bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of fluence- and dose-averaged linear energy transfer with passive luminescence detectors in clinical proton beams
Authors: Domingo Muñoz Iván , Van Hoey Olivier , Parisi Alessio , Bassler Niels , Grzanka Leszek , De Saint-Hubert Marijke , Vaniqui Ana , Olko Paweł , Sądel Michał , Stolarczyk Liliana , Vestergaard Anne , Jäkel Oliver , Gardenali Yukihara Eduardo , Brage Christensen Jeppe
Published: May 2024

Objective. This work investigates the use of passive luminescence detectors to determine different types of averaged linear energy transfer (

LET
―

) for the energies relevant to proton therapy. The experimental results are compared to reference values obtained from Monte Carlo simulations. Approach. Optically stimulated luminescence detectors (OSLDs), fluorescent nuclear track detectors (FNTDs), and two different groups of thermoluminescence detectors (TLDs) were irradiated at four different radiation qualities. For each irradiation, the fluence- (

LET
―

f

) and dose-averaged LET (

LET
―

d

) were determined. For both quantities, two sub-types of averages were calculated, either considering the contributions from primary and secondary protons or from all protons and heavier, charged particles. Both simulated and experimental data were used in combination with a phenomenological model to estimate the relative biological effectiveness (RBE). Main results. All types of

LET
―

could be assessed with the luminescence detectors. The experimental determination of

LET
―

f

is in agreement with reference data obtained from simulations across all measurement techniques and types of averaging. On the other hand,

LET
―

d

can present challenges as a radiation quality metric to describe the detector response in mixed particle fields. However, excluding secondaries heavier than protons from the

LET
―

d

calculation, as their contribution to the luminescence is suppressed by ionization quenching, leads to equal accuracy between

LET
―

f

and

LET
―

d

. Assessment of RBE through the experimentally determined

LET
―

d

values agrees with independently acquired reference values, indicating that the investigated detectors can determine

LET
―

with sufficient accuracy for proton therapy. Significance. OSLDs, TLDs, and FNTDs can be used to determine

LET
―

and RBE in proton therapy. With the capability to determine dose through ionization quenching corrections derived from

LET
―

, OSLDs and TLDs can simultaneously ascertain dose,

LET
―

, and RBE. This makes passive detectors appealing for measurements in phantoms to facilitate validation of clinical treatment plans or experiments related to proton therapy.
Ultra-short time-echo based ray tracing for transcranial focused ultrasound aberration correction in human calvaria
Authors: Manuel Thomas J , Bancel Thomas , Tiennot Thomas , Didier Mélanie , Santin Mathieu , Daniel Maxime , Attali David , Tanter Mickael , Lehéricy Stéphane , Pyatigorskaya Nadya , Aubry Jean-Francois
Published: May 2024

Objective. Magnetic resonance guided transcranial focused ultrasound holds great promises for treating neurological disorders. This technique relies on skull aberration correction which requires computed tomography (CT) scans of the skull of the patients. Recently, ultra-short time-echo (UTE) magnetic resonance (MR) sequences have unleashed the MRI potential to reveal internal bone structures. In this study, we measure the efficacy of transcranial aberration correction using UTE images.Approach. We compare the efficacy of transcranial aberration correction using UTE scans to CT based correction on four skulls and two targets using a clinical device (Exablate Neuro, Insightec, Israel). We also evaluate the performance of a custom ray tracing algorithm using both UTE and CT estimates of acoustic properties and compare these against the performance of the manufacturer’s proprietary aberration correction software. Main results. UTE estimated skull maps in Hounsfield units (HU) had a mean absolute error of 242 ± 20 HU (n=4). The UTE skull maps were sufficiently accurate to improve pressure at the target (no correction: 0.44 ± 0.10, UTE correction: 0.79 ± 0.05, manufacturer CT: 0.80 ± 0.05), pressure confinement ratios (no correction: 0.45 ± 0.10, UTE correction: 0.80 ± 0.05, manufacturer CT: 0.81 ± 0.05), and targeting error (no correction: 1.06 ± 0.42 mm, UTE correction 0.30 ± 0.23 mm, manufacturer CT: 0.32 ± 0.22) (n=8 for all values). When using CT, our ray tracing algorithm performed slightly better than UTE based correction with pressure at the target (UTE: 0.79 ± 0.05, CT: 0.84 ± 0.04), pressure confinement ratios (UTE: 0.80 ± 0.05, CT: 0.84 ± 0.04), and targeting error (UTE: 0.30 ± 0.23 mm, CT: 0.17 ± 0.15). Significance. These 3D transcranial measurements suggest that UTE sequences could replace CT scans in the case of MR guided focused ultrasound with minimal reduction in performance which will avoid ionizing radiation exposure to the patients and reduce procedure time and cost.
Correction of multiplexing artefacts in multi-pinhole SPECT through temporal shuttering, de-multiplexing of projections, and alternating reconstruction
Authors: Pells Sophia , Zeraatkar Navid , Kalluri Kesava S , Moore Stephen C , May Micaehla , Furenlid Lars R , Kupinski Matthew A , Kuo Phillip H , King Michael A
Published: May 2024

