bluuebunny/crossref_metadata_2025 huggingface dataset:
Statin treatment for primary and secondary prevention in elderly patients—a cross-sectional study in Stockholm, Sweden
Authors: Wettermark Björn , Kalantaripour Camelia , Forslund Tomas , Hjemdahl Paul
Published: July 2024

Background

Age is a major risk factor for atherosclerotic cardiovascular disease (CVD) and death, but there has been a debate about benefit-risk of statin treatment in the elderly with limited evidence on benefits for primary prevention, while there is strong evidence for its use in secondary prevention.

Aim

The aim of this study was to provide an overview of statin utilization in primary and secondary prevention for patients 75–84 years and ≥ 85 years in the Swedish capital Region Stockholm in 2019.

Methods

This is a cross-sectional study based on the regional healthcare database VAL containing all diagnoses and dispensed prescription drugs for all 174,950 inhabitants ≥ 75 years old in the Stockholm Region. Prevalence and incidence were analyzed by sex, age, cardiovascular risk, substance, and the intensity of treatment.

Results

A total of 35% of all individuals above the age of 75 in the region were treated with statins in 2019. The overall incidence in this age group was 31 patients per 1000 inhabitants. Men, individuals 75–84 compared to ≥ 85 years of age, and those with higher cardiovascular risk were treated to a greater extent. Simvastatin was used primarily by prevalent users and atorvastatin by incident users. The majority was treated with moderate-intensity dosages and fewer women received high intensity treatment.

Conclusions

Statins are widely prescribed in the elderly. Physicians seem to consider individual cardiovascular risk when deciding to initiate statin treatment for elderly patients, but here may still be some undertreatment among high-risk patients (especially women and elderly 85 + years) and some overtreatment among patients with low-risk for CVD.
Riding the storm: managing cytokine-related toxicities in CAR-T cell therapy
Authors: Hughes Andrew D. , Teachey David T. , Diorio Caroline
Published: July 2024

The advent of chimeric antigen receptor T cells (CAR-T) has been a paradigm shift in cancer immunotherapeutics, with remarkable outcomes reported for a growing catalog of malignancies. While CAR-T are highly effective in multiple diseases, salvaging patients who were considered incurable, they have unique toxicities which can be life-threatening. Understanding the biology and risk factors for these toxicities has led to targeted treatment approaches which can mitigate them successfully. The three toxicities of particular interest are cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and immune effector cell-associated hemophagocytic lymphohistiocytosis (HLH)-like syndrome (IEC-HS). Each of these is characterized by cytokine storm and hyperinflammation; however, they differ mechanistically with regard to the cytokines and immune cells that drive the pathophysiology. We summarize the current state of the field of CAR-T-associated toxicities, focusing on underlying biology and how this informs toxicity management and prevention. We also highlight several emerging agents showing promise in preclinical models and the clinic. Many of these established and emerging agents do not appear to impact the anti-tumor function of CAR-T, opening the door to additional and wider CAR-T applications.
Radiation exposure and estimated risk of radiation-induced cancer from thoracic and abdominal radiographs in 1307 neonates
Authors: Weiß Deliah , Beeres Martin , Rochwalsky Ulrich , Vogl Thomas J. , Schlößer Rolf
Published: July 2024

Objective

This study examined radiation exposure and the possible risk of radiation-induced cancer in a large sample of newborn and premature patients.

Material and methods

In this retrospective study, we included all hospitalised neonates treated at our university hospital who received at least one X-ray examination from 1 January 2013 to 31 December 2018. We evaluated the dose area product (DAP), effective dose (ED), and estimated risk. The International Commission on Radiological Protection Publication 60 defines values (2.8–13 × 10−2 Sv−1) to calculate the estimated risk in relation to the ED.

Results

Of the 3843 patients (aged 241.1 ± 35.45 days) treated in the neonatal care unit, 1307 (34%) received at least one X-ray. The mean number of X-ray examinations per patient was 3.19 and correlated negatively with birth weight. The mean cumulative DAP was 5.9 mGy*cm2, and the cumulative ED was 23.7 µSv per hospital stay. Patients with a birth weight of < 1000 g showed the highest cumulative ED and DAP (p < 0.001). Patients with a birth weight of < 2500 g had the highest ED and DAP per image (p < 0.001). The highest radiation exposure (ED/DAP) occurred for thoracic/abdominal examinations, especially for neonates < 500 g (p < 0.001).

Conclusion

There is a strong correlation between immaturity, the number of X-ray examinations, and radiation exposure. The total exposure was minimal, and the number of X-rays per patient has been decreasing in recent years.

Clinical relevance

Possible risks to newborns and premature infants caused by ionising X-rays are often the subject of scientific and clinical discussion. Nevertheless, conventional X-ray imaging remains a frequently used tool, and total exposure remains at a very low level.

Key Points

The number of X-rays per patient has been decreasing in a large university hospital.

Half of all patients received only one X-ray; most had a birth weight over 1500 g.

This radiation risk can be classified as ‘minimal’ for patients with a birth weight of < 500 g and as ‘negligible’ for others.
Automatic assessment of body composition in children with lymphoma: results of a [18F]FDG-PET/MR study
Authors: Giraudo Chiara , Cavallin Celeste , Pillon Marta , Carraro Elisa , Fichera Giulia , Cecchin Diego , Zucchetta Pietro
Published: July 2024

Objectives

To use Dixon-MR images extracted from [18F]FDG-PET/MR scans to perform an automatic, volumetric segmentation and quantification of body composition in pediatric patients with lymphoma.

