bluuebunny/crossref_metadata_2025 huggingface dataset:
Normal modes of the stretched horizon: a bulk mechanism for black hole microstate level spacing
Authors: Krishnan Chethan , Pathak Pradipta S.
Published: April 2024

Abstract

In 1984, ’t Hooft famously used a brickwall (aka stretched horizon) to compute black hole entropy up to a numerical pre-factor. This calculation is sometimes interpreted as due to the entanglement of the modes across the horizon, but more operationally, it is simply an indirect count of the semi-classical modes trapped between the stretched horizon and the angular momentum barrier. Because the calculation was indirect, it needed both the mass and the temperature of the black hole as inputs, to reproduce the area. A more conventional statistical mechanics calculation should be able to get the entropy, once the ensemble is specified (say via the energy, in a microcanonical setting). In this paper, we explicitly compute black hole normal modes in various examples, numerically as well as (in various regimes) analytically. The explicit knowledge of normal modes allows us to reproduce both the Hawking temperature as well as the entropy, once the charges are specified, making this a conventional statistical mechanics calculation. A quasi-degeneracy in the angular quantum numbers is directly responsible for the area scaling of the entropy, and is the key distinction between the Planckian black body calculation (volume scaling) and the ’t Hooftian calculation (area scaling). We discuss the (rotating) BTZ case in detail and match the thermodynamic quantities exactly. Schwarzschild and Kerr normal modes are discussed in less detail using near-horizon approximations. Our calculations reveal a new hierarchy in the angular quantum numbers, which we speculate is related to string theory.
Real time holography for higher spin theories
Authors: Hao Zezhuang
Published: April 2024

Abstract

Real time holography is studied in the context of the embedding space formalism. In the first part of this paper, we present matching conditions for on-shell integer spin fields when going from Euclidean to Lorentzian signature on AdS background. Using the BTZ black hole as an example, we discuss various ways of lifting the physical solution from the AdS surface to the whole embedding space. The BTZ propagator for higher spin field is expressed elegantly in terms of the embedding coordinates. In the second part of the paper, we develop the proposed duality between higher spin theory and vector models. We obtain a specific map between the field configurations of these two theories in real time, so called Lorentzian AdS/CFT map. We conclude by exploring the matching conditions for higher spin fields satisfying the proposed bulk quadratic action. The physical and ghost modes can be treated independently during the Wick rotation; only physical modes are considered to be external modes.
Drag force and heavy quark potential in a rotating background
Authors: Chen Jun-Xia , Hou De-Fu , Ren Hai-Cang
Published: April 2024

Abstract

We explored the gravity dual of a rotating quark-gluon plasma by transforming the boundary coordinates of the large black hole limit of Schwarchild-AdS5 metric. The Euler-Lagrange equation of the Nambu-Goto action and its solution become more complex than those without rotation. For small angular velocity, we obtained an analytical form of the drag force acting on a quark moving in the direction of the rotation axis and found it stronger than that without rotation. We also calculated the heavy quark potential under the same approximation. For the quarkonium symmetric with respect to the rotation axis, the depth of the potential is reduced by the rotation. For the quarkonium oriented in parallel to the rotation axis, the binding force is weakened and the force range becomes longer. We also compared our holographic formulation with others in the literature.
Impact of the timing of metformin administration on glycaemic and glucagon-like peptide-1 responses to intraduodenal glucose infusion in type 2 diabetes: a double-blind, randomised, placebo-controlled, crossover study
Authors: Xie Cong , Iroga Peter , Bound Michelle J. , Grivell Jacqueline , Huang Weikun , Jones Karen L. , Horowitz Michael , Rayner Christopher K. , Wu Tongzhi
Published: April 2024

Aims/hypothesis

Metformin lowers postprandial glycaemic excursions in individuals with type 2 diabetes by modulating gastrointestinal function, including the stimulation of glucagon-like peptide-1 (GLP-1). The impact of varying the timing of metformin administration on postprandial glucose metabolism is poorly defined. We evaluated the effects of metformin, administered at different intervals before an intraduodenal glucose infusion, on the subsequent glycaemic, insulinaemic and GLP-1 responses in metformin-treated type 2 diabetes.

Methods

Sixteen participants with type 2 diabetes that was relatively well-controlled by metformin monotherapy were studied on four separate days in a crossover design. On each day, participants were randomised to receive a bolus infusion of metformin (1000 mg in 50 ml 0.9% saline) via a nasoduodenal catheter at t = −60, −30 or 0 min (and saline at the other timepoints) or saline at all timepoints (control), followed by an intraduodenal glucose infusion of 12.56 kJ/min (3 kcal/min) at t = 0–60 min. The treatments were blinded to both participants and investigators involved in the study procedures. Plasma glucose, insulin and total GLP-1 levels were measured every 30 min between t = −60 min and t = 120 min.

Results

There was a treatment-by-time interaction for metformin in reducing plasma glucose levels and increasing plasma GLP-1 and insulin levels (p<0.05 for each). The reduction in plasma glucose levels was greater when metformin was administered at t = −60 or −30 min vs t = 0 min (p<0.05 for each), and the increases in plasma GLP-1 levels were evident only when metformin was administered at t = −60 or −30 min (p<0.05 for each). Although metformin did not influence insulin sensitivity, it enhanced glucose-induced insulin secretion (p<0.05), and the increases in plasma insulin levels were comparable on the 3 days when metformin was given.

