bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of chilling injury on global trade in tropical products
Authors: Heyes Julian A.
Published: December 2023

International trade in fresh products is dominated by products capable of long-term refrigerated storage, allowing marketing flexibility. For tropical products, postharvest chilling injury (PCI) is a barrier to long-term storage that limits trade by exacerbating the already-challenging requirements to minimise physical or biotic damage to products. In this review, the practical consequences of PCI in terms of international trade are described. Options for choosing to grow more resistant varieties or to predict the chilling injury risk of batches of fresh products can reduce overall losses by allowing better-informed sequencing of product marketing. Recent advances in technologies that reduce PCI risk or predict its severity, some of which can be used before harvest, are reviewed. At a more fundamental level, there is a growing number of excellent reviews on the potential for gene editing to alleviate postharvest chilling injury in tropical fruits and vegetables. Most are focused on research into ways to alleviate the consequences of chilling injury: i.e. oxidative stress arising from membrane dysfunction. A few recent reports show that reducing membrane dysfunction itself is possible, for example by increasing desaturation of membrane lipids, but this approach comes with a new and predictable problem: increased preharvest susceptibility to heat stress. Refined suggestions for strategies that could produce durable improvements in product quality hold the potential for significant increases in global trade with resulting economic benefits, particularly for developing countries.
BLK positively regulates TLR/IL-1R signaling by catalyzing TOLLIP phosphorylation
Authors: Li Wei-Wei , Fan Xu-Xu , Xu Zhi-Sheng , Zhu Zi-Xiang , Zhu Zhao-Yu , Cao Xue-Jing , Pei Dan-Shi , Wang Yi-Zhuo , Zhang Ji-Yan , Wang Yan-Yi , Zheng Hai-Xue
Published: December 2023

TLR/IL-1R signaling plays a critical role in sensing various harmful foreign pathogens and mounting efficient innate and adaptive immune responses, and it is tightly controlled by intracellular regulators at multiple levels. In particular, TOLLIP forms a constitutive complex with IRAK1 and sequesters it in the cytosol to maintain the kinase in an inactive conformation under unstimulated conditions. However, the underlying mechanisms by which IRAK1 dissociates from TOLLIP to activate TLR/IL-1R signaling remain obscure. Herein, we show that BLK positively regulates TLR/IL-1R–mediated inflammatory response. BLK-deficient mice produce less inflammatory cytokines and are more resistant to death upon IL-1β challenge. Mechanistically, BLK is preassociated with IL1R1 and IL1RAcP in resting cells. IL-1β stimulation induces heterodimerization of IL1R1 and IL1RAcP, which further triggers BLK autophosphorylation at Y309. Activated BLK directly phosphorylates TOLLIP at Y76/86/152 and further promotes TOLLIP dissociation from IRAK1, thereby facilitating TLR/IL-1R–mediated signal transduction. Overall, these findings highlight the importance of BLK as an active regulatory component in TLR/IL-1R signaling.
Size effects on atomic collapse in the dice lattice
Authors: Oriekhov D O , Voronov S O
Published: December 2023

We study the role of size effects on atomic collapse of charged impurity in the flat band system. The tight-binding simulations are made for the dice lattice with circular quantum dot shapes. It is shown that the mixing of in-gap edge states with bound states in impurity potential leads to increasing the critical charge value. This effect, together with enhancement of gap due to spatial quantization, makes it more difficult to observe the dive-into-continuum phenomenon in small quantum dots. At the same time, we show that if in-gap states are filled, the resonant tunneling to bound state in the impurity potential might occur at much smaller charge, which demonstrates non-monotonous dependence with the size of sample lattice. In addition, we study the possibility of creating supercritical localized potential well on different sublattices, and show that it is possible only on rim sites, but not on hub site. The predicted effects are expected to naturally occur in artificial flat band lattices.
An optimized Laplacian of Gaussian filter using improved sparrow search algorithm for bearing fault extraction
Authors: Feng Kezhu , Yang Rongrong , Wei Zhongbin
Published: December 2023

Precise detection of fault characteristics in rolling bearings is imperative for machine health management. However, due to the presence of interfering components including noise and periodic components caused by vibration sources, the extraction of weak fault-related information cannot be achieved precisely. In this study, we propose an optimized Laplacian of Gaussian (LoG) filtering technique to handle this issue. The proposed algorithm utilizes the envelope entropy and Gini of square envelope as an objection function to optimize two important parameters, namely standard deviation and filter order of the LoG filter, through an improved sparrow search algorithm (SSA) named adaptive spiral flying SSA. Afterward, the LoG filtering method with the optimal parameters is employed to filter the raw vibration data. Finally, the filtered signal undergoes envelope analysis for fault feature detection. A simulated test and two case studies demonstrate the effectiveness and superiority of the LoG technique.
LiDAR-SLAM loop closure detection based on multi-scale point cloud feature transformer
Authors: Wang Shaohua , Zheng Dekai , Li Yicheng
Published: December 2023

