bluuebunny/crossref_metadata_2025 huggingface dataset:
KI-gestützte Anwendungen in der physiotherapeutischen Dokumentation
Authors: Kaulisch Christopher , Klemme Beate
Published: September 2024

Hintergrund KI-gestützte Anwendungen könnten berufliche Tätigkeiten von Physiotherapeut*innen unterstützen. Besonders im Bereich der Dokumentation des physiotherapeutischen Prozesses könnten KI-gestützte, sprachbasierte Anwendungen zu einer Entlastung der Physiotherapeut*innen während der beruflichen Tätigkeiten führen.

Ziel Identifikation von Anforderungen, welche von leitenden stationär tätigen Physiotherapeut*innen an ein sprachgestütztes Dokumentations- und Assistenzsystem gestellt werden, um darauf aufbauend künftig eine nutzerorientierte Entwicklung und Erprobung einer KI- und sprachbasierten Anwendung für die physiotherapeutische Dokumentation zu ermöglichen.

Methode Qualitative halbstandardisierte, leitfadengestützte Interviews (N = 4) mit anschließender Auswertung mittels qualitativ inhaltlich strukturierender Inhaltsanalyse.

Ergebnisse Es konnten Anforderungen identifiziert werden, die sich 1. auf die Arbeitsaufgaben und Arbeitsprozesse, 2. auf die individuellen Wünsche und Bedürfnisse der potenziellen Nutzer*innen und 3. auf die institutionellen Rahmenbedingungen beziehen. In Abhängigkeit vom Tätigkeitsumfeld konnten zum Teil gegensätzliche Anforderungen an ein interoperables sprachgestütztes Dokumentations- und Assistenzsystem eruiert werden. Dabei bezieht sich die Interoperabilität auf die Fähigkeit des elektronischen Informationsaustauschs mit dem jeweiligen Krankenhausinformationssystem und auf den Informationsaustausch mit patienteneigenen Endgeräten, wie einem Smartphone. Deutlich wurde, dass die befragten Physiotherapeut*innen die möglichen Funktionen Sprachdokumentation, Sprachabfrage, Sprachsteuerung, Sprachanleitung und Sprachbenachrichtigung während ihrer beruflichen Tätigkeit zielgerichtet einbinden möchten.

Schlussfolgerung Eine sprach- und KI-gestützte Dokumentations- und Assistenzanwendung sollte die physiotherapeutische Dokumentation erleichtern und eine interprofessionelle und monoprofessionelle Kommunikation ermöglichen. Die Hard- bzw. Software sollte sich an individuelle Gegebenheiten, Nutzerbedürfnisse und die jeweiligen medizinischen Fachbereiche anpassen lassen. Die Funktionen Sprachdokumentation, Sprachabfrage, Sprachsteuerung, Sprachanleitung und Sprachbenachrichtigung sollten barrierearm und intuitiv genutzt werden können. Bei der Entwicklung und Nutzung eines sprachgestützten Dokumentations- und Assistenzsystems sollten insbesondere der geltende Datenschutz, die Interoperabilität zu den jeweiligen Krankenhausinformationssystemen und die gesetzliche Verpflichtung zu einer vollständigen Dokumentation des physiotherapeutischen Prozesses beachtet werden.
Palbociclib: Randomized Studies and Real-world Evidence as the Basis for Therapeutic Planning in Metastatic Breast Cancer
Authors: Ruckhäberle Eugen , Schmidt Marcus , Welt Anja , Harbeck Nadia , Wöckel Achim , Gluz Oleg , Park-Simon Tjoung-Won , Untch Michael , Lux Michael P.
Published: September 2024

Endocrine-based combination therapy with an inhibitor of the cyclin-dependent kinases 4 and 6 (CDK4/6 inhibitors) is currently the first-line therapy of choice for patients with hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-negative (HER2−), locally advanced or metastatic breast cancer (mBC). The efficacy and safety of the treatment with palbociclib, the first CDK4/6 inhibitor approved for this indication, have been confirmed in large randomized controlled clinical trials (RCTs) with strictly defined patient cohorts. Since then, many relevant questions about CDK4/6 inhibition with palbociclib for mBC have been investigated in RCTs and real-world studies. Based on this evidence, palbociclib is widely used in clinical practice since many years because of its efficacy and good tolerability.

The aim of this review is to summarize findings from RCTs and RWE considering clinically relevant aspects such as safety, tolerability, quality of life and efficacy with a focus on specific questions and patient characteristics. A critical discussion and review of the overall evidence for endocrine-based therapy with the CDK4/6 inhibitor palbociclib can contribute to support therapy decisions in daily clinical practice.
Development and Update of Guideline-based Quality Indicators in Lung Cancer
Authors: Utzig Martin , Hoffmann Hans , Reinmuth Niels , Schütte Wolfgang , Langer Thomas , Lobitz Jessica , Rückher Johannes , Wesselmann Simone
Published: September 2024

Background In 2022, an update of the German lung cancer guideline, first published in 2010 and revised in 2018, was released. This article aims to show the process of updating, developing, and implementing guideline-based quality indicators (QI) into the certification system for lung cancer centers (LCC).

Methods A multidisciplinary and interprofessional working group revised the guideline QIs from 2018 using the strong recommendations of the guideline update, a systematic review for QIs, and the results of the implemented QIs from LCC.

