graft techniques, fixation methods and training needs pertaining to graft use among an international cohort of dermatologists.

Methods

An online questionnaire was developed iteratively, and subsequently distributed between July and August 2022 to dermatologists from the UK, European countries and New Zealand (NZ).

Results

In total, 150 responses were obtained from the UK, Ireland, NZ, Australia, Brazil, USA and eight European countries. Among the respondents, 23.3% (35 of 150) undertook both FTSG and STSG; 46.7% (70 of 150) performed only FTSG; and 30.0% (45 of 150) did not undertake skin grafts in their practice. Of the 67 Mohs surgeons, only 42% (28 of 67) undertook both FTSG and STSG. Overall, common donor sites for FTSG included the preauricular area (86 of 105; 81.9%) and clavicle (75 of 105; 71.4%), while the thigh was the most common donor site for STSG (30 of 35; 86%). Grafts were fixed mostly with sponge tie-over dressings and basting/quilting sutures. For STSG, most were harvested using an electric dermatome (18 of 35; 51%), freehand skin-graft knife (17 of 35; 49%) and flexible razor blade (5 of 35; 14%). Of the total, 48.0% (72 of 150) considered skin grafting an essential skill in dermatology training, and most respondents cited a lack of training opportunity and insufficient surgical cases as significant barriers.

Conclusions

Our survey reveals diverse practices among an international cohort of dermatologists in the use of FTSG/STSG and highlights the need for further training.
Unveiling immunological signatures and predictors of response to immunosuppressive therapy in acquired aplastic anemia
Authors: Gupta Maya , Shanmukhaiah Chandrakala , Vundinti Babu Rao , Jose Amrutha , Tiwari Shashank , Bhowmick Amiya , Madkaikar Manisha
Published: August 2024

Acquired aplastic anemia (AA) often results from immune destruction of hematopoietic stem and progenitor cells. However, only 60%–70% of patients with AA respond to immunosuppressive therapy (IST). There is a lack of strong predictive markers for response to IST which can help therapy. Our study sought to pinpoint unique immune markers in AA patients and validate established predictors for response to IST. We enrolled 51 severe AA patients and analyzed 57 immunological parameters via flow cytometry. Additionally, we measured paroxysmal nocturnal hemoglobinuria (PNH) clone, telomere length, and thrombopoietin (TPO) levels prior to IST. After a 6-month follow-up, a response was observed. Patients with AA had a distinct immunological signature characterized by absolute lymphopenia, skewed CD4/CD8 ratio with expansion of CD8 T cells with activated and senescent phenotype. Treg counts were reduced, while the proportion of Treg A and B was comparable to controls. Treatment response was correlated with elevated absolute neutrophil count (ANC), absolute reticulocyte count (ARC), and reduced CD57+ CD8+ naive cells and B cell % before therapy. However, predictors like TPO, telomere length, and PNH did not emerge as indicators of treatment response. Identifying predictors for treatment response in AA is challenging due to abnormal hematopoiesis, genetic mutations, and treatment variables.
Prognostic and therapeutic monitoring value of plasma and urinary cytokine profile in primary membranous nephropathy: the STARMEN trial cohort
Authors: Rojas-Rivera Jorge Enrique , Hasegawa Takehiro , Fernandez-Juarez Gema , Praga Manuel , Saruta Yuko , Fernandez-Fernandez Beatriz , Ortiz Alberto ,   the Sysmex R&D Center Europe team and STARMEN working group, Egido Jesús , Praga Manuel , Rodríguez-Moreno Antolina , Rivas Begoña , Cao Mercedes , Gómez-Martino Juan Ramón , Ávila Ana , Bonet José , Quintana Luis , Agraz Irene , Diez-Encarnación Monserrat , Rabasco Cristina , Cabello Virginia , Feng Zhao , Lunding Hanna , Karalis Dimitris , Li Yun
Published: August 2024

Background

Primary membranous nephropathy (PMN) is usually caused by anti-phospholipase A2 receptor (PLA2R) autoantibodies. There are different therapeutic options according to baseline risk. Novel biomarkers are needed to optimize risk stratification and predict and monitor the response to therapy, as proteinuria responses may be delayed. We hypothesized that plasma or urinary cytokines may provide insights into the course and response to therapy in PMN.

