bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcomes of pediatric liver transplantation for progressive familial intrahepatic cholestasis
Authors: Vasudevan Anu K. , Shanmugam Naresh , Rammohan Ashwin , Valamparampil Joseph J. , Rinaldhy Kshetra , Menon Jagadeesh , Thambithurai Ravikumar , Namasivayam Saravanapandian , Kaliamoorthy Ilankumaran , Rela Mohamed
Published: September 2023

Background

Progressive familial intrahepatic cholestasis (PFIC) is a heterogenous group of inherited hepatocellular disorders and the clinical aspects, role of liver transplantation (LT), and its outcomes remain largely unelucidated. We present our data of LT for each type of PFIC and compare their early, and long‐term outcomes, highlighting their individual differences and management strategies.

Methods

Prospectively collected data over a decade (2011–2022) of children with PFIC who underwent LT was analyzed. The groups (PFIC 1–4) were compared with regard to early and long‐term outcomes including attainment of catch‐up growth.

Results

Of 60 children with PFIC who underwent LT, 13, 11, 31 & 5 were of PFIC 1, 2, 3 & 4, respectively. There were no significant differences in gender, PELD scores, BMI, type of grafts, cold and warm ischemia times, intraoperative blood loss, and morbidity among the groups. Post‐LT chronic diarrhea was observed in 6 (46.1%) children with PFIC‐I, and of them, 3 (23%) developed graft steatohepatitis. Three of these children underwent total internal biliary diversion (TIBD) and on 1‐year follow‐up, their graft steatosis resolved and they attained catch‐up growth. Catch‐up growth was significantly poorer in the PFIC1 group (44.4% vs. 88%, 90%, 100% p < .001). Overall 1‐ and 5‐year patient survival of the four PFIC groups (1–4) were 69.2%, 81.8%, 96.8%, 100% & 69.2%, 81.8%, 96.8%, 100%, respectively.

Conclusion

Ours is the largest to‐date series of LT for PFIC illustrating their short‐ and long‐term outcomes. While the results for the whole cohort were excellent, those after LT for PFIC1 was relatively poorer as reflected by catch‐up growth, graft steatosis, and post‐LT diarrhea, which can be optimized by the addition of TIBD during LT.
How much do customer ordering practices drive medical supplies distribution (in)efficiency for primary care markets?
Authors: Shockley Jeff , Merrick Jason R. W. , Liu Xiaojin , Smith Jeffery S.
Published: September 2023

Companies across many industries seek to understand how customer ordering impacts supply chain distribution performance. In the US medical supplies industry, wholesalers are uniquely positioned to use information about downstream customers to study and potentially influence buyer policies and practices due to their industry scale and data visibility. In this study, wholesale medical supplies buyers are first examined based on their ordering practices over a 2‐year window using the theoretical lens of data clumpiness—patterns of data non‐conformity to equal spacing—to derive insights into how their ordering practices affect the distribution efficiency of the medical supplies wholesale distributor. The analysis also considers how different buyer and industry characteristics moderate these upstream ordering effects. The results reveal several significant findings for both theory and practice. First, buyers exhibiting less clumpiness in order sizing and greater clumpiness in order‐timing practices drive greater distribution efficiencies for the wholesale distributor. These effects are greater when buyers have more category experience and lower when ordering across multiple categories. Industry customers’ use of centralized purchasing also tends to lower wholesale distributor efficiency. Still, these negative effects can be mitigated when customer ordering practices favor replenishment based on customer needs and consistent order sizing. After discussing the implications of our analysis, we offer additional practical and theoretical extensions of our approach that can be applied to study other industry supply chains or that could affect related healthcare purchasing markets.
The labour market and poverty impacts of COVID‐19 in South Africa
Authors: Bassier Ihsaan , Budlender Joshua , Zizzamia Rocco , Jain Ronak
Published: September 2023

We estimate COVID‐19‐related employment and poverty impacts in South Africa. We observe a 40% decline in active employment between February and April 2020, half of which was composed of job terminations rather than furloughs. Initially, vulnerable groups were disproportionately affected by the labour market shock. Exploiting the dataset's panel dimension and comparing lockdown incomes of job losers to reweighted job retainers, we estimate that approximately 15%–35% of job losers fell into poverty in April. We find evidence of a limited recovery in the labour market and a decrease in poverty by June, in part attributable to expanded emergency social assistance.
Effect of dental hygienists’ self‐efficacy on intention to provide dental care to autistic individuals
Authors: Hesse Lindsey G. , Smilyanski Irina , Boyd Linda D. , Vineyard Jared
Published: September 2023

Aims

The study aimed to investigate the influence of dental hygiene providers' self‐efficacy and the factors affecting self‐efficacy on their intent to provide care for autistic individuals.

Methods and Results

A cross‐sectional survey was conducted using a nonprobability sample of dental hygienists (n = 1075), yielding a completion rate of 70.6%. The survey included validated measures to assess participants' demographics, autism training and experience, autism knowledge, self‐efficacy, environmental factors, and intention to treat the autistic population. Participants’ self‐efficacy scores (r = 0.416; p < .001) and support from dental offices (r = [0.174; 0.465]; p < .001) had the greatest influence on intent. Clinicians who had more experience treating (r = 0.280; p = .005) and received more hours of training/education on treating autistic patients (r = 0.344; p < .001) showed a stronger inclination to provide care to this population. Notably, autism knowledge had a weaker impact on intent when compared to self‐efficacy and training/education.

