bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of pseudo-random number on the security of quantum key distribution protocol
Authors: Yang 杨 Xiao-Liang 晓亮 , Li 李 Yu-Qing 毓擎 , Li 李 Hong-Wei 宏伟
Published: December 2024

In the process of quantum key distribution (QKD), the communicating parties need to randomly determine quantum states and measurement bases. To ensure the security of key distribution, we aim to use true random sequences generated by true random number generators as the source of randomness. In practical systems, due to the difficulty of obtaining true random numbers, pseudo-random number generators are used instead. Although the random numbers generated by pseudo-random number generators are statistically random, meeting the requirements of uniform distribution and independence, they rely on an initial seed to generate corresponding pseudo-random sequences. Attackers may predict future elements from the initial elements of the random sequence, posing a security risk to quantum key distribution. This paper analyzes the problems existing in current pseudo-random number generators and proposes corresponding attack methods and applicable scenarios based on the vulnerabilities in the pseudo-random sequence generation process. Under certain conditions, it is possible to obtain the keys of the communicating parties with very low error rates, thus effectively attacking the quantum key system. This paper presents new requirements for the use of random numbers in quantum key systems, which can effectively guide the security evaluation of quantum key distribution protocols.
Rabbit heart bioartificial tissue: perfusion decellularization and characterization
Authors: Seitzhaparova Banu , Timur Leya , Mirasbek Baisunkar , Kadyr Sanazar , Lesbekov Timur , Zhakypbekova Aida , Erisken Cevat
Published: December 2024

Despite new approaches in the treatment of cardiovascular disease (CVD) such as percutaneous coronary intervention, coronary artery bypass graft, and left ventricular assist devices, which cannot fully compensate for the effectiveness of the original heart, heart transplantation still remains as the most effective solution. A growing body of literature recognizes the importance of developing a whole heart constructed from living tissues to provide an alternative option for patients suffering from diseases of the cardiovascular system. A potential solution that shows a promise is to generate cell-free, i.e., decellularized, scaffolds using native heart tissue to be later cellularized and transplanted. This study reports the decellularization process and efficiency in an effort to create a whole heart scaffold. The hearts harvested from rabbits were perfused and the final bioartificial scaffolds were characterized for the efficiency of decellularization in terms of DNA content, collagen, and glycosaminoglycan. The compressive biomechanical properties of decellularized and native hearts were also determined and compared. Findings revealed that the DNA content of decellularized hearts was significantly reduced while keeping collagen and GAG content unchanged. Biomechanical properties of the hearth became inferior upon removal of the nuclear material. Decellularized hearts have significant importance in treating CVD as they serve as bioartificial hearts, providing a more clinically relevant model for potential human use. Future work will focus on the recellularization of the heart using induced pluripotent or embryonic stem cells to test its functionality.
A compact multiband flexible antenna with a full ground plane for off body communication
Authors: Praveena A , Umamaheswari G , Dhayanithi G , Rai Jayant Kumar , Ranjan Pinku
Published: December 2024

A compact, multiband flexible antenna for off-body communication at 2.45 GHz and ultrawideband (UWB) low and high bands is presented as required by the IEEE 802.15.6™ standard, 2012. The antenna exhibits a directional radiation pattern and provides good gain along with a low specific absorption rate (SAR). The proposed antenna has a compact footprint of 44 × 32 × 1.5 mm3. It is fabricated by placing conductive fabric on a 1.5 mm thick polydimethylsiloxane (PDMS) polymer to enhance flexibility and durability. A full ground made of conductive textile is used on the underside of the dielectric to reduce the load directed toward the antenna from the layers of human tissue beneath it and to minimize back radiation from the human body. The proposed antenna design combines square and circular rings to achieve multiband characteristics. Edge chamfering, slotting, and stub addition are employed as bandwidth expansion techniques to achieve wide bandwidth. The antenna demonstrates exceptional resistance to the human body’s load and physical deformation. To the authors knowledge it is the compact single-layer substrate flexible FGP antenna operable in the WLAN (2.45 GHz), lower (3.2–4.6 GHz), and higher UWB (6.2–11 GHz) bands specified by IEEE 802.15.6.
Tapered curved-beam hinges for electret-based vibration energy harvesting devices
Authors: Hah Dooyoung
Published: December 2024

Interest in vibration energy harvesting have been growing recently for various applications. One of the major development goals for vibration energy harvesters has been improvement in energy conversion efficiency. To pursue that goal, one of the main approaches has been to broaden the spectra of harvesters. Employment of nonlinear springs, such as curved-beam hinges, has proven to be effective for that purpose. The main contribution of the current study is to introduce a lateral taper to the curved beam so as to further optimize the harvester performances. Via numerical analysis by using stochastic differential equations, the study shows that at 0.05g of vibration strength, tapered curved-beam hinges can result in higher electric power output than the non-tapered ones. Deformation-induced stress was taken into consideration as well, in reference to the fracture strength of the material (single-crystal silicon). At lower vibration strength (0.02g), spring nonlinearity becomes weaker, and as a result, the narrowest curved-beam hinge produces the highest output power. Overall, the current study demonstrates that tapering of the curved beam can be a useful addition in the vibration energy harvester design.
Optimization and experimental investigation of compression ignition diesel engine performance and emission characteristics with gulmohar biodiesel/diesel blends using response surface methodology
Authors: I Syed Sadiq Nawaz , M A Asokan
Published: December 2024