Materials and methods

Pediatric patients with lymphoma examined by [18F]FDG-PET/MR at diagnosis and restaging were included. At each time point, axial fat and water Dixon T1w images of the thighs were automatically segmented and muscle volume, subcutaneous, intramuscular, and intermuscular fat volume were quantified. The metabolic activity of the largest nodal lesion and of muscles and subcutaneous fat was recorded. The paired samples t-test and Spearman’s correlation coefficient were applied to evaluate potential differences between the two time points and the relationship between metabolic and body composition metrics, respectively. By logistic regression analysis, the prognostic role of the investigated variables was assessed. The applied significance level was p < 0.05 for all analyses.

Results

Thirty-seven patients (mean age ± SD 14 ± 3-years-old; 20 females) matched the inclusion criteria. After chemotherapy (interval between the two PET/MR scans, 56–80 days; median 65 days), muscle volume significantly decreased (629 ± 259 cm3 vs 567 ± 243 cm3, p < 0.001) while subcutaneous, intramuscular and intermuscular fat increased (476 ± 255 cm3 vs 607 ± 254 cm3, p < 0.001; 63 ± 20 cm3 vs 76 ± 26 cm3, p < 0.001; 58 ± 19 cm3 vs 71 ± 23 cm3, p < 0.001); the metabolic activity of the main nodal lesion, muscles, and subcutaneous fat significantly decreased (p < 0.05, each). None of the examined variables acted as predictors of the response to treatment (p = 0.283). A strong correlation between BMI and subcutaneous fat volume at diagnosis (r = 0.675, p < 0.001) and restaging (r = 0.600, p < 0.001) emerged.

Conclusions

The proposed method demonstrated that pediatric patients with lymphoma undergo muscle loss and an increase of subcutaneous fat during treatment.

Clinical relevance statement

The proposed automatic and volumetric MR-based assessment of body composition in children with lymphoma can be used to monitor the effect of chemotherapy and may guide tailored exercise programs during chemotherapy.

Key Points

T1w Dixon images can be used for the automatic segmentation and quantification of body composition.

Muscle and subcutaneous fat volume do not act as predictors of the response to treatment in children with lymphoma.

Chemotherapy induces changes in body composition in children with lymphoma.
Population Lorenz-monotonic allocation schemes for TU-games
Authors: Izquierdo Josep M. , Montes Jesús , Rafels Carlos
Published: July 2024

Sprumont (Games Econ Behav 2:378–394, 1990) introduces population monotonic allocation schemes (PMAS) and proves that every assignment game with at least two sellers and two buyers, where each buyer-seller pair derives a positive gain from trade, lacks a PMAS. In particular glove games lacks PMAS. We propose a new cooperative TU-game concept, population Lorenz-monotonic allocation schemes (PLMAS), which relaxes some population monotonicity conditions by requiring that the payoff vector of any coalition is Lorenz dominated by the corresponding restricted payoff vector of larger coalitions. We show that every TU-game having a PLMAS is totally balanced, but the converse is not true in general. We obtain a class of games having a PLMAS, but no PMAS in general. Furthermore, we prove the existence of PLMAS for every glove game and for every assignment game with at most five players.

Additionally, we also introduce two new notions, PLMAS-extendability and PLMAS-exactness, and discuss their relationships with the convexity of the game.
Functional outcome after interdisciplinary, acute rehabilitation in COVID-19 patients: a retrospective study
Authors: Elmer Nancy , Reißhauer Anett , Brehm Katharina , Drebinger Daniel , Schaller Stefan J. , Schwedtke Christine , Liebl Max E.
Published: July 2024

Background

Survivors of severe COVID-19 often exhibit a variety of sequelae including loss of mobility and ADL (activities of daily living) capacity. Acute rehabilitation (AR) is an interdisciplinary rehabilitation intervention applied early while still in a hospital setting. The goal of AR is to improve functional limitations and to increase functional independence at discharge. It is established in the treatment of patients with other severe diseases such as sepsis, polytrauma, or stroke. Data concerning AR in COVID-19 are sparse.

Aim

To evaluate the changes in physical function during AR in patients after severe COVID-19.

Methods

This monocentric, retrospective observational study examined the functional outcomes of a sample of COVID-19-patients who received interdisciplinary AR at a university hospital. Inclusion criteria were a positive SARS-CoV-2 test in 05/2020–01/2022 and transfer to AR after intensive care treatment. 87 patients were elegible for evaluation, 3 of whom were excluded because of death during AR. Data were extracted from the hospital information system. In a pre-post analysis, mobility (Charité Mobility Index), ADL (Barthel Index), and oxygen demand were assessed. In addition, discharge location after AR, factors associated with AR unit length of stay, and functional improvements were analyzed.

Results

Data of 84 patients were analyzed. Mobility increased significantly from a median of 4 [1.25-6] CHARMI points at admission to a median of 9 [8.25-9] at discharge (p < 0.001). ADL increased significantly from a median of 52.5 [35.0-68.75] Barthel Index points at admission to a median of 92.5 [85–95] at discharge (p < 0.001). Oxygen demand decreased from 80.7 to 30.5% of patients. The majority (55.9%) of patients were discharged home, while 36.9% received direct follow-up rehabilitation. Older age correlated significantly with lower scores on the discharge assessment for mobility (Spearman’s ϱ = -0.285, p = 0.009) and ADL (Spearman’s ϱ = -0.297, p = 0.006).

