bluuebunny/crossref_metadata_2025 huggingface dataset:
The use of Approximate Entropy analysis for flow pattern identification in radial compressors to detect instable operating conditions
Authors: Carrattieri Lorenzo , Cravero Carlo , Marsano Davide , Valenti Emiliano
Published: December 2024

This study uses a statistical analysis on given pressure signals to identify the surge condition in radial compressors, providing insight into their dynamics and performance. Specifically, the investigation focuses on a two-stage centrifugal compressor used in refrigeration applications. Through Computational Fluid Dynamics (CFD) Unsteady Reynolds-Averaged Navier-Stokes (URANS) simulations, static pressure time-series are collected to cover four distinct operational points of the machine, ranging from a stable condition to an unstable one. To assess the stability of the compressor operation, the analysis introduces the Approximate Entropy (ApEn) as a statistical parameter to measure the regularity and predictability of the time-series signals. The results show that the proposed methodology is effective in pattern recognition, able to identify sources of instabilities, and to distinguish between different operating conditions. This approach enhances the comprehension of the operational characteristics of centrifugal compressors and sets the stage for improved monitoring and diagnostic methodologies. ApEn can therefore be a useful index to analyse time-series from sensors easy to install in real compressor configurations. The proposed methodology is included in a set of models, based on machine learning techniques, previously developed by the authors, to identify compressor instability during operation.
Research on trajectory tracking of wheeled mobile robots using fuzzy PID based on TD3
Authors: Wang Kai , Deng Sanpeng , Zhang Xiangling , Cao Yucong , Zhang Shiping
Published: December 2024

This study addresses the issues and limitations of trajectory tracking for Non-holonomic wheeled mobile robot (NWMR) under traditional PID control, including low accuracy, high response delay, poor robustness, and stability concerns. We propose a strategy that combines the Twin Delayed Deep Deterministic Policy Gradient (TD3) algorithm with fuzzy PID control to optimize PID parameter tuning for more precise robot trajectory tracking. Fuzzy logic is introduced to adjust the PID controller parameters, making them more adaptive and robust. The bidirectional long short-term memory (BiLSTM) network enhances the time series processing capability of the Actor-Critic network, improving the system’s state representation and prediction abilities. A curiosity-driven exploration method is employed to increase policy diversity and avoid premature convergence. Simulation experiments using the ROS Noetic and Gazebo platforms demonstrate that this method significantly outperforms traditional PID and TD3 algorithms in terms of trajectory alignment, training time, accuracy, and stability.
Modeling and end vibration suppression of space manipulators based on structural flexibility
Authors: Liu Qingyu , Ding Yongkang , Wang Yuqing , Zhang Hongkang , Yang Han
Published: December 2024

With the rising demand for more flexibility and larger workspaces in collaborative robots, rigid-flexible coupling robotic systems have garnered increasing attention. This study focuses on trajectory tracking and vibration suppression for RFCRSs operating in 3D space. The nonlinear coupling between angular joint positions and flexible structural displacement leads to complex vibration behaviors. To address this issue, the assumed mode method is employed to curve-fit the first-order modal shape of the flexible arm, resulting in a shape function. This approach simplifies the nonlinear infinite-dimensional dynamics of RFCRSs into a fourth-order dynamical system. The reference trajectory is planned using the polynomial programming method based on the established kinetic model. The reference trajectory is tracked with a model reference adaptive control (MRAC) method to reduce the robot end vibration. Finally, the effectiveness of the robot model reduction method and the associated control strategy is validated through a comparison with PD control and MRAC, which does not account for arm flexibility.
Design of optical loss suppression for ultrathin and high-pressure resistant sensing fiber
Authors: Chen Dejie , Zhu Pingyu , Huang Tingyu , Xiong Danli , Li Jianlin , Wang Mingxing
Published: December 2024

High pressure resin transfer molding (HP-RTM) is a widely used method for molding fiber reinforced composites. It uses the fluidity of the resin to infiltrate the fiber material and cure it into a whole. The fiber optic sensors have the characteristics of small size and high sensing accuracy, and are often buried inside the fiber material for in-situ condition monitoring of the resin transfer molding (RTM) process. HP-RTM process requires higher leak tightness, and its molding molds are usually high-precision leak-tight molds with high clamping force on mold edges. In this paper, a fiber optic package process is proposed to prepare an ultra-thin and ultra-high-pressure resistant fiber optic encapsulation element using a composite of two materials, quartz sand and waterborne polyurethane (WPU). The relationship between the optical power and pressure of the fiber optic under this element package was also studied. The experimental results demonstrate that this package structure has excellent compressive strength and can protect the fiber optic from passing directly through the molded contact surface, which improves the application range of fiber optic sensors.
Optimization of energy storage based on floating charge lithium iron phosphate battery
Authors: Gu Guoxing , Ren Junlong , Wang Jiandong , Meng Xudong , Han Xu , Hu Liang
Published: December 2024