Loop closure detection is an important part of simultaneous localization and mapping (SLAM), used to detect and correct map and trajectory drift issues caused by accumulated errors. For the LiDAR-SLAM system, the sparsity and disorder of point clouds make position recognition based on 3D point clouds more challenging. In recent years, many deep learning-based closed-loop detection algorithms have been proposed. However, due to the sparsity of point clouds, current deep learning algorithms often convert point clouds into histograms or depth maps and then process them using deep learning algorithms, undoubtedly causing information loss. In this paper, we propose a closed-loop detection method based on multi-scale point cloud features transformer, which introduces multi-scale point cloud feature extraction and transformer global context modeling. We use voxel sparse convolution to obtain features of original point clouds at different resolutions and establish contextual relationships between features at different resolutions using the transformer network to achieve multi-scale feature fusion, and then obtain global descriptors. The obtained global descriptors can be used not only for closed-loop detection but also for front-end registration to address the challenges of point cloud processing in the SLAM system, especially in enhancing global modeling capabilities and reducing information loss. Our method directly processes point cloud data and integrates multi-scale point cloud feature information, which can better adapt to the characteristics of LiDAR-SLAM systems, improving the accuracy and robustness of localization and map construction, thus having broad application prospects in the field of measurement. We evaluated our method on multiple sequences of the KITTI and KITTI-360 datasets, each containing more than 5000 frames of point clouds, and extensively evaluated on a self-collected dataset of over 3.6 km. The experimental results show that our method achieves an accuracy of over 80% on multiple datasets and demonstrates superior performance in different environments.
A self-healing artificial muscle was realized by fitting the electrode membrane with the self-healing actuating membrane with a folded structure
Authors: Wang Junyao , Chen Yansong , Wang Jing , Liu Huan , Lang Tianhong , Hou Qi , Wang Rui , Cui Bowen , Quan Jingran , Pan Hongxu , Yang Hanbo , Xu Jianxin , Liu Yahao , Wang Baoliang
Published: December 2023

As a part of biomimetic gelatinous polymer actuator (BGPA), hydrogel artificial muscle has the advantages of extreme flexibility, low driving voltage and controllable driving direction. However, such artificial muscles do not have self-healing properties and it is difficult to continue using them if they break, which considerably reduces their lifespan. In this paper, we propose a hydrogel artificial muscle with self-healing capability by gluing a membrane of electrodes with a pleated structure to a self-healing actuator layer. The crosslinking reaction between polyacrylic acid molecular chains and carboxylated chitosan (CLC) molecular chains was utilized to fabricat e self-healing actuator layers, while multi-walled carbon nanotubes and chitosan were employed for electrode films. The impact of CLC doping content on the self-healing properties, mechanical properties, electrical response output force properties, and electrochemical properties of self-healing artificial muscles was investigated. Experimental results demonstrated that the output force density of the self-healing artificial muscle could reach 14.7 mN g−1 with an addition of 0.2 g CLC; even after fracture-self-healing, the maximum output force density of the artificial muscle still remained above 90%, and the maximum stretching stress of the actuator film maintained a range from 91% to 99%, showcasing exceptional self-healing performance.
The Impact of Serpentinization on the Initial Conditions of Satellite Forming Collisions of Large Kuiper Belt Objects
Authors: Farkas-Takács Anikó , Kiss Csaba
Published: December 2023

Kuiper Belt objects are thought to be formed at least a few million years after the formation of calcium–aluminum-rich inclusions (CAIs), at a time when the 26Al isotope—the major source of radiogenic heat in the early solar system—had significantly depleted. The internal structure of these objects is highly dependent on any additional source that can produce extra heat in addition to that produced by the remaining, long-lasting radioactive isotopes. In this paper, we explore how serpentinization, the hydration of silicate minerals, can contribute to the heat budget and to what extent it can modify the internal structure of large Kuiper Belt objects. We find that the extent of restructuring depends very strongly on the start time of the formation process, the size of the object, and the starting ice-to-rock ratio. Serpentinization is able to restructure most of the interior of all objects in the whole size range (400–1200 km) and ice-to-rock ratio range investigated if the process starts early, ∼3 Myr after CAI formation, potentially leading to a predominantly serpentine core much earlier than previously thought (≤5 Myr versus several tens of million years). While the ratio of serpentinized material gradually decreases with the increasing formation time, the increasing ice-to-rock ratio, and the increasing start time of planetesimal formation in the outer solar system, in the case of the largest objects a significant part of the interior will be serpentinized even if the formation starts relatively late, ∼5 Myr after CAI formation. Therefore it is feasible that the interior of planetesimals may have contained a significant amount of serpentine, and in some cases, it could have been a dominant constituent, at the time of satellite-forming impacts.
Influence of low-energy supersymmetric vector-like quirk particles on W mass increment and muon g–2 anomaly*
Authors: Zhou 周 Ping 平
Published: December 2023

In the low energy realization of the quirk assisted Standard Model, the couplings between the exotic particles "quirks" and gauge bosons may contribute to the W mass and muon

anomaly reported by FermiLab. We calculate the contributions from supersymmetric quirk particles as an example. By imposing the theoretical constraints, we determined that the CDF II W-boson mass increment strictly constrains the mixing and coupling parameters and the quirk mass

, while the muon

anomaly cannot be solely attributed to the involvement of exotic particles, considering their significantly large masses.
Strong decay of
in light cone sum rules*
Authors: Xie 谢 Yiling 易凌 , Sun 孙 Hao 昊
Published: December 2023