Conclusion

Autism‐focused education and training have a positive effect on provider self‐efficacy when caring for autistic individuals. Increased emphasis on such interventions is necessary at all levels of dental hygiene education. The findings from this study can help overcome barriers to preventive dental care for the autistic community.
Relational nonhuman personhood
Authors: Delon Nicolas
Published: September 2023

This article defends a relational account of personhood. I argue that the structure of personhood consists of dyadic relations between persons who can wrong or be wronged by one another, even if some of them lack moral competence. I draw on recent work on directed duties to outline the structure of moral communities of persons. The upshot is that we can construct an inclusive theory of personhood that can accommodate nonhuman persons based on shared community membership. I argue that, once we unpack the internal relation between directed duties, moral status, and flourishing, relations can ground personhood and include nonhuman animals.
Dermoscopic and reflectance confocal microscopic features of children scabies
Authors: Guan Zhiwei , Bi Tiantian , Li Qinfeng
Published: September 2023

Objective

To summarize the image features of dermatoscopy and reflectance confocal microscopy (RCM) in children with scabies, and to explore the clinical significance in the diagnosis of children scabies.

Methods

A retrospective analysis was conducted on 102 children scabies diagnosed clinically in the dermatology outpatient department of Tianjin Children's Hospital from April 2018 to June 2022. All children were examined by dermatoscopy and RCM, and images were collected.

Results

102 patients, 92 patients (90.2%) showed characteristic dermoscopic manifestations: white tunnels and small brown or dark brown triangular structures at their ends. 91 patients (89.2%) showed characteristic reflectance confocal microscopic manifestations: tunnels, scabies mites, feces, and eggs in the epidermal layer. All patients showed different degrees of non‐specific manifestations of dermoscopy and RCM.

Conclusion

Children scabies have typical dermatoscopic and reflectance confocal microscopic characteristics, and dermatoscopy and RCM are effective non‐invasive diagnostic methods with high clinical application value in the diagnosis and differential diagnosis of children scabies.
Evaluation of a rail logistics transmission system for the transportation of blood components within a medical centre
Authors: Chen Shaoheng , Zang Yan , Wang Lili , Zheng Jun , Deng Huimin , Li Meiting , Li Yaohua , Qian Baohua , Lu Yuanshan
Published: September 2023

Background and Objectives

Rail logistics transmission systems (RLTSs) are commonly used for the transportation of blood samples, pathological specimens and other medical materials in many hospitals, as they are rapid, secure, cost‐effective and intelligent. However, few studies have evaluated blood component transportation from blood banks to the patient care areas of hospitals using RLTS. In this study, we evaluate the RLTS used for the transportation of blood components within a medical centre.

Materials and Methods

The dispatch of blood components, including packed red blood cells (pRBCs), fresh frozen plasma (FFP), cryoprecipitate and platelet units, from a blood bank to critical care areas or general wards was done using RLTS. Parameters such as the delivery time, temperature, physical integrity and blood component quality were evaluated via analytical testing using specimens obtained before and after transportation by RLTS.

Results

The turnaround time and temperature of all tested blood units via RLTS transportation were able to meet the clinical demands of blood component delivery (median time: 323 s [118–668 s]; temperature variation: 4.5–8.9°C for pRBCs and FFP and 21.5–23.5°C for cryoprecipitate and platelet units). Furthermore, parameters of pRBC quality, including the haemolysis index and potassium and lactate dehydrogenase levels in plasma, were not significantly different before and after transportation through RLTS. Similarly, RLTS transportation affected neither the basic coagulation test results in FFP and cryoprecipitate specimens nor platelet aggregation and activation markers in apheresis platelet specimens.

Conclusion

Hospital‐wide delivery of blood components via RLTS seems to be safe, reliable and cost‐effective and does not have any negative impact on blood quality. Therefore, the establishment of standard criteria, protocols and guidelines based on further studies is needed.
Near braces and p$p$‐deformed braided groups
Authors: Doikou Anastasia , Rybołowicz Bernard
Published: September 2023

Motivated by recent findings on the derivation of parametric noninvolutive solutions of the Yang–Baxter equation, we reconstruct the underlying algebraic structures, called near braces. Using the notion of the near braces we produce new multi‐parametric, nondegenerate, noninvolutive solutions of the set‐theoretic Yang–Baxter equation. These solutions are generalizations of the known ones coming from braces and skew braces. Bijective maps associated to the inverse solutions are also constructed. Furthermore, we introduce the generalized notion of ‐deformed braided groups and ‐braidings and we show that every ‐braiding is a solution of the braid equation. We also show that certain multi‐parametric maps within the near braces provide special cases of ‐braidings.
Flexure Hinge Design and Optimization for Compact Anthropomorphic Grippers Made via Metal Additive Manufacturing
Authors: Tschiersky Martin , de Jong Jan J. , Brouwer Dannis M.
Published: September 2023