Results For 4 out of 8 indicators from the 2018 guideline, the LCC showed an improved implementation of the requirements in the last 3 years (2018–2020). For 3 indicators, the median of the results was constant at a very high level (≥96% or 100%). Only the “adjuvant cisplatin-based chemotherapy” indicator showed declining values between 2018 and 2020. The target values and plausibility limits were well achieved by LCC. After updating the guideline, one QI from 2018 was not included in the new QI set due to the small denominator population. Based on the new strong recommendations, 8 new QIs were defined. From the QI set of the guideline update, 13 of 15 indicators (7 since 2018 and 6 from 2022 on) were adopted into the certification program.

Conclusions The guideline recommendations are implemented by LCC at a high level. The process presented confirms the successful implementation of the so-called quality cycle in oncology. The QIs developed by the German Guideline Program in Oncology (GGPO) are adopted by the certification program. The implementation of the QI is measured in LCC, evaluated by the German Cancer Society (DKG), and reflected back to the GGPO. The “real world” data have led to the deletion of one QI and show a high implementation of most QIs in LCC.
A novel ultrasound-based algorithm for the detection of pancreatic stents placed for prophylaxis of post-ERCP pancreatitis: a prospective trial
Authors: Michael Florian Alexander , Feldmann Clara , Erasmus Hans-Peter , Kubesch Alica , Goerguelue Esra , Knabe Mate , Abedin Nada , Heilani Myriam , Hessz Daniel , Graf Christiana , Walter Dirk , Finkelmeier Fabian , Mihm Ulrike , Lingwal Neelam , Zeuzem Stefan , Bojunga Joerg , Friedrich-Rust Mireen , Dultz Georg
Published: September 2024

Before removal of retained pancreatic stents placed during endoscopic retrograde cholangiopancreatography to avoid post-ERCP pancreatitis, imaging is recommended. The aim of the present study was to evaluate a new ultrasound-based algorithm.

Patients who received a pancreatic stent for PEP prophylaxis were included. Straight 5Fr (0.035inch) 6cm stents with an external flap that were visualized by ultrasound were removed endoscopically with no further imaging. If the ultrasound result reported the stent to be dislodged or was inconclusive, X-ray imaging was performed. The endpoints were positive and negative predictive value, specificity, sensitivity, and contingency coefficient between ultrasound and X-ray and/or endoscopy.

88 patients were enrolled in the present study. X-ray was performed in 23 (26%) patients. Accordingly, the ultrasound algorithm saved an X-ray examination in 65 cases, leading to a reduction of 74%. Stents were retained in 67 patients (76%) and visualized correctly by ultrasound in 54 patients with a sensitivity of 81%. The positive predictive value was 83%. The specificity was 48%, because ultrasound described 10/21 dislodged stents correctly. The negative predictive value was 43%, since 10/23 stents were correctly classified by ultrasound as dislodged. In 11 patients (13%), esophagogastroduodenoscopy was performed even though the pancreatic stent was already dislodged.

A novel ultrasound-based algorithm reduced the need for X-ray imaging by three quarters. To avoid unnecessary endoscopic examinations, the algorithm should be implemented with a learning phase and procedures should be performed by experienced examiners. An important limitation might be stent length since shorter stents might be more difficult to visualize by ultrasound.
Is Endoscopic Retrograde Cholangiopancreatography with Balloon Sweeps a Must in Postcholecystectomy Stent Removal for Choledocholithiasis?
Authors: Sasikumar Deepak , Lad Saiprasad , Ingle Meghraj , Tailor Chintan , Rawat Vikramaditya , Shah Mit , Basavaraju Kiran , Lunagariya Yatin , Chopra Shivani , Borkar Vinay
Published: September 2024

Objectives This study aims to evaluate whether stent removal through endoscopic retrograde cholangiopancreatography (ERCP) with balloon sweeps is necessary or whether stent removal by forward-viewing gastroscope without cholangiogram is sufficient.

Materials and Methods A prospective, single-center study was conducted from April 2022 to March 2023 for 1 year. Adult patients with choledocholithiasis who underwent common bile duct (CBD) clearance and CBD stenting followed by cholecystectomy were included. Then, they underwent CBD stent removal either by gastroscope directly or by side-viewing endoscopy with balloon sweeps and occlusion cholangiogram. Recurrence of stones and complications after stent removal were studied in both groups.

Results Forty-seven patients were enrolled in the final study. A total of 64% of patients (n = 30) underwent CBD stent removal followed by balloon sweeps and cholangiogram, and the remaining 34% (n = 17) patients underwent direct stent removal. Time taken for the procedure was more in the balloon sweeps group compared with the direct stent removal group and was statistically significant. No statistically significant adverse events were seen in both groups.

Conclusion Patients who underwent CBD stenting for choledocholithiasis after cholecystectomy can safely undergo stent removal using a gastroscope rather than be subjected again to ERCP. This will significantly reduce the duration, unplanned adverse events, and cost of ERCP.
External validation and comparative analysis of the HOSPITAL score and LACE index for predicting readmissions among patients hospitalised with community-acquired pneumonia in Australia
Authors: Sharma Yogesh , Mangoni Arduino A. , Horwood Chris , Thompson Campbell
Published: September 2024