Conclusion

Acute rehabilitation is a viable option for COVID-19 patients with severe functional deficits after ICU treatment to achieve functional progress in mobility and ADL, reduce oxygen requirements and enable follow-up rehabilitation.

Trial registration number and date of registration for prospectively registered trials

Trial registration number: DRKS00025239. Date of registration: 08 Sep 2021.
Physics-informed neural network estimation of material properties in soft tissue nonlinear biomechanical models
Authors: Caforio Federica , Regazzoni Francesco , Pagani Stefano , Karabelas Elias , Augustin Christoph , Haase Gundolf , Plank Gernot , Quarteroni Alfio
Published: July 2024

The development of biophysical models for clinical applications is rapidly advancing in the research community, thanks to their predictive nature and their ability to assist the interpretation of clinical data. However, high-resolution and accurate multi-physics computational models are computationally expensive and their personalisation involves fine calibration of a large number of parameters, which may be space-dependent, challenging their clinical translation. In this work, we propose a new approach, which relies on the combination of physics-informed neural networks (PINNs) with three-dimensional soft tissue nonlinear biomechanical models, capable of reconstructing displacement fields and estimating heterogeneous patient-specific biophysical properties and secondary variables such as stresses and strains. The proposed learning algorithm encodes information from a limited amount of displacement and, in some cases, strain data, that can be routinely acquired in the clinical setting, and combines it with the physics of the problem, represented by a mathematical model based on partial differential equations, to regularise the problem and improve its convergence properties. Several benchmarks are presented to show the accuracy and robustness of the proposed method with respect to noise and model uncertainty and its great potential to enable the effective identification of patient-specific, heterogeneous physical properties, e.g. tissue stiffness properties. In particular, we demonstrate the capability of PINNs to detect the presence, location and severity of scar tissue, which is beneficial to develop personalised simulation models for disease diagnosis, especially for cardiac applications.
Homosexualität im Alter – Wahrung der Identität im Pflegekontext. Eine Literaturübersicht.
Authors: Boldt Dietmar , Brandstötter-Gugg Cornelia
Published: July 2024

Für ältere und hochaltrige homosexuelle Menschen ist die Wahrung der Identität im Pflegekontext häufig erschwert. Neben der generell vorherrschenden Tabuisierung oder Abwertung von Sexualität im Alter sind homosexuelle Personen zusätzlich oft mit heteronormativen Strukturen bis hin zu Diskriminierungserlebnissen konfrontiert. Literatur zum ethischen Handeln im Gesundheitswesen greift den Anspruch der Nichtexklusivität auf. Achtung und Würde stehen hierbei an erster Stelle und sollen allen Personen gleichermaßen zukommen.

Diese systematische Literaturübersicht verfolgt das Ziel, anhand von wissenschaftlicher Literatur ethische Ansätze und pflegerische Unterstützungsangebote herauszuarbeiten, die bei der Wahrung der Identität älterer und hochaltriger (> 60) homosexueller Menschen helfen können. Forschungsfrage: „Wie kann die Identität homosexueller älterer Menschen durch die Unterstützung von Pflegepersonen gewahrt werden?“

Anhand eines narrativen Reviews konnten sechs relevante Studien identifiziert werden. Die Recherche wurde in den Datenbanken PubMed und CINAHL durchgeführt.

Drei Hauptkategorien wurden identifiziert, die für das Thema Homosexualität im Alter mit seinen Herausforderungen übergreifende Maßnahmenempfehlungen darstellen: Aufklärung und Schulung von Fachkräften, strukturelle Rahmenbedingungen und ein sicheres Umfeld durch eine bedarfsgerechte Versorgung.

Pflegepersonen können die Wahrung der Identität homosexueller älterer Personen durch Anerkennung in Form von Zuwendung durch pflegerische Betreuung und soziale Wertschätzung fördern. Zudem ist es wichtig, dass eine rechtliche sowie strukturelle Gleichstellung homosexueller Personen im Pflegekontext und darüber hinaus erfolgt. Eine Auseinandersetzung mit ethischen Grundsätzen und Ansätzen ist hierfür unerlässlich.
The use of diffusion tensor imaging in spinal pathology: a comprehensive literature review
Authors: Scullen Tyler , Milburn James , Aria Kevin , Mathkour Mansour , Tubbs R. Shane , Kalyvas James
Published: July 2024

Study design

We reviewed the available literature systematically without meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Objective

To evaluate contemporary literature on use of spinal diffusion tensor imaging(sDTI) in spinal pathology.

Background

sDTI reveals the location and functional state of critical long tracts and is a potentially useful adjunct in disease management.

Methods

Studies were included if they presented or discussed data from investigative or therapeutic procedures involving sDTI on human subjects in the setting of surgically amenable spinal pathology. Studies were excluded if they were (1) restricted to computational models investigating parameters using data not obtained clinically, (2) about cranial DTI methods, (3) about spinal pathology data not related to surgical management, (4) discussions or overviews of methods/techniques with minimal inclusion of objective experimental or clinical data.