Objective. Single-photon emission computed tomography (SPECT) with pinhole collimators can provide high-resolution imaging, but is often limited by low sensitivity. Acquiring projections simultaneously through multiple pinholes affords both high resolution and high sensitivity. However, the overlap of projections from different pinholes on detectors, known as multiplexing, has been shown to cause artefacts which degrade reconstructed images. Approach. Multiplexed projection sets were considered here using an analytic simulation model of AdaptiSPECT-C—a brain-dedicated multi-pinhole SPECT system. AdaptiSPECT-C has fully adaptable aperture shutters, so can acquire projections with a combination of multiplexed and non-multiplexed frames using temporal shuttering. Two strategies for reducing multiplex artefacts were considered: an algorithm to de-multiplex projections, and an alternating reconstruction strategy for projections acquired with a combination of multiplexed and non-multiplexed frames. Geometric and anthropomorphic digital phantoms were used to assess a number of metrics. Main results. Both de-multiplexing strategies showed a significant reduction in image artefacts and improved fidelity, image uniformity, contrast recovery and activity recovery (AR). In all cases, the two de-multiplexing strategies resulted in superior metrics to those from images acquired with only mux-free frames. The de-multiplexing algorithm provided reduced image noise and superior uniformity, whereas the alternating strategy improved contrast and AR. Significance. The use of these de-multiplexing algorithms means that multi-pinhole SPECT systems can acquire projections with more multiplexing without degradation of images.
A quantitative assessment of Geant4 for predicting the yield and distribution of positron-emitting fragments in ion beam therapy
Authors: Chacon Andrew , Rutherford Harley , Hamato Akram , Nitta Munetaka , Nishikido Fumihiko , Iwao Yuma , Tashima Hideaki , Yoshida Eiji , Akamatsu Go , Takyu Sodai , Kang Han Gyu , Franklin Daniel R , Parodi Katia , Yamaya Taiga , Rosenfeld Anatoly , Guatelli Susanna , Safavi-Naeini Mitra
Published: May 2024

Objective. To compare the accuracy with which different hadronic inelastic physics models across ten Geant4 Monte Carlo simulation toolkit versions can predict positron-emitting fragments produced along the beam path during carbon and oxygen ion therapy. Approach. Phantoms of polyethylene, gelatin, or poly(methyl methacrylate) were irradiated with monoenergetic carbon and oxygen ion beams. Post-irradiation, 4D PET images were acquired and parent 11C, 10C and 15O radionuclides contributions in each voxel were determined from the extracted time activity curves. Next, the experimental configurations were simulated in Geant4 Monte Carlo versions 10.0 to 11.1, with three different fragmentation models—binary ion cascade (BIC), quantum molecular dynamics (QMD) and the Liege intranuclear cascade (INCL++) - 30 model-version combinations. Total positron annihilation and parent isotope production yields predicted by each simulation were compared between simulations and experiments using normalised mean squared error and Pearson cross-correlation coefficient. Finally, we compared the depth of the maximum positron annihilation yield and the distal point at which the positron yield decreases to 50% of peak between each model and the experimental results. Main results. Performance varied considerably across versions and models, with no one version/model combination providing the best prediction of all positron-emitting fragments in all evaluated target materials and irradiation conditions. BIC in Geant4 10.2 provided the best overall agreement with experimental results in the largest number of test cases. QMD consistently provided the best estimates of both the depth of peak positron yield (10.4 and 10.6) and the distal 50%-of-peak point (10.2), while BIC also performed well and INCL generally performed the worst across most Geant4 versions. Significance. The best predictions of the spatial distribution of positron annihilations and positron-emitting fragment production along the beam path during carbon and oxygen ion therapy was obtained using Geant4 10.2.p03 with BIC or QMD. These version/model combinations are recommended for future heavy ion therapy research.
Enhancing efficiency of Sb2Se3 solar cell through optimized optical and electrical properties with Bi-layer absorber
Authors: Chaudhary Pooja , Chauhan R K , Mishra Rajan
Published: May 2024

In this study, an innovative solar cell utilizing antimony selenide (Sb2Se3) as a base material and incorporating a dual absorber layer is comprehensively examined using the Solar Cell Capacitance Simulator (SCAPS-1D) tool. The aim is to assess the performance of the solar cell with different absorber layers in combination with Sb2Se3. Results demonstrate that the solar cell employing an organic CH3NH3SnI3 absorber layer alongside Sb2Se3 achieves superior efficiency compared to one with an inorganic CZTS absorber layer. The two absorber layers investigated are the inorganic Copper Zinc Tin Sulfide (CZTS) and the organic methylammonium tin iodide (CH3NH3SnI3 The dual absorber layer configuration proves advantageous by enhancing light absorption. The solar cell architecture comprises ZnO/i-ZnO/Sb2Se3/CZTS or CH3NH3SnI3/NiO layers, resulting in an improved efficiency of up to 36.70%. Throughout the analysis, parameters such as concentration, band gap, thickness, and temperature are systematically adjusted to evaluate the behavior of this unique solar cell structure. The findings from the study indicate a noticeable enhancement in the performance of Sb2Se3 solar cells when employing the bilayer absorber structure comprising Sb2Se3 and CH3NH3SnI3.
Simulation of non-resonant high-order harmonics energetic particle modes in tokamak plasmas
Authors: Liu Sheng , Ren Zhenzhen , Yang Jinhong , Ning Hongwei , Xiao Zheng , Wang Weihua
Published: May 2024

