bluuebunny/crossref_metadata_2025 huggingface dataset:
Initial experience with ICG fluorescence during total thyroidectomy in Mexico: The postoperative hypocalcemia index decreases?
Authors: Montalvo-Hernández Jorge , Palacios Doris M. , Mata Carlos Javier , Jordan Eduardo , Boy-Serratos Jorge , Morán Diana Ximena , Álvarez-López José Alfredo , Carrasco-Tobón José German
Published: June 2024

Background: Postoperative hypocalcemia is the most frequent complication of the total thyroidectomy. New techniques have recently emerged for the identification of the parathyroid glands, for example fluorescence with indocinaine green, which has been very well accepted by different groups of expert surgeons internationally. In this study we use it to assess the viability of the parathyroid glands after total thyroidectomy with the angiography image that it provides us.
Methods:
This is a cohort study including patients undergoing total thyroidectomy in 2020 using ICG fluorescence and they were evaluated for transient and permanent (>6 months) hypocalcemia postoperatively. In addition, results were compared with historical controls including patients treated by a low-volume thyroid surgeon (group A), and by a high-volume thyroid surgeon (group B). Several variables were included (number of auto-transplanted parathyroids, postoperative serum calcium leves, and symptoms of hypocalcemia) and analyzed between groups. The main aim of the study was to determine whether the use of ICG fluorescence associateswith a lower rate of postoperative hypocalcemia.
Results: A total of 18 patients were operated using ICG fluorescence. Of them 14 (75%) cases were females and median age were 54 ±13.5 years. 29 patients were included in group A (operated by a low-volume thyroid surgeon) and 50 patients in group B (by a high-volume thyroid surgeon). Autotransplantation was no necessary in ICG group compared with 3 and 1 in the group A and B respectively. Thyroid cancer were confirmed in 58 (59%) of cases by histopathology. Postoperative calcium levels were higher in ICG fluorescence group compared with groups A and B since day-1 to 6 months of follow-up (p=NS). Statistical analysis showed a significant difference in transient hypocalcemia and permanent hypoparathyroidism rates (p=0.011 and p=0.002 respectively) when contrasted between groups. The sub-analysis showed that ICG-fluorescence did not reach adequate statistical significance compared to group of high-volume surgeon (B), both for transient and permanent hypocalcemia (p= 0.039 and p= 0.28 respectively).
Conclusions: ICG fluorescence technique was associated with lower incidence of postoperative hypocalcemia specially when it is compared to low-volume thyroid surgeon.
Correlation of Ultrasonographic Findings with Estimated-Glomerular Filtration Rate in Chronic Kidney Disease
Authors: Kharel Amrit , Shrestha Shreejana , Karki Dan Bahadur
Published: June 2024

Introduction
Chronic Kidney Disease (CKD) is a condition characterized by kidney damage for three or more months or Glomerular Filtration Rate (GFR) less than 60ml/minute/1.73m2 for three or more months with or without kidney damage. Ultrasonography is the non invasive imaging modality to determine the renal morphology. The aim of this study was to find the correlation of ultrasonographic parameters with estimated Glomerular Filtration Rate (eGFR) in CKD patients visiting a tertiary hospital.
Methodology
This observational cross sectional study was carried at Patan Hospital in thirty five CKD diagnosed cases above the age of 18 years. Renal sonographic parameters like renal length, width, parenchymal thickness, and cortical echogenecity grade were obtained during ultrasonography. eGFR was calculated from CKD-EPI formula after obtaining serum creatinine. Ultrasonographic parameters were compared with eGFR using Spearman correlation test and Kruskal Wallis test was used to check difference in median eGFR among different echogenicity grade.
Result
Statistically significant moderate positive correlation was seen between eGFR and parenchymal thickness (rs = 0.51, p < 0.05) and eGFR and length (rs = 0.46, p < 0.05) but weak positive correlation was seen between eGFR and width (rs = 0.3, p < 0.05). A statistically significant relationship was also seen between eGFR and renal cortical echogenecity grade (p < 0.05).
Conclusion
Renal parenchymal thickness has maximum positive correlation with eGFR than other parameters to measure renal dimensions like renal length and width. Hence, renal parenchymal thickness is a better parameter to measure renal dimension in patients with CKD.
Deep learning from ultrasound images of breast cancer sentinel lymph nodes to predict metastasis
Authors: Luo Yunhao , Wei Zhuo , Chen Jie , Cao Wenbin , Feng Zhengquan , Li Chaonan , Liu Yuyan , Chen Qin , Luo Jing , Deng Jianhua , Luo Jun
Published: June 2024

Objectives
This study aims to develop a non-invasive assessment in breast cancer sentinel lymph node (SLN) using deep learning.
Materials and methods
Continuously retrospective patients with breast cancer who have undergone both contrast-enhanced ultrasound (CEUS) and two-dimensional ultrasound (TDUS) for sentinel lymph node examination. Those patients were randomly divided into training set, validation set, and internal test set in a ratio of 8:1:1. A Re-parameterization Visual Geometry Group-Convolutional Block Attention Module (RepVGG-CBAM) model was constructed based on the RepVGG network, embedding the CBAM attention mechanism. The area under the receiver operating characteristic curve (AUC) was used to evaluate diagnostic performance.
Results
In the test set, the AUC were experts in TDUS, CEUS, and combination ultrasound (CBUS), model in TDUS, CEUS and CBUS were 0.794, 0.806, 0.774, 0.861, 0.851, 0.842 respectively. The difference in AUC between Experts in TDUS (0.794) and Model in TDUS (0.861) was statistically significant (p = 0.043). The difference in AUC between Experts in TDUS (0.794) and Model in CEUS (0.851) was statistically significant (p<0.01). The difference in AUC between Experts in CBUS (0.774) and Model in TDUS (0.861) was statistically significant (p = 0.007). The difference in AUC between Experts in CBUS (0.774) and Model in CEUS (0.851) was statistically significant (p<0.001).
Conclusions
An algorithm model was developed to determine the SLN metastasis status of breast cancer patients.
Impact of Retinal Traction Induced by Epiretinal Membrane on Aniseikonia
Authors: Hirano Masayuki , Minakawa Shun , Imamura Yuta , Yamamoto Naoko
Published: June 2024

