bluuebunny/crossref_metadata_2025 huggingface dataset:
An intermediate polar candidate toward the Galactic plane
Authors: Mondal S. , Ponti G. , Haberl F. , Anastasopoulou K. , Campana S. , Mori K. , Hailey C. J. , Rea N.
Published: September 2022

Context. For the past decade, it has been suggested that intermediate polars (IPs), a subclass of magnetic cataclysmic variables (CVs), are one of the main contributors to the hard diffuse X-ray emission from the Galactic center (GC) and Galactic ridge.

Aims. In our ongoing XMM-Newton survey of the central region of the Galactic disk (20° ×2°), we detected a persistent IP candidate, 1.7° away from the GC. In this work, we better characterize the behavior of this source by looking at the new and archival XMM-Newton data.

Methods. We performed a detailed X-ray spectral modeling of the source. Furthermore, we searched for X-ray pulsations in the light curve as well as its counterpart at other wavelengths.

Results. The XMM-Newton spectrum (0.8–10 keV) of the source is described by a partial covering collisionally ionized diffuse gas with plasma temperature kT = 15.7−3.6+20.9 keV. In addition, the spectrum shows the presence of iron lines at E = 6.44, 6.65, and 6.92 keV with equivalent widths of 194−70+89, 115−75+79, and 98−74+93 eV, respectively. The X-ray light curve shows a coherent modulation with a period of P = 432.44 ± 0.36 s, which we infer is the spin period of the white dwarf. The white dwarf mass estimated from fitting a physical model to the spectrum results in MWD = 1.05−0.21+0.16 M⊙. We were able to find a likely optical counterpart in the Gaia catalog with a G magnitude of 19.26, and the distance to the source derived from the measured Gaia parallax is ∼4.3 kpc.

Conclusions. We provide an improved source localization with subarcsec accuracy. The spectral modeling of the source indicates the presence of intervening circumstellar gas, which absorbs the soft X-ray photons. The measured equivalent width of the iron lines and the detection of the spin period in the light curve are consistent with those from IPs.
Design of a Circular Patch Antenna with a reflector for GPR applications
Authors: Ismail Ouboudrar , Youssef Lagmich , Otman Oulhaj , Aghanim Amina
Published: September 2022

In this paper, a structure of a patch antenna operating at 0.5 GHz is proposed for ground-penetrating radar (GPR) applications, with an optimized performance at low frequencies. The structure was designed using FR4 substrate, with a 4.4 permittivity value, and a tangent loss equivalent to 0.021. The prototype design is backed by an optimized rectangular reflector, which has improved the antenna gain and directivity. The performance of the antenna is evaluated in terms of the return loss, gain, and the radiation pattern for two cases, with and without a reflector. When using the reflector, a good radiation pattern is obtained, a wide operational bandwidth ranging from 0.4GHz and 1.25 GHz is achieved, and an increased gain from 4.3 to 7.43dB was realized.
Design of High-Power High-Efficiency Broadband GaN HEMT Power Amplifier for S Band Applications using Load-Pull Technique
Authors: Ribate Mohamed , Mandry Rachid , Elabdellaoui Larbi , Aytouna Fouad , Benbrahim Mohammed
Published: September 2022

This work reveals the design for broadband high-power high-efficiency GaN HEMT power amplifier, operating in the frequency band ranging from 2.15 GHz to 2.65 GHz. The proposed structure is implemented using Cree GaN HEMT CGH40010 transistor. The high-power and high-efficiency performances over the broadband bandwidth are achieved using the load-pull technique. The proposed power amplifier is unconditionally stable over the entire operating frequency band. With the neatly designed matching circuits, the introduced power amplifier shows an excellent input/output matching. The simulated results show a flat power gain of 15 dB with an output 1-dB compression point of 14 dB. In terms of largesignal performance, the proposed amplifier reaches a saturated output power of 41.3 dBm (~13.6 Watts) with a PAE of 64% and a drain efficiency of 72%. The proposed design achieves an excellent linearity with an output third order two-tone intercept point TOI of 48 dBm.
Plotting Lamb waves dispersion curves of an aluminum plate by the Semi-Analytical Finite Element (SAFE) method and comparison with analytical curves
Authors: Jabiri Ayoub , Yacoubi Abdelali , El Allami Mhammed
Published: September 2022

It is well known that the propagation of Lamb waves in elastic solid medias depends on the frequency and on the material properties, but it does not depend on the propagation direction in isotropic medias and gives rise to two basic types of modes, symmetric and antisymmetric ones. This paper presents an application of the semi-analytical finite element (SAFE) method on an isotropic aluminum plate of thickness e = 2mm. The main goal of this paper is to make a quantitative evaluation of the SAFE method by carrying out the following tasks: a) calculation of the dispersion curves (wavenumber, phase velocity, group velocity, b) calculation of the relative error and validation of the proposed algorithm, c) comparison between the curves obtained by SAFE method on those obtained by Bisection method. It should be noted here that our study is restricted on the propagative modes.
Non-negative Matrix Factorization for Dimensionality Reduction
Authors: Olaya Jbari , Otman Chakkor
Published: September 2022

Abstract—What matrix factorization methods do is reduce the dimensionality of the data without losing any important information. In this work, we present the Non-negative Matrix Factorization (NMF) method, focusing on its advantages concerning other methods of matrix factorization. We discuss the main optimization algorithms, used to solve the NMF problem, and their convergence. The paper also contains a comparative study between principal component analysis (PCA), independent component analysis (ICA), and NMF for dimensionality reduction using a face image database.