Based on the parameters of the HL-2A experiment, the effect of energetic particles (EPs) on non-resonant high-order harmonics energetic particle modes (EPMs) with q
min>1 is investigated in the present work. Hybrid kinetic-magnetohydrodynamic nonlinear code M3D-K is performed to simulate the linear properties and the nonlinear evolution of the non-resonant EPM during neutral beam injection (NBI). To deeply understand the physical mechanism of interaction resonant between energetic-ions and non-resonant EPM, this work compares the effects of passing energetic particles and trapped energetic particles on the non-resonant EPM instabilities. It is numerically identified that EPs’ effects on high n harmonics (m/n = 2/2, 3/3, 4/4) instability are more obvious than the m/n = 1/1 mode. Furthermore, the effects of energetic particles injection energy, the minimum safety factor q
min , toroidal rotation and beam ion distribution on the features of high n harmonics are also investigated specifically. Toroidal rotation is found to suppress high n harmonics, which is more obvious for the modes driven by trapped particles. Nonlinear simulation results show that these non-resonant high n harmonics can induce larger energetic ion transport, which may affect the plasma confinement performance.
Empirical tight-binding method for large-supercell simulations of disordered semiconductor alloys
Authors: Phan Anh-Luan , Pecchia Alessandro , Di Vito Alessia , Auf der Maur Matthias
Published: May 2024

We analyze and present applications of a recently proposed empirical tight-binding scheme for investigating the effects of alloy disorder on various electronic and optical properties of semiconductor alloys, such as the band gap variation, the localization of charge carriers, and the optical transitions. The results for a typical antimony-containing III-V alloy, GaAsSb, show that the new scheme greatly improves the accuracy in reproducing the experimental alloy band gaps compared to other widely used schemes. The atomistic nature of the empirical tight-binding approach paired with a reliable parameterization enables more detailed physical insights into the effects of disorder in alloyed materials.
The BT-SAM-Net: a new framework of end-to-end periodic time-series fault diagnosis for aero-pipelines systems
Authors: Yang Tongguang , Dang Zhonghua , Duan Yicheng , Li Kaitai , Huang Xingyuan , Han Qingkai , Yu Xiaoguang
Published: May 2024

Accurate recognition of aero-engine pipeline faults is of great significance for engine maintenance costs and downtime. Pipeline signals have a strong periodic time series correlation under strong pump source pressure pulsation stimulation. However, very few studies have considered the correlation of features at pulsation period time points. Additionally, it is challenging to realize intelligent fault diagnosis of weak characteristics of pipeline faults due to the influence of vibration-noise coupling of aero-engines. The time information feature extraction model combined with self-attention mechanism (BT-SAM-Net), a newly created fault detection framework end-to-end time-series and anti-noise, is presented for the aero-pipeline in order to close the aforementioned research gaps. The primary goal of the proposed framework is to accomplish intelligent classification tasks by using the measured aero-pipeline raw data as the model input. Firstly, a two-way time series information fusion model is creatively designed, which is the first attempt to analyze the difference in time series correlation characteristics of faults for aero-pipelines. Secondly, The BT-SAM-Net framework incorporates the self-attention mechanism as an optimization tool to enhance the ultimate decision-making accuracy of the framework. Thirdly, the BT-SAM-Net framework was compared with 7 other methods. The results show the superiority and stability by demonstrating the BT-SAM-Net framework can identify various aero-pipeline fault states with greater accuracy.
Influence of a static electric field on a one-dimensional Bose-Fermi mixture confined in a double-well potential
Authors: Avella R , Nisperuza J , Rubio J P , Grajales D
Published: May 2024

In this study, we conducted a detailed investigation into the time evolution of the probability density within a 1D double-well potential hosting a Bose-Fermi mixture. This system comprised spinless bosons and spin one-half fermions with weak repulsive contact interactions. Notably, even at very low effective coupling constants, periodic probabilities were observed, indicating correlated tunneling of both bosons and fermions, leading to complete miscibility, which disappears when an external electric field is turned on. The electric field accentuated fermion-fermion interactions due to the Pauli exclusion principle, altering both boson density and interactions and leading to spatial redistribution of particles. These findings underscore the complex interplay between interactions, external fields, and spatial distributions within confined quantum systems. Our exploration of higher interaction strengths revealed conditions under which probability density functions are decoupled. Furthermore, we observed that increased fermion interaction, driven by the electric field, led to higher tunneling frequencies for both species because of the repulsive nature of the boson-fermion interaction. Conversely, increased boson-boson interaction resulted in complete tunneling of both species, especially when boson density was high, leading to effective fermion repulsion. Expanding our analysis to scenarios involving four bosons demonstrated that higher interaction values corresponded to increased oscillation frequencies in tunneling probabilities. Finally, by manipulating interaction parameters and activating the electric field, we achieved complete tunneling of both species, further increasing oscillation frequencies and resulting in intervals characterized by overlapping probability functions.
Feasibility of endovascular stimulation of the femoral nerve using a stent-mounted electrode array
Authors: Liu JingYang , Grayden David B , Keast Janet R , Booth Lindsea C , May Clive N , John Sam E
Published: May 2024