In this study, we assign the tetraquark state for the

resonance and investigate the mass and decay constant of

in the framework of SVZ sum rules through a different calculation technique. Then, we calculate the strong coupling

by considering soft-meson approximation techniques within the framework of light cone sum rules, and we use the strong coupling

to obtain the width of the decay

. Our prediction for the mass agrees with the experimental measurement, and that for the decay width of

is within the upper limit.
Machine learning-based real-time kinetic profile reconstruction in DIII-D
Authors: Shousha Ricardo , Seo Jaemin , Erickson Keith , Xing Zichuan , Kim SangKyeun , Abbate Joseph , Kolemen Egemen
Published: December 2023

Kinetic equilibrium reconstruction plays a vital role in the physical analysis of plasma stability and control in fusion tokamaks. However, the traditional approach is subjective and prone to human biases. To address this, the consistent automatic kinetic equilibrium reconstruction (CAKE) method was introduced, providing objective results. Nonetheless, its offline nature limits its application in real-time plasma control systems (PCSs). To address this limitation, we present RTCAKENN, a machine learning model that approximates 7 CAKE-level output profiles, namely pressure, inverse q, toroidal current density, electron temperature and density, carbon ion impurity temperature and rotation profiles, using real-time available inputs. The deep neural network consists of an encoder layer, where the scalars and interdependent inputs such as plasma boundary coordinates and motional Stark effect data are encoded using multi-layer perceptrons (MLPs), while profile inputs are encoded by 1D convolutional layers. The encoded data is passed through a MLP for latent feature extraction, before being decoded in the decoding layers, which consist of upsampling and convolutional layers. RTCAKENN has been implemented in the DIII-D PCS and our model achieves accuracy comparable to CAKE and surpasses existing real-time alternatives. Through clever dropout training, RTCAKENN exhibits robustness and can operate even in the absence of Thomson scattering data or charge exchange recombination data. It executes in under 8 ms in the real-time environment, enabling future application in real-time control and analysis.
Ultrafast erbium-doped fiber laser using electrodeposition coated MoS2 thin film as saturable absorber
Authors: Hong Jason Lee Lian , Tiu Zian Cheak , Batumalay Malathy , Harith Zuraidah , Diblawe Abdulkadir Mukhtar , Anand T Joseph Sahaya , Harun Sulaiman Wadi
Published: December 2023

In this work, we have experimentally demonstrated the ultrafast laser in Erbium-doped fiber laser using MoS2 as saturable absorber. The MoS2 SA in this work is prepared by bottom-up method. A three-electrode configuration is used to perform the electrodeposition to coat the MoS2 onto conductive film. The MoS2 saturable absorber is incorporated into the fiber laser system to induce mode-locking operation centered at 1560.8 nm. The proposed saturable absorber has achieved pulse width of 1.47 ps, with highest average pulse energy of 0.44 nJ and repetition rate of 1.88 MHz. The venture of electrodeposition coated MoS2 thin film as saturable absorber is potentially to pave the foundation toward the sustainable industry, innovation and infrastructure.
Improving bonding strength and reliability of brazed titanium/copper dissimilar joint using vanadium interlayer
Authors: Mengen Liu , Li Bai
Published: December 2023

Conventional practice of brazing titanium (Ti) to copper (Cu) using Ag-28Cu eutectic filler alloy is of limited success because of the generation of brittle Ti-Cu intermetallic compounds (IMCs). The bonding strength is unsatisfactory owing to embrittlement of IMCs, and it is difficult to reproduce the bonding strength as the joint microstructure is highly sensitive to brazing parameters. In the current study, it was demonstrated that the formation of such undesirable IMCs can be suppressed and strong Ti/Cu joint can be obtained by brazing at 850 °C using a refractory vanadium (V) interlayer 15 μm in thickness deposited on Ti substrate, in combination with an Ag-Cu-Ti active filler alloy. The V interlayer successfully blocked the interaction between Ti and filler alloy. Bonding mechanisms of the resultant joint can be deduced to be a synergy of active brazing in the V/Ag-Cu-Ti/Cu half and solid-state diffusion bonding at the Ti/V interface. The thus developed joint was comprised of continuous Ti-V solid solution, unconsumed V interlayer and remaining filler alloy. Attributed to elimination of brittle IMCs at joint interface, excellent bonding strength of ∼220 MPa which is comparable with strength of Cu base metal was achieved. Moreover, since the joint evolution was dominated by sluggish solid-state diffusion at the Ti/V interface and very limited erosion of V interlayer by the Ag-Cu-Ti filler, desirable IMC free joint can be obtained over a wide range of brazing time (2 ∼ 5 min), enabling outstanding reliability of the high bonding strength.
Inferring comparative advantage via entropy maximization
Authors: Bruno Matteo , Mazzilli Dario , Patelli Aurelio , Squartini Tiziano , Saracco Fabio
Published: December 2023