We investigated the effect of retinal traction caused by epiretinal membranes (ERMs) on aniseikonia and retinal microstructures in 81 unilateral ERMs. Retinal traction was quantified by measuring the maximum depth of the retinal fold (MDRF) using en face optical coherence tomography (OCT) images. Measurements included the mean inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), central retinal thickness (CRT), and interocular ratios of the foveal avascular zone (FAZ) area (FAZ ratio). Significant correlations were found between the preoperative MDRF and preoperative aniseikonia (P < 0.001), INL thickness (P < 0.001), CRT (P < 0.001), and FAZ ratio (P = 0.003). Preoperative aniseikonia was significantly correlated with preoperative INL and OPL-ONL thicknesses (P < 0.001 and P = 0.020, respectively) and CRT (P = 0.003). Multiple regression analysis revealed that preoperative aniseikonia was significantly associated with preoperative MDRF, INL, and OPL-ONL thicknesses (P = 0.029, 0.006, and 0.006, respectively). Twenty-nine eyes underwent membrane peeling, resolving all retinal folds 6 months postoperatively. A significant correlation was observed between preoperative MDRF and postoperative aniseikonia (P = 0.011). Our findings suggest that retinal traction by ERM is significantly associated with aniseikonia both pre- and postoperatively, alongside other OCT parameters.
Spatiotemporal Evolution of Nighttime Light During the COVID-19 Pandemic in Major Cities of South Korea
Authors: Park Sungjae , Nur Arip Syaripudin , Ramayanti Suci , Lee Seulki , Park Eunseok , Lee Chang-Wook
Published: June 2024

The government of South Korea implemented social distancing regulations to tackle the surging number of confirmed cases of coronavirus disease 2019 (COVID-19) to reduce transmission. Implementation of social distancing has affected human behavior in activities which can be observed through the change in nighttime light (NTL). Human activities at night can describe a situation during social restrictions and represent their response to the situation. Remote sensing technique supported by satellite capabilities provides NTL data in observing the earth’s surface at night from space. In this study, visible NTL data were acquired from the Suomi satellite. We collected 887 Suomi data from 1 January 2020 until 27 June 2022 to analyze the time series of NTL radiance change over six major cities in South Korea to investigate the relationship with social distancing regulation. A higher level of regulation restricting human activities was integrated with the closure of various facilities. The findings showed that the application of various social distancing levels impacted the temporal and spatial disparities in NTL radiance. In addition, the results of this study indicate that it is difficult to manage infectious diseases with only the government's control policy when the number of infections increases dramatically. Therefore, this study can be helpful for the government in reviewing and improving regulations in efforts to control and prevent COVID-19 outbreaks in the future.
SGLT2 Inhibitor and GLP-1 Receptor Agonist Co-Treatment: Liver Function Effects in Patients with Type 2 Diabetes Mellitus
Authors: Tsuriya Daisuke , Kobayashi Kazuo , Takeshita Kei , Hashimoto Takuya , Kimura Moritsugu , Muta Yoshimi , Yokomizo Hisashi , Takashi Yuichi , Tsukamoto Shunichiro , Tamura Kouichi , Kanasaki Keizo , Kawanami Daiji , Toyoda Masao
Published: June 2024

Purpose
We evaluated the effects of sodium-glucose cotransporter inhibitors (SGLT2is) and GLP-1 receptor agonists (GLP1Ras) combination treatment in patients with type 2 diabetes mellitus (T2DM).
Methods
We retrospectively analyzed data for 643 patients with T2DM receiving SGLT2i + GLP1Ra combination treatment for at least one year (331 and 312 patients in the GLP1Ra- and SGLT2i-preceding groups, respectively). We used multiple imputation to generate replacement values for missing data, and thereafter, performed sensitivity analysis on the complete dataset. Propensity score matching was used to compare the effects of the preceding drugs on liver function.
Results
The mean AST/ALT values at baseline, at the initiation of combination treatment, and at final observation were 29.8 ± 20.0/37.7 ± 29.5, 28.7 ± 17.3/35.3 ± 6.0, and 26.0 ± 14.6/30.1 ± 21.6 IU/L, respectively, indicative of significant improvements in liver function (p < 0.001). Conversely, the FIB-4 index increased significantly from 1.28 ± 0.80 at baseline to 1.38 ± 0.83 (p < 0.001). Subgroup analysis showed no significant increases in FIB-4 index and ALT values for patients with baseline FIB-4 index ≥ 1.3 and ALT ≥ 30 IU/L. The matched model showed no significant differences in liver function or FIB-4 index after combination treatment between the SGLT2i- and GLP1Ra-preceding groups.
Conclusion
SGLT2i + GLP1Ra combination treatment significantly improved liver function and prevented FIB-4 index increases among patients with FIB-4 index ≥ 1.3. Further, even though the preceding drug did not affect liver function, prior use of SGLT2is appeared to be beneficial for improving liver function.
High-dose intravenous iron use in hemodialysis patients: Results from the National Health Insurance System (2019–2020) in South Korea
Authors: Cho AJin , Bae Yoonjong , Kim Mina , Kim Do Hyoung , Lee Young-Ki , Park Hayne Cho
Published: June 2024