This research focuses on biodiesel production from Gulmohar seeds using the transesterification method, with methanol as a catalyst at a 75% yield of Gulmohar oil biodiesel. Further, the biodiesel mixed with diesel at various blend ratios such as B20, B30, B40 and B50 and physicochemical characteristics are examined. The experimental investigation of performance and emission characteristics on single cylinder diesel engine using gulmohar biodiesel and diesel blends and compare the results with those from diesel. According to the findings, B20 blend emission characteristics and performance are very similar to the diesel fuel trend. Under full load, the Brake Specific Fuel Consumption (0.305 kg kWh−1) and Brake thermal efficiency (26.02%) for the B20 blend, which is closer to diesel and variations are 4.81% and 8.1%, respectively. Throughout the experiment, HC, CO, and smoke emission parameters were either less or equal for gulmohar biodiesel and its blends compared to diesel. However, the NOx emission of the biodiesel blends is 2 to 12% higher than diesel, but B20 has a 2.35% higher and lowest value among all the other blends. In addition, a central composite design (CCD) model using Response Surface Methodology (RSM) will be created, and the outcomes of a Compression Ignition (CI) engine will be optimized. Both analyses concluded that B20 is the most optimal blend among other blends and serves as a substitute for diesel.
Beware of diffusion models for synthesizing medical images—a comparison with GANs in terms of memorizing brain MRI and chest x-ray images
Authors: Usman Akbar Muhammad , Wang Wuhao , Eklund Anders
Published: December 2024

Diffusion models were initially developed for text-to-image generation and are now being utilized to generate high quality synthetic images. Preceded by generative adversarial networks (GANs), diffusion models have shown impressive results using various evaluation metrics. However, commonly used metrics such as Frechet inception distance and inception score are not suitable for determining whether diffusion models are simply reproducing the training images. Here we train StyleGAN and a diffusion model, using BRATS20, BRATS21 and a chest x-ray (CXR) pneumonia dataset, to synthesize brain MRI and CXR images, and measure the correlation between the synthetic images and all training images. Our results show that diffusion models are more likely to memorize the training images, compared to StyleGAN, especially for small datasets and when using 2D slices from 3D volumes. Researchers should be careful when using diffusion models (and to some extent GANs) for medical imaging, if the final goal is to share the synthetic images.
Building Ethiopia’s food security resilience to climate and hydrological change
Authors: Murgatroyd Anna , Thomas Timothy , Koo Jawoo , Strzepek Kenneth , Hall Jim
Published: December 2024

Historically Ethiopia’s food security has been sensitive to climatic variability, but changes in future weather and climate could lead to overall reductions and increased variability in agricultural production, without further adaptation. We present an integrated modelling assessment framework which combines climate, crop, and hydrological modelling to quantify future risks to Ethiopia’s food security. We explore the impacts of 2°C and higher climate change scenarios on water availability and crop yields and simulate how future climate shocks may impact Ethiopia’s food. We consider three adaptations to agricultural management practices (improved seed varieties, increased use of nitrogen fertilizer and supplementary irrigation) and quantify their effectiveness in enhancing the resilience of Ethiopia’s food system to climate and hydrological change by 2050. Results show that, without policy intervention, climate change creates a risk of declining Meher season crop yields across Ethiopia. Under the worst climate change scenario, teff (−12.0%), barley (−6.7%), and wheat (−4.4%) are projected to have the largest decline in average yields, whilst maize (−0.1%) and sorghum (+0.9%) yields are less impacted thanks to more favourable growing conditions. However, the results also indicate that the adaptation options have a bigger beneficial effect than the climate impact. Of the policies evaluated, improved seeds have a relatively greater effect than increased fertilizer use. Supplementary irrigation could help to mitigate increases in crop water requirements under warmer climate conditions and is most effective in drought prone basins and for drought-vulnerable crops. Overall, the results show that locally relevant agricultural policies are necessary to build Ethiopia’s food system resilience to climate and hydrological change by the mid-century.
The number of symmetric chain decompositions
Authors: Tomon István
Published: December 2024

We prove that the number of symmetric chain decompositions of the Boolean lattice

2

[
n
]

2^{[n]}

is

(

n

2
e

+
o
(
n
)
)

2
n

.

\begin{equation*} \left (\frac {n}{2e}+o(n)\right )^{2^n}. \end{equation*}

Furthermore, the number of symmetric chain decompositions of the hypergrid

[
t

]
n

[t]^n

is

n

(
1
−

o
n

(
1
)
)
⋅

t
n

.

\begin{equation*} n^{(1-o_n(1))\cdot t^n}. \end{equation*}
The Fokker–Planck–Kolmogorov equation with nonlinear terms of local and nonlocal type
Authors: Bogachev V. , Salakhov D. , Shaposhnikov S.
Published: December 2024

Nonlinear Fokker–Planck–Kolmogorov equations are investigated. Sufficient conditions are obtained for the existence and uniqueness of a nonnegative solution with a prescribed value of the integral. Convergence of solutions for the Cauchy problem to a solution of the stationary equation is shown. An important distinction from the known results is a very general form of the nonlinearity, which makes it possible to consider simultaneously a local and nonlocal dependence of coefficients on solutions.
A Palm hierarchy for determinantal point processes with the confluent hypergeometric kernel, which resolves the problem of harmonic analysis on the infinite-dimensional unitary group
Authors: Bufetov A.
Published: December 2024

The main result of this note is that the shift of the parameter by 1 in the parameter space of decomposing measures in the problem of harmonic analysis on the infinite-dimensional unitary group corresponds to taking the reduced Palm measure at infinity for the decomposing measures in question. The proof proceeds by finite-dimensional approximation of the measures by orthogonal polynomial ensembles. The key remark is that taking the reduced Palm measure commutes with the scaling limit transition from finite to infinite particle systems.
Normalized ground state solutions for the fractional Sobolev critical NLSE with an extra mass supercritical nonlinearity
Authors: Zuo Jiabin , Zhong Yuyou , Repovš D.
Published: December 2024