Index Terms—NMF, PCA, ICA, dimensionality reduction.
Optimization of the non-stop switchover system control for the main fans used in mining applications
Authors: Yu Bao-Cai , Shao Liang-Shan
Published: September 2022

A stable ventilation system is an essential guarantee for the efficient production and safety of underground workers. In order to solve the big changes in underground air quantity, gas accumulation, and other problems caused by mine main fans switchover. This paper proposes a non-stop switchover system of the mine main fans based on intelligent control and establishes a dynamic optimization model for the switchover process of the mine main fans. The equilibrium optimizer algorithm is improved by chaos mapping and opposition learning machine based on refraction principle to solve the model, and the simulation experiment is carried out with MATLAB. The results show that the proposed method can effectively mitigate the change of underground air quantity during the switchover process of mine main fans. In the 120 s of system operation, the change rate of underground air quantity is consistently within 0.4%, and the two mine main fans always work in the stable interval, which proves the system's high efficiency, stability and safety.
Perspektivpapier „Zukunft
Präventionsforschung“: Koordinierte Forschung zu
Prävention und Gesundheitsförderung – aktuell und in der
Zukunft
Authors: Zeeb Hajo , Brandes Mirko , Bauer Ullrich , Forberger Sarah , Gelius Peter , Muellmann Saskia , Okan Orkan , Pfeifer Klaus , Renner Britta , Wright Michael
Published: September 2022

Von 2014 bis 2022 fördert das BMBF fünf
Forschungsverbünde der Präventionsforschung und
Gesundheitsförderung, die ebenfalls über eine gemeinsame
Koordination verfügen (Forschungsnetzwerk
Primärprävention und Gesundheitsförderung,
www.fp2g.net). Die Forschenden haben eine Vielzahl relevanter
Forschungsergebnisse erarbeitet und Erkenntnisse über wesentliche
Aspekte der Präventionsforschung und Gesundheitsförderung
gewonnen. Die Forschung der Verbünde konzentrierte sich auf Grundlagen,
anwendungsrelevante Erkenntnisse und Umsetzungsbedingungen einer langfristig
angelegten Prävention und Gesundheitsförderung für
nicht-übertragbare Erkrankungen (NCD). Den Einschränkungen durch
die Pandemie ab 2020 konnte z.T. durch Integration von Corona-bezogenen
Forschungs- und Transferaktivitäten begegnet werden. Die Bedeutung von
Resilienz für den Umgang mit den vielfältigen gesundheitlichen
und sozialen Herausforderungen wird in Zeiten der Pandemie verstärkt
analysiert und diskutiert. Für die Präventionsforschung gewinnen
Forschungsfragen etwa zur besseren Implementierung von
Präventionsmaßnahmen durch digitale Werkzeuge
zusätzliche Bedeutung. Gemeinsam stellen die Verbünde Erreichtes
und Desiderate zukünftiger Forschung dar. Dieses Perspektivpapier mit
den abschließend formulierten neun Thesen ist für eine
erfolgreiche Prävention und Gesundheitsförderung als
Diskussionsanregung für Förderer wie auch für die
Gemeinschaft der Forschenden gedacht. Es stellt sich explizit in die
Kontinuität der schon im Jahr 2012 erarbeiteten Memoranden zur
Präventionsforschung.
Das Persönlichkeitsinventar für ICD-11 (PiCD):
Reliabilität und Validität der Deutschen Version in einer
klinischen und nicht-klinischen Stichprobe
Authors: Damovsky Florian , Zettl Max , Zimmermann Johannes , Herbold Willy , Curtius Theresa , Bücker Susanne , Taubner Svenja , Volkert Jana
Published: September 2022

Mit der 11. Version der International Statistical Classification of Diseases and
Related Health Problems (ICD-11) erfolgt ein Paradigmenwechsel in der Diagnostik
von Persönlichkeitsstörungen: Deren Klassifikation erfolgt
künftig nicht mehr kategorial, sondern dimensional entlang der
Schweregrade von Persönlichkeitsbeeinträchtigungen und optional
der Präsenz maladaptiver Persönlichkeitsmerkmale. Diese Studie
untersucht die Reliabilität und Validität der deutschen Version
des Personality Inventory for ICD-11 (PiCD), ein Fragebogen zur Erfassung der
ICD-11 Persönlichkeitsdomänen, in einer klinischen und
nicht-klinischen Stichprobe (N=939). Die Faktorstruktur des PiCD wurde
mit Hilfe einer explorativen Faktorenanalyse (EFA) untersucht und zeigte eine
Tendenz für ein Vier-Faktoren Modell (Negative Affektivität,
Dissozialität, Distanziertheit und ein bipolarer Faktor
Enthemmung-Anankasmus). Die Subskalen des PiCD wiesen akzeptable bis exzellente
Reliabilitätskoeffizienten mit Cronbach‘s α=0,79
– 0,89 und McDonald‘s ω=0,76 – 0,90 auf.
Die konvergente und diskriminante Validität wurde anhand weiterer
Selbsteinschätzungsinstrumente untersucht und erwies sich als
zufriedenstellend. Die Ergebnisse legen nahe, dass es sich bei der deutschen
Version des PiCD um ein reliables und einigermaßen valides
Messinstrument zur Erfassung der maladaptiven Persönlichkeitsmerkmale
gemäß ICD-11 handelt. Es ist jedoch weitere Forschung zur
Faktorenstruktur, geeigneten Cut-Off- sowie Normwerten notwendig.
Familien mit erhöhtem elterlichen Stress und
Konfliktpotential: Eine Zielgruppe für psychosoziale
Unterstützungsangebote?
Authors: Ulrich Susanne Marlene , Renner Ilona , Lux Ulrike , Walper Sabine , Löchner Johanna
Published: September 2022

Ziel der Studie Psychosoziale Belastungen können die erste
Lebensphase von jungen Familien erschweren. Eine bisher wenig beleuchtete Gruppe
sind Familien mit erhöhtem elterlichen Stress und Konfliktpotential. In
diesem Beitrag sollen 1) die Kenntnis und Nutzung von
Unterstützungsangeboten elternstress- und konfliktbelasteter Familien
eingeordnet werden und 2) die Auswirkung von elterlichem Stress und
Konfliktpotential auf das Erziehungsverhalten untersucht werden.