Objective. Electrical stimulation of peripheral nerves has long been a treatment option to restore impaired neural functions that cannot be restored by conventional pharmacological therapies. Endovascular neurostimulation with stent-mounted electrode arrays is a promising and less invasive alternative to traditional implanted electrodes, which typically require invasive implantation surgery. In this study, we investigated the feasibility of endovascular stimulation of the femoral nerve using a stent-mounted electrode array and compared its performance to that of a commercially available pacing catheter. Approach. In acute animal experiments, a pacing catheter was implanted unilaterally in the femoral artery to stimulate the femoral nerve in a bipolar configuration. Electromyogram of the quadriceps and electroneurogram of a distal branch of the femoral nerve were recorded. After retrieval of the pacing catheter, a bipolar stent-mounted electrode array was implanted in the same artery and the recording sessions were repeated. Main Results. Stimulation of the femoral nerve was feasible with the stent-electrode array. Although the threshold stimulus intensities required with the stent-mounted electrode array (at 100–500 µs increasing pulse width, 2.17 ± 0.87 mA–1.00 ± 0.11 mA) were more than two times higher than the pacing catheter electrodes (1.05 ± 0.48 mA–0.57 ± 0.28 mA), we demonstrated that, by reducing the stimulus pulse width to 100 µs, the threshold charge per phase and charge density can be reduced to 0.22 ± 0.09 µC and 24.62 ± 9.81 µC cm−2, which were below the tissue-damaging limit, as defined by the Shannon criteria. Significance. The present study is the first to report in vivo feasibility and efficiency of peripheral nerve stimulation using an endovascular stent-mounted electrode array.
Bayesian estimation of group event-related potential components (BEGEP): testing a model for synthetic and real datasets
Authors: Ponomarev Valery A , Kropotov Jury D
Published: May 2024

Objective. The spatial resolution of event-related potentials (ERPs) recorded on the head surface is quite low, since the sensors located on the scalp register mixtures of signals from several cortical sources. Bayesian models for multi-channel ERPs obtained from a group of subjects under multiple task conditions can aid in recovering signals from these sources. Approach. This study introduces a novel model that captures several important characteristics of ERP, including person-to-person variability in the magnitude and latency of source signals. Furthermore, the model takes into account that ERP noise, the main source of which is the background electroencephalogram, has the following properties: it is spatially correlated, spatially heterogeneous, and varies over time and from person to person. Bayesian inference algorithms have been developed to estimate the parameters of this model, and their performance has been evaluated through extensive experiments using synthetic data and real ERPs records in a large number of subjects (N = 351). Main results. The signal estimates obtained using these algorithms were compared with the results of the analysis of ERPs by conventional methods. This comparison showed that the use of this model is suitable for the analysis of ERPs and helps to reveal some features of source signals that are difficult to observe in their mixture signals recorded on the scalp. Significance. This study shown that the proposed method is a potentially useful tool for analyzing ERPs collected from groups of subjects in various cognitive neuroscience experiments.
Energy demand and savings opportunities in the supply of limestone and olivine-rich rocks for geochemical carbon dioxide removal
Authors: Marco Serena De , Caserini Stefano , Amann Thorben , Grosso Mario
Published: May 2024

The large-scale implementation of geochemical Carbon Dioxide Removal (CDR) approaches such as Enhanced Weathering (EW) and Ocean Liming (OL) will require the extraction and processing of large amounts of limestone and olivine-rich rocks. Based on a literature review, surface mining, comminution, their related sub-stages, and long-haul transportation have carefully been surveyed to elucidate the order of magnitude of the energy demand, the technical challenges posed by each operation, and the potential energy-savings achievable by applying opportune strategies. This work confirms the significant energy-saving opportunities in fine and ultrafine grinding (one of the most energy-consuming activities along the raw material supply chain) as underlined by previous studies, and, in addition, it focuses on limestone and olivine-rich rocks providing new outcomes, it analyses data from a climate change perspective and extends calculations and discussion to transportation. The results show that the implementation of energy-saving strategies (cutting-edge energy efficiency solutions and best practices) to comminute such materials for OL and EW purposes in the near-medium term (2025–2050) would reduce the average electricity demand by 33%–65% in case of low carbon removal target (up to 27 MtC yr−1) and substantial energy efficiency improvement, and by 33%–36% in case of high carbon removal target (up to 69 MtC yr−1) and poor energy efficiency improvement.
Decreased thrombospondin-1 impairs endometrial stromal decidualization in unexplained recurrent spontaneous abortion
Authors: Hu Jianing , Qin Chuanmei , Xu Yichi , Liu Xueqing , Wei Xiaowei , Wu Jiayi , Zhao Xiaomiao , Chen Cailian , Lin Yi
Published: May 2024