Conclusions/interpretation

In well-controlled metformin-treated type 2 diabetes, glucose-lowering by metformin is greater when it is given before, rather than with, enteral glucose, and this is associated with a greater GLP-1 response. These observations suggest that administration of metformin before meals may optimise its effect in improving postprandial glycaemic control.

Trial registration

www.anzctr.org.au ACTRN12621000878875

Funding

The study was not funded by a specific research grant.

Graphical Abstract
Using rhetorical strategies to design prompts: a human-in-the-loop approach to make AI useful
Authors: Ranade Nupoor , Saravia Marly , Johri Aditya
Published: April 2024

The growing capabilities of artificial intelligence (AI) word processing models have demonstrated exceptional potential to impact language related tasks and functions. Their fast pace of adoption and probable effect has also given rise to controversy within certain fields. Models, such as GPT-3, are a particular concern for professionals engaged in writing, particularly as their engagement with these technologies is limited due to lack of ability to control their output. Most efforts to maximize and control output rely on a process known as prompt engineering, the construction and modification of the inputted prompt with expectation for certain outputted or desired text. Consequently, prompt engineering has emerged as an important consideration for research and practice. Previous conceptions of prompt engineering have largely focused on technical and logistic modifications to the back-end processing, remaining inaccessible and, still, limited for most users. In this paper, we look to the technical communication field and its methods of text generation—the rhetorical situation—to conceptualize prompt engineering in a more comprehensible way for its users by considering the context and rhetoric. We introduce a framework, consisting of a formula, to prompt engineering, which demands all components of the rhetorical situation be present in the inputted prompt. We present discussions on the future of AI writing models and their use in both professional and educational settings. Ultimately, this discussion and its findings aim to provide a means of integrating agency and writer-centric methods to AI writing tools to advance a more human-in-the-loop approach. As the use of generative AI and especially NLP-based technologies become common across societal functions, the use of prompt engineering will play a crucial role not just in adoption of the technology, but also its productive and responsible use.
Effects of the nerve agent VX on hiPSC-derived motor neurons
Authors: Schaefers Catherine , Schmeißer Wolfgang , John Harald , Worek Franz , Rein Theo , Rothmiller Simone , Schmidt Annette
Published: March 2024

Poisoning with the organophosphorus nerve agent VX can be life-threatening due to limitations of the standard therapy with atropine and oximes. To date, the underlying pathomechanism of VX affecting the neuromuscular junction has not been fully elucidated structurally. Results of recent studies investigating the effects of VX were obtained from cells of animal origin or immortalized cell lines limiting their translation to humans. To overcome this limitation, motor neurons (MN) of this study were differentiated from in-house feeder- and integration-free-derived human-induced pluripotent stem cells (hiPSC) by application of standardized and antibiotic-free differentiation media with the aim to mimic human embryogenesis as closely as possible. For testing VX sensitivity, MN were initially exposed once to 400 µM, 600 µM, 800 µM, or 1000 µM VX and cultured for 5 days followed by analysis of changes in viability and neurite outgrowth as well as at the gene and protein level using µLC-ESI MS/HR MS, XTT, IncuCyte, qRT-PCR, and Western Blot. For the first time, VX was shown to trigger neuronal cell death and decline in neurite outgrowth in hiPSC-derived MN in a time- and concentration-dependent manner involving the activation of the intrinsic as well as the extrinsic pathway of apoptosis. Consistent with this, MN morphology and neurite network were altered time and concentration-dependently. Thus, MN represent a valuable tool for further investigation of the pathomechanism after VX exposure. These findings might set the course for the development of a promising human neuromuscular test model and patient-specific therapies in the future.
Unconditional uniqueness and non-uniqueness for Hardy–Hénon parabolic equations
Authors: Chikami Noboru , Ikeda Masahiro , Taniguchi Koichi , Tayachi Slim
Published: April 2024

We study the problems of uniqueness for Hardy–Hénon parabolic equations, which are semilinear heat equations with the singular potential (Hardy type) or the increasing potential (Hénon type) in the nonlinear term. To deal with the Hardy–Hénon type nonlinearities, we employ weighted Lorentz spaces as solution spaces. We prove unconditional uniqueness and non-uniqueness, and we establish uniqueness criterion for Hardy–Hénon parabolic equations in the weighted Lorentz spaces. The results extend the previous works on the Fujita equation and Hardy equations in Lebesgue spaces.
Efficacy of flexible ureterorenoscopy with holmium laser in the management of calyceal diverticular calculi
Authors: Zeng Shi-Ping , Sun Yi-Fei , Yu Han-Yang , Yang Jian , Deng Ke-Fei
Published: March 2024