Lithium iron phosphate batteries are often used as power supplies, power batteries and energy storage batteries for electronic equipment, and their charge and discharge cycle characteristics have been studied extensively. However, when it is used as a new battery power source in a substation, the battery pack must be hung on the charger in a fully charged state for a long time and run for float charging. In this operating mode, the choice of the float billing voltage of the lithium iron phosphate battery, the size of the float charging existing, and features of unexpected discharge and battery life under lasting float charging still need to be studied. For that reason, a simulation model of the lithium battery power storage space system was developed, and the control criteria were adapted to make the particular curve constant with the examination information. Based on the real control logic of the energy storage inverter, a simulation model of the power storage inverter is built. With simulation screening and comparison with the actual outside characteristics of the inverter, the control parameters of the simulation model are continuously optimized to make them regular with the outside attributes of the actual inverter. The actual battery access point substation operating mode data is collected and sorted out, an appropriate equivalence on the battery system is performed, and an equivalence model in MATLAB/SIMULINK and PSCAD/EMTDC is built, which forms a complete simulation model together with the battery system model[1].
Adaptive frequency modulation optimization algorithm for supporting power grid of large-scale energy storage power station based on small samples
Authors: Yao Gang , Jiang Zhengtao , Lu Shuai , Xie Huan , Wu Chunyan , Li Haoran
Published: December 2024

Addressing frequency instability issues stemming from scarce modulation resources and limited willingness to modulate in large-scale energy storage power station grids, this paper introduces a small-sample-based adaptive optimization algorithm for frequency modulation. Leveraging cross-correlation coefficients of small sample nodes, it analyzes and extracts frequency modulation characteristics, optimizing existing fluctuations to enhance adaptive control efficiency. Experimental outcomes demonstrate its effectiveness in adaptively optimizing frequency modulation, yielding low modulation and initial disturbances across varying scenarios, thereby showcasing robust adaptive optimization performance.
Fast L1 compact difference methods for the time-fractional Burgers-Fisher equation
Authors: Chen Ke , Cao Yanhua , Yang Xiaozhong
Published: December 2024

In this paper, we provide a fast L1 compact difference scheme (FL1CDS) to solve the non-homogeneous time-fractional generalized Burger-Fisher (TFGBF) equations. Our approach involves using a fast L1 equation to approach the time-fractional derivative and CDS to approximate the spatial derivatives. We analyze the existence and uniqueness of solutions, as well as the convergence and stability of the FL1CDS. Numerical experiments demonstrate that our scheme, under strong regularity assumptions, converges to 0(τ2-α + h
4). This makes the FL1CDS an efficient method for solving the non-homogeneous TFGBF equations.
A balanced sample generation method for semi-supervised carotid ultrasound image classification via pseudo-label distribution and model confidence
Authors: Yu Wenjie , Gan Zhenyu , Zhou Ran
Published: December 2024

The rupture of carotid plaques dramatically increases the risk of stroke, making it essential to classify these plaques to promptly identify high-risk cases and assist in patient management. Deep learning-based plaque classification methods need large labeled datasets, which are often challenging to acquire. Semi-supervised learning offers a solution by enabling deep learning networks to perform well with fewer labeled images. However, this method filters pseudo-labels based on thresholds, resulting in imbalanced quantities and cognitive bias in the network. To tackle this issue, we present a Balanced Sample Generation based Pseudo-label algorithm (BSGP) for semi-supervised carotid ultrasound image classification. BSGP generates new samples based on pseudo-label distribution and model confidence in each category, reducing cognitive bias from imbalanced pseudo-label quantities. Evaluated on 1,270 ultrasound carotid plaque images, our BSGP outperformed other semi-supervised methods (FixMatch, FlexMatch, AdaMatch, FreeMatch) when using 10%, 30%, and 50% labeled data. This illustrates the efficacy of our method in leveraging unlabeled images for model training, potentially advancing the use of deep learning in ultrasound-based plaque classification and supporting clinical diagnoses.
Insects biodiversity on beras basah mangrove ecosystem in Langkat, Northern Sumatera
Authors: Siregar A Z , Basyuni M , Priawandiputra W , Sagala R A
Published: December 2024

Mangroves are an ecosystem with a unique function in the living environment. Mangroves are a typical coastal ecosystem determined by tides. Mangrove forests are unique ecosystems because of their tidal cycles. The vegetation consists of mangroves were Rhizopora stylosa, R. mucronata, R apiculata. The data collection techniques used nisbi (relative) methods sampling used three tools (Yellow Sticky Traps /YST, Blue Pan Trap/BPT, Sweep Net/SN) since January until February 2024. The data used in this research are primary data and secondary data obtained directly from the local community. The results showed that the insects caught were 9 orders, 32 families, 42 genera and 1518 individuals. Based on research conducted in the mangrove forest in Beras Basah Village, Pangkalan Susu District recorded 9 species of pests, namely: bagworms (Acanthopsyche sp), pagoda bagworm (Pagodiella sp.), termite pests (Prorhinotermes sp.), krama/tree climbing crab (Episesarma sp), nacerdes bettles (Xanthochroa sp), aphid (Prociphilus tessellatus), cobwebs, barnacles (Balanus amphitrite), leatherleaf slug (Vaginula bleekeri). The abiotic factors that influences are the temperature and humidity in the mangrove.
Paclobutrazol application effects on green leaf index, morphology, and productivity of maize (Zea mays)
Authors: Syafrizal Y , Wahyuningsih G I , Ulfah F , Pratama A B , Adileksana C
Published: December 2024