Objective Community-acquired pneumonia (CAP) is a leading cause of emergency hospitalisations globally and is associated with high readmission rates. Specific score systems developed for all medical conditions such as the HOSPITAL score and the LACE index can also usefully predict CAP readmissions. However, there is limited evidence regarding their performance in the Australian healthcare settings. Methods This multicentre retrospective study analysed adult CAP discharges from two metropolitan hospitals in South Australia between 1 January 2018 and 31 December 2023. Data for determining the HOSPITAL score and the LACE index were derived from electronic medical records. Demographic characteristics of patients readmitted within 30 days were compared with those who were not readmitted. The scores were evaluated for overall performance, discriminatory power and calibration, with discriminatory power assessed using the concordance statistic (C-statistic). Results Over 6 years, 7245 CAP discharges were recorded, with 1329 (18.3%) readmissions within 30 days. The mean (s.d.) age of the cohort was 74.4 (17.8) years. Readmitted patients were more likely to have multiple morbidities and frailty than those not readmitted (P < 0.05). They also had a higher mean number of emergency department presentations and hospital admissions in the previous year and a longer initial hospital stay (P < 0.05). Overall, the mean (s.d.) HOSPITAL score and LACE index were 3.4 (2.1) and 9.3 (3.6), respectively. Among readmissions, 28.4% occurred in patients with a HOSPITAL score >4 (intermediate and high-risk group), while 25.8% occurred in patients in the high-risk LACE category (LACE index > 10). The C-statistic for the HOSPITAL score and LACE index was 0.62 (95% CI 0.61–0.64) and 0.63 (95% CI 0.61–0.65), respectively, with no significant difference in the area under the receiver operating characteristic curves (P > 0.05). Conclusions The predictive abilities of the HOSPITAL score and the LACE index for CAP readmissions are modest and comparable in an Australian setting.
Pulsed Light Technology: Is it Sustainable?
Authors: Gómez-López Vicente M.
Published: September 2024

Pulsed light is a non-thermal method that was initially researched for microbial inactivation using high-power, broad-spectrum light pulses, with the UV-C light portion being the most lethal. This method was introduced to the Western hemisphere with the Hiramoto US patent in 1984 and was developed by PurePulse Technologies. It obtained the FDA approval for food use in 1996 and has been under continuous study and testing by academic institutions since 1998. It is linked to sustainable development goals 2, 3, 6, and 12, but its relation to goal 13 is particularly important, although hindered by lack of data. While numerous applications beyond microbial inactivation have been developed, only two are currently used industrially, namely, the decontamination of food contact surfaces for packaging and the enhancement of vitamin D concentration in edible fungi. Other potential applications include enzyme inactivation, phytochemical synthesis, water pollutant degradation, protein allergen inactivation, mycotoxin inactivation, modification of functional properties of proteins, and starch modification. The main advantage of pulsed light is its rapid effects although it is limited to surfaces and transparent liquids. Further refinement of dosimetry should facilitate the easier scaling up of laboratory results to more industrial applications.

Information

© The Author 2024
Experimental study on temperature distribution of double-layer solid cylinder under local heating source
Authors: Wei Yu-Cheng , Sun Zhi-Wei , Hu Yang-Ming , Dai Hong-Liang
Published: September 2024

Heating equipment is widely used in production and life, the transient temperature of the heated object reflects the effect of heating equipment, but also an important basis for the design of heating equipment. In the internal temperature measurement of micro heating equipment, some of the temperature measurement instruments are large in size, which makes it difficult to realize precision measurement, and the use of infrared measurement, laser temperature measurement and other methods cannot be used to accurately measure the temperature of the internal points of the material without destroying the material and equipment at the same time. In this study, based on the thermocouple temperature measurement technology and considering the problem of fragility and breakage caused by the small diameter of very fine thermocouple wires, a multi-point temperature synchronization measurement platform is constructed to realize the precise measurement of the temperature at multiple points inside the micro-heating element. Transient temperatures were measured at different locations of a water-containing porous medium inside a 15 mm long heating element under static heating and dynamic suction conditions in the case study. The results show that moisture and suction have a significant effect on the temperature inside the porous media layer. During the suction process, the temperature drop near the suction opening was larger, and the temperature drop near the wall was about 47% of the temperature drop inside. This study is a guide to the design of heating structures for vacuum drying equipment, electrically heated atomization systems and other micro-miniature heating equipment.
Design principles for

>

90
%

efficiency and

>

99
%

indistinguishability broadband quantum dot cavities
Authors: Dlaka D , Androvitsaneas P , Young A , Ma Q , Harbord E , Oulton Ruth
Published: September 2024

Quantum dots have the potential to be one of the brightest deterministic single photon sources with high end applications in quantum computing and cluster state generation. In this work, we re-examine the design of plain micropillars by meticulously examining the structural effects of the decay into leaky channels beyond an atom-like cavity estimation. We show that precise control of the side losses with the diameter and avoidance of propagating Bloch modes in the distributed Bragg reflectors can result in easy-to-manufacture broadband (

Q

≈
750

–2500) micropillars, allowing for broad optical coherent control pulses necessary for high single photon purity (

>

99.2%–99.99% achievable) while simultaneously demonstrating extremely high efficiency out the top (90.5%–96.4%). We also demonstrate that such cavities naturally decouple from the phonon sideband, with the phonon sideband reducing by a factor of 5–33 allowing us to predict that the photons should show 98.5%–99.8% indistinguishability without the need for filtering.
Image encryption algorithm based on a novel cascade chaotic system and DNA mutation
Authors: Li Peixin , Zhang Xiaoqiang
Published: September 2024