The purpose of this study was to evaluate the efficacy and safety of flexible ureteroscopy with holmium laser lithotripsy in the management of calyceal diverticular calculi. In this study, we retrospectively analyzed the clinical data of 27 patients with calyceal diverticular calculi admitted to the Department of Urology of the Zigong First People’s Hospital from May 2018 to May 2021. Intraoperatively, the diverticular neck was found in all 27 patients, but flexible ureterorenoscopy lithotripsy was not performed in 2 cases because of the slender diverticular neck, and the success rate of the operation was 92.6%. Of the 25 patients with successful lithotripsy, the mean operative time was 76.9 ± 35.5 (43–200) min. There were no serious intraoperative complications such as ureteral perforation, mucosal avulsion, or hemorrhage. Postoperative minor complications (Clavien classification I-II) occurred in 4 (16%) patients. The mean hospital stay was 4.4 ± 1.7 (3–12) days. The stone-free rate was 80% at the 1-month postoperative follow-up. After the second-stage treatment, the stone-free rate was 88%. In 22 cases with complete stone clearance, no stone recurrence was observed at 5.3 ± 2.6 (3–12) months follow-up. This retrospective study demonstrated that flexible ureterorenoscopy with holmium laser is a safe and effective choice for the treatment of calyceal diverticular calculi, because it utilizes the natural lumen of the human body and has the advantages of less trauma, fewer complications, and a higher stone-free rate.
The radiomics nomogram predicts the prognosis of pancreatic cancer patients with hepatic metastasis after chemoimmunotherapy
Authors: Lu Wenxin , Wu Guangyu , Miao Xianyuan , Ma Jingyu , Wang Yanling , Xu Haiyan , Shentu Daiyuan , Xue Shengbai , Xia Qing , Wang Yu , Wang Liwei
Published: March 2024

Objective

To construct a prognostic model based on MR features and clinical data to evaluate the progression free survival (PFS), overall survival (OS) and objective response rate (ORR) of pancreatic cancer patients with hepatic metastases who received chemoimmunotherapy.

Methods

105 pancreatic cancer patients with hepatic metastases who received chemoimmunotherapy were assigned to the training set (n = 52), validation set (n = 22), and testing set (n = 31). Multi-lesion volume of interest were delineated, multi-sequence radiomics features were extracted, and the radiomics models for predicting PFS, OS and ORR were constructed, respectively. Clinical variables were extracted, and the clinical models for predicting PFS, OS and ORR were constructed, respectively. The nomogram was jointly constructed by radiomics model and clinical model.

Result

The ORR exhibits no significant correlation with either PFS or OS. The area under the curve (AUC) of nomogram for predicting 6-month PFS reached 0.847 (0.737–0.957), 0.786 (0.566–1.000) and 0.864 (0.735–0.994) in the training set, validation set and testing set, respectively. The AUC of nomogram for predicting 1-year OS reached 0.770 (0.635–0.906), 0.743 (0.479–1.000) and 0.818 (0.630–1.000), respectively. The AUC of nomogram for predicting ORR reached 0.914 (0.828–1.00), 0.938 (0.840–1.00) and 0.846 (0.689–1.00), respectively.

Conclusion

The prognostic models based on MR imaging features and clinical data are effective in predicting the PFS, OS and ORR of chemoimmunotherapy in pancreatic cancer patients with hepatic metastasis, and can be used to evaluate the prognosis of patients.
Prenatal inflammation exposure accelerates lung cancer tumorigenesis in offspring mouse: possible links to IRE1α/XBP1-mediated M2-like polarization of TAMs and PD-L1 up-expression
Authors: Ma Jingbo , Tan Jian , Zhang Weiqiang , Bai Miaochun , Liu Keqiang
Published: March 2024

Background

Prenatal inflammation exposure (PIE) can increase the disease susceptibility in offspring such as lung cancer. Our purpose was to investigate the mechanisms of PIE on lung cancer.

Methods

Prenatal BALB/c mice were exposed to lipopolysaccharide (LPS), and then, their offspring were intraperitoneally instilled with urethane to establish the two-stage lung cancer carcinogenesis model. At the 48 weeks of age, the offspring mice were killed and lung tissues were collected for HE, immunohistochemistry, immunofluorescence, and Luminex MAGPIX®-based assays. CD11b + F4/80 + tumor-associated macrophages (TAMs) were sorted out from lung tumor tissues by cell sorting technique. Flow cytometry was employed to evaluate the extent of M2-like polarization of TAMs and PD-L1 expression.

Results

The offspring of PIE mice revealed more lung lesion changes, including atypical hyperplasia and intrapulmonary metastases. The number of lung nodules, lung organ index, and PCNA, MMP-9 and Vimentin positive cells in lung tissue of PIE group were higher than those of Control group. The increases of mRNA encoding M2 macrophage markers and cytokines in offspring of prenatal LPS-treated mice confirmed the induced effect of PIE on macrophage polarization. Additionally, PIE treatment increased the percentage of CD163 + CD206 + cells in the sorted TAMs. Importantly, endoplasmic reticulum (ER) stress-markers like GRP78/BIP and CHOP, p-IRE1α and XBP1s, and PD-L1 were up-regulated in TAMs from PIE group. Besides, we also observed that IRE1α inhibitor (KIRA6) reversed the M2-like TAMs polarization and metastasis induced by PIE.

Conclusions

IRE1α/XBP1-mediated M2-like TAMs polarization releases the pro-tumorigenic cytokines and PD-L1 expression, which may be the regulatory mechanism of accelerating lung cancer in offspring of mice undergoing PIE.
Is it possible to achieve multiplanar correction of complex deformities around the knee in children and adolescents using a monolateral external fixator?
Authors: Elbarbary Hassan , Abdelmohsen Ahmed , Zein Abo-Bakr , Arafa Amr , Hegazy Mohamed , Yaseen Ahmed , Afifi Ahmed
Published: April 2024

Purpose

To present the technique of correction of multiplanar deformities around the knee in children and adolescents using the monolateral external fixator. Also, to evaluate the results of the technique regarding radiological correction, time to union, and possible complications.