Results

Degenerative pathologies of interest were restricted to either cervical myelopathy (22/29,75.9%) or lumbar spondylosis 7/29,24.1%). Mass-occupying lesions included intradural pathology and discussed preoperative (7/9,77.8%) and intraoperative imaging(2/9,22.2%) as an adjunct to surgery 22.2%. Traumatic pathology focused on spinal cord injury prognosis and severity grading.

Conclusions

sDTI seems useful in surgical decision making and outcome measurements and in establishing clinical prognoses over a wide range of surgical pathologies. Further research is warranted with longer follow-up and larger population sizes in a prospective and controlled protocol.
Clinical management of bone loss in cervical total disc arthroplasty: literature review and treatment recommendations
Authors: Spece Hannah , Khachatryan Armen , Phillips Frank M. , Lanman Todd H. , Andersson Gunnar B. J. , Garrigues Grant E. , Bae Hyun , Jacobs Joshua J. , Kurtz Steven M.
Published: July 2024

Purpose

Cervical total disc replacement (cTDR) has been established as an alternative treatment for degenerative cervical radiculopathy and myelopathy. While the rate of complications for cTDR is reasonably low, recent studies have focused on bone loss after cTDR. The purpose of this work is to develop a clinical management plan for cTDR patients with evidence of bone loss. To guide our recommendations, we undertook a review of the literature and aimed to determine: (1) how bone loss was identified/imaged, (2) whether pre- or intraoperative assessments of infection or histology were performed, and (3) what decision-making and revision strategies were employed.

Methods

We performed a search of the literature according to PRISMA guidelines. Included studies reported the clinical performance of cTDR and identified instances of cervical bone loss.

Results

Eleven case studies and 20 cohort studies were reviewed, representing 2073 patients with 821 reported cases of bone loss. Bone loss was typically identified on radiographs during routine follow-up or by computed tomography (CT) for patients presenting with symptoms. Assessments of infection as well as histological and/or explant assessment were sporadically reported. Across all reviewed studies, multiple mechanisms of bone loss were suspected, and severity and progression varied greatly. Many patients were reportedly asymptomatic, but others experienced symptoms like progressive pain and paresthesia.

Conclusion

Our findings demonstrate a critical gap in the literature regarding the optimal management of patients with bone loss following cTDR, and treatment recommendations based on our review are impractical given the limited amount and quality evidence available. However, based on the authors’ extensive clinical experience, close follow-up of specific radiographic observations and serial radiographs to assess the progression/severity of bone loss and implant changes are recommended. CT findings can be used for clinical decision-making and further follow-up care. The pattern and rate of progression of bone loss, in concert with patient symptomatology, should determine whether non-operative or surgical intervention is indicated. Future studies involving implant retrieval, histopathological, and microbiological analysis for patients undergoing cTDR revision for bone loss are needed.
Exploring optimal microscopic keyhole access to the skull base: an anatomical evaluation of transciliary supraorbital and transpalpebral orbitofrontal craniotomy approaches
Authors: Corecha Santos Romel , Gupta Bhavika , Sabahi Mohammadmahdi , Dabecco Rocco , Santiago Raphael Bastianon , Najera Edinson , Kaye Brandon , Adada Badih , Yu Alexander , Mandel Mauricio , Borghei-Razavi Hamid
Published: July 2024

Purpose: The past two decades have witnessed the rise of keyhole microscopic minimally invasive surgeries, including the transciliary supraorbital approach (TCA) and transpalpebral approach (TPA), commonly known as the transorbital approach. This study aims to elucidate the nuances, specific indications, and advantages of each approach. Methods: A series of dissections were conducted on five formalin-fixed, alcohol-preserved cadaver heads. The TCA was performed on one side, and the TPA on the other. Virtual measurements of working angles for both approaches were recorded. Additionally, three clinical cases were presented to illustrate the practical application of the techniques. Results: For TCA, the craniotomy dimensions were 1.7 cm x 2.5 cm (Cranial-Caudal (CC) x Lateral-Lateral (LL)), while for TPA, they measured 2.1 cm x 2.9 cm (CC x LL). The measurements of anterior clinoid processes (ACP) were obtained and compared between approaches. In the TCA, the mean ipsilateral ACP measurement was 62 mm (Range: 61 –63 mm), and the mean contralateral ACP measurement was 71.2 mm (Range: 70 –72 mm). In TPA, these measurements were 47.8 mm (Range: 47 –49 mm) and 62.8 mm (Range: 62 –64 mm), respectively. TCA exhibited an average cranial-caudal angle of 14.9°, while TPA demonstrated an average of 8.3°. Conclusion: The anterior cranial fossa was better exposed by a TCA, which also featured shorter operative times, enhanced midline visualization, and a quicker learning curve. Conversely, the middle fossa was better exposed by a TPA, making it an excellent option for middle fossa pathologies, including those in the anterior temporal lobe. After sphenoid bone wing drilling, the TPA offers superior visualization from the lateral to the medial aspect and enhances the CC angle. Additionally, the TPA reduces the risk of postoperative frontalis palsy based on anatomic landmarks. However, the TPA requires a greater cranial osteotomy, and due to unfamiliarity with eyelid anatomy, the learning curve for most neurosurgeons is lengthier for this procedure.
Decalogue for mastering robotic transanal minimally invasive surgery (rTAMIS)
Authors: Guadalajara H. , Leon-Arellano M. , Dominguez-Tristancho J. L. , García-Olmo D.
Published: July 2024