This paper is concerned with the existence of normalized ground state solutions for the mass supercritical fractional nonlinear Schrödinger equation involving a critical growth in the fractional Sobolev sense. The compactness of Palais–Smale sequences will be obtained by a special technique, which borrows from the ideas of Soave (J. Funct. Anal. 279 (6) (2020), art. 1086102020). This paper represents an extension of previously known results, both in the local and the nonlocal cases.
On 𝛾_{ℒ}-capacities of Cantor sets
Authors: Mazalov M.
Published: December 2024

Let

C

\mathcal {C}

be a homogeneous elliptic second-order differential operator in

R

d

\mathbb {R}^d

,

d
≥
3

d\ge 3

, with constant complex coefficients. In terms of the capacities

γ

C

\gamma _{\mathcal {C}}

, the removable singularities of

L

∞

\mathrm {L} ^{\infty }

-bounded solutions of the equations

C

f
=
0

\mathcal {C} f=0

are described. For Cantor sets in

R

d

\mathbb {R}^d

it is shown that

γ

C

\gamma _{\mathcal {C}}

is comparable with classical harmonic capacities of the potential theory for all

C

\mathcal {C}

and corresponding

d
d

.
Prevalence of Cronobacter spp. in Tropical Seafood From Mumbai, India: Comparative Study of Isolation Media and PCR Detection
Authors: Bharti Deeksha , Lekshmi Manjusha , Kumar Sanath H , Nayak Binaya Bhusan
Published: December 2024

Background

Cronobacter species are opportunistic emerging pathogens associated with diverse foods of plant and animal origin. Considering the diversity of the Cronobacter group of bacteria and their co-existence with closely related Enterobacterales in the aquatic environment, their isolation from fish and shellfish is a challenge.

Objective

This study aimed to investigate the incidence of Cronobacter in finfish, shellfish, and dried fish, and to compare nine combinations of enrichment broth–selective isolation media for efficient isolation of Cronobacter spp.

Methods

Seventy-five seafood samples collected from five different retail markets were subjected to multiple selective-enrichment methods to isolate Cronobacter, which were presumptively identified by biochemical tests followed by confirmation with genus- and species-specific PCRs.

Results

Of 75 seafood samples analyzed, 24 (32%) were positive for Cronobacter spp. The highest incidence was in dried fish (21 samples, 47.72%), followed by 19 (43.18%) fresh finfish and four (9.09%) shellfish samples. Forty-four isolates from these samples were identified as Cronobacter spp. by PCR. Species-specific PCR further categorized these as C. sakazakii (25), C. malonaticus (16), and C. turicensis (1), while two isolates remained unidentified at species level. Enrichment in Cronobacter screening broth or Rappaport Vassiliadis (RV) medium, followed by isolation on chromogenic Cronobacter sakazakii agar was found to be the most effective combination for the isolation of Cronobacter spp. from seafood.

Conclusions

Dried fish is an important reservoir of C. sakazakii owing to its desiccation tolerance and absence of competing microbiota in dried fish. Although C. sakazakii is the only known pathogen among Cronobacter spp., improved and specific methods to identify diverse members of this genus are needed.

Highlights

Cronobacter sakazakii and C. malonaticus are predominant in tropical seafood. RV with chromogenic CS agar is the most efficient isolation medium for Cronobacter. Specificity of existing PCRs is limited to C. sakazakii and C. malonaticus only. Genus- and species-specific PCRs enhance Cronobacter identification.
Forearm mystery: rare flexor carpi radialis muscle cysticercosis
Authors: Khurram Mohd Fahud , Singh Nimisha
Published: December 2024

This case report describes a rare instance of muscle cysticercosis in a 16-year-old vegetarian female from an endemic region, highlighting the challenges in diagnosing atypical presentations of the disease. The patient presented with a 2-month history of persistent pain and swelling in the right forearm, which did not respond to over-the-counter analgesics. A clinical examination identified a non-tender, immobile swelling, and imaging studies suggested cysticercosis. Despite treatment with albendazole and non steroidal anti-inflammatory drugs (NSAIDs), the swelling persisted, necessitating surgical intervention. The excised cyst was confirmed as cysticercosis through histopathological examination. This case underscores the importance of considering cysticercosis in the differential diagnosis of soft tissue swellings, particularly in endemic areas, and emphasizes the role of imaging and histopathology in ensuring accurate diagnosis. Preventive measures such as improved sanitation and hygiene are crucial in controlling the spread of cysticercosis.
Quality of life and clinical gout assessments during pegloticase with and without methotrexate co-therapy: MIRROR randomized controlled trial exploratory findings
Authors: Botson John , Obermeyer Katie , LaMoreaux Brian , Padnick-Silver Lissa , Verma Supra , Weinblatt Michael E , Peterson Jeff
Published: December 2024

Objectives

Pegloticase lowers serum urate (SU) but is limited by anti-drug antibodies. Methotrexate (MTX) co-administration increases urate-lowering response rate and decreases infusion reaction risk. This is of importance in uncontrolled gout patients who have few treatment options and highly impacted quality of life (QOL). Here, we report exploratory QOL/clinical endpoints of MIRROR RCT (NCT03994731).