Methods

A total of 29 patients (47 limbs) were prospectively included in the study (14 males and 15 females). Their median age was 13 years (range, 7–17). All patients had at least a 2-plane deformity around the knee which was corrected using a monolateral external fixator. The primary outcome measure was deformity correction (correction of mechanical axis deviation (MAD) in both the coronal and sagittal planes with correction of rotational deformities). The secondary outcome measures included bony union, radiographic, and functional results (assessed by using the Association for the Study and Application of the Method of Ilizarov (ASAMI) score).

Results

The median pre-operative MAD improved from 6.3 to 0.4 cm post-operatively. According to the ASAMI scoring system, the radiographic scoring was excellent in all cases (100%), and the functional scoring was excellent in 22 cases (89.7%) and good in three cases (10.3%).

Conclusion

The simple monolateral fixator can be an effective tool for multiplanar correction of complex deformities around the knee without limb length discrepancy.
Relaxed notions of Condorcet-consistency and efficiency for strategyproof social decision schemes
Authors: Brandt Felix , Lederer Patrick , Romen René
Published: April 2024

Social decision schemes (SDSs) map the preferences of a group of voters over some set of m alternatives to a probability distribution over the alternatives. A seminal characterization of strategyproof SDSs by Gibbard (Econometrica 45(3):665–681, 1977) implies that there are no strategyproof Condorcet extensions and that only random dictatorships satisfy ex post efficiency and strategyproofness. The latter is known as the random dictatorship theorem. We relax Condorcet-consistency and ex post efficiency by introducing a lower bound on the probability of Condorcet winners and an upper bound on the probability of Pareto-dominated alternatives, respectively. We then show that the randomized Copeland rule is the only anonymous, neutral, and strategyproof SDS that guarantees the Condorcet winner a probability of at least 2/m. Secondly, we prove a continuous strengthening of Gibbard’s random dictatorship theorem: the less probability we put on Pareto-dominated alternatives, the closer to a random dictatorship is the resulting SDS. Finally, we show that the only anonymous, neutral, and strategyproof SDSs that maximize the probability of Condorcet winners while minimizing the probability of Pareto-dominated alternatives are mixtures of the uniform random dictatorship and the randomized Copeland rule.
External ventricular drainage in pediatric patients: indications, management, and shunt conversion rates
Authors: Atallah Oday , Krauss Joachim K. , Hermann Elvis J.
Published: April 2024

Purpose

Placement of an external ventricular drainage (EVD) is one of the most frequent procedures in neurosurgery, but it has specific challenges and risks in the pediatric population. We here investigate the indications, management, and shunt conversion rates of an EVD.

Methods

We retrospectively analyzed the data of a consecutive series of pediatric patients who had an EVD placement in the Department of Neurosurgery at Hannover Medical School over a 12-year period. A bundle approach was introduced to reduce infections. Patients were categorized according to the underlying pathology in three groups: tumor, hemorrhage, and infection.

Results

A total of 126 patients were included in this study. Seventy-two were male, and 54 were female. The mean age at the time of EVD placement was 5.2 ± 5.0 years (range 0–17 years). The largest subgroup was the tumor group (n = 54, 42.9%), followed by the infection group (n = 47, 37.3%), including shunt infection (n = 36), infected Rickham reservoir (n = 4), and bacterial or viral cerebral infection (n = 7), and the hemorrhage group (n = 25, 19.8%). The overall complication rate was 19.8% (n = 25/126), and the total number of complications was 30. Complications during EVD placement were noted in 5/126 (4%) instances. Complications during drainage time were infection in 9.5% (12 patients), dysfunction in 7.1% (9 patients), and EVD dislocation in 3.2% (4 patients). The highest rate of complications was seen in the hemorrhage group. There were no long-term complications. Conversion rates into a permanent shunt system were 100% in previously shunt-dependent patients. Conversion rates were comparable in the tumor group (27.7%) and in the hemorrhage group (32.0%).

Conclusion

EVD placement in children is an overall safe and effective option in children. In order to make further progress, carefully planned prospective and if possible randomized studies are needed controlling for multivariable aspects.
Landscape of brain myeloid cell transcriptome along the spatiotemporal progression of Alzheimer’s disease reveals distinct sequential responses to Aβ and tau
Authors: Wachter Astrid , Woodbury Maya E. , Lombardo Sylvia , Abdourahman Aicha , Wuest Carolin , McGlame Emily , Pastika Timothy , Tamm Joseph , Romanul Nandini , Yanamandra Kiran , Bennett Rachel , Lin Gen , Kwon Taekyung , Liao Fan , Klein Corinna , Grinberg Yelena , Jaisa-aad Methasit , Li Huan , Frosch Matthew. P. , Kummer Markus P. , Das Sudeshna , Dellovade Tammy , Karran Eric H. , Langlois Xavier , Ried Janina S. , Serrano-Pozo Alberto , Talanian Robert V. , Biber Knut , Hyman Bradley T.
Published: April 2024