This manuscript offers a detailed description of our successful tips for mastering transanal robotic surgery. It covers various aspects, including patient positioning, management of abdominal pressures to maintain a stable pneumorectum, platform positioning, camera alignment, trocar positioning to minimize collisions, instruments used, and approaches to tumor resection.
Revealing Detailed Cartilage Function Through Nanoparticle Diffusion Imaging: A Computed Tomography & Finite Element Study
Authors: Tuppurainen Juuso , Paakkari Petri , Jäntti Jiri , Nissinen Mikko T. , Fugazzola Maria C. , van Weeren René , Ylisiurua Sampo , Nieminen Miika T. , Kröger Heikki , Snyder Brian D. , Joenathan Anisha , Grinstaff Mark W. , Matikka Hanna , Korhonen Rami K. , Mäkelä Janne T. A.
Published: July 2024

The ability of articular cartilage to withstand significant mechanical stresses during activities, such as walking or running, relies on its distinctive structure. Integrating detailed tissue properties into subject-specific biomechanical models is challenging due to the complexity of analyzing these characteristics. This limitation compromises the accuracy of models in replicating cartilage function and impacts predictive capabilities. To address this, methods revealing cartilage function at the constituent-specific level are essential. In this study, we demonstrated that computational modeling derived individual constituent-specific biomechanical properties could be predicted by a novel nanoparticle contrast-enhanced computer tomography (CECT) method. We imaged articular cartilage samples collected from the equine stifle joint (n = 60) using contrast-enhanced micro-computed tomography (µCECT) to determine contrast agents’ intake within the samples, and compared those to cartilage functional properties, derived from a fibril-reinforced poroelastic finite element model. Two distinct imaging techniques were investigated: conventional energy-integrating µCECT employing a cationic tantalum oxide nanoparticle (Ta2O5-cNP) contrast agent and novel photon-counting µCECT utilizing a dual-contrast agent, comprising Ta2O5-cNP and neutral iodixanol. The results demonstrate the capacity to evaluate fibrillar and non-fibrillar functionality of cartilage, along with permeability-affected fluid flow in cartilage. This finding indicates the feasibility of incorporating these specific functional properties into biomechanical computational models, holding potential for personalized approaches to cartilage diagnostics and treatment.
HeartMate 3 for Heart Failure with Preserved Ejection Fraction: In Vitro Hemodynamic Evaluation and Anatomical Fitting
Authors: Langer Nina , Stephens Andrew F. , Šeman Michael , McGiffin David , Kaye David M. , Gregory Shaun D.
Published: July 2024

Heart failure with preserved ejection fraction (HFpEF) constitutes approximately 50% of heart failure (HF) cases, and encompasses different phenotypes. Among these, most patients with HFpEF exhibit structural heart changes, often with smaller left ventricular cavities, which pose challenges for utilizing ventricular assist devices (VADs). A left atrial to aortic (LA-Ao) VAD configuration could address these challenges, potentially enhancing patient quality of life by lowering elevated mean left atrial pressure (MLAP). This study assessed the anatomical compatibility and left atrial unloading capacity using a simulated VAD-supported HFpEF patient. A HeartMate3-supported HFpEF patient in an LA-Ao configuration was simulated using a cardiovascular simulator. Hemodynamic parameters were recorded during rest and exercise at seven pump flow rates. Computed tomography scans of 14 HFpEF (NYHA II–III) and six heart failure with reduced ejection fraction patients were analysed for anatomical comparisons. HFpEF models were independently assessed for virtual anatomical fit with the HM3 in the LA-Ao configuration. Baseline MLAP was reduced from 15 to 11 mmHg with the addition of 1 L/min HM3 support in the rest condition. In an exercise simulation, 6 L/min of HM3 support was required to reduce the MLAP from 29 to 16 mmHg. The HM3 successfully accommodated six HFpEF patients without causing interference with other cardiac structures, whereas it caused impingement ranging from 4 to 14 mm in the remaining patients. This study demonstrated that the HM3 in an LA-Ao configuration may be suitable for unloading the left atrium and relieving pulmonary congestion in some HFpEF patients where size-related limitations can be addressed through pre-surgical anatomical fit analysis.
State of the Art Modelling of the Breast Cancer Metastatic Microenvironment: Where Are We?
Authors: Nuckhir Mia , Withey David , Cabral Sara , Harrison Hannah , Clarke Robert B.
Published: July 2024

Metastatic spread of tumour cells to tissues and organs around the body is the most frequent cause of death from breast cancer. This has been modelled mainly using mouse models such as syngeneic mammary cancer or human in mouse xenograft models. These have limitations for modelling human disease progression and cannot easily be used for investigation of drug resistance and novel therapy screening. To complement these approaches, advances are being made in ex vivo and 3D in vitro models, which are becoming progressively better at reliably replicating the tumour microenvironment and will in the future facilitate drug development and screening. These approaches include microfluidics, organ-on-a-chip and use of advanced biomaterials. The relevant tissues to be modelled include those that are frequent and clinically important sites of metastasis such as bone, lung, brain, liver for invasive ductal carcinomas and a distinct set of common metastatic sites for lobular breast cancer. These sites all have challenges to model due to their unique cellular compositions, structure and complexity. The models, particularly in vivo, provide key information on the intricate interactions between cancer cells and the native tissue, and will guide us in producing specific therapies that are helpful in different context of metastasis.
A polynomial-time dynamic programming algorithm for an optimal picking problem in automated warehouses
Authors: Barbato Michele , Ceselli Alberto , Righini Giovanni
Published: July 2024