Flexure-based grippers offer an attractive alternative to conventional grippers used in robotics and automation. However, most existing designs appear to suffer from insufficient range of motion, loadability, and support stiffness. This article presents an approach to obtain well-performing flexure hinges for compact anthropomorphic grippers made via metal additive manufacturing. We propose a flexure hinge architecture that achieves a high range of motion despite the challenging combination of a small design space, high Young’s modulus, and limited minimum feature size. Furthermore, we present an optimization procedure to generate suitable tendon-driven designs with high loadability. Using this framework, a flexure hinge with an outer diameter of 21.5 mm and range of motion of ±30 deg is synthesized. For the range of 0–30 deg, simulations show a lateral loadability of 52.5–18.6 N and lateral support stiffness of 12,309–11,130 N/m, determined at a gripper interface located 41.2 mm from the hinge pivot axis. Experiments confirm a loadability of at least 15.4 N and determined a stiffness of 8982 to 9727 N/m for same conditions. The results show that the flexure hinge architecture has large potential for a wide range of applications, while in combination with the optimization procedure, superior designs for tendon-driven grippers can be obtained.
Data-Based Shape Self-Sensing of a Cable-Driven Notched Continuum Mechanism Using Multidimensional Intrinsic Force Information for Surgical Robot
Authors: Wang Zhengyu , Wei Xun , Yu Xiang , Jia Zirui , Qian Sen , Wang Daoming
Published: September 2023

The accurate shape-sensing capability of the continuum mechanism is fundamental to improve and guarantee the motion control accuracy and safety of continuum surgical robots. This paper presents a data-based shape self-sensing method for a cable-driven notched continuum mechanism using its multidimensional intrinsic force information, which mainly includes the multidimensional forces/torques and driving cable tensions. The nonlinear hysteresis compensation and the shape estimation of the notched continuum mechanism play significant roles in its motion control. Calibration compensation of the notched continuum mechanism is performed based on kinematic modeling to improve the accuracy of its preliminary motion control. The hysteresis characteristics of the continuum mechanism are analyzed, modeled, and compensated through considering the abundant dynamic motion experiments, such that a feedforward hysteresis compensation controller is designed to improve the tracking control performance of the continuum mechanism. Based on the kinematic calibration and hysteresis compensation, combined with the motor displacement, driving cable tensions, and six-dimensional forces/torques information of the continuum mechanism, a data-based shape self-sensing method based on particle swarm optimization back propagation neural network (PSO-BPNN) is proposed in this study. Experimental results show that this method can effectively estimate the loaded and unloaded shape of the notched continuum mechanism, which provides a new approach for the shape reconstruction of cable-driven notched continuum surgical robots.
Design of a Novel Flexible Spherical Hinge and Its Application in Continuum Robot
Authors: Li Guoxin , Yu Jingjun , Pan Jie , Pei Xu
Published: September 2023

Compliant mechanisms, which can be integrally machined and without assembly, are well suited as joints for continuum robots (CRs), but how to incorporate the advantages of the compliant mechanism into the arm design is a key issue in this work. In this paper, a novel type of flexible spherical-hinged (FSH) joint composed of tetrahedron elements with a fixed virtual remote center of motion (RCM) at the bottom is proposed, and then extended to the CR and end-effector. In the arm design, the error compensation principle is used to offset the parasitic motion of the CR under external load (pressure and torque) and improve the bending and torsional isotropy of the arm through different series combinations, and then the stiffness model of the FSH joint and the statics model of the CR are developed using the 3D chain pseudo-rigid body model (3D-CPRBM) and tested. The results show that the 3D-CPRBM can effectively predict the deformation of the FSH joint and the CR. Moreover, the maximum standard deviation of the bending angle of the FSH joint in each direction is only 0.26 deg, the repeatable positioning accuracy of the CR can reach 0.5 deg, and the end-effector has good gripping ability and self-adaptive capability.
Mechanical-acoustical analogy: From laboratory to home during the COVID-19 pandemic
Authors: Machuca-Tzili F. Arturo , Padilla-Ortiz A. L. , Martínez-Gutiérrez Daniel
Published: September 2023

A clear comprehension of the oscillatory nature of sound for acoustics undergraduate students is of paramount importance. In this paper, two online experiments were implemented to aid teaching of the oscillatory nature of sound through the analogy between a mechanical mass-spring model and a Helmholtz resonator. The study was conducted among undergraduate students taking a science course in the Electronic and Electrical Engineering career curriculum. These in-class experiments were conducted during the COVID-19 pandemic via the Zoom platform. Students measured the Helmholtz resonant frequency of a plastic bottle with a smartphone application and compared its oscillatory behavior with that of a conventional harmonic oscillator under a professor–student collaborative environment. The results of this study suggest that, with careful experiment design, students can effectively benefit from the use of common technology tools, which, in turn, poses these methodologies as a rather satisfactory alternative to face-to-face laboratory sessions.
Bayesian optimization with Gaussian process surrogate model for source localization
Authors: Jenkins William F. , Gerstoft Peter , Park Yongsung
Published: September 2023

Source localization with a geoacoustic model requires optimizing the model over a parameter space of range and depth with the objective of matching a predicted sound field to a field measured on an array. We propose a sample-efficient sequential Bayesian optimization strategy that models the objective function as a Gaussian process (GP) surrogate model conditioned on observed data. Using the mean and covariance functions of the GP, a heuristic acquisition function proposes a candidate in parameter space to sample, balancing exploitation (sampling around the best observed objective function value) and exploration (sampling in regions of high variance in the GP). The candidate sample is evaluated, and the GP conditioned on the updated data. Optimization proceeds sequentially until a fixed budget of evaluations is expended. We demonstrate source localization for a shallow-water waveguide using Monte Carlo simulations and experimental data from an acoustic source tow. Compared to grid search and quasi-random sampling strategies, simulations and experimental results indicate the Bayesian optimization strategy converges on optimal solutions rapidly.
Lifelong restructuring of 3D genome architecture in cerebellar granule cells
Authors: Tan Longzhi , Shi Jenny , Moghadami Siavash , Parasar Bibudha , Wright Cydney P. , Seo Yunji , Vallejo Kristen , Cobos Inma , Duncan Laramie , Chen Ritchie , Deisseroth Karl
Published: September 2023