Inappropriate endometrial stromal decidualization has been implied as an important reason of many pregnancy-related complications, such as unexplained recurrent spontaneous abortion, preeclampsia, and intrauterine growth restriction. Here, we observed that thrombospondin-1, an adhesive glycoprotein, was significantly downregulated in endometrial decidual cells from patients with unexplained recurrent spontaneous abortion. The immortalized human endometrial stromal cell line was used to investigate the possible THBS1-mediated regulation of decidualization. In vitro experiments found that the expression level of THBS1 increased with the normal decidualization process. Knockdown of THBS1 could decrease the expression levels of prolactin and insulin-like growth factor binding protein-1, two acknowledged human decidualization markers, whereas THBS1 overexpression could reverse these effects. The RNA sequencing results demonstrated that the extracellular regulated protein kinases signaling pathway was potentially affected by the knockdown of THBS1. We further confirmed that the regulation of THBS1 on decidualization was achieved through the ERK signaling pathway by the treatment of inhibitors. Moreover, knockdown of THBS1 in pregnant mice could impair decidualization and result in an increased fetus resorption rate. Altogether, our study demonstrated a crucial role of THBS1 in the pathophysiological process of unexplained recurrent spontaneous abortion and provided some new insights into the research of pregnancy-related complications.
A Bayesian semi-parametric model for learning biomarker trajectories and changepoints in the preclinical phase of Alzheimer’s disease
Authors: Wang Kunbo , Hua William , Wang MeiCheng , Xu Yanxun
Published: May 2024

It has become consensus that mild cognitive impairment (MCI), one of the early symptoms onset of Alzheimer’s disease (AD), may appear 10 or more years after the emergence of neuropathological abnormalities. Therefore, understanding the progression of AD biomarkers and uncovering when brain alterations begin in the preclinical stage, while patients are still cognitively normal, are crucial for effective early detection and therapeutic development. In this paper, we develop a Bayesian semiparametric framework that jointly models the longitudinal trajectory of the AD biomarker with a changepoint relative to the occurrence of symptoms onset, which is subject to left truncation and right censoring, in a heterogeneous population. Furthermore, unlike most existing methods assuming that everyone in the considered population will eventually develop the disease, our approach accounts for the possibility that some individuals may never experience MCI or AD, even after a long follow-up time. We evaluate the proposed model through simulation studies and demonstrate its clinical utility by examining an important AD biomarker, ptau181, using a dataset from the Biomarkers of Cognitive Decline Among Normal Individuals (BIOCARD) study.
248 MITICA - A PROSPECTIVE STUDY OF ACTIVE SURVEILLANCE (AS) VS IMMEDIATE SURGERY (IS) FOR PAPILLARY THYROID MICROCARCINOMA (PTMC)
Authors: Crocco A , Schettino C , D’Anna R , Casolino C , Arenare L , Panariello I , D’Angelo R , Matacena M , Perrone F , Pezzullo L
Published: May 2024

Background

Limited data are available on the impact on quality of life (QoL) of AS, that is an alternative to IS given the low risk of mortality and recurrence of papillary thyroid microcarcinoma PTMCs.

Methods

To study the impact on QoL we aimed to randomize PTMC patients 1:1 to AS or IS, allowing to those refusing randomization to choose AS or IS within two observational cohorts. Primary endpoint was QoL (EORTC QLQ-C30), but also anxiety/depression (HADS), and safety (CTCAE v 5.0 and PRO- CTCAE questionnaire) were assessed. Forty randomized patients were required.

Results

From April 2016 to March 2023, 70 patients were enrolled at one center, but only 4 accepted randomizations. Results are descriptive only. Among 30 AS pts, 4 underwent delayed surgery due to progressive disease (1 case) or anxiety (3 cases). Pts were mainly female (58/70; 83%), median age was 52yrs (IQR 46-61) in AS and 37yrs (IQR 30-46) in IS. Median tumor diameter was 8 and 10 mm in AS and IS, respectively. Cardiovascular comorbidity was reported in 3 AS pts vs none in IS. After treatment choice, baseline PRO-CTCAE, QoL and HADS showed some statistically significant differences between patients choosing AS or IS: those choosing AS had less problems of concentration, less headache, less anxiety, less depression, better scores of cognitive emotional, role and social functioning scales, less fatigue, and less sleeping disturbance.

Conclusions

The MITICA randomized trial failed, but available data suggest that the choice of undergoing IS for PTMC may be associated with immediate worsening of QoL.
81 INCIDENCE AND RISK FACTORS FOR EARLY SUPPLEMENTATION THERAPY AFTER HEMITHYROIDECTOMY FOR BENIGN CONDITIONS IN EUROPE
Authors: Del Moral J Villar , Arcelus Martínez J I , Becerra Massare A , Muñoz Pérez N , Arteaga Ledesma M , Acosta Gallardo C , Mohamed Chairi M H , Olvera-Porcel M C , Martínez-Santos C
Published: May 2024

Background

The incidence and risk factors of hypothyroidism after hemithyroidectomy (HT) remain poorly defined. Regarding its treatment, national or local policies can influence on early (first visit) prescription of replacement therapy (EPRT). Our aim was to know EPRT rates after HT in Europe and what factors can impact on this decision.

Methods

Retrospective multicentric Eurocrine©-based study focused on patients undergoing HT. Exclusion criteria: cancer in pathological report, and posterior completion thyroidectomy. Analyzed variables include the country and epidemiological, clinical, surgical, pathological and follow-up data. Dependent variable was EPRT or not at first visit, 30-45 days after surgery. The relationship among qualitative variables and the likelihood to receive EPRT were tested with Chi-square or Fisher tests. A predictive multivariate logistic regression model for relevant independent variables was used.