We revise the procedure proposed by Balassa to infer comparative advantage, which is a standard tool in Economics to analyze specialization (of countries, regions, etc). Balassa’s approach compares a country’s export of a given product with what would be expected from a benchmark based on the total volumes of countries and product flows. Based on results in the literature, we show that implementing Balassa’s idea leads to conditions for estimating parameters conflicting with the information content of the model itself. Moreover, Balassa’s approach does not implement any statistical validation. Hence, we propose an alternative procedure to overcome such a limitation, based upon the framework of entropy maximization and implementing a proper test of hypothesis: the ‘key products’ of a country are, now, the ones whose production is significantly larger than expected, under a null-model constraining the same amount of information defining Balassa’s approach. What we found is that country diversification is always observed, regardless of the strictness of the validation procedure. Besides, the ranking of countries’ fitnesses is only partially affected by the details of the validation scheme employed for the analysis while large differences are found to affect the rankings of product complexities. The routine for implementing the entropy-based filtering procedures employed here is freely available through the official Python Package Index PyPI.
MLGN: multi-scale local-global feature learning network for long-term series forecasting
Authors: Jiang Maowei , Wang Kai , Sun Yue , Chen Wenbo , Xia Bingjie , Li Ruiqi
Published: December 2023

Although Transformer-based methods have achieved remarkable performance in the field of long-term series forecasting, they can be computationally expensive and lack the ability to specifically model local features as CNNs. CNN-based methods, such as temporal convolutional network (TCN), utilize convolutional filters to capture local temporal features. However, the intermediate layers of TCN suffer from a limited effective receptive field, which can result in the loss of temporal relations during global feature extraction.To solve the above problems, we propose to combine local features and global correlations to capture the overall view of time series (e.g. fluctuations, trends). To fully exploit the underlying information in the time series, a multi-scale branch structure is adopted to model different potential patterns separately. Each pattern is extracted using a combination of interactive learning convolution and causal frequency enhancement to capture both local features and global correlations. Furthermore, our proposed method,multi-scale local-global feature learning network (MLGN), achieves a time and memory complexity of O(L) and consistently achieve state-of-the-art results on six benchmark datasets. In comparision with previous best method Fedformer, MLGN yields 12.98% and 11.38% relative improvements for multivariate and univariate time series, respectively. Our code and data are available on Github at https://github.com/Zero-coder/MLGN.
A stable undoped low-voltage memristor cell based on Titania (TiOx)
Authors: Ullah Fateh , Tarkhan Mahdi , Fredj Zina , Su Yi , Wang Tianjun , Sawan Mohamad
Published: December 2023

An asymmetric memristive device fabricated with a titania (TiOx)-based switching layer deposited through atomic layer deposition with a thickness of ∼37 nm was investigated. X-ray photoelectron spectroscopy and high-resolution transmission electron microscopy coupled with energy-dispersive x-ray spectroscopy were employed for device structural characterization. A unipolar resistive switching behavior (both at positive and negative voltages) was observed through the memristor’s current–voltage characteristics. A remarkably smaller forming voltage (from the top Pt electrode to the grounded Au electrode) of 0.46 V was achieved, while it approached (positive bias from the Au electrode and holding Pt electrode as grounded) 0.25 V, which is a much smaller forming voltage than has ever been reported for titanium-based oxides without doping. The retention and endurance characterization over 2000 switching cycles were satisfactory without degradation.
Comprehensive whole-genome analyses of the UK Biobank reveal significant sex differences in both genotype missingness and allele frequency on the X chromosome
Authors: Chen Desmond Zeya , Roshandel Delnaz , Wang Zhong , Sun Lei , Paterson Andrew D
Published: December 2023

The UK Biobank is the most used dataset for genome-wide association studies (GWAS). GWAS of sex, essentially sex differences in minor allele frequencies (sdMAF), has identified autosomal SNPs with significant sdMAF, including in the UK Biobank, but the X chromosome was excluded. Our recent report identified multiple regions on the X chromosome with significant sdMAF, using short-read sequencing of other datasets. We performed a whole genome sdMAF analysis, with ~410 k white British individuals from the UK Biobank, using array genotyped, imputed or exome sequencing data. We observed marked sdMAF on the X chromosome, particularly at the boundaries between the pseudo-autosomal regions (PAR) and the non-PAR (NPR), as well as throughout the NPR, consistent with our earlier report. A small fraction of autosomal SNPs also showed significant sdMAF. Using the centrally imputed data, which relied mostly on low-coverage whole genome sequence, resulted in 2.1% of NPR SNPs with significant sdMAF. The whole exome sequencing also displays sdMAF on the X chromosome, including some NPR SNPs with heterozygous genotype calls in males. Genotyping, sequencing and imputation of X chromosomal SNPs requires further attention to ensure the integrity for downstream association analysis.
Invasive fusariosis in patients with leukaemia in the era of mould-active azoles: increasing incidence, frequent breakthrough infections and lack of improved outcomes
Authors: Matsuo Takahiro , Wurster Sebastian , Jiang Ying , Sasaki Koji , Tarrand Jeffrey , Lewis Russell E , Kontoyiannis Dimitrios P
Published: December 2023

Objectives

Historically, patients with leukaemia and invasive fusariosis (IF) have experienced poor outcomes in the setting of persistent immunosuppression. Herein, we retrospectively reviewed the incidence, presentation and outcomes of IF that are scarcely studied in contemporary cohorts of leukaemia patients.

Methods

We identified adult leukaemia patients with proven or probable IF at MD Anderson Cancer Center during 2009–21. Independent risk factors for 42 day mortality after IF diagnosis were determined using a multivariable logistic regression model. Combined with historical data, the annual IF incidence density over the past 23 years was estimated using Poisson regression analysis.