The image is an important medium for information transfer. To ensure image security and improve encryption efficiency, a novel image encryption algorithm is proposed in this paper. Firstly, a new chaotic map is proposed by combining traditional chaotic maps. The SHA-256 algorithm processes the input image to produce chaotic parameters that generate random sequences associated with the plaintext. Secondly, the plain image is encoded using a fast-dynamic DNA encoding method to obtain the DNA matrix. Thirdly, a new DNA sequence operation method called DNA frame shift mutation is designed. The DNA matrix after performing the frame shift mutation transformation is decoded into a pixel matrix. Finally, coordinate matrices are constructed and the pixel positions are randomly selected for dynamic diffusion, which enables simultaneous scrambling and diffusion at the pixel level. The values of the information entropy are all greater than or equal to 7.9993. Experimental results show that the proposed algorithm is secure and it can be resistant to various attacks. Meanwhile, it has sound encryption efficiency.
Investigation of circularly polarized MIMO antenna with enhanced isolation for sub-6 GHz application
Authors: Kansal Parul , Mandpura Anup Kumar , Kumar Narendra
Published: September 2024

This article demonstrates the design process for a unique, two-port, circularly polarized (CP) multiple input multiple outputs (MIMO) antenna for fifth-generation (5G) applications operating at sub-6 GHz. The proposed 2-port CP MIMO antenna comprises a patch antenna with a distinctive slot and a circular split ring resonator (SRR) at the ground plane. The circular patch antenna’s resonant frequency is moved to a lower frequency by the addition of a circular SRR at the ground plane. Investigating a special slot at the patch antenna can help in the enhancement of circular polarization and bandwidth. A sequence of parasitic elements in the shape of ‘h’ is placed in the space between the two antenna elements for decoupling. The minimum 20 dB inter isolation among the antenna elements in the proposed 2-port CP MIMO antenna’s operating band is made possible by these h-shaped parasitic elements. In addition, to ensure the proposed antenna is more reliable for 5G applications at sub-6 GHz, other diversity parameters including Envelop Correlation Co-efficient (ECC), Mean Effective Gain (MEG), Diversity Gain (DG), TARC (Total Active Reflection Co-efficient) and CCL (channel capacity loss) are also calculated . In comparison to existing MIMO systems of the same order, the proposed 2-port CP MIMO antenna appears to have the minimum channel capacity loss and excellent diversity performance. The proposed 2-port CP MIMO antenna achieves an impedance bandwidth of 3.3 to 3.6 GHz with impedance matching better than 10 dB and has an axial ratio bandwidth of 3.35 to 3.51 GHz with a steady radiation pattern in both planes over the operating frequency bands.
Efficient control of high-precision three-dimensional atom localization via probe absorption in a five-level phase-coherent atomic system
Authors: Banerjee Aniket , Panchadhyayee Pradipta , Kumar Dutta Bibhas
Published: September 2024

We propose a new scheme for high-precision three-dimensional (3D) atom localization by observing the spatially modulated absorption of a weak probe field operating in a partially closed-loop dependent five-level atomic system. Different spatial structures of localization patterns are presented by controlling the Rabi frequency, detuning, and field-induced collective phase-coherence with a variety of superposed standing wave field configurations. Our results highlight that 100% detection probability of atom is possible in the present model in many ways with high precision measurement of spatial absorption. It has been shown that, in the presence of standing wave fields, position information of the atom with maximum detection probability can be efficiently controlled by employing the travelling-wave field in the system. In the present work, we note that the maximum detection probability of the atom is attainable with the limit of spatial resolution better than λ/50. The efficacy of the present model is to find its application in atom nanolithography and atom-imaging having importance in quantum information processing.
Weighing massive neutrinos with Lyman-α observations
Authors: Sarkar Anjan Kumar , Sethi Shiv K.
Published: September 2024

The presence of massive neutrinos has still not been revealed by the cosmological data. We consider a novel method based on the two-point line-of-sight correlation function of high-resolution Lyman-αdata to achieve this end in the paper. We adopt semi-analytic models of Lyman-αclouds for the study. We employ Fisher matrix technique to show that it is possible to achieve a scenario in which the covariance of the two-point function nearly vanishes for both the spectroscopic noise and the signal. We analyze this near `zero noise' outcome in detail to argue it might be possible to detect neutrinos of mass rangemν≃ 0.05–0.1 eV with signal-to-noise of unity with a single QSO line of sight. We show that this estimate can be improved to SNR ≃ 3–6 with data along multiple line of sights within the redshift rangez≃ 2–2.5. Such data sets already exist in the literature. We further carry out principal component analysis of the Fisher matrix to study the degeneracies of the neutrino mass with other parameters. We show that Planck priors lift the degeneracies between the neutrino mass and other cosmological parameters. However, the prospects of the detection of neutrino mass are driven by the poorly-determined parameters characterizing the ionization and thermal state of Lyman-αclouds. We have also mentioned the possible limitations and observational challenges posed in measuring the neutrino mass using our method.
Bondi-Hoyle-Lyttleton accretion around the rotating hairy Horndeski black hole
Authors: Dönmez O.
Published: September 2024