Results

13,606 patients undergoing HT due to benign conditions between 2015 and 2022 were included. Median age was 52.5 years, and 78% were females. The most frequent indications were excluding malignancy (55%) and compressive symptoms (37%). Overall, 4,580 (33.6%) received EPRT, with a large variability among countries, ranging from 8.6 to 97%. Emerging risk factors for EPRT from multivariate model included younger age, malignancy and thyrotoxicosis as surgical indications, Bethesda III as cytology results, a shorter operation time, a heavier surgical specimen, thyroiditis in pathological report, and country where HT was done.

Conclusions

One third of patients undergoing HT needed EPRT. That prescription is more prone facing younger patients, malignancy and thyrotoxicosis as surgical indications, Bethesda III cytology, and thyroiditis in pathological report. In addition to those features, also country matters.
136 OUTPATIENT PARATHYROID SURGERY. OPEN ROAD TO THE FUTURE
Authors: Morales D , Soler R , Fernández J L , Guillermo P , Dominguez M D , Pérez L , Adarve A , Ocaña L T
Published: May 2024

Background

Outpatient surgery (OS) is consolidated in many pathologies, but there are still controversies regarding endocrine surgery. The objective of this study was to present the results about OS parathyroid surgery program in a reference hospital.

Methods

The patient selection criteria included those patients with a diagnosis of primary hyperparathyroidism (HPT1°) due to parathyroid adenoma, with two positive localization tests, ages between 18 and 80 years, with an ASA I, II or III pre-anesthetic assessment, who live less than an hour from the hospital center, have a contact telephone number and are accompanied. Histological confirmation is performed through intraoperative biopsy, as well as PTH determinations according to the Miami criteria. After surgery, patients move to the post-anesthetic recovery and readaptation area. If tolerance is correct, postoperative pain is controlled and there is no evidence of clinical hypocalcemia, they are discharged. Next morning a phone call is made.

Results

From March 2019 to March 2023, 143 patients with HPT1° have been operated and 78 have been performed as OS, 11 were male and 67 female, mean age of 60±7 years. The average surgery time was 38±15 minutes. The time spent in the unit from admission in the early morning until discharge was 9.5±2 hours, with no mortality or readmission. Regarding complications, only one case of symptomatic hypocalcemia at 48 hours and a wound seroma.

Conclusions

OS HPT1° surgery, with correct patient selection and in expert teams, can be performed in outpatient surgery with complete safety.
121 TRANSPLANTATION AND NON-INVASIVE LONGITUDINAL IN VIVO IMAGING OF PARATHYROID CELLS – A PROOF-OF-CONCEPT STUDY
Authors: Bränström R , Van Krieken P , Fröbom R , Shabo I , Aspinwall C A
Published: May 2024

Background

The parathyroid cell is a vital regulator of extracellular calcium levels, operating through the secretion of parathyroid hormone (PTH). Despite its importance, the regulation of PTH secretion remains complex and not fully understood, representing a unique interplay between extracellular calcium, intracellular calcium, and hormone secretion. One significant challenge in parathyroid research has been the difficulty in maintaining cells ex vivo for in-depth cellular investigations.

Methods

We introduce a novel platform for parathyroid cell transplantation and non-invasive in vivo imaging using the anterior chamber of the eye as a transplantation site.

Results

We found that parathyroid tissue transplanted into the mouse eye engrafted onto the iris, became vascularized, and retained cellular composition. Transplanted animals exhibited elevated PTH levels, indicating a functional graft. With in vivo confocal microscopy, we were able to repetitively monitor parathyroid graft morphology and vascularization.

Conclusions

In summary, there is a pressing need for new methods to study complex cellular processes in parathyroid cells. Our study provides a novel approach for non-invasive in vivo investigations that can be applied to understand parathyroid physiology and pathology under physiological and pathological conditions. This innovative strategy can deepen our knowledge on parathyroid function and disease.
86 GERMLINE MUTATIONS OF GCM2 CAUSE A NOVEL VARIANT OF HEREDITARY PRIMARY HYPERPARATHYROIDISM WITH MULTIGLANDULAR INVOLVEMENT
Authors: Iacobone M , Fernando-Watutantrige S , Stefania Z , Pellegrini R , Taschin E , Massimiliano Ferrara F , Augenti V , Lizarazo J L C , Torresan F
Published: May 2024

Background

Primary hyperparathyroidism (pHPT) rarely (10%) occurs as hereditary disease. GCM2 germline mutations have been recently described as responsible for the development of a novel variant of hereditary pHPT. This study was aimed to determine the prevalence of GCM2 germline variants in pHPT and evaluate the main features of this variant.

Methods

Demographics, laboratory, surgical data were assessed in a series of 10 index cases carrying GCM2 mutations undergoing surgery for pHPT.

Results

The GCM2 germline pathogenetic variants c.1181A>C p.(Tyr394Ser) was detected in 80% of cases. GCM2-related pHPT affected subjects of both sexes (F/M= 6/4); it was diagnosed at a median age of 60 yrs. (range 49 – 71). Preoperative median calcium and PTH levels were 2.9 mmol/L (range 2.7-3.4) and 215 pg/ml (range 103-459), respectively. Family history of pHPT was absent in 70% of cases; multiglandular involvement was preoperatively suspected because of equivocal preoperative imaging studies (absent, multiple, or discordant localization) in 60% of patients. Complete clinical, surgical and follow-up data were available for 5 patients. Bilateral neck exploration with subtotal parathyroidectomy was performed in 4/5 patients and focused exploration with selective parathyroidectomy in 1 case. All patients undergoing subtotal parathyroidectomy were cured and are disease-free at a median follow up of 4 years (range 3-10), while the patient undergoing selective parathyroidectomy had persistent pHPT.