The cerebellum contains most of the neurons in the human brain and exhibits distinctive modes of development and aging. In this work, by developing our single-cell three-dimensional (3D) genome assay—diploid chromosome conformation capture, or Dip-C—into population-scale (Pop-C) and virus-enriched (vDip-C) modes, we resolved the first 3D genome structures of single cerebellar cells, created life-spanning 3D genome atlases for both humans and mice, and jointly measured transcriptome and chromatin accessibility during development. We found that although the transcriptome and chromatin accessibility of cerebellar granule neurons mature in early postnatal life, 3D genome architecture gradually remodels throughout life, establishing ultra–long-range intrachromosomal contacts and specific interchromosomal contacts that are rarely seen in neurons. These results reveal unexpected evolutionarily conserved molecular processes that underlie distinctive features of neural development and aging across the mammalian life span.
Implantable bioelectronic systems for early detection of kidney transplant rejection
Authors: Madhvapathy Surabhi R. , Wang Jiao-Jing , Wang Heling , Patel Manish , Chang Anthony , Zheng Xin , Huang Yonggang , Zhang Zheng J. , Gallon Lorenzo , Rogers John A.
Published: September 2023

Early-stage organ transplant rejection can be difficult to detect. Percutaneous biopsies occur infrequently and are risky, and measuring biomarker levels in blood can lead to false-negative and -positive outcomes. We developed an implantable bioelectronic system capable of continuous, real-time, long-term monitoring of the local temperature and thermal conductivity of a kidney for detecting inflammatory processes associated with graft rejection, as demonstrated in rat models. The system detects ultradian rhythms, disruption of the circadian cycle, and/or a rise in kidney temperature. These provide warning signs of acute kidney transplant rejection that precede changes in blood serum creatinine/urea nitrogen by 2 to 3 weeks and approximately 3 days for cases of discontinued and absent administration of immunosuppressive therapy, respectively.
Evelyn M. Witkin (1921–2023)
Authors: Sweasy Joann B. , Hanawalt Philip C.
Published: September 2023

Pioneer of cell mutagenesis and DNA repair research
Budget fight raises fears of spending cuts, research limits
Authors:   Science News Staff
Published: September 2023

Lawmakers return from recess to full plate of issues
Exploiting a rodent cell block for intrinsic resistance to HIV-1 gene expression in human T cells
Authors: Behrens Ryan T. , Rajashekar Jyothi Krishnaswamy , Bruce James W. , Evans Edward L. , Hansen Amelia M. , Salazar-Quiroz Natalia , Simons Lacy M. , Ahlquist Paul , Hultquist Judd F. , Kumar Priti , Sherer Nathan M.
Published: September 2023

HIV-1 virion production is inefficient in cells derived from mice and other rodents reflecting cell-intrinsic defects to interactions between the HIV-1 auxiliary proteins Tat and Rev and host dependency factors CCNT1 (Cyclin T1) and XPO1 (exportin-1, also known as CRM1), respectively. In human cells, Tat binds CCNT1 to enhance viral RNA transcription and Rev recruits XPO1 to mediate the nuclear export of intron-containing viral RNA. In mouse cells, Tat’s interactions with CCNT1 are inefficient, mapped to a single species-specific residue Y261 instead of C261 in humans. Rev interacts poorly with murine XPO1, mapped to a trio of amino acids T411/V412/S414 instead of P411/M412/F414 in humans. To determine if these discrete species-specific regions of otherwise conserved housekeeping proteins represent viable targets for inhibiting HIV-1 replication in humans, herein, we employed CRISPR/Cas9 to recode the relevant regions of CCNT1 and XPO1 in human CD4+ T cells. While efforts to modify XPO1 were inconclusive, we generated isogenic CCNT1.C261Y cell lines exhibiting remarkable resistance to HIV-1 Tat, exhibiting near total inactivation of viral gene expression for all X4- and R5-tropic HIV-1 strains tested, as well as the more distantly related primate lentiviruses HIV-2 and SIV
agm
. Induction of viral reactivation using latency reversal agents (LRAs) was also restricted in CCNT1.C261Y cells. These studies validate a minor and naturally occurring, species-specific difference in a conserved human host factor as a compelling potential target for achieving broad-acting cell-intrinsic resistance to HIV’s post-integration phases.