Modeling of the shock cone formed around a stationary, hairy Horndeski black hole with
Bondi-Hoyle-Lyttleton (BHL) accretion has been conducted. We model the dynamical changes of the
shock cone resulting from the interaction of matter with the Horndeski black hole, where the
scalar field and spacetime have a strong interaction. The effects of the scalar hair, the black
hole rotation parameter, and the impacts of the asymptotic speed have been examined, revealing the
influence of these parameters on the shock cone and the trapped QPO modes within the
cone. Numerical calculations have shown that the hair parameter significantly affects the
formation of the shock cone. As the absolute value of the hair parameter increases, the matter in
the region of the shock cone is observed to move away from the black hole horizon. The rate of
matter expulsion increases as h/M changes. After h/M < -0.6, a visible change in the physical
structure of the shock cone occurs, ultimately leading to the complete removal out of the shock
cone. On the other hand, it has been revealed that the asymptotic speed significantly affects the
formation of the shock cone. As h/M increases in the negative direction and the asymptotic speed
increases, the stagnation point moves closer to the black hole horizon. When the value of the hair
parameter changes, the rest-mass density of the matter inside the cone decreases, whereas the
opposite is observed with the asymptotic speed. Additionally, the formed shock cone has excited
QPO modes. The deformation of the cone due to the hair parameter has led to a change or complete
disappearance of the QPOs. Meanwhile, at asymptotic speeds of V
∞/c < 0.4, all
fundamental frequency modes are formed, while at V
∞/c = 0.4, only the azimuthal mode is
excited, and 1:2:3:4:… resonance conditions occur. No QPOs have formed at V
∞/c =
0.6. The results obtained from numerical calculations have been compared with theoretical
studies for M87*, and it has been observed that the possible values of h/M found in the
numerical simulations are consistent with the theory. Additionally, the results have been compared
with those for the GRS 1915+105 black hole, and the hair parameters corresponding to the observed
frequencies have been determined.
Effect of evanescent wave on vector vortex beams on higher-order Poincaré sphere
Authors: Jia Xinting , Jia Jing
Published: September 2024

Based on the vector angular spectrum representation, the contributions of the propagating and evanescent waves to the vector vortex Laguerre–Gaussian beams on the higher-order Poincaré sphere are investigated in the nonparaxial regime. The evolution properties of the propagating and evanescent waves are closely related to the topological charge, the radial order, the ellipticity angle, and the waist width. The influences of the evanescent waves on the intensity, the spin and orbital angular momenta of the vector vortex beams are discussed in detail.
Determination of the discreteness correction in dislocation equations for sphalerite crystals
Authors: Zhang Huili , Lu Defang , Li Yanyan
Published: September 2024

The discreteness correction for simple lattices has been determined, however, there is still no detailed and rigorous derivation of the discreteness correction for compound lattices due to the relatively complex structure (simple lattices have only one set per slip system, while complex lattices have at least two sets). A lattice dynamics model which takes into account the energy increments caused by changes in bond length and bond angle is constructed for sphalerite crystals and the relationships between discreteness parameters and elastic constants are determined for the

110

111

slip system. Compared to glide set, the discreteness correction for shuffle set is much larger due to it is mainly contributed by the interactions between nearest neighbor atoms. Based on the results obtained from the model, the dislocations in ZnS crystal are investigated. The theoretical prediction result of Peierls stress for shuffle

60
°

dislocation closely matches the experimental critical shear stress. It is inferred that the initial plastic deformation of ZnS is closely related to the movement of shuffle

60
°

dislocations.
Effects of different corrugated rolls on the performance of BTW1/Q345R composite plate
Authors: Liu Pengtao , Wang Ke , Zhi Chenchen , Zhao Guanghui , Ma Lifeng , Gao Xiangyu , Li Aifeng , Ma Lianwei
Published: September 2024

BTW1/Q345R composite plate not only has the advantages of high strength and high wear resistance, but also helps to reduce energy consumption and production cost. This paper proposes a novel rolling process based on corrugated rolls for the preparation of wear-resistant steel BTW1/Q345R composite plates. In order to analyze and study the microstructure, and mechanical properties of BTW1/Q345R composite plates after rolling, techniques such as electron backscatter diffraction (EBSD) were used. The results indicate that the composite plate obtained through rolling with the corrugated roll of 72 cycles (3# corrugated roll) exhibits a yield strength of 550 MPa, tensile strength of 705 MPa, elongation at break of 17.57%, and shear strength of the composite interface at 242 MPa. Notably, the rolling process with a 3# corrugated roll yields the best combination of tensile mechanical performance and interface bonding performance for the composite plate.
Encapsulation of human natural killer cells into novel gelatin-based polymeric hydrogel networks
Authors: Cendere Sibel , Yuksel Ceren , Ovali Ercument , Kinikoglu Beste , gok ozgul
Published: September 2024

In the innate immune system, natural killer (NK) cells are effector lymphocytes which control several tumor types and microbial infections by limiting disease spread and tissue damage. With tumor cell killing abilities, with no priming or prior activation, NKs are potential anti-cancer therapies. In clinical practice, NKs are used in intravenous injections as they typically grow as suspension, similar to other blood cells. In this study, we designed a novel and effective biomaterial-based platform for NK cell delivery, which included in-situ NK cell encapsulation into three-dimensional (3D) biocompatible polymeric scaffolds for potential anti-cancer treatments. Depending on physical cross-linking between an alginate (ALG) polymer and a divalent cation, two natural polymers (gelatin (GEL) and hyaluronic acid (HA)) penetrated into pores and generated an inter-penetrating hydrogel system with improved mechanical properties and stability. After extensive characterization of hydrogels, NK cells were encapsulated inside using our in-situ gelation procedure to provide a biomimetic microenvironment.
Bridged Treatment Comparisons: an Illustrative Application in HIV Treatment
Authors: Zivich Paul N , Cole Stephen R , Edwards Jessie K , Shook-Sa Bonnie E , Breskin Alexander , Hudgens Michael G
Published: September 2024