Background
Intravenous (IV) iron administration is used widely for treating anemia in hemodialysis (HD) patients. In this study, we investigated the safety of IV iron therapy in this population.
Methods
This study analyzed claims data from the National Health Insurance System and included patients with end-stage renal disease who were receiving HD for more than 3 months as of January 1, 2019. Monthly doses of IV iron were measured for these patients from January 1 to June 30, 2019. Patients were classified into a high- or low-dose group based on the cutoff of a monthly dose of 300 mg iron sucrose. Study outcomes were infection-related hospitalization, cardiovascular events, and all-cause mortality and hospitalization that occurred from July 1, 2019, to December 31, 2020.
Results
Among 33,527 HD patients, 13,609 (40.6%) and 363 (1.1%) patients were administered IV iron at doses of 1–299 mg/month and ≥300 mg/month, respectively. The mean age was 63 years, and 60.4% were men. Compared with the low-dose group, the high-dose group was younger, had higher percentages of men and Medicaid recipients, and had higher prevalence rates of diabetes and hypertension. The rates of infection-related hospitalization, cardiovascular events, and all-cause hospitalization and mortality were not significantly higher in the high-dose than in the low-dose group. Compared with the 1–100 mg IV iron sucrose dose, higher doses were not associated with an increased risk of outcome events.
Conclusion
High-dose IV iron administration did not increase rates of mortality or morbidity in HD patients.
Image Classification on Small Datasets using Query Attention Module
Authors: Jiang Chunyu , Wang Chen , Zhang Hanxiang , Li Renwei
Published: June 2024

Visual Transformers (VTs) are increasingly popular in computer vision due to their robust global modeling. However, they do not have the same learning advantages as Convolutional Neural Networks (CNNs), which can be trained effectively with less data. This paper presents a simple "query attention" module that enhances VTs for small datasets. This module combines channel and spatial data to improve results without the need for pre-training. The query attention shows strong learning abilities and makes the model more efficient. Even with a reduced VTs backbone, the module improves performance over other methods. We tested this on four small datasets (CIFAR10/100, CINIC10, and Tiny-ImageNet) and found that our approach performed better. For instance, by using fewer layers in ViT with the query attention, we reduced parameters by 20\% and increased accuracy by 4.26\% on Tiny-ImageNet.
Enhancing Kharif Pearlmillet (Pennisetum Glaucum) Growth and Yield Through Integrated Approaches: a Comprehensive Field Study on Animal Dung Composts, Cow-based Bio-enhancers and Fertilizer Management in Loamy Sand
Authors: Patel D. M. , Jat J. R. , Meena O. P. , Chauhan K. J. , Kachhiyapatel K. A. , Desai L. J. , Patel K. K. , Patel R. M.
Published: June 2024

Field trial experiments were carried out during the June to November 2021 and 2022. Throughout both years, the trials were carried out at the same location. Obtained results showed that among the different composts made from different animal dung, goat dung compost at a rate of 100 quintal/ha was found to be superior in the case of plant height, effective tillers, earhead length, pearlmillets’ seed and straw yield. Cow-based bio-enhancers, particularly Panchagavya, enhanced plant height, effective tillers per plant, length of earhead and seed yield and straw yield compared to cow urine and Jivamrut. Fertilizer levels significantly affected plant height, effective tillers and earhead length, with the recommended dose of fertilizer outperforming 75%. Interaction effect revealed synergies between goat dung compost, Panchagavya and 100% fertilizer dose, superior plant height, earhead length and seed yield. The study highlights the potential for integrated approaches involving specific compost, cow-based bio-enhancers and fertilizer levels to optimize pearlmillet growth and yield.
Social determinants of health and use of neoadjuvant chemotherapy and germline genetic testing in patients with early stage triple negative breast cancer (TNBC) in the community oncology setting
Authors: Reid Robert , Danso Michael , Dye Joseph , Leong Traci , Raska Paola , kuntz Barb , kidd Angel , Espirito Janet , Tedesco karen , Goudar Ranjit , Lewis Tifany , Clark Becky , Adger Rachael , kocemba Leanne , Mendenhall Molly , Robert Nicholas
Published: June 2024

Purpose
Triple negative breast cancer is a biologically aggressive cancer with limited treatment options. The disease behaves more aggressively in Black women, producing higher mortality rates.
Methods
With the aim of understanding reasons for this difference in outcomes, a retrospective, observational cohort study was conducted. We sought to correlate social determinants of health with use of germline genetic testing and administration of neoadjuvant chemotherapy.
Results
We observed lower use of germline genetic testing among patients who were Black (OR = 0.43, p = 0.007 vs. White) or from lower socioeconomic status neighborhoods (OR = 0.98, p = 0.001). Nonetheless, lower administration of neoadjuvant chemotherapy was seen in those of older age (OR = 0.95, p < 0.001) or on Medicaid insurance (OR = 0.54, p = 0.020 vs. commercial insurance), while higher administration was seen among patients that were Black (OR = 1.57, p = 0.044 vs. White), obese (OR = 1.46, p = 0.048 vs. normal BMI), or stages over IIA (all stages above IIA p < 0.001 vs. IIA).
Conclusion
Findings suggest that differences in outcomes seen in Black patients may be due to reduced use of germline genetic testing, but not reduced administration of neoadjuvant chemotherapy.
Genome-wide identification and comprehensive analysis of the AP2/ERF gene family in Prunus sibirica under low-temperature stress
Authors: Zhang Hongrui , Wang Shipeng , Zhao Xin , Dong Shengjun , Chen Jianhua , Sun Yongqiang , Sun Qiaowei , Liu Quangang
Published: June 2024