Human microglia are critically involved in Alzheimer’s disease (AD) progression, as shown by genetic and molecular studies. However, their role in tau pathology progression in human brain has not been well described. Here, we characterized 32 human donors along progression of AD pathology, both in time—from early to late pathology—and in space—from entorhinal cortex (EC), inferior temporal gyrus (ITG), prefrontal cortex (PFC) to visual cortex (V2 and V1)—with biochemistry, immunohistochemistry, and single nuclei-RNA-sequencing, profiling a total of 337,512 brain myeloid cells, including microglia. While the majority of microglia are similar across brain regions, we identified a specific subset unique to EC which may contribute to the early tau pathology present in this region. We calculated conversion of microglia subtypes to diseased states and compared conversion patterns to those from AD animal models. Targeting genes implicated in this conversion, or their upstream/downstream pathways, could halt gene programs initiated by early tau progression. We used expression patterns of early tau progression to identify genes whose expression is reversed along spreading of spatial tau pathology (EC > ITG > PFC > V2 > V1) and identified their potential involvement in microglia subtype conversion to a diseased state. This study provides a data resource that builds on our knowledge of myeloid cell contribution to AD by defining the heterogeneity of microglia and brain macrophages during both temporal and regional pathology aspects of AD progression at an unprecedented resolution.
Lavender oil preparation Silexan is effective in mild-to-moderate major depression: a randomized, placebo- and reference-controlled trial
Authors: Kasper Siegfried , Volz Hans-Peter , Möller Hans-Jürgen , Schläfke Sandra , Klement Stephan , Anghelescu Ion-George , Seifritz Erich
Published: April 2024

Anxiety and depressive disorders have overlapping symptoms and share common neurobiological pathways. Antidepressant drugs have been demonstrated to be efficacious in anxiety as well. Vice versa, it may also be promising to investigate the efficacy of anxiolytic drugs such as silexan in major depressive disorder (MDD). Patients with a mild or moderate, single or recurrent episode of MDD and a total score of 19–34 points on the Montgomery Åsberg Depression Rating Scale (MADRS) were randomized to receive 1 × 80 mg/d silexan, 1 × 50 mg/d sertraline, or placebo double-blind, double-dummy for 56 days. The primary outcome measure was the MADRS total score change between baseline and treatment end. Treatment groups were compared using a treatment policy estimand. 498 subjects (silexan 170, sertraline 171, placebo 157) were treated and analyzed. After 8 weeks, silexan and sertraline were superior to placebo for MADRS total score reduction, with absolute differences to placebo of 2.17 (95% confidence interval: 0.58; 3.76) points and 2.59 (1.02; 4.17) points, respectively (p < 0.01). Moreover, silexan was superior to placebo for alleviation of functional impairment according to the Sheehan Disability Scale with a difference of 2.40 (1.04; 3.76) points (p < 0.001). Both treatments were well tolerated; eructation was the most frequent adverse effect of silexan. The study confirms the antidepressant efficacy of silexan in mild or moderate MDD, including significant improvements in the subjects’ functional capacity. The results for sertraline confirm the assay sensitivity of the trial. Both drugs were well tolerated.

Trial registration

EudraCT2020-000688–22 first entered on 12/08/2020.
Grasping tiny objects
Authors: Giesel Martin , De Filippi Federico , Hesse Constanze
Published: March 2024

In grasping studies, maximum grip aperture (MGA) is commonly used as an indicator of the object size representation within the visuomotor system. However, a number of additional factors, such as movement safety, comfort, and efficiency, might affect the scaling of MGA with object size and potentially mask perceptual effects on actions. While unimanual grasping has been investigated for a wide range of object sizes, so far very small objects (<5 mm) have not been included. Investigating grasping of these tiny objects is particularly interesting because it allows us to evaluate the three most prominent explanatory accounts of grasping (the perception-action model, the digits-in-space hypothesis, and the biomechanical account) by comparing the predictions that they make for these small objects. In the first experiment, participants ($$N=26$$

N
=
26

) grasped and manually estimated the height of square cuboids with heights from 0.5 to 5 mm. In the second experiment, a different sample of participants ($$N=24$$

N
=
24

) performed the same tasks with square cuboids with heights from 5 to 20 mm. We determined MGAs, manual estimation apertures (MEA), and the corresponding just-noticeable differences (JND). In both experiments, MEAs scaled with object height and adhered to Weber’s law. MGAs for grasping scaled with object height in the second experiment but not consistently in the first experiment. JNDs for grasping never scaled with object height. We argue that the digits-in-space hypothesis provides the most plausible account of the data. Furthermore, the findings highlight that the reliability of MGA as an indicator of object size is strongly task-dependent.
Using neural networks to autonomously assess adequacy in intraoperative cholangiograms
Authors: Badgery Henry , Zhou Yuning , Bailey James , Brotchie Peter , Chong Lynn , Croagh Daniel , Page Mark , Davey Catherine E. , Read Matthew
Published: April 2024

Background

Intraoperative cholangiography (IOC) is a contrast-enhanced X-ray acquired during laparoscopic cholecystectomy. IOC images the biliary tree whereby filling defects, anatomical anomalies and duct injuries can be identified. In Australia, IOC are performed in over 81% of cholecystectomies compared with 20 to 30% internationally (Welfare AIoHa in Australian Atlas of Healthcare Variation, 2017). In this study, we aim to train artificial intelligence (AI) algorithms to interpret anatomy and recognise abnormalities in IOC images. This has potential utility in (a) intraoperative safety mechanisms to limit the risk of missed ductal injury or stone, (b) surgical training and coaching, and (c) auditing of cholangiogram quality.