Comparisons of treatments, interventions, or exposures are of central interest in epidemiology, but direct comparisons are not always possible due to practical or ethical reasons. Here, we detail a fusion approach to compare treatments across studies. The motivating example entails comparing the risk of the composite outcome of death, AIDS, or greater than a 50% CD4 cell count decline in people with HIV when assigned triple versus mono antiretroviral therapy, using data from the AIDS Clinical Trial Group (ACTG) 175 (mono versus dual therapy) and ACTG 320 (dual versus triple therapy). We review a set of identification assumptions and estimate the risk difference using an inverse probability weighting estimator that leverages the shared trial arms (dual therapy). A fusion diagnostic based on comparing the shared arms is proposed that may indicate violation of the identification assumptions. Application of the data fusion estimator and diagnostic to the ACTG trials indicates triple therapy results in a reduction in risk compared to monotherapy in individuals with baseline CD4 counts between 50 and 300 cells/mm3. Bridged treatment comparisons address questions that none of the constituent data sources could address alone, but valid fusion-based inference requires careful consideration of the underlying assumptions.
BRD3308 suppresses macrophage oxidative stress and pyroptosis via upregulating acetylation of H3K27 in sepsis-induced acute lung injury
Authors: Liu Bohao , Li Ning , Liu Yi , Zhang Yan , Qu Limei , Cai Hongfei , Li Yang , Wu Xiaojing , Geng Qing
Published: September 2024

Background

Sepsis-induced acute lung injury (ALI) leads to severe hypoxemia and respiratory failure, contributing to poor prognosis in septic patients. Endotoxin dissemination triggers oxidative stress and the release of inflammatory cytokines in macrophages, initiating diffuse alveolar damage. The role of epigenetic histone modifications in organ injury is increasingly recognized. The present study aimed to investigate the use of a histone modification inhibitor to alleviate sepsis-induced ALI, revealing a new strategy for improving sepsis patient survival.

Methods

In vivo models of ALI were established through the intraperitoneal injection of lipopolysaccharide and cecal ligation and puncture surgery. Furthermore, the disease process was simulated in vitro by stimulating Tamm-Horsfall protein-1 (THP-1) cells with lipopolysaccharide. Hematoxylin and eosin staining, blood gas analysis and pulmonary function tests were utilized to assess the extent of lung tissue damage. Western blot analysis, real-time polymerase chain reaction, enzyme-linked immunosorbent assay and immunofluorescence were used to measure the levels and distribution of the indicated indicators within cells and tissues. Reactive oxygen species and autophagic flux alterations were detected using specific probes.

Results

BRD3308, which is a inhibitor of histone deacetylase 3, improved lung tissue damage, inflammatory infiltration and edema in ALI by inhibiting Nod-like receptor protein3-mediated pyroptosis in macrophages. By upregulating autophagy, BRD3308 improved the disruption of redox balance in macrophages and reduced the accumulation of reactive oxygen species. Mechanistically, BRD3308 inhibited histone deacetylase 3 activity by binding to it and altering its conformation. Following histone deacetylase 3 inhibition, acetylation of H3K27 was significantly increased. Moreover, the increase in H3K27Ac led to the upregulation of autophagy-related gene 5, a key component of autophagosomes, thereby activating autophagy.

Conclusions

BRD3308 inhibits oxidative stress and pyroptosis in macrophages by modulating histone acetylation, thereby preventing sepsis-induced ALI. The present study provides a potential strategy and theoretical basis for the clinical treatment of sepsis-induced ALI.
Reshaped commensal wound microbiome via topical application of Calvatia gigantea extract contributes to faster diabetic wound healing
Authors: Ding Xiaotong , Yang Chenxi , Li Yue , He Tangtang , Xu Yan , Cheng Xuxi , Song Jinyun , Xue Nannan , Min Wen , Feng Weimeng , Zhao Hongyu , Dong Jie , Liu Pei , Wang Yiwei , Chen Jun
Published: September 2024

Background

Calvatia gigantea (CG) is widely used as a traditional Chinese medicine for wound treatment. In this study, we aimed to determine the effects of CG extract (CGE) on diabetic wound healing and the commensal wound microbiome.

Method

A wound model was established using leptin receptor-deficient db/db mice, with untreated mice as the control group and CGE-treated mice as the treatment group. The wound healing rate, inflammation and histology were analyzed. Additionally, wound microbiome was evaluated via 16S ribosomal RNA (rRNA) gene sequencing.

Results

CGE significantly accelerated the healing of diabetic ulcer wounds, facilitated re-epithelialization, and downregulated the transcription levels of the inflammatory cytokines, interleukin-1β and tumor necrosis factor-α. Furthermore, CGE treatment positively affected the wound microbiome, promoting diversity of the microbial community and enrichment of Escherichia–Shigella bacteria in the CGE-treated group.

Conclusions

Overall, CGE enhanced diabetic wound healing by modulating the wound microbiome and facilitating macrophage polarization during inflammation. These findings suggest modulation of the commensal wound microbiome using medicinal plants as a potential therapeutic strategy for diabetic wounds.
Goldfinger: a case of a patient with metal tattooing mimicking recurrent melanoma
Authors: Victory Liana , Quigley Claire , Doheny Jane , Flynn Aoibheann , Potter Shirley , Moloney Fergal J
Published: September 2024