Methods

Patients with uncontrolled gout (sUA ≥ 7 mg/dl, urate-lowering tehraoy (ULT) failure/intolerance, and ≥1 gout sign/symptom [≥1 tophus, ≥2 flares in past year, chronic gouty arthritis]) were administered pegloticase (biweekly 8 mg infusion; 52 weeks) with oral MTX (15 mg/week) or placebo co-therapy. Key exploratory outcomes included change from baseline (CFB) in Physician Global Assessment of Gout [PhGA, score: 0–10], CFB in tender/swollen joint counts [TJC/SJC, score: 0–68/0–66], and gout chronic response rate (GCR50, GCR70; 50%/70% reduction in ≥3 of TJC, SJC, HAQ-Health, HAQ-Pain). Least-square mean (±S.E.) CFB to week 52 was estimated using a mixed model for repeated measures.

Results

In total, 100 patients were randomized to pegloticase + MTX; 52 to pegloticase + PBO. At baseline, patients had poor overall health (HAQ-Health [MTX, PBO]: 44.9 ± 28.6, 39.1 ± 27.4; PhGA: 5.5 ± 2.1, 5.4 ± 2.2) and many affected joints (TJC: 5.4 ± 7.8, 6.7 ± 8.4; SJC: 8.3 ± 12.2, 11.0 ± 15.9). QOL progressively improved during treatment, with similar CFB at week 52 in MTX vs. PBO groups in PhGA (−4.2 ± 0.2 vs. −3.8 ± 0.3) and TJC/SJC (−6.1 ± 0.5 vs. −7.0 ± 0.8/−5.1 ± 0.4 vs. −6.0 ± 0.6). However, at week 52, more MTX patients met GCR50 (58.0% vs. 38.5%) and GCR70 (52.0% vs. 30.8%) criteria.

Conclusion

In the MIRROR RCT, pegloticase treatment with or without MTX co-therapy led to meaningful clinical/QOL improvements in uncontrolled gout patients. However, patients receiving MTX co-therapy had greater benefits because of a higher sustained SU-lowering rate (60.0% vs. 30.8% in the PBO group at week 52).

Trial registration

ClinicalTrials.gov, http://clinicaltrials.gov, NCT03994731.
Untreated Osteoporosis in Lumbar Fusion Surgery Patients
Authors: Köhli Paul , Hambrecht Jan , Wang Shu-Han , Zhu Jiaqi , Chiapparelli Erika , Schönnagel Lukas , Guven Ali E. , Evangelisti Gisberto , Kienzle Arne , Shue Jennifer , Tsuchiya Koki , Burkhard Marco D. , Pumberger Matthias , Sama Andrew A. , Girardi Federico P. , Cammisa Frank P. , Hughes Alexander P.
Published: December 2024

Study Design.

Secondary analysis of a prospective single-center study.

Objective.

To analyze the prevalence and risk factors for untreated osteoporosis in patients undergoing lumbar spinal fusion surgery (LFS) and its impact on bone mineral density (BMD) and bone turnover markers.

Background.

Osteoporosis is a risk factor for mechanical complications in LFS, which can be mitigated by antiosteoporotic treatment. However, there is limited research on factors leading to untreated osteoporosis before LFS and its impact on preoperative bone status.

Materials and Methods.

A secondary analysis of a prospective study enrolling adults undergoing LFS for degenerative conditions (2014–2024) with preoperative quantitative CT osteoporosis screening was performed. Demographic data and medical history were analyzed for prevalence and risk factors of untreated osteoporosis, while BMD, vitamin D, PTH levels, and bone turnover markers were assessed for the effects of lacking treatment.

Results.

A total of 445 patients (48% female, median age 64) were included, of which 137 patients (31%) had osteoporosis. Of these, 66 (48%) were untreated and 71 (52%) were treated, with 40 (56%) receiving pharmacological and 31 (44%) nonpharmacologic treatment, including vitamin D supplementation and lifestyle modifications. Of the untreated patients, 55 (80%) were identified by preoperative screening. Seventy-one percent of osteoporotic men versus 35% of osteoporotic women were untreated (P<0.001). Multivariable logistic regression confirmed male sex as a significant contributing factor (OR: 4.3, 95% CI: 1.9–10.1, P<0.001) for untreated osteoporosis. Treated osteoporotic patients had higher BMD (P<0.001), higher vitamin D levels (P=0.023), and lower levels of bone resorption parameters (P=0.004) than untreated patients.

Conclusion.

Untreated osteoporosis is common before LFS, especially in men, with untreated having lower BMD and higher bone resorption marker levels than treated patients. Identification of osteoporotic cases and subsequent osteological optimization could potentially reduce the risks of adjacent fractures or screw loosening.
The Impact of Proton Pump Inhibitor Use on Fusion Rates Following Single-level Anterior Cervical Discectomy and Fusion
Authors: Chang Yu , Huang Chih-Yuan , Chuang Ming-Tsung , Chi Kuan-Yu , Song Junmin , Lin Hong-Min
Published: December 2024

Study Design:

Cohort study.

Objective:

This study explores how proton pump inhibitors (PPIs) affect fusion rates following anterior cervical discectomy and fusion (ACDF), using a large-scale data analysis.

Background:

ACDF is essential for treating cervical disc herniation leading to myelopathy and radiculopathy, involving disc removal and vertebral fusion, crucial for long-term stability and symptom relief. Notably, PPIs, which are commonly prescribed for acid-related disorders, have been linked to altered bone health and healing processes.

Materials and Methods:

Utilizing the TriNetX network database spanning from 2008 to 2023, we identified patients undergoing single-level ACDF, classified into cohorts based on PPI usage following ACDF. A 1:1 propensity score matching was performed to balance demographics and comorbidities between the two groups. The study focused on the incidence of non-fusion, indicated by the International Classification of Disease-10 code M96.0, within 6 months to 2 years postoperatively.