Background AP2/ERF transcription factors (TFs) are plant-specific transcription factors involved in the regulation of plant growth and development and in response to stresses. Although AP2/ERF TFs have been identified in numerous species and analyzed in many, such as Oryza sativa, Arabidopsis thaliana, and Populus trichocarpa, studies on the Prunus sibirica AP2/ERF (PsAP2/ERF) gene family have not been reported. In the study, 112 PsAP2/ERFs were identified and categorized into 16 subfamilies.
Results The same subfamilies of PsAP2/ERFs typically exhibited similar exon-intron structures and motif compositions. In all, 50 pairs of segmentally duplicated genes were identified within the PsAP2/ERF gene family. The results showed that 20 PsAP2/ERFswere highly expressed in leaves, roots, and pistils, and highly expressed under different conditions of low temperature stress.
Conclusions This study provides a solid scientific foundation for follow-up research on the evolutionary characteristics of AP2/ERFs in P. sibirica, leading to an improved understanding of the molecular basis of their developmental and low-temperature stress responses, and further investigating the functional expression of PsAP2/ERFs.
Effect of the non-uniform pressure on the deformation and instability of the sheet in flexible-die bulge forming
Authors: Wang Zeyu , Wang Zhongjin
Published: June 2024

In recent years, the application of non-uniform pressure in flexible-die forming, such as viscous pressure forming and magnetorheological pressure forming, has been utilized in manufacturing many thin-walled components. However, the non-uniform pressure is mainly applied to change the shape of the sheet. The effects of the non-uniform pressure on thickness reduction and fracture are still intricate. In this study, the mechanism of the non-uniform pressure to decrease thickness reduction and delay fracture instability in the bulge test is revealed. The non-uniform pressure changes the principal stresses, causing distinct deformation behaviors. There are two opposite effects on thickness reduction and fracture instability. If the pressure at the bulged pole decreases, the shape is more prolate, leading toa decreased average thickness and a decreased polar curvature. The thickness reduction tends to be severe, and the diffuse necking is easy to produce. If the pressure at the bulged pole increases, the shape is more oblate, leading to an increased strain gradient. The thickness reduction tends to be severe, and the localized necking is easy to produce. Characteristics of the pressure to decrease thickness reduction and delay instability are presented. Viscous pressure bulge tests are carried out. Experiment results of the shape, thickness uniformity, polar strain, and fracture verify the theory. The fracture strain increases by 5.6 % compared with the uniform pressure condition. This study proves that non-uniform pressure can promote sheet formability, indicating that non-uniform pressure has broad application prospects in sheet metal forming.
Grading of Oral Epithelial dysplasia: Comparison of WHO three tier grading and the binary grading of Classical and Differentiated dysplasia
Authors: Selvan Preetha , Ranganathan Kannan
Published: June 2024

Background: The WHO Oral Epithelial Dysplasia (OED) three-tier grading is widely used to assess the risk of malignant transformation. There are other grading systems that address the limitations of the WHO grading, but these have not been widely used, and need to be validated. These include the binary systems of low/high grade dysplasia and differentiated/classical dysplasia. This study was done to evaluate the correlation and reproducibility of the grading, between these three systems
Methods: Twenty-four OED cases were histologically graded, independently by two oral pathologists. The grading systems used were: the WHO three tier, the binary grading system proposed by Kujan’s (high and low risk) and the binary system of differentiated and classic dysplasia by Arsenic and Kurrer’s . The results were tabulated and kappa statistics was analysed using SPSSTM (version 25) to assess the inter and intra-observer variability
Results: Among the twenty-four cases evaluated, 25% (6 cases) were classified as differentiated dysplasia, while the remaining 75% (18 cases) were categorized as classical dysplasia. All the six cases of differentiated dysplasia were high risk by the Kujan’s binary categorization, and by the WHO grading five of the six were severe and one was moderate dysplasia. In the binary system -Kujan’s; of the 24 cases 12 cases were graded as high-risk dysplasia and 12 as low-risk dysplasia by both the observers. The six cases of differentiated dysplasia were all high risk according to the binary categorization by both the observers.
Conclusion: The grading of differentiated dysplasia correlates well with the WHO three tier and Kujan’s binary system. These findings highlight the usefulness of identifying differentiated dysplasia and necessity to further validate these grading systems for better prediction models of malignant transformation
FOXF1 inhibits invasion and metastasis of lung adenocarcinoma cells and enhances anti-tumor immunity via MFAP4/FAK signal axis
Authors: Wang Zhenyu , Xie MengXia , Jia Zhongyue , Tao Ziwei , Zhao Ping , Ying Muying
Published: June 2024