Methodology

Semantic segmentation masks were applied to a dataset of 1000 cholangiograms with 10 classes. Classes corresponded to anatomy, filling defects and the cholangiogram catheter instrument. Segmentation masks were applied by a surgical trainee and reviewed by a radiologist. Two convolutional neural networks (CNNs), DeeplabV3+ and U-Net, were trained and validated using 900 (90%) labelled frames. Testing was conducted on 100 (10%) hold-out frames. CNN generated segmentation class masks were compared with ground truth segmentation masks to evaluate performance according to a pixel-wise comparison.

Results

The trained CNNs recognised all classes.. U-Net and DeeplabV3+ achieved a mean F1 of 0.64 and 0.70 respectively in class segmentation, excluding the background class. The presence of individual classes was correctly recognised in over 80% of cases. Given the limited local dataset, these results provide proof of concept in the development of an accurate and clinically useful tool to aid in the interpretation and quality control of intraoperative cholangiograms.

Conclusion

Our results demonstrate that a CNN can be trained to identify anatomical structures in IOC images. Future performance can be improved with the use of larger, more diverse training datasets. Implementation of this technology may provide cholangiogram quality control and improve intraoperative detection of ductal injuries or ductal injuries.

Graphical abstract
Enhancing coffee bean classification: a comparative analysis of pre-trained deep learning models
Authors: Hassan Esraa
Published: April 2024

Coffee bean production can encounter challenges due to fluctuations in global coffee prices, impacting the economic stability of some countries that heavily depend on coffee production. The primary objective is to evaluate how effectively various pre-trained models can predict coffee types using advanced deep learning techniques. The selection of an optimal pre-trained model is crucial, given the growing popularity of specialty coffee and the necessity for precise classification. We conducted a comprehensive comparison of several pre-trained models, including AlexNet, LeNet, HRNet, Google Net, Mobile V2 Net, ResNet (50), VGG, Efficient, Darknet, and DenseNet, utilizing a coffee-type dataset. By leveraging transfer learning and fine-tuning, we assess the generalization capabilities of the models for the coffee classification task. Our findings emphasize the substantial impact of the pre-trained model choice on the model's performance, with certain models demonstrating higher accuracy and faster convergence than conventional alternatives. This study offers a thorough evaluation of pre-trained architectural models regarding their effectiveness in coffee classification. Through the evaluation of result metrics, including sensitivity (1.0000), specificity (0.9917), precision (0.9924), negative predictive value (1.0000), accuracy (1.0000), and F1 score (0.9962), our analysis provides nuanced insights into the intricate landscape of pre-trained models.
Enhanced prairie dog optimization with Levy flight and dynamic opposition-based learning for global optimization and engineering design problems
Authors: Biswas Saptadeep , Shaikh Azharuddin , Ezugwu Absalom El-Shamir , Greeff Japie , Mirjalili Seyedali , Bera Uttam Kumar , Abualigah Laith
Published: March 2024

This study proposes a new prairie dog optimization algorithm version called EPDO. This new version aims to address the issues of premature convergence and slow convergence that were observed in the original PDO algorithm. To improve performance, several modifications are introduced in EPDO. First, a dynamic opposite learning strategy is employed to increase the diversity of the population and prevent premature convergence. This strategy helps the algorithm avoid falling into local optima and promotes global optimization. Additionally, the Lévy dynamic random walk technique is utilized in EPDO. This modified Lévy flight with random walk reduces the algorithm’s running time for the test function’s ideal value, accelerating its convergence. The proposed approach is evaluated using 33 benchmark problems from CEC 2017 and compared against seven other comparative techniques: GWO, MFO, ALO, WOA, DA, SCA, and RSA. Numerical results demonstrate that EPDO produces good outcomes and performs well in solving benchmark problems. To further validate the results and assess reliability, the authors employ average rank tests, the measurement of alternatives, and ranking according to the compromise solution (MARCOS) method, as well as a convergence report of EPDO and other algorithms. Furthermore, the effectiveness of the EPDO algorithm is demonstrated by applying it to five design problems. The results indicate that EPDO achieves impressive outcomes and proves its capability to address practical issues. The algorithm performs well in solving benchmark and practical design problems, as supported by the numerical results and validation methods used in the study.
Digital screening for mental health in pregnancy and postpartum: A systematic review
Authors: Clarke Jocelyn R. , Gibson Melanie , Savaglio Melissa , Navani Rhea , Mousa Mariam , Boyle Jacqueline A.
Published: April 2024

Purpose

This systematic review aimed to determine if digital screening for mental health in pregnancy and postpartum is acceptable, feasible and more effective than standard care (paper-and pen-based screening or no screening). The second aim was to identify barriers and enablers to implementing digital screening in pregnancy and postpartum.

Method

OVID MEDLINE, PsycINFO, SCOPUS, CINAHL, Embase, Web of Science, Joanna Briggs Database and All EMB reviews incorporating Cochrane Database of Systematic Reviews (OVID) were systematically searched for articles that evaluated digital screening for mental health in pregnancy and postpartum between 2000 and 2021. Qualitative articles were deductively mapped to the Theoretical Domains Framework (TDF).

Results

A total of 34 articles were included in the analysis, including qualitative, quantitative and mixed-methods studies. Digital screening was deemed acceptable, feasible and effective. TDF domains for common barriers included environmental context and resources, skills, social/professional role and identity and beliefs about consequences. TDF domains for common enablers included knowledge, social influences, emotion and behavioural regulation.