Results:

The initial cohort comprised 1269 PPI users and 23,932 non-users, adjusted to 1266 per group after matching. Postmatching analysis indicated minimal differences in demographics and comorbidities between the cohorts. Our results showed that postoperative PPI users have a significantly higher risk of non-fusion following single-level ACDF surgery at 1 year (odds ratio: 1.35, 95% CI: 1.05–1.73) and 2 years (odds ratio: 1.42, 95% CI: 1.11–1.81) follow-up.

Conclusions:

Our study showed a significant link between postoperative PPI use and increased long-term pseudarthrosis risk after ACDF surgery. These findings suggest careful consideration of PPI use in these patients.
aYAP1-2 contributes to bFGF-induced proliferation In gastric cancer
Authors: Chen Hui , Xue Di-Kai , Wang Yi-Xuan , Jiang Tian-Fang
Published: December 2024

Gastric cancer (GC) is one of the leading causes of cancer-related deaths in humans worldwide. Fibroblast growth factor family (FGFs) and the Hippo signaling pathway play an important role in the epithelial-mesenchymal transition (EMT) process of GC. YAP1, a key mediator of the Hippo pathway, plays an important role in tumor genesis. Alternative splicing of human YAP1 mRNA results in two major isoforms: YAP1-1, which contains a single WW domain, and YAP1-2, which contains two WW domains, respectively. There are significant differences in post-transcriptional regulation and function. Basic FGF (bFGF) treatment promoted the EMT process of most GC cell lines, and the proliferation ability was enhanced. This process may be related to the upregulation of YAP1, the proliferation ability of GC was significantly alleviated upon YAP1 knockdown. bFGF treatment can induce EMT of GC through YAP1-2 and enhance their proliferative ability. In this process, bFGF may enhance the nuclear localization of YAP1-2.In the mouse model of intraperitoneal implantation tumorigenesis, it was shown that under the action of bFGF, the expressing YAP1-2 cell lines could form larger tumors than the expressing YAP1-1, but both of them were larger than the YAP1 knockdown. Our results show that YAP1-2 is the main subtype of bFGF-induced EMT and proliferation of GC cells.
YKL-06-061 exerts antitumor effect through G1/S phase arrest by downregulating c-Myc and inhibition of metastasis via SIK1 upregulation in pancreatic cancer
Authors: Zeng Chao-Yang , Wang Wen-Die , Shang Yue , Xi Shuo-Han , Li Li-Ping , Chen Shu-Zhen
Published: December 2024

Pancreatic cancer ranks fourth among cancer-related deaths with a low 5-year overall survival rate of less than 13%. At present, treatment of pancreatic cancer is still based on chemotherapy, but the efficacy is limited. Thus, a novel therapeutic agent for pancreatic cancer therapy is urgently needed. A library of compounds was screened, and YKL-06-061, a selective inhibitor of salt-inducible kinases (SIKs), was discovered for its ability of inhibiting the proliferation and metastasis of pancreatic cancer cells in vitro and reducing the growth of xenografts in nude mice in vivo. The results from transcriptome analysis showed that YKL-06-061 influenced the mRNA levels of many genes related to c-Myc and SIK1 signals. Based on this, it was found that YKL-06-061 induced cell cycle arrest at the G1 phase and decreased the levels of c-Myc, CDK4, and cyclin D1 protein. At the same time, YKL-06-061 inhibited invasion and metastasis of cancer cells, increased the levels of SIK1 and E-cadherin protein, and lowered vimentin and ZEB-1. Moreover, YKL-06-061 effectively enhanced the antiproliferation of gemcitabine or doxorubicin in pancreatic cancer cells in a synergistic manner. Collectively, these findings implicate YKL-06-061 as a promising therapeutic agent for patients with pancreatic cancer.
Case Report: A Comprehensive Early Childhood Mental Health Evaluation for Children in the Foster Care System
Authors: Lucke Cara M. , Stone Katie J. , Gustafson Kimara , Kroupina Maria G.
Published: December 2024

Background:

Children in the foster care system often have a host of prenatal and postnatal risk factors that can compromise development including disruptions in important attachment relationships. We argue that to effectively address this complex history and inform specific recommendations for intervention, it is important for an Early Childhood Mental Health (ECMH) evaluation to include both an assessment of the caregiver-child relationship status and neurodevelopment.

Case presentation:

We describe an ECMH evaluation for a 21-month-old girl who was referred to a multidisciplinary birth to three specialty clinic for difficulties separating from her preadoptive mother, indiscriminate friendliness, and emotional and behavioral dysregulation. She had a history of prenatal substance exposure and several disruptions in important attachment relationships. We gained insight into the caregiver-child relationship through behavioral observations and used standardized testing to assess neurodevelopment. This combination of assessment techniques revealed inconsistencies in secure base attachment patterns between the parent and child. She also performed lower than what would be expected for her age across several domains of development.

Conclusion:

This case highlights a comprehensive approach to an ECMH evaluation. Recommendations for intervention prioritized the parent-child relationship given the importance of attunement between caregiver and child to first optimize stress regulation and thus set the foundation for higher-order cognitive processes to develop.
Deep Learning for Automated Segmentation of Basal Cell Carcinoma on Mohs Micrographic Surgery Frozen Section Slides
Authors: Varra Vamsi , Shahwan Kathryn T. , Johnson Kirsten , Kirven Rachel M. , Walker Trent D. , Geijs Daan , Litjens Geert , Carr David R.
Published: December 2024

BACKGROUND

Deep learning has been used to classify basal cell carcinoma (BCC) on histopathologic images. Segmentation models, required for localization of tumor on Mohs surgery (MMS) frozen section slides, have yet to reach clinical utility.