Results

Among 140 leukaemia patients with IF (114 proven), 118 patients (84%) had relapsed/refractory leukaemia and 124 (89%) had neutropenia at IF diagnosis. One hundred patients (71%) had pulmonary IF, 88 (63%) had disseminated IF and 48 (34%) had fungaemia. Coinfections were common (55%). Eighty-nine patients (64%) had breakthrough IF to mould-active triazoles. Most patients (84%) received combination antifungal therapy. Neutrophil recovery [adjusted OR (aOR), 0.04; 95% CI, 0.01–0.14; P < 0.0001], pulmonary IF (aOR, 3.28; 95% CI, 1.11–9.70; P = 0.032) and high SOFA score (aOR, 1.91 per 1-point increase; 95% CI, 1.47–2.50; P < 0.0001) were independent predictors of 42 day mortality outcomes. From 1998 to 2021, IF incidence density increased significantly at an annual ratio of 1.03 (95% CI, 1.01–1.06; P = 0.04).

Conclusions

IF is predominantly seen in patients with relapsed/refractory leukaemia and increasingly seen as a breakthrough infection to mould-active triazoles. Despite frequent combination antifungal therapy, high mortality rates have persisted in patients with lasting neutropenia.
Disease- and stage-specific alterations of the oral and fecal microbiota in Alzheimer's disease
Authors: Troci Alba , Philippen Sarah , Rausch Philipp , Rave Julius , Weyland Gina , Niemann Katharina , Jessen Katharina , Schmill Lars-Patrick , Aludin Schekeb , Franke Andre , Berg Daniela , Bang Corinna , Bartsch Thorsten
Published: December 2023

Microbial communities in the intestinal tract are suggested to impact the ethiopathogenesis of Alzheimer's disease (AD). The human microbiome might modulate neuroinflammatory processes and contribute to neurodegeneration in AD. However, the microbial compositions in patients with AD at different stages of the disease are still not fully characterized. We used 16S rRNA analyses to investigate the oral and fecal microbiota in patients with AD and mild cognitive impairment (MCI; n = 84), at-risk individuals (APOE4 carriers; n = 17), and healthy controls (n = 50) and investigated the relationship of microbial communities and disease-specific markers via multivariate- and network-based approaches. We found a slightly decreased diversity in the fecal microbiota of patients with AD (average Chao1 diversity for AD = 212 [SD = 66]; for controls = 215 [SD = 55]) and identified differences in bacterial abundances including Bacteroidetes, Ruminococcus, Sutterella, and Porphyromonadaceae. The diversity in the oral microbiota was increased in patients with AD and at-risk individuals (average Chao1 diversity for AD = 174 [SD = 60], for at-risk group = 195 [SD = 49]). Gram-negative proinflammatory bacteria including Haemophilus, Neisseria, Actinobacillus, and Porphyromonas were dominant oral bacteria in patients with AD and MCI and the abundance correlated with the cerebrospinal fluid biomarker. Taken together, we observed a strong shift in the fecal and the oral communities of patients with AD already prominent in prodromal and, in case of the oral microbiota, in at-risk stages. This indicates stage-dependent alterations in oral and fecal microbiota in AD which may contribute to the pathogenesis via a facilitated intestinal and systemic inflammation leading to neuroinflammation and neurodegeneration.
‘Insight’ in medical training: what, why, and how?
Authors: Ng Isaac K S , Lin Norman H Y , Goh Wilson G W , Teo Desmond B , Tan Li Feng , Ban Kenneth H K
Published: December 2023

The term ‘insight’ is generically defined in English language as the ability to perceive deeper truths about people and situations. In clinical practice, patient insight is known to have important implications in treatment compliance and clinical outcomes, and can be assessed clinically by looking for the presence of illness awareness, correct attribution of symptoms to underlying condition, and acceptance of treatment. In this article, we suggest that cultivating insight is actually a highly important, yet often overlooked, component of medical training, which may explain why some consistently learn well, communicate effectively, and quickly attain clinical competency, while others struggle throughout their clinical training and may even be difficult to remediate. We herein define ‘insight’ in the context of medical training as having an astute perception of personal cognitive processes, motivations, emotions, and ability (strengths, weaknesses, and limitations) that should drive self-improvement and effective behavioural regulation. We then describe the utility of cultivating ‘insight’ in medical training through three lenses of (i) promoting self-regulated, lifelong clinical learning, (ii) improving clinical competencies and person-centred care, and (iii) enhancing physician mental health and well-being. In addition, we review educational pedagogies that are helpful to create a medical eco-system that promotes the cultivation of insight among its trainees and practitioners. Finally, we highlight several tell-tale signs of poor insight and discuss psychological and non-psychological interventions that may help those severely lacking in insight to become more amenable to change and remediation.
Phenotypic Fungicide Resistance and Cross-Resistance Among Nothopassalora personata Populations
Authors: Renfroe-Becton Hope , Croft Jonathan , Davis Charles , Varn Joe , Culbreath Albert K. , Langston David B. , Anco Daniel J.
Published: December 2023