We consider an optimization problem arising when a set of items must be selected and picked up from given locations in an automated storage and retrieval system by a crane of given capacity, minimizing the overall distance traveled. The problem has been classified as open in a recent taxonomy of optimal picking problems in automated warehouses. In this paper, we analyze some non-trivial properties of the problem and we describe a polynomial-time dynamic programming algorithm to solve it to proven optimality.
Hot deformation behavior of laser powder bed fusion newly developed MS400 grade maraging steel
Authors: Król Mariusz , Snopiński Przemysław , Nowak Agnieszka J. , Radoń Adrian , Karpiński Marcin , Kowalski Aleksander , Osadnik Małgorzata , Burian Wojciech , Żak Artur , Jóźwik Bartosz
Published: July 2024

In this work, the hot deformation mechanism of as-printed laser powder bed fusion process (LPBF) newly developed MS400 grade maraging steel was investigated. The optimization processes allowed for obtaining samples with an average density of 8.200 ± 0.002 g cm−3 and hardness of 417 ± 5 HV. The hot compression procedure of maraging steel was carried out with the DIL 805 A/D dilatometer at different temperatures in the range of 1050 °C-1200 °C and strain rates of 0.01 s−1–1 s−1 in an inert gas atmosphere. The measured melt flow stress data were used to develop a constitutive model to determine the behavior of the alloy during hot deformation. The proposed equation can be used as an input to the finite element analysis to obtain the flow stress at a given strain, strain rate and temperature, useful for predicting flow localization or fracture during thermomechanical simulation. The activation energy for hot deformation was calculated to be 388.174 kJ mol−1, which corresponds to that of M350 grade. The proposed equation can be used during finite element analysis to calculate the flow stress at any strain, strain rate and temperature to determine the location of a flow or crack during a thermomechanical simulation.
An efficient image classification and segmentation method for crime investigation applications
Authors: Sedik Ahmed , Kolivand Hoshang , Albeedan Meshal
Published: July 2024

The field of forensic science is experiencing significant growth, largely driven by the increasing integration of holographic and immersive technologies, along with their associated head-mounted displays. These immersive systems have become increasingly vital in resolving critical crimes as they facilitate communication, interaction, and collaboration. Given the sensitive nature of their work, crime investigators require substantial technical support. There is a pressing need for accurate documentation and archiving of crime scenes, which can be addressed by leveraging 3D scanned scenes to accurately represent evidence and expected scenarios. This study aims to develop an enhanced AR. system that can be deployed on hologram facilities such as the Microsoft HoloLens. The proposed system encompasses two main approaches, namely image classification and image segmentation. Image classification utilizes various deep learning models, including lightweight convolutional neural networks (CNNs) and convolutional Long-Short Term Memory (ConvLSTM). Additionally, the image segmentation approach is based on the fuzzy active contour model (FACM). The effectiveness of the proposed system was evaluated for both classification and segmentation tasks, utilizing metrics such as accuracy, sensitivity, precision, and F1 score. The simulation results indicate that the proposed system achieved a 99% accuracy rate in classification and segmentation tasks, positioning it as an effective solution for detecting bloodstain patterns in AR applications.
Observer-based adaptive memory event-triggered consensus tracking control for high-speed train under DoS attacks
Authors: Sun Nan , Zhang Tong
Published: July 2024

This paper focuses on the event-triggered consensus tracking of high-speed trains under denial-of-service (DoS) attacks. A novel anti-disturbance control strategy is proposed, based on an adaptive memory state observer and a disturbance observer. A memory is introduced to buffer system output information which enhancing the precision of the state observer, and the gust disturbance during the high-speed train operation is estimated by the disturbance observer. The Linear Matrix inequality technique is used to obtain the observer feedback coefficient and the controller gain, and the Lyapunov theory is employed to demonstrate the controller’s consistency tracking performance. Applying the memory to the event-triggered mechanism, a new adaptive memory event-triggered scheme is designed to better ensure system performance and effectively prevent the occurrence of Zeno behavior. To achieve precise identification of DoS attacks in the event-triggered environment, a new detection algorithm is proposed. Finally, simulation examples are used to validate the effectiveness and practicality of the proposed scheme.
Elucidation of the life cycle of a saprotrophic inoperculate discomycete that is associated with pinesap using a polyphasic taxonomic approach
Authors: Demir Özge , Chen Yanpeng , Lambert Christopher , Schüffler Anja , Surup Frank , Stadler Marc
Published: July 2024