Based on the joint analysis of multi-omic data and the biological experiments, we demonstrate that FOXF1 inhibits invasion and metastasis of lung adenocarcinoma cells and enhances anti-tumor immunity via regulating MFAP4/FAK signal axis in this study. The levels of FOXF1 and MFAP4 are significantly down-regulated in LUAD, and the increased levels of two genes can improve the clinical prognosis of LUAD patients. Fluorescein reporter gene determination, chromatin immunoprecipitation and gene co-expression analysis indicate that MFAP4 level is positively regulated by transcription factor FOXF1. The function enrichment analysis shows that the levels of FOXF1 and MFAP4 are closely associated with an enrichment of tumor metastasis signatures. FOXF1 can inhibit the migration and invasion of LAUD cells by transcriptionally activating MFAP4 expression. And the overexpression of FOXF1/MFAP4 can reduce Focal Adhesion Kinase (FAK) phosphorylation, while their knockdown result in the opposite effects. The increased levels of FOXF1/MFAP4 enhance the antitumor immunity by increasing the infiltration of dendritic cells (DCs) and CD4 + T cells, and the interactions between LUAD cells and immune cells, and activating multiple anti-tumor immunity-related pathways. In conclusion, our study reveals the potential function of FOXF1/MFAP4/FAK signal axis in inhibiting metastasis of LUAD cells and modulating anti-tumor immunity of LUAD patients.
Phytochemical Screening of Coconut Water and Bitter Leaf Extract and Antibiogram of the Mixture (Coconut Water + Bitter Leaf) on Salmonella Typhi and Streptococcus Spp
Authors: Matthew Emmanuel Oluwatimileyin , Ozigi Ibrahim Abdulkarim , Uthman Abdulgafar Ishola , ADELEYE ADEYERI DAVID
Published: June 2024

Background Nigeria, a significant player in the global economy, has a rich agricultural heritage that includes diverse crops with potential medicinal properties. Among these, coconut (Cocos nucifera) and bitter leaf (Vernonia amygdalina) are notable for their traditional medicinal uses. This study aimed to evaluate the phytochemical composition and antibacterial efficacy of extracts from these plants, individually and in combination, against Salmonella typhi and Streptococcus pyogenes, addressing the need for alternative antibacterial therapies in the face of rising antibiotic resistance.Methods Bitter leaf and coconut were collected from Bakindogo market, Kaduna, and authenticated by a botanist. The plants were prepared and macerated, with the extracts subjected to phytochemical screening using standard methods. The antibacterial activity was assessed through agar disk diffusion, determining the zones of inhibition at various extract concentrations. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were established for both pathogens.Results Phytochemical analysis revealed the presence of alkaloids, flavonoids, tannins, saponins, terpenoids, and carbohydrates in both extracts, with anthraquinones present only in Vernonia amygdalina. The extracts showed significant antibacterial activity, particularly the mixture of Vernonia amygdalina and Cocos nucifera water. The mixture exhibited higher efficacy against Salmonella typhi, with zones of inhibition ranging from 9.5mm to 17mm, compared to Streptococcus pyogenes, which showed inhibition zones from 9.0mm to 13mm. The MIC for Salmonella typhi was 25mg/ml, with an MBC of 100mg/ml, indicating bactericidal properties at higher concentrations. Streptococcus pyogenes showed an MIC of 100mg/ml, but the MBC was not applicable, suggesting bacteriostatic effects.Conclusions The study confirms the significant antibacterial potential of Vernonia amygdalina and Cocos nucifera water extracts, particularly against Salmonella typhi. These findings support their traditional use and highlight their potential as alternative antibacterial agents. Further research and pharmaceutical exploration are recommended to fully harness these plants' medicinal properties, particularly for developing new treatments for bacterial infections.
SGLT2 inhibition reduces cardiac surgery-associated acute kidney injury: An open-label randomized study.
Authors: Snel Lars Ivar Pieter , Oosterom-Eijmael Maartina J.P. , Rampanelli Elena , Lankadeva Yugeesh R. , Plummer Mark P. , Preckel Benedikt , Hermanides Jeroen , Raalte Daniël van , Hulst Abraham H.
Published: June 2024

Background Currently, no effective preventative strategies exist to mitigate Cardiac surgery-associated acute kidney injury CSA-AKI. Sodium-glucose transporter-2 (SGLT2) inhibitors reduced acute kidney injury (AKI) incidence in large, randomized placebo-controlled outcome trials. We hypothesized that perioperative SGLT2 inhibition could also reduce CSA-AKI.
Methods In this open-label phase IV, randomized, parallel-group, pilot study, adult patients undergoing elective cardiac surgery with cardiopulmonary bypass were randomized to receive either daily an SGLT2 inhibitor, (empagliflozin (10 mg; oral)) from three days prior to surgery until postoperative day two or standard-of-care. Serum and urine biomarkers for acute kidney injury were measured, including NGAL, KIM-1, and HIF-1 α . Additional outcomes included AKI incidence according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria as well as metabolic parameters, including ketone body concentrations and glycemic control.
Results Between March 2022 and April 2023, 55 patients were included (sex: 73% male, age: 66 ± 10 years, BMI: 28 ± 4 kg/m2, empagliflozin n = 25, control n = 30) in the intention-to-treat analysis. Empagliflozin significantly reduced the incidence of CSA-AKI (20% vs 66.7%; absolute difference 46.7%, 95% CI, -69.7 – -23.6; P=.001). Following surgery, NGAL, and KIM-1 were found to increase in both arms, whereas a significant increment in serum HIF-1α after surgery was solely observed in the control group. We observed no between-group differences in the incidence of (euglycemic) ketoacidosis or hypoglycemic events.
Conclusions Perioperative SGLT2 inhibition, compared with standard of care, significantly reduced the incidence of CSA-AKI. These findings warrant validation in large-scale, double-blind, placebo-controlled, randomized trials
Overdamping of vibration resonances by liquid crystal elastomers
Authors: Elmadih Waiel , Terentjev Andrew , Liang Hsin-Ling , Terentjev Eugene
Published: June 2024