Methodik Hierzu wurden Daten aus einer repräsentativen
Querschnittsstudie des Jahres 2015 mit N=7 549 Familien sowie der
Folgestudie mit n=905 Familien analysiert. Eltern, die mit ihrem Kind in
einer Kinderarztpraxis bei einer U3-U7a-Untersuchung waren, füllten
einen schriftlichen Fragebogen aus. Kenntnis und Nutzung der Angebote wurden bei
vier Belastungsgruppen (unbelastet, sozioökonomisch belastet,
elternstress- und konfliktbelastet und hochbelastet) untersucht.

Ergebnisse Familien mit erhöhtem elterlichem Stress und
Konfliktpotential nehmen trotz leicht erhöhter Kenntnis selektive
Angebote seltener in Anspruch als sozioökonomisch hochbelastete
Familien. Sie berichten häufiger dysfunktionales
Erziehungsverhalten.

Schlussfolgerung Dies wirft die Frage auf, ob Familien mit
erhöhtem elterlichen Stress und Konfliktpotential zu wenig
Unterstützung erhalten, weil sie keinen deutlich sichtbaren Hilfebedarf
haben oder ob sie aufgrund sozioökonomischer Ressourcen, der hohen
Angebotskenntnis und der Nutzung universeller medizinischer und
Familienbildungsangeboten ausreichend versorgt sind. Die Ergebnisse liefern
wichtige Hinweise für die Versorgung von Familien in unterschiedlichen
Belastungslagen und tragen dazu bei, den Unterstützungsbedarf
einzuschätzen.
Anforderungen an die heilberufliche Stellungnahme nach § 35a SGB VIII und Anregungen zur Umsetzung
Authors: Hiller Therese , Esch Lena-Maria , Gindele Verena , Böge Isabel , Witt Andreas , Fegert Jörg M.
Published: September 2022

Legislative Neuerungen und damit verbundene Veränderungen in der Praxis machen eine Anpassung der heilberuflichen Stellungnahme nach § 35a SGB VIII erforderlich. Der vorliegende Artikel bietet einen Vorschlag zur Anpassung der heilberuflichen Stellungnahme. Berücksichtigung finden dabei die gesetzlichen Neuerungen durch das Kinder- und Jugendstärkungsgesetz sowie das Bundesteilhabegesetz, außerdem die in Kraft tretende International Classification of Disease-11 (ICD-11) und die International Classification of Functioning, Disability and Health (ICF).

Die Anpassung der heilberuflichen Stellungnahme bietet die Diagnostik sowohl nach ICD-10 als auch nach ICD-11 an, eine Einschätzung der Funktionen nach ICF aus Kapitel V ICD-11, eine Einschätzung der Teilhabebeeinträchtigung sowie von Umweltfaktoren in Anlehnung an die ICF und schließlich eine Zusammenfassung nach dem bio-psycho-sozialen Modell. Vor allem durch die Möglichkeit der Einschätzung nach ICD-11 und den starken Bezug zur ICF entsteht ein edukativer Effekt für Fachkräfte. Diese Vorlage soll zudem in der Praxis dazu dienen, die Systemlogiken der Jugendhilfe sowie der Eingliederungshilfe einander anzupassen und die Jugendhilfe auf die „große Lösung“ 2028 vorzubereiten.
Can Serum Thyroglobulin Levels Help to Identify the Involved Neck
Compartment of Differentiated Thyroid Carcinoma?
Authors: Bahçecioğlu Adile Begüm , Ozkan Elgin , Araz Mine , Elhan Atilla Halil , Erdoğan Murat Faik
Published: September 2022

We aimed to evaluate the predictive ability of serum thyroglobulin (Tg) levels on
the localization of the metastatic lymph node compartments in locoregional
metastases of papillary thyroid cancer (PTC). This retrospective study included
143 patients who underwent neck dissections for a total of 172 for
persistent/recurrent locoregional PTC. They were grouped according to
the localization of lymph node metastasis (LNM): Central (C-LNM), Lateral
(L-LNM), both central and lateral LNM (C+L LNM). To confirm that the Tg
cutoff discriminated LNM localizations, the sample was categorized as suppressed
(<0.1 mU/l) or non-suppressed (>0.1 mU/l)
according to TSH and ROC analysis. Mixed-effects models were used to investigate
the effect of LNM localization on Tg levels and to eliminate the confounding
effects of TSH, tumor burden (defined as the number and the largest diameter of
LNM), and RAI. Mean Tg levels were 1.43 μg/l for C-LNM
(n=47), 3.7 μg/l for L-LNM (n=99), and
8.60 μg/l for C+L LNM (n=26).
Independent of TSH, tumor burden and RAI, the mean Tg levels of L-LNM and
C+L LNM groups were not significantly different, while that of C-LNM was
significantly lower than those of L-LNM and C+L LNM. To discriminate
C-LNM from L-LNM and C+L LNM in patients with TSH>0.1
mU/l, the optimal cutoff for Tg was 1.05 μg/l
(sensitivity=74.7%, specificity=70.4%,
PPV=87.7%). L-LNM increases serum Tg levels more than C-LNM in
persistent/recurrent locoregional nodal disease of PTC. Tg above
1.05 μg/l may indicate lateral LNM. Tg may be an
important marker for the localization of LNM in the neck.
LINC02875 Upregulation Contributed to Poor Prognosis for the
Hepatocellular Carcinoma and Progression for the Cancerous Cells
Authors: Liu Yujian , Yang Jingrui , Ke Rui-Sheng , Wu Lupeng , Hong Zaifa , Guo Ping , Feng Liuxing , Li Zhimin
Published: September 2022