Methods

Overall, 192 data points from 34 participants in the STARMEN trial (NCT01955187), randomized to tacrolimus–rituximab (TAC-RTX) or corticosteroids–cyclophosphamide (GC-CYC), were analysed for plasma and urine cytokines using a highly sensitive chemiluminescence immunoassay providing a high-throughput multiplex analysis.

Results

Baseline (pretreatment) urinary C-X-C motif chemokine ligand 13 (CXCL13) predicted the therapeutic response to TAC-RTX. Cytokine levels evolved over the course of therapy. The levels of nine plasma and six urinary cytokines correlated with analytical parameters of kidney damage and disease activity, such as proteinuria, estimated glomerular filtration rate and circulating anti-PLA2R levels. The correlation with these parameters was most consistent for plasma and urinary growth differentiation factor 15 (GDF15), plasma tumour necrosis factor α and urinary TNF-like weak inducer of apoptosis. Decreasing plasma GDF15 levels were associated with response to GC-CYC. Four clusters of cytokines were associated with different stages of response to therapy in the full cohort, with the less inflammatory cluster associated with remission.

Conclusion

PMN displayed characteristic plasma and urine cytokine patterns that evolved over time as patients responded to therapy. Baseline urinary CXCL13 concentration could be a prognostic marker of response to TAC-RTX.
Point-of-care ultrasound training in nephrology: a position statement by the International Alliance for POCUS in Nephrology
Authors: Koratala Abhilash , Argaiz Eduardo R , Romero-González Gregorio , Reisinger Nathaniel , Anwar Siddiq , Beaubien-Souligny William , Bhasin-Chhabra Bhavna , Diniz Hugo , Vaca Gallardo Marco , Graterol Torres Fredzzia , Husain-Syed Faeq , Hanko Jennifer , Jaberi Aala , Kazory Amir , Raina Rupesh , Ronco Claudio , Salgado Octavio J , Sethi Sidharth Kumar , Villavicencio-Cerón Vanessa , Yadla Manjusha , Bastos Marcus Gomes
Published: August 2024

Point-of-care ultrasonography (POCUS) has rapidly evolved from a niche technology to an indispensable tool across medical specialties, including nephrology. This evolution is driven by advancements in technology and the visionary efforts of clinicians in emergency medicine and beyond. Recognizing its potential, medical schools are increasingly integrating POCUS into training curricula, emphasizing its role in enhancing diagnostic accuracy and patient care. Despite these advancements, barriers such as limited faculty expertise and ‘lack of’ standardized guidelines hinder widespread adoption and regulation. The International Alliance for POCUS in Nephrology (IAPN), through this position statement, aims to guide nephrologists in harnessing the diagnostic power of POCUS responsibly and effectively. By outlining core competencies, recommending training modalities and advocating for robust quality assurance measures, we envision a future where POCUS enhances nephrology practice globally, ensuring optimal patient outcomes through informed, evidence-based decision-making. International collaboration and education are essential to overcome current challenges and realize the full potential of POCUS in nephrology and beyond.
Spiny dogfish, Squalus suckleyi, shows a good tolerance for hypoxia but need long recovery times
Authors: De Boeck Gudrun , Lardon Isabelle , Eyckmans Marleen , Vu Trung Nghia , Laukens Kris , Dommisse Roger , Wood Chris M
Published: August 2024