This study deals with the elucidation of the life cycle of an inoperculate discomycete that was eventually collected from conifer wood in South Germany and has become famous for the extraordinary diversity of its secondary metabolites when it was studied extensively during the 1990s. It had then been identified as Lachnum papyraceum (Lachnaceae, Helotiales) based on morphological traits, and extracts from its mycelial cultures were found to possess extraordinary nematicidal and antibiotic activities. Over 60 different secondary metabolites were finally identified from this fungus after extensive variation of culture media and scale-up of production up to 100-L scale. Among the main active principles were mycorrhizin A and chloromycorrhizin A, which had first been reported in 1977 from an unnamed “mycorrhizal” fungus of the hemiparasitic plant, Monotropa hypopitys (pinesap), that was isolated in Sweden. We noted that both the Lachnum strain and the original mycorrhizin producer were still available in the public domain and decided to study them for comparison using a multilocus phylogeny and also generated secondary metabolite profiles of both strains using analytical high performance liquid chromatography coupled to diode array and mass spectrometric detection (HPLC–DAD/MS). Surprisingly, the sequence data as well as the secondary metabolite profiles of both strains were highly similar, and it was also confirmed by phylogenetic methods that the strains are indeed nested within the genus Lachnum by comparison of their ITS, LSU, and RPB2 sequences. The specimen called L. papyraceum in the old publications was tentatively re-identified by Hans-Otto Baral as L. cf. subvirgineum, but substantial further work on the taxonomy of the genus remains to be done, anyway. We conclude that some Lachnum species have a highly complex but all the more interesting life cycle, and the mycorrhizal symbiont partner may invade the host plant, where it may persist as an endophyte and finally turn saprotrophic on the wood of the senescent pine tree. The taxonomy of these fungi should also be further resolved in the future, using a polythetic concept that includes chemotaxonomic data and a multi-locus genealogy.
The Side-Effects of Imprisonment: Harm to the Family
Authors: Catuara Leonara G.
Published: July 2024

Imprisonment affects prisoners’ families. Empirical research tells us that some families benefit from this separation, particularly when they are victims of crime or abuse. But for many, imprisonment has a negative impact on family life, which can be intensified by other pre-existing factors. The main literature on the harm that imprisonment causes family members is empirical, but these empirical findings raise difficult moral questions. How might we approach these side-effects? One view, The Simple View, suggests these side-effects are proportionate so long as the overall harm produced does not outweigh the good punishment aims to achieve. This paper defends The Complex View. Here, proportionality requires us to think about factors beyond the magnitude of harm. Drawing upon existing moral and political philosophy, I aim to show three other factors that may alter how certain harms and benefits figure in proportionality calculations.
Macht-Wissens-Komplexe, Normen und Hierarchien in polyamoren Beziehungen: Kommunikation, Mustergültigkeit und Diskriminierung
Authors: Aurel Tonina Liriel
Published: July 2024

Der Begriff Polyamorie verweist auf romantische Beziehungen zwischen mehreren Personen, welche durch hohe Vielfalt und Individualität gekennzeichnet sind. Angesichts der Vielfältigkeit und Komplexität von polyamoren Beziehungen, ist zu erwarten, dass Normen und Macht-Wissens-Komplexe eine wichtige Rolle spielen, vielleicht sogar Polyamorie als solche prägen. Um Macht und Normen als für Polyamorie bedeutsame Strukturen zu verstehen, erscheint eine Untersuchung einzelner Normen oder spezifischer Erfahrungsdimensionen unzureichend. Um nachzuvollziehen, was polyamore Beziehungen prägt, braucht es eine Untersuchung der Zusammenhänge zwischen Elementen polyamorer Lebensformen wie Normen, Macht-Wissens-Komplexen und Hierarchisierungen innerhalb der Beziehungen. Daher wird in diesem Beitrag untersucht, inwiefern sich Macht-Wissens-Komplexe, Normen und Hierarchisierungen in diskursiven Strukturen innerhalb polyamorer Beziehungen manifestieren und in welchem Maße wechselseitige Verknüpfungen zwischen ihnen bestehen.

Mithilfe problemzentrierter, diskursanalytisch ausgewerteter Interviews mit 16 Personen, die sich als polyamor verstehen, wurden drei analytische Kategorien gebildet: die allumfassende Kommunikation, die konsequente Mustergültigkeit und das Diskriminierungsparadoxon. Diese Kategorien wurden anhand der Identifikation, Konzeptualisierung und Verdichtung interviewübergreifender Themen entwickelt und anschließend zueinander in Beziehung gesetzt, um die Komplexität vielfältiger polyamorer Beziehungen nachvollziehen zu können. Die Kategorien sind dahingehend miteinander verknüpft, dass es Normen innerhalb polyamorer Beziehungen gibt, die Verhaltensweisen fördern oder stigmatisieren. Wird diesen Normen gefolgt, erhalten Individuen Anerkennung und Macht. Sie verhalten sich konsequent mustergültig und werden zu Expert*innen, die Abweichungen sanktionieren, Verhalten regulieren und Ideale fördern. Voraussetzung dafür ist allumfassende Kommunikation. Expert*innen exkludieren jene, die normativ unzureichend kommunizieren. Mittels Mustergültigkeit wird argumentiert, gesellschaftlich inkludiert zu werden, wobei es um die Erfüllung eines Bedürfnisses nach Anerkennung geht.
Influence of Artificial Pit on Corrosion Fatigue Behavior of 316LN SS and Its Weldment
Authors: Poonguzhali A. , Ningshen S. , Amarendra G.
Published: July 2024