The prognostic implications and physiological effect of LINC02875 are unknown in
hepatocellular carcinoma (HCC). We sought to examine the prognostic value of
LINC02875 in HCC and assessed its role in HCC cellular function. LINC02875
expression was evaluated by RT-qPCR in HCC specimens and cell lines. LINC02875
expression was subjected to assess the correlation with clinical parameters by
Chi-squared test and overall survival by Kaplan – Meier curve and Cox
regression analysis. The effects of LINC02875 on the biological characteristics
of HCC cells were studied by MTS and Transwell assay. LINC02875 was
high-expressed in HCC, and this was associated with unfavorable clinical
features and poor prognosis of HCC, especially HBV-related HCC. Knockdown of
LINC02875 inhibited the proliferation, migration, and invasion of HCC cells.
miR-485–5p was a downstream microRNA of LINC02875. LINC02875 affects the
prognosis of HCC patients, especially HBV-related ones. LINC02875 represents a
suitable therapeutic target for HCC.
Treatment of Metastatic Colorectal Cancers in Resource-Constrained Low- and Middle-Income Countries (LMICS) Scenario—Outcomes, Practice Patterns, and Commentary on Treatment Costs
Authors: Ramaswamy Anant , Babu Vasu , Kothari Rushabh , Abhinav Ram , Desouza Ashwin , Ventrapati Pradeep , Kumar Amit , Kapoor Akhil , Das Shasanka , Engineer Reena , Saklani Avanish , Ostwal Vikas
Published: September 2022

Introduction The overall survival (OS) of metastatic colorectal cancers (mCRCs) in clinical practice and resource-constrained low- and middle-income countries (LMICS) like India is not known.

Materials and Methods Data of patients with mCRC treated between January 2013 and August 2017 were accessed from a prospectively maintained database. Demographics, disease characteristics, chemotherapeutic regimens, use of monoclonal antibodies, and survival outcomes in treated patients were collected and analyzed. Costs of treatment options as off 2017 were also interpreted.

Results The data of 403 patients satisfied prespecified inclusion criteria and were included for analysis. The median age of the cohort was 48 years (range: 17–86) with a predominance of rectal cancers (63.3%), liver alone metastases (47.1%), and resected primary (69.7%). Signet ring histology was present in 82 patients (20.3%). The most commonly used first-line regimen (CT1) was modified capecitabine-oxaliplatin (53.3%). Two hundred and nineteen patients (54.3%) received second-line systemic therapy (CT2). Patients received a median of two lines of therapy (range: 1–6). MoAbs were used by 48 patients (13.4%) with CT1 and 34 patients (15.5%) with CT2. Median OS of the entire cohort was 17.61 months (95% confidence interval: 15.48–19.74), which was within the predicted range, as per investigator hypothesis. The presence of signet ring histology (p<0.001), raised carcinoembryonic antigen at baseline (p=0.017), and the absence of a resected primary (p<0.001) predicted inferior median OS.

Conclusions Survival of patients with mCRC in a resource-constrained LMIC scenario like India is approximately 12 to 15 months lower than published trial data. Limited access to targeted therapy and newer expensive treatment options due to financial constraints may contribute to this disparity.
Once-a-Day Ceftriaxone–Amikacin Combination as Empiric Antibiotic Therapy to Enable Outpatient Management of Febrile Neutropenia in Children—16-Year Experience from a Single Institute
Authors: Kanvinde Shailesh , Mulay Atul , Deshpande Anand , Deshmukh Chetan , Patwardhan Sampada
Published: September 2022

Background To enable outpatient department (OPD) management of febrile neutropenia (FN), we used once-a-day (OD) ceftriaxone–amikacin (CFT-AMK) as empiric antibiotic therapy. Our experience over 16-year period is presented.

Methods This was a retrospective study conducted from January2002 to December2017. Inclusion criteria were <18 years of age, undergoing cancer chemotherapy, and having FN. Exclusion criteria were FN after palliative chemotherapy, bone marrow transplantation, or at diagnosis of malignancy. Empiric CFT-AMK was used in all, except those having respiratory distress, hypotension, altered sensorium, paralytic ileus, or clinical evidence of peritonitis. Admission criteria were age <1 year, acute myeloid leukemia (AML) chemotherapy, poor performance status, need for blood transfusions, convenience, insurance, or persistent fever >48 to 72 hours after CFT-AMK. Outcomes analyzed were response (defervescence within 48–72 hours), OPD management, antibiotic upgrade, and mortality. AML diagnosis, >7 days to absolute neutrophil count >0.5 × 109/L, poor performance status, and malignancy not in remission were considered high-risk FN criteria.

Results CFT-AMK was given in 877/952 (92.2%) FN episodes. Seventy-six percent had hematolymphoid malignancies. Response, antibiotic upgrade, and mortality were seen in 85.7 and 65.5% (p < 0.0001), 15 and 45.5% (p < 0.0001), and 0 and 2% (p = 0.003) of low- and high-risk patients, respectively. Treatment was started in OPD in 52%, of which 21.6% required subsequent admission. Of those initially admitted, early discharge (hospital stay < 5 days) was possible in 24.6%. Forty-one percent episodes were managed entirely on OPD. Overall, 80% of low-risk and 42% of high-risk episodes received treatment wholly or partially on OPD.