This work aims to compare the capability of vibration attenuation by standard elastomeric polymers, and by the new anomalously damping nematic liquid crystal elastomers. We use the most mainstream materials in both categories, and design two testing platforms: the ASTM-standard constrained layer plate resonance geometry, and the attenuation of resonances in a commercial device (electric drill) where the damping polymers were inserted into the casing. In the standard plate resonance testing, we find that LCE outperforms all standard damping materials, moreover, it brings the vibrating plate into the overdamped condition, which is unique for a non-fluid dissipative system. In the attenuation of high-frequency vibrations of a device, we also found LCE dissipates these vibrations much better, although we did not find the optimal insertion configuration for the damping polymer, and did not reach overdamping.
A Strongly Polynomial-Time Algorithm forWeighted General Factors with Three Feasible Degrees*
Authors: Shao Shuai , Živný Stanislav
Published: June 2024

General factors are a generalization of matchings. Given a graph G with a set π(v) of feasible degrees, called a degree constraint, for each vertex v of G, the general factor problem is to find a (spanning) subgraph F of G such that degF(v) ∈ π(v) for every v of G. When all degree constraints are symmetric Δ-matroids, the problem is solvable in polynomial time. The weighted general factor problem is to find a general factor of the maximum total weight in an edge-weighted graph. In this paper, we present a strongly polynomial-time algorithm for a type of weighted general factor problems with real-valued edge weights that is provably not reducible to the weighted matching problem by gadget constructions.
Predictors of high-flow nasal cannula failure in COVID-19 patients in a northern Peruvian hospital.
Authors: Calle-Peña Sara Teresita , Tavara Edwin David Diaz , Aguirre-Milachay Edwin , León-Figueroa Darwin A. , Valladares-Garrido Mario J.
Published: June 2024

Objectives: To determine the predictors of high-flow nasal cannula (HFNC) failure in COVID-19 patients in a hospital in northern Peru.
Methodology: A retrospective cohort study was conducted during the months of March and May 2021. Data collection was based on a follow-up of 156 hospitalized patients with a diagnosis of COVID-19 who were users of HFNC, and outcomes and factors were analyzed from medical records. Epidemiological, analytical, and HFNC use-related characteristics were described using measures of absolute and relative frequencies, measures of central tendency, and dispersion. A multivariate Poisson regression analysis with robust variance and a 95% confidence interval was performed.
Results: We found that age, SpO2/FiO2 and work of breathing (WOB) at admission, degree of involvement and type of infiltrate on CT scan, lymphocytes, c-reactive protein, and D-dimer were significantly associated with failure of HFNC (p< 0.05). In addition, WOB, PaO2/FiO2, SaO2/FiO2, and ROX index were variables that presented statistical significance (p<0.0001). In the multivariate analysis model, a risk of failure of HFNC was determined with age >= 60 years [RRa 1.39 (1.05–1.85)] and PaO2/FiO2 score less than 100 [RRa 1.65 (0.99–2.76)].
Conclusions: Predictors to failure of HFNC are age older than 60 years and minimally significantly lower PaO2/FiO2 than 100.
Analyzing the COVID-19 intensive care unit bed occupancy with random regression coefficient Poisson models
Authors: Diz-Rosales Naomi , Lombardía María José , Morales Domingo
Published: June 2024

COVID-19 has shown the need for spatio-temporal monitoring of the saturation of healthcare capacity in epidemic contexts. However, the scarcity and lack of homogeneity of data is a challenge. Under a random regression coefficient Poisson model, this work derives area-level predictors of occupied bed counts and occupancy ratios in intensive care units, and introduces bootstrap estimators of mean squared errors. Maximum likelihood estimators of model parameters and mode predictors of random effects are calculated using a Laplace approximation algorithm. Simulation experiments are conducted to investigate the behaviour of the fitting algorithm, the predictors and the mean squared error estimators. A forward prediction study is also initiated, defining the out-of-sample predictors and their mean squared errors. The new statistical methodology is applied to data from the Spanish region Castilla y León. The target is to estimate and predict the proportions of beds occupied by COVID-19 patients in intensive care units by health areas and days.
Mathematics Subject Classiffication: 62F40 Bootstrap, jacknife and other resampling methods; 62J12 Generalized linear models; 62P10 Applications of statistics to biology and medical sciences.
Efficient, Calibrated, and Interpretable Uncertainty Quantification for Deep Learning Classification
Authors: Hollis Andrew , Pazdernik Karl , Wilson Alyson , Smith Ralph C.
Published: June 2024

Deep learning models often produce accurate classifiers but do not always produce outputs that are easily interpretable by decision-makers or appropriate estimates of uncertainty or confidence for the classification decision. Furthermore, for some larger architectures, existing uncertainty quantification (UQ) approaches can be computationally expensive. In this paper, we propose two new variational inference loss functions for fitting deep learning classification models and obtaining approximate Bayesian uncertainty quantification. Using text and image datasets, we demonstrate that the proposed framework is more computationally tractable than standard UQ approaches like dropout, and, compared with the competing approaches we consider, yields outputs that better reflect our prior conception of class similarity making the outputs more interpretable and easier to explain to decision-makers. We also demonstrate that the proposed framework balances producing well-calibrated class probabilities with producing posterior credible sets for the class labels that have appropriate coverage.
Refining Pre-Seismic Thermal Anomaly Detection from MODIS Data with Standard Deviation Thresholds and RETIRA Model
Authors: Wongpornchai Pisanu , Suwanprasit Chanida
Published: June 2024