Indonesia’s growing demand for maize has necessitated the development of strategies to enhance crop yields. Paclobutrazol (PBZ), a growth regulator, presents a promising solution for improving plant growth and achieving crop production sustainability in maize. This study investigated the impact of various concentrations of PBZ on maize growth and yield. The study employed a single-factor randomized complete block design (RCBD), incorporating four treatments (0 ppm, 200 ppm, 400 ppm, and 600 ppm) and six replications. Data analysis employed Analysis of Variance (ANOVA) at the 5% significance level and followed by regression analysis. Results revealed significant effects of PBZ on agronomic and productivity variables in maize. Regression analysis demonstrated a linear correlation between PBZ and various parameters, including stem diameter, leaf area, leaf area index, plant dry weight, cob weight, and cob length. Furthermore, we identified a polynomial relationship between PBZ concentrations and both the green leaf index and corn-husk dry weight, with the optimal concentrations of PBZ are 567.5 ppm and 410.83 ppm, respectively. Additionally, various concentrations of PBZ showed a tendency for higher productivity at PBZ concentrations of 400 and 600 ppm. Therefore, 400 ppm became the lowest effective concentration of paclobutrazol for optimizing maize growth and yield.
The change in phytochemical content affected by harvesting stages and storage duration of “Gajah” Ginger (Zingiber officinale var officinarum)
Authors: Ketaren B R , Hidayat I Y , Nusa M I , Novita A , Julia H
Published: December 2024

“Gajah” ginger (Zingiber officinale) is a biopharmaceutical plant one of Horticultural Plant group, which is the largest producer, exporter, and harvest area in Indonesia. Chemical constituent in ginger was affected by harvesting ages and sensitive due to storage duration. Therefore, the objective of this research was to investigate Fresh ‘Gajah’ ginger rhizomes were harvested at 5, 7 and 9 months and were stored at 0, 1 and 2 months (room temperature). The treatments were examined to found the effects of harvesting stages and storage durations on postharvest chemical qualities of ginger rhizomes. The experiment showed significant interaction effects between harvesting stages and storage durations for Protein, 9 months harvest age is 50% higher protein content from 5 and 7 months but for carbohydrate were at 5 months of harvest, 41% higher than the 9 months harvest time of 38% and at 7 months harvest of 19%. and vitamin C the highest content was found at 5month harvest age, for storage duration the highest content of protein and vitamic C were found at 1 month followed by the highest content of carbohydrate was found in control (0) month of storage durations.
Physicochemical and proximate composition of cincalok (fermented shrimp) mixed with red onion powder, red chilli pepper and musk lime juice
Authors: Nurhayati Y , Mat Rahim N N , Mohd Juhari N I , Tang J Y H
Published: December 2024

Cincalok has a pungent smell and salty-sour taste and is served with various recipes to improve its quality. Herbs in cincalok enhance sustainability by lowering the demand for artificial additives in meals. This study aims to compare the physicochemical properties and proximate compositions of cincalok before and after adding red onion powder (ROP), red chilli pepper powder (RCPP), and musk lime juice (MLJ). Three variations of cincalok were made by mixing commercial cincalok with 5% of ROP, RCPP, and MLJ and fermenting for ten days at room temperature. The samples’ physicochemical properties (pH, water activity, titratable acidity and colour) and proximate compositions were measured. The results showed that the pH decreased after mixing and fermentation. The water activity ranged from 0.88 to 0.86, and titratable acidity from 2.54 to 1.96 after fermentation for all samples. The result also showed that cincalok mixing with RCPP had the highest value of ash (12.48%), protein (19.54%), fat (7.00%), and fibre (6.42%) content after fermentation. In conclusion, incorporating ROP, RCPP, and MLJ into cincalok influences its physicochemical and proximate composition, highlighting the benefits of using locally sourced herbs as natural food additives.
Effect of Virgin Coconut Oil (VCO) Percentage and Emulsifier Ratio on the Physicochemical Characteristics of Beverages Emulsions using Local Hybrid Coconut from Indonesian Local Resource
Authors: Nurminah M , Arwanti Karunia D , Julianti E
Published: December 2024

This research was conducted to determine the physicochemical characteristics of VCO-emulsified beverage with differences in VCO percentage and emulsifier ratio. This research was conducted using the factorial Completely Randomized Design (CRD) method with two factors: the percentage of VCO (V): (20%; 30%; 40%) and the emulsifier ratio tween 80: span 80 (E): (2:3; 1:1; 3:2). The results showed that the interaction effect of VCO percentage and emulsifier ratio had a significant effect (P<0.05) on the creaming index but had an insignificant effect (P>0.05) on total dissolved solids, viscosity, free fatty acids, pH, of VCO beverage emulsion. The emulsion beverage with the best quality in terms of creaming index parameters and free fatty acid content was an emulsion beverage with a VCO percentage of 30% and an emulsifier ratio of 1:1.
Analysis of factors affecting Indonesian nutmeg export volumes to sustainability of Indonesian nutmeg production
Authors: Supriana T , Pane T C , Sihombing L , Salsabillah
Published: December 2024

Indonesia stands as one of the foremost nutmeg exporters universally. Indonesian nutmeg export volume has developed every year. However, the development of Indonesian nutmeg Export amount to leading target countries was still experiencing fluctuating developments. The present study aims are to analysis the comparative advantages of Indonesian nutmeg exports in the global market, to analysis of factors affecting Indonesian nutmeg export volumes to sustainability of Indonesian nutmeg production. This examination engaged panel data using the gravity model and the following methods: Generalized Leapt Square (GLS), Symmetry Revealed Comparative Advantage (SRCA), and Revealed Comparative Advantage (RCA). According to the RCA and SRCA analyses, Indonesian nutmeg has a significant competitive advantage in the global market. In the meantime, the exchange rate and the Exporter GDP variable have a positive and considerable impact on nutmeg exports, according to the panel data study. The amount of Indonesian nutmeg exported is significantly and negatively impacted by importer GDP and population. The amount of Indonesian nutmeg exported is positively but marginally impacted by the SRCA and Trade Costs variables.
Realizing multimodal lithography effects by adjusting laser exposure power ranges for TeOx inorganic photoresist
Authors: Liu Liqin , Zhao Zeyu , Wang Changtao , Jiang Weiwei , Yang Dingyu , Sun Hui , Zeng Tixian
Published: December 2024