Importance

Unlike humans, mice are unable to support HIV-1 infection. This is due, in part, to a constellation of defined minor, species-specific differences in conserved host proteins needed for viral gene expression. Here, we used precision CRISPR/Cas9 gene editing to engineer a “mousified” version of one such host protein, cyclin T1 (CCNT1), in human T cells. CCNT1 is essential for efficient HIV-1 transcription, making it an intriguing target for gene-based inactivation of virus replication. We show that isogenic cell lines engineered to encode CCNT1 bearing a single mouse-informed amino acid change (tyrosine in place of cysteine at position 261) exhibit potent, durable, and broad-spectrum resistance to HIV-1 and other pathogenic lentiviruses, and with no discernible impact on host cell biology. These results provide proof of concept for targeting
CCNT1
in the context of one or more functional HIV-1 cure strategies.
Extensively infarcted breast cancer
Authors: Tan Si Ying , Tan Puay Hoon , Tan Veronique Kiak Mien , Leong Lester Chee Hao
Published: September 2023

This is a case of a tumour that appeared largely unviable after near complete infarction. The lesion presented as a regular shaped mass with cystic appearance lacking definitive malignant radiological signs. Together with the initial non-diagnostic histological result, this could have easily led to a missed diagnosis of cancer.
Association of autism spectrum disorder with Waardenburg syndrome in a toddler
Authors: George Fatima Shirly Anitha , Sam Liji Elizabeth , Tanwar Meenakshi , Wall Lisa
Published: September 2023

Waardenburg syndrome is a rare genetic condition with an incidence of 1 in 212 000. The condition is classically associated with distinctive facial features, congenital hearing loss and pigmentary changes of the hair, iris and skin. There is a paucity of literature about the association of neurodevelopmental conditions with this syndrome. We present a toddler with Waardenburg syndrome type 1 who was referred to our service for developmental delay concerns. The child was diagnosed with the condition at birth, had distinctive facial features, but the hearing was normal. The child’s father also shares a similar mutation. Following a multidisciplinary assessment, the child was diagnosed to have autism spectrum disorder with possible regression. We acknowledge that there may not be a causal relationship between autism spectrum and Waardenburg syndrome. However, this highlights the need for developmental surveillance among children diagnosed with Waardenburg syndrome and to consider its association with neurodevelopmental conditions.
Laparoscopic management of combined cholecystogastric and cholecystocolonic fistulae
Authors: Zhu Christina , Zeitouni Ferris , Vaughan Justin , Santos Ariel P.
Published: September 2023

Cholecystogastric and cholecystocolonic fistulae are rare sequelae of longstanding cholelithiasis and can complicate surgical management. Our case involves a male patient in his early 40s with a history of chronic cholelithiasis who presented to the emergency department with severe abdominal pain. Findings on imaging were consistent with acute calculous cholecystitis. During laparoscopic cholecystectomy, the presence of both cholecystogastric and cholecystocolonic fistulae was discovered. Fistula resection with cholecystectomy in a one-step approach using indocyanine green (ICG) angiography was performed. The patient improved and was discharged 3 days later. Laparoscopic management complemented by ICG angiography is a viable surgical approach in patients with cholecystogastric and cholecystocolonic fistulae.
Bagasse dust exposure and chronic respiratory symptoms among workers in the Metehara and Wonji sugar factories in Ethiopia: a longitudinal study design
Authors: Debela Mitiku , Kebeta Negussie Deyessa , Begosaw Achenef Motbainor , Okello Gabriel , Azage Muluken
Published: September 2023

Background

Ethiopia’s sugar factories are growing by creating job opportunities for thousands of workers with varying educational, professional and socioeconomic backgrounds. These sugar factories are a source of several hazards that severely harm the workers’ health. In this context, there is inconclusive evidence on the level of bagasse dust exposure and chronic respiratory health symptoms. This study aimed to assess the degree of bagasse dust exposure and chronic respiratory health symptoms.

Methods

In this longitudinal study, five workstations were selected for dust sampling. A stratified random sampling technique was used to select 1043 participants. We measured the dust intensity using a calibrated handheld real-time dust monitor once a month for 5 months, totalling 50 dust samples. Chronic respiratory symptoms were assessed using the American Thoracic Society’s respiratory symptoms questionnaire.

Results

A 1 hour time-weighted average of bagasse dust intensity in the boiler, power turbine and evaporation plant was 8.93 mg/m3, 8.88 mg/m3and 8.68 mg/m3, respectively. This corresponded to an exposure level to bagasse dust of 85.52% (95% CI 83.2% to 87.6%). The level of chronic respiratory health symptoms was 60.6% (95% CI 59.2% to 61.9%). The most common respiratory symptoms were wheezing (96.8%), coughing (89.7%) and breathlessness (80.9%). The identified risk factors were lack of dust control technology (β= 0.64, 95% CI 0.53 to 0.75), not practising wet spray (β = 0.27, 95% CI 0.21 to 0.41) and not wearing proper respiratory protection devices (β = 0.12, 95% CI 0.30 to 0.56).

Conclusions

Bagasse dust exposure and respiratory health abnormalities were worrying concerns. The absence of dust control technologies and no practice of wet spraying elevated the level of exposure. Not wearing proper respiratory protection gear increased the odds of having respiratory abnormalities. Hence, the use of mechanical solutions to stop dust emissions at their sources and the wearing of proper respiratory protection gear are highly advised.
Synergic prognostic value of 3D CT scan subcutaneous fat and muscle masses for immunotherapy-treated cancer
Authors: Decazes Pierre , Ammari Samy , Belkouchi Younes , Mottay Léo , Lawrance Littisha , de Prévia Antoine , Talbot Hugues , Farhane Siham , Cournède Paul-Henry , Marabelle Aurelien , Guisier Florian , Planchard David , Ibrahim Tony , Robert Caroline , Barlesi Fabrice , Vera Pierre , Lassau Nathalie
Published: September 2023

Background

Our aim was to explore the prognostic value of anthropometric parameters in a large population of patients treated with immunotherapy.