OBJECTIVE

To train a segmentation model to localize BCC on MMS frozen section slides and to evaluate performance by BCC subtype.

MATERIALS AND METHODS

The study included 348 fresh frozen tissue slides, scanned as whole slide images, from patients treated with MMS for BCC. BCC foci were manually outlined using the Grand Challenge annotation platform. The data set was divided into 80% for training, 10% for validation, and 10% for the test data set. Segmentation was performed using the Ultralytics YOLOv8 model.

RESULTS

Sensitivity was .71 for all tumors, .87 for nodular BCC, .79 for superficial BCC, .74 for micronodular BCC, and .51 for morpheaform and infiltrative BCC. Specificity was .75 for all tumors, .59 for nodular BCC, .58 for superficial BCC, .83 for micronodular BCC, and .74 for morpheaform and infiltrative BCC.

CONCLUSION

This study trained a segmentation model to localize BCC on MMS frozen section slides with reasonably high sensitivity and specificity, and this varied by BCC subtype. More accurate and clinically relevant performance metrics for segmentation studies are needed.
Microfocused Ultrasound With Visualization: A Systematic Review of Adverse Events and Risk of Subsequent Facelift Compromise
Authors: Humphrey Victoria S. , Rambhia Pooja H. , Gmyrek Robyn , Chapas Anne
Published: December 2024

BACKGROUND

Plastic surgery colleagues have expressed unconfirmed concerns regarding the deleterious implications of noninvasive energy-based therapies for skin laxity, such as microfocused ultrasound with visualization (MFU-V), on preexisting facial fat or subsequent surgical facelifts.

OBJECTIVE

The authors conducted a systematic review to summarize treatment-related adverse events (TRAEs) following MFU-V and elucidate their impact on future rhytidectomies.

MATERIALS AND METHODS

The authors performed a PubMed/MEDLINE search using the keywords “MFU-V,” “fat loss,” “adverse events,” “facelift,” and their derivatives. In addition, the authors searched the manufacturer and user facility device experience (MAUDE) database using the brand name “Ulthera.”

RESULTS

Nineteen articles with data on 506 patients were identified. Transient edema, erythema, and postprocedural pain were observed most often. Instances of significant TRAEs were limited in the scientific literature, apart from 1 case of subcutaneous atrophy. Data from 106 records were extracted from the MAUDE database. Notably, lipoatrophy, neurologic sequelae (including nerve damage, focal numbness, dysesthesia, and ptosis), and scarring were reported with the most frequency. There was 1 report of facelift compromise.

CONCLUSION

While the scientific literature lacks supporting evidence regarding the impact of MFU-V on subsequent facelift procedures, anecdotal, largely unverified reports exist. Hence, peer-reviewed literature detailing such occurrences would be valuable in understanding the potential ensuing risks.
Menopausal age, adipokines, and heart failure incidence in postmenopausal women of the Multi-Ethnic Study of Atherosclerosis
Authors: Ebong Imo A. , Wilson Machelle , Michos Erin D. , Appiah Duke , Schreiner Pamela J. , Racette Susan B. , Allison Matthew , Watson Karol , Bertoni Alain
Published: December 2024

Objective

The mechanisms through which menopausal age influences heart failure (HF) development are controversial. Adiposity increases after menopause and could affect HF risk by influencing serum adipokine secretion. We investigated the associations of early menopause, and serum adipokines with incident HF in postmenopausal women.

Methods

We included 746 postmenopausal women from the Multi-Ethnic Study of Atherosclerosis who reported their menopausal age and had data on adipokines and incident HF at the end of follow-up. Multivariable Cox proportional hazards models were used for analysis.

Results

The mean age was 65.1 years. Over a median follow-up period of 17.8 years, 45 HF events occurred. After adjusting for waist circumference, other cardiovascular disease risk factors and myocardial infarction, the hazard ratios (95% confidence intervals) of incident HF attributable to early menopause were 4.50 (1.41-14.3), 4.64 (1.46-14.7), and 5.16 (1.59-16.7) in models that additionally included adiponectin, leptin, and resistin, respectively. In adjusted analyses, adiponectin was independently associated with incident HF 2.20 (1.35-3.57), while leptin and resistin were not. The interaction terms of early menopause with adiponectin, leptin, and resistin for incident HF were not significant (P
int = 0.08-0.82).

Conclusions

Early menopause was significantly associated with incident HF. This association did not differ by serum adipokine levels. Only adiponectin was independently associated with incident HF in postmenopausal women when waist circumference, body mass index, and waist-hip ratio were used as the adiposity metric.
Management of Complex Postburn Scar Contracture of the Dorsum of Pediatric Hand
Authors: Akkour Mousa , Almadani Jamal , Alammar Alwaleed , Alsaeed Ahmed , Alshammery Ahmad , Gabr Mostafa , Al-Qattan Mohammed
Published: December 2024

This case report details the challenging management of a 3-year-old girl with a severe left-hand extension contracture resulting from a scald burn. Delayed presentation prompted a 2-stage surgical approach. The first stage involved excising contracted skin and using a groin flap for reconstruction. Two weeks later, donor site closure was performed. The patient later underwent syndactyly release and extensor tenotomy, achieving significant metacarpophalangeal and proximal interphalangeal joint flexion. This case underscores the importance of burn injury intervention and reconstructive surgery for functional and aesthetic outcomes in challenging hand deformities.
Optical Microangiography and Progressive Retinal Nerve Fiber Layer Loss in Primary Angle Closure Glaucoma
Authors: Rao Harsha L. , Dasari Srilakshmi , Puttaiah Narendra K. , Pradhan Zia S. , Moghimi Sasan , Mansouri Kaweh , Webers Carroll A.B. , Weinreb Robert N.
Published: December 2024

Précis:

Younger patient age (coefficient: 0.10, P=0.04) and greater peak IOP during follow-up (coefficient: −0.14, P=0.03), but not baseline optical microangiography parameters, were significantly associated with a faster rate of RNFL loss in mild-moderate PACG.