Suboxide chalcogenide thin films like TeO
x
are promising inorganic lithography materials. Different from previous reports of single-mode lithography based on TeO
x
films at low laser power, this study proposes multimodal lithography effects at low, medium, and high laser power ranges. The TeO
x
films were fabricated by reactive magnetron sputtering, exhibiting super smooth surface with an RMS 0.33 nm. The lithographic performance was researched using a laser direct writing system with a wavelength of 780 nm. The experiment results showed that different kind of lithographic patterns were achieved by changing laser power ranges. At low exposure powers (5 mW to 9 mW), TeO
x
film transforms from amorphous to crystalline, generating patterns with single-trench since only the crystalline state dissolves in alkaline developers. At medium exposure powers (10 mW to 15 mW), the center of the laser spot that has greater power turns the film from amorphous to crystalline and then back to amorphous due to the rapid quenching process, while the outer region cools slowly to form crystalline, resulting in the patterns with double-trenches, with feature size 119 nm (about 1/7 λ). At high exposure powers (>16 mW), the laser power is capable of ablating the TeO
x
film, resulting in the ablation and redeposition patterns. Therefore, multimodal lithographic nano-patterns on the same TeO
x
photoresist film can be realized with only one lithography process by precisely manipulating the laser power ranges, which has significant implications in the fields of nano-manufacturing and optical storage.
The ones that got away: chemical tagging of globular cluster-origin stars with Gaia BP/RP spectra
Authors: Kane Sarah G , Belokurov Vasily , Cranmer Miles , Monty Stephanie , Zhang Hanyuan , Ardern-Arentsen Anke
Published: December 2024

Globular clusters (GCs) are sites of extremely efficient star formation, and recent studies suggest they significantly contributed to the early Milky Way’s stellar mass build-up. Although their role has since diminished, GCs’ impact on the Galaxy’s initial evolution can be traced today by identifying their most chemically unique stars – those with anomalous nitrogen and aluminum overabundances and oxygen depletion. While they are a perfect tracer of clusters, be it intact or fully dissolved, these high-[N/O], high-[Al/Fe] GC-origin stars are extremely rare within the current Galaxy. To address the scarcity of these unusual, precious former GC members, we train a neural network (NN) to identify high-[N/O], high-[Al/Fe] stars using low-resolution Gaia Blue Photometer/Red Photometer spectra. Our NN achieves a classification accuracy of approximately $\approx 99~{{\ \rm per\ cent}}$ and a false positive rate of around $\approx 7~{{\ \rm per\ cent}}$, identifying 878 new candidates in the Galactic field. We validate our results with several physically motivated sanity checks, showing, for example, that the incidence of selected stars in Galactic GCs is significantly higher than in the field. Moreover, we find that most of our GC-origin candidates reside in the inner Galaxy, having likely formed in the proto-Milky Way, consistent with previous research. The fraction of GC candidates in the field drops at a metallicity of [Fe/H]$\approx -1$, approximately coinciding with the completion of spin-up, i.e. the formation of the Galactic stellar disc.
Non‐invasive point‐of‐care optical technique for continuous in vivo assessment of microcirculatory function: Application to a preclinical model of early sepsis
Authors: Eskandari Rasa , Milkovich Stephanie , Kamar Farah , Goldman Daniel , Welsh Donald G. , Ellis Christopher G. , Diop Mamadou
Published: December 2024

Increased amplitude of peripheral vasomotion is a potential early marker of sepsis‐related microcirculatory impairment; however, previous reports relied on clinically unsuitable invasive techniques. Hyperspectral near‐infrared spectroscopy (hsNIRS) and diffuse correlation spectroscopy (DCS) are non‐invasive, bedside techniques that can be paired to continuously monitor tissue hemoglobin content (HbT), oxygenation (StO2), and perfusion (rBF) to detect vasomotion as low‐frequency microhemodynamic oscillations. While previous studies have primarily focused on the peripheral microcirculation, cerebral injury is also a common occurrence in sepsis and hsNIRS‐DCS could be used to assess cerebral microcirculatory function. This work aimed to use a hybrid hsNIRS‐DCS system to continuously monitor changes in the peripheral and cerebral microcirculation in a rat model of early sepsis. It was hypothesized that the skeletal muscle would be a more sensitive early indicator of sepsis‐related changes in microhemodynamics than the brain. Control animals received saline while the experimental group received fecal slurry to induce sepsis. Subsequently, hsNIRS‐DCS measurements were acquired from the skeletal muscle and brain for 6 h. Peripheral rBF rapidly decreased in septic animals, but there were no significant changes in peripheral HbT or StO2, nor cerebral HbT, rBF, or StO2. The power of low‐frequency peripheral oscillations in all parameters (i.e., HbT, StO2, and rBF) as well as cerebral HbT oscillations were elevated in septic animals during the final 4 h. These findings suggest that in the early stages of sepsis, while vital organs like the brain are partly protected, changes in peripheral perfusion and vasomotor activity can be detected using hsNIRS‐DCS. Future work will apply the technique to ICU patients.
Exploring Opioid Use Disorder Outcomes by Quantitative Urinalysis: Post Hoc Analysis of a Phase 3 Randomized Clinical Trial
Authors: Peterson Stefan , Nunes Edward V. , Lofwall Michelle R. , Walsh Sharon L. , Tiberg Fredrik
Published: December 2024

Objectives

Opioid use disorder (OUD) is a global concern. Urine drug screening uses opioid immunoassays to monitor OUD treatment response but is limited to yes/no results. Analytical cutoff variation complicates interstudy comparisons. This study investigated whether quantitative urinalysis can provide additional clinically meaningful treatment efficacy information and assessed the impact of different cutoffs on treatment differences.