Methods

We retrospectively included 623 patients with advanced non-small cell lung cancer (NSCLC) (n=318) or melanoma (n=305) treated by an immune-checkpoint-inhibitor having a pretreatment (thorax-)abdomen-pelvis CT scan. An external validation cohort of 55 patients with NSCLC was used. Anthropometric parameters were measured three-dimensionally (3D) by a deep learning software (Anthropometer3DNet) allowing an automatic multislice measurement of lean body mass, fat body mass (FBM), muscle body mass (MBM), visceral fat mass (VFM) and sub-cutaneous fat mass (SFM). Body mass index (BMI) and weight loss (WL) were also retrieved. Receiver operator characteristic (ROC) curve analysis was performed and overall survival was calculated using Kaplan-Meier (KM) curve and Cox regression analysis.

Results

In the overall cohort, 1-year mortality rate was 0.496 (95% CI: 0.457 to 0.537) for 309 events and 5-year mortality rate was 0.196 (95% CI: 0.165 to 0.233) for 477 events. In the univariate Kaplan-Meier analysis, prognosis was worse (p<0.001) for patients with low SFM (<3.95 kg/m2), low FBM (<3.26 kg/m2), low VFM (<0.91 kg/m2), low MBM (<5.85 kg/m2) and low BMI (<24.97 kg/m2). The same parameters were significant in the Cox univariate analysis (p<0.001) and, in the multivariate stepwise Cox analysis, the significant parameters were MBM (p<0.0001), SFM (0.013) and WL (0.0003). In subanalyses according to the type of cancer, all body composition parameters were statistically significant for NSCLC in ROC, KM and Cox univariate analysis while, for melanoma, none of them, except MBM, was statistically significant. In multivariate Cox analysis, the significant parameters for NSCLC were MBM (HR=0.81, p=0.0002), SFM (HR=0.94, p=0.02) and WL (HR=1.06, p=0.004). For NSCLC, a KM analysis combining SFM and MBM was able to separate the population in three categories with the worse prognostic for the patients with both low SFM (<5.22 kg/m2) and MBM (<6.86 kg/m2) (p<0001). On the external validation cohort, combination of low SFM and low MBM was pejorative with 63% of mortality at 1 year versus 25% (p=0.0029).

Conclusions

3D measured low SFM and MBM are significant prognosis factors of NSCLC treated by immune checkpoint inhibitors and can be combined to improve the prognostic value.
Fulvestrant increases the susceptibility of enzalutamide-resistant prostate cancer cells to NK-mediated lysis
Authors: Dahut Madeline , Fousek Kristen , Horn Lucas A , Angstadt Shantel , Qin Haiyan , Hamilton Duane H , Schlom Jeffrey , Palena Claudia
Published: September 2023

Background

Enzalutamide, a next-generation antiandrogen agent, is approved for the treatment of metastatic castration-resistant prostate cancer (CRPC). While enzalutamide has been shown to improve time to progression and extend overall survival in men with CRPC, the majority of patients ultimately develop resistance to treatment. Immunotherapy approaches have shown limited clinical benefit in this patient population; understanding resistance mechanisms could help develop novel and more effective treatments for CRPC. One of the mechanisms involved in tumor resistance to various therapeutics is tumor phenotypic plasticity, whereby carcinoma cells acquire mesenchymal features with or without the loss of classical epithelial characteristics. This work investigated a potential link between enzalutamide resistance, tumor phenotypic plasticity, and resistance to immune-mediated lysis in prostate cancer.

Methods

Models of prostate cancer resistant to enzalutamide were established by long-term exposure of human prostate cancer cell lines to the drug in culture. Tumor cells were evaluated for phenotypic features in vitro and in vivo, as well as for sensitivity to immune effector cell-mediated cytotoxicity.

Results

Resistance to enzalutamide was associated with gain of mesenchymal tumor features, upregulation of estrogen receptor expression, and significantly reduced tumor susceptibility to natural killer (NK)-mediated lysis, an effect that was associated with decreased tumor/NK cell conjugate formation with enzalutamide-resistant cells. Fulvestrant, a selective estrogen receptor degrader, restored the formation of target/NK cell conjugates and increased susceptibility to NK cell lysis in vitro. In vivo, fulvestrant demonstrated antitumor activity against enzalutamide-resistant cells, an effect that was associated with activation of NK cells.

Conclusion

NK cells are emerging as a promising therapeutic approach in prostate cancer. Modifying tumor plasticity via blockade of estrogen receptor with fulvestrant may offer an opportunity for immune intervention via NK cell-based approaches in enzalutamide-resistant CRPC.
Application of EULAR and European Society of Cardiology recommendations with regard to blood pressure and lipid management in antiphospholipid syndrome
Authors: Drosos George C , Konstantonis George , Sfikakis Petros P , Tektonidou Maria G
Published: September 2023

Background

To examine blood pressure (BP) and lipid treatment eligibility in antiphospholipid syndrome (APS) according to European Alliance of Associations for Rheumatology (EULAR) and European Society of Cardiology (ESC) recommendations.

Methods

Systematic Coronary Risk Evaluation (SCORE), modified-SCORE, diabetes mellitus (DM)-equivalent risk classifiers (DIME) and disease-related classifiers –type of thrombotic events (APSevents), antiphospholipid-antibody profile (aPLprofile) and adjusted Global APS Score for cardiovascular disease– were used to calculate predicted low-moderate, high and very-high cardiovascular risk (CVR) in 111 patients with APS without prior atherosclerotic cardiovascular events or DM. Actual CVR (AR) was determined according to ESC guidelines, including carotid/femoral plaque presence. In low-moderate SCORE-predicted risk patients, classification ability and agreement for BP or lipid treatment was tested with Matthews’ correlation coefficient (MCC) and Cohen’s kappa, respectively, using the AR classes as reference qualifiers.