Purpose:

To evaluate the association between optical microangiography (OMAG) measurements and progressive retinal nerve fiber layer (RNFL) loss in primary angle closure glaucoma (PACG).

Methods:

In a prospective study, 45 eyes of 30 PACG patients (86 hemifields) with mild to moderate functional damage were longitudinally studied for at least 2 years and with a minimum of 3 optical coherence tomography (OCT) examinations. OMAG imaging was performed at the baseline visit. Effect of clinical parameters (age, sex, presence of systemic diseases, central corneal thickness, mean, peak, and fluctuation of intraocular pressure during follow-up), baseline hemifield mean deviation (MD) and baseline OMAG [quadrant peripapillary and macular perfusion density(PD)] on the rate of RNFL change was evaluated using linear mixed models.

Results:

The average (±SD) hemifield MD, RNFL thickness, peripapillary PD and macular PD of the analyzed quadrants at baseline were −6.0±3.4 dB, 89±21 µm, 40.1±3.5%, and 29.6±10.3%, respectively. The rate of quadrant RNFL change was −2.5±1.7 µm/year. Multivariate mixed models showed that younger patient age (coefficient: 0.10, P=0.04) and higher peak IOP during follow-up (coefficient: −0.14, P=0.03) were significantly associated with a faster rate of RNFL loss.

Conclusions:

Younger patient age and greater peak IOP during follow-up were significantly associated with a faster rate of RNFL loss in PACG patients with mild to moderate severity of functional damage. None of the OMAG parameters at baseline were associated with RNFL thinning suggesting a limited role of OCTA imaging in predicting structural progression in mild-moderate PACG.
Midterm Effects of SARS-CoV-2 on Respiratory Function in Judokas With and Without Exercise-Induced Bronchoconstriction: A Retrospective Study
Authors: Bostancı Özgür , Karaduman Emre , Yılmaz Ali Kerim , Kabadayı Menderes , Bilgiç Sait
Published: December 2024

Objectives:

The clinical consequences of coronavirus infection in elite judokas with exercise-induced bronchoconstriction (EIB) are unclear. We aimed to determine potential respiratory function abnormalities and recovery in athletes with and without EIB after severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection.

Design:

Retrospective cohort study.

Setting:

Türkiye Olympic Preparation Centre.

Participants:

This retrospective study analyzed data collected from 25 consecutive elite judokas diagnosed with and without EIB and SARS-CoV-2 infection, routinely followed at an Olympic Sports Center between September 2020 and 2021.

Independent Variables:

Respiratory muscle strength and pulmonary function data were collected before and up to 90 days after SARS-CoV-2 infection.

Main Outcome Measures:

Measurements included maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, and peak expiratory flow (PEF).

Results:

Infected athletes with EIB had more markedly reduced respiratory muscle strength and pulmonary function than those without EIB. Maximal inspiratory pressure was decreased by 14% and MEP by 8% from baseline in infected athletes with EIB during follow-up. Likewise, FEV1 and FVC decreased by 4%. Maximal inspiratory pressure, MEP, FEV1, and FVC remained abnormal after 90 days of SARS-CoV-2 infection in EIB athletes but normalized rapidly in non-EIB athletes. Peak expiratory flow seemed unaffected during follow-up. Exercise-induced bronchoconstriction severity was moderately correlated with the maximum fall in MEP during follow-up.

Conclusions:

Severe acute respiratory syndrome coronavirus-2 infection notably decreases respiratory muscle strength and pulmonary function in judokas, especially those with pre-existing EIB, thereby prolonging spontaneous recovery time.
Preferences and Acceptability of Testing for Sexually Transmitted Infections in an HIV Pre-Exposure Prophylaxis clinic in Hanoi, Vietnam
Authors: Bui Hao T. M. , Adamson Paul C. , Nguyen Thanh C. , Dau Nguyen S. , Nguyen Khanh D. , Pham Loc Q. , Le Giang M. , Klausner Jeffrey D.
Published: December 2024

Background

Men who have sex with men (MSM) using HIV Pre-Exposure Prophylaxis (PrEP) are a vulnerable population with a high prevalence of sexually transmitted infections (STIs). Self-collection of specimens could improve STI testing, yet implementation in low-resource settings is limited. The study aimed to assess the feasibility and acceptability of self-collection for STI testing and to understand STI testing preferences among PrEP clients in Hanoi, Vietnam.

Methods

From January to December 2022 MSM aged 16 and older, participating in a clinic-based HIV PrEP program were enrolled. Participants self-collected pharyngeal, anal, and urine samples for Chlamydia trachomatis and Neisseria gonorrhoeae testing. Testing preferences were assessed through conjoint analysis using eight hypothetical testing profiles across five testing attributes; each profile was rated on a Likert scale (0-5) to create an impact score. Differences between attributes were assessed using a two-sided, one-sample t-test of the impact score.