Metal tattooing can be a clinical mimic of melanoma, of which dermatologists should be aware. Metal tattoos can vary in size and shape depending on the causative injury, and usually they are blue, grey or black in colour. We report the case of a 73-year-old patient diagnosed with a nodular subungal melanoma on his middle left finger. Six months following his amputation, he attended dermatology follow-up and was noted to have multiple blue–grey cutaneous macules measuring 1–2 mm in size proximal to the amputation scar. Although a careful occupational history in this patient’s case suggested the source of the dermal blue–grey deposits around the scar, it remains important to confirm this histologically, especially in patients at high risk of recurrent melanoma.
199. YOUNGER AGE AS AN INDEPENDENT FACTOR FOR SUBSEQUENT HEAD AND NECK CANCER AFTER CURATIVE ESOPHAGECTOMY FOR ESOPHAGEAL SQUAMOUS CELL CARCINOMA
Authors: Tsai Ping-Chung , Tang En-Kuei
Published: September 2024

Background

Post-operative survival of esophageal cancer patients has improved with advances in technology and treatment modalities. However, squamous cell carcinoma often affects the esophagus together with the head and neck regions, with second primary head and neck cancer (SPHNC) adversely influencing the patients’ quality of life. Therefore, patients with esophageal squamous cell carcinoma (ESCC) should be carefully followed up post-operatively. This study evaluated the risk of developing SPHNCs after an esophagectomy for ESCC.

Methods

Patients with ESCC who underwent curative esophagectomy from January 2008 to December 2017 from two tertiary medical centers, Taipei Veteran General Hospital and Kaohsiung Veteran General Hospital, were retrospectively reviewed. SPHNC development was documented according to anatomic region and the cumulative incidence rate and risk factors were analyzed.

Results

The median observation time of the 435 patients included in our study was 48.5 months [interquartile range (IQR) 16.7–92.4 months]. Among the ESCC patients after curative esophagectomy, younger age <50 [hazard ratio (HR) 4.13, 95% CI: 2.53–6.75, p < 0.001) was the only independent factor for developing SPHNCs in the multivariable analysis. The cumulative incidence rate of SPHNCs of patients aged < 50 years old was 14.3%, 22.1%, and 34.2% after 3, 5, and 10 years, respectively.

Conclusion

There was a high risk of secondary cancer after ESCC in the upper aerodigestive tract, especially the head and neck regions, therefore active surveillance is strongly recommended, especially in younger patients.
204. ALTERATIONS IN LOCAL OESOPHAGEAL MICROBIOTA AND OUTCOMES AFTER OESOPHAGECTOMY FOR OESOPHAGO-GASTRIC CANCER: A PILOT STUDY
Authors: Stokes Matthew , (Frank) Yu Zirong , Schlebusch Sanmarie , Jennison Amy , Graham Rikki , Cooper Caroline , Smithers B Mark , Barbour Andrew , Thomson Iain , Frankel Adam
Published: September 2024

Oesophageal cancer is a global health burden, with an estimated 600,000 new cases and 550,000 deaths per year. It is the 9th most common cancer yet is ranked fifth for cancer mortality. The current gold standard curative strategy includes oesophagectomy, which is a morbid procedure. In particular, anastomotic leaks are a feared complication postoperatively that result in significant morbidity.

Studies of patients undergoing colorectal cancer surgery show that alterations in the local microbiota can contribute to complications including anastomotic leak. Furthermore, some pathogenic bacterial species have been implicated in shorter recurrence-free survival periods after curative oncologic surgery.

Unlike bacterial culture, which requires viable bacteria to be preserved from the time of sampling through to processing, 16S RNA sequencing can be performed on both fresh and fixed tissues. However, there are few studies using either tissue source and to date, none that compare results from the same patient.

The aims of this pilot study were to:

1. Assess the feasibility of testing archived histological specimens (i.e. formalin fixed) that in turn facilitates retrospective analysis of patients with known clinical outcomes (i.e. anastomotic leaks)

2. Identify any difference (variance, reduce or over-abundance) between the microbiota of patients who suffered anastomotic leak and those who did not

3. Generate preliminary data to inform sample sizes, statistical methods, workflow and cost of a future prospective trial

Using an established Upper GI Cancer Surgery Database, we performed propensity score matching to identify 15 patients who had a clinically evident anastomotic leak to be matched with 15 patients who did not have an anastomotic leak. Known predictors of anastomotic leak (e.g. neoadjuvant radiotherapy, smoking status, COPD, chronic kidney disease, diabetes mellitus, chronic liver disease) have been controlled for.

Fresh frozen and formalin-fixed samples for the same patients were available. The formalin-fixed tissue was comprised of the "anastomotic doughnuts" created at the time of the circular stapled anastomosis. This tissue was chosen because of its immediate proximity to the anastomosis.

All samples were analysed using 16S RNA sequencing to obtain a full microbial profile. Sequencing data was analysed by scientific investigators blinded to the clinical outcome (i.e. anastomotic leak vs. no leak) using a pre-existing workflow and bioinformatics pipeline.
222. LONG-TERM SURVIVAL OF ROBOT-ASSISTED ESOPHAGECTOMY AND ITS UTILITY IN TREATING CT4B ESOPHAGEAL CANCER
Authors: Makino Tomoki , Momose Kota , Yamashita Kotaro , Tanaka Koji , Eguchi Hidetoshi , Doki Yuchiro
Published: September 2024

(Background)

Robot-assisted esophagectomy (RAMIE) has lately been introduced to many hospitals after its insurance approval. However, long-term outcome of RAMIE or its utility in treating cT3br-T4 esophageal cancer remains unclear.

(Methods)

A total of 188 esophageal cancer patients who underwent RAMIE between 2017 and 2022 were eligible in the present study. Among them, 20 cases with cT3br-T4 were reviewed to evaluate short-term outcome. Also, a comparison between RAMIE (n=66) and VATS (n=277) group with 2-year and longer follow-up time was made to evaluate their long-term outcomes.