Methods

Quantitative urine drug test data were analyzed from a randomized, active-controlled, parallel-group, double-blind, 31-week phase 3 trial (N = 428; December 29, 2015, to October 19, 2016) assessing CAM2038 subcutaneous (SC) buprenorphine (BPN) extended-release injections compared to daily sublingual (SL) BPN/naloxone (BPN/NX) tablets, and equivalent placebos, in OUD treatment (NCT02651584). Urine samples were analyzed by gas or liquid chromatography with mass spectrometry. The European Medicines Agency (EMA)–directed primary endpoint, based on opioid detection above the lower limit of quantification (LLOQ), was explored using different cutoffs.

Results

Using the LLOQ, the mean percentage of opioid-negative samples was 35.1% and 28.4% for CAM2038 and SL BPN/NX, respectively (mean difference [95% confidence interval], 6.7% [−0.1% to 13.6%]). Using standard cutoffs (1 ng/mg creatinine [fentanyl/norfentanyl], 300 ng/mg creatinine [other opioids]), results were 41.2% and 32.2% (9.0% [1.8%–16.1%]). Increasing cutoffs led to greater differences favoring CAM2038. Significant differences in mean concentrations over time and cumulative distribution of exposure to different opioids also favored CAM2038. The difference in fentanyl exposure between treatments was nonsignificant.

Conclusions

Quantitative urinalysis provides insights into opioid use beyond assessment of abstinence. Study outcomes are impacted by analytical thresholds, which should be carefully considered when designing, interpreting, and comparing clinical trial results.
Subperiosteal Tunneled Allograft Reconstruction of the Symphyseal Ligaments (STARS) in Bladder Exstrophy Epispadias Complex
Authors: Kenawey Mohamed , Morakis Emmanouil , Keene David , Mariotto Ariana , Cervellione Raimondo
Published: December 2024

Background:

Because of the lack of symphyseal ligaments, pubic symphysis re-diastasis is the rule after iliac osteotomies for bladder exstrophy reconstruction. Progressive symphyseal diastasis may cause pelvic organ prolapse in females and penile retraction in males. This study assesses the results of tendon allograft symphyseal reconstruction for maintaining pubic approximation with iliac osteotomies in exstrophy repair.

Methods:

Eleven consecutive patients had symphyseal reconstruction with delayed exstrophy repair, 7 classic bladder exstrophy, 2 cloacal exstrophy, and 2 exstrophy variants. There were 4 males and the average age at surgery was 14 months (9 to 20 mo). The average preoperative diastasis was 52 mm (43 to 79 mm). After pubic approximation with modified oblique iliac osteotomies, tendon allografts were looped subperiosteally around the pubic bones and through the obturator foramina, and reinforced by suturing anterior chondro-periosteal flaps. With the legs in a mermaid dressing, external fixators were kept for 3 to 4 weeks. All patients had preoperative pelvic computed tomography scans and pelvic x-rays before fixator removal and at the latest follow-up.

Results:

All patients had successful urologic closure. The mean postoperative inter-pubic distance was 20.5 mm (8 to 29 mm). The mean postoperative follow-up was 10 months (4 to 19 mo). The mean inter-pubic distance at the latest follow-up was 21.6 mm (3 to 35 mm). We had maintained or even decreased inter-pubic distance in 9 out of 11 cases with the average postoperative interpubic distance of 19.3 mm compared with 18.9 mm at an average 11 months follow-up. In 2 patients, the inter-pubic distance increased from 25 and 26 mm postoperatively to 33 and 35 mm at 4 months follow-up.

Conclusion:

The interpubic distance was stable or decreasing in 9 out of 11 patients with average follow-up of 11 months. Further reduction in the interpubic distance was observed due to bone formation medial to the pubic bones caused by the subperiosteal dissection. Longer-term follow-up is required to confirm stable pubic approximation.

Level of Evidence:

Level III.
Adjunctive Midodrine Therapy for Vasopressor-Dependent Shock in the ICU: A Systematic Review and Meta-Analysis
Authors: Kilcommons Sebastian J. , Hammal Fadi , Kamaleldin Mostafa , Opgenorth Dawn L. , Fiest Kirsten M. , Karvellas Constantine J. , Kutsogiannis Demetrios J. , Lau Vincent I. , MacIntyre Erika J. , Rochwerg Bram , Senaratne Janek M. , Slemko Jocelyn M. , Sligl Wendy I. , Wang Xiaoming X. M. , Bagshaw Sean M. , Rewa Oleksa G.
Published: December 2024

OBJECTIVES:

To summarize the efficacy of midodrine as an adjunctive therapy in critically ill patients. Safety of midodrine was assessed as a secondary outcome.

DATA SOURCES:

We performed a systematic review and meta-analysis using a peer-reviewed search strategy combining the themes of vasopressor-dependent shock, critical care, and midodrine and including MEDLINE, Ovid Embase, CINAHL, and Cochrane library databases until September 14, 2023.