Results

SCORE underestimated high/very-high-AR in >50% of cases. SCORE-guided BP/lipid treatment eligibility was 4.2%/12.6% for high, 10.5%/16.8% for very-high AR patients, while 5.3% of low-moderate AR cases were eligible for lipid-lowering therapy. For BP treatment, MCC was higher using DIME for low-moderate and very-high-risk (0.33 and 0.32, respectively), and using modified-SCORE+APSevents(MCC=0.25) for high-risk patients. Eligibility agreement was better with DIME+APSevents or aPLprofile(kappa=0.51) for high-risk, and DIME (kappa=0.31) for very-high-risk patients. For lipid treatment, both classification ability and eligibility agreement were stronger with SCORE (or modified-SCORE)+APSeventsin low-moderate (MCC/kappa=0.43/0.41) and very-high risk (MCC/kappa=0.30/0.30), and with DIME+aPLprofile(MCC/kappa=0.50/0.50) in high-risk patients, respectively.

Conclusion

Multimodal risk assessment including disease-related and cardiometabolic features used for high-risk diseases such as DM can improve CVR management in APS.
Discrete element analysis of geogrid–aggregate interface shear behavior under cyclic normal loading
Authors: Wang Ya-Qiong , Feng Shi-Jin
Published: September 2023

The stability of a geogrid-stabilized structure affected by cyclic normal loading (CNL) is significant but has not been fully revealed. Using the discrete element method (DEM), the effect of CNL on the microscale mechanical responses (i.e., stress states, contact evolution, fabric deformation) of the geogrid–aggregate interface direct shear test is first investigated. The complex shear behaviors at the interface with normal cyclic excitation at different frequencies and amplitudes are simulated. The DEM model is able to capture the macroscopic dynamic shear laws at the geogrid–aggregate interface in a similar way to those tested experimentally. The detailed behavior of the aggregate interacting with the geogrid under CNL is investigated. Compared with the simulation under static normal loading (SNL), CNL makes the stabilized layer more prone to failure, which could be quantitively evaluated by analyzing the local shear strain and the interparticle interlocking level. Microscale studies on the load wave propagation process and the confinement zone indicate that the present method can provide an applicable tool for dynamic service assessment and reliable forecasting of the undesirable effect of CNL on a mechanically stabilized layer.
Arbitrary bias control of LiNbO3 based Mach-Zehnder intensity modulators for QKD system
Authors: Teng Jun , Wang Shuang , Yin Zhen-Qiang , Chen Wei , Fan-Yuan Guan-Jie , Guo Guang-Can , Han Zheng-Fu
Published: September 2023

Quantum key distribution (QKD) can help distant agents to share unconditional secret keys, and the achievable secret key rate can be enhanced with the help of decoy-state protocol. To implement QKD experimentally, the agents are supposed to accurately transmit a number of different intensity pulses with the LiNbO3 based Mach-Zehnder (LNMZ) intensity modulator. However, the bias drift of LNMZ intensity modulator may affect the performance of a QKD system. In this letter, we reveal a simple RC circuit model to demonstrate the bias drift in the LNMZ intensity modulator. And based on the model, we propose a multi-step bias stable scheme to control the bias working point. Experimental result shows that our scheme can eliminate the bias drift of at arbitrary working point within a long time range. Besides, there is no need of any feedback mechanisms in the scheme. This means our scheme will not lead to any increasement in system complexity, making it more suitable for a QKD system.
The United States, the European Union, and China: A Global Triangle of Rivalry and Cooperation
Authors: HALIŻAK EDWARD , JARCZEWSKA ALEKSANDRA
Published: September 2023

This paper analyzes the new triangle of relations between the United States, the European Union, and China through the concept of trilateralism from polarity theory. Following this model, we examine the three bilateral relationships of US-China, US–EU, and EU–China that make up this global triangle. Economic relations between the United States and China provide the operational framework for this triangle and should currently be viewed as a cooperative rivalry rather than a traditionally hostile one like that seen in the Cold War. The EU also plays a key role in the triangle due to its strategic autonomy and significance to the other two. We argue that relations in the global US–EU–China triangle can be characterized in terms of cooperation but do not exclude rivalry. These global trilateral relations are marked by flexibility and openness that encourage the development of relations with third countries.
Optimal Loan Portfolio under Regulatory and Internal Constraints
Authors: Okawara Makoto , Takahashi Akihiko
Published: September 2023

The environment surrounding banks is becoming increasingly severe. Particularly, to prevent the next financial crisis, Basel III requires financial institutions to prepare higher levels of capitals by 1 January 2028, and the financial stability board (FSB) suggests the risk appetite framework (RAF) as their internal risk management. Hence, efficient usage of their own capitals for banks is more important than ever to improve profitability. Under such circumstances, this paper is the first to consider an optimization problem for a typical loan portfolio of international banks under comprehensive risk constraints with realistic profit margins and funding costs to achieve an efficient capital allocation. Concretely, after taking concentration risks on large individual obligors into account, we obtain a loan portfolio that attains the maximum profit under Basel regulatory capital and loan market constraints, as well as internal management constraints, namely, risk limits on business units and industrial sectors. Moreover, we separately calculate credit risk amounts of the internal constraints in terms of regulatory and economic capitals to compare the optimized profits. In addition, considering sharp increases in default probabilities of all obligors as in the global financial crisis, we perform a stress test on the optimization results to investigate the effects of changes in risk amounts and profits. As a result, we propose to unify risk constraints on the business units and industrial sectors by using credit risk amounts in terms of economic capitals.
A Function-Based Approach to Interactive High-Precision Volumetric Design and Fabrication
Authors: Uchytil Christopher , Storti Duane
Published: September 2023