Conclusion Our results show empiric OD CFT-AMK allows OPD management for most of the low-risk and a proportion of high-risk FN following chemotherapy in children, without compromising clinical outcomes.
18F-Fluorodeoxy Glucose and 11C-Methionine Accumulation in Demyelinating Lesions
Authors: Tomura Noriaki , Saginoya Toshiyuki , Kaneko Chikako
Published: September 2022

Background Few studies have evaluated the accumulation of 18F-fluorodeoxyglucose (FDG), 11C-methionine (MET), and other positron emission tomography (PET) tracers in patients with demyelinating disease.

Purpose This study aimed to investigate the accumulation of FDG-PET/computed tomography (CT) and MET-PET/CT in demyelinating lesions.

Material and Methods A retrospective search of the patient database in our hospital identified five patients with demyelinating disease in whom PET studies performed in the past 10 years revealed accumulation of FDG or MET. The clinical diagnoses were multiple sclerosis (n=1), myelitis (n=1), limbic encephalitis (n=1), chronic inflammatory demyelinating polyneuropathy (CIDP; n=1), and acute demyelinating encephalomyelitis (ADEM; n=1). Two patients received FDG-PET/CT alone and three patients received both FDG-PET/CT and MET-PET/CT on the same day. Images were visually and conjointly reviewed by two radiologists. In semiquantitative evaluation, the maximum standardized uptake value (SUVmax) of the lesion was measured. The lesion-to-normal brain uptake ratio (L/N ratio) was calculated.

Results FDG and/or MET accumulated to a part of the lesions seen on MRI. SUVmax on FDG-PET/CT ranged from 3.8 to 10.3, and L/N ratio on MET-PET/CT ranged from 16.6 to 2.4.

Conclusion It has been established that neoplastic and demyelinating lesions can be differentiated on the basis of FDG or MET uptake. However, as accumulation of FDG and MET can also occur in demyelinating lesions; knowledge of this possibility is of clinical importance.
Second Adjuvant Radioiodine Therapy after Reoperation for Locoregionally Persistent or Recurrent Papillary Thyroid Carcinoma
Authors: Cadena-Piñeros Enrique , Escobar Judith Vásconez , Carreño Jose A. , Rojas Julian G.
Published: September 2022

Introduction Differentiated thyroid carcinoma (DTC) has increased incidence. Intermediate- and high-risk patients have lymph node relapse rate ranging from 10 to 50%, and receive multiple reinterventions, increasing the morbidity of the disease. Currently, there are no established guidelines for the use of second radioactive iodine (RAI) therapy after the reintervention for local recurrence.

Materials and Methods This is a retrospective review of the medical records of 1,299 patients treated from January 2016 to July 2019 with DTC. We included 48 patients who received total thyroidectomy, RAI remnant ablation, surgery to remove the locally recurrent/persistent papillary thyroid carcinoma (PTC), and received a second RAI therapy.

Results There were no significant differences between thyroglobulin (Tg) levels before reoperation (Tg0), Tg levels postoperatively (Tg1), and Tg levels after 6 months of second adjuvant RAI therapy (Tg2). However, we evidenced a 69.79% drop in first Tg levels (Tg0: 24.7 vs. Tg1: 7.56, p=0.851) and 44.4% decrease in second Tg levels (Tg1: 7.56 vs. Tg2: 4.20, p=0.544). Also, 77.1% of the patients did not have another documented recurrence. The median relapse-free time was 10.9 months (range: 1.3–58.2 months).

Conclusion The results of the study cannot assess that a second RAI treatment after reoperation for locoregionally persistent or recurrent disease have a significant impact on treatment outcomes in intermediate- or high-risk patients with PTC. However, the 77.1% of patients have not presented a second documented recurrence and the median values of Tg and TgAb levels showed a substantial decrease after surgery and second RAI treatment.
Thrombosis Risk Assessment in Myeloproliferative Neoplasm—Is There a Role for Viscoelastic Testing?
Authors: Lim Hui Yin , Ho Prahlad
Published: September 2022

Philadelphia chromosome-negative myeloproliferative neoplasms include polycythemia vera, essential thrombocythemia, and myelofibrosis. They are associated with increased thrombotic events, and the primary goal of therapy, in particular those with polycythemia vera and essential thrombocythemia, is the prevention of thrombotic complications typically with antiplatelet therapy and/or cytoreduction. While several patient-, disease-, and genomic-related factors have been identified to influence thrombotic risks, there are no routine laboratory investigations to date that are sufficiently accurate to assess the underlying procoagulant state and predict the thrombotic risks. Conventional coagulation testing only measures time to clot formation and cannot reliably predict bleeding and thrombotic risks. Global coagulation assays such as thromboelastography, thrombin, and fibrin generation may provide a more thorough assessment of hemostatic function. Thromboelastography and thromboelastometry are viscoelastic tests which measure the mechanical properties of the hemostatic process, including the global dynamics of clot formation, stabilization, and dissolution. While viscoelastic testing is gaining traction in the investigations of coagulopathies and goal-directed blood product replacement in trauma and massive transfusion settings, the role of these assays in thrombosis is less well defined. Here, we provide a review of the current evidence of the role of viscoelastic testing in myeloproliferative neoplasm, particularly in the thrombotic risk assessment.
Criteria for Cerebrospinal Fluid Diversion in Retractorless Sphenoid Wing Meningioma Surgery: A Technical Report
Authors: Vetsa Shaurey , Nadar Arushii , Vasandani Sagar , Gorelick Evan , Bungard Jillian , Barak Tanyeri , Fulbright Robert K. , Marianayagam Neelan J. , Moliterno Jennifer
Published: September 2022

Objective Sphenoid wing meningiomas (SWMs) can present surgical challenges, in that they are often obscured by overlying brain, encase critical neurovascular structures, and obliterate cerebrospinal fluid (CSF) cisterns. While brain retraction can enable access, its use can have potentially deleterious effects. We report the benefits and outcomes of the criteria we have developed for use of cerebrospinal diversion to perform retractorless surgery for SWMs.