Conclusions

GCM2 germline mutations may cause hereditary pHPT, even if it may mimic sporadic variant because of the absence of familial history and late onset. The main feature is multiglandular involvement, needing bilateral neck exploration and subtotal parathyroidectomy.
52 DOES CENTRAL NECK DISSECTION NEGATIVELY INFLUENCE HYPOPARATHYROIDISM AFTER ANGIOGRAPHY-GUIDED THYROIDECTOMY?
Authors: Moreno-Llorente P , Barrasa A G , Pascua-Solé M , de Nova J L M
Published: May 2024

Background

Central neck dissection (CND) may have a negative effect on parathyroid glands (PGs) function. Indocyanine-green angiography (ICG) has shown that only one well-vascularized PG is enough to avoid postoperative hypocalcemia. Angiography-guided thyroidectomy (A-GT) was reported to significantly reduce postoperative hypocalcemia by preserving more well-vascularized PGs. We evaluated the effect of CND on postoperative hypocalcemia in patients undergoing A-GT.

Methods

Consecutive patients undergoing total thyroidectomy (TT) + CND from April 2016 to September 2023. A-GT was routinely performed since September 2020. In the Study group, ICG was initially injected to enhance the vascular map supplying PGs, then A-GT was performed. PGs perfusion was evaluated in every single PG after lobectomy+CND in all patients (control and study group) by using the 0-black, 1-gray, 2 white scoring system.

Results

wTT+CND was performed in 97/181 patients (71 bilateral CND, 26 unilateral) therefore 168 “sides” (lobectomies+CND) were included in the study: 97 “sides” (54 patients) in the control group and 71 sides (43 patients) in the study group. Superior PGs were significatively better preserved after A-GT, (p = 0.026) and CND didn’t significatively reduce the quality of their perfusion (p = 0.510). A-GT patients showed a significant reduction of hypoparathyroidism episodes (p = 0.007) minimizing the deleterious effect of CND on inferior PGs function.

Conclusions

1.- A-GT preserved more well-perfused superior PGs reducing the number of hypocalcemic episodes significatively. 2.- After AG-T, CND didn´t have a deleterious effect on hypocalcemic episodes rate.
The Case for an Intersectional Approach to Trauma-Informed Practices in K–12 Schools for Black Girls
Authors: Joseph-McCatty Andrea , Bamwine Patricia , Sanders Jane
Published: May 2024

Black girls are the only group of girls across the United States disproportionally suspended from school. Studies have documented that disproportionality cannot be explained solely by greater misbehavior among students of color. Instead, discipline disparities are also informed by punitive/inequitable discipline policies and practices, less discussed has been the relationship between childhood adversity and school discipline outcomes at the intersection of race and gender. Examining this phenomenon is important and timely as schools are increasingly providing trauma-informed practices to support socioemotional learning. Yet doing so without data-driven practices rooted in an understanding of disproportionate adversity may render these practices insufficient for Black girls. Thus, this study asks, what types of childhood adversities do Black girls have the greatest risk of experiencing? Using 2016–2019 data from the National Survey of Children’s Health (N = 63,674), risk ratios and Pearson’s chi-square test of independence were performed to determine across-race and within-gender group differences by the type of childhood adversity. Analyses demonstrated that Black girls had a greater risk for six out of nine adversities compared with other girls of color and seven out of nine compared with White girls.
Seasonal variation in attraction to plant volatiles by Cacopsylla pyricola (Foerster) (Hemiptera: Psyllidae)
Authors: Cooper W Rodney , Serrano Jacqueline M , Horton David R , Ohler Bonnie J , Waters Tim D
Published: May 2024

Pear psylla, Cacopsylla pyricola (Foerster) (Hemiptera: Psyllidae), occurs as 2 seasonal morphotypes. Summerforms occur on pear (Pyrus communis L.; Rosales: Rosaceae) where they are a significant pest. The larger and darker winterform morphotype develops in response to shortening daylengths and begins winter in reproductive diapause characterized by the absence of ovarian development. Diapausing winterforms often leave pear to overwinter on coniferous shelter plants and then return to pear in late winter and early spring to begin depositing the eggs that produce the first summerform generation. Cacopsylla pyricola adults are attracted to the color of foliage most of the year, but little is known about the role of plant volatiles in host finding and in seasonal dispersal between host and shelter plants by the psyllid. We used a Y-tube olfactometer and choice assays to investigate the response by C. pyricola adults to volatiles emitted by pear and an evergreen tree (cypress) often used as a shelter plant by wintering C. pyricola. Attraction to pear and cypress volatiles varied by season, tree phenology, and psyllid physiology. Cacopsylla pyricola were attracted to cypress volatiles and preferred to settle on cypress shoots during winter and early spring but then shifted to a marked preference for the pear developmental host in late spring and summer. Female C. pyricola exhibited stronger responses to pear volatiles than did males. Our study is the first to show that plant volatiles have a role in host finding by C. pyricola and provides a foundation for research on chemical ecology and management of C. pyricola.
The Clinical Effectiveness of Fidaxomicin Compared to Vancomycin in the Treatment of Clostridioides difficile Infection, A Single-Center Real-World Experience
Authors: Alsoubani Majd , Chow Jennifer K , Rodday Angie Mae , McDermott Laura A , Walk Seth T , Kent David M , Snydman David R
Published: May 2024

Background

The use of fidaxomicin is recommended as first-line therapy for all patients with Clostridioides difficile infection (CDI). However, real-world studies have shown conflicting evidence of superiority.