Late leaf spot, caused by Nothopassalora personata, is an economically important disease of peanut that routinely requires several applications of preventative fungicides. The objectives of this study were to quantify the risk of phenotypic fungicide resistance and potential cross-resistance among N. personata populations. A total of 59 samples of N. personata isolates were collected from 28 grower or research fields in South Carolina, Georgia, and Virginia. Phenotypic resistance of isolates was evaluated against 14 fungicides and a nontreated control, with active ingredients from the quinone outside inhibitor, demethylation inhibitor, and succinate-dehydrogenase inhibitor (SDHI) classes. Overall, visual incidence of lesion development 15% or greater was observed with nearly all isolates for at least one of the active ingredients tested. Correlations between active ingredients penthiopyrad and pydiflumetofen, as well as bixafen plus flutriafol and pydiflumetofen, and their lesion development risk indicate potential N. personata populations with SDHI cross-resistance. Although these data do not confirm the presence of genetic resistance markers, results paired with observed reduced efficacy in the field reinforce the strong need for an integrated approach in managing late leaf spot. In areas with high probabilities for resistance to several modes of action, longer rotations out of peanut, varieties with greater levels of resistance, earlier planting, and continued incorporation of active ingredients with a multi-site mode of action in fungicide programs are advised for preserving fungicide efficacy or reducing selection pressure.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
A Pilot Study of a Finger Kinematic Parameter-Based Tool for Evaluating Degenerative Cervical Myelopathy
Authors: Li Xingyu , Wang Hui , Xu Zeng , Lu Zhengzhong , Zhang Wenyu , Wang Yunhao , Wang Jianxi , Zang Fazhi , Yuan Wen , Chen Huajiang , Wu Xiaodong
Published: December 2023

Study Design.

This is a cross-sectional study.

Objective.

To evaluate the effectiveness of a novel finger Kinematic Parameter-Based Tool in grip-and-release (G&R) test for assessing degenerative cervical myelopathy (DCM).

Summary of Background Data.

The development and progression of DCM symptoms are gradual and obscure. Although previous studies have objectively evaluated hand movements specific to myelopathy using the G&R test, virtual reality, or wearable sensors, these methods have limitations, such as limited discrimination or inconvenience for simple screening. Consequently, there is a need to develop effective screening methods.

Methods.

297 asymptomatic volunteers and 258 DCM patients were enrolled. This system comprises a wearable acceleration/gyro (A/G) sensor. The A/G sensor was placed on the little finger of the participants to perform 40 cycles of full-range G&R as quickly as possible. The collected data were then transformed into kinematic parameters using sensor-based software and R studio. Gender, age, and BMI subgroups (classified as BMI<18.5—below normal weight; 18.5≤BMI<25—normal weight group; BMI≥25—overweight group) were matched as predictor variables, and 201 pairs were matched. Non-parametric analysis using the Mann-Whitney U test was used for diagnosing the differences between the two groups, and the Kruskal-Wallis’s test followed by the Mann-Whitney U test was used for analyzing the differences among three different age groups (<40 yrs., 41-60 yrs. and >60 yrs. group). The cut-off value of 10s G&R cycles and a combined parameter were determined using receiver operating characteristics (ROC) curve analysis, area under the curve (AUC) and Youden index.

Results.

We found that little finger kinematic parameters were significantly lower in DCM patients than in asymptomatic participants. The optimal diagnostic indicator appeared to be the average top 10 linear accelerations with an AUC of 0.923.

Conclusion.

The Finger Kinematic Test System is an objective, practical and quantitative utility that appears to have the capacity to diagnose and evaluate the severity of DCM.

Level of Evidence.

3
Application of Global Leadership Initiative on Malnutrition criteria in patients with liver cirrhosis
Authors: Jiang Minjie , Chen Juan , Wu Muchen , Wu Jing , Xu Xiaotong , Li Juan , Liu Can , Zhao Yaping , Hua Xin , Meng Qinghua
Published: December 2023

Background:

The Global Leadership Initiative on Malnutrition (GLIM) criteria were published to build a global consensus on nutritional diagnosis. Reduced muscle mass is a phenotypic criterion with strong evidence to support its inclusion in the GLIM consensus criteria. However, there is no consensus regarding how to accurately measure and define reduced muscle mass in clinical settings. This study aimed to investigate the optimal reference values of skeletal muscle mass index for diagnosing sarcopenia and GLIM-defined malnutrition, as well as the prevalence of GLIM-defined malnutrition in hospitalized cirrhotic patients.

Methods:

This retrospective study was conducted on 1002 adult patients with liver cirrhosis between January 1, 2018, and February 28, 2022, at Beijing You-An Hospital, Capital Medical University. Adult patients with a clinical diagnosis of liver cirrhosis and who underwent an abdominal computed tomography (CT) examination during hospitalization were included in the study. These patients were randomly divided into a modeling group (cohort 1, 667 patients) and a validation group (cohort 2, 335 patients). In cohort 1, optimal cut-off values of skeletal muscle index at the third lumbar skeletal muscle index (L3-SMI) were determined using receiver operating characteristic analyses against in-hospital mortality in different gender groups. Next, patients in cohort 2 were screened for nutritional risk using the Nutritional Risk Screening 2002 (NRS-2002), and malnutrition was diagnosed by GLIM criteria. Additionally, the reference values of reduced muscle mass in GLIM criteria were derived from the L3-SMI values from cohort 1. Multivariate logistic regression analysis was used to analyze the association between GLIM-defined malnutrition and clinical outcomes.