Design Technical report.

Setting Yale School of Medicine and Yale New Haven Hospital.

Participants Between May, 2019 and December, 2020, ten consecutive patients were included who met the presented criteria for SWM surgery with preoperative lumbar drain (LD) placement.

Main Outcome Measures Length of hospital stay, surgical complications, and extent of resection.

Results We have developed the following criteria for LD placement in patients with SWMs such that LDs are preoperatively placed in patients with tumors with one or more of the following criteria: (1) medial location along the sphenoid wing, (2) vascular encasement resulting in obliteration of the optic carotid cistern and/or proximal sylvian fissure, and/or (3) the presence of associated edema. CSF release, after craniotomy and sphenoid wing removal, allowed for optimization of exposure, leading to the maximal safe extent of tumor resection without brain retraction or any complications.

Conclusions Preoperative LD placement is effective in allowing for maximal extent of resection of SWMs and may be considered in cases where local CSF release is not possible. This technique is useful in those tumors located more medially, with encasement of the vasculature and/or associated with edema.
Laboratory Diagnosis of von Willebrand Disease (VWD): Geographical Perspectives
Authors: Favaloro Emmanuel J. , Pasalic Leonardo
Published: September 2022

von Willebrand disease (VWD) is reportedly the most common inherited bleeding disorder, and can also arise as an acquired (von Willebrand) syndrome (AVWS). The hemostasis laboratory plays a key role in the diagnosis or exclusion of VWD/AVWS, which may otherwise be suspected due to the patient's clinical (bleeding) history. VWD/AVWS arise from deficiency and/or defects in the adhesive plasma protein, von Willebrand factor (VWF). VWF undertakes various roles within hemostasis, but principally acts within primary hemostasis to anchor platelets to sites of vascular damage, thereby facilitating thrombus formation to arrest bleeding. The diagnosis or exclusion of VWD/AVWS requires laboratory testing for both VWF level and activity, with the latter potentially comprising several of a potential plethora of different assays. Complete diagnosis of VWD also requires the differentiation of VWD type, with six types comprising the current classification (i.e., qualitative [types 2A, 2B, 2M, 2N VWD] vs. quantitative [types 1 and 3 VWD] deficiency/defects). Although appropriate diagnosis and type classification hold important therapeutic consequences, these remain problematic and sometimes elusive for some laboratories to achieve. This report reviews the laboratory aided diagnosis or exclusion of VWD from a geographic perspective, and focuses on the disparities of approaches and methods in different regions of the world. This is primarily done from the perspective of data available from published reports related to external quality assessment (or proficiency testing) from different geographic localities. Moreover, differences in approaches between laboratories may arise due to differential adherence of particular guidelines, as well as regulatory aspects and predominance of local manufacturers and suppliers.
Exposure of Ophthalmology Residents to Cornea and Keratorefractive Surgeries in the United States
Authors: Tsou Brittany C. , Eller Zachary M. , Fliotsos Michael J. , Qiu Mary , Zafar Sidra , Srikumaran Divya , Bower Kraig , Woreta Fasika A.
Published: September 2022

Purpose To describe the cornea and keratorefractive surgeries experience of U.S. ophthalmology residents.

Methods Deidentified case logs of residents graduating in 2018 were collected from ophthalmology residency program directors in the United States. Using Current Procedure Terminology codes, case logs were reviewed in the categories of cornea and keratorefractive surgeries. Accreditation Council for Graduate Medical Education national graduating resident surgical case logs on cornea procedures published from 2010 to 2020 were also analyzed.

Results Case logs were received for 152/488 (31.1%) residents from 36/115 (31.3%) ophthalmology residency programs. The most common procedures logged by residents as primary surgeons were pterygium removal (4.3 ± 4.2) and keratorefractive surgeries (3.6 ± 6.2). Residents logged an average of 2.4 keratoplasties as primary surgeon, performing an average of 1.4 penetrating keratoplasties (PKs) and 0.8 endothelial keratoplasties (EKs). As assistants, the most common procedures logged were keratorefractive surgeries (6.1 ± 4.9), EKs (3.8 ± 3.3), and PKs (3.5 ± 2.3). Medium or large residency class size was associated with higher cornea procedural volumes (odds ratio: 8.9; 95% confidence interval: 1.1–75.6; p < 0.05).

Conclusion The most common cornea surgeries performed by residents include keratoplasty, keratorefractive, and pterygium procedures. Larger program size was associated with greater relative cornea surgery volume. More specific guidelines for logging of procedures could provide a more accurate assessment of resident exposure to critical techniques such as suturing as well as reflect trends in current practice such as the overall increase in EKs.
Postoperative Pain, Analgesic Choices, and Ileus: A Snapshot from a Teaching Hospital in a Developing Country
Authors: Al-Jasim Ameer , Aldujaili Alaa A. , Al-Abbasi Ghaith , Al-Abbasi Hasan , Al-Sahee Saif
Published: September 2022

Background Pain relief can be achieved by diversity of methods with analgesics being the basic form of treatment. Analgesic safety and clinical effectiveness are the core factors in determining the analgesic of choice. One adverse effect of concern with opioids is the postoperative ileus (POI).

Objective In this study, we looked at the severity of postoperative pain, the type of analgesics used to control the pain, and the incidence of POI at Baghdad Teaching Hospital. We hypothesized that we would find an association between the type of analgesia used and POI.