Methods

We conducted a retrospective single-center study of patients diagnosed with CDI between 2011 and 2021. A primary composite outcome of clinical failure, 30-day relapse, or CDI-related death was used. A multivariable cause-specific Cox proportional hazards model was used to evaluate fidaxomicin compared to vancomycin in preventing the composite outcome. A separate model was fit on a subset of patients with C. difficile ribotypes adjusting for ribotype.

Results

There were 598 patients included, of whom 84 received fidaxomicin. The primary outcome occurred in 8 (9.5%) in the fidaxomicin group compared to 111 (21.6%) in the vancomycin group. The adjusted multivariable model showed fidaxomicin was associated with 63% reduction in the risk of the composite outcome compared to vancomycin (hazard ratio [HR] = 0.37; 95% confidence interval [CI], .17–.80). In the 337 patients with ribotype data after adjusting for ribotype 027, the results showing superiority of fidaxomicin were maintained (HR = 0.19; 95% CI, .05–.77).

Conclusions

In the treatment of CDI, we showed that real-world use of fidaxomicin is associated with lower risk of a composite end point of treatment failure.
Reasons for the Exclusion of Women from Peace Processes: The Case of Georgia
Authors: Vassileva Julia
Published: May 2024

With the Russian invasion of Ukraine in 2022, security perception in the South Caucasus has been impacted considerably and this has highlighted the need for the international community to pay increased attention to unresolved, “frozen” conflicts. Against this background and the call for an effective and inclusive peace process in Georgia, the article focuses in particular on the inclusion of women in the Georgian peace process. By conducting document analysis and triangulating the findings with original interview data from thirty-one semi-structured interviews conducted in Tbilisi in spring 2023, the article argues that women's substantive inclusion in Georgia's peace processes continues to be limited and that the influence of women remains mostly on track II and III channels. It finds that the following reasons explain this continued exclusion: (1) elite-dominated hard power negotiation structures, (2) cultural factors, (3) the need for empowerment and linking the Women, Peace and Security (WPS) and Youth, Peace and Security (YPS) agendas, and (4) insufficient implementation of commitments made to include women under the existing policy and legal framework. Aiming to spell out the multiple reasons underpinning the exclusion, this article speaks to the importance of ensuring more effective, sustainable, and inclusive peace processes in Georgia and beyond.
#1568 Cardiometabolic benefits of low dose zibotentan and dapagliflozin 10 mg in the ZENITH-CKD study
Authors: Ambery Philip , Teruel Jose Luis Górriz , Romeo Maria José Soler , Wijkmark Emma , Lin Annie , Greasley Peter J , Heerspink Hiddo Lambers
Published: May 2024

Background and Aims

Positive effects of endothelin receptor antagonists on blood pressure and urinary albumin excretion have been well described, although their use in a wider population of patients with chronic kidney disease with increased cardiovascular risk has been limited by potential fluid retention. Here we present the effects of low dose zibotentan in combination with dapagliflozin on a range of cardiometabolic risk factors.

Method

In a post-hoc analysis of the ZENITH-CKD trial, a randomized, double-blind, active-controlled trial conducted in 170 clinical sites in 19 countries, adults with a urinary albumin-creatinine ratio (UACR) of 150 to 5000 mg/g and eGFR ≥20 mL/min/1.73 m2 not on SGLT2i were randomized to zibotentan/dapagliflozin, 0.25 mg/10 mg, zibotentan/dapagliflozin, 1.5 mg/10 mg, or placebo/dapagliflozin 10 mg. Effects on fluid retention events, defined as body weight increase from baseline >3% (of which at least 2.5% from total body water) or BNP increase >100% to >200 pg/mL without atrial fibrillation or 100% increase to >400 pg/mL with atrial fibrillation were assessed (NCT04724837).

Results

Data from the full analysis set is presented including 91 participants treated with 0.25 mg zibotentan and 10 mg dapagliflozin, and 177 participants treated with 10 mg dapagliflozin and placebo. UACR reduction for 0.25 mg zibotentan and 10 mg dapagliflozin was −47.7%, for 10 mg dapagliflozin alone it was −28.3%, making an adjusted mean difference for the combination versus dapagliflozin alone of −27.0%. Cardiometabolic markers are shown in the table.

Conclusion

In the ZENITH-CKD study zibotentan used at low dose combined with dapagliflozin had incremental effects versus dapagliflozin alone on a range of cardiometabolic risk markers including blood pressure, LDL cholesterol, HbA1c and uric acid, without a significant increase in fluid retention.