Results

There were 529 participants enrolled; all were male. Specimens from three sites were provided by 97.9% (518/529). Mean satisfaction with self-collection was 4.3 (SD: 1.0), 99.4% reported they would perform again. In conjoint analysis, cost (free vs. $17USD) had the highest impact on testing preference (Impact Score: 25.2; p = <0.001). A one-week time to test result notification was preferred to 90 minutes (Impact Score: -0.8; p = 0.03).

Conclusion

We found high acceptability of self-collection for STI testing among HIV PrEP clients in Vietnam. Cost was the most important factor affecting testing uptake. Expanding self-collection and lowering costs could improve STI testing in HIV PrEP programs.
The Environmental Impact of Iodinated Contrast Media: Strategies for Optimized Use and Recycling
Authors: Toia Giuseppe V. , Ananthakrishnan Lakshmi
Published: December 2024

Iodinated contrast media (ICM) is an integral and ubiquitous component of modern diagnostic imaging. Although most radiology practices are familiar with ICM administration and physiological excretion, they may be less aware of how much ICM is wasted on a per exam basis. Furthermore, radiologists may not recognize the environmental fate of discarded ICM waste. In an evolving world where medical practices are increasingly cognizant of their environmental footprint and radiology practices are considered high consumers of resources, it behooves the radiology community to understand the ICM lifecycle and ways to mitigate unnecessary waste. This review article explains the origin and environmental fate of discarded ICM, with special focus on wastewater contamination. Secondly, the article focuses on feasible options to both optimize use and decrease consumable waste. Specifically, the article addresses ICM vial size inventory diversification, multi-use ICM vials, syringeless contrast injectors, and the potential for using multi-energy imaging (dual-energy or photon counting CT) to accomplish these goals. Finally, the authors share their institutional experience participating in an ICM recycling program and its current departmental impact.
Resident Education in the Age of AI
Authors: Gomez Erin , Lin Cheng Ting
Published: December 2024

Artificial intelligence (AI) is a rapidly expanding field of interest to radiologists for its utility as an adjunct in detecting and reporting disease and its potential influence on the role of radiologists and their practices. As radiology educators, we are responsible for developing and providing access to curricular elements that will prepare residents to be good stewards of artificial intelligence resources while also acquiring fundamental knowledge and skills that are essential to daily practice. Residency programs should consider collaborative approaches as well as solicit support from national societies in the development and curation of their AI curricula.
Posterior Maxillary Segmental Osteotomy for Management of Insufficient Intermaxillary Vertical Space: An Updated Treatment Sequence
Authors: Brito Gabriel Conceição , Peres Aline Coelho Gonzalez , Sverzut Alexander Tadeu
Published: December 2024

The effect of the time-to-treat for prosthetic rehabilitation of edentulous areas of the jaws can generate several intra-arch and inter-arch clinical changes over time, including alveolar or dentoalveolar block extrusion. To treat these conditions, posterior maxillary segmental osteotomy (PMSO) is a surgical option. This study reports a case of a patient who developed dentoalveolar block extrusion after postponing implant-supported prosthetic rehabilitation for 5 years. The PMSO was planned with the aid of model surgery and virtual planning. Under local anesthesia and oral sedation, the horizontal and vertical osteotomies were performed with a piezo saw and curved chisels. The block was fixed with a readapted titanium mesh, and an interim prosthesis was fixed on the dental implants. Although it’s a technique with a long-time description, few published cases were found. In this sense, there is a need to improve the planning methods and surgical techniques with new technologies and materials that increasingly favor the predictability of the procedure and comfort to the patient.
Predicting In-Hospital Mortality in Critical Orthopaedic Trauma Patients with Sepsis Using Machine Learning Models
Authors: Long Ze , Tan Shengzhi , Sun Baisheng , Qin Yong , Wang Shengjie , Han Zhencan , Han Tao , Lin Feng , Lei Mingxing
Published: December 2024

Purpose: This study aims to establish and validate machine learning-based models to predict death in hospital among critical orthopaedic trauma patients with sepsis or respiratory failure.

Methods: This study collected 523 patients from the Medical Information Mart for Intensive Care database. All patients were randomly classified into a training cohort and a validation cohort. Six algorithms, including logistic regression (LR), extreme gradient boosting machine (eXGBM), support vector machine (SVM), random forest (RF), neural network (NN), and decision tree (DT), were used to develop and optimize models in the training cohort, and internal validation of these models were conducted in the validation cohort. Based on a comprehensive scoring system, which incorporated ten evaluation metrics, the optimal model was obtained with the highest scores. An artificial intelligence (AI) application was deployed based on the optimal model in the study.

Results: The in-hospital mortality was 19.69%. Among all developed models, the eXGBM had the highest area under the curve (AUC) value (0.951, 95%CI: 0.934-0.967), and it also showed the highest accuracy (0.902), precise (0.893), recall (0.915), and F1 score (0.904). Based on the scoring system, the eXGBM had the highest score of 53, followed by the RF model (43) and the NN model (39). The scores for the LR, SVM, and DT were 22, 36, and 17, respectively. The decision curve analysis confirmed that both the eXGBM and RF models provided substantial clinical net benefits. However, the eXGBM model consistently outperformed the RF model across multiple evaluation metrics, establishing itself as the superior option for predictive modeling in this scenario, with the RF model as a strong secondary choice. The SHAP analysis revealed that SAPS II, age, respiratory rate, OASIS, and temperature were the most important five features contributing to the outcome.

Conclusions: This study develops an artificial intelligence application to predict in-hospital mortality among critical orthopaedic trauma patients with sepsis or respiratory failure.