Earthquakes arise from tectonic plate movements and seismic waves, profoundly affecting populations and infrastructure. Remote sensing technologies are invaluable for investigating these phenomena by monitoring the earth surface processes. This study examines pre-seismic thermal anomalies preceding a 4.9 Mw earthquake on February 20, 2019, in Wang Nuea district, Lampang province, Thailand. The Moderate Resolution Imaging Spectroradiometer (MODIS) and applied standard deviation thresholds along with the Robust Estimator of Thermal Infrared Anomalies (RETIRA) index were integrated. Anomalies were categorized based on standard deviation thresholds: normal (≤ 1.0 S.D.), moderate (1.5 S.D.), significant (2.0 S.D.), high (2.5 S.D.), and extreme (≥ 3.0 S.D.). Our findings revealed significant temperature increases near fault lines and lineament structures over the eight days before the earthquake, normalizing post-event. The average temperature elevation was 2.968°C above the pixel-wise mean temperature. A targeted survey of 13 locations identified that 23.08% were along faults or lineaments, 69.23% were devoid of such features, and 7.69% yielded indeterminate results. Non-fault areas, typically dynamic farmlands, were also associated with thermal anomalies. These insights underscore the utility of remote sensing in earthquake studies and its potential to enhance disaster readiness and mitigation efforts.
High strength anhydrite cement based on lime mud from water treatment process: one step synthesis in water environment, characterization and technological parameters
Authors: Kamarou Maksim , Tan Hongbin , Moskovskikh Dmitry , Ma Xiaoling , Yang Feihua , Beletskii Evgenii , Alekseeva Elena , Yudin Sergey , Romanovski Valentin
Published: June 2024

In the process of water treatment from surface water sources, lime mud as waste is formed. This waste contains CaO, Ca(OH)2 and CaCO3. The article proposes a comprehensive method for processing lime mud into high strength anhydrite cement. The method involves the interaction of lime mud with waste sulfuric acid from the production of polymer fibers using a structure-controlled method in the (CaO·Ca(OH)2·CaCO3) – H2SO4 – H2O system at a temperature of 40°C. X-ray diffraction analysis showed the presence of CaSO4 and CaSO4·0.62H2O phases with a purity of 99.8%. The structure-controlled method makes it possible to control the formation and growth of calcium sulfate crystals of the required shape and size, due to which it is possible to obtain anhydrite cement with desired properties. Combined grinding of synthetic anhydrite with activator additives makes it possible to obtain anhydrite cement with a strength of up to 28.5 MPa.
A pause in the weakening of the Atlantic meridional overturning circulation since the early 2010s
Authors: Lee Sang-Ki , Kim Dongmin , Gomez Fabian , Lopez Hosmay , Volkov Denis , Dong Shenfu , Lumpkin Rick , Yeager Stephen
Published: June 2024

The current state-of-the-art climate models suggest that the anthropogenic weakening of the Atlantic Meridional Overturning Circulation (AMOC) has already begun since the mid-1980s. However, direct observational records during the past two decades have shown remarkable resilience of the AMOC. To shed light on this apparent contradiction, here we attempt to attribute the interdecadal variation of the historical AMOC to the anthropogenic and natural signals, by analyzing multiple climate and surface-forced ocean model simulations together with direct observational data. Our analysis suggests that an extensive weakening of the AMOC occurred in the 2000s, as evident from the surface-forced ocean model simulations, and was primarily driven by anthropogenic forcing and possibly augmented by natural variability. However, since the early 2010s, the natural component of the AMOC has greatly strengthened due to the development of a strong positive North Atlantic Oscillation. The enhanced natural AMOC signal in turn acted to oppose the anthropogenic weakening signal, leading to a near stalling of the AMOC weakening. Further analysis suggests that the tug-of-war between the natural and anthropogenic signals will likely continue in the next several years.
Leveraging Feature Sensitivity and Relevance: A Hybrid Feature Selection Approach for Improved Model Performance in Supervised Classification
Authors: Saranya G , Rajendran Rakesh , Jaganathan Subash Chandra Bose , Pandimurugan V
Published: June 2024

Many feature selection algorithms primarily give importance to identifying relevant features and eliminating redundant features. This hybrid work determines the significant features, based on the estimated individual feature sensitivities and the degree of relevance between the feature and target outcome. The majority of works currently in existence employ mutual information (MI) to calculate the degree of information between two variables. By scaling the range of the MI to [0,1], Symmetrical Uncertainty (SU) can be viewed as the normalized MI. In this proposed work, Symmetrical Uncertainty-Relevance (SU-R) is used to measure the relevance between each feature and the target outcome. Per Feature Sensitivity Analysis (PFS) is used to measure the individual feature sensitivity with the target outcome. Features are ranked based on the sum of the ranks of features calculated individually using Symmetrical Uncertainty-Relevance (SU-R) and Per Feature Sensitivity analysis (PFS). Less significant features are iteratively eliminated starting from discarding the least ranked feature identified using the combination of SU-R and PFS Analysis.To evaluate how well our proposed method identifies important features, we assess the influence of each feature on the model's performance using metrics like F1 score and accuracy. This evaluation is conducted on two diverse public datasets from the UCI Machine Learning repository, allowing us to assess the method's robustness across different data types.This hybrid work identified the best 450 significant features out of 754 in the Parkinson’s disease dataset, and the top 150 features out of 562 in the smart phone dataset. The efficacy of the SVM classifier with the selected number of significant features with the proposed hybrid PF and SU-R technique outperforms the SVM when applied with existing feature selection methods.
A novel dynamics modeling method for the heavy cargo airdrop based on reduced multibody system transfer matrix method
Authors: Wang Youyu , Wang Guoping , Sun Yutian , Gu Lilin , Zhang Jin
Published: June 2024