(Results)

Background factors; age=71 (42-86), gender (M/F)= 145/43, tumor location (Ut/Mt/Lt, Ae)= 25/84/79, cT1/2/3/4= 36/31/101/20, cN0/1/2/3= 65/82/34/7, cM0/1= 155/33, and preoperative treatment (none/chemo/CRT/both)= 39/139/10. Surgical outcomes; operation time = 508 (273-833) min, console time=244 (108-479) min, estimated blood loss= 130 (0-2090) ml, overall postoperative morbidity (CD classification≧grade2) = 53.2% (pneumonia= 29.3%, atelectasis=9.0%, palsy of recurrent laryngeal nerve=10.1%, surgical site infection=5.9%, chylothorax=5.9%, and anastomotic leakage=5.9%). Postoperative hospital stay was 21 (12-385) days. The palsy rate of recurrent laryngeal nerve decreased from 9.1 to 0.7% after introducing intraoperative continuous nerve monitoring (NIM). In terms of RAMIE for cT3br-T4 cases (n=20), no convert to open or intraoperative complications were observed while all cases achieved R0 resection. Regarding survival comparison between the RAMIE (n=66) and the VATS (n=277) group, disease-free and overall survival were 74.8 vs 70.9% (P=0.4582), 76.4 vs 78.5% (p=0.7626), respectively.

(Conclusion)

NIM system reduced the palsy of recurrent laryngeal nerve during RAMIE while the comparable survival was identified between the two groups. Given its advantage, RAMIE seems to be particularly useful in treating cT3br-T4 cases. Our surgical videos of cT3br-T4 cases will be also presented in the meeting.
235. A NOVEL TUMOR STAGING SYSTEM INCORPORATING CN STATUS FOR STRATIFYING EARLY STAGE ESOPHAGEAL SQUAMOUS CELL CARCINOMA PATIENTS AFTER TRIMODAL THERAPY
Authors: Li Xiaokun , Yuan Yong , Shen Yi
Published: September 2024

Background

This study aims to assess the prognostic significance of cN status in early-stage esophageal squamous cell carcinoma (ESCC) patients following neoadjuvant chemoradiotherapy (nCRT) and develop a novel staging model for personalized survival prediction.

Methods

Patients with ESCC who underwent nCRT and esophagectomy were included. The Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) were employed to evaluate the validity of various oncological staging systems. A reduction in AIC and BIC values indicates improved predictive capability and accuracy.

Results

We established a novel staging model by incorporating ypTNM stage and cN status, effectively stratifying ypI ESCC patients. Cox regression analysis showed that only cN status was an independent prognostic factor for both overall survival (p = 0.030) and disease-free survival (p = 0.019) in patients with stage ypI. The newly developed ypTNM-cN staging exhibited a superior alignment with overall survival trends compared to the AJCC 8th ypTNM staging, with a significantly lower AIC of 3143.014 versus 3149.950. This superiority was further supported by a BIC of 3146.605 compared to 3153.541. In terms of disease-free survival outcomes, the emerging ypTNM-cN staging, with AIC and BIC values of 3196.057 and 3199.648, respectively, outperformed the AJCC 8th ypTNM staging, which recorded values of 3203.853 and 3207.444.

Conclusion

We have devised a novel staging system based on ypTNM stage and cN status to accurately categorize patients with ypI stage. Our ypTNM-cN staging system offers valuable insights into the classification of ypI ESCC and demonstrates reliable classification efficacy for all ESCC patients following nCRT and surgery.
236. THE ROLE OF ADJUVANT THERAPY FOLLOWING NEOADJUVANT CHEMORADIOTHERAPY AND ESOPHAGECTOMY IN ESOPHAGEAL CANCER
Authors: Li Xiaokun , Yuan Yong
Published: September 2024

Background

The objective of this study was to assess the role of adjuvant therapy following neoadjuvant chemoradiotherapy and esophagectomy in esophageal squamous cell carcinoma (ESCC).

Methods

We conducted a retrospective analysis involving 506 ESCC patients who underwent trimodal therapy. The clinical significance of adjuvant therapy on overall survival and disease-free survival was evaluated using Kaplan–Meier curves with log-rank tests, the Cox regression model, and a forest plot displaying hazard ratios (HR) with 95% confidence intervals.

Results

Among the 506 patients who had clinically positive lymph nodes and no metastasis after neoadjuvant chemoradiotherapy and esophagectomy, those who received adjuvant therapy exhibited shorter post-resection overall survival (OS) and disease-free survival (DFS), with a statistically significant difference between the two groups (Log-Rank, OS: P = 0.002; DFS: P < 0.001). Adjuvant therapy was not identified as an independent prognostic factor for OS (HR: 1.249; 95% CI: 0.869-1.796; P = 0.230), but it was a significantly unfavorable independent prognostic factor for DFS (HR: 1.868; 95% CI: 0.349-2.586; P < 0.001).

Conclusion

Adjuvant therapy is associated with poorer overall survival (OS) and disease-free survival (DFS) outcomes in ESCC patients with ypTNM stage I and II on final pathology following neoadjuvant chemoradiotherapy and esophagectomy. However, there was no significant difference observed in patients with ypTNM stage III or IV. Therefore, it is not recommended to undergo postoperative adjuvant therapy for patients with ypTNM stage I and II ESCC. However, for patients with ypTNM stage III and IV ESCC, further research is needed to explore adjuvant treatment strategies.