Methods This observational study was conducted among 100 patients who were residents at the general surgery wards of Baghdad Teaching Hospital. A structured questionnaire was employed focusing on types of analgesics, degree of pain control, and the presence of ileus.

Results Sixty-nine percent of patients received a combination of opioids and nonopioids. Moderate-to-severe pain was the most commonly reported category on pain scales. More than half of the patients (57%) were found to have POI during their hospital stay and there was a statistically significant association between the type of analgesia and POI development (p=0.001).

Conclusions A mix of analgesics (opioids and nonopioids) was the most common regimen at our center. The majority of the surgical inpatients reported having moderate-to-severe pain on both pain scales used in this study. Ileus incidence following abdominal surgeries (61%) was significantly higher than the reported incidence worldwide (10–30%). Postoperative ileus has multifactorial causes, one of which is the use of opioids for pain control. Considering the high incidence of ileus in our center and the association we found between the use of opioids and ileus, further studies should look at the doses of opioids used and whether alternative analgesic methods might result in less ileus.
Migration of Distal End of VP Shunt into the Scrotum: A Management Review
Authors: Taha Mahmoud M. , Almenshawy Hassan A. , Ezzat Mohammad , Elbadawy Mohamed Kh.
Published: September 2022

Ventriculo-peritoneal (VP) shunt is the typical and most common procedure for the treatment of hydrocephalus. Many complications have been associated with VP shunts, migration of the distal end of the VP tube into the scrotum is a rare one. We report the presentation and management of a case of 3 month age infant who had scrotal swelling primarily diagnosed as hydrocele. Investigations proved the presence of shunt migration. The possibility of shunt migration should be considered. Early diagnosis and management of such complications is easy and can prevent subsequent serious sequelae.
Activated Partial Thromboplastin Time and Prothrombin Time Mixing Studies: Current State of the Art
Authors: Adcock Dorothy M. , Moore Gary W. , Montalvão Silmara de Lima , Kershaw Geoffrey , Gosselin Robert C.
Published: September 2022

Mixing studies have long been in the clinical laboratory armamentarium for investigating unexpected, prolonged activated partial thromboplastin time (aPTT) or prothrombin time (PT). The purpose of the mixing study is to identify whether the aPTT/PT prolongation is secondary to a factor deficiency versus an inhibitor, which would present as a “corrected” and “noncorrected” mixing study, respectively. The differentiation between a factor deficiency and inhibitor may likely further direct clinical decisions, including additional diagnostic testing or factor replacement therapy. While aPTT/PT mixing studies are simple tests to perform, there is a lack of standardization for both the testing protocol and the interpretation of what is considered to be a corrected or noncorrected mixing study result. This review will describe the common indications for the mixing test, preanalytic variables that may affect mixing study performance, and describe several methods for interpreting the results of aPTT and PT mixing tests.
Accuracy Assessment of Outpatient Telemedicine Encounters at an Academic Ophthalmology Department
Authors: Schempf Tadhg , Kalra Gagan , Commiskey Patrick W. , Bowers Eve M. , Davis Amani , Waxman Evan L. , Fu Roxana , Williams Andrew M.
Published: September 2022

Purpose We assess the clinical accuracy of direct-to-patient real-time outpatient video visit encounters at our eye center.

Design This was a retrospective longitudinal study.

Subjects and Methods Patients who completed a video visit over a 3-week period between March and April 2020 were included. Accuracy assessment was determined by comparing diagnosis and management from the video visit with subsequent in-person follow-up over the next year.

Results A total of 210 patients (mean age 55±18 years) were included, of whom 172 (82%) were recommended a scheduled in-person follow-up encounter after their video visit. Among the 141 total patients who completed in-person follow-up, 137 (97%) had a diagnostic agreement between telemedicine and in-person evaluation. Management plan agreed for 116 (82%), with the remainder of visits either escalating or deescalating treatment upon in-person follow-up with little substantive change. Compared with established patients, new patients had higher diagnostic disagreement following video visits (12 vs. 1%, p=0.014). Acute visits trended toward more diagnostic disagreement compared with routine visits (6 vs. 1%, p=0.28) but had a similar rate of management change on follow-up (21 vs. 16%, p=0.48). New patients were more likely to have early unplanned follow-up than established patients (17 vs. 5%, p=0.029), and acute video visits were associated with unplanned early in-person assessments compared with routine video visits (13 vs. 3%, p=0.027). There were no serious adverse events associated with the use of our telemedicine program in the outpatient setting.

Conclusions Video visits had high diagnostic and management agreement with subsequent in-person follow-up encounters.
Classification and Stratification of Pulmonary Embolisms
Authors: Russell Cody , Keshavamurthy Suresh , Saha Sibu
Published: September 2022

Pulmonary embolism remains a leading cause of cardiovascular mortality. Presentation and outcomes are variable among patients and require rapid risk stratification for assessment and prognosis, as well as selection of appropriate treatment. Over the past several decades, several different models and parameters have become available to assess risk and classify pulmonary embolism into different risk categories. Some patients may be candidates for early discharge or complete outpatient treatment, while some may require invasive diagnostics and intensive monitoring. In this review, we summarize contemporary guidelines and methods for classification and risk stratification in an effort to provide tools for physicians to use in their management of patients with acute pulmonary embolisms.
Effects of infection fatality ratio and social contact matrices on vaccine prioritization strategies
Authors: Schulenburg Arthur , Cota Wesley , Costa Guilherme S. , Ferreira Silvio C.
Published: September 2022