Conclusion

When planning to implement digital screening, consideration should be made to have adequate training, education and manageable workload for healthcare professionals (HCP’s). Organisational resources and support are important, as well as the choice of the appropriate digital screening assessment and application setting for women. Theory-informed recommendations are provided for both healthcare professionals and women to inform future clinical practice.
Orbital fractures treated in a university hospital of southern Italy: epidemiology, outcomes and prognostic factors resulting from 538 retrospectively analyzed cases
Authors: Colangeli Walter , Ferragina Francesco , Kallaverja Elvis , Celano Chiara , Cristofaro Maria Giulia
Published: April 2024

Purpose

Orbital fractures are common injuries and represent an interesting chapter in maxillofacial surgery. This retrospective study analyses data collected from 528 patients surgically treated at the University Hospital “Magna Graecia”, Catanzaro, Italy, from 1st January 2007 to 31st January 2021.

Methods

The inclusion criteria were a diagnosis of orbital bone fracture, complete clinical and radiological records, and a minimum follow-up of 12 months. We analyzed gender, age, etiology, fracture type, treatment, timing of repair, and associated complications.

Results

The most frequent cause of trauma was road accidents (37.88%), followed by domestic accidents (25.95%). The manifestation of diplopia (72.35%), infraorbital nerve hypoesthesia (53.41%), extrinsic eye movement limitation (51.70%), and enophthalmos (41.29%), determined the indication for surgery. Our trauma team preferred the sub-eyelid approach (79.36%). The study shows a statistical significance in the correlation between the severity of the herniation of the lower rectus muscle and the presence of preoperative diplopia (p-value = 0.00416); We found the same statistical significance for the post-postoperative diplopia (p-value = 0.00385). Patients treated two weeks after the trauma show a higher rate of diplopia and a greater limitation of long-term post-operative eye movements than those treated within two weeks (diplopia 23.08% vs. 15.56%; eye movements limitation 13.33% vs. 7.69%). Early surgical treatment (> 14 days) reduces the likelihood of functional and structural damage to the lower rectus muscle.

Conclusion

Our data will support future maxillofacial traumatology studies, and the education and prevention measures taken will reduce the incidence of orbital trauma.
Brivaracetam use in clinical practice: a Delphi consensus on its role as first add-on therapy in focal epilepsy and beyond
Authors: Lattanzi Simona , Chiesa Valentina , Di Gennaro Giancarlo , Ferlazzo Edoardo , Labate Angelo , La Neve Angela , Meletti Stefano , Di Bonaventura Carlo ,   Consensus Collaborators Group, Audenino Daniela , Boero Giovanni , Cianci Vittoria , Coletti Moja Mario , Cumbo Eduardo , Dainese Filippo , Didato Giuseppe , Fallica Elisa , Giordano Alfonso , Le Piane Emilio , Panebianco Mariangela , Piccioli Marta , Pignatta Pietro , Puligheddu Monica , Pulitano Patrizia , Ranzato Federica , Renna Rosaria , Rosati Eleonora , Vergine Stella
Published: April 2024

Background

Antiseizure medications remain the cornerstone of treatment for epilepsy, although a proportion of individuals with the condition will continue to experience seizures despite appropriate therapy. Treatment choices for epilepsy are based on variables related to both the individual patient and the available medications. Brivaracetam is a third-generation agent antiseizure medication.

Methods

We carried out a Delphi consensus exercise to define the role of brivaracetam in clinical practice and to provide guidance about its use as first add-on ASM and in selected clinical scenarios. A total of 15 consensus statements were drafted by an expert panel following review of the literature and all were approved in the first round of voting by panelists. The consensus indicated different clinical scenarios for which brivaracetam can be a good candidate for treatment, including first add-on use.

Results

Overall, brivaracetam was considered to have many advantageous characteristics that render it a suitable option for patients with focal epilepsy, including a fast onset of action, favorable pharmacokinetic profile with few drug-drug interactions, broad-spectrum activity, and being well tolerated across a range of doses. Brivaracetam is also associated with sustained clinical response and good tolerability in the long term.

Conclusions

These characteristics also make it suitable as an early add-on for the elderly and for patients with post-stroke epilepsy or status epilepticus as highlighted by the present Delphi consensus.
Hearing dysfunction heralds an increase in non-motor burden and a worse quality of life in Parkinson’s disease: new insights from non-motor spectrum
Authors: Garasto Elena , Stefani Alessandro , Pierantozzi Mariangela , Conti Matteo , Moleti Arturo , Sisto Renata , Viziano Andrea , Liguori Claudio , Schirinzi Tommaso , Mercuri Nicola Biagio , Cerroni Rocco
Published: April 2024

Background

Sensorial non-motor symptoms (NMSs) in Parkinson’s disease (PD) still lack appropriate investigation in clinical practice.

This study aimed to assess if and to what extent auditory dysfunction is associated with other NMSs in PD and its impact on patient’s quality of life (QoL).

Methods

We selected patients with idiopathic PD, without other concomitant neurological diseases, dementia, or diagnosis of any audiological/vestibular disease. Demographic and clinical data were collected. Patients underwent otoscopic examination, audiological testing with pure tone audiometry (PTA) and distortion product otoacoustic emissions (DPOAEs) and completed Non-Motor Symptoms Scale (NMSS) and Parkinson’s Disease Questionnaires-39 (PDQ-39). ANCOVA and partial correlation analysis have been used for statistical analysis.