The effect of cyclic loading on smooth and pre-pitted type 316LN stainless steel and its weldment in acidified chloride environment is investigated in this study. The onset of fatigue cracks at the bottom of the pit is brought on by the maximum stress concentration effect in acidified chloride environment. Pre-pitted specimens exhibit a more pronounced fatigue life reduction compared to smooth specimens at lower stress amplitudes. The growth of a microscopic crack from an artificial pit, which is influenced by the combined effects of the pit electrolyte and stress concentration factor, is vital for maintaining structural integrity.
Evaluation of extra pixel interpolation with mask processing for medical image segmentation with deep learning
Authors: Rukundo Olivier
Published: July 2024

Current mask processing operations rely on interpolation algorithms that do not produce extra pixels, such as nearest neighbor (NN) interpolation, as opposed to algorithms that do produce extra pixels, like bicubic (BIC) or bilinear (BIL) interpolation. In our previous study, the author proposed an alternative approach to NN-based mask processing and evaluated its effects on deep learning training outcomes. In this study, the author evaluated the effects of both BIC-based image and mask processing and BIC-and-NN-based image and mask processing versus NN-based image and mask processing. The evaluation revealed that the BIC-BIC model/network was an 8.9578% (with image size 256 × 256) and a 1.0496% (with image size 384 × 384) increase of the NN-NN network compared to the NN-BIC network which was an 8.3127% (with image size 256 × 256) and a 0.2887% (with image size 384 × 384) increase of the NN-NN network.
Cascading Recovery of Added-Value Cocoa Bean Shell Fractions Through Autohydrolysis Treatments
Authors: Sánchez Marta , Ferreira-Santos Pedro , Gomes-Dias Joana S. , Laca Amanda , Rocha Cristina M. R.
Published: July 2024

In this work, an autohydrolysis treatment was applied to cocoa bean shells (CBS) to obtain different potentially added-value fractions rich in phenolic compounds with antioxidant potential and oligosaccharides with potential prebiotic properties. The final residue was enzymatically treated to deliver sugars that can undergo fermentation-based biotransformation. This hydrothermal pretreatment was assessed for maximum temperatures (Tmax) between 120 to 200 °C and severities (S0) between 1.1 and 3.4. The highest oligosaccharide concentration (5.5 g/L) was achieved at S0 of 3.4. The increase of S0 during the process allowed to increase the recovery of interesting bioactive compounds, achieving a maximum TPC and antioxidant activity of 2.8 g/L and 17178.5 µmol Fe2+/L, respectively, when the Tmax reached 200 °C. However, at this temperature, a significant amount of degradation products such as organic acids and HMF was already formed, and a compromise temperature of 160 °C was chosen for further tests. It was possible to obtain a maximum glucose yield of 71% when the pretreated solids were enzymatically hydrolysed. Hence, the use of autohydrolysis, avoiding the use of toxic chemicals, has proved to be a sustainable alternative to obtain different CBS fractions with interesting composition to be potentially employed in multiple sectors.
ESenTRy: an on-site earthquake early warning system based on the instrumental modified Mercalli intensity
Authors: Kafadar Özkan , Tunç Süleyman , Tunç Berna
Published: July 2024

Earthquake early warning systems (EEWSs) are real-time seismology-based applications that purpose to reduce earthquake damage by taking some precautions for environments that are likely to be damaged. These systems are divided into two categories as on-site and regional. In this study, an on-site EEWS called ESenTRy, consisting of an accelerometer, GPS and communication components, has been designed. In this scope, a Windows operating system-based software has been developed using the .NET Framework and C# language. The developed software has the ability to read the Güralp Compressed Format strong motion data in real-time, compute the strong motion indices such as destructive intensity, real-time intensity and instrumental modified Mercalli intensity, issue an alarm in the target area and alert the defined Modbus clients. To test the reliability of ESenTRy, two simulations have been performed using the strong motion data belonging to the magnitude 7.7 Kahramanmaraş-Pazarcık earthquake that occurred in Türkiye on February 6, 2023, at 01:17:32 UTC and magnitude 5.9 Düzce-Gölyaka earthquake that occurred in Türkiye on December 23, 2022, at 01:08:15 UTC. In the test applications, depending on the distance between the stations and earthquake epicenters, the time difference between the Level-2 alarm trigger times and S-wave arrival times varied between 1.5 and 16 s, while the time difference between the Level-2 alarm trigger times and P wave arrival times varied between 0.5 and 29.5 s. The flowchart diagrams of the developed algorithm and results obtained from the simulations are presented in detail.
Uncertainty modeling and propagation for groundwater flow: a comparative study of surrogates
Authors: Ernst Oliver G. , Sprungk Björn , Zhang Chao
Published: July 2024

We compare sparse grid stochastic collocation and Gaussian process emulation as surrogates for the parameter-to-observation map of a groundwater flow problem related to the Waste Isolation Pilot Plant in Carlsbad, NM. The goal is the computation of the probability distribution of a contaminant particle travel time resulting from uncertain knowledge about the transmissivity field. The latter is modelled as a lognormal random field which is fitted by restricted maximum likelihood estimation and universal kriging to observational data as well as geological information including site-specific trend regression functions obtained from technical documentation. The resulting random transmissivity field leads to a random groundwater flow and particle transport problem which is solved realization-wise using a mixed finite element discretization. Computational surrogates, once constructed, allow sampling the quantities of interest in the uncertainty analysis at substantially reduced computational cost. Special emphasis is placed on explaining the differences between the two surrogates in terms of computational realization and interpretation of the results. Numerical experiments are given for illustration.