Effective strategies of vaccine prioritization are essential to mitigate the impacts of severe infectious diseases. We investigate the role of infection fatality ratio (IFR) and social contact matrices on vaccination prioritization using a compartmental epidemic model fueled by real-world data of different diseases and countries. Our study confirms that massive and early vaccination is extremely effective to reduce the disease fatality if the contagion is mitigated, but the effectiveness is increasingly reduced as vaccination beginning delays in an uncontrolled epidemiological scenario. The optimal and least effective prioritization strategies depend non-linearly on epidemiological variables. Regions of the epidemiological parameter space, in which prioritizing the most vulnerable population is more effective than the most contagious individuals, depend strongly on the IFR age profile being, for example, substantially broader for COVID-19 in comparison with seasonal influenza. Demographics and social contact matrices deform the phase diagrams but do not alter their qualitative shapes.
Action potential and chaos near the edge of chaos in memristive circuits
Authors: Ying Jiajie , Liang Yan , Wang Guangyi , Jin Peipei , Chen Long , Chen Guanrong
Published: September 2022

Memristor-based neuromorphic systems have a neuro-bionic function, which is critical for possibly overcoming Moore's law limitation and the von Neumann bottleneck problem. To explore neural behaviors and complexity mechanisms in memristive circuits, this paper proposes an N-type locally active memristor, based on which a third-order memristive circuit is constructed. Theoretical analysis shows that the memristive circuit can exhibit not only various action potentials but also self-sustained oscillation and chaos. Based on Chua's theory of local activity, this paper finds that the neural behaviors and chaos emerge near the edge of chaos through subcritical Hopf bifurcation, in which the small unstable limit cycle is depicted by the dividing line between the attraction basin of the large stable limit cycle and the attraction basin of the stable equilibrium point. Furthermore, an analog circuit is designed to imitate the action potentials and chaos, and the simulation results are in agreement with the theoretical analysis.
Oblique stagnation point flow of micropolar nanofluid impinge along a vertical surface via modified Chebyshev collocation method
Authors: Haq Rizwan Ul , Sajjad Tabinda , Usman Muhammad , Naseem Anum
Published: September 2022

This article contains a study of mixed convection in micropolar nanofluid near an oblique stagnation point in the presence of a magnetic field. Similarity transformations are used to convert governing partial differential equations to non-linear ordinary differential equations. Modified Chebyshev collocation method in computational software Maple is used for the solution of governing nonlinear differential equations. A comparison of numerical results obtained by modified Chebyshev collocation method and finite difference method is made to show the accuracy of the method. Graphical results for velocity components, microrotation, temperature, and flow patterns are part of this study. Numerical values for free parameter (A), skin friction, and Nusselt numbers for different parameters are also calculated. It is found that microrotation profiles are enhanced by increasing the effect of stretching while decline with enhancing angle of strike γ. Also, the temperature of micropolar nanofluid is increased by increasing the value of the magnetic parameter and micropolar coefficient. The temperature gradient of nanofluid shows a decline when values of stretching parameter and the angle of the strike are increased.
Near-cancellation of up- and down-gradient momentum transport in forced magnetized shear-flow turbulence
Authors: Tripathi B. , Fraser A. E. , Terry P. W. , Zweibel E. G. , Pueschel M. J.
Published: September 2022

Visco-resistive magnetohydrodynamic turbulence, driven by a two-dimensional unstable shear layer that is maintained by an imposed body force, is examined by decomposing it into dissipationless linear eigenmodes of the initial profiles. The down-gradient momentum flux, as expected, originates from the large-scale instability. However, continual up-gradient momentum transport by large-scale linearly stable but nonlinearly excited eigenmodes is identified and found to nearly cancel the down-gradient transport by unstable modes. The stable modes effectuate this by depleting the large-scale turbulent fluctuations via energy transfer to the mean flow. This establishes a physical mechanism underlying the long-known observation that coherent vortices formed from nonlinear saturation of the instability reduce turbulent transport and fluctuations, as such vortices are composed of both the stable and unstable modes, which are nearly equal in their amplitudes. The impact of magnetic fields on the nonlinearly excited stable modes is then quantified. Even when imposing a strong magnetic field that almost completely suppresses the instability, the up-gradient transport by the stable modes is at least two-thirds of the down-gradient transport by the unstable modes, whereas for weaker fields, this fraction reaches up to 98%. These effects are persistent with variations in magnetic Prandtl number and forcing strength. Finally, continuum modes are shown to be energetically less important, but essential for capturing the magnetic fluctuations and Maxwell stress. A simple analytical scaling law is derived for their saturated turbulent amplitudes. It predicts the falloff rate as the inverse of the Fourier wavenumber, a property which is confirmed in numerical simulations.
Spin-generation in magnetic Weyl semimetal Co2MnGa across varying degree of chemical order
Authors: Safi Taqiyyah S. , Chou Chung-Tao , Hou Justin T. , Han Jiahao , Liu Luqiao
Published: September 2022

Recently discovered magnetic Weyl semimetals (MWSM), with enhanced Berry curvature stemming from the topology of their electronic band structure, have gained much interest for spintronics applications. In this category, Co2MnGa, a room temperature ferromagnetic Heusler alloy, has garnered special interest as a promising material for topologically driven spintronic applications. However, until now, the structural-order dependence of spin current generation efficiency through the spin Hall effect has not been fully explored in this material. In this paper, we study the evolution of magnetic and transport properties of Co2MnGa thin films from the chemically disordered B2 to ordered L21 phase. We also report on the change in spin generation efficiency across these different phases, using heterostructures of Co2MnGa and ferrimagnet CoxTb1−x with perpendicular magnetic anisotropy. We measured large spin Hall angles in both the B2 and L21 phases, and within our experimental limits, we did not observe the advantage brought by the MWSM ordering in generating a strong spin Hall angle over the disordered phases, which suggests more complicated mechanisms over the intrinsic, Weyl-band structure-determined spin Hall effect in these material stacks.