STUDY SELECTION:

We included studies if they: 1) included patients with vasopressor-dependent shock, 2) were performed in the ICU, 3) evaluated oral midodrine therapy compared with placebo or usual care, and 4) evaluated one of the outcomes of interest.

DATA EXTRACTION:

We extracted data independently in duplicate using standardized data abstraction forms, which included the following specific variables: patient characteristics, age, sex, type of ICU, etiology of shock, number of patients, study inclusion and exclusion criteria, and geographical location. We also captured the type, dose, and duration of IV vasopressors, any cointervention used, and outcome data.

DATA SYNTHESIS:

We identified seven randomized controlled trials (six included in the pooled analysis) and ten observational studies (four included in the pooled analysis) that met eligibility criteria. Adjunctive midodrine may decrease ICU length of stay (LOS) and there is low certainty of effect on hospital LOS. Midodrine may decrease IV vasopressor support duration, ICU mortality, and hospital mortality. Pooled observational data was based on very low certainty data for all outcomes of interest. The trial sequential analysis-informed required sample size was not met for ICU LOS or IV vasopressor duration and this contributed to Grading of Recommendations, Assessment, Development, and Evaluations assessments of imprecision for both outcomes.

CONCLUSIONS:

Adjunctive midodrine may decrease ICU LOS, duration of IV vasopressor therapy, and mortality in critically ill patients. However, required sample sizes was not met to determine our outcomes of interest. Midodrine may increase risk of bradycardia. While midodrine may provide benefit for patient-centered outcomes, due to increased risk of adverse events, further large-scale studies are needed to inform and guide its routine use in the ICU.
Melanoma in the head and neck region: the value of preoperative imaging in melanoma stage I–II
Authors: Witteveen Sonja J. , Klop W. Martin C. , van Dijk-de Haan Margriet C. , Karssemakers Luc H.E.
Published: December 2024

The management of head and neck melanoma (HNM) is constantly being fine-tuned in the era of immunotherapy. HNM have different metastatic patterns and a worse prognosis than melanoma of the trunk, asking for a more fine-tuned managing strategy. In clinically node-negative HNM patients, the ultrasound (US) with fine needle aspiration cytology (FNAC) and chest X-ray (CXR) are optional modalities in the preoperative staging workup. The contribution of imaging seems limited in this stage of disease. This study aims to research the value of the US-FNAC and CXR in clinically node-negative HNM patients. Clinical stage I–II HNM patients from 2016 to 2021 were retrospectively reviewed. A total of 373 patients were analyzed. Patient characteristics, surgery and follow-up details, recurrences, tumor characteristics, staging, imaging, sentinel node procedure (SNP) details, and lab results were collected from the patient files. All patients received preoperative US. A total of 65 FNACs were performed, which found metastatic lymph nodes in two patients (0.54%). The CXR was performed in 336/373 patients and did not find any pulmonary metastases. The SNP was performed in 242 patients and demonstrated 40 positive patients, with 86% having micrometastases, isolated tumor cells, or submicrometastases. This study demonstrated a low number of relevant findings by both the US and CXR. We can conclude that both imaging modalities do not have a significant contribution to the routine staging procedure of clinical stage I–II HNM in our study group, with our results being in line with current general melanoma guidelines.
Impact of an Inpatient Telepalliative Care Consult Service in Rural Hospitals
Authors: Bhushan Anup , Hurley Scott D. , Coyne Patrick J.
Published: December 2024

Palliative care has become a standard of care for patients with serious illnesses. However, many rural hospitals do not have access to specialized palliative care consultation. This article describes the journey taken by a palliative care team to improve access to palliative care and overall patient outcomes at rural hospitals throughout the state of South Carolina by using the telehealth modality. The impact, challenges, and benefits of the program are discussed.
A Rapid Review on Shared Decision Making in Pediatric Palliative Care and End-of-Life Care
Authors: Fisher Beth , Cormack Carrie L. , Haskamp Amy Corey , Hagen Kerry A. , Logan Ayaba
Published: December 2024

Shared decision making is a concept essential to establishing meaningful goals of care that reflect one's preferences, values, beliefs, culture, and quality of life. This rapid review considered shared decision making from the perspective of seriously ill or medically complex children receiving inpatient palliative or end-of-life care, where shared decision making is made on behalf of and in the child's best interest. A total of 118 articles were screened, resulting in the selection of 12 articles using a systematic process. Emergent themes noted and discussed include the roles of family and clinicians, explorative communication, transparency, cultural implications, and ethical challenges.
Clinicopathologic Features of Breast Tumors in Germline TP53 Variant–Associated Li-Fraumeni Syndrome
Authors: Narasimhamurthy Mohan , Le Anh , Boruah Nabamita , Moses Renyta , Kelly Gregory , Bleiweiss Ira , Maxwell Kara N. , Nayak Anupma
Published: December 2024