Pacific spiny dogfish, Squalus suckleyi, move to shallow coastal waters during critical reproductive life stages and are thus at risk of encountering hypoxic events which occur more frequently in these areas. For effective conservation management, we need to fully understand the consequences of hypoxia on marine key species such as elasmobranchs. Because of their benthic life style, we hypothesized that S. suckleyi are hypoxia tolerant and able to efficiently regulate oxygen consumption, and that anaerobic metabolism is supported by a broad range of metabolites including ketones, fatty acids and amino acids. Therefore, we studied oxygen consumption rates, ventilation frequency and amplitude, blood gasses, acid–base regulation, and changes in plasma and tissue metabolites during progressive hypoxia. Our results show that critical oxygen levels (Pcrit) where oxyregulation is lost were indeed low (18.1% air saturation or 28.5 Torr at 13°C). However, many dogfish behaved as oxyconformers rather than oxyregulators. Arterial blood PO2 levels mostly decreased linearly with decreasing environmental PO2. Blood gases and acid–base status were dependent on open versus closed respirometry but in both set-ups ventilation frequency increased. Hypoxia below Pcrit resulted in an up-regulation of anaerobic glycolysis, as evidenced by increased lactate levels in all tissues except brain. Elasmobranchs typically rely on ketone bodies as oxidative substrates, and decreased concentrations of acetoacetate and β-hydroxybutyrate were observed in white muscle of hypoxic and/or recovering fish. Furthermore, reductions in isoleucine, glutamate, glutamine and other amino acids were observed. After 6 hours of normoxic recovery, changes persisted and only lactate returned to normal in most tissues. This emphasizes the importance of using suitable bioindicators adjusted to preferred metabolic pathways of the target species in conservation physiology. We conclude that Pacific spiny dogfish can tolerate severe transient hypoxic events, but recovery is slow and negative impacts can be expected when hypoxia persists.
Presentation and outcomes of women and men undergoing surgery for degenerative mitral regurgitation
Authors: van Kampen Antonia , Butte Sophie , Paneitz Dane C , Nagata Yasufumi , Langer Nathaniel B , Borger Michael A , D’Alessandro David A , Sundt Thoralf M , Melnitchouk Serguei
Published: August 2024

OBJECTIVES

Degenerative mitral regurgitation is associated with heart failure, arrhythmia and mortality. The impact of sex on timing of surgical referral and outcomes has not been reported comprehensively. We examined preoperative status and surgical outcomes of male versus female degenerative mitral valve regurgitation patients undergoing surgery.

METHODS

We reviewed our institutional database for all patients undergoing surgery for degenerative mitral regurgitation between 2013 and 2021. Preoperative clinical and echocardiographic variables, surgical characteristics and outcomes were compared, and left atrial strain in available images.

RESULTS

Of 963 patients, 314 (32.6%) were female. Women were older (67 vs 64 years, P = 0.031) and more often had bileaflet prolapse (19.4% vs 13.8%, P = 0.028), mitral annular calcification (12.1% vs 5.4%, P < 0.001) and tricuspid regurgitation (TR; 31.8% vs 22.5%, P = 0.001). Indexed left ventricular end-diastolic and end-systolic diameters were higher in women, with 29.4 vs 26.7 mm/m2 (P < 0.001) and 18.2 vs 17 mm/m2 (P < 0.001), respectively, and left atrial conduit strain lower (17.6% vs, 21.2%, P = 0.001). Predicted risk of mortality was 0.73% vs 0.54% in men (P = 0.023). Women required mechanical circulatory support more frequently (1.3% vs 0%, P = 0.011), had longer intensive care unit stay (29 vs 26 h, P < 0.001), mechanical ventilation (5.4 vs 5 h, P = 0.036), and overall hospitalization (7 vs 6 days, P < 0.001). There was no difference in long-term reoperation-free survival (P = 0.35).

CONCLUSIONS

Women undergoing mitral valve repair are older and show indicators of more advanced disease with long-standing left ventricular impairment. Guidelines may need to be adjusted and address this disparity, to improve postoperative recovery times and outcomes.