We present a novel function representation (F-Rep) based geometric modeling kernel tailor-made to support computer aided design (CAD) and fabrication of high resolution volumetric models containing hundreds of billions of voxel grid elements. Our modeling kernel addresses existing limitations associated with evaluating, storing, and accessing volumetric data produced by F-Reps in contexts outside of rendering. The result is an F-Rep modeling kernel well suited for CAD-based applications.

Our kernel utilizes a sparse volume data structure to manage F-Rep data while efficient F-Rep evaluation is achieved through a combination of interval arithmetic (IA), just-in-time (JIT) compilation of user-defined functions, and massively parallel evaluation on the GPU. We employ IA as the basis for local pruning of the function evaluation tree to minimize total function evaluations, we use a novel JIT compilation scheme to optimize function execution, and we take advantage of GPU-parallelism to enhance computational throughput. We illustrate the kernel’s effectiveness in visualizing and slicing models with complex defining functions and detailed geometry, and utilize the geometry kernel to manufacture a physical part. Additionally, we present performance metrics across multiple hardware configurations demonstrating significant performance improvements over existing F-Rep geometry kernels, and we examine how our geometry kernel scales with computing power.
Confidential Computing: Elevating Cloud Security and Privacy
Authors: Russinovich Mark
Published: September 2023

Confidential Computing (CC) fundamentally improves our security posture by drastically reducing the attack surface of systems. While traditional systems encrypt data at rest and in transit, CC extends this protection to data in use. It provides a novel, clearly defined security boundary, isolating sensitive data within trusted execution environments during computation. This means services can be designed that segment data based on least-privilege access principles, while all other code in the system sees only encrypted data. Crucially, the isolation is rooted in novel hardware primitives, effectively rendering even the cloud-hosting infrastructure and its administrators incapable of accessing the data. This approach creates more resilient systems capable of withstanding increasingly sophisticated cyber threats, thereby reinforcing data protection and sovereignty in an unprecedented manner.
Understanding the Effect of Electrochemical Properties and Microstructure on the Microgalvanic Corrosion of Mg Alloys via Phase-Field Simulations
Authors: Goel Vishwas , Montiel David , Thornton Katsuyo
Published: September 2023

In this work, we apply a phase-field model to gain insights into the corrosion behavior of Mg alloys. Specifically, we study the effect of electrochemical properties of the materials and their environment and the spatial distribution of second phases in a magnesium alloy. To this end, we perform sensitivity analyses in which we separately vary the exchange current density and corrosion potential of the second phase, as well as the electrolyte conductivity. We describe the effects of these parameters on the corrosion current and the resulting corrosion-front morphology. We also confirm that the ratio between the Wagner length, calculated for the anodic phase, and the initial width of the anodic domain is a good predictor of the morphological characteristic of the corroding surface. In addition, we examine the effect of the microstructure on the corrosion behavior in both 2D and 3D systems by varying the shape, size, and distribution of the second-phase regions. Our findings provide insights into the influence of the two-phase microstructure on the corrosion behavior in a magnesium alloy.
Electrooxidation of Toxic Sulfite Material Using Ni-Ru-Based Heterometallo Supramolecular Polymer as Electrocatalyst: Synthesis and Kinetics Study
Authors: Islam Santa , Awal Abdul , Abu Nayem S. M. , Naher Shamsun , Delwar Hossain Md. , Ahammad A. J. Saleh
Published: September 2023

Considering the adverse effect of sulfite (SO3
2−), an effective Ni(II)- and Ru(II)-based heterometallic-supramolecular polymer (HMSMP) (polyNiRu) has been synthesized. PolyNiRu was characterized by Field-emission scanning electron microscopy (FE-SEM), and Fourier transmission infrared (FT-IR) spectroscopy. The formation of HMSMP was confirmed via UV–Vis spectroscopy. The molecular weight of polyNiRu (4.77 × 105 Da) was measured through intrinsic viscosity measurement following Mark-Houwink equation. The electrochemical behavior of polyNiRu modified glassy carbon electrode (polyNiRu_GCE) was investigated via CV and DPV. Furthermore, we have investigated the Tafel plot for this heterogeneous electrochemical system to calculate the number of transferred electrons during redox reactions. The limit of detection was found as 0.25 μM with a wide linear dynamic range of 10 to 600 μM. A probable surface mechanism has been studied toward SO3
2− oxidation at the interface of polyNiRu_GCE. Using the Butler-Volmer equation, the heterogeneous kinetic rate transfer constant and charge transfer coefficient were found as 1.02 × 10−6 cm2 s−1 and 0.68 respectively. These obtained parameters were further evaluated by simulated CV, which agreed with the experimental value. Excellent recovery with lower relative standard deviation (RSD) and high stability for 4000 s in analytic solution confirmed the reliability of using this polyNiRu_GCE in the practical assessment.