Results:

The optimal cut-off values of L3-SMI were 39.50 cm2/m2for male patients and 33.06 cm2/m2for female patients. Based on the cut-off values, 31.63% (68/215) of the male patients and 23.3% (28/120) of the female patients had CT-determined sarcopenia in cohort 2. The prevalence of GLIM-defined malnutrition in cirrhotic patients was 34.3% (115/335) and GLIM-defined malnutrition was an independent risk factor for in-hospital mortality in patients with liver cirrhosis (Wald= 6.347,P = 0.012).

Conclusions:

This study provided reference values for skeletal muscle mass index and the prevalence of GLIM-defined malnutrition in hospitalized patients with liver cirrhosis. These reference values will contribute to applying the GLIM criteria in cirrhotic patients.
Comparing the impact of three-dimensional digital visualization technology versus traditional microscopy on microsurgeons in microsurgery: a prospective self-controlled study
Authors: Xu Andi , Yao Ying , Chen Wenben , Lin Yuanfan , Li Ruiyang , Wang Ruixin , Pan Liuqing , Ye Qingqing , Pang Yangfei , Wu Xiaohang , Lin Duoru , Zhao Lanqin , Jin Ling , Shao Hang , Liu Wei , Gao Kun , Zhang Xin , Yan Pisong , Deng Xinpei , Wang Dongni , Huang Weiming , Zhang Xulin , Dongye Meimei , Li Jinrong , Lin Haotian
Published: December 2023

Background:

Emerging three-dimensional digital visualization technology (DVT) provides more advantages than traditional microscopy in microsurgery; however, its impact on microsurgeons’ visual and nervous systems and delicate microsurgery is still unclear, which hinders the wider implementation of DVT in digital visualization for microsurgery.

Methods and material:

Forty-two microsurgeons from the Zhongshan Ophthalmic Center were enrolled in this prospective self-controlled study. Each microsurgeon consecutively performed 30 min conjunctival sutures using a three-dimensional digital display and a microscope, respectively. Visual function, autonomic nerve activity, and subjective symptoms were evaluated before and immediately after the operation. Visual functions, including accommodative lag, accommodative amplitude, near point of convergence and contrast sensitivity function (CSF), were measured by an expert optometrist. Heart rate variability was recorded by a wearable device for monitoring autonomic nervous activity. Subjective symptoms were evaluated by questionnaires. Microsurgical performance was assessed by the video-based Objective Structured Assessment of Technical Skill (OSATS) tool.

Results:

Accommodative lag decreased from 0.63 (0.18) diopters (D) to 0.55 (0.16) D (P=0.014), area under the log contrast sensitivity function increased from 1.49 (0.15) to 1.52 (0.14) (P=0.037), and heart rate variability decreased from 36.00 (13.54) milliseconds (ms) to 32.26 (12.35) ms (P=0.004) after using the DVT, but the changes showed no differences compared to traditional microscopy (P>0.05). No statistical significance was observed for global OSATS scores between the two rounds of operations [mean difference, 0.05 (95% CI: −1.17 to 1.08) points; P=0.95]. Subjective symptoms were quite mild after using both techniques.

Conclusions:

The impact of DVT-based procedures on microsurgeons includes enhanced accommodation and sympathetic activity, but the changes and surgical performance are not significantly different from those of microscopy-based microsurgery. Our findings indicate that short-term use of DVT is reliable for microsurgery and the long-term effect of using DVT deserve more consideration.
Postoperative results, learning curve, and outcomes of pancreatectomy with arterial resection: a single-center retrospective cohort study on 236 procedures
Authors: Napoli Niccolò , Kauffmann Emanuele F. , Lombardo Carlo , Ginesini Michael , Di Dato Armando , Lami Lucrezia , Annunziata Elena , Vistoli Fabio , Campani Daniela , Cappelli Carla , Amorese Gabriella , Boggi Ugo
Published: December 2023

Background:

Newer chemotherapy regimens are reviving the role of pancreatectomy with arterial resection (PAR) in locally advanced pancreatic cancer. However, concerns about the early outcomes and learning curve of PAR remain. This study aimed to define the postoperative results and learning curve of PAR and provide preliminary data on oncologic outcomes.

Materials and methods:

A single center’s experiences (1993–2023) were retrospectively analyzed to define the postoperative outcomes and learning curve of PAR. Oncologic results were also reported.

Results:

During the study period 236 patients underwent PAR. Eighty PAR (33.9%) were performed until 2012, and 156 were performed thereafter (66.1%). Pancreatic cancer was diagnosed histologically in 183 patients (77.5%). Induction therapy was delivered to 18 of these patients (31.0%) in the early experience and to 101 patients (80.8%) in the last decade (P<0.0001). The superior mesenteric artery (PAR-SMA), celiac trunk/hepatic artery (PAR-CT/HA), superior mesenteric/portal vein, and inferior vena cava were resected in 95 (40.7%), 138 (59.2%), 189 (80.1%), and 9 (3.8%) patients, respectively. Total gastrectomy was performed in 35 (18.5%) patients. The 30-day mortality rate was 7.2% and 90-day mortality rate was 9.7%. The learning curve for mortality was 106 PAR [16.0 vs. 4.6%; odds ratio, OR=0.25 (0.10–0.67), P=0.0055]. Comparison between the PAR-SMA and PAR-CT/HA groups showed no differences in severe postoperative complications (25.3 vs. 20.6%), 90-day mortality (12.6 vs. 7.8%), and median overall survival. Vascular invasion was confirmed in 123 patients (67.2%). The median number (interquartile range) of examined lymph nodes was 60.5 (41.3–83) and rate of R0 resection was 66.1% (121/183). Median overall survival for PAR was 20.9 (12.5–42.8) months, for PAR-SMA was 20.2 (14.4–44) months, and for PAR-CT/HA was 20.2 (11.4–42.7). Long-term prognosis improved by study decade [1993–2002: 12.0 (5.4–25.9) months, 2003–2012: 15.1 (9.8–23.4) months, and 2013–present: 26.2 (14.3–51.5) months; P<0.0001].