We present one of the largest cohorts of TP53-pathogenic germline variants (PGVs) associated with patients with Li-Fraumeni syndrome (n = 82) with breast tumors (19 to 76 y; median age: 35). Most had missense variants (77%), followed by large gene rearrangements (LGRs; 12%), truncating (6%), and splice-site (5%) variants. Twenty-one unique germline missense variants were found, with hotspots at codons 175, 181, 245, 248, 273, 334, and 337. Of 100 total breast tumors, 63% were invasive (mostly ductal), 30% pure ductal carcinoma in situ, 4% fibroepithelial lesions, and 3% with unknown histology. Unlike BRCA-associated tumors, approximately half of the breast cancers exhibited HER2-positivity, of which ~50% showed estrogen receptor coexpression. Pathology slides were available for review for 61 tumors (44 patients), and no significant correlation between the type of TP53 PGVs and histologic features was noted. High p53 immunohistochemistry expression (>50%) was seen in 67% of tumors tested (mostly missense variant). Null pattern (<1% cells) was seen in 2 (LGR and splicing variants carriers). Surprisingly, 2 tumors from patients with an LGR and 1 tumor from a patient with a truncating variant showed p53 overexpression (>50%). The subset of patients with the Brazilian p.R337H variant presented at a higher age than those with non-p.R337H variant (46 vs 35 y) though statistically insignificant (P = 0.071) due to an imbalance in the sample size, and were uniquely negative for HER2-overexpressing tumors. To conclude, breast cancer in carriers of TP53 PGVs has some unique clinicopathological features that suggest differential mechanisms of tumor formation. p53 immunohistochemistry cannot be used as a surrogate marker to identify germline TP53-mutated breast cancers.
PSMA Accumulation in Lower Extremity Lymphedema and Hydrocele
Authors: Tobar Merve Nida Calderon , Perktas Lutfi , Önner Hasan
Published: December 2024

The development of radiolabeled small-molecule prostate-specific membrane antigen (PSMA) inhibitors has advanced molecular imaging in prostate cancer. The use of 177Lu-PSMA is especially beneficial because its therapeutic β-emission combined with γ-radiation enables precise treatment and comprehensive imaging in patients with prostate cancer. We present a case of a prostate cancer patient who developed lower extremity lymphedema and hydrocele secondary to prior radiotherapy. Posttherapy whole-body imaging following 177Lu-PSMA treatment revealed dermal backflow with a notable accumulation of soft tissue in the lower extremities and hydrocele.
Longitudinal Evaluation of FDG Uptake in a Synovial Herniation Pit in 8 Years
Authors: Wu Chenxi , Takalkar Amol Madan
Published: December 2024

Synovial herniation pit, also known as Pitt’s pit, is a benign osseous lesion incidentally seen on imaging studies. Most of them will not show FDG uptake, but some herniation pits could show intense FDG uptake on PET/CT scans mimicking osseous metastasis. Here we report a case of synovial herniation pit in a patient with T-cell lymphoma through 8-year trajectory of FDG PET/CT scans, revealing its changing FDG uptake in relation to chemotherapy and final outcome.
Modified Orbicularis-tarsus Fixation in Double Eyelid Blepharoplasty: A New Approach Using Conjoined Fascia Readhesion
Authors: Zhang Zhilu , Wei Siqi , Wang Yu , Wang Yongqian
Published: December 2024

Traditional fixation methods for double eyelid blepharoplasty, such as orbicularis-levator and orbicularis-tarsus techniques, have achieved satisfactory results but face challenges like shallow or disappearance of supratarsal folds. To address these limitations, the authors introduced a modified orbicularis-tarsus fixation approach incorporating conjoined fascia readhesion. This technique involves dissecting the orbicularis oculi muscle from the conjoined fascia, allowing for scar-based readhesion between these structures, resulting in enhanced stability of the supratarsal fold. A total of 67 patients underwent double eyelid blepharoplasty by the same surgeon using this modified technique. Patients were followed up from 3 to 24 months, with a mean period of 10.3 months. Of the 67 patients, 62 (92.54%) were very satisfied, and 5 (7.46%) were satisfied with the surgical results. Four patients experienced relatively pronounced early swelling, all resolved without particular treatment within 8 weeks. This novel approach by using conjoined fascia readhesion ensures a firmer fixation and improves the aesthetic outcomes. It is a highly applicable and reliable approach for upper-eyelid blepharoplasty.
The optic nerve in spaceflight: novel concepts in the pathogenesis of optic disc edema in microgravity
Authors: Kadipasaoglu Cihan M. , Lee Virginia A. , Ong Joshua , Lee Andrew G.
Published: December 2024

Purpose of review

Spaceflight-associated neuro-ocular syndrome (SANS) encompasses a unique constellation of neuro-ocular findings in astronauts, including optic disc edema (ODE), globe flattening, chorioretinal folds, and hyperopic refractive shift. Although there are numerous neuro-ocular findings in SANS, the purpose of this review is to describe the novel, emerging concepts of the pathogenesis for the ODE specifically in SANS.

Recent findings

While the initial hypotheses on the pathogenesis of ODE in SANS focused on possible elevated intracranial pressures (i.e., papilledema), the most prominent current hypothesis is microgravity-induced cephalad fluid shift. More recent studies however suggest that the pathogenesis of the ODE in SANS is likely multifactorial including possible underlying metabolic and genetic components.