Airdrop technology transfers cargo to a predetermined location using a parachute deceleration system. Relevant researchers establish multibody system dynamics models using ordinary dynamics methods to simulate different particular airdrop system configurations, which require global dynamics equations. The system matrix order is equal to the number of degrees of freedom of the airdrop system. The reduced multibody system transfer matrix method (RMSTMM) is developed to model and simulate airdrop system in this paper, which avoids the symbolically deriving dynamics equations. It does not require global dynamics equations and has high programming and computing efficiency. The effectiveness of recursive algorithm of RMSTMM is validated. The multibody system dynamics modeling and simulation for the whole process of a heavy cargo airdrop are presented by the dynamics topology figures. The variation regularity of displacement, velocity, attitude angle, and overload of the cargo under windless and windy conditions are analyzed. The paper develops a theoretical foundation for rapid modeling, simulation, design, and optimization for the heavy cargo airdrop.
2.53W of 261nm Continuous wave generation in a Pr:YLF laser pumped by blue laser diode at 444.2nm
Authors: Yao Yi , zheng quan , chen xi , wang jinyan , xiao huidong , wang yan , wang yuning , liu huizhen , tian donghe
Published: June 2024

We demonstrate the generation of a watt-level continuous wave deep ultraviolet laser at 261nm by efficient frequency doubling of a blue-diode-pumped Pr:YLF laser at 522nm for the first time. With a novel coating method and LD collimating method, a TEM00 mode deep UV laser radiation at 261nm with an output power of 2.53W was obtained. To the best of our knowledge, this is the first report on a watt-level Pr:YLF laser operating at 261nm.
An Adaptive Auxiliary Framework for Teleoperated Laparoscopic Surgery
Authors: Yiwei Wang , Haoyuan Cheng , Yubo Sheng , Huan Zhao
Published: June 2024

Novice surgeons perform poorly during robotic surgical teleoperation because of poor consistency, a laparoscopic view that lacks depth information, and low proficiency. To make the novice surgeon perform close to expert operation during teleoperation, this article proposes an auxiliary framework for robotic surgery. A Bayesian statistics-based target prediction algorithm is used to realize the prediction of the operator’s intention, and the information entropy is used to measure the credibility of the predicted target. An adaptive velocity-position hybrid control method based on dynamic bubbles is proposed to realize the efficient performance of surgical tasks by seamlessly switching between slow, precise movements and fast, less precise tasks with no need for frequent grasping and repositioning. Assistance for teleoperation is achieved using virtual fixture force assistance based on task guidance constraints and posture adaptive adjustment based on the predicted target. The proposed framework has been validated on a platform for simulated laparoscopic surgery based on a sigma7 teleoperated primary device and a redundant degree-of-freedom surgical robot secondary device to evaluate its usability and effectiveness. It has also shown its superiority in various metrics in a comprehensive performance comparison with the baseline solution.
Developing and Assessinginexact Multiplierarchitectures for Imageprocessing
Authors: Anguraj Parthibaraj , Krishnan Thiruvenkadam
Published: June 2024

In the realm of approximate computing, the inexact multiplier architecture stands out as a cornerstone, playing a pivotal role acrosserror-tolerated applications. This article delves into the intricacies ofthree distinct inexact multiplier architectures tailored specifically forimage processing tasks. The study revolves around efficiently partitioning the partial product stage into smaller modules and thenemploying decoder algorithms/truncation techniques, to obtain thesuggested multiplier’s final result. The resulting 8×8 imprecise multipliers are engineered with reduced design overhead and reasonableerror metrics. Through simulation with the Cadence RTL compilerusing TSMC 90 nm technology, the realization showcases substantialarea and power savings compared to conventional imprecise multipliers. Comparing one of the proposed approximate models to precisemultipliers reveals significant reductions in both the area and thepower requirement, amounting to 37.19% and 46.14%, respectively, allwhile ensuring acceptable error metrics. Furthermore, in comparison toalternative approximation multiplier designs, the suggested 8×8 multiplier showcases superior performance metrics. It achieves justifiablemean Structural Similarity Index (SSI) values, making it particularlyadvantageous for tasks such as picture multiplication and sharpening.
AET:Auxiliary and Embedded Teacher for Online Mutual Knowledge Distillation for Image Classification
Authors: Liu Wen , Liang Xingzhu , Bi Feilong , Lin Yu-e
Published: June 2024

Distillation (OKD) has emerged as a powerful technique for model compression, eliminating the need for pre-trained teachers in traditional methods. While recent advancements in feature fusion have further improved OKD's capabilities, existing approaches solely focus on final-layer fusion, potentially hindering the effectiveness of the fused classifier. In this work, we propose a novel Auxiliary and Embedded Teacher (AET) approach to tackle these challenges. AET addresses the critical issues of feature fusion position selection and potential performance degradation after fusion. We introduce embedded teachers, formed by combining multiple mid-level sub-networks, to promote mutual learning among student networks. Additionally, auxiliary teachers provide enriched information and guide the fusion classifier, ultimately enhancing overall performance. Extensive evaluations on four benchmark datasets (CIFAR-10/100, CINIC-10, and ImageNet2012) demonstrate the superiority of the proposed AET approach. Code is available: https://github.com/JSJ515-Group/AET