Conclusions:

In recent times, PAR is associated with improved outcomes despite a steep learning curve. Pancreatic surgeons should be prepared to face the technical challenge posed by PAR.
From early risk to 1-year mortality: a comprehensive assessment of postoperative venous thromboembolism in upper gastrointestinal cancer patients – a nationwide cohort study
Authors: Thereaux Jérémie , Badic Bogdan , Fuchs Basile , Leven Cyril , Caillard Anais , Lacut Karin , Metges Jean-Philippe , Couturaud Francis
Published: December 2023

Background:

Venous thromboembolism (VTE) is a well-recognized complication following gastrointestinal cancer surgery, particularly early postoperatively. The incidence and risk factors of VTE within 1-year after esophageal (including esophago-gastric junction) (ECS) and gastric (GCS) cancer surgeries, and especially its impact on 1-year global mortality, are yet under-explored.

Methods:

This nationwide observational population-based cohort study used data extracted from all patients undergoing ECS and GCS in France between 1 January 2015 and 31 December 2017. Multivariate logistic regression was used to identify risk factors for 90 postoperative days (POD) VTE (OR 95% CI). Cox proportional hazards models investigated the impact of 1-year postoperative VTE on 1-year global mortality [HR (95% CI)].

Results:

During the study period, 8005 patients underwent ECS (N=3429) or GCS (N=4576) (31.8% female; 66.7±12.1 years old). Majority (N=4951) of patients had preoperative treatment (chemotherapy or radiochemotherapy). Ninety POD incidence of VTE were 4.7% (ECS=6.2%) (GCS=3.6%) (44.7% during first hospitalization, 19.0% needing readmission, and 36.3% ambulatory management). Main risk factors were three and two field esophagectomy [3.6 (2.20–5.83) and 2.2 (1.68–3.0)], obesity [1.9 (1.40–2.58)] and history of VTE [5.1 (2.72–9.45)]. Late-onset VTE rates (occurring between the 6th and 12th month) represented 1.80 and 1.46% of the overall ECS and GCS groups. Patients with VTE within 1-year had higher risks of 1-year global mortality: (2.04 1.52; 2.73) and 2.71 (2.09; 3.51), respectively.

Conclusion:

Our extensive analysis of a nationwide database highlights the significant risk of postoperative VTE after ECS and GCS, persisting within 90 POD and up to 1-year. Crucially, a higher risk of global mortality within 1-year for patients experiencing early or late VTE was found. These findings could advocate for further research into extended prophylactic regimens, particularly for those most at risk.
Artificial intelligence-based diagnosis of standard endoscopic ultrasonography scanning sites in the biliopancreatic system: a multicenter retrospective study
Authors: Tian Shuxin , Shi Huiying , Chen Weigang , Li Shijie , Han Chaoqun , Du Fan , Wang Weijun , Wen Hongxu , Lei Yali , Deng Liang , Tang Jing , Zhang Jinjie , Lin Jianjiao , Shi Lei , Ning Bo , Zhao Kui , Miao Jiarong , Wang Guobao , Hou Hui , Huang Xiaoxi , Kong Wenjie , Jin Xiaojuan , Ding Zhen , Lin Rong
Published: December 2023

Background:

There are challenges for beginners to identify standard biliopancreatic system anatomical sites on endoscopic ultrasonography (EUS) images. Therefore, the authors aimed to develop a convolutional neural network (CNN)-based model to identify standard biliopancreatic system anatomical sites on EUS images.

Methods:

The standard anatomical structures of the gastric and duodenal regions observed by EUS was divided into 14 sites. The authors used 6230 EUS images with standard anatomical sites selected from 1812 patients to train the CNN model, and then tested its diagnostic performance both in internal and external validations. Internal validation set tests were performed on 1569 EUS images of 47 patients from two centers. Externally validated datasets were retrospectively collected from 16 centers, and finally 131 patients with 85 322 EUS images were included. In the external validation, all EUS images were read by CNN model, beginners, and experts, respectively. The final decision made by the experts was considered as the gold standard, and the diagnostic performance between CNN model and beginners were compared.

Results:

In the internal test cohort, the accuracy of CNN model was 92.1–100.0% for 14 standard anatomical sites. In the external test cohort, the sensitivity and specificity of CNN model were 89.45–99.92% and 93.35–99.79%, respectively. Compared with beginners, CNN model had higher sensitivity and specificity for 11 sites, and was in good agreement with the experts (Kappa values 0.84–0.98).

Conclusions:

The authors developed a CNN-based model to automatically identify standard anatomical sites on EUS images with excellent diagnostic performance, which may serve as a potentially powerful auxiliary tool in future clinical practice.