Results

60 patients were enrolled and completed PTA and DPOAEs. 32 patients with hearing impairment (HI), assessed by PTA, (hearing threshold ≥ 25 dB) showed similar disease duration, motor impairment, and staging, compared to patients without HI, but higher scores both in NMSS and in PDQ-39, except for cardiovascular (CV), gastrointestinal (GI), urogenital (U) and sexual function (SF) of NMSS. In addition, DPOAEs showed a significant correlation with higher scores both in NMSS and PDQ-39, except for CV, SF, GI, U and perceptual problem subdomains of NMSS.

Conclusion

This study demonstrated that PD patients with HI have a greater burden of NMS and lower related QoL and functioning. Our results highlight the importance to reconsider HI as a NMS, in parallel with the others. HI evaluation, even in asymptomatic patients, may reveal a wider pathology with a worse QoL.
Plasma concentrations of glial fibrillary acidic protein, neurofilament light, and tau in Alexander disease
Authors: Ashton Nicholas J. , Di Molfetta Guglielmo , Tan Kübra , Blennow Kaj , Zetterberg Henrik , Messing Albee
Published: April 2024

Introduction

Alexander disease (AxD) is a rare leukodystrophy caused by dominant gain-of-function mutations in the gene encoding the astrocyte intermediate filament, glial fibrillary acidic protein (GFAP). However, there is an urgent need for biomarkers to assist in monitoring not only the progression of disease but also the response to treatment. GFAP is the obvious candidate for such a biomarker, as it is measurable in body fluids that are readily accessible for biopsy, namely cerebrospinal fluid and blood. However, in the case of ASOs, the treatment that is furthest in development, GFAP is the target of therapy and presumably would go down independent of disease status. Hence, there is a critical need for biomarkers that are not directly affected by the treatment strategy.

Methods

We explored the potential utility of biomarkers currently being studied in other neurodegenerative diseases and injuries, specifically neurofilament light protein (NfL), phosphorylated forms of tau, and amyloid-β peptides (Aβ42/40).

Results and Conclusions

Here, we report that GFAP is elevated in plasma of all age groups afflicted by AxD, including those with adult onset. NfL and p-tau are also elevated, but to a much lesser extent than GFAP. In contrast, the levels of Aß40 and Aß42 are not altered in AxD.
Synthesis and characteristics of biocidal oil composites enhanced with thymol and salicylic acid
Authors: Staroń Anita , Pucelik Barbara , Barzowska Agata , Pulit-Prociak Jolanta
Published: April 2024

The research aimed to develop composite materials based on waste cooking oil containing thymol or salicylic acid and assess their antimicrobial properties against selected Gram-positive and Gram-negative bacteria strains. The study also investigated whether the use of a binder, such as catalyzed waste cooking oil, and the performing of annealing process would affect the antimicrobial effectiveness of the natural additive. The composite materials were characterized using FT–IR spectroscopy, thermal analysis, and scanning electron microscopy. Mechanical properties were also evaluated, along with abrasion resistance and soakability. Thymol-modified materials showed higher activity against E. coli strain; while, salicylic acid-modified materials were more effective against P. aeruginosa. The antibacterial activity against Gram-positive bacteria was generally lower than against Gram-negative bacteria. Flow cytometry and confocal microscopy were used to visualize and quantify bacterial death induced by the composite materials. The materials showed interactions with bacterial cells, leading to cell damage and inhibition of bacterial division. The most effective biocidal composite against the suspension of P. aeruginosa bacteria was 22 T (99% inactivation), containing 4% thymol. Against E. coli, composite 41 T containing 1% thymol caused a significant decrease in the viability of these bacteria by up to 45%. Similarly, on S. aureus, composites with the addition of thymol also exhibited strong effects, reaching up to 70% reduction, as observed in 43 T with 7% thymol. Composites containing salicylic acid also demonstrated biocidal properties, resulting in a 52% reduction in E. coli (33SA containing 7% salicylic acid); 99% reduction in P. aeruginosa (15SA containing 1% salicylic acid); 20% reduction in S. aureus (41SA containing 1% salicylic acid); and approximately 25% reduction in S. epidermidis (43SA with 7% salicylic acid). Furthermore, the composite materials demonstrated low cytotoxicity against human keratinocytes, indicating their potential safe use when contacted with human skin.

Graphical Abstract
The impact of cognitive filters on strategic actions and relationships: an analysis from local environmental advocacy in the Aegean Region, Turkey
Authors: Can Ozge , Gonenc Defne
Published: April 2024

Although several internal and external factors may influence environmental non-governmental organizations’ (ENGOs) action sets and networking behaviors, their values and priorities deserve special attention. Existing research highlights the importance of mobilizing resources and utilizing political opportunities in environmental advocacy; however, there is relative silence regarding the impact of how ENGOs cognitively position themselves in a contested field. Through a quantitative analysis of survey data from 117 local ENGOs in the Aegean Region of Turkey, we examine whether and how organizational identity, scope of environmental issues, and core environmental purpose (transactional or informational) as three cognitive filters play a role in shaping grassroots ENGO activities and relationships with diverse actors. A set of regression models indicates that claiming an activist identity, pursuing a higher number of environmental issues, and having a confrontational goal significantly influences local ENGOs’ strategic actions and the type and intensity of their external ties. These findings contribute to the discussions around resource mobilization theory and the political opportunity structure framework by highlighting the importance of intangible, less visible, ideological dimensions, and of cognitive framing in mobilizing for environmental causes.