We review the literature on ODE in SANS including recent work integrating the complex physiologic interactions of microgravity-induced disruption in intracerebral and intraocular fluid dynamics, vascular congestion, cellular stress responses, and genetic predisposition. We believe that the development of ODE in SANS is likely multifactorial in origin, and further understanding of the mechanical, cellular, metabolic, and genetic components is of utmost importance to develop future countermeasures in preparation for possible future crewed missions to the moon, the asteroid belt, and Mars.
Consistent long-distance foraging flights across years and seasons at colony level in a neotropical bat
Authors: Calderón-Capote María C. , van Toor Mariëlle L. , O’Mara M. Teague , Bayer Travis D. , Crofoot Margaret C. , Dechmann Dina K. N.
Published: December 2024

All foraging animals face a trade-off: how much time should they invest in exploitation of known resources versus exploration to discover new resources? For group-living central place foragers, this balance is challenging. Due to the nature of their movement patterns, exploration and exploitation are often mutually exclusive, while the availability of social information may discourage individuals from exploring. To examine these trade-offs, we GPS-tracked groups of greater spear-nosed bats (
Phyllostomus hastatus
) from three colonies on Isla Colón, Panamá. During the dry season, when these omnivores forage on the nectar of unpredictable balsa flowers, bats consistently travelled long distances to remote, colony-specific foraging areas, bypassing flowering trees closer to their roosts. They continued using these areas in the wet season, when feeding on a diverse, presumably ubiquitous diet, but also visited other, similarly distant foraging areas. Foraging areas were shared within but not always between colonies. Our longitudinal dataset suggests that bats from each colony invest in long-distance commutes to socially learned shared foraging areas, bypassing other available food patches. Rather than exploring nearby resources, these bats exploit colony-specific foraging locations that appear to be culturally transmitted. These results give insight into how social animals might diverge from optimal foraging.
Discovery and functional analysis of a novel ALPK1 variant in ROSAH syndrome
Authors: Snelling Tom , Garnotel Leo O. , Jeru Isabelle , Tusseau Maud , Cuisset Laurence , Perlat Antoinette , Minard Geoffrey , Benquey Thibaut , Maucourant Yann , Wood Nicola T. , Cohen Philip , Ziegler Alban
Published: December 2024

Retinal dystrophy, optic nerve oedema, splenomegaly, anhidrosis and migraine headache (ROSAH) syndrome is an autosomal dominant disorder and to date is known to be caused by either the Thr237Met or Tyr254Cys variant in the protein kinase ALPK1. Here, we identify a family in which ROSAH syndrome is caused by a novel variant in which Ser277 is changed to Phe. All six patients examined display ocular inflammation and optic nerve elevation, four have retinal degeneration and four are registered blind. In contrast to wild-type ALPK1, which is activated specifically by bacterial ADP-heptose, ALPK1[Ser277Phe] is also activated by the human metabolites UDP-mannose and ADP-ribose and more strongly than the most frequent ROSAH-causing variant (ALPK1[Thr237Met]) but, unlike ALPK1[Thr237Met], ALPK1[Ser277Phe] is also activated by GDP-mannose. These observations can explain why ALPK1 variants causing ROSAH syndrome display constitutive activity in human cells. The side chains of Ser277 and Tyr254 interact in the crystal structure of ALPK1, but mutational analysis established that it is not the loss of this hydrogen bond between Ser277 and Tyr254 that alters the specificity of the ADP-heptose-binding pocket in the Ser277Phe and Tyr254Cys variants. The characterization of ALPK1 variants that cause ROSAH syndrome suggests ways in which drugs that selectively inhibit these disease-causing variants may be developed.
The proline-rich antimicrobial peptide B7-005: low bacterial resistance, safe for human cells and effective in zebrafish embryo bacteraemia model
Authors: Di Stasi Adriana , Bozzer Sara , Pacor Sabrina , de Pascale Luigi , Morici Martino , Favero Lara , Spazzapan Mariagiulia , Pegoraro Silvia , Bulla Roberta , Wilson Daniel N. , Macor Paolo , Scocchi Marco , Mardirossian Mario
Published: December 2024

Proline-rich antimicrobial peptides (PrAMPs) have gained attention due to their antimicrobial properties and low cytotoxicity. B7-005, a small optimized PrAMP, exhibits a broader spectrum of activity than native PrAMPs, due to an antimicrobial mechanism based on inhibiting prokaryotic protein synthesis and destabilizing bacterial membranes. However, the toxicity and the
in vivo
efficacy of B7-005 remain poorly understood, so
in vitro
and
in vivo
microbiology and toxicology experiments were used to assess its suitability as an anti-infective agent. The incidence of resistance towards B7-005 by
E. coli
was lower than for other PrAMPs and antibiotics; moreover, it maintained antimicrobial activity in the presence of human serum. B7-005 exerted its antimicrobial effect at a much lower concentration than those causing harmful effects on four different cell types, such as membrane permeabilization or non-lytic depolarization of mitochondria. The latter effect may be related to the inhibition of eukaryotic protein synthesis by B7-005 observed
in vitro
. In a zebrafish embryo model, B7-005 was well tolerated and reduced mortality from pre-existing
E. coli
bacteraemia. Overall, B7-005 was safe for human cells and effective against systemic infection
in vivo
, making it a promising lead for developing new antibiotics.
The effect of target scarcity on visual foraging
Authors: Hughes A. E. , Statham H. R. , Clarke A. D. F.
Published: December 2024

Previous studies have investigated the effect of target prevalence in combination with the effect of explicit target value on human visual foraging strategies, though the conclusions have been mixed. Some find that individuals have a bias towards high-value targets even when these targets are scarcer, while other studies find that this bias disappears when those targets are scarcer. In this study, we tested for a bias for scarce targets using standard feature versus conjunction visual foraging tasks, without an explicit value being given. Based on the idea of commodity theory and implicit value, we hypothesized that participants would show a scarcity bias. The bias was investigated using a Bayesian statistical model which has been developed for predicting target-by-target foraging behaviours. However, we found no evidence of a scarcity bias in our experiment, suggesting that participants did not inherently find rarer targets more rewarding.